bluuebunny/crossref_metadata_2025 huggingface dataset:
DEATHS FROM ISCHEMIC HEART DISEASE IN PERSONS AGED 65 OR YOUNGER IN HELSINKI IN 1970: With Special Reference to Patho‐anatomic Findings in Hearts
Authors: Rissanen Viljo , Romo Matti , Sarna Seppo , Siltanen Pentti
Published: August 2010

Abstract Deaths from ischemic heart disease (IHD) occurring during a period of one year in Helsinki in persons aged 65 years or younger have been investigated by the Ischaemic Heart Disease Register. Altogether 526 fatalities were registered. Autopsy data were collected in 432 cases, the autopsy rate being 82%. The results are presented separately for persons autopsied in the pathologic departments, representing mostly delayed deaths in hospitals, and for medico‐legally autopsied persons representing sudden deaths outside hospitals. The diagnosis of IHD death was either based on the positive patho‐anatomic or clinical evidence of an acute heart attack or supported by a history of clinical IHD in 92 % of all registered fatal cases. In the remaining fatalities the possibility of other causes of death had been more or less definitely excluced. All persons with an acute attack of IHD and all autopsied cases showed a division into four socio‐economic groups very similar to that of the population of Helsinki. Men belonging to the lowest social group were over‐represented among medico‐legally autopsied cases. A history of a previous heart disease, visits to a doctor and the use of digitalis were less common in persons autopsied medicolegally than in those autopsied in the pathologic departments. In the former an aucte infarction was most often located in the posterior wall and in the latter in the anterior wall of the left ventricle. The prevalence of an occlusion was highest in the right coronary artery in the former and in the left anterior descending coronary artery in the latter. In medico‐legally autopsied cases in which a recent myocardial infarction was observed the interventricular septum was involved in 81%, but in cases with an old infarction the septum was involved in only 52%. No difference in the size of the hearts, the frequency of an old infarction or the prevalence of coronary occlusions was found between persons autopsied in the pathologic and forensic departments. Although a previous angina was about equally common in both sexes, old infarctions were more common in men. The increase in heart weight had occurred proportionally to the same extent in both sexes.
THE THYROID IN ULCERATIVE COLITIS AND CROHN'S DISEASE
Authors: Järnerot Gunnar
Published: August 2010

AbstractIn order to investigate the prevalence of iodine depletion in chronic inflammatory bowel disease two separate studies have been performed. One was devoted to the 24‐hour urinary iodine excretion and 50 patients with ulcerative colitis or Crohn's disease were examined and compared with 102 controls. In the other study the thyroid131I uptake was compared in 38 patients and 36 controls. Ten of the 50 patients with chronic inflammatory bowel disease had a 24‐hour urinary iodine excretion less than 40 μ.g, compared with 5 of the 102 controls (p< 0.01). Sixteen of the 38 patients had a 24‐hour thyroid131I uptake of 50% or more of the administered test dose, compared with 4 of the 36 controls (p< 0.01). These results are compatible with an increased occurrence of iodine deficiency in patients with chronic inflammatory bowel disease. Treatment with corticosteroids or Salazopyrin® or a milk‐free diet did not influence these findings. No evidence was found of an impaired absorption of inorganic iodide from the gut.
THE THYROID IN ULCERATIVE COLITIS AND CROHN'S DISEASE
Authors: Järnerot G. , Truelove S. C. , von Schenck H.
Published: August 2010

Abstract The thyroxine binding globulin (TBG), thyroxine binding prealbumin (TBPA), albumin, thyroxine (T4) and the triiodothyronine uptake test (T3‐test) values have been estimated in serum of twenty patients with ulcerative colitis (UC) or Crohn's disease. The patient group was compared with twenty healthy control subjects matched for sex and age. The T4 and the T3‐test values were similar in the two groups. TBPA and albumin in serum were significantly lower, while the TBG values were significantly higher in the patients than in the controls. Treatment with corticosteroids influenced the results significantly. It is also concluded that in UC and Crohn's disease sometimes both the T4 and the T3‐test values can be abnormal so that a misdiagnosis of hyperthyroidism is easy to make.
INSULIN RELEASE IN FASTING MAN INDUCED BY IMPURE BUT NOT BY PURE PREPARATIONS OF CHOLECYSTOKININ
Authors: Hedner Pavo , Persson Gunnar , Ursing Dag
Published: August 2010

Abstract Most preparations of cholecystokinin reported to release insulin have been impure. When highly purified preparations of extracted cholecystokinin and also the synthetic C‐terminal octapeptide of the hormone became available for use in humans, we investigated their insulinotropic activity in comparison with a cruder preparation of cholecystokinin in 10 fasting non‐diabetic subjects. The doses employed were 75 Ivy dog units, except for the synthetic C‐terminal octapeptide of cholecystokinin that was given in a dose of 200 Ivy dog units to compensate for a shorter half‐life. Blood samples for determination of insulin and glucose were drawn every minute during 10 min after each injection, thereafter at intervals of 5 min. The mean plasma insulin level increased significantly, reaching a peak 4–5 min after i. v. injection of the cruder cholecystokinin preparation, but after the other two preparations the plasma insulin level was not significantly changed. The blood glucose level was not significantly changed by any of the preparations used. It is concluded that the plasma insulin peak seen in man after i.v. injection of the less highly purified preparation was due not to cholecystokinin but to some other agent present in this less pure preparation. The identity of this factor is discussed.
ERYTHRODERMIA SÉZARY WITH IMMUNOLOGICAL DEFICIENCY AND ANTIBODIES AGAINST HUMAN ALBUMIN
Authors: Iliescu Valentin , Lindholm Leif , Ehrnst Anneka
Published: August 2010

Abstract A case of erythrodermia Sézary, in which lymphocyte stimulation tests and quantitation of T and B lymphocytes were performed, is reported. The patient developed during 10 years of evolution an immunological deficiency with low IgA, IgG and IgM values. Passive hemagglutination techniques showed an antibody titer of 1:8000 against human serum albumin.
HEME CATABOLISM, CARBON MONOXIDE PRODUCTION AND RED CELL SURVIVAL IN ANEMIA
Authors: Lundh B. , Cavallin‐Ståhl Eva , Mercke C.
Published: August 2010

Abstract Total heme catabolism has been studied through measurement of the endogenous production of carbon monoxide (V̇CO) in 8 patients with hemolysis, 7 with hypoproliferative anemia, 10 with refractory anemia and hypercellular bone marrow and 7 with splenomegaly, 6 of whom had myeloid metaplasia. Simultaneously, catabolism of circulating red cell hemoglobin heme (Vheme‐c) was measured through labelling of the red cells with 51Cr, and the V̇CO/V̇heme‐c ratio was calculated for each patient. From a control group it was calculated that this ratio should vary around 1.5. Since no isotope studies were performed in the control group, no range could be defined. Among patients with hemolysis the V̇CO/V̇heme‐c ratio was found to vary between 1.3 and 1.8 except in 2 cases of paroxysmal nocturnal hemoglobinuria (PNH) and PNH?, respectively, in whom the ratios were found to be 0.6 and 0.7 suggesting some heme catabolism without corresponding CO formation. In the hypoproliferative group the ratio varied between 1.2 and 1.8 except in one patient treated with androgens, in whom the ratio was found to be 2.9, suggesting increased extraerythrocytic heme turnover. In patients with myeloid metaplasia the ratio varied between 1.3 and 1.8. On the other hand, the ratio varied between 2.4 and 3.0 among patients with refractory anemia and hypercellular bone marrow, thus confirming earlier findings that in this type of anemia turnover of bone marrow heme is markedly increased. A significant correlation was found between V̇CO and initial morning COHb% (r=0.84). The conclusions drawn are (a) that V̇heme‐c sometimes represents less than 50% of total heme turnover and (b) that COHb and/or V̇CO reflect total heme turnover except in patients with blood loss or intravascular hemolysis with hemoglobinuria.
OXYGEN UPTAKE, ARTERIAL BLOOD GASES AND BLOOD LACTATE CONCENTRATION DURING SUBMAXIMAL AND MAXIMAL EXERCISE IN ADULT SUBJECTS WITH SHUNT‐OPERATED TETRALOGY OF FALLOT
Authors: Eriksson Bengt O. , Bjarke Björn
Published: August 2010

Abstract Ten female and six male adult subjects with shunt‐operated tetralogy of Fallot have been studied at rest and during submaximal and maximal exercise on an average 20 years after the palliative operation. There was a considerable reduction in the aerobic work capacity, maximal oxygen uptake (V̇O2) being 1.00 1/min STPD. Though ventilation (V̇E) was out of proportion to V̇O2 as indicated by an abnormally high ventilation equivalent (52.1), values for V̇Emax were low (50.8 1/min BTPS) and of approximately the same order as in a comparable group of totally corrected TOF patients. In spite of increased V̇E in relation to V̇O2 the PaCO2 increased from 30 mmHg at rest to 49 mmHg during maximal exercise, while PaO2 decreased from 60 mmHg at rest to 44 mmHg during submaximal exercise I. During heavier exercise no further fall was noted. Base excess decreased from ‐2.9 to ‐9.8 mEq/1. Thus a combined respiratory and metabolic acidosis was at hand during exercise, the metabolic component, however, being normal. Maximal blood lactate concentrations were low (5.8 mmol/l) and contrasted with the high intramuscular lactate concentrations earlier reported in some of the patients. The low values found for V̇O2 max indicate that a palliative operative procedure in TOF is no alternative to an intracardiac repair in the long‐term course. The two main factors limiting exercise tolerance were acidosis and accumulation of lactate within the muscle cell.
SUBSTRATE INCORPORATION INTO HEPATIC LIPIDS AND PROTEINS IN VITRO IN PATIENTS WITH PRE‐β HYPERLIPOPROTEINEMIA
Authors: Stakeberg H. , Scherstén T.
Published: August 2010

Abstract Fifty‐three patients operated on for uncomplicated gallstone disease have been studied concerning the hepatic synthesis rate in vitro of glycerides and proteins. Thirteen of the patients had pre‐β hyperlipoproteinemia. Five of them and four normolipoproteinemic patients were fed a sucrose‐enriched diet for two weeks prior to the operation. In the non‐sucrose‐fed hyperlipoproteinemic patients the liver concentration of triglycerides (TG) and the incorporation rate of precursors into TG were increased. A significant correlation was found between the synthesis rate of TG in liver tissue and the plasma TG concentration in these hyperlipoproteinemic patients. After sucrose feeding of patients with hyperlipoproteinemia the concentration of phosphoglycerides (PG) the incorporation rate of labelled precursors into PG were significantly lower than in normolipoproteinemic patients and in hyperlipoproteinemic patients on an ordinary diet. The incorporation rate of leucine into hepatic proteins and the hepatic protein concentration were the same in non‐sucrose‐fed controls, sucrose‐fed, and non‐sucrose‐fed hyperlipoproteinemic patients. The results indicate an increased vulnerability of the hepatic PG and protein metabolism for dietary sucrose in patients with pre‐β hyperlipoproteinemia.
CLINICAL LISTERIOSIS IN RENAL ALLOTRANSPLANTATION
Authors: Christensen Erik
Published: August 2010

Abstract Two cases of Listeria monocytogenes meningitis among 212 kidney transplanted patients (total of 339 patient years of observation) under immunosuppression with azathioprine and prednisone are presented. Both cases developed shortly after an increase of the immunosuppression. The first case appeared in a 27‐year‐old man 5 days after a minor increase of the azathioprine dose from 75 to 100 mg/day. The course was relatively mild, and the patient was cured by tetracycline. The second case appeared in a 52‐year‐old woman 5 days after a massive increment of the steroid dose and administration of a moderate azathioprine dose, carried out to revert a rejection of the graft. This case had a fulminant course and was complicated by Listeria sepsis with hemolysis, pronounced oliguria and thrombocytopenia leading to fatal internal bleedings, primarily in the brain. Considering the poor prognosis of this complication it is suggested that cytotoxic drugs are temporarily discontinued and the steroid dose reduced at the height of the infection.
DYNAMICS OF α‐ADRENERGIC INHIBITION OF THE ADENYL CYCLASE—CYCLIC AMP SYSTEM IN HUMAN ADIPOSE TISSUE
Authors: Grill Valdemar , Rosenqvist Urban
Published: August 2010

AbstractIn short‐term incubations of fat cells isolated from human adipose tissue, noradrenaline (0.2–2 × 10‐5M), a mixed α‐ and β‐adrenergic agonist, stimulated only slightly cyclic AMP accumulation. In the presence of the α‐adrenergic blocking agent phentolamine (0.05–5 μg/ml), noradrenaline markedly augmented the amount of labelled cyclic nucleotide. The stimulatory effect of noradrenaline and noradrenaline plus phentolamine was abolished by propranolol (0.1–10 μg/ml). Theophylline (10‐4‐10‐3M) slightly increased the [3H] cyclic AMP levels per se, and magnified the stimulatory action of other agents, but did not mimic the potentiating effect of phentolamine on noradrenaline action. Stimulation of [3H] cyclic AMP was rapid in onset, maximal at 3–6 min and followed by a decline or leveling off regardless of the agent or the combination of agents causing the initial stimulation. The results are compatible with the hypothesis of α‐adrenergic activity being mediated through inhibition of adenyl cyclase, though the possibility of a stimulatory action on the phosphodiesterase enzymes has not been ruled out.
REMOVAL OF EXOGENOUS TRIGLYCERIDES IN HUMAN FOREARM MUSCLE AND SUBCUTANEOUS TISSUE
Authors: Kaijser Lennart , Rössner Stephan
Published: August 2010

Abstract The removal of exogenous triglyceride (TG) in forearm muscle and subcutaneous tissue of 7 healthy male volunteers has been studied by nephelometric determinations of arterial‐deep venous (a‐dv) and arterial‐superficial venous (a‐sv) differences in concentration of fat particles. Exogenous TG was administered as a constant i.v. infusion of Intralipid® over a period of 30 min at rest and another 15 min during forearm work. At rest a significant positive a‐dv difference in fat particle concentration of 121 ± 21 μmol TG/l (mean ± S.E.M.) was found, which corresponds to a fractional extraction of 10.3 ± 2.0%. Also the a‐sv difference was significant, 81 ± 14 μmol TG/l, 5.7 ± 0.8% of the arterial concentration. During exercise no further significant removal was found. Thus both skeletal muscle and subcutaneous tissue seem to be able to remove exogenous TG in substantial amounts under resting conditions. In the exercising muscle, however, the direct removal of exogenous TG does not seem to be of significant importance.
SCINTIGRAPHY WITH 131I‐19‐IODOCHOLESTEROL IN ADRENAL DISEASE: An Evaluation
Authors: Jørgensen Hans , Norman Nils , Sundsfjord Johan A.
Published: August 2010

Abstract Adrenal scintigraphy after i.v. injection of 131I‐19‐iodocholesterol has been performed in 4 patients with primary aldosteronism, 5 with Cushing's syndrome and 1 patient with phaeochromocytoma. In primary aldosteronism a unilateral adrenocortical adenoma was demonstrated in 2 patients, while the method failed in 1 patient to visualize a tumour that was localized by measurements of aldosterone concentrations in the adrenal veins and by adrenal venography; in 1 patient none of the methods demonstrated a tumour. In Cushing's syndrome, adrenal scintigraphy indicated bilateral adrenocortical hyperplasia in 1 patient and visualized the tumour in 2 patients with adrenocortical adenoma. In all patients with Cushing's syndrome due to unilateral adrenocortical tumour, the accumulation of radioactivity in the contralateral adrenal was suppressed. However, a delayed and slight accumulation of the isotope in the suppressed gland contralateral to an adrenocortical carcinoma was misinterpreted and led to exploration on the wrong side since the tumour did not concentrate radioactivity at all. The method failed in 1 patient to localize the adrenocortical tissue responsible for the relapse of Cushing's syndrome after bilateral adrenalectomy for hyperplasia. In the patient with phaeochromocytoma, no radioactivity was found on the tumour side due to compression of the adrenal cortex by the tumour. It is concluded that adrenal scintigraphy is a safe and valuable method for localization of adrenal tumours and their differentiation from adrenocortical hyperplasia. Some diagnostic pitfalls do, however, exist, as demonstrated in this series of patients.
REGISTRATION OF SINUS NODE RECOVERY TIME IN PATIENTS WITH SINUS RHYTHM AND IN PATIENTS WITH DYSRHYTHMIAS
Authors: Grendahl Helge , Miller Målfrid , Sivertssen Egil
Published: August 2010

Abstract Sinus node recovery time (SRT) after rapid atrial pacing has been recorded in 66 patients, 28 with coronary heart disease, 11 with advanced AV block, 10 with sick sinus syndrome and 17 with paroxysmal tachyarrhythmias. In patients with a normal functioning sinus node SRT was related to the basal heart rate. On an average SRT was 130% of the basal P‐P interval with an upper limit of 160%. In patients with a presumed normal atrial function the mean SRT was found to be 1080 msec, with an upper limit of 1500 msec. This corresponds with previously published observations. In all 5 patients examined, β‐receptor blockade (propranolol 5 mg i.v.) prolonged SRT. The prolonged SRT was related to sinus bradycardia. Verapamil (Isoptin® 5 mg i.v.) had no effect of SRT in the 7 patients examined. The observation of an SRT of more than 1500 msec indicates a poor sinus node function. Recording of a normal SRT, however, cannot exclude a sinus node dysfunction, as normal SRT is occasionally found even in patients with a clinically proved dysfunction.
MINOXIDIL—HAEMODYNAMIC AND CLINICAL EXPERIENCES WITH A NEW PERIPHERAL VASODILATOR
Authors: Sannerstedt Rune , Brorson Leif , Berglund Göran , Werkö Lars
Published: August 2010

AbstractMinoxidil, a new peripheral vasodilator, given orally to hypertensive men in single doses of 5–25 mg, produced no haemodynamic changes within one hour after administration. After repeated oral doses within 24 hours to a total of 15–45 mg and after 10 mg t.i.d. orally for one week, moderate decreases in BP were seen concomitant with tendencies to increased heart rate and cardiac output. Clinically, oral minoxidil 10–50 mg daily in combination with diuretics and adrenergic β‐receptor blocking agents achieved an improved BP control in five patients with sustained arterial hypertension and unsatisfactory response to previous treatment. However, in four of the five patients minoxidil had to be withdrawn because of side‐effects. It is concluded that minoxidil, producing a hypotensive effect of slow onset, may find a place as a therapeutic addition to symptomatic patients with severe and therapy‐resistant hypertensive cardiovascular disease, provided adequate measures are taken to counteract side‐effects, especially water retention and development of oedemas.
OVARIAN CYSTS IN WOMEN ON CHRONIC INTERMITTENT HAEMODIALYSIS
Authors: Thaysen Jørn Hess , Ølgaard Klaus , Jensen Herluf G.
Published: August 2010

Abstract In a consecutive material of 42 female patients, who were treated with intermittent dialysis for chronic renal failure between May 1964 and Nov. 1971, 21 developed ovarian cysts. The cysts were found only among the 29 women, who had menstrual periods from commencement of dialysis (16 cases) or who started menstruating on dialysis after a period of secondary amenorrhoea (13 cases). No cysts were found in the remaining 13 patients, who had amenorrhoea throughout, and of whom 6 were in all probability postmenopausal. Seven of the 21 patients with ovarian cysts had pronounced symptoms, necessitating acute surgery in 4. Fourteen asymptomatic cases were diagnosed at routine gynaecological examination, which was performed at regular intervals in all patients. There is strong evidence suggesting that the development of ovarian cysts was somehow related to the dialytic treatment and neither to the uraemic state nor to the nature of the primary renal disease. The mechanism by which dialytic treatment may be operational in the development of this hitherto undescribed complication is discussed, but no clear‐cut explanation can be given.
EPIDEMIOLOGY OF RENAL STONES IN A MIDDLE‐AGED MALE POPULATION
Authors: Ljunghall Sverker , Hedstrand Hans
Published: August 2010

Abstract The natural history of upper urinary tract stones has been studied retrospectively in 49–50‐year‐old men in an urban population. The prevalence of stones in 2 322 men was found to be 13.7%, with the highest incidence of onset of the disease during the fifth decade. Recurrences had occurred in 42 % of all cases, the frequency increasing with the observation time. On some occasion 23 % of the patients had been admitted to hospital and 12.3% had been operated on, 94.5% of all stones passed spontaneously. A family history of kidney stones was significantly more common in stone patients than in healthy controls, and patients with a family history of stones were more prone to early and repeated recurrences. It is suggested that the raised incidence of stone disease in some families may be attributed to environmental rather than genetic factors. This could be of importance for prophylaxis. Analysis of hospital admission rates supported previous findings of a steady rise in stone incidence. The advantages of population studies for comparative analyses are pointed out.
GLUCOSE‐INSULIN TREATMENT OF LACTIC ACIDOSIS IN PHENFORMIN‐TREATED DIABETICS
Authors: Kristensen Ole , Andersen Hans Harrestrup , Jensen Jørgen Borup
Published: August 2010

AbstractFour cases of lactic acidosis in phenformin‐treated diabetics are presented. Blood lactate before treatment was 5.7, 9.4, 10.7 and 17.8 mM/l, respectively. Treatment with glucose, insulin and bicarbonate resulted in correction of acidosis and hyperlactataemia. This therapy is recommended in phenformin‐induced lactic acidosis.
THE SMOKING HABITS OF MEN WITH INTERMITTENT CLAUDICATION
Authors: Lithell Hans , Hedstrand Hans , Karlsson Roland
Published: August 2010

Abstract Smoking habits among 54 male patients with intermittent claudication (IC) and 200 healthy 50‐year‐old men from the same county have been studied. The prevalence of smokers at the age of 50 was 98 % among the IC patients against 46% among the healthy controls. The percentage of heavy smokers and the total tobacco consumption were not significantly different in the two groups. However, the percentage of smokers who began to smoke before the age of 15 was significantly higher in IC patients than in the healthy group, 28 % to 7 %.
ANTIHYPERTENSIVE EFFECT OF β‐1‐RECEPTOR BLOCKADE AND β‐2‐RECEPTOR STIMULATION IN ESSENTIAL HYPERTENSION
Authors: Andersson Owe , Berglund Göran
Published: August 2010

Abstract The antihypertensive effect of practolol, a β‐1‐blocker, alone and in combination with a β‐2‐stimulating drug, salbutamol, has been studied in a double‐blind cross‐over trial on 19 patients. Practolol treatment induced a significant BP reduction, while the addition of salbutamol failed to give any further decrease.
THE IMPACT OF AUGUST KROGH ON THE INSULIN TREATMENT OF DIABETES AND OUR PRESENT STATUS
Authors: Poulsen Jacob E.
Published: August 2010

Abstract.The influence of August Krogh on the introduction of insulin preparations in Scandinavia is mentioned, and his outstanding physiological background is outlined.

Developments in preparation of insulin depending on the progress in protein‐chemistry are summarized. The latest step in the purification of insulin extracted from pork pancreas now allows treatment of diabetics with protamine‐pork‐insulin without causing formation of insulin‐antibodies in at least 90 per cent treated with insulin through several months. In only 3 out of 51 diabetics was it possible to demonstrate insulin‐antibodies.

This new step may be of great interest in two ways

 it is now possible to make insulin‐estimations in the plasma of insulin‐treated cases and

 it will be possible to find out whether elimination of insulin‐antibody‐formation will reduce the degree of vascular lesions in diabetics, such lesions being the greatest problem in clinical diabetes.
Morphological Effects of Rapeseed Oil in Rats
Authors: ENGFELDT BENGT , BRUNIUS EDVARD
Published: August 2010

Light microscopy of paraffin embedded and frozen sections, supplemented with electron microscopy, was performed on the heart muscle of young rats fed rapeseed oil in short‐term experiments. It was confirmed that high levels of rapeseed oil, which contains erucic acid, produce severe lipoidosis of the heart muscle fibres within 10 days.

An attempt was made to find out the lowest level of erucic acid in the rat diet to give rise to pathological fatty accumulation. Several frozen sections from each heart or serial sections in combination with electron microscopy were used for this evaluation. The level found to give rise to pathological fatty accumulation was about 2 % by weight (w/w), while rats fed 1 % erucic acid showed normal myocardium.

No direct proof that erucic acid is of importance in human pathophysiology has hitherto been presented. It is concluded, however, that the similarity in reaction among the many species of experimental animals tested by different workers, as well as the basic metabolic disturbances demonstrated, are in strong favour of a similar effect in man.
Observations on Lipid Composition with Particular Reference to Cardiolipin of Rat Heart after Feeding Rapeseed Oil*
Authors: BLOMSTRAND ROLF , SVENSSON LENNART
Published: August 2010

The influence of dietary rapeseed oil on the lipid classes and fatty acid pattern of rat heart homogenate and mitochondria has been investigated after feeding a diet with 9.8 weight‐ % erucic acid for 10 days and 1.4 and 2.6 % erucic acid for 28 days.

The rats treated with 9.8 % erucic acid showed a significant increase in the triglycerides of the heart mitochondria. This tendency was much less pronounced in rats treated with 1.4 resp. 2.6 % erucic acid. These results confirm those of other investigators. A slight increase in the cholesterol esters of the mitochondria could be seen in all the treated rats.

The total phospholipids were decreased in the experiment with 9.8 % erucic acid and slightly increased in experiments with 1.4 and 2.6 % erucic acid. The concentration of phosphatidylcholine showed a tendency to increase and the concentration of phosphatidylethanolamine to decrease in the experiment with 9.8 % erucic acid in the diet. The concentration of cardiolipin was mainly unchanged.

In all experiments the triglycerides of the heart mitochondria showed a high content of erucic acid. The fatty acids of the cholesterol esters of the heart mitochondria were also influenced of dietary rapeseed oil but to a less extent than the triglycerides. The fatty acids of phosphatidylcholine, phosphatidylethanolamine and cardiolipin were all influenced by the dietary rapeseed oil, but the erucic acid seemed to have a specific affinity to cardiolipin.

Cardiolipin of rat heart mitochondria was isolated and identified with gas chromatography and mass spectrometry. The isolated cardiolipin was found to contain 12 per cent erucic acid after feeding 9.8 % erucic acid as rapeseed oil for 10 days. Similar results were obtained after feeding glyceryl trierucate for 5 days to rats. The incorporation of erucic acid into cardiolipin was followed by a corresponding decrease of linoleic acid. This observation is of great interest because the molecular structure of fatty acids in lipid molecules has a profound influence of the packing of these molecules in a bilayer. Since cardiolipin is a component of the inner membrane of mitochondria its high affinity for erucic acid might influence the normal function of the inner membrane of heart mitochondria.
Smallpox Vaccination: The End of an Era
Authors: KARZON DAVID T.
Published: August 2010

Summary. In 1971 it wasrecommended that routine immunization against smallpox be discontinued in the United States. While smallpox vaccine has had a venerable record of disease control, deliberations which led to the reversal of the longstanding public health plicy reflect a reconsideration of smallpox status in the world. Smallpox was introduced into the western hemishere almost 450 yeas ago. Immunoprophylaxis was initiated in the United States more than 250 years ago. The record of smalpox vaccine is impressive. It may bbe credited with the reduction of cases in the United States from more than 110,000 in 1920 to an absence of cases since 1949. However, we cannot credit the continued maintenance of a smallpox‐free country to the routine use of vaccine and cannot credit the level of immunity of our population for the prevention of importations. The fact is that our “herd immunity” has not been challenged for 25 years.

As the incidence of smallpox in the world has fallen, and with the disappearance of the disease altogether in the developed countries, the substantial toxicity of the vaccine began to stand out in bold relief. In the United States, 7–8 deaths attributable to complicatins of the smallpox vaccine occurred each year. In addition, significant nerrologic and dermal complications of the smallpox vaccine occurred each year. In addition, significant neurologic and dermal complications have occurred at the rate of 8,000 per year. These complications occurred among 5–6 million primary and 7–8 million revaccinees each year.

The risk of importation of cases of smallpox in a given country is proportionate to the incidence of endemic smallpox in the world and the number of tramellers from endemic areas. World incidence of smallpox has fallen dramatically. As late as 1962, 61 countries reported smallpox. The current list includes only 4 countries where smallpox is endemic‐India, Pakistan, Bangladesh and Ethiopia. Exportations in the first portion of 1974 have been confined almost exclusively to adjacent land areas. Recently, the Americas, having gone without endemic cases for 2 years were declared disease free; Indonesia has recently received similar status.

The success of recent control and eradication programs on a world‐wide basis is based upon a new understanding of smallpox epidemiology and a new and vigorous approach to its containment. Emphasis upon epidemiologic investigation of all suspected cases and systematic vaccination of contacts ha proved very effective. However, importations into non‐epidemic areas can theoretically occur as long as small‐pox exists anywhere in the world. Expericnce has shown that selective “ring vaccination” of contacts of such imported cases can effectively control spread. This policy plus continued vaccination of high risk individuals, i.e., health personnel and travellers to and from endemic areas, provides the least toll in morbidity and mortality. Continued active support is required for smallpox surveillance and eradication programs around the world.
Measles and Rubella Vaccination
Authors: BEALE A. JOHN
Published: August 2010

Summary. Both measles and rubella vaccine have been proven effective and there is increasing confidence about the matters for concern; namely duration of immunity and untoward reactions. These diseases can now be reduced to insignificance as diphtheria and poliomyelitis have been before them, provided only that there are adequate public health schemes of immunization backed by continued surveillance of immune status and of untoward reactions.
New Approaches to the Prevention of Influenza
Authors: KILBOURNE EDWIN D.
Published: August 2010

Summary. More than 30 years after development of the first effective influenza vaccine, influenza remains virtually uncontrolled by human intervention. The explanation of this paradox is to be found in the nature of the causative virus, which is unique among infectious agents in its capacity for rapid and frequent intigenic changes. Therefor, the limited effectiveness of present day vaccines is less a problem in immunology than it is in the rapid obsolescence of vaccines. The continual need for “updating” of vaccines presents recurrent problems attendant upon the selection, development and production of new vaccine virus strains. Another problem, common also to most other inactivated vaccines, is the transient immunity induced by parenteral administration of conventional inactivated influenza vaccines, even if they are homotypic to the challenge virus. Thus, the problem of influenza immunization requires new approaches, and a variety of new currently under study. These approaches include:

Better standardization of vaccines and increase in antigenic mass. This prosaic but necessary step has reduced one cause of vaccine failure of the past‐i.e. insufficient antigen.

Better purification of vaccines to reduce toxicity related to non‐viral materials.

Induction of local immunity by topical application of vaccine to the respiratory tract. It is logical to induce immunity at the site of subsequent challenge (as with live poliovirus vaccine), although the relative importance of humoral and local immunity in influenza has been insufficiently studied. Such immunity can be stimulated either by live or inactivated vaccines, but much more effectively by the former.

Laboratory selection of antigenic mutants in anticipation of their selection in nature. This approach attempts to simulate in the laboratory the evolution of strain in the laboratory the evolution of strains in nature by passage of virus with antiserum. The objective is to accelerate the selection process so that a pan‐antigenic vaccine virus is derived that can protect against future variants of the subtye.

Gentic manipulation of viruses by recombination and induction and selection of mutants.(The creation of new viruses with desirable properties.)
The Newer Live Virus Vaccines
Authors: HILLEMAN MAURICE R.
Published: August 2010

Summary. The economic and social considerations in relation to diseases deman the application of preventive measures. As the more devastating viral diseases are controlled, the less important diseases move up in their own sequence to be the impotrant disease entities in the contemporary time perios. Each, in turn, seeks a preventive.

The most recent group of viral vaccines‐those against measles, mumps and rubela‐have provided a new technology for disease control and each has lived up to its expectations. Immunity following use of these vaccines has generally exceeded 95% and the proved duration of immunity has exceeded 13 years for rubella. Most importantly, mass immunization of the chils population in the U.S.A. has forestalled the expected epidemic of congenital rubella and has reduced this syndrome to minor incidence.

Administration of these vaccines in combined form has provided a means for simplification of vaccination rpograms with reduction in cost without decreased efficacy and without change in clinical reactions.
Serum Cholesterol and Triglyceride Concentrations of Finns and Finnish Lapps
Authors: Björkstén F. , Aromaa A. , Eriksson A. W. , Maatela J. , Kirjarinta M. , Fellman J. , Tamminen M.
Published: August 2010

Abstract. Only small differences in serum cholesterol means and somewhat larger, but still modest differences in log(TG) means were observed, when seven Finnish population groups were compared. Semiurban and industrial groups had the highest triglyceride levels. Cholesterol levels tended to be lower in South Finland than in East or North Finland and lowest in semiurban population groups. Between 15–59 years of age, rural Finns of both sexes had higher and after this age lower cholesterol means than the Finns in the other population groups. The highest cholesterol levels below the age of 60 were observed in a rural population group in East Finland. The Finnish Lapps and the rural Finns had nearly identical serum lipid levels in spite of the differences in genetic background and way of life. The serum lipid concentration means were quite similar to those reported from the other Nordic countries, Denmark, Norway and Sweden. The differences between the populations of the Nordic countries are no larger than those observed between the Finnish population groups. However, no population in Scandinavia or elsewhere can confidently be said to have higher serum lipid levels than the Finns. The similarity of the lipid levels observed in different areas in Finland and in the larger Nordic area is remarkable in view of the large differences in the incidence of coronary heart disease and in mortality rates. It is conceivable that part of the variations in disease rates is attributable to differences in the prevalence of hyperlipidemias, although the present study does not prove this hypothesis. Such differences could occur in spite of similarities in the lipid concentration means. Prevalences of hyperlipidemias in Finland are given.
Changes in Plasma and Extracellular Fluid Volume during Long‐term Treatment with α‐methyldopa in 11 Thiazide‐treated Patients with Essential Hypertension
Authors: Leth A. , Ibsen H.
Published: August 2010

Abstract.In eleven patients with essential hypertension, plasma volume (T‐1824) (PV), extracellular fluid volume (82Br‐distribution space) (ECFV), blood pressure (BP) and the ratio plasma to interstitial fluid volume (PV/IF) have been determined three times before treatment, after more than two months of thiazide treatment and after three and six months of combined thiazide–α‐methyldopa (AMD) therapy. During combined treatment, PV/IF showed a significant increase, whereas PV and ECFV did not change significantly. Compared to values during thiazide therapy, PV and PV/IF increased, whereas ECFV was unchanged. BP was reduced significantly after thiazide treatment and showed a further significant fall when AMD was added. Based on the results and a review of the literature, it is concluded that AMD acts by interfering with the normal sympathetic activity, thereby producing a reduced venomotor tone and increased venous capacity. The concomitant reduced venous return of blood to the heart is suggested to contribute to the antihypertensive effect of AMD by means of a decreased cardiac output.
The Influence of Diabetic Regulation on the Diurnal Variation in Blood and the Urinary Excretion of Ketone Bodies
Authors: Wildenhoff K. E.
Published: August 2010

Abstract. A typical diurnal variation of blood ketone bodies (acetoacetate+3‐hydroxybutyrate) has been found in 23 newly diagnosed, untreated diabetics regardless of diabetic type. It was characterized by high morning concentrations, followed by a fall, and later on a rise in concentration during the evening and night. Satisfactory diabetic regulation, judged from glucose measurements, did not change this diabetic pattern, which differed fundamentally from the normal diurnal variation. In the regulated state the morning concentration of ketone bodies in blood was still abnormally high in the juvenile and the non‐obese maturity onset diabetics, while the concentration in the phenformin‐treated diabetics had increased on each sampling time. The 24‐hour urinary excretion of ketone bodies also remained abnormally high in the phenformin‐treated patients.
The Effect of Glycerol Infusion in Acute Cerebral Infarction
Authors: Frithz G. , Werner I.
Published: August 2010

Abstract. Intravenous administration of glycerol has been used in an effort to improve the prognosis for patients with acute cerebral infarction. Fifty patients were treated actively and 56 served as a control group. The neurological status before, during and after treatment for six days was assessed by a score system. The patients were grouped according to the initial score. Those with the highest and lowest scores did not improve from glycerol infusion. However, the treated patients with intermediate scores, where the prognosis is known to be dubious, showed a significant improvement compared to the controls. The mortality was not influenced. No undesirable side‐effects from glycerol were registered.
Ectopic Pituitary Function
Authors: Lindholm J. , Korsgaard O. , Rasmussen P.
Published: August 2010

Abstract. Two patients with acromegaly have been treated with hypophysectomy. Because the disease was still active, the patients were reoperated. No pituitary tissue could be found at the second operations. Besides the acromegaly, one of the patients had diabetes mellitus (appeared after the first operation), Cushing's syndrome, probably ACTH‐dependent, and evidence of thyrotoxicosis. In both patients extopic pituitary tissue was suspected. One of the patients reacted with a normal fall in plasma growth hormone to growth hormone releasing‐inhibiting hormone. Ectopic pituitary function should be suspected, if pituitary function is retained after a hypophysectomy.
A 3‐year Follow‐up of Middle‐aged Men with Borderline Blood Pressure
Authors: Hedstrand Hans , Åberg Hans
Published: August 2010

Abstract. Ninety‐eight middle‐aged men with untreated borderline raised blood pressure (BP) have been reexamined after three years. Twenty‐five subjects were considered to be hypertensive, motivating a shorter interval for rescreening. Systolic BP had decreased in 23%, diastolic BP in 46% and both pressures in 15%. Those who developed hypertension had higher systolic BP at the initial examination. A family history of hypertension was more common in this group.
A Case of Disseminated Hemangiomatosis with Cutaneous, Hepatic and Skeletal Manifestations and Increased Urinary Excretion of Glycosaminoglycans
Authors: Gordin Ariel , Edgren Johan , Friman Claes , Holmström Teddy
Published: August 2010

Abstract. A case of disseminated hemangiomatosis with cutaneous, hepatic and extensive skeletal manifestations is reported. The diagnosis was established by means of bone X‐ray, hepatic angiography, and skin and bone biopsies. A moderately increased urinary excretion of glycosaminoglycans (GAG) was found. The main GAG fraction excreted was tentatively identified as a heparan sulphate.
High Pacemaker Implantation Rate Following “Cardiogenic Neurology”
Authors: Abdon Nils‐Johan , Malmcrona Raoul
Published: August 2010

Abstract. This paper gives data on symptomatic patients with bradycardia found not at random but as the result of greatly expanded facilities for recognition of arrhythmias. The incidence of patients with symptomatic bradycardia was very high. Most patients had intermittent arrhythmias and diagnosis was often only possible after long‐term ECG screening. Symptoms were as severe, and relief of symptoms with treatment was as good, as in pacemaker‐treated patients described by others. Our conclusion is that indications for arrhythmia screening should be increased, as the diagnosis and treatment are very worthwhile. We refer to the systematized active diagnosis and treatment of arrhythmias in patients with cerebral symptoms as cardiogenic neurology.
Verapamil in the Treatment of Atrial Tachycardia with Block
Authors: Storstein Ole , Landmark Knud H.
Published: August 2010

Abstract. Atrial tachycardia (A‐T) with block is easily converted as a rule to sinus rhythm by DC shock, but the recurrence rate is high. So far drug treatment of this arrhythmia has been unsatisfactory. There is no drug of choice in the treatment of A‐T with block. We report on the effect of verapamil on this arrhythmia in 14 patients. Ten of them reverted to sinus rhythm, but A‐T with block later recurred in 4. The best effect was found in patients with no or only minimal heart enlargement and in patients with short duration of the arrhythmia. The effect of verapamil on A‐T with block may support the concept of this arrhythmia being due to atrioventricular (A‐V) nodal reentry, as the main effect of verapamil is a prolongation of the effective refractory period of the A‐V node.
A Double‐blind Placebo‐controlled Cross‐over Study with Lidoflazine (Clinium®) in Post‐infarction Patients
Authors: Meilink‐Hoedemaker Laura J. , Pool Jan , Muste‐Heijns Margje M.
Published: August 2010

ABSTRACTThe effects of lidoflazine on exercise tolerance have been tested during a double‐blind cross‐over trial in 14 male post‐infarction patients with a median age of 47 years (range 24–58). Each treatment phase lasted three months. Lidoflazine dosage was one 60 mg tablet t.i.d. At rest, significant decreases in diastolic blood pressure (DBP) and heart rate (HR) were noted during lidoflazine treatment. Bicycle ergometric tests revealed a significant increase in maximum work load and a significant decrease in the product HR × systolic BP at a 100 W work load during lidoflazine. No similar changes were recorded during placebo periods. Five patients were able to resume their professional activities whilst on lidoflazine, against only two on placebo.
Is Streptokinase Useful in the Treatment of Deep Vein Thrombosis?
Authors: Bieger Robert , Boekhout‐Mussert Ria J. , Hohmann Frits , Loeliger Emil A.
Published: August 2010

ABSTRACT Because of its fibrinolytic action, streptokinase is believed to reduce the severity of the postthrombotic syndrome in patients with deep vein thrombosis. A prospective and a retrospective study have been undertaken in an attempt to determine when this therapy is useful for patients with deep vein thrombosis. The prospective study included 15 patients with deep vein thrombosis: 5 were treated in the hospital with streptokinase and heparin and 5 only with heparin, 5 were treated at home with only phenprocoumon. Ail the patients received oral anticoagulant therapy for at least 6 months. Three to four months after the acute episode, phlebography and venous pressure measurements were carried out. Streptokinase appeared to give the best results but with more side‐effects. In the retrospective study, 51 patients who had had deep vein thrombosis in 1969 were reexamined 31–47 months later. It was found that more than 50 % of the patients with a thrombosis in the femoral and/or iliac vein developed a severe postthrombotic syndrome, in contrast to only 9% of those with a thrombosis in the popliteal vein or lower. It is recommended, on the basis of both the prospective and the retrospective study, that patients with a thrombosis in the femoral and/or iliac vein should be treated with either heparin or streptokinase during the early stage. It is probable that streptokinase will significantly decrease the frequency and severity of the postthrombotic syndrome in these patients in particular, although this has not yet been proven.
A Comparative Study of the Effects of Cholestyramine and Neomycin in the Treatment of Type II Hyperlipoproteinaemia
Authors: Schade R. W. B. , van Laar A. , Majoor C L. H. , Jansen A. P.
Published: August 2010

ABSTRACT A comparative study of the effects of cholestyramine and neomycin has been carried out in 35 patients with severe type II hyperlipoproteinaemia. Both agents were administered during a period of 18 weeks, the daily dosages being 12, 16 or 20 g cholestyramine and 1, 1.5 or 2 g neomycin. The mean decrease in cholesterol concentration was 22% with cholestyramine and 23% with neomycin. There was no difference in effect between the two agents and between the doses used. No significant influence on triglyceride concentration and on body weight was observed. No signs of deficiencies in fat‐soluble vitamins were found. Anticoagulant requirements increased during cholestyramine medication. No signs of hyperchloraemic acidosis were observed during treatment with cholestyramine. Cholestyramine was tolerated less well than neomycin: it had to be discontinued in 8 cases. Neomycin was not tolerated by 3 patients. The majority of the patients preferred neomycin.