Postgraduate Medical JournalEDITOR

B. I Hoffbrand

ADVISORY EDITORIAL BOARD

D. BarltropI. ChanarinK. M.. CitronD. J. ColtartA. H. CrispI. J. T. DaviesC. D. M. Drew

H. EllisR. GouldingJ. P. HopewellD. IngramH. S. JacobsD. G. James

R. S. KocenJ. G. LewisJ. S. MalpasA. PatonP. TurnerR. G. TwycrossD. Innes Williams

EDITORIAL REPRESENTATIVE FOR AUSTRALIA

J. R. Lawrence

EDITORIAL ASSISTANT

Mrs J. M. Coops

The Fellowship of Postgraduate Medicine wasfounded by a group of London consultants after theFirst World War to assist postgraduates, particularlythose coming to London from the Commonwealth, topursue their studies. The Fellowship first publishedthe Postgraduate Medical Journal to give informationabout lectures, conferences and courses and toprovide a monthly review of all branches of medi-cine.

Postgraduate Medical Journal publishes originalpapers on subjects of current clinical importance andwelcomes review articles with extensive, up-to-datebibliographies as guides to further reading. Severalsymposia are published each year, each devoted to asingle subject and written by specialists in differentdisciplines. Most issues include authoritative CurrentSurveys of clinical problems, and well documentedReports of cases of particular interest, and BookReviews.A 'Notice to Contributors' is published on the

inside back cover of this issue. The Editor reservesthe right to make changes which may clarify orcondense papers where this is considered desirable.The Journal is covered by Current Contents,

Biological Abstracts, ASCA, ISI/BIOMED and Sci-ence Citation Index.

EDITORIAL MATTERSAll editoyial correspondence, including books forreview and reprint orders, should be addressed toThe Editor, The Postgraduate Medical Journal,Chandos House, 2 Queen Anne Street, LondonWIM 9LE (Tel. 01-580 3210).

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SUBSCRIPTION INFORMATIONPostgraduate Medical Journal is published monthlyfor the Fellowship of Postgraduate Medicine byBlackwell Scientific Publications Ltd. The subscrip-tion price for 1984 is £60.00 (U.K.), £72.00 (overseas),$142.50 (U.S.A. & Canada) post free. Subscribers inthe U.S.A. and Canada should send their orders toLippincott/Harper, Journal Division, 2350 VirginiaAvenue, Hagerspown, Maryland 21740, U.S.A. Theprice of single issues is £6.00 ($11.70), postage extra.If payments are made by bank transfer, all chargesshall be at the remitter's expense. Current issues forNorth and South America, the Indian Sub-Conti-nent, Australasia and the Far East are sent by air toregional distribution points from where they areforwarded to subscribers by surface mail. Any backnumbers are normally despatched by surface to allregions except North America and India, where theyare sent by air freight. U. S.; Mailing Agent:Expediters of the Printed Word Ltd, 515 MadisonAve, Suite 1217, New York, NY 10022. Second classpostage paid at New York, NY. Postmaster: sendaddress corrections to Postgraduate Medical Journal,c/o Expediters of the Printed Word Ltd., 515Madison Avenue, New York, NY 10022 (US mailingagent). Orders and business correspondence shouldbe addressed to Blackwell Scientific publications Ltd,Osney Mead, Oxford OX2 OEL (Telephone Oxford240201).

COPYRIGHT AND PHOTOCOPYING© 1984 The Fellowship of Postgraduate Medicine.Authorization to photocopy items for internal orpersonal use, or the internal or personal use ofspecific clients, is granted by The Fellowship ofPostgraduate Medicine for libraries and other usersregistered with the Copyright Clearance Center(CCC) Transactional Reporting Service, providedthat the base fee of £02.00 per copy is paid directly toCCC, 21 Congress Street, Salem, MA 01970, U.S.A.Special requests shuld be addressed to the Editor.0032-5473/84 $02.00.

Postgraduate Medical Journal (December 1984) 60

-'.- CURI6NTCOLUMIIA UNIVERSITY

IAN0815HUALTH SCIENCES

LIBRARY

Recent advances in the understandingand management of pain

Edited by: DR R. G. TWYCROSS

Postgraduate Medical Journal (December 1984) 60, 914-916

Books received

Advances in World Diabetes Research. Reviewed Contents of 1982'sMajor Diabetes Congresses. Edited by FRANSCESCO BELFIORE andSILVIA IANNELLO. Frontiers in Diabetes. Vol. 5. Pp. vii + 257.Karger, Basel, Munchen, Paris, London, New York, Tokyo,Sydney, 1984. £51.65. SFr. 165; DM 198; $99.00.

Annual Review of Medicine: Selected Topics in the Clinical Sciences.Vol. 35. Edited by W. P. CREGER, C. H. COGGINS and E. W.HANCOCK. Pp. 720, illustrated. Annual Reviews, Palo Alto,California, 1984. $27.00 (U.S.A.), $30.00 (elsewhere).

Annual Review of Public Health. Vol. 5. Edited by LESTER BRESLOW,JONATHAN E. FIELDING and LESTER B. LAVE. Pp. vi+473,illustrated. Annual Reviews, Palo Alto, California, 1984. $27.00(U.S.A.), $30.00 (elsewhere). Prices include postage and handling.

The Arthritis Book. A Guide for Patients and their Families. ByEPHRAIM P. ENGLEMAN and MILTON SILVERMAN. British editionadapted by Robin Withrington. Pp. 88, illustrated. PenguinBooks, London, 1984. £1.95.

Aspects of Occupational Health. Edited by W. M. DIXON and SUSANM. G. PRICE. Pp. 276, illustrated. Faber and Faber, London,Boston, 1984. £5.25.

Clinical Manual of Infectious Diseases. By MICHAEL W. RYTEL andWILLIAM J. MOGABGAB. Pp. xii + 524, illustrated. Year BookMedical Publishers, Chicago, 1984. £21.50.

Clinical Optics. By ANDREW R. ELKINGTON and HELENA J. FRANK.Pp. ix + 164, illustrated. Blackwell Scientific Publications, Oxford,London, Edinburgh, Boston, Palo Alto, Melbourne, 1984. £12.00.

A Comprehensive Guide to the Therapeutic Use of Trasicor. Pharman-ual Series. Edited by STEVO JULIUS. Pp. 115, illustrated. Karger,Basel, Munchen, Paris, London, New York, Tokyo, Sydney, 1984.£11.90.

Expedition Medicine. A Planning Guide. 3rd edn. By ROBIN N.ILLINGWORTH. Pp. vii + 55. Blackwell Scientific Publications,Oxford, London, Edinburgh, Boston, Melbourne, 1984. £4.95.

A History of Women's Bodies. By EDWARD SHORTER. Pp. xiv + 398.Penguin Books, London, 1984. £3.95, $9.95 (Australia), $13.50(New Zealand).

The Liver and Biliary System. Aids to Higher Medical Training Series.By P. W. BRUNT, M. S. LOSOWSKY and S. E. READ. Pp. 247,illustrated. William Heinemann Medical Books, London, 1984.£7.95.

Medical Pharmacology: Principles and Concepts. I1th edn. ByANDRES GOTH. Pp. xii + 815, illustrated. C. V. Mosby, St Louis,Toronto, 1984. £26.00.

Multiple Choice Questions in Neurology. By D. BATES and N. E. F.CARTLIDGE. Pp. 180. Pitman, London, 1984. £5.95.

A Photographic Quiz in Medicine. By PHILIP EBDEN, ALAN PEIRISand MICHAEL J. DEW. Pp. 216, illustrated. Lloyd-Luke (MedicalBooks), London, 1984. £9.00.

The Physically Handicapped Child. An Interdisciplinary Approach toManagement. Edited by GILLIAN T. MCCARTHY. Pp. 375, illus-trated. Faber and Faber, London, Boston, 1984. £6.95 (paper-back), £12.50 (cased).

A Primer of Medicine. 5th edn. By M. H. PAPPWORTH. Pp. v + 378,illustrated. Butterworths, London, Boston, Durban, Singapore,Sydney, Toronto, Wellington, 1984. £19.50.

Self-Assessment for MRCP (Part 1). 2nd edn. By C. F. CORKE. Pp.x + 244. Blackwell Scientific Publications, Oxford, London, Edin-burgh, Boston, Palo Alto, Melbourne, 1984. £7.50.

Self-Assessment in Psychiatry. By ROGER FARMER. Pp. viii+206.Blackwell Scientific Publications, Oxford, London, Edinburgh,Boston, Melbourne, 1984. £7.50.

The Year Book of Emergency Medicine. Edited by DAVIDK. WAGNER, RICHARD W. ALTREUTER, STEVEN J. DAVIDSON,MICHAEL I. GREENBERG and STEVEN D. MORSE. Pp. 392,illustrated. Year Book Medical Publishers, Chicago, 1984. £34.50.

The Year Book of Psychiatry and Applied Mental Health, 1984.Edited by DANIEL X. FREEDMAN, JOHN A. TALBOTT, REGINALDS. LOURIE, HERBERT Y. MELTZER, JOHN C. NEMIAH and HER-BERT WEINER. Pp. 439, illustrated. Year Book Medical Publishers,Chicago, 1984. £34.50.

Book reviews

Medical Diagnosis, from Student to ClinicianBy JANET GALE and PHILIP MARSDEN. Pp. xii + 218. OxfordUniversity Press, Oxford, New York and Toronto, 1983. £17.50.

Dr Gale in her Ph.D. thesis studied, by questionnaire and video tapestimulated recall sessions, diagnostic thinking processes of medicalstudents, house officers and registrars in neurology and endocrino-logy. The main body of the book consists of detailed accounts ofthemethods, results and their interpretation. There is an introductorychapter reviewing models and descriptions of diagnostic thinkingprocesses and three final chapters concerned with the psychology ofdiagnostic thinking processes, the teaching of such processes basedon learning theory principles and current practical approaches, andthe authors' suggestions for what they call a new approach toteaching.The questionnaires consisted of three sets of multiple choice

questions examining respectively the subjects' mastery of factualknowledge, interpretation of symptoms and signs, and the selectionand testing of diagnostic possibilities. The fourth section, based oncase histories, tested diagnostic ability. We are not given the detailedquestionnaires but the topics in the endocrinology section inparticular bear little relation to the pattern of endocrinologicalpractice in that only 8 of 27 are concerned with thyroid and diabetesmellitus. The results show not unexpected differences in knowledge

and skills between students and registrars, the development ofcognitive skills being a particular feature of the practice rather thanthe study of clinical medicine. The authors conclude as have othersbefore them of the need for students and teachers to be aware thethought processes that go into diagnosis.

In view of the variability and uncertainties of clinical methodsthere are no simple proposals for teaching or learning based onlearning or problem solving theory. Whilst awareness of theproblems is half the battle, those explored in the basic study are onlypart of the clinical process. All too often there is no 'diagnosis', theproblem to be solved is one of excluding 'diagnosis' and always oneof management. What you do or do not do for your patient is whatcounts.

It is all too easy to criticise a book whose original data are derivedfrom a study of uncertain relevance to clinical practice, and onewhich retains some of the drawbacks of its dissertation pedigree withmuch reportage of other publications and not enough synthesis andopinion. It is a particular pity that the summaries at the end of eachchapter do not give the authors' conclusions, but simply an accountof with what the chapter dealt.

Nonetheless this book contains a very full review of the problems(there are no solutions) of understanding diagnostic thoughtprocesses and as such can be recommended to those who are

Postgraduate Medical Journal (December 1984) 60, 917-918

CONFERENCE REPORT

Captopril for hypertension-a coming of age?

It is less than 8 years since chemists at the Squibb researchlaboratories in Princetown U.S.A. produced the first orally activeangiotensin converting enzyme (ACE) inhibitor, captopril. Sincethen at least 35 more converting enzyme inhibitors have beensynthesized by other drug companies, but the overwhelmingmajority of scientific information relates to the use of captopril inboth hypertension and heart failure. A recent meeting organised bythe Squibb cardiovascular group held as a satellite to the 10thInternational Society of Hypertension, sought to examine criticallythe current role of captopril in the treatment of hypertension(Angiotensin converting enzyme inhibition in clinicalpractice. Interna-tional Symposium, Geneva, 22-23 June 1984. Journal of Cardiovascu-lar Pharmacology, in press).Although many ofthe pharmacological characteristics of captopril

are ideal, there are significant defects in terms of absorption,duration of action and route of excretion (predominantly renal).However, Squibb chemists have produced three further differentchemical classes of ACE inhibitor of which zofenopril and fosfeno-pril seem particularly promising. A further novel development hasbeen the addition of a thiazide diuretic to the basic chemicalstructure of an ACE inhibitor, so that within one molecule twoseparate pharmacological actions are available. Nonetheless capto-pril is difficult to improve upon so the differences between it andother ACE inhibitors are unlikely to be fundamental. In the future itis probable that orally active renin substrate inhibitors will rivalACE inhibitors, and thus shift the focus of pharmacological debate.

Captopril lowers blood pressure by lowering total peripheralresistance; but in contrast to other vasodilators which either tend tocause reflex tachycardia when the vasodilatation is predominantlyon the arterial side (e.g. hydralazine), or tend to produce orthostatichypotension when there is predominant venodilatation (e.g. prazo-sin, nitrates), captopril is remarkably free of counteracting reflexresponses. Blockade of angiotensin II production seems to attenuatebaroreceptor sensitivity at a receptor level, so that reflex adrenergicmechanisms fail to produce tachycardia as with other vasodilators.Furthermore, the fluid retention seen with many vasodilators ismediated via the angiotensin system and this cannot occur withcaptopril.Of course, the crucial issue with vasodilator drugs relates not to

the magnitude of lowering of total peripheral resistance, but to theregional distribution ofblood flow. There is good evidence to suggestthat captopril has a favourable effect on cerebral auto-regulation sothat cerebral blood flow is maintained even with large falls in arterialblood pressure. There is also a striking increase in renal blood flow(in the absence of renal artery stenosis) but without the potentiallydamaging effects of glomerular hyperfiltration. Perhaps one of themost exciting potential values of ACE inhibitors is their apparentability to reverse the abnormal stiffness of arterial walls which ischaracteristically found in hypertension. This has great potential forreducing cardiovascular mortality, but as yet is only a theoreticalattraction.

Use of captopril in hypertension

Captopril can be used alone or with a variety of well establishedhypotensive drugs. In the treatment of mild to moderate essentialhypertension, normal blood pressure may be expected in about 40 to50% of patients with captopril alone, a similar response to that which

would be expected with diuretics alone; the combination of the twodrugs is effective in 80 to 90%o of mild to moderate hypertensives.

Is it sensible to give a beta-blocker with captopril? One of themajor effects of beta-blockers is to inhibit renin release so thecombination might be thought illogical. However, beta-blockersprolong the duration of effect of captopril with good blood pressurecontrol for 24 h a day.The combination of an ACE inhibitor and a calcium entry blocker

(such as verapamil, nifedipine, diltiazem) is perhaps the most elegantcombination of drugs which closest approximates our currentunderstanding of the pathophysiology of most forms of hyperten-sion. The combination seems extremely potent and is a regime inwhich a diuretic is not obligatory.

Side effects

The first 4 years of captopril, 1976-1980, are probably years thatthe manufacturers would rather forget, but which are rememberedby many clinicians. In that era captopril was used at enormous dosesin patients with highly complicated forms of hypertension includingcollagen-vascular disease, severe renal fallure, and hypertension thathad failed all other forms of treatment. Proteinuria and neutropeniaemerged as the most worrying adverse affects of the drug. Since 1980however, the drug has been evaluated systemically in nearly 7,000further patients in far more moderate dosage than previously. Onlysix further cases of neutropenia have been reported to the companyof which only two were due to captopril, and occurred in patientswith renal impairment.The overall incidence of proteinuria calculated by a life table

method was 0-7% at 12 months, but of these patients who developedproteinuria, three-quarters had prior evidence of renal disease orhypertensive nephrosclerosis at the start of treatment.Rash and taste disturbance occurred in 1-6% of patients and

depended to greater or lesser degree on dose and renal function. Inthe presence of normal renal function and with a dose ofcaptopril of150 mg daily or less, only about 2% of patients may be expected todevelop rash or taste disturbance and these are usually transientphenomena not requiring modification of dosage.

Dizziness and hypotension were reported in 5% of patients whichprobably reflects the potency of the drug. In contrast to conventionalhypotensive drugs, electrolyte disorders, hyperuricaemia, hyperlipi-daemia, drowsiness and impotence were not seen.

The current role of captopril in hypertension

When should captopril be used then? Originally introduced as alogical drug for severe, renal and renovascular hypertension(characteristically 'high renin' hypertension) it is now only used inthese conditions with extreme caution in view ofthe enhanced risk ofadverse effects in these situations. In contrast, in mild to moderateessential hypertension, the therapeutic efficacy of captopril andother ACE inhibitors is undisputed despite our lack of understand-ing of the role of the renin-angiotensin system in essentialhypertension. Current evidence clearly shows that captopril is bothsafe and effective so the drug is now challenging for a role as a frontline agent in mild to moderate hypertension.

It is very expensive however; far more so than thiazide diureticsand considerably more than beta-blockers. Thus we need to answer

918 Conference report

not questions relating to efficacy and safety but rather to look at theunderlying reasons for treating hypertension in the first place.We treat hypertension to prolong survival by reducing cardiovas-

cular complications, but this benefit may be offset by detrimentaleffects on the quality of life. Much has been made ofcaptopril's lackof adverse effects on exercise tolerance, sexual potency and mentalfunctioning, but evidence for this is largely anecdotal. Until thislikely benefit of captopril has been established by clinical trial (nowin progress) most clinicians will continue to use captopril only whendiuretics and beta-blockers have failed. Nonetheless, should this trialconfirm clinical suspicions that patient well-being is superior with

captopril than with conventional agents, there is likely to be a swingin favour of captopril before evidence is available about mortalityreduction.Such is the life of any hypotensive agent: no doubt when captopril

has been proven to reduce cardiovascular events, it will already benearly obsolete and the same questions will be asked of the nextgeneration of drugs. Has captopril come of age? Almost.

A. NICHOLLS,Royal Devon and Exeter Hospitals,

Exeter, Devon

POSTGRADUATE MEDICAL JOURNAL

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L POSTGRADUATEMEDICAL JOURNAL

VOLUME 60

January to December 1984

PUBLISHED FORTHE FELLOWSHIP OF POSTGRADUATE MEDICINE

BY BLACKWELL SCIENTIFIC PUBLICATIONSOXFORD LONDON EDINBURGH BOSTON MELBOURNE

Subject Index

*denotes case report

Abdominal incisions, vertical or transverse? June, 407Accidents, childhood, and health education. April, 260Acid secretion, mastication. April, 272

*Acidosis, distal rental tubular, and nephrogenic diabetesinsipidus, associated with idiopathic hypergammaglobu-linaemia. July, 493

Acupuncture and transcutaneous electrical nerve stimula-tion. December, 893

*Acyclovir, for treatment of herpes simplex type 2 meningi-tis. April, 282

*Addison's disease and thyrotoxicosis, presenting simulta-neously. July, 478

Adrenal disease, endocrine disorders in pregnancy, man-agement. May, 312

Adult respiratory distress syndrome-I. Aetiology and mechanisms. August, 505

II. Management. September, 573*Agranulocytosis during malaria prophylaxis with Malo-

prim [pyrimethamine and dapsonel. August, 566*Airflow obstruction

caused by laryngocoele, six cases. April, 290chronic. March, 194

*Akathisia, persistent, associated with early tardive dyski-nesia. May, 359 correspondence. December, 916

*Alcoholic cardiomyopathy, reversibility. February, 151*Aldosteronoma, bilateral, associated with renovascular

hypertension. August, 533Aluminium magnesium silicate and three other antacids

compared. September, 592*Amitriptyline and ischaemic colitis. August, 564*Amoebic granuloma, an unusual cause of caeco-colic

intussusception. February, 168*Amphetamine use, intracerebral haemorrhage and vasculi-

tis. June, 429*Amyloidosis, renal, associated with non-specific aorto-

arteritis. September, 626Anaemia and cricoid webs, Indian patients, incidence and

follow-up. May, 346Analgesia, regional, for pain management. December, 897Analgesics in pain. December, 876

*Aneurysms, cerebral arterial, two, simultaneous presenta-tion. February, 135

Angiotensin converting enzyme, serum, in Sjogren's syn-drome, 22 cases. April, 270

Antacids, four, comparative study. September, 592*Antiarrhythmic agent, new class IC, propafenone, associ-

ated with fatal ventricular tachycardia. February, 155Anti-tuberculosis chemotherapy. March, 189

*Aorto-arteritis, non-specific, associated renal amyloidosis.September, 626

Appendicitis, study of incidence, death rates and consump-tion of hospital resources. May, 341

*Arteritis, Takayasu's, associated renal amyloidosis. Sept-ember, 626

Asilone and three other antacids compared. September,592

Asthmalogical approach. March, 201nocturnal, and ipratropium bromide. August, 526recurrence following removal of noradrenaline-secreting

phaeochromocytoma. May, 364treatment in general practice. May, 336

*Ataxia and bilateral deafness, and meningococcal menin-gitis. October, 668

*Autoimmune haemolytic anaemia and coeliac disease.September, 629

*Autoimmune haemolytic crisis, marrow failure with sider-oblasts. August, 554

Avery Jones, Sir Francis, Festschrift, Fifty years ofmedical practice 1934-1984. November, 715-831: cur-riculum vitae 716-717: medical career 718: bibliography828

*Azathioprine hypersensitivity in myasthenia gravis. May,362

Bacteria flora after cimetidine in peptic ulcer. July, 464Barium meal and cholecystogram combined, analysis of

1,444 patients. August, 518BCG vaccination. March, 188Beclomethasone dipropionate aqueous nasal spray, aque-

ous and pressurized comparison in seasonal rhinitis.June, 404

Behavioural science and chronic pain. December, 865Beta-adrenceptor and epoprostenol (prostacycin) respon-

siveness of lymphocytes, migraine patients. June, 391Bleeding, gastrointestinal, present-day management.November, 760

*Boerhaave's syndrome, with unusual clinical presentationof pneumoperitoneum. January, 60 correspondence.May, 382

*Bone mineral loss, severe, hypogonadism, and immobiliza-tion hypercalcaemia. June, 415

*Bowel, small, prolapse, and entero-vaginal fistula, rup-tured procidentia, carcinoma of vagina presenting as.June, 435

*Breastcancer with development of Homer's syndrome. Febru-

ary 140in male with hypogonadotropic hypogonadism. Au-gust, 542

mycobacterial infection, haemodialysis patient. Febru-ary, 164

problems in 1,000 consecutive referrals to surgicaloutpatients. October, 653

Bronchialcarcinoma, primary, pre-operative mediastinal evalua-

tion, review of staging investigations: review article.February, 83

intubation, selective, for treatment of severe localizedpulmonary interstitial emphysema. January, 58

Index to Volume 60

Bronchoscopy, fibreoptic, current status. March, 213*Brucellosis, relapsing, transient electrocardiographic

changes during two episodes. August, 544Bullouseruption, carbamazepine-induced, or bullous pem-

phigoid: correspondence. April, 307

*Caeco-colic intussusception, amoebic granuloma an un-usual cause. February, 168

*Caecocystoplasty, extreme hypernatraemia in associationwith renal failure following. October, 700

* Campylobacter jejuni, causing spontaneous bacterial peri-tonitis. July, 487

Cancer pain, causes and management. December, 852Captopril

in hypertension after renal transplantation. February,132a coming of age? December, 917

* induced acute renal artery thrombosis and persistentanuria, in documented pre-existing renal artery steno-sis and renal failure. August, 561

* successful reduction of pulmonary hypertension,CREST syndrome. October, 672

Carbamazepine-induced bullous eruption, or bullous pem-phigoid: correspondence. April, 307

Carbohydrate, isocaloric high, and high fat test meals,diabetics, comparison. February, 129

*Carcinoembryonic antigen, serum, and cardiac failure andhepatic congestion. January, 56

*Carcinomata, primary, six different tumours in one pa-tient. October, 687

*Cardiacarrhythmias and hyperpyrexia, thioridazine-induced,and hyperthyroidism. June, 445

* failure, hepatic congestion and increased level of serumcarcinoembryonic antigen. January, 56

* tamponade, in rheumatoid arthritis. July, 474* tumour, relapse of lymphoma after 10-year remission.

September, 607*Cardiomyopathy* alcoholic, reversibility. February, 151* peripartum, in patient with hyperprolactinaemia. Janu-

ary, 49Cardiovascular death, acute, and phaeochromocytoma,

with special reference to myocardial infarction. Febru-ary, 111

*Celestin tube insertion, complicated by hypertrophicpulmonary osteoarthropathy. July, 480

*Cerebellum, neuroenteric cyst. April, 287*Cerebral

arterial aneurysms, two, simultaneous presentation.February, 135occlusion and intracranial venous thrombosis, and

oral contraceptives. June, 426infarction, non-atheromatous causes: leading article.

June, 386ischaemia, focal, investigation, role of echocardiogra-

phy. February, 116Cervical carcinoma, effect of colposcopy, district general

hospital. July, 461*Charcoal haemoperfusion and haemodialysis, in acute

inorganic mercury poisoning. September, 636

Chest pain, indigestion or impending heart attack. May,338

Childhood accidents, and health education. April, 260*Chloroquine treatment, possible benefit in eosinophilic

fasciitis in an African. October, 685*Chlorpromazine and ischaemic colitis. August, 564*Cholecystitis, associated with myelomatosis. July, 485*Cholecystoduodenocolic fistula and gallstone ileus. Octo-

ber, 698Cholecystogram and barium meal combined, analysis of

1,444 patients. August, 518Choledochal cysts, three cases and review. June, 397Cholesterol plasma concentration and extra lipid band inmonoclonal gammopathies. July, 449

Cimetidineeffect on maintenance of healing of gastric ulceration.

October, 665therapy and prevention of rebleeding from peptic

ulceration. June, 400twice-daily, effect on gastric bacterial flora. July, 464

*Cirrhosis, liver, and impaired monocyte function, develop-ment of Hodgkin's disease. July, 482

*Coeliac diseasewith autoimmune haemolytic anaemia. September,629present trends. November, 773recent changes in pattern. November, 733

*Coeliac ganglion, phaeochromocytoma, in pregnancy.May, 377

*Colitis, ischaemic, associated with psychotropic drugs.August, 564

Colonoscopy, clinical yield. November, 803Colposcopy, effect of introduction into district general

hospital. July, 461*Coma, prolonged, and delayed peripheral neuropathy,

after phenoxyacetic acid weedkiller ingestion. January,76

Computed tomographydiagnosis of dementia due to corpus callosum tumours.May, 321

thorax. March, 208Conference report, 10th scientific meeting of the Interna-

tional Society of Hypertension, Interlaken, June 1984.October, 712

Constipation, dietary fibre, and large bowel functioncontrol. November, 811

Controlled trial, design and development associated withAvery Jones. November, 719

Copper losses, urinary, and urinary iron loss, nephroticsyndrome, unusual cause of iron deficiency. February,125

Corneal ulcer, hypnosis. April, 263Coronary heart disease

death, prevention, and hypertension. January, 34mortality, falling, United States, lessons. January, 15

introduction to Conference. January, 1life style and national and international trends.January, 3major risk factors, cigarette smoking. January, 20

national diet. January, 26recent trends, implications for U.K., ConferenceLondon, 30th June, 1983. January, 1-46trends for the Republic of Ireland. January, 9

Postgraduate Medical Journal

planning for prevention. January, 39prevention, report of W.H.O. Expert Committee, ab-

stract. January, 44summing up. January, 42

Corpus callosum, tumours causing dementia. May, 321Corticosteroids, effect on mood. July, 467

*Creosote poisoning, fatal case. July, 499*CREST syndrome, successful reduction of pulmonary

hypertension by captopril. October, 672Cricoid webs, Indian patients, incidence and follow-up

study. May, 346*Crohn's disease and pericarditis. October, 682*Cushing's syndrome and acute pancreatitis. September,

618Cystic fibrosis, clinical aspects and management of older

patient. March, 225Cysts

choledochal, three cases and review. June, 397neuroenteric, cerebellum. April, 287

Davidson, Maurice 1883-1967, respiratory medicine, pro-gress since his time. March, 178

*Deafness, bilateral, and ataxia, and meningococcal men-

ingitis. October, 668Deep venous thrombosis, idiopathic, significance. April,275

Dementia due to tumours of corpus callosum. May, 321*Dermatobia hominis infestation. February, 162*Dexamethasone, relieving malignant ureteric obstruction.

June, 437*Diabetes insipidus, nephrogenic, and distal renal tubular

acidosis, associated with idiopathic hypergammaglobu-linaemia. July, 493

*Diabetes mellitus, hyperkalaemia in, potential hazards ofcoexisting hyporeninaemic hypoaldosteronism. May,370

Diabetics, isocaloric high carbohydrate and high fat testmeals, comparison. February, 129

Diet, national, and coronary heart disease mortality.January, 26

Dietary fibre, constipation, and large bowel functioncontrol. November, 811

*DiGeorge's syndrome, immuno-reconstitution by thymictransplant. August, 537

Digestive disease, chronic, recent changes in pattern,United Kingdom. November, 733

Disopyramide, oral, after hospital admission with sus-pected acute myocardial infarction. February, 98

*Disulfiram-induced hepatitis, case report and review ofliterature. September, 639

*Diverticula, duodenal, occurring in a family, chance or

inheritance. July, 489*Diverticulum, gastric, ulcerated, haematemesis and mela-

ena causing. October, 693*Dothiepin intoxication, severe, two cases. June, 442*Down's syndrome, basal ganglia calcification and psycho-

sis. February, 137*Dressler's syndrome, after right ventricular infarction.

April, 298Dumping syndrome, surgery, gastric emptying after. July,458

*Duodenaldiverticula, occurring in a family, chance or inheritance.

July, 489ulcer effect of H2-receptor antagonist ranitidine on

depression and anxiety. May, 353mastication and acid secretion. April, 272

Dyskinesia, early, and persistent akathisia: correspon-dence. December, 916

Dysphagia, review of treatment and trends. November, 737

*Ear piercing, acute post-streptococcal glomerulonephritisfollowing. January, 73

Echocardiography, role in investigation of focal cerebralischaemia. February, 116

Effective renal plasma flow and glomerular filtration rate,prospective measurement during treatment of malignantessential hypertension. October, 662

Elastic supports for venous diseases of the lower limb,clinical comparison. May, 349

*Electric shock, progressive muscular atrophy and posteriordislocation of humerus following. February, 143

Electrical nerve stimulation, transcutaneous, and acupunc-ture. December, 893

*Encephalocoele, basal, and hypothalamic hypopituitarism,treatment with luteinizing hormone-releasing hormone.September, 597

*Encephalopathy, hypertensive, complicating transplantrenal artery stenosis. May, 356

Endocrine disorders, in pregnancy, management.Part I-thyroid and parathyroid disease: review article.

April, 245Part II-pituitary, ovarian and adrenal disease: review

article. May, 312Endometriosis, intestinal: review article. August, 514Enteral nutrition, practical techniques and problems.

November, 779*Enteritis, treatment with neomycin, salmonella meningitis

following. April, 284*Entero-vaginal fistula and prolapse of small bowel, rup-

tured procidentia, carcinoma of vagina presenting as.June, 435

Enuresis alarm device, sleep and nocturnal activity. April,280

*Eosinophilic fasciitis in an African, possible benefit ofchloroquine treatment. October, 685

*Epilepsy, and myxoedema. September, 605Epoprostenol (prostacycin) and beta-adrenoceptor re-

sponsiveness of lymphocytes, migraine patients. June,391

*Erythema nodosum, sarcoid, and immune complexes.August, 549

*Evan's syndrome, one case. August, 554Exercise, severe repetitive, and haematological status. July,454

*Exocrine pancreatic insufficiency and idiopathic haemo-chromatosis. October, 675

Fat, high, and isocaloric high carbohydrates, test meals,diabetics, comparison. February, 129

*Femoral hernia, and strangulated stomach. May, 376Fibreoptic bronchoscopy, current status. March, 213Focal cerebral ischaemia, investigation, role of echocardi-

ography. February, 116

iV

Index to Volume 60

*Galactorrhoea following hypophysectomy in boy withprolactinoma. August, 540

*Gallstoneileus and cholecystoduodenocolic fistula. October, 698perforation of ileum without obstruction. October, 6%

*Ganglia calcification, basal, and psychosis in Down'ssyndrome. February, 137

*Gastricdistension, massive, in acute pancreatitis, two cases.

September, 631diverticulum, ulcerated haematemesis and melaena

causing. October, 693emptying, after surgery for dumping syndrome. July,

458ulceration, effect of cimetidine on maintenance of

healing. October, 665Gastrinomas and gastrins, pathophysiology and physio-

logy. November, 767Gastroenterology, practice, medical-surgical collaboration.November, 725

Gastrointestinalbleeding, present-day management. November, 760mucosa, organ culture, technique for study of human

gastrointestinal tract: review article. October, 645Gaviscon and three other antacids compared. September,

592*Genital herpes, meningitis, treated with acyclovir. April,

282*Germ cell carcinoma and benign Leydig cell tumour in

situ, in young man with gynaecomastia. January, 66*Giant cell arteritis presenting with peripheral neuropathy.

October, 670Glomerular filtration rate and effective renal plasma flow,

prospective measurement during treatment of malignantessential hypertension. October, 662

*Glomerulonephritisacute post-streptococcal, following ear piercing. Janu-

ary, 73associated with staphylococcal infection, and acute renal

failure. June, 433Gonorrhoea, asymptomatic, male patient. October, 691

*Goodpasture's syndrome, treatment. January, 52*Granuloma, midline, idiopathic, case report and review.

July, 471Grass pollen sensitivity and BDP sprays. June, 404Groin

discoloured lump, and acute pancreatitis. May, 374swellings, unusual: leading article. May, 309

Gynaecomastia, benign Leydig cell tumour and germ cellcarcinoma in situ, young man. January, 66

H2-receptor antagonist ranitidine, effect on depression andanxiety in duodenal ulcer patients. May, 353see also Cimetidine

*Haematemesis and melaena causing ulcerated gastricdiverticulum. October, 693

Haematological status, severe repetitive exercise. July, 454Haematoma, hypnosis. April, 263

*Haematopoiesis, extramedullary, in myelofibrosis, spinalcord compression. January, 62

*Haemochromatosis, idiopathic, and exocrine pancreaticinsufficiency. October, 675

*Haemodialysisand charcoal haemoperfusion, in acute inorganic mer-

cury poisoning. September, 636* patient, breast mycobacterial infection. February, 164*Haemophilus influenzae, acquired from the mother, causing

fatal neonatal septicaemia and meningitis. October, 707*Haemopneumothorax, spontaneous, in association with

sarcoidosis. September, 621*Haemorrhage, intracerebral, and vasculitis, secondary to

amphetamine use. June, 429Headache, diagnosis and management. December, 841Health education, preventing childhood accidents. April,260

*Hemipelvectomy, for liposarcoma, unusual case andcourse. January, 70

Heparin osteoporosis, severe, in pregnancy. June, DD24*Hepatic congestion, cardiac failure and increased level of

serum carcinoembryonic antigen. January, 56*Hepatitis, disulfiram-induced, case reort and review of

literature. September, 639Herpes simplex

hypnosis. April, 263* type 2 meningitis, treated with acyclovir. April, 282

virus and the nervous system: review article. April, 253*Hodgkin's disease

development in course of liver cirrhosis and impairedmonocyte function. July, 482

* presenting as idiopathic thrombocytopenic purpura.September, 614

*Horner's syndrome, with ipsilateral vocal cord and phrenicnerve palsies. February, 140

'Hospice' versus 'hospital' care, re-evaluation after 1O yearsas seen by surviving spouses. February, 120

*Human placental lactogen (hPL) deficiency, in a normalpregnancy. October, 689

*Humerus, posterior dislocation, and progressive muscularatrophy, following electric shock. February, 143

*Hypercalcaemia, immobilization, with severe bone min-eral loss and hypogonadism. June, 415

*Hypergammaglobulinaemia, idiopathic, associated withnephrogenic diabetes insipidus and distal renal tubularacidosis. July, 493

*Hyperkalaemia in diabetes mellitus, potential hazards ofcoexisting hyporeninaemic hypoaldosteronism. May, 370

*Hypernatraemia, extreme, in association with renal failurefollowing caecocystoplasty. October, 700

Hyperprolactinaemiaand hyperthyroidism due to inappropriate TSH secre-

tion. May, 328* peripartum cardiomyopathy in. January, 49*Hyperpyrexia, thioridazine-induced, and cardiac arrhyth-

mias, and hyperthroidism. June, 445Hypertension

captopril for, a coming of age? December, 917and coronary heart death prevention in general practice.

January, 34malignant essential, prospective measurement of glom-

erular filtration rate and effective renal plasma flowduring treatment. October, 662

mild to moderate, comparison of nifedipine (retardformulation) and mefruside. August, 529

v

Postgraduate Medical Journal

* pulmonary, successful reduction by captopril, CRESTsyndrome. October, 672

after renal transplantation, captopril in. February, 132* renovascular, associated with bilateral aldosteronoma.

August, 533*Hypertensive encephalopathy complicating transplant re-

nal artery stenosis. May, 356Hyperthyroidismand immune thrombocytopenia. October, 657due to inappropriate TSH secretion with associated

hyperprolactinaemia. May, 328* and thioridazine-induced hyperpyrexia and cardiac

arrhythmias. June, 445Hyperthyroxinaemia, high serum thyroxine-binding

globulin as important cause. May, 324*Hypertrophic pulmonary osteoarthropathy, complicating

Celestin tube insertion. July, 480Hypnosis, acute pain treatment, emergency department.

April, 263*Hypocalcaemic cataract, as a presenting syndrome of renal

insufficiency. February, 166*Hypogrammaglobulinaemia, acquired, and sarcoidosis.

August, 551*Hypoglycaemia and septicaemia. June, 431*Hypogonadism, immobilization hypercalcaemia, and se-

vere bone mineral loss. June, 415*Hypogonadotropic hypogonadism, and breast carcinoma

in males. August, 542*Hypokalaemia and hypophosphataemia, causing myocar-

dial damage. October, 679*Hypokalaemic paralysis, and medullary sponge kidney.

April, 303*Hypophosphataemia and hypokalaemia, causing myocar-

dial damage. October, 679*Hypophysectomy, in boy with prolactinoma, galactor-

rhoea following. August, 540*Hypopituitarism, associated with myalgia. April, 293*Hyporeninaemic hypoaldosteronism, coexisting with hy-

perkalaemia, in diabetes mellitus, potential hazards.May, 370

*Hypotension, severe postural, and polyester resins. July,497

*Hypothalamic hypopituitarism with basal encephalocoele,treatment with luteinizing hormone-releasing hormone.September, 597

*Hypothyroidism, impaired nitrazepam metabolism. April,296

*Immunecomplex mediated lung haemorrhage and nephritis,

treatment with plasma exchange, haemodialysis andimmunosuppressive drug therapy. January, 52

* complexes, in a sarcoid erythema nodosum. August, 549thrombocytopenia and hyperthyroidism. October, 657

*Immunodeficiency and digital vasculitis, associated withtoxoplasmosis, dilemma in diagnosis. September, 616

*Immunosuppressive drug therapy of nephritis and lunghaemorrhage. January, 52

Incisions, abdominal, vertical or transverse? June, 407*Incontinence, urinary, caused by vulval adhesions. Sept-

ember, 634

Inflammatory bowel disease, chronic, recent changes inpattern. November, 733

Inguinal swelling and pancreatitis: correspondence. Octo-ber, 711

Insulinomas, neurological aspects. September, 577*Insulins, conventional bovine and highly purified por-

cine/bovine, and paradoxical lipodystrophic changes.June, 439

Interstitial lung disease, approaches to treatment. March,183

Intestinalendometriosis: review article. August, 514motility and the irritable bowel. November, 791

*Intracerebral haemorrhage and vasculitis, secondary toamphetamine use. June, 429

*Intracranial venous thrombosis and cerebral arterial occlu-sion, and oral contraceptives. June, 426

*Intussusceptioncaeco-colic, amoebic granuloma an unusual cause.

February, 168* retrograde ileo-ileal. January, 75Ipratropium bromide and nocturnal asthma. August, 526

*Ipsilateral vocal cord and phrenic nerve palsies, Homer'ssyndrome. February, 140

Iron loss, urinary, nephrotic syndrome, unusual cause ofiron deficiency with note on urinary copper losses.February, 125

Irritable bowel, intestinal motility. November, 791Ivalon sponge rectopexy, complete rectal prolapse, results.

June, 411

*Kidneys, lymphomatous infiltration, acute oliguric renalfailure secondary to. August, 556

King's Fund and quality of medical care. November, 825*Koebner phenomenon and Paget's disease. April, 301

Large boweldistal, excision in ulcerative colitis. April, 278function, control, constipation and dietary fibre. Novem-

ber, 811*Laryngocoele causing airflow obstruction, six cases. April,

290*Leukaemia, acute lymphoblastic, cutaneous manifestation

mimicking urticaria pigmentosa. May, 366*Leukoencephalopathy, progressive multifocal, myelodys-

plastic syndrome type II and prostatic carcinoma.February, 157

*Leydig cell tumour, benign, and germ cell carcinoma insitu, in young man with gynaecomastia. January, 66

*Lindau's disease and renal carcinoma. September, 624*Lipodystrophic changes, paradoxical, due to conventional

bovine and highly purified porcine/bovine insulins.June, 439

Lipoproteins in benign monoclonal gammopathy. July,449

*Liposarcoma, hemipelvectomy, unusual case and course.January, 70

Listeriosis, adult, review, 18 cases. April, 267*Liver cirrhosis, alcoholic, with spontaneous bacterial

peritonitis. July, 487

Vi

Index to Volume 60

Lower limb, venous diseases, clinical comparison of elasticsupports. May, 349

Lungcancer, areas of progress. March, 218

* haemorrhage and nephritis, immune complex mediated,treatment. January, 52

see also Pulmonary*Luteinizing hormone-releasing hormone treatment, in

hypothalamic hypopituitarism caused by basal ence-phalocoele. September, 597

Lymphocytes, beta-adrenoceptor and epoprostenol (pros-tacyclin) responsiveness, migraine patients. June, 391

*Lymphomakidney, presenting as acute oliguric renal failure. August,556

* relapse after 10-year remission. September, 607

Maalox and three other antacids compared. September,592

*Malaria prophylaxis with Maloprim (pyrimethamine anddapsone), agranylocytosis during. August, 566

Malignancy, overt, after idiopathic deep venous thrombo-sis. April, 275

Malignant essential hypertension, prospective measure-ment of glomerular filtration rate and effective renalplasma flow during treatment. October, 662

Malinal and three other antacids compared. September,592

*Maloprim (pyrimethamine and dapsone), malaria prophy-laxis, and agranulocytosis. August, 566

*Marrow failure with sideroblasts in autoimmune haemo-lytic crisis. August, 554

Mastication, and acid secretion. April, 272Mediastinal

evaluation, pre-operative, primary bronchial carcinoma,review of staging investigations: review article. Febru-ary, 83

* obstruction, osteosarcoma of breast. February, 159*Medullary sponge kidney, presenting with hypokalaemic

paralysis. April, 303Mefenamic acid-induced interstitial nephritis and renal

failure: correspondence. January, 82Mefruside and nifedipine (retard formulation), compari-

son in mild to moderate hypertension. August, 529*Melaena and haematemesis causing ulcerated gastric

diverticulum. October, 693*Meningitis

and fatal neonatal septicaemia, due to Haemophilusinfluenzae acquired from the mother. October, 707

* herpes simplex type 2, treated with acyclovir. April, 282* salmonella, following treatment of enteritis with neomy-

cion. April, 284tuberculous, in the elderly. September, 586

*Meningococcal meningitis presenting with bilateral deaf-ness and ataxia. October, 668

*Mercury poisoning, acute inorganic, haemodialysis andcharcoal haemoperfusion. September, 636

*Metoprolol, oral, and verapamil, probable adverse interac-tion. October, 705

*Middle mediastinal mass, thymoma. September, 611*Midline destructive disease, idiopathic, case report and

review. July, 471

Migrainebeta-adrenoceptor and epoprostenol (prostacycin) re-

sponsiveness of lymphocytes. June, 391pain, diagnosis and management. December, 841

Monoclonal gammopathies, plasma cholesterol concentra-tion and extra lipid band. July, 449

*Monocyte function, impaired, and liver cirrhosis, develop-ment of Hodgkin's disease. July, 482

*Muscular atrophy, progressive, and posterior dislocation ofthe humerus, following electric shock. February, 143

*Myalgia, association with hypopituitarism. April, 293*Myasthenia gravis, hypersensitivity to azathioprine. May,

362*Mycobacterial infection, breast, haemodialysis patient.

February, 164*Myelodysplastic syndrome type II, progressive multifocal

leukoencephalopathy, and prostatic carcinoma. Febru-ary, 157

*Myelofibrosis, extramedullary haematopoiesis, spinal cordcompression. January, 62

Myeloma, multiple, plasma cholesterol concentration.July, 449

*Myelomatosis, and cholecystitis. July, 485*Myocardial

damage due to hypokalaemia and hypophosphataemia.October, 679

infarction and chest pain. May, 338phaeochromocytoma and acute cardiovascular death.

February, 111post- see Post-myocardial infarction

* right ventricular, Dressler's syndrome after. April, 298suspected, oral disopyramide after hospital admission.

February, 98*Myocarditis associated with relapsing brucellosis. August,

544*Myxoedema presenting as epilepsy. September, 605*Myxomas, bi-atrial, presenting as recurrent pulmonary

emboli. February, 147

National Association of Clinical Tutors, report, summermeeting, Birmingham, May 1984. August, 571

*Neomycin, for enteritis treatment, salmonella meningitisfollowing. April, 284

*Nephritis and lung haemorrhage, immune complex medi-ated, treatment. January, 52

Nephrotic syndrome, urinary iron loss, unusual cause ofiron deficiency with note on urinary copper losses.February, 125

Nervous system, and herpes simplex virus: review article.April, 253

*Neuroenteric cyst, cerebellum. April, 287Neurosurgical treatment of chronic pain. December, 905

*Niclosamide in tapeworm lasting over 20 years. July, 495Nifedipine (retard formulation) and mefruside, compari-

son in mild to moderate hypertension. August, 529*Nitrazepam metabolism, impaired, in hypothyroidism.

April, 296Nocturnal activity, enuresis alarm device. April, 280*Nodular regenerative hyperplasia of liver and variceal

haemorrhage, elderly patient. July, 476

. .

Postgraduate Medical Journal

Noradrenaline-secreting phaeochromocytoma, recurrenceof asthma following removal. May, 364

Nutrition, enteral, practical techniques and problems.November, 779

Oesophagus, distal, spontaneous rupture (Boerhaave'ssyndrome), with unusual clinical presentation of pneu-moperitoneum. January, 60: correspondence. May, 382

*Oral contraceptives, cerebral arterial occlusion and intra-cranial venous thrombosis. June, 426

Osteoporosis, problem of bone formation: leading article.June, 383

*Osteoporosisregional migratory. June, 420

* severe, heparin, in pregnancy. June, 424*Osteosarcoma of breast, recurring with mediastinal ob-

struction. February, 159Ovarian disease, endocrine disorders in pregnancy, man-

agement. May, 312

Paget's disease, and psoriasis. April, 301Pain

acute, hypnosis treatment, emergency department. April,263

analgesics in. December, 876cancer, causes and management. December, 852chest, indigestion or impending heart attack. May, 338chronic, and behavioural science. December, 865non-malignant origin, approach. December, 858neurosurgical treatment. December, 905psychological approaches. December, 886

disorders of peripheral nerves. December, 869management: editorial. December, 833

with regional analgesia. December, 897postoperative. December, 847psychology. December, 835recent advances. December, 833-913

*Pancreatic insufficiency, exocrine, and idiopathic haemo-chromatosis. October, 675

*Pancreatitis, acutecomplicating excessive intake of phenolphthalein. July,

491* and Cushing's syndrome. September, 618* and massive gastric distension, two cases. September, 631* presentation as discoloured lump in groin. May, 374

and inguinal swelling: correspondence. October, 711*Paralysis, hypokalaemic, and medullary sponge kidney.

April, 303Parathyroid and thyroid disease, endocrine disorders in

pregnancy, management. April, 245*Pasteurella multocida pneumonia, complicated by Staphy-

lococcus aureus. February, 145Pepsinogens

cell biology, physiology and pathophysiology. Novem-ber, 743

plasma group I, measurement. September, 582Peptic ulcer

gastric emptying after surgery for dumping syndrome.July, 458

medical management. November, 751recent changes in pattern. November, 733

twice-daily cimetidine, effect on gastric bacterial flora.July, 464

cimetidine therapy and prevention of rebleeding. June,400

Perforation, typhoid, gut. August, 523*Pericarditis and Crohn's disease. October, 682*Peripartum cardiomyopathy, in patient with hyperprolac-

tinaemia. January, 49Peripheral

nerve disorders, pain. DecmIber, 869* neuropathy, delayed, and prolonged coma, after phe-

noxyacetic acid weedkiller ingestion. January, 76* and giant cell arteritis. October, 60*Peritonitis, spontaneous bacterial, due to Campylobacter

jejuni, July, 487Phaechromocytomaand acute cardiovascular death (with special reference to

myocardial infarction). February, 111* in coeliac ganglion in pregnancy. May, 377* noradrenaline-secreting, recurrence of asthma following

removal. May, 364*Phenolphthalein, excessive intake, acute pancreatitis com-

plicating. July, 491Phosphorus, serum levels in pulmonary tuberculosis. June,394

*Phrenic nerve palsies and ipsilateral vocal cord, Horner'ssyndrome. February, 140

Pituitary, ovarian and adrenal disease, endocrine disordersin pregnancy, management. May, 312

*Placental lactogen, human, deficiency in a normal preg-nancy. October, 689

Plasma group I pepsinogens, measurement. September, 582*Pneumoperitoneum,

spontaneous rupture of distal oesophagus (Boerhaave'ssyndrome), unusual clinical presentation. January, 60:correspondence, May, 382

*Polycysticovarian syndrome, identical twins. January, 64

* renal disease associated with mycobacterial infection.February, 164

*Polyester resins and severe postural hypotension. July,497

Polyp story. November, 820Post-myocardial infarction teaching programme, adminis-

tered by nurses, patients' evaluation. February, 108Postoperative pain. December, 847Pregnancy

endocrine disorders, management, pituitary, ovarianand adrenal disease. May, 312

thyroid and parathyroid disease. April, 245* normal, human placental lactogen (hPL) deficiency.

October, 689* and severe heparin osteoporosis. June, 424

splenic rupture: correspondence. July, 504*Prolactinoma, galactorrhoea following hypophysectomy.

August, 540*Propafenone, associated with fatal ventricular tachycardia,

new class IC antiarrhythmic agent. February, 155Prostacyclin responsiveness of lymphocytes, migraine pa-

tients. June, 391*Prostatic carcinoma, myelodysplastic syndrome type II,

and progressive multifocal leukoencephalopathy. Febru-ary, 157

viii

Index to Volume 60

*Proteinuna, heavy, following urinary diversion. October,702

*Psonasis and Paget's disease. April, 301Psychological approaches to treatment of chronic pain.

December, 886Psychology of pain. December, 835

*Psychosis and basal ganglia calcification, Down's syn-drome. February, 137

Psychotropic drugs. December, 881* and ischaemic colitis. August, 564*Pulmonary

emboli, recurrent, bi-atrial myxomas presenting as.February, 147

* hypertension, successful reduction by captopril, CRESTsyndrome. October, 672

* interstitial emphysema, severe localized, treatment byselective bronchial intubation. January, 58see also Lung

Ranitidine, H2-receptor antagonist, effect on depressionand anxiety in duodenal ulcer patients. May, 353

*Raynaud's phenomenom and immunodeficiency, associ-ated with toxoplasmosis, dilemma in diagnosis. Septem-ber, 616

Rectal prolapse, complete, Ivalon sponge rectopexy, re-sults. June, 411

*Recurrent laryngeal nerve palsy, associated with breast orlung cancer. February, 140

Regional analgesia for pain management. December, 897*Reiter's disease, bilateral retinal detachment. January, 47*Renal

artery stenosis, transplant, complicated by hypertensiveencephalopathy. May, 356

* thrombosis and persistent anuria, captopril-induced, indocumented pre-existing renal artery stenosis andrenal failure. August, 561

* carcinoma in Lindau's disease. September, 624colic, hypnosis. April, 263

* failure, acute, due to glomerulonephritis associated withstaphylococcal infection. June, 433

* oliguric, secondary to lymphomatous infiltration ofkidneys. August, 556

* in association with extreme hypernatraemia followingcaecocystoplasty. October, 700

and mefenamic acid-induced interstitial nephritis:correspondence. January, 82

* insufficiency, hypocalcaemic cataract as a presentingsymptom. February, 166

transplantation, hypertension after, captopril in. Febru-ary, 132

Respiratory distress syndrome, adult-I. Aetiology and mechanisms. August, 505

II. Management. September, 573*Retinal detachment, bilateral, Reiter's disease. January, 47*Rheumatoid arthritis, cardiac tamponade. July, 474Rhinitis, seasonal, management, comparison of aqueousand pressurized beclomethasone dipropionate nasalspray. June, 404

*Right ventricular infarction, Dressler's syndrome after.April, 298

Risk factors, coronary heart disease mortality, cigarettesmoking. January, 20diet, national. January, 26

*Salmonellameningitis following treatment of enteritis with neomy-

cin. April, 284* septicaemia, recurrent, infant. August, 546*Sarcoidosis

and acquired hypogammaglobulinaemia. August, 551* acute, associated with cutaneous leucocytoclastic vascu-

litis. August, 549pathogenesis, epidemiology, investigations, treatment.March, 234

presenting with spontaneous haemopneumothorax.September, 621

*Septicaemiaand hypoglycaemia. June, 431

* neonatal, fatal, and meningitis due to Haemophilusinfluenzae acquired from the mother. October, 707

* salmonella, recurrent, infant. August, 546*Sideroblasts in autoimmune haemolytic crisis with marrow

failure. August, 554Sjogren's syndrome, serum angiotensin converting en-zyme, 22 cases. April, 270

Sleep, nocturnal activity, and enuresis alarm device. April,280

Smoking, cigarette, and coronary heart disease mortality.January, 20

*Spinal cord compression by extramedullary haematopoi-esis in myelofibrosis. January, 62

*Spleen, ruptured,occult, two unusual clinical presentations. February, 171in pregnancy: correspondence. July, 504

*Staphylococcal infection associated with glomerulonephri-tis, and acute renal failure. June, 433

*Staphylococcus aureus, complicating Pasteurella multocidapneumonia. February, 145

*Stomach, strangulated, within a femoral hernia. May, 376*Stroke and oral contraceptives. June, 426*Styrene intoxication causing severe postural hypotension.

July, 497Sunlight exposure and vitamin D deficiency, Saudi Ara-

bian women. September, 589Surgeons' glove, starch-free: correspondence. March, 244

*Tachycardia, ventricular, fatal, in association with propaf-enone, new class IC antiarrhythmic agent. February, 155

* Taenia saginata (tapeworm) human infestation, lastingover 20 years. July, 495

*Tardive dyskinesia, and persistent akathisia. May, 359*Thioridazine-induced hyperpyrexia and cardiac arrhyth-

mias, and hyperthyroidism. June, 445Thorax, computed tomography. March, 208Thrombocytopenia, immune, and hyperthyroidism. Octo-

ber, 657*Thrombocytopenic purpura, idiopathic, rare presentation

of Hodgkin's disease. September, 614Thrombosis

deep venous, idiopathic, significance. April, 275* intracranial venous, and cerebral arterial occlusion, and

oral contraceptives. June, 426*Thymic transplant, immuno-reconstitution, in DiGeorge's

syndrome. August, 537

IX

Postgraduate Medical Journal

*Thymoma presenting as middle mediastinal mass. Septem-ber, 611

Thyroid and parathyroid disease, endocrine disorders inpregnancy, management. April, 245

*Thyrotoxicosis and Addison's disease, presenting simulta-neously. July, 478

Thyrotrophin, inappropriate secretion, causing hyperthy-roidism with associated hyperprolactinaemia. May, 328

Thyroxine-binding globulin, high serum, important causeof hyperthyroxinaemia. May, 324

*Toxoplasmosis associated with digital vasculitis and im-munodeficiency, dilemma in diagnosis. September, 616

Transcutaneous electrical nerve stimulation and acupunc-ture. December, 893

Trial, controlled, design and development associated withAvery Jones. November, 719

Tuberculosischanging pattern: review article. February, 92pulmonary, serum phosphorus levels. June, 394trends. March, 187meningitis. March, 187in the elderly. September, 586

*Twins, identical, polycystic ovarian syndrome. January, 64Typhoid perforation, gut. August, 523

Ulcerative colitisdistal large bowel excision. April, 278medical treatment. November, 797

*Ureteric obstruction, malignant, relieved by dexametha-sone. June, 437

*Urinary diversion, heavy proteinuria following. October,702

*Urticaria pigmentosa, cutaneous manifestation of acutelymphoblastic leukaemia mimicking. May, 366

*Uterus, primigravid, spontaneous rupture, finding at elec-tive Caesarean section. August, 559

*Vagina, carcinoma presenting as ruptured procidentia withan entero-vaginal fistula and prolapse of small bowel.June, 435

*Variceal haemorrhage, assosiated with nodular regenera-tive hyperplasia of liver, elderly patient. July, 476

Varicose veins, clinical comparison of elastic supports.May, 349

*Vasculitiscutaneous leucocytoclastic, associated with acute sarcoi-

dosis. August, 549* and intracerebral haemorrhage, secondary to ampheta-

mine use. June, 429*Ventricular tachycardia, fatal, in association with propafe-

none, new class IC antiarrhythmic agent. February, 155*Verapamil and oral metoprolol, probable adverse interac-

tion. October, 705Vitamin D deficiency and exposure to sunlight, SaudiArabian women. September, 589

*Vulval adhesions causing urinary incontinence. September,634

*Weedkillers, phenoxyacetic acid, prolonged coma anddelayed peripheral neuropathy after ingestion. January,76

x

Author Index

*denotes case report

Aber, C.P., see Simpson, F.G.Abu-Aisha, H., see Fonseca, V.Ackrill, P., see Williams, P.S.Adams, J., see Morris, D.V.Ahmed-Jushuf, I.H., Selby, P.L. and Brownjohn, A.M.:

Acute post-streptococcal glomerulonephritis followingear piercing. January, 73

Alderman, B., see Parkinson, D.J.Allan, N.C., see Murphy, W.G.

*Allen, S.C.: Eosinophilic fasciitis in an African-possiblebenefit of chloroquine treatment. October, 685

Allington, M., see O'Connor, N.T.J.*Allison, M.C. and Jeha, M.T.: Marrow failure with

sideroblasts in an autoimmune haemolytic crisis. August,554

Altmann, G., see Samra, Y.*Amin, R.: Homer's syndrome with ipsilateral vocal cord

and phrenic nerve palsies. February, 140Anani, A.R., see Campbell, I.W.Anderson, J.R., Wilson, B.G. and Parks, T.G.: Complete

rectal prolapse-the results of Ivalon sponge rectopexy.June, 411

Ansell, E., see Kilfeather, S.A.Ansell, I.D., see Somerville, K.W.Appenzeller, O., see Atkinson, R.Arribas-Jimenez, A., see Sanchez-Garcia, P.Atkinson, R. and Appenzeller, O.: Headache. December,

841Attwood, E.C., see Ross, J.H.Aviram, M., see Levy, Y.

Bachar, A., see Deutsch, A.A.Baggott, P.J., see Dunn, A.M.Bailey, D., see Robinson, A.C.R.Baines, M.J.: Cancer pain. December, 852Baker, L.R.I., Cattell, W.R., Levison, D.A. and Edelman,

J.B.: Mefenamic acid-induced interstitial nephritis andrenal failure: correspondence, 82

Ball, K.P.: Recent trends in coronary mortality: introduc-tion. January, 1

*Banks, J., Davis, B.R. and Monie, R.D.H.: Laryngocoelecausing airflow obstruction-a case report and summaryof clinical manifestations in five other patients. April,290

Bansal, A., see Hardy, C.*Barber, P., Gorst, D.W., Morris, J.A. and Pearson, J.D.:

Progressive multifocal leukoencephalopathy, myelodys-plastic syndrome type II and prostatic carcinoma.February, 157

Barker, L.C. see Booth, F.*Barnes, T.R.E. and Braude, W.M.: Persistent akathisia

associated with early tardive dyskinesia. May, 359Baron, J.H., editor, Festschrift for Sir Francis Avery Jones.

Fifty years of medical practice 1934-1984: November,715-831. Foreward, 715

Barry, R.E., see Bourne, J.T.Barton, C.J., see Booth, F.Bates, D., see Crawford, D.C.

Baylis, P.H., see Spruce, B.A.Beer, M., see Levine, D.F.

*Belcon, M.C., Bensen, W.G. and Zahoruk, R.M.: Bilateralretinal detachment in a case of Reiter's disease. January,47

*Bell, A.J., Mufti, G.J. and Hamblin, T.J.: Relapse oflymphoma in the heart after a 10-year remission.September, 607

Bell, G.D., see Somerville, K.W.Bensen, W.G., see Belcon, M.C.Berciano, J., see Mont6n, F.Bewick, M., see McGonigle, R.J.S.Bexton, R.S., see Nathan, A.W.Bhatia, R., see Mehta, V.S.Bhuyan, U.N., see Dash, S.C.

*Bloodworth, L., Wilson, A., Collins, P. and Rainford, D.J.:Severe dothiepin intoxication-a report of two cases.June, 442

*Bradford, R., Cohen, S.L., McLlelland, J. and Goldstraw,P.: Thymoma presenting as a middle mediastinal mass.September, 611

Bradley, J.W.P., see Shankar, S.Braude, W.M., see Barnes, T.R.E.Brennan, M.J.W., see Sandyk, R.Brook, G.J., see Levy, Y.Brown, E.A., Sampson, B., Muller, B.R. and Curtis, J.R.:

Urinary iron loss in the nephrotic syndrome-an un-usual cause of iron deficiency with a note on urinarycopper losses. February, 125

Brownjohn, A.M., see Ahmed-Jushuf, I.H.Bojic, P., see Vircburger, M.I.Bonica, J.J.: Management of pain with regional analgesia.December, 897

*Booth, F., Barker, L.C., Barton, C.J. and Naik, R.B.:Agranulocytosis during malaria prophylaxis with Malo-prim (pyrimethamine and dapsone). August, 566

Bourne, J.T., Mountford, R.A. and Barry, R.E.: Twice-daily cimetidine does not increase gastric bacterial flora.July, 464

Bowley, M.A., see Minchom, P.E.*Bowman, C.E., Muhleman, M.F. and Walters, E.: A fatal

case of creosote poisoning. July, 499Boyd, E.J.S., see Jacyna, M.R.Boyd, R.V., see Somerville, K.W.Bullingham, R.E.S.: Postoperative pain. December, 847Burnet, R., see Horowitz, M.Burnett, P.J., Milne, J.R., Greenwood, R., Giles, M.R. andCamm, J.: The role of echocardiography in the investi-gation of focal cerebral ischaemia. February, 116

Buttoo, S., see McNeil, N.I.Byrne, E., see Horowitz, M.

*Cade, R.J. and Lane, R.H.S.: Strangulated stomach withina femoral hernia. May, 376

Cameron, I.R., see Shee, C.D.Camm, A.J., see Nathan, A.W.Camm, J., see Burnett, P.J.

Postgraduate Medical Journal

*Campbell, I.W., Duncan, C. and Anani, A.R.: Paradoxicallipodystrophic changes due to conventional bovine andhighly purified porcine/bovine insulins. June, 439

Campbell, R.C., see Watt, P.C.H.Carr, P.H., see Large, D.M.Carr-Locke, D.L., Taverner, D. and Wicks, A.C.B.:

Cimetidine therapy does not prevent rebleeding frompeptic ulceration. June, 400

Carter, A., see Levy, Y.Carter, R.D., see Jones, D.B.Cattell, W.R., see Baker, L.R.I.Cayley, A.C.D., see Dixon, P.E.Cederholm-Williams, S.A., see O'Connor, N.T.J.Chan, M.K., Sweny, P., El Nahas, A.M., Farrington, K.,

Fernando, O.N. and Moorhead, J.F.: Captopril inhypertension after renal transplantation. February, 132

Chandler, G.N., see Mulcahy, F.Chandrashekhar, L., see Daga, S.R.Chard, M.D., see Machin, N.D.*Chattopadhyay, B.: Fatal neonatal septicaemia and men-

ingitis due to Haemophilus influenzae acquired from themother. October, 707

* and Teli, J.C.: Asymptomatic gonorrhoea in a malepatient. October, 691

Chowdhury, C., see Mehta, V.S.Citron, K.M.: Symposium in thoracic medicine-MauriceDavidson commemoration issue: introduction. March,177Trends in tuberculosis. March, 187

*Clague, H.W., Warren, B. and Krasner, N.: Acute pan-creatitis and Cushing's syndrome. September, 618

Clark, F., see Hutton, C.Clarke, S.W., see Rowell, N.P.Clunie, R.W.D., see Parsons, J.Cohen, C.D. and Dent, D.M.: Phaeochromocytoma and

acute cardiovascular death (with special reference tomyocardial infarction). February, 111

Cohen, S.L., see Bradford, R.Colbourne, G., see Jenkins, B.Coleridge-Smith, P.D., see Ellis, H.Collins, J.V., see Dhillon, D.P.

Mitchell, D.M.Collins, P., see Bloodworth, L.Connell, A.M.: Intestinal motility and the irritable bowel.November, 791

Cordero-Sanchez, M., see Sanchez-Garcia, P.Corston, R., see Watts, G.F.Cox, I.D., Hughes, D.T.D. and McDonnell, K.A.: Ipratro-pium bromide in patients with nocturnal asthma.August, 526

Cox, M., see Kenny, R.A.Cox, P.J., see Ellis, H.Craig, K.D.: Psychology of pain. December, 835*Crawford, D.C., Nightingale, S., Bates, D. and Tomlinson,

B.E.: Spinal cord compression by extramedullary haem-atopoiesis in myelofibrosis. January, 62

Crawley, E.O., see Harries, A.D.Crisp, A.H., Sireling, L.I. and Faizey, J.: Nocturnal

activity and the enuresis alarm device. April, 280Critchley, E.M.R.: Non-atheromatous causes of cerebral

infarction: leading article. June, 386Crue, B.L. and Pinsky, J.J.: An approach to chronic pain ofnon-malignant origin. December, 858

Cummings, J.H.: Constipation, dietary fibre and thecontrol of large bowel function. November, 811

Curtis, J.R., see Brown, E.A.

*Daga, S.R., Siddiqui, H.M., Lokhande, M.P., Chandrashe-khar, L., Prabhu, P.G. and Kansaria, B.N.: Immuno-reconstitution by thymic transplant in DiGeorge's syn-drome. August, 537

Daggett, P. and Nabarro, Sir J.: Neurological aspects ofinsulinomas. September, 577

Daly, L., see Hickey, N.*Dan, M., Hassner, A., Jedwab, M. and Shibolet, S.:

Development of Hodgkin's disease in the course of livercirrhosis and impaired monocyte function. July, 482

*Dandona, P., Mohiuddin, J. and Lindsay, K.W.: Galactor-rhoea following hypophysectomy in a boy with aprolactinoma. August, 540

*Dash, S.C., Sharma, R.K., Malhotra, K.K. and Bhuyan,U.N.: Renal amyloidosis and non-specific aorta-arteri-tis-a hitherto undescribed association. September, 626

Davies, D., see Leahy, B.C.Davies, I.J.T. Report of National Association of Clinical

Tutors summer meeting, May 1984, Birmingham.August, 571

Davies, M., see Large, D.M.Davis, B.R., see Banks, J.Davison, A.M., see Worth, D.P.Daw, E., see Howat, J.M.T.de Buitleir, M., see Hanly, J.de Portugal-Alvarez, J., see Sanchez-Garcia, P.Dean, H.G., see Harvey, J.N.del Pino-Montes, J., see Sanchez-Garcia, P.Deltito, J.A.: Hypnosis in the treatment of acute pain in theemergency department setting. April, 263

*Dennison, A.R. and Royle, G.T.: Acute pancreatitis-pre-sentation as a discoloured lump in the groin. May, 374

Dent, D.M., see Cohen, C.D.*Deutsch, A.A., Bachar, A. and Reiss, R.: Hemipelvectomy

for liposarcoma: and unusual case and course. January,70see also Sternberg, A.

Dew, M.J., see Harries, A.D.Dharmadasa, K., see Jayasinghe, K.S.A.Dhillon, D.P. and Colfins, J.V.: Current status of fibreoptic

bronchoscopy. March, 213Dimond, A.H., see Nagendran, V.Dinbar, A., see Witz, M.Dixon, P.E., Hoey, C. and Cayley, A.C.D.: Tuberculosis

meningitis in the elderly. September, 586Dobbie, J.W., see Leung, A.C.T.Doll, Sir Richard: The controlled trial. November, 719Douglas-Jones, A.P. and Mitchell, A.D.: Comparison of

nifedipine (retard formulation) and mefruside in thetreatment of mild to moderate hypertension-a prospec-tive randomized double-blind crossover study in generalpractice. August, 529

*Drew, P.J.T., Newland, A.C. and Marsh, F.P.: Immunecomplex mediated lung haemorrhage and nephritis-successful treatment with plasma exchange, haemodia-lysis and immuno-suppressive drug therapy. January, 52

xii

Index to Volume 60

Drumm, J., see Waldron, R.Dubey, P. and Nundy, S.: Mastication and acid secretion.

April, 272Dunbar, E.M., see Ellis, M.E.Duncan, C., see Campbell, I.W.Dunn, A.M., Wilson, R.S.E. and Baggott, P.J.: A compari-son of beclomethasone dipropionate aqueous nasalspray and beclomethasone dipropionate pressurizednasal spray in the management of seasonal rhinitis. June,404

Dux, S., see Streifler, J.

Edelman, J.B., see Baker, L.R.I.Ediyanto, S.P., see Kardjito, T.Edwards, D.A.W.: Dysphagia. November, 737

*Eisenberg, J.N.H. and Oakley, G.D.G.: Probable adverseinteraction between oral metoprolol and verapamil.October, 705

Ekanayake, R., see Jayasinghe, K.S.A.El-Hazmi, M., see Fonseca, V.El Nahas, A.M., see Chan, M.K.Elliott, J.A.: Pre-operative mediastinal evaluation in pri-mary bronchial carcinoma-a review of staging investi-gations: review article. February, 83

Ellis, H., Coleridge-Smith, P.D. and Joyce, A.D.: Abdomi-nal incisions-vertical or transverse? June, 407and Cox, P.J.: Breast problems in 1,000 consecutive

referrals to surgical out-patients. October, 653*Ellis, M.E., Webb, A.K. and Dunbar, E.M.: Toxoplasmosis

associated with digital vasculitis and immunodeficiency-a dilemma in diagnosis. September, 616

Elyashiv, A., see Witz, M.Epstein, F.H.: Lessons from falling coronary heart disease

mortality in the United States. January, 15

Faizey, J., see Crisp, A.H.Farrands, P.A. and Taylor, I.: Unusual groin swellings:

leading article. May, 309Farrington, K., see Chan, M.K.Ferdeghini, M., see Giampietro, 0.

Fernando, O.N., see Chan, M.K.Feuerman, E.J., see Ingber, A.

*Fink, R.S., Mann, M.S., Hopewell, J.P. and Ginsburg, J.:Benign Leydig cell tumour and germ cell carcinoma insitu in a young man with gynaecomastia. January, 66

Fitzgerald, M.X., see Hanly, J.Murphy, M.B.

Fletcher, E.W., see O'Connor, N.T.J.Fonseca, V., Tongia, R., El-Hazmi, M. and Abu-Aisha, H.:Exposure to sunlight and vitamin D deficiency, in SaudiArabian women. September, 589

Fordyce, W.E.: Behavioural science and chronic pain.December, 865

Forslund, T., see Ponka, A.*Foulds, I.S., Woodcock, B.E. and Slater, D.N.: A cutane-

ous manifestation of acute lymphoblastic leukaemiamimicking urticaria pigmentosa. May, 366

*Francis, D.A. and Heron, J.R.: Progressive muscularatrophy and posterior dislocation of the humerusfollowing electric shock. February, 143

Fraser, I., see Robinson, A.C.R.*Frustaci, A., Pennestri, F. and Scoppetta, C.: Myocardial

damage due to hypokalaemia and hypophosphataemia.October, 679

Gabizon, D., see Modai, D.Gandhi, D.B., Palmar, J.R., Lewis, B. and Schraibman,

I.G.: Clinical comparison of elastic supports for venousdiseases of the lower limb. May, 349

Geddes, D.M.: Chronic airflow obstruction. March, 194Gefel, D., see Gur, H.George, C.F., see Hardy, C.Ghose, R.R.: Prospective measurement of glomerular

filtration rate and effective renal plasma flow duringtreatment of malignant essential hypertension. October,662

*Giampietro, O., Ferdeghini, M. and Scatena, P.: Humanplacental lactogen (hPL) deficiency in a normal preg-nancy. October, 689

Gibbons, C.P.: Pancreatitis and inguinal swelling: corre-spondence. October, 711

* and Harvey, L.: An ulcerated gastric diverticulum-arare cause of haematemesis and melaena. October, 693

* and Ross, B.: Cholecystoduodenocolic fistula and gall-stone ileus. October, 698

Giles, M.R., see Burnett, P.J.Gillies, J.G., see Moore, P.G.Ginsburg, J., see Fink, R.S.Giri, D.D., see Patra, S.B.Glasser, B., see Spitz, I.M.Goldstraw, P., see Bradford, R.

*Gollock, J.M. and Thomson, J.P.S.: Ischaemic colitisassociated with psychotropic drugs. August, 564

*Gomm, S.A.: An unusual presentation of sarcoidosis-spontaneous haemopneumothorax. September, 621

Gorgolewska, G., see Kilfeather, S.A.Gorst, D.W., see Barber, P.Graham, I., see Hickey, N.Grange, J.M., see Kardjito, T.Gray, J.A.M.: Coronary heart disease-planning for pre-

vention. January, 39Greenwald, M., see Streifler, J.Greenwood, R., see Burnett, P.J.

*Griffiths, H.T. and Liu, D.T.Y.: Severe heparin osteoporo-sis in pregnancy. June, 424

Grunwald, M.H., see Ingber, A.Gumpel, J.M., see Prouse, P.J.

*Gur, H., Gefel, D. and Tur-Kaspa, R.: Transient electro-cardiographic changes during two episodes of relapsingbrucellosis. August, 544

Hamblin, T.J., see Bell, A.J.Hamilton, D.V., see Maher, E.R.Hanks, G.W.: Psychotropic drugs. December, 881

*Hanly, J., de Buitleir, M., Shaw, K., Maurer, B. andFitzgerald, M.X.: Bi-atrial myxomas presenting as recur-rent pulmonary emboli in a girl. February, 147

Hansky, J.: Gastrins and gastrinomas. November, 767*Hardy, C., Bansal, A., Lowes, J.A. and George, C.F.:

Salmonella meningitis following treatment of enteritiswith neomycin. April, 284

.x.

Postgraduate Medical Journal

Harries, A.D., Dew, M.J., Crawley, E.O., Leach, K.G.,Salaman, J.R. and Rhodes, J.: Gastric emptying aftersurgery for the dumping syndrome. July, 458

Harrington, J.M., see MacFarlane, I.A.Harrison, M.J.G.: Dementia due to tumours of the corpus

callosum. May, 321Hart, J.T.: Hypertension and the prevention of coronary

heart death in general practice. January, 34*Harvey, J.N., Dean, H.G. and Lee, M.R.: Recurrence of

asthma following removal of a noradrenaline-secretingphaeochromocytoma. May, 364

Harvey, L., see Gibbons, C.P.Hassner, A., see Dan, M.Hellestrand, K.J., see Nathan, A.W.Hellman, C., see Streifler, J.Hendy, M.S., see Williams, P.S.*Heron, J.R., see Francis, D.A.Hertz, M., see Samra, Y.Hetzel, M.R.: A more logical approach to asthma. March,

201Hickey, N., Mulcahy, R., Daly, L. and Graham, I.:

Mortality from coronary heart disease-trends for theRepublic of Ireland. January, 9

Hirsch, H.J., see Spitz, I.M.Hirschowitz, B.I.: Pepsinogen. November, 743Hockaday, T.D.R., see Jones, D.B.Hodson, M.E.: Cystic fibrosis. March, 225Hoey, C., see Dixon, P.E.Hoffbrand, B.I.: Conference report, 10th scientific meeting

of the International Society of Hypertension, Interlaken,June 1984. October, 712

Hopewell, J.P., see Fink, R.S.*Horowitz, M., Byrne, E. and Burnet, R.: Hypopituitarism

associated with myalgia. April, 293see also Need, A.G.

*Howat, J.M.T., Stassan, L., Mohandas, I. and Daw, E.:Carcinoma of the vagina presenting as a rupturedprocidentia with an enterovaginal fistula and prolapse ofthe small bowel. June, 435

Howdle, P.D.: Organ culture ofgastrointestinal mucosa-atechnique for the study of the human gastrointestinaltract: review article. October, 645

Hughes, D.T.D., see Cox, I.D.*Hutton, C., and Clark, F.: Polycystic ovarian syndrome in

identical twins. January, 64*Hutton, C.W. and Strang, C.: Osteosarcoma of breast

recurring with mediastinal obstruction. February, 159

Impallomeni, M., see Kenny, R.A.Ingber, A., Grunwald, M.H. and Feuerman, E.J.: Carba-

mazepine-induced bullous eruption or bullous pemphi-goid?: correspondence. April, 307

Jacobs, H.S., see Morris, D.V.Van der Spuy, Z.M.

Jacobs, P., Majoos, F. and Perrotta, A.: Hyperthyroidismand immune thrombocytopenia. October, 657

Jacyna, M.R., Boyd, E.J.S. and Wormsley, K.G.: Compar-ative study of four antacids. September, 592

Jain, S., see Wright, E.P.

James, D.G.: Sarcoidosis. March, 234and Mishra, B.B.: The changing pattern of tuberculosis:review article. February, 92

James, O.F., see Moore, P.G.*Jansen, P.L.M., Thien, Th., Lamers, C.B.H.W., Yap, S.H.,

Reekers, P. and Strijk, S.: Exocrine pancreatic insuffici-ency and idiopathic haemochromatosis. October, 675

*Jayasinghe, K.S.A., Mendis, B.L.J., Mohideen, R., Ekana-yake, R., Sheriff, M.H.R. and Dharmadasa, K.: Medul-lary sponge kidney presenting with hypokalaemic para-lysis. April, 303

Jedeikin, R., see Witz, M.Jedwab, M., see Dan, M.Jeha, M.T., see Allison, M.C.Jenkins, B., Mayberry, J.F., Kent, S. and Colbourne, G.:

Patients' evaluation of a post-myocardial infarctionteaching programme administered by nurses. February,108

*Johnston, C. and Kennedy, C.: Cutaneous leucocytoclasticvasculitis associated with acute sarcoidosis. August, 549

Jones, B., see Sherlock, D.Jones, D.B., Patel, P., Slaughter, P., Carter, R.D., Mann,

JI. and Hockaday, T.D.R.: A comparison of isocalorichigh carbohydrate and high fat test meals in diabetics.February, 129

Joyce, A.D., see Ellis, H.Juby, L.D., see Mulcahy, F.

Kafetz, K., see Kenny, R.A.Kansaria, B.N., see Daga, S.R.Kardjito, T., Ediyanto, S.P. and Grange, J.M.: Serumphosphorus levels in pulmonary tuberculosis. June, 394

Kay, J., see Simpson, F.G.*Kazi, G.Q., Phillips, C.I., Lambie, A.T., and Winney, R.J.:

Hypocalcaemic cataract as a presenting symptom ofrenal insufficiency. February, 166

Keene, M., see Morris, D.V.Kennedy, C., see Johnston, C.Kennedy, P.G.E.: Herpes simplex virus and the nervous

system: review article. April, 253*Kenny, R.A., Kafetz, K., Cox, M., Timmers, J. and

Impallomeni, M.: Impaired nitrazepam metabolism inhypothyroidism. April, 296

Kent, S., see Jenkins, B.Kerr, D.N.S., see Spruce, B.A.Khanna, A.K. and Misra, M.K.: Typhoid perforation of

the gut. August, 523Khosla, S.N.: Cricoid webs-incidence and follow-up

study in Indian patients. May, 346Kilfeather, S.A., Massarella, A., Gorgolewska, G., Ansell,

E. and Turner, P.: Beta-adrenoceptor and epoprostenol(prostacyclin) responsiveness of lymphocytes in mig-raine patients. June, 391

Kinloch, J.D., Pearson, A.J.G., Woolf, I.L. and Young,P.H.: The effect of cimetidine on the maintenance ofhealing of gastric ulceration. October, 665

Kott, I, see Sternberg, A.Krasner, N., see Clague, H.W.*Kupari, M.: Reversibility of alcoholic cardiomyopathy.

February, 151

XIV

Index to Volume 60

*La Ferla, G. and Thomson, W.O.: A patient with sixprimary carcinomata. October, 687

Lahiri, A., see Prouse, P.J.Laing, I., see Large, D.M.

Leahy, B.C.Lambie, A.T., see Kazi, G.Q.

*Lambrianides, A.L. and Rosin, R.D.: Acute pancreatitiscomplicating excessive intake of phenolphthalein. July,491

Lamers, C.B.H.W., see Jansen, P.L.M.Lane, R.H.S., see Cade, R.J.Langman, M.J.S.: Recent changes in the patterns of

chronic digestive disease in the United Kingdom.November, 733

*Large, D.M., Carr, P.H., Laing, I. and Davies, M.:Hyperkalaemia in diabetes mellitus-potential hazardsof coexisting hyporeninaemic hypoaldosteronism. May,370

Leach, K.G., see Harries, A.D.Leahy, B.C., Davies, D., Laing, I. and Walton, L.: Highserum thyroxine-binding globulin-an important causeof hyperthyroxinaemia. May, 324

Ledgerwood, M.J., see Worth, D.P.*Lee, C.A.: Acquired hypogammaglobulinaemia and sar-

coidosis. August, 551Lee, M.R., see Harvey, J.N.Lennard-Jones, J.E.: Medical treatment of ulcerative

colitis. November, 797Letchworth, A.T., see Parsons, J.

Pill, C.F.*Leung, A.C.T., McKean, M., Mactier, R. and Dobbie,

J.W.: Acute oliguric renal failure secondary to lympho-matous infiltration of the kidneys. August, 556

Levine, D.F. and Beer, M.: Measurement of plasma groupI pepsinogens. September, 582

Levison, D.A., see Baker, L.R.I.*Levy, D.M., and Sagar, H.J.: Herpes simplex type 2

meningitis treated with acyclovir. April, 282Levy, Y., Aviram, M., Spira, G., Tatarsky, I., Brook, G.J.and Carter, A.: Plasma cholesterol concentration andextra lipid band in monoclonal gammopathies. July, 449

Lewins, A.M., see Worth, D.P.Lewis, B., see Gandhi, D.B.Lindsay, K.W., see Dandona, P.Liu, D.T.Y., see Griffiths, H.T.Lokhande, M.P., see Daga, S.R.Lowes, J.A., see Hardy, C.Lucke, W., see Robins, A.H.

McCarthy, C.F., see Waldron, R.McColl, I.: The King's Fund and quality of medical care.November, 825

McDonnell, K.A., see Cox, I.D.McFadyen, M.L., see Robins, A.H.*MacFarlane, I.A., Wilkinson, R. and Harrington, J.M.:

Severe postural hypotension following home canoeconstruction from polyester resins. July, 497

*McGonigle, R.J.S., Bewick, M., Trafford, J.A.P. andParsons, V.: Hypertensive encephalopathy complicatingtransplant renal artery stenosis. May, 356

McGurk, J.J., see Watt, P.C.H.

Machin, N.D., Chard, M.D. and Paice, E.W.: Serumangiotensin converting enzyme in Sjogren's syndrome-a case report and study of 21 further cases. April, 270

McKean, M., see Leung, A.C.T.McLlelland, J., see Bradford, R.*McNeil, N.I., Buttoo, S. and Ridgway, G.L.: Spontaneous

bacterial peritonitis due to Campylobacter jejuni. July,487

McPhie, J.L.: Carbamazepine-induced bullous eruption orbullous pemphigoid?: correspondence reply. April, 307

Mactier, R., see Leung, A.C.T.*Maher, E.R., Hamilton, D.V., Thiru, S. and Wheatley, T.:

Acute renal failure due to glomerulonephritis associatedwith staphylococcal infection. June, 433

Majoos, F., see Jacobs, P.*Major, G.A.C.: Regional migratory osteoporosis. June, 420Malhotra, K.K., see Dash, S.C.Mann, J.I., see Jones, D.B.Mann, M.S., see Fink, R.S.*Manomohan, V., Subbuswamy, S.G. and Willoughby,

C.P.: Crohn's disease and pericarditis. October, 682Marmot, M.G.: Life style and national and international

trends in coronary heart disease mortality. January, 3Marsh, F.P., see Drew, P.J.T.

*Martyn, V. and Swift, D.: Pasteurella multocida pneumo-nia complicated by Staphylococcus aureus. February, 145

Mason, W.P., see Morris, D.V.Massarella, A., see Kilfeather, S.A.*Matharu, G.S. and Oelbaum, M.H.: Peripartum cardiomy-

opathy in a patient with hyperprolactinaemia. January,49

Maurer, B., see Hanly, J.Mayberry, J.F., see Jenkins, B.Mehta, H.S., see Patra, S.B.*Mehta, V.S., Chowdhury, C. and Bhatia, R.: Neuroenteric

cyst of the cerebellum. April, 287Melzack, R. and Wall, P.D.: Acupuncture and transcuta-

neous electrical nerve stimulation. December, 893Mendis, B.L.J., see Jayasinghe, K.S.A.Merskey, H.: Psychological approaches to the treatment of

chronic pain. December, 886*Miller, D.G.: Coeliac disease with autoimmune haemolytic

anaemia. September, 629Milne, J.R., see Burnett, P.J.Minchom, P.E., Sibert, J.R., Newcombe, R.G. and Bow-

ley, M.A.: Does health education prevent childhoodaccidents? April, 260

Mishra, B.B., see James, D.G.Misiewicz, J.J.: Medical management of peptic ulcer.

November, 751Misra, M.K., see Khanna, A.K.Mitchell, A.D., see Douglas-Jones, A.P.Mitchell, D.M. and Collins, J.V.: Do corticosteroids really

alter mood? At our mother's knee-an occasionalreview. July, 467

*Mitchell-Jones, P.J. and Sankey, R.J.: A case of recurrentsalmonella septicaemia in an infant. August, 546

*Mitra, A. and Roth, R.N.: Retrograde ileoileal intussus-ception. January, 75

*Modai, D., Weissgarten, J., Reiff, R., Siegal, B. andGabizon, D.: Breast mycobacterial infection in a haemo-dialysis patient. February, 164

Mohandas, I., see Howat, J.M.T.

xv

Postgraduate Medical Journal

Mohideen, R., see Jayasinghe, K.S.A.Mohiuddin, J., see Dandona, P.Monie, R.D.H., see Banks, J.*Monk, B.: Psoriasis and Paget's disease. April, 301*Mont6n, F., Rebollo, M., Quintana, F. and Berciano, J.:

Cerebral arterial occlusion and intracranial venousthrombosis in a woman taking oral contraceptives. June,426

*Moore, P.G., Gullies, J.G., James, O.F. and Saltos, N.:Occult ruptured spleen-two unusual clinical presenta-tions. February, 171

Moorhead, J.F., see Chan, M.K.Morley, A.R., see Spruce, B.A.

*Morris, D.V., Mason, W.P., Wilson-Holt, N., Adams, J.,Keene, M., Tanner, J. and Jacobs, H.S.: Hypothalamichypopituitarism in a patient with a basal encephalocoele-treatment with luteinizing hormone-releasing hor-mone. September, 597

Morris, H.A., see Need, A.G.Morris, J.A., see Barber, P.Morson, B.C.: The polyp story. November, 820Mountford, R.A., see Bourne, J.T.Mufti, G.J., see Bell, A.J.Muhleman, M.F., see Bowman, C.E.*Mulcahy, F., Juby, L.D. and Chandler, G.N.: Giant cell

arteritis presenting with peripheral neuropathy. October,670

Mulcahy, R., see Hickey, N.Muller, B.R., see Brown, E.A.Murphy, B., see Waldron, R.*Murphy, M.B. and Fitzgerald, MX.: Does hyperthyroid-

ism predispose to thioridazine-induced hyperpyrexiaand cardiac arrhythmias? June, 445

*Murphy, W.G., Allan, N.C., Perry, D.J. and Stockdill, G.:Hodgkin's disease presenting as idiopathic thrombocy-topenic purpura. September, 614

*Murray, W.J.G.: Massive gastric distension in acutepancreatitis-a report of two cases. September, 631

Nabarro, Sir, J., see Daggett, P.*Nagendran, V. and Dimond, A.H.: Renal carcinoma in

Lindau's disease. September, 624Naik, R.B., see Booth, F.Nakano, G., Ritchie, J.K. and Thomson, J.P.S.: Ulcerative

colitis treated by excision of the distal large bowel alone.April, 278

*Nassberger, L.: Disulfiram-induced hepatitis-report of acase and review of the literature. September, 639

*Nathan, A.W., Bexton, R.S., Hellestrand, K.J. and Camm,A.J.: Fatal ventricular tachycardia in association withpropafenone, a new class IC antiarrhythmic agent.February, 155

*Need, A.G., Morris, H.A., Horowitz, M. and Nordin,B.E.C.: Immobilization hypercalcaemia with severebone mineral loss and hypogonadism. June, 415

Newcombe, R.G., see Minchom, P.E.Newland, A.C., see Drew, P.J.T.*Newrick, P.G.: Addison's disease and thyrotoxicosis pre-

senting simultaneously. July, 478Nicholas, P.: Starch-free surgeons' glove: correspondence.March, 244

Nicholls, A.: Captopril for hypertension-a coming ofage?: conference report. December, 917

Nightingale, S., see Crawford, D.C.Noble, A.D., see Pill, C.F.Nordin, B.E.C., see Need, A.G.Nundy, S., see Dubey, P.*Nunzi, E., Rongioletti, F. and Rebora, A.: Dermatobia

hominis infestation. February, 162

Oakley, G.D.G., see Eisenberg, J.N.H.O'Connor, N.T.J., Cederholm-Williams, S.A., Fletcher,

E.W., Allington, M. and Sharp, A.A.: Significance ofidiopathic deep venous thrombosis. April, 275

Oelbaum, M.H., see Matharu, G.S.O'Halloran, M.J., see Robinson, A.C.R.

*Oliver, J.E. and Smith, I.J.: Treatment of severe localizedpulmonary interstitial emphysema by selective bron-chial intubation. January, 58

*Olobo-Lalobo, J.H.: A hole in a primigravid uterus-anunusual finding at elective Caesarean section. August,559

*O'Reilly, J.F.: Prolonged coma and delayed peripheralneuropathy after ingestion of phenoxyacetic acid weed-killers. January, 76

Paice, E.W., see Machin, N.D.Palmar, J.R., see Gandhi, D.B.Parker, M., see Shankar, S.Parkes, J., see Parkes, C.M.Parkes, C.M. and Parkes, J.: 'Hospice' versus 'hospital'care-re-evaluation after 10 years as seen by survivingspouses. February, 120

*Parkinson, D.J. and Alderman, B.: Vulval adhesioncausing urinary incontinence. September, 634

Parks, T.G., see Anderson, J.R.*Parsons, J., Clunie, R.W.D. and Letchworth, A.T.: Phaeo-

chromocytoma in a coeliac ganglion in pregnancy. May,377

Parsons, V., see McGonigle, R.J.S.Patel, P., see Jones, D.B.

*Patra, S.B., Giri, D.D., Shukla, G.N. and Mehta, H.S.:Amoebic granuloma-an unusual cause of caeco-colicintussusception. February, 168

Paunkovic, N., see Vircburger, M.I.Pav6n-Osuna, P., see SAnchez-Garcia, P.Pearson, A.J.G., see Kinloch, J.D.Pearson, J.D., see Barber, P.Pennestri, F., see Frustaci, A.Peric, L.A., see Vircburger, M.I.Perrotta, A., see Jacobs, P.Perry, D.J., see Murphy, W.G.Perry, G., see Streifler, J.Phillips, C.I., see Kazi, G.Q.Pill, C.F., Letchworth, A.T. and Noble, A.D.: Effect of

introduction of colposcopy into a district general hospi-tal. July, 461

Pinsky, J.J., see Crue, B.L.Pitlik, S., see Streifler, J.*Ponka, A. and Forslund, T.: Cardiac failure, hepatic

congestion and increased level of serum carcinoembry-onic antigen. January, 56

XVI

Index to Volume 60

Poole, D., see Shee, C.D.Prabhu, P.G., see Daga, S.R.Prelevic, G.M., see Vircburger, M.I.

*Prince, R.L.: Carcinoma of the breast in a male withhypogonadotropic hypogonadism. August, 542

*Prouse, P.J., Lahiri, A. and Gumpel, J.M.: The CRESTsyndrome-successful reduction of pulmonary hyper-tension by captopril. October, 672

Quintana, F., see Mont6n, F.

Raffin, T.A., see Stevens, J.H.Rainford, D.J., see Bloodworth, L.Read, A.E.: Gastrointestinal bleeding. November, 760Rebollo, M., see Mont6n, F.Rebora, A., see Nunzi, E.Reekers, P., see Jansen, P.L.M.Reiff, R., see Modai, D.Reiss, R., see Deutsch, A.A.

Stemnberg, A.Reiss, R., see Stemnberg, A.Rhodes, J., see Harries, A.D.Ridgway, G.L., see McNeil, N.I.Ritchie, J.K., see Nakano, G.Robins, A.H., Lucke, W., McFadyen, M.L. and Wright,

J.P.: Effect of the H2-receptor antagonist ranitidine ondepression and anxiety in duodenal ulcer patients. May,353

*Robinson, A.C.R., Fraser, I., Bailey, D. and O'Halloran,M.J.: Idiopathic midline destructive disease-case reportand review of the literature. July, 471

Rongioletti, F., see Nunzi, E.Rosenfeld, J.B., see Streifler, J.Rosin, R.D., see Lambrianides, A.L.Ross, B., see Gibbons, C.P.Ross, J.H. and Attwood, E.C.: Severe repetitive exerciseand haematological status. July, 454

Roth, R.N., see Mitra, A.*Rowell, N.P. and Clarke, S.W.: Myxoedema presenting as

epilepsy. September, 605Royle, G.T., see Dennison, A.R.

Sagar, H.J., see Levy, D.M.Salaman, J.R., see Harries, A.D.

*Salanova, V. and Taubner, R.: Intracerebral haemorrhageand vasculitis secondary to amphetamine use. June, 429

Saltos, N., see Moore, P.G.Sampson, B., see Brown, E.A.Samra, Y., Hertz, M. and Altmann, G.: Adult listeriosis-a

review of 18 cases. April, 267*Sanchez-Garcia, P., Cordero-Sanchez, M., Pavon-Osuna,

P., Arribas-Jimenez, A., del Pino-Montes, J. and dePortugal-Alvarez, J.: Cardiac tamponade in rheumatoidarthritis. July, 474

Sandyk, R.: Persistent akathisia associated with earlydyskinesia: correspondence. December, 916

* and Brennan, M.J.W.: Meningococcal meningitis pre-senting with bilateral deafness and ataxia. October, 668

Sankey, R.J., see Mitchell-Jones, P.J.Scadding, J.G.: Maurice Davidson 1883-1967-progress in

respiratory medicine since his time. March, 178Scatena, P., see Giampietro, 0.Schraibman, I.G., see Gandhi, D.B.Scoppetta, C., see Frustaci, A.Selby, P.L., see Ahmed-Jushuf, I.H.

*Shankar, S., Bradley, J.W.P. and Parker, M.: Gallstoneperforation of the ileum without obstruction. October,696

Sharma, R.K., see Dash, S.C.Sharp, A.A., see O'Connor, N.T.J.Shaw, K., see Hanly, J.Shee, C.D., Poole, D. and Cameron, I.R.: Treatment ofasthma in a general practice. May, 336

Sheinfeld, M., see Spitz, I.M.Sheriff, M.H.R., see Jayasinghe, K.S.A.

*Sherlock, D. and Jones, B.: Cholecystitis associated withmyelomatosis. July, 485

Shibolet, S., see Dan, M.Shiner, M.: Present trends in coeliac disease. November,773

*Short, C.D.: Heavy proteinuria following urinarydiversion. October, 702

Shpitz, B., see Witz, M.Shukla, G.N., see Patra, S.B.Sibert, J.R., see Minchom, P.E.Siddiqui, H.M., see Daga, S.R.Siegal, B., see Modai, D.Silber, W.: Spontaneous rupture of distal oesophagus

(Boerhaave's syndrome) with unusual clinical presenta-tion of pneumoperitoneum: correspondence. May, 382

Silk, D.B.A.: Enteral nutrition. November, 779Simpson, C.J.: Splenic rupture in pregnancy: correspon-

dence. July, 504Simpson, D.: Trends in major risk factors. Cigarette

smoking. January, 20Simpson, F.G., Kay, J. and Aber, C.P.: Chest pain-indi-

gestion or impending heart attack? May, 338Sircus, W.: Medical-surgical collaboration in the practiceof gastroenterology. November, 725

Sireling, L.I., see Crisp, A.H.Slater, D.N., see Foulds, I.S.Slaughter, P., see Jones, D.B.Smith, A.: Recent trends in coronary mortality: summing

up. January, 42Smith, I.J., see Oliver, J.E.Smith, R.: Osteoporosis-a problem of bone formation?:

leading article. June, 383*Somerville, K.W., Boyd, R.V., Ansell, I.D., Williams, C.B.

and Bell, G.D.: An unusual cause of variceal haemor-rhage in an elderly patient. July, 476

S0reide, O.: Appendicitis-a study of incidence, deathrates and consumption of hospital resources. May,341

Spence, R.A.J., see Watt, P.C.H.Spira, G., see Levy, Y.Spiro, S.G.: Lung cancer-areas of progress. March,218

Spitz, I.M., Sheinfeld, M., Glasser, B. and Hirsch, H.J.:Hyperthyroidism due to inappropriate TSH secretionwith associated hyperprolactinaemia-a case report andreview of the literature. May, 328

x.ii

Postgraduate Medical Journal

*Spruce, B.A., Baylis, P.H., Kerr, D.N.S. and Morley, A.R.:Idiopathic hypergammaglobulinaemia associated withnephrogenic diabetes insipidus and distal renal tubularacidosis. July, 493

Stassan, L., see Howat, J.M.T.*Sternberg, A., Deutsch, A.A., Kott, I. and Reiss, R.:

Duodenal diverticula occurring in a family-chance orinheritance? July, 489

Stevens, J.H. and Raffin, T.A.: Adult respiratory distresssyndrome-I. Aetiology and mechanisms: review article.August, 505II. Management: review article. September, 573

Stockdill, G., see Murphy, W.G.Strang, C., see Hutton, C.W.

*Streifler, J., Pitlik, S., Dux, S., Perry, G., Hellman, C.,Greenwald, M. and Rosenfeld, J.B.: Dressler's syndromeafter right ventricular infarction. April, 298

Strickland, B.: Computed tomography of the thorax.March, 208

Strijk, S., see Jansen, P.L.M.Subbuswamy, S.G., see Manomohan, V.Sweny, P., see Chan, M.K.Swift, D., see Martyn, V.

Takeda, F.: Neurosurgical treatment of chronic pain.December, 905

Tanner, J., see Morris, D.V.Tatarsky, I., see Levy, Y.Taubner, R., see Salanova, V.Taverner, D., see Carr-Locke, D.L.Taylor, A., see Worth, D.P.Taylor, I., see Farrands, P.A.Teli, J.C., see Chattopadhyay, B.*Thase, M.E.: Basal ganglia calcification and psychosis in

Down's syndrome. February, 137Thien, Th., see Jansen, P.L.M.Thiru, S., see Maher, E.R.*Thomas, A.M.C.: Simultaneous presentation of two cere-

bral arterial aneurysms. February, 135Thomson, J.P.S., see Gollock, J.M.

Nakano, G.Thomson, W.O., see La Ferla, G.Thurston, C.J., see Walker, W.S.Timmers, J., see Kenny, R.A.Todorovic, P., see Vircburger, M.I.Tomlinson, B.E., see Crawford, D.C.Tongia, R., see Fonseca, V.Townell, N.H. and Vanderwalt, J.D.: Intestinal endome-

triosis: review article. August, 514Trafford, J.A.P., see McGonigle, R.J.S.Tur-Kaspa, R., see Gur, H.Turner, P., see Kilfeather, S.A.Turner-Warwick, M.E.H.: Approaches to treatment of

interstitial lung disease. March, 183Twycross, R.G.: Analgesics. December, 876

Pain: editorial. December, 833

U.K. Rythmodan Multicentre Study Group: Oral disopy-ramide after admission to hospital with suspected acutemyocardial infarction. February, 98

Van der Spuy, Z.M. and Jacobs, H.S.: Management ofendocrine disorders in pregnancy. Part I-hyroid andparathyroid disease: review article. April, 245: PartII-pituitary, ovarian and adrenal disease: review arti-cle. May, 312

Vanderwalt, J.D., see Townell, N.H.*Vircburger, M.I., Prelevic, G.M., Todorovic, P., Bojic, P.,

Peric, L.A. and Paunkovic, N.: Renovascular hyperten-sion associated with bilateral aldosteronoma. August,533

Waldron, R., Drumm, J., McCarthy, C.F. and Murphy, B.:Choledochal cysts-report of three cases and review.June, 397

Walker, C.L.: Trends in major risk factors: The nationaldiet. January, 26

*Walker, W.S. and Thurston, C.J.: Extreme hypernatrae-mia in association with renal failure following caecocys-toplasty. October, 700

Wall, P.D., see Melzack, R.*Walsh, T.D.: Hypoglycaemia and septicaemia. June, 431* and West, T.S.: Malignant ureteric obstruction relieved

by dexamethasone. June, 437Walters, E., see Bowman, C.E.Walton, L. see Leahy, B.C.Warren, B., see Clague, H.W.Watt, P.C.H., Spence, R.A.J., Campbell, R.C., McGurk,

J.J. and Whytes, D.G.C.: Combined barium meal andcholecystogram-an analysis of 1,444 patients. August,518

*Watts, G.F. and Corston, R.: Hypersensitivity to azathio-prine in myasthenia gravis. May, 362

Webb, A.K., see Ellis, M.E.Weissgarten, J., see Modai, D.West, T.S., see Walsh, T.D.Wheatley, T., see Maher, E.R.Whytes, D.G.C., see Watt, P.C.H.Wicks, A.C.B., see Carr-Locke, D.L.Wilkins, W.E., see Young, J.B.Wilkinson, R., see MacFarlane, I.A.Williams, C.B.: The clinical yield of colonoscopy. Novem-

ber, 803see also Somerville, K.W.

*Williams, P.S., Hendy, M.S. and Ackrill, P.: Captopril-induced acute renal artery thrombosis and persistentanuria in a patient with documented pre-existing renalartery stenosis and renal failure. August, 561

Willoughby, C.P., see Manomohan, V.Wilson, A., see Bloodworth, L.Wilson, B.G., see Anderson, J.R.Wilson, R.S.E., see Dunn, A.M.Wilson-Holt, N., see Morris, D.V.Winney, R.J., see Kazi, G.Q.Withrington, R.H., see Wynn Parry, C.B.

*Witz, M., Jedeikin, R., Zager, M., Shpitz, B., Elyashiv, A.and Dinbar, A.: Spontaneous rupture of distal oesopha-gus (Boerhaave's syndrome) with unusual clinical pre-sentation of pneumoperitoneum. January, 60

Woodcock, B.E., see Foulds, I.S.Woolf, I.L., see Kinloch, J.D.Wormsley, K.G., see Jacyna, M.R.

xviii

Index to Volume 60

*Worth, D.P., Davison, A.M., Lewins, A.M., Ledgerwood,M.J. and Taylor, A.: Haemodialysis and charcoalhaemoperfusion in acute inorganic mercury poisoning.September, 636

*Wright, E.P. and Jain, S.: Human infestation by Taeniasaginata lasting over 20 years, July, 495

Wright, J.P., see Robins, A.H.Wynn Parry, C.B. and Withrington, R.H.: Painful dis-

orders of peripheral nerves. December, 869

Yap, S.H., see Jansen, P.L.M.*Young, J.B. and Wilkins, W.E.: Hypertrophic pulmonary

osteoarthropathy complicating Celestin tube insertion.July, 480

Young, P.H., see Kinloch, J.D.

Zager, M., see Witz, M.Zahoruk, R.M., see Belcon, M.C.

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Postgraduate Medical Journal

VOLUME 60 NUMBER 710 DECEMBER 1984

Recent advances in the understanding and management of painEditorialROBERT G. TWYCROSS .833

Psychology of painKENNETH D. CRAIG. 835

HeadacheRUTH ATKINSON AND OTTO APPENZELLER .841

Postoperative painR. E. S. BULLINGHAM .847

Cancer painM. J. BAINES. 852

An approach to chronic pain of non-malignant originB. L. CRUE AND J. J. PINSKY .858

Behavioural science and chronic painW. E. FORDYCE. 865

Painful disorders of peripheral nervesC. B. WYNN PARRY AND R. H. WITHRINGTON .869

AnalgesicsROBERT G. TWYCROSS .876

Psychotropic drugsG. W. HANKS .881

Psychological approaches to the treatment of chronic painH. MERSKEY .886

Acupuncture and transcutaneous electrical nerve stimulationRONALD MELZACK AND PATRICK D. WALL .893

Management of pain with regional analgesiaJOHN J. BONICA. 897

Neurosurgical treatment of chronic painFUMIKAZU TAKEDA .905

Books received; book reviews .914Letter to Editor .916Conference Report .917

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