bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herpes encephalitis
Authors: Campbell A M G 
Published: December 2008

Summary
The three forms of herpetic encephalitis have been outlined and particular stress has been laid on herpes simplex encephalitis, which accounts for a large percentage of cases showing necrotizing encephalitis.
The possible application of antiviral drugs such as idoxuridine in the treatment of this disease has been mentioned.
A case of herpes B encephalitis contracted from a monkey bite has been described, and care in the handling of monkeys has been stressed.
Para-infectious and post-vaccinal encephalomyelitis
Authors: Croft P B 
Published: December 2008

Summary
The incidence of encephalomyelitis in association with acute specific fevers and prophylactic inoculations is discussed. Available statistics are inaccurate, but these conditions are of considerable importance—it is likely that there are about 400 cases of measles encephalitis in England and Wales in an epidemic year.
The pathology of these neurological complications is discussed and emphasis placed on the distinction between typical perivenous demyelinating encephalitis, and the toxic type of encephalopathy which occurs mainly in young children.
The clinical syndromes occurring in association with measles, chickenpox and German measles are considered. Although encephalitis is the most frequent complication, myelitis and polyradiculitis also occur. There is evidence that ‘uncomplicated measles’ is associated with brain involvement in the prodromal phase. Similar para-infectious disorders occur in association with other infections including smallpox and influenza.
The post-vaccinal types of encephalomyelitis are also considered with particular reference to post-vaccinial encephalitis and rabies post-vaccinal encephalitis.
The pathogenesis of these disorders is discussed and it is concluded that there is direct viral invasion of the nervous system, followed by an antigen-antibody reaction. At times virus may remain latent within the nerve cell without destroying it.
Subacute sclerosing panencephalitis: measles encephalitis of temperate evolution
Authors: Dayan A D 
Published: December 2008

Summary
Subacute sclerosing panencephalitis is a rare disorder of late childhood and early adolescence Affected patients usually show behavioural and intellectual disturbance and involuntary movements before dying in coma after about 12 months. At some stage most have characteristic electroencephalographic abnormalities. Pathologically, changes in the brain are those of subacute encephalitis with a variable gliosis of the white matter, and sometimes intranuclear inclusion bodies in neurones and glial cells.
Recent studies in many patients have shown high levels of circulating anti-measles antibodies, measles antigen in cells in the brain, and sometimes, myxo-virus filaments in cells there. These findings suggest that SSPE may be a slow measles virus infection of the nervous system. Possible explanations for the slow evolution of the encephalitis include disordered immune mechanisms and intracellular persistence of virus in a defective phase.
Circulatory patterns in clinical shock
Authors: Walters G 
Published: December 2008

Summary
The term ‘shock’ is used to denote a pathological process, but in clinical practice it must be recognized by clinical methods.
Successful treatment requires both the haemodynamic abnormality and also the causal disease to be defined.
Because of the dynamic nature of the shock process and the multiplicity of the precipitating causes the clinical signs vary with time and also from case to case. Nevertheless, certain broad patterns tend to occur and their relationship to diagnosis and treatment are discussed.
Endotoxin shock—distinct entity or universal accompaniment?
Authors: Mee W M 
Published: December 2008

Summary
If an experimental animal is subjected to graded hypotension by bleeding into a reservoir, it will usually recover if the shed blood is returned to the circulation within 2 hr. If hypotension (40 mmHg) is prolonged to 6 hr, most of the animals will die despite the return of all the blood to the circulation at the end of this period. Fine and his co-workers have suggested that this state of irreversible shock is due to endotoxaemia. Fine’s evidence in support of this thesis is presented and discussed together with apparently contradictory evidence from other sources.
Sympatho-adrenal hyperactivity—the key to irreversible shock?
Authors: Irving M H 
Published: December 2008

Summary
There would appear sound evidence on which to incriminate sustained sympatho-adrenal hyperactivity as a deleterious factor of prime importance in hypovolaemic shock. The use of sympathomimetics in the treatment of shock of this type is irrational and deleterious. Their rational use in those few cases of clinical shock where they are indicated will have to await knowledge of plasma catecholamine levels in such cases.
Experimental studies involving α- and β-adrenergic blockade, unilaterally and in combination, have revealed that, contrary to previous theories, deterioration is mediated through both receptor types.
Many of the current concepts of the pathophysiology of shock will need reassessment in the light of as yet unappreciated facets of catecholamine activity.
Haemovascular changes in septic shock
Authors: Litton A 
Published: December 2008

Summary
In refractory hypotension of doubtful origin, bacterial factors should be suspected and blood cultures taken. Gram-negative organisms accounted for the majority of cases of bacteraemia.
Unlike haemorrhagic shock, the blood volume estimated in patients in shock associated with infection was not found to be reduced.
In some patients, when vital signs became stabilized, a marked expansion in the vascular capacity was demonstrated.
Plasma of patients in bacteraemic shock was markedly vasoconstrictor.
The metabolic acidosis present in cases of septic shock was due to lactic-acidaemia.
Sepsis can be suspected when thrombocytopenia is associated with leucocytosis.
The effect of environment on the response to injury in the rat
Authors: Stoner H B 
Published: December 2008

Summary
Recent work on the effect of changes in the environmental temperature on the local and general response to injury is discussed.
Both the acute and delayed responses to injury are affected by changes in environmental temperature.
Thermoregulation in the rat is impaired by an injury and there is an optimum temperature for survival after the injury.
The acute response to injury in the rat is also affected by the animal’s previous environmental history.
The increased sensitivity to catecholamines produced by cold acclimation alters some of the initial responses.
Shock and active vasodilatation in skeletal muscle
Authors: Walder D N 
Published: December 2008

Summary
The vasodilatation which occurs in the skeletal muscle of the cat following the stimulation of some fibres of the sympathetic nerves and that which follows the intravenous injection of small doses of adrenaline takes place in different vessels. It is, therefore, possible to obtain an augmented effect when both the above stimuli are applied simultaneously. Both mechanisms must be blocked to completely abolish active vasodilatation in skeletal muscle.
The role of the liver in the development of lactic acidosis in low flow states
Authors: Schröder R , Gumpert J R W , Pluth J R , Eltringham W K , Jenny M E , Zollinger R M 
Published: December 2008

SummaryThe role of the liver in lactate metabolism in an experimental low flow state induced by cardiac tamponade was investigated in dogs.Arterial and venous lactate, and pyruvate levels and arterio-venous oxygen content differences were measured for the liver, gut, forequarter and hind limbs. Cardiac output and regional blood flows were determined by electromagnetic flow probes.The contribution of the liver to the development of lactic acidosis was found to be variable. When hepatic oxygen consumption was decreased, the liver was documented as the major site of lactate production with an associated increase in the lactate-pyruvate ratio of hepatic venous blood. In some experiments, however, the hepatic oxygen consumption was maintained, or even increased slightly; in these circumstances the liver was, in part, responsible for the development of lactic acidosis by impaired lactate consumption.
Sugar intake, serum insulin and platelet adhesiveness in men with and without peripheral vascular disease
Authors: Yudkin John , Szanto Stephen , Kakkar V V 
Published: December 2008

Summary
Both the level of serum insulin and the adhesiveness of platelets are correlated with sucrose intake in men with peripheral vascular disease. These correlations do not exist in men who have no signs or symptoms of the disease, or of predisposing conditions such as hypertension.
The results support the suggestion of Szanto & Yudkin (1969) that an habitual high intake of sugar raises the insulin level in some individuals but not all, and that these individuals are susceptible to the effect of sucrose in producing occlusive arterial disease.
Barbiturate automatism—myth or malady?
Authors: Aitken R C B , Proudfoot A T 
Published: December 2008

Summary
Patients admitted to the Regional Poisoning Treatment Centre at the Royal Infirmary, Edinburgh, were assessed to identify cases of drug automatism and those who denied the act of self-poisoning.
Only two out of 994 instances of poisoning could be attributed to barbiturate automatism. The case histories of these patients are reported.
Twenty-nine patients on thirty-one admissions denied the act of self-poisoning and clinical data on this sample are reviewed.
It is suggested that there is insufficient evidence for accepting barbiturate automatism as a clinical entity and that the failure of these patients to remember the ingestion of more than a therapeutic dose is the result of psychogenic defence mechanisms.
It is concluded that the use of the term automatism contributes nothing to the management of patients poisoned with these drugs.
Fractures of the femoral shaft in children
Authors: Burwell H Nevile 
Published: December 2008

Summary
A series of 133 fractures of the shaft of the femur in children (during the first 12 years) is discussed. The injury is much more common in boys. The highest incidence is in 3-year-old children.
A gentle reduction is desirable and anaesthesia is rarely necessary.
In the age group under consideration ½ in. of shortening in reduction is desirable; angulation should be avoided.
Initial immobilization in younger children on Bryant’s traction and in older children on a Thomas’ splint has been found satisfactory.
The application of a plaster spica after 2 or 3 weeks allows the child to return home and in this way saves hospital beds. Physiotherapy is not required.
Complications should be avoided particularly with good nursing care but regular observation for vascular impairment (particularly after traffic accidents) is necessary.
The management of this injury is usually uncomplicated and provides good experience for junior medical staff under supervision.
Clinical use of the hyperbaric oxygen bed
Authors: Ashfield R , Drew C E 
Published: December 2008

Summary
The Vickers hyperbaric oxygen bed is described and details of its use are given in the treatment of 207 patients with a wide variety of clinical conditions. As part of a deliberate policy, a special study was made of its place in the treatment of severe acute myocardial infarction.
No major procedural difficulties were encountered. Results are generally encouraging and frequently of dramatic benefit.
Intestinal electrical activity: a means of assessing viability
Authors: Archampong E Q , Reinis Stanislav 
Published: December 2008

Summary
Experiments on ten dogs confirm the impression that electromyographic activity is an important criterion of viability of the intenstine subjected to vascular insults.
In all animals gangrene occurred only with complete loss of electrical activity; minimal activity (0·3 mV) was compatible with recovery.
For acceptance in clinical practice it will be essential to prove by further experimental work that an electrically inactive bowel is indeed gangrenous.
The cavity electrocardiogram in emergency artificial pacing
Authors: Chatterjee K , Layton C A , Sutton Richard , Edwards Ann 
Published: December 2008

Summary
Effective temporary pacing was achieved using the cavity ECG as a guide in twenty-five of twenty-six patients, twenty of whom were too ill to be moved to the fluoroscope.
In all patients U.S.C.I. unipolar or bipolar electrodes were used and in eleven patients this method of pacing was applied during resuscitation; four patients survived to leave hospital.
This technique is described and is recommended for emergency pacing when a bedside image intensifier is unavailable.
Exchange and simple transfusion in sickle-cell diseases in pregnancy
Authors: Buckle A E R , Price T M L , Whitmore D N 
Published: December 2008

Summary
The management of sickle-cell crisis in a pregnant patient by exchange transfusion is described, the procedure leading to immediate and dramatic improvement in the condition.
Partial exchange transfusion in three other patients with sickle-cell anaemia, judged by episodes of crisis in previous pregnancies to be at particular risk, is also reported and the value of this method of management discussed.
Renal scintiscanning. A review
Authors: Davies E Rhys 
Published: December 2008

SummaryRenal scintiscanning is a simple investigation that does not require special preparation and is well tolerated by patients.Radiopharmaceuticals used in linear scanning are accumulated in the renal cortex. This accumulation is diminished: (a) when the cortex is destroyed, e.g. by pyelonephritis, injury, etc.; and (b) when the amount available to the cortex is reduced, e.g. by ischaemia. The scintigram depicts the kidneys unimpeded by bowel contents, gives a qualitative assessment of renal function and shows the distribution of zones of normal function. Recent technical improvements show great promise in deriving a quantitative measure of renal function in some circumstances.The location of normally functioning cortex is often important in the management of renal diseases and the value of scintiscanning is then considerable. It is occasionally useful in planning surgery.The anatomy of the renal collecting system can be shown only by urography. High dose techniques achieve this even in the face of renal failure, and scintiscanning has few indications in investigating lesions that distort the renal anatomy, e.g. tumours and cysts.Renal scintiscanning is a very valuable additional method to urography, arteriography and renography in investigation of renal disorders.
Glomerular lesions in acute tubular necrosis
Authors: Handa S Paul 
Published: December 2008

Summary
Infraglomerular epithelial reflux has been described as an early microscopic lesion in the kidney of patients with acute renal failure. In our series of forty-four cases of acute tubular necrosis none showed this finding; however, in two cases lesions remotely similar to infraglomerular epithelial reflux and often known as ‘glomerular masses’ were present. No significance can be attached to these lesions.
Pseudoxanthoma elasticum
Authors: Tay Chong Hai 
Published: December 2008

Summary
Eight cases of pseudoxanthoma elasticum seen in a Medical Unit in Singapore are described. Of these six belonged to one family.
The clinical presentations of these cases, especially the first case who was a diagnostic problem for 5 years, are described. Transmission in this family is autosomal-recessive.
Eye changes were absent. Skin lesions were minimal and the axillary folds were more involved than the skin of the neck.
Of the eight cases, three were asymptomatic except for cutaneous lesions, three had suffered a haemetemesis and four a haemoptysis, while three had mental changes, and two had cerebrovascular involvement. Case 1 had in addition, bleeding from the nose, urinary tract and uterus. She also had a fatty liver, peripheral neuropathy and hysterical fits.
Only one case presented as a cosmetic problem.
The pathogenesis of PXE is discussed; the primary defect is believed to be in the elastic and not the collagenous tissue.
Enzymes for trauma
Authors: Miller Russell R , De Young Dirk V , Paxinos James 
Published: December 2008

Summary
We will discuss the mechanism of action, efficacy and side-effects of the proteolytic enzymes. Their exact mechanism of action remains vague which may be partly responsible for the uncertainty about their therapeutic value.
Use of chymotrypsin (Alpha-Chymar) in lens extractions has gained general acceptance and the topical use of trypsin-chymotrypsin (Biozyme), streptokinase-streptodornase (Varidase) and fibrinolysin-desoxyribonuclease (Elase) will also be shown to be of some value.
The merits of oral, buccal or intramuscular administration, however, will not be conclusively demonstrated. Studies showing favourable results for non-topically administered enzymes are not completely acceptable, primarily due to the lack of precise techniques of measurement.
The effectiveness of systemically administered preparations of proteolytic enzymes as anti-inflammatory agents will remain to be established.
An epidemic of ECHO 6 virus infection
Authors: Mary A S , Swallow J H 
Published: December 2008

Summary
Fourteen cases of infection with ECHO 6 virus in the Chelmsford area from August to December 1968 are described. A comparative account of the seasonal, geographical and age incidence is given, and its relationship to certain epidemiological aspects is discussed.
Aseptic meningitis occurred in eleven patients, pharyngitis in seven and myalgia in five. One patient suffered from pericarditis, a manifestation of this infection which has not hitherto been recognized. Another patient suffering from aseptic meningitis developed nephritis during the course of the illness, an association which has not been reported with ECHO 6 infection.
A relapse occurred in one patient with meningitis. No permanent ill-effects followed in any case.
Daunorubicin in acute leukaemia
Authors: Souhami R L , Prankerd T A J 
Published: December 2008

Summary
Daunorubicin has been used in the treatment of six cases of acute lymphoblastic and thirteen cases of acute myeloblastic and mono-myeloblastic leukaemia.
Complete remissions were obtained in eight patients, three with acute lymphoblastic leukaemia and five with acute myeloblastic leukaemia.
Marrow aplasia makes the drug difficult to administer, but no patients died from this cause, in this series.
In some patients good remissions were obtained with relatively low doses of daunorubicin after preliminary treatment with 6-mercaptopurine.
A bedside computer in foetal assessment
Authors: Curran James T 
Published: December 2008

Summary
The time has now come when mere survival of an infant can no longer be considered the index of successful obstetrics. It is thought that as many as one in ten surviving infants suffer some degree of damage in the process of labour. The two techniques to be described in this paper are attempts to derive methods for prognosing the ability of a foetus to withstand this process.
1. The Foetal Electrocardiogram: The examination of the FECG by the traditional methods of cardiology have proved very disappointing and unrewarding. If, however, the FECG is merely used as a means of recording the beat-to-beat interval of the foetal heart, statistical evaluation of this information can yield a valuable prognostic index.
2. The Foetal Ballistocardiogram: The purpose of the foetal heart (or for that matter the adult heart) is not to generate electrical signals but to propel blood through the circulation. One method of measuring this function in the adult is the ballistocardiogram and the application of modern signal recovery techniques has made it possible to derive the foetal ballistocardiogram.
Problems in histological interpretation in sarcoidosis
Authors: Drury R A B 
Published: December 2008

Summary
The sarcoid granuloma has a histological structure that is similar to that seen in many other diseases. Some of its diagnostic features are negative, but an accurate diagnosis can be made from biopsy tissues if numerous, monotonously uniform granulomata are present. Histological confidence is often proportional to the number of granulomata seen in the specimen.
Mediastinal lymph nodes taken at mediastinoscopy have been positive in 90% of seventy-four patients with sarcoidosis.
Problems in the histological interpretation of Kveim biopsies may be due to failure to include the injection site in the biopsy, to inadequate sectioning of the specimen and to equivocal cellular reactions. Despite these difficulties, dual blind reading of sections of mediastinal lymph nodes and Kveim reaction biopsies from patients with sarcoidosis has shown that the observer variation that is likely to be of clinical significance is approximately 5% in each group.
Skin changes in sarcoidosis
Authors: Cronin Etain 
Published: December 2008

Summary
The skin changes which occur in sarcoidosis are erythema nodosum and specific granulomata.
The incidence of erythema nodosum and its frequency in England and Scandinavia is contrasted with its comparative rarity among Negro patients in the United States. The various types of granulomata are described and classified. In contrast with erythema nodosum, granulomata are more common in Negro than in Caucasian patients.
The late stages of pulmonary sarcoidosis
Authors: Scadding J G 
Published: December 2008

Summary
Pulmonary sarcoidosis is frequently preceded by bilateral hilar lymph-node enlargement (BHL). Although it is normally difficult to be certain in a patient without BHL that a stage of BHL has not in fact occurred in the past but been missed, there is good evidence that some cases of pulmonary sarcoidosis arise without preceding BHL. Although a prefibrotic infiltration of the lungs will usually show signs either of resolution or of developing fibrosis within 2 years, such an infiltration may remain apparently non-progressive, producing little functional defect, for much longer than this, and in such a case, substantial resolution remains possible. A high proportion of those who develop fibrosis show a characteristic pattern of strand-like fibrosis in the middle zones and lower part of the upper zones of the lungs, with emphysematous changes above and below. In densely fibrotic parts of the lungs, cavities may appear, probably from necrosis at the centres of large masses of hyaline fibrosis. A rare complication is the development of a ‘fungus ball’ due to the growth of Aspergillus in such a cavity.
Occasionally, fine focal fibrosis develops without distortion of lung architecture, but with severe disability.
A rare but important event is the development of bronchial stenoses. These may affect main, segmental or subsegmental bronchi, more especially the proximal parts of segmental or subsegmental bronchi.
Calcification has been observed to develop in a characteristic symmetrical fashion in the hilar lymphnodes and occasionally in small foci in the lungs in about 5% of patients with pulmonary sarcoidosis who initially had BHL, followed for periods ranging from 5 to 20 years.
In the late stages of sarcoid fibrosis of the lungs, the specific granuloma may be no longer convincingly demonstrable.