bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac achalasia in childhood
Authors: Singh Harjit , Sethi R S , Gupta H L , Khetarpal S K 
Published: December 2008

SummaryCardiac achalasia is a disorder not unknown in the paediatric age-group and may occur even in the neonatal period. This disorder should, therefore, be considered in all cases presenting with persistent vomiting, as well as in those with chronic respiratory disease in whom more common causes have been excluded.It is almost universally accepted that the disorder results from a disturbed function of ganglion cells in the distal oesophagus, as the disease has been reproduced in laboratory animals by denervation of the distal oesophagus. The exact pathogenesis of this degenerative change is not well understood. However, in at least some of the cases congenital absence of the ganglion cells may be responsible for this functional disturbance. This is inferred from the fact that the disease may be found in association with Hirschsprung disease, in which there is a congenital absence of ganglion cells in the terminal colon. Moreover, the occurrence of the disease in the neonatal period itself favours a congenital lesion.Surgery was preferred to other forms of treatment in the paediatric age-group in view of the reported equivocal response to mechanical dilatation and pre-disposition of children to respiratory complications. The results of surgery were satisfactory.
The investigation of an arbovirus encephalitis
Authors: Webb H E 
Published: December 2008

Summary
A definition of an arbovirus and a broad idea of the groups and the numbers isolated and causing human infection are given. The small incidence of clinical disease compared with overall infection rates is stressed. The conditions for the successful survival of arboviruses is outlined. The investigation of the illness and origin of infection is described. The role of viral antibody in the development of encephalitis and the use of cortisone in treatment is discussed. The over-wintering of arboviruses and their capacity for latency is considered in relationship to the perpetuation of virus and the pathogenic effects on the hosts involved.
Modern trends in leprosy
Authors: Jamison D G 
Published: December 2008

Summary
Leprosy is being regarded more and more as a general medical condition. The available data about its manifestations and treatment are becoming more widely known.
The problems of infectivity, animal inoculation and cultivation remain to a large extent unsolved. The recent successful inoculation of irradiated mice with fresh organisms is a major advance. It may well prove a means of testing new drugs and of confirming claims of successful cultivation, and more important still, of determining the viability of organisms obtained from both active and treated cases of leprosy.
Finally, it is in the field of delayed hypersensitivity (CMI) and autoimmune processes initiated by the mycobacterial infections that this slowly progressive, greatly variable and widely disseminated infection may become a most rewarding subject for study by the immunologist of the future.
The neurological manifestations of dissecting aneurysm of the aorta
Authors: Condon John R , Rose F Clifford 
Published: December 2008

Summary
Six cases of dissecting aneurysm of the aorta, four with cerebral manifestations, one with peripheral neuropathy and one with ischaemic necrosis of the spinal cord are reported. Cerebral manifestations include confusion and stupor, syncope, grand mal epilepsy, ischaemia of the spinal medulla, carotid artery occlusion and cerebral hemisphere infarction.
Ischaemic neuropathy is characterized by severe limb pain not of peripheral nerve distribution, but associated with areflexia and a peripheral pattern of sensory loss.
Ischaemic necrosis of the cord is characterized by flaccid paraplegia and sphincter disturbances with segmental sensory loss exhibiting an upper level on the trunk.
The differential diagnosis of the neurological complications of aortic dissection is discussed and a brief review of advances in management made.
Aspects of the psychological status of patients treated with cardiac pacemakers
Authors: Crisp A H , Stonehill E 
Published: December 2008

Summary
An initial clinical observation that patients with externally located cardiac pacemakers are more distressed and depressed than those with internally sited pacemakers has been confirmed. The total patient group is also characterized by its tendency to report that it does not worry about getting an incurable illness. At the same time, it is evident to others that it does have such an illness. Those patients who acknowledge that they did worry in this way were found to score significantly higher on several scales of a standardized psychoneurotic index than did the overall ‘pacemaker’ population.
Possible reasons for the greater psychological distress displayed by the group of patients with external pacemakers are discussed.
The use and limitations of isotope studies in clinical shock
Authors: Vickers M D A 
Published: December 2008

Summary
Blood volume measurements can only be of value in the treatment of clinical shock if the results are obtained quickly. In a changing situation, such as continuing haemorrhage, erroneous conclusions are inevitable.
Assumptions which are commonly made concerning tracer loss rates and mixing rates may be invalid. Semi-automated machines can introduce new sources of error.
The measurement of blood volume should be regarded as an aid to assessing the relative contributions of intravascular volume and vascular tone to the resulting intravascular pressures.
Local and general responses to injury in the newborn rabbit
Authors: Little R A 
Published: December 2008

Summary
Some physiological responses to experimental bilateral hind limb ischaemia have been studied and compared in neonatal and young rabbits.
The fluid loss into the injured limbs after removal of the tourniquets has been expressed as a percentage of the plasma volume and of the total body water at the different ages.
The reactivity of skin blood vessels to a variety of known mediators of an inflammatory response has been investigated using labelling techniques.
Gastroscopy combined with intragastric photography
Authors: Gibbs D D , Parry D J 
Published: December 2008

Summary
This paper relates experience in the use of the Olympus GTF fibrescope and intragastric camera. One hundred and eighty-four examinations were made in 157 patients.
The instrument was usually easy to introduce into the stomach and examinations were well tolerated. The youngest patient examined was aged 16 years and the oldest 86. Fibroscopy in the elderly seldom presented difficulties.
This model (GTF) was particularly suited to examination of the mid-stomach and antrum, the view often extending to the pylorus. The range proximal to the angulus on the lesser curve and posterior wall was often limited.
Intragastric photographs of high quality could be taken; they enhanced the value and added to the interest of examinations. Serial pictures, taken at intervals, provided evidence of alterations in the appearances of gastric lesions.
Gastric endoscopy is complementary to radiological examination of the stomach. Its use often increases diagnostic accuracy and understanding of gastric diseases. Within the limits of design of a particular instrument, fibreoptic apparatus renders the procedure simple and efficient.
The relationships between plasma cholesteryl polyunsaturated fatty acids, age and atherosclerosis
Authors: Kingsbury K J , Stovold R , Morgan D M , Brett C G 
Published: December 2008

Summary
The ages, plasma cholesteryl dienoic acid, 2-hr blood sugar and plasma cholesterol concentrations of 146 patients with aorto-iliac and femoro-popliteal atherosclerosis, were compared with their arterial lesions classified into occlusions, irregularities and stenoses by pulses and arteriograms.
The arterial lesions were also compared with the patient’s prognosis in terms of the development of angina or myocardial infarction.
The results showed that reduced concentrations of cholesteryl dienoic acids were specifically related to an increase in the number of arterial occlusions, independently of the patients’ ages, plasma cholesterol and 2-hr blood sugar levels, arterial irregularities or stenoses.
The arterial occlusions in turn related to the development of myocardial infarction but not angina.
It is concluded that a relationship existed between the reduced concentrations of cholesteryl dienoic acids and the occlusive element of human atherosclerosis which is a major factor in the patient’s prognosis.
Severe acute myocardial infarction treated with hyperbaric oxygen. Report on forty patients
Authors: Ashfield R , Gavey C J 
Published: December 2008

Summary
Forty patients, aged 35-72, who had had an acute myocardial infarct in the preceding 24 hr, and who were seriously ill, were treated in a hyperbaric oxygen bed at 2 atm (atmospheres) absolute for sessions of 2 hr in and 1 hr out for an average period of 4 days.
There were thirty-seven survivors after the treatment, giving an immediate mortality of 7·5%, but three of those died later before leaving hospital, giving a total mortality of 15% in seriously ill patients.
Pain and dyspnoea were usually improved in the first hyperbaric session, relapsed in air and progressively improved in successive sessions.
Arrhythmias, including heart block, showed similar benefit. No case of cardiac arrest occurred while the patients were actually receiving hyperbaric oxygen.
There was, in the opinion of the authors, during a period of over 2 years’ experience, a consistent pattern of improvement over and above that expected as spontaneous improvement.
The hyperbaric oxygen bed is a promising method of treatment for the acute phase of myocardial infarction, and it is simple to use. There will of course always be an irreducible minimum of patients who will die from obstruction of both coronary arteries or other structural lesions such as rupture or emboli.
Familial sarcoidosis terminating as neurosarcoidosis
Authors: Salm R 
Published: December 2008

Summary
A case of sarcoidosis is recorded in a 27-year-old male, whose elder sister has also been suffering from sarcoidosis.
The disease was characterized by involvement of the mucosa of the upper respiratory tract, gross transient peripheral lymphadenopathy and terminal neurosarcoidosis, death being due to an acute obstructive hydrocephalus.
The association of syphilis with hepatic cirrhosis: a report of six cases and a review of the literature
Authors: Karmi G , Thirkettle J L , Read A E A 
Published: December 2008

Summary
Among forty-nine patients with cirrhosis admitted to the Bristol Royal Infirmary in the years between 1962 and 1967 inclusive, six cases were found who also had syphilis.
The possible significance of this association is discussed and a short review of the literature presented.
The importance of routine serological testing for syphilis on all cirrhotic patients, particularly male, is stressed.
Psychiatric referrals since the Abortion Act 1967
Authors: Kenyon F E 
Published: December 2008

Summary
During the 1st year of the Abortion Act, 1967, sixty-five patients were seen for a psychiatric opinion. Of these 50% were single, 36% married and 14% separated or divorced.
Referral was by the general practitioner in 60%, gynaecologist 36% and ‘other’ 4%.
Mean length of psychiatric history was 18·9 months. Half had had unhappy childhoods and family relationships were frequently disturbed. Four (6%) were University students.
Mean length of pregnancy was 11·0 weeks and for 87% of the single patients it was their first; for 36% of the married group it was their third. In fourteen (21%) the pregnancy resulted from a contraceptive failure.
There was a previous psychiatric history in 69%. The commonest diagnosis was depression, mainly of neurotic type (52%) but 29% had no gross psychiatric disorder.
Termination of pregnancy was recommended in thirty-two (49%), this included six where sterilization was also advised.
Thrombocytosis following thrombocytopenia in man
Authors: Ogston D , Dawson Audrey A 
Published: December 2008

Summary
Observations are presented on the changes in the platelet count of patients during the treatment of Addisonian pernicious anaemia with vitamin B12, of thrombocytopenic purpura with prednisone, and of malignant disease with methotrexate.
In each of these clinical situations, thrombocytopenia was succeeded, after a delay of a number of days, by a phase of thrombocytosis.
Vascular changes in the lungs on the plain radiograph of the chest
Authors: Kerr I H 
Published: December 2008

Summary
The normal anatomy of the pulmonary vessels is considered and correlated with the angiographic appearances.
Some pathological conditions causing an alteration in the vascular pattern as seen on the plain films are considered and the changes are described.
It is concluded that an appreciation of these changes in vascular pattern may indicate to the clinician the presence of local or distant disease.
The influence of the platelet count on the incidence of thrombotic and haemorrhagic complications in polycythaemia vera
Authors: Dawson Audrey A , Ogston D 
Published: December 2008

SummaryIn polycythaemia vera, those patients who have an elevated platelet count develop more thrombotic and more haemorrhagic complications than those with a normal count, even when the haematocrit is maintained by therapy within the normal range.
The evolution of diabetes from prediabetes
Authors: Danowski T S 
Published: December 2008

Summary
Temporary stress-induced undue hyperglycaemia following an oral carbohydrate load taken during hospitalization is being tested as a possible indicator of prediabetes.
Observations in patients 15 months after hospitalization have permitted us to compare the blood sugar, insulin and growth hormone patterns evoked by an oral glucose load before and after glucose intolerance has appeared, viz. to speculate upon the evolution of diabetes from prediabetes. Though the numbers of such instances are as yet limited, they already suggest several possible sequences. Thus, our data support the concept that glucose intolerance, in addition to stemming from a decrease in insulin levels, can develop with true increases or with no evident decrease in the insulin responses to oral glucose.
The simplified in-hospital carbohydrate tolerance test employed in assembling groups of possibly prediabetic individuals is also an efficient means of detecting permanent glucose intolerance of the diabetes mellitus type.
One-session treatment of gonorrhoea in males with procaine penicillin plus probenecid
Authors: Cobbold R J C , Morrison G D , Spitzer R J , Willcox R R 
Published: December 2008

Summary
Six hundred and thirteen male patients with acute uncomplicated gonorrhoea have been treated alternately with single injections of 1·2 mega-units of aqueous procaine penicillin alone or with the same dose and preparation of penicillin with an additional 1·0 g of probenecid given orally immediately prior to injection.
Whether the failure rates were assessed on the basis of an absence of further sexual exposure or by classifying all recurrences within 1 or 2 weeks regardless of history as treatment failures the results were significantly better when probenecid was also given.
The use of a single dose of probenecid is thus capable of maintaining the success of single injection procedures for the treatment of gonorrhoea based on procaine penicillin and thus represents a bulwark for the future should the powers of penicillin against the gonococcus in London deteriorate further.
Developing viable medical equipment, in general and for patient monitoring
Authors: Taylor D J W 
Published: December 2008

Summary
The importance of the relationship between demonstrable clinical advantage and total costs in the use of equipment, the role of the professional medical administrator in its development and the differences between the industrial and the ethical medical approaches to marketing are stressed.
In the final analysis routine service equipment should be assessed by actual profitability, recognizing the effects of philanthropic or research funding when it occurs.
The patient-sensor interface
Authors: Crockett G S 
Published: December 2008

Summary
During the assessment of monitoring equipment on acute medical cases in a general ward, a quantitative investigation of technical faults revealed that 44% of these occurred at the patient-sensor interface.
While the attachment of the equipment was accepted by the patient and was suitable for application by nursing staff, this degree of technical breakdown indicates that more progress is necessary in the design of this aspect of monitoring equipment before it is possible to have a reliable system.
Axillary skin excision as a treatment for axillary hyperhidrosis
Authors: Weaver P C 
Published: December 2008

Summary
This report describes three severe cases of axillary hyperhidrosis successfully treated with the Hurley-Shelley operation. It appears to be a simple and effective method of dealing with a condition which is certainly not rare and in its most severe form can be a great social embarrassment to the patient.
P wave abnormalities with myocardial infarction: an aid to the diagnosis of left ventricular failure
Authors: Hassell T A , Hoffbrand B I 
Published: December 2008

Summary
An investigation during a prospective study of myocardial infarction has confirmed previous observations of P wave changes in association with left ventricular failure. Although an indicator of pre-existing left ventricular disease as well as acute left atrial distension, a negative deflection of 1 mm or more in the P wave of lead V1 should raise strong suspicions about the presence of this serious complication.
Calcium metabolism in sarcoidosis
Authors: Dent C E 
Published: December 2008

Summary
Fifteen patients with hypercalcaemia and sarcoidosis have been studied. Twelve were males of average age 34; the three females averaged 53.
Cases included widely varying sarcoid manifestations, but five gave a clear history of rather excessive ingestion of low-dosage vitamin D preparations. The data confirm that in most cases there is an undue sensitivity to all the actions of vitamin D, the situation therefore mimicking vitamin D intoxication. Two patients volunteered to receive ultra-violet irradiation and became hypercalcaemic with corresponding clinical and biochemical changes.
Steroids make normal the calcium abnormalities just as they do in straight vitamin D intoxication. However, in three further patients the hypercalcaemia did not respond to steroids and was shown to be due to the presence of an over-acting parathyroid gland, removal of which corrected the abnormality. There are a sufficient number of other similar cases in the literature to suggest that the development of parathyroid adenomas is another even rarer complication of sarcoidosis which must be carefully distinguished from vitamin D sensitivity.
Sarcoidosis in bone
Authors: Pygott F 
Published: December 2008

Summary
Radiologically demonstrable bone change is found in about one in every six patients with sarcoidosis. The hands and feet are affected and rarely the trunk, an unusual distribution for a disseminate disease.
Osteoporosis, cortical thinning and mottled rarefaction are the earliest signs, followed by cystic changes due to the coalescence of adjacent lesions and perhaps pathological fractures.
The nasal bones may be directly involved in patients with lupus pernio. Changes in the rest of the skull, in the spine and pelvis are rare and may be bizarre.
The treatment of sarcoidosis
Authors: Israel Harold L 
Published: December 2008

Summary
A discouraging conclusion to many years of study of the natural history of sarcoidosis is the realization that the proper word for the course of sarcoidosis is ‘unpredictable’. An impressive lesson of a controlled study was the frequency with which unexpected and dramatic improvement occurred in the placebo group. Although patients with pulmonary infiltration, uveitis and cutaneous sarcoid have a worse prognosis than the asymptomatic patient with hilar adenopathy, many patients in the former category will recover and some in the latter will go on to death.
A trial of prednisone therapy in a small number of patients with disease restricted to the mediastinal and hilar nodes (Stage I) suggests that prednisone treatment in this form of sarcoidosis may minimize dissemination and progression. An extended trial in Stage I sarcoidosis appears warranted. In more disseminated forms of the disease, the effects of corticosteroids seem to be merely palliative: there is no persuasive evidence that their use in pulmonary sarcoidosis averts fibrosis.
Occasionally corticosteroid therapy is contraindicated, poorly tolerated, or ineffective. In such circumstances chlorambucil or methotrexate may be given a trial. It is clear that both drugs exert an antiinflammatory action similar to that of the corticosteroids; in a few instances these agents appear to surpass corticosteroids in effectiveness.
Obesity: some current views regarding its aetiology
Authors: Sheldon Joanna 
Published: December 2008

Summary
Obesity results from an imbalance between calorie intake and calorie output. Although an excessive calorie intake is the most obvious and usual explanation for the development of obesity, a variety of factors influencing calorie expenditure may also be involved. Some of these factors may even be inborn.
Recent work on controls of energy utilization, and on the relation between obesity and changes in the size and number of adipocytes in the body, is reviewed.
Acanthocytosis, normolipoproteinaemia and multiple tics
Authors: Critchley E M R , Nicholson J T , Betts J J , Weatherall D J 
Published: December 2008

Summary
A chronic degenerative neurological disorder is described which is characterized by tics, grimacing, involuntary movements, a severe disturbance of swallowing and a concurrent malformation of the erythrocytes. This condition is clearly different from familial hypo-betalipoproteinaemia and abetalipoproteinaemia, the two previously described neurological disorders associated with abnormal red cells.
Acanthocytosis with normolipoproteinaemia: biophysical aspects
Authors: Betts J J , Nicholson J T , Critchley E M R 
Published: December 2008

Summary
The electrokinetic properties of normal and pathological red cells and platelets are compared.
The electrophoretic mobilities and isoelectric points of normal and pathological erythrocytes do not differ significantly, adsorption of calcium and uranyl ions occur to the same extent and treatment with neuraminidase induces almost identical mobility decreases.
The pathological platelet-plasma system is more sensitive to adenosine diphosphate (ADP) than normal systems; platelet aggregation and electrophoretic mobility increases are induced by much lower concentrations of ADP than those normally required. The pathological platelet system shows a greater tendency to aggregate spontaneously. The abnormal sensitivity to ADP of the pathological platelet-plasma system is considered in terms of plasma components.
The double glucagon test, a new liver function test
Authors: Verhaegen H , Verhaegen-Declercq M L , de Beukelaer A , Krug F 
Published: December 2008

Summary
A double glucagon test was performed in 100 patients and seventeen control subjects. Two intravenous doses of glucagon (1 mg) were administered at a 1-hr interval. Glucose was determined before the first injection and 20, 25 and 30 min after both doses, and the increases after each successive dose were added up.
In normal persons, the total increase in glycaemia was higher in the second than in the first hour and reached at least 110 mg. Normal values were found in cases of obstructive jaundice, cholelithiasis and adult diabetes, and abnormal values in patients with infective hepatitis, liver congestion and cirrhosis.
The double glucagon test was found to be very useful for the differential diagnosis of liver cell impairment and hepatic obstruction.