bluuebunny/crossref_metadata_2025 huggingface dataset:
STUDIES IN URINARY TRACT INFECTIONS
Authors: Mabeck C. E.
Published: August 2010

Abstract. Bacteriuria was present in 46% of 742 non‐pregnant women referred by general practitioners due to clinical symptoms of urinary tract infection. Impaired urinary concentrating ability and radiological signs of chronic pyelonephritis were most frequently found in patients with previous episodes of fever and flank pain. There was no correlation between the number of previous episodes of lower urinary tract symptoms and current signs of acute or chronic pyelonephritis. Only a minority of patients with laboratory signs of acute pyelonephritis, i.e. temporarily impaired concentrating ability or raised coli antibody titre, showed clinical symptoms of renal involvement. Among placebo‐treated patients the clinical symptoms disappeared despite the persistence of bacteriuria, and it is stressed that relief of symptoms does not indicate success of treatment. During the follow‐up, 39% of recurrent infections were asymptomatic.
ADENOSINEDIPHOSPHATE INDUCED PLATELET ADHESIVENESS IN DIABETES MELLITUS WITH COMPLICATIONS
Authors: Hellem Arvid J.
Published: August 2010

Abstract.The ADP‐induced platelet adhesiveness in 79 patients with diabetes mellitus and 70 healthy controls has been investigated. The mean platelet adhesiveness in the control group was 38% (S.D. 16.7), in patients on insulin 53% (S.D. 15.9), and in patients without insulin 44% (S.D. 13.9). In the group of insulin‐treated patients, the mean platelet adhesiveness increased significantly with the number of complications. No correlation between platelet adhesiveness and total cholesterol, blood sugar or dosage of insulin was found.
STIMULATORY EFFECT IN VITRO OF PROSTAGLANDIN E1ON NORADRENALINE‐INDUCED LIPOLYSIS IN SUBCUTANEOUS ADIPOSE TISSUE FROM HYPOTHYROID SUBJECTS
Authors: Rosenqvist U. , Efendić S.
Published: August 2010

Abstract.The lipolytic action of noradrenaline in vitro is markedly reduced in subcutaneous adipose tissue of hypothyroid subjects. This is due to an increased responsiveness of the alpha adrenergic receptors to noradrenaline, resulting in the suppression of the lipolytic effect of the hormone mediated by the beta receptor. Prostaglandin E1(PGE1) inhibited noradrenaline‐induced lipolysis in euthyroid subjects. In contrast, PGE1significantly stimulated the lipolytic action of noradrenaline in adipose tissue from hypothyroid subjects. This has been interpreted as an inhibitory effect of PGE1upon alpha as well as upon beta adrenergic receptor responses to cate‐cholamines. In tissues from euthyroid subjects the main effect of PGE1was an inhibition of the beta adrenergic response to noradrenaline. In adipose tissue from subjects where alpha receptor responsiveness dominates, the action of PGE1mainly results in alpha receptor inhibition.
IMPAIRMENT OF GLOMERULAR FILTRATION IN FASTING FOR OBESITY
Authors: Edgren B. , Wester P. O.
Published: August 2010

Abstract. When obese subjects are subjected to therapeutic fasts there is always a small increment of serum creatinine. In ten patients studied, the average creatinine value was 0.94 ± 0.17 mg% before fasting and 1.35 ± 0.18 (mean ± S.D.) during fasting (p< 0.001). In seven patients endogenous creatinine clearance was lowered from 137 ± 33 ml/min to 87 ± 18 ml/min by fasting (p<0.01). Inulin clearance values gave similar clearance values. Paraaminohippuric acid (PAH) clearance was studied in five subjects and was found to be unaffected by fasting. Renal function was restored rapidly by refeeding. We have at present no explanation for the described phenomenon.
ABSORPTION STUDIES IN PATIENTS WITH CROHN'S DISEASE AND IN PATIENTS WITH ULCERATIVE COLITIS
Authors: Andersson H. , Dotevall G. , Gillberg R. , Jagenburg R. , Kock N. G.
Published: August 2010

Abstract. Absorption studies were carried out in 52 patients with Crohn's disease and in 25 patients with ulcerative colitis. Vitamin B12 in serum and folate in serum and whole blood were determined. Absorption of D‐xylose, fat and vitamin B12 were studied. The patients with Crohn's disease were divided into three groups with respect to the localization and extension of the lesions. Subnormal values of D‐xylose excretion were found in 14 out of 52 patients with Crohn's disease but without preference for any of the groups. Malabsorption of fat was common both in patients with Crohn's disease and in patients with ulcerative colitis. In all patients with extensive involvement of Crohn's disease in the small bowel fat absorption was impaired. Abnormally low absorption of vitamin B12 (Schilling test below 5%) was noted predominantly in patients who had previously undergone small bowel resection for Crohn's disease.
HYPERPARATHYROIDISM AND MAXIMAL GLUCOSE REABSORPTION
Authors: Aurell Mattias , Hansson Göran , Jagenburg Rudolf , Nilsson Olov
Published: August 2010

Abstract. The maximal tubular reabsorptive capacity for glucose (TmG) has been determined in patients admitted to the hospital for suspected hyperparathyroidism. One group consisted of 19 cases with proved hyperparathyroidism. The other group consisted of 14 cases with normal serum calcium concentration on repeated determinations, and in four of these patients normal parathyroid glands were found at neck exploration. No significant difference in TmG was found between the groups, either when comparing the absolute values of TmG or when comparing TmG at equal values of glomerular filtration rate (GFR). Thus the results do not support the previously stated opinion that determination of the maximal tubular reabsorptive capacity for glucose is of value as a diagnostic aid in hyperparathyroidism.
ARRHYTHMIC COMPLICATIONS AFTER PARASYMPATHOLYTIC TREATMENT OF BRADYARRHYTHMIAS IN A CORONARY CARE UNIT
Authors: Mogensen L. , Orinius E.
Published: August 2010

Abstract. Parasympatholytic treatment of bradyarrhythmias is part of the policy in coronary care units (CCU). Because of psychotic central nervous reactions following repeated i.v. doses of atropine, this drug was replaced by methyl scopolamine, and no such reactions have occurred since then. During a period of continuous ECG‐recording in a CCU, 27 patients with bradyarrhythmias were given at least one dose of 0.12‐0.5 mg methyl scopolamine. Its maximal effect as measured by the peak QRS‐rate occurred after about 10 min. Within this time atrial fibrillation appeared for the first time in 2 patients, and ventricular tachycardia and ventricular fibrillation in another subject. During the following 2 hours no further major arrhythmias were observed. All of these arrhythmias occurred in the 16 patients with AMI and none in the 11 subjects with other diagnoses. The possibility of a causal relationship between treatment with methyl scopolamine and appearance of tachyarrhythmias is discussed. The arrhythmic complications described in this study have made us reduce the initial i.v. dose of methyl scopolamine from 0.5 to 0.06‐0.12 mg, which often is satisfactory.
TREATMENT OF HYPERTENSION WITH PROPRANOLOL AND HYDRALAZINE
Authors: Hansson L. , Olander R. , Åberg H. , Malmcrona R. , Westerlund A.
Published: August 2010

Abstract. The effects on arterial pressure of long‐term treatment with propranolol and hydralazine have been determined in 17 hypertensive patients (5 with renovascular hypertension and 12 with essential hypertension). The treatment reduced blood pressure in all 17 patients during 28 weeks of treatment (average); daily dose of propranolol was 320 mg (average) and of hydralazine 137 mg (average). Few side‐effects occurred but treatment had to be withdrawn in one patient because of tiredness. The results are compared to those obtained in a group of 82 hypertensive patients, who received propranolol as the only treatment. It is concluded that the combined use of the two drugs may be purposeful not only to achieve improved blood pressure control but also to diminish the side‐effects of each drug.
COMPARATIVE STUDY OF THE CLINICAL EFFECT OF ACENOCOUMAROL (SINTROM®) AND PHENPROCOUMON (MARCOUMAR®) IN MYOCARDIAL INFARCTION AND ANGINA PECTORIS
Authors: Fekkes N. , De Jonge H. , Veltkamp J. J. , Bieger R. , Loeliger E. A.
Published: August 2010

Abstract.A controlled clinical trial was performed in more than 250 patients with myocardial infarction or angina pectoris to determine whether any difference in clinical effect could be observed between acenocoumarol (Sintrom®) and phenprocoumon (Marcoumar®). The average observation period was almost three years. For the myocardial infarction group (both with and without relative contraindications) there proved to be a small but significant difference in the stability of the hypocoagulability of these two coumarin preparations: phenprocoumon gave the most stable results. Judging from the mortality, morbidity, and the number and severity of the bleeding complications, however, there was no statistically significant difference between the groups treated with these two anticoagulants. The favourable results obtained in this study with the short‐acting acenocoumarol are based on the strict supervision of patients on prolonged anticoagulant treatment provided by the Netherlands Thrombosis Service, in which the control by nurses plays an important role.
II. Development of an indirect LE factor test
Authors: LARSEN ROLF A. , BØYUM ARNE
Published: August 2010

An indirect LE factor technique, including a simple method for separation of leucocytes, is described. In the test a standardized amount of serum reacts with a constant amount of damaged nuclei serving as antigen, and fagocytosis is secured by addition of a constant amount of freshly‐prepared leucocytes. It is possible to titrate LE sera. The titration of LE sera gives a regular succession of different phenomena associated with LE cell. This gradual change in the morphology has been described. Granulocyte‐ and lymphocyte‐specific LE factors are demonstrated.
CLINICAL ANALYSES OF FACTORS INFLUENCING L‐DOPA TREATMENT OF PARKINSON'S SYNDROME
Authors: Granerus Ann‐Kathrine , Steg Göran , Svanborg Alvar
Published: August 2010

AbstractOne hundred and twenty‐three patients with Parkinson's disease have been treated with L‐dopa for 6–31 months. Rigidity was improved in 85%, hypokinesia in 93%, tremor in 69%, speech disturbances in 30% and mental depression in 48% of the patients. The existence of any correlations between measured variables was tested in 260 tests. The L‐dopa dosage was higher in men than in women. Improvement in ADL disability was inversely correlated to age. This improvement was directly correlated to the occurrence of tremor before treatment and to the appearance of involuntary movements during treatment. There was a correlation between the appearance of involuntary movements and the appearance of muscular hypotonia. These and other observations allowed conclusions concerning the proper indications for L‐dopa treatment of Parkinson's syndrome.
EFFECTS OF DDAVP, A SYNTHETIC ANALOGUE OF VASOPRESSIN, IN PATIENTS WITH CRANIAL DIABETES INSIPIDUS
Authors: Andersson K.‐E. , Arner B.
Published: August 2010

Abstract DDAVP, 1‐deamino‐8‐D‐arginine vasopressin, is a synthetic analogue of vasopressin with a higher anti‐diuretic potency, less vasopressor activity, and a longer duration of action than the vasopressin preparations at present in clinical use. The effects of DDAVP have been studied in ten patients with vasopressin sensitive diabetes insipidus previously treated with 8‐lysine vasopressin, chlorpropamide, chlorthalidone, or combinations of these substances. Five patients were given 1 or 2 μg DDAVP i.v., and the effect of these amounts lasted from 5 to more than 12 hours compared with 45–90 min for corresponding amount of 8‐lysine vasopressin. In all ten patients DDAVP administered intranasally in doses of 15 μg one to three times daily normalized the urine production also in cases where previous therapy had failed. No side‐effects have been observed during treatment with DDAVP for 6–12 months. It is concluded that DDAVP, because of its freedom from side‐effects and long duration of action, is a safe and effective substance in the treatment of cranial diabetes insipidus.
DISPLACEMENT AND FRACTURE OF PACEMAKER ELECTRODE DURING PHYSICAL EXERTION
Authors: Ohm Ole‐Jørgen
Published: August 2010

Abstract Three patients with electrode failure arising during permanent pacemaker treatment for AV block are discussed. The physical capacity of all three was improved after pacemaker implantation. In patients 1 and 3 electrode displacement took place during apple picking and lobster fishing. In patient 2 pacemaker implantation was carried out in connection with the insertion of an aortic ball valve prosthesis. He has later been in functional class I. Electrode fracture took place while he was carrying a 50‐kg flour sack, the central fragment of the electrode being displaced to the right ventricle, where it has remained coiled up for 2 years, the battery and peripheral fragment of the electrode having been removed. Patients with good cardiac function after pacemaker implantation should therefore be warned against vigorous physical exertion which may directly affect the pacemaker system.
PRIMARY CARDIOMYOPATHY
Authors: Orinius Erik , Pernow Bengt
Published: August 2010

Abstract This prospective clinical and physiological study included ten consecutive patients with primary cardiomyopathy (obstructive and alcoholic cases excluded). Five of them were of the hypertrophic and five of the congestive type. The hypertrophic group was characterized by a systolic murmur of late onset and T wave inversion maximal in the apical lead, while dyspnea, atrial fibrillation and cardiac enlargement were more common in the congestive group. In the exercise test the hypertrophic group as a whole performed the predicted work and the congestive group only half of it. During a follow‐up period of 3–6 years two patients of each group died (sudden death). The two deceased patients of the congestive group were characterized by being the only two with persistent atrial fibrillation, having the lowest physical working capacity and being the only two in this group with abnormally high left ventricular end‐diastolic pressure during exercise. In the hypertrophic group the two deceased patients were the only ones with dyspnea on effort and large heart volumes in relation to the total amount of hemoglobin. These two patients also had the lowest working capacity and the lowest end‐diastolic pressure of the left ventricle during exercise in this group.
GENERALIZED SCLERODERMA
Authors: Jacobsen Bendt Brock , Pedersen Mogens , Herting Svend Erik
Published: August 2010

Abstract A 64‐year‐old female farmhand developed generalized scleroderma, causing death nine months after the first manifestation of symptoms. The cause of death was acute sclerodermic nephropathy with characteristic clinical changes in kidneys and skin. The BP remained normal. A concomitant severe haemolytic anaemia is described, and the importance of an associated serous cystadenocarcinoma of the ovaries is discussed.
MORBIDITY IN AZOTEMIA AND MORTALITY IN UREMIA
Authors: Ahlmén J. , Gustafsson Å. , Storm B.
Published: August 2010

Abstract A retrospective investigation in Göteborg of the morbidity in moderate azotemia and the so‐called calculated mortality in uremia, i.e. patients who actually died in uremia plus actively treated patients in 1966–68, comprising the age group 16–75, indicates a decrease in morbidity as well as in the calculated mortality. The incidence of morbidity in azotemia is 10.3 cases/year in the age group 16–65 and correlated to 100 000 inhabitants. The decrease (from 11.5 in 1966 to 8.8 in 1968) of azotemia is clear in the same age group and correlated to the population. In the pyelonephritic group the decreasing tendency is most pronounced and seems to correlate with the decreasing frequency of analgesic abuse from 55% of the case histories in 1966 to 38% in 1968. The calculated mortality rate in uremia is 8.7 cases/year correlated to the population and age of 16–65 years. The present figures show a decrease compared with an earlier investigation of chronic uremic mortality in Göteborg. The decrease (from 10.4 in 1966 to 7.4 in 1968) in the calculated mortality is mainly due to decreasing figures of the pyelonephritic calculated mortality. Diminishing figures are also found for glomerulonephritic mortality. Some speculative explanations are discussed. Only 39% of the uremic patients included in the figures of calculated mortality were actively treated with dialysis or renal transplantation. Nearly half of the patients who actually died in uremia were suitable for active treatment, according to current criteria, but for different reasons could not receive this treatment at that time.
CHANGE OF LIPOPROTEIN PATTERN BY CLOFIBRATE IN HYPERGLYCERIDAEMIA AND MIXED HYPERLIPIDAEMIA
Authors: Miettinen T. A. , Penttilä I. M. , Lampainen E.
Published: August 2010

Abstract The effect of clofibrate on plasma lipids, immunological β‐lipoprotein and the electrophoretic (cellulose acetate) lipoprotein pattern has been studied in 13 and 27 patients with a mild form of type IV and mixed hyperlipoproteinaemia (MH), respectively. Serum cholesterol and β‐lipoprotein, which were correlated with each other only in type IV and which correlated negatively with relative b.wt. in type IV and positively in MH, were only slightly decreased by the drug. Thus the changes which were correlated positively with the initial values were insignificant for cholesterol in type IV and for β‐lipoprotein in MH. Total triglycerides, which were correlated with pre‐β‐lipoprotein but not with relative b.wt., decreased equally (29%) in both groups, the decrement being correlated with the initial values. Lipoprotein electrophoresis revealed a relative fall of pre‐β‐lipoprotein and a relative increase of α‐lipoprotein, the increment of the relative β‐lipoprotein value being significant only in type IV in which the immunological β‐lipoprotein was decreased. The change of the latter tended to correlate negatively with that of triglycerides in type IV and positively in MH. The results suggested that the serum lipid pattern is normalized by clofibrate in about one third of hyperglyceridaemic patients seen in the general population and that, owing to the rare occurrence of gross pre‐β‐hyperlipoproteinaemia, a reciprocal increase of β‐lipoprotein by the drug is seen infrequently.
FLUOROSCOPIC SCREENING FOR LEFT VENTRICULAR ANEURYSM FOLLOWING ACUTE MYOCARDIAL INFARCTION
Authors: Orinius Erik , Säwe Urbain
Published: August 2010

Abstract Before discharge from hospital after an acute myocardial infarction 75 consecutive survivors have been examined for postinfarction aneurysm by fluuroscopy. Nine (12%) showed paradoxical pulsation of the left ventricle. Six months later the paradoxical pulsation could be observed in only five of the eight patients still alive.
TREATMENT OF HEREDITARY ANGIONEUROTIC OEDEMA WITH TRANEXAMIC ACID
Authors: Blohmé G.
Published: August 2010

Abstract Five patients with hereditary angioneurotic oedema (HANE) have been treated, in a random double‐blind cross‐over study, with tranexamic acid (trans‐AMCHA). Three patients have reacted positively to the treatment. The positive effect in these cases has been so obvious that a specific effect of trans‐AMCHA seems probable even if it cannot be definitely ruled out that spontaneous variations have been the cause of this effect. Therapeutic trials with fibrinolytic inhibitors should be made on patients with HANE.
STROKE IN HYPERPARATHYROIDISM
Authors: Boström Harry , Alveryd Alv
Published: August 2010

Abstract Twelve patients with signs and symptoms indicative of major stroke and five patients who had suffered from syncope and other signs of minor stroke were found to have coexistent hyperparathyroidism (HPT) when admitted to hospital as emergency cases. The mean age of the former group, consisting of three males and nine females, was 69.7 years (range 53–84). The mean age of the second group, two males and three females, was 66 years (range 56–84). Fourteen patients were operated on. In ten of them parathyroid adenoma was found, in three primary parathyroid hyperplasia, in one parathyroid cancer. Three patients died before parathyroid exploration could be undertaken. Parathyroid adenomas were revealed at autopsy. Of the operated patients one died of a new stroke 1 month after operation and another of metastasis of parathyroid cancer. The neurological and mental condition of all the 12 surviving patients improved. The possible relation between the development of signs of major or minor stroke and HPT is discussed. The importance of normalization of the parathyroid function in these patients, in order to facilitate the rehabilitation of the patients with major stroke, is stressed. In patients with minor stroke and HPT early operation might prevent development of major stroke.
BUDD CHIARI SYNDROME AND POLYNEURITIS
Authors: Waern Urban , Frithz Göran , Björk Lars
Published: August 2010

Abstract A 39‐year‐old man with an obstruction of the hepatic vein with concomitant ascites and oedema of the lower extremities is described. The cause seems to be a congenital stenosis of the hepatic vein. At surgery there were no possibilities of relief. One cause of that failure may have been bleeding from collateral vessels caused by an earlier laparotomy. The literature on the Budd Chiari syndrome is briefly reviewed. Modern surgery combined with angiographic and catheterization techniques makes this grave disorder a potentially curable one. This should especially be possible in the case of the above mentioned congenital strictures and webs, which in increasing numbers are diagnosed. The other and various causes of this syndrome, including malignancies, septic thrombosis etc., will most likely be diagnosed at autopsy. No connection between polyneuritis and this syndrome has been mentioned in the literature, as far as we can find. The origin of the polyneuritis in our case remains undetermined. One may speculate whether a disturbed hepatic metabolism may be the cause. The co‐existence of two separate diseases must also be considered.
OBSERVATIONS ON TEMPORAL ARTERITIS
Authors: Wadman Bengt , Werner Ivar
Published: August 2010

Abstract Clinical and laboratory findings in 53 consecutive cases of temporal arteritis, 48 verified at biopsy, are reported. The remaining 5 had typical history and a tender thickening of one or both temporal arteries. Signs of ocular involvement were present in 14 cases. The ESR was over 50 mm/h in all cases, in 42 over 100. Most cases had a slight anemia, hypoalbuminemia and raised α‐2‐globulin and fibrinogen. Twenty‐nine of 48 cases had elevated serum alkaline phosphatases. BSP tests (20 mg/kg b.wt.) were carried out in 16 patients. All gave abnormal results. The test was more abnormal in the patients with ocular involvement. With this single exception there was no constant difference in clinical or laboratory findings between the groups with and without ocular engagement.
THE RENAL EXCRETION OF ACETOACETATE AND 3‐HYDROXYBUTYRATE DURING ABSOLUTE FASTING
Authors: Wildenhoff K. E.
Published: August 2010

Abstract During absolute fasting with increasing ketosis the renal excretion of acetoacetate (AA) and 3‐hydroxybutyrate (3‐HB) has been in principle found to be identical. At low plasma concentrations the urinary excretion rate was near 0. With AA concentrations greater than approximately 0.09 mmol/1 and 3‐HB concentrations greater than approximately 1 mmol/1 the urinary excretion rate of both AA and 3‐HB increased rectilinearly with the plasma concentration, indicating that clearance was constant. AA/creatinine clearance ratio and 3‐HB/creatinine clearance ratio increased, accordingly, from approximately 0 to an average of 0.15 and 0.19, respectively. These results are in agreement with the view that at low plasma concentrations the ketone bodies are reabsorbed almost completely, whereas an amount corresponding to about 1/5 of the filtered amount is excreted at higher plasma concentrations. Binding of ketone bodies to plasma proteins was not found in filtration studies and therefore both AA and 3‐HB are apparently completely ultrafiltrable.
FATTY ACID COMPOSITION OF SERUM LIPIDS IN WIVES OF MEN WITH MYOCARDIAL INFARCTION
Authors: Kirkeby Knut , Ingvaldsen Per , Bjerkedal Inger
Published: August 2010

Abstract Two groups of healthy married women, aged 40–70 years, have been studied to determine the concentrations of major serum lipid fractions and their fatty acid composition. One group consisted of wives of men with recent myocardial infarction, and the other of wives of healthy men. No significant differences were observed in cholesterol, phospholipids, or triglyceride concentrations between the two groups or in the fatty acid composition of these lipid fractions. It has previously been demonstrated that the linoleic acid percentages in the serum lipids of men with myocardial infarction are lower than in healthy men. If dietary factors are responsible for the low linoleic acid percentages in men with myocardial infarction, the reason lies in individual habits rather than in the particular dietary habits of their families.
FRUCTOSE METABOLISM IN ADIPOSE TISSUE
Authors: Froesch E. R.
Published: August 2010

Abstract. The rate limiting step of fructose metabolism in adipose tissue is fructose transport into the cell. The step is accelerated by insulin only in the absence of glucose, so that insulin has no effect on fructose transport under physiologic conditions. The fructose carrier has a relatively high apparent Km for fructose transport so that significant quantities are transported only at relatively high concentrations of fructose in the blood.

Fructose is the phosphorylated to fructose‐6‐phosphate by the enzyme hexokinase. Glucose does not compete because it is not present intracellularly in sufficiently high concentrations. This statement is correct only for adipose tissue.

Fructose uptake by adipose tissue of diabetic animals is reduced as is glucose uptake, but to a lesser extent.

In vivo, most of the C14‐incorporation of fructose‐C14 into triglycerides or C14O2 by adipose tissue occurs after hepatic conversion of C14‐fructose to C14‐glucose. Insulin is required for glucose transport into adipose tissue.
CONTROL OF HEPATIC FRUCTOSE‐METABOLIZING ENZYMES: FRUCTOKINASE, ALDOLASE AND TRIOKINASE
Authors: Adelman Richard C.
Published: August 2010

Abstract. Physiological factors which may regulate the catalytic activity of three key enzymes of hepatic fructose metabolism, fructokinase, aldolase and triokinase, are reviewed. Possible relationships between these potential control mechanisms and hepatic fructose metabolism per se are discussed at three distinct levels: 1) characterization in vitro of purified enzyme preparations; 2) variation of enzyme activity in vivo under various dietary and hormonal conditions; and 3) variation of enzyme activity in vivo following development of liver tumors of different growth rate and degree of cellular differentiation.
EFFECT OF FRUCTOSE ON CELLULAR RESPIRATION IN PERFUSED RAT LIVER
Authors: Hassinen I. E. , Ylikahri R. H. , Kähönen M. T.
Published: August 2010

Abstract.

 The regulation of energy metabolism is reviewed with special reference to the metabolism of fructose. Fructose metabolism in liver by‐passes the main regulatory step of glycolysis, the formation of fructose‐6‐phosphate. Therefore the overall regulation of energy metabolism is possibly adjusted in a new way. The by‐pass and the high activity of liver fructokinase cause metabolic alterations characterized by an accumulation of fructose‐1‐phosphate and depletion of inorganic phosphate and adenine nucleotides in the liver.

 The effects of fructose on the redox state of nicotinamide nucleotides and mitochondrial flavoproteins and cytochromes were studied by surface fluorometry and transmission spectrophotometry in isolated perfused rat liver.

Oxygen consumption was inhibited and nicotinamide nucleotides were reduced concomitant with phosphate depletion. The spectrophotometry of intact tissue showed inhibition of electron transport at the first phosphorylation site of the mitochondrial respiratory chain.

The fructose‐induced alterations in the cellular redox state can be interpreted as acceptor control for inorganic phosphate during the metabolism of fructose. The role of the metabolism of glyceraldehyde in these redox changes is discussed.
FRUCTOSE AND PURINE METABOLISM
Authors: Raivio K. O. , Kekomäki M. , Mäenpää P.
Published: August 2010

Abstract.The interactions between fructose and purine metabolism are reviewed. Hyperuricemia and increased production of uric acid after fructose administration have been documented in man as well as in the rat. These effects appear to be dependent on the rapid phosphorylation of fructose, mainly in the liver. This results in a depletion of intracellular ATP and inorganic phosphate. As a consequence, the adenylate deaminase reaction is deinhibited and increased breakdown of adenine nucleotides to uric acid ensues.

Some considerations of the hazards involved in the clinical use of fructose are presented, and other possible points of interaction between fructose and purine metabolism are discussed.
METABOLISM OF FRUCTOSE AND GLYCERALDEHYDE IN THE ISOLATED PERFUSED PIG LIVER
Authors: Sestoft L. , Damgaard S. , Tygstrup N. , Lundquist F.
Published: August 2010

Abstract. Isolated pig livers were perfused under near physiological conditions, i.e. use of pigs blood, perfusion via both arterial and portal system, and constant pH (7.4). Fructose uptake and the production of a number of metabolites were measured in relation to the fructose concentration in the perfusion medium. A Michaelis type kinetics was found with Vm about 3 μmoles/g liver x min and Km about 5 mM. Fructose‐1‐phosphate was observed to accumulate as a consequence of the inhibition of the aldolase step, presumably by glyceraldehyde, AMP and IMP. Sorbitol formation is of small importance under our experimental condition.

During continuous fructose infusion the concentration of glyceraldehyde was low (less than 0.5 mM). Therefore the metabolism of glyceraldehyde was studied separately. Measurement of the reaction products glycerol and glycerate as a function of the glyceraldehyde concentration support the assumption that glyceraldehyde is metabolized by several pathways.

Measurement of acid production during metabolism of either fructose or D‐glyceraldehyde suggests that a considerable accumulation of acids occur in the liver, as only a minor part of the titration value is accounted for as the organic acids measured, of which lactic acid is the quantitatively most important.

Only 20–30 % of the carbon of fructose and glyceraldehyde is accounted for through formation of lactate and glucose. The rest is oxidized or accumulates in some form in the liver.

The oxygen consumption during fructose metabolism was increased about 30 %, and the lactate/pyruvate ratio showed small, but reproducible changes.
THE INTERRELATIONSHIP BETWEEN FRUCTOSE AND ETHANOL METABOLISM IN THE ISOLATED PERFUSED PIG LIVER
Authors: Damgaard S. E. , Sestoft L. , Lundquist F. , Tygstrup N.
Published: August 2010

Abstract. In the isolated perfused pig liver the rate of ethanol elimination is about 0.7 μmol/min/g. The acetate produced from ethanol is metabolized at a rate of about 0.5 μmol/min/g. Metabolism of ethanol does not affect oxygen or acetate uptake in this preparation. Alcohol dehydrogenase activity in pig liver is about 2 μmol/min/g and is assumed to account for practically all of the ethanol oxidation observed under the experimental conditions. Fructose increases the ethanol elimination rate to more than twice the control value. Oxygen consumption is similarly increased during this stimulation. A relationship between the fructose elimination rate and the stimulation of ethanol elimination is obtained. Pyruvate and D‐glyceraldehyde stimulate ethanol elimination, but in both cases the increase is less than 50 % of the increase observed with fructose. Uncoupling of oxidative phosphorylation from respiration by dinitrophenol does not affect the basal ethanol elimination rate, but it decreases the fructose effect on ethanol oxidation to less than half. Accumulation of reduced metabolites during stimulation of ethanol elimination by fructose and D‐glyceraldehyde only accounts for a minor part of this effect. From these observations it is assumed that an energy dependent cyclic process (the ‘malic enzyme shuttle’) converts the reduction equivalents produced in the alcohol dehydrogenase reaction as NADH to NADPH.
MODIFICATION OF METABOLIC EFFECTS OF ETHANOL BY FRUCTOSE
Authors: Ylikahri Reino H. , Kähönen Matti T. , Hassinen Ilmo
Published: August 2010

Abstract. Present knowledge of the metabolic interactions between fructose and ethanol in man and laboratory animals is reviewed. The possible biochemical mechanisms of these interactions are considered. Some new data on the effects of fructose and ethanol on carbohydrate and lipid metabolism are included.

Fructose increases the effects of ethanol on the hepatic lactate/pyruvate and a‐glycerophosphate/dihydroxyacetone phosphate ratios. Thus it augments the basic metabolic effect of ethanol, i.e. reduction of the hepatic redox state.

The ethanol‐induced increase in hepatic a‐glycerophosphate concentration has been regarded as an important factor in the pathogenesis of the acute alcoholic fatty liver. But although fructose causes hypertriglyceridaemia and augments the effect of ethanol on hepatic a‐glycerophosphate concentration, it was found to diminish the ethanol‐induced accumulation of triglycerides in the liver. Glucose had a similar effect. The reason for this is uncertain, but the inhibition of peripheral lipolysis by fructose and glucose might be partly responsible.

The most important effect of ethanol on carbohydrate metabolism is to inhibit hepatic gluconeogenesis by producing NADH in excess. Although the production of glucose from fructose is not directly dependent on the redox state of the liver, it is slightly inhibited by ethanol in vitro. However, in vivo fructose is effectively converted to glucose even during ethanol oxidation, and in ethanol‐induced hypoglycaemia it rapidly restores the blood glucose level.
EFFECT OF FRUCTOSE AND OTHER SUGARS ON ISLET FUNCTION IN VITRO
Authors: Hager Diana , Pipeleers Daniel G. , Herchuelz André , Malaisse Willy J.
Published: August 2010

Abstract. Glucose and mannose stimulate insulin release, insulin biosynthesis and calcium uptake in rat isolated islets. Their insulinotropic action is enhanced by caffeine or theophylline. Ribose and xylitol might also exert a minor insulinotropic action. Fructose and galactose do not stimulate insulin release whether in the presence or absence of methylxanthine (10.0 mM), and do not affect insulin biosynthesis or calcium uptake by the islets. These converging findings on several parameters of islet function support the concept that the insulinotropic effect of sugars is dependent on their intracellular metabolism, or possibly on the activation of a highly‐selective glucoreceptor.
METABOLISM OF FRUCTOSE IN DIABETES
Authors: Roch‐Norlund A. E. , Hultman E. , Nilsson L. H:son
Published: August 2010

Abstract. Fructose and glucose (4 g/kg body‐weight during 4 hours) were given intravenously to normal subjects and to patients with diabetes without insulin treatment.

Liver and muscle glycogen content was determined before and after the infusion. In normal subjects glucose and fructose gave similar increases in muscle glycogen stores, while the liver glycogen increased 4 times more after fructose infusion as compared to glucose. In the diabetics only fructose gave a liver glycogen increase and neither fructose nor glucose affected the muscle glycogen content.

The mechanism for the glycogen increase in the liver of diabetics after fructose infusion could be due to allosteric activation of glycogen synthetase D and/or to availability of fructokinase.
THE EFFECT OF FRUCTOSE ON HEPATIC SYNTHESIS OF FATTY ACIDS
Authors: Zakim David
Published: August 2010

Abstract. The synthesis of fatty acids from fructose and glucose has been compared in rat and human liver. In both species fructose is a better precursor of fatty acids than glucose, primarily as a result of the greater rate of glycolysis of fructose as compared to glucose. The high rate of fructose utilization and relatively low rates of glucose utilization by liver is reflected by the activity of fructokinase which is considerably greater than the total hexokinase and glucokinase activities. Although it is not possible to exclude that the high rate of fructolysis produces a metabolic intermediate which alters the functional state of the fatty acid synthesizing enzymes, the experimental evidence indicates that hepatic fatty acid synthesis in carbohydrate‐fed animals is limited by the supply of substrate. Because the hepatic metabolism of fructose can supply acetyl CoA to the fatty acid synthesizing enzymes at greater rates than can glucose, hepatic fatty acid synthesis is enhanced in fructose‐ or sucrose‐fed animals. Since estimates of maximum rates of fatty acid synthesis in human liver based on in vitro measurement of the activity of acetyl‐CoA carboxylase suggest that de novo synthesis of fatty acids in human liver can be large in comparison to the turnover of triglycerides in very low density lipoproteins, the data are compatible with the conclusion that enhanced rates of hepatic fatty acid synthesis contribute significantly to fructose‐ or sucrose‐induced hypertriglyceridemia in normal men.
EFFECT ON SERUM LIPIDS OF DIETARY SUCROSE AND FRUCTOSE
Authors: Macdonald Ian
Published: August 2010

Abstract. Though the measurement of the concentration of substances in the serum may provide misleading evidence for metabolic studies, nevertheless findings of changes in the levels of various serum lipids have a high degree of association with vascular disease. Sucrose or one of its constituent monosaccharides, fructose, has been found to have an influence on serum triglyceride concentration — the effect on the serum cholesterol level being minimal — when compared with glucose or its polymers.

After the acute ingestion of sucrose a less striking fall is found in the serum triglyceride level than after glucose ingestion. Experimental diets containing a large proportion of carbohydrate result in a level of triglyceride that is higher when the carbohydrate contained fructose than when it contained glucose. The effect of dietary fructose on the fasting level of serum triglyceride is modified by the sex of the consumer, the amount and type of fat accompanying the fructose, the type of protein in the diet, the frequency of intake, etc.

The few studies on long term ingestion of fructose suggest that the rise in triglyceride concentration following fructose ingestion falls.

There is some evidence that in vascular disease the fructose metabolism may be more disturbed than that of glucose.
EFFECTS OF DIETARY FRUCTOSE AND SUCROSE ON PLASMA TRIGLYCERIDE METABOLISM IN PATIENTS WITH ENDOGENOUS HYPERTRIGLYCERIDEMIA
Authors: Nikkilä Esko A. , Kekki Matti
Published: August 2010

Abstract. Since fructose is now marketed as a nutrient a study has been initiated to compare the effects of fructose, sucrose and starch at a conventional dietary intake level on the plasma triglyceride concentration and turnover in patients with endogenous hypertriglyceridemia. Preliminary results are presented here.

Fructose or sucrose in a daily amount of 75 to 80 grams were added to the diet in an isocaloric exchange for starch in twelve hyperglyceridemic patients under hospital conditions. Each dietary period lasted for 10 to 20 days and the triglyceride turnover was studied by endogenous glycerol labeling technique at the end of each period. Five of the patients had manifest diabetes managed by diet or oral antidiabetic drugs.

Plasma triglyceride response to fructose was variable and the average change from the level observed during fructose‐free diet was not significant. However, in nondiabetic subjects a definite rising trend of triglyceride was noticeable. Sucrose caused a significant increase of triglyceride concentration above that measured during fructose and starch diets. Diabetics were not included into the sucrose group, however. The fractional removal rate of plasma triglycerides was identical during all three diets but the triglyceride production rate showed a rising trend during fructose and, particularly, during sucrose diet as compared to starch. Because of the limited number of subjects studied so far, these results do not justify any definite conclusions.
THE SIGNIFICANCE OF SUCROSE IN PRODUCTION OF HYPERTRIGLYCERIDEMIA
Authors: Kaufmann N. A. , Kapitulnik J.
Published: August 2010

Abstract. The relationship between endogenous and carbohydrate‐induced hypertriglyceridemia (C‐HTG) is reviewed. Different effects of sucrose, glucose, fructose, and starch on serum lipid levels in patients with C‐HTG are demonstrated. The significance of these effects in patients with C‐HTG, and their relation to those in normal subjects is discussed.
Chapter XI PHYSICAL ACTIVITY IN A POPULATION SAMPLE OF WOMEN AND IN WOMEN WITH ISCHAEMIC HEART DISEASE
Authors: Bengtsson Calle
Published: August 2010

Abstract. Physical activity, both at work and during leisure, decreased with age, as found from a population study of women. Physical inactivity, both at work and during leisure, had been significantly more common during the age period 20–38 in women who later had an acute myocardial infarct than in women in the general population. The same was found when comparing later periods of life. A similar tendency was noted in women with angina pectoris, though the differences mostly did not reach significant levels.
Chapter XII PREVALENCE OF MULTIPLE “RISK FACTORS” FOR ISCHAEMIC HEART DISEASE IN WOMEN WITH AND WITHOUT KNOWN ISCHAEMIC HEART DISEASE
Authors: Bengtsson Calle
Published: August 2010

Abstract. A larger number of co‐existing “risk factors” for ischaemic heart disease was found in women who had suffered myocardial infarction than in women in the general population. Similar observations were made when comparing women who had angina pectoris or women who had ECG changes suggestive of ischaemic heart disease with women in the general population, though these differences were smaller. Diabetes mellitus, smoking and high triglycerides were especially common in women who had had myocardial infarction. At least one of these “risk factors” was present in 95 % of these women compared to 48 % of the women with angina pectoris, 43 % of women with ECG changes suggestive of ischaemic heart disease and 47 % of the women in the general population. It seems that the prevalence of a large number of “risk factors” ‐ even though the factors may differ only moderately from those usually found in the population ‐ per se acts as an important “risk factor” for ischaemic heart disease in women.
MILD DIABETES IN YOUNG SUBJECTS
Authors: Johansen Klaus
Published: August 2010

AbstractThe clinical aspects and the plasma insulin response patterns in young subjects with mild diabetes are described. Young subjects with mild diabetes have no or very few symptoms and can be controlled by diet or oral antidiabetic drugs. The mild diabetics are divided into two groups according to the fasting blood glucose concentration. Subjects having anormalfasting blood glucose concentration but a diabetic glucose tolerance test are calledjuvenile glucose tolerance test diabeticsand those withelevatedfasting blood glucose concentration and a diabetic glucose tolerance test are designatedmild juvenile diabetics.

It is demonstrated that juvenile glucose tolerance test diabetics have a normal plasma insulin response after i.v. glucose and tolbutamide. The plasma insulin response to oral glucose, however, is weak and slow in comparison to non‐diabetics. In contradistinction, mild juvenile diabetics exhibit a weak and delayed plasma insulin response both to i.v. and oral glucose and to i.v. tolbutamide. In comparison with classic juvenile diabetics, juvenile glucose tolerance test diabetics and mild juvenile diabetics have a much higher plasma insulin level during the tests.
ERYTHROCYTE SEDIMENTATION RATE AND PLASMA LIPIDS
Authors: Böttiger L. E.
Published: August 2010

Abstract A highly significant positive correlation (p <0.001) has been found between erythrocyte sedimentation rate (ESR) and serum cholesterol and triglycerides and—in a much smaller group—a negative correlation (p < 0.05) between the ESR and serum lysolecithin. These correlations exist regardless of age variations. It is suggested that it is probably the lipoprotein content of plasma that influences the ESR.
FATTY ACID AS A DETERMINANT OF MYOCARDIAL SUBSTRATE AND OXYGEN METABOLISM IN MAN AT REST AND DURING PROLONGED EXERCISE
Authors: Wahlqvist M. L. , Kaijser L. , Lassers B. W. , Carlson L. A.
Published: August 2010

AbstractThe relationship of fatty acids to the metabolism of the human heart has been investigated in 41 healthy fasting men. In some subjects low plasma free fatty acid (FFA) concentrations were produced by infusing nicotinic acid. There existed negative correlations between myocardial extraction of glucose, lactate and pyruvate and that of FFA. Furthermore significant negative linear relationships between myocardial extraction of glucose and lactate and that of FFA were also present on partial correlation analysis eliminating the influence of other carbohydrate substrates. Possible explanations for these findings were discussed. Myocardial extraction of oxygen was positively related to that of FFA at rest unrelated to heart rate. The possibility, and its clinical implications, that FFA may increase myocardial oxygen requirements was discussed.
THE MECHANISM OF MYOCARDIAL INFARCTION FOLLOWING PROSTHETIC AORTIC VALVE REPLACEMENT
Authors: Storstein Ole , Efskind Leif , Torgersen Olav
Published: August 2010

Abstract During a 5‐year period 62 of 243 patients, subjected to prosthetic aortic valve replacement at the University Hospital in Oslo, died. Nine of these patients died from myocardial infarction. The mechanism of myocardial infarction in these patients has been studied by correlation between clinical, ECG, coronary angiographical and autopsy studies. Two patients died from thrombosis on the artificial valve extending into a coronary artery, one from coronary embolism (?), two from surgical interference with the coronary circulation. In two patients the myocardial infarction was related to coronary atheromatosis. In the last two patients the coronary arteries were normal. In both these patients there was extensive subendocardial hemorrhage and myocardial necrosis. In order to prevent myocardial infarction in the postoperative period it is important to monitor these patients for arrhythmias and to prevent postoperative hypotension. Anticoagulant treatment should be carried out with strict supervision of its efficacy. Agents to prevent platelet thrombosis should be evaluated in these patients with a high risk of thrombus formation.
BENIGN, IDIOPATHIC PULMONARY HYPERTENSION?
Authors: Trell Erik
Published: August 2010

Abstract Two further cases of unusually long duration of idiopathic pulmonary hypertension are reported and briefly discussed in relation to the pertinent literature.