An ether anaesthesia at Stroud in 1847--a report in search of a date.

About the middle of 1847, Doctor Buchanan of the Australian Agricultural Company ligated a popliteal aneurysm under ether anaesthesia at Stroud, N.S.W.

Cardiac tamponade caused by caval catheter--a radiological demonstration of an unusual complication.

An adult male developed shock some hours after the start of intravenous alimentation. The caval catheter, which had been inserted through the right subclavian vein, was later radiographically demonstrated to be in the pericardial sac. We reviewed the literature on this and other complications of caval catheters.

Plasma renin activity during the development of paracetamol (acetaminophen) induced acute renal failure in man.

Plasma renin activity has been measured daily in 36 patients suffering from self poisoning with acetaminophen. In 3 developing porto-systemic encephalopathy terminal renal failure developed with high plasma renin activity. In 2 who developed acute renal failure without porto-systemic encephalopathy, plasma renin activity was noted to rise before serum creatinine and to return to initial levels after 3 or 4 days while renal failure persisted.

Clinical evaluation of computer processing of liver gamma camera scans.

A prospective study to assess the clinical usefulness of computer processing of liver scans has been carried out on 203 patients. All patients have had six months follow up to confirm the diagnostic accuracy of the scan results. Four presentations have been studied using ROC analysis: (i) original gamma-camera pictures; (ii) processed images obtained using a non-stationary filter; (iii) images processed using nine-point smoothing; (iv) images obtained by linear interpolation at 25 isocount levels of display.

Upper airway problems associated with facio-maxillary trauma. Traumatic intermaxillary fixation. Case report.

An unusual case of facio-maxillary trauma is presented. Its management is outlined and discussed. The experience of the Royal Newcastle Hospital Dental Department with facial trauma as it effects airway patency is examined in order to find indications for tracheostomy in facio-maxillary trauma.

Intestinal perforation in ascariasis--case reports.

Two cases of intestinal perforation in association with ascariasis are described. In both cases adult ascarids were found either in the gut or lying free in the peritoneal cavity. Neither patient had typhoid fever, one had Hodgkin's lymphoma.

The spectrum of paracetamol (acetaminophen) overdose: clinical and epidemiological studies.

In a regional survey of paracetamol overdose, 201 patients were admitted to hospital over 12 months. Chronic alcoholism was present in 10% of cases. Over 25% of patients were females aged 20 years or less.

Clinical usefulness of computer controlled presentation in isocount levels of gamma camera liver scans.

Results of investigations comparing computer displays in isocount levels with ordinary gamma camera scans are presented. The study on 109 patients with 12 month follow up shows that isocount level 25 is the best to see a smoothed out image of liver and is superior to conventional polaroid gamma camera scan in picking out more focal lesions (P less than 0.05).

Occupational vitiligo induced by p-tert-butylphenol, a systemic disease?

Vitiligo, morphologically indistinguishable from true vitiligo, was detected in 54 of 198 men exposed to p-tert-butylphenol (P.T.B.

Bacterial overgrowth syndrome without "blind loop": A cause for malnutrition in the elderly.

Probable bacterial contamination of the small bowel without an anatomical sump occurred in 5 elderly patients (age 68--94). They presented with severe general deterioration in health rather than with obvious features of malabsorption. This syndrome has not been clearly described before.

Acute respiratory failure in a regional respiratory unit.

One thousand, six hundred and sixteen patients with acute respiratory failure were managed in a regional respiratory unit. The patients are classified according to cause, the need for artificial ventilation and results.

Hepatic drug acetylation and oxidation: effects of aging in man.

The half lives of acetanilide and isoniazid ("model" substrates for oxidation and acetylation respectively) were measured in populations of young (aged 20-35 years) and elderly (aged over 65 years) people. Whereas acetanilide half lives were significantly longer in the elderly, isoniazid half lives were distributed similarly in both populations. The results suggest that liver function does not decline uniformly with age and that heterozygotes for acetylation do not possess survival advantages during their middle years of life.

Liver function and structure in survivors of acetaminophen poisoning. A follow-up study of serum bile acids and liver histology.

A series of 30 patients, hospitalized with acetaminophen overdose, were studied during initial admission and again three months later. The quantity of acetaminophen ingested varied from 5 to 50 g and 19 patients developed raised transaminase levels in the serum during the initial period. Liver damage, on the basis of needle biopsy findings, was categorized as severe in 5, moderate in 7, and mild or minimal in 18 patients.

Cardiovascular effects of atropine sulfate preparations in vagotomized dogs under halothane anesthesia.

The cardiovascular effects of 3 preparations of atropine sulfate were studied acutely in open-chest, vagotomized dogs under endotracheal halothane anesthesia. Indices of myocardial performance (LVdp/dt/CPIP and maximum ascending aortic blood acceleration) showed insignificant changes when varying doses of IV atropine (0.04 mg/kg and 0.

Respiratory failure after injury: a review and a plea for accuracy.

The more recent developments regarding respiratory failure due to injury are briefly discussed. The manner of presentation of this condition and its pathophysiology are outlined and classified, emphasizing some factors which are common, regardless of cause, and others which are peculiar to certain etiologic factors. The management principles are outlined.

Severe bronchial asthma: factors influencing intensive care management and outcome.

Over a seven year period 2933 patients were admitted with asthma. Respiratory failure occurred on 106 occasions. A total of 26 patients died including 11 of the 106 who developed respiratory failure.

The sleep state characteristics of apnea during infancy.

The sleep state characteristics of infant sleep apnea were studied in 36 twins examined by polygraphy at 40, 44, and 52 weeks after conception. The definition of sleep apnea is dependent upon the length of apnea, sleep state, and post-conceptional age. None of the infants had apnea longer than 20 seconds and apnea of 10 seconds or longer was uncommon.

Caroli's disease with intrahepatic gall-stones and salmonella infection.

At operation for small bowel intussusception, a 26-year-old man was found to have an enlarged liver and spleen. Subsequent investigations suggested bile passage infection associated with numerous intrahepatic gall-stones but symptomatic cholangitis did not present until 5 months later. Retrograde cholangiography showed cavernous ectasia of the bile ducts which contained gall-stones.

Evaluation of paracetamol-induced damage in liver biopsies. Acute changes and follow-up findings.

In 100 patients who had taken an acute overdose of paracetamol the liver was biopsied percutaneously on the 4th day or as soon thereafter as recovery of the clotting mechanism allowed. A system for grading the histological changes in the liver is described. The hallmark of severe (grade III) damage is centrizonal necrosis, for which there is probably a dosage threshold.

Study of reticuloendothelial phagocytic capacity in patients with cholestasis.

The phagocytic capacity of the reticuloendothelial system was studied by the clearance from the plasma of microaggregated iodinated human serum albumin. About half of the patients with cholestasis showed impaired Kupffer-cell phagocytosis. The finding may be relevant to the occurrence of surgical complications in patients with obstructive jaundice.