bluuebunny/crossref_metadata_2025_split huggingface dataset:
OBSERVATIONS ON THE TREATMENT OF SEVERE DIABETIC KETOSIS
Authors: HUDSON BRYAN , BICK MARJORIE , MARTIN F. I. R. 
Published: September 2017

SummaryA series of 32 patients with severe diabetic ketosis treated by us during 1956–1957 has been compared with a similar group of 67 patients admitted to the Alfred Hospital, Melbourne, between 1952 and 1955.This comparison has shown that the mortality has decreased during 1956–1957. The reasons for this have been analysed and discussed, and the rationale for the present regime of treatment is presented.It is concluded that the reduction in mortality has been due to several factors, which include the following: (i) the management of diabetic ketosis by one unit; (ii) the use of alkaline solutions at the commencement of treatment; (iii) the administration of potassium salts early in treatment; (iv) a reduction in the severity of the condition on the patients' admission to hospital.The need is stressed for educating patients and practitioners in the early recognition of this disorder so that mortality may be further reduced.
SERUM COMPLEMENT LEVELS IN SYSTEMIC LUPUS ERYTHEMATOSUS AND OTHER DISEASES
Authors: ASHERSON G. L. 
Published: September 2017

SummarySerum hæmolytic complement has been measured in 166 patients. Low levels of complement occurred in systemic lupus erythematosus, in the nephrotic syndrome, and in parenchymal liver damage. High levels of complement occurred in obstructive jaundice and in conditions characterized by tissue destruction. The low serum complement level in systemic lupus erythematosus was attributed to complement‐fixing antibodies against human tissues found in that condition.
PRIMARY ALDOSTERONISM‐CONN'S SYNDROME
Authors: SIMPSON F. O. , BARNETT A. 
Published: September 2017

SummaryElectrolyte‐balance studies on a patient with primary aldosteronism are reported.An aldosterone antagonist, spironolactone (“ SC 9420 ”, “ Aldactone ”, Searle), was effective in promoting sodium excretion and, to some extent, potassium retention.Spironolactone had some effect also after removal of the tumour.Vasopressin caused an increase in urine flow in this case.
THYROID‐STIMULATING HORMONE AND TRIIODOTHYRONINE AS AIDS IN THE DIAGNOSIS OF THYROID DISORDERS
Authors: HUDSON BRYAN , WINIKOFF DORA , TAFT H. PINCUS , MARTIN F. I. R. 
Published: September 2017

SummaryThe administration of thyroid‐stimulating hormone (T.S.H.) and 3 : 5 : 3′‐triiodothyronine (T3) has been applied in the assessment of thyroid function in cases of doubtful hypothyroidism, in myxoedema of uncertain origin and in cases of suspected hyperthyroidism. The indices used were plasma protein‐bound iodine (P.B.I.) and I131 uptake by the thyroid.After T.S.H., the rise in P.B.I. levels was greatest in euthyroid patients (regardless of previous thyroid administration), least in primary thyroid failure and intermediate in pituitary myxoedema. The rise in I131 uptake after T.S.H., on the other hand, distinguished only the euthyroid group from patients with primary myxcedema, being significantly higher in the former group.After T3 administration, suppression of I131 uptake, regardless of the initial value, was observed in the euthyroid group, whilst in thyrotoxicosis no such suppression occurred. Changes in P.B.I. levels were of no diagnostic significance in these cases.
DIVIDENDS FROM MITRAL VALVOTOMY : A TWO TO SEVEN YEARS' FOLLOW‐UP
Authors: LEAROYD B. M. , BLACKET R. B. , SINCLAIR-SMITH B. C. , MILLS F. H. , HALLIDAY J. H. , MADDOX J. K. 
Published: September 2017

SummaryStudies have been made of 87 patients treated by finger‐fracture valvotomy for mitral stenosis five or more years ago, and of 224 patients followed for only two years. At the time of operation the mean age of the patients was 38 years, and 34% had atrial fibrillation.The functional classification of the patients and the results of the operation in each group are presented. The operative mortality was 5%, but ranged from 2.5 % in Class II patients to 25% in Class IV patients. When the total number operated on is used as the base line, 61% of patients had a good result (improvement by at least one functional class) at two years. At five years this figure had fallen to 51%. The best results were obtained in the less severe cases.Age in itself did not materially affect the outcome, but atrial fibrillation, whose incidence increased with age, lessened the prospects of success. Considerable cardiac enlargement was also an adverse factor.Mitral incompetence present before operation or produced by surgery had an unfavourable effect on the outcome, and severe incompetence proved lethal. When moderate incompetence was present after operation, roughly two‐thirds of the patients had a good result at two years, but this figure fell to one‐third by five years.The most significant factor in continued post‐operative improvement was the completeness of separation of the adherent valve cusps. Division of one commissure gave temporary benefit to many patients, but by five years only one in four maintained their improvement. Deterioration was due to restenosis, which may also occur even when both commissures are adequately split.We conclude that mitral valvotomy as originally practised leaves much to be desired. The pathology of advanced mitral stenosis does not readily lend itself to correction. We advise surgical treatment early in the disease, when disability is first noticeable and atrial fibrillation, embolism and valvular distortion have not occurred.The results of more recent surgical techniques, although initially encouraging, remain to be evaluated.
EXPERIMENTAL CHOLANGITIS FOLLOWING BILIARY OBSTRUCTION
Authors: RONAI P. M. , MAGAREY F. R. 
Published: September 2017

SummaryExperiments have been performed on rats in which biliary obstruction has been created and followed by an intravenous injection of a suspension of Bacterium coli. Rats with obstruction only and with injection of B. coli only have been used as controls.The experiments show not only that biliary obstruction predisposes to infection of the liver and bile ducts, but also that the infection is accentuated and accelerated.The results also clearly indicate that the invading microorganisms reach the liver and bile ducts by the hæmatogenous route.
PLASMA TRANSAMINASE IN LIVER DISEASE
Authors: O'BRIEN E. N. , PATERSON BETTY , RALSTON MARY , MACKAY IAN R. 
Published: September 2017

SummaryThe plasma glutamic oxalacetic transaminase level (G‐O.T.) was estimated in 206 cases of liver disease. Levels over 500 units favoured a diagnosis of acute viral hepatitis ; but levels of this order and higher occurred in active chronic hepatitis and lupoid hepatitis during an exacerbation. Levels between normal and 200 units were found in all forms of liver disease.Serial G‐O.T. estimations proved of considerably greater diagnostic and prognostic aid than single readings, and were of value in studying the progress of liver disease, the assessment of therapeutic response and the detection of sensitivity to hepatotoxic drugs.The value of G‐O.T. estimation in obstructive jaundice was limited, since the results overlapped those found in parenchymal liver diseaseThe histological finding of hepatocellular necrosis was never associated with normal G‐O.T. levels ; but no close association could be shown between the degree of liver cell necrosis and the G‐O.T. level.
A CASE OF PROTEIN‐LOSING ENTEROPATHY
Authors: FREEMAN ZELMAN 
Published: September 2017

SummaryThe case described is of a woman, aged 61 years, presenting with diarrhoea, fever and œdema associated with hypoproteinæmia. Biopsy of the intestine showed acute non‐specific ileitis, and biopsy of the liver showed severe fatty degeneration. Laparotomy revealed some vascular engorgement of the subserosal vessels in the lower ileal area. After the commencement of prednisone therapy, there was considerable improvement in the clinical features, the hypoproteinæmia and the histological appearances in the liver. In the state of remission, studies with radioactive labelled albumin showed a degradation rate of 0.46 gramme per day per kilogram, and studies with radio‐iodinated polyvinylpyrrolidone showed a fMcal loss of 2.9% in 96 hours. Both figures are twice to three times normal.
RENAL BIOPSY
Authors: MACKAY IAN R. , TAFT L. I. 
Published: September 2017

SummaryIn this study diagnostically adequate tissue was obtained by aspiration biopsy of the kidney in 200 (78%) of the 257 patients investigated. Diabetic nephropathy most often complicated long‐standing diabetes ; but diabetic renal lesions did not depend on the duration and severity of the diabetes or on the degree of diabetic control with insulin. Twenty‐five patients with lupus nephritis were treated with cortisone ; “ mild ” and “ moderate ” glomerular lesions showed histological arrest ; but improvement was exceptional. Histological study of 38 cases of subacute glomerulo‐nephritis supported the validity of Allen's (1955) classification. In a limited analysis, the long‐term prognosis of patients treated with cortisone was not significantly better than that of untreated cases.A fluorescent antibody reagent was applied to a portion of the renal biopsy specimen in 71 cases, in order to determine the possible part played by antibodies in the production of nephritis. Positive reactions, suggesting localization of human globulin in the glomerulus, were obtained chiefly in lupus nephritis and in diffuse membranous glomerulo‐nephritis.Renal biopsy proved of most value in early diffuse renal disease wherein diagnosis, prognosis and probable response to treatment are best assessed on morphological grounds ; it was of less value in advanced renal disease with sclerosis.
STRONTIUM “ RICKETS ” : BONE, CALCIUM AND STRONTIUM CHANGES
Authors: STOREY E. 
Published: September 2017

SummaryWhen rats were fed increasing levels of strontium in the diet, inhibition of calcification was shown by increased width of epiphyseal cartilage, presence of uncalcified bone matrix and decreased ash weight of bone. When ash weight was used as an indicator of mineralization, inhibition of calcification became greater as the dietary strontium level increased. This inhibition became most obvious when the calcium‐strontium ratio in serum, expressed on a molar basis, became less than 10 : 1.In contrast to ash weight, the percentage ash in bone was a less sensitive indicator of rhachitic change, because both mineral and organic weight decreased proportionately, and consequently the percentage ash remained unchanged until high dietary levels of strontium were reached.The incorporation of strontium into bone varied, not with dietary strontium levels, but with the ratio of calcium to strontium. The two ions were treated similarly, for the decrease in calcium‐strontium ratio in the bone was almost directly proportional to that in diet for both young and old rats. In growing animals, addition of new bone crystals was probably the most important mechanism whereby strontium became incorporated into ash, while in slowly‐growing rats ion exchange assumed a more important role.At low dietary levels of strontium, bone matrix formation decreased roughly proportionately to inhibition of calcification, but at higher levels uncalcified bone matrix became prominent. These results may be of significance to the problem of osteoporosis, for they demonstrate that disorder of calcification can be associated with decreased growth of bone matrix. This suggests that “ osteomalacic ” and “ anti‐anabolic ” mechanisms are not mutually exclusive, but may be interrelated factors in the pathogenesis of osteoporosis.
THE EFFECT OF NIALAMIDE ON ENDOGENOUSLY AND EXOGENOUSLY ELEVATED BLOOD AMMONIA LEVELS IN PATIENTS WITH LIVER DISEASE
Authors: BEAL R. W. , BLACKBURN C. R. B. 
Published: September 2017

SummaryNialamide (1‐[2‐benzylcarbamyl)ethyl]‐2‐isonicotinoyl‐hydrazine), an analogue of iproniazid, has been shown to lower the blood ammonia levels of patients with liver disease. Twelve studies were carried out on nine patients with elevated blood ammonia levels due to liver disease (eight cases) or to uræmia (one case). In each study the intravenous injection of 100 mg. of nialamide significantly reduced the blood ammonia level, the reductions ranging from 18% to 75% of the initial levels. It was also effective in lowering arterial blood ammonia levels artificially raised by the continuous intravenous infusion of ammonium chloride in eight patients with liver disease. Clinical benefit in patients with hepatic coma or pre‐coma did not parallel the improvement in arterial or venous blood ammonia levels.
THE d‐XYLOSE ABSORPTION TEST
Authors: JOSKE R. A. , CURNOW D. H. 
Published: September 2017

SummaryThe metabolism of d‐xylose in man is reviewed and the physiological and chemical basis of the d‐xylose absorption test outlined.Study of 50 normal Australian subjects showed the normal result of the test to be 6·6 ± 1·4 grammes, and the lower limit of normal was taken as 3·8 grammes. The urinary volume was 414±164 ml., and the two‐hour blood level 37·0±7·2 mg. per 100 ml. These results agree with others in the literature. Two hundred xylose absorption tests were performed on 186 patients. It was found that impaired xylose absorption was almost always accompanied by other evidence of malabsorption, although steatorrhoea could be gross with normal xylose absorption. Xylose absorption was usually depressed in sprue, adult coeliac disease, severe infective enteritis and other primary small bowel diseases, as well as in elderly patients with extensive vascular disease. The test gave variable results after gastrectomy and in liver disease, the reticuloses and rheumatoid arthritis. The result was usually normal in pernicious anaemia, pancreatic disease and diabetes mellitus. Impaired xylose absorption was significantly related to hypo‐albuminæmia, but not to folic acid, vitamin B12 or fat absorption, or to serum calcium or potassium levels.
TREATMENT OF THYROID OPHTHALMOPATHY WITH CORTICOID ANALOGUES
Authors: HALES IAN B. , THOMAS IAN DAVIES 
Published: September 2017

SummaryThe role of corticoid analogues in thyroid ophthalmopathy has been reevaluated. Eight consecutive patients with progressive ophthalmopathy have been given corticoids. In all cases progression was prevented and a varying degree of regression of symptoms and signs occurred. Ophthalmoplegia responded completely only in those patients treated less than eight weeks after its appearance. The possible mechanisms by which corticoids act are discussed.
EXPERIENCE WITH THE FOREIGN GAS METHOD FOR THE DETECTION OF LEFT‐TO‐RIGHT INTRACARDIAC SHUNTS
Authors: BERNSTEIN L. , JOSE A. D. 
Published: September 2017

SummaryWe have reported and discussed our results of using the nitrous oxide test for studying intracradiac left‐to‐right shunts in too patients. The significant advantages of this test over serial oxygen content measurements have been confirmed. The use of gas chromatography for nitrous oxide analysis has made the test quicker, more accurate and easier to apply during cardiac catheterization.
ASTHMA IN QUEENSLAND PUBLIC HOSPITALS IN 1957
Authors: DERRICK E. H. , THATCHER R. H. 
Published: September 2017

SUMMARYAsthma was responsible for 2673, or 1·62%, of all admissions to Queensland public hospitals in 1957. Males predominated in childhood and after the age of 55 years. Females predominated in the intervening years. A striking fall in the male incidence in the second decennium suggests a favourable prognosis for most asthmatic boys. The apparent incidence of asthma varied considerably from place to place throughout the State. The geographical variation could not be explained simply in terms of latitude, altitude, temperature, rainfall or distance from the coast. The seasonal distribution changed significantly at about the Tropic of Capricorn. To the south, the main incidence was in autumn; to the north, no seasonal pattern had a wide prevalence.An ætiological study of asthma must take into account the variation in the complex of causes with sex, age, season and locality.
HYPOCHROMIC ANÆMIAS NOT CAUSED BY IRON DEFICIENCY
Authors: MOORE CARL V. 
Published: September 2017

SUMMARYThe causes of hypochromic anæmia not due to iron deficiency have been reviewed. Because of their frequency the various thalassæmic syndromes are clinically of most importance, but the other forms are of great theoretical interest. Information about the biochemical defects or lesions responsible for the non‐iron‐deficient hypochromias is not complete enough to pinpoint the abnormalities. In‐vitro study of hæm synthesis has provided many interesting data, but final answers must wait until techniques are also available to study globin formation within nucleated red blood cells, and until the union of pigment and protein portion of the hæmoglobin molecule can be followed.
THE EFFECT OF THYROTROPHIC HORMONE ON THE PLASMA THYROID HORMONES IN MAN
Authors: WELLBY MAURICE L. , HETZEL BASIL S. , ISAACHSEN MARGARET L. 
Published: September 2017

SUMMARYThe effect of thyrotrophic hormone administration on the plasma pattern of the iodine‐containing amino acids has been studied in 11 normal and 12 thyrotoxic subjects. The method employed a paper chromatographic separation of the individual iodinated compounds in plasma extracts prepared with an anion exchange resin. The iodine‐containing amino acids were then located by chemical staining by means of the ceric sulphate‐arsenious acid reaction. Parallel chemical and radioactive studies were carried out in eight of the thyrotoxic subjects after I131 therapy.In the normal subjects, the intramuscular administration of thyrotrophic hormone (TSH ; hog origin), 30 U.S.P. units, was followed by the appearance of diiodotyrosine (DIT) and increased amounts of the iodothyronines, particularly triiodothyronine (T3) in the plasma. In hyperthyroid subjects TSH administration was followed by increases in the iodothyronine fraction. In most cases DIT was present before TSH administration, and the increases in DIT after TSH administration were smaller than those seen in normal subjects. Similar results were obtained in the parallel radioactive studies.The pattern of iodine‐containing amino acids previously described in hyperthyroidism has been reproduced in normal subjects by the administration of TSH. The association of the presence of DIT with increased amounts of T3 under conditions of thyroid over‐activity suggests that these two phenomena may be related. It is suggested that the release of DIT from the gland under these conditions may indicate a biosynthetic mechanism for the production of greater amounts of the more rapidly acting T3.
EXPERIMENTAL FIBRINOLYSIS
Authors: FANTL P. 
Published: September 2017

SUMMARYThe commercial preparation “Thrombolysin” intended for intravenous infusion in the treatment of thrombosis has properties which can be imitated by a mixture prepared from streptokinase as the major and plasmin as a minor component. Such mixtures have fibrinolytic activity which increases with concentration. This is in contrast to streptokinase, which shows inhibitory properties at higher concentrations.Intravenous infusions of “Thrombolysin” were well tolerated. According to the amount injected, a corresponding decrease in blood plasminogen level occurred. In the dosage recommended for injection, no influence on prothrombin, fibrinogen or other plasma proteins was detected.Plasma taken several minutes after infusion of “Thrombolysin” no longer showed proteolytic activity.Adequate amounts of streptokinase added during clot formation in vitro produced short lysis time of fibrin, but streptokinase added after clot formation showed considerably less activity.
RADIOACTIVE ARSENIC IN THE DIAGNOSIS OF INTRACRANIAL TUMOURS
Authors: FARRER P. A. , MCRAE J. 
Published: September 2017

SUMMARYIn 92 patients studied by automatic scintillation scanning of the head following intravenous injection of positron‐emitting arsenic‐74, accurate detection and localization resulted in 30 of 36 cases of proven space‐occupying cerebral lesions (83%). The lesions were not detected in the other six cases (17%), whilst false positive localization occurred in two of the group of 50 patients (4%) whom subsequent investigations placed in the normal category.The procedure is harmless, painless and simple to perform. It requires no general anæsthesia and may be performed on poor‐risk patients. It is of special value in patients who pose difficulty in the performance of angiography on anatomical grounds. Scanning has been found to outline the site and extent of the tumour bed in infiltrative and posterior hemisphere neoplasms, in the detection of which neuroradiological studies are frequently not helpful.The present study confirms that positron scanning is a reliable screening test for supratentorial tumours of the brain. It may be repeated safely at appropriate intervals without radiation or pharmacological hazard.
ORAL I131‐TRIOLEIN TOLERANCE CURVES IN NORMAL, ATHEROSCLEROTIC AND HYPERLIPÆMIC SUBJECTS
Authors: PRIOR I. A. M. , ARMSTRONG W. E. , CARR A. H. 
Published: September 2017

SUMMARYThe levels of whole blood and trichloracetic precipitable radioactivity have been studied after the oral administration of I131‐labelled triolein in 30 atherosclerotic, seven hyperlipæmic and 20 apparently normal subjects. A very abnormal pattern with high peak levels and persistently high levels at 24, 48 and 72 hours has been found in the hyperlipæmic subjects. The mean levels were significantly higher in the atherosclerotic as compared with the normal subjects, but considerable overlap was present between the groups, and the test clearly lacks sensitivity in detecting all subjects with manifest atherosclerosis.Estimation of the lipæmia clearance rate showed no significant difference in the atherosclerotic as compared with the control group, but the figure was significantly slower in the hyperlipæmic group in the first 24 hours. The effect of anticoagulants given by mouth was observed in eight subjects, and repeat observations made while they were on and off anticoagulants failed to confirm any significant effect from the anticoagulants on mean levels or on rate of clearing.The limitations and future value of the oral I131 triolein test are discussed.
OBSERVATIONS ON TRIAMTERENE—A NEW DIURETIC
Authors: BARNETT A. J. , BAUMGARTEN A. , BRANDSTATER M. 
Published: September 2017

SUMMARYIn subjects without cedema, triamterene given orally caused increased urinary excretion of sodium and chloride, but not of potassium, in the 12 hours following administration, but continued administration produced no effect on the 24‐hour electrolyte excretion.In a short‐term trial, in which patients were treated for four‐day periods with triamterene, chlorothiazide and combined therapy, triamterene and chlorothiazide had similar effects on weight loss and sodium excretion, but there was less loss of potassium with triamterene. Combination of the two drugs resulted in increased excretion of sodium, but not in weight loss or larger urine volume.In the long‐term treatment of refractory cedema, triamterene alone was unavailing, but when combined with chlorothiazide or with chlorothiazide plus spironolactone, it was of distinct value. The dose required (450 mg. per day) was higher than that used by other workers (100 to 300 mg. per day). No side effects were observed which could be attributed to the drug.