bluuebunny/crossref_metadata_2025 huggingface dataset:
Exercise Performance and Body Dimensions in Anorexia Nervosa before and after Rehabilitation
Authors: Fohlin Lars
Published: August 2010

ABSTRACT. Three boys and five girls (mean age 15.0 y.) with anorexia nervosa (AN) were studied before and after a treatment which restored their body weight to normal. Before treatment the patients' average weight loss was 25% of their pre‐morbid weight. The function and dimensions of the oxygen transport system were determined with heart (HV) and blood (BV) volumes, lean body mass (LBM) and exercise tests on a bicycle ergometer with determination of maximal aerobic power (Vo2 max). Before treatment, the patients had bradycardia and hypotension. HV and BV decreased in proportion to the loss of body weight. During maximal exercise, attainable oxygen uptake and heart rate were low. Vo2 max decreased out of proportion to the circulatory and body dimensions. After treatment, HV and BV increased in proportion to the rise in body weight. LBM increased significantly in all patients. Heart rates at rest and during exercise were within the range of normal and Vo2 max increased. It is concluded that the circulatory system is highly adaptive to the low caloric intake in AN and is totally normalized after weight gain.
Serum Zinc Concentrations in Finns
Authors: Björkstén F. , Aromaa A. , Knekt P. , Malinen L.
Published: August 2010

ABSTRACT. Serum zinc concentrations were measured in 1416 Finns aged 15 years and above and belonging to 18 population groups living in various parts of the country. The mean serum zinc concentration was for men 12.7 μmol/1 (82 μg/100 ml) and for women 11.7 μmol/1 (77 μg/100 ml). Zinc levels varied with sex, age, length of fast, time of day and geographic area. It is noted that the incidence of coronary heart disease, the occurrence of a number of elements in soil and water, and the zinc level in human sera can in a statistical sense be linked to soil composition in Finland. Causal relationships, however, remain obscure.
Taste Dysfunction and Changes in Zinc and Copper Metabolism during Penicillamine Therapy for Generalized Scleroderma
Authors: Knudsen Lone , Weismann Kaare
Published: August 2010

ABSTRACT. The taste function and the zinc and copper levels in serum and urine were followed for up to 16 weeks in ten patients who were started on penicillamine therapy for generalized scleroderma (9 patients) and rheumatoid arthritis (one patient). During therapy the serum zinc concentration remained unchanged, whereas the serum copper concentration increased significantly during the first 4–5 weeks and then tended to decrease. Urinary copper rose significantly and remained considerably above the upper normal limit throughout the study. Six of the patients complained after about 4–5 weeks of a decreased taste function, which was gradually restored whether the medication was stopped or continued. The alterations in the taste acuity for sweet, salt, sour, and bitter significantly paralleled the variations in urinary copper before as well as during therapy. Thus, the patients who showed the most pronounced loss of taste, had a lower urinary copper output than those whose taste acuity was less disturbed.
Intracutaneous Herniation of Fat in Connection with Microangiopathia Diabetica
Authors: Einarsson Kurt , Hård Stig , Leijd Barbro , Neumann Emit
Published: August 2010

ABSTRACT. Three women with diabetes mellitus presented an unusual change in the skin on the distal and acral parts of the extremities, most distinctly on the upper surface of the hands. The surface was raised in small cushions but had the colour of intact skin. The skin felt doughy and swollen on palpation but there was no oedematous pitting. It had been suspected earlier that these skin changes indicated myxoedema or heart disease and the patients had been treated with diuretics. In all three cases, however, histological examinations revealed a more or less reduced, atrophic dermis with here and there an appreciable dislocation of the subcutaneous layer of fat, which with the sweat glands formed an intracutaneous herniation up against the epidermis. These histological changes explained the clinical picture of cushions in the skin. As these patients had diabetes mellitus and the histological picture also included vascular changes of the type associated with a diabetic microangiopathy, it is considered that this form of intradermal herniation of fat is yet another skin change which may be elicited by diabetes mellitus.
Influence of Sodium Intake on Hydrochlorothiazide‐Induced Changes in Blood Pressure, Serum Electrolytes, Renin and Aldosterone in Essential Hypertension
Authors: van Brummelen P. , Schalekamp M. , de Graeff J.
Published: August 2010

ABSTRACT. To determine the influence of dietary sodium intake on the effects of hydrochlorothiazide (HCT) on blood pressure (BP), serum electrolytes, renin and aldosterone, nine male patients with uncomplicated essential hypertension were studied during the following therapeutic regimes: 1) sodium restriction alone (50 mmol/day), 2) sodium restriction combined with HCT (50 mg twice daily), 3) HCT alone, and 4) sodium restriction combined with HCT. Low sodium diet alone and HCT alone lowered BP to the same extent. The combination of HCT and sodium restriction had no extra effect on supine BP, but elicited complaints of dizziness and weakness in each patient, and overt orthostatic hypotension in three cases. Sodium restriction during HCT treatment caused hyponatraemia and aggravated hypokalaemia. Hyponatraemia could not be accounted for solely by changes in cumulative sodium balance. Plasma renin concentration rose markedly during the combined treatment. Plasma aldosterone was normal during HCT alone, but elevated when HCT was combined with sodium restriction. These results cast some doubt on the therapeutic value of prescribing a low sodium diet to patients with essential hypertension treated with thiazide diuretics. Overactivity of the renin‐angiotensin‐aldosterone system during this regime might explain both the lack of a beneficial effect on BF and the adverse influence on serum potassium.
Oesophageal Function and Coronary Angiogram in Patients with Disabling Chest Pain
Authors: Svensson Olof , Stenport Göran , Tibbling Lita , Wranne Bengt
Published: August 2010

ABSTRACT.Sixty‐four patients with a history of disabling chest pain belonging to groups III or IV classified according to the NYHA criteria were examined with oesophageal function tests, coronary angiography and bicycle ergometry and also answered a symptom questionnaire. At the exercise test, 52 had effort angina; 45 (89%) of them had a pathological coronary angiogram and 22 (42%) had signs of oesophageal dysfunction (OD). OD as the single possible etiological factor for typical effort angina therefore seemed unlikely. Chest pain was absent or atypical at the exercise test in 12 patients, 11 (92%) of whom had signs of OD. This incidence is significantly higher (p<0.01) than that found in the patients with effort‐related chest pain. Five (42%) of the 12 patients with atypical chest pain at the exercise test had a pathological coronary angiogram, an incidence which is significantly lower (p<0.001) than that found in the group with effort‐related chest pain. In patients with a history of disabling chest pain but with atypical chest pain in connection with the exercise test, OD was more frequent than coronary disease and therefore more likely to have caused the symptoms.
Renin Release in Relation to Plasma Noradrenaline during Supine Exercise in Cardiac Patients
Authors: Hesse Birger , Christensen Niels Juel , Andersen Ellen Damgaard
Published: August 2010

ABSTRACT. Plasma renin activity in the brachial artery and in the renal vein together with arterial noradrenaline Concentration were determined repeatedly during and after 10 min of dynamic exercise in eight cardiac patients. Arterial renin increased slightly during exercise and gradually returned to control level after exercise. Renal vein renin increased markedly during exercise and returned to the resting value immediately after exercise, similarly to the changes in plasma noradrenaline and heart rate. A close temporal relationship between the changes in the renal veno‐arterial renin difference, plasma noradrenaline and heart rate strongly suggests that the sympathetic nervous system is a major determinant of renin release in man during exercise.
Salmon Calcitonin in the Acute Treatment of Moderate and Severe Hyperealcemia in Man
Authors: Nilsson Ove , Almqvist Sven , Karlberg Bengt E.
Published: August 2010

ABSTRACT. The effect of i.v. infusions with salmon calcitonin was evaluated in the treatment of acute hypercalcemia in 12 patients. Clinical improvement and a less critical level of serum calcium were achieved within 24 hours for eight of the patients, for another two after treatment for 48 hours. In malignant conditions (six patients) calcitonin was less effective, which could be evaluated within 24 hours. In addition to rehydration, the rapid onset of action and the lack of side‐effects make calcitonin a drug of first choice in the treatment of acute hypercalcemia.
C‐Reactive Protein, C3, C4 and Properdin during the Jarisch‐Herxheimer Reaction in Early Syphilis
Authors: Kindmark Claes‐Otto , Möiler Halvor , Persson Kenneth
Published: August 2010

ABSTRACT. The Occurrence of plasma CRP during the febrile response after the first injection of penicillin was followed in 10 patients with early syphilis. An increase in CRP was noted after 12 hours, with a maximum after 24 hours. The appearance of this acute phase protein could not be correlated to cutaneous reaction, increased body temperature or leukocytosis, nor were baseline values of CRP correlated to clinical or serological activity of the infection. Patients with high levels of CRP prior to treatment suffered the most intense systemic reactions. No activation of the complement system during the Jarisch‐Herxheimer reaction was detected from sequential determinations of C3, C4 and properdin.
Severity of Aortic Stenosis Assessed by Carotid Pulse Recordings and Phonocardiography
Authors: Nesje Ola Alfred
Published: August 2010

ABSTRACT. The external carotid pulse, the PCG, and the ECG were studied in 26 adult patients with valvular aortic stenosis whose systolic peak pressure gradients ranged from 18 to 165 mmHg. A significant correlation was found between the rapidity of the pulse upstroke, as measured by the T‐time, and the location of the peak of the systolic murmur during ventricular ejection, on the one hand, and the gradient, on the other. The left ventricular ejection time (LVET) related directly and the pre‐ejection period (PEP) indirectly with the gradient. There was a significant inverse relationship between the PEP/LVET quotient and the pressure gradient but this quotient did not classify the patients according to the severity of the stenosis as well as the T‐time and the location of the peak of murmur. When a combination of the T‐time, the PEP/LVET, and the location of the peak of murmur was used in each patient, a good discrimination between the patients was achieved. When the pressure gradient was above 50 mmHg, at least one of these measurements was abnormal and when it exceeded 100 mag, at least two measurements were abnormal. The study further showed that it is possible to separate patients with valvular aortic stenosis from those with hypertrophic obstructive cardiomyopathy (idiopathic hypertrophic subaortic stenosis) or mitral insufficiency on the basis of carotid pulse tracings and PCGs.
Natural History and Life Expectancy in Severe Alpha1‐Antitrypsin Deficiency, Pi Z
Authors: Larsson Christer
Published: August 2010

ABSTRACT. Clinical data from 246 adult Swedish individuals with severe α1‐antitrypsin deficiency, Pi Z, diagnosed in 1963‐77, were analyzed. Primary emphysema was present in 109 cases. Of 75 Pi Z patients with other types of chronic obstructive pulmonary disease (COPD), all but 7 showed signs of emphysema. Median age at onset of dyspnoea in Pi Z smokers was 40 years, compared to 53 in non‐smokers (p<0.001). Of the Pi Z individuals over the age of 50, 19% had a diagnosis of liver cirrhosis and 15% signs of glomerular renal damage. Of 91 deceased patients, 56 died from COPD and 12 from liver disease. A greatly reduced survival was demonstrated in Pi Z individuals, regardless of sex. Smoking Pi 2 individuals had a significantly lower life expectancy than Pi Z non‐smokers (p<0.01).
Myxoedema and Thyrotoxicosis: Relations between Clinical State and Concentrations of Thyroxine and Triiodothyronine in Blood
Authors: Johansen Klaus , Hansen Jens Mølholm , Skovsted Lis
Published: August 2010

ABSTRACT. The clinical manifestations in thyrotoxic and myxoedematous subjects were assessed by clinical diagnostic score indices and related to the free thyroxine index (FT4I) and the free triiodothyronine index (FT3I), basal metabolic rate (BMR) and in the hypothyroid patients to serum thyrotropin (TSH) level. The clinical score index was significantly correlated to both FT4I and FT3I in both groups of patients. No difference existed in degree of correlation between the clinical score index, on the one hand, and FT3I and FT4I, on the other, in either thyrotoxlc or myxoedematous subjects. The degree of correlation between clinical sore index and FT3I and FT4I was higher than that between the thyroid hormones and BMR. The clinical score index thus appears to be a better indicator of severity of hyper‐and hypothyroidism than BMR. Serum TSH concentration was not correlated to the clinical state.
Ventricular Extrasystoles and Intracellular Electrolytes in Hypokalemic Patients before and after Correction of the Hypokalemia
Authors: Dyckner Thomas , Wester P. O.
Published: August 2010

ABSTRACT. Fifty‐four initially hypokalemic patients, 43 of whom were on diuretic treatment, were given potassium supplementation until they showed a repeatedly normal serum potassium level. Muscle specimens obtained by percutaneous biopsy revealed that there were no concomitant increases in muscle potassium content, nor in intracellular potassium concentration, except in the very small group (6 patients) with a muscle magnesium content of >3.95 mmol/100 g fat free dry solids (FFDS) and an initially lower muscle potassium content (<39.9 mmol/100 g FFDS). ECG, registered for 3 hours on a portable ECG tape recorder before and after correction of the serum potassium level, showed no change in the frequency of ventricular ectopic beats.
Premonitory Symptoms and Stress Factors Preceding Sudden Death from Ischaemic Heart Disease
Authors: Rissanen Viljo , Romo Matti , Siltanen Pentti
Published: August 2010

ABSTRACT. Premonitory symptoms as well as acute and long‐standing stress preceding death were studied in 118 cases of prehospital sudden death, 62% of whom had shown premonitory symptoms. Prodromes were found in 94% of those whose fatal attack lasted longer than 2 hours. Premonitory symptoms seemed often to be unspecific in nature in cases of sudden death compared with those experienced by survivors of acute myocardial infarction. The occurrence of prodromes correlated with normal heart weight but not with the severity of the coronary artery disease or the presence of coronary thrombosis. Heavy smoking and a definite myocardial infarction revealed at autopsy were more frequent in those who had prodromes classifiable as unstable angina than in those with unspecific symptoms or without prodromes. The significance of acute and long‐standing stress was most evident in the fatality of subjects with no long history of clinical disease. Although stress factors seemed to modify the course of the attack, a basic factor in the fatality was the coronary artery disease of critical severity. Stress factors did not play a major role in the precipitation of premonitory symptoms. Stress in patients with triple vessel disease in the coronaries was, however, more frequently (88%) conductive to prodromes than in those with double or single vessel disease (50%).
Cerebral Attacks due to Excessive Vagal Tone in Heavily Trained Persons
Authors: Rasmussen Verner , Haunsø Stig , Skagen Knud
Published: August 2010

ABSTRACT. Cardiac syncopes appeared in four heavily trained male patients without a history of cerebral or heart disease. Three were young athletes participating in competitive sport, one had trained intensively for years after poliomyelitis complicated by paraplegia. On admission all patients had sinus bradycardia; one had second degree atrioventricular (AV) block at rest, and one had transient sinoatrial (SA) block. His bundle studies demonstrated prolonged recovery time of the SA node (SAN) in two, prolonged atrio‐His interval in three, and appearance of second degree AV block at abnormally low pacing rates in two. Refractory periods of the AV node (AVN), determined in three, tended to reach the upper limit of the normal range. The dysfunction of SAN and AVN was temporarily abolished in all patients by 1 mg of atropine i.v., and disappeared during exercise test, which was done by the three young athletes. The patient with paraplegia and one of the young athletes, who had second degree AV block at rest, were given atropine, 0.5 mg six times a day, and all three active sportsmen reduced training activity considerably. After 6–12 months all patients were re‐examined. None had cerebral symptoms or other complaints. They were in regular sinus rhythm and in excellent physical condition.
The Shock Liver
Authors: Birgens Henrik S. , Henriksen Jens , Matzen Peter , Poulsen Hemming
Published: August 2010

ABSTRACT. Five patients with severe heart disease developed cardiogenic shock of more than 24 hours' duration. As a sequela to the shock, severe liver affection was demonstrated. Serum aspartate aminotransferases and serum lactate dehydrogenases showed very high activities. The prothrombin‐proconvertin index was reduced to less than 25% of the normal. Four of the patients were jaundiced. The condition gave rise to some differential diagnostic problems. Liver biopsies were available from four of the patients, and histological examination of an autopsy specimen of the liver was performed in each case. The liver histology showed centrilobular necrosis and haemorrhage in all patients. It seems that centrilobular fibrosis develops later in the condition. The pathogenesis of this liver affection is probably hypoxic injury to the centrilobular areas of the liver lobule due to reduced liver blood flow.
Non‐Secretory or Low‐Secretory Myeloma with Intracellular Kappa Chains
Authors: Turesson Ingemar , Grubb Anders
Published: August 2010

ABSTRACT. This report concerns six cases of multiple myeloma characterized by either no demonstrable monoclonal immunoglobulin in plasma or urine or by trace amounts (≤0.1 g/***1) of monoclonal kappa chains in the urine. In all cases there was an infiltration of the bone marrow by plasma cells containing kappa chains but no heavy chains. A retrospective analysis was made of 126 consecutive cases of Bence Jones myeloma. The number of kappa and lambda cases was approximately the same. AH cases secreting ≤0.1 g light chains per 1 urine were of kappa type. This contrasts with a kappa/lambda ratio of 1.4‐1.9 among reported series of M‐components containing both heavy and light chains. A review of reported cases of non‐secretory myeloma revealed a preserved capacity for Ig synthesis in the majority of cases and among these a preponderance of kappa chain producing clones. These observations might be explained by a higher tendency for kappa chain producing cells to mutate to low secretors or to cells producing abnormal light chains which are catabolized rapidly. The clinical data from our patients do not indicate a more pessimistic prognosis in non‐ or low‐secretory myeloma, than in other cases of multiple myeloma.
Quantitation of J Chain in Human Biological Fluids by a Simple Immunochemical Procedure
Authors: Grubb Anders O.
Published: August 2010

ABSTRACT. The molecular form and immunochemical properties of the J chain populations released on reduction and carboxymethylation of normal human plasma, milk, saliva and of plasma containing IgA or IgM M‐components were investigated. A procedure was devised to release the entire J chain population from these various sources and to produce immunochemically identical J chain populations containing only J chain monomers. AH identical standard J chain population was purified and quantitated by physiochemical means. A specific rabbit anti‐J chain antiserum was raised against this pure J chain population. A simple and rapid immunochemical method for J chain quantitation in complex biological fluids as well as in solutions of pure polymeric immunoglobulins was constructed on these grounds. The J chain concentration was found to be (mean +S.D.) 1.74+0.65 μM in normal human plasma, 1.94+1.21 μM. in human milk and 0.48+0.26 +M in human saliva. The J chain/IgA molar ratio was found to be (mean+S.D.) 0.4S+0.07 in human milk and 0.52+0.09 in human saliva when the IgA concentration was expressed as monomeric units per volume unit. The range of the J chain/IgA molar ratios in plasma samples with highly concentrated IgA M‐components was 0‐0.64. The J chain/IgM molar ratio in plasma samples with highly concentrated IgM M‐components was between 1 and 2 when the IgM concentration was expressed as pentameric units per volume unit.
Congenital Aortic Stenosis
Authors: Vukas M. , Carlgren L.‐E. , Swedberg J.
Published: August 2010

ABSTRACT. The magnitude of the peak systolic pressure gradient (PSPG) over the aortic valve was often the determining factor when deciding for or against operation of the congenital aortic stenosis. The impression that PSPG alone was an inadequate parameter for assessment of the degree of stenosis was supported by the present retrospective analysis of 32 patients operated upon for this anomaly. A gradient of 75 mmHg or more indicates a tight stenosis but a lower value does not exclude a pronounced constriction of the orifice, any more than does absence of symptoms or signs of left ventricular hypertrophy (LVH) on the ECG. It is probably not only the size of the stenotic orifice that determines the prognosis in aortic stenosis but also other factors, e.g. function of the left ventricular myocardium. A hypothesis was put forward by one of us (M. V.) that the location of the valvular ostium, central or peripheral, can be of importance and that turbulence‐induced vibrations of the left ventricular wall may depress the myocardium. Differences in the pathoanatomy of the stenotic aortic valves did not explain the poor correlation between e.g. symptoms or LVH and PSPG or the size of the remaining orifice in the present study.
The Diagnostic Value of Protein Clearances in Rejection of Human Renal Allografts
Authors: Hemmingsen L. , Jensen H. , Jest P. , Skaarup Dr.P.
Published: August 2010

ABSTRACT. The relative clearances of transferrin, haptoglobin, IgG, and IgA were used as a diagnostic test for detection of acute rejection episodes after renal transplantation, using an automated immunoprecipitin reaction. Thirty‐six out of 40 rejections were predicted by 0–5 days. The sensitivity and specificity were 90% and 98%, respectively. The predictive value of a positive diagnostic test was 86% and of a negative 99%. False positives caused by fever and urinary obstruction could probably be excluded by the finding of an increased urinary excretion of β2‐microglobulin prior to the increased relative clearance of transferrin, haptoglobin, IgG and IgA. This would improve the predictive value of a positive test to 95%. Daily or more frequent protein clearance determinations should be performed in renal transplant patients, since the method used was easy, rapid and suited for sequential analysis, and the procedure was without risk for the patient.
Platelet Aggregation in Diabetes Mellitus
Authors: Petersen Hans Draminsky , Gormsen Johs.
Published: August 2010

ABSTRACT. Thirty‐eight patients with juvenile diabetes mellitus, aged 21–77, were tested for platelet aggregation in vitro. Vascular complications were found in 20 patients and diabetic retinopathy in 16 of these. All patients received their usual dose of insulin in the morning on the day of the examinations, which were carried out shortly before or 2–3 hours after lunch. Ninety normal controls were tested at the same time of day. The aggregation was estimated turbidometrically and defined by the threshold concentration of adenosine diphosphate or adrenaline that produced a secondary aggregation with a light transmission not less than 80% of that given by the platelet‐poor plasma. No significant differences could be demonstrated in platelet aggregation between the normal controls and the patients with diabetes mellitus or any subgroup of these. No correlation was found between the threshold concentrations and the plasma levels of glucose or β‐hydroxybutyric acid.
The Excretional Patterns of Lactate, Pyruvate and α‐Ketoglutarate in Renal Transplants
Authors: Hansen Hans Erik , Skov Poul Erik
Published: August 2010

ABSTRACT. The excretional patterns of lactate, pyruvate and α‐ketoglutarate were investigated after renal transplantation in 36 patients. Fourteen patients had received a living‐donor kidney with short ischemia time and good initial graft function, 22 had a cadaver transplant with an initial 125iothalamate clearance of more than 6 ml/min. The excretion of lactate and pyruvate did not vary significantly from that seen in normal controls or patients with uremia. In six patients with cadaver transplants, clearance values of α‐ketoglutarate exceeded that of the glomerular filtration rate, indicating a net tubular secretion of this substance. During acute rejection episodes in 5 patients, no changes were seen in the excretional patterns of lactate, pyruvate and α‐ketoglutarate.
Surgical Treatment of Myelomatosis—A Review of 18 Cases
Authors: Unander‐Scharin L. , Waldenström J. G. , Zettervall Olle
Published: August 2010

ABSTRACT. The authors review 18 patients with multiple myeloma who had bone destruction of a kind that indicated surgical therapy. Eight patients had paraplegic myelopathy and one had compression of the cauda equina. Four of them displayed partial to complete regression. One patient lived for 77 months after the operation, most of the time in excellent condition. The operative technique is discussed, with laminectomy, exeresis, filling of bone with cement and, in some instances, mechanical support from metal plates. Early diagnosis and operation is imperative, postoperative irradiation obligatory in severe cases. Radiation alone may be the method of choice in early stages. The other 9 patients were operated upon for bone destruction in the limbs. A Moore operation on the destroyed hip was performed in one patient, who lived in excellent condition for about four years. Active surgical therapy combined with radiation and cytostatics seems to be of value in many patients with multiple myeloma.
Serum Inorganic Phosphate and Serum Calcium in Middle‐Aged Men
Authors: Lindgärde Folke , Trell Erik
Published: August 2010

ABSTRACT.Fasting scrum inorganic phosphate and fasting serum calcium were measured in 752 49‐year‐old Malmö males, in whom an oral or i.v. glucose tolerance test, in 189 cases including plasma insulin measurements, was performed as part of an internal medical screening examination. The serum inorganic phosphate and calcium levels were analysed statistically in relation to various glucose and insulin response parameters. A significant, positive correlation of serum inorganic phosphate with the early insulin response in the i.v. glucose tolerance tests was found but not with any of the other glucose or insulin response parameters included in the study. Serum calcium showed no significant correlations. These findings are discussed in relation to the pertinent literature.
Plasma Renin Activity, Aldosterone and Sodium Excretion in Women with High and Low Casual Blood Pressure Levels
Authors: Thulin Thomas , Karlberg Bengt E. , Scherstén Bengt
Published: August 2010

ABSTRACT. Sixty‐four women not under treatment for hypertension were selected from a population survey and examined with respect to the relationships of BP levels to plasma renin activity (PRA), plasma aldosterone as well as to the 24‐hour urinary excretion of aldosterone, potassium and sodium under strictly defined conditions. The subjects were selected from groups with BP levels above the 95th (group A) and below the 30th percentile (group B). The two groups were age‐matched. PRA and plasma aldosterone were measured after one hour of complete rest in the recumbent position (basal PRA and basal plasma aldosterone), PRA was also measured after four hours of ambulation (upright PRA), as well as four hours after oral administration of 80 mg frusemide (stimulated PRA). The decline of PRA and of urinary aldosterone excretion with increasing age were related to the BP level but not to the menopause. No correlations were found between PRA or plasma aldosterone, on the one hand, and urinary sodium excretion, on the other, in women on random diets. Therefore, it is doubtful whether the correction of PRA levels for urinary sodium excretion is worthwhile unless marked sodium depletion or sodium loading is used. Basal plasma aldosterone showed a high interindividual variability and was not correlated to age or BP.
Glomerulonephritis in Dermatitis Herpetiformis
Authors: Pape J. F. , Mellbye O. J. , øystese B. , Brodwall E. K.
Published: August 2010

ABSTRACT. A patient with dermatitis herpetiformis, proteinuria and reduced renal function is described. A renal biopsy studied by light and immunofluorescence microscopy revealed a glomerulonephritis with deposits of predominantly IgA and complement C3. Deposits of IgA and C3 were also demonstrated in a biopsy from normal skin, and a common pathway for the skin and renal lesions is suggested.
Activated F IX Concentrate (FEIBA) Used in the Treatment of Haemophilic Patients with Antibody to F VIII
Authors: Stenbjerg S. , Jørgensen J.
Published: August 2010

ABSTRACT. Bleeding episodes in five haemophiliacs with antibody to F VIII were treated by activated F IX concentrate (FEIBA). Relief of pain and haemostasis in affected muscles and joints were recorded in each case. One patient developed a mild attack of disseminated intravascular coagulation with an uneventful recovery. A substantial rise in natural inhibitors of coagulation was seen in two patients, and all but one experienced a rise in F VIII antibody titer.
Analysis of Extramedullary Erythropoiesis in the Spleen by a Semiquantitative Method Using Indium‐111
Authors: Rojer R. A. , Mulder N. H. , Nieweg H. O. , Edin M. R. C. P. , Beekhuis H. , Piers D. A. , Woldring M. G.
Published: August 2010

ABSTRACT. A semiquantitative method for evaluating the splenic uptake of 111In is described. With this method the uptake of indium in the spleen was significantly higher in seven patients with extramedullary erythropoiesis (EME) than in a control group of seven patients with comparable degrees of splenomegaly but without clinical and/or histological signs of EME. The discrimination between these groups could be further improved by also taking the degree of splenomegaly into account. It is concluded that the described technique is a valuable non‐invasive aid for establishing the presence of EME in the spleen.
Conversion of the Electrophoretic Pattern of Type IV Hyperlipidaemia to Type III by Intravenous Heparin
Authors: Olsson A. G. , Carlson L. A. , Carlson K.
Published: August 2010

ABSTRACT.Heparin was given i.v. to subjects with type IV hyperlipoproteinaemia who had only ordinary pre‐βlipoproteins and no late pre‐βlipoproteins (LP‐β) in their very low density lipoproteins (VLDL,d >1.006) upon agarose gel lipoprotein electrophoresis. Within 15 min the electrophoretic pattern of VLDL had changed completely. The normal pre‐βlipoproteins had disappeared and a discrete LP‐βlipoprotein had appeared. This new electrophoretic pattern, induced 15 min after heparin, is similar to that diagnostic of type HI hyperlipoproteinaemia. It is suggested that the LP‐βlipoproteins represent an end stage in the catabolism of VLDL.
Myocardial Scintigraphy with 99mTc‐Pyrophosphate in Patients with Unstable Angina Pectoris
Authors: Lessem Jan , Johansson Bengt W. , Nosslin Bertil , Thorell Jan
Published: August 2010

ABSTRACT. A total of 400 patients, aged 25–82 years, admitted to the Coronary Care Unit due to clinical suspicion of acute myocardial infarction, were examined with 10 mCi 99mTc labelled to pyrophosphate. The examinations were carried out 4–120 hours post onset of symptoms, with a mobile gamma camera. Scintigrams were evaluated with regard to presence, localization and intensity of an uptake. Among 249 patients with a verified acute myocardial infarction, uptake was found in 237. Sixty‐two of 85 patients with unstable angina showed a diffuse uptake with low intensity. Scintigraphy could not be used as a prognostic index of which patients would later develop an infarct. However, the scintigraphic pattern was useful as an aid in the differential diagnosis between acute myocardial infarction and unstable angina.
Patients with High‐Grade Atrioventricular Block Treated and not Treated with a Pacemaker
Authors: Ohm Ole‐Jørgen , Breivik Kjell
Published: August 2010

ABSTRACT.One‐hundred and eighty‐one patients with chronic and with intermittent high‐grade atrioventricular block (AVB) were studied retrospectively. Seventy‐one were treated with fixed‐rate, 51 with demand‐type pacemaker, 59 were treated conservatively. Observation time was three years minimum and 14.5 years maximum. The mean age was about seven years higher, and 8.7% more patients had chronic AVB in the conservatively treated than in the pacemaker‐treated group. About 12% more patients had Adams‐Stokes attacks in the pacemaker group than in the conservatively treated group. There were 7% more patients with coronary heart disease (CHD) in the pacemaker group, and 10% more with aortic valve disease among the conservatively treated. Totally 4.4% of the patients had a calcification of the mitral annulus fibrosus. The two groups were comparable as regards functional class (NYHA) and heart size. Survival showed 31% more sudden deaths in the conservatively treated than in the pacemaker group. Sudden deaths were not more frequent among the patients with CHD than in those without. Long‐term survival showed the more favourable result for the patients with than without pacemaker treatment. There were eight (11.3%) unexplained sudden deaths among the patients treated with fixed‐rate pacemaker, only three (5.9%) among those treated with a demand unit. The fixed‐rate and the demand units showed a mean longevity of 37.2 and 34.6 months, respectively.
10. THALLIUM201 EXERCISE TESTING IN CORONARY ARTERY DISEASE
Authors: Murray R.G. , McKillop J.H. , Bessent R.G. , Greig W.R. , Lorimer A.R.
Published: August 2010

Myocardial imaging was performed following intravenous administration of Thalliumzo1 (TIm1)at rest and during maximal exercise testing in 39 patients presenting with chest pain. Image data were computer analysed and compared with the results of coronary arteriography and left ventriculography.

In 26 patients with coronary artery disease (CAD) TIm1 perfusion defects were present in 12 at rest and 24 on exercise. In 13 patients with normal vessels, perfusion defects were present in 2 at rest and one on exercise.

Resting TI201 image data corresponded to the presence or absence of impaired LV wall mo‐ tion in 21 of 26 patients with coronary artery disease. Exercise scans were more accurate than rest scans in detecting the presence of CAD,(TI201:scintigram‐rest sensitivity‐ 46 %; exercise sensitivity‐92 %; P < 0.005). Perfusion defects on the exercise T1201 scinti‐ gram tended to reflect the distribution of vessel disease, but prediction of individual coronary lesions from the scan findings was not possible.

These data suggest that TI201 myocardial im‐ aging is a useful non‐invasive technique for the investigation of patients presenting with chest pain. Rest P I scintigrams correspond to LV appearance on the ventriculogram and perfusion defects on the exercise TIrn1 scintigram detect the presence of CAD.
Creatine kinase isoenzymes in the confirmation of acute myocardial infarction
Authors: Konttinen Aarne
Published: August 2010

Serum MB isoenzyme of creatine kinase is the most specific and sensitive indicator of myocardial infarction. Despite these virtues, its clinical use is handicapped by rapid normalization after the onset of myocardial injury. In patients suffering brain accidents, the increase of serum CK‐MB isoenzymes indicates simultaneous myocardial damage and means poor prognosis.
The Effect of Suppressive Therapy of Nontoxic Diffuse Goiter on Serum Levels of Thyroxine, 3,5,3‘‐Triiodothyronine and 3,3’,5‘‐Triiodothyronine
Authors: Johansen Klaus , Hansen Jens Mölholm , Perrild Hans , Skovsted Lis , Kampmann Jens Peter
Published: August 2010

ABSTRACT We studied the effect of suppressive therapy with graded doses of thyroxine (T4) on serum levels of T4, 3,5,3′‐triiodothyronine (T3) and 3,3′,5′‐triiodothyronine (rT3) in patients with diffuse, nontoxic goiter. For comparison and in order to elucidate the degree of suppression of the pituitary thyroid axis by T3 the effect of suppressive therapy with T3 was studied in the same type of patients. We found that T4 in serum rose significantly to a constant level during T4 treatment (0.10, 0.15 and 0.20 mg/day). Dose‐related rises in T4 were only seen after 3 months of treatment. T3 and rT3 only changed minimally. The T4/T3 ratio rose to a constant level during the initial 3 months of treatment. T3/rT3 ratio remained unchanged. No dose‐related differences in T3/rT4 and T3/rT3 ratio were observed.

Treatment with T3 in doses of 0.06 mg per day caused a significant but slow fall in T4 and rT3 to hypothyroid levels while T3 only rose slightly. The T4/T3 ratio dropped significantly during T3 therapy.
Incidence of Insulin‐Dependent Diabetes Mellitus (0–29 Years at Onset) in Denmark
Authors: Christau Bjørn , Kromann Hans , Christy Morten , Andersen Ole Ortved , Nerup Jørn
Published: August 2010

ABSTRACT Incidence data from Denmark on the insulin‐dependent diabetes mellitus in the age group 0–29 years have been collected in two different geographical areas (West and South Jutland plus Copenhagen and North Zealand).

An incidence of 13.3 per 100 000 per year (range 12.5–13.6) was registered (N = 792). No difference was found between the two areas. The male incidence exceeded the female incidence by 25.4 per cent.

The age distribution showed rising values until a peak in the early puberty with a decline until a rather constant level after puberty. From year to year a seasonal variation of onset was demonstrable with maximum in the winter and minimum in the summer for males only.

Ascertainment was found to be between 87.7 and 98.6 per cent and the annual number of new insulin‐dependent diabetics in Denmark in the age group 0–29 years can be calculated to 310–350.
Pancreatic Beta Cell Secretion during Oral and Intravenous Glucose Administration
Authors: Faber Ole K. , Madsbad Sten , Kehlet Henrik , Binder Christian
Published: August 2010

ABSTRACT The contribution of decreased hepatic insulin extraction to the relative hyperinsulinemia after oral glucose load as compared to intravenous glucose load was studied in 6 normal weight male volunteers by means of an analysis of the relationship between peripheral venous concentrations of insulin and C‐peptide following similar glycemic stimuli after oral and intravenous glucose administration.

The incremental areas under the insulin and C‐peptide curves were higher during oral as compared to intravenous glucose administration, 436 (251–762) per cent and 267 (124–378) per cent respectively (mean and range). The ratio between corresponding incremental areas of insulin and C‐peptide were 53 (17–103) per cent higher during oral glucose load. These findings suggest that the augmented peripheral insulin levels after oral glucose administration are caused by a combination of increased beta cell secretion and decreased hepatic insulin extraction.
Sexual Function and Pituitary Axis in Insulin Treated Diabetic Men
Authors: Jensen Søren Buus , Hagen Claus , Frøland Anders , Pedersen Peter Beck
Published: August 2010

ABSTRACT The prevalence of sexual dysfunction and the pituitary‐gonadal function were studied in 72 consecutive diabetic male patients. Sexual dysfunction was found in 43% and in these patients peripheral neuropathy was significantly more frequent than in patients with normal sexual function. Sexual dysfunction was more frequent in patients at the age of 50–55 years than in young diabeties (age 25–30 years). No significant correlation between sexual dysfunction and the duration of the disease and no difference in the serum concentrations of luteinizing hormone, follicle stimulating hormone, prolactin, testosterone and oestradiol‐17β between patients with normal and reduced sexual function was found.

It is concluded, that sexual dysfunction is not accompanied by altered serum concentrations of testosterone, oestradiol‐17β, gonadotropins or prolactin. Sexual dysfunction correlates with peripheral neuropathy, but the high prevalence of dysfunction in males with short duration of diabetes without neuropathy makes other causes likely.
Protein Correction of Serum Calcium in Mild Primary Hyperparathyroidism
Authors: Transbøl Ib , Christiansen Claus , Hornum Ib
Published: August 2010

ABSTRACT Simultaneous determinations of serum total calcium (TOCa), protein corrected total calcium (TOCac), ultrafiltrable calcium (UFCa) and ionised calcium (Ca++) were undertaken in 63 controls and in 76 patients with primary hyperparathyroidism. Raised levels of Ca++ were used as one criterion of the diagnosis which was confirmed by operation in all.

For the purpose of estimating the relative value of TOCa and TOCac in the detection of mild hyperparathyroidism we selected all patients with TOCa values below 3.00 mmol/1 (n = 46). As a group these patients turned out to be mildly hypoproteinaemic (p < 0.01), probably because of high age and complicating conditions. Further subdivision of this group into frank hypcrcalcaemia, borderline hypercalcaemia and normocalcaemia was undertaken according to the respective 99% and 95% confidence limits of normal. Twenty‐seven patients were classified as frankly hypercalcaemic by TOCa as well as by TOCac. The distribution of the remaining 19 patients within the three categories was 1:6:12 as judged from TOCa while TOCac gave a better distinction from normal, 9:4:6 (p < 0.01). This compared well with the classification obtained by UFCa, 10:5:4.

It is concluded that TOCac is definitely advantageous to TOCa in the detection of hypercalcaemia in mild primary hyperparathyroidism.
Kidney Function in Acromegaly
Authors: Eskildsen P. C. , Parving H.‐H. , Mogensen C. E. , Christiansen J. Sandahl
Published: August 2010

ABSTRACT Creatinine clearance and daily urinary albumin and β2‐microglobulin excretion rates (radio‐immunoassays) were measured several times in 14 patients with acromegaly. Eleven patients were treated with bromocriptine, 5 to 55 mg/day. The activity of the disease was assessed by measuring urinary growth hormone excretion (radio‐immunoassay).

In agreement with previous investigations we found the creatinine clearance elevated. However, no correlation was found between this variable and the urinary growth hormone excretion. Urinary albumin and β2‐microglobulin excretion rates were not significantly different from our previous results in 27 adults control subjects. There was no correlation between urinary growth hormone excretion and urinary albumin or β2‐microglobulin excretion rates. Bromocriptine treatment reduced urinary growth hormone excretion from 220 to 91 ng/24 hours, p<0.01, but no significant alterations were induced in the above mentioned kidney function variables.
The Effect of Different Sulfonamides on Phenytoin Metabolism in Man
Authors: Hansen J. Mølholm , Kampmann J. P. , Siersbæk‐Nielsen K. , Lumholtz I. B. , Arrøe M. , Abildgaard U. , Skovsted L.
Published: August 2010

ABSTRACTThe influence on the metabolism of phenytoin of some sulfonamides given in common clinical doses has been studied. In single dose experiments sulfaphenazole increased phenytoin half‐life (T/2) by 237% and decreased phenytoin metabolic clearance rate (MCR) by 67%. Sulfadiazine, sulfamethizole, sulfamethoxazole + trimethoprim and trimethoprim increased phenytoin T/2 by 80, 66, 39 and 51% respectively, and decreased phenytoin MCR by 45, 36, 27 and 30% respectively. Sulfamethoxazole gave a small but significant increase in phenytoin T/2 but not a corresponding fall in phenytoin MCR. No changes were found in phenytoin T/2 and MCR after treatment with sulfamethoxypyridazine, sulfadimethoxine and sulfamethoxydiazine. Steady state experiments confirmed the findings of the single dose experiments. It is suggested that sulfaphenazole, sulfadiazine, sulfamethizole, sulfamethoxazole + trimethoprim and trimethoprim inhibit hepatic metabolism of phenytoin.
Evaluation of Quinidine Lipettes®— a Sustained Release Preparation
Authors: Eriksson Jan‐Erik , Hanson Arne , Hörlin Roland , Johansson Bengt W. , Ohlsson Ola , Otto Uno , Syrén Gösta
Published: August 2010

ABSTRACT.A new sustained release preparation (Lipettes®) of quinidine has been evaluated with regard to dissolution, absorption, serum concentration and side‐effects. The serum levels of quinidine after single oral doses and after long‐term treatment have been compared with the serum levels after administration of some other quinidine preparations on the Swedish market. The side‐effects of the sustained release preparations have also been studied. Results indicated that this new sustained release quinidine preparation yields more even serum concentrations of quinidine and seemed to cause less troublesome side‐effects than the marketed preparations.
Non‐Invasive Assessment of Cardiac Function in Meningitis
Authors: Brubakk Oddbjørn
Published: August 2010

ABSTRACT. Non‐invasive registration of systolic time intervals (STI) and ECG were used in evaluating cardiac function in 12 patients with bacterial and 16 with viral meningitis. On admission, 14 (50%) of the patients had abnormal STI. The preejection period (PEP) was prolonged in 11 patients, while left ventricular ejection time (LVET) was prolonged in two and shortened in four. The PEP/LVET index was increased in eight patients. At discharge PEP was still prolonged in eight patients; seven of these were from the viral meningitis group. LVET increased significantly (p < 0.02) from the first to the last registration. In the patients with abnormal PEP and PEP/LVET on admission, there was a significant fall (p < 0.05 and p = 0.02, respectively) to discharge. There was no difference in STI between the patients with viral or bacterial meningitis. Eighteen (64%) of the patients had abnormal STI on one or more registration. ST–T changes in ECG and prolongation of the Q–T interval were found in three patients. Cardiac affection in meningitis seems to occur more often than can be shown by ECG.
Interferon Therapy in Multiple Myeloma
Authors: Ideström Kajsa , Cantell Kari , Killander Dick , Nilsson Kenneth , Strander Hans , Willems Jan
Published: August 2010

ABSTRACT. A woman with multiple myeloma relapsed after 6 years of satisfactory tumor control with melphalan therapy. When progression then occurred, she was given exogenous human leukocyte interferon, 3times106 reference units twice daily i.m., as the sole therapy. Side‐effects of the interferon therapy consisted of fever reactions and thrombocytopenia. One month after the initiation of interferon therapy there was 1) improvement of general health with less pain and tiredness, 2) reduction of the M‐component, IgG‐lambda, in the serum, and 3) a reduced plasma cell concentration in the bone marrow. After 5 months of interferon therapy tumor progression occurred despite continuous interferon treatment. At the same time, the tumor cells were less sensitive to interferon in in vitro tests than prior to interferon therapy. It is suggested that interferon therapy should be given as initial treatment to a few patients with multiple myeloma in a phase I trial.