bluuebunny/crossref_metadata_2025_split huggingface dataset:
SOME FACTORS AFFECTING RIGHT AND LEFT ATRIAL WEIGHTS AND VOLUMES AND TOTAL HEART WEIGHT
Authors: GORDON RICHARD , NEILSON GRAEME , SILVERSTONE HAROLD 
Published: September 2017

SUMMARYThe hearts from 156 patients who came to routine hospital autopsy were examined. The amount of epicardial fat was assessed by macroscopic examination, the amount of atrial fat was assessed by microscopic examination and the thickness of the body fat was measured at the midline ventral incision. The patient's age, sex, and height were recorded, and the degree of rigor mortis of the heart assessed. The hearts were weighed, the volume of each atrium was measured, and the atria were individually dissected and weighed.Correlations were sought between atrial weights and volumes and the patient's age, sex, height, amount of body and heart fat, and the degree of rigor mortis of the heart.The total heart weight, both atrial weights and both atrial volumes were greater for males than for females. For each sex the right atrial volume was significantly greater than the left atrial volume, but right and left atrial weights did not differ significantly. Significant positive correlations existed between right and left atrial weights. For both sexes, also, each atrial weight was correlated with its corresponding atrial volume.For males, atrial magnitudes were positively correlated with body height and with the thickness of body fat. For females, left atrial volumes only were positively correlated with the thickness of body fat, and there were no positive correlations with height. For females, but not for males, both atrial weights were positively correlated with age. The total heart weight for males was greatest in taller, fatter subjects, but for females it was greatest in shorter, fatter subjects. For both sexes, atrial magnitudes correlated positively with total heart weight, independently of the amount of heart fat. The amount of epicardial fat (assessed by macroscopic examination) was positively correlated with the thickness of subcutaneous fat, while the amount of atrial fat (assessed by microscopic examination) was not.
HÆMORRHAGE INTO THE UPPER PART OF THE GASTRO‐INTESTINAL TRACT IN THREE PATIENTS WITH HERITABLE DISORDERS OF CONNECTIVE TISSUE
Authors: GRANT A. KERR , ALDOR T. A. M. 
Published: September 2017

SummaryThree patients with rare, heritable disorders of connective tissue presented with hæmorrhage of the upper part of the gastro‐intestinal tract. The latter is not commonly described in Ehlers‐Danlos syndrome, but may be a presenting feature in Grönblad‐Strandberg syndrome. Two sisters with the former condition demonstrated a remarkably similar distribution of connective tissue defects, including multiple jejunal diverticula. Recognition of the underlying disorder in the latter syndrome depends upon competent ophthalmoscopic examination.
ADULT CYSTIC FIBROSIS PRESENTING WITH MECONIUM ILEUS EQUIVALENT AND DIAGNOSED BY SELENOMETHIONINE SCANNING OF THE PANCREAS
Authors: QUINLAN M. F. , WAYS N. J. , JOSKE R. A. 
Published: September 2017

SummaryA case of cystic fibrosis in a man, aged 28 years, is described, in whom the presenting feature was obstruction of the small bowel due to impacted bowel content—” meconium ileus equivalent “. The presence of pancreatic insufficiency was confirmed by the result of a pancreas scan with 75Se‐labelled selenomethionine. The use of pancreatic scanning in the diagnosis of chronic pancreatic insufficiency is discussed.
THE INVESTIGATION OF HYPOPITUITARISM
Authors: LAZARUS L. 
Published: September 2017

SummaryA dynamic scheme is described for the investigation of patients suspected of having hypopituitarism. The hypothalamus and pituitary are investigated as a single functional unit by the use of basal studies of each trophic hormone and the subsequent hormonal response to stimuli. The basal studies include the measurement of the total 17‐oxogenic steroid content in the urine, total pituitary gonadotrophin content in the urine, thyroidal uptake of 131I and serum growth hormone levels. The stimuli used include insulin‐induced hypoglycæia and the administration of metyrapone, pyrogens and vasopressin. The majority of patients with hypopituitarism have partial hypopituitarism, and unihormonal deficiencies are not uncommon. Classification of the disorder should be on a functional basis.
SOME EFFECTS OF THE INTRAVENOUS ADMINISTRATION OF CALCIUM IN MAN
Authors: SMALLWOOD R. A. 
Published: September 2017

SummaryCalcium was administered by intravenous infusion or injection into 19 subjects, in doses ranging from 180 to 864 mg. The effects observed were bradycardia and sinus arrhythmia, an increased pulse pressure, shortening of the Q‐T
c interval with depression and inversion of T waves, and an increase in gastric secretion. Atropine prevented the development of the bradycardia, sinus arrhythmia and the increase in gastric secretion, but did not prevent the increase in pulse pressure. None of the changes occurring ran parallel with the serum calcium levels, and with the exception of the T‐wave changes, which persisted after the serum calcium levels had returned to normal, they appeared to be related to the acute rise in serum calcium levels.
THE INTERPRETATION OF THE RESULTS OF ORAL GLUCOSE TOLERANCE TESTS IN OLDER SUBJECTS
Authors: DE COEK NANETTE M. 
Published: September 2017

SummaryThe results are presented of glucose tolerance tests on 85 apparently non‐diabetic male subjects, 58 of them aged over 54 years. The results were as follows : 47 “normal” ; 11 “glucose tolerance test diabetics” ; 15 “lag‐storage”; 9 “group C” ; and 3 “unclassifiable”. In the older groups of the subjects studied, there was a tendency for the peak of the curve to be displaced to the right, and it is therefore suggested that the test period for the G.T.T. should be increased to three hours for subjects aged over 54 years, and that diagnostic post‐prandial blood sugar levels should be estimated at this time. The association of abnormal glucose tolerance and the clinical manifestations of vascular disease is discussed, as well as the possible effect of medication being taken by the patients. It is concluded that, although there is a decline in glucose tolerance as age advances, it is likely to be overemphasized if a two‐hour test is used, and inadequate notice taken of current medication.
RELATIONSHIP BETWEEN S‐T SEGMENT DEPRESSION DURING EXERCISE AND INCREMENTS IN THE URINARY EXCRETION OF 3‐METHOXY 4‐HYDROXY MANDELIC ACID IN MEN WITH CORONARY HEART DISEASE
Authors: NESTEL P. J. , HAMMOND JUDY 
Published: September 2017

SummaryThe urinary excretion of the major catecholamine metabolite, 3‐methoxy 4‐hydroxy mandelic acid (VMA) was measured in subjects with coronary heart disease before and after an exercise study. The electrocardiographic changes induced by exercise were measured continuously before and throughout exercise. The following findings were observed :

The magnitude of the S‐T segment change was significantly related to the post‐exercise increment in urinary VMA excretion.
The magnitude of the S‐T segment change was also significantly related to the rise in heart rate.
3. The rise in heart rate was significantly related to the increment in the urinary excretion of VMA.
Although the mechanisms responsible for these findings have not been established, we conclude that an association exists between sympathetic nervous responsiveness during exercise and the development of myocardial ischxmia.
THE RESPONSE OF THE BLOOD PRESSURE TO AN INFUSION OF ANGIOTENSIN IN PATIENTS WITH ESSENTIAL, MALIGNANT AND RENOVASCULAR HYPERTENSION
Authors: MORGAN TREFOR 
Published: September 2017

SummaryThe angiotensin infusion test was performed on 251 patients.The results of the test were reproducible and not affected by hypotensive therapy in the case of patients with essential hypertension.The mean pressor dose was the same for normotensive subjects and for patients with hypertension with or without disease of the renal parenchyma.The mean pressor dose for patients with renal artery stenosis or malignant hypertension was increased. The pressor dose fell to normal when hypertension was controlled. Renal artery surgery improved hypertension in nine patients. The pressor dose was normal pre‐operatively for four patients.The angiotensin infusion test was able to detect most patients with renal artery stenosis. The large number of false positive responses and the occurrence of some false negative responses reduce its value as a screening test.
THE HÆMORRHAGIC SYNDROME OF EARLY CHILDHOOD
Authors: LOVRIC V. A. , JONES R. F. 
Published: September 2017

SummaryA syndrome manifested with an acquired hæmorrhagic tendency after the neonatal period in 25 children is described. The results of coagulation studies were indicative of severe lack of factors partaking in the prothrombin complex formation. The clotting indices were sufficiently low to account for spontaneous bleeding.Clinical improvement coinciding with return to normal of hæmostatic mechanisms was recorded after vitamin K therapy.Malabsorption of vitamin K was considered the cause of hæmorrhages in 12 chronically ill, wasted children.No ætiological factors responsible for this lack of vitamin K could be detected in the other 13 patients. Some presented with acute bilateral subdural hæmatoma, and the implications of this finding are discussed.Vitamin K prophylaxis may be desirable in all surgical patients in the first four months of life.
A TRANSIENT CIRCULATING ANTICOAGULANT LEADING TO ACUTE RENAL FAILURE
Authors: Hicxs, N. D. , SAGE R. E. , LAWRENCE J. R. 
Published: September 2017

SummaryA case is reported of an extremely severe, transient, antithrombin‐type anticoagulant, which resulted in gross hæmaturia, clot obstruction and acute renal failure. No cause for the appearance of the anticoagulant was discovered. The patient made a full recovery and remains well one year later.This is believed to be the first report of any circulating anticoagulant with such a transient course.
STUDIES OF THE NATURE OF PLASMA THYROID STIMULATING ACTIVITY IN HYPERTHYROIDISM
Authors: HOFFMANN M. J. , MASON E. K. , GOOD B. F. , HETZEL B. S. , FERGUSON K. 
Published: September 2017

SummaryPrevious reports from this and other laboratories indicate the importance of the activity of abnormal plasma long‐acting thyroid stimulator (LATS) characteristic of thyrotoxicosis in relation to the various clinical features of the disease.Studies on the nature of this agent have now been carried out by comparison of its thyroid stimulating activity in the 131I‐labelled mouse with that of bovine pituitary thyrotropic stimulating hormone (TSH) and plasma from hypothyroid patients in which an excess of pituitary TSH has been demonstrated, as well as by chemical studies.A short‐acting response with a maximum at three hours is characteristic of pituitary TSH. A long‐acting response with maximum at eight hours or longer is characteristic of LATS. However, in the present study a long‐acting response with a maximum at eight hours has been demonstrated after multiple injections of bovine TSH. A long‐acting response can also be produced by injecting bovine TSH after it has been mixed with an appropriate concentration of rabbit antiserum to bovine TSH. These findings indicate that the pattern of response is not necessarily a distinguishing feature differentiating LATS and TSH.In contrast to the activity of TSH, LATS activity is unaffected by an antiserum to bovine TSH prepared in the rabbit. However, LATS activity is diminished by mixing it with an antiserum to human 7S gamma globulin prepared in the sheep, which in turn fails to affect the thyroid stimulating activity of bovine TSH on plasma from hypothyroid patients. These findings indicate that there is a distinct immunological difference between LATS and TSH.Large plasma samples from three thyrotoxic patients have been subjected to gel filtration (with the use of a “Sephadex” G‐200 apparatus). LATS activity was mainly confined to the 7S gamma globulin peak; although there was a degree of overlap into the macroglobulin and albumin peaks, starch gel electrophoresis revealed 7S gamma globulin was invariably a component of these fractions. Further purification was achieved by DEAE‐ “Sephadex” chromatography. This produced three fractions—the first two were found to have LATS activity and to contain 7S gamma globulins on starch gel electrophoresis, while the third contained beta globulins and albumin but was devoid of 7S gamma globulin and was inactive in the mouse assay.These findings are consistent with the findings of other laboratories, in that they clearly indicate that LATS belongs to the 7S gamma globulins and is therefore probably an antibody. These data strongly support clinical evidence indicating the importance of immunological mechanisms in the pathogenesis of hyperthyroidism. The possibility of hyperthyroidism being an autoimmune disorder is discussed.
CYTOPLASMIC LINKAGE BETWEEN LYMPHOID CELLS IN MIXED CULTURES
Authors: MAGLAURIN B. P. 
Published: September 2017

SUMMARYCytoplasmic connections have been demonstrated between living lymphoid cells, both in the early and late stages of prolonged mixed lymphocyte cultures.In early culture, these connections appear to have an anchoring function. By linkage between cells in rosette formation, they may permit rapid activation of large numbers of uncommitted small lymphocytes.Late in mixed culture, cytoplasmic linkage between cells is more striking. It is suggested that this linkage could provide a pathway for the direct transfer of antibody or other toxic agents from immune cell to target cell.
PROTEIN CATABOLISM IN STARVATION AFTER DIETS HIGH AND LOW IN PROTEIN
Authors: UTLEY D. , WHYTE H. M. 
Published: September 2017

SUMMARYTwo subjects ate diets high (HP) and low (LP) in protein for 14 days, then continued them for a further three control days, starved for three days (taking only water, salt and vitamins) and then took 300 grammes of sucrose each day for three days.Urea and creatinine clearance rates were 17% to 38% lower on the LP than on the HP diet.Starvation was easily tolerated after the HP diet but was severely distressing after the LP diet.Starvation caused the daily urinary nitrogen loss to decrease after the HP diet from 14·8 to 11·9 grammes, and to increase after the LP diet from 6·8 to 12·2 grammes. The suggested explanation is that protein catabolism reverted in starvation to the rate which was appropriate for metabolizing the amount of protein habitually eaten before the experiment.The practical issue is that tissue destruction during a foreseeable period of starvation, as after surgery, and which is of particular importance to patients with renal failure, is not substantially reduced by short‐term pre‐conditioning with a low protein diet.
THE USE OF THE XANTHINE OXIDASE INHIBITOR, ALLOPURINOL, IN THE CONTROL OF HYPERURICÆMIA, GOUT AND URIC ACID CALCULI
Authors: EMMERSON B. T. 
Published: September 2017

SUMMARYAllopurinol, an inhibitor of xanthine oxidase, was administered to 11 patients with various disorders of urate metabolism and observations were made of the resultant effects on the serum and urine concentrations of urate and of the oxypurines, xanthine and hypoxanthine. The renal clearance rates of urate, creatinine and the oxypurines were estimated before and during allopurinol therapy. Doses of allopurinol of between 300 and 400 mg. per day restored the serum urate concentrations to normal in all cases and were associated with a slight rise in the serum concentrations of the oxypurines. The urinary excretion of urate fell and that of the oxypurines rose. The total urinary excretion of urate and the oxypurines was reduced by allopurinol therapy. The oxypurines were excreted well even in the presence of renal impairment. No serious complications of therapy were observed, although some patients continued to be troubled by attacks of acute gouty arthritis during the first few months of therapy.
JEJUNAL BIOPSY IN MALIGNANT DISEASE
Authors: DELLER DONALD J. , MURRELL TIMOTHY G. C. , BLOWES ROMALA 
Published: September 2017

SUMMARYThe appearance of the small bowel mucosa and mucosal measurements are described in 45 patients with various malignant conditions and compared with the findings in 25 control subjects. The mean villous height and mean total mucosal thickness were significantly reduced in the patients with malignant disease. The mucosa in malignant disease was normal in 38%, and showed simple atrophy in 31%, partial villous atrophy in 29% and subtotal villous atrophy in 2% of cases. The mucosal changes were related to the duration of illness and the degree of loss of weight. They were less frequently detected in patients with bronchial carcinoma. The presence of metastases, the treatment given, the interval before death and the presence of steatorrhœa were not related to the abnormal mucosa. Steatorrhœa was detected in one‐third of the patients, but it was usually slight. Steatorrhœa did not account for weight loss and abnormalities in the small bowel mucosa appeared to be unrelated to the steatorrhœa.
GARDNER'S SYNDROME WITH ADRENAL CARCINOMA
Authors: MARSHALL W. H. , MARTIN F. I. R. , MACKAY IAN R. 
Published: September 2017

SUMMARYA young woman with familial polyposis of the colon, multiple sebaceous cysts and osteomata (Gardner's syndrome) presented with Cushing's disease associated with carcinoma of the adrenal gland. This appears to be the first recorded case of Gardner's syndrome with adrenal carcinoma, and the first case wherein a metastasizing tumour other than carcinoma of the colon has been fully documented.
BACTERIAL ENDOCARDITIS DUE TO NEISSERIA PERFLAVA IN A PATIENT HYPERSENSITIVE TO PENICILLIN
Authors: BRESLIN A. B. X. , BIGGS J. C. , HALL G. V. 
Published: September 2017

SUMMARYA case of bacterial endocarditis caused by Neisseria perflava is presented; the virulence of the organism is stressed and evidence is given that the organism was hæmolytic in vivo.The case adds another to the nine previously reported cases of bacterial endocarditis in patients hypersensitive to penicillin being treated with steroids and penicillin G.Some evidence is given to suggest cross allergy between penicillin G and cephaloridine.Early recourse to aortic valve replacement had a marked influence on the subsequent outcome for this patient.
IDIOPATHIC ŒSOPHAGEAL EPITHELIAL CAST
Authors: DONALD K. J. , PATERSON R. A. 
Published: September 2017

SUMMARYA case of idiopathic œsophageal epithelial cast is described. The patient suffered little discomfort and there were no complications. Previously reported cases are briefly reviewed and the mechanism of production is discussed. A comparison with a case of œsophageal cast resulting from the ingestion of hydrochloric acid is made.
SUBMUCOSAL JEJUNAL HÆMORRHAGE WITH PHENINDIONE
Authors: LEIGH J. 
Published: September 2017

SUMMARYA case of subacute intestinal obstruction arising during anticoagulant therapy is presented. Pre‐existing symptoms obscured early diagnosis, and the patient died despite all attempts at therapy.Post‐mortem examination revealed a single hæmatoma in the jejunum, blood‐stained peritoneal fluid, coronary thrombosis and cholelithiasis.The case is compared with previously reported similar cases.
THE SOURCE OF A GASTRIC SECRETORY INHIBITOR FROM HUMAN SALIVA
Authors: BAUME PETER E. , BAXTER CHRISTINE H. , NICHOLLS ANNETTE 
Published: September 2017

SummaryThe contribution made by oral bacteria to the content of substances in human saliva which inhibit rat gastric acid secretion on intravenous injection was assessed. It was found that, when growth of bacteria in saliva was prevented, the saliva had no capacity to inhibit rat gastric acid secretion, whereas when no antibacterial precautions were taken for three hours saliva did possess such activity. It was found that oral bacteria cultured free of saliva possessed the capacity to inhibit gastric acid secretion. Three oral bacteria (Neisseria catarrhalis, α‐hæmolytic Streptococcus spp. and Lactobacillus casei) were studied in detail, and were found to inhibit rat gastric acid secretion to 50% of control values in doses of 400 to 800 μg. per kilogram. Studies on fragmented bacteria indicated that inhibitory activity resided in the supernatant fraction derived mainly from the bacterial cytoplasm. Preparations of bacterial cell walls were without any inhibitory activity. It was shown that the effect on gastric acid secretion was not due simply to the embolic effects of bacterial injection, and it is concluded that the phenomenon is probably due to a specific metabolic effect of a bacterial cell component.
ABSORPTION OF PHENOXYMETHYL PENICILLIN IN PATIENTS WITH STEATORRHŒA
Authors: DAVIS A. E. , PIROLA R. C. 
Published: September 2017

SummaryThe absorption of phenoxymethyl penicillin has been studied in normal subjects and in patients with steatorrhœa by the estimation of the serum values obtained after the oral administration of a standard dose. Patients with gluten‐sensitive enteropathy failed to absorb phenoxymethyl penicillin, while patients with other forms of steatorrhœa had serum curves within the normal range.It is considered that in the acute stage of any illness phenoxymethyl penicillin, and presumably other drugs, should be administered by the parenteral route to patients with gluten‐sensitive enteropathy.
STUDIES CONCERNING A COMPUTER ANALYSIS OF PATIENTS WITH PRIMARY, SECONDARY OR STRESS POLYCYTHÆMIA
Authors: CAPON I. N. , JELLETT L. B. 
Published: September 2017

SummaryPreviously published hæmatological data concerning patients with primary, secondary or stress polycythæmia have been analysed by digital computer. The mathematical model utilized is presented, and the results of the analysis have been related to the clinical and laboratory findings. It is emphasized that different mathematical methods of treating the data may produce variable results. Accordingly, the results of computer analysis should be regarded critically and with an awareness of the limitations of the mathematical methods involved.Complex data are often assembled under less than ideal conditions for subsequent computer analysis. However, the present study concerning previously published hæmatological data indicates that such material may be amenable to certain statistical techniques provided that the subsequent computer results are interpreted carefully.It is further emphasized that computer analysis of any medical data must involve close cooperation between clinician and mathematician if the resultant information is to be regarded as accurate.