bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of hypocalcaemia on glucose tolerance, insulin release and free fatty acid levels in human subjects
Authors: Bansal S , Rizvi S N A , Rao M B , Vaishnava H 
Published: December 2008

Summary
Eight patients with hypocalcaemia who presented with frank or latent tetany due to parathyroid insufficiency or nutritional osteomalacia were studied. Their serum calcium ranged from 6·85 to 7·7 mg/100 ml (mean 7·33±0·36 mg/100 ml). In six of them, serum calcium after treatment varied from 8·4 to 9·2 mg/100 ml. In ten healthy normal subjects the serum calcium levels were 9·0-10·2 mg/100 ml (9·50±0·47 mg/100 ml). The blood glucose levels during a 3 hr oral GTT were significantly elevated during hypocalcaemia and returned to normal levels after treatment. Serum insulin levels were low at 60 and 120 min after the administration of glucose in hypocalcaemia but returned to normal once the serum calcium levels were above 8·4 mg/100 ml. The FFA levels were high during the low calcium state and reached normal levels after treatment. The above studies suggest that an optimal level of serum calcium is essential for glucose-induced insulin release.
Clinical types and drug therapy of renal impairment in cirrhosis
Authors: Rodés J , Bosch J , Arroyo V 
Published: December 2008

SummaryFour separate types of renal failure in cirrhosis are described: functional renal failure; diuretic induced uraemia; acute tubular necrosis; chronic intrinsic renal disease.Functional renal failure may arise spontaneously or be precipitated by such factors as haemorrhage, surgery, or infection. It carries a poor prognosis but preliminary results of treating this condition with plasma volume expansion in combination with high doses of furosemide are encouraging.
Renal failure in obstructive jaundice—clinical aspects
Authors: Dawson J L 
Published: December 2008

Summary
The patient with obstructive jaundice has an increased risk of developing renal failure. The commonest clinical situations in which this is seen is after surgical operation, as a result of percutaneous cholangiography or in association with severe ascending cholangitis. The risk of acute renal failure is decreased by ensuring adequate hydration and maintaining a high urine flow, if necessary using mannitol or some other osmotic diuretic. In patients undergoing percutaneous cholangiography, prophylactic antibiotics are probably indicated. Early surgery to control severe ascending cholangitis may be life saving and also prevent the development of renal failure.
Renal failure in obstructive jaundice—pathogenic factors
Authors: Wardle E N 
Published: December 2008

SummaryIn the patient with obstructive jaundice, preliminary dehydration, combined with the toxic effects of free bilirubin and serum bile acids, together with factors which cause inhibition of fibrinolysis, determine a high degree of renal susceptibility to ischaemia. Evidence from animals and man suggests that intravascular coagulation determined by endotoxaemia from the obstructed biliary system occurs at the onset of acute renal failure. Endotoxin is unique in being able to produce all those factors which separately cause a primary increase of renal arteriolar constriction.
Treatment of ascites by reinfusion of concentrated peritoneal fluid—a review of 318 procedures in 210 patients
Authors: Lévy V G , Pauleau N , Opolon P , Caroli J 
Published: December 2008

Summary
A modified plate dialyser (Rhône-Poulenc) was used 318 times to concentrate ascites for reinfusion in 210 patients, most of them having longstanding ascites refractory to diuretic treatment.
The advantages of this method of treatment are its rapidity and efficacy, ascites being reduced in a mean time of 21±13 hr. Hyponatraemia is easily corrected by a sodium load during reinfusion. There was improvement in renal function in 11 of 37 cases. Adverse effects are fever, pulmonary oedema, peritoneal infections and coagulation disorders. Ascites recurred in 84% of the cases, but the procedure shortens hospital stay and reduces the cost of the treatment.
Ascites reinfusion using the Rhodiascit apparatus—clinical experience and coagulation abnormalities
Authors: Wilkinson S P , Henderson J , Davidson A R , Williams Roger 
Published: December 2008

Summary
The results of twenty-four ascitic reinfusions in twenty patients, using the Rhodiascit procedure, are reported. The procedure was of no value in the management of patients with spontaneous functional renal failure, but was of considerable value in accelerating hospital discharge of patients with tense ascites but good renal function. Complications of the procedure were few, but tests of blood coagulation became abnormal, the most likely cause of which was deposition of fibrin on to the filtration membrane.
Haemorrhoids—postulated pathogenesis and proposed prevention
Authors: Burkitt D P , Graham-Stewart C W 
Published: December 2008

Summary
The very high prevalence of haemorrhoids in the most economically developed countries is contrasted with their low prevalence in rural communities in developing countries. Traditional concepts of causation are shown to be no longer tenable. It is argued from epidemiological, clinical and experimental evidence that the fundamental cause of piles is straining at viscid stools which are the result of fibre-depleted diets.
Surgical emphysema, bilateral pneumothorax, pneumomediastinum and pneumoperitoneum complicating intubation for anaesthesia
Authors: Scott J K , Viner J 
Published: December 2008

Summary
A combination of surgical emphysema, bilateral pneumothorax, pneumomediastinum and pneumoperitoneum complicating anaesthesia using endotracheal intubation has been reported only once before. Its occurrence twice in a recent period of 4 months at one hospital suggests that it may not be rare. Recognition of the early signs should enable steps to be taken before irreversible cerebral damage has occurred.
Small intestinal biopsy in childhood coeliac disease
Authors: Risdon R A , Wadbrook D G , Meinhard E A , Keeling J W 
Published: December 2008

Summary
Small intestinal biopsies from children with treated and untreated coeliac disease have been analysed morphometrically and compared with controls. Two methods have been used; one, described by Dunnill and Whitehead (1972) provides indices of surface-to-volume ratio and of mucosal volume. The other, described by Meinhard, Wadbrook and Risdon (1965), involves tracing the microscopic image of the biopsy on to computer data cards to produce measured encoded data for direct analysis with a computer.
Biopsies from untreated coeliacs were clearly distinguished from control specimens by both techniques. Comparison of these two groups by computer card morphometry shows the mucosal lesion in coeliac disease to be associated with a spatial redistribution of the tissue components rather than a change in their absolute amounts. No difference in the total mucosal volume was found so that a true mucosal atrophy does not occur in this condition.
Surface-to-volume (c: lh) ratios were measured in twenty-eight children treated empirically with a gluten-free diet for suspected coeliac disease, in biopsies taken before and after a gluten challenge. By this means the diagnosis of coeliac disease was confirmed in eighteen of these patients.
In morphologically normal biopsies correlation of c: lh ratios with age showed significantly smaller values in younger children. Slight changes in biopsies from young children should, therefore, be interpreted cautiously and should not necessarily be regarded as pathological on the evidence of the villous pattern alone.
Cell counting in the human brain: traditional and electronic methods
Authors: Corsellis J A N , Alston R L , Miller A K H 
Published: December 2008

Summary
Whether or not a proportion of nerve cells disappears from the human brain during adult life remains a controversial question 80 years after it was first asked. In this paper the authors review briefly the reasons for this uncertainty and describe an attempt to find an answer in so far as the cerebellar Purkinje cells are concerned. A loss of about 2·5% per decade was identified. The problems raised by cell counting in the cerebral cortex are outlined and a new method is described which may prove suitable for neuronal counting in these regions using an image analysing system.
Kinetics of lead interaction with human erythrocytes
Authors: Barltrop D , Smith A M 
Published: December 2008

SummaryThe kinetics of the interaction of lead with human erythrocytes has been investigated in vitro by means of tracer studies with 203Pb. The elution characteristics of lead from erythrocytes in contact with EDTA suggest the existence of two binding sites differing in their affinity for lead. The findings are consistent with the existence of two compartments for lead binding in the cell, and a model system based on this concept is proposed.
Absorption of lead from dust and soil
Authors: Barltrop D , Thornton I , Strehlow C D , Webb J S 
Published: December 2008

Summary
The lead burdens for children and mothers exposed to lead-contaminated soils and dusts have been investigated in a rural district with minimal atmospheric pollution. A significant relationship was observed between the lead content of blood and hair of children exposed to soils of mean lead content in the range 420-13,969 p.p.m. The blood lead concentration of children was consistently greater than that of their mothers. No consistent relationship was found between blood lead values and pica for soil. In this situation, lead in soil provided a small additional burden for children but in itself was insufficient to constitute a hazard.
Smell as a diagnostic marker
Authors: Liddell K 
Published: December 2008

SummaryThe odour emitted by the patient may be one of the first major clues leading to an early diagnosis. Certain dermatological conditions produce an obnoxious smell and several metabolic diseases are associated with a characteristic odour. Schizophrenia and several rare inborn errors of metabolism associated with enzyme deficiencies are linked with distinctive body odour.
Sputum and mucociliary clearance mechanisms
Authors: Reid Lynne 
Published: December 2008

Summary
Bronchial secretion forms a periciliary liquid layer and may also give rise to thicker secretion that moves on the tips of the cilia. This latter material as collected at bronchoscopy or coughed up as sputum is a viscoelastic substance behaving in a characteristic way over a wide range of shear rates. The anatomical basis of secretion is described and its control as established by organ culture.
Further experience with discriminant functions in differential diagnosis of hypercalcaemia
Authors: Fraser Patricia , Healy Michael , Watson Lyal 
Published: December 2008

Summary
Further experience has been obtained in the use of discriminant functions in the differential diagnosis of hypercalcaemia from the study of 140 new patients. The discriminant functions described in an earlier paper were derived from the results for plasma inorganic phosphate, alkaline phosphatase, chloride, bicarbonate and urea obtained from hypercalcaemic patients on admission to hospital. They indicated the correct diagnosis in ninety-two of 103 new hypercalcaemic patients (89·3%) admitted to University College Hospital and in thirty-one of thirty-seven hypercalcaemic patients at two other hospitals.
Revised discriminant functions have been calculated including the erythrocyte sedimentation rate as a sixth variable. These revised functions have led to some improvement in diagnostic accuracy. The correct diagnosis was indicated in ninety-three of ninety-eight patients (94·9%) at University College Hospital and in thirty-three of the thirty-seven patients at the two other hospitals.
Oats and barley toxicity in coeliac patients
Authors: Baker P G , Read A E 
Published: December 2008

Summary
The effect of addition of oats and barley to the glutenfree diets of a group of patients with coeliac disease has been studied using the oral 5 g xylose excretion test to assess small bowel function before and after these supplementations.
Both oats and barley were found to be potentially harmful to coeliac patients although the toxic effect of barley was more readily produced than that of oats.
On the basis of their results, the authors recommend the exclusion of both barley and oats, in addition to wheat and rye, from the coeliac diet. In view of the well recognized risk of the development of malignancy, such a diet should be followed particularly rigorously in those patients with a persistence of symptoms and of marked villous atrophy.
Left lobe amoebic liver abscess
Authors: Rasaretnam Rudra , Wijetilaka Shelton E 
Published: December 2008

Summary
For reasons which are not quite clear amoebic liver abscesses in the left lobe are relatively uncommon. On account of the lesser bulk of the left lobe, and the potentially greater space under the left hemidiaphragm, expansive lesions within it remain less obtrusive than corresponding lesions in the right. Sixteen such cases are analysed and five distinct modes of clinical presentation have been found. Eight of the patients presented late with perforation into either the peritoneal or pleural cavities. In seven of eight remaining cases, an abdominal mass suggestive of a left lobe lesion was present. Anaemia, leucocytosis and a raised erythrocyte sedimentation rate were usually present, and in the five cases seen in the last year a positive reaction was obtained to the indirect fluorescent antibody test. Confirmatory radiological features were present only in advanced cases.
Exophthalmos in the Guillain-Barré syndrome. An unusual presentation
Authors: Boddie Grahame , Sambrook Michael A , Mohr Peter D 
Published: December 2008

Summary
Papilloedema, multiple cranial nerve palsies, and autonomic nervous system dysfunction have become increasingly well recognized as occurring in the Guillain-Barré syndrome. Such a patient was recently encountered in whom the additional presenting feature of severe bilateral exophthalmos led to delay in reaching the correct diagnosis. Because of this delay and ensuing respiratory complications, permanent visual failure secondary to papilloedema occurred.
Use of temperature-sensitive mutants of influenza A virus as live virus vaccine strains. Evaluation in laboratory animals, adults and children
Authors: Murphy Brian R , Richman Douglas D , Spring Susan B , Chanock Robert M 
Published: December 2008

SummaryTemperature-sensitive (ts) recombinants of influenza A virus were evaluated for use in a live virus vaccine. Evidence from several sources suggested that the ts lesions were responsible for attenuation of these mutants. Specification of attenuation by defined genetic lesions which can be assayed for in the laboratory offers an advantage to the use of ts viruses for vaccination. This means that ts recombinants can be assessed for genetic stability during vaccine development, production and later during usage in man. One ts virus, influenza A/Hong Kong/68-ts-1[E], with a 38°C shut-off temperature, had the following properties desirable for a live virus vaccine: (1) satisfactory infectivity for seronegative (serum HI antibody titre ≤ 1:8) adults; (2) satisfactory attenuation for adults; (3) capacity to stimulate local and serum anti-haemagglutinin and anti-neuraminidase antibodies in seronegative volunteers; (4) stimulation of resistance to virulent, wild type virus; (5) relative genetic stability in vivo; (6) lack of communicability in man; (7) replication to high titre in avian leucosis virus-free eggs; and (8) localization of ts lesions to genes that do not code for the haemagglutinin and neuraminidase. The ts lesions of influenza A/Hong Kong/68-ts-1[E] virus were transferred to more current viruses within the H3N2 subtype (influenza A/Udorn/307/72 and influenza A/Georgia/101/74). These recombinant Udorn/72 and Georgia/74 ts viruses, which possessed the same shut-off temperature and the same ts lesions as the influenza A/Hong Kong/68-ts-1[E] parent virus, exhibited a pattern of infection and attenuation in hamsters and man similar to their ts parent. These data suggest that ts mutants which are sufficiently attenuated for man, could serve as donors of ts lesions for the rapid production of an attenuated vaccine when new antigenic variants arise.When the influenza A/Hong Kong/68-ts-1[E] virus was administered to children who lacked both anti-haemagglutinin and anti-neuraminidase antibody the virus replicated for a longer period than in adults and mild fever developed in some of the young vaccinees. A minority of children shed wild type revertant virus. The emergence of wild type virus in children, but not in adults, probably reflected the more extensive replication of the virus in the doubly seronegative children. The implications of these findings to the development and testing of live influenza A virus vaccines were discussed.
The production of live attenuated influenza A strains by recombination with A/Okuda/57 (H2N2)
Authors: McCahon D , Beare A S , Stealey V 
Published: December 2008

Summary
A new recombination system for the production of live attenuated influenza-A vaccine strains is described. The attenuated parent is the Japanese strain A/Okuda/57 (H2N2) which has a known passage history and a good record of human safety. This virus has been recombined with two recent field isolates, A/England/42/72 and A/Finland/4/74, and in each case several recombinants were isolated and tested in volunteers. These recombinants differed in their degree of attenuation, but on each occasion it was possible to choose one that was suitably attenuated for a candidate vaccine strain. The genetic stability of such a recombinant produced with the A/England/42/72 strain was demonstrated by subjecting it to three successive human passages. A single intra-nasal dose of the A/Finland/4/74 recombinant vaccine gave a seroconversion rate of 75%.
This recombination system offers considerable advantages for the production of live influenza virus vaccines.
Detection of high coronary risk
Authors: Rose Geoffrey 
Published: December 2008

Summary
Signs of early myocardial ischaemia are the most powerful available predictors of myocardial infarction and CHD death. The main primary risk factors are of undiminished importance in such persons, but screening for myocardial ischaemia is not recommended without evidence that intervention at this late stage is effective.
Estimates are presented of the relative importance to individuals of the main primary risk factors. Their importance as population risk factors is different, depending on the product of attributable risk and prevalence: a high risk with low prevalence, as from severe hypercholesterolaemia, is of small importance compared with that arising from the numerous individuals with smaller elevations. Most cases of CHD arise from the common and therefore inconspicuous combination of slight increases in two or three factors in the same individual. Selective and opportunistic risk factor screening is recommended, not a general service.
An extension of clinical responsibility in the direction of preventive responsibility is generally accepted as proper, even though it is slow in being applied. When someone with symptomless hypertension is given hypotensive drugs with the object of reducing the risk of stroke, that is preventive medicine. The subject having made no complaint is not strictly a patient: but the clinician accepts a responsibility for him because of the high risk that he will become a patient if nothing is done. This is an analogy for our concern with identifying subjects with a high coronary risk, and the attempt in such persons to prevent the onset of major ischaemia.
Primary and secondary prevention trials in coronary heart disease
Authors: Shaper A G 
Published: December 2008

Summary
Trials in primary and secondary prevention of coronary heart disease (CHD) are reviewed. The results of completed primary prevention trials suggest that dietary changes in middle-aged men may lower the incidence of CHD. Multifactorial trials may achieve an even greater reduction in CHD. Secondary prevention trials indicate that stopping smoking and the use of beta-blocking agents are effective in reducing recurrence rates.
Agranulocytosis and systemic candidiasis following clomipramine therapy
Authors: Souhami R L , Ashton C R , Lee-Potter J P 
Published: December 2008

Summary
A case of agranulocytosis following clomipramine treatment is described. The period of agranulocytosis lasted for 19 days and was complicated by systemic Candida infection which was successfully treated with flucytosine.
An eighteen months' study of the clinical response to metoprolol, a selective α1-receptor blocking agent, in patients with angina pectoris
Authors: Comerford M B , Besterman E M M 
Published: December 2008

SummaryFollowing an initial dose response study, metoprolol, a selective beta1-receptor blocking agent, was compared with equipotent dosages of propanolol in a double blind cross-over study, including exercise tolerance tests, on fourteen patients with angina pectoris. Long term therapy with metoprolol then followed until the seventy-second week. Patients performed 8% more total work on metoprolol with 15% more work recorded up to the onset of S-T depression, in comparison with propranolol. In the long term, ther was no significant difference in work performed when the daily dosage of metoprolol was changed from a q.i.d. to a b.d. regime. Metoprolol was shown to be an effective anti-anginal compound with good tolerance and safety, with gradual improvement in underlying myocardial ischaemia during long term treatment.
The use of plastic isolators to prevent infection in neutropenic patients
Authors: Goldman J M , Spiers A S D , Trexler P C , Gaya H , Gordon A M 
Published: December 2008

Summary
Over the last 5 years plastic isolators have been used for the prevention of infection in patients with severe neutropenia. Fifteen patients in differing stages of acute myeloid and chronic granulocytic leukaemia were managed in isolators for a total of 110 patient-weeks. The mean duration of isolation for each patient was 7·4 weeks with a range of 2-14 weeks. There was no evidence that any of the isolated patients acquired infection with any exogenous micro-organism. The psychological problems of isolation proved less onerous for the patients than had been anticipated by the medical and nursing staff and no patient had to be removed from isolation for psychiatric reasons. Unfortunately the reduced incidence of clinical infection in the isolated patients was not obviously associated with an increase in effectiveness of their anti-leukaemic treatment.
Protection of Health Service staff
Authors: Lunn J A 
Published: December 2008

Summary
The practical problems involved in immunizing hospital staff are discussed as well as some of the changing priorities for protection as a result of a changing incidence of infectious disease. Some skin problems are mentioned with a view to improving protection for staff at risk. The cost and value of routine stool testing of catering workers is discussed, and the question raised as to whether money saved from these tests might be better spent on improving kitchen hygiene and working facilities.
Phaeochromocytoma with myocarditis managed with alpha-methyl-p-tyrosine
Authors: Begnall W E , Salway J G , Jackson E W 
Published: December 2008

Summary
A case of bilateral phaeochromocytoma with catecholamine-induced myocarditis is described. The two operations needed allowed comparison of the use of alpha-methyl-p-tyrosine alone and in conjunction with adrenergic blocks in the management of the patient. The combination of both drugs was particularly successful in the relief of symptoms and reduction of catecholamine metabolism as monitored by 4-hydroxy-3-methoxymandelic acid (HMMA) excretion. As myocarditis is a potentially fatal complication, further investigation of the combined use of alpha-methyl-p-tyrosine and adrenergic blocking drugs is suggested in the pre-operative management of patients with phaeochromocytoma.