bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serial Thallium‐201 Myocardial Perfusion Scanning in Acute Myocardial Infarction*
Authors: Dunnt R. F. , Kelly D. T. , Freedman S. B. , Uren R. F. 
Published: March 2008

Summary Serial myocardial perfusion scanning was performed in 30 patients with acute myocardial infarction. Scanning was commenced less than six hours after onset of symptoms in 12 patients, 6–24 hr in eight and 24–120 hr in ten. All 30 patients showed thallium defects corresponding to the ECG site of infarction.When initial and four‐hour scans were compared, constant defects were present in ten patients and changing defects in 20. Of the 169 segments with defects on the initial scan, 117 (69%) remained constant, 41 (24%) improved, and 11 (7%) deteriorated. More defects changed in the patients scanned earlier (< 6hr) than in the patients scanned later (> 6hr) (42% vs 23% P < 0·025), and more defects changed in patients with subendocardial compared to transmural infarction (49% vs 26% P < 0·025).During a mean follow‐up period of 18 months, seven patients died, two developed left ventricular failure, seven had angina and 14 remained asymptomatic. The non‐survivors had significantly larger thallium defects than the survivors (55 ± 15% vs 37 ± 14%, P < 0·005). Serial change on thallium scanning was not related to the clinical course.Perfusion defects on serial thallium scanning are useful in detecting and localising early myocardial infarction and the size of defects is related to the subsequent clinical course. Changing perfusion defects on serial scanning suggesting peri‐infarctional ischaemia are common, and make assessment of therapeutic interventions to limit infarct size difficult, but are not related to the clinical course.
Exercise Testing and Thallium‐201 Myocardial Imaging in Relation to Coronary Artery Disease in Patients with Severe Aortic Valve Disease*
Authors: Taylor R. R. , Mews G. C. , Van der Schaal A. , Dickie G. , Surveyor I. 
Published: March 2008

Summary Thirty‐three patients with aortic valve disease, fifteen with regurgitation, eleven with stenosis and seven with mixed disease, undergoing assessment for valve replacement which included adequate coronary angiography, were studied. A symptom limited graded treadmill exercise test was undertaken with administration of 40–70 MBq of 201TI. Myocardial imaging was started within 15 minutes and repeated after four hours using a 37 PM tube Searle gamma camera.Myocardial images were read independently by three observers. Of the 33 sets of images, 21 were‐ve, 5 + ve, 2 I (Indeterminate) and 5 D (Difference of opinion). Eight of the 33 patients had significant coronary artery disease (CAD) and of these three were scored + ve (all triple vessel). Two patients without CAD were scored + ve. Eight subjects developed angina during exercise testing, of whom four had CAD, and four with CAD did not develop angina. Historically, 13 of the 33 subjects had typical angina, six having CAD; an additional eight had other significant chest pain, two having CAD.In these subjects with severe aortic valve disease, exercise testing and myocardial imaging with 201TI was of little value in detecting CAD. All patients with CAD gave a history of significant chest pain.
Treatment of Atrial Arrythmias After Cardiac Surgery With Intravenous Disopyramide
Authors: Campbell T. J. , Morgan J. J. 
Published: March 2008

Summary The aim of this study was to investigate the efficacy of intravenous disopyramide in patients with persistent atrial tachyarrhythmias after open‐heart surgery.Thirty patients whose arrhythmia persisted more than four hours after an initial bolus of intravenous digoxin 0–75 mg were randomly assigned to two groups (15 in each group). One group was given a further 12 hr of intravenous digoxin therapy, and the second was given 12 hr of intravenous disopyramide as a loading dose (2 mg/kg) followed by a constant infusion.Patients who had not reverted 12 hr after randomisation were “crossed‐over” to the alternate therapy for 12 hr. Of the 25 patients eventually given disopyramide for a 12‐hr period, 17 returned to sinus rhythm during that period (68%) and 13 of these reversions occurred within the first hour. These results were significantly better (P < 0–01) than for the 21 patients given 12 hr of digoxin therapy of whom only five reverted (none within one hour).It is concluded that intravenous disopyramide administered after a loading dose of digoxin is an effective therapy for postoperative atrial arrhythmias.
The Association of Diabetes Insipidus with Hypoparathyroidism, Addison's Disease and Mucocutaneous Candidiasis
Authors: Clifton‐Bligh P. , Lee C. , Smith H. , Posen S. 
Published: March 2008

Summary: A case of central diabetes insipidus is reported in association with idiopathic hypoparathyroidism, adrenal failure and mucocutaneous candidiasis.The diabetes insipidus was recognised at the same time as the discovery of aldosterone and cortisol deficiency, and occurred several years after the initial onset of mucocutaneous candidiasis and hypocalcaemia. Control of the diabetes insipidus was achieved initially with nasal aqueous lysine vasopressin and later with desmopressin.The development of diabetes insipidus may be a further aspect of endocrine secretory failure associated with idiopathic hypoparathyroidism.
Cost and Effectiveness of Clinical Investigation: The State of the Art
Authors: Clarke R. M. , Mason B. , Leeder S. R. 
Published: March 2008

Summary: Clinical investigation by means of special technical tests has increased in clinical practice during recent years. Pressures causing this increase are said to include: rapid technological change making many more tests available, clinical uncertainty, peer pressure, greater patient awareness, and concern for diagnostic completeness. Cost factors do not appear to have influenced test‐ordering behaviour to any large extent, and those ordering investigations are frequently ignorant of the cost of the tests which they are ordering, both to the patient and the community.The relation of clinical investigational activity to quality of outcome of patient care remains largely unestablished. Studies of the possible modification of test‐ordering behaviour through educational and institutional policy pressures are reviewed. A rational approach to investigating the effectiveness of techniques designed to encourage the more economic and effective use of investigations is presented in brief on the basis of this review of previously published work.
Immunoreactivity in vitro to Human Testis in Patients with Lepromatous Leprosy*
Authors: Wall J. R. , Walters B. A. J. 
Published: March 2008

Abstract: Patients with lepromatous leprosy and tuber‐culoid leprosy, together with normal aged matched controls, were tested for in vitro immunoreactivity against a panel of soluble extracts prepared from normal human tissues. The panel consisted of a soluble homogenate of human testis as well as two partially purified fractions of this extract, and control extracts from other human tissues. Immunoreactivity was assessed by extract induced peripheral blood lymphocyte (PBL) transformation, leucocyte migration inhibition (LMI) and leucocyte adherence inhibition (LAI).Although no difference in PBL transformation, LMI, or LA1 was obtained between the groups with the control tissue extracts, significant reactivity was obtained for the patients with lepromatous leprosy in at least one of the in vitro tests, when one of the testis extracts was used (Mann‐Whitney test). No such reactivity to the testis extracts was obtained in the patients with tuberculoid leprosy or the normal control subjects. Of the twenty‐two patients studied with lepromatous leprosy, thirteen had clinical evidence of testicular disease and nine of these patients had raised PBL transformation and LAI reactivity to the testis extracts.This finding of immunoreactivity against testicular extracts in a significant number of patients with lepromatous leprosy by at least one of the in vitro tests used, suggests that the associated in vivo testicular atrophy that occurs in these patients may have an autoimmune basis.
Glyoxalase Phenotypes in Patients with Diabetes Mellitus
Authors: McCann V. J. , Davis R. E. , Welborn T. A. , Constable I. J. , Beale D. G. 
Published: March 2008

Abstract: Caucasian diabetic patients in Australian surveys showed a significant difference in the distribution of glyoxalase phenotypes. Insulin dependent diabetic patients with age of onset less than 40 years had a relative excess of glyoxalase homozygote 1–1 and a deficiency of types 2–7 and 2–2. Non‐insulin dependent diabetic patients were not significantly different from non‐diabetic subjects in the distribution of glyoxalase phenotypes.Insulin dependent diabetic patients without the complications of retinopathy or neuropathy also showed a significant excess of glyoxalase type 1–1 in relation to the control group. Genes controlling glyoxalase polymorphism appear to be associated with the variations of diabetes and its complications.
Effect of High Dose Busulphan on Leukaemic Progenitor Cells in Chronic Myeloid Leukaemia
Authors: Morstyn G. , Sullivan J. , Fairhead S. , Cowling D. , Hurley T. 
Published: March 2008

Abstract: Six patients with Philadelphia positive chronic myeloid leukaemia (CML) were treated with single high doses of busulphan. The action of busulphan on the in vivo kinetics of circulating progenitor cells (colony forming cells) was measured using an agar culture system which involved scoring of total colonies and clusters at 7 days and of granulocyte, monocyte and eosinophil colonies at 14 days.High dose busulphan was found to be effective in suppressing circulating granulocyte, monocyte and eosinophil progenitor cells. The effect of busulphan on progenitor cells was rapid and their levels fell by at least 83% within five days. By contrast, the white blood cells fell by only 9% and the platelets fell by 10% over this time. Subsequently, the white cell count and platelet count fell to near normal levels. The progenitor cell levels began to rise again at a mean of 35 days following busulphan treatment and the white blood cells at a mean of 39 days in four patients. One patient remained in haematological remission for six months following 100 mg of busulphan with less than 1 progenitor per 5 × 105 peripheral blood nucleated cells. One patient in myeloblastic transformation had a previously not described culture pattern consisting of a high cluster to colony ratio at 7 days and of an increased number of predominantly eosinophilic colonies at 14 days. There was no significant fall in progenitor cell levels following busulphan and this patient died.
Cardiac Beat to Beat Variation: Age Related Changes in the Normal Population and Abnormalities in Diabetics*
Authors: Chipps D. R. , Kraegen E. W. , Zelenka G. S. , McNamara M. E. , Chisholm D. J. 
Published: March 2008

Abstract: Determination of heart rate variation (RR interval variation) is a non‐invasive technique which may be used for assessment of diabetic autonomic dysfunction. Interpretation has been complicated by age changes in the normal population and by uncertainty as to the optimum conditions for the performance of the test. This study was designed to establish a normal age‐related range for RR interval variation performed under the simplest conditions (resting, seated) applicable to an outpatient diabetic clinic and to compare these measurements with augmented RR variation due to deep breathing (ARRIV) and with the Valsalva ratio (VR).Using an ECG recorder and a computer analysis program, resting RR interval variation (RRIV) was assessed in 100 non‐diabetics (N) aged 12–80 years and 60 randomly selected diabetics (D) aged 14–74 years. RRIV, the standard deviation of RR intervals, declined progressively after age 40 in normal subjects. The diabetics had significantly (p < 0.001) reduced RRlV compared with normals; 65% having RRIV values more than 1 SD and 25% more than 2 SD below the age related mean for normals.RRlV was compared with ARRIV in 54 subjects (N40, 014) and with VR in 84 subjects (N54, D27). There was a significant correlation of RRlV with both indices but RRlV resulted in greater discrimination between N and D than ARRIV or VR. There was no significant correlation between RRlV and duration of diabetes but mean RRlV was significantly reduced in diabetics with peripheral neuropathy compared to those without. In seven diabetics studied both before and after substantial improvement in metabolic control RRlV improved by a mean of 51% (p < 0.005).Measurement of RRlV is a simple non‐invasive technique for assessment of diabetic autonomic dysfunction. Interpretation, however, depends on knowledge of an age‐related reference range.
Infective Endocarditis: A Lethal Disease
Authors: Ormiston J. A. , Neutze J. M. , Agnew T. M. , Lowe J. B. , Kerr A. R. 
Published: March 2008

Abstract: One‐hundred‐and‐eighty‐nine episodes of Infective Endocarditis were seen in 177 patients in the Green Lane Cardiology Unit over an 18‐year period. Hospital survival was 79% and 13‐year actuarial survival was 47%. A number of factors including the underlying cardiac lesion, infecting organism, clinical features and surgical intervention were related to outcome. No patient with extreme heart failure survived without operation. Hospital survival in patients with severe heart failure was 69% (9/13 patients) where surgery was carried out before completion of antibiotic treatment, and 40% (6/15 patients) where the antibiotic course was completed. Survival was 53% in patients who still had a fever after one week of antibiotic treatment and 96% if the temperature was normal. In 61% of patients with a fever at one week, extended infected pannus was present compared with 6–10% where the temperature was normal. In patients undergoing operation before completion of antibiotics, the surgical mortality was higher but neither the incidence of recurrence of endocarditis nor the need for re‐operation was increased. We believe that better results will be achieved with a policy of surgical intervention when signs of infection and heart failure have not settled within one week of treatment.
The Management of Patients with Suspected Wolff‐Parkinson‐White Syndrome—A Four Year Review
Authors: Hamer A. W. F. , Vohra J. K. , Sloman J. G. , Hunt D. 
Published: March 2008

Abstract: Thirty‐six patients with the electrocardiographic pattern of Wolff‐Parkinson‐White (WPW) Syndrome had electrophysiological (EP) studies over a four year period. Thirty‐two patients were symptomatic and supraventricular tachycardia (SVT) or atrial fibrillation (A Fib) had been demonstrated in 19 of these patients. Four patients were asymptomatic. The diagnosis of WPW was confirmed in 33 of the 36 patients at EP studies and in 24 of 33 the location of the accessory atrioventricular connection (AAVC) from the surface ECG was confirmed at EP studies. The effective refractory period of the AAVC in 30 patients ranged from 200–550 ms (m 284 ± 58 ms). A Fib could be induced in 20 of the 32 patients and SVT in 21 of the 33 patients. In 14 of 21 patients the SVT had narrow QRS complexes; in three patients the QRS was wide and in four patients both types were noted. In three patients the diagnosis of WPW was disproved at EP studies. On the basis of EP studies, drug therapy was recommended in 21 patients. In 12 of the 21 patients previous drug therapy was changed. Nine of these 12 patients showed symptomatic improvement. Of the remaining patients one required surgery because of failed medical treatment; the two other patients died and their deaths could be attributed to failure of medical therapy. In seven patients no change was made in drug therapy and in two, intermittent drug therapy was recommended. In six patients no drug therapy was prescribed. Two patients were treated with magnetactivated implantable pacemakers capable of delivering coupled, fixed‐interval right ventricular extrastimuli. Neither of these was successful and thus surgery was recommended. Six patients have undergone surgical section of their AAVC with complete control of tachycardia; two patients are awaiting surgery. EP studies were helpful in the management of the majority of symptomatic patients with suspected WPW Syndrome. Surgery offers an attractive alternative to long term, and occasionally unsuccessful, drug therapy and should be considered in suitable patients.
Myelography with Metrizamide—An Analysis of the Complications Encountered in Cervical, Thoracic and Lumbar Myelography
Authors: McCormick C. C. , ApSimon H. T. , Chakera T. M. H. 
Published: March 2008

Abstract: Detailed analysis of complications in 363 patients undergoing myelography with metrizamide is presented. Patients have been separated into three groups: those who had lumbar myelograms via lumbar puncture; patients who had cervical myelograms via lumbar route and patients who had cervical myelograms via cervical puncture (lateral C1/C2. approach). Analysis has revealed that the incidence of minor complications like headaches, nausea, and vomiting is higher than that associated with myodil myelography. Nevertheless, it is concluded that because of lack of long term disability of arachnoiditis, and because of greater diagnostic accuracy, metrizamide represents the best contrast medium for myelography currently available.
Vocal Cord Paralysis (VCP)—An Aetiologic Review of 100 Cases Over 20 Years
Authors: Kearsley J. H. 
Published: March 2008

Abstract: A retrospective analysis of the aetiology of 100 cases of vocal cord paralysis (VCP) seen over two consecutive decades at a large general hospital has been performed. One half of the cases seen were due to malignancy, mainly carcinoma of lung; 16% of cases were due to trauma or surgical procedures, while cardiac and neurological‐related diseases were associated with 7% and 6% of cases respectively and miscellaneous causes accounted for 6%. Fifteen per cent of all cases remained undiagnosed. When the first and second decades were compared for evolving trends, there was a decrease in the incidence of VCP as a complication of lung cancer, but no significant change following thyroid surgery. The nature of idiopathic VCP is discussed in some detail.
Amrinone—A New lnotropic Agent in Chronic Resistant Congestive Cardiac Failure
Authors: Robinson P. J. , Lvoff R. , Chong B. , Barrett P. A. 
Published: March 2008

Abstract: A patient with severe cardiac failure due to idiopathic congestive cardiomyopathy resistant to conventional therapy, responded to amrinone, a new non‐glycosidic non‐catecholamine positive inotropic agent. Amrinone produced significant haemodynamic improvement during both intravenous and oral administration. Thrombocytopaenia, however, was induced, necessitating cessation of the drug. Amrinone is a promising, orally effective inotropic agent for patients with refractory congestive cardiac failure, but is limited by its tendency to cause thrombocytopaenia.
Fulminant Meningococcemia
Authors: Kearsley J. H. , Delohery J. , Croll F. J. 
Published: March 2008

Abstract: A case of fulminant meningococcal septicemia is reported in whict an acute gastroenteritis was the presenting symptom. Disseminated intravascular coagulation, profound hypotension and a haemorrhagic skin rash were the dominant clinical features. Successful treatment was directed towards the replacement of coagulation factors, treatment of the underlying infection and reversal of hypotension with the inotropic agent, dopamine. Corticosteroids were used in pharmacological doses, but heparin was not used.The pathogenesis of several abnormalities in this disease is briefly reviewed.
Comparison of Five Guaiac Resin Paper Tests for Demonstrating the Presence of Blood in Faeces
Authors: Frommer D. , Logue T. 
Published: March 2008

Abstract: Four recently available kits of guaiac resin‐impregnated paper for demonstrating the presence of blood in faeces were compared with Hemoccult II® in in vitro testing. Hemo‐FEC® most closely resembled Hemoccult II® in its sensitivity with freshly prepared kits and kits prepared one week earlier with or without rehydration before testing. Gamma Fe‐Cult and Fecatest® were more sensitive than Hemoccult II® whereas Camco‐Pac® Guaiac was much less sensitive. Rehydration of kits prepared several days beforehand appears to be useful in restoring sensitivity lost by all the kits tested.
Relationship of Psychological Factors to Failure of Antihypertensive Drug Treatment
Authors: Zacest R. , Barrow C. G. , O'Halloranz M. W. , Wilson L. L. 
Published: March 2008

Abstract: Personality traits and pretreatment symptoms of 69 hypertensive patients were documented witn self‐administered questionnaires. Thirteen patients (19%) dropped out during 12 months of treatment. Five of these were lost from follow up and eight failed to tolerate their allotted medication. In this series treatment failure did not seem dependent on the type of drug used, but was linked with a high suspiciousness level and a high pretreatment symptom score. Both measures varied independently of one another and a select group of 10 patients who scored highly on both, had a failure rate of 60%. Our results suggest that hypertensives with an increased predisposition to drug treatment failure can be identified at the pretreatment stage. Recognition of such individuals should assist in their routine clinical management and in the design of antihypertensive drug trials.
AUTOANTIBODIES TO SMALL NUCLEAR RIBONUCLEOPROTEINS. A STRONG ASSOCIATION BETWEEN ANTI‐SS‐B (La), HLA‐B8, and SJÖGREN'S SYNDROME
Authors: WHITTINGHAM S. , MACKAY I. R. , TAIT B. D. 
Published: March 2008

Abstract:The heterogeneity within multisystem autoimmune disease was evaluated according to the presence of antinuclear antibodies to ribonucleoproteins and the HLA‐A1, B8, DR3 phenotype. Patients with various multisystem autoimmune diseases were tested by a highly sensitive radioimmunoassay for autoantibodies to the small nuclear ribonucleoproteins known as SS‐B (La) and ribonucleoprotein (RNP), and HLA phenotypes were determined. The 210 patients included 64 with systemic lupus erythematosus (SLE), 11 with “atypical SLE”, 41 with Sjögren's syndrome, 22 with mixed connective tissue disease (MCTD), 21 with rheumatoid arthritis (RA), 16 with primary biliary cirrhosis (PBC) and 35 with autoimmune chronic active hepatitis (A‐CAH).Anti‐SS‐B (La) was present in high frequency in Sjögren's syndrome and was strongly associated with HLA‐A1, B8, DR3. Anti‐RNP was detected predominantly in MCTD and had no association with HLA‐A1, B8, DR3. There were sharply defined serological and genetic differences between primary Sjögren's syndrome and Sjögren's syndrome associated with RA. Anti‐SS‐B (La) was present in 70% of patients with primary Sjögren's syndrome but in none with Sjögren's syndrome with RA, and the respective frequencies of HLA‐A1, B8, and DR3 were 88%, 94% and 75% in the former compared with 38%, 29% and 14% in the latter. Thus primary Sjögren's syndrome differs immunogenetically from Sjögren's syndrome with RA. There was a notable absence of anti‐SS‐B (La) in PBC, an autoimmune disease associated with the Sjögren's syndrome. These findings illustrate the value of studying immunological and genetic markers in detecting heterogeneity within groups of diseases whose symptoms cannot be distinguished clinically. (Aust NZ J Med 1983; 13: 565–570.)