bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous mid-oesophageal rupture
Authors: Holt S , Millar J W , Heading R C , Charles R G 
Published: December 2008

Summary
The clinical presentation and management of spontaneous rupture of the middle third of the oesophagus is described in two patients. Early presentation and treatment in one case led to uncomplicated recovery. In the other patient late presentation and diagnosis resulted in delayed surgical intervention with an unsuccessful outcome. The nature of this rare lesion is discussed and nine previously described cases are reviewed.
Subacute sclerosing panencephalitis
Authors: Bellman M H , Dick G 
Published: December 2008

SummarySubacute sclerosing panencephalitis (SSPE) is now considered to be caused by measles virus. There are four diagnostic criteria, namely the clinical picture, a characteristic EEG, serology of serum and CSF and brain histology. A register of cases in the U.K. has been kept since 1971, and up to September 1977, ninety-six patients have been reported. The male/female ratio is 2:1. The disease most commonly affects children between the ages of nine and eleven years who usually have had measles at a very early age. The average delay between the measles infection and onset of SSPE was 6.8 years and of the thirty-four patients known to have died the average survival times was 1.2 years. There are still many questions about the pathogenesis and epidemiology of SSPE that have yet to be answered.
Creutzfeldt—Jakob disease
Authors: Matthews W B 
Published: December 2008

Summary
The laboratory transmission to animals of an apparently degenerative disease of the nervous system, Creutzfeldt-Jakob disease (CJD), is now well established. Important questions arising from this observation are the possibility of natural transmission or infectivity and the existence of other similarly transmissible diseases. Epidemiological studies have revealed some possible clusters of CJD and also an association with previous craniotomy, but there is no definite evidence of natural infection. A few instances have been reported of experimental CJD in animals following inoculation with material from Alzheimer's disease, but apart from this there is so far no evidence of transmission of any other form of degenerative nervous disease.
A case of multiple endocrine adenomatosis with primary amenorrhoea
Authors: Vandeweghe M , Braxel K , Schutyser J , Vermeulen A 
Published: December 2008

Summary
A well documented sporadic case of multiple endocrine adenomatosis (MEA) type I, with the pituitary tumour presenting as a prolactinoma, is described in a 28-year-old female. Primary amenorrhoea, resulting from hyperprolactinaemia, was the first symptom of the polyglandular neoplasia. A gastrinoma was removed from the head of the pancreas and latent hyperparathyroidism appeared to be present. Treatment with bromocriptine was poorly tolerated; neurosurgical intervention was refused by the patient. The possibility that a serum prolactin determination may be useful in detecting pituitary involvement in MEA deserves consideration.
Hypocalcaemic cardiac failure
Authors: Brenton D P , Gonzales J , Pollard A B 
Published: December 2008

SummaryA 35-year-old patient who presented with recurrent chest infection, pulmonary oedema and cardiac failure was found to be grossly hypocalcaemic owing to previously undiagnosed hypoparathyroidism. The cardiac failure was not easily relieved by digoxin and diuretics but it quickly responded when the plasma calcium was restored to normal with dihydrotachysterol. With dihydrotachysterol as sole treatment for more than 2·5 years he had normal exercise tolerance and no features of cardiac failure.
Positive myocardial scintigraphy at the bedside—evaluation using a portable gamma camera
Authors: Dymond D S , Jarritt P H , Britton K E , Langley D , Spurrell R A J 
Published: December 2008

Summary
A study was undertaken to evaluate the role of positive infarct scintigraphy in the diagnosis of acute myocardial infarction (AMI), using Technetium99m stannous pyrophosphate (Tc-PYP) and a portable gamma camera. Sixty-one patients admitted to the Coronary Care Unit (CCU) with a presumptive diagnosis of AMI or ischaemic cardiac pain were studied. Positive scans were present in 24/25 (96%) patients with AMI and new Q waves, and in 10/12 (83%) patients with AMI and no Q waves. Nine of eleven (82%) patients with chest pain and no infarction had negative scans. Of thirteen patients with unstable angina, ten (77%) had positive scans. A further eight patients undergoing coronary artery bypass surgery for angina pectoris were studied pre- and postoperatively. Two patients had strongly positive postoperative scans. The Tc-PYP scan is valuable in the detection of peri-operative infarction following coronary artery surgery, and in patients with unstable angina the technique may detect small amounts of myocardial necrosis undetectable by more conventional means. When the diagnosis of infarction is obvious from the ECG, enzymes, or a combination of the two, the Tc-PYP scan provides no extra information helpful in patient management.
Response to thyrotrophin-releasing hormone in atrial dysrhythmias
Authors: Symons C , Myers A , Kingstone D , Boss M 
Published: December 2008

SummarySeventy-eight clinically euthyroid patients with atrial dysrhythmias, either established or paroxysmal, and sixty-three patients in sinus rhythm with coronary disease were screened for hyperthyroidism using thyroid function tests including the thyroid-stimulating hormone (TSH) response to thyrotrophin-releasing hormone (TRH). All had normal levels of serum thyroxine (T4) apart from three with dysrhythmias who were found to have hyperthyroidism. Twenty per cent of patients with atrial dysrhythmias and 10% of those in sinus rhythm had exaggerated TSH response to TRH. Thirty-six per cent of patients with an exaggerated response of TSH to TRH had significant titres of thyroid auto-antibodies compared with 15% with positive antibodies in those with normal TSH response to TRH. Auto-immune thyroid disease may be more closely related to heart disease than has previously been recognized. Rapid atrial dysrhythmias may occur in the presence of a normal serum thyroxine, high levels of TSH and positive thyroid antibodies.
Immunoblastic lymphadenopathy—report of a case
Authors: Joshi K , Shrinivasa R , Shankar S K 
Published: December 2008

Summary
A case of immunoblastic lymphadenopathy has been presented which had the characteristic clinical and histological features. The patient did not respond to chemotherapy and succumbed to the disease. Instead of the usual polyclonal gammopathy associated with this condition, he showed a fall in IgM levels, IgG and IgA being within normal limits. The significance of the latter finding is not known.
Tuberculous abscess of the brain
Authors: Mohanty S , Rao C J 
Published: December 2008

Summary
A bacteriologically confirmed case of tuberculous abscess of the brain is reported. Tuberculous brain abscess unlike tuberculoma does not exhibit the typical granulomatous changes and the diagnosis is confirmed by demonstration of tubercle bacilli either by staining or culture. An antituberculous regime should be started immediately the diagnosis has been established.
Bilateral neuralgic amyotrophy complicating Weil's disease
Authors: Cumming W J K , Thrush D C , Kenward D H 
Published: December 2008

Summary
The case of a patient with leptospirosis (treated with trimethoprim) with late neurological complications manifesting as a bilateral plexus syndrome is described. The probable reasons for the continued weakness, in this patient, of the muscles supplied by the anterior interosseus nerve, despite improvement in the proximal muscles, are briefly discussed.
The Budd-Chiari syndrome in pregnancy
Authors: Tiliacos M , Tsantoulas D , Tsoulias A , Kokka E , Eudaimon E , Aphentoglou S , Metzantonakis C 
Published: December 2008

Summary
A case of Budd-Chiari syndrome in a young woman, which started probably in the last trimester of pregnancy, is described. The diagnosis was made clinically and was confirmed by inferior venacavography and on exploratory laparotomy. The possible connection of the syndrome with the pregnancy is discussed.
Barium granuloma of the transverse colon
Authors: McKee P H , Cameron C H S 
Published: December 2008

Summary
A case of barium sulphate granuloma of the transverse colon following gunshot wounds to the abdomen has been described. Scanning electron microscopy with electron probe microanalysis was used to confirm the presence of barium sulphate and the absence of lead or other elements related to the gunshot wounds.
Disease due to echovirus type 19 in Birmingham, England, 1975: relationship to ‘epidemic neuromyasthenia’
Authors: Ball A P 
Published: December 2008

Summary
In the summer of 1975 an extensive epidemic of disease due to echovirus type 19 occurred in the West Midlands. The features of this outbreak, and their relationship to the syndrome referred to as ‘epidemic neuromyasthenia’, are discussed. The two diseases are considered to be separate entities.
Cursive and gelastic epilepsy: probable sequelae of physical abuse
Authors: Woon T H , Vignaendra V 
Published: December 2008

Summary
An abandoned 8-year-old male child, who was subjected to physical abuse, presented with abnormal behaviour and focal seizures. The focal seizures included involuntary running attacks (epilepsia cursiva) and uncontrollable laughter (gelastic epilepsy). The occurrence of cursive and gelastic seizures in the same patient is extremely rare. These fits were probably a late sequel of head trauma.
Pyoderma gangrenosum associated with acute myeloproliferative disease (? erythroleukaemia)
Authors: Toolis Francis , Parker Alistair C , Barnetson Ross 
Published: December 2008

Summary
Pyoderma gangrenosum at the site of sternal marrow aspirate was observed in a patient with acute myeloproliferative disease characterized by a high peripheral blood basophilia. Lesions with a similar appearance were also seen on the palate. No other disease known to be associated with pyoderma gangrenosum could be demonstrated. A review of the literature suggests that myeloproliferative disease should now be recognized as occurring in association with pyoderma gangrenosum.
Erythro-myeloid aplasia following D-penicillamine treatment in primary biliary cirrhosis
Authors: Jones S , Corringham R E T , Jain Stephan 
Published: December 2008

Summary
A woman with primary biliary cirrhosis and a high liver copper concentration was treated with D-penicillamine as a participant in a controlled trial of the drug. After 14 weeks she developed a Pseudomonas septicaemia and was found to have erythro-myeloid aplasia. Similar, but not identical blood dyscrasias have previously been reported as complications of D-penicillamine therapy. She survived after treatment with antibiotics and granulocyte transfusions, and bone marrow function returned to normal.
Fatal retroperitoneal haemorrhage complicating anticoagulant therapy
Authors: Lowe G D O , McKillop J H , Prentice A G 
Published: December 2008

Summary
Eight cases are reported of extensive retroperitoneal haemorrhage in patients receiving anticoagulant therapy who subsequently died and underwent postmortem examination. No patient had an obvious source of bleeding, and in 5 cases no other cause for death was apparent. Three patients had had vascular surgical procedures: the other 5 were given anticoagulants for suspected venous thrombo-embolism. Six cases presented as unexpected circulatory collapse with rapid demise. Four patients had in addition gastro-intestinal bleeding of varying degree, with no obvious source. This acute massive type of retroperitoneal bleeding contrasts with the commoner presentations of pain, swelling, bruising and compression neuropathy: a high index of suspicion and urgent treatment are required if mortality is to be reduced.
Leiomyoma of the duodenum presenting as a pyogenic liver abscess
Authors: Selvam A , Donaldson L J , Sokhi G S 
Published: December 2008

Summary
Leiomyoma of the duodenum is a rare condition which is most often diagnosed only as an incidental finding at post-mortem. It may present clinically with pain or haemorrhage. A case is described of degeneration of a leiomyoma of the fourth part of the duodenum giving rise to pyogenic liver abscess. There is no previous report of this association in the literature.
Approaches towards rational antiviral chemotherapy
Authors: Oxford J S 
Published: December 2008

Summary
Present epidemic influenza is uncontrolled by immuno- or chemoprophylaxis. Mutants of varying antigenic composition arise with relatively high frequency in nature and are able to circumvent herd, or induced, immunity. Also, drug-resistant viruses can be selected in vitro and this resistance can be exchanged to other viruses by gene reassortment. Combined immuno- and chemoprophylaxis may provide a more effective approach to the ultimate control of the disease. Most antiviral compounds have been selected by random screening in the laboratory. Application of more specific enzyme assays such as the virion-associated RNA transcriptase assays may produce other compounds with a defined mode of action - semi-rational chemotherapy. RNA and polypeptide sequence studies are in progress elsewhere to define transcription and translation initiation sites or virus adsorption sites. Such knowledge could lead to a new generation of antiviral compounds. Specific delivery of virus inhibitory compounds is an interesting problem. Liposomes are lipid spheres, and these have been used for the delivery of antiviral compounds.
The influenza virus: Antigenic composition and immune response
Authors: Schild G C 
Published: December 2008

SummaryThe architecture and chemical composition of the influenza virus particle is described with particular reference to the protein constituents and their genetic control. The dominant role in infection of the surface proteins - haemagglutinins and neuraminidases - acting as antigens and undergoing variation in time known as antigenic drift and shift is explained. The immuno-diffusion technique has illuminated the interrelationships of the haemagglutinins of influenza A viruses recovered over long periods of time. The H0 and H1 haemagglutinins are now regarded as a single sub-type with H2 and H3 representing the haemagglutinins of the 1957 and 1968 sub-types. Animal influenza viruses of pigs, horses and birds are described. A relation to human influenza strains has been shown to exist in certain instances as is the capacity of some human strains to pass to the animal kingdom.
Chronic ulcerative jejunitis without symptoms
Authors: Kane S P , Parkins R A 
Published: December 2008

Summary
A patient is presented who, in addition to subtotal villous atrophy, had superficial ulcers of the jejunum, as well as a wide band of granulation tissue deep to the crypts suggesting recurrent past ulceration. In spite of these changes she had no intestinal symptoms at the time of her presentation with reflux oesophagitis, and her only nutritional abnormality was a mild folate deficiency. Withdrawal of dietary gluten produced some improvement of the jejunal mucosa but this was not sustained on continued low-grade ingestion. She has containued to be virtually symptom-free over a 3-year period of follow-up.
Heterogeneity of failure of visual acuity in Graves' disease
Authors: Sachdev Y , Chatterji J C , Sharma R C 
Published: December 2008

Summary
The eye manifestations of Graves' disease are usually mild and self-limiting. Occasionally they follow a progressive course leading to visual loss and total blindness. The ocular manifestations bear no relationship to the metabolic state and may appear before, during or after onset of thyrotoxicosis. Characteristically they become evident at about the time of onset of hypermetabolism. Various factors responsible for the failure of visual acuity are discussed with case illustrations.
The clinical pathology of heart failure and atrial fibrillation in old age
Authors: Hodkinson H M , Pomerance A 
Published: December 2008

Summary
The factors associated with the development of heart failure and of atrial fibrillation in elderly patients were studied in a prospective clinico-pathological series of 171 cases. Multiple logistic analyses allowed the contributions of multiple factors to be assessed simultaneously.
Senile cardiac amyloidosis, ischaemic heart disease and atrial fibrillation were significantly associated with heart failure and had additive effects. Senile cardiac amyloidosis, ischaemic heart disease, mitral valve ballooning and higher age were significantly associated with atrial fibrillation but their additive effects were modified by significant interactions between ischaemic heart disease and mitral valve ballooning (whose effects were multiplicative) and senile cardiac amyloidosis and age (the age effect being confined to those without amyloidosis).
The incidence of postoperative pulmonary perfusion defects
Authors: Griffiths N J , Wighton R J , Festenstein J B 
Published: December 2008

Summary
The incidence of postoperative thromboembolism was studied using radioisotope lung perfusion and ventilation scanning. 26% of patients had defects on their pre-operative scans and 8% developed new unmatched perfusion defects postoperatively, indicating possible pulmonary emboli. This latter figure was much lower than some previously recorded results and was similar in 2 groups of patients—one receiving dextran 70 prophylaxis during operation and the other a control group who received saline.
Hip fracture after hemiplegia
Authors: Mulley G , Espley A J 
Published: December 2008

Summary
In a series of 57 hemiplegic patients who subsequently fractured their hips, it was found that hip fracture occurred significantly more often on the hemiplegic side. Hip fracture was equally common in right- and left-sided hemiplegia, and often occurred within one year of the stroke.
Two factors seem to be important in the genesis of hip fractures in hemiplegic patients: the tendency of stroke patients to fall to the affected side as a result of impaired locomotor function, and the development of disuse osteoporosis in the hemiplegic limb.
Levamisole in the treatment of cyclical neutropenia
Authors: Proctor S J , Reid M M , Low W T 
Published: December 2008

Summary
A child with cyclical neutropenia was observed before and during treatment with levamisole. Marked clinical improvement occurred while on levamisole. Deterioration occurred after stopping treatment. The improvement was not associated with changes in the neutrophil or monocyte counts, nor did tests of phagocytic cell function convincingly demonstrate improvement while the child was on treatment.
The physiology of thyroid function in pregnancy
Authors: Feely J 
Published: December 2008

Summary
Pregnancy has a variety of effects on maternal thyroid function. Thyroid gland enlargement is common particularly in areas of relative iodine deficiency. The renal clearance of iodine is increased in pregnancy and together with an increased volume of iodine distribution, leads to a low plasma inorganic iodine and thus increases the thyroidal iodine clearance. However, the absolute iodine uptake and hormone production rate remain unchanged.
There is an increase in the serum thyroxine (T4)and triiodothyronine (T3) concentration largely due to an increase in thyroid hormone-binding proteins. Free thyroxine and free T3 remain unchanged in pregnancy as does the Free Thyroxine Index, which gives the single most accurate measure of thyroid function. The placenta secretes a number of thyroid stimulators including human chorionic gonadotrophin and possibly chorionic thyrotrophin and molar thyrotrophin whose physiological role is to date poorly understood.
The fetal thyroid develops independently, and although fetal T4 Concentration Rises PROGRESSIVELY To maternal by term, the T3 concentration is markedly reduced owing to preferential formation of inactive reverse T3.
Clinical aspects of diabetes in pregnancy
Authors: Robinson R E 
Published: December 2008

Summary
The introduction of insulin produced a rapid improvement in the maternal prognosis in pregnancy associated with diabetes mellitus. Within years, maternal mortality fell from 50% and has become a rarity. Improvement in fetal survival was less dramatic until the work of Pedersen (1952); Peel and Oakley (1950) and White (1949) demonstrated that with determined antenatal control of diabetes the fetal outcome was greatly improved. Further improvement in the care of the fetus of the pregnant diabetic with fetal monitoring, both ante- and intra-partum, together with modern neonatal expertise, had brought the perinatal and neonatal morbidity and mortality for this group of patients close to that of the non-diabetic. An account is given of the author's present day practice in this group of patients.
Coagulation problems in human pregnancy
Authors: Redman C W 
Published: December 2008

Summary
Coagulation problems in pregnancy are primarily associated with overactivity of the intrinsic clotting system. This accounts for the increased incidence of thrombo-embolism during pregnancy. Where specific obstetric complications cause clotting problems the common underlying feature is usually placental pathology as in abruptio placentae, pre-eclampsia or hydatidiform mole.
Abnormal activation of the clotting system is an early, and occasionally the first detectable feature of pre-eclampsia, but there is no evidence that this is a primary change. Therefore the role of anticoagulant treatment in the management of pre-eclampsia remains questionable. A new test for estimating factor VIII consumption is proving to be a sensitive index of early activation of the clotting system and can be used for the diagnosis of early pre-eclampsia.
Exercise and hormonal secretion
Authors: Gawel M J , Park D M , Alaghband-Zadeh J , Rose F C 
Published: December 2008

Summary
The effect of graded exercise on the secretion of cortisol, testosterone, prolactin, growth hormone, thyroid stimulating hormone (TSH), luteinizing hormone and follicle stimulating hormone (FSH) is reported. While cortisol, prolactin, growth hormone and testosterone rise during the period of exercise, a rise in luteinizing hormone becomes evident only after rest. Levels of FSH and TSH remained unchanged.
Cholelithiasis and biliary tract disease in sickle-cell disease in Nigerians
Authors: Akinyanju O , Ladapo F 
Published: December 2008

SummaryThe incidence of biliary tract disease was investigated by oral cholecystography and/or intravenous cholangiography in 77 unselected Nigerians with homozygous sickle-cell disease (SCD). They included 32 males and 45 females with ages ranging from 8 to 31 years. The prevalence of cholelithiasis was 9% with equal sex incidence. The stones were always multiple and 71.4% of them were radio opaque. Visualization and contractility of all gall bladders examined were normal. The only patient with symptoms and signs which suggested biliary tract disease had no radiographic evidence of cholelithiasis and it was impossible to predict the presence of cholelithiasis from the incidence of abdominal crises in the patients.The prevalence of cholelithiasis is significantly less than that reported in American patients with SCD (35%) and different dietary habits are probably responsible for this.
Birmingham Medical Research Expeditionary Society 1977 Expedition: the diuresis and related changes during a trek to high altitude
Authors: Howell A , Cove D H 
Published: December 2008

Summary
Continuous 24-hr urine collections were made by 17 subjects during a trek to 5400 m. Fluid intake was recorded by diary. Weight and fat folds were measured daily. The results were compared with daily measurements of packed cell volume (PCV) and reticulocyte count. Early fluid retention was matched by a fall in PCV. There was a diuresis with negative fluid balance towards the end of the ascent and again early in descent. There was a slight trend for fluid retention to occur in those most affected by acute mountain sickness but the effect was not marked.