bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE MEASUREMENT OF ANDROGEN PRODUCTION IN NORMAL SUBJECTS
Authors: HUDSON BRYAN , DULMANIS AUSMA , COGHLAN JOHN P. , W1NTOUR MARELYN 
Published: September 2017

SUMMARYThe discovery of testosterone in urine and the development of methods for its measurement in plasma and urine have provided fresh approaches for the evaluation of androgen function in man. Production rates of testosterone have been measured in normal men and women by means of the principle of isotope dilution. The specific activity of urinary testosterone is measured after the administration of a tracer dose of isotopically labelled testosterone. Production rates have also been estimated by measuring the concentration of testosterone in plasma and its rate of clearance from plasma, the product of these two values being the blood production rate. In 14 males blood and urinary production rates were not significantly different, but in females the blood production rates were significantly lower than those determined from the specific activity of urinary testosterone.The possible reasons for this discrepancy are analysed.
RELATIONSHIP BETWEEN RESISTANCE TO INSULIN AND BODY WEIGHT
Authors: NESTEL P. J. , MATAR K. 
Published: September 2017

SUMMARYThe relationship between increased body weight and resistance to insulin was studied in a group of 14 healthy men. The reduction in blood glucose and plasma free fatty acid (FFA) levels was measured during one‐hour infusions of insulin given in doses which would lead to physiological concentrations of insulin in the plasma.A relationship could not be demonstrated between the blood glucose response and body weight. However, the FFA concentrations fell to lower levels in the leaner than in the heavier subjects, so that a highly significant direct relationship was found between body weight and the post‐insulin plasma FFA concentration.The studies therefore show that, over a range of commonly encountered body weights, resistance to insulin develops with increasing fatness. The study also shows that the plasma FFA response to insulin is a more sensitive index of insulin resistance than the blood glucose response.
INULIN, 57Co‐LABELLED VITAMIN B12 AND ENDOGENOUS CREATININE CLEARANCES IN THE MEASUREMENT OF GLOMERULAR FILTRATION RATE IN MAN
Authors: JEREMY D. , MCIVER M. 
Published: September 2017

SUMMARY
In 14 cases, simultaneous clearances of inulin (range 39 to 160 ml. per minute) and endogenous creatinine were measured, and in 11 of these cases, the results were compared with the simultaneous clearance of radioactive (57Co) vitamin B12.
The clearance of free (dialysable) 57Co vitamin B12 correlates closely with inulin clearance (ρ=0·985), and can be used as a measure of glomerular filtration rate. [Clearance of vitamin B12 (free)=1·07 clearance of inulin—10·9±5·48 (2 S.D.). ]
The protein bound (non‐dialysable) fraction of the plasma 57Co vitamin B12 varied from patient to patient, and in the same patient at different times (range, 9·6% to 35·7%; mean, 17·7% of total), in spite of presaturation with stable vitamin B12. Because of this, the clearance of vitamin B12 is a valid measure of glomerular filtration rate only when correction is made for plasma protein binding as measured in the individual subject.
The correlation between inulin and endogenous creatinine clearance was less precise. [Ratio of clearance of creatinine to clearance inulin=1·20±0·38 (2 S.D.).]
A CLINICAL METHOD FOR ASSESSING THE VENTILATORY RESPONSE TO CARBON DIOXIDE
Authors: READ D. C. 
Published: September 2017

SummaryA simple method of studying the regulation of ventilation has been developed so that rapid serial observations can be made in sick patients. The method is based on the progressive increase of Pco2 and the resulting stimulation of ventilation which occurs during rebreathing from a bag. A small bag is used in which the initial Pco2 is close to the Pco2 of mixed venous blood. With this technique, a Pco2 equilibrium is rapidly established between mixed venous blood, arterial blood and end‐expiratory gas. Subsequently, parallel changes develop in end‐expiratory Pco2 and ventilation. Under these conditions, changes in end‐expiratory Pco2 reflect the changes of medullary chemoreceptor Pco2 and the developing carbon dioxide stimulus.Experiments are reported which establish the linearity, reproducibility and normal range of response‐curves relating ventilation (V̇E) to end‐expiratory Pco2. These V̇E/Pco2 response‐lines were only slightly disturbed by simulated abnormality of the body carbon dioxide storage capacity or acute depletion of the body carbon dioxide stores. V̇E/Pco2 response‐lines obtained by rebreathing and by the prolonged steady‐state method differed significantly in position but not in slope. The similarity in slope implies that the same proportion, Δ end‐expiratory Pco2/Δ chemoreceptor Pco2, is established for the two methods. The difference in position indicates a smaller Pco2 gradient between arterial blood and chemoreceptor tissue in the rebreathing method.The method is particularly suited for clinical use, being rapid, tolerable and easily repeated. It avoids the necessity for sampling arterial or internal jugular venous blood, and can be performed by the bedside with the use of simple apparatus.
“ A.T. 10 “ AND DIHYDROTACHYSTEROL
Authors: PARFITT A. M. 
Published: September 2017

SummaryThe effect of pure dihydrotachysterol (D.H.T.) was compared with that of the old “ A.T. 10 ” in eight patients with hypoparathyroidism, and it was found that the “ A.T. 10 ” available in 1963–1964 was equivalent in therapeutic activity to 0.1 mg. of D.H.T. per capsule (or 0.2 mg. of D.H.T. per millilitre). It is concluded that the new “ A.T. 10 ” (containing 0.25 mg. of D.H.T. per millilitre) is 25% stronger than the old, and that patients whose therapy is changed to the new preparation in the same dose (by volume) may occasionally develop hypercalcaemia as a result.The history of the various changes in the methods of assay of “ A.T. 10 ” is reviewed and the reasons why they were all fallacious are explained.As judged by reported maintenance doses, the “ A.T. 10 ” available in 1963–1964 was only one‐third as potent in the treatment of hypoparathyroidism as that available in 1934–1942.
THE INCIDENCE OF GASTRECTOMY AND GASTRIC SECRETION IN MOTOR NEURON DISEASE
Authors: STIEL J. N. 
Published: September 2017

SummaryIn a review of 125 patients with motor neuron disease, no instance of gastrectomy was recorded, and the gastric secretions in five patients with motor neuron disease were found to be normal. These observations lead one to doubt the reported association between gastrectomy and motor neuron disease.
UNBALANCED C/E TRANSLOCATION EXHIBITING SOME CLINICAL FEATURES OF TRISOMY E
Authors: ILBERY P. L. T. , ALEXANDER J. M. 
Published: September 2017

SUMMARYA male infant showed some features of trisomy E with a karyotypic appearance which was unbalanced. There were 44 autosomes and the chromosome sex was male. One of the autosomes interpreted as Chromosome 6 was longer than its partner in respect of the length of its long arms. The father had a balanced chromosome pattern exhibiting the same abnormal Chromosome 6, together with a chromosome interpreted as Number 17, showing deletion of most of its long arms.The lack of some characteristics usually associated with trisomy E in the infant, especially the dermatoglyphic changes, are discussed in relation to chromosome mapping.
THE DIURETIC RESPONSE TO THE INTRAVENOUS ADMINISTRATION OF FRUSEMIDE
Authors: MCIVER MARGOT , JEREMY D. 
Published: September 2017

SUMMARYObservations were made on the effect of frusemide given by intravenous injection on the glomerular filtration rate and the water and electrolyte excretion in 12 subjects.The intravenous administration of frusemide caused either no change or slight reduction in the glomerular filtration rate. The basis for the “washout” effect in causing false clearance results is discussed.Changes in free water clearance suggest that the drug has an action on the thick ascending limb of the loop of Henle.Onset of diuresis was detectable in the third minute and the volume and saline diuresis reached a peak as early as the fifth minute after administration of the diuretic. A mean of 22% (range, 4·7% to 34·5%) of the glomerular filtrate, and 14·5% (range, 5·4% to 23%) of the filtered load of sodium, was excreted in the 45 minutes after the intravenous administration of frusemide.
MYASTHENIA GRAVIS : CLINICAL, SEROLOGICAL AND HISTOLOGICAL STUDIES IN RELATION TO THYMECTOMY
Authors: MACKAY I. R. , WHITTINGHAM S. , GOLDSTEIN G. , CURRIE T. T. , HARE W. S. C. 
Published: September 2017

SummaryIn 10 cases of myasthenia gravis correlative studies were made by means of autoimmune serological tests, electromyography, thymic X‐ray examination (pneumomediastinography) and assessment of thymic morphology in relation to the effects of thymectomy (nine cases) and thymic irradiation (one case).The 10 patients were placed in three groups, namely (a) three young females with a non‐involuted thymus showing “thymitis” and negative results to serological tests who derived benefit from thymectomy, (b) four older females with thymic atrophy and positive results to serological tests who for the most part gained no benefit from thymectomy, and (c) three males with thymomas and positive results to serological tests who obtained benefit from thymectomy in two instances.The presence of the characteristic autoantibody—the myoid antibody which reacted with thymic myoid cells and skeletal muscle—was helpful in diagnosis but did not appear to be related to neuromuscular block, neither was it of value in predicting the response to thymectomy. Electromyography with the decamethonium test showed, with one exception, the characteristic myasthenic responses irrespective of the patient's age, the presence or absence of myoid antibody, or the nature of the microscopic lesion in the thymus. The radiographic outline of the thymus as determined by pneumomediastinography correlated well with the size and shape of the resected thymus. The typical histological appearance in the thymus of abundant cortex and prominent medullary germinal centres and lymphocytosis was termed “thymitis” ; it was characteristic of the thymus of patients in group (a) and the residual thymus of patients with thymoma in group (c).Our clinical observations could be correlated with experimental studies, indicating that myasthenia gravis is associated with a destructive “autoimmune thymitis”. It is suggested that “thymitis” is associated with the release from the medulla of an uncharacterized humoral agent which causes neuro‐muscular block.
ANTINUCLEAR FACTORS AND HUMAN LEUCOCYTES: REACTION WITH GRANULOCYTES AND LYMPHOCYTES
Authors: SMALLEY M. J. , MACKAY I. R. , WHITTINGHAM S. 
Published: September 2017

SummaryWe compared the reaction of antinuclear factor (ANF) with nuclei of lymphocytes, granulocytes and liver cells by retesting III sera known to have given a positive test for antinuclear factor with human blood smears. These sera could be placed in three groups, as follows: Group 1, 47 sera, reacted to equal titre with the nuclei of lymphocytes, granulocytes and rat liver nuclei; Group 2, 25 sera, reacted to much higher titre with the nuclei of granulocytes than with nuclei of lymphocytes and liver cells; Group 3, 39 sera, reacted only with the nuclei of granulocytes. Thus, reactive sera contained separate antinuclear factors for nuclei of lymphocytes and liver cells, and for granulocytes.The presence of high titre lymphocyte‐reactive ANF characterized systemic lupus erythematosus, and was associated with lymphopenia (but not granulocytopenia) and a positive result to the LE cell test. Granulocyte‐specific ANF occurred in 4% of healthy subjects, but only to low titre (10 or less) ; high titres occurred in a range of diseases considered to be “ autoimmune ”, but had little diagnostic specificity and were not associated with cytopenias.The fixed blood film has some advantages for ANF tests: it is inexpensive and readily available, the incidence and titre of reactions with lymphocyte nuclei and tissue nuclei are similar, and the granulocyte‐specific ANF can be recognized. However, it should be specified whether positive reactions are with all nuclei or only granulocyte nuclei.
THE CLINICAL USES OF HUMAN GONADOTROPHINS
Authors: TAFT PINCUS , ADEY F. D. , BROWN J. B. , DE KRETSER D. M. , EVANS J. H. , HUDSON BRYAN 
Published: September 2017

SummaryWith the recent preparation of hormones from human pituitaries and human postmenopausal urine, a wider range of pituitary gonadotrophin activity has become available for clinical use. To the luteinizing and interstitial cell stimulating effects of gonadotrophin prepared from human placentas can now be added the follicle stimulating activity of pituitary and urinary gonadotrophin.The clinical applications of these hormones lie in both the diagnostic and therapeutic fields. Their administration as gonadal stimulants followed by measurement of gonadal response allows an assessment of function and the determination of the level of gonadal failure. The range of biological gonadotrophic activity of these hormones allows their use as effective replacement therapy in gonadotrophin deficiency states in both sexes and for the infertile female, even in the absence of obvious hypogonadotrophinism.
CYTOGENETIC STUDIES IN FAMILIAL LEUKÆMIAS
Authors: BAIKIE A. G. , GARSON O. MARGARET , SPIERS A. S. D. , FERGUSON JEAN 
Published: September 2017

SUMMARYFamilial aggregation of chronic granulocytic leukæmia is rare and even the occurrence of chronic granulocytic leukæmia in onto member of a family and another type of leukæmia in a close relative is very uncommon. When such instances occur they provide an opportunity for ascertaining if the Philadelphia chromosome (Ph1), characteristic of chronic granulocytic leukæmia, is ever an inherited rather than an acquired anomaly. The possible existence of a special liability to other chromosomal aberrations can be investigated in such families.In a man with chronic granulocytic leukæmia whose mother had died of the same disease, the Ph1 was identified in bone marrow cells and in 50% of the dividing cells of peripheral blood cultured during a period of relapse. No Ph1‐positive cells were identified in a culture of subcutaneous fibroblasts, and so it may be assumed that in this patient the Ph1 was an acquired and not an inherited chromosomal abnormality.The Ph1 was not present in cultures of peripheral blood leucocytes or of subcutaneous fibroblasts from a girl with acute leukemia whose father died of chronic granulocytic leukæmia.These studies provide further evidence of the status of the Philadelphia chromosome as an acquired cytogenetic anomaly.
LONG‐TERM TREATMENT OF PORTAL‐SYSTEMIC ENCEPHALOPATHY WITH LACTULOSE
Authors: MA M. H. , McLEOD J. G. , BLACKBURN C. R. B. 
Published: September 2017

SUMMARYTen patients with chronic portal‐systemic encephalopathy have been treated with lactulose and dietary restriction of protein. The treatment was found to be effective in six cases for periods up to 12 months. Two patients with very advanced cirrhosis and hepatic decompensation failed to respond. Two other patients were intolerant of lactulose. It is concluded that lactulose is an effective drug in the treatment of chronic portal‐systemic encephalopathy, and is a useful substitute for neomycin.
THE ACUTE EFFECTS OF PORCINE CALCITONIN IN MAN
Authors: MARTIN T. J. , MELICK R. A. 
Published: September 2017

SUMMARYThe acute response to porcine calcitonin was studied in five normal subjects, four patients with thyrotoxicosis, eight with osteoporosis, and in two patients with hypercalcremia some months after renal transplantation. Serum calcium level was lowered in the thyrotoxic and hypercalcremic patients, and in three of those with osteoporosis. In all groups, calcitonin caused an increased rate of phosphate, calcium and sulphate excretion. Urinary hydroxyproline excretion was reduced only in those patients whose serum calcium level was lowered.The results confirm that calcitonin lowers serum calcium level only in states of rapid bone resorption. They suggest that calcitonin may be of use in the study and treatment of osteoporosis.
The Pathogenesis of the Vascular and Glomerular Lesions of Rejection in Renal Allografts and their Modification by Antithrombotic and Anticoagulant Drugs
Authors: Kincaid-Smith Priscilla 
Published: September 2017

SummaryThe pathogenesis of the vascular and glomerular lesions of allograft rejection has been studied in 254 percutaneous biopsies from patients who have received cadaveric allografts. Evidence is presented that thromboses and residual lesions following organisation of thrombi are the major changes in vessels and glomeruli in allograft rejection and that these lead to glomerular and vascular obliteration and graft failure. The ultramicroscopic features of the glomerular lesions are thought to be typical of intravascular thrombosis and similar to those seen in a variety of other conditions where thrombi develop in glomerular capillaries.Considerable modification of the vascular lesions was noted in patients treated early and continuously with dipyridamole combined with phenindione or heparin.The similarities between vascular and glomerular lesions in allograft rejection and a wide variety of other renal diseases is noted. On the basis of these findings it is suggested that antithrombotic and anticoagulant drugs may modify the many glomerular and vascular lesions including those of glomerulonephritis, hypertension, thrombotic microangiopathy and the collagen diseases all of which have features in common with those of allograft rejection.
Heart‐Reactive Antibody, Serum Enzymes and Isoenzymes in the Diagnosis of Acute Rheumatic Fever
Authors: Jose D. G. , Barry H. , Goldblatt E. , Penfold J. , Welch J. S. 
Published: September 2017

SummaryThree groups of laboratory tests were assessed for possible clinical application in the diagnosis of rheumatic carditis.Serum antibody cross‐reactive with human myocardium and group A streptococcal cell membrane (heart‐reactive antibody—H.R.A.) was found in titres above the normal range in most patients with post‐streptococcal carditis, arthritis or glomerulonephritis and less often in patients with surgical myocardial damage. Patients with acute rheumatic carditis had lower titres on admission than those with acute rheumatic arthritis alone; after treatment titres rose in the carditis group but fell in children with arthritis. These findings suggested a possible pathogenic role for this antibody in rheumatic carditis, and suggest its determination to be useful in diagnosis.Serum levels of glutamic oxaloacetic transaminase, lactic dehydrogenase and creatine phosphokinase were significantly higher in children with cardiac damage and in those with high titres of H.R.A., but the differences were not sufficiently great to be of clinical value.Relative increases in the fast‐migrating isoenzyme of serum lactic dehydrogenase were found in patients with carditis, and its determination is considered to be of potential clinical value.
Catecholamine Excretion with Myocardial Ischaemia and Infarction
Authors: Rosenbaum Maurice , Doyle Austin E. 
Published: September 2017

SummarySerial daily estimations were made of the urinary catecholamine excretion in 64 patients during the first two weeks after the onset of myocardial infarction and in 27 patients after the onset of chest pain subsequently diagnosed as myocardial ischaemia. In most patients with myocardial infarction, the total excretion rate of catecholamines was elevated, mainly due to elevation of the noradrenaline excretion rate. The level of catecholamine excretion correlated well with the peak levels of S.G.O.T., LD.H. and w.e.e. Higher levels of all these variables were found in patients with cardiac failure, hypotension and ventricular arrhythmias. On the other hand, catecholamine excretion, enzyme levels and wee were only slightly elevated in the patients with sinus or nodal bradycardia, and catecholamine excretion was barely elevated in patients who suffered chest pain without infarction. Thus, catecholamine excretion after myocardial infarction correlates with the degree of cardiac damage, functional impairment and the incidence of some arrhythmias. It is concluded that the increased catecholamine excretion originates from the sympathetic nerve endings as a reflex result of the haemodynamic disturbance, with some possible contribution from the sympathetic endings in the damaged heart muscle.
Resistiveness to Care as Experienced by Family Caregivers Providing Care for Someone With Dementia
Authors: Spigelmyer Pamela C. , Hupcey Judith E. , Smith Carol A. , Loeb Susan J. , Kitko Lisa 
Published: September 2017

AbstractPurposeThis research explored family caregivers’ lived experiences of resistiveness to care when they provided care for people with dementia. The goal was to identify a general meaning of family caregivers’ lived experiences to target potential areas for future nursing interventions to help family caregivers manage their caregiving role and provide a base for future research surrounding resistiveness to care.DesignDescriptive phenomenology was used to provide descriptions of eight family caregivers who provided care for someone with dementia and experienced resistiveness to care. Family caregivers were recruited from Alzheimer's support groups from June to November 2014.MethodCaregiver interviews were transcribed verbatim and analyzed using scientific phenomenology to identify essential constituents of the experience.FindingsThe identified general meaning structure contained five essential constituents. These included self‐questioning of abilities; signal for increased future caregiver responsibilities; changed perception of personal self; unexpected emotional responses; and seeing a changed person, not the disease.ConclusionsStudy findings represent family caregivers’ lived perceptions of resistiveness to care, which are different from current research findings regarding nurses’ perceptions of resistiveness to care. The identified meaning structure indicates focus areas for future research and for nursing interventions to help family caregivers manage their distress when experiencing resistiveness to care.Clinical RelevanceIdentification of the meaning caregivers ascribe to their lived experience of resistiveness to care (five essential constituents) provides nurses with opportunities to help family caregivers (coproviders of care) holistically. Supporting caregivers in their caregiving role can decrease caregiver distress when resistiveness to care occurs.