bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transvenous endomyocardial biopsy—application of a method for diagnosing heart disease
Authors: Caves Philip , Coltart John , Billingham Margaret , Rider Alan , Stinson Edward 
Published: December 2008

Introduction
Although biopsy of the kidney, liver, and many other organs is routine in clinical medicine, biopsy of the heart is infrequently performed. In consequence, little is known of the serial histological changes which occur in non-fatal myocardial disease. Published techniques for obtaining myocardial biopsies have included percutaneous needle biopsy of the left ventricle, catheter needle biopsy of the interventricular septum, and open thoracotomy. The associated morbidity and mortality with these methods have precluded their widespread acceptance (Shirey et al., 1972).
Secondary syphilis presenting with jaundice
Authors: Bhowmick B K , Simpson B , Way S P B 
Published: December 2008

Summary
A patient with secondary syphilis presenting with jaundice is reported. Hepatic histology showed evidence of non-specific granuloma and active hepatitis but no cholestasis. This has been treated successfully with antisyphilitic therapy. The possibility of syphilitic pancreatitis and diabetes mellitus is discussed. The importance of serological tests for syphilis in jaundice of obscure origin is emphasized.
Diabetes mellitus and primary hyperparathyroidism
Authors: Walsh C H , Soler N G , Malins J M 
Published: December 2008

Summary
Eight patients suffering from primary hyperparathyroidism and diabetes mellitus are reported. All of the patients are female. The clinical problems resulting from the co-existence of these two endocrine disorders and the similarity of their symptoms are discussed. The experience from a large diabetic clinic population suggests that the association of hyperparathyroidism with diabetes merits further investigation.
Neurosurgery in the older patient
Authors: Stewart Ian , Millac Paul , Shephard R H 
Published: December 2008

Summary
The outcome of brain and spinal surgery has been assessed in 141 patients who were over the age of 65 at the time of operation. Patients tolerated investigation and surgery remarkably well and good results were obtained for benign lesions. Survival times and the contribution of surgery to reducing disability in malignant disease were disappointing.
Poikiloderma atrophicans vasculare as a pointer to reticulosis of the skin
Authors: Chapman Robert S , Paul C Jose 
Published: December 2008

Summary
A case of reticulosis of the skin (mycosis fungoides) terminating in reticulum cell sarcoma is described where the features of poikiloderma atrophicans vasculare had been present for 40 years. The likelihood of reticulosis eventually developing after such a change in the skin is believed to be around 50%.
A brainstem syndrome associatedxb with Mycoplasma pneumoniae infection—A report of two cases
Authors: Jachuck S J , Gardner-Thorpe C , Clark F , Foster J B 
Published: December 2008

Summary
Two patients with a serologically-proved infection with Mycoplasma pneumoniae (MP) developed cranial nerve pareses which cleared spontaneously within 1 month of the onset. The sixth and seventh cranial nerves were the most severely affected. It is suggested that the signs were due to a mild brainstem encephalitis associated with the MP infection. The benign course of the syndrome is emphasized. The neurological complications of MP infection may be commoner than has been generally supposed.
Pathogenesis of renal failure in cirrhosis and fulminant hepatic failure
Authors: Wilkinson S P , Hurst D , Portmann B , Williams Roger 
Published: December 2008

Summary
Acute renal failure in cirrhosis and fulminant hepatic failure represents a spectrum with ‘functional renal failure’ at one end and acute tubular necrosis at the other. In fulminant hepatic failure the development of renal failure is not necessarily a measure of the severity of liver damage.
Functional renal failure is due to active renal vasoconstriction which may, at least in fulminant hepatic failure, be initiated by systemic endotoxaemia.
Factors relating to sodium excretion in experimental ascites
Authors: Blendis L M 
Published: December 2008

Summary
Although there is some disagreement about the role of the proximal convoluted tubule in the sodium retention of caval dogs, most authors agree that the major site of increased sodium resorption is the ascending loop of Henle. Furthermore, although the majority of experimental evidence suggests that the increase in sodium resorption is caused by alteration in physical factors, presumably in the vasa recti, there is some evidence that circulating substances may also be involved.
The significance of hyponatraemia in liver failure
Authors: Ring-Larsen H 
Published: December 2008

Summary
It is possible by means of peritoneal dialysis to correct hyponatraemia occurring in liver failure. The normalization is not, however, attended by any apparent improvement in liver function, hepatic encephalopathy or renal function. Likewise correction of the serum ammonia level did not improve the clinical picture.
A correction of the extracellular ion concentration and a possible more normal intracellular composition achieved by peritoneal dialysis may thus eliminate one life-threatening factor in severe liver failure. However, this does not seem to improve the chances of survival of the patients.
A rational approach to the treatment of ascites
Authors: Arroyo V , Rodés J 
Published: December 2008

Summary
A rational approach to the diuretic therapy of ascites is proposed. Fifty-five patients were classified according to their ability to excrete sodium and free water. Patients with a high urinary sodium excretion can be treated by low sodium intake alone. In most patients with a low sodium excretion but high free water clearance, distal diuretics (spironolactone or triamterene) with a low sodium diet will relieve ascites. Patients with low values for sodium excretion and free water clearance also have poor glomerular filtration rate and only a few of these will respond to diuretic therapy.
Evaluation of baclofen (Lioresal) for spasticity in multiple sclerosis
Authors: Hedley D W , Maroun J A , Espir Michael L E 
Published: December 2008

Summary
The effect of baclofen on spasticity and muscle spasms was assessed in thirty-five patients with multiple sclerosis. Benefit from reduction of spasticity was obtained in sixteen patients. A higher proportion of patients confined to a wheelchair was helped than ambulant patients, but overall functional improvement was limited. Twenty-one of the thirty-five patients had troublesome spasms and thirteen of them had significant relief on baclofen. Substituting identical dummy tablets confirmed that benefit was attributable to the pharmacological effects of baclofen in ten of the sixteen patients whose spasticity was reduced and in eight of the thirteen whose muscle spasms were relieved. In two of the remainder, benefit appeared to be due to placebo effect, and the others maintained their improvement after stopping the drug.
The drug had to be withdrawn in nine patients because of increased weakness and in ten other patients who had intolerable side effects. The optimum dose of baclofen tolerated ranged from 15 mg to 80 mg daily. The importance of adjusting the dose regime to the requirement of each individual and starting with small doses in multiple sclerosis is emphasized.
Severe Guillain-Barré syndrome following urethritis with cardiovascular and ophthalmic involvement
Authors: Marshall A J , Rogerson F Elizabeth 
Published: December 2008

Summary
A patient with a severe form of the Guillain-Barré syndrome is described and the case illustrates the rare cardiovascular and ophthalmic complications which can occur. Urethritis, probably due to gonorrhoea, preceded neurological symptoms and this association has not been previously reported.
Hypertrophic osteoarthropathy associated with Fallot’s tetralogy—a case report
Authors: George B Olu , Mabayoje J Olu 
Published: December 2008

SummaryA case of Fallot’s tetralogy associated with hypertrophic osteoarthropathy in a young Nigerian female is described. The clinical spectrum of hypertrophic osteoarthropathy is reviewed. The rarity of this syndrome is stressed. Some other aspects of the clinical manifestation of cyanotic congenital heart disease which may mimic the skeletal syndrome are mentioned.
Cryptococcal meningitis in steroid-treated systemic lupus erythematosus
Authors: Khan M Anees , Sbar Sidney 
Published: December 2008

Summary
A case of cryptococcal meningitis complicating steroid-treated systemic lupus erythematosus (SLE) which was successfully treated with amphotericin B is described.
Although apparently rare, this mycotic infection has been reported from six patients with SLE in the medical literature over the past 10 years. Four of the six had been treated with steroids for periods ranging from 10 weeks to 6 years. In only one of these was the fungal infection diagnosed and effectively treated. Because effective therapy is available it is imperative that cryptococcal meningitis be not confused with progressive central nervous system involvement of SLE.
Familial dwarfism: case report
Authors: Nader S , Fisher J A , Doyle F H , Mashiter K , Joplin G F 
Published: December 2008

Summary
Three sisters are described, of consanguinous parents, with multiple trophic hormone deficiencies presenting as short stature. In two of them the size of the sella turcica is large in relation to the skeletal age and height. All three show an acute metabolic response to an administered preparation of human growth hormone.
Agreement and disagreement between pathologists in histological diagnosis
Authors: Sissons H A 
Published: December 2008

Summary
Studies on differences of observation and interpretation between pathologists in connection with histological diagnosis are rare. The present paper gives a general account of such a study, by members of the Cancer Research Campaign’s Bone Tumour Panel, of certain histological features of ‘malignant round-cell tumours’ of bone. Significant differences were found, not only between the different cases studied, but between the observations of the different pathologists, and between the repeated observations of individual pathologists.
The influence of nutritional factors on lead absorption
Authors: Barltrop D , Khoo H E 
Published: December 2008

SummaryThe nutritional factors which affect lead absorption have been studied. Synthetic diets of known composition were compounded to contain 0·075% Pb as PbCl2 labelled with 203Pb. Rats were exposed to lead for periods of 48 hr. The dietary intake was then measured and the absorption of lead determined by means of a whole-body counter. Lead absorption was increased by high fat, low mineral, low protein and high protein diets but was decreased by high mineral diet. Low fat, low fibre, high fibre, low vitamin and high vitamin diets had no effects on lead absorption.
Transient psychological syndrome following diazepam therapy for tetanus
Authors: Malatinský J , Procházka M , Kadlic T 
Published: December 2008

Summary
Two cases of transitory reversible pathopsychological changes associated with diazepam therapy in tetanus are described. The psychopathology developed owing to an abrupt discontinuance of diazepam or to a sudden reduction of its dosage. The reinstitution of diazepam in low doses and the administration of regulators of cerebral metabolism resulted in a progressive normalization of the psychological state.
It is suggested that the described syndrome was caused by two aetiological factors; the toxinfectious factor giving rise to the primary cerebral dysfunction, and the prolonged action of high doses of diazepam with a sudden withdrawal, playing a role as precipitating factor.
EEG findings showed widespread abnormality which corresponded with the clinical diagnosis. Even the normalization in EEG correlated well with the disappearance of psychiatric symptomatology.
To avoid such undesirable psychic side effects, a gradual discontinuance of the drug is recommended.
VP 16-213 in acute myelogenous leukaemia
Authors: Smith I E , Clink H MacD , Gerken M E , McElwain T J 
Published: December 2008

SummaryThe use of the epipodophyllotoxin VP 16-213 is described in twenty patients with acute myelogenous leukaemia resistant to other chemotherapy. The drug was usually given in 5-day courses of 50 mg/m2 daily and occasionally in 24-hr infusions of 250 mg/m2, on the basis of its phase-activity.Complete remission was achieved in only two patients: in one of these, remission was maintained with VP 16-213 for 8 months, and in the other for 10 weeks. A partial response was achieved in one other patient. Seventeen patients showed no response. No responses or remissions were achieved when the drug was used in a 24-hr infusion. Side effects were minimal, and the degree of marrow depression much less than for most other agents known to be active in acute myelogenous leukaemia. It was of interest that remission was achieved in one patient without the customary period of marrow hypoplasia. It is suggested that, although VP 16-213 appears to have minimal activity in the dosage used here, improvement might be sought by increasing the dosage, by scheduling the drug in a different way, or by using it in a combination chemotherapy regime.
Inhibition of platelet release reaction by acetylsalicylic acid
Authors: Rowan R M , Renton R L , McDonald G A , Corne S J , Brown D F 
Published: December 2008

SummaryThe inhibitory potency and duration of action of single doses of aspirin B.P., claradin (a low sodium effervescent preparation of acetylsalicylic acid) and aloxiprin (an aluminium co-polymer of acetylsalicylic acid) on platelet release reaction induced by adenosine diphosphate (ADP) were studied in seventeen volunteers. Aspirin B.P. and claradin at 300 mg and 150 mg inhibited release reaction in all subjects within 24 hr; 75 mg was effective only in some subjects. Aloxiprin gave less marked response and a dose of 300 mg was required to inhibit the effect in all volunteers. Where occurring, inhibition of release reaction persisted for three days after treatment with all preparations and restoration to normal occurred in most subjects by the sixth day.A daily dose of 50 mg claradin for 12-15 days in five volunteers produced complete inhibition of release reaction for most of the treatment period. Inhibition of release reaction took up to 3 days to occur. Normal aggregation returned within 3 days of discontinuing treatment in all subjects. A daily dose of 25 mg claradin gave inconsistent results.It is suggested that if a trial of acetylsalicylic acid be undertaken for the prevention of arterial thrombosis based on its ability to inhibit platelet release reaction then a daily dose of 50 mg would be sufficient.
The effect of desmethylimipramine on the absorption of alcohol and paracetamol
Authors: Hall R C , Carter R , Brown Deirdre , Kendall M J 
Published: December 2008

SummaryMany drugs can delay gastric emptying and may thereby impair the absorption of other drugs. Desmethylimipramine (DMI) is an antidepressant with anticholinergic properties which might be expected to delay the rate of gastric emptying. In five out of six subjects, DMI significantly delayed both the absorption of alcohol (assessed by a breathalyser) and of paracetamol, and there was a correlation between the two. The breathalyser can therefore be used to predict the extent to which one may impair the absorption of another drug by its effect on gastrointestinal motility.
Effects of β-adrenergic blockade and stimulation on airways in normal subjects
Authors: Bradley G W , Henderson A K , Mills R J 
Published: December 2008

Summary
The effects of propranolol and salbutamol on conventional pulmonary function tests and closing volume have been studied in ten normal subjects. Propranolol and salbutamol had minor effects on measurements of airways resistance but had no effect on closing volume which is particularly sensitive to changes in peripheral airways. It was concluded that propranolol had negligible overall effect on central and peripheral airways properties in normal subjects, and it would appear that β-adrenergic activity has little measurable influence on peripheral airways in normal man at rest.
5-Hydroxytryptamine (5-HT) in the whole-blood of patients with depressive illness
Authors: Coppen A , Rowsell A R , Turner P , Padgham Cheryl 
Published: December 2008

Summary
Whole-blood 5-HT was examined in thirty-five depressive patients not on antidepressants, and in comparable control subjects. The concentration of whole-blood 5-HT was significantly lower during depression, but returned to normal after clinical recovery.
GM1-generalized gangliosidosis variant with cardiomegaly
Authors: Benson P F , Brown S P , Babarik A , Mann T P 
Published: December 2008

SummaryA female infant with generalized GM1-gangliosidosis differing in several aspects from previously reported cases is described. Clinically she is the first case to have cardiomegaly, unilateral congenitial dislocation of the hip and normal facial appearance. She had a higher residual leucocyte β-galactosidase activity towards two synthetic substrates, namely p-nitrophenyl-β-D-galactoside (PNP-β-gal) and 4-methylumbelliferyl-β-D-galactoside (MU-β-gal) than in previously reported cases. Total β-hexosaminidase activity was raised in cultured fibroblasts, leucocytes, brain, kidneys and liver of the patient, and in fibroblasts from the parents. The parents' leucocytes had normal β-galactosidase activity towards PNP-β-gal but slightly reduced activity towards MU-β-gal. The parents' cultured fibroblast enzyme, however, had moderately low activities towards both substrates.It is suggested that she may represent a genetic variant of generalized GM1-gangliosidosis and that assay of leucocyte β-galactosidase activity should be added to the list of investigations for infantile cardiomegaly of unknown origin.
The role of humoral immunity in host defence against influenza A infection in mice
Authors: Virelizier J L , Oxford J S , Schild G C 
Published: December 2008

SummaryThe respective roles of cell-mediated immunity and humoral immunity in host defence were investigated in mice infected with influenza A/PR8 virus. Transferred immune spleen cells were shown to provide full protection only when they were actually secreting antibody. Serum antibody transferred in ‘physiological’ amounts was found to be protective in immunologically intact or in immunosuppressed animals. The specificity of the transferred antibody was shown to be critical, since antibody to internal components of the virus was inefficient while antibody to haemagglutinin, especially that to the strain-specific determinants of the haemagglutinin molecule, was highly efficient.
Assessment of vaccine efficacy by challenge studies in man
Authors: Tyrrell D A J 
Published: December 2008

Summary
The only final test of the potency of a vaccine is its ability to protect against exposure in an epidemic. Laboratory tests for control purposes attempt to predict this capacity. It is suggested that challenging small groups of volunteers with attenuated influenza virus is a good index of immunity which could be used to check and refine present tests and to evaluate new ones.
Planning for influenza epidemics
Authors: Beare A S 
Published: December 2008

Summary
In the present circumstances, influenza vaccination cannot produce a significant reduction in the incidence of the disease without preliminary preparation and planning. The epidemiological situation is constantly changing, and vaccines should be chosen for their suitability for prevailing conditions. When viral antigens undergo appreciable change, and immunity in the population is low, people are especially susceptible to infection with live vaccines made from the new variants. Because of their potential high yield, it is therefore possible at this time to consider the use of these vaccines on a large scale. In interpandemic years, killed vaccines should be used selectively for the protection of individuals, but may also be considered for more general use in closed communities. Vaccines should as far as possible contain the same antigens as the epidemic virus. Reassessment of the influenza situation should be made annually, taking into account the types of viruses in circulation, the immune state of the population and any other factors likely to affect influenza outbreaks. Regular attempts to do this would ultimately improve the standard of forecasting.
Random immunization, as is practised for other virus diseases, is unprofitable in influenza.
Glucose intolerance, diabetes mellitus and atherosclerosis; prospects for prevention
Authors: Keen Harry 
Published: December 2008

Summary
Increased prevalence and incidence of arterial disease has become the major cause of disability and death in diabetics in Western cultures—but is much less common among Japanese and African diabetics. In the West, the presence of lesser, ‘subdiabetic’ degrees of glucose intolerance are probably independent ‘risk factors’ for accelerated atherosclerosis. Although many explanations for the link have been advanced—among them direct effects of glucose and insulin on the arterial wall, less direct effects of circulating lipoproteins, abnormalities of blood clotting and fibrinolysis and elevated blood pressure, even the influence of antidiabetic treatment itself—none has been clearly established. Nevertheless there is scope and hope that appropriate measures may reduce the raised arterial disease risk in the diabetic.
Exertional hypotension due to postganglionic sympathetic blocking drugs
Authors: Talbot S , Gill G W 
Published: December 2008

SummaryDebrisoquine, guanethidine and bethanidine may produce troublesome hypotensive symtoms related to exertion. Thirteen patients with such symptoms were exercised on a treadmill and the response of blood pressure and heart rate was compared to that of thirty patients without these symptoms, who were exercised to the same extent. There was a slight drop of systolic and diastolic pressures on standing in both groups, but after exertion there was a significantly greater drop of systolic pressure in the group with symptoms than in the asymptomatic group. The diastolic pressure after exertion was significantly lower in the group with symptoms. It was impossible to predict from the standing blood pressure levels at rest which patients would develop hypotensive symptoms after exertion. All three drugs had a similar negative chronotropic effect at rest and on exercise. It is suggested that patients are exercised during control of hypertension in order to identify those prone to exertional hypotension. Patients with such hypotension should be exercised on each attendance before the blood pressure is measured. Treatment other than postganglionic sympathetic blocking drugs should be employed whenever possible in patients with milder hypertension.
Betahistine hydrochloride in Méniére's disease
Authors: Frew I J C , Menon G N 
Published: December 2008

Summary
A double-blind, placebo-controlled, cross-over clinical trial was performed to assess the effect of betahistine hydrochloride (Serc) in Ménière's disease. The diagnosis was based on paroxysmal attacks of rotational vertigo, with tinnitus, and a fluctuating sensori-neural deafness, together with the results of auditory and vestigular tests. Twenty-eight patients were admitted to the trial over 3 years. Twenty-two patients completed the trial. In total, they received betahistine 32 mg daily, for a period of 16 weeks, and placebo also for the same length of time, preceded in every case by a 4-week pre-treatment period. Daily symptom score cards were kept. There was a statistically significant improvement in favour of the drug with regard to vertigo, tinnitus and deafness. Vertigo was the most responsive symptom. No adverse reactions were observed.