bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Value of Fibrinopeptide A and Beta‐Thromboglobulin in Acute Deep Venous Thrombosis and Pulmonary Embolism
Authors: van Hulsteijn Harry , Briët Ernest , Koch Carl , Hermans Jo , Bertina Rogier
Published: August 2010

ABSTRACT. The purpose of this study was to assess the predictive values of the assays of fibrinopeptide A (FPA), β‐thromboglobulin (BTG) and their combination in patients suspected of having acute deep venous thrombosis (DVT) or pulmonary embolism (PE). In 80 controls the mean (± SD) plasma concentrations of FPA and BTG were 0.72±0.47 and 28.2±10.1 ng/ml, respectively. In 26 patients, in whom DVT was confirmed by phlebography and Doppler ultrasound, clearly raised mean FPA (5.62 ng/ml) and BTG (70.6 ng/ml) concentrations were measured compared to those in 13 patients in whom this disorder was excluded (1.00 and 33.6 ng/ml, respectively). Also in 25 patients, in whom PE was established by perfusion lung scanning, clearly increased mean FPA (6.28 ng/ml) and BTG (82.4 ng/ml) concentrations were measured compared to those in 12 patients without this disease (1.03 and 32.5 ng/ml, respectively). Raised FPA and BTG concentrations were also found in 20 patients with inflammatory disorders and in 10 with various types of malignancy. The mean FPA and BTG concentrations did not differ between patients with renal failure or diabetes mellitus and patients without these diseases. From the predictive values of these assays and their combination it can be concluded that raised FPA and BTG concentrations are not specific for thrombosis. However, when normal FPA and BTG concentrations are present, acute DVT or PE can safely be excluded in symptomatic patients. In the group with confirmed DVT/PE, anticoagulant treatment (heparin and phenprocoumon) brought down the mean FPA concentration to levels within the normal range in less than 1 hour while the mean BTG concentration remained elevated throughout the 10‐day study period.
Abrupt and Gradual Change from Clonidine to Beta Blockers in Hypertension
Authors: Lilja Mauno , Jounela Antti J. , Juustila Heikki J. , Paalzow Lennart
Published: August 2010

ABSTRACT.Elective change of antihypertensive therapy from clonidine to β‐blockers was studied in 18 hypertensive inpatients on diuretic treatment. An abrupt cessation of clonidine (0.3 mg t.i.d.) and start of treatment 12 hours later with atenolol (50 mg b.i.d.) resulted, within 24–36 hours, in severe rise of blood pressure and intolerable symptoms of clonidine withdrawal in all 4 patients studied. Plasma noradrenaline levels were elevated 18–24 hours after the last dose of clonidine. Halving the previous daily clonidine dose (0.15 mg t.i.d.) and discontinuing it after three days on concomitant treatment with atenolol or timolol in increasing doses proved successful and caused only few side‐effects in 14 hypertensive inpatients.
Correlation of Electrophysiology and Morphology in Myocardial Sarcoidosis
Authors: Petersen Erik la Cour , Vesterby Annie , Baandrup Ulrik , Nielsen Johan Lanng
Published: August 2010

ABSTRACT. A 44‐year‐old man with systemic sarcoidosis for 11 years developed myocardial sarcoidosis with left bundle branch block and recurrent ventricular tachycardia prior to death. Autopsy showed granulomas and fibrosis in the myocardium including the left ventricular free wall, septum and His bundle, particularly the left bundle branch. This is in accordance with the ECG findings.
Splenic Granulomas in Farmer's Lung Disease
Authors: Venho K. K. K. , Selroos O. , Haahtela T. , Mönkäre S.
Published: August 2010

ABSTRACT. Five out of ten patients with acute or subacute farmer's lung disease had granuloma‐like lesions in splenic fine‐needle aspirates. The splenic lesions were indistinguishable from certain lesions usually seen in early sarcoidosis. It is suggested that the immunological response in extrinsic allergic alveolitis in an acute stage is not exclusively defined to the pulmonary tissue.
Studies on Ethylene Glycol Poisoning
Authors: Jacobsen Dag , Østby Nils , Bredesen Jan Erik
Published: August 2010

ABSTRACT. Toxicokinetic studies during hemodialysis are presented in two patients with blood ethylene glycol concentrations of 40 and 41 nunol/1, respectively. Treatment involved bicarbonate, ethanol and hemodialysis with a 1.6 m2 dialysator. Both patients developed acute renal failure and one was discharged with permanent cerebral impairment. The other made an uneventful recovery. The average dialysator clearance of ethylene glycol at a blood flow of 200 ml/min was 145 and 148 ml/min, respectively. Assuming a volume of distribution of ethylene glycol of 0.7 l/kg, the dialysator represented about 92 and 95%, respectively, of the total body clearance of ethylene glycol during ethanol treatment. During hemodialysis a blood ethanol concentration of about 15 nunol/1 (0.7 g/1) caused a near complete inhibition of ethylene glycol metabolism at ethylene glycol concentrations up to about 25 rhmol/l (1.6 g/l). We recommend prompt hemodialysis in ethylene glycol poisoning to supplement alkali and ethanol treatment.
The Biological Properties of Human Insulin
Authors: Sestoft L. , Vølund Aa. , Gammeltoft S. , Birch K. , Hildebrandt P.
Published: August 2010

ABSTRACT.Semisynthetic human insulin (Novo) was compared with porcine insulin with regard to absorption from subcutaneous depots, blood glucose control and plasma insulin concentrations in patients, and the binding to insulin receptors of porcine and human origin. The binding affinities of semisynthetic human insulin and porcine insulin were identical with human erythrocyte receptors and receptors on porcine hepatocytes. The subcutaneous absorption of semisynthetic human and porcine125I‐labelled insulin both of soluble and lente type was identical. The metabolic control study was performed as a double‐blind crossover study in eight type I diabetics. They received semisynthetic human insulin and porcine insulin (of soluble as well as lente type) for 10 days each, the last 7 days in each period being the observation period. Blood glucose concentration was measured 9 times per 24 hours. No statistically significant differences were found between mean blood glucose levels at the 9 samplings or in the overall mean blood glucose concentration. Further, the blood glucose control was evaluated as a function of time by a computerized method for time series analysis of a complex dynamic system. This method described adequately each blood glucose value as a linear function of the immediately preceding blood glucose value and that measured 24 hours before. No difference was found between human and porcine insulin when the blood glucose control was assessed by this method. Plasma concentrations of total insulin (IRI) and free IRI before and 3 hours after the morning insulin injection were identical in the two treatment periods. It is concluded that human and porcine insulin can be interchanged in the treatment of diabetics without changing the dose.
On Metabolic Effects of Diuretics and β‐Blockers
Authors: Bengtsson C. , Lennartsson J. , Lindquist O. , Lindstedt G. , Lundberg P. A. , Noppa H. , Sigurdsson J. A. , Tibblin E.
Published: August 2010

ABSTRACT.A population sample of women in Göteborg, Sweden, was studied in 1968–69 and re‐studied in 1974‐75. A number of metabolic variables could be studied cross‐sectionally (in 1974–75) and longitudinally (intraindividual changes between 1968–69 and 1974–75). When studied cross‐sectionally, increased serum urate concentrations were observed in women on diuretics and increased serum triglycerides in women on β‐blockers, compared to other women, while no obvious differences were found in blood glucose and serum cholesterol concentrations or in packed red cell volume (PCV). When studied longitudinally, a slight decrease in serum triglyceride concentration was found in women who started to take diuretics and an increase in women who started to take β‐blockers compared to other women. Serum urate concentration tended to increase in women who started to take diuretics and PCV tended to decrease in women who started to take β‐blockers. Blood glucose was unimpaired. In conclusion, the differences observed were rather small and seemed to be rather unimportant compared to the threat presented by the arterial hypertension itself.
Thrombosis of Superior Vena Cava as a Complication of Transvenous Pacemaker Treatment
Authors: Gundersen Torstein , Abrahamsen Arne M. , Jargensen Ingrid
Published: August 2010

ABSTRACT. A complication of permanent transvenous pacing leading to thrombotic obstruction of the superior vena cava and left brachiocephalic vein is reported. Symptoms of the superior vena cava syndrome were successfully treated with anticoagulants. The patient has no symptoms of venous obstruction 36 months after the complication.
Magnesium Deficiency Contributing to Ventricular Tachycardia
Authors: Dyckner Thomas , Wester Per‐Olov
Published: August 2010

ABSTRACT. Two cases of ventricular tachycardia (VT), possibly caused by magnesium deficiency, are presented. Skeletal muscle biopsies and blood samples were taken before and after magnesium infusions. These infusions resulted in a significant retention of magnesium, and the VT attacks vanished permanently in one case and temporarily in the other.
Prenalterol in the Treatment of Congestive Heart Failure Developing during Beta‐Blocking Therapy
Authors: Dahlström Ulf , Karlsson Erling
Published: August 2010

ABSTRACT. In 30 patients with suspected or verified acute myocardial infarction (AMI) who developed symptoms and/or signs of congestive left ventricular failure, probably because of concomitant β‐adrenergic receptor blocking therapy, the antidote effect of prenalterol and frusemide was compared. The drugs were administered intravenously in repeated doses at 10 min intervals. The total dose of prenalterol was 100–150 μg/kg b.wt. and that of frusemide 40–100 mg. Symptoms of congestive heart failure and pulmonary rales disappeared in all patients who could complete the study, 11 of 15 in the prenalterol and 13 of 15 in the frusemide group. Prenalterol administration resulted in a significant increase in heart rate (HR) of about 18 beats/min (p<0.001), and a rise in systolic and diastolic blood pressure (SBP and DBP) of 10 and 8 mmHg, respectively (p<0.01). Frusemide did not change significantly the HR but both SBP and DBP were significantly lowered (p<0.01). Neither prenalterol nor frusemide was effective in 5 patients with atrial fibrillation to whom digoxin had to be given to restore sinus rhythm. The only serious adverse effect of prenalterol administration was a marked sinus tachycardia with concomitant chest pain in one patient. The results of this study indicate that frusemide should be the drug of choice in patients with AMI who develop mild congestive left heart failure during β‐adrenergic receptor blocking therapy. On the other hand, in patients with more severely depressed cardiac performance (such as bradycardia, low cardiac output and hypotension) prenalterol would be preferable.
Reconstructive Vascular Surgery for Intermittent Claudication
Authors: Sonnenfeld Tomas
Published: August 2010

ABSTRACT. Over an 8‐year period, 140 patients underwent 172 vascular reconstructions (187 reconstructed limbs) to relieve disabling intermittent claudication: bilateral aortoiliac or aortoileofemoral thrombendarterectomy (30 limbs), unilateral iliac or ileofemoral thrombendarterectomy (41 limbs), simultaneous unilateral ileofemoral thrombendarterectomy and femoropopliteal saphenous vein bypass graft (23 limbs), femoropopliteal saphenous vein bypass graft alone (93 limbs). The cumulative 5‐year limb patency rates varied between 100 and 85.6% in the four groups. Age and diabetes did not influence patency rates. Only 2 limbs required amputation. These results indicate that reconstruction can be undertaken with a high rate of long‐term patency and symptomatic relief in patients with restricting claudication due to aortoiliac, ileofemoral and/or femoropopliteal occlusion.
Fatal Hepatitis Following Irradiation and Vincristine
Authors: Hansen Mogens Mørk , Ranek Leo , Walbom Sven , Nissen Nis I.
Published: August 2010

ABSTRACT. The increasing use of combination therapy with irradiation and cytostatics in malignant disease increases the risk of toxicity. An account is given of a patient with liver toxicity terminating fatally, in whom increased radiosensitivity may have been induced by vincristine.
Plasma Exchange and Moderate Dose of Cytostatics in Advanced Macro(cryo)globulinemia
Authors: Pihlstedt Peter
Published: August 2010

ABSTRACT. Three cases of advanced macroglobulinemia (two with severe cryoglobulinemia) have been treated for 6, 4 and 3 years, respectively, with regular plasma exchange and, during the last two years, also with short courses of cytostatics. The plasma exchange regimen has given the patients a marked relief from hyperviscosity symptoms and may have contributed to the improved peripheral blood values and lowered P‐IgM levels. Addition of cytostatics, however, was necessary to obtain a lasting remission.
Current Status of Swedish Hemophiliacs
Authors: Larsson S. A. , Nilsson I. M. , Blombäck M.
Published: August 2010

ABSTRACT. A comprehensive survey of the Swedish hemophilic population (hemophilia A and B) was undertaken in 1980. The total number of known hemophiliacs was 564. The ratio of hemophilia A to B was 4:1. The severe form constituted about 30% of each type. The incidence has remained fairly constant since 1957 and was 1.67 per year per 10000 males born. The prevalence was 6.8 per 100000 inhabitants. There was an increase in the prevalence in all counties but the increase varied considerably, 19–383%. The overall increase of hemophilia was 123%. Among mild cases the increase was 245%, whereas it was only 48% among the severe hemophiliacs. This skewness was attributed to better laboratory diagnoses and increased life expectancy. The proportion of mild cases increased from 35% in 1960 to 54% at the time of the present investigation. The situation was the reverse for the severe cases, a decrease from 45% to 30%. The mean and median ages among moderate and mild hemophiliacs deviated only little from the corresponding figure in the total population. Among severe cases, however, mean and median age were 8–13 years less than in the normal population.
Non‐invasive Evaluation of Anthracycline‐induced Cardiotoxicity in Man
Authors: Lahtinen R. , Uusitupa M. , Kuikka J. , Länsimies E.
Published: August 2010

ABSTRACT. Measurements of radionuclide first‐pass left ventricular ejection fraction (LVEFm) were carried out in 37 patients receiving doxorubicin and/or daunorubicin treatment for their malignant disease. The validity of the systolic time intervals (STI) and echocardiography (ECHO) in the detection of left ventricular dysfunction was evaluated using LVEFm as reference method. LVEFm showed a significant decrease in left ventricular function with cumulative anthracycline doses in patients with and without previous clinical evidence of cardiovascular disease. A multiple regression analysis showed that the impairment in LVEFm was significantly correlated with the cumulative anthracycline dose, patient's age and previous cardiovascular disease. In five patients (one without previous cardiac disease, one with coronary artery disease, three with hypertension) the drug had to be withdrawn due to signs or symptoms of cardiac dysfunction. The sensitivity and the specificity of STI and ECHO in the detection of left ventricular dysfunction remained rather low as compared with the results by LVEFm.
Liver Injury in Subjects Occupationally Exposed to Chemicals in Low Doses
Authors: Sotaniemi Eero A. , Sutinen Seppo , Sutinen Sirkka , Arranto Arno J. , Pelkonen R. Olavi
Published: August 2010

ABSTRACT. The hepatic injury developing during occupational exposure to chemicals was investigated in 23 male patients, aged 23–49 years, by comparing case histories, liver function tests, hepatic microsomal enzyme activities in vivo and in vitro with histology. The subjects, 15 chemical industry workers and 8 painters, had disturbed liver tests after years of exposure to solvents, paints and lacquers. Characteristic for the patients was a 2–4‐fold increase in serum aminotransferases associated with normal liver or reactive hepatitis with or without fatty liver. AU patients, except subjects with fatty change, had meta‐bolically active liver which was reflected as adaptive and toxic changes in cellular ultrastructure. The biochemical liver tests normalized within 3–6 weeks after cessation of the exposure. The findings demonstrate that occupational exposure to chemical solvente may insidiously damage the liver. The injury is detectable by biochemical, metabolic and histological investigations in the early phase.
Cardiac Conduction Disturbances, an Underestimated Manifestation in Ankylosing Spondylitis
Authors: Bergfeldt L. , Edhag O. , Vallin H.
Published: August 2010

ABSTRACT. Cardiac conduction disturbances were found in 22 (33%) of 68 patients during the course of ankylosing spondylitis (AS) of more than 25 years' duration. Complete heart block occurred in six patients, four of whom received a permanent pacemaker and one made a complete recovery. The high prevalence of conduction disturbances in AS in this report, exceeding what has previously been reported, is partly explained by the finding of intermittently occurring atrioventricular blocks.
Drug‐Induced Neutropenia—A Survey for Stockholm 1973–1978
Authors: Arneborn Per , Palmblad Jan
Published: August 2010

ABSTRACT. Hospital records of 256 patients discharged with a diagnosis of agranulocytosis during 1973–78 in the Stockholm County region were reviewed. In 84 cases the neutropenia was probably caused by drugs other than cytostatics, giving an annual incidence of 0.009%c. The commonest drugs were sulfonamides, thyreostatics and thenalidine. Metamizole (Dipyrone), previously the commonest cause of drug‐induced neutropenia in Sweden, has not been marketed since 1973 and, as a result, only two cases were seen (the drug had been obtained abroad). Comparison of the number of cases of neutropenia with drug sales showed the highest frequency for thenalidine, followed by thyreostatics, penicillamine and sulfonamides, in that order. Only about 35% of the cases had been reported to the authorities. Nine (11%) of the patients died. It is concluded that the pattern of drugs causing neutropenia has changed in Sweden since the studies from the latter half of the 60s and that early detection of this side‐effect requires directed and continuous follow‐up studies.
Does the Patient Appear Acutely or Chronically Ill?
Authors: Gjørup T. , Hamberg O. , Knudsen J. , Rosenfalck A. M. , Bugge P. M. , Hendriksen C. , Binder V. , Wulffand H. R. , Jensen A. M.
Published: August 2010

ABSTRACT. The general appearance of 201 patients was assessed by a team of observers. Each patient was seen by two experienced physicians, two junior physicians and two medical students who stated whether the patients did not appear ill or whether the patient appeared acutely or chronically ill. The interobserver variation was considerable and the kappa‐values ranged from around 0 to 0.75. The level of agreement did not seem to depend on the clinical experience of the observers. One experienced clinician assessed the patients differently from the others.
Hyperosmolar Non‐Ketotic Coma in Diabetic Stroke Patients
Authors: Asplund K. , Eriksson S. , Hägg E. , Lithnei F. , Strand T. , Wester P. O.
Published: August 2010

ABSTRACT. Hyperosmolar non‐ketotic coma in diabetes is a life‐threatening condition. We describe three patients, aged 59–67 years, who developed hyperosmolar coma during the first ten days after admission for stroke. Common to all three were normal plasma osmolality and slightly elevated plasma creatinine levels on admission, treatment with diuretics, parenteral dextrose administration before and low urinary glucose output during the coma. In the five days preceding the coma, total fluid deficits were 3.8, 6.5 and 9.4 l, respectively. In one patient the rate of glucose delivery had clearly exceeded utilization during adequate insulinization, in another a marked reduction in urinary glucose output preceded extreme hyperglycaemia and coma. Two of the three patients died, both from extensive thrombus formation in cerebral arteries and multiple emboli to the lungs. We conclude that enhanced endogenous glucose production and reduced renal clearance of glucose may contribute to precipitate hyperosmolar non‐ketotic coma. A close monitoring of fluid and dextrose administration seems mandatory in diabetic stroke patients, in particular if renal function is impaired or if diuretics are given. Insulin treatment should be considered in all diabetic patients during the first days after a stroke.
Chlorpropamide‐alcohol Flushing and Blood Kinins
Authors: Jerntorp Peter , Hulthén U. Lennart , Almér Lars‐Olof
Published: August 2010

ABSTRACT. In a pilot study six patients with noninsulin dependent diabetes, three positive and three negative to chlorpropamide‐alcohol flushing (CPAF), were tested. The patients were tested both without and with chlorpropamide premedication. Blood kinin concentrations were determined before and after ingestion of small quantities of alcohol. No rise in blood kinin concentrations were found during the flush suggesting that kinins do not play a major part in chlorpropamide‐alcohol flushing.
Ventricular Arrhythmias in Healthy Young Men during Physical Exhaustion
Authors: Viitasalo M. T.
Published: August 2010

ABSTRACT. The occurrence of ventricular arrhythmias was studied in 25 healthy young men, with the aid of ambulatory ECG monitoring, during maximal bicycle tests, short term running, exhausting route marches, and during a 16 h period after brief and long term exercise. The bicycle test allowed prediction of 4 out of the 12 cases (33%) with ventricular premature beats (VPB) during running. The bicycle test combined with ambulatory ECG monitoring over a 16 h period allowed prediction of 12 out of the 14 cases (86%) with VPBs during marching. All 9 subjects who became exhausted during marching had VPBs, whereas 5 out of the 16 who were not exhausted had VPBs (p < 0.001). In men with VPBs during all three exercise tests, the heart rates at the time of the VPBs were lowest during exhausting route marching. In conclusion, VPBs can be regarded as a physiological phenomenon if they occur only when exhaustion ensues.
The Diagonal Ear‐Lobe Crease, Heredity and Coronary Heart Disease
Authors: Kaukola Sirkka
Published: August 2010

ABSTRACT. A total of 41 male patients (age range 29–50 years; mean 44) with previous myocardial infarction (MI) and their 134 first‐degree relatives including 5 fathers, 11 mothers, 45 brothers, 26 sisters, 22 sons and 25 daughters, (age range 9–72 years), were examined for the presence or absence of the ear‐lobe crease (ELC) in an attempt to study the heritability of this sign which has been reported to be associated with coronary heart disease (CHD). ELC was present in 24 MI patients (59%) and absent in 17 (41%). They had 74 and 61 relatives, respectively. All relatives with CHD in each group also had ELC, which was also found in approximately half of the parents without clinical CHD and about one quarter of the healthy brothers of both patient groups. The healthy sisters of MI patients with ELC showed the ear sign remarkably often (31%), but it was found in only 1 sister of the MI patient without ELC. None of the children had ELC. The present findings support an association between ELC and CHD and may reflect, in addition, a connection between ELC and clinically silent coronary atherosclerosis in these selected families. The results do not indicate that ELC is an inheritable sign as such. Rather, it develops together with CHD as has been supposed previously.
Capillary Permeability in Skeletal Muscle of Normal Subjects
Authors: Leinonen Hannu
Published: August 2010

ABSTRACT. Capillary diffusion capacity (CDC) and muscle blood flow (MBF) were determined from the anterior tibial muscle in 25 normal subjects by measuring the simultaneous clearance of 133xenon and sodium131iodide. The subjects were divided into two groups: one with a mean age of 31 years and the other with a mean age of 51. The older group had a significantly lower MBF (54.6 ± 9.0 vs. 64.2 ± 9.5 ml/100 g/min; p < 0.05) and a significantly greater CDC (7.6 ± 1.2 vs. 6.1 ± 1.3 mol/min; p < 0.01) than the younger group. There was a significant correlation between the CDC increase and the age of the subjects (r = 0.61; p < 0.01). Furthermore, MBF decreased with increasing age (r = 0.48; p < 0.05). No differences were found in MBF or CDC between female and male subjects. The mechanisms of increased capillary permeability are discussed.
Hemoperfusion in Acute Intoxication
Authors: Haapanen E. J.
Published: August 2010

ABSTRACT. Hemoperfusion was performed on 58 occasions to treat 48 patients with severe intoxication, of which 23 had taken on overdose of barbiturate or meprobamate. With one exception they all showed remarkable improvement during the treatment. In addition in many other intoxications patients greatly benefited from hemoperfusion, as with salicylate, paracetamol, quinidine, propranolol and mushroom intoxications. Hemoperfusion was of doubtful value or ineffective in intoxications due to tricyclic antidepressants, phenothiazine, digoxin and methanol. Four of the patients (7%) died. More side effects are seen during hemoperfusion than during hemodialysis. The disposable supplies of hemoperfusion are more costly than those for hemodialysis. Therefore if both kinds of treatment are equally effective, one has to prefer hemodialysis. Unfortunately intoxications exist, which do not respond to either hemoperfusion or hemodialysis.
Gemfibrozil in the Treatment of Dyslipidaemia A 5‐year follow‐up study
Authors: Manninen V. , Mälkönen M. , Eisalo A. , Virtamo J. , Tuomilehto J. , Kuusisto P.
Published: August 2010

ABSTRACT. The efficacy and safety of gemfibrozil in treating dyslipidaemias was investigated in a 5‐year follow‐up study of 254 patients with primary dyslipidaemias. Most were middle‐aged males of type IIA or IIB. A significant correction of serum lipid level was seen in about 90% of dyslipidaemias, irrespective of the type. It was not possible to find a clear cause for non‐responsiveness, although cirrhosis of the liver was suggested in some cases. Overall, gemfibrozil decreased serum total cholesterol by 16% LDL cholesterol by 23% and the triglyceride level by 40%; HDL cholesterol rose by 23% and HDL cholesterol as percentage of total cholesterol from 14.3% to 20.8% to approach the value of matched controls in the population without dyslipidaemia (24.2%). Side‐effects were few. Among the treated subjects the observed number of myocardial infarctions was much less (4 vs 14) than expected. This by no means proves that gemfibrozil will prevent myocardial infarction, but is evidence to support that raising HDL and lowering LDL may give clinical benefit in the prevention of coronary heart disease. A more substantial primary prevention study in a population of patients at high risk, i.e. middle‐aged males with dyslipidaemia, is warranted.
Studies on Hypoxic Dyslipidaemia. Effect of Lipid Modulating Drugs
Authors: Mälkönen M. , Muona M. , Manninen V.
Published: August 2010

ABSTRACT. Haemorrhagic anaemia, exposure to altitude and depression of cell respiration are known to increase plasma triglyceride and cholesterol levels. The common triggering mechanism in all 3 instances is oxygen deficiency but mode of action is not known. The present study was intended to investigate whether lipid lowering drugs clofibrate or gemfibrozil could counteract such hypoxic dyslipidaemia in rats induced by altitude exposure. It was unexpectedly found that in normal rats gemfibrozil elevated plasma total cholesterol with an increase in the HDL‐cholesterol component whereas clofibrate caused a rise in LDL‐cholesterol. Nicotinic acid had no consistent effect. In hypoxia control rats showed an increase in cholesterol and triglyceride level. Both gemfibrozil and clofibrate prevented the rise of triglycerides. Total cholesterol fell in rats treated either with gemfibrozil or clofibrate during altitude exposure, indicating that neither natural nor gemfibrozil‐augmented hyper‐HDL‐aemia could be maintained during oxygen deficiency.
Kidney and Liver Function in Rats during the Edema following Constriction of Thoracic Inferior Vena Cava with and without Adrenalectomy or Hypophysectomy
Authors: Bagrov Ya. Yu. , Gusev G. P. , Krestinskaya T. V. , Manninen V. , Mälkönen M. , Vasileva V. F.
Published: August 2010

ABSTRACT. In several animal species, constriction of the thoracic inferior vena cava (TIVCC) is known to increase proximal sodium reabsorption and inhibit natriuresis following saline loading, leading to edema. To eluicidate the role of adrenal and hypophyseal hormones in the development of edema, kidney and liver functions after TIVCC were compared in adrenalectomised or hypophysectomised rats, and in intact controls. It was found that edema (body weight increase) and kidney and liver affliction were much less pronounced after the operations. The roles of aldosterone and ADH deficiency in renal sodium and water excretion are discussed. It is concluded that adrenal and hypophyseal hormones do not initiate edema but modulate its extent. The absence of edematous changes in the liver of hypophysectomised and adrenalectomised rats deserves further attention.
Usefulness of Multiaxis Echocardiography in Assessment of the Left Ventricle in Ischemic Heart Disease
Authors: Nieminen Markku S. , Heikkilä Juhani
Published: August 2010

ABSTRACT. Echoventriculography, a multiaxis M‐mode echocardiographic technique, was developed to examine in detail the regional wall motions of the left ventricle. The basic technical aspects and limitations are described, and experience is reviewed on 263 healthy subjects or patients with ischaemic heart disease. The reliability in detecting site and size of asynergic segments was excellent as related to electrocardiographic and thallium scintigraphic sites of acute infarction, and with left ventricular cineangiograms in chronic coronary heart disease. The correlation with pathologic anatomic size of infarct in 24 consecutive patients was r = 0.88 (p < 0.001) when expressed by a percentage of the left ventricular horizontal circumference. 94% of 111 infarcted segments were correctly detected by echo; only the posteroseptal and the most lateral regions remain out of the methodological range. The method separated old infarct scars from fresh necrosis. Decreasing echo contraction index correlated with increasing severity of coronary obstructions in 43 patients studied for coronary artery surgery. In 15 infarct patients the M‐mode technique was more sensitive than two‐dimensional echocardiography in recording asynergic segments or endocardial echoes. The multiple segmental echoventriculographic index decreased parallel with clinical severity of acute infarction (r = ‐0.79, p < 0.001; 30 patients). There was a 88% (p < 0.01) concordance between the reduction of the ST segments (‐30%) and the recovery of the mechanical function in the ischaemic myocardial segments (+ 26%) after beta blockade with pindolol in 22 patients with acute infarction. Methylprednisolone showed no improvement. With dopamine the left ventricular size decreased markedly (p < 0.0005). Echoventriculography thus seems to be very informative in evaluation of chronic or acute left ventricular dysfunction, despite the rather demanding nature of the technique in practice.
Coupling between the β‐adrenergic receptor and the adenylate cyclase – pathophysiological implications
Authors: Wesslau Christian
Published: August 2010

ABSTRACTMost β‐adrenergic effects are mediated by activation of the enzyme adenylate cyclase. Hormone binds to the receptor leading to an accelarated binding of GTP to the coupling protein, the N‐protein, which is activated. This causes an activation of the adenylate cyclase and an increased formation of cAMP, the intracellular second messenger. The same principles hold good for other hormones coupled to adenylate cyclase. The sensitivity of the adenylate cyclase may be altered in different clinical and experimental conditions. An increased sensitivity is seen in hyperthyroidism in man and in the rat, and during starvation in rats. A decreased sensitivity is seen in hypothyroidism, in patients with pheochromocytoma, pseudohypoparathyroidism type I or multiple symmetric lipomatosis. Several reasons for the altered sensitivity have been suggested. The number of hormone receptors, the coupling between receptor and N‐protein, the amount or function of the N‐protein or the PDE activity may all vary in different conditions.
Adrenergic blockade and hypoglycaemia
Authors: Lager Ibe
Published: August 2010

ABSTRACTThe metabolic effects of β‐adrenoceptor blocking agents during hypoglycaemia in patients prone to hypoglycaemia are of interest as diabetics are often treated with these drugs because of hypertension or angina pectoris. Compared with non‐diabetics these patients also have impaired glucose compensation after hypoglycaemia, partly secondary to deficient release of glucagon. This makes the diabetics more dependent on adrenergic mechanisms to recover from low blood glucose concentrations. Non‐selective β‐adrenoceptor blockade (propranolol) significantly impairs the glucose recovery rate after hypoglycaemia in insulin dependent diabetics, whereas selective β‐adrenoceptor blockade (metoprolol) does not have this side effect. The mechanism of the effect of propranolol is probably an attenuation of the gluconeogenesis secondary to deficient release of the important gluconeogenic substrates lactate and glycerol.
Circulatory Effects of Noise
Authors: Andrén L. , Hansson L. , Eggertsen R. , Hedner T. , Karlberg B. E.
Published: August 2010

Thirteen patients with mild essential hypertension, mean age 44 years (range 21–59), were studied during “stress” before and after postsynaptic α‐adrenoceptor blockade and combined postsynaptic α‐ and non‐selective β‐adrenoceptor blockade. Loud broad band noise (100 dBA for 10 min) was used as the stress stimulus. Exposure to noise caused a significant increase in systolic (7%, p<0.05), diastolic (9%, p<0.01) and mean arterial pressure (6%, p<0.01). The blood pressure elevation was caused by an increase in total peripheral resistance (12%, p<0.05). There was no significant change in heart rate, stroke volume or cardiac output. The blood pressure response during noise stimulation was not affected by postsynaptic α‐adrenoceptor blockade (prazosin, 2 mg orally). The hemodynamic reaction pattern, however, was totally reversed. Thus, the cardiac output increased significantly (9%, p<0.05), while the total peripheral resistance tended to decrease. Combined postsynaptic α‐ and non‐selective β‐adrenoceptor blockade (la‐be talol, 200 mg orally) inhibited the increase in systolic blood pressure caused by noise, while the diastolic and mean arterial pressures still increased significantly (5%, p<0.01). Labetalol effectively blocked the stress‐induced increase in total peripheral resistance and there was no significant increase in cardiac output after combined α‐ and β‐adrenoceptor blockade. Exposure to noise caused a significant increase in circulating noradrenaline (20%, p<0.05). Plasma adrenaline and plasma renin activity were not affected by noise stimulation. These results suggest that blood pressure elevation is essential during “stress” but that the hemodynamic pattern causing blood pressure elevation may vary and may be affected by pharmacological blockade of various parts of the sympathetic nervous system.
Iliac Crest Biopsy in the Diagnosis of Metabolic Bone Disease
Authors: Nilsson Bo E. , Wiklund Per‐Erik
Published: August 2010

The Burkhardt instrument is a useful tool for obtaining bone biopsies from the iliac crest in order to study bone tissue. Information on bone mass, however, is rather unreliable and iliac crest biopsy has also a low predictive value for spinal bone mass, whereas estimation of osteoid is more useful and this variable cannot be studied by any other means. Even if the precision is only 20% or even less, the differences between patients are considerable and useful information can therefore be obtained. It was demonstrated in an unselected group of patients that, even if the number of cases which could be classified as osteomalacia was small, there were significant deviations in the amount of osteoid in many groups.
Prolonged Campylobacter Gastroenteritis in a Patient with Hypogammaglobulinaemia
Authors: Pönkä Antti , Tilvis Reijo , Kosunen Timo U.
Published: August 2010

A female patient with hypogammaglobulinaemia had gastroenteritis due to Campylobacter fetus ssp jejuni of exceptionally long duration—4 months. The illness did not subside until a second course of erythromycin was given for 3 weeks. In patients with hypogammaglobulinaemia, Campylobacter fetus ssp jejuni infection should be kept in mind as a cause of prolonged diarrhoea in addition to Salmonella, Giardia lamblia and inflammatory diseases of the intestines.
Studies on High Density Lipoproteins in Fish Eye Disease
Authors: Carlson Lars A. , Holmquist Leif
Published: August 2010

ABSTRACT Serum high density lipoproteins (HDL) were isolated by preparative ultracentrifugation from two patients with fish eye disease (FED). Compared to HDL from control subjects the HDL particles of FED were characterized by their abnormally small size and a relative enrichment with polar lipids. No qualitative abnormalities of the HDL apolipo‐proteins were revealed upon Polyacrylamide disc gel electrophoresis or isoelectric focusing. The plasma pool of apolipoprotein A was reduced by 90%.
Serum Antibodies to Pigeon Antigens in Smokers and Nonsmokers
Authors: Andersen P. , Christensen K. M.
Published: August 2010

ABSTRACT Antibodies to pigeon antigens were determined by double immunodiffusion and ELISA in 80 pigeon breeders without pigeon breeder's disease. Precipitating antibodies to pigeon serum and droppings were found in 5 and 8%, respectively, of 39 breeders who were smokers and in 46 and 51 %, respectively, of 41 breeders who were nonsmokers (p<0.001). By ELISA, IgG antibodies to pigeon serum and droppings were detected in 44 and 54%, respectively, of smokers and in 81 and 85%, respectively, of nonsmokers (p<0.01). The antibody titres were generally higher in nonsmokers than in smokers. These findings may partly explain why allergic alveolitis occurs most often in nonsmokers.
The Drug‐Consuming Patient and His Drugs
Authors: Holmberg L. , Böttiger L. E.
Published: August 2010

ABSTRACTPatient characteristics and pre‐hospital drug consumption have been studied in 506 consecutive patients acutely admitted to a department of medicine. Women were older (median 69 years) than men (median 63 years) and weighed less (mean 60 vs. 74 kg). Serum creatinine values were above the normal limits in 110 patients (22%). Forty‐eight per cent of men and 26% of women were smokers. Heavy alcohol intake was found in 12 % of men and 4 % of women. It is concluded that a typical patient group shows much greater variations in age, weight, renal function, smoking and drinking habits—factors all known to influence the results of drug treatment—than is generally taken into account when routine drugs are prescribed.
Interferon Therapy in Recurrent Renal Carcinoma
Authors: Magnusson Kjartan , Christophersen Ivan Strøyer , Jordal Robert , Holm Hans Henrik , Mygind Thorkild
Published: August 2010

ABSTRACT Seven patients with recurrent renal carcinoma, who had previously been treated with progesterone and vinblastine for progressive disease, were treated with human leukocyte interferon (HuIFNα). Five patients received daily escalating i.m. IFN doses from 4times;10 up to 16×106 U during a minimum of 4 weeks, while two patients received intralesional IFN, 20×106 U/dose. No serious side‐effects were observed. No tumor response was found in any of these patients.
Plasma Lipid Transfer in Fish‐Eye Disease
Authors: Calvert G. D. , Carlson Lars A.
Published: August 2010

ABSTRACT Fish‐eye disease is a familial condition characterized by corneal opacities and dyslipoproteinaemia with, i.a., pronounced enrichment of plasma low density lipoprotein (LDL) with triglycerides. Cholesterol ester and triglyceride transferase activities in lipoprotein‐free plasma have been measured in two patients with fish‐eye disease and found to be normal. This indicates that a deficiency of plasma lipid transfer protein is not involved in the abnormal composition of LDL in fish‐eye disease.
Serum HDL Cholesterol in a High Coronary Risk Population in Eastern Finland
Authors: Salonen J. T. , Puska P. , Tanskanen A. , Virtamo J. , Tuomilehto J. , Huttunen J. K.
Published: August 2010

ABSTRACT The serum high density lipoprotein (HDL) and total cholesterol levels and their determinants were explored in a random population sample from eastern Finland, an area with an exceptionally high mortality and morbidity from coronary heart disease (CHD). A total of 1792 persons aged 14–65 years were studied. Serum HDL cholesterol was determined in one series by using an enzymatic method after precipitation by dextran‐magnesium chloride. The mean serum HDL cholesterol was 1.41 mmol/l in men and 1.62 mmol/l in women. Although a multivariate linear regression model explained 21% (for men) and 28% (for women) of the variation in serum total cholesterol, the same variables were able to account for only 9 and 4%, respectively, of the variation in serum HDL cholesterol. Among men, obesity and the daily consumption of tobacco products were inversely associated and the weekly consumption of beer and age were directly associated with serum HDL cholesterol and the serum HDL cholesterol/total cholesterol ratio.
Improvement of Peripheral Nerve Function after Institution of Insulin Treatment in Diabetes Mellitus
Authors: Agardh Carl‐David , Rosén Ingmar , Scherstén Bengt
Published: August 2010

ABSTRACT The influence of improved diabetic control on peripheral nerve function was studied before and 3–4 months after institution of insulin treatment in 22 diabetics unsatisfactorily controlled by oral hypoglycemic agents. After institution of insulin treatment, diabetic control was improved as demonstrated by decreasing levels of HbA1. There was an overall tendency towards improvement of motor and sensory conduction velocities, however significant only in the upper extremities. There was a tendency towards improved temperature sensitivity in the legs, while no changes occurred in the hands and face. The sensation for vibration did not change. It is concluded that improved diabetic control, even in elderly patients with long‐standing diabetes, is followed by neurophysiological signs of improved peripheral nerve function.
Incidence of Farmer's Lung Leading to Hospitalization and Its Relation to Meteorological Observations in Finland
Authors: Terho Erkki O. , Heinonen Olli P. , Lammi Seppo
Published: August 2010

ABSTRACT The standardized annual incidence of farmer's lung (FL) leading to hospitalization during 1980 in Finland was 50 per 100 000 persons employed in farming. Using preset uniform criteria, data were collected from all pulmonary disease units in the country. There were 186 new cases of FL in 1980. The mean age was 46 years, and 64% were women. Using the national population in 1975 as standard, the rates were standardized for age and sex. There were differences both in the incidence and in the sex ratio of FL among the farming population of the six districts of Finland. These differences are closely related to prevalent proportions of cattle raising among farmers and local cultural traditions in the various districts. Seasonal variation in the incidence of FL was statistically significant (Roger's test, p<0.001), the peak occurring in April. This confirms an earlier observation. The incidence rates were statistically significantly correlated with the sum and the mean of daily rainfall during the haymaking period preceding the diagnosis of FL.
Sustained Antihypertensive Effect of Captopril Combined with Diuretics and Beta‐adrenergic Blocking Drugs in Patients with Resistant Hypertension
Authors: Forslund Terje , Fyhrquist Frej , Hortling Lars
Published: August 2010

ABSTRACT Ten patients with severe hypertension and unsatisfactory blood pressure control during combined therapy with β‐adrenergic blocking drugs, diuretics, and vasodilators were treated with gradually increasing doses of captopril. Vasodilators were discontinued 24 hours prior to captopril administration. Six patients had essential, two renal, and two renovascular hypertension. Mild renal impairment was observed in four patients. Captopril effectively decreased blood pressure for 3 hours in all patients after the first dose. The antihypertensive effect appeared to be triphasic and was sustained in all but one patient during 12 months of observation. Captopril doses of 25–75 mg t.i.d. were sufficient to achieve acceptable blood pressure control (RR≦160/100 mmHg) when given in the above mentioned combination. Side‐effects were few and tolerable and discontinuation of captopril was not required.
Serum Ascorbic Acid in Patients Undergoing Chronic Hemodialysis
Authors: Pönkä Antti , Kuhlbäck Börje
Published: August 2010

ABSTRACT Serum presupplementation ascorbic acid levels were subnormal in 8 out of 10 patients undergoing chronic hemodialysis with capillary film and capillary flow dialyzers, the mean duration of treatment being 11 months. Supplementation with 100 mg ascorbic acid daily for two weeks raised the ascorbic acid values to normal in 9 out of 10 patients. After supplementation with 500 mg daily, all patients had ascorbic acid levels exceeding the normal upper limit, and 3 of them had gastrointestinal side‐effects. The mean blood pH value, measured in 24 patients on chronic hemodialysis, showed a significant, though slight, decrease during supplementation with 500 mg daily as compared with the mean presupplementation value, but no statistically significant changes were observed in blood bicarbonate, base excess or Pco2 values.
Evaluation of Euglobulin Clot Lysis Time as a Screening Method for Determination of Blood Plasma Fibrinolytic Activity after Venous Occlusion
Authors: Boberg M. , Killander A.
Published: August 2010

ABSTRACT Determination of the fibrinolytic activity should be performed in patients with recurrent thromboembolic disease. As a screening procedure we suggest the euglobulin clot lysis time test after venous occlusion. This test is sufficiently reliable and easier to perform than the fibrin plate method, especially outside coagulation laboratories.
Malignant Carcinoid Tumour Complicating Coeliac Disease
Authors: Hallert Claes , Norrby Klas
Published: August 2010

ABSTRACT A man with coeliac disease diagnosed in adult life developed a malignant carcinoid tumour in the ileum. Although previously unreported, the association may not be fortuitous in the light of recent observations showing consistent abnormalities in the enterochromaffin cell population in the damaged coeliac mucosa
Reduction of the Veno‐Arteriolar Reflex Induced Arteriolar Constriction in Forearm Subcutaneous Tissue after Surgical Repair of Aortic Coarctation
Authors: Henriksen Ole , Skagen Knud , Amtorp Ole
Published: August 2010

ABSTRACTArteriolar constriction in subcutaneous tissue elicited by the local sympathetic veno‐arteriolar axon reflex was studied in subcutaneous tissue of forearm and leg in 4 patients before and after correction of aortic coarctation. Before the operation the local axon reflex induced an average increase of 154 % in vascular resistance in the “hypertensive” forearm and of 76% in the leg. Following coarctectomy the local axon reflex induced increase in vascular resistance decreased in the forearm within 6 months in all patients. Now average increase in vascular resistance was only 109% 3 months after the operation and 45% 6 months after. Minimal vascular resistance in the papaverine relaxed vascular bed was reduced, whereas no systematic changes were seen in the distensibility of the vascular bed. The results indicate that adaptive vascular changes underlying the augmented arteriolar constriction during lowering as well as the increased “minimal vascular resistance” in the forearm are at least partly reversible following coarctectomy.