bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE NATURE OF THE PIGMENTARY DISTURBANCE IN ADDISON'S DISEASE
Authors: HUDSON BRYAN , BENTLEY G. A. 
Published: September 2017

SUMMARYIt is suggested that the pigmentary disorder in Addison's disease results from an excessive production of pituitary melanocyte‐stimulating hormone.The hormones were assayed by the use of intact toads, where concentration was high (for example, pituitary extracts) and of isolated toad skin for low concentrations (for example, blood). A method for isolation of the hormone from blood is outlined.With these methods it has been shown that in persons with Addison's disease an excessive amount of melanocyte‐stimulating hormone is present in the blood, and that this decreases after treatment with cortisone or its derivatives. It has also been shown that the blood melanocyte‐stimulating hormone concentration is lowered in patients with destructive lesions of the pituitary.The significance of these findings in relation to disorders of melanin pigmentation is discussed.
STUDIES OF PLATELET FUNCTION AS A GUIDE TO THE SEVERITY OF THROMBOCYTOPENIC PURPURA AND THE POSSIBLE MECHANISM OF PURPURA AND HÆMORRHAGE
Authors: BONNIN J. A. 
Published: September 2017

SUMMARYAbnormal results from 121 tests of platelet thromboplastic function were recorded in 30 patients with thrombocytopenic purpura of various types. The presence and degree of hemorrhage or purpura, and the platelet count were also recorded at the time the platelet function tests were performed. The results showed that when the platelet thromboplastic function was below 12%, all patients were frankly bleeding ; when it was between 12% and 25%, some patients were hemorrhagic, while others showed purpura only ; when it was above 25%, virtually nc patients were haemorrhagic. Purpura occurred over the range 25% to 53% platelet thromboplastic function. There was very little correlation between the degree of hemorrhage and platelet function, and between platelet numbers and the occurrence of purpura and hæmorrhage.It is thought that purpura is a manifestation of vascular endothelial damage, but that hemorrhage follows only when the coagulation mechanism is severely deranged by platelet dysfunction.The test of platelet thromboplastic function has proved useful in the assessment of the severity of thrombocytopenic purpura and in predicting the occurrence of hæmorrhage.
THE HISTOLOGY OF GENERALIZED PULMONARY EMPHYSEMA
Authors: MCLEAN K. H. 
Published: September 2017

SUMMARYThe evolution of morphological changes in the air passages from the early focal lesions of emphysema to those associated with the clinical disease is presented.Progress of the focal lesions leads to involvement of the whole of the secondary lobule, at which stage the emphysema is no longer focal but “diffuse”. This diffuse change occurs at different stages of development of the focal lesions in different lungs ; the morphological evolution of both early and late change is described along with some of the more common intermediate forms.Observations supporting the hypothesis of pathogenesis of emphysema presented in Part I of this paper have been made, and the hypothesis is extended to account for diffuse change. These diffuse lesions are aggravated by bronchospasm and, relatively late in the morphological evolution of the disease, by expiratory collapse of bronchioles. The emphysematous changes themselves, in turn, aggravate this last factor.The hypothesis of pathogenesis is reviewed, and morphological evidence is correlated with several aspects of physiological observations on alterations of lung function in the disease.The relation of chronic bronchitis to emphysema is analysed in view of these observations, and it is concluded that chronic bronchitis cannot be said to “cause” emphysema, but, rather, both are related by way of the common factor of inflammatory disease of the bronchioles.
THE HISTOLOGY OF LOCALIZED EMPHYSEMA
Authors: McLEAN K. H. 
Published: September 2017

SUMMARYThe histological features of several types of lesions showing localized emphysema are presented. Most such lesions were associated macroscopically with either bronchiectasis (or bronchiolectasis) or “ scarring ” in the affected area ; examples of each type are described.In several of these localized lesions it was possible to demonstrate unequivocally that the emphysematous region was wholly aerated by collateral ventilation and that the original bronchiole that supplied the area was obliterated. These observations provide conclusive morphological evidence to support the hypothesis of pathogenesis of emphysema which was presented to account for the histological changes observed in the generalized condition, in which the evidence for the hypothesis was, to a large extent, deductive.The close relation between the localized and the generalized disease is emphasized by the observation that bronchiolar inflammatory damage and obliteration is similar in pattern and the initial lesion is centrolobular (or “ focal ”) in both. The features of any emphysematous lesion, either localized or generalized, are shown to be determined largely by the nature of the causative inflammatory process, the emphysema itself being due to a single process—“ trapping ” of collaterally ventilated air.This study of localized lesions also emphasizes the intimate association of the three manifestations of permanent inflammatory damage to the lung—emphysema, bronchiectasis and “ scarring ” ; it also indicates that these three are properly regarded as sequelæ of inflammatory obstruction and obliteration of bronchioles.Man is in truth ever the same ; even when the direct succession of cause and effect does not come in, we see that in times and places most remote from one another like events follow upon like causes.E. A. FREEMAN : “ Comparative Politics ”.
PHONOCARDIOGRAPHY IN THE ASSESSMENT OF MITRAL VALVE DISEASE
Authors: GARDINER JAMES M. 
Published: September 2017

SUMMARYPhonocardiograms of 250 consecutive subjects of mitral valve disease have been examined. The findings in mild mitral stenosis and in predominant mitral incompetence are described.Seventy cases in which the state of the mitral valve was ascertained at operation have been analysed in more detail. The typical findings of “tight” mitral stenosis are described. Variations from this picture may occur where there is heavy mitral valve calcification, where severe pulmonary hypertension accompanies the development of a high pulmonary vascular resistance, and where there is significant aortic valve disease.The importance of the group of cases with severe pulmonary hypertension is emphasized. Cases in this group are often misdiagnosed, either because the signs are wrongly interpreted as being due to mitral incompetence or because the presence of mitral stenosis as the underlying cause of pulmonary hypertension is not recognized.The part played by phonocardiography in the diagnosis of these cases of mitral valve disease, and in the correct assessment of the state of the mitral valve in these and other cases, is stressed.
CONGENITAL DEFICIENCY OF FACTOR VII
Authors: PITNEY W. R. 
Published: September 2017

SummaryLaboratory investigations are described in a female patient who suffers from a congenital hæmorrhagic disorder due to deficiency of Factor VII. The one‐stage prothrombin time using brain extract was greatly prolonged, but using viper venom was normal. All tests of the intrinsic blood coagulation mechanism, including the thromboplastin generation test, were normal. The patient provides the eighth recorded case of Factor VII deficiency with this pattern of laboratory findings.Evidence is presented which supports the concept that Factor VII consists of at least two components, deficiency of either producing a prolonged one‐stage prothrombin time using brain extract. Cases reported in the literature of Factor VII deficiency associated with an abnormal thromboplastin generation test and prolonged plasma venom time probably represent deficiency of the second component. The Factor VII component deficient in this patient is reduced early in therapy with “Dindevan”.The patient has three children, all with reduced concentrations of Factor VII. It is considered that the children represent the heterozygous state of Factor VII deficiency and that the defect is transmitted in a recessive manner.
THE SYNDROME OF HYPOPARATHYROIDISM, ADDISION'S DISEASE AND MONILIASIS
Authors: HETZEL B. S. , ROBSON H. N. 
Published: September 2017

SummaryAn eighth example of the rare combination of idiopathic hypoparathyroidism and Addison's disease is reported. A girl, aged 16 years, had suffered epileptic fits since the age of 10. Investigations showed cerebral calcification, with low serum calcium, raised inorganic phosphorus and normal blood urea nitrogen content. She also showed typical clinical and biochemical features of Addison's disease. Treatment with cortisone and large doses of A.T.10 led to improvement in her clinical state and also in her I.Q., electroencephalogram and electrocardiogram. The, initial administration of cortisone led to a fall in serum calcium content, and, subsequently, control of the Addison's disease necessitated larger than usual doses of A.T. 10. The clinical course of this and other previously reported cases provides some evidence of an antagonism between the parathyroid and adrenal glands.
THE LOCALIZATION AND BINDING OF SERUM PROTEINS IN THE GLOMERULI OF KIDNEY BIOPSIES IN DISSEMINATED LUPUS ERYTHEMATOSUS AND GLOMERULONEPHRITIS
Authors: TAFT L. I. , DINEEN J. K. , MACKAY IAN R. 
Published: September 2017

SummaryA report has been presented on the use of fluorescent antibody (fluorescein coupled with rabbit anti‐human gamma globulin), in the localization of serum protein in kidney tissue obtained by needle biopsy.Serum protein or fractions thereof have been localized bound to the glomerular capillary walls in kidney biopsies obtained from seven patients with glomerulonephritis associated with disseminated lupus erythematosus or related diseases, from one patient with fatal progressive glomerulonephritis and to a lesser degree from one patient with diabetic nephropathy. No such localization could be demonstrated in the glomeruli of seven normal kidneys and in ten other cases of kidney disease.It is suggested that this binding of serum protein represents an antigen‐antibody reaction. Alternatively it may he due to a secondary adsorption of plasma by the damaged capillary wall, or a combination of these processes.
INTRAPULMONARY GAS MIXING STUDIED BY THE CLOSED‐CIRCUIT HELIUM TECHNIQUE
Authors: READ JOHN 
Published: September 2017

SummaryThe closed‐circuit helium method of assessing regional ventilatory inequality (uneven mixing) in the lungs has been further explored by means of a model lung containing one or two chambers.A single, uniformly ventilated chamber produces a linear fall of helium concentration when plotted on a semi‐logarithmic scale, and such a result may be used as a criterion of uniform ventilation. Katharometer lag has been shown to be constant throughout a mixing experiment, and the rate of fall to be independent of the rate of breathing (when the abscissa is expressed as “number of breaths”). These findings help to overcome technical difficulties of analysis and to eliminate approximate “scale‐up” factors.When the model lung consists of two unequally ventilated chambers, a semi‐logarithmic plot of the mixing process produces a curved line. A new method of analysing this curve produces estimates of the well and poorly ventilated spaces which are more accurate than those obtained with previous methods of analysis of closed‐circuit data. It is unlikely that more accurate information would be obtained from open‐circuit data.A new index of “ventilatory defect” has been developed.
THE CARBON MONOXIDE DIFFUSING CAPACITY OF THE LUNG IN NORMAL SUBJECTS
Authors: HOLLAND R. A. B. , BLACKET R. B. 
Published: September 2017

SummaryThe mean diffusing capacity of the lung by the steady state carbon monoxide method was 22.2 millilitres per minute in 29 normal subjects. The diffusing capacity rose with exercise to about double the resting figure at maximum exertion.The possible errors of the method have been examined, and it is concluded that our own figures are probably some 5% to 15% too low owing to neglect of carboxyhaemoglobin in the blood and to use of the Bohr equation. When these errors are allowed for, there is no significant difference between our own results in the steady state and those of Scandinavian and American workers using single‐breath techniques.
A SURVEY OF LEUKIEMIA IN THE COMMONWEALTH
Authors: COLTON R. S. 
Published: September 2017

SUMMARYA study is presented of the type, age and sex incidence of leukæmia in Adelaide public hospitals from 1933 to 1953, and of the numerical incidence of the disease from mortality rates in both South Australia and the Commonwealth of Australia from 1929 to 1956.The findings indicate that a considerable increase in mortality rates in both State and Commonwealth has occurred, and that this increase has been comparable to that reported from the United States of America. In South Australia, the incidence of deaths from leukwmia per 100,000 rose from 1.03 in 1929 to 5.18 in 1956.In the Commonwealth as a whole, the rise over the same period was from 1.88 to 5.21. A statistical analysis of the Commonwealth figures suggests a steady rate of increase from 1940 to 1945 and from 1947 to 1956, with a sudden increase in frequency of deaths at 1947. The rate of increase from 1933 to 1940 was nearly 10% per annum.
The mortality rates for 1933, 1940, 1947 and 1954 divided into quinquennial age periods also suggest that the increase after 1940 has been mainly in the older age groups.The type, age and sex incidence studied from 295 hospital cases in Adelaide show few unusual features. Chronic myeloid leukæmia was the commonest type, but a greater increase in acute leukæmia and the chronic lymphatic type had occurred over the final ten years of the survey.No obvious seasonal trend or pattern of presentation of acute leukæmia is noted ; but more patients were admitted to hospital from the metropolitan area of Adelaide as opposed to rural areas, than would be accounted for by differences of population.
AMENORRHCEA AND PROLONGED LACTATION, INCLUDING A FURTHER REPORT OF THE CHIARI‐FROMMEL SYNDROME
Authors: COHEN ALEX 
Published: September 2017

SUMMARYTwo cases of amenorrhœa and prolonged lactation are described. The first conforms to the case descriptions of Chiari and Frommel and was accompanied by utero‐ovarian atrophy. The second was associated with the presence of a pituitary tumour. The physiology of lactation is briefly reviewed and discussed in the conflicting light of these two cases. Other states in which amenorrhœa and prolonged lactation occur are presented, and an attempt is made to differentiate these from one another.
DAY‐TO‐DAY VARIATION OF HÆMOGLOBIN VALUE, HÆMATOCRIT READING AND ERYTHROCYTE SEDIMENTATION RATE IN HEALTHY SUBJECTS
Authors: COTTER HELEN , LANCASTER H. O. , WALSH R. J. 
Published: September 2017

SummaryThe effects of menstruation and day‐to‐day variation of the blood hæmoglobin, hæmatocrit and sedimentation values have been studied. In our series of 13 women, there was no premenstrual fall in the hæmoglobin and hæmatocrit values, although there appeared to be a slight fall in the mean hæmoglobin value during the first four days of the menstrual cycle. The mean values of the Wintrobe and Westergren sedimentation rates were raised during the first four days. The correlations between the hæmatological values were computed. The hæmoglobin value was positively and strongly correlated with the hæmatocrit value. There was good agreement between the results of the two sedimentation methods, and the coefficients of variation were approximately equal. The weight was negatively correlated with the hæmatocrit, Westergren sedimentation and Wintrobe sedimentation values.
PULMONARY ALVEOLAR PROTEINOSIS
Authors: MCDOWELL C. , WILLIAMS S. E. , HINDS J. R. 
Published: September 2017

SummaryA case of pulmonary alveolar proteinosis is reported, in the belief that this is the first case to be recognized in New Zealand and possibly in Australasia. This condition, of unknown ætiology, was first described in June, 1958, by Rosen, Castleman and Liebow. This chronic and sometimes fatal illness often begins with a pneumonic episode followed by dyspnœa, cough, chest pain and loss of weight. Characteristically, the symptoms, physical and radiological signs and pathological changes are limited to the lower part of the respiratory tract and the lung parenchyma. Equally characteristically, the physical signs fail to reflect the often gross radiological changes of extensive, pulmonary infiltration. The essential histological feature is the plugging of alveolar and other distal air spaces in the lungs with a proteinaceous material rich in lipids. This patient was ill for approximately four years before making a complete recovery.
SOME ACQUIRED HÆMOLYTIC ANÆMIAS OF CHILDHOOD
Authors: HARLEY JOHN , DODS LORIMER 
Published: September 2017

SummaryA review has been made of the case records of eight children suffering from acquired hæmolytic anæmia, who were admitted to the Royal Alexandra Hospital for Children, Sydney, during the period 1954 to 1957.Four of the eight children were of Mediterranean racial extraction. This incidence is significantly higher than the mean incidence of children of Mediterranean racial extraction in the Australian community.Recovery from the illness was complete in each of the eight cases; in seven, the duration of the hæmolytic episode was less than four weeks. It is suggested that acquired hæmolytic anemia in childhood is usually an acute disease of short duration.In one case, excessive hæmolysis persisted for more than two years; for 16 weeks of this period, reticulocytopenia was present. The pathogenesis and prognosis of reticulocytopenia complicating autoimmune hæmolytic anæmia are discussed.In one case the hæmolytic anæmia followed closely upon ingestion of fresh broad beans. Inquiry has established the fact that the common broad bean grown in Australia is Vicia fava. The glutathione content of the erythrocytes of this child, estimated more than one year after the hæmolytic episode, was found to be significantly reduced.The significance of glutathione deficiency of the erythrocytes, in cases of acquired hæmolytic anæmia following ingestion of Vicia fava, naphthalene, sulphonamides and para‐amino salicylic acid, is briefly discussed.
THE DIAGNOSIS OF ADDISON'S DISEASE, WITH SOME REFERENCE TO THE ESTIMATION OF STEROID HORMONES
Authors: STEINBECK A. W. 
Published: September 2017

SummaryIn 1855, Addison published a treatise entitled "On the Constitutional and Local Effects of Disease of the Suprarenal Capsules", vividly describing the condition now known by his name, and before the turn of that century, Osler had administered a glycerol extract of porcine glands to an Addisonian patient with benefit. Nevertheless, it was 1917 before animal experimentation convincingly demonstrated that the adrenal medulla was not necessary for life, and 1927 before the significant experiment of maintaining life in adrenalectomized animals with adrenocortical extracts was carried out. This, and similar experiments, led to the definition of "cortin" as the adrenocortical hormone essential for life, and in 193o, Osler's observation and substitution therapy in animals were substantiated clinically by the treatment of a severely ill Addisonian patient with "cortin".Adrenocortical activity was detected in urine in 1937, by a glycogenic bioassay method, and this led to a study of its clinical variations, a crystalline substance being isolated in 1944. With a different bioassay, similar activity was found in adrenal vein blood in 1943 and in peripheral blood in 1948, and in 1951 cortisol was suggested as the major corticosteroid of normal human plasma.
THE DIAGNOSIS AND TREATMENT OF ADDISON'S DISEASE
Authors: HUDSON BRYAN 
Published: September 2017

SummaryExperience with 21 patients suffering from Addison's disease is described. Twenty patients are alive and able to lead active and normal lives. One patient died in Addisonian crisis at the time of diagnosis. The presenting symptoms and signs of the patients have been analysed.These patients have been drawn from a larger series of 41 cases in which the diagnosis of adrenal insufficiency was suspected. The conditions with which Addison's disease is commonly confused include : states of malabsorption, occult malignant disease, chronic renal disease, anorexia nervosa, other anxiety states, and orthostatic hypotension.Recent laboratory procedures have simplified the problems of differential diagnosis. The value of various diagnostic investigations is discussed, and the need for ACTH stimulation in diagnosis is stressed. Examples are cited of the application of the different procedures in diagnosis to patients in this series.An analysis has been made of the cause of the disease. This shows that the incidence of tuberculosis has become conspicuously less.Treatment of patients is outlined and discussed. All patients have been successfully maintained on cortisone or hydrocortisone for periods of up to six years. Eight patients receive mineralocorticoid supplement.It is concluded that the outlook for the patient with Addison's disease has improved with the introduction of newer methods for diagnosis, particularly ACTH stimulation, and with the availability of cortisone or hydrocortisone for treatment.
THE PHONOCARDIOGRAM IN CONGENITAL HEART DISEASE
Authors: GARDINER M. 
Published: September 2017

SummaryPhonocardiograms recorded in a series of 440 cases of congenital heart disease have been analysed, and the patterns found in the chief conditions described. These patterns are typical in the great majority of cases, and a well‐taken phonocardiogram, while a relatively simple test, will greatly assist in establishing the diagnosis. It may also give a good indication of the severity of the lesion, and of the presence of associated physiological disturbances, such as pulmonary hypertension. Records of diagnostic value may be obtained even in infancy.Phonocardiography serves to make clinical auscultation more precise, so that the maximum amount of information may be obtained from it. It also provides a permanent record of heart sounds and murmurs, which assists in following the progress of patients. It is a valuable adjunct in the study of congenital heart disease.
CLINICO‐PATHOLOGICAL FEATURES OF ACUTE HÆMORRHAGIC LEUCOENCEPHALITIS
Authors: VANDERFIELD G. K. , TOMPKINS MARION , JELIHOVSKY TATIANA 
Published: September 2017

SummaryThree cases of acute hæmorrhagic leucoencephalitis are described; the patients were admitted to the one hospital over a period of three months. All cases were associated with an acute respiratory illness.As these cases presented a definite clinical syndrome, with headache, scattered cerebral signs and sterile cerebro‐spinal fluid containing polymorphs, it is our view that in future cases, once cerebral abscess has been excluded, it may well be possible to establish a diagnosis during life and to institute therapy.