bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE ADRENOCORTICAL RESPONSE TO CORTICOTROPHIN IN ADDISON'S DISEASE AND PANHYPOPITUITARISM
Authors: FOGGITT FRANCES , STEINBECK A. W. 
Published: September 2017

SUMMARYIn Addison's disease the daily output of 17‐ketogenic steroids in isolated 24 hour urine specimens fall below or within the normal range, but is not increased by corticotrophin.In panhypopituitarism the daily output of 17‐ketogenic steroids in isolated 24 hour urine specimens is lowered and may either increase after the exhibition of corticotrophin, but less than normally, or remain unaltered.The daily urinary outputs of 17‐hydroxycorticosteroids and steroidal dihydroxyacetones follow patterns in both conditions.The diagnostic significance of the results is illustrated and some clinical features are noted.
OBSERVATIONS ON KURU: II. CLINICAL FEATURES
Authors: SIMPSON D. A. , LANDER H. , ROBSON H. N. 
Published: September 2017

SUMMARYStudy of the clinical features of kuru shows that the most prominent neurological signs are those of a progressive, ultimately very gross motor incoordination suggesting cerebellar dysfunction. Passive tone is not constantly increased ; but when it is, its character is compatible with extrapyramidal disorder. Apart from tendon hyperreflexia, signs attributable to pyramidal dysfunction are scanty.Mental changes, mainly of affect, are prominent.Disturbances of sensation or of cranial nerve functions are not found.The pattern and course of the disease is strikingly uniform, but the rate of deterioration may be quite uneven. Recovery has been claimed, but this remains uncertain, and may be due to hysterical mimicry.
RECOVERY OF RENAL FUNCTION AFTER ACUTE RENAL FAILURE
Authors: EDWARDS K. D. G. 
Published: September 2017

SummaryRenal function tests, including those of plasma creatinine level and endogenous creatinine clearance, were performed on 15 patients for periods of up to 76 weeks after the onset of recovery from acute renal failure. Hypertension was common in the first two weeks, and persisted in one patient. Proteinuria occurred commonly during the early diuretic phase, but disappeared in all except two cases. Microscopically evident hæmaturia and cylindruria were present in most cases initially and persisted in two.Renal tract infection during recovery was common, but was cleared up by appropriate antibacterial agents. Streptomycin was avoided, and the dosage of other agents was reduced in proportion to reduction in renal function.The glomerular filtration rate, measured as endogenous creatinine clearance, improved steadily during the first three to 12 weeks, and in all cases except one reached normal levels within 12 weeks. One patient had persistently impaired renal function.
HÆMOLYTIC DISEASE OF THE NEW‐BORN
Authors: WALSH R. J. , WARD H. K. 
Published: September 2017

SummaryThe fate of the infants of 395 immunized Rh‐negative women has been analysed.The severity of the disease in the first affected child frequently sets the pattern for subsequent children. If the first affected child is mildly affected, the subsequent children are more likely to survive than to die ; and first‐born severely affected children are likely to be followed by stillbirths or fatally affected children. The parity of the mother when the first affected child is born is not related to the chances of survival of the infant. The severity of the disease increases as the mean titre of the incomplete antibody in the maternal serum rises, but there are numerous exceptions to the general rule. The effects of immunization by a blood transfusion are similar to those when immunization follows a pregnancy. The frequency of stillbirths is not significantly greater when immunization follows transfusions.The significance of these findings is discussed.
ANÆMIA OF RENAL ORIGIN, STUDIED BY MICRODISSECTION OF THE KIDNEY
Authors: BIALESTOCK DORA 
Published: September 2017

SummaryClinical data and animal experimentation imply that the kidney may be the site of formation of a substance responsible for normocyte maturation and the release of erythrocytes from bone marrow.A quantitative and qualitative study by means of microdissection of nephrons has been carried out on the kidney from a four months old infant, G.K., who had suffered from severe anæmia and renal disease since birth.The dimensions of nephrons in the baby G.K. are compared with those from a normal baby.The changes in the anatomy of the nephron include variations in size and shape of glomeruli, hypertrophic proximal tubules, and very short loops of Henle. In addition, two types of atrophic tubules, blind‐ending collecting tubules, diverticula and cysts were found.In this patient G.K., the short loops of Henle were found universally throughout the kidney. In the normal subject, the loop of Henle may prove to be the site for the formation of the erythrocyte‐stimulating factor, and in the present subject, the absence of the loop may have been an important factor in the causation of the anæmia.
SMALL‐BOWEL BIOPSY WITH THE SUCTION BIOPSY TUBE
Authors: RALSTON MARY , WOOD I. J. , HUGHES A. 
Published: September 2017

SummaryIn 1948 a suction gastric biopsy tube was designed in our Unit. In 1956 Shiner, of London, modified this tube for jejunal biopsy. In the present study minor alterations were made to Shiner's tube, and 51 successful biopsies were performed on 46 patients at 74 attempts, fragments of jejunum being obtained in 38 and fragments of duodenum in 13.Eight representative cases and their corresponding biopsy findings are described, the conditions present including atrophic gastritis, pernicious anæmia and subacute combined degeneration of the cord with gastric atrophy, malabsorption with steatorrhœa and Whipple's disease.Pronounced jejunal atrophy was present in two cases of malabsorption, and the villi were distended with P.A.S.‐staining cells in the case of Whipple's disease. No constant major abnormality of the jejunum was found to be associated with atrophic gastritis or gastric atrophy.Our limited experience suggests that gastric atrophy and jejunal atrophy have not a common causal factor.
LIVER INVOLVEMENT IN “Q” FEVER
Authors: POWELL O. W. 
Published: September 2017

SummaryIn 72 consecutive cases of “Q” fever, hepatomegaly occurred in 47, and jaundice in three.Abnormal results for serum cephalin‐cholesterol flocculation, thymol turbidity or serum alkaline phosphatase activity were found in 61 cases. The test that most commonly produced an abnormal result was the cephalin‐cholesterol flocculation test (56 cases); this was followed by the serum alkaline phosphatase estimation (26 cases) and the thymol turbidity test (25 cases). During the first four weeks, the serum alkaline phosphatase level was related to the degree of cephalin‐cholesterol flocculation. Positive cephalin‐cholesterol flocculation commonly persisted for several months.Increased serum alkaline phosphatase levels were frequently the first, and occasionally the only, biochemical evidence of liver involvement. Quite high values were seen at times.Serum transaminase activity was only moderately increased, even in jaundiced patients.Liver biopsy was performed on 13 patients of the series, and on an additional jaundiced patient admitted to hospital subsequently. The predominant histological pattern was one of focal inflammation. This was of all grades, from small collections of mixed inflammatory cells to frank granulomas with central necrosis and fibroblastic reaction. In one patient a focal inflammatory lesion was found in the liver 17 weeks after the onset of the illness.
ACUTE HÆMOLYTIC ANÆMIA IN MEDITERRANEAN CHILDREN WITH GLUCOSE‐6‐PHOSPHATE DEHYDROGENASE—DEFICIENT ERYTHROCYTES
Authors: HARLEY JOHN D. 
Published: September 2017

SummaryA review has been made of certain clinical features of 20 episodes of acute hæmolytic anaemia sustained by 15 Australian children of Mediterranean racial extraction. When possible, metabolic studies were made on the erythrocytes of these 15 children.Deficiency of the enzyme glucose‐6‐phosphate dehydrogenase (G6PD) was found in the erythrocytes of the 13 children tested. Marked instability of reduced glutathione (GSH) and susceptibility to Heinz‐body formation on incubation with acetyl phenylhydrazine were demonstrated in the G6PD‐deficient erythrocytes of 10 of these 13 children.The outstanding feature of the clinical study was the high incidence of males, of springtime illness, and of exposure to Vicia fava. Ingestion of broad beans closely preceded the onset of nine hæmolytic episodes, and five additional episodes occurred in ambulant males in spring. The erythrocytes of these children were characterized by very marked degrees of G6PD deficiency, GSH instability and susceptibility to Heinz‐body formation.A second striking feature was the demonstration of erythrocyte G6PD deficiency in three infants with severe neonatal hyperbilirubinæmia. One infant had received 2 mg. of a vitamin K analogue, another may have ingested phenacetin or acetylsalicylic acid in maternal breast milk, and in the third case no toxic agent was found. One infant subsequently sustained an attack of favism.Erythrocyte G6PD deficiency was also found in one child who developed acute hæmolytic anæmia with acute glomerulonephritis, and in another who sustained a mild hæmolytic episode in association with intestinal salmonellosis.The relationship between neonatal jaundice, favism and drug‐induced hæmolysis has been discussed in terms of the mode of genetic transmission of G6PD deficiency, with reference to the protection of potentially susceptible individuals from potentially hæmolytic agents.
ARTIFICIAL COUGHING FOR PATIENTS WITH RESPIRATORY PARALYSIS
Authors: COLEBATCH H. J. H. 
Published: September 2017

SummaryA simple machine by which exsufflation with negative pressure (E.W.N.P.) can be performed to provide an artificial cough is described. Artificial coughing by this means allowed the control of lung complications in 20 patients with respiratory paralysis in whom retained bronchial secretions were an important problem. Massive collapse was relieved on eight occasions in seven patients. Prophylactic coughing makes possible the removal of a tracheotomy tube from patients with negligible respiratory muscle power.E.W.N.P. produces changes essentially similar to those occurring during normal human coughing and does not appear to have any harmful effect on the lungs or circulation.Besides patients with respiratory muscle weakness, artificial coughing is likely to be of greatest value in conditions in which there is prolonged unconsciousness.
THE EFFECTS OF PROLONGED CORTICOSTEROID THERAPY
Authors: MADDOCKS I. 
Published: September 2017

SummarySixty‐six patients suffering from various diseases who received more than 10 grammes of cortisone for a period of more than three months were assessed for response to treatment and incidence of complications.Long‐term corticosteroid therapy in this series was associated with a 60% incidence of complications, and a mortality rate of 6% attributable to corticosteroids. The complications were frequently insidious in onset. The incidence of complications was not influenced by age or sex, but increased with increasing total dose and duration of corticosteroid therapy. A favourable initial response to cortisone was associated with fewer complications. Particular complications were found more frequently in some diseases than in others ; dyspepsia and peptic ulcer were most frequently found in rheumatoid arthritis and psychological change in systemic lupus erythematosus. The incidence per patient for complications from corticosteroid therapy was greatest in rheumatoid arthritis and systemic lupus erythematosus, and lowest in chronic hepatitis.
NEPHROTIC SYNDROME OF ACUTE ONSET WITH HYPOVOLÆMIA
Authors: READER RALPH , JOHNSON J. R. , GOULSTON KERRY 
Published: September 2017

SummaryA male patient, aged 21 years, presented with abrupt onset of circulatory failure one month after the prophylactic administration of antitetanic serum. This patient developed a typical uncomplicated nephrotic syndrome and was subsequently maintained for two years on continuous corticosteroid therapy.The acute onset of circulatory failure was due to grossly depleted plasma protein, with massive proteinuria and plasma volume reduced to 35% of normal. This is discussed with reference to the usual reduced plasma protein concentration and plasma volume in the nephrotic syndrome, which adjusts itself gradually to achieve an equilibrium. Corticosteroid therapy appeared to decrease the permeability of the glomerular membrane for protein.
MEGALOBLASTIC AND TRANSITIONAL MEGALOBLASTIC ANÆMIA FOLLOWING PARTIAL GASTRECTOMY
Authors: DELLER D. J. 
Published: September 2017

SUMMARYStudies of nine patients with megaloblastic anæmia and 18 patients with transitional megaloblastic erythropoiesis following partial gastrectomy are reported.The 27 patients had had either gastric ulcer or duodenal ulcer and had been operated on by the Pólya or Billroth I technique. Free acid had been present in the gastric secretion before surgery in those patients on whom the test had been performed, and the histological picture of the stomach removed at operation had not resembled the gastric atrophy of Addisonian pernicious anæmia. A long latent period (average 10 years) elapsed between gastric surgery and the diagnosis of anæmia. Atrophic glossitis was detected in seven patients, and subacute combined degeneration of the spinal cord was present in two patients. Loss of weight, weakness, anorexia, fullness after eating, the “dumping” syndrome, bilious vomiting and diarrhœa were frequent symptoms after operation.The majority of the patients were shown to have subnormal levels of vitamin B12 in the serum, reduced levels of iron in the serum, impaired absorption of labelled vitamin B12 which was corrected by intrinsic factor, steatorrhœa, achlorhydria, reduced uropepsinogen excretion, atrophic gastritis and jejunitis. Considered as a group, patients with megaloblastic anæmia had lower serum levels of vitamin B12, greater degrees of anæmia and less severe iron deficiency than patients with transitional megaloblastic erythropoiesis.It is considered that the present study provides evidence that megaloblastic anæmia is not a chance association with gastrectomy, and that the relationship is causal. Megaloblastic anæmia and transitional megaloblastic erythropoiesis after partial gastrectomy are usually due to a deficiency of vitamin B12. Resection of part of the stomach which secretes intrinsic factor, together with progressive atrophy of the remaining stomach, leads to the reduced secretion of gastric intrinsic factor and so to defective absorption of vitamin B12 contained in food. Clinical vitamin B12 deficiency develops many years later.
EFFECTS ON LYMPHOID CELLS OF OCCUPATIONAL EXPOSURE TO LOW DOSES OF IONIZING RADIATION
Authors: SHIELS D. O. 
Published: September 2017

SUMMARYIn Leishman‐stained blood films of persons exposed to considerably less than 0·1r per week of whole‐body ionizing radiation, there are highly significant effects on the ratio of large lymphocytes plus monocytes to small lymphocytes, on the percentage of the lymphocytes which show red‐staining granules in the cytoplasm and on a factor, Index I, derived from these factors.
THE DIFFERENTIAL DIAGNOSIS OF MEGALOBLASTIC ANÆMIAL
Authors: PITNEY W. R. 
Published: September 2017

SUMMARYIn a series of 179 adult patients with megaloblastic anæmia there were 95 cases of pernicious anæmia and 38 cases of nutritional megaloblastic anæmia. These two conditions were difficult to distinguish clinically in many instances, especially if the patient was elderly and did not have an obviously faulty diet. The estimation of serum vitamin B12 concentration and radioactive vitamin B12 absorption tests were valuable in differential diagnosis ; but there was some overlap in results in the two groups, and these tests need interpretation in the light of other clinical and laboratory findings.Fourteen patients suffered from post‐gastrectomy megaloblastic anæmia. In five, the mechanism appeared to be lack of intrinsic factor secretion, in five, nutritional deficiency of folic acid, and in four, intestinal malabsorption.
PRACTICAL METHODS FOR ESTIMATING THE BASIC WATER REQUIREMENT DURING OLIGURIC RENAL FAILURE
Authors: ASHLEY B. C. E. , WHYTE H. M. 
Published: September 2017

SUMMARYA quantitative approach to the analysis of water requirements of anuric subjects is presented, showing the importance of cell water as an occult gain to the water balance during under‐nutrition.Methods of varying accuracy and complexity have been developed for prescribing the daily basic water requirement, and for determining the desirable daily weight loss. The usefulness of the methods has been tested by applying them to four “theoretically anuric” obese subjects, in whom the state of water balance was accurately measured during a period of 12 days' under‐nutrition.The daily basic water requirement for an average adult anuric is about 400 ml. if uræmia is mild, and less if uræmia is developing rapidly.
IRRADIATION IN JURY TO THE GASTRO‐INTESTINAL TRACT: CLINICAL FEATURES, MANAGEMENT AND PATHOGENESIS
Authors: WOOD I. J. , RALSTON M. , KURRLE G. R. 
Published: September 2017

SUMMARYCure of cancer by radiotherapy may be achieved only at the expense of some damage to healthy tissue. In so far as the abdomen is concerned, the bowel is particularly vulnerable. In the treatment of abdominal cancer, it may be justifiable, on occasions, to risk limited bowel necrosis to produce adequate tumour destruction if there is a reasonable chance of a net gain in health status. In the present communication the signs, symptoms and pathology of irradiation injury to the stomach and bowel are illustrated by the description of three patients, treated for carcinoma of the cervix uteri, seminoma of the testis and malignant teratoma of the testis respectively. In all three cases the primary tumour had been removed, and irradiation was given for proven or suspected recurrence of the cancer. The irradiation caused both direct irradiation injury to the intestinal epithelium and injury to blood vessels with depletion of blood supply ; the latter process probably produced the greater damage. A variety of lesions occurred in the bowel, including ulceration, hæmorrhage, perforation, fibrosis, obstruction and malabsorption. Limited bowel resection became necessary in all three cases. Two patients have survived, with impaired health but without clinical evidence of recurrence ; the one treated for carcinoma of the cervix is surviving after two years, and the one treated for seminoma of the testis is surviving after three years. Improved methods of irradiation are discussed.
SENSORY LOSS IN POLIOMYELITIS
Authors: LANCE J. W. , WHITE S. W. , DODGSON M. C. H. 
Published: September 2017

SUMMARYAt the height of an epidemic of poliomyelities at the end of 1961, four patients were admitted to Prince Henry Hospital with the clinical syndrome of acute transverse myelitis. The level of sensory loss ascended in three patients, two of whom died. Poliovirus Type 3 was grown from the fæces of one patient, and antibody titres indicated past or present infection with poliovirus in all four patients.Histological study of the spinal cords in the two fatal cases showed the cellular changes characteristic of poliomyelitis. In addition, focal lesions were noted in the white matter of one patient.The major cause of sensory loss, which involved chiefly the modalities of pain and temperature, is considered to be the extension of cellular destruction into the posterior horns of grey matter.As there is no correlation between the annual incidence of poliomyelitis and that of “acute transverse myelitis”, it appears that it is uncommon for infection by poliovirus to present in this fashion.
BUNDLE BRANCH BLOCK: SOME USUAL AND SOME UNUSUAL FEATURES
Authors: BAUER G. E. 
Published: September 2017

SummaryOne hundred and sixty‐seven patients with bundle branch block personally examined have been studied, with special reference to ætiology and prognosis. Twenty‐seven patients were examined before the development of the bundle branch block, and 10 patients with transient and nine patients with intermittent bundle branch block were observed. A previously unsuspected association of right bundle branch block and aortic incompetence was seen in eight patients. The mechanism of bundle branch block is discussed in the light of these experiences.
STUDIES ON THE NEPHROTOXIC EFFECT OF NEOMYCIN
Authors: EMMERSON B. T. , PRYSE-DAVIES J. 
Published: September 2017

SummaryNeomycin given parenterally produces a toxic lesion of the proximal renal tubules, which in the rat is manifest by glycosuria, amino aciduria and an increase of proteinuria. This lesion is accompanied by a decrease of enzyme activity in this region, particularly for alkaline phosphatase and lactate dehydrogenase, and changes in the amounts of these enzymes present have been followed by histochemical and biochemical techniques. The progress of lesions of differing severity in rats was followed at intervals for a period of seven weeks. By this time, tubular regeneration was occurring, and, except in a few focal areas, enzymic activity had almost returned to normal. Renal toxicity was also demonstrated after very large oral doses of neomycin. Certain similarities in the responses of the alimentary and renal epithelia to neomycin were demonstrated.
Expressions of p53 and PUMA in fibroblasts of systemic sclerosis patients are normal at transcription level
Authors: Mahmoudi Mohammad Bagher , Abed Khojasteh Majid , Alsahebfosoul Fereshteh , Gharibdoost Farhad , Mostafaei Shayan , Ganjalikhani‐hakemi Mazdak , Mahmoudi Mahdi 
Published: September 2017

SummaryBackgroundSystemic sclerosis (SSc) fibroblasts show resistance apoptosis mechanisms, which enhances the fibrosis stage of the disease. Impaired function of p53 upregulated modulator of apoptosis (PUMA) has been related to deficits in p53‐dependant apoptosis pathway. This study aimed to evaluate the transcriptional levels of p53 and PUMA mRNAs in fibroblasts from SSc patients and compare it with healthy individuals.MethodsIn this case‐control study, skin biopsy samples were obtained from 19 patients with diffuse cutaneous SSc (DcSSc) and 16 healthy controls. Afterward, dermal fibroblasts were isolated and cultured. After extraction of total RNA from cultured fibroblasts, complementary DNA (cDNA) was synthesized. mRNA quantification was carried out using real‐time PCR, SYBR Green PCR master mix, and specific primers for p53 and PUMA.ResultsNo significant alteration was observed in mRNA expression levels of p53 and PUMA (P = .99 and .23, respectively) in fibroblasts from SSc patients compared with controls.ConclusionsApoptosis pathways are impaired in fibroblasts from patients with SSc, leading to chronic fibrosis. Nonetheless, PUMA/p53 pathway may not be involved in dysfunction of apoptosis mechanisms in fibroblasts of patients with SSc.