bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transitional cell carcinoma of the upper renal tract in rubber workers
Authors: Chapple C R , Newman J , O'Brien J M , Considine J 
Published: December 2008

Summary
We report two patients where transitional cell carcinoma of the upper urinary tract developed after occupational exposure to known carcinogens, in the rubber industry. Although carcinoma of the bladder is well recognized in this context, to our knowledge, this association has not been reported previously.
Carcinoid tumour arising in a Meckel's diverticulum
Authors: Payne-James J J , Law N W , Watkins R M 
Published: December 2008

Summary
A patient with a carcinoid tumour arising in a Meckel's diverticulum and presenting with acute small intestinal obstruction is described. Review of previously reported cases indicates that the initial clinical presentation of carcinoid tumours occurring in a Meckel's diverticulum is usually similar to that of appendiceal carcinoids. While most carcinoids in Meckel's diverticula present as incidental findings at post-mortem examination or laparotomy, their metastatic potential and subsequent behaviour resembles that of other small intestinal carcinoid tumours.
Plasma arginine vasopressin in hyponatraemic patients receiving diuretics
Authors: Ghose R R 
Published: December 2008

Summary
Random estimations of plasma arginine vasopressin concentration were undertaken in 6 non-oedematous patients receiving diuretic therapy for hypertension, who were admitted to hospital with severe hyponatraemia. Hyponatraemia resolved within 2 weeks of discontinuing the diuretic. Measurable amounts of plasma arginine vasopressin were detected in all 6 patients.
Sequential biochemical measurements in one patient, performed when plasma sodium concentration and osmolality were returning to the normal range, disclosed that urine osmolality remained higher than plasma osmolality during the first 5 days, when urine volume and sodium excretion were low. Thus the rise in plasma sodium was not initially related to water diuresis. The ability to excrete a water load was severely limited on the fifth day, but improved progressively by the tenth and seventeenth days.
Diuretic-induced hyponatraemia is associated with incomplete suppression of anti-diuretic hormone secretion arising from non-osmotic stimulation, in conjunction with transient impairment of renal diluting ability which could be due to net sodium deficit.
Peripheral vascular disease—the geriatrician's tale
Authors: Coni N K 
Published: December 2008

Summary
One hundred and twenty four elderly patients with peripheral vascular disease were seen by a geriatrician over a period of just under 4 years. Half of them presented with critical ischaemia and had not been previously known to have peripheral vascular disease. Two-thirds were shown to have bilateral disease; 14.5% of the series developed manifestations of the condition during the course of acute systemic illnesses and in 5 cases this was almost certainly, and in several more probably, due to haemodynamic crises. A third were dead within 3 months and so far a further 18.5% are known to have died within 2 y of first encounter. Of those who survived 3 months, at least 37% required treatment for persistent rest pain or had skin ulceration or necrosis, or had developed gangrene or come to amputation. Only 5 patients, after investigation, underwent successful limb salvage procedures. Peripheral vascular disease in old people is common, is likely to continue to be so, carries a dismal prognosis, and appears on the evidence presented here to be under-suspected until an advanced stage in the disease. Those dealing with the aged must be constantly on the alert for it since it calls for scrupulous care of the feet and for especial vigilance during acute systemic illness.
Granulocytic sarcoma preceding leukaemic transformation in myelofibrosis
Authors: Jacobs P , Sellars S 
Published: December 2008

Summary
A granulocytic sarcoma expanded the malar region in a patient with proven myelofibrosis over a 22 month period before undergoing rapid increase in size concomitantly with transformation to acute granulocytic leukaemia in the marrow and the widespread appearance of subcutaneous tumour deposits. Rapid response was obtained with local radiotherapy, and the systemic disease manifestations were controlled on combination courses of oral 4′-demethoxydaunorubicin and the epipodophyllotoxin VP16-213. This appears to be the first example of a granulocytic sarcoma occurring in a patient with myelofibrosis.
Haemodynamic evaluation of diastolic abnormalities in hypertrophic cardiomyopathy
Authors: Grossman William , Paulus Walter , Lorell Beverly H 
Published: December 2008

Summary
Haemodynamic studies suggest that an important abnormality in diastolic relaxation is characteristic of advanced hypertrophic cardiomyopathy. Current evidence supports the concept that cytosolic Ca++ overload is the pathophysiological basis for this impaired relaxation, and may in turn represent impaired membrane Ca++ pumping activity.
Myocardial gallium-67 imaging in dilated cardiomyopathy
Authors: O'Connell John B , Henkin Robert E 
Published: December 2008

Summary
The use of gallium-67, an isotope that is avid for areas of inflammation in patients with dilated cardiomyopathy, is described and compared with endomyocardial biopsy in 68 consecutive patients with dilated cardiomyopathy. Myocarditis was diagnosed in 8% on biopsy and the likelihood of a positive biopsy when the gallium scan was positive for inflammation, rose to 36%. It is concluded that gallium scanning is a useful adjunct to biopsy in detecting myocarditis in patients with dilated cardiomyopathy and in following patients with evidence of myocarditis on biopsy.
Disadvantages of gallium-67 imaging include the radiation dose accumulated with multiple scans and 72h delay from initial injection of the isotope to imaging. It is suggested that definitive conclusions regarding the technique should await the results of a large multicentre trial evaluating gallium in comparison with endomyocardial biopsy in the diagnosis of myocarditis.
Objective relief of vasospasm by glyceryl trinitrate in secondary Raynaud's phenomenon
Authors: Coppock J S , Hardman J M , Bacon P A , Woods K L , Kendall M J 
Published: December 2008

Summary
An objective response to topical glyceryl trinitrate was shown by digital plethysmography in a study of 17 patients with Raynaud's phenomenon. Improvement was significant (P &lt; 0.005) in those in whom the disease was secondary to an underlying connective tissue disorder. The response suggests that the effect of this drug is mediated locally.
Pseudo-splenomegaly as a result of subphrenic abscess
Authors: Snape J , Baker A R , Rees Y 
Published: December 2008

Summary
A case of left-sided subphrenic abscess, secondary to perforation of a carcinoma of stomach, is described. The patient presented with a palpable spleen which was shown to be normal in size but displaced by the subphrenic collection. The importance of correct interpretation of this physical sign is discussed.
Polyarteritis nodosa and monocytic leukaemia
Authors: Leung A C T , McLay A , Boulton-Jones J M 
Published: December 2008

Summary
A 67 year old man presented with a polyarteritis nodosa-like syndrome with renal, pulmonary joint and neurological involvement during the ‘preleukaemic’ stage of monocytic leukaemia. The association between these two conditions is discussed.
Gastrointestinal bleeding due to large bowel infiltration by chronic lymphocytic leukaemia
Authors: Tucker J , Cachia P G 
Published: December 2008

Summary
A 66 year old woman with a 9 year history of chronic lymphocytic leukaemia developed intermittent rectal bleeding for 9 months; sigmoidoscopic biopsy proved that this was due to large bowel infiltration by leukaemia. This is a very rare occurrence.
Mefenamic acid-induced bullous pemphigoid
Authors: Shepherd A N , Ferguson J , Bewick M , Bouchier I A D 
Published: December 2008

Summary
A 52 year old man developed bullous pemphigoid, Coombs' positive haemolytic anaemia and diarrhoea related to the use of mefenamic acid. Clinical manifestation of the bullous pemphigoid, haemolytic anaemia and diarrhoea resolved following discontinuation of the mefenamic acid. Mefenamic acid should be added to the list of agents that are known to induce bullous pemphigoid.
Vitamin E—its role in neurological function
Authors: Muller D P R 
Published: December 2008

SummaryStudies in patients with abetalipoproteinaemia, other chronic and severe fat malabsorptive states and a selective defect in vitamin E absorption, together with neuropathological studies in the vitamin E deficient human, monkey and rat indicate that vitamin E is important for normal neurological function. Appropriate vitamin E supplementation is, therefore, advisable for all patients with chronic fat malabsorption who have low serum vitamin E concentrations. Serum vitamin E concentrations should also be measured in patients with spinocerebellar disorders, whatever the aetiology.
Effect of a long acting beta-adrenoceptor blocker on diurnal variation of cardiac dysrhythmias
Authors: Mir M A 
Published: December 2008

Summary
To investigate circadian variation of cardiac arrhythmias ambulatory electrocardiogram monitoring was carried out before and after one week's treatment with a long acting beta-adrenoceptor blocker, nadolol, in 26 patients who presented with symptoms attributable to arrhythmias. Analysis of the 24 hour profile of premature ventricular contractions showed a significantly (P &lt; 0.05) higher frequency during midday to midnight than between midnight and midday. The frequency of supraventricular tachycardia was significantly (P &lt; 0.05) higher during the periods from 12.00 hours to 16.00 hours (11.0 ± 12) and 16.00 hours to 20.00 hours (11.3 ± 11) than during the periods of 00.00 hours to 04.00 hours (3.6 ± 3) and 04.00 hours to 08.00 hours (6.0 ± 8). The period of the highest incidence of all arrhythmias was between 16.00 hours to 24.00 hours, and that of lowest during the period between 04.00 hours to 12.00 hours (P &lt; 0.01). After one week's treatment with nadolol the frequency of all arrhythmias was strikingly reduced but their pattern of occurrence remained unchanged. These studies suggest that patients who present with symptoms attributable to arrhythmias tend to have these more frequently during the physical and mental activities of the day and evening presumably due to the accompanying sympathetic overactivity.
Minimal change nephropathy associated with anaplastic carcinoma of bronchus
Authors: Singer C R J , Boulton-Jones J M 
Published: December 2008

Summary
Nephrotic syndrome associated with extra-renal malignancy shows a characteristic pattern: carcinoma is most frequently associated with membranous glomerulonephritis and Hodgkin's disease with minimal change nephropathy. We report a patient with minimal change nephropathy in association with anaplastic carcinoma of the bronchus. Strong temporal evidence of a causal relationship is presented. The dissociation in the response of the two conditions to treatment of the tumour after relapse may be evidence of an indirect pathogenesis.
The effect of oral digoxin on sodium excretion, renin-angiotensin-aldosterone system and blood pressure in normotensive subjects
Authors: Cappuccio F P , Markandu N D , Sagnella G A , MacGregor G A 
Published: December 2008

SummaryThe effect of digoxin (0.25 mg t.d.s.) given orally for 5 days, on sodium excretion, plasma renin activity, plasma aldosterone and blood pressure has been studied in 6 normotensive subjects, on a constant sodium intake. Average serum digoxin level measured in 5 subjects on the 5th day of treatment was in the upper range of the therapeutic level (1.92 ± 0.3 nmol/l). Red cell sodium content increased from 9.75 ± 1.2 mmol/l of cells in the control period to 15.3 ± 1.7 mmol/l of cells on the 5th day of digoxin treatment when measured in 4 of the 6 subjects. In spite of this evidence of inhibition of the red cell sodium pump, there was no detectable change in sodium excretion, blood pressure, plasma renin activity and aldosterone.
Femoral vein occlusion following Mc-Vay repair
Authors: Klausner J M , Noveck H , Skornick Y , Lelcuk S , Rozin R R 
Published: December 2008

Summary
Three cases of femoral vein occlusion following a Mc-Vay repair for femoral and inguinal hernias are presented. Phlebography demonstrated constriction of the femoral vein at the site of the repair. This complication is due to compression of the femoral vein by too tight a repair.
Megaloblastic anaemia due to sulphasalazine responding to drug withdrawal alone
Authors: Grieco A , Caputo S , Bertoli A , Caradonna P , Greco A V 
Published: December 2008

Summary
A 60 year old man with ulcerative colitis since 1975 and treated with sulphasalazine, presented with severe megaloblastic anaemia caused by folate deficiency. The drug was stopped, and the anaemia recovered promptly. There was no relapse one year later.
Clostridial myonecrosis in association with etoposide therapy presenting as severe thigh pain
Authors: Smith D , Harris M , Thatcher N 
Published: December 2008

Summary
The case is described of a 68 year old man who was immunosuppressed as a result of receiving chemotherapy for small cell lung cancer and who presented with severe right thigh pain. This proved to be due to clostridial myonecrosis with none of the classical clinical features of clostridial infection. This is believed to be the first reported case of spontaneous clostridial infection associated with etoposide administration.
Indium-111 leucocyte scintigraphy in the investigation and management of inflammatory bowel disease
Authors: Fotherby K J , Wraight E P , Garforth H , Hunter J O 
Published: December 2008

SummaryThe results of indium-111 tropolonate leucocyte scintigraphy in 105 patients with known inflammatory bowel disease are reviewed. Scintigraphy is as sensitive as radiology in detecting and assessing the extent of active colonic disease, and probably more sensitive in assessing small bowel disease. In a further 40 patients scintigraphy was successfully used as a screening test to identify, or exclude, bowel inflammation in patients with gastrointestinal symptoms. Scintigraphy has advantages over barium studies, being safe, non-invasive, more sensitive than small bowel radiology and giving additional information such as the bowel identification of intra-abdominal abscesses. The time required to label the leucocytes (about 2 hours) and the higher unit cost, unless many scintigrams are performed, are disadvantages.
Thymectomy in myasthenia gravis during pregnancy
Authors: Ip M S M , So S Y , Lam W K , Tang L C H , Mok C K 
Published: December 2008

Summary
A 24 year old woman with myasthenia gravis suffered an antepartum exacerbation which failed to respond to increasing dosages of pyridostigmine. Thymectomy performed in the second trimester was followed by clinical improvement and full term vaginal delivery with no puerperal deterioration.
Recurrent hypercalcaemia in a young man with mono-ostotic Paget's disease
Authors: Bannister P , Roberts M , Sheridan P 
Published: December 2008

Summary
A 32 year old man presented on two separate occasions with severe hypercalcaemia. Both episodes followed the fracture of a single pagetic bone but were not associated with immobilization. To our knowledge this patient, the youngest described with hypercalcaemia secondary to Paget's disease of bone is also the only reported case of recurrent hypercalcaemia in this condition.
Pneumonectomy in pulmonary mucormycosis complicating Behçet's disease
Authors: Santo M , Levy A , Levy M J , Weinberger A , Mor R , Avidor I , Rousso I , Pinkhas J 
Published: December 2008

Summary
A 37 year old man with Behçet's disease who was maintained on prolonged corticosteroid therapy, developed diabetic ketoacidosis and pneumonia. Secondary infection with mucor intervened with abscess formation cured by pneumonectomy. The association of Behçet's disease and mucormycosis has not been previously reported, although diabetes mellitus was almost certainly the predisposing cause. Surgical treatment offers the best chance of survival in similar cases.
Hodgkin's disease in an adult with acute lymphoblastic leukaemia
Authors: Zuiable A , Borthwick-Clarke C , Maitland J , Clink H , Powles R 
Published: December 2008

Summary
A 53 year old woman with common acute lymphoblastic leukaemia (ALL) developed Hodgkin's disease 20 months after the initial diagnosis of ALL. This is by far the oldest case of Hodgkin's disease complicating ALL. The unusual presentation and the aetiology of Hodgkin's disease in ALL are discussed.
Human serum parvovirus associated vasculitis
Authors: Li Loong T C , Coyle P V , Anderson M J , Allen G E , Connolly J H 
Published: December 2008

Summary
A 48 year old man had a severe symmetrical arthritis of knee and ankle joints accompanied by an extensive purpuric rash of both legs and several areas of skin necrosis. No other system was clinically involved. Human serum parvovirus-specific IgM was present in a blood sample taken 2 weeks after the onset of the clinical illness indicating recent infection with this virus. The patient was treated with complete bed rest, and the application of saline soaks to both legs. He had a recurrence of the rash 5 weeks after onset, but otherwise made a complete recovery. Purpura with skin necrosis has not previously been reported in association with this virus.
Radionuclide assessment of left ventricular function in hypertrophic cardiomyopathy
Authors: Sugrue D D , McKenna W J 
Published: December 2008

Summary
To determine the relationship of left ventricular function and ventricular tachycardia, 48 hour ECG monitoring and technetium-99m gated equilibrium radionuclide angiography were performed in 84 consecutive patients with hypertrophic cardiomyopathy and sinus rhythm. Measurements of ejection fraction (EF), peak ejection rate (PER, edv/s), peak filling rate (PFR, edv/s) and time to peak filling rate (PFR, ms) were derived from radionuclide activity time curves generated from data acquired in list-mode. Left ventricular function was compared in patients with and without ventricular tachycardia. Left ventricular ejection fraction was significantly lower in 16 patients with ventricular tachycardia compared to 68 patients without (67 ± 17 vs 78 ± 10, P &lt; 0.05) and time to peak filling rate was significantly prolonged (152 ± 32 vs 120 ± 36, P &lt; 0.05). Thus patients with hypertrophic cardiomyopathy at greatest risk of sudden death had significant impairment of systolic and diastolic left ventricular function.
The role of echocardiography in the assessment of hypertrophic cardiomyopathy
Authors: Rakowski H , Fulop J , Wigle E D 
Published: December 2008

Summary
Echocardiography has greatly simplified the diagnosis of hypertrophic cardiomyopathy and routine haemodynamic studies are usually only required in patients being considered for myectomy or the assessment of coexistent coronary disease. A complete echo Doppler study should be performed in all patients with hypertrophic cardiomyopathy to define the degree of obstruction, the degree of asymmetric hypertrophy and abnormalities of diastolic function. In this manner the patient can be classified according to haemodynamic subgroup, thus influencing the choice of treatment and helping to determine prognosis. These studies also provide a simple quantitative method of assessing the beneficial effects of medical or surgical therapy.
Arrhythmias in dilated cardiomyopathy
Authors: Neri R , Mestroni L , Salvi A , Camerini F 
Published: December 2008

Summary
Sixty-five patients with dilated cardiomyopathy underwent 24 hour electrocardiographic monitoring: 62 (95.4%) showed ventricular arrhythmias and 52 (80%) complex ventricular arrhythmias (multiform ventricular extrasystoles, paired ventricular extrasystoles and ventricular tachycardia).
Complex ventricular arrhythmias correlated significantly with some haemodynamic indices of ventricular dysfunction: patients with multiform and paired ventricular extrasystoles and with ventricular tachycardia had lower values of ejection fraction (31.9 ± 11.8%, P = 0.002) and of cardiac index (2.9 ± 0.7 litres/min/m2, P = 0.029) than the others (41.1 ± 11.1% and 3.5 ± 0.9 litres/min/m2 respectively).
Patients were followed for a period of 30 ± 18 months (20 days to 64 months). During follow-up 19 died and mortality was higher among patients with multiform and paired ventricular extrasystoles and/or ventricular tachycardia.
Complex ventricular arrhythmias are frequent in dilated cardiomyopathy: ventricular tachycardia and multiform and paired ventricular extrasystoles seem to be related to a more depressed ventricular function and to a poor prognosis. The importance of antiarrhythmic treatment in these patients has still to be evaluated.
Tuberculous meningitis due to Mycobacterium bovis: a report of two cases
Authors: Wilkins E G L , Griffiths R J , Roberts C , Green H T 
Published: December 2008

Summary
Two Caucasian patients with bovine tuberculous meningitis are described. Classical Mycobacterium bovis was isolated from the cerebrospinal fluid on both occasions. Despite the elimination of cattle tuberculosis in this country, reactivated primary disease due to the bovine tubercle bacillus may still occur.
Femoral hernia causing pneumoperitoneum
Authors: King H A , Boulter P S 
Published: December 2008

Summary
Richter's hernia, in which only a portion of the circumference of the intestine lies within the sac, is a common complication of femoral hernia. This case report is of 39 year old female who presented with a pneumoperitoneum and was found at laparotomy to have a right femoral Richter's hernia containing a knuckle of perforated small bowel. This is a previously unreported presentation of femoral hernia.
Mechanisms by which stress can lead to coronary heart disease
Authors: Henry J P 
Published: December 2008

Summary
Much stress is of psychological origin and due to emotional arousal. The mechanisms by which anger, helplessness, or a sense of control and serenity exert their various neuroendocrine effects are discussed. Primacy is given to three systems; to the catecholamines, to testosterone and to cortisol. Evidence that they interact to accelerate the arteriosclerotic process is cited. The protective aspects of intimacy are discussed together with evidence that certain personality types promote it in the marital situation while others do not. It is suggested that the post-traumatic stress syndrome may relate to the coronary-prone personality for it involves an alexithymic disturbance of the emotional competence required for successful intimacy.
Mesenchymal hamartoma of the liver—report of an unusual case
Authors: Salisbury J R , Darby A J , Portmann B C 
Published: December 2008

Summary
An 8 year old girl presented with gross hepatomegaly, anaemia and pyrexia unresponsive to antibiotics. At laparotomy a cystic mass 19 cm in diameter was found arising from the liver. The cyst contained 2.4 litres of changed blood and an abscess cavity filled with thick pus was present in the cyst wall. Histological examination showed the appearances of a mesenchymal hamartoma of the liver, a rare diagnosis at this age. This case is unusual as mesenchymal hamartoma has not been previously reported presenting with pyrexia and anaemia as well as hepatomegaly.
Colitis caused by non-steroidal anti-inflammatory drugs
Authors: Ravi S , Keat A C , Keat E C B 
Published: December 2008

Summary
Four cases of acute proctocolitis associated with non-steroidal anti-inflammatory drug therapy are presented. The drugs implicated were flufenamic acid, mefenamic acid, naproxen and ibuprofen. After resolution of symptoms and signs of proctocolitis three of the four patients were subsequently rechallenged with the implicated drug: in each there was a rapid relapse.