bluuebunny/crossref_metadata_2025 huggingface dataset:
Chapter X SOCIAL FACTORS, STRESS EXPERIENCE, AND PERSONALITY TRAITS IN WOMEN WITH ISCHAEMIC HEART DISEASE, COMPARED TO A POPULATION SAMPLE OF WOMEN
Authors: Bengtsson Calle , Hällström Tore , Tibblin Gösta
Published: August 2010

Abstract. No significant differences in socio‐economic status were found between women with IHD and women in the general population. No correlation was found between status incongruity of husband and wife and ischaemic heart disease. Women who had four children or more were significantly over‐represented among those who had myocardial infarction and among those with ECG changes suggestive of ischaemic heart disease. Psychological stress, both when measured as psycho‐social stress factors and as subjective stress experience, was significantly more common in women with myocardial infarction and in women with angina pectoris than in women in the general population. Among personality traits assessed, the level of aggression and neurotic self‐assertiveness was significantly higher in women with myocardial infarction. Achievement and dominance displayed a tendency in the same direction but the differences did not reach statistical significance.
BONE MARROW BIOPSY IN DIAGNOSIS OF WHIPPLE'S DISEASE
Authors: Rausing Alf
Published: August 2010

Abstract It is known from autopsy studies that the bone marrow often contains cells typical of Whipple's disease. This knowledge has, however, apparently never been utilized for diagnosis of the condition intra vitam. Typical cells have now been found in a bone marrow smear. Electron microscopy of post mortem tissue from the bone marrow confirmed the presence of bacteriumlike structures in histiocytes.
DURATION OF SMOKING AND QUANTITY OF TOBACCO USED BY PATIENTS WITH GASTRIC CANCER
Authors: Zacho Alfred , Cederqvist Christian , Nielsen Jørgen , Larsen Vagn
Published: August 2010

Abstract 221 patients with gastric cancer (g.c), 174 of them current or ex‐smokers, have been questioned about their smoking habits. Data regarding 157 patients (131 men and 26 women) who had smoked more than a total of 20 kg have been analysed. While the women start smoking at different ages, the men start early, at approximately the same age, the majority before 16. The average duration of smoking was 48 years for men and 37 years for women. The average quantity of tobacco used was 378 kg for men and 176 kg for women. Among the women there is a marked dispersion in respect to the duration of smoking as well as the age on admission for g.c. Among the men there was an accumulation of admissions around the age of 64, i.e. after an average of 48 years of smoking. Thus in men there is a definite concurrence between the duration of smoking and the time of admission for g.c. In men over 60 years there is a statistically significant relation between the average total amount of tobacco used and the time of admission for g.c, independent of the patient's age. It is concluded that the use of tobacco may be one of the causes of the higher frequency of g.c. in men than in women.
REPRODUCIBILITY OF THE ECG CLASSIFICATION SYSTEM OF THE MINNESOTA CODE IN THE STUDY OF PATIENTS WITH CORONARY HEART DISEASE
Authors: Björnson Jan , Hjermann Ingvar , Leren Paul
Published: August 2010

Abstract Electrocardiograms of 412 male postmyocardial infarction patients recorded 1–2 years after their first infarction have been classified according to the Minnesota Code by two independent readers (physicians). A study of the inter‐ and intra‐observer error or reliability was then performed. The degree of accuracy and reproducibility thus obtained was related to degree of experience in the use of the Minnesota Code. Reproducibility was greater towards the end of the study when the readers were more experienced. The importance of substantial and continuous experience with the use of the Minnesota Code is stressed as well as the importance of at least two observers reading the ECGs independently. A final arbitration is no problem. These criteria must be fulfilled before the use of the Minnesota Code in clinical or epidemiological studies on coronary heart disease.
IMMUNOGLOBULINS IN PULMONARY EOSINOPHILOSIS (TROPICAL EOSINOPHILIA)
Authors: Viswanathan R.
Published: August 2010

Abstract At the V. P. Chest Institute of Delhi studies on pulmonary eosinophilosis (tropical eosinophilia) have been going on since many years. The investigations have concerned, among other factors, the pathogenesis of the disease. As regards the pathogenesis and aetiology it is at present being discussed whether infection with human filaria is the original cause of the disease. This microfilaria has, however, not generally been found in the blood or the lung tissue, but it is known that the filarial larvae and microfilariae are rapidly destroyed in the tissues. Immunological studies with the aim of disentangling some obscure points concerning the pathogenesis of the condition are at present performed at the King Gustaf V Research Institute, Stockholm, Sweden. So far it has been found that there exist distinct disturbances of the immunoglobulins. Thus there is a high percentage of IgM, but also an increase of IgG. Studies of isolated fractions of these globulins are in progress.
A NEW HEMODIALYSIS CONSOLE
Authors: Dawids Steen Gamwell , Boe Christian , Andreasen Mogens Myrup
Published: August 2010

Abstract A description is given of some constituent parts in a new single‐patient hemodialysis console. The parts, which were all developed especially for use in hemodialysis, are: proportionating pump, inductive conductivity meter, heating and deaerating system, blood leak detector, pressure regulator, micro‐infusion pump, disposable blood pressure transducer and disposable blood flow meter.
CELL SIZE AND LIPOLYSIS BY HUMAN SUBCUTANEOUS ADIPOSE TISSUE
Authors: östman Jan , Backman Lars , Hallberg Dag
Published: August 2010

Abstract Specimens of human subcutaneous adipose tissue were removed from subjects with marked difference in body weight, patients with recent onset of diabetes mellitus of juvenile and adult type, and from obese subjects before and after intestinal shunt operation. The production of glycerol by sections of adipose tissue of the non‐diabetics under basal (glucose cone. 5.5 mM) as well as stimulated conditions was positively correlated to the mean cell volume estimated according to the histiometric procedure. The maximal lipolytic responses to theophylline and N6,O2‐dibutyryl 3′5′ AMP, expressed as the relative change in the glycerol production above the basal values, were negatively related to the mean cell volume. The addition of the α‐adrenergic blocking agent phentolamine increased more markedly the noradrenalineinduced glycerol production by small fat cells than that by enlarged cells. The findings clearly show that the size of the fat cells has a substantial influence on the lipolysis of human fat cells. Adipose tissue of large cells might respond with less marked lipid mobilization than adipose tissue composed of small cells. This could be of relevance for the understanding of the non‐ketotic hyperglycemic syndrome.
CAUSES AND DURATION OF RENAL FAILURE AND DURATION OF WORKING DISABILITY IN DIALYSIS CANDIDATES
Authors: Pasternack A.
Published: August 2010

Abstract. A retrospective study of 104 dialysis candidates with end‐stage renal failure has shown this is rarely caused by pyelonephritis. A proportion of 8.7% of the patients had confirmed chronic pyelonephritis (chronic urinary tract infection). If chronic interstitial nephritis and pyelonephritis are considered as one group, this constituted 26% of the series. Most patients had glomerulonephritis (53.8%) and reached the end‐stage at a younger age than patients with pyelonephritis and chronic interstitial nephritis. The progression from moderate renal failure to end‐stage failure was more rapid in patients with glomerulonephritis than in those with pyelonephritis and interstitial nephritis. Working disability had not presented a major problem in this group of patients with severe renal failure.
SUCROSE FEEDING IN MAN
Authors: Smith Ulf , Cahlin Erling , Scherstén Tore
Published: August 2010

Abstract. In four patients with hyperlipoproteinemia and in one with a normal serum lipoprotein pattern 800 kcal of the daily caloric intake were replaced by sucrose for two weeks. Studies of the adipose tissue metabolism in vitro showed that the lipid synthesis from glucose, the basal as well as the noradrenaline‐stimulated lipolysis, were considerably increased as compared to the controls. Furthermore, no antilipolytic effect of a physiological concentration of insulin was found. It was suggested that sucrose feeding induces changes in adipose tissue metabolism which may be of importance for the increased triglyceride levels noted in these patients.
PREGNANCY IN A PATIENT AFTER CADAVERIC RENAL TRANSPLANTATION
Authors: Horbach J. , van Liebergen F. , Mastboom J. , Wijdeveld P.
Published: August 2010

Abstract. This paper describes the course of a pregnancy in a 25‐year‐old primipara after transplantation of a cadaver kidney. Signs of chronic rejection occurred during this pregnancy and increased abruptly after about 35 weeks. A caesarean section was performed, after which the graft function did not improve. Data on histocompatibility of donor, husband, patient and child and other possible relationships between pregnancy and graft function are discussed. The urinary total estrogen excretion was low during pregnancy. This could not be ascribed to abnormalities in placental steroid synthesis. The child is a boy in good physical and mental health.
THE HUMAN IMMUNE RESPONSE TO α‐HAEMOCYANIN OF HELIX POMATIA
Authors: de Gast G. C. , The T. H. , Snijder J. A. M.
Published: August 2010

Abstract. The immune response to α‐haemocyanin of Helix pomatia (α‐HPH) has been studied in 12 normal subjects. Humoral immunity was assessed by haemagglutination titres, cellular immunity by intracutaneous skin tests and the number of sensitized lymphocytes in the peripheral blood by in vitro lymphocyte stimulation. Immunological responsiveness to α‐HPH (1.0 mg) was established with these parameters in all immunized subjects. The antibodies after primary immunization were nearly exclusively 2‐mercaptoethanol‐sensitive (2‐MES) antibodies. Intracutaneous skin tests with 0.1 mg α‐HPH after 28 days did not disturb the primary immune response, except in one subject who showed a rise in antibody titre although the antibodies remained 2‐MES. Low levels of specific antibodies were present before immunization, probably so‐called “natural” antibodies induced by exposure to cross‐reacting antigens. After secondary immunization a rapid rise in antibody titre occurred and the antibodies were nearly exclusively 2‐MER (IgG). For the investigation of patients with immune deficiencies it will generally be sufficient to assess haemagglutination titres, delayed hypersensitivity and in vitro lymphocyte stimulation before and 3 weeks after immunization.
LYSOLECITHIN AS A FACTOR INFLUENCING ERYTHROCYTE SEDIMENTATION RATE
Authors: Berlin Ragnar , Böttiger Lars Erik , Vikrot Olle
Published: August 2010

Abstract.In an experimental study increasing amounts of lysolecithin have been added to aliquots of plasma from 18 patients with a high erythrocyte sedimentation rate (ESR) and the final concentration of lysolecithin in the samples has been determined by means of thin layer chromatography and subsequent phosphorus determination as well as determination of the ESR. It was found that the ESR remained high in the different plasma samples until a critical level of lysolecithin was reached, whereafter the ESR abruptly dropped to lower values. This change took place within a very narrow concentration range, usually between 4.5 and 5.5 μg lysolecithin P/ml, and at a concentration of 7–8 μg/ml the ESR was consistently very low. In additional experiments, using decreasing amounts of red cells to the various plasma samples, the ESR had a normal tendency to increase inversely to the hematocrit, but in this case no threshold level could be observed. These findings clearly demonstrate that the lysolecithin concentration is of considerable importance for the ESR value. A low lysolecithin content of the plasma means a higher ESR value than expected from the amount of protein components, and a high lysolecithin concentration means a low ESR in spite of an unchanged protein pattern. Normally a decrease of the ESR takes place on incubation of a plasma sample due to the enzymatic formation of lysolecithin from lecithin. This phenomenon is explained by an increase of the lysolecithin amount above the demonstrated critical level. In a number of pathological conditions this “heat‐stabilization” process does not occur, and in these cases the lysolecithin concentration is characteristically low and does not rise above the critical level even after incubation. A number of possible explanations of this drastical decrease of the ESR at a certain lysolecithin level are discussed in this presentation, but the most likely is that lysolecithin is bound to plasma proteins, e.g. albumin. In this form it is unable to exert its physiological effect on the red cell surface membranes until the saturation limit of the carrier protein is reached and “free” lysolecithin appears.
ACID‐BASE DISTURBANCES IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors: Helmers C. , Mogensen L. , Nordlander R. , Orinius E. , Sjögren A. , Wester P. O.
Published: August 2010

Abstract. In two years 417 cases of AMI without pulmonary disease were treated in a CCU. During this period arterial blood gas samples were drawn by routine on the first day. The tape‐stored data from the first day at the CCU were compared to pH, standard bicarbonate (SB) and base excess (BE) values. Low SB, BE and pH values were associated with high mortality and also with a high incidence of hypotension, shock and frank pulmonary oedema during the first day. Left heart failure without frank pulmonary oedema showed no such relation. As regards various arrhythmias, left bundle branch block was more common in patients with low pH, SB and BE values. Supraventricular tachycardia was a more frequent finding in patients with low SB and BE values. High values of pH, SB and BE were not combined with an increased incidence of any arrhythmia.
A POPULATION STUDY ON RENAL AND URINARY TRACT DISEASES
Authors: Alwall Nils , Lohi Aarne
Published: August 2010

Abstract. A total of 3 998 persons aged 21–69, 49% men and 51% women, have been screened for symptoms of renal and urinary tract disease. The screening was free of charge, as was any medical examination undertaken because of pathological findings on screening. Each screened person completed a form at home, answering questions relating to previous diseases of the said kind, or symptoms thereof, and hypertension. The completed questionnaire, together with urine specimens, was sent to our laboratory. Because of findings on screening 1 633 persons (40.6% of those screened), 35.4% men and 64.6% women, underwent nephrological examination. To check the quality of the screening methods used 643 persons (16.1% of those screened) with negative screening were subjected to nephrological examination. Such checking does not seem to be customary in health surveys.
PRIMARY AMYLOIDOSIS WITH POLYNEUROPATHY
Authors: Anderson R. , Hofer P.‐Å.
Published: August 2010

Abstract. Biopsy specimens from 30 patients with primary amyloidosis and polyneuropathy have been reviewed with regard to the histopathological methods used and to the kind of tissues examined. The importance of using modern histopathological methods to establish the amyloid diagnosis was demonstrated. Biopsy of the rectal mucosa of 18 patients was positive for amyloid in all. Skin biopsy was positive in 22 of 25 patients. In one patient the first skin and rectal biopsies were negative; new specimens after one year and three years, respectively, were positive for amyloid. In all 30 patients amyloid deposits were found either in the rectal mucosa or in the skin. Rectal and skin biopsies are recommended as valuable procedures to confirm the clinical diagnosis of primary amyloidosis with polyneuropathy.
MULTIPLE JEJUNAL STRICTURES ASSOCIATED WITH MEGALOBLASTIC ANAEMIA AND MYELOPATHY
Authors: Elsborg Lars
Published: August 2010

Abstract. In a patient with multiple strictures, chronic stasis and dilatation of the jejunum, neurological defects suggestive of subacute combined degeneration of the spinal cord developed over a 10‐year period. In spite of optimal substitution therapy with vitamin B12 the bone marrow was megaloblastic, which was ascribed to folate deficiency resulting from malabsorption of folic acid. A possible association between the neurological lesions and the folate deficiency was not established, as there may also have been a deficiency of other nutritional factors of significance for nervous tissue. Malabsorption carries a grave prognosis in this condition, but in the case presented all symptoms of malabsorption were relieved by surgical removal of the jejunal strictures.
DIAGNOSTIC ERRORS DISCOVERED AT AUTOPSY
Authors: Britton Mona
Published: August 2010

Abstract.It has been questioned whether routine autopsies are needed any longer for control and correction of causes of death, specially in clear‐cut cases. This question was therefore studied in connection with deaths in a department of internal medicine. Among 400 consecutive deaths autopsy was performed in 383 (96%). Causes of death diagnosed before autopsy were compared with those established by the same clinicians after autopsy. As main cause of death the clinical diagnosis was thereby confirmed as correct in 57% of cases, and as erroneous in 30%. In the remaining 13% it had not been possible to make a definite diagnosis ante mortem. Fewer diagnostic errors were encountered among patients below than above 70 years of age. There were also fewer errors when clinical diagnoses had been considered fairly certain than when estimated only as probable. However, even in the case of deceased patients below 70 years of age with fairly certain diagnoses, 15% were revealed to be erroneous at autopsy. The main cause of death was a circulatory disorder in 67% of cases, and a neoplastic in 17%. All other groups of diseases together accounted for the remaining 16% of deaths. Clinical diagnoses of neoplasms were more seldom found to be erroneous than diagnoses of other groups of diseases. Contributory causes of death were clinically underestimated. Of the disorders established as contributory after post‐mortem 46% had been unrecognized before death. It is concluded that autopsies are still needed for control and correction of causes of death, also in “clear‐cut” cases.
IRON INTOXICATION IN TWO ADULT PATIENTS
Authors: Eriksson Folke , Johansson Stig V. , Mellstedt HÅkan , Strandberg Olle , Wester Per Olov
Published: August 2010

Abstract. Iron intoxication in adults is very rare. Only a few cases are reported in the literature. This paper describes two successfully treated adult patients, one without complications and the other with circulatory failure, hepatic involvement and hemolysis. The current opinions on pathogenesis and therapy are reviewed.
THE VAGARIES OF ERYTHROLEUKAEMIA
Authors: Karle Hans , Killmann S.‐Aa. , Jensen M. Krogh , Nielsen J. Boye
Published: August 2010

Abstract. A 10‐year material of erythroleukaemia from a department of medicine subspecialized in haematology is presented. A total of 14 cases fulfilled the following criteria for erythroleukaemia: erythroblastic hyperplasia of the bone marrow, either normo‐ or megaloblastic, ineffective erythropoiesis, no evidence of vitamin B12 or tolic acid deficiency, relatively few myeloblasts in the bone marrow in the initial stage, a lethal outcome and leukaemic infiltrates in later bone marrow aspirates and often in the organs at autopsy. The great variability in the clinical picture, in the morphology of the red blood cell precursors, and in the course of erythroleukaemia is emphasized, and the connection with other so‐called myeloproliferative disorders is illustrated by the common transformation to acute myeloid leukaemia and the development of erythroleukaemia from polycythaemia vera and chronic myeloid leukaemia.
APLASTIC ANAEMIA: CONSIDERATIONS ON THE PATHOGENESIS
Authors: Benestad Haakon B.
Published: August 2010

Abstract. Modern concepts of haematopoiesis and its regulation are reviewed. Observations from several forms of aplastic anaemia are analysed in the light of this new knowledge. The pathogenetic mechanism in the aplasia caused by chloramphenicol is probably a stem cell damage of an autoimmune or idiosyncratic nature. Chlorpromazine aplasia is apparently due to a constitutionally defective DNA synthesis, so that a normal compensatory reaction cannot take place against the inhibiting effects of the drug on DNA synthesis. The chlorpromazine aplasia is normally transient, since transit cells of the bone marrow—and not the stem cells—are affected. The hepatitis‐associated aplasia may possibly be precipitated by an autoimmune attack on multipotent stem cells or on transit cells of one or more cell lines after virus‐induced change of antigenicity of the cell surface. The thymoma‐associated aplasia may likewise be due to autoimmunity directed against transit cells. Finally, there are indications that the Fanconi aplasia may be pathogenetically heterogeneous, with constitutionally defective stem cells, transit cells, or stromal cells. Otherwise stromal failure rarely seems to play a role in human aplastic anaemia. Furthermore, “maturation arrest” probably does not exist. Neither “stem cell exhaustion” nor situations with missing or defective haemopoietins apparently produce aplasia on their own. A research strategy, supplementary to the routine haematological investigations, is proposed. It is recommended that modern immunological techniques in particular should be applied in combination with stem cell assays.
RAPID EVALUATION OF CREATININE CLEARANCE
Authors: Kampmann J. , Siersbæk‐Nielsen K. , Kristensen M. , Hansen J. Mølholm
Published: August 2010

Abstract.Endogenous creatinine clearance, serum creatinine and urinary creatinine excretion have been determined in 368 patients hospitalized with various medical diseases, and without known renal disease. The patients were divided into 10‐year age groups and the results were analysed for age and sex differences. The average creatinine clearance in males showed a steady decline from 110 to 34 ml/min/1.73 m2from the age group 20–29 to the age group 90–99 years. The mean serum creatinine values did not show any significant variations with age, but urinary creatinine (mg/kg b.wt./24 h) decreased from 23.8 in the age group 20–29 to 9.4 in the age group 90–99 years. In females creatinine clearance declined from 95 to 39 ml/min/ 1.73 m2, serum creatinine was without significant change and urinary creatinine (mg/kg b.wt./24 h) decreased from 19.7 in the age group 20–29 to 8.4 in the age group 90–99 years. The finding of considerably decreased creatinine clearance values without elevation of serum creatinine values in the elderly is probably explained by a great reduction with age in lean body mass and thereby in creatinine production. In a group of 106 patients with serum creatinine values between 1.4 and 5.0 mg/100 ml the urinary creatinine (mg/kg b.wt./24 h) was not significantly different from that of patients without renal disease. A risk of overestima‐tion of glomerular filtration rate seems to exist if serum creatinine is used as the only parameter of renal function in these patients and might lead to intoxication with drugs which are mainly excreted by the kidney. The authors suggest a nomogram for rapid evaluation of creatinine clearance in ml/min.
THE INCIDENCE OF ECG ABNORMALITIES IN ACUTE CEREBROVASCULAR ACCIDENTS
Authors: Hansson Lennart , Larsson Owe
Published: August 2010

Abstract. Based on an epidemiological study, ECGs have been studied in 77 patients with cerebrovascular accidents. In the group with intracerebral hemorrhage ECG abnormalities of the T or U wave of the kind first described by Burch et al, were seen in 65% of all cases. In addition 16 of 17 patients in this group showed abnormal prolongations of the Q‐T interval (average 124% of normal). ECG had been recorded in only 5 of 18 patients with subarachnoidal hemorrhage and consequently no firm conclusions can be drawn regarding the incidence of specific ECG abnormalities in this group. Four of the 5 patients, though, had prolonged Q‐T duration. The incidence of T or U wave changes in the groups with thromboembolic disorders or transient ischemic attacks was low (14%) or non‐existent. Furthermore Q‐T durations varied, the averages being only 106% and 105% of normal. Finally, in the unspecified group, 28% showed T or U wave changes and rather marked Q‐T prolongations. As discussed previously, these cases may represent patients with undiagnosed intracerebral bleedings. In conclusion, ECG changes with marked increase of the Q‐T interval and specific T or U wave changes were most commonly found in patients with intracerebral hemorrhage, 94% of all showing abnormally long Q‐T intervals while 65% showed T or U wave abnormalities as well.
GENITOURINARY DISTURBANCES IN FAMILIAL AND SPORADIC CASES OF PRIMARY AMYLOIDOSIS WITH POLYNEUROPATHY
Authors: Andersson R. , Hofer P.‐Å.
Published: August 2010

Abstract. The occurrence of genitourinary disturbances has been analysed in 34 successive patients (24 males and 10 females) with familial or sporadic amyloidosis with polyneuropathy. Thirteen patients died, autopsy was performed on 9 of them. Out of 25 patients 9 had urinary retention and 10 both retention and incontinence. Advanced stages of urinary bladder dysfunction were characterized by loss of sensation of bladder fullness, reduced desire to void and difficulty in initiating the voiding. The incontinence usually had the character of ischuria paradoxa (overflow incontinence). Amyloid deposition occurred in the wall of the urinary bladder, located in the nerves, vessel walls, and in the smooth musculature of the detrusor muscle. The function of the urinary bladder was obviously impaired by the affection of the nerves to the bladder, and presumably also by the amyloid deposition in the detrusor musculature. Total impotence, occurring in 16 out of the 24 male patients, was considered to be due mainly to the amyloid affection of the nerves. Uraemia appeared in two patients only, signs of a nephrotic syndrome in one of them. The amounts of amyloid deposits in the kidneys varied within wide limits. The substance could even be absent. Out of 9 cases examined glomerular deposits were found in 4, all of whom had proteinuria. Thirteen out of 28 patients examined had bacteriuria, 10 of them also proteinuria. The cause of proteinuria in this form of amyloidosis may be either amyloid deposition in the kidneys or infection of the urinary tract.
SUPPRESSION OF FACTOR VIII ANTIBODY BY COMBINED FACTOR VIII AND CYCLOPHOSPHAMIDE
Authors: Nilsson Inga Marie , Hedner Ulla , Holmberg Lars
Published: August 2010

Abstract. Four patients with severe haemophilia A complicated by inhibitors of factor VIII (corresponding to 0.5, 0.7, 1.0 and 2.5 U/ml plasma) and a non‐haemophilic woman with an acquired inhibitor of factor VIII (corresponding to 160 U/ml plasma) have been treated with a large single dose of factor VIII concentrate (4 000–8 000 U factor VIII) and cyclophosphamide in connection with severe bleeding episodes. In three of the haemophiliacs this treatment had a good haemostatic effect, it immediately raised factor VIII level to about 50% and suppressed the antibody titre. The inhibitor level remained at zero for 5–10 days, after which it began gradually to return toward its original level. No secondary rise in antibody titre was seen. In the fourth haemophiliac the factor VIII level could only be raised to 8%, and a marked secondary increase occurred in antibody titre. In the woman with an acquired inhibitor of factor VIII in extremely high titre it was not possible to neutralize the inhibitor, but constant suppression of antibody titre was achieved. Patients with haemophilia A and inhibitors and non‐haemophiliacs with acquired inhibitors of factor VIII can thus be treated with advantage with a large dose of factor VIII concentrate combined with cyclophosphamide, provided factor VIII is administered in doses large enough to neutralize the inhibitor and to raise factor VIII level to about 50%. Although it is not possible to prevent the production of antibody, such treatment can suppress the production long enough to permit effective substitution therapy in connection with severe bleeding episodes and surgical procedures.
LEUCOERYTHROBLASTIC ANAEMIA, THROMBOCYTOPENIA AND EOSINOPHILIA IN ASSOCIATION WITH BRONCHIAL ADENOCARCINOMA IN A YOUNG WOMAN
Authors: Waern U. , Killander A. , Wilander E.
Published: August 2010

Abstract. A case of rapidly fatal bronchial adenocarcinoma in an 18‐year‐old woman is reported. Remarkable features of the case included early metastasis to bone and development of leucoerythroblastic anaemia with thrombocytopenia and eosinophilia.
THE DIAGNOSTIC SIGNIFICANCE OF A HIGH ASAT/ALAT (GOT/GPT) RATIO IN PATIENTS WITH VERY HIGH SERUM AMINOTRANSFERASE LEVELS
Authors: Wallerstedt S. , Olsson R. , Waldenström J.
Published: August 2010

Abstract. A consecutive study of 160 patients with very high (>500 U/1) serum ASAT activity has revealed that this was most commonly due to acute hepatitis, circulatory disturbances, or malignant liver disease. In acute hepatitis the ASAT increase was usually accompanied by a similar rise in ALAT. An ASAT/ALAT ratio > 3 was almost entirely restricted to patients with circulatory disturbances or malignant liver disease. The latter diagnosis should thus be suspected in patients with markedly increased serum aminotransferase activity and an ASAT/ALAT ratio > 3 without evidence of circulatory disturbances.
THE EFFECT OF SOYA LECITHIN ON SERUM LIPID VALUES IN TYPE II HYPERLIPOPROTEINEMIA
Authors: ter Welle H. F. , van Gent C. M. , Dekker W. , Willebrands A. F.
Published: August 2010

Abstract. A group of 12 patients with type II hyperlipopro‐teinemia has been treated orally with a soya lecithin preparation. After an initial control period of 4 weeks 1.2 g soya lecithin was given per day. This amount was doubled after 4 months for an additional period of 4 months. The investigation was concluded with a second control period of 4 months. The following lipid parameters were determined: total lipids, total cholesterol, triglycerides, phospholipids, total lipids in the lipoprotein fractions, and the weight percentage of linoleic acid in serum cholesterol esters and the serum lecithin. No clinically relevant changes in these parameters were observed.
SERUM PRE‐β‐1 LIPOPROTEIN FRACTION IN CORONARY ATHEROSCLEROSIS
Authors: Frick M. H. , Dahlén G. , Furberg C. , Ericson C. , Wiljasalo M.
Published: August 2010

Abstract.Using two separate electrophoretic techniques the presence of pre‐β‐1 lipoprotein fraction in serum has been studied in a series of 46 patients. Twenty‐five of these had normal coronary arteries and 21 coronary atherosclerosis documented by angiography. Six patients with normal coronaries (24%) and 11 with coronary artery disease (52%) had pre‐β‐1 in the serum (p<0.05). The distribution of elevated serum cholesterol and/or triglycerides was roughly equal in the two angiographically different groups. The occurrence or absence of the pre‐β‐1 lipoprotein fraction was related to the family history for coronary heart disease, yielding suggestive evidence of a genetically determined lipid abnormality.
URINARY GROWTH HORMONE IN ACROMEGALY
Authors: Hanssen Kristian F. , Rasmussen Peter
Published: August 2010

Abstract. Urinary growth hormone compared to plasma growth hormone during peroral glucose tolerance test has been studied in 16 patients with clinically obvious acromegaly. The urinary excretion of growth hormone was clearly elevated in all patients with acromegaly when compared to a normal group. One of the patients with established acromegaly had normal fasting plasma growth hormone levels, but urinary growth hormone was grossly elevated. No significant correlation was found between plasma and urinary growth hormone in the individual patient. Neither plasma nor urinary growth hormone were well correlated to the clinical activity of the disease. It is concluded that measurement of urinary growth hormone is a valuable tool in the diagnosis of acromegaly. The measurement might be of special interest in the early period of acromegaly before the disfiguring changes have taken place in the patients.
THE PROGNOSIS FOR PATIENTS WITH COMPLETE HEART BLOCK TREATED WITH PERMANENT PACEMAKER
Authors: Hansen Jørgen Fischer , Meibom Jørgen
Published: August 2010

Abstract. A follow‐up study of the survival rate of 164 patients with complete heart block treated with permanent pacemaker showed 87% survival after one year, 76 after two, and 50% after five years. These figures indicate an excess mortality per year in the first five years of 6–7 % compared with a population with the same age and sex distribution. Analysis of the survival curve shows that the excess mortality is caused by other coexisting diseases, such as renal failure, diabetes or cancer, valvular heart diseases or other types of cardiovascular affections, or heart failure.
ACUTE MYOCARDIAL INFARCTION COMPLICATED BY THIRD DEGREE ATRIOVENTRICULAR BLOCK TREATED WITH TEMPORARY PACEMAKER
Authors: Leth Arne , Hansen Jørgen Fischer , Meibom Jørgen
Published: August 2010

Abstract. During the period Jan. 1, 1968 ‐ Dec. 31, 1970, 57 patients with acute myocardial infarction (AMI) complicated by third degree atrioventricular (AV) block have been treated with temporary pacing. The hospital lethality in anterior AMI (75%) was significantly higher than in inferior AMI (22%). Cardiogenic shock, Adams‐Stokes attacks, prolonged QRS complex and development of third degree AV block directly from sinus rhythm occurred significantly more frequently in anterior wall infarction and were followed by a significantly higher lethality. Age, previous AMI, ventricular fibrillation, route of admission, degree of cardiac incom‐pensation, number of Adams‐Stokes attacks or asystole, heart rate prior to pacing and time from onset of AMI to third degree AV block were found to be of no importance for the lethality. The cumulative survival rate was 50% at 12 and 47% at 24 months after the infarction. In anterior AMI it was 15% at 12 months and in inferior AMI 73% and 65% at 12 and 24 months, respectively. The long‐term prognosis was not improved in patients with anterior AMI treated by pacemaker compared to medically treated patients. In inferior AMI the importance of pacemaker treatment is not yet clarified. Based on the literature and our own results it is concluded that patients with AMI complicated by third degree AV block should still be treated with pacemaker.
SPLENOMEGALY ASSOCIATED WITH CHRONIC CONSUMPTION COAGULOPATHY
Authors: Gerrits W. B. J. , van Aken W. G. , van der Meer J. , Vreeken J.
Published: August 2010

Abstract.In a group of six patients suffering from various diseases accompanied by splenomegaly, low levels of factor V and fibrinogen have been observed apart from thrombo‐cytopenia. No circulating fibrin degradation products (FDP) and fibrin monomers were present and anticoagulants did not correct the coagulation disorder. However, other findings, such as the presence of fibrin deposits in the enlarged spleen, and correction of the hemostatic defect after splenectomy strongly suggest local consumption of platelets and clotting factors in the enlarged spleen. The data obtained show that a decreased concentration of clotting factors in patients with splenomegaly can be caused by local consumption alone. The absence of an elevated FDP level distinguishes our findings from those found in consumption coagulopathy accompanying diffuse intravascular clotting (DIC).
PERICARDITIS FOLLOWING CARDIOVERSION
Authors: Ström Stellan
Published: August 2010

Abstract. Pericarditis following DC countershock in a patient with atrial flutter is described and the literature on complications of cardioversion is discussed, with special emphasis on the possibilities of induced perimyocardial damage.
OCCURRENCE OF HEPATIC IMPAIRMENT IN WOMEN JAUNDICED BY ORAL CONTRACEPTIVES AND IN THEIR MOTHERS AND SISTERS
Authors: Dalén Elisabet , Westerholm Barbro
Published: August 2010

Abstract. The occurrence of hepatic impairment has been investigated in women jaundiced by oral contraceptives and among their mothers and sisters. A comparison was made with a matched control group, the investigated material thus comprising 129 matched pairs. It could be shown that the patients had experienced pruritus and jaundice during pregnancy more often than the controls. The patient group also showed a higher incidence of hepatitis, gall stone symptoms and cholecystectomy. The patients' mothers had experienced pruritus during pregnancy to a greater extent than their controls. The patients' sisters showed a significantly higher incidence of pruritus during pregnancy and oral contraceptive treatment than their controls. Gall stone symptoms and cholecystectomy were also found more often in the group of the patients' sisters. The present study supports the hypothesis that genetic factors play a part in the occurrence of jaundice during oral contraception and late pregnancy. The investigation also indicates that patients with jaundice due to oral contraceptive treatment must be considered as high risk patients with regard to their proneness to develop gall bladder disease.
PARTIAL LIPODYSTROPHY AND CHRONIC HYPOCOMPLEMENTEMIC GLOMERULONEPHRITIS
Authors: Ljunghall Sverker , Fjellström Karl‐Erik , Wibell Lars
Published: August 2010

Abstract. In partial lipodystrophy serious renal disease is common and often has the appearance of chronic hypocomplementemic glomerulonephritis. In this case report a young woman with typical clinical history is described. Low serum levels for C3 were not affected by long‐time immunosuppression, nor was the presence of C3NeF. The degree of renal insufficiency exerted no influence on C3. Transplantation resulted in normalization of C3 and disappearance of C3NeF, persisting even in terminal graft failure.
INTRABRONCHIAL ASPIRATION OF METALLIC MERCURY
Authors: Einarsson Kurt , Hellström Kjell , Schütz Andrejs , Skerfving Staffan
Published: August 2010

Abstract. By accident a 60‐year‐old man aspirated about 20 g metallic mercury into the bronchial tract. Most of the metal disappeared within one year and there was no evidence of acute or chronic mercurialism. Repeated analyses demonstrated elevated levels of mercury in blood and urine. However, the combined results from these studies indicate that most of the mercury was eliminated with the sputum or possibly by the breath.
ASSOCIATION BETWEEN A LOW ADIPOSE TISSUE CONTENT OF POLYUNSATURATED FATTY ACIDS AND BOTH GLUCOSE INTOLERANCE AND HYPERTRIGLYCERIDEMIA IN APPARENTLY HEALTHY MEN
Authors: Carlson Lars A. , Walldius Göran
Published: August 2010

Abstract The fatty acid spectrum of adipose tissue (AT) lipids has been determined in 43 apparently healthy men with different levels of plasma triglycerides (TG) and different degrees of glucose tolerance (GT). Compared to men with normal plasma TG levels those with hypertriglyceridemia (HTG) had a similar percentage of linoleic acid (18: 2) but lower amount of fatty acids, tentatively identified as linolenic (18: 3) and arachidonic (20: 4) acid. Men with HTG also had lower k‐values for the i.v. GT. The content of 18: 3 and 20: 4 was positively correlated to the k‐value of the GT and negatively to plasma TG. These correlations were independent of each other. As usual there was a negative correlation between plasma TG levels and the k‐value, which however disappeared after partial correlation analysis when 18: 3 was kept constant. Apparently a low content of 18: 3 in AT is common both in HTG and glucose intolerance (GI) and might partly explain the often seen association between these two metabolic abnormalities. Since the content of 18: 2 was normal it is suggested that the low amount of 18: 3 and 20: 4 was caused by metabolic rather than dietary factors. The possibility that a low content of 18: 3 and 20: 4 might play a role in the pathogenesis of GI and HTG is discussed.
THE EFFECT OF HYDROCHLOROTHIAZIDE AND AMILORIDE ADMINISTERED TOGETHER ON MUSCLE ELECTROLYTES IN NORMAL SUBJECTS
Authors: Bergström Jonas , Fridén Anne‐Marie
Published: August 2010

Abstract Hydrochlorothiazide, 150 mg daily, and amiloride, 15 mg daily, have been administered together to 10 normal subjects during one week. Muscle biopsies were performed before and after the period of administration of the diuretics and the material was analysed for water and electrolytes. The body weight decreased by 1.9 kg. The serum sodium, chloride and potassium concentrations decreased significantly and standard bicarbonate and blood pH increased. In muscle tissue, extracellular water, chloride and sodium contents and intracellular sodium concentration decreased but the muscle potassium content, the intracellular potassium concentration and the muscle magnesium content were unchanged. A comparison with the results of an earlier study, in which hydrochlorothiazide was given without amiloride, showed that the intracellular potassium depletion and the increase in intracellular sodium concentration, observed with the benzothiazide diuretic, could be fully prevented by simultaneous administration of amiloride. The degree of hypokalemia and alkalosis was also smaller with hydrochlorothiazide+amiloride than with hydrochlorothiazide alone.
Interferon Therapy: Obvious and not so Obvious Applications
Authors: GRESSER ION
Published: August 2010

Summary. Animal experiments have demonstrated that exogenous interferon is effective in treating viral infected animals. Interferon is effective not only when given probhylactically to experimental animals but also when treatment is intiated after viral infection has occured. Apart from inhibiting the replication of both RNA and DNA containing viruses, interferon exerts many other effects in animal cells. The therapeutic effect may be the resultant of some of those. So far interferon therapy has not yet received a fair evaluation in man. However, the evaluation of interferon in prevention and treatment of viral resiratory disease in man is in progress as are studies on its effect in herpes simplex and herpes zoster infection.
Utilization of Cost/Benefit Analysis in Planning Prevention Programs
Authors: SENCER DAVID J. , AXNICK NORMAN W.
Published: August 2010

Summary. Benefit‐cost analysis is a type of policy analysis still in a developing stage, particularly with respect to investments in people. Policy analysts, policy makers, and other users concur this type of analysis cannot be a sufficient basis for public policy decisions. For health programs, it is an approach that can supplement medical and epidemiologic bases for public investment decisions. It is a useful tool where an understanding of health problems is deficient in some areas. This paper discusses some examples of the use of benefit‐cost analysis in planning disease prevention programs and the explicit consideration to the quality of life benefits associated with reduced disease.
The Di Guglielmo Syndrome: A Study of 17 Cases
Authors: Søndergaard‐Petersen Helena
Published: August 2010

Abstract. Based on a series of 17 patients with Di Guglielmo's syndrome, i.e., erythraemic myelosis and erythroleukaemia, a description is given of the clinical and haematological manifestations of this disease. Three cases were anerythraemic, i.e. no erythroblasts were seen in the blood smears, and three were aleukaemic, i.e. no myeloblasts and/or promyelocytes were found in the blood. The percentage of erythroblasts in the bone marrow smears varied from 34 to 96. In all cases, abnormalities (often megaloblastoid changes) of varying severity were observed in the erythroblasts. Proerythroblasts showing erythrophagocytosis, multinuclearity and vacuolation of the cytoplasm are features of great diagnostic importance. Five patients had myeloblasts or promyelocytes containing Auer rods, six had neutrophilic granulocytes showing pseudo‐Pelger‐ Huët anomaly, and in most cases agranular polymorphonuclears were present. Brief comments are given on the PAS, nuclear arylsulphatase and naphtol‐AS‐D‐chloroacetate‐esterase staining methods. Four of five patients studied cytogenetically revealed abnormal stem lines. The survival times after the onset of the disease ranged from 17 days to 20 months. The disease is closely related to myeloblastic leukaemia. In the course of Di Guglielmo's syndrome, the leukaemic component often becomes more conspicuous, so that, in the terminal phase, the disease cannot be distinguished from typical myeloblastic leukaemia. As, in Di Guglielmo's “leukaemia”, the diagnostic problems are greater than and different from those in typical myeloblastic leukaemia, it is still reasonable to place this disease in a separate group under acute granulocytic leukaemia.
Studies in Asymptomatic Primary Hyperlipidaemia
Authors: Olsson Anders G. , Eklund Brita
Published: August 2010

Abstract. The occurrence of early signs of peripheral vascular disease (PVD) of the lower limbs has been studied with digital pulse plethysmography in 160 men and 123 women above the age of 35, who were all subjectively healthy but were found to have primary hyperlipoproteinaemia (HLP) at a health control centre. Quantitative analysis of serum lipoproteins with cholesterol and triglyceride (TG) determination of each of the very low (VLDL), low (LDL) and high (HDL) density lipoprotein classes together with lipoprotein paper electrophoresis was performed. Identical investigations were performed on control subjects with non‐elevated serum lipids. Inclination time (IT) was substantially prolonged in 12% of HLP males and 7% of HLP females. The frequency of male subjects with prolonged IT was lower when only LDL was elevated (type II A) than in the other types of HLP. The subjects with prolonged IT had three characteristic features. 1) Moderate elevations of both serum cholesterol and TG. These elevations occurred often in both VLDL and LDL lipoprotein classes. IT prolongations were not seen when VLDL or LDL lipoproteins were singly markedly elevated. 2) High frequency of smokers. 3) Most of the subjects were above the age of 50. The results suggest that the most atherogenic lipoprotein abnormalities to the arteries of the lower limb are on the one hand the relatively TG‐rich part of the LDL (LDL1) fraction and on the other hand the relatively cholesterol‐rich part of the VLDL fraction. Furthermore the results stress the deleterious influence of smoking even in the preclinical stage of PVD.
Factors Related to Blood Pressure in a General Population Sample of Swedish Men
Authors: Berglund Göran , Wilhelmsen Lars
Published: August 2010

Abstract. Blood pressure (BP), heart rate (HR), height, weight, hereditary factors, smoking habits and physical activity have been determined in a random population sample of men aged 47–54 years attending a screening examination, which was part of a multifactor primary preventive trial. Of the 9 967 men who were invited to the study, 83% answered a postal questionnaire and 75% took part in the screening examination. Of all persons not on antihypertensive treatment, 10% had systolic blood pressure (SBP) >175 mmHg and 6% had diastolic blood pressure (DBP) >115 mmHg. Of those on hypotensive treatment 43% had SBP >175 mmHg and 30% had DBP >115 mmHg, indicating that the hypertension was not well controlled. A weak positive correlation was found between HR and BP and between relative body weight (RBW) (defined as [weight/height] – 100) and BP. Both HR and RBW were higher in the treated hypertensives than in the remainder of the population studied. Subjects with a positive heredity for myocardial infarction or stroke had a significantly higher BP than persons with a negative heredity, but the absolute differences were small. A weak relationship was demonstrated between smoking habits and DBP, with the lowest BP in persons smoking >25 cigarettes a day. There was no relationship between the degree of physical activity and BP.