bluuebunny/crossref_metadata_2025_split huggingface dataset:
Local Injection of Bevacizumab (Avastin) and Angiolytic KTP Laser Treatment of Recurrent Respiratory Papillomatosis of the Vocal Folds: A Prospective Study
Authors: Zeitels Steven M. , Barbu Anca M. , Landau-Zemer Tali , Lopez-Guerra Gerardo , Burns James A. , Friedman Aaron D. , Freeman Mason W. , Halvorsen Yuan-Di , Hillman Robert E. 
Published: January 2017

Objectives: Photoangiolytic laser treatment of recurrent respiratory papillomatosis (RRP) is effective, but does not reliably prevent recurrence. Therefore, sublesional injections of the antiangiogenic agent bevacizumab (Avastin) were given to assess the adjunctive effect on disease recurrence. Since bevacizumab is a new therapeutic modality for RRP, there were also primary safety objectives to determine whether there was a negative impact on the voice and whether there were local or systemic complications. Methods: A prospective open-label investigation was conducted in 20 adult patients with bilateral vocal fold RRP. The patients underwent planned 532-nm pulsed KTP laser photoangiolysis of bilateral glottal disease 4 times with an approximately 6-week interval between procedures. At each planned laser procedure, the vocal fold that on initial presentation had a greater volume of disease also underwent 4 serial sublesional bevacizumab injections (7.5 to 12.5 mg in 0.3 to 0.5 mL). A sham injection with saline solution was administered to the other vocal fold as a control. Disease resolution was compared between subjects' vocal folds, and objective measures of vocal function (acoustic, aerodynamic), as well as patients' self-assessments of vocal function (Voice-Related Quality of Life survey), were obtained. Results: All 20 patients completed the study, and there were no local or systemic complications. After 4 injections, 3 of the 20 patients had no discernible disease in either vocal fold. Of the remaining 17 subjects, 16 had less disease in the bevacizumab-treated vocal fold despite starting with more disease. Only 1 of the 17 had more disease in the bevacizumab-treated vocal fold after 4 injections. Moreover, 7 of the 20 patients (35%) did not require a laser procedure in the vocal fold that had received 4 bevacizumab injections, as compared with 3 of the 20 vocal folds (15%) that were treated with laser alone. All of the vocal function measures displayed statistically significant posttreatment improvements, except for average fundamental frequency in the 3 female patients, in whom it fell below the normal range. Conclusions: This prospective investigation provided evidence that bevacizumab injections enhanced KTP laser treatment of glottal papillomatosis without systemic or local complications. Coupling the antiangiogenesis agent bevacizumab with KTP laser photoangiolysis is conceptually synergistic and scientifically promising since the mechanisms of action are complementary.
Norway's Continental Shelf and the Boundary Question on the Seabed
Authors: Sollie Finn 
Published: January 2017

One of the most important problems that should be solved at the UN Conference on the Law of the Sea, is that of determining the exact boundary between the continental shelf, where coastal states have exclusive rights of exploration and exploitation of resources, and the deep seabed, which is to be an international area and the common heritage of mankind. With her long coastline and the generally very broad continental shelf lying off it, Norway is one of the countries which, both relatively and absolutely, have the greatest interest attached to their national seabed territories. However, the Norwegian continental shelf differs rather significantly from the ‘international norm’. Thus, large parts of the Norwegian shelf lie at greater depths than is normal off other countries. Also, the Norwegian shelf is exceptionally broad, especially in the north, where it has a width of more than 1,000 kilometers from the coast of Finnmark to the edge fronting the deep waters of the Arctic Ocean. Because of these extreme conditions, Norway could be adversely affected if an international agreement for a fixed boundary to the extent of the dominion of the coastal state over the seabed were to be based on global averages. Such an outcome to the negotiations taking place within the framework of the UN Conference on the Law of the Sea could be especially disadvantageous on the Norwegian shelf, where a narrowly-drawn boundary could, at worst, lead to a partition of the shelf between Norway and Svalbard (Spitsbergen); With the international agreement which applies to the Svalbard islands, and the special security policy situation which exists in the northern region, such a partition would be most unfortunate for Norway. The Norwegian ‘problem’ in the seabed issue arises because Norway negotiates from a position marked by extreme natural conditions and against the background of a security policy situation which makes the country especially dependent on a favorable outcome.
Natural Resources and Problems of Development
Authors: Antonsen Per 
Published: January 2017

The author focuses on problems in the economy of the developing countries likely to arise as a consequence of mineral exploitation in the new territories. A general shortage of mineral resources, although predicted, should not uncritically be adopted as a sufficient explanation of the demonstrated interest of industrial enterprises in undertaking heavy investments in the new territories. The economic security claimed by institutions financing large-scale investments, may just as likely force the companies to seek options for long-term supplies from these areas, unhampered by the politically caused instabilities perceived in the Third World. This development may tend to push the developing countries into the role of subsidiary suppliers in the world market. The committees preparing the UN Conference on the Law of the Sea have so far taken no realistic measures to counteract this possibility, which may prove detrimental to the economies of several developing countries. The Conference will, in the opinion of the author, provide little but a settlement of disputed interests among the coastal states.
The Diagnosis of Drowning by Quantitative and Qualitative Diatom Analysis
Authors: Pachar J V , Cameron J M 
Published: January 2017

The reliability and applicability of quantitative and qualitative diatom analysis in the diagnosis of drowning has been evaluated. Water and organ samples of immersion cases reported in the area covered by the Department of Forensic Medicine of the London Hospital Medical College, were analysed using both light and scanning electron microscopy. Controls included organ samples of the bodies of people who died from natural causes and exclusion of contamination. Organ samples of both immersion and control cases were prepared by chemical digestion with concentrated nitric acid. Diatoms were present in the majority of samples of organs of both immersion and control cases but there was a significant quantitative difference between the number of diatoms in control and immersion cases. Qualitative analysis of water and organ samples of immersion cases supported the diagnosis of death due to aspiration of water in approximately a third of the total of bodies found in water. It has been suggested that the present analysis can be used as basic criteria for standardization of the diatom method.
1. A Bolt from the Blue
Authors: Claydon S. M. 
Published: January 2017

The crossbow was one of the most efficient military weapons of the Middle Ages but the development of portable firearms meant that it was eventually relegated to the museum shelf. The medieval crossbow was accurate and deadly but took some time to load because of the windlass used to wind the string, thus increasing the velocity and range of the bolt, or quarrel. By contrast, the English longbows of Crecy and Agincourt were far less accurate but could fire six arrows in the time taken to shoot one bolt and the continual raining-down of missiles proved more successful in battle than accuracy of aim. This paper describes the homicide of a young business woman outside her London flat in 1987. Today crossbow fatalities are extremely rare on both sides of the Atlantic but Dr Siva described a case of suicide in 1979 and Professor Gresham presented a case of crossbow homicide to the BAFM in June 1976.
Changes in Patterns of Acute Medical Receiving in Scotland 1996 to 2001
Authors: Dorward A. 
Published: January 2017

The purpose of this study was to review changes in working practises of physicians and hospitals from 1996 to 2001 in the light of rising medical admissions and published reports into the organisation of acute admissions. Information was gathered by direct discussion with the appropriate lead doctor for each hospital's acute service in February 2001. The results were compared with a previously published study, which recorded the situation as of October 1996. The hospitals which were studied were the twenty seven Scottish hospitals which admit more than 3000 acute medical patients each year. There has been a 25% increase in number of consultants carrying out receiving duties. Nearly all hospitals now have an acute admission unit. Four hospitals have appointed acute care physicians. Triage of appropriate patients to more specialised ward based care has increased. There has been a rise in geriatricians involvement in acute receiving from four to fifteen hospitals. New developments include early discharge for chronic obstructive airway disease, outpatient management of venous thrombosis, discharge planning and streamlining investigation of chest pain. Two hospitals have specific alcohol support services. There continues to be progress and changes within medical and geriatric services over the last five years stimulated by the continuing rise in number of medical admissions.
Hypovitaminosis C and Splenic Rupture
Authors: Morrison I. A. , Wosornu J. L. 
Published: January 2017

Two cases of splenic rupture in patients with hypovitaminosis C are reported. In Case 1 the deficiency was dietary in origin; this patient also had pernicious anaemia with an associated thrombocytopenia. These 2 abnormalities are considered significant in predisposing to splenic rupture on minimal trauma. In Case 2, in which the vitamin C deficiency was due to dietary deficiency and to malabsorption following partial gastrectomy, the low leucocyte ascorbic acid was the only abnormality detected, and the splenic rupture was spontaneous. A splenectomy was carried out and at operation there was noted to be persistent oozing of blood from muscle and subcutaneous tissue, and post-operatively, from the wound. It is suggested that in cases of spontaneous rupture of the spleen, as in any case of unexplained haemorrhage, the diagnosis of scurvy should be considered.
Mitral Valve Disease and Hypertension
Authors: Laurie H. C. 
Published: January 2017

The case records of 187 patients with mitral valve disease were studied to assess whether hypertension occurred more commonly than in the general population and if so what mechanism might be involved. Hypertension (diastolic pressure > 90 mm. Hg) was commoner in patients with mitral valve disease only in the presence of atrial fibrillation. Blood pressure values of those in sinus rhythm tended to be lower than those of the general population. Mitral valvotomy was found to reduce the incidence of hypertension and peripheral embolism even in those with atrial fibrillation. Post-mortem findings, although small in number, supported the evidence that renal infarction is associated with hypertension in those with mitral valve disease. We suggest that these findings provide further evidence that hypertension in mitral valve disease results from renal emboli following atrial fibrillation.
Changing Paediatrics
Authors: Riley Ian D. 
Published: January 2017

The changes in the types of disease admitted to a childrens' unit over a period of 18 years are reviewed. Tuberculosis and rheumatic fever declined whereas increases took place in renal infections, nocturnal enuresis, poisoning, congenital heart disease, coeliac disease, gastroenteritis and iron deficiency anaemia. The incidence of respiratory disease varied considerably from year to year. The mortality during this period, fell from 8.7 per cent to 1.8 per cent. The effect upon the demand for beds was to reduce the numbers required for older children but to increase those required for infants. This made much greater demands upon nursing staff.
Experience with Off-Line Processing by Computer of Chemical Laboratory Data
Authors: Whitby L. G. , Proffitt J. , McMaster R. S. 
Published: January 2017

This paper reviews experience extending over 18 months obtained with the Elliott Automatic Laboratory Analysis (A.L.A.) system, coupled with a Teletype link for communicating with a computer situated half-a-mile away. The system has been used for the off-line processing by an Elliott 803 computer of data collected from AutoAnalyzers carrying out urea and electrolyte determinations. The A.L.A. equipment itself has proved reliable, apart from faults in the translator-timers occurring mostly during the first 3 months of routine operation, but the Teletype link has been subject to frequent breakdowns. The advantages of using the A.L.A. system of data-collection and computation have been confirmed, but disadvantages of this off-line system are discussed and reasons given why an on-line system of data-collection from AutoAnalyzers is preferred. The importance of reliable performance of laboratory data-acquisition and data-processing equipment in routine operation, and the need for good servicing arrangements, are stressed. The system described in this paper has been deficient in back-up servicing arrangements in respect of the A.L.A. equipment itself and of the Elliott 803 computer, but most of all in respect of the Teletype units. Alphabetical coding patterns have proved of little value as a means of reducing the number of reports requiring detailed scrutiny, but they have served to draw attention to markedly abnormal results.
Mitral Valve Replacement
Authors: Reid J. M. , Barclay R. S. , Stevenson J. G. , Welsh T. M. , McSwan N. 
Published: January 2017

A series of 78 patients with advanced mitral incompetence treated by mitral valve replacement with a Starr-Edwards prosthesis is reported. The overall early mortality was 24 (30.7 per cent) and a further 3 died later. The causes of these early and late deaths are fully analysed. Most occurred in the early part of the series, and there has been a dramatic decline in both mortality and morbidity in the later cases since adoption of continuous clamping of the ascending aorta during the period necessary for excising the valve and suturing the prosthesis in position. The average duration of aortic clamping has been 20 minutes. During the last year (1967) there have been only 5 deaths in 32 patients, representing a mortality of 15.6 per cent. It is emphasised that only patients who have severe incapacity due to mitral incompetence require operation, and neither age nor the degree of pulmonary vascular resistance is a bar to surgery. Advanced renal disease, generalised pulmonary emphysema, and recent myocardial infarction are the only three absolute contraindications. The 54 survivors from operation have been closely supervised for periods varying from several months to as long as 4 years, and as mentioned above 3 have died during this time. The remaining 51 have shown a striking improvement in exercise tolerance, with reduction in heart size. The various surgical procedures available for dealing with mitral incompetence are discussed. Plication of the valve would appear in our experience to be limited to a small number with non-calcific, mildly sclerotic, and only slightly distorted valves. Pig aortic heterografts or pulmonary autografts may offer scope in the future, but we contend that the Starr-Edwards ball-valve prosthesis, although admittedly not as yet ideal, is the best available at present. With the introduction of the latest modification of this valve (now marketed in Britain), thrombo-embolic phenomena should be reduced to a minimum.
A Search for Sub-Clinical Rickets in Glasgow Children
Authors: Richards I. D. G. , Hamilton Frances M. W. , Taylor Elaine C. , Sweet Elizabeth M. , Bremner Eleanor , Price H. 
Published: January 2017

Two random samples of Glasgow children aged 12 to 24 months were examined for clinical, biochemical and radiological evidence of subclinical rickets. No cases of florid rickets were discovered. One-third of the first sample studied (202 children) were estimated to be receiving less than 100 i.u. of vitamin D daily from all sources except sunshine. A poor dietary intake was most prevalent in the higher birth ranks and in social classes II and III (non-manual). The mean serum alkaline phosphatase level was 20 K.A. units per 100 ml. (S.D. 8 units) and 11 per cent had levels of 25 K.A. units per 100 ml. or above. No reason, either dietary or clinical, was found which would account for these high levels. Bone changes were observed in the wrist X-rays of about 9 per cent of children. They disappeared gradually with vitamin D therapy and there is some correlation with a raised alkaline phosphatase level and with tallness. They may be due to a relative insufficiency of vitamin D. Serum alkaline phosphatase estimations and wrist radiography do not appear to be useful methods for estimating the prevalence of hypovitaminosis D in the community or as screening procedures in the detection of individual cases of subclinical rickets.
An Epidemiological Method to Improve Tuberculosis Control
Authors: Hawthorne V. M. 
Published: January 2017

An account is given of the prevalence, incidence and decline of tuberculosis in Scotland with particular regard to the West. It is concluded that there is still considerable morbidity from the disease as measured by a persisting annual attack rate of post-primary tuberculosis of 1 per thousand in Mantoux positive (5 to 20 mm. and exclusive of larger reactors) male and female schoolchildren aged 14 to 15 years with negative chest radiographs 1 year previously. It is predicted that in 1975 there may still be 160 deaths and 927 new notifications of tuberculosis in Scotland, 460 of which could be detected by the mass radiography service. A predictive epidemetric model is described whereby the annual radiological surveillance of 18,596 older residents of Paisley would be tested over two years in relation to tuberculin status at initial examination, as a method of intervening in the intergenerational cycle of infection. If resources are available it is considered that the model is feasible and should be implemented without delay if the present epidemiological situation, particularly in regard to the attack rate in schoolchildren, is unchanged over the next 2 years. If the model should prove successful then mass radiography resources could concentrate on the annual or bi-annual prophylactic radiological surveillance of older urban populations with positive reactions to tuberculin testing at or just before the critical age for change in tuberculin reactivity.
The Ecology of Drug-Resistant Tubercle Bacilli in Eastern Glasgow
Authors: Tinne J. E. 
Published: January 2017

A study was made of cases of tuberculosis treated by chemotherapy in Eastern Glasgow between 1963 and 1968 which developed drug-resistant bacilli. The commonest resistance pattern was to the combination of 3 drugs—streptomycin, p-aminosalicylic acid (P.A.S.) and isoniazid in contrast to resistance to streptomycin alone which predominated 12 years ago. In strains from 6 patients no less than 6 drugs had become ineffective. Experiments with Escherichia coli confirmed that the ‘high mutation rate’ in the presence of streptomycin, which is characteristic of other tuberculostatic drugs also, is attributable to predictable and progressive mutations. Six examples are given where outbreaks of cross-infection by drug-resistant bacilli can be assumed.
Viral Meningitis
Authors: Gray J. A. , Moffat Margaret A. J. , Sangster G. 
Published: January 2017

From a review of 530 patients with viral meningitis during a 10-year period, no new epidemiological features emerged. Mumps virus was responsible for 24 per cent of the infections and in 20 per cent of these no salivary swellings occurred. Good evidence incriminating a particular virus was found in only 20 per cent of the others. The paucity of physical signs indicating a specific virus was confirmed; only 5 per cent had rashes and 1.5 per cent pleurodynia. A small number showed temporary encephalitic features, the proportion being higher in mumps infections. In this variety fever tended to be higher and the E.S.R. lower than in enteroviral infections. The C.S.F. findings confirmed the mixed pleocytosis and the higher but more lymphocytic counts in mumps. Relatively few patients had normal C.S.F. findings within 2 weeks of onset and resolution appeared to be slower in mumps.
Ventilatory Function in Pregnancy
Authors: Cameron S. J. , Bain H. H. , Grant I. W. B. 
Published: January 2017

In this investigation 60 pregnant patients underwent serial estimation of forced vital capacity (FVC) and forced expiratory volume (FEV1) throughout pregnancy and after delivery. No significant change occurred in the group mean figures of these measurements of ventilatory function. When patients were divided into those who were non-smokers and those who smoked more than 10 cigarettes daily it appeared that both FVC and FEV1 during the last 8 weeks of pregnancy were slightly reduced in the smokers. Previous studies on the effects of pregnancy upon ventilatory function are reviewed. In this report individual patients had greater variation in both amount and direction of serial recordings than was shown by control subjects. This individual variation may have been responsible for the conflict in some earlier reports which studied smaller numbers of patients. It is suggested that the maintenance of FEV1 and FVC during pregnancy in spite of increasing uterine size and increasing blood volume is the result of hormonal action upon the brain stem, chest wall and lung.
Therapeutic Abortion: A Follow-up Study
Authors: Sclare A. B. , Geraghty B. P. 
Published: January 2017

A psychiatric and psychological follow-up assessment of 21 patients accepted for abortion on psychiatric grounds, 21 patients denied abortion on psychiatric grounds and 11 patients accepted for abortion on medical grounds was carried out. A history of prior psychiatric illness appeared to be a pointer towards therapeutic termination of pregnancy when psychiatrically disturbed pregnant women were referred for assessment. Despite a high incidence of short-lived guilt reactions, this particular group of patients generally reported a beneficial effect on their lives 2 years later. Many, but not all, of the psychiatrically disturbed patients who were refused abortion became reconciled to the decision. The medical group who were aborted tended to view the operation as an unfortunate necessity. A decision for or against termination of pregnancy must take account of many factors—previous psychiatric history, present mental state, patient's attitude towards the pregnancy, marital adjustment, personality structure and medical condition