bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE FAILURE OF EXPERIMENTAL RENAL TUBULONECROSIS TO PRODUCE OLIGURIA IN THE RAT
Authors: FINCKH E. S. 
Published: September 2017

SummaryAcute tubulonecrosis was produced in rats by temporary clamping of the renal artery and by the subcutaneous injection of glycerol. Comparison of the mean urinary output of these animals with that of controls, both immediately after the renal damage was initiated and at 24 hours, when tubulonecrosis was clearly established, showed that there was a statistically significant increase rather than a decrease in volume. These results are interpreted as showing that tubulonecrosis itself is not an important cause of oliguria. It is concluded that it is misleading and incorrect to use the term "acute tubular necrosis" as synonymous with the acute anuria syndrome.
FIBRINOLYSIS, BLOOD CLOTTING, SERUM LIPIDS AND BODY BUILD IN NATIVES OF NEW GUINEA AND AUSTRALIANS
Authors: GOLDRICK R. B. 
Published: September 2017

SummaryMeasurements of height, weight, body bulk and fatness (skinfold thickness) and of serum lipids and fibrinolytic activity of fasting blood, were made in three groups of males—40 healthy Australians, aged 25 years, 35 atherosclerotic Australians, aged 60 years, and 40 healthy natives, aged 25 years. Measurements of the “Stypven” clotting time were also made in the Australians and compared with previous observations among the natives.The atherosclerotic group had the highest concentrations of serum cholesterol, phospholipid and beta lipoprotein cholesterol (paper electrophoresis and cholesterol elution), and the lowest serum P/C ratio. The concentration of alpha lipoprotein cholesterol was highest in the healthy Australians and lowest in the natives, while the serum P/C ratio was higher, and the serum cholesterol lower, in the natives than in the healthy Australians.Ultracentrifugal studies revealed that the higher serum P/C ratio in the natives was due to their high‐density lipoprotein, which carried as much phospholipid as, but less cholesterol than, the corresponding fraction in healthy Australians. Increasing fatness among young Australians was associated with a decrease in alpha and an increase in beta lipoprotein cholesterol.Clotting times differed significantly in all groups, being longest in the healthy Australians and shortest in the natives. Alpha lipoprotein was associated with prolongation of clotting in the “Stypven” test.Fibrinolytic activity was similar in both groups of Australians, but was greatly increased in the natives. Slowing of the rate of fibrinolysis was associated with increasing body fatness and body bulk in the Australians. In the natives muscle, not fat was the major contributor to body bulk, and increasing body bulk was associated with an acceleration of fibrinolysis.The results are discussed especially in regard to the thrombogenic and lipid theories of atherogenesis.
PULMONARY DIFFUSING CAPACITY IN CHRONIC OBSTRUCTIVE LUNG DISEASE: STUDIES AT REST AND ON EXERCISE BY THE STEADY STATE, PHYSIOLOGICAL DEAD SPACE METHOD
Authors: HOLLAND ROBERT A. B. , BLACKET RALPH B. 
Published: September 2017

SummaryStudies of 19 cases of chronic obstructive lung disease are reported. The mean value for the ratio of residual volume to total lung capacity in the series was 0·61, and the mean maximum breathing capacity was 31 L/min.Arterial blood gas findings were confirmatory of those of other workers, arterial oxygen unsaturation at rest, frequently relieved on exercise, being common. Minor degrees of carbon dioxide retention were common.An increase in physiological dead space and in the ratio of dead space to tidal volume was found in nearly all cases at rest and in most cases on exercise.Diffusing capacity for carbon monoxide (DCO) was estimated by the steady state “Filley” method. Resting DCO was reduced in all cases, the reduction being extreme in some. The mean was 7·2 ml./min./mm. Hg. In all patients able to exercise, diffusing capacity rose, but the values on exercise were well below those of normal subjects exercising at the same level of oxygen consumption. DCO reduction did not correlate with arterial oxygen unsaturation or with the degree of airway obstruction.Some of the lowering of DCO is attributed to the presence of non‐uniformity in the lungs, but a true reduction does appear to be present. Possible explanations are discussed of the frequent finding by others that single‐breath DCO is little reduced in this condition.
CUSHING'S SYNDROME
Authors: STEINBECK A. W. 
Published: September 2017

SummaryNineteen cases of Cushing's syndrome have been studied. The clinical features before and after operation have been analysed. The plasma steroidal dihydroxyacetones (SDHA) have been estimated, before and after an intravenous infusion of corticotrophin when possible.In Cushing's syndrome, plasma SDHA levels are likely to be raised, but may fall within the normal range or be doubtfully elevated. Also fluctuation in levels is possible. In hyperplasia, after corticotrophin the levels may progressively increase throughout the infusion, exceeding normal values throughout and with greater than normal increments in concentration. However, the individual levels, although raised, may not show the typical progressive increase: in some cases, they may even fail to show a normal increase. In a case of adrenocortical carcinoma, corticotrophin had no effect on plasma SDHA levels, and in a case of adenoma, the levels increased progressively throughout the infusion.Difficulties in the interpretation of raised plasma SDHA levels are discussed. The possible value of SDHA estimations in differential diagnosis is indicated, and their limitations in diagnosis are also considered.Studies with an 11β‐hydroxylase inhibitor in the case of an adrenal adenoma are referred to, as well as the possible interpretations of the corticotrophin test after adrenalectomy.Diagnostic difficulties are discussed briefly, and clinical reasons are given for preferring total to subtotal adrenalectomy in adrenocortical hyperplasia.
INNOCENCE AND THE STAPHYLOCOCCUS
Authors: PLUECKHAHN V. D. , BANKS JOAN 
Published: September 2017

SummaryA bacteriological and clinical survey is described of infection due to Staphylococcus aureus in 8473 babies delivered over the period 1956 to 1959 in a 95 bed maternity hospital. The incidence of minor staphylococcal disease was 41% at the commencement of the survey, and was reduced to 7·9% with the institution of accepted means of control.A “carrier rate” of 90% of infants by the third and fourth days of life was present in 1957, and remained at this level in 1959 despite the reduction in the incidence of staphylococcal disease.“Rooming in” and its part in the control of staphylococcal disease in the new‐born are discussed.Despite the consistently high incidence of minor staphylococcal disease in the new‐born, the resultant morbidity in the first six months of life was low (0·3%) and the mortality less than 0·1%.The incidence of breast abscess in 7438 mothers was 1·3%.Phage pattern 80/81 and the question of “virulence” are discussed.It is stressed that much remains to be discovered with regard to the modes of transmission of the staphylococcus and the part played by factors other than those directly related to the organism.
TRIPARANOL AND NICOTINIC ACID IN THE MANAGEMENT OF HYPERCHOLESTEROLÆMIA
Authors: DOAK P. B. , NICHOLSON G. I. , NORTH J. D. K. 
Published: September 2017

SummaryTriparanol has been studied alone and in conjunction with nicotinic acid in 50 cases of ischemic heart disease with associated hypercholesterolæmia. Triparanol caused an average fall of 32 mg. per 100 ml. in apparent serum cholesterol level. There was a wide variation between individual patients in response to triparanol. Nicotinic acid caused a further fall of 28 mg. per 100 ml. in apparent serum cholesterol level. Desmosterol (24‐dehydrocholesterol) and true serum cholesterol were measured in 20 patients during treatment with triparanol. Desmosterol interferes with the measurement of serum cholesterol, and the fall in apparent serum cholesterol level (29 mg. per 100 ml.) during treatment with triparanol in these 20 patients is less than the fall in true serum cholesterol level (51 mg. per 100 ml.).
THE EFFECT OF SALICYLATE ON THE PLASMA PROTEIN‐BOUND IODINE LEVEL IN VARIOUS STATES OF ENDOCRINE DISORDER IN MAN
Authors: HETZEL BASIL S. , GOOD BRIAN F. , WELLBY MAURICE L. , BEGG MALCOLM W. 
Published: September 2017

SummaryThe effect of salicylate on the plasma protein‐bound iodine (PBI) level has been compared in patients with various states of thyroid, adrenal and pituitary gland function. The salicylate was administered in a dosage of 6 grammes daily for four days as the calcium acetyl salt. This dosage produced a consistent fall in plasma PBI level in normal subjects (mean levels of 6·0 μg. per 100 ml. before, fell to 4·5 μg. per 100 ml. after four days on salicylate therapy).In comparison with six normal subjects, a significant but smaller fall in plasma PBI level was found in a group of six hypothyroid subjects maintained on desiccated thyroid (mean levels of 5·7 μg. per 100 ml. before, fell to 5·1 μg. per 100 ml. after four days on salicylate therapy). Taken in conjunction with other evidence, this finding suggests that salicylate is inhibiting thyroid secretion via thyrotropic hormone (TSH) depression in the normal subjects and also altering the peripheral distribution of thyroid hormone in both groups.In eight untreated hyperthyroid subjects, a significant fall in plasma PBI level (proportionately greater than in the normal group) was also noted (mean levels of 13·9 μg. per 100 ml. before, fell to 9·6 μg. per 100 ml. after salicylate therapy). This observation indicates the susceptibility of the hyperthyroid gland to TSH depression.In two hypoadrenal patients maintained on cortisone, in two patients with hypothalamic lesions and in one acromegalic, responses similar to those observed in normal subjects were found. In another patient with a chromophobe adenoma of the pituitary and mild hypothyroidism, no fall was observed : this could be due to some interference with TSH secretion by the tumour.The possibility that these effects of salicylate on the plasma PBI level may be due to alterations in plasma binding of thyroid hormones is considered, but this hypothesis does not account for all the findings in hyperthyroidism. The possibility remains that salicylate has a direct effect on TSH secretion.
THE SURVIVAL OF 51Cr LABELLED AUTOTRANSFUSED RED CELLS IN PATIENTS WITH THALASSÆMIA
Authors: HILLCOAT B. L. , WATERS A. H. 
Published: September 2017

SummaryThe fate of 51Cr‐labelled autotransfused red cells has been studied in five children with thalassmia, two of whom had undergone splenectomy before the present study. The value of this procedure in the clinical assessment of such patients is discussed.Thirty to forty per centum of the labelled red cells left the circulation in the first two days, and the mean cell life was greatly reduced, ranging from three to six days. There was no correlation between the degree of anemia and the rate of red‐cell destruction, and there was no apparent difference between the red‐cell survival in the patients who had undergone splenectomy and those who had not.Excess red‐cell destruction occurred in the spleen in the most severely anæmic patient, and in the liver in both of the patients who had undergone splenectomy.
PURULENT MENINGITIS : PRINCIPLES AND RESULTS OF REVISED STANDARDIZED TREATMENT IN 281 CASES
Authors: FORBES J. A. 
Published: September 2017

SummaryThis paper describes the methods and results of standardized treatment of 281 patients with purulent meningitis. In treating these patients, antibiotics were administered intramuscularly, but not intrathecally whatever the causal organism or the severity of meningitis, the intravenous administration of fluids was avoided and corticosteroids were used as an adjunct to antibiotics. The intramuscular injection of penicillin and chloramphenicol formed the initial treatment, which was varied subsequently according to the causal agent and the likelihood of associated infection such as pneumonia.The importance of the prevention or treatment of relatively common complications, such as airway obstruction and mixed infections in “open” sites, is emphasized. Cranial surgical procedures were avoided : exploration of the subdural space was considered unnecessary. In general, attempts were made to reduce management to the simplest essential measures, particularly in the case of infants, excessive handling of whom may lead to poor results.The overall mortality rate in 281 patients with purulent meningitis was 3·2%. Amongst patients with pneumococcal meningitis, the mortality rate was 7·1%. Other rates were as follows : Hamophilus influenza meningitis, 2·7% ; meningococcal meningitis, 1·4% ; unidentified purulent meningitis, 2%.The ages of the patients are grouped in relation to the causal organisms and mortality. Subsequent review of these patients has shown that serious sequeke are infrequent and almost confined to pneumococcal meningitis. Patients with purulent meningitis who have a prior history of head injury should receive penicillin prophylactically after apparent cure of the meningitis.
ALDOSTERONE AND THE CIRCULATION
Authors: STUART-HARRIS C. H. , COX J. R. , LEONARD P. J. , SINGER BERTHA 
Published: September 2017

SummaryStudies have been made in Sheffield on volunteers placed on a dietary regime inducing sodium depletion, in order to observe the effect of alteration in the volume of the body fluid compartments on the measured output of aldosterone in the urine. Fluid volumes decreased during sodium depletion. Subsequent treatment with vasopressin injections and free fluids during continued sodium restriction induced an increase of fluid volumes in some only of the volunteers. Aldosterone output increased during salt depletion and fell during hydration, but continued to increase in those who failed to retain excess water. Changes in the extracellular fluid volume, but not in the plasma volume, were inversely correlated with changes in aldosterone output. Total exchangeable sodium measured before and after sodium depletion and after attempted hydration permitted an estimate of the intracellular sodium by means of the calculated extracellular sodium. The latter decreased and increased pari passu with changes in the extracellular fluid volume to a much greater extent than did the total exchangeable sodium. Changes probably occur therefore in the electrolyte composition of the cells during hydration and salt depletion. The view is expressed that intracellular electrolyte changes rather than fluid volumes may trigger the mechanism which controls the release of aldosterone.The paper reviews the changes observed in aldosterone output in patients with heart failure and also discusses the therapeutic use of aldosterone antagonists.
CONGENITAL HEPATIC FIBROSIS
Authors: HICKIE JOHN B. , GARVAN J. M. 
Published: September 2017

SUMMARYA family with a high incidence of hepatomegaly, normal liver function and stillbirths is described. In one member biopsy material confirmed the diagnosis of congenital hepatic fibrosis. This patient's sister probably died of the same disorder. Unusual hepatic sinusoidal prominence was present in the patient described and in one of her daughters, from whom biopsy material is available. Regional adiposity also occurred in three generations.Congenital hepatic fibrosis should be suspected in patients with firm hepatomegaly and normal liver function. It is a familiar vascular anomaly of the liver. It may be symptomless, or it may cause death in childhood or adult life from portal hypertension or renal failure secondary to polycystic disease of the kidneys.
PROGNOSIS IN AUTOIMMUNE HÆMOLYTIC ANÆMIA
Authors: DACIE J. V. 
Published: September 2017

SUMMARYFactors reported to influence the prognosis for patients with autoimmune hæmolytic anæmia are reviewed and compared with experience at the Postgraduate Medical School, London. In the idiopathic warm‐antibody type of hæmolytic anæmia, prognosis depends on the amount of antibody formed and its quality. Of 50 patients in the London series, 23 died, mostly within two years of the onset of the disease, whilst 10 underwent clinical and hæmatological cure. The idiopathic cold‐antibody type of disease is in general not so serious ; nine patients in the London series of 16 have survived for five years or more, and not all deaths have been related to the disease or its treatment. The prognosis in cases of secondary autoimmune hæmolytic anæmia is dominated by the nature of the underlying disease.
DIAGNOSIS AND TREATMENT OF STROKES: RADIOLOGICAL ASPECTS
Authors: BLADIN PETER F. 
Published: September 2017

SUMMARYA series of 150 consecutive patients admitted to hospital with the diagnosis of “stroke” was investigated radiologically by vascular and ventricular contrast studies. Comparison of clinical and radiological diagnoses showed that in many cases clinical impressions were incorrect. This particularly applies to the unsuspected presence of lesions such as aneurysms and subdural clots.In cases of suspected cerebral ischæmia, it has been shown that a complete survey of cervical and cerebral vessels is necessary to gain an overall idea of the position of the atheromatous lesions causing interference with cerebral blood flow. This is of great importance with regard to corrective surgical therapy.In many cases no actual occlusion of any vessels was found ; but the survey indicates the common occurrence of ectasia in both carotid and vertebral systems. The pathological lesion was found to be a defect in the elastica of the affected vessels. In view of the paucity of actual occlusions demonstrated compared with the frequency of a clinical diagnosis of “cerebral thrombosis”, it would seem that a reappraisal of nomenclature and pathological ætiology is in order.The position of radiological investigation with regard to practicability and safety is discussed, and it is concluded that it has a great deal to offer both diagnostically and therapeutically.
CALCIUM METABOLISM AND THE BONES AFTER PARTIAL GASTRECTOMY
Authors: DELLER D. J. , BEGLEY M. D. 
Published: September 2017

SUMMARYThe incidence of skeletal rarefaction was investigated in 100 control subjects and in 100 patients studied two to 15 years after partial gastrectomy. The two groups were comparable in age, sex and social class. Skeletal rarefaction was assessed subjectively by visual inspection of the X‐ray films and objectively by the measurement on the X‐ray films of the degree of wedging of the dorsal part of the spine, the degree of biconcavity of the lumbar part of the spine, and the cortical bone thickness of the shaft of the femur and the metacarpal.Rarefaction of the bones was twice as frequent in the gastrectomy group as in the control group. Furthermore, the skeletal abnormality was more severe in the patients after partial gastrectomy, as evidenced by the number of crush fractures of the vertebræ, the history of fractured bones following minimal trauma, and the presence of pain in the bones.Radiological evidence of bone rarefaction was more frequent in women than men in both the control group and the gastrectomy group. However, this difference of frequency in the sexes became less obvious in the post‐gastrectomy group, in which the percentage of men showing rarefaction more closely approached the percentage in women.Changes in the bones became increasingly frequent with advancing age in both of the groups that were investigated. Even so, bone disease was present at an earlier age in the patients after partial gastrectomy than in the control subjects.The incidence of skeletal rarefaction increased with the interval of time after partial gastrectomy, although there was no correlation between the age of the patient and the length of time after operation.Loss of weight, anæmia, the “dumping” syndrome and diarrhœa were more frequent in the patients with skeletal changes after gastrectomy than in the patients with normal bones.Judged by clinical criteria, 11 patients after partial gastrectomy appeared to have spinal osteoporosis and 18 patients had a syndrome resembling osteomalacia. Males predominated in the group with the condition resembling spinal osteoporosis, whereas the majority of patients with clinical features of osteomalacia were women. There was a long latent interval between operation and the development of skeletal symptoms. Eight patients had crush fractures of the spine and one patient had rib fractures and Looser's zones in the fibulæ. The high incidence of psychological disturbance, anæmia and undernutrition made evaluation of the skeletal symptoms difficult.
STUDIES OF THE LIFE SPAN AND FATE OF PLATELETS
Authors: CASTALDI P. A. , FIRKIN B. G. 
Published: September 2017

SUMMARYChromium‐51 labelling of platelets has been employed to study their life span and to assess the role of the spleen in platelet dynamics in idiopathic thrombocytopenic purpura, congestive splenomegaly and congenital hæmolytic anæmia with splenomegaly.Surface scanning has not provided unequivocal evidence of splenic sequestration in the majority of the patients studied. It may be possible to predict the response to splenectomy in idiopathic thrombocytopenic purpura, but larger numbers of patients require to be studied before a clear pattern can be established.Estimations of platelet yield before and after splenectomy, together with some evidence from surface scanning, suggest that the thrombocytopenia of congestive splenomegaly with short platelet survival may be due to splenic removal of platelets.It is suggested that, in some circumstances, the enlarged spleen may remove many platelets from the circulation. This effect may not be reflected in thrombocytopenia and may be detectable only by studies of platelet dynamics.