bluuebunny/crossref_metadata_2025 huggingface dataset:
PERSISTENT PARESES AFTER PORPHYRIC ATTACKS
Authors: Sørensen A. W. S. , With Torben K.
Published: August 2010

Abstract. During a 25‐year period 1942–1967 95 patients with acute porphyric attacks have been indexed in The Danish Porphyria Register. Fifty of these were abdominal, only 4 showed psychosis without pareses, and the remaining 41 were paralytic. Of the latter 17 died and 24 recovered, but 12 of the 24 exhibited residual pareses after three years. Of the patients with persistent pareses 50% were males as against only 24% of the total material. Contrary to the generally accepted view porphyric pareses cannot be regarded as essentially reversible. A substantial number of patients do not recover completely from their paralysis, a phenomenon which seems to be more common in males than in females.
THE EFFECT OF DIFFERENT DIGOXIN DOSES ON SUBJECTIVE SYMPTOMS AND PHYSICAL WORKING CAPACITY IN PATIENTS WITH ATRIAL FIBRILLATION
Authors: Redfors Arne
Published: August 2010

Abstract.In a dose‐response study 14 patients with atrial fibrillation have been treated with increasing digoxin doses, 0.125, 0.25, 0.375, 0.50, 0.75 and 1.00 mg daily, until toxic symptoms or signs appeared. Dosage was changed every 14th day. The size of the doses was unknown to the patients. In this paper the effect on subjective well‐being and physical working capacity is presented. The mean “optimal” dose was 0.44 mg/day varying from 0.25 to 0.75 mg/day. An improvement was, however, achieved also at lower digoxin doses. The increase in physical working capacity, measured on a bicycle ergometer, was less impressive than the improvement in subjective well‐being and in physical capacity observed by the patients in their daily activities. Mean toxic dose was 0.65 mg/day. The toxic symptoms and some reasons for the great individual differences found in digoxin tolerance are discussed.
DIGOXIN DOSAGE AND VENTRICULAR RATE AT REST AND EXERCISE IN PATIENTS WITH ATRIAL FIBRILLATION
Authors: Redfors Arne
Published: August 2010

Abstract.In a dose‐response study ventricular rate at rest and during exercise has been studied in 14 patients who during 14‐day periods were treated with increasing digoxin doses from 0.125 mg/day up to toxic dosages. Mean ventricular rate at rest was successively reduced from 78 beats/min at 0.125 mg/day to 61/min at the “optimal” and 56/min at the toxic dosage. In absolute figures ventricular rate during exercise was somewhat more reduced than the rate at rest. The highest ventricular rate registered in the exercise tests was, however, least influenced by the glycoside. Mean ventricular rate increased almost linearly with the work load, but in the individual case the increase was varying and mostly non‐linear. The shape of the curves was influenced by the digoxin dosage and could to some extent be associated with individual differences in the R‐R interval pattern. At all dosages there was a great individual scattering of the ventricular rate; consequently the adequacy of the treatment could not with any precision be judged from ventricular rate at rest or exercise.
ADIPOSE TISSUE FAT CELL SIZE AND NUMBER IN RELATION TO METABOLISM IN ENDOGENOUS HYPERTRIGLYCERIDEMIA
Authors: Björntorp Per , Gustafson Anders , Persson Bengt
Published: August 2010

Abstract. Adipose tissue fat cell size and number have been determined in patients with endogenous hypertri‐glyceridemia. In addition to increased plasma triglycerides these patients were characterized, as previously well known, by a decreased glucose tolerance, less frequently an increase in fasting plasma insulin and plasma insulin during glucose tolerance, as well as by moderate obesity. The obesity was due to increased fat cell size rather than fat cell number. In the hypertriglyceridemic patients statistical associations were found between fasting plasma insulin and fat cell size.
DISTRIBUTION OF SERUM LIPIDS IN NORWEGIAN RECRUITS
Authors: Romslo Inge
Published: August 2010

Abstract. 324 young men attending medical examination for military service had their sera tested for cholesterol and triglycerides. The subjects were grouped according to physical fitness, relative weight, smoking habits, blood pressure and ischaemic heart disease among relatives. Serum triglyceride values were found correlated to relative weight, smoking habits and ischaemic heart disease among relatives. A similar, but less obvious, trend was observed in serum cholesterol.
ANTAGONISM BETWEEN GLUCOSE AND EPINEPHRINE REGARDING INSULIN SECRETION
Authors: Cerasi Erol , Luft Rolf , Efendić Suad
Published: August 2010

Abstract. A dose‐response study of the inhibitory effect of epinephrine on glucose‐induced insulin secretion in man has been performed. The results demonstrate the exquisite sensitivity of the pancreatic β‐cells to epinephrine, as small a dose as 3 mμg/kg/min inducing a 50% inhibition. These studies emphasize the physiological significance of epinephrine for the regulation of insulin secretion. They also show that in previous studies in man and animals supramaximal amounts of epinephrine have been employed. Our results also suggest that the actions of epinephrine and glucose on insulin secretion are competitive. Infusion of aminophylline had only a minor inhibitory effect on the action of epinephrine. Therefore, our data do not permit the conclusion that epinephrine suppresses insulin release exclusively by diminishing the rate of synthesis of cyclic AMP. Other possible mechanisms are discussed.
ORAL CONTRACEPTIVES AND THROMBOEMBOLIC DISEASE
Authors: Böttiger L. E. , Westerholm B.
Published: August 2010

Abstract. An analysis of almost 400 cases of thrombo‐embolic disease in women on oral contraceptives, reported to the Swedish Adverse Drug Reaction Committee during the years (1965) 1966‐70, is presented. The risk of getting a thromboembolic manifestation may be calculated at 1: 3600 in users of oral contraceptives as compared with 1: 23000 among non‐users and 1: 340 during a normal pregnancy. The mortality risk is 0.9 patient per 100000 users and year. Details are presented for the 15 fatal cases. It is emphasized that although statistical evidence has demonstrated a significant relationship between the use of oral contraceptives and thromboembolic disease, in the individual case we have no way of telling what actually brought about the thromboembolic condition.
CORONARY CIRCULATION DURING PACING‐INDUCED TACHYCARDIA
Authors: Holmberg Stig , Varnauskas Edvardas
Published: August 2010

Abstract. Coronary and systemic circulation has been studied in 10 patients with complete atrioventricular block and in 4 patients with sinus rhythm. Studies were performed during spontaneous rhythm, during pacing‐induced tachycardia (PIT) of varying frequency and during a combination of PIT and exercise. Coronary flow and myocardial oxygen uptake varied linearly with heart rate. If exercise was superimposed on PIT with unchanged pacing frequency both coronary flow and myocardial oxygen uptake increased further. The coronary flow increased mainly because of a decrease in coronary vascular resistance. The results were compared with data from a previous study in which the heart rate was increased with exercise in a group of 11 patients without signs of major heart disease. In the PIT study the increase in coronary flow and myocardial oxygen uptake for a given increment in heart rate was less than half of that found in the previous exercise study. The main explanation for this difference is probably on the one hand that wall tension decreased during PIT while it increased during exercise and on the other hand that increase in contractility was more pronounced during exercise. The same relation of coronary flow or myocardial oxygen uptake to the product of systolic pressure and heart rate (BP3 × HR) was found in both groups although the values in the PIT study were in a lower range than those in the previous exercise study. This indicates that this product is a fairly good approximation of myocardial oxygen demand over a wide range of heart rates regardless of the method used for cardio‐acceleration. It is concluded from this study that PIT is less efficient than exercise in testing the coronary vascular reserve because the stress imposed on the myocardium is low during PIT even during high heart rates.
CHANGES IN RESPIRATORY MECHANICS IN MYASTHENIA GRAVIS WITH THERAPY
Authors: Ringqvist Ivar , Ringqvist Torsten
Published: August 2010

Abstract. The effects of anticholinesterase, and subsequently sympathomimetics, on respiratory mechanics have been studied in ten patients, with moderate to rather severe myasthenia gravis, one of them being studied separately. A systematic increase in lung resistance was first shown to occur. The latter seemed to increase with larger doses of anticholinesterase while sympathomimetics gave a return to the initial values. Subsequently, increases in the maximum respiratory pressures (P1max and PEmax), the static lung volumes with maximum inspiration included and all dynamic lung volumes were found. Considering the basic disease, the increases in respiratory forces were thought of causal importance for the increased lung volumes. Using the functional relationships found in the untreated state this could also be shown for the change in the vital capacity. For the dynamic lung volumes the changes in the forced inspiratory (FIV1.0) and expiratory volume (FEV1.0) were primarily mediated by this dimensional effect i.e. increase in vital capacity. The increase in maximum voluntary ventilation (MVV) was, however, dependent on the dimensional effect to about the same extent as on a more direct muscular effect on the ventilatory forces. These changes are in principle in agreement with existing conditions in healthy controls. The successive deterioration of the disease in one patient and varying degrees of medication made it possible to instructively illustrate both these mechanical interrelationships and important implications for a simultaneous slight airway obstructive disease when administering anticholinesterase. Thus, the present results indicate that the clinical improvement in myasthenia gravis reported in other studies after ephedrine medication may to a significant extent be explained by its sympathomimetic action on the smooth bronchial muscles.
THE EFFECTS OF MORPHINE ON THE ARTERIAL AND MIXED VENOUS BLOOD GAS STATE AND ON THE HEMODYNAMICS IN PATIENTS WITH CLINICAL PULMONARY CONGESTION
Authors: Hoel Bjørn L. , Bay Gunnar , Refsum Harald E.
Published: August 2010

Abstract. The arterial and mixed venous blood gases and the pressures in the systemic and pulmonary circulation have been determined before and after an injection of 1.5 cg of morphine chloride intramuscularly in eight patients with left heart failure and auscultatory and roentgenologic signs of pulmonary congestion. Before morphine all patients showed clearly elevated mean pulmonary artery pressure (PAP), while only two of them showed markedly increased mean pulmonary capillary venous pressure (PCVP). All patients showed normal PaCO2, low PaO2, and low SaO2, except the two patients with high PCVP, who showed markedly reduced PaCO2 and normal PaO2. All patients showed clearly reduced PvO2 and SvO2, and an abnormally high a‐vO2 difference, suggesting poor myocardial function or cardiac output response to hypoxia. The base excess was, however, slightly increased, indicating that there was no tendency to metabolic acidosis. After morphine the two patients with increased PCVP showed a clear fall in mean PAP, mean systemic arterial pressure (FAP) and heart rate, while only one of them showed a transient fall in PCVP. In the other patients there was no change in any of these parameters. There was a slight increase in PaCO2, reaching maximum about 60 min after the injection, and a relatively smaller decrease in PaO2, indicating some respiratory depression, but no further impairment of the alveolar/arterial gas exchange. PvO2 and SvO2 remained unchanged and a‐vO2 was thus reduced. The base excess remained unchanged. The constancy of the base excess and SvO2 showed that no impairment of tissue oxygenation occurred after morphine, not even in the two patients with high PCVP and a marked fall in FAP after morphine. The data suggest that morphine led to a reduction of the cardiac work in the two patients with high PCVP. The remarkable constancy of PvO2 throughout the investigation, even in the presence of substantial fluctuations in PaO2, SaO2 and systemic blood pressure, suggests some O2‐dependent regulation of the peripheral circulation on the venous side.
III. Presence of LE factor in relatives and spouses
Authors: LARSEN ROLF A.
Published: August 2010

LE factor was determined in sera of 928 family members of 72 patients with SLE by an indirect LE factor test. The prevalence of LE factor was significantly increased in relatives compared with their spouses, female first degree relatives presenting the highest frequencies. The presence of LE factor in relatives was correlated to presence of rheumatic disease, but LE factor also occurred in apparently healthy relatives. The frequency of LE factor was independent of size of sibships and families and residence of the relatives.
IV. Presence of antinuclear factors (ANFs) in the total populations of relatives and spouses, and the correlation to rheumatic disease
Authors: SOLHEIM BJARTE G. , LARSEN ROLF A.
Published: August 2010

The distribution of antinuclear factors in sera of 615 relatives, and their 313 spouses, of 72 SLE probands is presented. A statistically significant, but irregular, aggregation of ANFs occurred in relatives. When the different patterns of nuclear fluorescence were analysed, the homogeneous type, but not the speckled type of ANF separated the relatives and the spouses. The correlation between ANFs and rheumatic disease was more manifest for relatives than for spouses. Non‐rheumatic relatives and spouses did not differ with regard to any type of ANF.
V. Presence of antinuclear factors (ANTFs) in and spouses of selected SLE probands
Authors: LARSEN ROLF A. , SOLHEIM BJARTE G.
Published: August 2010

Antinuclear factors (ANFs) were studied in sera of 51 SLE probands, 615 relatives and their 313 spouses who served as controls.

The frequency of ANFs in the relatives was correlated to certain variables present in the SLE probands: i: A very marked accumulation of speckled ANF was found in relatives of SLE probands with marked arthritis, whose female relatives above forty years of age more frequently had a present of past history of effusions in large joints than female relatives of SLE probands without arthritis. The frequency of ANFs in relatives was also correlated with ii: the titer of ANFs in the proband and with iii: the presence of numerous LE cells at the time of diagnosis of SLE in the proband.

Selection of subroups of SLE probands with defined clinical and/or serological characteristics appears to be valuable in family studies of SLE.
SPECIFIC DETERMINATIONS OF PROTHROMBIN DURING ANTICOAGULANT TREATMENT
Authors: Norén Ingrid , Blombäck Margareta
Published: August 2010

Abstract A specific two‐stage prothrombin assay has been applied for the control of oral anticoagulant treatment in comparison with a one‐stage prothrombin assay and an immunological assay of reactive prothrombin, as well as with Thrombotest and the prothrombin‐proconvertin (P‐P) method and with specific assays of factors IX and X. All the methods used were fairly well correlated but showed different activity levels. Prothrombin values of 20–45% corresponded to P‐P values of 10–25% and Thrombotest values of 5–20%. Values of the present two‐stage prothrombin assay were in accordance with prothrombin values immunologically determined. A large number of patients on long‐term anticoagulant treatment were routinely controlled with Thrombotest, patients with complications with the present prothrombin method as well. Minor bleeding complications occurred in patients with values within the therapeutic range of both methods and to the same extent. The activity of the inhibitor induced by the treatment was about the same in patients with bleeding complications as in the other patients. It does not seem necessary for the treatment to register this activity. The specific prothrombin assay seems to be as useful an indicator of the effect of anticoagulant treatment as the methods generally used.
A RAPID PROCEDURE FOR LABORATORY CONTROL OF SIMULTANEOUS TREATMENT WITH INTRAVENOUS HEPARIN AND ORAL ANTICOAGULANT
Authors: Nyman Dag , Wahlberg Peter
Published: August 2010

Abstract A procedure is described by which the laboratory control of simultaneous i.v. heparin and oral anticoagulant treatment may take place without interruption of the heparin treatment. Heparin is administered as an i.v. infusion in a dose which gives a capillary micro thrombin time of 6–13 sec according to a method described in this paper. Under these circumstances the standard Thrombotest (TT) procedure may be used without neutralization of the heparin with protamine. The recommended range of capillary micro thrombin time gives an optimal heparin effect without risk of overdosage. The capillary micro thrombin time may be recorded at the bedside simultaneously with the TT.
CLINICAL AND MORPHOLOGICAL SIDE‐EFFECTS OF BUSULFAN (MYLERAN) TREATMENT
Authors: Dahlgren Sven , Holm Göran , Svanborg Nils , Watz Ragnar
Published: August 2010

Abstract Development of side‐effects after long‐term treatment with busulfan is described in a 61‐year‐old woman with chronic myelogenous leukemia. She developed severe pulmonary fibrosis and bilateral cataracts. Cellular atypia in bronchial and uterine cervical epithelium was present after 4 years of busulfan treatment, and in addition cellular abnormalities in the convoluted and collecting tubules of the kidney as well as in the liver were demonstrated. An Addisonian‐like syndrome appeared with hyperpigmentation of the skin, fatigue, loss of weight and diarrheas. Her respiratory symptoms as well as her general clinical condition did not improve after therapy was discontinued. The side‐effects of busulfan treatment are discussed and the literature is reviewed.
PLATELET PRODUCTION RATE IN POLYCYTHEMIA VERA AFTER MYELOSUPPRESSIVE THERAPY
Authors: Kutti Jack
Published: August 2010

Abstract In nine cases of polycythemia vera (PV) treated with myelosuppressive agents and considered to be in remission the platelet production rate has been determined. Six of them did not have splenomegaly; their values for platelet production rate were within the range of a control group consisting of hematologically normal subjects. In the remaining three subjects with splenomegaly the platelet production rate was above normal. Four of the nine subjects were studied twice, before and after myelosuppressive therapy, and in all of them a considerable fall in platelet production rate was observed after myelosuppression. It is concluded that in PV the platelet production rate after myelosuppressive therapy cannot be evaluated from the peripheral platelet count alone. If splenomegaly persists after remission induced by myelosuppressive drugs, the platelet production rate is likely to be considerably increased, even though the peripheral platelet count has fallen to values within normal limits.
MEDICAL TREATMENT AND MORTALITY IN CARDIOGENIC SHOCK
Authors: Takkunen J. , Oilinki O. , Huhti E. , Vuopala U. , Koivisto O.
Published: August 2010

Abstract 110 patients with cardiogenic shock, mostly due to myocardial infarction, were treated with a pure α‐ and β‐sympathomimetic. The subsequent 137 patients received a combination of sympathomimetic and α‐sympatholytic. In the series treated with the combination, glucagon was used in cases of heart failure. Comparison of the mortality figures after one week and after one month revealed no difference between the series. Neither the sympatholytic used nor the glucagon given in cases of failure increased the survival rate. According to current investigations the favourable results obtained with sympatholytic and glucagon in small materials are not confirmed by the findings in larger materials like ours of cardiogenic shock with myocardial infarction as the primary etiology.
PTA (FACTOR XI) DEFICIENCY AND PROLONGED BLEEDING TIME
Authors: Karaca Mustafa , Nilsson Inga Marie
Published: August 2010

Abstract A 23‐year‐old man with an inherited haemorrhagic diathesis characterized by factor XI deficiency and prolonged Ivy bleeding time is reported. The platelets aggregated normally with ADP, but the disaggregation of platelets was rapid. The release of ADP induced by kaolin or adrenaline was defective, as was the release of PF‐3 induced by kaolin. Thrombopathy was therefore diagnosed and the prolonged bleeding time was attributed to a platelet defect. Administration of fresh platelets shortened the bleeding time. The level of factor XI was 1–5%. Although the administration of platelet‐poor plasma corrected the coagulation defect, it had no effect on bleeding time.
DETERMINANTS OF THE RESPONSE TO COUMARIN ANTICOAGULANTS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors: Ristola Pentti , Pyörälä Kalevi
Published: August 2010

Abstract Determinants of the response to coumarin anticoagulant, warfarin, have been analysed in a series of 19 patients with acute myocardial infarction. Cardiac failure developing in the acute phase of the disease seemed to be without any great influence on the plasma half‐life of warfarin, with the exception of patients in whom serious circulatory catastrophes occurred. In patients who had received other drugs regularly before the hospital admission the plasma half‐life of warfarin showed a significant prolongation within 3 weeks—a phenomenon apparently caused by a decreasing induction of microsomal drug‐metabolizing enzymes in the liver. The plasma half‐life of warfarin was found to explain 44% of the variance in the daily requirement of warfarin during maintenance treatment. The steady state “therapeutic” plasma warfarin level showed a wide range of individual variation—from 0.8 to 4.1 mg/l, with a median value of 1.5 mg/l. The results indicate that in addition to the rate of coumarin anticoagulant metabolism other factors have a marked influence on the response to coumarin drugs in patients with myocardial infarction.
CLINICAL AND RADIOLOGICAL SIGNS OF LEFT VENTRICULAR FAILURE IN ACUTE MYOCARDIAL INFARCTION
Authors: Hull Russel , Björk Lars , Cullhed Ingemar , Lönnerholm Torsten
Published: August 2010

Abstract To analyse the value of clinical signs and chest X‐ray parameters in the diagnosis of left ventricular (LV) failure in proven acute myocardial infarction a correlative study has been performed in 110 patients during the first three days of hospitalization, whilst in the Coronary Care Unit. The clinical signs assessed were: 1) third heart sound, 2) basal crepitations, mild and marked, and 3) frank pulmonary oedema. The radiological parameters indicative of LV failure were: 1) pulmonary vessel (venous) dilatation, moderate and marked, 2) pulmonary oedema, patchy and diffuse, 3) Kerley's (septal) lines, and 4) pleural effusion. The incidence of LV failure on the first three days, if clinical signs only were utilized, was 31%, 30% and 14%, respectively. If radiological signs only were used, the incidence of LV failure on days 1, 2 and 3 was 56%, 43% and 29%, respectively. If both clinical and radiological findings were used, the incidence of LV failure on days 1, 2 and 3 was 60%, 48% and 34%, respectively. A total of 45 of the 110 patients (41%) showed clinical evidence of LV failure, and 63 (57%) showed radiological evidence of LV failure. These figures do not include the patients who died shortly after admission, before a chest X‐ray could be taken. The chest X‐ray proved to be more sensitive in the detection of LV failure, and it also detected LV failure earlier. LV failure was detected in the chest X‐ray, one day earlier than by clinical signs, in 17% of these patients with LV failure. Intra‐alveolar pulmonary oedema, shown in the X‐rays, was not associated with clinical signs in 43% of cases. The earliest radiological parameter of LV failure was pulmonary vessel dilatation, which gives rise to no auscultatory signs.
SPLENECTOMY — INDICATIONS AND RESULTS
Authors: Böttiger L. E. , Edhag O. , Forsgren L.
Published: August 2010

Abstract 182 splenectomies performed in two large hospitals during a 20‐year period have been analysed. The frequency of splenectomies has risen, especially during the last 5‐year period. “Surgical” indications are predominantly traumatic lesions of the spleen. The most common “medical” indications have been haemolytic anaemia and thrombocytopenia. No death has occurred ascribable to the splenectomy as such. It is emphasized that splenectomy in many instances should be regarded as one of several therapeutic possibilities and that it should not be saved as a “last” resort.
THE PRIMARY CAUSE OF RHEUMATOID ARTHRITIS IS AN INFECTION—THE INFECTIOUS AGENT EXISTS IN MILK
Authors: Svartz Nanna
Published: August 2010

AbstractThe theory of an infection as the primary cause of rheumatoid arthritis (RA) has been discussed periodically since more than four decades. The present author has made investigations on this problem over a period of many years. Several clinical symptoms, particularly as regards the findings in the joint fluid and in the granulation tissue, speak in favour of this opinion. Experimental research on animals with the aim of provoking an arthritis similar to RA has lent considerable support to the theory of an infection as the basis for RA. In my opinion the arthritis provoked by a type of Diplostreptococcus agalactiae belonging to the streptococci group B constitutes the condition of experimental arthritis most similar to human RA. In this respect it is important to consider that the experimental arthritis provoked by agalactiae is combined with the production of a hemagglutinating macroglobulin which, with our present methods, cannot be differentiated from the human rheumatoid factor (RF). We have long been engaged at our Institute in research into the source of infection. In our opinion it is a question of a milk infection and, as most milk consumed is pasteurized, the infection for the most part derives from pasteurized milk. In this connection it is important to emphasize that agalactiae cocci are resistant to the temperature used for pasteurizing milk. Furthermore, agalactiae can be cultivated from the nasopharynx in about 75–80% of RA cases. All RA patients investigated showed antibodies to agalactiae cultivated from the nasopharynx and from milk as well. Experimental arthritis and a rheumatoid‐factor‐like macroglobulin can be produced by the agalactiae cocci cultivated from pasteurized milk.
THROMBOPHLEBITIS FOLLOWING INTRAVENOUS LIGNOCAINE INFUSION
Authors: Nordell K. , Mogensen L. , Nyquist O. , Orinius E.
Published: August 2010

Abstract A high incidence of thrombophlebitis has been noted in a Coronary Care Unit, where 2% lignocaine was given prophylactically to every second patient. The incidence of thrombophlebitis after 16–24 hours was about 50% when giving glucose as a drip in association with lignocaine from a pump. When only a glucose drip was given, or when lignocaine was replaced by glucose in the pump, the incidence was 4–10%. Therefore, lignocaine solution seems to promote the development of thrombophlebitis in i.v. infusions.
GAMMA HEAVY CHAIN DISEASE
Authors: Westin Jan , Eyrich Raili , Falsen Enevold , Lindholm Leif , Lundin Per , Lönnroth Ivar , Weinfeld Aleksander
Published: August 2010

Abstract Three cases of γ‐heavy chain disease (γ‐HCD) are reported. Two of the patients had a clinical picture of malignant lymphoma, similar to most of the cases earlier described. One patient, however, had a benign process characterized by a symptomless splenomegaly and a moderate plasmocytosis in bone marrow and spleen. This patient, followed since 1964, is still alive and in good health. In all three cases the existence in serum and urine of an M‐component with IgG specificity was demonstrated. Gel filtration and immunoelectrophoresis showed that these proteins had a molecular weight below that of normal IgG and that they did not react with antisera against light chains. The clinical and morphological features of the earlier reported cases of γ‐HCD are briefly reviewed and compared with the findings in our patients. It is further discussed whether the presence of an M‐component consisting only of γ‐heavy chains is an accidental finding in cases with a proliferation of immunocompetent cells or whether patients with this abnormality represent a uniform disease entity.
APLASTIC ANAEMIA
Authors: Böttiger L. E. , Westerholm B.
Published: August 2010

Abstract Twenty‐eight cases of drug‐induced aplastic anaemia have been reported to the Swedish Adverse Drug Reaction Committee during its first five years of existence. This corresponds to an incidence of 0.7 cases in 1 mill. each year but seems to represent only one third of the occurring cases. The drugs most commonly involved are oxyphenbutazone (Tanderil®), chloramphenicol and phenylbutazone (Butazolidin®) in that order. The mortality is high, 66%.
STATISTICAL EVALUATION OF LIVER SCANNING IN COMBINATION WITH LIVER FUNCTION TESTS
Authors: Liewendahl K. , Schauman K.‐O.
Published: August 2010

Abstract The diagnostic information of liver scanning has been evaluated statistically. A focal defect in a liver scan can be considered a highly reliable abnormal finding. A diffuse decrease in liver radioactivity is of limited value, because such a finding is often obtained not only in patients suffering from a diffuse liver disease but also in patients with small focal liver lesions or with no liver disease. By statistical comparison between liver scanning and a number of liver function tests the diagnostic value of liver scanning was found to be superior to any of the liver function tests studied. This was true for liver diseases classified both as focal and diffuse. However, in focal liver diseases serum alkaline phosphatase was abnormal almost as often as liver scanning, and the combined use of this laboratory test and liver scanning seems to be a very reliable diagnostic procedure in detecting focal liver lesions, especially metastases in the liver. Multiple discriminant analysis clearly demonstrated the diagnostic value of performing liver scanning in addition to liver function tests for separating patients with a normal liver from those with focal liver disorders. Liver scanning was also of some value in distinguishing patients with a normal liver from patients with diseases generally considered as affecting the liver diffusely.
COMPARISON BETWEEN ALPRENOLOL AND PROPRANOLOL AS ANTIHYPERTENSIVE AGENTS
Authors: Bengtsson Calle
Published: August 2010

AbstractA double‐blind cross‐over study comparing alprenolol and propranolol in equipotent β‐blocking doses has been performed in 26 subjects with mild hypertension. Alprenolol and propranolol had an almost identical BP‐reducing effect. Propranolol reduced the heart rate significantly more than alprenolol, indicating different mechanisms of action for the antihypertensive effect. Subjective symptoms which could be interpreted as side‐effects were few and transient with both drugs. Both alprenolol and propranolol seem well suited for the treatment of mild hypertension.
RECURRENT THROMBOSIS IN A YOUNG WOMAN WITH A CIRCULATING ANTICOAGULANT DIRECTED AGAINST FACTORS XI AND XII
Authors: Åberg Hans , Nilsson Inga Marie
Published: August 2010

Abstract A young woman with discoid lupus erythematosus and a potent circulating anticoagulant directed against factors XI and XII is described. The patient had no bleeding symptoms, but had had repeated episodes of venous thrombosis. The fibrinolytic activity of the vein walls was found to be decreased. It was apparent that a circulating anticoagulant against factors XI and XII will not prevent thrombus formation in a patient with low fibrinolytic activity of the vessel walls, which is known to predispose to thrombosis.
ANXIETY, GROWTH HORMONE AND GLUCOSE TOLERANCE IN NORMAL CHILDREN
Authors: Lundbæk Knud , Johansen Klaus , Ørskov Hans , Speich Erik
Published: August 2010

Abstract Serum growth hormone and insulin responses to oral and i.v. glucose have been measured in 13 schoolchildren who had normal but relatively low oral glucose tolerance as judged from a preliminary study of a total population of 320 schoolchildren. The results were compared with those from 13 children paired for sex, age, weight and height but having average glucose tolerance. Serum growth hormone curves showed an initial peak starting before glucose ingestion in both groups. The rise was significantly higher in oral as well as i.v. glucose tolerance tests in the group with relatively low tolerance. This group had also a tendency to higher serum insulin values. It is suggested that the low carbohydrate tolerance in these children is produced by high growth hormone secretion, elicited by emotional lability.
RECURRENT PULMONARY EMBOLISM‐INCIDENCE, PREDISPOSING FACTORS AND PROGNOSIS
Authors: Wilhelmsen Lars , Hagman Marianne , Werkö Lars
Published: August 2010

Abstract A series of 33 patients with recurrent pulmonary embolism (RPE) collected during 14 years has been compared with all 145 patients with pulmonary embolism (PE) during one year in the same hospital concerning age distribution, sex ratio and predisposing diseases or states. The symptoms and signs of RPE and the results of heart catheterization and blood gas analyses are discussed. Dyspnea and hyperpnea were predominant symptoms and the grade of dyspnea was related to the mean pulmonary artery pressure (PPA), which also had a strong bearing on the prognosis. PaO2 and SaO2 decreased with increasing PPA, and with a PPA above 50 mmHg the chances of recovery seem small. However, one case is reported with a fairly good outcome, a marked fall in PPA and decreasing pulmonary vascular resistance during long‐term dicoumarol treatment.
METABOLISM OF FRUCTOSE IN LIVER
Authors: Heinz Fritz
Published: August 2010

Abstract. For liver a metabolic pathway for fructose has been described in which the ketosugar is phosphorylated by ketohexokinase to fructose‐1‐phosphate, which is then converted by liver aldolase to D‐glyceraldehyde and dihydroxyacetone phosphate, an intermediate of the glycolytic pathway. D‐glyceraldehyde could be oxidized to glycerate. By phosphorylation glycerate becomes an intermediate of the Embden‐Meyerhof pathway, like D‐glyceraldehyde if phosphorylated directly by triokinase. The reduction of D‐glyceraldehyde forming glycerol, which could be phosphorylated to L‐glycerol 3‐phosphate is in variance with isotope studies with fructose‐6‐14C.

This special metabolic pathway is limited to warmblooded animals and man, because only in the liver of these species ketohexokinase could be detected.

An adaption of enzymes was found in rats, which have had a high fructose diet over three weeks.

The activity of ketohexokinase estimated under optimal conditions and 37°C agrees well with fructose extraction rates found in liver perfusion for rat and in in vivo experiments for human liver. The fast catabolism of fructose in human liver, in contrast to glucose, is due to higher enzyme levels of ketohexokinase, in contrast to hexokinase and glucokinase. By this high phosphorylation capacity and the low activity of aldolase together with the action of metabolic inhibitors on this enzyme and the equilibrium far at the side of fructose‐1‐phosphate, fructose‐1‐phosphate will accumulate if high fructose concentrations were offered. But even under these conditions, the levels of metabolites following fructose‐1‐phosphate were enlarged.

Enzyme regulations based on the high fructose‐1‐phosphate and low ATP levels were discussed.
HEREDITARY FRUCTOSE INTOLERANCE
Authors: Perheentupa J. , Raivio K. O. , Nikkilä E. A.
Published: August 2010

Abstract. The clinical and metabolic aspects of hereditary fructose intolerance (HFI) are reviewed and some new observations on children with HFI are reported. The acute rise in plasma FFA level which was earlier shown to follow an acute exposure to fructose in these patients, was found to be associated with an increase in epinephrine excretion and a decrease in plasma TG level. Abolition of the fructose induced hypoglycemia by an infusion of glucose after injection of fructose prevented the rise in plasma FFA, but did not modify the increase in plasma lactate or urate concentration. Maintaining normal or high plasma inorganic phosphate levels after fructose injection by infusion of phosphate buffer did not alter the fructose‐induced changes in blood glucose or lactate, or in plasma FFA or urate concentration. The hyperuricemia and hyperuricosuria after fructose were larger in HFI patients than in normal children. Administration of fructose in the small doses of 0.33‐1.3 g/kg daily for 3–5 days brought about a gradual fall in plasma cholesterol level, and a rise in the excretion of urate and 17‐ketogenic steroids, but no increase in proteinuria.
EFFECTS OF FRUCTOSE, GLUCOSE AND GLYCERALDEHYDE ON THE TOXICITY OF ETHANOL IN HYPERTHYROID RATS
Authors: Hillbom M. E. , Lindros K. O. , Eriksson C. J. P.
Published: August 2010

Abstract.The effects of single or repeated intraperitoneal injections of fructose and glyceraldehyde were compared with those of glucose and saline in the treatment and prevention of the toxicity of ethanol in hyperthyroid rats. Glyceral‐dehyde potentiated the lethal effect of ethanol on these animals. The dose of ethanol (3 g/kg body wt.) produced only slight ketosis. Fructose, despite of its antiketogenic action, was equal in value to glucose or saline in the treatment of the intoxication syndrome. Ethanol‐induced hypoglycemia, which was previously assumed to be causally related to the toxicity of ethanol in hyperthyroid rats, was counteracted by giving repeated intraperitoneal injections of fructose or glucose, but the mortality of the animals was the same as in saline‐treated controls. The results suggest that hypoglycemia is not the principal cause of death in ethanol‐intoxicated hyperthyroid rats.
Chapter II PREVALENCE OF ISCHAEMIC HEART DISEASE IN WOMEN IN GÖTEBORG, SWEDEN
Authors: Bengtsson Calle
Published: August 2010

Abstract. From a population study of middle‐aged women in Göteborg, Sweden, the prevalences are given of history of myocardial infarction, angina pectoris, and ECG changes suggestive of ischaemic heart disease. A comparison is made with men of the same ages living in the same area. The prevalence of myocardial infarction was found to be higher in men than in women, while that of angina pectoris was about the same in both sexes. Q wave changes of the ECG were more common in men than in women, while other ECG changes suggestive of ischaemic heart disease such as ST depression and T wave inversion were as common in women as in men.
Chapter VIII DIABETES MELLITUS, CARBOHYDRATE TOLERANCE AND EARLY INSULIN RESPONSE TO AN INTRAVENOUS GLUCOSE INJECTION IN A POPULATION SAMPLE OF WOMEN AND IN WOMEN WITH ISCHAEMIC HEART DISEASE
Authors: Bengtsson Calle , Blohmé Göran , Waldenström Johan
Published: August 2010

Abstract. The prevalence of manifest diabetes mellitus was significantly higher in women with myocardial infarction than in women in the general population. This was not the case for women with angina pectoris or ECG changes suggestive of ischaemic heart disease. There were no differences in fasting blood glucose or fasting serum insulin values between non‐diabetic women who had angina pectoris or who had had myocardial infarction and non‐diabetic women in the general population. Intravenous glucose injection did not reveal significant differences in glucose tolerance or mean values of early insulin response. However, there was an over‐representation of women with a very low early insulin response in the women who had had myocardial infarction.
Chapter XIII “RISK FACTORS” FOR ISCHAEMIC HEART DISEASE ‐ A COMPARISON BETWEEN THE MALE AND FEMALE POPULATIONS IN GÖTEBORG, SWEDEN
Authors: Bengtsson Calle , Tibblin Gösta , Wilhelmsen Lars
Published: August 2010

Abstract. A cohort of men examined when aged 50 and 54 was compared with a population sample of women in the age strata 50 and 54. Smoking and alcohol consumption were found to be significantly more common in men than in women. Men reported continuous stress experience during the year previous to the study more often than women. Haematocrit was significantly higher in men than in women. There were no important differences between the sexes concerning arterial blood pressure, serum cholesterol, serum triglycerides or diabetes mellitus. Sex differences in “risk factors” for IHD seem to explain only some part of the difference in the incidence of MI between men and women.
OCCURRENCE OF DIABETIC TYPE OF PLASMA FFA AND GLYCEROL RESPONSES TO PHYSICAL EXERCISE IN PREDIABETIC SUBJECTS
Authors: Nordlander Sune , östman Jan , Cerasi Erol , Luft Rolf , Ekelund Lars‐Göran
Published: August 2010

AbstractThe mobilization of glycerol and free fatty acids (FFA) from fat stores during physical exercise has been studied in 6 patients with insulin‐dependent diabetes, 3 with diabetes in clinical remission, 10 with prediabetes and in 11 healthy control subjects. They were all submitted to the same relative exercise test calculated as about 60% of the maximal capacity. All subjects with manifest diabetes, 4 of the prediabetics and one of the diabetics in remission, but none of the controls, demonstrated exaggerated increases in plasma glycerol and FFA during the exercise test. There were no consistent differences between the groups as regards the changes in glucose, insulin and growth hormone (GH) in plasma during exercise. The findings of elevated plasma glycerol and FFA could not be attributed to subnormal increase in the lactate levels during exercise. A possible explanation of the increased lipolytic response might be that in certain prediabetics the diminished insulin response to hyperglycemia results in decreased antilipolytic capacity of adipose tissue. The increased lipid mobilization in some of the prediabetics seems to add another feature to this phase of diabetes.
A CYTOTOXIC EFFECT ON MONKEY KIDNEY CELLS INDUCED BY SERA FROM PATIENTS WITH ACUTE RENAL FAILURE AND SUGGESTING ENDOTOXINAEMIA
Authors: Fritz Hans
Published: August 2010

Abstract Altogether 547 sera, obtained from 320 individuals in different reference groups and from 27 patients with acute renal failure, have been studied for cytotoxicity on monkey kidney cells and, in 2 of the cases, also on human amniotic cells. The sera had a characteristic cytotoxic effect in 1 (0.3%) of the 320 reference cases, a cholecystectomized woman, and in 11 (41%) of the 27 patients with acute renal failure. The clinical background of 10 of these 11 patients revealed peritonitis, intra‐abdominal abscesses, paralytic ileus, prolonged shock and/or septicaemia, conditions which were less common among the 16 patients with acute renal failure but without demonstrated serum cytotoxicity. The serum was most often cytotoxic in the early phase of renal insufficiency. The cytotoxicity disappeared with clinical improvement. The cellular changes produced by the cytotoxic sera were characterized by a heavy granulation of the cytoplasm and, in the monkey kidney cell cultures, also by a loss of the normal, elongated shape of the cells. These cellular changes resemble those seen in the same kind of cells incubated with sera from rabbits injected i.v. with endotoxin. From the clinical data and in accordance with the animal experiments it is concluded that the cytotoxic effect of the human sera may have been caused by endotoxinaemia.
A‐V NODAL RHYTHM IN ACUTE MYOCARDIAL INFARCTION
Authors: Asplund J. , Edhag O. , Mogensen L. , Orinius E. , Sjögren A. , Wester P. O.
Published: August 2010

Abstract A‐V nodal rhythm (NR) has been observed on monitoring during the first 24 hours in 79 (18%) of a consecutive series of 450 admissions to a coronary care unit (CCU) subsequently diagnosed as having an acute myocardial infarction. The concomitant CCU mortality was 23% as compared to 8% of the remainder. Similarly the hospital mortality of 33% significantly differs from 19% in the remainder. The survivors were younger, more rarely showed signs of power failure, and a history of previous myocardial infarction was less common. In 7 of the 26 patients who died, NR appeared for the first and only time immediately prior to death. Survival of a period of NR by more than one hour was not associated with a raised mortality. Distinguishing features for patients with NR were a lower rate of previous myocardial infarction, a higher incidence of larger infarctions as judged by SGOT maximum levels and also of inferior infarcts. The validity of the finding of NR in routine monitoring has been assessed by comparing with continuous ECG recording in 95 consecutive patients. Of the 23 (24%) patients with NR on the ECG recording, the arrhythmia was observed in 14, and in a further 4 cases where NR was claimed it could not be verified.
LOSS OF CONSCIOUSNESS FROM ARRHYTHMIA: THE PATIENT'S EXPERIENCE
Authors: Biörck G. , Edhag O.
Published: August 2010

Abstract With improved treatment of circulatory arrest our knowledge of patients' experiences from such situations has increased. This report is based upon interviews with patients treated in a CCU or stimulated with an artificial pacemaker. As reported earlier, the patients suffering from arrhythmic syncopes felt no anxiety at the time of the attacks. The attitude of the physician after the resuscitation and the information given to the patient seem to be of great importance for the patient's attitude afterwards. A penetrating report is given of the reactions of one patient with 50 attacks of ventricular fibrillation to the ECG monitoring and the attitude of the staff in the CCU. Examples of reactions of relatives of resuscitated patients with resulting “cerebral death” and of relatives of desperately ill pacemaker‐treated patients are also briefly reported.
EFFECT OF G‐SUIT IN TREATMENT OF POSTURAL HYPOTENSION
Authors: Rosenhamer Gunnar , Thorstrand Curt
Published: August 2010

Abstract Continuous, daily use of a modified aviator's g‐suit has effectively prevented severe symptoms of postural hypotension in two cases where other methods of treatment had failed. Hemodynamic effects were studied on a tilt table. Inflation of the g‐suit resulted in considerably higher systemic arterial pressure at heart level in the head‐up position. Increases were recorded in pulmonary arterial pressure and cardiac output. It is suggested that the g‐suit exerted its effect mainly by redistribution of blood volume into the intrathoracic compartment.
THE GASTROINTESTINAL ABSORPTION OF DIGOXIN IN SEVEN PATIENTS WITH GASTRIC OR SMALL INTESTINAL RECONSTRUCTIONS
Authors: Beermann Björn , Hellström Kjell , Rosén Anders
Published: August 2010

AbstractDigoxin‐12α‐3H and polyethylene glycol (PEG, unabsorbable marker) have been given orally to 5 patients (nos. 1–5) with partial gastrectomy, one patient (no. 6) with vagotomy and plastic reconstruction of the pylorus, and one (no. 7) with jejunocolostomy. A slight to moderate steatorrhoea was found in 5 patients (nos. 2–5 and 7). The ratio between the radioactivity/mg PEG in intestinal aspirates and that of the test solution demonstrated that about 55% of the label was absorbed in the upper gastrointestinal tract of patients 1–5. This value as well as those recorded for blood levels and cumulative excretion of radioactivity in the urine were within the limits previously encountered in healthy control subjects. Although not indicated by the blood levels of label, the absorption of radioactivity appeared to be slightly impaired in patients 6 and 7.
CHANGES IN ANTITHROMBIN III LEVELS FOLLOWING CESSATION OF ANTICOAGULANT THERAPY
Authors: Refvem Olav , Fagerhol Magne K. , Abildgaard Ulrich
Published: August 2010

Abstract Antithrombin III (At‐III), α2‐macroglobulin and fibrinogen have been followed for 4 weeks after cessation of warfarin treatment in 20 individuals. There were no significant changes in fibrinogen or α2‐macroglobulin levels. At‐III decreased significantly in serum and in plasma. It is suggested that these changes reflect a low grade continuous coagulation which was suppressed during anticoagulant treatment.