bluuebunny/crossref_metadata_2025_split huggingface dataset:
The diagnosis of pulmonary embolism: a review with particular reference to the use of radionuclides
Authors: Cook David J , Lander Harry 
Published: December 2008

SummaryPulmonary embolism was first recognized as an important entity early in the nineteenth century. The evolution of our knowledge of this disorder has been reviewed with particular emphasis on the various diagnostic techniques which have been used to assist in its recognition. These have included physical examination to demonstrate the presence of classical physical signs, electrocardiography, biochemical tests, radiological examinations, pulmonary function tests, ultra-sound and methods employing radionuclides. The wide variety of techniques applied to this problem clearly indicates that no currently available test is entirely satisfactory alone. Probably the most significant advance in recent years has been the development of lung perfusion scanning which has provided at the very least a valuable screening test and a ready method of studying serially the natural history of the perfusion defects produced by thromboembolic disease.
Metacarpal bone dimensions in young and aged South African Bantu consuming a diet low in calcium
Authors: Walker Alexander R P , Walker B F , Richardson B D 
Published: December 2008

Summary
Groups of South African Bantu boys and girls of 14 years, compared with local Caucasian children, have lower cortical thickness, cortical score, and crosssection and volume scores for second metacarpal. Yet, when these parameters on groups of aged Bantu men and women, 70-79 years, are compared with published values on corresponding Caucasians, there are no significant differences. Further, aged Bantu have lower prevalences of hip fracture and severe collapse of vertebral bodies. Since a low calcium intake, and in aged Bantu women numerous pregnancies and long lactations, are compatible with satisfactory bone data, it is questioned whether the present insistence on a high calcium intake is justified.
Prevention of hepatitis with immunoglobulin
Authors: Reid Daniel 
Published: December 2008

Summary
Immunoglobulin appears to be effective in preventing the clinical features of infectious hepatitis among contacts of the disease provided it is given before the later stages of the incubation period. A single dose of 750 mg gives protection for a period of up to 7 months.
The evidence of the value of immunoglobulin for contacts of serum hepatitis is conflicting.
Haemodialysis-associated hepatitis
Authors: Finn Ronald 
Published: December 2008

Summary
Outbreaks of hepatitis have occurred in renal units all over Europe and the U.S.A. and have carried a high mortality.
This is an iatrogenic disease, transmitted by blood from carriers of SH virus, uraemic patients often suffering subclinical attacks.
The risks to the staff of these units are so high that they should not be asked to undertake this work if outbreaks cannot be controlled.
Sexual inadequacy in the male
Authors: Bancroft John 
Published: December 2008

Summary
The adequacy of sexual functioning in the male depends on a complex interaction between psychological, hormonal and neurophysiological factors. Disturbance of any one of these factors may lead to sexual inadequacy. In the majority of cases no gross abnormality is found but the absence of gross hormonal or neurophysiological abnormality does not necessarily imply a purely psychological cause. Individual variations in the pattern of response of the autonomic nervous system or in the ability to learn control of autonomic responses such as erection or ejaculation may be sufficient to account for some cases of inadequacy and in others may increase the susceptibility to psychological factors. Further research is required to clarify these undoubtedly important psychophysiological relationships.
Treatment has been most successful when it has taken into account both psychological and physiological factors. The advances made by Masters & Johnson (1970) in this area have partly depended on their earlier physiological and anatomical studies of sexual response (Masters & Johnson, 1966).
It may be that in some cases the use of anxiety-reducing drugs or androgens will be all that is required but further work is required to identify such cases. The placebo effects of such preparations should not be overlooked particularly as many cases of sexual inadequacy are based on lack of confidence or ignorance and require little more than good advice or reassurance.
Considerable advances in our understanding of these problems have been made in the past 20 years and techniques of endocrine, physiological and behavioural assessment are now available which should enable further progress to be made in the near future.
The insulin response to glucose in patients with non-diabetic glycosuria
Authors: McKiddie M T , Scott R T A , Cole R 
Published: December 2008

Summary
Glucose tolerance tests (GTT) were performed and plasma insulin levels measured by immunoassay in eighty-nine subjects previously found to have non-diabetic glycosuria (fifty-six with renal glycosuria and thirty-three with lag curves). The time-interval between the two tests varied from 6 months to 13 years.
Ten patients had developed chemical diabetes but only three had symptoms. Two had initially renal glycosuria and eight lag curves. This significantly different incidence may have been due to an excess of older patients in the lag-curve group.
The mean insulin response was higher in those with diabetes than in those in whom the second test was normal. The individual insulin responses were abnormal by our criteria in twenty-six subjects including six of the ten diabetics. In twenty-four subjects plasma insulin levels had been measured during the initial GTT. The insulin response had been abnormal in thirteen of these, four of whom were diabetic at follow up. In contrast only one of the eleven subjects with an initially normal insulin response had developed diabetes.
It is suggested that an abnormal insulin response to glucose may be an indication of potential diabetes.
Fructose in medicine
Authors: Huttunen Jussi K 
Published: December 2008

Summary
A review is given of the metabolism of fructose in the mammalian organism, and its significance in medicine. Emphasis is laid upon the absorption and assimilation of fructose through pathways not identical with those of glucose. The metabolism of fructose is largely insulin-independent, although the ultimate fate of fructose carbons is determined by the presence or the absence of insulin.
Clinical and experimental work has suggested that fructose may exert beneficial effects as a component of the diet for patients with mild and well-balanced diabetes. Fructose is absorbed slowly from the gut, and does not induce drastic changes in blood sugar levels. Secondly, fructose is metabolized by insulin-independent pathways in the liver, intestinal wall, kidney and adipose tissue.
As a consequence of the rapid and efficient utilization of fructose, it has been used widely for intravenous feeding in medicine and surgery. However, it has been shown that the rapid infusion of large amounts of fruetose may cause accumulation of lactic acid in the extracellular fluid. The possibility of lactate acidosis, with concomitant impairment of the acid-base balance, already disturbed, constitutes a relative contraindication to the use of intravenous fructose in the treatment of diabetic ketoacidosis.
Fructose is known to accelerate ethanol metabolism in the liver. No well-documented reports on the use of fructose in the treatment of ethanol intoxication have been published, although it has recently been suggested that fructose might be of value in the treatment of delirium tremens.
Fructose may be less cariogenic than sucrose, at least in short-term experiments. Long-term trials are lacking, and thus the potential advantages of fructose in preventive odontology have not been determined.
Fructose does not seem to have any side-effects when used in reasonable amounts. However, it has been reported that the administration of fructose in large amounts induces hyperlipidemia both in man and in experimental animals. Earlier suggestions concerned with the atherogenic properties of fructose have recently been challenged. The apparent increase in the incidence of coronary disease among sucrose users seems to be a statistical artefact, caused by the increased ingestion of coffee and soft drinks by cigarette smokers.
Tuberculosis in England and Wales in the next 20 years
Authors: Bignall J R 
Published: December 2008

Summary
Present trends in the incidence of tuberculosis are reviewed.
Extrapolation suggests that there will only be about 1200 notifications in 1980. By 1990 it is probable that the disease will be no commoner than non-tuberculous meningitis is now, and by 2010 it should be of interest to the medical historian only.
The hypoglycaemic action of metformin
Authors: Frayn K N , Adnitt P I , Turner Paul 
Published: December 2008

Summary
Twenty-four-hour excretion of D-xylose after oral administration in nine diabetic patients, and of 3-0-methyl-D-glucose in six patients, showed no significant change after treatment with metformin. There was, however, a significant reduction in mean fasting blood glucose levels in thirteen patients from 160 to 115 mg/100 ml (P &lt;0·001), and the intravenous glucose tolerance improved in twelve of these patients (P &lt;0·01), during treatment with metformin.
It is concluded that the hypoglycaemic action of metformin does not depend primarily on an intestinal effect.
The early diagnosis of lung cancer
Authors: Deeley T J 
Published: December 2008

SummaryEarlier diagnosis of malignant disease in the lung may bring about improvements in the treatment. This article discusses the effects of early diagnosis on the prognosis. Cancer of the lung may be associated with other lung pathology, thus increasing the problems of diagnosis. Diagnosis depends on radiological examination, cytology of the sputum, radio-isotope lung scanning and mediastinoscopy: an account is given of how these may be used to diagnose the condition whilst it is still at an early stage and suitable for radical treatment.
The value of brain scanning
Authors: Riddoch D , Drolc Z 
Published: December 2008

Summary
Over a 3-year period, 667 brain scans were performed, of which the results in 632 have been analysed.
Positive scans were found in 68% of 204 cerebral tumours. There was a high rate of detection of meningiomas and malignant gliomas. Scanning was less helpful in visualizing slowly growing gliomas, and those tumours situated in the mid-line or posterior fossa. Metastases occupied an intermediate position.
Positive scans occurred in a proportion of patients following acute cerebro-vascular accidents, and in a few other miscellaneous disorders.
Virtually all patients with transient cerebral ischaemia, migraine, epilepsy and presenile dementia had normal brain scans.
The value and limitations of this investigation have been discussed.
Infection associated with modern surgical procedures
Authors: Shaw D 
Published: December 2008

Summary
In postoperative wound infections due to Escherichia coli, 59% of the sepsis was caused by ten O-serotypes. For each serotype, except O6, the frequency of sepsis mirrors the frequency of carriage. Endogenous wound infection: evidence was presented but not discussed. Eleven patients had wound infections due to serotype O6, five were carriers of this serotype at the time of operation. Serotype O6 occurred significantly more frequently in wounds than in carriage specimens. In this study the strains showed enhanced infectivity in wounds.
Assessment of electrical conversion of supraventricular arrhythmiasPresented at Symposium of the Royal College of Physicians of Ireland and the American College of Physicians in Dublin, Eire, on 18 September, 1971.
Authors: Kernohan R J 
Published: December 2008

Summary
Direct current shock therapy in 244 cases of atrial fibrillation, fifty cases of paroxysmal supraventricular tachycardia, and eighteen cases of atrial flutter has been assessed. The administration of intravenous diazepam (Valium) allowed direct current shock therapy without general anaesthesia and tracheal intubation.
Seventy percent of cases of atrial fibrillation, 96% of cases of paroxysmal supraventricular tachycardia, and 94% of cases of atrial flutter reverted to sinus rhythm. The 190 patients first treated were followed up after the attempt at conversion until relapse of the arrhythmia or for a minimum of 2 years. The best results were obtained in arrhythmia of thyrotoxic aetiology. In patients with ischaemic/hypertensive heart disease and rheumatic heart disease the results were disappointing.
The success rate with direct current shock therapy is inversely related to the cardiothoracic index, and with increase in heart size there is also deterioration in the long-term results. Only one of the patients who had a cardiothoracic index of more than 55% remained in sinus rhythm at the end of 2 years.
The success rate decreases with increasing duration of the preceding arrhythmia, particularly when it had been present for more than 1 year, and the stability of the attained sinus rhythm also decreases with increasing duration of the preceding arrhythmia.
Direct current shock therapy is the method of choice in most cases of atrial flutter. Direct current shock therapy is seldom indicated in paroxysmal supraventricular tachycardia except in cases with underlying serious heart disease. Direct current shock therapy is contra-indicated in digitalis-induced arrhythmias.
The effect of fenfluramine on glucose tolerance, insulin, lipid and lipoprotein levels in patients with peripheral arterial disease
Authors: Bliss B P , Kirk C J C , Newall R G 
Published: December 2008

Summary
An investigation has been undertaken to determine the effects of fenfluramine on glucose tolerance, insulin, fasting lipid and lipoprotein levels, in a series of twenty-five patients suffering from peripheral arterial disease.
The results indicate that fenfluramine significantly improved glucose tolerance and that this was not the result of increased insulin production. Small but significant reduction in fasting cholesterol and β lipoprotein levels also occurred in most of the patients. Fenfluramine had no consistent effect on fasting nonesterified fatty acid, glycerides or pre-β lipoproteins.
The pharmacokinetics of an oral form of carbenicillin in patients with renal failure
Authors: Bailey R R , Eastwood J B , Vaughan R B 
Published: December 2008

Summary
An orally active ester of carbenicillin was administered to patients with varying degrees of renal dysfunction. The peak serum levels and serum half-life were found to be increased in patients with renal failure. Urine levels, however, in these patients were above the minimum inhibitory concentration for the majority of urinary tract pathogens.
Hyperfunctioning carcinoma of the parathyroid gland
Authors: Gale T C , Owens C W I 
Published: December 2008

Summary
Carcinoma of the parathyroid gland is rare, constituting about 1% of most series of patients with hyperparathyroidism. In 1969 a collective review identified forty-six unequivocal cases, and since then a further seven cases have been described in the literature.
A brief review of the condition is presented, and one further case of hyperfunctioning adenocarcinoma of the parathyroid gland is reported in detail. Primary treatment is discussed, together with postoperative biochemical problems, and the therapeutic manoeuvres available to deal with recurrences are presented.
Diagnosis of listerial infections in infants
Authors: Harper I A , Howells C H L 
Published: December 2008

SummaryFive cases of suspected listerial infection are presented; four were proved to be genuine. Problems arose in the microscopy of smears of cerebrospinal fluid; the organism was not detected in one case, and in two other cases it was described as another type of bacterium. Difficulties in identifying the organism culturally are also discussed.
Coeliac disease and small bowel carcinoma
Authors: Kenwright Simon 
Published: December 2008

Summary
Small bowel carcinoma can occur in association with villous atrophy in the jejunum. In most reported cases there is doubt as to which of these represents the primary lesion. These cases are reviewed here. A further case is reported in which a carcinoma developed in a patient known to be suffering from coeliac disease for some years, although he was not on a gluten-free diet for the time preceding the diagnosis of carcinoma. On dietary restriction he remains well at 2-year follow-up. Possible aetiological factors are discussed.
Maternal bronchial carcinoma and its possible relation to neonatal hypoglycaemia
Authors: Sharp J C , Carty M J , Logan R W 
Published: December 2008

Summary
A neonate whose mother had been diagnosed as suffering from bronchial carcinoma presented with many of the features characterizing the syndrome shown by babies of diabetic mothers. It is suggested that over-production of corticotrophin in the mother was responsible for the hypoglycaemia and other manifestations in the infant.
Clostridial brain abscess and hyperbaric oxygen
Authors: Keogh A J 
Published: December 2008

Summary
The first case of ‘gas gangrene’ of the brain treated with hyperbaric oxygen is reported. It is suggested that there is no place in clostridial infection confined to the central nervous system for hyperbaric oxygen treatment. The early onset of symptoms in clostridial brain abscess with the presence of a gas bubble localizing the abscess were again confirmed. The importance of taking a careful history and obtaining skull radiographs in suspected penetrating wounds is stressed.
Inactivated vaccines. 1. Volunteer studies with very high doses of influenza vaccine purified by zonal ultracentrifugationPresented by the senior author before the symposium on Influenza Vaccines, London, 27 April 1972.
Authors: Mostow Steven R , Schoenbaum Stephen C , Dowdle Walter R , Coleman Marion T , Kaye Harold S 
Published: December 2008

Summary
In these studies very high doses (up to 4800 CCA units in adults) of formalin inactivated influenza vaccine purified by density gradient centrifugation were given safely to more than 5000 volunteers drawn from adolescent, middle aged and elderly populations. The relative paucity of reactions, compared with those groups receiving much lower doses of formalin-inactivated vaccine produced by Sharples centrifugation, suggests that reactions are due to non-viral substances rather than to toxic properties of the viruses, and that these substances are removable.
Homologous serum HI antibody responses increased with increasing vaccine dosage and there was no plateau effect at the higher dose level. In those groups studied, the appearance of neutralizing activity in post-vaccination nasal washings correlated closely with the higher vaccine doses and higher HI antibody titres.
The occurrence of the ‘Hong Kong flu’ epidemic in two of the groups, including over 3000 vaccine recipients, provided a unique opportunity to study the efficacy of the various vaccines used. Only those groups receiving high doses of a Hong Kong-like antigen (A2/Aichi/2/68) enjoyed significant reduction in illness (70%). Furthermore, there was a 90% reduction in the incidence of fever in that group.
These results indicate that very large doses of purified influenza vaccine can be given safely. Significant prevention and modification of disease caused by influenza via the vaccine approach is dependent on the administration of large doses of the appropriate antigen.
Studies on influenza vaccine in industry
Authors: Smith J W G , Pollard R 
Published: December 2008

Summary
Large scale studies of influenza vaccination in industry have recently been started. The studies are of two types: (a)Vaccination was offered to a factory and a record maintained of sickness absence of all employees, both the vaccinated volunteers and the non-volunteers. In five different factories, the average acceptance rate was 42%.An analysis of the volunteers in one factory indicated that acceptance of vaccination was highest in middle-aged married women and low in younger and older men.(b)In the Post Office telecommunications branch vaccination was offered to 26,317 employees in eighty-eight units in different parts of the country; 42% of these accepted vaccination. Ninety-eight other units, employing 25,202 employees, are acting as unvaccinated controls. Sickness absence is being recorded in both groups of units.
In both these groups of studies it is aimed to compare the absence experience of the immunized and non-immunized groups for a prolonged period, both when influenza is and is not occurring.
Preliminary findings are presented of the absence figures for January and February 1972, during which time a mild outbreak of influenza occurred, with only a small effect on sickness absence. Vaccinated persons in factories had lower absence rates than the non-vaccinated persons, and telecommunications units in which vaccination was offered experienced lower absence rates with less respiratory absence.
The significance of these findings is discussed.
The protective effect of intranasal immunization with inactivated influenza virus vaccine
Authors: Liem K S , Jacobs J , Marcus E A , van Strik R 
Published: December 2008

Summary
Protection against influenza after killed influenza spray vaccine was assessed in nine double blind, placebocontrolled clinical trials and two field studies, involving a total number of 10,000 subjects.
Monovalent vaccine, containing 300–360 IU A/Hong Kong/1/68 (H3N2) or bivalent vaccine, containing 300–360 IU A/Aichi/2/68 (H3N2) and 200–240 IU B/Mass/3/66 per dose was used.
Administration by the intranasal route appeared to be acceptable as an alternative to the parenteral route. The protective efficacy found was comparable with that attained after parenteral vaccination. It has, however, the advantages of a characteristic lack of side-effects and of the fact that no injection is involved. This will probably enhance the acceptance of influenza immunization by the population and thus lead to a higher vaccination rate in the communities we want to protect against influenza.
A new subunit influenza vaccine: acceptability compared with standard vaccines and antigenicity in increasing dosageTaken from an article originally published in the Journal of Infectious Diseases (1972) 125, 656.
Authors: Ruben Frederick L , Jackson George Gee 
Published: December 2008

SummarySubunit influenza vaccines have the advantage of purity and a broad dosage range. Clinical studies were done with a new subunit vaccine produced by detergent fractionation with tri-(n-butyl) phosphate (TNBP). Acceptability by the recipients was compared in volunteers given 400 CCA units of A2 and 300 of B Influenza vaccine as either Sharples, zonal centrifuged, ether subunit, or TNBP subunit bivalent vaccines. When given subcutaneously, subunit vaccine caused only slightly less pain and erythema induration than zonal or Sharples vaccine. Compared with the i.m. route, the same vaccine given subcutaneously produced twice the local pain and eight times the erythema induration. Fever was infrequent and low grade by either route. HI antibody rises were good in all groups. Increasing dosages of TNBP vaccine up to 6400 CCA units of A2 and 4800 of B given i.m. as monovalent vaccine, produced no local and few febrile responses. An augmentation of the antibody titre occurred with the highest CCA unit dosages. Subunit vaccine given i.m. permitted administration of high CCA unit dosage beyond that accepted for standard vaccine without any increase in local reactions and with a measurable increase in antibody production and the induction of antibodies against related heterologous strains.
Tumours of the sigmoid colon following ureterosigmoidostomy
Authors: Lien W M 
Published: December 2008

Summary
A case of bilateral adenomatous polyps and a case of adenocarcinoma of the sigmoid colon following ureterosigmoidostomy are described. The recent literature is reviewed. The possible causes and the mucosal changes of the large bowel after ureterosigmoidostomy are briefly discussed.