bluuebunny/crossref_metadata_2025 huggingface dataset:
Purpura, Pigmentation and Yellow Nails of the Lower Extremities in Diabetics
Authors: Lithner Folke
Published: August 2010

ABSTRACT This article describes purpura and pigmentations of the lower extremities as well as yellow nails mainly in elderly diabetics but also in persons not known to have diabetes. When the latter were compared to controls, it appeared that their glucose tolerance was altered in a diabetic direction. Precipitating factors could generally be established for these lesions, predominantly cardiac decompensation with edema of the legs, and were more common in patients not known to have open diabetes than in patients with open diabetes. Petechiae were transformed into small, pigmented, non‐atrophic spots. Petechiae and pigmented spots were often seen simultaneously. In a few patients small, pigmented, non‐atrophic spots were seen as pronounced brown‐black pigmentation on the lower legs and feet. In a number of patients with open diabetes or diabetic glucose tolerance, erysipelas with purpura within the area of erysipelas was observed on the lower extremities. Patients with no purpura within the area of erysipelas generally had normal glucose tolerance. The pathogenesis of these lesions is discussed. Atrophic circumscribed skin lesions (Melin), cutaneous erythema, with or without necrosis, purpura, pigmentation, red toes, as well as rubeosis plantarum, yellow nails and neuropathy are often seen simultaneously on the lower extremities of patients with open diabetes as well as of those without open diabetes but with diabetic glucose tolerance.
Long‐term Hypotensive Effect of Atenolol (ICI 66.082), a New β‐adrenergic Blocking Agent
Authors: Hansson L. , Karlberg B. E. , Åberg H. , Westerlund A. , Jameson S. , Henningsen N. C.
Published: August 2010

ABSTRACT A report is given from an on‐going multicenter trial in Sweden, in which 117 hypertensive patients have been treated with a new cardioselective β‐adrenergic blocking agent, atenolol (ICI 66.082, Tenormin®) for an average of six months (range 2–21). Statistically significant reductions of BP were observed, recumbent by 29/19 mmHg (p < 0.0001) and standing by 28/18 mmHg (p < 0.0001). Few and comparatively mild sideeffects were seen.
A Blood Pressure Information Campaign Including Mass Screening for Hypertension in Copenhagen Supermarkets
Authors: Schnohr Peter , Hansen Anders Tybjærg
Published: August 2010

ABSTRACT During its “Heart‐week” in Feb. 1975, the Danish Heart Foundation drew the attention of the public to the importance of blood pressure measurements as a vital part of health control and prevention. In all, 24 thousand men and women attending supermarkets in Copenhagen took advantage of an offer to have their BP checked. 23% of the screened, who had systolic BP ≥ age + 110 (and this sum exceeded 145) and/or diastolic BP ≥100 mmHg for all ages, were advised to contact a general practitioner for further evaluation. The campaign showed that it is possible to measure BP and obtain reliable results in an easy, quick, inexpensive and unorthodox way accepted by a public accustomed to free medical care.
Serum Lipids in Alcoholics
Authors: Böttiger L. E. , Carlson L. A. , Hultman E. , Romanus V.
Published: August 2010

ABSTRACT Fasting serum lipid values (cholesterol, triglycerides and phospholipids) have been analysed in a group of 85 male and 10 female alcoholics of various ages in connection with an acute drinking bout and compared to the values of twice as many control subjects. The most prominent finding was an increase in the mean concentration of triglycerides and phospholipids, most marked in the younger age groups. The elevations, however, were moderate and most alcoholics had the same serum lipid values as the controls. Serum triglyceride values above 2 and 3 mmol/1, respectively, occurred in 23% and 4% in controls and in 28% and 13% in alcoholics. It is suggested that excessive intake of alcohol induces hypertriglyceridaemia only when other factors are present. One such factor may be a reduced i.v. fat tolerance.
Ventricular Fibrillation after Intravenous Atropine for Treatment of Sinus Bradycardia
Authors: Lunde Per
Published: August 2010

ABSTRACT A patient with acute myocardial infarction and sinus bradycardia has been treated with 0.5 mg atropine intravenously. Shortly after the injection he showed a sinus tachycardia, then developed ventricular ectopic beats, ventricular tachycardia and ventricular fibrillation, which was treated successfully with electrical countershock.
Systemic Lupus Erythematosus in Twin Sisters Following Ten Years of Hyperglobulinemic Purpura (Waldenström)
Authors: Zaharia L. , Hill J. M. , Loeb E. , MacLellan A. , Khan A. , Hill N. O.
Published: August 2010

ABSTRACTUniovular twin sisters have been diagnosed 10 years ago as having hyperglobulinemic purpura (Waldenström) at age 12. The diagnosis was documented by purpura of the lower extremities, increased γ‐globuün after serum electrophoresis, and increased 7S component upon ultracentrifugation. In addition, there was an elevated ESR, a positive rheumatoid arthritis latex test, and their LE prep. was negative at that time. At a later date, however, both of them developed polyarthritis. After 9 years for the one and 10 years for the other, their LE prep. became strongly and constantly positive, while their γ‐globulin remained within abnormal limits.
Right Atrial Monophasic Action Potential in Healthy Males
Authors: Brorson Leif , Olsson S. Bertil
Published: August 2010

ABSTRACTRight atrial monophasic action potentials (MAP) have been recorded in 40 healthy males. At least one MAP recording was performed in each individual during spontaneous sinus rhythm. Right atrial pacing and simultaneous MAP recording were performed in 25 of the 40 individuals. The paced cycle length was successively decreased in steps of 100 msec between 800 and 400 msec. The durations of the MAP at 50 and 90% repolarization and the relative repolarization rate during phase 3 (RRR ph 3) were calculated and normal values for the variables are given. A correlation was demonstrated between the duration of the MAP and the cycle length—the longer the cycle length, the longer the duration of the MAP—both during sinus rhythm and during atrial pacing. A significant correlation was also shown between the RRR ph 3 and the duration of the MAP at 90% repolarization—the shorter the MAP, the faster the RRR ph 3. One age group (45–54 years) deviated significantly from the rest in some respects, but in general there was no age trend in the whole material.
The Effect of Different Oral Anticoagulants on Diphenylhydantoin (DPH) and Tolbutamide Metabolism
Authors: Skovsted L. , Kristensen M. , Hansen J. Mølholm , Siersbæk‐Nielsen K.
Published: August 2010

ABSTRACTThe effect of bishydroxycoumarin, phenprocoumon, warfarin and phenindione on the metabolism of diphenylhydantoin (DPH) and tolbutamide has been studied in 54 patients. The half‐lives of DPH and tolbutamide in blood following i.v. injections were studied in 33 patients before and after one week of anticoagulant treatment. Bishydroxycoumarin increased the mean half‐life values of DPH from 8.8 to 37.4 hours and of tolbutamide from 4.9 to 17.5. Phenprocoumon prolonged DPH half‐life from a mean value of 9.9 to 14.0 hours but did not change the tolbutamide half‐life. Warfarin and phenindione did not affect DPH or tolbutamide half‐lives. Steady state concentration studies in 21 patients showed a rise in serum DPH during bishydroxycoumarin and phenprocoumon treatment but not during treatment with warfarin and phenindione. A rise in serum tolbutamide was noted during treatment with bishydroxycoumarin. These findings suggest that bishydroxycoumarin inhibits the betab‐olism of DPH and tolbutamide and that phenprocoumon inhibits DPH metabolism. No effect on DPH and tolbutamide metabolism could be demonstrated following administration of warfarin and phenindione.
Iron Absorption after Renal Transplantation
Authors: Milman Nils , Larsen Lars
Published: August 2010

ABSTRACT. Gastrointestinal iron absorption has been measured by means of whole body counting in 13 patients after renal allotransplantation. Whole body retention 14 days after oral administration of 10 μCi 59Fe together with a carrier dose of 9.9 mg Fe2+ was used as an expression of absorption. The percentage incorporation in the total erythrocyte mass of administered 59Fe (erythrocyte incorporation) and absorbed 59Fe (red cell utilization) was estimated as well. Geometric mean iron absorption was 12.4+2.5 (S.D.) % and geometric mean erythrocyte incorporation 11.1 +3.0 (S.D.) % while arithmetic mean red cell utilization was 95.6+8.6 (S.E.M.) %. None of these parameters differed significantly from those obtained in normal subjects (p>0.2, p>0.1, p>0.3, respectively). Iron absorption and erythrocyte incorporation in renal transplanted patients did not differ significantly from the values measured in non‐dialysed and dialysed patients with chronic renal failure (p>0.1). The correlation between iron absorption and erythrocyte incorporation was highly significant (r=0.96, p<0.001).
Effects of Chlorthalidone on Serum and Total Body Potassium in Hypertensive Patients
Authors: Leemhuis M. P. , van Damme K. J. , Struyvenberg A.
Published: August 2010

ABSTRACT. Total body potassium has been estimated in 26 hypertensive patients who were hypokalaemic as a result of long‐term chlorthalidone treatment (mean 20.5 months), while they were on chlorthalidone and 4 weeks after this had been discontinued. The mean difference amounted to only 95 mEq (not significant). In 6 additional patients not previously treated with chlorthalidone, serial total body potassium estimations revealed a mean potassium deficiency of 245 mEq after 33 days and of 106 mEq after 100 days. These results suggest that the mechanism causing the initial potassium loss is partly reversed or compensated later on. In patients with uncomplicated hypertension, no significant potassium deficiency was detected during long‐term treatment. Eighteen of our patients received 39 mEq potassium chloride supplements daily for 4 weeks; this caused a mean rise in serum potassium from 3.23 mEq/1 to 3.38 mEq/1 (not significant). Total body potassium did not change at all. We conclude that potassium chloride supplements are not an effective treatment of hypokalemia in this condition. Correction of the extracellular pH by ammonium chloride in 6 patients on chlorthalidone, who demonstrated a slight metabolic alkalosis, gave rise to a mean increase in plasma potassium from 2.78 mEq/1 to 2.96 mEq/1 (not significant). The hypokalaemia in hypertensive patients on long‐term chlorthalidone treatment cannot be explained by either a potassium deficiency or the change in extracellular pH.
Attempted Diagnosis of Ventricular Mural Thrombi in Acute Myocardial Infarction Using 125I‐labelled Fibrinogen
Authors: Erhardt L. R. , Sjögren A.
Published: August 2010

ABSTRACT. In an attempt to diagnose ventricular mural thrombi complicating acute myocardial infarction (AMI), 80 patients have been given 100 /μCi 123I‐labelled fibrinogen after admission to a CCU. Precordial radioactivity was recorded for the following 6 days over four sites corresponding to chest leads CR1‐CR4. A sustained rise in radioactivity of at least 15 % of initial recordings was classed as type A pattern, a minor rise or flattened response as type B pattern and a rapid decrease as type C pattern; 28% showed a type A, 19% a type B and 54% a type C pattern. There was no significant difference between the groups in incidence of pericardial friction rub but when patients with suspected pericarditis (as evidenced by characteristic pains) were added, pericarditis was significantly overrepresented in the type A group. Smaller infarctions (SGOT<100 U/l) were significantly more common in patients with a type C decay pattern. No differences were noted between the groups as regards type and site of the infarction. A sustained rise in precordial radioactivity after an AMI may be an indication of mural thrombosis but the influence of other factors secondary to an infarction, e.g. pericarditis, cannot be determined at present.
Acute Poisoning with Dextropropoxyphene
Authors: Gustafson Arne , Gustafsson Bengt
Published: August 2010

ABSTRACT.Out of 14 cases of poisoning assumed to be due to dextropropoxyphene‐containing drugs, propoxyphene and its main metabolite norpropoxy‐phene could be demonstrated in 11. The concentrations of the drugs were determined shortly after admission and then after 2, 4, 6 and 10 hours (in four cases also after 16 hours). The highest plasma concentration of propoxyphene, 0.74 μg/ml, was found in one case of fatal poisoning. Another patient with a plasma concentration of 0.51 μg/ml showed signs of severe respiratory depression but survived after respirator therapy. In the patients with lower plasma concentrations the poisoning had a benign course. In most cases the plasma concentration of norpropoxyphene exceeded that of propoxyphene even in the first blood sample.
Relationship between Plasma Aldosterone Concentration and Plasma Potassium in Patients with Essential Hypertension during Alprenolol Treatment
Authors: Pedersen E. B. , Kornerup H. J.
Published: August 2010

ABSTRACT. Plasma aldosterone concentration (PAC), plasma renin concentration (PRC), plasma potassium, plasma sodium and blood pressure (BP) have been measured in 22 patients with essential hypertension before and after treatment for one month with alprenolol. PAC, PRC and BP decreased and plasma potassium increased significantly during treatment. Plasma sodium, however, was unchanged. Changes in PAC were inversely correlated to changes in plasma potassium. No relationship could be demonstrated between PAC and plasma sodium. Mean BP was inversely correlated to PAC during alprenolol treatment, but not before treatment. No relationship was found between changes in BP and changes in PRC. The results suggest that plasma potassium is an important regulatory factor for aldosterone secretion during alprenolol treatment. Other factors, however, must have a modulating influence and since the renin—angiotensin system is not suppressed to very low values, this system is possibly the most important of these factors. It is suggested that aldosterone secretion is not of primary importance in BP regulation during alprenolol treatment.
Serum Vitamin B12Levels in the Aged
Authors: Elsborg L. , Bastrup‐Madsen P. , Lund V.
Published: August 2010

ABSTRACT.In an attempt to throw light on the question of age‐related variations in the normal blood content of cobalamin and on the frequency of deficiencies of antimegaloblastic nutriments in the elderly, 273 geriatric patients have been investigated. Low serum vitamin B12values were found in one third of these patients, due to latent pernicious anaemia in five and malabsorption in seven cases, and probably caused by nutritional deficiency of folate or cobalamin in 78 cases. In that part of the series with apparently normal vitamin B12levels, the mean value (379+14 pg/ml) was lower than the mean (465+20 pg/ml) for a younger control group. However, this cannot be taken as a sign of a physiological lowering of the cobalamin values with age, as nutritional deficiencies could not be ruled out in this part of the series. It is concluded that serum vitamin B12assays should be performed rather liberally in the aged. Patients with nutritional deficiency of cobalamin orfolate should be treated, even if frank megaloblastic anaemia is not present.
Iron Therapy in Patients Undergoing Maintenance Hemodialysis
Authors: Milman Nils
Published: August 2010

ABSTRACT. Twelve patients in maintenance hemodialysis, receiving long‐term oral iron therapy, have been treated with i.v. iron dextran, in order to evaluate the effect on the Hb level. Both Hb and hematocrit were unchanged before and after the iron dextran infusion (p>0.5, p>0.7, respectively). Oral iron therapy is usually sufficient to maintain an adequate iron balance in dialysed patients and should be preferred to parenteral iron in view of the better utilization and absence of side‐effects. The indication for parenteral iron should be limited to patients with impaired gastrointestinal iron absorption.
Multiple Endocrine Adenomatosis of Mixed Type
Authors: Hansen O. Påske , Hansen Mogens , Hansen Heine H. , Rose B.
Published: August 2010

ABSTRACT. A case of multiple endocrine adenomatosis (MEA) of mixed type is presented. The syndrome, observed in a 65‐year‐old female, consisted of multiple neurofibroadenomatosis, medullary thyroid carcinoma, multiple adenomata of the parathyroids, adrenal cortical adenoma and small cell anaplastic bronchogenic carcinoma. Thus, it was composed of type 1 as well as of type 2 MEA. On the basis of another seven cases, collected from the literature, the MEA syndrome of mixed type is reviewed with special reference to the phylogenetic origin of the cells of the APUD system.
Hemodynamic Influence of Multiple Congenital Arteriovenous Fistulas
Authors: Björkholm M. , Aschberg S.
Published: August 2010

ABSTRACT. A 16‐year‐old girl complained of sensations of weight, swelling, warmth and frequent sweating from her right arm and hand. Varicose veins were seen on the dorsal aspect of her right hand, her right arm was longer than the left. Since birth she had a capillary hemangioma involving her right shoulder. Right arm and aortocervical arteriograms disclosed large arteriovenous fistulas. Cardiac output was markedly increased. No cardiac enlargement was seen at X‐ray examination. The prognosis and future management of the patient are discussed.
Prognosis of Patients with Complete Heart Block or Arrhythmic Syncope
Authors: Edhag O. , Swahn Å.
Published: August 2010

ABSTRACT. This paper reports the results of a retrospective study carried out with special reference to the survival rate in a series of 101 selected cases including patients with complete heart block (CHB) combined or not combined with Adams‐Stokes attacks and patients with arrhythmic syncope without ECG evidence of CHB. All these patients were treated in our Department during 1958‐68, none being artificially paced. Twenty‐seven patients were alive at the end of the follow‐up, i.e. 6–15 years after admission to this Department on account of syncopal episodes or CHB. The survival rate—higher in females than males—was lower in the cases of CHB combined with Adams‐Stokes attacks than in the cases of asymptomatic CHB. This applied also to the instances in which a complicating disease such as ischaemic heart disease (IHD), hypertension, diabetes, digitalis intoxication or cardiac enlargement coexisted. The survival rate in the 68 cases of CHB was higher at one year (68%) as well as at 5 years (37%) than that reported by other investigators. When assessing the survival rate in cases treated with artificial pacemakers, it is important to study the individual case histories with special reference to a previous or coexisting condition such as IHD, hypertension, diabetes or the presence of cardiac enlargement. The present results support the view that the indications for treatment with artificial pacing should be wide, albeit that the prognosis in this series was more favourable than might have been anticipated from observations by others.
CENTRAL HYPOTENSIVE EFFECTS OF ANGIOTENSIN II IN THE RAT
Authors: Karppanen Heikki , Liukkonen Tapani , Paakkari Ilari , Paakkari Pirkko
Published: August 2010

Abstract. The floor of the fourth cerebral ventricle of urethane‐anaesthetized rats was exposed through the occipital foramen. Angiotensin II (10–1000 ng), applied onto the surface of the area postrema, induced a rapid lowering of the blood pressure. Pretreatment of the rats with reserpine abolished the hypotensive response to angiotensin II. It is concluded that the local application of angiotensin II induced in the vicinity of the area postrema a release of some biogenic amine, which has an inhibitory effect on the cardiovascular centres.
The treatment of hypertension ‐ an analysis of drug prescription data.
Authors: Boethius G.
Published: August 2010

This paper describes a study of the degree of continuity in the drug treatment of hypertension. An analysis of antihypertensive drugs dispensed to 916 individuals during 1970–74 revealed that 22% of the men and 27% of the women were without treatment for 20–50% of their observation time. A closer examination of 46 patients under 60 years of age showed that between 2 and 20 physicians had been involved in the antihypertensive treatment of the individual patient. The time without treatment in this group of unselected patients varied between 0 and 77% of the observation time, the degree of discontinuity being insignificantly correlated to the resulting blood pressure level. Non‐compliance was the cause for discontinuing a drug in at least every fifth case.
Energy Deprivation in Man—Methodological Problems and Possibilities
Authors: Kjellberg Jan , Levi Lennart , Palmblad Jan , Paulsson Lennart , Theorell Töres , Yensen Roy
Published: August 2010

ABSTRACT Various approaches to the study of physiological and behavioural effects of energy deprivation are presented and discussed. An experimental, total energy deprivation in 20 healthy human volunteers during an 11‐day period, preceded and followed by 4‐day control periods, is described. Potentially pathogenic reactions which occurred in spite of precautions are analysed. It is concluded that the present controlled real‐life model with acute total energy deprivation serves the purpose of studying hypotheses concerning potentially pathogenic mechanisms occurring in deprivational situations under conditions of natural and man‐made catastrophes.
ECG Recording in Emergency Home Visits
Authors: Petersen H. , Hansen G. , Andersen P. , Dybdahl J. H. , Horgen ö. , Barkve T.
Published: August 2010

ABSTRACT During the first half of 1974, 756 emergency home calls have been made by 6 doctors in the City of Oslo. A portable ECG instrument was available at all visits. The visits were unselected as regards complaints. ECG was recorded in 7% of all patients and in 19% of all patients over 60 years of age. The main indication for recording an ECG was chest pain (nearly 2/3 of all recordings). In only a small number of cases did the recording give a definite result as regards diagnosis or management of the case. However, a slight additional benefit was obtained with a majority of the ECG recordings, including what we defined as a psychotherapeutic benefit. The results of this study indicate that the value of a portable electrocardiograph is very limited for emergency home calls in a city.
Thrombocythaemia and Multiple Myeloma
Authors: Selroos O. , van Assendelft A.
Published: August 2010

ABSTRACTA report is presented on two patients with the very rare combination of thrombocythaemia and multiple myeloma. Both patients displayed an increase in monoclonal immunoglobulin in the serum, an increased amount of plasma cells in the bone marrow, and multiple osteolytic lesions in the skeleton, along with a platelet count exceeding 1 mill./mm3, haemorrhagic diathesis, and thromboembolic complications. In case 1, both diseases reacted favourably to treatment with melphalan during a 36‐month follow‐up. In case 2, the thrombocythaemia had been brought under control with busulphan prior to the diagnosis of myeloma. The latter patient died before initiation of treatment of the myeloma. The significance of the combination is discussed.
Family Study of High Density Lipoprotein Cholesterol and the Relation to Age and Sex
Authors: Mjøs O. D. , Thelle D. S. , Førde O. H. , Vik‐Mo H.
Published: August 2010

ABSTRACT A family study of serum high density lipoprotein (HDL) cholesterol and total serum cholesterol concentration has been undertaken, and the relation to age, sex, cigarette smoking, physical activity and familial occurrence of myocardial infarction (MI) was examined. HDL cholesterol was determined in 251 females and 194 males and total serum cholesterol in 677 females and 657 males, all aged 0–49 years. With respect to HDL cholesterol, significant sex differences were observed both in absolute level and in age‐related change. A negative correlation between HDL cholesterol and total serum cholesterol was observed in all age groups except females aged 0–19 years, supporting the hypothesis of HDL as a “clearing” lipoprotein. HDL cholesterol showed a positive correlation only in pairs of first‐degree relatives involving the mother and in sib‐sib pairs of the same sex. On the other hand, for serum cholesterol a positive correlation was found among all family members, although significantly higher between first‐degree relatives than between spouses. No relation was found between cigarette smoking, physical activity or familial occurrence of MI and the HDL cholesterol or total serum cholesterol concentrations. In accordance with the “HDL hypothesis”, the present finding could partly explain the higher incidence of ischaemic heart disease (IHD) in males than in females, and partly also the high risk which is transmitted from women with IHD to their first‐degree relatives.
Renin‐dependent Hypertension in Patients with Unilateral Kidney Disease not Caused by Renal Artery Stenosis
Authors: Delin Krister , Aurell Mattias , Granerus Göran
Published: August 2010

ABSTRACT The practical value of renin secretion studies in hypertension associated with unilateral kidney disease, other than renal artery stenosis, has not been documented. This study, comprising 19 patients of this kind, disclosed three who had an abnormal renin secretion from the diseased kidney. The level of peripheral renin under basal conditions, and the change from this level as a result of provocation of renin secretion, were used to evaluate the importance of an arteriovenous renin gradient in the diseased kidney. The three patients were the only ones to become normotensive when the diseased kidney was removed in seven of the cases studied. When nephrectomy is considered in severe hypertension with unilateral kidney disease, there is a place for renin secretion studies, but a screening procedure is advisable. Measuring peripheral renin under basal conditions and after provocation of renin secretion, should reveal whether the renin‐angiotensin system might be playing a part in maintaining the high BP. The finding of diminishing kidney function in many of the patients, despite good BP control, emphasizes the importance of sparing kidney function whenever possible.
Decrease in α‐Lipoprotein Cholesterol in Men after Cessation of Exposure to Chlorinated Hydrocarbon Pesticides
Authors: Carlson Lars A. , Kolmodin‐Hedman Birgitta
Published: August 2010

ABSTRACT Eight men who in 1970 had been exposed to chlorinated pesticides and for whom the exposure had ceased in 1976, showed a significant fall in α‐lipoprotein (HDL) cholesterol between these years. The cholesterol concentration of the other lipoprotein classes showed no significant trend. The data support our previous suggestion that exposure to chlorinated pesticides, mainly lindane, may raise the α‐lipoprotein levels.
Amoeboid Movement Configuration in Tumour Cells of Bone Marrow Smears from Patients with Leukaemia
Authors: Sjögren Ulf , Norberg Bo , Rydgren Lars
Published: August 2010

ABSTRACT The incidence of amoeboid movement configuration (AMC), a cell shape suggestive of cell locomotion at the moment of fixation, has been studied in the tumour cells of bone marrow smears from leukaemia patients at the time of diagnosis. The groups of patients with CML (n=8), ALL (n=5) and CLL (n=9) were small, and the incidences of AMC were close to those found in the corresponding cell lines from healthy probands. In 39 patients with AML, the incidence of AMC was higher than in the other cell lines investigated. A positive skew distribution of AMC values and a positive significant correlation between incidence of AMC were found at the time of diagnosis and subsequent survival of the patients with AML, in spite of differences in treatment. It is suggested that this positive correlation may be due to an immune reaction of the patients against their tumour cells.
Bilateral Atrial Myxomas Diagnosed by Echocardiography
Authors: Gustafson Arne G. , Edler Inge G. , Dahlbäck Olov K.
Published: August 2010

ABSTRACT Bilateral atrial myxomas have been demonstrated with the aid of echocardiography in a 31‐year‐old male patient. The diagnosis was confirmed by angiography and the tumors were removed successfully at operation.
Prognostic Value of Colony‐stimulating and Colony‐forming cells in Peripheral Blood in Acute Non‐lymphoblastic Leukemia
Authors: Hörnsten Per , Granström Marta , Wahren Britta , Gahrton Gösta
Published: August 2010

ABSTRACT Colony‐forming cells (CFC) and colony‐stimulating activity (CSA) in peripheral blood cells have been studied before and repeatedly during treatment of 30 patients with acute non‐lymphoblastic leukemia. WBC obtained after Isopaque‐dextran separation were cultured in vitro by a double‐layer agar technique. Before treatment 16 patients out of 30 had CSA and 22 out of 29 had CFC; both CSA and CFC were found in 15 patients. In follow‐up studies during treatment, CSA was mainly unaffected during the leukopenic phase, while CFC were suppressed. No CFC were found at WBC counts below 900/mm3. This seems to imply that CFC are more sensitive to cytotoxic agents than colony‐stimulating cells. Twelve patients entered remission; all of them had CSA and all the 11 who were investigated for CFC had CFC before treatment. Fourteen out of 18 non‐responders lacked one or both types of cells. The presence of CSA and CFC in peripheral blood therefore appears to be a sign of favorable prognosis, while the absence of CSA and/or CFC implies lack of response to treatment.
Treatment of Advanced Breast Cancer with Chemotherapeutics and Inhibition of Coagulation and Fibrinolysis
Authors: Åstedt Birger , Mattsson Willy , Tropé Claes
Published: August 2010

ABSTRACT A case of advanced breast cancer with cerebral metastasis and pleurisy is reported in which irradiation and cytostatics had failed to retard progressive growth and spread of the tumour. Adjuvant therapy with heparin combined with the fibrinolytic inhibitor tranexamic acid was followed by regression of the cerebral metastasis as well as the pleurisy. When last seen one year later, the patient was free from symptoms.
ADP‐induced Platelet Aggregation In Vitro in Patients with Ischemic Heart Disease and Peripheral Thromboatherosclerosis
Authors: Gormsen Johs. , Nielsen Jørn Dalsgaard , Andersen Leif Agerskov
Published: August 2010

ABSTRACTADP‐induced platelet aggregation in vitro has been studied in 90 normal controls and in 30 patients with ischemic heart disease (IHD) and 22 with peripheral thromboatherosclerosis (PTA). The sensitivity to ADP was defined by the threshold concentration which produced secondary aggregation with an amplitude corresponding to not less than 80% of the transmission obtained by platelet‐poor plasma. In the normal controls the threshold concentration was significantly lower in women aged 50 or more than in women under that age. The geometric means were lower in the patients than in the controls. Significantly lower threshold concentrations than in the corresponding age groups of controls were found in the following age groups of patients: Men and women ≥50 years with IHD (p<0.005 and p<0.001, respectively), men and women under 50 with IHD (p<0.05). Men and women ≥50 years with PTA (p<0.002 and p<0.01, respectively), men and women under 50 with PTA (p<0.005).
The Peripheral Platelet Count in Response to Intravenous Infusion of Salbutamol
Authors: Kutti Jack , Olsson Lars‐Bertil , Lundborg Per , Fredén Krister
Published: August 2010

ABSTRACT Five healthy male volunteers received i.v. infusions of salbutamol, a relatively selective β‐2‐receptor‐stimulating agent, in doses of 0.03, 0.06, 0.09 and 0.27 μgxkg‐1xmin‐1 over a period of 6 min. At the three low doses the heart rate remained essentially unchanged and no significant decrease in the platelet count occurred. However, in response to 0.27 μgxkg‐1xmin‐1 of salbutamol the heart rate increased by 25% over basal value (p<0.01) and a significant lowering (p<0.005) of the platelet count was obtained. The present findings suggest that the drop in the peripheral platelet concentration in response to adrenergic β‐receptor stimulation is mediated via β‐1‐receptors.
Significance of Enzyme Release from Ischemic Isolated Rat Heart
Authors: Waldenström Anders P. , Hjalmarson Åke C. , Jodal Mats , Waldenström Johan
Published: August 2010

ABSTRACT Whole‐heart ischemia has been induced in isolated working rat heart. The distribution of the reduced coronary flow was even, as judged by 3H‐antipyrine autoradiographs. Reducing the coronary flow resulted in myocardial ischemia, as indicated by a lowered tissue content of glycogen, ATP and creatine phosphate and accumulation of lactate. After a reperfusion period of 30 min there was a restoration of glycogen, ATP and creatine phosphate for hearts that were ischemic for 5 and 10 min, with a concomitant normalization of tissue lactate. Hearts that were ischemic for 30 min did not show restoration of high energy phosphates and glycogen. There was a leakage of ASAT, CK and LD in all groups of hearts, suggesting that a release of these enzymes does not necessarily indicate an irreversibly damaged myocardial cell.
Electrocardiographic Changes in Massive Pulmonary Embolism
Authors: Ahonen Antti
Published: August 2010

ABSTRACT A retrospective analysis of the changes in ST segment and T wave has been made in 35 patients (16 male, 19 female) with massive pulmonary embolism in whom the diagnosis was confirmed at autopsy. Parameters of the last two ECGs available were measured and compared. It was found that during massive pulmonary embolism the most characteristic abnormalities were a decrease in ST segment, which took place in about 70 % in leads I and V5‐V6. Another common change was the inversion of the T wave, which took place in 43 % in aVF, and in 37 % in lead II. None of the changes, however, was statistically significant.
Atenolol in the Treatment of Angina Pectoris
Authors: Erikssen J. , Osvik K. , Dedichen J.
Published: August 2010

ABSTRACT Nineteen men, aged 41–64 years, with stable angina pectoris have completed a random double‐blind study of atenolol, 50 mg b.i.d., atenolol, 100 mg b.i.d., and placebo. Fifteen patients had subjective improvement on atenolol, two were unchanged and two felt worse (because of asthenia/leg fatigue). No significant placebo effect was found. On both atenolol dosages there were highly significant reductions in heart rate at rest and during exercise and in BP. Only the maximal heart rate decreased significantly more on 100 mg atenolol than on 50 mg (p<0.01). Fourteen patients had the same or a better physical performance on the 50 mg b.i.d. regimen than on the 100 mg b.i.d. regimen, although this difference was not significant. Sixteen patients had higher bicycle exercise performance on atenolol than on placebo. Disregarding the three non‐responders, a mean increase of 44% in bicycle performance was found. No serious side‐effects were seen. Most individuals reported an increased feeling of well‐being on atenolol.
Urinary Cyclic AMP: Relation to Calcium Balance and Comparison of Assay Methods
Authors: Israelsson Bo , Lindgärde Folke , Malmquist Jörgen
Published: August 2010

ABSTRACT Urinary adenosine 3′, 5′‐monophosphate (cyclic AMP, cAMP) has been determined in 84 males. Two protein‐binding assays were used: the method of Gilman and the Amersham assay kit. The results were in close agreement. The excretion of cAMP was not correlated to urinary calcium or to estimated calcium intake.
Blood Pressure and Renin during Treatment with Pindolol
Authors: Fyhrquist F. , Kurppa K. , Huuskonen M. , Koistinen A.
Published: August 2010

ABSTRACT Beta‐receptor blocking drugs are known to decrease BP and plasma renin activity (PRA) in hypertensive patients. We treated 31 hypertensive patients with the β‐receptor blocking drug, pindolol, for 3 months. During the first month (mean daily dose 10 mg) and the second month (mean daily dose 14.2 mg) BP and PRA decreased. During the third month of pindolol therapy (mean daily dose 19.0 mg) 16 patients had an unexpected rise of BP towards control levels and PRA levels rose, too. The remaining IS patients maintained a good antihypertensive drug effect and suppression of PRA. Pretreatment PRA was not related to BP reduction. The change in diastolic BP was not significantly related to that in PRA. The results indicate that low doses of pindolol, 10–15 mg daily, will suffice in mild essential hypertension. An increasing frequency of partial drug resistance may be a result of unnecessarily high doses of pindolol.
Renal Glueosuria and Aminoaciduria
Authors: Gøtzsche Ole
Published: August 2010

ABSTRACT A follow‐up examination of five patients in whom renal glueosuria had been diagnosed 7–15 years previously, showed that the condition was unchanged. There was no indication of hormonal abnormalities. Oral glucose tolerance test, with determination of insulin, growth hormone and free fatty acids, showed no difference between the patients and a group of normal subjects. The urinary excretion of insulin and albumin was normal, but two patients turned out to have an increased excretion of certain amino acids, aspartic acid in one and glutamic acid, citrulline and alanine in the other.
Myocardial Scintigraphy with 99mTechnetium Stannous Pyrophosphate in Patients with Possible Acute Myocardial Infarction
Authors: Knutsen K. M. , Otterstad J. E. , Strøm O.
Published: August 2010

ABSTRACT Fifty‐six patients with a preliminary diagnosis of possible acute myocardial infarction (AMI) were studied on the second or third day after onset of symptoms by 99mtechnetium stannous pyrophosphate myocardial imaging. The scintigraphy was positive in 25 (44.6%). The final clinical diagnoses upon discharge were: definite AMI in 11 with positive scintigraphy in 9 (82 %), intermediate coronary syndrome (ICS) in 37 with positive scintigraphy in 15 (40.5%), postinfarction failure in 4 with positive scintigraphy in 1, no diagnosis of coronary heart disease in 4 patients with negative scintigraphy in all. Of the 37 patients with a final diagnosis of ICS, 25 were admitted to the Coronary Care Unit with chest pain as the only symptom. In this group the mean percentage increase in ASAT was significantly higher in 9 patients with positive scintigrams than in 16 with negative. It is therefore assumed that among patients with ICS, a positive scintigraphy may reflect a more serious myocardial injury than a negative scintigram. Of six patients with an acute tachyarrhythmia and ICS, scintigraphy was positive in the three with the most long‐lasting or severe arrhythmias. False negative scintigrams may be seen in some patients with definite AMI.
Deposits of Plasma Proteins in the Skin during Treatment with Carbamazepine and Diphenylhydantoin
Authors: Permin Henrik , Sestoft Leif
Published: August 2010

ABSTRACT Biopsies from skin of normal appearance from 18 patients treated with carbamazepine and diphenylhydantoin were investigated by a direct immunofluorescence technique. Seventeen had deposits of plasma proteins at the dermoepidermal junction, 16 had deposits in the vessel walls, and one had autofluorescence of the nuclei in the epidermis and vessel walls. These findings did not correlate with changes in serum IgG, IgA, IgM, IgD, IgE or α2‐macroglobulin. Eight patients had elevated alkaline phosphatase, 4 elevated IgG and one elevated IgA. Three had low values of IgA, and all had normal values of IgM, IgD and IgE, and blood cells. In three patients, carbamazepine was withdrawn, whereupon the deposits disappeared in two and decreased in the third, who changed to another drug. The changes were quantitatively and qualitatively similar to those seen in systemic lupus erythematosus induced by these drugs.
Tachycardia, Hypertension and Syncope
Authors: Nielsen Ingolf , Pedersen‐Bjergaard Ole , Hansen Anders Tybjærg , Welner Joseph
Published: August 2010

ABSTRACT A case of orthostatic syncope with tachycardia and hypertension is described. Initially the condition was interpreted as a dysfunction in the neurovascular orthostatic regulation, but extensive physiologic examinations failed to give a comprehensive explanation. A psychiatric examination demonstrated the condition eventually to be hysteriform and the patient was completely cured by psychotherapy.
Complement Studies in Adipose Patients Treated with Intestinal Bypass
Authors: Møller B. Broch , Jensen J. , Nielsen I. Lind
Published: August 2010

ABSTRACT Seventeen consecutive patients subjected to jejunoileostomy for obesity have been investigated for complement abnormalities and cryoglobulinaemia. The study took place 1–9½ years after the operation. A concomitant clinical examination revealed recurrent arthritis in 6 (30%) of the patients. In 6 of the patients complement abnormalities were found, as activation of the classical pathway in 3 and activation of the alternative pathway in another 3 could be suspected from immunochemical data. One patient showed activation of both the classical and the alternative pathway. Two of the patients with arthritic symptoms belonged to the group showing activation of the alternative pathway. It is suggested that deficient inactivation of bacterial products from intestinal bacteria (lipopolysaccharides) have a role in the complement abnormalities found. No patient exhibited the cryoprotein complexes found earlier in this type of patients.
Respiratory Distress Syndrome and Thrombotic, Non‐Bacterial Endocarditis after Amitriptyline Overdose
Authors: Lindström Folke D. , Footmark Wolof , Gustafson Bertie
Published: August 2010

ABSTRACT Three patients with documented or suspected amitriptyline poisoning developed a uniform clinical picture with progressive respiratory insufficiency, thrombocytopenia and evidence of embolization. Post‐mortem examination revealed equally uniform changes: thrombotic, non‐bacterial endocarditis (TNBE) with multiple embolization and marked pulmonary stiffness with extensive invasion of alveoli with connective tissue. The lung pathology and clinical picture of progressive respiratory insufficiency are in agreement with the respiratory distress syndrome (RDS) in the adult. The simultaneous occurrence of RDS and TNBE suggests a similar pathogenesis. Prophylactic measures are described.
Clinically Undiagnosed Active Tuberculosis
Authors: Juul Asger
Published: August 2010

ABSTRACT The incidence of clinically undiagnosed active tuberculosis (CUDAT) was 0.1% in an autopsy material comprising about 75% of all autopsies carried out in Denmark during the period 1.1.1969–1.1.1974. This incidence, corresponding to one case in every 895 autopsies, is a minimum value. From the present study it is apparent that the miliary form is predominant. CUDAT is most often found in elderly patients from medical units. The most common cause of death is the active tuberculosis, especially the miliary form. Fever often occurs during the stay in hospital and is an almost invariable sign in miliary tuberculosis. Many of the patients had been treated with corticosteroids and/or cytostatics for associated diseases, especially malignancies.
Presymptomatic Primary Biliary Cirrhosis
Authors: Hanik Lad , Eriksson Sten
Published: August 2010

ABSTRACT Clinical, laboratory and follow‐up results in 13 patients with primary biliary cirrhosis (PBC) collected during the last 10 years in a well defined population of 250000 inhabitants are presented. The mean observation time was 5.5 years. 77% of these patients have been asymptomatic for many years. Characteristic laboratory features in asymptomatic patients are high alkaline phosphatases and glutamyl transpeptidases and very high levels of polyclonal IgM. ESR is often increased. Signs of active cell destruction are slight and functioning cell mass is well preserved. High titers of mitochondrial antibodies are consistently present. Needle biopsy is seldom sufficient for diagnosis but permits staging of the disease. There is no correlation between clinical features and histological evolution stage. Compared with a preceding 10‐year period, the incidence of PBC has risen threefold. This increase can be fully explained by the extended use of laboratory facilities, resulting in the detection of asymptomatic patients.
Cerebrospinal Fluid Sorbitol and Myoinositol in Diabetic Polyneuropathy
Authors: Servo Carita , Bergström Lea , Fogelholm Rainer
Published: August 2010

ABSTRACT Changes in cerebrospinal fluid (CSF) concentrations of sorbitol and myoinositol in 21 patients with diabetic polyneuropathy were studied with gas‐liquid chromatography. The sorbitol concentration was significantly increased in diabetic patients with elevated plasma glucose. Myoinositol concentration was significantly decreased in patients with polyneuropathy compared with the controls. Both alterations in polyol concentrations of the CSF were present already two months from onset of symptoms of diabetes. Patients with peripheral polyneuropathy receiving oral hypoglycemic drugs did not have elevated plasma glucose and CSF sorbitol levels, but showed significantly decreased CSF myoinositol concentrations compared with the controls. These observations suggest that myoinositol concentration may be decreased in the central nervous system in adult onset mild diabetes with normal plasma glucose and that the decrease in the myoinositol in CSF possibly is connected with the development of neuropathy.
Angina Pectoris and Myocardial Infarction
Authors: Wilhelmsson Claes , Vedin J. Anders , Elmfeldt Dag , Tibblin Gösta , Wilhelmsen Lars
Published: August 2010

ABSTRACT Angina pectoris was studied in a representative series of male patients (n=504) with a first myocardial infarction (MI) surviving the hospital stay. The prevalence of questionnaire angina before MI was 28% and of effort‐induced chest pain alone 40%. Of the patients with effort‐induced chest pain, 72% retained symptoms also after MI. No correlation with age was found. Three months after and one year after infarction the prevalence of effort‐induced chest pain was 55% and 45%, respectively. The patients with effort‐induced chest pain before MI had a somewhat more severe clinical course and a significantly higher death rate (15% versus 6%) than those without chest pain.
Comparison of Postoperative Coumarin, Dextran 40 and Subcutaneous Heparin in the Prevention of Postoperative Deep Vein Thrombosis
Authors: van Geloven F. , Wittebol P. , Sixma J. J.
Published: August 2010

ABSTRACT A double‐blind study was carried out to investigate the effectiveness of several preventive regimens in postoperative deep vein thrombosis (DVT). The regimens consisted of postoperative (p. o.) acenocoumarin, dextran 40 + p. o. acenocoumarin, subcutaneous (s. c.) heparin alone and s. c. heparin + p. o. acenocoumarin. The 313 patients studied were stratified according to age (40–60 vs. >60 years) and type of operation (laparotomy, thoracotomy, hip replacement). Dextran 40 + p. o. acenocoumarin was more effective than p. o. acenocoumarin alone, which acted as control. Subcutaneous heparin alone or together with p. o. acenocoumarin was not more effective than p. o. acenocoumarin alone during the first part of the study, when about 4000 IU twice daily were administered accidentally. When the dose had been changed to 5000 IU twice daily, better results were obtained (DVT incidence 5.9%). The results were strongly influenced by age and type of operation. Almost no DVT occurred in patients below 60 years of age with elective abdominal surgery. The incidence of perfusion disturbances in lung scans in patients with DVT was lowest in those treated with s. c. heparin in combination with acenocoumarin.