bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHRONIC PYELONEPHRITIS AND HYPERTENSION
Authors: GWYNNE J. F. 
Published: September 2017

SummaryThe autopsy incidence of chronic pyelonephritis has been investigated in a series of zoo hypertensive patients. Evidence of the disease was found in 51.5%, the condition being unilateral in 4.5%. The findings indicate that “essential” hypertension is rare in young patients. Malignant hypertension and uræmia should suggest the presence of primary renal disease. Only 10% of the cases were diagnosed clinically, and the condition is often overlooked or misdiagnosed pathologically.The suggestion is put forward that full urine examination, X‐ray investigation of the abdomen and intravenous pyelography should be used more often and with greater care, in order that the clinical recognition of the disease may be improved.
“ Q ” FEVER : CLINICAL FEATURES IN 72 CASES
Authors: POWELL OWEN 
Published: September 2017

SummaryIn 72 consecutive cases of “ Q ” fever, with no death, the commonest symptoms were headache and anorexia. Myalgia, sore eyes, cough, chills and sweats were also frequent. The commonest signs were a relative bradycardia, hepatomegaly and splenomegaly. Minor chest signs were frequently found. The total duration of fever was 10 days or less in the majority of cases. The longest duration of continuous fever was 24 days, and of intermittent fever 34 days.Common laboratory findings included an increased erythrocyte sedimentation rate, the presence of atypical mononuclear cells during the acute illness and an absolute lymphocytosis during convalescence. Only three patients had radiologically demonstrable pneumonic changes. However, respiratory infection of a lower severity was frequent, and this suggests that local strains of Coxiella burneti may be less virulent than overseas strains. Subclinical involvement of the liver was common, and in seven cases there was electrocardiographic evidence of transient myocardopathy.About 70% of patients returned to work within six weeks from the onset, but the convalescence of the remainder was protracted. The duration of convalescence was prolonged with increasing age. Infection with C. burneti may become chronic.Cases are described in which “ Q ” fever was complicated by pneumonia, pleural effusion, thrombocytopenia, encephalitis and endocarditis, and in which the problem of chronicity is illustrated.
SOME OBSERVATIONS ON EJECTION SOUNDS
Authors: WAGNER G. R. 
Published: September 2017

SummaryThe properties of ejection sounds are described as they were found in a limited number of proven cases of simple pulmonary stenosis, pulmonary hypertension, congenital aortic stenosis and coarctation of the aorta.Pulmonary ejection sounds are commonly found in pulmonary stenosis, even in severe cases. They tend to occur earlier in systole in cases of severe stenosis than in cases of mild or moderate stenosis. They vary in intensity with respiration.In pulmonary hypertension, ejection sounds are also frequently present. They occur later in systole than in pulmonary stenosis and show little variation in intensity with respiration.Aortic ejection sounds are commonly found in congenital aortic stenosis and in coarctation of the aorta. They occur later in systole in coarctation than in aortic stenosis, and in the former they are often less sharp and less click‐like to the ear and rather broad and “split‐up” phonocardiographically.Ejection sounds are an additional physical sign in the conditions described, and they may at times be helpful in diagnosis.
NEUTROPHIL ALKALINE PHOSPHATASE
Authors: WYLLIE R. G. 
Published: September 2017

SummaryNeutrophil alkaline phosphatase (N.A.P.) levels were studied in 665 patients. In 511 patients, 24 hours after the onset of acute inflammation, the N.A.P. level was proportional to the extent and severity of the lesion. In 20 patients unexplained weak N.A.P. responses were observed. In 132 patients with a wide variety of non‐inflammatory diseases (excluding infarction, liver disease and blood dyscrasias), N.A.P. levels were normal. In two patients, raised N.A.P. levels occurred without demonstrable cause. It is concluded that N.A.P. levels reflect the progress of acute inflammation and can be of value in diagnosis.
IN‐VIVO ABSORPTION OF IRON FROM TREATED BLOOD AND LIVER
Authors: SANFORD RONA 
Published: September 2017

SUMMARYRats were injected with iron‐59 to obtain blood and liver labelled with this element. These materials were cooked and then some of the cooked blood and cooked liver were subjected to peptic digestion in vitro, with the production of supernatant fluids and residues.Different groups of rats were then fed each of these several substances.It was found that the rats absorbed the same amount of iron from the supernatant fluids as they did from the cooked blood or cooked liver, but very little iron was absorbed from the residues.
“LATE” NEONATAL JAUNDICE IN INFANTS WITH GLUCOSE‐6‐PHOSPHATE DEHYDROGENASE‐DEFICIENT ERYTHROCYTES
Authors: HARLEY JOHN D. , ROBIN HELEN 
Published: September 2017

SummaryA review has been made of certain clinical features of the episodes of “late” neonatal jaundice sustained by five infants, who appeared to be either hemizygous or heterozygous for the gene responsible for an erythrocytic defect of the enzyme glucose‐6‐phosphate dehydrogenase (G6PD). Each of these infants seemed well on discharge from the obstetric hospital, but was subsequently readmitted to hospital as a result of the appearance of jaundice. The age of onset of these episodes ranged from 10 to 23 days.Four infants were males of Italian extraction, with erythrocytes grossly deficient in G6PD activity. Each was receiving maternal breast milk over the period preceding the onset of jaundice. One mother was concurrently taking phenacetin and acetylsalicylic acid, and another was receiving sulphamethoxypyridazine for a mild urinary tract infection. One male infant was found to be suffering from an inflamed umbilicus, from which Escherichia coli was grown on culture, at the same time as the episode of jaundice.Subsequently, each of the four males developed anæmia, with or without evidence of excessive haemolysis; possible ætiological factors included Vicia fava, chloramphenicol, sulphamethoxypyridazine and bacterial or viral infections. Two brothers were found to have hypochromic microcytic anæmia, which appears to be responding to oral iron therapy; radiological evidence of cholelithiasis was demonstrated, at the age of 22 years, in the G6PD‐deficient mother of these brothers.The fifth infant was a female of Maltese extraction. The G6PD activity was within the normal range in the child, but very low in her father's erythrocytes. In this infant, jaundice of mild degree was accompanied by evidence of slightly increased hæmolysis, and persisted for approximately 13 weeks.These episodes of neonatal jaundice have been discussed in terms of current concepts of the clinical significance of G6PD deficiency, with emphasis on the interrelations between the syndromes which may occur in individuals with enzyme‐deficient erythrocytes.
THE VARIABLE FUNCTIONAL PROGRESSION OF CHRONIC OBSTRUCTIVE LUNG DISEASE
Authors: PAIN M. C. F. , READ D. J. C. , COLEBATCH H. J. H. , READ JOHN 
Published: September 2017

SummaryStudies of respiratory function in three patients with chronic obstructive lung disease over periods of two and a half to five years are reported to illustrate the variability of functional progression in this condition. One patient showed little or no change over five years; one showed deterioration from an initial state of respiratory and cardiac failure, but has survived for four years; the third showed no change in overall ventilatory function, but changes in the distribution of ventilation and blood flow led to a worsening of blood gas disturbances. The importance of the latter factor in determining functional progression is emphasized; serial studies which do not include accurate measurement of blood gases may be misleading.Accurate prediction of functional prognosis for the individual patient is not possible in our present state of knowledge. The observations in one case reemphasize that survival after the onset of cur pulmonale heart failure is not necessarily limited to two years.
GOODPASTURE'S SYNDROME AND WEGENER'S GRANULOMATOSIS
Authors: JOHNSON J. R. , MCGOVERN V. J. 
Published: September 2017

SUMMARYThe case histories of six patients with Goodpasture's syndrome are contrasted with those of three patients with Wegener's granulomatosis. There is a similarity between the two, because each is initially a respiratory disorder complicated by glomerulonephritis. In each the glomerular lesions vary from deposits of fibrinoid material through exudative and proliferative reactions towards complete obliteration of all glomeruli. The pulmonary lesions, however, differ markedly. The typical lesion in Goodpasture's syndrome is hæmorrhage into the lungs giving rise eventually to pulmonary siderosis, whereas in Wegener's syndrome there is replacement of the lining of bronchi and of accessory nasal sinuses by necrotizing granulomatous tissue which may simulate carcinoma or tuberculosis. Widespread arteritis is a constant feature of Wegener's granulomatosis, but is seldom found in Goodpasture's syndrome. It was present in one of the six examples of Goodpasture's syndrome, but was of only minor importance.Although renal biopsy cannot distinguish between the two conditions, it is helpful in directing attention to these disorders. Biopsy of the upper air passages, however, may be diagnostic in Wegener's granulomatosis, as it was in two of the three cases in this survey.In one case of Goodpasture's syndrome, corticosteroids may have caused some mitigation of the disorder, but in the other five cases of Goodpasture's syndrome and in the case of Wegener's granulomatosis in which corticosteroids were used, any benefit was only temporary.
REDUCTION OF PLASMA CHOLESTEROL LEVELS IN ATHERO‐SCLEROSIS BY DIET AND DRUG TREATMENT
Authors: BARNETT A. J. , CARSON VALERIE J. 
Published: September 2017

SUMMARYA trial has been conducted of the following methods for the reduction of serum cholesterol level in patients with atherosclerosis: (i) The use of a low‐fat, low‐cholesterol diet with the addition of corn oil; (ii) the exhibition of triparanol (0·25 to 0·5 gramme per day); (iii) the administration of nicotinic acid (up to 3 grammes per day); (iv) the administration of a combination of nicotinic acid and triparanol. The results were as follows.With the dietetic method, a fall in plasma cholesterol level usually occurred. However, this was only of very modest degree (mean of 42 mg. per 100 ml. in 10 patients). Although a proportion of the patients treated by diet considered that their vascular symptoms were relieved, this could not be confirmed by step tests or by clinical examination.When triparanol was used, significant lowering of the plasma cholesterol level (determined by the Bloor method) was observed in 17 of 22 patients treated for six months (mean lowering, 69 mg. per 100 ml.). Desmosterol accumulated in the plasma, and the true lowering of the cholesterol level was somewhat greater than this; the lowering of the total plasma sterol levels was somewhat less. We were unable to demonstrate desmosterol in the intimas of patients treated with triparanol. Treatment was not associated with any clinical benefit, nor were there any side effects which could be attributed to the drug.The administration of nicotinic acid was associated with a moderate lowering of the plasma cholesterol level (mean of 38 mg. per 100 ml. in 10 patients). Although a few patients said that they had experienced clinical benefit, this was of doubtful significance. Side effects were common and prevented the administration of a full dose in most cases. No toxicity was demonstrated.The use of a combination of nicotinic acid and triparanol produced an additional fall in the plasma cholesterol level (mean of 60 mg. per 100 ml. in nine patients). The addition of triparanol treatment to nicotinic acid treatment also produced an additional fall (mean of 44 mg. per 100 ml. in five patients).These findings are discussed, and it is concluded that it is possible to lower the plasma cholesterol level by diet or drug treatment, but that this is not of great clinical value if it is employed for a relatively short period or in the treatment of elderly patients. Treatment is more likely to be of value in younger men with early atherosclerosis or a raised plasma cholesterol level, but, as treatment must be carried on over many years, the method used must be devoid of serious toxicity.
DIAGNOSIS AND TREATMENT OF STROKES: CLINICAL ASPECTS
Authors: BILLINGS JOHN 
Published: September 2017

SUMMARYA detailed investigation of patients admitted to St. Vincent's Hospital, Melbourne, with the diagnosis of “cerebrovascular accident” has been carried out. The radiological studies in particular have demonstrated that clinical diagnosis is very inadequate. A common mistake is the diagnosis of infarction in the presence of localized intracerebral hæmorrhage.The variable symptomatology of apparently identical vascular lesions can be understood only when the whole of the vascular tree from the aortic arch upwards is displayed by arteriography. In more than 20% of cases of cerebral infarction, no evidence of vascular obstruction could be obtained. A “flow‐failure” theory is postulated in some of these cases ; in the presence of generalized degenerative changes in the vessels of the neck and the brain, a transient fall of blood pressure, possibly due to weakened left ventricular contraction, may cause cerebral infarction.
THE LEAD CONTENT OF BONE IN SUBJECTS WITHOUT RECOGNIZED PAST LEAD EXPOSURE AND IN PATIENTS WITH RENAL DISEASE
Authors: EMMERSON B. T. , LECKY D. S. 
Published: September 2017

SUMMARYIn 18 subjects without renal disease and without any history of significant past lead exposure, the mean lead content of skull bone was 2·1±1·0 mg. per 100 grammes, the values varying from 0·7 to 4·0 mg. per 100 grammes. The upper figure for the mean plus two standard deviations was 4·1 mg. per 100 grammes. It is suggested that a value close to this be taken as a suitable upper limit of normal for the lead content of skull bone.As a test of the suitability of such a value, it was found that patients with renal disease not caused by lead all had a mean lead content of skull bone less than this figure, while patients with renal disease caused by childhood lead poisoning all had a mean lead content of skull bone greater than this figure. Renal failure of itself, therefore, does not result in accumulation of lead in bone.
THE USE OF DTPA IN THE DIAGNOSIS AND MANAGEMENT OF IDIOPATHIC HÆMOCHROMATOSIS
Authors: WALSH R. J. , PERKINS K. W. , BLACKBURN C. R. B. , SANFORD RONA , CANTRILL SHIRLEY 
Published: September 2017

SUMMARYA test to measure the extent of iron overload in patients with idiopathic hæmochromatosis was developed with the chelating agent diethylene triamine penta‐acetic acid (DTPA). One gramme of DTPA in 100 ml. of saline was injected intravenously, and the iron excreted in the urine during the next five hours was measured. Normal subjects excreted less than 0·25 mg. of iron, and six untreated patients who had been diagnosed as suffering from hæmochromatosis excreted between 4·0 and 16·1 mg.The test was also performed on 51 patients who had been treated by removal of blood for varying periods, and who were divided into three groups. Sixteen who still had saturated transferrin excreted between 0·6 and 9·4 mg. of iron in the urine. The second group of 29 patients, whose transferrin had been unsaturated for varying periods, excreted between 0 and 1·5 mg. The remaining six patients had been adequately treated, but had not attended for some time, and the transferrin had again become saturated. Only one excreted less than 0·6 mg. The DTPA test was also performed on 13 asymptomatic relatives of patients with hæmochromatosis, all of whom had saturated transferrin, and some excreted abnormal amounts of iron.It is suggested that the DTPA test provides a measure of iron overload in patients with hæmochromatosis and gives a better guide to the progress of therapy than do serum iron and transferrin values. The test is simple to perform, is safe, and causes little inconvenience to the patient.
MACROGLOBULINÆMIA WITH CHROMOSOMAL ANOMALY
Authors: FERGUSON JEAN , MACKAY IAN R. 
Published: September 2017

SUMMARYIn one case of Waldenström's macroglobulinæmia with myelosclerosis, approximately half the blood cells had a normal chromosome complement of 46 and the remainder contained a large extra “W” chromosome; the chromosomes of the skin cells were normal. The chromosomes of the blood cells of two other patients were normal. Chromosomal anomalies may reflect the occurrence of somatic mutation in cases of macroglobulinæmia; but whether this is an essential cellular genetic lesion for pathological macroglobulin synthesis is still undetermined.
THE ISOLATION OF SALMONELLAE FROM MEAT PRODUCTS AND FERTILIZERS IN ADELAIDE
Authors: ANDERSON KEVIN , CROWDER ERNEST F. , GIBBS MALCOLM H. 
Published: September 2017

SUMMARYReports by American authors that a significant proportion of meat purchased in the retail market is contaminated with salmonellæ have been confirmed in South Australia. The distribution of various intestinal pathogens in meat and meat products is noted, and attention is drawn to the hazards which may arise during storage and cooking.An investigation into a variety of domestic fertilizers containing animal residues has failed to reveal any significant contamination with intestinal pathogens. The apparent discrepancy between the high yield of salmonellæ from meatmeal samples and the absence of these organisms from mixtures of meatmeal and inorganic salts may be explained by the low pH of the latter.
CALCIUM METABOLISM AND THE BONES AFTER PARTIAL GASTRECTOMY
Authors: DELLER D. J. , EDWARDS R. G. , ADDISON M. 
Published: September 2017

SUMMARYSome aspects of calcium metabolism were investigated in 100 patients after partial gastrectomy in an endeavour to define the nature of the skeletal abnormality and to detect factors responsible for its development. Fifty subjects not operated upon were used as the control group. The following abnormal biochemical values were found in the patients after partial gastrectomy : low serum calcium levels in six patients ; low serum phosphate levels in six patients ; raised serum alkaline phosphatase levels in 15 patients ; low serum total protein level in one patient ; and low serum albumin level in one patient. In addition, the excretion of calcium in the urine was lower in the patients after gastrectomy than in the control subjects, and the “clearance” of phosphate was higher in the patients after gastrectomy. Patients with changes in the bones after gastrectomy differed from the patients with normal bones after operation in having a higher mean serum level of alkaline phosphatase and a lower mean urinary excretion of calcium.Twenty‐two patients after partial gastrectomy were further investigated by bone biopsy, the calcium infusion test and fæcal fat determination. Eight control subjects also underwent the calcium infusion test. On the basis of these investigations, 13 patients were considered to have an “osteomalacic” syndrome. The main features of the syndrome were generalized skeletal pain, bone tenderness, skeletal rarefaction and histological changes of osteoporosis and early osteomalacia. We have used the term “osteomalacic” syndrome to describe this condition, because the classical biochemical features of osteomalacia were only infrequently present, and because osteomalacia and osteoporosis were present together. The biochemical changes that were present in the 13 patients with the syndrome were elevation of the serum alkaline phosphatase levels in five patients, increased retention of infused calcium in the calcium infusion test in seven patients, hypocalcæmia in one patient and hypophosphatæmia in another patient. Anæmia, steatorrhœa and an inadequate diet were frequently present in these cases.Factors that appeared to be of importance in the pathogenesis of the bone disorder following gastrectomy were inadequate intake of calcium and protein in the diet, and steatorrhœa. A deficiency of vitamin D also was inferred to account for the changes that were detected.The observations made in the present investigation suggest that bone disease is relatively common after gastric surgery, but that in most cases the disorder is only of moderate severity and does not constitute a serious disability to the patient. However, an awareness of the association of bone disease and gastric surgery is important, as some patients after gastrectomy may require treatment with calcium, vitamin D and an anabolic steroid.
EXPERIMENTAL ENCEPHALOMYELITIS: ITS RELATION TO DISSEMINATED SCLEROSIS1
Authors: SZEGO G. , ANDERSON R. MCD. , ROBERTS J. T. 
Published: September 2017

SummaryExperimental allergic encephalomyelitis was produced in guinea‐pigs, rabbits and ferrets, whilst an attempt in mice was not successful. The clinical and histological responses in these groups of animals differed, and in the animals with a more highly developed central nervous system the lesions were more demyelinating in character. A combination of intracerebral injection of herpes simplex virus and experimental allergic encephalomyelitis, in ferrets, produced demyelination resembling that seen in disseminated sclerosis. A similar procedure carried out in guinea‐pigs was unsuccessful.
IRON ABSORPTION IN HÆMOCHROMATOSIS AND CIRRHOSIS OF THE LIVER
Authors: DAVIS A. E. , BIGGS J. C. 
Published: September 2017

SummaryThe absorption of iron with and without a preceding dose of pancreatic extract has been studied in patients with hæmochromatosis and cirrhosis of the liver. The addition of pancreatic extract caused a significant reduction in iron absorption in both groups of patients.It is proposed that a specific derangement of pancreatic function leads to the excess absorption of iron which occurs in these conditions.
RADIOLOGICALLY DEMONSTRABLE ARTERIAL CALCIFICATION IN DIABETES MELLITUS
Authors: FERRIER T. M. 
Published: September 2017

SummaryA radiological study of the lower limbs of 250 diabetics and 250 controls has shown that medial arterial calcification at the knee and foot level is some two and a half times more frequent in the diabetic group. The incidence of intimal calcification at the knee level was higher in the diabetic group, but the difference was not statistically significant. Intimal calcification was not seen in the small arteries of the feet.In the diabetic group, there was correlation between the incidence of medial arterial calcification in the feet and the incidence of medial arterial calcification at the knee, but not with the incidence of intimal calcification at the knee.The incidence of arterial calcification in the feet of the diabetics bore a definite relationship to increasing patient age, sex (males being more affected), duration of the diabetes in the under‐fifty‐years age group, the presence of retinopathy and the incidence of gangrene. There was no correlation with the severity of, or control of, the diabetes.In a small group of non‐diabetic patients showing advanced arterial calcification in the feet, fasting blood sugar levels were slightly higher than in a control group, but response to a sugar load was similar. This did not support the hypothesis that advanced arterial calcification in arteries of the feet was a manifestation of the prediabetic state.