bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECT OF ADRENALINE ON BLOOD KININ LEVELS IN CARCINOID SYNDROME AND IN NORMAL SUBJECTS
Authors: MASHFORD M. L. , ZACEST R. 
Published: September 2017

SUMMARYThree cases are briefly discussed in which the carcinoid syndrome was confidently diagnosed. In two cases there were elevated resting levels of bradykinin in the arterial blood, and in all three the level rose in association with an increase in the vascular symptoms. In two cases adrenaline infusion caused flushing, at the height of which the bradykinin level in the arterial blood was higher than the resting concentration. This contrasts with the findings in six subjects not suffering from the carcinoid syndrome, in whom adrenaline infusion caused a fall in arterial blood bradykinin levels.
PAPILLARY FIBROMYXOMA OF THE PULMONARY VALVE
Authors: CAMPBELL C. B. 
Published: September 2017

SUMMARYA papillary fibromyxoma of the pulmonary valve, discovered incidentally at autopsy, is recorded. It consisted of a pedunculated papillary growth containing fibrous and myxomatous tissue in similar proportions. The lesion was vascular and contained a mucopolysaccharide extractable with hyaluronidase.
KURU : THE ENDOCRINE STATUS
Authors: BUTTFIELD I. H. , HETZEL B. S. , HORNABROOK R. W. 
Published: September 2017

SUMMARYInvestigations of thyroid and adrenal cortical function have been carried out on subjects suffering from kuru in the Australian‐administered Territory of Papua and New Guinea. Determinations of radioiodine uptake at 24 hours by 15 subjects revealed a level of 66±12% compared to one of 65±12% for 24 control subjects. These findings are consistent with the wide prevalence of iodine deficiency in the New Guinea highlands. Determinations of plasma protein bound iodine levels revealed levels of 6·4±2·2 µg. per 100 ml. in nine subjects with kuru and 5·1±0·1 µg. per 100 ml. in seven control subjects.Determinations of plasma cortisol levels revealed a normal figure of 15·7±6·1 µg. per 100 ml. in 13 subjects with kuru, while 15 control subjects showed an elevation of cortisol levels‐24·1±5·4 µg. per 100 ml.—probably as a result of stress.Determinations of urine levels of 17‐oxosteroid gave figures of 6·2±2·2 mg. per day in 10 subjects with kuru, and of 5·4±2·2 mg. per day in seven control subjects ; the urine levels of 17‐oxogenic steroids were respectively 8·3±6·7 mg. per day and 9·0±4·0 mg. per day.Determinations of the response to metyrapone revealed no difference between subjects with kuru and control subjects. The results of a water excretion test were also normal in four subjects with kuru. It is concluded that both thyroid and adrenal cortical function are normal in kuru.
EXPERIENCES WITH LEFT ATRIAL MYXOMA
Authors: NEILSON GRAEME H. 
Published: September 2017

SummaryFour cases of left atrial myxoma discovered in the course of 159 mitral commissurotomies are described. Mitral valve disease was mimicked closely in every case, both clinically and hæmodynamically.Hæmodynamic data are presented for three cases, including one in which the myxoma was removed.The diagnosis should be suspected in mitral disease of recent or sudden onset with constitutional symptoms or systemic embolism, especially with sinus rhythm. The classical description of syncope on change of posture occurs only in 18% of patients. It was not a feature of any of these cases.Left atrial myxoma is best shown by angiography with injection into the pulmonary artery.
THE ELECTROPHORETIC INDEX : A PARAMETER OF THYROID FUNCTION
Authors: TAYLOR KATHLEEN , WINIKOFF DORA 
Published: September 2017

SummaryThe capacity of serum thyroxine‐binding globulin (T.B.G.) and albumin to bind added radiothyroxine in vitro has been utilized as a diagnostic test of thyroid function.After electrophoresis on cellulose acetate, the ratio of radioactivity in the α1‐ to α2 globulin zone to the total radioactivity present in the protein area, expressed as a percentage, is termed the electrophoretic index (E. I.).The normal range of values lies between 61% and 75% (mean, 68·9±3·86). The hyperthyroid range is below the lower limit (mean, 54·9±6·03), while hypothyroid values are above the upper limit (mean, 79·8±2·90). The E.I. for normal pregnancy is invariably over 80%.The clinical conditions under which the E.I. is most contributory to correct diagnosis, in the presence of conflicting protein bound iodine and resin uptake results, include treated thyroid disease and suspected thyroid dysfunction in which there is a high blood level of iodine as a result of laboratory contamination, the use of X‐ray media or the intake of iodine preparations.In the case of those patients who have an abnormal binding capacity of T.B.G. because of changes in the protein pattern which are either inherent, disease‐induced, or the result of the intake of drugs or hormones, the estimation of the E.I. is of value in establishing the underlying cause.A knowledge of the E.I. is also helpful in the detection of hypothyroidism in early infancy, and its use gives consistently reliable results in the diagnosis of thyrotoxicosis coinciding with pregnancy.
RESPIRATORY DEATH AFTER RENAL HOMOTRANSPLANTATION
Authors: BALE PATRICIA M. , LE QUESNE D. M. , STEWART J. H. 
Published: September 2017

SummaryRenal transplantation from the father was performed on a girl aged 16 years. Apart from a controlled episode of rejection, the graft functioned well. Dyspnœa and cyanosis with alveolar‐capillary block developed 73 days after transplantation and progressed to death 10 days later.At autopsy, thrombi were found in pulmonary and small systemic vessels, and their age coincided with the duration of symptoms. Although Pneumocystis carinii was found in the lungs, it was greatly concentrated in infarcts. The evidence suggests that pulmonary thrombi are an important feature of “transplantation pneumonia”.
CHRONIC LYMPHOCYTIC LEUKEMIA IN A CHILD PRESENTING AT THE AGE OF TWO YEARS AND EIGHT MONTHS
Authors: CASEY T. P. 
Published: September 2017

SummaryChronic lymphatic leukæmia in childhood is a rare condition. A case is reported in which the condition was diagnosed in a child aged two years and eight months, although it had probably been present before this. The pancytopenia improved and a considerable increase in leukæmic lymphocytosis took place after splenectomy. The child remains well on chlorambucil treatment three years after the initial presentation.
PULMONARY CRYPTOCOCCOSIS IN SOUTH AUSTRALIA
Authors: RICHARDSON J. P. 
Published: September 2017

Summary

Twelve cases of pulmonary cryptococcosis occurring over a 10‐year period in South Australia (which has a population of approximately one million) are reported. All lesions were resected surgically.
A significantly large proportion of these patients were of Australian Aboriginal stock.
Eight cases were complicated by the presence of cryptococcal meningitis.
Meningo‐encephalitis appears to be the most significant clinical complication of the disease, and was the cause of two deaths in this series.
Surgical resection of the pulmonary lesion is recommended to prevent infection or reinfection of the central nervous system by hæmatogenous spread. No mortality nor morbidity can be ascribed to pulmonary resection in this series.
Provided meningeal infection can be controlled initially by chemotherapy, subsequent resection of a residual pulmonary lesion may cure the patient of cryptococcosis.
ANTIBODY TO GASTRIC INTRINSIC FACTOR IN BLOOD DONORS AND HOSPITAL PATIENTS
Authors: UNGAR BERTA 
Published: September 2017

SUMMARYAntibody to gastric intrinsic factor was detected in the serum of five of 700 hospital patients (0·7%) aged over 50 years, but in none of 400 hospital patients aged below 50 years and in none of 500 blood donors aged below 60 years. Four of these five patients were further investigated : all four had latent pernicious anæmia and two of the patients had extremely low serum levels of vitamin B12 (30 and 60 pg. per millilitre).It is suggested that the presence of circulating intrinsic factor antibody in five of 700 hospital patients could indicate an overall incidence of latent pernicious anæmia in the vicinity of 1% in hospital patients aged over 50 years.
METABOLIC AND HORMONAL STUDIES IN A PATIENT WITH PRIMARY ALDOSTERONISM, PRESENTING WITH ACUTE HYPOKALÆMIC PARESIS INDUCED BY CHLOROTHIAZIDE
Authors: STOKES G. S. , GENTLE JANICE L. , EDWARDS K. D. G. , SCOGGINS B. A. , COGHLAN J. P. 
Published: September 2017

SummaryPrimary aldosteronism was discovered in a woman aged 27 years known to have been hypertensive for four years, and who presented with severe muscular weakness of acute onset after one week's treatment with chlorothiazide. Metabolic studies were carried out at three levels of sodium intake—“ normal ”(84 mEq per day), “ high ”(200 mEq per day) and “ low ”(16 mEq per day)—and also during treatment with desoxycorticosterone acetafe or spironolactone. Sodium loading caused a significant fall in the serum potassium concentration from 4·6 to 3·4 mEq/l., and a significant increase in the urinary potassium excretion from 165 mEq per day to 215 mEq per day. The plasma renin activity was abnormally low, being suppressed under all conditions of testing to a level below the lower limit of sensitivity of the assay used. The plasma aldosterone concentration was consistently high (mean 45, range 18 to 64 mµg. per 100 ml). Removal of an aldosterone‐producing tumour resulted in correction of the abnormal plasma levels of aldosterone and renin, and relief of hypertension and hypokalæmia.
NATURAL HISTORY OF ACTIVE CHRONIC HEPATITIS
Authors: MISTILIS STEVEN P. , SKYRING A. P. , BLACKBURN C. R. B. 
Published: September 2017

SummaryThe aim of the present study was to outline the natural history of active chronic hepatitis. Data from 82 patients, suitably arranged for electronic data processing, relating to the onset, clinical course, liver function, morbidity, mortality, prevalence of endocrine changes and diseases in other organs, L.E. cell phenomenon and tissue antibody reactions, were analysed. Cumulative survival was calculated by the life table method.The criteria for the diagnosis of active chronic hepatitis are defined and features permitting differentiation from other closely related disorders emphasized. Most patients were females with a peak age incidence of 11 to 30 years. One‐third had an onset identical with viral hepatitis, and two‐thirds had an insidious onset with a variable clinical presentation. The presence or absence of jaundice, hyperglobulinæmia and L.E. cells, the particular age group or sex, multi‐organ involvement, endocrine changes, marked elevation of the SGOT level or abnormal tissue antibody reactions, made little difference to the over‐all clinical picture. Florid signs of hypercorticism were distinctly uncommon in the absence of steroid therapy.The serum bilirubin content was usually below 10 mg. per 100 ml., the SGOT level rarely exceeded 500 units per millilitre, and hyperglobulinæmia exceeding 7·0 grammes per 100 ml. was found in only nine cases. Hypersplenism was common, and antinuclear factors were frequently detected in patients who had no L.E. cells.Recurrent episodes of active liver disease, with or without liver failure, punctuated the course. Twentyper centumof patients had an anicteric disease. Hypersplenism was common, even in the absence of cirrhosis. Patients spent 6% to 30% of their time in hospital. The disease became inactive in 41%. In no case could reversibility of disease be documented. All patients eventually developed cirrhosis with or without portal hypertension.There were 21 deaths. Only six patients have so far survived for 10 years. Fiftyper centumof deaths occurred in the first few years, when the disease was most active. Certain factors appear to influence the prognosis. Cumulative survival was only slightly better than that reported in other forms of cirrhosis.
NATURAL HISTORY OF ACTIVE CHRONIC HEPATITIS
Authors: MISTILIS STEVEN P. 
Published: September 2017

SUMMARYThis study was designed to clarify the natural history of active chronic hepatitis in terms of its pathology. One hundred and fifty liver biopsy sections were studied from 82 patients with the disorder. Attention was directed to the diagnostic changes in various stages of the disease, to the histogenesis of cirrhosis and to those changes important in predicting prognosis. The importance of a liver biopsy in diagnosis was assessed and the pathological changes were compared with findings in clinically related disorders such as persistent hepatitis, cryptogenic cirrhosis, primary biliary cirrhosis, acute infectious hepatitis and pericholangitis. An attempt was made to assess the relationship between clinical manifestations and severity of active chronic hepatitis on the one hand, and the type and severity of the histological change on the other. Biopsy changes in treated patients were compared with changes in those who did not receive corticosteroids, azathioprine or 6‐mercaptopurine.Active chronic hepatitis may be diagnosed from aspiration biopsy specimens, which show the changes of both acute and chronic perilobular hepatitis. The changes appear to be specific and biopsy often provides the only means of diagnosing the disorder. The course of the disease is highly variable and is characterized by repeated episodes of necrosis.·, Necrosis of entire consecutive lobules may account for clinical episodes of spontaneous hepatic coma. Patients with evidence of lobular or submassive necrosis have a subsequent poor prognosis. All patients eventually develop cirrhosis, but over half have histologically active disease during the entire course. In no case could reversibility of the process be demonstrated. There is no justification for previous terminology which divides the disease into sub‐groups, as these appear to be merely clinical variants of the same pathological process.
THE EXCRETION OF FREE NORADRENALINE AND ADRENALINE BY HEALTHY YOUNG SUBJECTS AND BY PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: NESTEL P. J. , DOYLE A. E. 
Published: September 2017

SUMMARYThe possible relationship between arterial pressure and the excretion of free noradrenaline and adrenaline in the urine was the subject of a study of 58 university students and 33 patients with untreated essential hypertension. The urine was collected during the morning with the subjects fasting, recumbent and undisturbed.The mean excretion rate of free noradrenaline by the students was 0.94 µg. per hour and by the hypertensives, 1.65 µg. per hour. The mean excretion rates of free adrenaline were 0.47 and 0.73 µg. per hour respectively. Although the difference in catecholamine excretion rates between the two groups was highly significant (P = < 0.01), there was a considerable overlap.There was a significant correlation with the student group between the excretion of both free noradrenaline and adrenaline and the systolic blood pressure, demonstrating that, in normal subjects, casual blood pressure at rest is partly although not very closely related to catecholamine production. Although catecholamine excretion rates were higher in the hypertensive group, a significant correlation with blood pressure was not found.
LACTOSE INTOLERANCE IN VARIOUS ETHNIC GROUPS IN SOUTH‐EAST ASIA
Authors: BOLIN T. D. , CRANE G. G. , DAVIS A. E. 
Published: September 2017

SUMMARYA study to determine the incidence of lactose intolerance in asymptomatic Australian, Chinese and Indian students and a group of New Guinea natives was made. No Australian student had lactose intolerance, but the incidence among a group of 21 Chinese students was 86%. All the eight New Guinea natives studied were affected, as were four of the five Indian students.The retiology of primary adult lactose intolerance is discussed. An adaptive decline in intestinal lactase activity after weaning is favoured as the probable cause. The socio‐economic implications of milk in food aid programmes are stressed.
A FUNCTIONING MALIGNANT PHÆOCHROMOCYTOMA OCCURRING IN A PATIENT WITH NEUROFIBROMATOSIS
Authors: CAMPBELL C. B. , MORTIMER R. H. 
Published: September 2017

SUMMARYA man aged 43 years with von Recklinghausen's neurofibromatosis presented originally with exertional angina. The subsequent development of a metastatic lesion near the left scapula led to the diagnosis of a functioning malignant phæochromocytoma with widespread secondary deposits. Clinical and necropsy findings are reported and pathological features are discussed. The association of neurofibromatosis with phæochromocytomas is well documented, but very few cases with undoubted malignancy have been previously reported.
FIBRINOLYSIS AND OBESITY: THE EFFECT OF WEIGHT REDUCTION
Authors: GRACE C. S. 
Published: September 2017

SUMMARYIn eight obese subjects the initially low level of fibrinolytic activity increased after significant weight reduction. Reduction to a normal weight resulted in normal fibrinolytic activity, which was maintained when an isocaloric diet was resumed. Subsequent weight gain in two subjects caused a return of fibrinolytic activity to its initially low level. Overall, the ultimate level of fibrinolysis achieved was closely related to the degree of obesity.The changes in fibrinolysis appeared to be unrelated to changes in plasma levels of fibrinogen, triglyceride, cholesterol, free fatty acids and glucose.
HYPOFIBRINOGENÆMIA WITH A POSSIBLY DEFECTIVE FIBRINOGEN ASSOCIATED WITH FIBRINOLYSIS
Authors: FANTL P. 
Published: September 2017

SUMMARYBlood coagulation tests carried out on a patient about to undergo prostatectomy revealed a prolonged plasma‐thrombin coagulation time which was shown to be due to the presence of abnormal fibrinogen in the patient's blood. Details are given of the coagulation studies performed, together with a discussion of the little known group of coagulation deficiencies caused by fibrinogen disorders.
A PLATELET CYCLE IN NORMAL INDIVIDUALS
Authors: MORLEY ALEC 
Published: September 2017

SUMMARYOscillation of the platelet count was found in 4 of 11 normal individuals. This finding suggests that platelet production in at least some normal individuals is controlled by a negative feedback circuit containing a time delay. This type of circuit is known to be capable of stable oscillation. The periods of oscillation were between 21 to 35 days and are similar to those found in cyclical thrombocytopenia. These and previous findings suggest that many physiological parameters might be oscillatory due to the action of normal homeostasis. Periodic disease could then result from the oscillation being rendered more apparent or from the system changing from damped to stable oscillation.
THE HORMONAL RESPONSE TO PHYSICAL EXERCISE
Authors: SUTTON J. R. , YOUNG J. D. , LAZARUS L. , HICKIE J. B. , MAKSVYTIS J. 
Published: September 2017

SUMMARYStudies of the hormonal response to physical exercise were performed on young males who were classified as physically fit or unfit. The studies included serial measurements of blood sugar, plasma free fatty acids (FFA), serum growth hormone (HGH), serum insulin, serum glucagon and plasma cortisol levels during and following a 30‐minute period of maximal physical exercise.The hormonal response in both groups was similar except in the case of HGH. In both groups there was an elevation of HGH level during exercise, but in the fit group HGH returned to basal levels within 30 minutes, whereas in the unfit group the HGH level continued to rise for a further hour before decreasing.These results confirm that HGH secretion occurs during vigorous muscular exercise, and that in the unfit subject there is a delay in the return of HGH to basal levels following exercise. Studies during submaximal exercise revealed an elevation of HGH only in the unfit group. The possibility of anaerobic metabolites acting as the stimulus for HGH in exercise was investigated by infusion of sodium lactate, which caused a significant elevation of HGH level.From the above data we conclude that a characteristic of physical fitness is a rapid return of HGH secretion to basal levels following vigorous muscular exercise.
SOME EXPERIMENTAL OBSERVATIONS RELATING TO THE PATHOGENESIS OF RENAL PAPILLARY NECROSIS
Authors: HAM K. N. , TANGE J. D. 
Published: September 2017

SUMMARYRenal papillary necrosis was induced in female Wistar rats by a single dose of vinylamine. Damage to the renal papilla invariably ensued and was evident on light microscopy eight hours later. The changes comprised intracellular and extracellular œdema, endothelial damage, and necrosis of interstitial and epithelial cells ; these changes commenced at the tip of the papilla and spread towards but not beyond its base.The state of the medullary circulation was assessed by using colloidal carbon, which was injected intravenously and allowed to clear from the systemic circulation before tissues were taken for examination. As the lesion progressed, carbon accumulated in vessels, first at the tip and later at the base of the pyramid, and protein in the loops of Henle at the same levels. Extensive carbon labelling of damaged vessels in the early lesion indicated that the circulation continued for a time through this zone. After the histological appearances of necrosis were fully developed, there was no carbon labelling and no circulation could be demonstrated in the damaged tissue. There was no evidence of significant vascular lesions outside the papilla. Intravascular fibrin could not be demonstrated histochemically.It seems probable that vinylamine damages the cells of the medulla, and that there is severe fluid and protein loss into the interstitial tissue. Such fluid loss, in its turn, is followed by impaction of red cells and further slowing of the already sluggish circulation in the venous limbs of the medullary capillary loops.In rats allowed to survive for weeks or months, the necrotic papilla sloughed and the adjacent tissue became covered with epithelium. In the cortex, areas of tubular atrophy, tubular dilatation, and scarring alternated with normal tissue. Such areas of cortical damage were often small and focal. These findings suggest that tubular obstruction is not inevitable after loss of the papilla and that other factors may influence the associated renal cortical scarring.The same general pathological processes determine the occurrence of renal papillary necrosis in various clinical and experimental situations. The observations recorded here suggest that two of these processes are direct local tissue injury and venous circulatory stasis.
EXPERIENCES WITH EMERGENCY PORTA‐CAVAL SHUNT
Authors: HOFFMAN D. C. , JEPSON R. P. , HARRIS J. D. 
Published: September 2017

SUMMARY(1) Our experiences with 20 cases of emergency porta‐caval shunt for bleeding cesophageal varices are reviewed.(2) The difference in behaviour between cryptogenic and alcoholic cirrhotics is outlined, and the need for strict selection in the case of the latter group is emphasized.(3) It is our view that, if liver function is good, this operation is the preferred emergency treatment for persistent bleeding from cesophageal varices.(4) For those alcoholics with significantly impaired liver function, no adequate therapy appears available.
PARAPROTEIN PATTERNS IN AUSTRALIA
Authors: PENNY RONALD 
Published: September 2017

SUMMARYSeventy‐eight patients with serum and/or urinary paraproteins were studied, and their clinical and immunological features are presented. The clinical manifestations that depend on the biological activity of the paraprotein are emphasized.The disorders associated with the presence of the paraprotein included myeloma (47 cases), macroglobulinremia (14 cases), amyloidosis (six cases) and various tumours, for example carcinoma, sarcoma, hepatoma (seven cases). The paraproteins were gamma‐G (41 cases), gamma‐A (w cases), gamma‐M (17 cases), gamma‐D (two cases), Bence Jones protein alone (six cases) and diclonal (two cases).In those patients without myeloma or macroglobulinremia, an abnormal or long‐standing stimulus to the immune system is found in a proportion of cases, and this may be of pathogenetic significance.