摘要:

Summary:Emerging patterns of hepatitis B chronic liver disease in Australia. G. W. McCaughan, C. Parsons and N. D. Gallagher, Aust. N.Z. J. Med., 1979, 9, pp. 359–364.Until now, the hepatitis B virus has been thought to play a minor role in the aetiology of chronic liver disease in Australia. This is a report of 21 patients with cirrhosis and/or primary hepatocellular carcinoma with hepatitis B antigenaemia. Primary hepatocellular carcinoma occurred in six patients, five of whom had underlying cirrhosis. The disease occurred mainly in non‐Australian born males, and was not often associated with a previous history of hepatitis. The death of 16 patients within 12 months of presentation is in contrast to previous concepts of the benign nature of hepatitis B associated cirrho

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04157.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Is pancreatic polypeptide estimation of value in diagnosing gastrinomas (Zollinger‐Ellison syndrome)? D. J. Byrnes, J. Marjason, L. Henderson, N. Gallagher and D. Fabricatorian, Aust. N.Z. J. Med., 1979, 9, pp. 364–366.Serum levels of pancreatic polypeptide (PP) were determined in 32 normal subjects, 18 patients with gastrinoma, 19 patients with pituitary adenoma and 11 patients with duodenal ulceration.Mean serum levels of PP in patients with gastrinomas (67±31 pmol/ (SD)) were significantly (P<0·01) higher than in the normal subjects (47 ± 15 pmol/). However, only five of 18 of the patients with gastrinomas had PP levels above the upper limit of normal and elevations of similar magnitude were observed in patients with other disease processes. It is therefore concluded that serum PP estimations are not of value in the diagnosis of gastr

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04158.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04159.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:The effect of cirnetidine on gastrin release in ulcer disease. M. G. Korman. J. Hansky and J. Waugh, Aust. N.Z. J. Med., 1979, 9, pp. 367–369.The effect of a single dose of 400 mg of the H2‐receptor antagonist cimetidine on protein meal stimulated immunoreactive gastrin was assessed in ten patients with gastric ulcer and ten patients with duodenal ulcer. In gastric ulcer patients, serum gastrin (mean±SE) rose from 34±2·2 pmol∖l‐1to a peak of 80±5·0 pmol∖l‐1at 45 minutes without and from 36±2·2 to 107±8·0 pmol∖l‐1at 60 minutes with cimetidine; in duodenal ulcer it rose from 26±3·0 to 47±5·1 pmol∖l‐1at 45 minutes without and 26±3·2 to 52±5·1 pmol∖l‐1at 60 minutes with cimetidine. Integrated gastrin responses in gastric ulcer were 4900±800 pmol∖l‐1720 minutes without and 7000±900 pmol∖l‐1720 minutes with cimetidine and 1560±300 pmol∖l‐1720 minutes without and 2620±400 pmol∖l‐1720 minutes with cimetidine in duodenal ulcer patients. These gastrin increases after cimetidine are comparable to those achi

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04160.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Immune complexes in diabetes mellitus. J. A. Charlesworth, L. V. Campbell, J. Quin, L. Lazarus and G. J. Macdonald, Aust. N.Z. J. Med., 1979, 9, pp. 370–373.Sera from 86 well controlled diabetics were examined for the presence of immune complexes. Thirty‐six patients were receiving standard insulins, 19 monocomponent preparations, 24 oral hypoglycaemic agents and seven dietary restriction alone. Three methods were used to detect complexes: measurement of complement components, a Clq binding assay (BA) and the Raji cell radioimmunoassay (RIA). Complement components were normal in all patients. Eleven (31%) of the group on standard insulins had a positive Raji cell RIA; none had an abnormal Clq‐BA. One patient on monocomponent therapy had a mildly positive Raji cell RIA; Clq‐BA was negative in each patient of this group. Thirteen (54%) of the patients on oral hypoglycaemic agents were positive on one or both assays while one patient on diet alone was abnormal on both assays. These data show that immune complex production is common in both insulin‐requiring and non‐insulin‐requiring diabetics and that this phenomenon is strikingly less frequent in patients on mono‐component insulins. Such observations could bear relevance to the pathogenesis of microvascular complicati

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04161.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Home blood pressure monitoring and changes in plasma catecholamines during once or twice daily treatment with atenolol in patients with mild hypertension. B. P. McGrath, L. J. Beilin, T. Schofield, C. R. Benedict, N. P. Barker and R. Cooper, Aust. N.Z. d. Med., 1979, 9, pp. 374–381.1. The effects of atenolol on diurnal blood pressure control, heart rate and plasma catecholamines were studied in nine hypertensive, six of whom also received diuretics. The patients completed a double‐blind trial in which the effects of once and twice daily administration of atenolol were compared with placebo.2. Atenolol (100 mg) given once a day produced significant reduction in diurnal blood pressures recorded at home but the effect was slightly less than either 50 mg given twice a day or 200 mg once a day.3. Effects on heart rate and blood pressure were seen within 36 hours of the first dose, and were near maximal at 72 hours. After cessation of the drug, mean resting heart rate increased gradually and reached pre‐treatment levels five days later, suggesting strong tissue binding of atenolol. Blood pressure increased more slowly over 8–10 days.4. Plasma noradrenaline levels were increased at rest with atenolol. This argues strongly against the antihypertensive effect of atenolol being due to a reduction of sympathetic nerve activity.5. Once daily administration of atenolol in this group of patients with mild hypertension produced satisfactory diurnal blood pressure control and beta blockade without “rebound” hypertension on cessation

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04162.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Heparinized chemotherapy in the treatment of disseminated lung cancer. G. G. Jamieson and R. C. Angove, Aust. N.Z. J. Med., 1979, 9, pp. 381–384.Fourteen patients with inoperable or metastatic carcinoma of the lung were entered in this study. All of them received one or more courses of multiple chemotherapy (cyclophosphamide, 5‐fluorouracil, methotrexate and vincristine) with prior and concurrent heparin ant/coagulation.No tumour regression was noted in any patient although one patient is alive and well at two years. Five patients developed sudden increase in pleural effusion whilst on heparin therapy and in four of these patients the effusion was a significant factor in their de

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04163.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Thyroid hormone response to thyro‐trophin releasing hormone stimulation in subjects from endemic goitre regions of Sarawak, Malaysia. G. F. Maberly, C. J. Eastman and J. M. Corcoran, Aust. N.Z. J. Med., 1979, 9, pp. 385–390.In iodine deficient subjects a common finding has been subnormal T4 levels, normal or slightly elevated T3 levels together with normal or elevated TSH levels. A comparative study of circulating thyroid hormone concentrations in 165 severely goitrous (prevalence of 99%) and 122 non‐goitrous control subjects from two regions in Sarawak, Malaysia confirmed serum levels consistent with these findings.There has been some uncertainty whether these altered serum hormone concentrations found in endemic goitrous subjects arise primarily from thyroidal secretion or increased peripheral conversion of T4 to T3 or altered disposal of these hormones. A 20 mg dose of oral TRH was administered to ten goitrous and five non‐goitrous subjects and the serum thyroidal response measured over four hours. The mean maximal increment in TSH in the goitrous (43±2 mU) was almost double that of the non‐goitrous (23±2 mU/) subjects (P<0·02). Despite this the mean maximal increment in T4 in the goitrous (14·2±16·7 nmol/) was less than one quarter of the non‐goitrous group (94±32 nmol/; P<0·02). The mean maximal increment in T3, in the two groups, however, were similar (goitrous, 1·21±0·1 nmol/; non‐goitrous 1·32±0·7 nmol/). Serum thyroid hormone concentrations measured 24 hours following 10 IU parenterally administered bovine TSH to 14 goitrous and seven non‐goitrous subjects gave a similar pattern. TSH suppressed to low levels in both groups. The mean increment in T3 was almost identical in both groups (goitrous, 1·55±0·12 nmol/; non‐goitrous, 1·57±0·12 nmol/). The mean increment in T4 in the goitrous (14±2·10 nmol/) was less than one quarter of the non‐goitrous group (62±14 nmol/; P<0·05). These findings support evidence, thus far mainly derived from animal studies, that the altered serum thyroid hormone concentrations seen in endemic goitre arise primarily from thyroidal secretion. It is further suggested that the pattern arises from the iodine deficient gland being unable to maintain a normal T4 secretion rather than an adaptation by the thyroid to main

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04164.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:The cardiovascular system in Paget's disease of bone and the response to therapy withcalcitonin and diphosphonate. J. W. Henley, R. S. Croxson and H. K. Ibbertson, Aust. N.Z. J. Med., 1979, 9, pp. 390–397.The cardiovascular status of 39 patients with Paget's disease of bone was studied before and after treatment with porcine calcitonin or diphosphonate (disodium etidronate).Cardiovascular abnormalities were detected in 32 patients. Systemic hypertension was present in four, ischaemic heart disease in five, cardiac enlargement in ten and evidence of valvular and/or arterial calcification in 14.Before treatment the cardiac index was elevated in 27 of 39 patients (69%) and there was a significant direct correlation with the serum alkaline phosphatase (r = 0·68, P<0·001), urine total hydroxyproline (r = 0·51, P<0·001) and percentage skeletal involvement (r = 0·51, P<0·001). After 24 weeks' treatment with either diphosphonate or calcitonin, there was a fall in cardiac index in 17 of 18 patients; the mean reduction being 12·7% for the calcitonin group and 27% for the diphosphonate treated patients. There was a rise in mean arterial pressure and peripheral resistance in both groups (P<0·025) and a fall in cardiothoracic ratio (P<0·005) but no change in heart rate.In 17 patients studied 24 weeks after the end of therapy, similar, though less marked changes were observed. The cardiac index was lower than the pretreatment value in all eight diphosphonate treated patients but cardiac index and biochemical indices were higher than basal levels in three of nine patients who had received calcitonin.This study confirms a high incidence of cardiovascular complications and an increased cardiac output in most patients with moderate or severe Paget's disease of bone. There was a significant correlation between these abnormalities, the biochemical indices of disease activity and the radiological evidence of skeletal disease.Treatment with either diphosphonate or calcitonin caused partial or complete biochemical remission and a reduction in cardiac index in most patien

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04165.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Summary:Hodgkin's disease terminating in acute leukaemia. M. M. Wolf, I. A. Cooper and J. C. Ding, Aust. N.Z. J. Med., 1979, 9, pp. 398–402.Acute nonlymphocytic leukaemia developed in seven patients treated for Hodgkin's disease. All had received intensive radiotherapy and chemotherapy. One patient had clinical evidence of active Hodgkin's disease at the time of diagnosis of acute leukaemia, and of four other patients who had a post mortem examination another showed evidence of Hodgkin's disease. The median time from the first presentation with Hodgkin's disease to the development of acute leukaemia was 7·7 years. Chromosomal abnormalities were found in four patients. A preleukaemic phase was present in three patients. Survival following diagnosis of acute leukaemia was short (median four weeks) and only one patient achieved a complete remission. Although published data suggests that radiation exposure is an important aetiologic factor in the induction of acute leukaemia in patients with Hodgkin's disease, it appears likely that additional chemotherapy may have a significant potentiating effe

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1979.tb04166.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY