bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metastatic teratoma from a regressed impalpable testicular primary
Authors: Abel P D , Williams G 
Published: December 2008

Summary
A young man presented with a perineal tumour which despite intensive investigation, remained of unknown origin and required radical excision. It was subsequently shown to be a metastasis from a primary regressed testicular teratoma. It is important to exclude a testicular origin in these patients wherever possible because such tumours are often chemosensitive.
The BMRES 1984 Medical Research Expedition to the Himalayas
Authors: Bradwell A R , Coote J H 
Published: December 2008

Summary
Twenty-one subjects formed a trekking expedition to study the effects of acetazolamide on exercise performance and acclimatization at high altitude. Subjects were randomized to acetazolamide or placebo on a double blind basis. During ascent to and stay for 6 nights at 4846 m studies were carried out on blood gases, 2,3 diphosphoglycerate (2,3 DPG), proteinuria, exercise testing, intestinal absorption, purine metabolism and changes in body composition. The results showed beneficial effects of acetazolamide on exercise performance and preservation of muscle mass.
Effects of acetazolamide on cerebral blood flow and brain tissue oxygenation
Authors: Lassen N A , Friberg L , Kastrup J , Rizzi D , Jensen J J 
Published: December 2008

Summary
Oral administration of 1 g of acetazolamide to 8 normal subjects studied at sea level and in normoxia caused an acute increase in cerebral blood flow (CBF). During the subsequent prolonged oral treatment with 1 g of acetazolamide daily, CBF returned to normal within 2 days. The alveolar CO2 tension decreased gradually to 70% of the control value, indicating hyperventilation. At sea level hyperventilation will not increase brain oxygenation significantly in normal man, as the arterial oxygen content only increases minimally, while CBF is unchanged. At high altitude the beneficial effects of acetazolamide on the symptoms of acute mountain sickness may well be due to an improved oxygen supply to the brain, as hyperventilation will, at the low ambient PO2, cause a significant increase of the arterial oxygen content, while CBF presumably is unaffected by the drug. During hypoxia at high altitude the overall effect of prolonged acetazolamide treatment may thus be equivalent to a descent by several hundred metres.
Slow-release potassium and perforation of Meckel’s diverticulum
Authors: Layer G T , Scott-Jupp R H , Maitra T K , Darke S G 
Published: December 2008

Summary
A case of peritonitis following perforation of gastric-type mucosa in a Meckel’s diverticulum is described. At laparotomy a wax core of a combined diuretic-slow-release potassium preparation was found extruding through the perforation and a further pellet was found free in the peritoneal cavity. Intestinal perforation due to potassium-containing drugs is recognized and led to the development of enteric-coated and slow-release delivery systems. The association of perforation of Meckel’s diverticulum with a slow-release potassium perforation has not previously been described.
Growth hormone responses to hp GRF 1-44 amide, bromocriptine and stress in acromegaly are correlated
Authors: Belchetz P E 
Published: December 2008

Summary
The results of testing growth hormone (GH) reserve using human pancreatic growth hormone-releasing factor 1-44 amide (hp GRF 1-44 amide) have been compared with the GH responses in a variety of other dynamic tests in seven acromegalic patients. The GH release following hp GRF 1-44 amide correlated with the GH suppression following bromocriptine, but showed an inverse correlation with the GH release following stress tests (insulin-induced hypoglycaemia/glucagon). There was no correlation between the GH responses in these three tests and any of the other tests: TRH, GnRH and glucose. A hypothesis is proposed to explain these findings on the basis of varying degrees of GH secretion from adenomatous and normal pituitary somatotrophs in acromegaly.
Primary malignant neoplasms associated with chronic lymphocytic leukaemia
Authors: Lishner M , Prokocimer M , Ron E , Shaklai M 
Published: December 2008

Summary
The relationship between chronic lymphocytic leukaemia (CLL) and primary malignant neoplasms was evaluated using data from the Hematology Division in Beilinson Medical Center and the Israel Cancer Registry.
The study population consisted of 81 patients diagnosed between 1962 and 1984. A total of 16 patients were found to have 21 malignant neoplasms in addition to their CLL. Excluding patients with nonmelanoma skin tumours, a 1.7 increased risk (statistically not significant) for developing second malignant neoplasms in CLL patients was detected.
The only tumour which occurred significantly more than expected subsequent to CLL diagnosis was brain cancer. The coexistence of multiple cancers in the same patient was diagnosed in four of the patients.
The results of this study further support the hypothesis that patients with CLL are prone to develop second neoplasms.
Real time ultrasound, arterial pulsation and neonatal cerebral infarction
Authors: Donaldson B 
Published: December 2008

SummaryThis paper describes an infant whose cranial ultrasound scan showed marked unilateral cerebral arterial pulsation and enlargement without other abnormality. Subsequent computerized tomogram showed extensive cortical infarction in an area not readily accessed by ultrasound.It is concluded that the real time dimension of cranial ultrasound is of diagnostic value in the absence of demonstrable parenchymal or intraventricular abnormality.
Familial dysalbuminaemic hyperthyroxinaemia
Authors: Fleming S J , Applegate G F , Beardwell C G 
Published: December 2008

Summary
Familial dysalbuminaemic hyperthyroxinaemia (FDH) can be confused with thyrotoxicosis if clinical signs and laboratory tests are misinterpreted. We describe three members of the same family with FDH who were erroneously treated for thyrotoxicosis. Screening of other family members resulted in the discovery of a further six patients at risk of being misdiagnosed as thyrotoxic. Clinical and biochemical findings relevant to the diagnosis of FDH are discussed.
Surgical complications of amyloid disease
Authors: O’Doherty D P , Neoptolemos J P , Bouch D C , Wood K F 
Published: December 2008

Summary
The case of a man with primary systemic amyloidosis without myelomatosis and long-term survival is described. The patient has had major surgical complications from large amyloid deposits in the colon, dorsal spine and peritoneal cavity. The patient remains well 14 years after diagnosis.
Profound hypotension after the first dose of ketanserin
Authors: Waller P C , Cameron H A , Ramsay L E 
Published: December 2008

SummaryTwo patients developed profound hypotension approximately one hour after taking an initial oral dose of ketanserin 40 mg. The reaction appeared similar to that reported with prazosin, and may have been due to the alpha 1-adrenoceptor antagonist action of ketanserin. Both patients were taking regular beta-blocker therapy, which may exacerbate such a reaction.
A serial study of platelet reactivity throughout the first six months after myocardial infarction: its modification by sulphinpyrazone
Authors: Kubik M M , Richardson S G N 
Published: December 2008

SummaryPlatelet reactivity was studied immediately after and throughout the first 6 months following myocardial infarction. Its modification by sulphinpyrazone was observed.Out of 65 consecutive patients admitted to the coronary care unit, ten did not meet the protocol criteria. Fifty five received either placebo or sulphinpyrazone in a double-blind trial for 6 months, treatment being started within 6 days of infarction. Forty four patients completed the study (19 on placebo and 25 on sulphinpyrazone). An additional ten patients commenced treatment within one day of infarction and were studied daily for one week. Platelet hyper-reactivity was demonstrable in all patients at presentation and persisted throughout the 6 months in the control group. This effect was reversed by sulphinpyrazone, the modification of reactivity being established by the third day of treatment.
Impaired splenic function in systemic amyloidosis
Authors: Selby C D , Sprott V M A , Toghill P J 
Published: December 2008

Summary
In four cases of biopsy proven amyloidosis there was evidence of impaired splenic function. All had absent or grossly reduced splenic uptake on colloid isotope scans and three had haematological changes consistent with hyposplenism. Poor splenic function with a normal sized or enlarged spleen may be a clue to underlying amyloid.
Salmonella intracerebral and subdural abscess--report of two cases
Authors: Mahapatra A K , Bhatia R 
Published: December 2008

SummaryTwo cases of the rarely encountered Salmonella typhi subdural empyema are reported. The first was in an 11 month old infant and the second in a 25 year old adult. Neither of them suffered from typhoid fever. The causative organism was not suspected until the culture report was obtained. Both patients responded satisfactorily to therapy.
Amiodarone-induced pulmonary toxicity mimicking metastatic lung disease
Authors: Patel P , Honeybourne D , Watson R D S 
Published: December 2008

Summary
A 65 year old man developed atrial arrhythmias secondary to a congestive cardiomyopathy which were resistant to quinidine and disopyramide. Amiodarone controlled the paroxysmal atrial tachycardia but 4 months after starting the drug he developed increasing dyspnoea and radiological changes highly suggestive of metastatic lung disease. Lung biopsy showed change of drug-induced pneumonitis and 4 months after stopping amiodarone his symptoms resolved and the chest X-ray had cleared. Amiodarone may cause pulmonary toxicity mimicking metastatic lung disease.
Granulocytic sarcoma: a diagnosis to be considered in unusual lymphoma syndromes
Authors: Mansi J L , Selby P J , Carter R L , Powles R L , McElwain T J 
Published: December 2008

Summary
A series of 7 patients with granulocytic sarcoma is presented to illustrate its varied clinical picture. In particular, this condition may present with features which suggest a non-Hodgkin lymphoma. The diagnosis will only be made if a high index of suspicion is maintained and special histopathological methods are used. Granulocytic sarcoma should be treated like an acute myeloid leukaemia.
Crohn’s disease of late onset in Blackpool
Authors: Lee F I , Giaffer M 
Published: December 2008

Summary
Fifty five (26%) of two hundred and fifteen patients presenting with Crohn’s disease in the Blackpool area over a 15 year period (1969-1983) were over 60 years of age. There were twice as many women as men (38:17). In 60% disease was limited to the large bowel compared to only 29% in the younger age group. Many of these were women with mild distal colitis. Twenty one patients required operative management. In general, the prognosis was good in colonic disease, but in small bowel and ileocolonic disease the necessity for early operative intervention was potentially fatal. Delayed diagnosis, poor nutritional state and associated disease were relevant adverse factors. The majority of patients at the time of review were well and, where necessary, were coping satisfactorily with a stoma.
The journal club and medical education: over one hundred years of unrecorded history
Authors: Linzer M 
Published: December 2008

Summary
Sir William Osler organized a journal club at McGill University in 1875, and several authors suggest that journal clubs were found in certain European countries (in particular, Germany and England) prior to that time. The evolution and development of the journal club, however, has not been recorded in the medical literature. Through personal communications and interviews with senior clinicians and historians, I have traced the history of the journal club as an educational modality. In the early 1900s in Germany, journal clubs were routinely found in departments of medicine and medical schools. From 1917-1975, journal clubs evolved into a forum for continuing medical education. Recently, journal clubs have been designed to teach critical appraisal skills to physicians-in-training. Journal clubs are currently found in the fields of medicine, surgery, psychiatry, nursing, pharmacy, obstetrics and gynaecology, paediatrics and geriatric social service.
This powerful educational tool has played an active role in medical education for over a century. The journal club should be more formally incorporated into the medical educational curriculum.
Haemorrhage into a urachal cyst presenting as an ‘acute abdomen’
Authors: Davidson B R , Brown N J , Neoptolemos J P 
Published: December 2008

Summary
A previously well 3 year old Asian girl presented as an emergency with the acute onset of generalized abdominal pain. On examination her abdomen was distended with generalized tenderness and guarding most marked centrally. Under anaesthesia a central abdominal mass arising from the pelvis was palpated which on proceeding to laparotomy was found to be a blood-filled urachal cyst. This was excised and her recovery was uneventful. Subsequent investigations have revealed no associated renal tract abnormalities.
Malakoplakia associated with adrenal and islet cell hyperplasia and glucagonoma
Authors: McClure John , Fairweather D S , Mene A R , Banerjee S S 
Published: December 2008

Summary
Extensive involvement of the urinary tract and related structures by malakoplakia presented difficult diagnostic problems in two elderly individuals. At post-mortem examination there was bilateral adrenal cortical hyperplasia in both patients and, in one, there was also a pancreatic glucagonoma and diffuse hyperplasia of the pancreatic islet tissues. There is now an increasing body of evidence that malakoplakia is associated with hypercorticosteroidism possibly due to an effect on macrophage exocytotic mechanisms. The coexistence of malakoplakia and glucagonoma has not been previously described.
Abdominal tuberculosis in East Birmingham--a 16 year study
Authors: Sharp J F , Goldman M 
Published: December 2008

Summary
Abdominal tuberculosis, although rare, occurs mainly in immigrants from the Indian subcontinent. Such people comprise 13.5% of our local population and contributed 90% of a series of 72 patients presenting in the last 16 years; a local disease incidence of 1:6000 for Asian immigrants.
Men and women were equally affected, but on average women were much younger. Diagnosis was made from one month to 10 years after immigration. No clinical feature was diagnostic, but abdominal pain, night sweats and weight loss occurred in more than half the patients. The erythrocyte sedimentation rate (ESR) was elevated in 95% and no patient tested had a negative Mantoux test. In 20 patients diagnosis was by clinical suspicion and response to therapeutic trial. In 52, including 39 who had a laparotomy, histological and culture material was obtained but these patients fared no better. Only one organism was resistant (to streptomycin) and rapid response to chemotherapy was the rule. Successful outcome was not related to the type of presentation, operative findings or specific chemotherapeutic agents.
We would suggest that in Asians presenting with difficult-to-diagnose abdominal symptoms accompanied by malaise, raised ESR and a positive Mantoux test, a therapeutic trial of anti-tuberculous therapy should precede diagnostic laparotomy.
Dystrophia myotonica and pregnancy--an instructive case
Authors: Chung H T , Tam A Y C , Wong V , Li D F H , Ma J T C , Huang C Y , Yu Y L , Woo E 
Published: December 2008

Summary
Two cases of dystrophia myotonica, a mother and her newborn child, are reported. The diagnosis in the mother was only made after seven years and two eventful deliveries. The obstetrical and anaesthetic complications, as well as the neonatal form of dystrophia myotonica, are reviewed.
Systemic lupus erythematosus and primary cerebral lymphoma
Authors: Woolf A S , Conway G 
Published: December 2008

Summary
A woman with a 21 year old history of systemic lupus erythematosus (SLE) is presented. During a period of low connective tissue disease activity she developed sudden difficulty in walking and after much investigation was found to have a primary lymphoma of the brain. She died 6 months after this diagnosis from meningeal spread, despite radiotherapy to the tumour. The association between SLE and lymphoma is discussed.
The use of a new glycopeptide antibiotic, teicoplanin, in the treatment of bacterial endocarditis
Authors: Webster A , Wilson A P R , Williams A H , Treasure T , Grüneberg R N 
Published: December 2008

Summary
Teicoplanin, a new glycopeptide antibiotic, has been used to treat twelve patients with bacterial endocarditis due to Gram-positive organisms. Teicoplanin has activity against Gram-positive bacteria similar to vancomycin but therapeutic levels are maintained by a single daily dose, given as an intravenous bolus.
Of six patients with native valve infections, two cases, due to viridans streptococci, were successfully treated with teicoplanin alone and two others, caused by Streptococcus faecalis, were cured by combinations including teicoplanin. One of these patients sustained high tone hearing loss during treatment. The remaining two patients were drug addicts with endocarditis due to Staphylococcus aureus which recurred despite repeated multiple therapy. Of six prosthetic valve infections, antibiotic combinations including teicoplanin cured three cases, caused by streptococci. Infection persisted or treatment was curtailed in three cases of Staphylococcus epidermidis endocarditis.
In this small open study, teicoplanin appeared as effective as vancomycin in the treatment of endocarditis but had the considerable advantage of ease of administration.
Unusual causes of calf swelling--1. Unusual presentation of a tibial artery false aneurysm
Authors: Rowe P , Taylor P , Franklin A , McColl I , Missen A , Spencer J 
Published: December 2008

Summary
Peripheral aneurysms of the leg are rare, and nearly always involve the popliteal artery. We describe the unusual presentation of a swollen leg caused by a large false aneurysm of a branch of the posterior tibial artery. This developed in the absence of either a history of trauma, local infection or infective endocarditis.
Unusual causes of calf swelling--2. Rhabdomyolysis mimicking deep vein thrombosis
Authors: Small M , Alzaid A , Gray H W 
Published: December 2008

Summary
A 55 year old woman with pain and swelling of the leg was heparinized on the basis of a clinically diagnosed ilio-femoral deep vein thrombosis (DVT). Subsequent investigation showed her to have extensive rhabdomyolysis of the leg. Rhabdomyolysis can mimic the appearance of deep vein thrombosis and this case further illustrates the importance of venography in the assessment of the swollen leg.
Investigation of cereal toxicity in coeliac disease
Authors: Ciclitira P J , Ellis H J 
Published: December 2008

Summary
Coeliac disease is exacerbated by wheat gluten. A review of methods for the purification, identification and quantitation of wheat proteins to investigate coeliac disease is presented. Recent developments including amino acid sequencing and expression of wheat protein peptides in E. coli should permit characterization of the cereal peptide that exacerbates coeliac disease.
Pulmonary berylliosis on corticosteroid therapy, with cavitating lung lesions and aspergillomata--report on a fatal case
Authors: O’Brien A A J , Moore D P , Keogh J A B 
Published: December 2008

SummaryA fatal case of pulmonary berylliosis in a 42 year old male is described. The patient was exposed to beryllium while working in a chemical plant over a 9 year period, and presented two years after ceasing such employment. The berylliosis was diagnosed on open lung biopsy in 1971. The patient was commenced on steriod therapy at that time. He suffered progressive dyspnoea from severe restrictive lung disease over the next 14 years. A chest X-ray of June 1985 revealed a lesion in the left upper lobe suggestive of a mycetoma. Before any therapy could be instituted he suffered a massive haemoptysis and died. Post-mortem examination revealed two large mycetomata in the right and left upper lobes. Parenchymal histology showed evidence of chronic inflammation with non-caseating granulomata and the cavity wall showed localized invasion by Aspergillus fumigatus. It is possible that the long term steroid therapy with multiple boosters of treatment may have contributed to the development of the mycetoma. This is the first case report known to the authors of a fatal aspergilloma in association with chronic berylliosis treated with steroids.
Acute renal failure following Yersinia pseudotuberculosis septicaemia
Authors: Davenport A , O’Connor B , Finn R 
Published: December 2008

Summary
Although Yersinia pseudotuberculosis has not been previously reported to cause acute renal failure, it accounted for two cases reported here out of eighty referrals with acute renal failure to our renal unit over the last year. This may suggest that the incidence of Yersinia pseudotuberculosis may be greater than that previously reported, and it should be suspected in patients presenting with bloody diarrhoea in association with renal failure. The septicaemic form of the disease is life threatening and requires intensive supportive therapy.
Fatty retroperitoneal tumours--plain film and computed tomographic appearances
Authors: Fitzgerald E J , Lyons K 
Published: December 2008

Summary
Three patients with large fatty retroperitoneal tumours are presented. In all three the fatty mass was visible (but initially not recognized as such) on plain abdominal radiographs. Computed tomography (CT) confirmed the presence of fat within these tumours. Attention is drawn to the importance of the correct interpretation of the plain abdominal radiograph when such fatty tumours are present. Computed tomography then proves the presence of fat as well as site of origin of such tumours.
Severe reversible cardiac failure associated with methanol intoxication
Authors: Cavalli A , Volpi A , Maggioni A P , Tusa M , De Pieri G 
Published: December 2008

Summary
Methanol intoxication produces a well recognized clinical picture characterized by gastrointestinal, ocular and nervous system symptoms. The effect of poisoning on the cardiovascular system has not been well documented. We report the case of a 55 year old man whose acute methanol intoxication caused severe reversible cardiac failure. This represents the first description of an association between methanol toxicity and acute cardiac dysfunction in man.
Is the current use of thyroid scintigraphy rational?
Authors: Tindall H , Griffiths A P , Penn N D 
Published: December 2008

Summary
One hundred and thirty-one consecutive requests for thyroid scintigraphy were analysed to assess their diagnostic contribution to the subsequent medical management of the patient. Forty one per cent of requests were to investigate the presence of a clinically detectable solitary nodule and, of these, one fifth had hot nodules. Diffuse goitres accounted for 38% of all referrals, but in only two patients (non-toxic hot nodule) did the results change management. A further 11% of referrals were for multinodular goitres and 8% for retrosternal goitres. In all cases of goitre no additional useful information was obtained from scintigraphy. It is concluded that thyroid scintigraphy was an unnecessary investigation in approximately 45% of cases. Its primary role was in the investigation of the solitary nodule and in detecting toxic nodules in thyrotoxic patients who had no evidence of Graves’ disease. Greater discrimination of requests would avoid investigating patients unnecessarily and reduce costs.