bluuebunny/crossref_metadata_2025 huggingface dataset:
Lymphocytic Thyroiditis
Authors: Maagøe Henrik , Reintoft Ingermarie , Christensen Hans Ewald , Simonsen Jørn , Mogensen Erik F.
Published: August 2010

ABSTRACT Biopsies from the thyroid glands in 32 selected patients with goitre and lymphocytic thyroiditis have been investigated with quantitation of the morphological changes. This permitted a comparison with immunological and clinical findings. The three main elements in the destruction of glandular tissue—lymphocytes, plasma cells and fibrosis—varied relatively independently of each other as an expression of the great variation in the appearance of the tissue lesion. Thyroglobulin antibodies showed a correlation to the number of plasma cells, whereas the microsomal thyroid antibodies showed a correlation to the number of lymphocytes. The morphologic changes were independent of the duration of the disease. The degree of fibrosis increased parallel with age and there was a tendency towards glandular fibrosis in myxoedematous patients.
The Prognosis in Ebstein's Disease of the Heart
Authors: Hansen J. Fischer , Leth A. , Dorph S. , Wennevold A.
Published: August 2010

ABSTRACT A follow‐up study of 22 patients with Ebstein's anomaly has been performed. Nine patients died 1–21 years (mean 9) after the initial admission while the 13 patients alive at the end of the observation period had been followed for 5–26 years (mean 15). Clinical, ECG, radiological, and haemodynamic features were analyzed with reference to their prognostic significance. The presence or absence of cyanosis due to right‐to‐left shunt through an atrial septal defect (ASD) distinguished best between a good and a poor prognosis. Right‐sided heart failure and dyspnoea at rest, often associated with palpitations, precordial pains and syncopes, were grave prognostic findings. After the initial signs of heart failure there was a rapid deterioration, death ensuing within a few years. Operation with insertion of a prosthetic valve (and closure of the ASD) should be seriously considered at the appearance of heart failure.
Low Threshold Endocardial Electrodes for Permanent Cardiac Pacing
Authors: Wahlberg I. , Edhag O. , Lagergren H. R.
Published: August 2010

ABSTRACT Three different electrodes, i.e. conventional large and small surface endocardial electrodes and a new large contact area‐small active surface electrode, have been compared with respect to their stimulation thresholds for cardiac pacing in 94 patients with 96 electrodes. Both capacitor discharge and constant current pulses were used for the measurements. The average 2 msec impulse threshold for the 47 mm2 electrode reached its maximum on the 14th postoperative day and was 3.6±1.4 V and 4.4±1.8 mA. One month after insertion, the threshold was 3.2±1.4 V and 3.9±1.7 mA. Corresponding values after one month for the 6 mm2 electrode were 2.0±1.0 V and 1.7±0.9 mA and for the new electrode 1.7±0.9 V and 1.4±0.8 mA. Thresholds increased by about 20% when the impulse duration was diminished from 2 to 0.5 msec. The new large area‐small active surface electrode offers the advantages of significantly smaller increases in stimulation thresholds during the first month after insertion and good attachment to the endocardium.
Ultrasound as a Complementary Diagnostic Method in Deep Vein Thrombosis of the Leg
Authors: Lindqvist Rune
Published: August 2010

ABSTRACT The ultrasound method for detection of deep vein thrombosis (DVT) of the leg has been used in a study comprising 47 patients. This method was compared in the same group with a clinical evaluation and was controlled by venography. Clinical evaluation gave a correct diagnosis in 28 (59.6%) of 47 patients, false positive or false negative in 19 (40.4%). With the ultrasound method, the correct diagnosis was made in 41 (87.2%) of 47 patients, false positive in 3 (6.4%) and false negative in 3 (6.4%). No cases were missed of thrombosis situated proximal to the popliteal vein. The method was less accurate in cases of thrombosis situated in or distal of the popliteal vein; the 3 patients in whom a false negative diagnosis was made, belonged to this group. Since the ultrasound method has been shown to give few false positive and false negative results, it should be suitable as a screening procedure in patients with symptoms suggestive of DVT.
The Effect of Clofibrate on Glucose Tolerance, Insulin Secretion, Triglycerides and Fibrinogen in Patients with Coronary Heart Disease
Authors: Enger Sven Chr. , Johnsen Villy , Samuelsen Anna , Laws Elaine A.
Published: August 2010

ABSTRACT The effects of clofibrate treatment have been monitored in a double‐blind cross‐over study conducted in 16 male patients with coronary heart disease. Most had latent diabetes mellitus with elevated and delayed insulin release after i.v. glucose administration. Blood glucose and insulin levels were measured during repeated i.v. glucose tolerance tests in each patient and serum triglyceride and plasma fibrinogen were estimated at intervals. Clofibrate treatment significantly lowered fasting blood glucose levels (p<0.01) and improved the glucose tolerance (p<0.01). Fasting plasma insulin levels and those at 30 min after glucose loading were reduced (p<0.05). Serum triglycerides (p<0.001) and plasma fibrinogen levels (p<0.05) were lowered during the treatment period. The change in k‐value (glucose utilization) did not correlate to changes in triglyceride or fibrinogen. This study confirms the beneficial effect of clofibrate therapy on abnormal glucose tolerance observed by other workers. It is suggested that clofibrate acts by reducing peripheral insulin resistance.
A Family with Dominantly Inherited Mild Juvenile Diabetes
Authors: Johansen Klaus , Gregersen Gunnar
Published: August 2010

ABSTRACT A family of 53 members is described in which mild diabetes in young, non‐obese subjects is transmitted through four generations from parents to children, the ratio diabetic/non‐diabetic offspring of diabetic parents being 3:2 and all affected individuals having a diabetic parent. In this family, mild juvenile diabetes thus appears to be inherited as an autosomal Mendelian dominant.
Bone Composition and Vitamin D after Pólya Gastrectomy
Authors: Tougaard L. , Rickers H. , Rödbro P. , Thaysen E. Hess , Christensen Merete Sanvig , Lund B. , Sörensen O. Helmer
Published: August 2010

ABSTRACT With the aim of evaluating bone phosphorus/hydroxyproline ratio (P/Hypro) as an index of osteomalacia, this bone index and the bone mineral content (BMC) have been investigated together with other indices of calcium metabolism in 27 gastrectomized patients. None of the patients had clinically manifest bone symptoms. The mean values of bone P/Hypro, BMC, plasma calcium and plasma magnesium were subnormal; the mean values of serum parathyroid hormone (iPTH) and plasma alkaline phosphatase were elevated. Mean serum 25‐hydroxycholecalciferol (25‐OH‐D) did not differ from normal. A significant positive correlation was found between bone P/Hypro and serum 25‐OH‐D, but no significant correlation between bone P/Hypro and BMC. Serum 25‐OH‐D and bone P/Hypro were significantly lower and serum iPTH was significantly higher in a subgroup of 12 patients with no regular supplementary intake of vitamin D. In conclusion, the gastrectomized patients had blood biochemical evidence of a mild vitamin D insufficiency and the low bone P/Hypro values can be explained by mild osteomalacic changes in bone.
The Urinary Sediment in Endemic Benign Nephropathy
Authors: Wahlin Anders , Lindqvist Bengt , Nyström Kurt
Published: August 2010

ABSTRACTUrinary sediments from 30 patients with endemic benign (epidemic) nephropathy (EBN) have been examined with phase contrast microscopy. Casts, often with an irregular outline, were found in 80% of the patients, most commonly in those showing the most advanced impairment of kidney function, as judged by the maximum concentration of serum creatinine registered during the acute phase of the disease. Conspicuously thin and long thread‐like objects of a kind not previously reported in the literature on the urinary sediment were seen in 40% of the patients; they possibly represented casts formed in the loop of Henle. Leukocyturia (>5 leukocytes per visual field) was present in 20% of the cases. A number of cells sufficient for differential count was found in nearly all urine specimens examined: 15% granulocytes, 35% mononuclear leukocytes, 50% renal epithelial cells (REP) (mean values), a proportion of REP greater than that found at phase contrast microscopy of the urinary sediment in kidney diseases other than EBN. Microscopic hematuria of a few days' duration was found in 10% of the cases, a figure considerably smaller than previously reported. The findings seem to be almost pathognomonic for EBN and most of them were readily explained by the histopathologic changes found in percutaneous needle biopsy specimens of the kidney during the acute phase of the disease.
Mitochondrial Antibodies without Antinuclear Antibodies in Non‐hepatic Diseases
Authors: Diederichsen Hans , Pallisgaard Gunnar
Published: August 2010

ABSTRACT The term “pseudo‐LE syndrome” was previously used to describe an SLE‐like disease in which AMA, but not ANA, were found in serum. In an attempt to find patients with this syndrome, we tested 9358 sera for AMA and ANA. AMA without ANA was found in six patients without liver disease. One of these patients had an SLE‐like disease. Two of the others had diseases of the thyroid and one had rheumatoid arthritis—diseases in which AMA have previously been described. One patient had allergic vasculitis and one hypercholesterolaemia; these diseases are not known to be associated with the presence of AMA.
Role of Bran in Normals
Authors: Weinreich Jørgen , Pedersen Oluf , Dinesen Kirsten
Published: August 2010

ABSTRACT After the intake of approximately 24 g wheat bran daily for 5 weeks, 25 trainee nurses showed no changes in the serum levels of cholesterol, triglyceride, calcium or total 3α‐hydroxycholanic acid. On the other hand, the study revealed a reduced intestinal transit time with good correlation to an increased frequency of bowel movements. Average body weight fell significantly, by 0.4 kg. The daily caloric intake remained constant throughout the study period, whereas the calcium intake was significantly increased. Among the serum parameters and the dietary constituents, good correlation was found only between serum cholesterol and the dietary cholesterol content. In addition, an inverse relationship was demonstrated between the serum levels of cholesterol and total 3α‐hydroxycholanic acid. The significance of this observation is as yet unknown.
Nocturnal Hypertriglyceridemia and Hyperinsulinemia Following Moderate Evening Intake of Alcohol
Authors: Taskinen Marja‐Riitta , Nikkilä Esko A.
Published: August 2010

ABSTRACT The study was made to determine whether a moderate intake of alcohol in the evening influences the serum triglyceride and plasma insulin levels during the night and in the following morning. Ethanol (1.5 g/kg) was given orally between 5 and 9 p.m. to 34 subjects. The serum triglyceride and plasma insulin levels were followed during the night and the values compared with those taken after a sober evening. The average maximal blood alcohol concentration was 1.1‰ (110 mg/dl). In 24 nor‐molipidemic subjects, alcohol caused a definite nocturnal hypertriglyceridemia and hyperinsulinemia, the mean maximal rise of serum triglyceride being 1.00 mM above the corresponding value for the control night. In most cases the elevated triglyceride levels persisted until 8 a.m. next morning and 25% of the subjects would have been diagnosed as having a type IV hyperlipoproteinemia on the basis of these morning triglyceride values, taken after 11 hours' overnight fast. In 10 patients with primary endogenous hypertriglyceridemia the mean maximal increase of serum triglyceride after ethanol was 3.65 mM and the average morning triglyceride value was still 2.40 mM higher than the corresponding level after a sober evening. There was a highly significant correlation between the serum triglyceride and plasma insulin responses to ethanol (r=+0.58, p<0.001). It is concluded that conventional moderate drinking may be a common cause of hypertriglyceridemia, whether occasional or more constant.
The Concentration of Cadmium in Renal Tissue from Smokers and Non‐Smokers
Authors: Østergaard Karen
Published: August 2010

ABSTRACT The concentration of cadmium is determined by atomic absorption spectrophotometry of renal tissue excised at autopsy. Tissue from 19 non‐smokers and 42 smokers of either sex in the age group 45–65 years has been analysed. The concentration of cadmium in kidneys from 16 subjects who had been smoking pipes, cigars or cheroots did not differ significantly from the concentration in non‐smokers and cigarette smokers. On the other hand, in both normotensive and hypertensive individuals, the concentration of cadmium in kidneys from cigarette smokers was twice as high as in kidneys from non‐smokers.
Pheochromocytoma and Renovascular Hypertension
Authors: Alvestrand A. , Bergström J. , Wehle B.
Published: August 2010

ABSTRACT A case of hypertension with simultaneous occurrence of a para‐aortal pheochromocytoma and a functionally significant membranous renal artery stenosis is reported. The pheochromocytoma was excised surgically and a vein patch angioplasty was performed. Postoperatively the BP returned to normal. Three years after surgery the patient is normotensive and urinary catecholamines are normal. On the basis of this case and 27 previously reported cases of pheochromocytoma and renal artery stenosis, the possible relationship between the two conditions is discussed.
Idiopathic Hypoparathyroidism and Hyperthyroidism
Authors: Farup Per G.
Published: August 2010

ABSTRACTA case of idiopathic hypoparathyroidism is reported. The patient had presented symptoms for 16 years and various treatments and diagnoses had been tried before the correct conclusion was reached. Adequate treatment resulted in normalization of most of the symptoms. The patient also had hyperthyroidism, an exceptional combination. A possible relationship between the two diseases is discussed.
Total and Subtotal Colonoscopy with Short Instrument and without Fluoroscopy
Authors: Cronstedt Jean , Deurell Sven‐Ingmar , Vestergaard Peter
Published: August 2010

ABSTRACT The technique and results of 111 consecutive colonoscopies with a short colonoscope without the use of X‐ray screening are reviewed. The caecum could be reached in 44% of the cases. No complications occurred. The great clinical value of the procedure is shown by the following findings: X‐ray‐negative lesions—including 2 cases of carcinoma—were found in 35% of the cases, radiologically demonstrated lesions could be defined more precisely in 18%, and the presence of colonic lesions could be ruled out in 11% in spite of equivocal X‐ray findings. It is concluded that many more centres ought to take up the procedure, which offers the prospect of significantly reducing suffering and death from colonic disease.
Serum Bile Acids in Man during Vitamin C Supplementation and Restriction
Authors: Kallner Anders
Published: August 2010

ABSTRACT A daily dosage of 5 g ascorbate was given to 14 persons during one month. Various routine biochemical parameters were studied and the concentrations of individual bile acids in serum were determined. A significant increase in chenodeoxy‐cholic acid concentration was found on interruption of vitamin C supplementation, whereas no other changes in bile acid concentrations were significant. One person, used to a large ascorbate intake (1 g/day), was deprived of ascorbate. On resuming the high ascorbate intake, serum bile acid concentrations showed an increasing trend. Urinary oxalate excretion and concentrations were impressively increased during vitamin C supplementation but no effects on kidney function were observed.
Low‐Dose Insulin Treatment of Diabetic Ketoacidosis
Authors: Eskildsen Peter Claes , Nerup Jøm
Published: August 2010

ABSTRACT Twenty‐four consecutively admitted episodes of acute diabetic dysregulation in 22 patients were treated with a low‐dose insulin regimen, given as hourly i.m. injections of 5 IU insulin. The fall in blood glucose was almost linear during the first 8 hours of treatment, on an average 10% per hour of the initial value. The hyperglycemia and acidosis were corrected by 2–12 hours of treatment. The deficiency of water and electrolytes, especially potassium, was treated with infusion from the beginning, and the fluid balance was corrected within 12–16 hours. A severe fall in plasma potassium was never seen, but hypokalemia (<3.6 mEq/l) was still present in some cases after 24 hours of treatment. One patient died on account of a large myocardial infarction, but otherwise the patients were restored to habitual condition in 1–4 days. The regimen was found to be simple, safe and effective in all cases, without risk of late hypoglycemia or severe hypokalemia. The study indicates, however, that the parenteral supply of potassium advocated previously, 12.5 mEq/hour, is not sufficient when the plasma potassium on admission is below 5.0 mEq/l. In such cases it is recommended that the rate of potassium infusion is increased.
Carnitine Concentration in Skeletal Muscle Tissue from Patients with Diabetes Mellitus
Authors: Cederblad G. , Lundholm K. , Scherstén T.
Published: August 2010

ABSTRACT L‐Carnitine concentration was determined in vastus lateralis and abdominal rectus muscle tissue from 15 patients with diabetes mellitus and 66 controls. Nine of the diabetics were treated with diet and hypoglycemic drugs only and six with insulin. The carnitine concentration was determined enzymatically with labeled [i‐14C] acetyl‐coenzyme‐A as a substrate and given per weight of non‐collagen protein. The concentration in muscle tissue did not differ significantly between patients and controls. Patients with insulin‐treated diabetes had the same concentration of carnitine in muscle tissue as those treated with hypoglycemic drugs. The drastic decreases in carnitine muscle concentration and in carnitine body pool seen in alloxan‐diabetic rats are not observed in skeletal muscle of diabetic humans.
Myocardial Scintigraphy as a Supplementary Diagnostic Tool in Heart Disease
Authors: Gustafson Arne , Larsson Ingemar , Olsson Lars , Svensson Sven‐Eric , Westling Håkan
Published: August 2010

ABSTRACT Myocardial scintigraphy with cesium‐131 and thallium‐201 was performed in 191 patients. Previous myocardial infarctions localized to the anterior and lateral wall of the left ventricle were correctly diagnosed with both radionuclides. Inferior and posterior infarctions were only detected when thallium was used. In patients with non‐informative ECG changes like bundle branch block, non‐specific ST‐T changes or with atypical symptoms, myocardial imaging made an essential contribution to the establishment of a correct diagnosis. The potential value of myocardial imaging in patients with valvular heart disease and in cardiomyopathy is described.
Vitamin B12 Absorption Determined with a Double Isotope Technique Employing Incomplete Stool Collection
Authors: Hjelt K. , Munck O. , Hippe E. , Bärenholdt O.
Published: August 2010

ABSTRACT In 19 control patients and 10 patients with pernicious anemia (PA), the vitamin B12 (B12) absorption was determined simultaneously with whole‐body counting (FRB12) and with a double isotope technique employing incomplete stool collection (FAB12). The test dose was administered orally and consisted of 8 ml of a 10 ml solution containing 0.5 μg of 58Co‐B12 (approximately 0.4 μCi) and 2 mg of 51CrCI3 (approximately 20 μCi). Two ml of the solution were used as standard. In order to follow the passage of the inabsorbable tracer, 51CrCI3, the patients were given 25 radiopaque pellets and 4 carmine tablets (2 g) to swallow immediately after the test dose. Counting of a 3–4 ml specimen from one of the first two red stools was sufficient for calculating FAB12. The findings correlated closely with the FRB12 values (r=0.99, N=39, p<0.001). In the control subjects, the FAB12 averaged 74% (range 37–88). In the patients with PA given intrinsic factor (IF), the FAB12 averaged 40% (range 22–59). When IF was not given, FAB12 averaged 2% (range 0–9). The test, therefore, is a valid indicator of pernicious anemia. Reproducibility: For the mean value of 74%, the standard deviation (S.D.) was 5%, corresponding to a coefficient of variation (CV) of 7%. In the patients not given IF, S.D. was 1% and CV 50%, and in those given IF, S.D. was 8% and CV 20%. This shows the test to be as reliable as whole‐body counting. Carmine tablets proved to be a good indicator of isotope‐containing stool. The test is easy to perform and requires only a scintillation well‐counter. No co‐operation on the part of the patients is necessary. The test is also suitable for outpatients. Furthermore, it is independent of kidney function and flushing with B12 is avoided.
Hemodynamic Effect of Long‐term Treatment with Pindolol in Essential Hypertension with Special Reference to the Resistance and Capacitance Vessels of the Forearm
Authors: Atterhög Jan‐Henrik , Dunér Hans , Pernow Bengt
Published: August 2010

ABSTRACT Ten patients with essential hypertension have been studied at rest, during and after exercise following oral treatment for on an average 16 months with a β‐adrenoreceptor blocking agent, pindolol. The study was a direct continuation of an earlier, performed after 2 months' treatment. The hypotensive effect of pindolol was highly significant after 2 as well as 16 months of treatment. Heart rate was similarly lowered at 2 and 16 months, while cardiac output, which was significantly lower during exercise after 2 months, had increased to the pre‐treatment level after 16 months. Peripheral vascular resistance, which was not affected after 2 months, had decreased significantly during and after exercise in the long‐term study. A comparison between the hemodynamic situations after 2 and 16 months thus suggests that while a decrease in cardiac output is an early mechanism in the lowering of BP, changes in systemic vascular resistance seem to be more important after long‐term treatment with pindolol.
Management of Septicemia and Early Death in Acute Leukemia
Authors: Lantz Bo , Reizenstein Peter
Published: August 2010

ABSTRACT The frequency of fever days was measured in 67 patients with acute leukemia in the initial phase until remission was obtained or the patient died. A total of 3411 hospital days were studied. Three antibiotic schedules were examined between 1970 and 1975. There were 50% fever days when penicillin and streptomycin were combined as intitial antibiotics, 37% when cephalosporin and gentamycin were used, and 31% when, in addition, semi‐isolation was used prophylactlcally and granulocytes were given in a therapeutic attempt (0.05>p>0.01). The corresponding frequencies of early death were 9/21 (43%), 6/23 (26%) and 5/23 (22%). Early death occurred on an average 14, 23 and 21 days after admission. The frequencies of remission (complete and partial) were 8/21 (38%), 12/23 (52%), and 13/23 (57%). A randomized subgroup (12 patients) with intestinal sterilization was studied separately. It had 28% fever days, which is significantly less (p<0.01) than in the 13 patients given the same systemic antibiotics without intestinal sterilization. Fever was significantly lower (0.05>p>>0.01) on the day after a series of granulocyte transfusions than before, although only 109 granulocytes were given. However, this fever reduction may have been due to concomitant antibiotics.
Peripheral Haemodynamics in Essential Hypertension
Authors: Sivertsson Ramon
Published: August 2010

Abstract. Previous studies have indicated the existance of haemodynamically important structural vascular changes in patients and animals with hypertension.

Possible pathophysiological implications of these changes are discussed.

Two studies dealing with the question of reversibility of the structural changes on long‐term blood pressure lowering therapy are described. The results indicate that the changes are partially but not completely reversible.
Effects of Beta‐Adrenoceptor Blocking Agents on Haemodynamic Parameters
Authors: Hansson Lennart
Published: August 2010

Abstract. A review is given of some of the important studies dealing with the haemodynamic effects of beta‐adrenoceptor‐blockade in the treatment of hypertension.

Emphasis is put on the haemodynamic changes that occur during long‐term beta‐adrenoceptor‐blockade and comparisons are made between acute and long‐term effects, particularly as regards the change of total peripheral vascular resistance.

As hypertension is a multifactorial disease, one should not expect to find one single mechanism by which the antihypertensive mode of action of beta‐adrenoceptor‐blocking agents could be explained. However, irrespective of whether a humoral or a neurogenic or other possible mechanism is favoured, it is axiomatic that such mechanisms would have to influence blood pressure through changes of either cardiac output or total peripheral vascular resistance (or both). For this reason the haemodynamic changes will always be of importance.

The topic of combined treatment of hypertension using a beta‐adrenoceptor‐blocking agent in conjunction with a vasodilator and the haemodynamic effects thereof is briefly discussed, and finally some data are presented on the effect of beta‐adrenoceptor‐blockade on regional haemodynamics.
Alpha‐Methyldopa and Drug Fever
Authors: Valnes K. , Hillestad L. , Hansen T. , Arnold E.
Published: August 2010

ABSTRACT.The metabolism of α‐methyldopa was studied in 5 patients with febrile reactions to the drug, and compared with the metabolism in 5 patients without such reactions and in 4 normal subjects. A depression of the drug metabolism was found in drug fever patients, which may affect either the intestinal mucosal conjugation of the drug or the hepatic transformation. The decreased metabolism is assumed to be a possible causative mechanism of the adverse drug reaction.
Massive Doses of Procainamide for Ventricular Tachyarrhythmias due to Myocardial Infarction
Authors: Mattiasson Ingrid , Hanson Arne , Johansson Bengt W.
Published: August 2010

ABSTRACT.Three patients are described in whom malignant ventricular arrhythmias appeared in connection with a reinfarction some days after hospitalization for an acute myocardial infarction and in whom massive doses of procainamide, up to 7.5 g/day i.v., were necessary to prevent these arrhythmias. The serum concentration of procainamide was 2–4 times higher than the recommended upper level, but no side‐effects were observed. With the dose given, one would have expected still higher serum concentrations. Several reasons for this finding are discussed, including the effects of renal function, intestinal leakage, storage of the drug in tissues and hitherto unknown metabolic pathways of procainamide in patients, who are slow acetylators.
The Effect of Propranolol on Serum Levels of T4, T3 and Reverse‐T3 in Hyperthyroidism
Authors: Kallner Gunnar , Ljunggren Jan‐Gustaf , Tryselius Monica
Published: August 2010

ABSTRACT. The effect of propranolol (40 mg t.d.s.) on the peripheral levels of T4, T3 and reverse‐T3 was studied in 26 patients with hyperthyroidism. The compounds were measured by specific radioimmunoassay techniques. The levels were followed for five weeks and compared with the levels before treatment. The results show that propranolol had no significant effect on the peripheral levels of T4 despite a rapid amelioration of clinical symptoms. A significant reduction of T3 levels was obtained during the first to fourth week of treatment. No significant decrease was obtained after the fourth week. A significant elevation in reverse‐T3 levels was obtained during the second to fourth week of treatment. No significant change was obtained either during the first week or after the fourth week. Inconsistent fluctuations in hormone levels, both before and during treatment, could be seen in individual cases. The results suggest that the reduction of clinical symptoms must be caused by an extrathyroidal action of propranolol which does not seem to involve the pituitary gland.
Does a Disturbed Insulin Release Promote Hypoglycemia in Alcoholics?
Authors: Hed Ragnar , Nygren Arne , Röjdmark Sven , Sundblad Lars
Published: August 2010

ABSTRACT. Peroral glucose tolerance tests, i.v. tolbutamide tests and postfasting alcohol tests were performed in three alcoholics, who had been admitted to hospital with hypoglycemic symptoms. In one case the findings indicated extreme insulin sensitivity and in two cases there was evidence of a disturbed insulin release. These two factors might have a bearing on the occurrence of hypoglycemic symptoms in alcoholics.
Vitamin B12 Body Stores during Oral and Parenteral Treatment of Pernicious Anaemia
Authors: Berlin Ragnar , Berlin Hans , Brante Gunnar , Pilbrant Åke
Published: August 2010

ABSTRACT. Oral treatment of pernicious anaemia patients with 1 mg cyanocobalamin daily has been shown before to be as effective as conventional injection therapy. The result of this study indicates that oral treatment also keeps the vitamin B12 body stores adequately filled, a confirmation of earlier results obtained in another way.
Glucagon Effects on Plasma Cyclic AMP and other Reactants in Normals and Low Insulin Responders
Authors: Israelsson Bo , Fex Göran , Malmquist Jörgen , Nordén Gunnela
Published: August 2010

ABSTRACT. The metabolic response to i.v. glucagon was evaluated in 11 normal individuals and 8 healthy low insulin responders. Elevations of plasma cyclic AMP and blood glucose were similar in both groups. Accordingly, no indications were seen of differing hepatic responsiveness to glucagon. In contrast, the groups differed in the course of plasma glycerol during the test.
A Tetracycline‐Based Histomorphometric Evaluation of Bone Resorption and Bone Turnover in Hyperthyroidism and Hyperparathyroidism
Authors: Mosekilde Leif , Melsen Flemming
Published: August 2010

ABSTRACT. Increased bone resorption previously found in hyperthyroidism might be caused by a direct stimulating effect of thyroid hormone(s) on bone cells or by an increased sensitivity to circulating parathyroid hormone. In order to disclose qualitative differences in the response of bone resorbing cells to excess parathyroid hormone and excess thyroid hormone(s), histomorphometric analysis of iliac crest biopsies was performed in 25 hyperparathyroid and 40 hyperthyroid patients after tetracycline double‐labelling. The main target cells for parathyroid and thyroid hormones were different. Parathyroid hormone stimulated osteocytic osteolysis and increased osteoclastic resorption surfaces equally in trabecular and cortical bone. The osteoclastic resorption was inactive. Thyroid hormone(s) had no effect on osteocytes but increased the osteoclastic resorption surfaces in trabecular and cortical bone, with a pronounced preponderance in cortical bone. The osteoclastic resorption was active and followed by a significant loss of both cortical and trabecular bone. The findings support the assumption that increased bone resorption in hyperthyroidism is caused by a direct stimulating effect of thyroid hormone(s).
Prophylactic Treatment with Miconazole in Patients Highly Predisposed to Fungal Infection
Authors: Brincker Hans
Published: August 2010

ABSTRACT. In a placebo‐controlled double‐blind study the prophylactic value of oral systemic treatment with the antimycotic agent miconazole was assessed in 30 highly predisposed patients receiving intensive cytostatic chemotherapy because of haematological malignancies. Patients colonized with Candida before treatment were not freed from this micro‐organism by miconazole treatment. However, only 3 out of 6 initially non‐colonized miconazole‐treated patients became colonized during the study, against 10 out of 10 placebo‐treated patients (p =0.036). Seven out of 15 patients in the placebo group developed clinical mycosis, against only two out of 15 in the miconazole group. The miconazole‐treated patients remained clinically free of mycosis for 252 out of 264 treatment days, while the placebo‐treated patients remained free of mycosis for only 263 out of 338 treatment days (p =0.0001). The results indicate that systemic miconazole treatment protects highly predisposed patients from colonization with Candida and prevents or postpones clinically established candidosis.
Small Cell Carcinoma of the Lung: Serum Calcitonin and Serum Histaminase (Diamine Oxidase) at Basal Levels and Stimulated by Pentagastrin
Authors: Hansen Mogens , Hansen Heine H. , Tryding Nils
Published: August 2010

ABSTRACT. Investigations were performed to evaluate the incidence of increased serum calcitonin and histaminase in 79 patients with untreated small cell carcinoma of the lung (SSC). In addition, serum calcitonin was measured following pentagastrin stimulation in 19 of these patients. Serum calcitonin was elevated in 54 of 79 patients (68%), 20 patients (25%) having a level usually associated with the diagnosis of medullary carcinoma of the thyroid (MCT). The levels of histaminase, on the other hand, did not differ from the distribution in normals. In three of 19 patients undergoing the pentagastrin stimulation test, calcitonin was significantly increased. Thus, serum calcitonin is frequently elevated in patients with SCC and a positive pentagastrin test is not pathognomonic of MCT.
Absorption and Side‐Effects after Peroral Administration of Sustained Release Iron Tablets
Authors: Levy F. , Andersen P. , Ekren T.
Published: August 2010

ABSTRACT.Study I. In 13 iron deficient patients the absorption from 100 mg ferrous sulphate (Ferro‐Retard®) after 3 and 5 hours was comparable to the absorption from 176 mg ferrous gluconate in rapidly disintegrating tablets (Ferronicum®).Study II. (a) The serum iron elevation in 14 blood donors with normal Hb after administration of ferrous sulphate (100 mg Fe2+) in Ferro‐Retard or Duroferon Duretter® seemed to be equal when tested on the 4th day after donation of 450 ml blood. (b) The iron absorption, measured by the elevation of serum iron 5 and 8 hours after administration of sustained release tablets, proved to be better on the 11th and especially on the 16th day than on the 4th day after donation.Study III (side‐effects). In a study on 113 subjects the total number of complaints was unusually high both before and after administration of placebo, rapidly disintegrating and sustained release ferrous sulphate tablets. The selection of participants and other methodological factors have probably been of importance. Hence, comparisons between different studies of side‐effects should always be carried out with caution.
Lidocaine and the Quarternary Ammonium Compound QX‐572 in Acute Myocardial Infarction
Authors: Bergdahl Björn , Karlsson Erling , Magnusson Jan‐Olof , Sonnhag Christine
Published: August 2010

ABSTRACT.Patients with suspected or proven acute myocardial infarction complicated by ventricular arrhythmias not corrected by lidocaine therapy (bolus dose 100 mg followed by infusion 2 mg/min) were treated either with an increased dose of lidocaine (bolus dose 50 mg followed by infusion 3 mg/min) or with 600 mg N,N‐bis dimethylammonium chloride (QX‐572, Astra, Sweden) as an i.v. infusion during 30 min (3 patients) or 60 min (13 patients). In the lidocaine group the arrhythmias were controlled in 6 out of 15 patients, in the QX‐572 group in 12 out of 16, a difference that is not statistically significant. However, the frequency of side‐effects was significantly higher (p<0.001) in the QX‐572 group (15 out of 16 patients) than in the lidocaine group (4 out of 15 patients). They were also more severe, including pronounced tachycardia and hypertension. It is concluded that despite the high antiarrhythmic effect of QX‐572, an increase of the lidocaine dose would be safer and preferable in the clinical situation studied.
The Preferential Role of Triiodothyronine in the Regulation of Basal Metabolic Rate in Hyper‐ and Hypothyroidism
Authors: Johansen Klaus , Hansen Jens Mølholm , Skovsted Lis
Published: August 2010

ABSTRACT. The free triiodothyronine index (FT3I) was significantly correlated to basal metabolic rate (BMR) in hyperthyroid (r = +0.63, p<0.01) and hypothyroid patients (r=+0.61, p<0.05). Elimination of the effect of the free thyroxine index (FT4I) on the total correlation between BMR and FT3I by partial correlation analysis gave partial r=+0.60, p<0.01 in hyperthyroid patients and partial r=+0.43, p<0.1 in hypothyroid patients. The FT4I did not correlate to BMR in either hyper‐ or hypothyroid patients. These results point to triiodothyronine as the major regulator of BMR in hyper‐and hypothyroidism.
TSH Response Pattern to TRH Test and Optimum Time of Blood Sampling in Sporadic Euthyroid Goitre
Authors: Blichert‐Toft Mogens , Christiansen Claus , Axelsson Christen K. , Egedorf Jørgen
Published: August 2010

ABSTRACT. Attempts were made to estimate the response pattern of thyrotrophin (TSH) to thyrotrophin‐releasing hormone (TRH) and the optimum time of blood sampling in patients with sporadic euthyroid goitre. Of the 65 subjects studied, 21 served as a reference group and 44 were patients with sporadic euthyroid goitres, divided into diagnostic subgroups according to type of goitre. Patients with a single autonomous thyroid adenoma were excluded. The classification of goitre was based on clinical features, thyroid function tests, thyroid imaging studies using 99mTc pertechnetate uptake, and examination of thyroid specimens originating from selective goitre resection carried out after the laboratory investigations. A standardized i.v. TRH test was performed in all probands and the TSH response was followed for 60 min postinjection. There was a definite trend towards lack of response with increasing nodularity of the thyroid gland. Moreover, no further information concerning the TSH response pattern was achieved by extending the blood sampling period beyond the +2 min limit of the time axis. The study lends support to the view that increasing functional autonomy is a general trend in goitre evolution.
Clinical Value of Total T4 and T3 Determinations in Patients with Suspect Hyperthyroidism before and after Correction for Binding Proteins
Authors: Kallner Gunnar , Kågedal Bertil , Ljunggren Jan‐Gustaf , Tryselius Monica
Published: August 2010

ABSTRACT. In a previous Investigation we found that the determination of serum T3 by a radioimmunoassay procedure was superior to both the determination of serum T4 and the TRH test for laboratory discrimination between eu‐ and hyperthyroidism. The investigation comprised 50 patients in whom hyperthyroidism could not be excluded by the first clinical examination alone. The complete investigation showed that 26 of the patients had hyperthyroidism and 24 had normal thyroid function. The aim of the present study was to elucidate whether the discriminatory power of T3 and T4 estimations in these patients could be increased by correction for variations in the hormone‐binding proteins. The influence of the proteins was estimated by the T3 uptake test and determination of the TBG level by radioimmunoassay technique. The free T4 and T3 indices were calculated according to standard procedure. The results demonstrate that all subjects had TBG values within the reference levels. In the discrimination between normal and hyperthyroid states, the kee T4 index gave more reliable results than the uncorrected T4 or the T4: TBG ratio. However, the discriminatory power of T3 was superior to both T4, T4: TBG ratio and free T4 index. No improvement was obtained by calculation of the T3: TBG ratio. A slight improvement was obtained by calculation of the free T3 index. It is concluded that estimation of the total serum T3 level is superior to the total serum T4 level in the laboratory discrimination between euand hyperthyroidism even subsequent to correction for the binding proteins.
Coronary Arteriographic Findings in Patients with Previous Acute Myocardial Infarction
Authors: Hansen J. Fischer
Published: August 2010

ABSTRACT. In a consecutive series of 234 patients admitted for selective coronary arteriography, 49 had had definite acute myocardial infarction (AMI) three months to ten years previously. More than 75% stenosis in at least one of the major coronary arteries was found in 80% of the patients. Two and three‐vessel disease was demonstrated in 31% of the patients, which differs significantly from the 75–80% reported in autopsy studies in patients dying from AMI. At ventriculography all 22 patients with pathological Q waves had dyssynergy of the left ventricle.
Oesophageal Disease Revealed by Endoscopy in 1000 Patients Referred Primarily for Gastroscopy
Authors: Cronstedt Jean , Carling Lasse , Vestergaard Peter , Berglund Jonas
Published: August 2010

ABSTRACT. Of 1000 patients referred primarily for gastroscopy, almost 18% had endoscopic signs of clinically important oesophageal disease. Erosive oesophagitis, a disease that is notoriously difficult to diagnose on X‐ray, was demonstrated in almost 10% and oesophageal varices in 3.6% of the patients. It is concluded that a thorough examination of the oesophagus should be included in every routine upper gastrointestinal endoscopy.
“Non‐Secretory” Plasma Cell Dyscrasia with Normal Serum Immunoglobulins
Authors: Wille Leif E. , Førre Øystein , Mathiesen Per M. Schjelderup , Hovig Torstein , Sorteberg Kåre
Published: August 2010

ABSTRACT.A well documented case of non‐secretory myelomatosis with extensive skeletal lesions has been studied by immunohistologic techniques, electron microscopy, various electrophoretic procedures and different studies of serum and urine. In addition, the various lymphocyte populations have been studied by immunofluorescent techniques, rosette formation and stimulation with PHA and PWM mitogens. The ultrastructural studies revealed a well preserved structure of most of the plasma cells, often with a prominent nucleolus. The Golgi apparatus (GOL) was often large and in some cells there appeared to be a striking development of non‐granular (smooth) endoplasmic reticulum in association with the GOL. Various non‐crystalline inclusions were seen outside the cisternae of the endoplasmic reticulum. The cells contained large amounts of immunoglobulins of the IgG (kappa) class. No paraprotein was present in serum. Normal amounts of serum Immunoglobulins were detected. No abnormalities could be demonstrated in the B or T cell system. It is concluded that the defect must be localized to the plasma cells themselves and not to the precursor cells of the B system.
Interferon and Spontaneous Cytotoxicity in Man
Authors: Einhorn Stefan , Blomgren Henric , Strander Hans
Published: August 2010

ABSTRACT. The spontaneous cytotoxicity of peripheral lymphoid cells from five tumor patients was measured before and at various times after the first injection of human leukocyte interferon (IF). Four of the patients' lymphocytes exhibited cytotoxicity before the IF injection. After injection of IF there was an initial decrease in cytotoxicity, followed by an increase to 1.5‐5 times above the preinjection level, the peak being reached at 12 hours. Thereafter the spontaneous cytotoxicity decreased but usually remained elevated for 24 hours after the injection. The lymphocytes of the fifth patient had very low spontaneous cytotoxicity before the injection of IF, and this did not markedly change afterwards. The proportion of E‐rosette forming cells seemed to decrease slightly in all patients after the injection, followed by a normalization at 24–48 hours.
Interaction by Cholestyramine on the Uptake of Hydrocortisone in the Gastrointestinal Tract
Authors: Johansson C. , Adamsson U. , Stierner U. , Lindsten T.
Published: August 2010

ABSTRACT. An absolute reduction of the plasma cortisol levels and a delay of the peak concentrations were recorded in 10 healthy subjects, when a bile‐sequestering anionic exchange resin, cholestyramine, was given prior to a single oral hydrocortisone dose, indicating that the resin interferes with the uptake of a neutral sterol in the human gastrointestinal tract. The possibility of a direct binding of drug to resin is supported by the affinity of hydrocortisone to cholestyramine in vitro, which was uninfluenced by the presence of sodium taurocholate. Cholestyramine significantly delayed the gastric emptying of a glucose solution, indicating that the resin not only decreases but also delays hydrocortisone absorption. Careful supervision is recommended when treatment with cholestyramine is given concomitant to neutral sterol drugs.
The Tromsø Heart Study
Authors: Førde O. H. , Thelle D. S. , Miller N. E. , Mjøs O. D.
Published: August 2010

ABSTRACT. There are indications that subjects of Lappish ethnic origin have a lower incidence of coronary heart disease than subjects of Norse or Finnish descent, despite their having a similar coronary risk factor status as assessed by serum lipid concentrations, BP and cigarette consumption. The possibility that this reflects a more favourable serum lipoprotein pattern in Lapps has been examined in 116 non‐fasting male subjects of Norse, Finnish and Lappish descent matched for age (mean age 39 years) and level of habitual physical activity. No significant differences between the three ethnic groups were observed, however, in either the serum total cholesterol concentration or the distribution of serum cholesterol between the high density (HDL, density (d) 1.063–1.21 g/ml) and lower density (<1.063 g/ml) lipoprotein classes. In view of recent evidence of an association of several coronary risk factors with a low HDL level in other populations, the relationship of HDL cholesterol concentration to other variables was explored by stepwise multiple regression analysis. As in other communities, HDL cholesterol was inversely related to the d <1.063 cholesterol concentration. HDL cholesterol showed no significant correlation, however, with either relative body weight, cigarette consumption or BP. Any relationship of these variables to coronary risk in the Tromsø population must operate, therefore, through mechanisms unrelated to HDL.
Antibodies against Double‐Stranded DNA in Patients with Connective Tissue Diseases
Authors: Permin Henrik , Halberg Poul , Christiansen Erik
Published: August 2010

ABSTRACT. Antibodies against double‐stranded (ds) DNA were demonstrated by an immunofluorescence technique using Crithidia luciliae kinetoplast as antigen, and by means of the Farr technique. Both techniques were used simultaneously in 172 sera from patients with systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), juvenile rheumatoid arthritis (JRA), temporal arteritis (TA) and from healthy controls. Comparable results were obtained with the two techniques. SLE patients with active disease had higher titres of IgA antibodies than patients with inactive disease. Of the patients with RA and JRA, 10% had significant titres of dsDNA antibodies. Patients with TA and normal controls had either no dsDNA antibodies in their sera or very low titres without complement‐fixing properties.
Increase in Serum Alkaline Phosphatase (S‐ALP) in Chronic Myelocytic Leukemia—Sign of Drug‐Induced Cholestasis?
Authors: Hast Robert
Published: August 2010

ABSTRACT. In four patients with chronic myelocytic leukemia, a solitary rise in serum alkaline phosphatase (S‐ALP) was noted 2–12 months prior to death. All patients had received busulphan (Myleran®) therapy for longer than 12 months (total dosage 1.0–2.4 g). It is suggested that the increase in S‐ALP was due to a cholestatic liver damage, possibly secondary to the busulphan treatment.