bluuebunny/crossref_metadata_2025 huggingface dataset:
HLA‐B27‐Negative Arthritis Related to Campylobacter Jejuni Enteritis in Three Children and Two Adults
Authors: JOHNSEN KNUT , ØSTENSEN MONIKA , CHRISTINE ANNE , MELBYE SCHMIDT , MELBY KJETIL
Published: August 2010

ABSTRACT. Five out of 37 patients with proven Campylobacter jejuni enteritis developed arthritis. Two adult patients presented with classical Reiter's syndrome. One of the three children had reactive arthritis, and clinical suspicion of septic arthritis could not be confirmed in two. The acute synovitis subsided usually without treatment in all patients within 3–7 days, while arthralgia persisted longer in 4 patients. HLA‐B27 was not present in the 5 patients with arthritis, but was found in 4 others. In Northern Norway, Campylobacter fetus ssp. jejuni is more frequently isolated from stool specimens than Salmonella, Shigella and Yersinia enterocolitica. Synovial fluid should be cultured following Campylobacter jejuni enteritis in arthritis patients.
Fibrinolytic Activity in Men with Acute Myocardial Infarction before 60 Years of Age
Authors: FRANZÉN J. , NILSSON B. , JOHANSSON B. W. , NILSSON I. M.
Published: August 2010

ABSTRACT. Fibrinolytic activity in plasma after venous occlusion was determined on two consecutive days 1–5 years after an acute myocardial infarction sustained before the age of 60 years in a group of 66 non‐diabetic men with normal serum cholesterol levels, and in an age‐ and sex‐matched reference group of 32 men. The infarction group was divided into 2 subgroups: one with normal (n = 42), the other with elevated (n = 24) diastolic blood pressure. Variance analysis did not reveal any statistically significant differences in fibrinolytic activity after repeated provocation between the three groups, but in a Student's test the value was significantly lower in the infarction group with high diastolic pressure than in the reference group. A relationship was found between apolipoprotein AI and fibrinolytic activity after repeated provocation.
Influence of Time and Physical Activity on Blood Pressure and Heart Rate during Treatment with β‐Blocking Agents Once Daily
Authors: DANIELSON MATS , KJELLBERG JAN , KUYLENSTIERNA JÖRGEN , LUNDKVIST LENNART , SVENSSON OLOF
Published: August 2010

ABSTRACT. In a cross‐over study of 52 middle‐aged patients with mild to moderate essential hypertension, we have compared the effect and tolerability of 100 mg atenolol and 100 mg metoprolol given once daily. After 1 1/2 and 3 months of treatment, both systolic and diastolic blood pressure 24 hours after drug intake were significantly lower on atenolol. There were no significant differences after 3 months when blood pressure was read 3–4 hours after dose intake. During exercise, systolic blood pressure and heart rate were—at all work‐loads—significantly lower on atenolol. Four patients on metoprolol and one patient on atenolol discontinued treatment owing to side‐effects. The results support the need for thorough analysis of the duration of action and influence of physical activity and sympathetic tone in comparisons between presumedly equivalent antihypertensive drugs.
No Effect of Delayed Cutaneous Hypersensitivity Testing (Multitest) on Blood Lymphocyte Counts and Functions
Authors: BJÖRKHOLM M. , HOLM G. , MELLSTEDT H.
Published: August 2010

ABSTRACT. The effects of delayed cutaneous hypersensitivity (DCH) testing (Multitest, Institute Mérieux) on lymphocyte counts and functions were studied in seven healthy women. All had normal DCH responses and lymphocyte functions. No influence of the DCH testing on subsequent tests for lymphocyte subpopulations and mitogen‐ and antigen‐induced DNA synthesis was observed. The PPD skin test did not boost or otherwise alter the in vitro lymphocyte response to PPD. It may be concluded that Multitest is a simple way of assessing DCH and that this test does not interfere with repeated in vitro tests of lymphocyte capacity.
Predictive Value of Arterial Blood Pressure in Old Age
Authors: AGNER ERIK
Published: August 2010

ABSTRACT In a 10‐year longitudinal study of men and women aged exactly 70 at entry and otherwise only selected according to geography, the predictive value of arterial blood pressure was evaluated concerning cardiovascular disease (CVD) at entry and CVD development or death during the following decade. At 70 the prevalence of arterial hypertension (≤ 160/95 mmHg) was 46% in men and 45% in women. At 80 these prevalences were 19 and 30%, respectively. In women, this fall could partly be explained by an association between high blood pressure and excess mortality. In both sexes it could partly be explained by an increasing part of the population being treated with antihypertensives/diuretics, partly by an association with myocardial degnereration. In a Cox's regression model for competing risks at 70, high systolic blood pressure had independent, predictive value for excess CVD mortality in the eighth decade in women alone, and for excess CVD development in both sexes. High diastolic blood pressure had no independent predicitive value for any of these end points.
Monoclonal Gammopathy—a Diagnostic Challenge
Authors: RÖDJER STIG , SWOLIN BIRGITTA , WESTIN JAN
Published: August 2010

ABSTRACT Four patients with IgG multiple myeloma (MM) and an unusually indolent course are presented. They had received no cytostatic therapy for 12–23 years. The M‐component was initially 25–33 g/l, the bone marrow plasma cell percentage was 4–6%, but bone lesions were not demonstrated. A marked increase in size of the M‐component and in the plasma cell percentage was noted in all patients, but a definitely neoplastic proliferation in only one patient. Spontaneous regression of the M‐component was observed in two patients. In the light of the present cases we believe that neither a high level of the M‐component nor an increase in its size should be used alone as indicators of a malignant course in MM patients. An indolent, non‐progressive variant obviously occurs as one extreme in the clinical spectrum of this disorder with a course sometimes extended over 10–20 years.
Hemodialysis and Cell Toxicity in Vitro Related to Plasma Triglycerides, Post‐heparin Lipolytic Activity and Free Fatty Acids
Authors: WESSEL‐AAS TERJE , BLOMHOFF JAN P. , WIRUM ELIN , NILSEN TURID
Published: August 2010

Abstract Plasma triglyceride (TG) concentrations, post‐heparin lipolytic activities and the free fatty acid (FFA) pattern of uremic and normal plasma were compared and correlated to plasma toxicity as measured by the effect on human mononuclear phagocytes cultured in vitro. Plasma TG concentration and FFA: albumin molar ratios were significantly higher in uremic plasma, and a correlation was found between TG concentrations prior to heparinization and post‐heparin FFA concentrations. Uremic plasma toxicity was significantly correlated to increased post‐heparin FFA: albumin molar ratio. The post‐heparin lipoprotein lipase activity in uremic plasma collected 120 min after heparinization was higher than in normal plasma. Qualitative and quantitative experiments in vitro showed increased plasma toxicity with increasing FFA: albumin molar ratios. The proportion of unsaturated FFA in uremic post‐heparin plasma increased compared to saturated FFA during incubation for 96 hours. Altered lipid metabolism after systemic heparinization thus seems to be important for the cell toxicity of uremic plasma in vitro.
The Effect of Systemic Heparinization on Plasma Lipoproteins and Toxicity in Patients on Hemodialysis and Continuous Ambulatory Peritoneal Dialysis
Authors: WESSEL‐AAS TERJE , BLOMHOFF JAN P. , WIDERØE TOR‐ERIK , WIRUM ELIN , NILSEN TURID
Published: August 2010

Abstract The lipid patterns of plasma from 6 patients on hemodialysis (HD) and 6 patients on continuous ambulatory peritoneal dialysis (CAPD) were compared and correlated to plasma toxicity as measured by the survival of human macrophages cultured in vitro. The median values for plasma triglycerides (TG), cholesterol, low density lipoprotein (LDL) cholesterol, apolipoprotein B and lipolytic activities (lipoprotein lipase and hepatic lipase) were insignificantly higher in CAPD plasma than in HD plasma. The median high density lipoprotein (HDL) cholesterol/LDL cholesterol ratio was significantly higher in HD plasma than in CAPD plasma. In both groups systemic heparinization was followed by a significant increase in free fatty acids and in plasma toxicity. The difference in plasma toxicity was insignificant. In the whole group of patients (n=12) toxicity in post‐heparin plasma was correlated to pre‐heparin very low density lipoprotein (VLDL) TG, but not to LDL TG. Separately post‐heparin toxicity in CAPD plasma was correlated to pre‐heparin total TG, VLDL TG and post‐heparin LDL TG.
Unconsciousness after One Therapeutic Dose of Nalidixic Acid
Authors: GRANSTRÖM GÖSTA , SANTESSON BERNDT
Published: August 2010

Abstract Administration of a single dose of 2 g nalidixic acid to a young previously healthy woman led to three hours of unconsciousness combined with intracranial hypertension and hyperkinetics of the facial musculature. An unexpectedly high serum concentration of nalidixic acid was recorded during the period of unconsciousness. After omission of nalidixic acid, the symptoms were reversed without any persisting sequelae. To our knowledge, this type of adverse reaction has not been described previously.
The Antithrombotic Effect of Heparin in Deep Venous Thrombosis: Relation to Four Heparin Assays
Authors: HOLM H. ASBJØRN , ABILDGAARD ULRICH , KALVENES SIGMUND , ANDERSSEN NORMAN , ANKER ERIK , ARNESEN KJELL‐ERIK , BLIKOM DAG , DRIVENES AUDUN
Published: August 2010

Abstract In a prospective study, 280 patients with phlebographically proven deep venous thrombosis intravenous heparin infusion; 224 of the patients were subjected to control phlebography after 5–8 days of treatment. Females above 70 years showed least phlebographic improvement despite similar heparin dosage and heparin activity. Heparin activity in daily drawn blood samples was determined by four different assays. Chromogenic substrate (CS) assay (Coatest heparin), activated partial thromboplastin time (Cephotest), and thrombin time with recalcified plasma (CaTT) showed weak but significant correlations with thrombus resolution judged by phlebography (p=0.004, 0.003 and 0.018, respectively). A linear prediction equation showed that the phlebographic result was about equally influenced by the mean dose and by the result of any of the three heparin assays. Thrombin time with citrated plasma showed no correlation. CS assay and CaTT showed significantly lower mean heparin activity in patients with (n=13) than without clinically diagnosed pulmonary embolism (p=0.012 and 0.001, respectively).
Mycoplasmal Pneumonia Associated with Mesangiocapillary Glomerulonephiritis Type II (Dense Deposit Disease)
Authors: VON BONSDORFF MARTIN , PÖNKÄ ANTTI , TÖRNROTH TOM
Published: August 2010

Abstract A 20‐year‐old man developed pneumonia and glomerulonephritis concomitantly with significantly rising Mycoplasma pneumoniae complement‐fixing antibody titres. Renal biopsy showed mesangiocapillary glomerulonephritis type II (dense deposit disease). Attempts to demonstrate mycoplasmal antigen in the glomeruli failed. This is the third of five previously reported cases of glomerulonephritis associated with Mycoplasma pneumoniae and exhibiting dense deposit disease.
Side‐Effects of Piroxicam (Feldene®)
Authors: LAAKE K. , KJELDAAS L. , BORCHGREVINK C. F.
Published: August 2010

ABSTRACT In the first year after registration, 103 reports on suspected adverse reaction to piroxicam (Feldene®) were submitted to the Norwegian Adverse Drug Reaction Committee. Eighty‐three reactions were classified as probable side‐effects, and 73 of these were related to the upper gastrointestinal tract. Peptic ulcer and upper gastrointestinal haemorrhages predominated. Two deaths were classified as probably due to piroxicam. There were 8 life‐threatening reactions, all due to haemorrhages. No severe cutaneous reactions were reported. A significant fraction of the gastrointestinal reactions occurred in patients with a previous history of peptic ulcer disease. Nearly every fourth patient with proven ulcer or haematemesis/melaena had simultaneously been taking other drugs with the propensity of causing gastrointestinal haemorrhage. The gastrointestinal adverse reactions to piroxicam can probably be reduced by a more accurate selection of patients.
Skin Capillary Abnormalities in Patients with Raynaud's Phenomenon
Authors: KIMBY E. , FAGRELL B. , BJÖRKHOLM M. , HOLM G. , MELLSTEDT H. , NORBERG R.
Published: August 2010

ABSTRACT The digital skin microcirculation was studied by vital capillaroscopy in 32 consecutive patients with Raynaud's phenomenon. A detailed classification (stages 0–6) of the capillary abnormalities based upon observations of the capillaries in many different sites of the fingers was used. Associated diseases were searched for by an extensive clinical and immunological investigation. Seventeen (53%) of the patients had distinct structural changes in the capillaries but only 6 of them showed a restricted total digital circulation. Fifteen (88%) of these 17 patients displayed an underlying disease and/or immunological abnormalities. The corresponding figure for patients with mild or no capillary changes was 40% (p<0.01). Thus, the presence of marked (≥stage 3) skin capillary abnormalities seems to be a good indicator of an associated systemic disease. The majority of patients in this category improved their capillary status during successful treatment of the underlying disease. We conclude that the form of capillaroscopy used in this study is a sensitive method for evaluating disturbances of the skin microcirculation in patients with Raynaud's phenomenon. The method may also contribute to the clinical evaluation of patients with this syndrome by identifying those with an underlying systemic disease.
The Prevalence of Mitral Valve Prolapse in Healthy Men and Women in Sweden: An Echocardiographic Study
Authors: BRYHN MORTEN , PERSSON STIG
Published: August 2010

ABSTRACT An asymptomatic population of 100 women and 101 men was studied with M‐mode echocardiogram to determine the prevalence of mitral valve prolapse (MVP). One of the two patterns characteristic for MVP was found in 8% of the females and 7% of the males. The diastolic mitral valve excursion was significantly higher in the MVP group (p≤0.001). A typical M‐mode pattern in combination with a high mitral valve excursion probably enhances the diagnostic specificity.
Scintigraphic Visualization of Haemostatic and Thromboembolic Processes Using 111Indium‐labelled Platelets
Authors: SCHMIDT K. GJERLØFF , RASMUSSEN J. WÆVER
Published: August 2010

ABSTRACT Five cases of scintigraphic imaging of haemostatic and thromboembolic processes after injection of autologous 111In‐labelled platelets are presented. The site of a liver puncture, atherosclerotic plaques in the abdominal aorta, deep vein thrombi, pulmonary embolism and the tip of an indwelling venous catheter could be visualized. Activity measurements corresponding to atherosclerotic plaques suggest that an increased sensitivity of this method may be achieved by extending the investigation period to 4–5 days after injection of 111In platelets.
Tuberculosis of the Colon in a Kidney Transplant Patient
Authors: FORSLUND TERJE , LAASONEN LEENA , HÖCKERSTEDT KRISTER , STENMAN SVANTE , EDGREN JOHAN
Published: August 2010

ABSTRACT A 58‐year‐old woman experienced recurrent fever episodes after kidney transplantation. She was treated with antibiotics because of suspicion of staphylococcus infection. Abdominal pain combined with haemorrhagic diarrhoea occurred eight months after transplantation. A barium enema revealed a stenotic process in the middle part of the ascending colon mimicking carcinoma, and hemicolectomy was consequently performed. Histological examination revealed tuberculosis with little granuloma formation and abundant acid‐fast tubercle bacilli in the mucosa and submucosa, and only slight perigranulomatous reactions. The patient was successfully treated with triple antituberculous chemotherapy without deterioration of allograft function. Tuberculosis should be suspected in immuno‐suppressed patients suffering from pyrexia of unknown origin, even when chest X‐ray is normal.
Myeloma‐Associated Cardiac Amyloidosis: A Case Report
Authors: WAHLIN ANDERS , OLOFSSON BERT‐OVE , ERIKSSON ANDERS , BACKMAN CHRISTER
Published: August 2010

ABSTRACT A patient with Bence‐Jones myeloma and amyloidosis was treated with cytotoxic drugs and plasmapheresis, resulting in rapid improvement of myeloma‐associated symptoms and signs. However, amyloidosis‐associated symptoms, especially hypotension, grew worse. Echocardiographic examination demonstrated hypertrophy and a hyperrefractile appearance of the myocardium, thought to be pathognomonic of amyloid heart disease. A permanent pacemaker was inserted for treatment of Adams‐Stokes attacks caused by sick sinus syndrome and atrioventricular conduction disturbances. Postmortem examination of the heart demonstrated abundant amyloid deposits corresponding to the altered acoustic qualities of the myocardium. Echocardiographic examination is a valuable non‐invasive method for demonstration of amyloid deposits in the heart in multiple myeloma.
Heart and Kidney Involvement during Antihypertensive Treatment
Authors: SAMUELSSON OLA , WIKSTRAND JOHN , WILHELMSEN LARS , BERGLUND GÖRAN
Published: August 2010

ABSTRACT The prevalence of signs of heart (Minnesota‐coded ECG, chest X‐ray) and kidney involvement (proteinuria, abnormal serum creatinine) was studied before and after 5 years' antihypertensive treatment in 686 middle‐aged, hypertensive men derived from a screening examination of a random population sample. The prevalences of heart enlargement (X‐ray) and abnormally high serum creatinine increased. A pronounced regression of S‐T and T wave changes in the ECG was achieved. In a subgroup of 375 patients without digitalis therapy and not having had myocardial infarction, ECG signs of left ventricular hypertrophy decreased.
Polymeric Bence Jones Proteins in Serum in Myleoma Patients with Renal Insufficiency
Authors: SØLLING K. , SØLLING J. , NIELSEN J. LANNG
Published: August 2010

ABSTRACT The polymeric forms of Bence Jones protein (BJ) in serum and the influence on renal function were investigated in 59 patients with multiple myeloma and 2 with Waldenström's macroglobulinemia. Eight of 35 patients with kappa and 26 with lambda type BJ protein had decreased renal function. The investigation showed a considerable variation between patients in serum concentrations of tetrameric (T), dimeric (D) and monomeric (M) forms of BJ protein. A significantly higher fraction of D forms of BJ protein resulting in a high D/M ratio was found in the myeloma patients compared with polyclonal light chains in 10 normal controls. The renal function in multiple myeloma was, however, not correlated to the D/M ratio or to the BJ protein tetramers. This suggests that the nephrotoxicity of BJ proteins is not associated with polymerization of BJ proteins in serum. BJ proteins of aberrant size were found in 3 patients with rapidly decreasing renal function. Histological investigation in 2 of these patients revealed nodular glomerulosclerosis.
Amiodarone in Atrial Fibrillation
Authors: BLOMSTRÖM PER , EDVARDSSON NILS , OLSSON S. BERTIL
Published: August 2010

ABSTRACT Twenty‐seven patients with atrial fibrillation without any concomitant conduction abnormality have been treated with oral amiodarone in a daily maintenance dose of 200 mg. The drug has been used for three purposes: 1) to block atrioventricular conduction, thereby decreasing the ventricular rate during atrial fibrillation (9 patients), 2) as prophylaxis against paroxysmal atrial fibrillation (8 patients), 3) as prophylaxis against recurrence of atrial fibrillation after DC conversion to sinus rhythm (13 patients). All patients were considered refractory to other antiarrhythmic drugs in these respects. In the second group, 4 of the 8 patients reported complete cessation of attacks and the others a marked reduction of the attack rate. In the third group, 10 of the 13 patients have maintained sinus rhythm for a longer period on treatment with amiodarone than with other drugs, resulting more than a triple prolongation of the time in sinus rhythm. In 3 patients the drug has been discontinued because of side‐effects. In conclusion, amiodarone affords protection from episodes of paroxysmal atrial fibrillation, as well as from recurrence of atrial fibrillation after DC conversion to sinus rhythm. If the drug is ineffective in either of these respects, it may still be useful as a means of moderating the ventricular response in atrial fibrillation.
PROSTAGLANDINS, RENIN, ALDOSTERONE, AND CATECHOLAMINES IN PREECLAMPSIA
Authors: Pedersen E.B. , Christensen N.J. , Christensen P. , Johannesen P. , Kornerup H.J. , Kristensen S. , Lauritsen J.G. , Leyssac P.P. , Rasmussen A.B. , Wohlert M.
Published: August 2010

ABSTRACT. Urinary excretion of prostaglandin E2 (PGE2) and F2a (PGF2α), plasma concentrations of renin (PRC), aldosterone (PAC), noradrenaline (PNA) and adrenaline (PA) were determined in the third trimester of pregnancy, 5 days and 3 months after delivery in preeclampsia and normotensive pregnant and non‐pregnant control subjects. PGE2 was higher in pregnant control subjects than in non‐pregnant subjects, but reduced to non‐pregnant level in preeclampsia. PGF2a was the same in preeclampsia and normotensive pregnancy but higher than in the non‐pregnant group. PRC and PAC were increased during pregnancy, but considerably lesser in preeclampsia than during normotensive pregnancy. PNA and PA were the same in all three groups. All parameters were normal 3 months after delivery. There were no correlations between any of the hormones and blood pressure in any of the groups. PGE2 was positively correlated to PRC. The lack of renal PGE2 in preeclampsia might be responsible for the decrease in renal blood flow and sodium excretion, and the changes in PRC and PAC are supposed to be secondary to changes in PGE2. It is hypothesised that preeclampsia is a state of prostaglandin deficiency.
Calcium Influx Blockers in the Treatment of Essential Hypertension
Authors: Hulthén U.L. , Bolli P. , Bühler F.R.
Published: August 2010

Elevated vascular resistance is the key factor in most cases of essential hypertension. Vascular resistance is determined by the sarcoplasmatic concentration of free Ca2+. Experimental studies have shown an increased dependence for the noradrenaline‐induced contraction on extracellular Ca2+ from the aorta to the small resistance vessels. This is in accordance with the potent vasodilating effect found with Ca2+‐influx inhibitors in man. Furthermore, a selective enhancement of the vasodilating response to verapamil has been found in patients with essential hypertension as compared to normotensive subjects. The verapamil‐induced vasodilation in the hypertensive patients was positively correlated to plasma adrenaline concentration. These findings suggest accentuated Ca2+‐influx dependent vasoconstriction in essential hypertension, which is related to the activity of the sympathetic nervous system.

Acute administration of verapamil and nifedipin results in a distinct fall in blood pressure in patients with essential hypertension but not in normotensive subjects. Generally, the percentage fall in blood pressure with Ca2+‐channel blockers has been closely positively correlated to the initial blood pressure level and in an open study with 43 patients with essential hypertension the decrease in blood pressure to verapamil was also positively correlated to the age of patients.

These data may provide the basis for a new treatment concept for essential hypertension proposing a Ca2+‐channel blocker as the first choice for the older patients and a beta‐adrenoceptor blocking agent as the first line drug for the younger patients. Combined treatment with a beta‐adrenoceptor blocking agent and a Ca2+‐channel blocker seems most efficient in normalizing blood pressure in many therapy‐resistant hypertensive patients.
Relation between Drug Utilization and Morbidity Pattern
Authors: MD Barbro Westerholm , Agenas Ingegerd , Dahlström Monica , Nordenstam Ingrid
Published: August 2010

ABSTRACT. Do drug utilization data, versus other health care data–such as causes of death and sick reports, discharge diagnoses, and number of days on the sick list–give a similar picture of the health status in Sweden? Though a number of discrepancies excist between these sources of information, analyses show that the similarities between the pictures they give of the health status are considerable, provided due consideration is given the facts that–for self‐evident reasons–certain illnesses and injuries are not to be found in all the sources.
Laser‐Doppler Flowmetry—a Non‐invasive and Continuous Method for Blood Flow Evaluation in Microvascular Studies
Authors: ÖBERG P. ÅKE , TENLAND TORSTEN , NILSSON GERT E.
Published: August 2010

ABSTRACT. Skin viability has during the last decades been studied by a number of different techniques. Some of these are briefly presented in this paper. One method, based on the laser‐Doppler principle, makes possible continuous and noninvasive measurement of blood flow in the outermost layer (1 mm) of the skin. The basic physical principles and the properties of this flowmeter are presented. Some clinical and research applications of laser‐Doppler flowmetry in a number of medical disciplines are discussed.
Wound Assessment in Clinical Practice
Authors: FORREST RICHARD D. , GAMBORG‐NIELSEN POVL
Published: August 2010

ABSTRACT. This review describes the methods that may be used clinically for the assessment of open wounds and indicates potential limitations in their usefulness. None of the methods available for the appraisal of wounds in human subjects measures healing directly but a number of objective variables may be used to shed light on the healing process. Research methods have been suggested that may be clinically useful in assessing healing but are not generally available at present.
Amputations in Diabetics and Nondiabetics in Umeå County 1971–1977
Authors: BORSSÉN BENGT , LITHNER FOLKE
Published: August 2010

ABSTRACT. A consecutive series of 95 unselected patients submitted to amputation of the lower leg (59%) or at the thigh (41%) during 1971–1977 are the material of this retrospective study. Fifty‐three were diabetic and 42 nondiabetic, the mean age was 77.2 and 73.1 years, respectively. There were no differences between diabetics and nondiabetics concerning age, lower leg/thigh amputations, postoperative healing, rehabilitation using prosthesis or subsequent amputation of the second leg.
Extrapancreatic Effects of a Sulphonylurea
Authors: KOLLIND M. , ADAMSON U. , LINS P. E. , OHLSÉN P.
Published: August 2010

ABSTRACT The effects of glipizide on the absorption of glucose and d‐xylose were studied in six type II diabetics on diet treatment alone. Glipizide was given intravenously (12 μg/kg at 0 min) or orally (5 mg at ‐30 min). Oral glucose (15 g) and xylose (25 g) loads were given at zero time. Glipizide stimulated insulin secretion and reduced glucose and xylose levels significantly with both routes of administration. The suppression of xylose levels lasted longer after oral than after intravenous administration of the drug. It is suggested that part of the influence of glipizide on postprandial glucose levels may represent interference with absorptive mechanisms.
Serum Lipoprotein and Apolipoprotein Concentrations in Patients with Hyperthyroidism and the Effect of Treatment with Carbimazole
Authors: BOBERG JONAS , DAHLBERG PER‐ANDERS , VESSBY BENGT , LITHELL HANS
Published: August 2010

ABSTRACT Forty patients, 32 women and 8 men, with hyperthyroidism were investigated concerning serum lipoprotein lipid and apolipoprotein concentrations before, during and after treatment with carbimazole to euthyroidism. During the hyperthyroid condition the patients had significantly lower serum concentrations of low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol. The serum lipoprotein triglyceride concentrations were within the normal ranges. During treatment to euthyroidism the low serum concentrations of LDL and HDL cholesterol increased to normal values. LDL and HDL concentrations increased in the female patient group by 46±12 and 25±9% and in the male patient group by 50±12 and 19±11%, respectively. During treatment serum apolipoprotein B and A‐I concentrations increased significantly in females by 58±9 and 18±5% and in males by 60±9 and 13±8%, respectively.
ADP‐induced Platelet Aggregation in Young Female Survivors of Acute Myocardial Infarction and Their Female Controls
Authors: VILÉN LARS , JOHANSSON SAGA , KUTTI JACK , CRONBERG STIG , VEDIN ANDERS , WILHELMSSON CLAES
Published: August 2010

ABSTRACT Adenosine diphosphate (ADP)‐induced platelet aggregation was studied in 35 young female survivors of acute myocardial infarction (AMI) 14–46 (median 30) months after the infarction. The results were compared to those obtained for 35 control females of comparable age. Five different final ADP concentrations (0.2–1.0 μM) were employed, and the object was to assess the slope for the primary wave of aggregation as well as the threshold ADP concentration for secondary aggregation. The results showed that AMI patients and control subjects did not differ with respect to the primary wave of aggregation. However, secondary platelet aggregation was recorded to a significantly higher extent (p<0.02) in AMI patients than in their controls. The results therefore support the concept that enhanced platelet reactivity is present in patients with documented ischemic heart disease.
Highly Refractile Myocardial Echoes in Familial Amyloidosis with Polyneuropathy: A Correlative Echocardiographic and Histopathological Study
Authors: ERIKSSON PETER , ERIKSSON ANDERS , BACKMAN CHRISTER , HOFER PER‐ÅKE , OLOFSSON BERT‐OVE
Published: August 2010

ABSTRACT Two‐dimensional echocardiography in systemic amyloidosis has in most cases shown highly refractile myocardial echoes. The morphological basis for this finding has so far been little examined. In the present study, echocardiographic examinations were performed in vitro on autopsied hearts from ten patients with familial amyloidosis with polyneuropathy (FAP). An ultrasonically visible needle was used to localize the abnormal echoes, and samples were taken for histological analysis of the region of the echocardiographic abnormality. Our results indicate that the highly refractile myocardial echoes in FAP are due to nodules composed of collagen and amyloid.
Transient Effect of the Combination of Insulin and Sulfonylurea (Glibenclamide) on Glycemic Control in Non‐Insulin Dependent Diabetics Poorly Controlled with Insulin Alone
Authors: GROOP L. , HARNO K. , NIKKILÄ E. A. , PELKONEN R. , TOLPPANEN E.‐M.
Published: August 2010

ABSTRACT In a double‐blind cross‐over study we compared the effects of insulin plus glibenclamide, 5 mg twice daily, with insulin plus placebo during 8‐week periods on metabolic parameters in 13 non‐insulin dependent diabetic (NIDDM) patients poorly controlled with insulin alone. The combination therapy improved diabetic control as assessed by fasting blood glucose (p<0.001), 24‐hour urinary glucose (p<0.01) and glycohemoglobin (HbA1) concentrations (p<0.05 at week 12). The effect tended to cease with time. Significantly higher C‐peptide values were found during combination treatment than during insulin‐placebo (p<0.01) and the changes in fasting C‐peptide concentrations correlated positively with the changes in HbA1 concentrations (r=0.56, p<0.05). There was no difference in glucagon concentrations, insulin binding to erythrocytes or insulin sensitivity between the two study periods. Neither did the combination therapy influence blood lipids significantly. The present study shows that the combination of insulin and glibenclamide may be of limited value in the treatment of NIDDM patients poorly controlled with insulin alone. However, thus far the long‐term results are uncertain. In the absence of significant effects on insulin binding and insulin sensitivity, the improved diabetic control seems to be explained, at least partly, by glibenclamide‐induced stimulation of insulin secretion.
Treatment of Hyperthyroidism with Standard Doses of Radioiodine Aiming at Ablation
Authors: ERIKSSON EVA , ERIKSSON KRISTIAN , WAHLBERG PETER
Published: August 2010

ABSTRACT Sixty patients with hyperthyroidism were treated with standard doses of 131I during 1969–83 in our department. The doses were 10–25 mCi (370–920 MBq), mostly 15 mCi (550 MBq). 38 of the patients have become hypothyroid, mostly within one year after treatment. There were 3 early relapses of hyperthyroidism; these patients became hypothyroid within one year after an additional dose of radioiodine. All hypothyroid patients had early substitution with l‐thyroxine before overt clinical symptoms and signs had developed. There were no late relapses of hyperthyroidism. 15 patients had died during the follow‐up; all were euthyroid or hypothyroid with adequate substitution. 28 of the 60 patients have been followed for 5–14 years, 14 for 2–5 years, 7 for 1–2 years and 10 for less than one year. Standard dose 131I treatment offers certain advantages compared with attempted individualized treatment. Late hypothyroidism after individualized dosage may be difficult to anticipate and detect, whereas early hypothyroidism after ablative standard dose treatment is easy to detect and control. Generally speaking, hypothyroidism is not to be regarded as a complication of radioiodine treatment for hyperthyroidism, but as its natural end result. The fixed dose schedule is especially well suited for regions where hyperthyroidism with no goitre or a small goitre is common.
Reversal of Increased Whole Blood and Plasma Viscosity after Treatment of Hypothyroidism in Man
Authors: LARSSON HANS , VALDEMARSSON STIG , HEDNER PAVO , ODEBERG HÅKAN
Published: August 2010

ABSTRACT Blood and plasma viscosity was measured in 13 patients with hypothyroidism before and during replacement therapy with l‐thyroxine. Blood viscosity was measured at natural hematocrit and after adjustment to 40%. The values were compared to those of 12 healthy subjects. Both blood viscosity at hematocrit 40% and plasma viscosity were increased in the hypothyroid state and decreased to the levels of the reference group after treatment. The therapy‐induced changes in blood and plasma viscosity were intercorrelated at low but not at high shear rates. The changes in viscosity were not correlated to the reductions in lipoprotein concentrations resulting from therapy. The institution of l‐thyroxine replacement therapy was also followed by reductions in erythrocyte sedimentation rate and diastolic blood pressure, both with significant correlations to the decrease in blood viscosity. It is concluded that in hypothyroidism there are changes in both plasma and erythrocytes that increase blood viscosity, with normalization upon treatment with l‐thyroxine to euthyroidism.
Positive Correlation between Urinary Excretion of Catecholamine Metabolites and Tumour Mass in Pheochromocytoma
Authors: STENSTRÖM GUNNAR , WALDENSTRÖM JOHAN
Published: August 2010

ABSTRACT In a series of 53 pheochromocytoma patients operated on at Sahlgren's Hospital during 1956‐82, a positive linear correlation is established between the 24‐hour urinary excretion of vanilmandelic acid (μmol/24 h) and tumour mass (g). A similar corrrelation was found between the excretion of metanephrines and tumour mass in 33 subjects. The patients were subgrouped according to their type of hypertension. A statistically significant correlation between vanilmandelic acid excretion and tumour mass persisted in groups IA (sustained hypertension without attacks), IB (sustained hypertension with attacks), and II (paroxysmal hypertension) but not in group III (miscellaneous patients). There was also a correlation between metanephrine excretion and tumour mass in groups IB (n=8) and II (n=12). In 10 patients with the syndrome of multiple endocrine neoplasia, a positive correlation was found between tumour mass and the excretion of vanilmandelic acid, metanephrines and adrenaline.
Prolactinomas in Men: Clinical Characteristics and the Effect of Bromocriptine Treatment
Authors: HULTING A.‐L. , MUHR C. , LUNDBERG P. O. , WERNER S.
Published: August 2010

ABSTRACT Thirty‐seven men with prolactin (PRL) producing pituitary adenomas were studied to elucidate if patient's delay might cause the predominance of large tumours in men as compared to women in whom microadenomas predominate. We found two clinical subgroups; one presented with short duration of symptoms, dominated by local signs from the growth of notably large tumours, the other exhibited a long history of disease with hypogonadism as the dominating symptom. There was a correlation between tumour size and PRL levels. The age at the time of diagnosis showed no correlation to duration of symptoms, size of adenoma or PRL levels. Four patients with small adenomas, moderate hyperprolactinemia and short duration of symptoms showed signs of hypergonadotropic hypogonadism. Surgery or irradiation, performed in 14 patients, did not normalize PRL levels. Bromocriptine was equally beneficial in the two clinical subgroups, improving clinical symptoms and normalizing PRL levels in all but three patients. The study shows that the predominance of large tumours in men does not depend on patient's or doctor's delay, but on a high frequency of presumably rapidly growing PRL producing tumours. In the majority of patients, these tumours do not give signs of hypogonadism before the tumour is revealed by local signs of tumour growth.
Prognosis in Glomerulonephritis
Authors: BRAHM M. , BALSLØV J. T. , BRUN C. , GERSTOFT J. , JØRGENSEN F. , JØRGENSEN H. E. , LARSEN M. , LARSEN S. , LORENZEN I. , LØBER M. , THOMSEN Å. C.
Published: August 2010

ABSTRACT Between 1967 and 1977, 395 consecutive cases of glomerulonephritis (GN) were collected by a Copenhagen study group. The diagnosis was established by histological and biochemical criteria. Light microscopy investigations of thin silver‐stained sections were applied. In a follow‐up in 1980 all cases were categorized by one of the following end points: death without uremia, uremia, recovery, or censored cases. The course is presented in figures showing the cumulated distribution of outcomes in relation to observation time. Each histological subgroup of GN had its own characteristic course with respect to initial rates of changes in the renal state, as well as to frequency of recovery, uremia and death. The prognosis was good in minimal changes GN and proliferative GN, bad in unclassified GN and worst in extracapillary GN. When part of a connective tissue disease, GN carried a poor prognosis. We conclude that histological classification of GN based on light microscopy offers a reliable means of predicting the long‐term prognosis.
Plasmapheresis in Hyperviscosity Syndrome
Authors: AVNSTORP CHRISTIAN , NIELSEN HENRIK , DRACHMANN OLE , HIPPE ERIK
Published: August 2010

ABSTRACT Three patients with Waldenström's macroglobulinaemia developed circulatory complications due to increased plasma viscosity, i.e relative viscosity value above 4. Plasmapheresis was performed either in a Haemonetics 30 S cell separator, by plasma filtration through a CPS 10 TM filter or by a double‐double pack Fenwal® system. All three methods reduced the plasma viscosity and abolished the clinical symptoms. In cases of acute hyperviscosity syndrome, apheresis of small amounts of plasma by the double‐double pack system may serve as an alternative to the more advanced techniques.
A Case of Brucellosis Complicated by Endocarditis and Disseminated Intravascular Coagulation
Authors: ALMÉR LARS‐OLOF
Published: August 2010

ABSTRACT Brucellosis, being eradicated among domestic animals in some countries, is still prevalent in some others where it poses a potential threat to the consumers of milk and cheese and those working with animals and meat. The patient presented below had contracted a severe and long‐standing Brucella abortus infection by ingesting raw camel milk. She had signs of endocarditis and disseminated intravascular coagulation, but recovered when treated with tetracyclin and streptomycin.
Volume Changes in Polycystic Kidneys during Chronic Dialysis and after Renal Transplantation
Authors: THAYSEN JØRN HESS , THOMSEN HENRIK S. , SASS ANTON , KRISTENSEN JØRGEN KVIST
Published: August 2010

ABSTRACT Renal volume was determined by repeated CT scanning in 26 patients with adult polycystic kidney disease after institution of replacement therapy for terminal renal failure. Thirteen patients, treated for an average period of 6.7 years (SD 3.4, range 1.1–13.7), had a functioning necrokidney graft at the close of the study and had been grafted for 80.8% (SD 18) of the total treatment time. They showed a reduction of renal volume averaging 1.07% (SD 0.89) per month. Thirteen patients, treated for an average period of 5.7 years (SD 3.3, range 1.2–12.2), were on dialysis at the close of the study. Four had been on dialysis only, 9 had carried one or more (rejected) necrokidney grafts for 22.8% (SD 25) of the total treatment time. Three of them showed a significant increase in renal volume, whereas ten showed a decrease. The average change of renal volume in the entire group was ‐0.28% (SD 1.36) per month, significantly smaller than in the transplanted patients (p<0.01). It is concluded that polycystic kidneys shrink after successful grafting, whereas volume changes vary on dialysis treatment.
Thyroid Hormones Affect Serum Angiotensin I Converting Enzyme Levels
Authors: GRÖNHAGEN‐RISKA C. , FYHRQUIST F. , VÄLIMÄKI M. , LAMBERG B.‐A.
Published: August 2010

ABSTRACT Serum angiotensin I converting enzyme (ACE) was measured in 10 patients with Graves' disease and 2 with thyroiditis during different stages of the diseases. The effect of thyroxine on serum ACE levels was also recorded in 12 patients with thyroid cancer, who were on thyroxine suppression. Serum ACE levels correlated positively with clinically assessed thyroid function and peripheral thyroid hormone levels, especially during hyper‐or hypofunction. ACE was measured both with an enzyme kinetic and a new, quantitative inhibitor binding assay. The methods gave similar results, which indicates that ACE increments during thyroid hyperfunction were quantitative, and not a result of increased enzyme activity. Serum ACE increments associated with high lysozyme concentrations are signs of immunologic activation or proliferation of monocytic cells. In this study there was no correlation between the two enzymes, which may indicate either increased synthesis or possibly shedding of ACE from endothelial cells or delayed metabolic clearance of this enzyme. Serum ACE measurements may provide a useful tool for assessing thyroid function and the effect of thyroxine treatment.
Controlled Clinical Trial of Treatment with Cimetidine for Non‐ulcer Dyspepsia
Authors: KELBÆK HENNING , LINDE JØRGEN , ERIKSEN JAN , MUNKGAARD STIG , MOESGAARD FLEMMING , BONNEVIE OLAF
Published: August 2010

ABSTRACT The effect of cimetidine (1 g daily) and placebo was studied in a controlled clinical trial comprising 50 patients with non‐ulcer dyspepsia in whom an organic abnormality responsible for the dyspeptic symptoms was not disclosed by a standardized and extensive examination programme. Reduction of symptoms occurred in 13 (54%) out of 24 patients treated with cimetidine and in 16 (62%) out of 26 treated with placebo. The difference was insignificant, as were the alterations in the individual dyspeptic symptoms between the groups. Only 6 patients (25%) on cimetidine and 8 (31%) on placebo treatment had a total relief of symptoms. Of these, all cimetidine‐treated patients remained free from symptoms during the successive 3‐month observation period, while the dyspeptic symptoms relapsed in 3 (38%) placebo‐treated patients. Subsequent resumption of placebo treatment reduced the symptoms in all 3 patients, but only one became free from symptoms. Cimetidine does not seem to be superior to placebo in the treatment of non‐ulcer dyspepsia in patients without any previous history of ulcer or without any sign on endoscopy of an active or previous ulcer disease.
Tolerability to Treatment with Metoprolol in Acute Myocardial Infarction in Relation to Age
Authors: HERLITZ J. , HJALMARSON Å. , HOLMBERG S. , PENNERT K. , SWEDBERG K. , WAAGSTEIN F. , WEDEL H. , VEDIN A. , WALDENSTRÖM A. , WALDENSTRÖM J. , WILHELMSEN L. , WILHELMSSON C.
Published: August 2010

ABSTRACT A double‐blind trial with the β1‐selective blocker metoprolol in suspected acute myocardial infarction and during 3 months' follow‐up included 1 395 patients, aged 40–74 years, 698 on metoprolol and 697 on placebo. In order to further evaluate the tolerability to β‐blockade in the elderly, the total series was divided into 2 groups according to median age (61 years) and into quartiles, the lowest quartile (40–57 years) being compared with the highest (67–74 years). The decrease in heart rate and systolic blood pressure after intravenous metoprolol in the acute phase was similar in the elderly and the younger patients. Hypotension was observed more often in the metoprolol‐treated than in the placebo‐treated younger patients, while no difference was observed in the elderly. Bradycardia was observed more often in the motoprolol group in both age groups, while there was no difference regarding the incidence of congestive heart failure in either the younger or in the elderly patients. The effect on mortality, serious ventricular arrhythmias and chest pain seemed to be similar in different age groups. From the present series we conclude that hemodynamic reactions and tolerability to β‐blockade can be expected to be similar in elderly and younger patients.
Body Temperature in General Population Samples
Authors: ERIKSSON HENRY , SVÅRDSUDD KURT , LARSSON BO , WELIN LENNART , OHLSON LARS‐OLOF , WILHELMSEN LARS
Published: August 2010

ABSTRACT Oral body temperature was measured in 816 men, 57 and 67 years old, sampled from the general population of Göteborg, Sweden, and 22 physically highly active men, sampled on clinical grounds. The measurements were taken in the morning for 14 months. After adding 0.3°C to the readings to make them comparable with rectal readings, the mean body temperature was 36.8±0.4°C. There was a seasonal variation with a peak during the winter and a trough during the summer. Body temperature was inversely correlated with height and positively correlated with weight and body fat but not with lean body mass. High physical activity and sensitivity to heat were associated with a higher than average body temperature. Sensitivity to cold was associated with a lower than average body temperature. Smoking prior to the measurements did not appear to affect body temperature.
Prolonged Severe Cholestasis Induced by Oxacillin Derivatives
Authors: TAURIS PALLE , JØRGENSEN NIELS F. , PETERSEN CLAUS M. , ALBERTSEN KAI
Published: August 2010

ABSTRACT. Tauris P, JØrgensen NF, Petersen CM, Albertsen K. (Department of Internal Medicine and Infectious Diseases, Marselisborg Hospital, University of Aarhus, Aarhus, Denmark.) Prolonged severe cholestasis induced by oxacillin derivatives.

Two patients with osteomyelitis who developed reversible cholestatic jaundice during treatment with oxacillin derivatives are described. The clinical course as well as the biochemical pattern and the investigation of liver biopsy specimens enabled us to establish the diagnoses of drug‐induced canalicular and hepatocanalicular cholestasis.