bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential Count of Urinary Leucocytes and Renal Epithelial Cells by Phase Contrast Microscopy
Authors: Lindqvist Bengt , Wahlin Anders
Published: August 2010

Abstract. A total of 291 urine sediments from 255 patients with various renal or urinary tract diseases have been studied by phase contrast microscopy. Based upon morphological criteria, leucocytes were distinguished from renal epithelial cells and the white blood cells were classified either as mononuclear or polynuclear in 179 patients. The percentage of the different cell types varied considerably between and within the different diseases. The median values for polynuclear granulocytes were higher than 90% in bacterial renal or urinary tract disease and in polycystic kidney disease. In interstitial nephritis, nephrosclerosis and in renal transplanted patients the percentage of polynuclear granulocytes was somewhat lower, 76–85%. In diabetes, amyloidosis, tubular nephrosis (necrosis) glomerulonephritis, lupus nephritis and endemic benign nephropathy there were 14–66% polynuclear granulocytes. 29–33% mononuclear leucocytes were found in lupus nephritis and endemic benign nephropathy. The greatest proportion of renal epithelial cells was found in endemic benign nephropathy, namely 49%. 36% renal epithelial cells were found in tubular nephrosis (necrosis) and in glomerulonephritis. The technique is rapid and inexpensive. It facilitates differential diagnostics of urinary tract disease with pyuria.
CELL VOLUME REGULATION IN ACUTE MYOCARDIAL ISCHEMIC INJURY*
Authors: Jennings Robert B.
Published: August 2010

Thin freehand slices of left ventricular papillary muscle of the dog, exhibit good cell volume regulation when incubated at 37° for 60 minutes in oxygenated Krebs Ringer phosphate solution. The fine structure of the cells is maintained throughout the incubation. This in vitro system was developed in order to test the capacity of myocardial cells irreversibly injured by 60 minutes of ischemia to maintain cell volume. The results showed that irreversibly damaged cells were unable to maintain volume. They swelled markedly, lost Mg2+ and K+ and exhibited structural defects in the plasma membrane of the sarcolemma. These observations establish that loss of cell volume regulation is one of the early events associated with the development of irreversibility in severe myocardial ischemic injury.
Malplacement of Endocardial Pacemaker Electrodes in the middle cardiac vein
Authors: Kemp A. , Johansen J. Kjersgaard , Kjærgaard E.
Published: August 2010

ABSTRACT Endocardial transvenous pacemaker electrodes have been implanted in 246 patients owing to symptomatic bradycardia. The electrode was malplaced in the middle cardiac vein in 12 patients. All the patients were on stable ventricular pacing at the time of implantation. The electrodes were still in function in six patients after 5–96 months (average 55). The electrode was replaced in three patients owing to the occurrence of exit block. Three patients died during the period under study. Right‐sided bundle branch block (RBBB) configuration of paced QRS complexes was observed on the ECG when the electrode was malplaced in the middle cardiac vein. As RBBB only occurs with malplacement, the ECG can be employed to ensure correct positioning of the electrode.
Comparison between Metoprolol and Propranolol as Antihypertensive Agents
Authors: Bengtsson C.
Published: August 2010

ABSTRACTA new selective β‐adrenergic blocking agent—metoprolol—is compared to a non‐selective β‐adrenergic blocking agent—propranolol—according to a double‐blind cross‐over technique in 23 hypertensive women, who had previously taken alprenolol and propranolol during different periods. No significant differences were found for blood pressure, heart rate, body weight or serum uric acid. No side‐effects which could be related to the therapy were seen with either drug.
Leucocyte Migration Inhibitory Activity of Concanavalin‐A‐stimulated Human Lymphocytes
Authors: Coeugniet Edouard , Bendtzen Klaus , Bendixen Gunnar
Published: August 2010

ABSTRACTThe in vitro effects of heparin, dipyridamole (DIPY) and lysine‐acetylsalicylate (LASA) on human peripheral blood leucocyte migration and upon production/release and effect of leucocyte migration inhibitory activity (LMIA) from lymphocytes stimulated with concanavalin‐A (con‐A) have been studied. The final concentration of each drug was of the same order of magnitude as during clinical treatment. The leucocyte migration under agarose was significantly increased by DIPY at a concentration of 100μg/ml. The release/production of LMIA was inhibited by DIPY at 1μg/ml and by LASA at 0.3μg/ml. Heparin had no influence on LMIA release, even at 10 IU/ml. The LMIA of supernatants from con‐A‐stimulated lymphocyte cultures was inhibited by DIPY at a concentration of 10μg/ml, by LASA at 3μg/ml and by heparin at 10 IU/ml. The findings suggest that DIPY and LASA could have a dual role as modifiers of inflammation: 1) the well known role as antiaggregants tending to limit and impede thrombosis, and 2) as antagonists to the lymphocytemediated (type IV) immune reaction through a depressive action on Iymphokine production/release and activity.
The Effect of Indomethacin on Proteinuria and Kidney Function in the Nephrotic Syndrome
Authors: Arisz L. , Donker A. J. M. , Brentjens J. R. H. , van der Hem G. K.
Published: August 2010

ABSTRACT In 19 nephrotic patients on a dietary intake of 20 mEq sodium/24 hours, indomethacin caused an immediate decrease in glomerular filtration rate (GFR) and urinary protein excretion, an effect completely reversible upon withdrawal of the drug. As a consequence of lower protein excretion, there was eventually a rise in GFR. It is proposed that the therapeutic effect of indomethacin in nephrotic syndrome is caused by its inhibiting action on renal prostaglandin synthesis, thereby potentiating the effect of the renin‐angiotensin system on the kidney. The difference between the decrease in GFR (mean 35%) and proteinuria (mean 55%) and the more selective proteinuria during indomethacin administration may be explained by quantitative and qualitative differences in protein leakage between outer cortical and inner cortical nephron populations.
Importance of Season and Clearance Correction in the Definition of Hypercalciuria
Authors: Transbøl I. , Jørgensen F. Schønau , Lund B. , Sørensen O. H.
Published: August 2010

The urinary excretion of calcium derives from the complex interplay of the factors influencing the filtered load and the tubular handling of this ion. Obviously, in order to define hypercalciuria, the dietary intake of calcium has to be controlled (5) and the inter‐ and intraindividual variations in the clearance of creatinine must be corrected (4, 6, 9, 10, 11). As a matter of fact, without this correction hypercalciuria may even be undetectable in idiopathic renal stone‐formers studied on a free diet (1). But one must also consider the possibility of additional variables. The recent observation of rather marked seasonal variations in the plasma level of the intermediary vitamin D3 metabolite, 25‐hydroxy‐cholecalciferol (25‐OHCC), (2, 8) suggests that part of the normal variability in the renal excretion of calcium may be season‐related. To elucidate this problem we undertook the present pilot study of the seasonal variations in the clearance‐corrected renal calcium excretion of healthy volunteers taking a standard diet.
Studies on Cerebrovascular Strokes
Authors: Frithz G. , Werner I.
Published: August 2010

ABSTRACT This paper reports the second part of an investigation of first‐time cerebrovascular strokes in people under 70 years of age. The clinical data of 344 patients, together with the short‐term outcome of the disease, are presented. The immediate (one month) overall mortality was 38 %. The corresponding percentage for cerebral haemorrhage was 86, for cerebral infarction 20 and for cerebral embolism 28. Of the surviving patients, 111 had to be transferred to some form of institution at discharge after the acute phase; 103 were able to return to their homes. The influence of various factors upon the immediate prognosis is discussed. Of the clinical findings, the level of consciousness and a calculated score based on the neurological symptoms on admission, proved to have the highest predictive value. Using this score it was possible to predict the outcome in about 85%. Single factors very highly associated with a poor prognosis were the co‐existence of cardiac disease and renal insufficiency. There was a notably high prevalence of hypercalcaemia.
Hemodynamic Long‐term Effects of Timolol at Rest and during Exercise in Essential Hypertension
Authors: Lund‐Johansen Per
Published: August 2010

ABSTRACT Sixteen men with previously untreated essential hypertension in WHO stage I have been studied as out‐patients. Oxygen consumption, heart rate (HR), cardiac output (Q) (Cardiogreen) and intraarterial brachial pressure were recorded at rest in supine and sitting position and during steady state work at 300, 600 and 900 kpm/min. The subjects were treated with timolol as the sole drug for one year and the hemodynamic study was repeated. BP was reduced approximately 18% at rest and 14% during exercise, HR approximately 26% and the cardiac index 28% at rest supine and 32% at rest sitting. During exercise the reductions in Q were 25–30%. The calculated total peripheral resistance was significantly increased at rest as well as during exercise. The product of mean arterial pressure and HR was reduced about 40%. No severe side‐effects were seen.
Distribution of Immunoglobulin‐containing Cells in Human Bone Marrow and Lymphoid Tissues
Authors: Turesson Ingemar
Published: August 2010

ABSTRACTCell suspensions of human bone marrow, spleen, lymph nodes and palatine tonsils have been investigated for the presence of intracellular immunoglobulins by a direct immunofluorescence technique, using monospecific antisera against human Ig heavy chainsα, μand γ and light chainsKandΛ. Serum Ig levels were determined and the number of positive cells was compared with the concentration and calculated synthetic rate of serum Ig in each individual. The 28 patients studied covered a wide range of diagnoses and included those with normal as well as pathologically decreased or increased serum Ig levels. There was a high correlation between the calculated synthetic rate of each Ig class and the percentage of cells positive for the same Ig class in the bone marrow but not in the spleen, lymph nodes or tonsils. The Ig‐containing cells constituted a much larger proportion of the total lymphoid cell population in the bone marrow than in the peripheral lymphoid organs. The estimated total number of Ig‐containing cells was also much larger in the bone marrow than in the other organs investigated. It is concluded that in man the bone marrow is the major site of serum Ig synthesis and that the average synthetic rate per cell is the same regardless which of the three major Ig classes is produced. The role played by different lymphoid organs in humoral immunity is discussed in the light of the present results and reported data regarding lymphocyte and plasma cell kinetics in mammals.
Lysozyme Activity in Cerebrospinal Fluid
Authors: Reitamo Sakari , Klockars Matti
Published: August 2010

ABSTRACT The concentration of lysozyme (LZM) in cerebrospinal fluid (CSF) has been studied in 148 patients to evaluate its possible significance in the differential diagnosis of various diseases affecting the central nervous system (CNS). In the control group only 3 of 45 patients had detectable LZM in their CSF, the highest value being 1.3 μg/ml. The diabetic and epileptic groups did not differ from the control group. Of 8 patients with primary intracranial tumours, 4 had raised CSF‐LZM levels. Twenty of 23 uraemic patients had elevated CSF‐LZM, the highest value being 3.3 μg/ml. The highest values were found in patients with bacterial meningitis, tuberculous meningitis and leptomeningitis due to Aspergillus. A positive correlation was found between CSF‐LZM and protein concentrations. The measurement of LZM may be of value in the diagnosis of inflammatory processes affecting the CNS and in the diagnosis of certain intracranial tumours.
Light Chain Myeloma with Features of the Adult Fanconi Syndrome: Six Years Remission Following one Course of Melphalan
Authors: von Schéele Christian
Published: August 2010

ABSTRACT A 41‐year‐old woman, presenting with renal failure, renal glucosuria and moderate anemia, was found to have light chain myeloma, indicated by a kappa chain M‐component in the serum, heavy urinary excretion of kappa chains and plasma cell infiltration of the bone marrow. After administration of one course of melphalan, resulting in transient pancytopenia, the light chains disappeared completely, renal function returned to normal, glucosuria disappeared and the Hb concentration normalized. During an observation period of six years she has remained in good health and there has been no sign of relapse.
Blood Ketone Body Disappearance Rate in Diabetics and Normals after Rapid Infusion of DL‐3‐hydroxybutyrate
Authors: Wildenhoff K. E.
Published: August 2010

ABSTRACT. Ketone body tolerance has been studied in 26 newly diagnosed diabetics and 9 normal control persons after rapid i.v. infusion of dl‐3‐hydroxybutyrate. In juvenile diabetics with high initial fasting concentrations of ketone bodies, disappearance rates of acetoacetate and total ketone bodies in blood were low before diabetic regulation. Insulin treatment normalized disappearance rates. In the non‐obese maturity onset diabetics, on the other hand, ketone body disappearance rates remained abnormally low after treatment with glibenclamide. In the obese maturity onset diabetics, disappearance rates, being normal before diabetic regulation, decreased during phenformin treatment, the rate constants becoming significantly lower than in the normals. Decreased tissue uptake of ketone bodies thus seems to contribute to the increased ketone body level in blood in this group of diabetics. Disappearance rates were not correlated to preinfusion ketone body concentration. In the normals, no change in serum insulin was observed following the infusion, while a significant decrease was seen in plasma glucose.
Liver Enzymes in Alcohol‐discordant Twins
Authors: Myrhed Mårten , Bergström Kurt
Published: August 2010

ABSTRACT. Seventy moderately alcohol‐discordant male twin pairs have been investigated with respect to some liver enzymes. No differences were found as regards S‐ALAT, while significantly higher enzyme levels were demonstrated for S‐ASAT, S‐ALP and S‐GT among the high alcohol consumers compared to their low consuming co‐twins. Especially S‐GT was found to be a valuable and sensitive test in the detection of even a moderate alcohol intake in working and socially well adapted subjects. These results were obtained in a subject group in which the influence of genetic factors was kept to a minimum.
The Tromsø Heart Study
Authors: Thelle Dag S. , Førde Olav H. , Try Kenneth , Lehmann Egil H.
Published: August 2010

ABSTRACT. The mortality from coronary heart disease (CHD) in Norway increased rapidly during 1951‐70, the highest mortality rates as well as the most rapid increases being found in Northern Norway. Several surveys of CHD were then planned, one of them is reported here. All men, 20–49 years of age, living in the municipality of Tromsø, Troms county, were called up for examination. In total, 6 595 men, 74.4% of those invited, were examined. Cholesterol, triglyceride and Hb values, BP, body weight and height, the percentage of smokers, and cigarette consumption have been tabulated according to area, age, work schedule, health condition, physical activity and ethnic background. The results suggest that the relatively high mortality from CHD in Northern Norway is associated with high serum cholesterol concentrations as well as a relatively high prevalence of smoking. During the screening there were indications of changes in dietary habits in the municipality, presumably as a result of accompanying publicity.
Body Composition and Glucose Metabolism in Hypertensive Middle‐aged Males
Authors: Berglund Göran , Larsson Bo , Andersson Owe , Larsson Owe , Svärdsudd Kurt , Björntorp Per , Wilhelmsen Lars
Published: August 2010

ABSTRACT. Body fat, body cell mass, fasting blood sugar, glucose tolerance and fasting insulin have been determined in 106 hypertensive males aged 47–54 years and in 41 normotensive 50‐year‐old males. Both groups were derived from screening examinations in random population samples. The hypertensive subjects were more often obese and had more often an impaired glucose tolerance and a higher fasting insulin compared with the normotensive subjects. The metabolic differences were not explained simply by the higher degree of obesity in the hypertensive subjects, as the differences remained when the hypertensive subjects were matched for body fat with normotensive controls. The impaired glucose metabolism demonstrated quantitatively in an unselected group of hypertensive subjects, might be one of the factors explaining the variable prognosis in hypertensive subjects.
Relationship between Intracellular Cyclic AMP and Lipolysis in Human Adipose Tissue
Authors: Arner Peter
Published: August 2010

ABSTRACT.Human subcutaneous adipose tissue has been incubated in vitro in the presence and absence of isoprenaline (ISNA). The tissue concentration of cyclic AMP (cAMP) and the release of glycerol into the incubation medium were measured after various incubation periods. In the presence of ISNA (6×10‐5mol/1), the tissue concentration of cAMP reached a peak after around 10 min and then declined to a level significantly lower than that at the start of the incubation. In contrast, the ISNA‐in‐duced rate of lipolysis was a linear function of the incubation time. The addition of propranolol (13 μmol/1) at different timesafterISNA did not influence the rate of lipolysis, although it resulted in a decrease in the tissue level of cAMP. There was a positive correlation between the maximal increase in tissue cAMP and the rate of lipolysis in adipose tissue exposed to ISNA, both in individual experiments and in a group of 23 persons. No correlation was found between the rate of lipolysis and the tissue level of cAMP in adipose tissue incubated under basal conditions. The findings are compatible with the theory that the β‐adrenergic‐induced lipolysis by human adipose tissue is a function of the maximal rise in the concentration of tissue cAMP. It is concluded that this peak level of cAMP represents a single compartment of the nucleotide.
Pure Mitral Regurgitation
Authors: Amlie Jan P. , Langmark Fröydis , Storstein Ole
Published: August 2010

ABSTRACT. The varied etiology of pure mitral regurgitation is demonstrated in this clinicopathological study, comprising 59 surgically treated cases with this condition. One third of the cases was of rheumatic origin, one fifth had ischemic heart disease, another fifth floppy valves and one eighth an isolated rupture of the chordae with necrosis of the chord matrix. To our knowledge the histopathological findings in the last group have not been described before. Congenital mitral regurgitation, bacterial endocarditis and cardiomyopathy were rare causes of mitral regurgitation. Differences between the groups were observed in the sex ratio, duration of history, auscultatory findings, ECG signs, compliance of the left ventricle and in the morphological findings.
Changes in the Adrenergic Control and the Rate of Lipolysis of Isolated Human Adipose Tissue during Fasting and after Re‐feeding
Authors: Östman Peter Arner and Jan
Published: August 2010

ABSTRACT. The influence of changes in nutritional state on lipid mobilization has been investigated, using subcutaneous fat portions removed from 8 obese patients submitted to fasting for one week. The maximal rise in the tissue level of cyclic AMP (cAMP) and the rate of glycerol release were determined when adipose tissue was exposed to noradrenaline (6times 10‐6 mol/1), isopropylnoradrenaline (6times10‐6 mol/1) or none of the agents (basal medium). Fasting resulted in significant increases in the tissue level of cAMP and the rate of lipolysis in adipose tissue unexposed to lipolytic agents. Noradrenaline decreased the level of cAMP, in contrast to isopropylnoradrenaline, and significantly inhibited the rate of lipolysis during fasting. These noradrenaline effects were abolished by the simultaneous presence of phentolamine (13 mmol/1) in the incubation medium. Re‐feeding with Meritene® for one day resulted in a diminished rate of basal lipolysis, whereas the cAMP level was unaffected. The response of the cAMP accumulation to isopropylnoradrenaline was further augmented by re‐feeding. Noradrenaline produced a significant rise in the level of cAMP and significantly stimulated the rate of glycerol production. It is concluded that the nutritional changes are of significance for the adrenergic regulation of lipolysis as indicated by the response of cAMP to the catecholamines. In pharmacological terms, fasting for one week resulted in increased α‐ as well as /3‐adrenergic responsiveness. Increased basal lipolysis during fasting may be related to an increased level of cAMP or a direct activation of lipase.
Clinical and Laboratory Findings in Subjects with Hypercalcaemia
Authors: Christensson T. , Hellström K. , Wengle B.
Published: August 2010

ABSTRACT. Primary hyperparathyroidism (PHPT) was the most likely diagnosis in 68 non‐thiazide‐treated patients with hypercalcaemia detected in a health screening. The group comprised 55 females and 13 males, with a mean age of 55.0+0.7 (S.E.M.) years. On a pair basis these patients (the observation group) were compared with a series of 68 age‐ and sex‐matched normocalcaemic subjects (the control group) selected from the health screening register. Renal calculi and reduced creatinine clearance were encountered less frequently in the observation group than in many reports of hospitalized patients with PHPT. Compared with the control group, the observation group comprised a greater number of subjects with renal calculi (usually multiple and bilateral), constipation, mental depression and reduced creatinine clearance. The ECG Q‐T interval was shorter in the observation group than in the control group. No differences were found with respect to the occurrence of gastritis and/or peptic ulcer, polydipsia, polyuria and general muscle weakness. On the basis of this and a previous study it was concluded that at least 3%‰ of the 15903 subjects participating in the health screening suffered from “asymptomatic” hypercalcaemia and most probably from “asymptomatic” PHPT.
Menopausal Age of Females with Hypercalcaemia
Authors: Christensson T.
Published: August 2010

ABSTRACT. The mean age at natural menopause of 7 328 women participating in a health screening conducted by the Stockholm City and County Council was 50.2 years. The corresponding age encountered for a subgroup of 49 women with hypercalcaemia (very probably due to primary hyperparathyroidism) confirmed in repeated determinations was 45.7+0.4 (mean+S.E.M.) and significantly lower than that (50.1+0.4 years) of a normocalcaemic age‐matched control group (p<0.001). The health screening was performed about eight years after the women's menopause. The observation and control groups showed a significant difference with regard to the serum calcium level but no difference was found with respect to marital, parital or socio‐economic status or disorders that may result in early or late menopause.
Blood Levels of 3,5,3‘‐Triiodothyronine and Thyroxine: Differences between Children, Adults, and Elderly Subjects
Authors: Westgren U. , Burger A. , Ingemansson S. , Melander A. , Tibblin S. , Wåhlin E.
Published: August 2010

ABSTRACT. The serum levels of 3,5,3'‐triiodothyronine (T3) and thyroxine (T4) in children, adolescents, adults, and elderly subjects have been measured by radioimmunoassays. It was found that while the T4 levels were essentially equal in all age groups examined, the T3 levels were markedly different. In children and adolescents (1–15 years), high values were recorded; indeed, they exceeded the upper normal limit in adults (20–80 years). From the age of 20, the T3 levels remained unaltered until the age of 80, after which there was a further reduction, to values approaching the lower normal limit for T3 in middle‐aged subjects. The findings emphasize that separate normal values must be established for different age groups, in order to avoid diagnostic misinterpretations and therapeutic failures.
The value of an oscilloscope in routine checking of pacemakers
Authors: EDHAG O. , FAGRELL B. , SJOGREN A.
Published: August 2010

ABSTRACT. An evaluation has been made of the usefulness of the oscilloscope at routine check‐ups of cardiac pacemakers. Measurements of 100 consecutive implanted pacemakers, obtained after their removal have been compared with changes in rate and changes in impulse duration and amplitude obtained at previous routine controls. Other changes in pacemaker characteristics have also been evaluated.

Eight faulty pacemakers were found. Six had a decreased voltage, none however, less than 3.5 volts. Five of them had shown a decrease in rate by at least 7 impulses per minute, while in one QRS‐synchronized pacemaker the synchronizing circuit did not function. In one pacemaker the stimulating rate had increased with 20 impulses while in one P‐synchronized pacemaker the delay time had decreased.

In 6 patients a significant decrease of the impulse amplitude was noticed without fall in voltage or electronic failure and in 3 others no decrease of the impulse duration was noticed in spite of decreased voltage at check after explantation.

The present study therefore indicates that, at routine check‐ups of the presently analyzed pacemakers with voltage depending stimulation rate, an analysis of the latter gives satisfactory information of pacemaker function and can be used instead of oscilloscope test, eventually in combination with electronic measurements of impulse duration.
SITE AND MODE OF ACTION OF CLONIDINE IN THE CENTRAL NERVOUS SYSTEM
Authors: Paakkari Ilari , Karppanen Heikki , Paakkari Pirkko
Published: August 2010

Abstract.In urethane‐anaesthetized rats clonidine was administered intravenously (i.v.), intra‐cerebroventricularly (Lev.) or onto the surface of the area postrema which protrudes into the fourth cerebral ventricle. In each Instance clonidine induced a dose‐dependent lowering of the blood pressure. The region of the area postrema appears to be the most sensitive site for the action of clonidine so far studied. In order to obtain similar blood pressure effects, approximately 8 times higher amounts were needed i.c.v., and about 80 times higher amounts i.v., than onto the surface of the area postrema.

A pretreatment of the rats with the specific histamine H2‐receptor blocking drug, metiamide (4.5 μmoles/rat i.c.v.) shifted the dose‐response curve of clonidine (i.c.v.) to the right.

The results suggest that clonidine exerts its hypotensive effect in the rat via a stimulation of histamine H2‐receptors in, or in the vicinity of, the area postrema.
Bioavailability of Propylthiouracil: Interindividual Variation and Influence of Food Intake
Authors: Melander A. , WÅhlin E. , Danieison K. , Hanson A.
Published: August 2010

ABSTRACT The bioavailability of 6‐propylthiouracil (PTU) has been examined in eight healthy volunteers, with respect to interindividual variation and influence of food intake. PTU was given as a single oral dose, both in a fasting state and together with a standardized breakfast. Numerous venous blood samples were taken during 5 hours after PTU ingestion, and the concentration of unmetabolized PTU in serum was determined by a specific gas‐chromatographic technique. The observations indicate that the amount of PTU absorbed is subject to a large interindividual variation, and that concomitant food intake may exert a minor and non‐systematic influence on PTU absorption. Hence, the major issue in PTU therapy is the individualization of the size and interval of dosage. Testing of single‐dose PTU kinetics in patients would apparently be helpful.
Accumulation of Myoinositol in Plasma and Red Cells of Diabetic Patients
Authors: Servo Carita
Published: August 2010

ABSTRACT The concentration of myoinositol in plasma, cerebrospinal fluid and red cells and its elimination by the kidneys have been studied in 51 diabetic patients with normal or impaired kidney function, 16 non‐diabetic patients with renal failure and 37 healthy controls. All diabetic patients had higher red cell concentrations of myoinositol than the controls. However, only in those diabetic patients who had a glomerular filtration rate considerably below normal, was the plasma concentration of myoinositol higher than in controls. The findings show that the rise in plasma concentration of myoinositol most probably results from a decreased glomerular filtration rate. In diabetic patients, urinary excretion of myoinositol correlated with an exponential increase in glucose excretion. That myoinositol accumulates in red cells of diabetic patients may be the result of its retention within these cells caused primarily by a transient, abnormal increase in the plasma concentration of myoinositol after an average meal.
Restricted Lignocaine Prophylaxis in Acute Myocardial Infarction
Authors: Löfmark R. , Orinius E.
Published: August 2010

ABSTRACT In a consecutive series of 274 AMI cases ventricular tachycardia (VT), defined as three or more ventricular premature beats (VPBs) in succession but not VPBs, has been used as the indication for ventricular fibrillation (VF) prophylaxis. No primary VF occurred, and this fits with the hypothesis of VT as a sufficient indication for prophylaxis against primary VF. Six patients developed complicating VF (preceded by rales or hypotension but not frank pulmonary edema or shock). Four of the six patients (67%) had VT (0–1.5 hours) before VF, while the mean VT incidence of the six corresponding monitoring periods in 247 non‐VF patients was 5%. Three of the four VT patients were on lignocaine/procainamide when VF developed. Thus, VT is acceptable as the only warning arrhythmia even in complicating VF but antiarrhythmic drugs do not seem to have the same prophylactic efficacy in complicating VF as in primary VF. Another 21 patients developed VF during shock, frank pulmonary edema or manipulating a pacemaker catheter within the heart.
Haemodynamic Effects of Four Months' Mefruside Therapy in Hypertensive Patients
Authors: Bevegård Sture , Castenfors Jan , Danielson Mats
Published: August 2010

ABSTRACT The haemodynamic changes after 4 months' mefruside therapy in 13 patients with essential hypertension have been studied. Intraarterial BP was significantly reduced both at rest supine and during standardized leg exercise in sitting position. The reduction was caused mainly by a decrease in cardiac output in about half of the patients and mainly by a decrease in total peripheral vascular resistance in the remainder. Thus, for the total material there was no significant change in either cardiac output or total peripheral vascular resistance. At rest, however, there was a significant decrease in stroke volume (p<0.05) and an increase in heart rate (p<0.05). On changing from supine to sitting position, the average systolic and diastolic pressures increased before and decreased after therapy, the differences being significant. The results indicate that the hypotensive effect of long‐term saluretic therapy is accomplished by a decrease in cardiac output and/or peripheral vascular resistance, with large interindividual variations.
Cardiac Arrhythmias in Chloral Hydrate Poisoning
Authors: Gustafson Arne , Svensson Sven‐Eric , Ugander Lars
Published: August 2010

ABSTRACTIn three patients admitted to hospital after ingestion of an overdose of chloral hydrate, the ECG showed supraventricular and ventricular tachyarrhythmias. The possible mechanism for the arrhythmias may be an enhanced automaticity of supraventricular and ventricular pacemaker cells caused by metabolites of chloral hydrate. The ventricular arrhythmia responded to i.v. treatment with lignocaine in one patient, and to phenytoin in another in whom lignocaine failed to restore a normal sinus rhythm.
S‐Tryptophan Concentrations after Intestinal Bypass in extreme Obesity
Authors: Backman L. , Johansson C. , Thorén P. , Allgén L.‐G. , Hallberg D.
Published: August 2010

ABSTRACT Treatment of extreme obesity with jejunoileostomy was followed by a decreased level of S‐tryptophan; permanently low concentrations were recorded postoperatively in 29 out of 52 patients. Patients in the low tryptophan group had a higher rate of weight loss and a higher incidence of electrolyte disturbances and signs of liver injury. Symptoms of depression and anxiety were slightly more common in patients with low S‐tryptophan. The influence of a decreased S‐albumin and a deranged amino acid pattern on the non‐protein‐bound fraction of S‐tryptophan needs further investigation. Serum levels of tryptophan rose significantly after two weeks' oral supplementation with 1.2 g L‐tryptophan daily; this dosage was insufficient to normalize a low S‐tryptophan level in patients who have undergone jejunoileostomy.
Auricular Catecholamine Content in Ischaemic Heart Disease
Authors: Penttilä O. , Merikallio E. , Siltanen P. , Klinge E.
Published: August 2010

ABSTRACT The noradrenaline (NA) content (mean±S.D.) of tissue samples from the right atrial appendage in 19 patients with ischaemic heart disease (IHD) was 2.81±0.94 μg/g and in 7 patients with valvular heart disease (VHD) 2.79±1.12 μg/g. In 10 patients with uncomplicated atrial septal defect (ASD) the NA content was 1.64±0.32 μg/g and in 11 patients with congestive heart failure (CHF) 0.75±0.41 μg/g. The difference in NA content between the IHD group and the ASD and CHF groups is significant (p<0.001). Small amounts of adrenaline and dopamine were found in all groups. There was no significant correlation between auricular NA content and either systemic diastolic blood pressure, age, or left ventricular end‐diastolic pressure. The relatively high level of NA in the IHD group is assumed to be a contributory factor in the intracellular metabolic as well as in the systemic changes typical of ischaemia and infarction.
The Significance of AV Block I in Asymptomatic Young Men
Authors: Ahlborg Björn , Atterhög Jan‐Henrik , Ekelund Lars‐Göran , Ericsson Gunnar
Published: August 2010

ABSTRACTTwenty‐nine young men with AV block I (P‐R interval >0.22 sec), without any history of heart disease, have been compared with 112 randomly selected healthy men of the same age. In 24 subjects who were free from concomitant ECG changes the P‐R interval was normalized during orthostatic test and/or physical exercise. This group did not differ from the controls regarding anthropometric data and physical work capacity except for a higher heart rate at rest, thus suggesting that in these subjects an occurrence of AV block I has no pathological significance. However, it cannot be excluded that the block is a sequela, for instance, to myocarditis. Three subjects with AV block I and inverted T waves in the precordial leads and two subjects with unchanged P‐R intervals to increased sympathetic tone had on average a smaller body size, a higher HR and systolic BP in recumbent position and smaller blood volumes.
The Treatment of End‐stage Renal Failure in Insulin‐dependent Diabetic Patients
Authors: Thayssen P. , Roed‐Petersen K. , Nielsen F. U. , Svendsen V. , Kemp E.
Published: August 2010

ABSTRACT Twenty‐six insulin‐dependent patients with diabetes mellitus have been treated for end‐stage renal failure during a 5‐year period. The cause of this failure was diabetic nephropathy in 24 cases. Eleven patients were temporarily treated with diet alone for their uraemia; 23 patients, 7 of whom had previously been treated with diet alone, were treated with dialysis and 9 of these patients were later subjected to kidney transplantation. One patient received a kidney graft directly, while his uraemia was treated with diet alone. At the time of initiation of the treatment for renal insufficiency, the diabetes had lasted for 22 years and the kidney disease for 5 years (average values). Peritoneal dialysis presented no complications. The main problem with haemodialysis was difficulty with the arteriovenous shunt. The regulation of the diabetes caused problems in all 10 patients subjected to kidney grafts; all required increased doses of insulin. Infection and hypertension were prevalent among these patients, while rejection of the graft occured in only 2 cases. No definite changes were found in the cardiac status, retinal changes or BP during treatment. The average period of observation for all 26 patients was 10 months. The total mortality was 65%; approximately half of the deaths were due to cardiovascular causes and about 1/3 to infection. The cumulative survival after 3 years was 25% for all patients and 41% after 2 years for the graft recipients. The present investigation shows that both dialysis and kidney transplantation are possible in patients with diabetes mellitus and end‐stage renal failure. The goal of future treatment must therefore be kidney transplantation, as it makes it possible to offer the patient an acceptable life.
Raynaud's Phenomenon
Authors: Wouda A. A.
Published: August 2010

ABSTRACT A study has been made of the changes in the amplitudes shown on photoelectric plethysmographs of the fingers of one hand of controls (17 men and 17 women without Raynaud's phenomenon) during cooling and warming up of the hand. This is called the cooling and warming up test. The hands of the women appeared to cool more quickly than of the men, besides getting warm more quickly and remaining warm for a longer period. This difference is already apparent at the lowest water temperatures (6 and 3°C) and may be ascribed to a difference in hand volume, with a hunting reaction due to extreme cold. The lowest values of controls appear to be useful for the clinical differentiation of patients with a serious Raynaud's phenomenon. The test is said to be positive when the values are below the lowest values of the controls. The test was performed on 50 of 58 out‐patients suffering from Raynaud's phenomenon. In serious cases the severity of the disease could be assessed objectively. In less serious cases the test was sometimes negative.
Coffee Consumption and Coronary Heart Disease in Middle‐aged Swedish Men
Authors: Wilhelmsen Lars , Tibblin Gösta , Elmfeldt Dag , Wedel Hans , Werkö Lars
Published: August 2010

ABSTRACT The possible association between coffee and myocardial infarction (MI) has been studied both prospectively in a random population sample of Swedish men aged 50 years (n=834) and with case control methodology in non‐selected male patients surviving a MI (age 40–57 years, n=230). Coffee consumption was significantly associated with two other important risk factors for MI, namely smoking and alcoholic intemperance, but weak (non‐significant) relationships were found with serum cholesterol, serum triglycerides, systolic or diastolic BP, and dyspnoea on exertion. In the prospective study there was no significant relationship between coffee and MI, either with univariate or multivariate analysis. The retrospectively reported coffee consumption of MI patients was higher than of those who later suffered a MI (the population sample). With the aid of non‐parametric multivariate analysis of the combined population sample and the series of MI patients, a significant association was found between coffee consumption and MI. The experience of having had a MI may have affected the patients' rating of coffee consumption, or their consumption may have really increased during some months or a few years before the MI.
Oesophageal Acid Perfusion Test as a Complement to Work Test in Patients with Chest Pain
Authors: Areskog M. , Tibbling L. , Wranne B.
Published: August 2010

ABSTRACTOut of 121 patients referred to a work test on account of chest pain, 67 with a case history typical for oesophageal dysfunction have been further investigated with an acid perfusion test during continuous ECG monitoring. Neither arrhythmias nor ST‐T changes were induced by the procedure. Of the 67 patients, 6 had a “positive related” acid perfusion test, 23 a “positive unrelated” and the remainder a negative test. Five of the 14 patients with pathological effort ECG belonged to the group with a positive acid perfusion test. The acid perfusion test, as a safe routine in close connection with the effort ECG in selected patients, is a useful technique for establishing whether or not the patient's symptoms have an oesophageal component.
Primary Purulent Meningococcal Pericarditis with Tamponade
Authors: Solheim Kaare , Molnár Istvan , Aandahl Magne , Wilhelmsen Thorleif
Published: August 2010

ABSTRACT A case of primary purulent meningococcal pericarditis, presenting with hemodynamic derangement due to tamponade, is reported. Treatment was successfully fulfilled with antibiotics and surgical drainage, using continuous percutaneous subxiphoidal catheter drainage with the Seldinger technique. Less than ten cases of this potentially lethal entity have been reported in the literature.
Bone Composition and Parathyroid Function in Chronic Renal Failure
Authors: Tougaard Lars , Sørensen Egon , Christensen Merete Sanvig , Brøchner‐Mortensen Jens , Rødbro Paul , Sørensen Arne W. S.
Published: August 2010

ABSTRACT The development of bone abnormalities has been studied in 24 patients with severe chronic renal failure. The glomerular filtration rate (GFR) was between 5 and 25 ml/min. The mean values of plasma calcium, degree of bone mineralization (P/Hypro) and bone mineral content (BMC) were subnormal, whereas the mean values of plasma phosphorus and serum parathyroid hormone (PTH) were elevated. Analysis of the data revealed that the various parameters became increasingly pathological with decreasing renal function. Serum PTH correlated inversely with both GFR and plasma calcium. The decrease in bone P/Hypro with decreasing renal function could be explained by an inverse correlation to serum PTH. Plasma alkaline phosphatase correlated inversely to both bone P/Hypro and BMC. The present study on individual patients with varying degrees of renal insufficiency shows that the development of secondary hyperparathyroidism correlates with a reduction in the degree of bone P/Hypro and suggests that significant bone changes appear when the GFR falls below 15 ml/min.
Bullous Dermatosis among Patients with Chronic Renal Failure on High Dose Frusemide
Authors: Heydenreich Gerhard , Pindborg Torben , Schmidt Henning
Published: August 2010

ABSTRACT Twelve of 56 patients with chronic renal failure, all treated with frusemide (Lasix®) in daily doses of 0.5–2 g, developed bullae in areas exposed to light. In most cases the bullae developed during summer months and disappeared later in the year whether the frusemide treatment was continued or not. In two patients the eruption reappeared when treatment was resumed. Disturbance of the porphyrin metabolism was not found, neither could a change in the frusemide metabolism be demonstrated. Tissue typing and blood groups showed no difference from the average population. It is concluded that the condition presumably is a photo reaction due to the frusemide treatment but it cannot be said whether it is allergic or toxic.
Screening for and Treatment of Bacteriuria in a Middle‐aged Female Population
Authors: Takala Jorma , Jousimies Hannele , Sievers Kai
Published: August 2010

ABSTRACT In connection with the screening programme of the Säkylä‐Köyliö project, the prevalence of untreated bacteriuria, urinary tract infection (UTI) under treatment and UTI symptoms has been investigated among the middle‐aged (40–64 years) female population (n=1312) of the Säkylä and Köyliö municipalities; 93.2% of the total population participated in the screening. The Uricult® dip‐slide was used in the quantitative urine culture. Before collection of the urine specimens, the subjects were interviewed about symptoms of UTI and use of related medications. The total prevalence of untreated bacteriuria among the women was 4.5%, asymptomatic bacteriuria accounting for the majority of cases (82%). This prevalence increased with age, tripling in the oldest age group. A total of 2.5% of the women were being treated for UTI at the time of the examination. Thus the combined prevalence of untreated bacteriuria and UTI under treatment was 7%. Altogether 6.4% of the women had symptoms of UTI, with an almost equal distribution among the age groups. The total prevalence of symptoms of UTI without actual UTI (treated and untreated bacteriuria) was 5.0%. Every fourth woman with dysuria had been treated for UTI during the previous year and about every third at some time earlier than that. This frequency suggests an etiology of UTI for the discomfort.
Renal Excretion of Pyruvate, Lactate and α‐ketoglutarate in Kidney Donors before and after Nephrectomy and in Patients with Terminal Uremia
Authors: Skov Poul Erik , Hansen Hans Erik
Published: August 2010

ABSTRACT The excretional patterns of lactate, pyruvate and α‐ketoglutarate have been investigated in 7 patients with terminal uremia and in 10 kidney donors with normal renal function before and after unilateral nephrectomy. Methods for analysis of the three substances in urine were elaborated. In all patients, the levels of renal excretion of lactate and pyruvate were very low, and clearance values were independent of the glomerular filtration rate (GFR). α‐ketoglutarate clearance varied to some extent with renal function, but no correlation to GFR was found, and exceeded the GFR in uremic patients, indicating that the net result of renal handling of α‐ketoglutarate may be a tubular secretion.
Bioavailability of D‐Propoxyphene, Acetyl Salicylic Acid, and Phenazone in a Combination Tablet (Doleron®): Interindividual Variation and Influence of Food Intake
Authors: Melander A. , Berlin‐Wahlén A. , Bodin N.‐O. , Danielson K. , Gustafsson B. , Lindgren S. , Westerlund D.
Published: August 2010

ABSTRACT The influence of food intake on the bioavailability of three analgesic compounds—propoxyphene chloride, acetyl salicylic acid and phenazone—in a combination tablet, Doleron®, has been examined in eight healthy volunteers. A single oral dose was given both on an empty stomach and together with a standardized breakfast meal. The plasma concentrations of propoxyphene, its major metabolite norpropoxyphene, salicylic acid and phenazone were determined by mass fragmentography, spectrofluorimetry and gas chromatography. Concomitant food intake had no consistent influence on the bioavailability of any of the components. Hence, Doleron may be taken together with meals as well as between meals. Large interindividual variations in propoxyphene and phenazone concentrations were found, indicating that an optimal effect will not always be obtained by standard doses.
The Study of Women in Gothenburg 1968–1969
Authors: Lenner Ragnhild Arvidsson , Bengtsson Calle , Carlgren Gunilla , Isaksson Björn , Lundgren Birgitta K. , Petersson Ingegerd , Tibblin Elisabeth
Published: August 2010

ABSTRACTWomen from five age groups (38, 46, 50, 54, and 60 years), participating in the population study “Women in Gothenburg 1968–1969”, were subjected to a 24‐hour recall dietary interview (n=1361). In a randomized subsample (n=418), a dietary history was obtained and individuals in another randomized subsample (n=755) submitted a 24‐hour urine specimen for nitrogen analyses. There were significant differences between the 24‐hour recall and dietary history figures in all five age groups with respect to energy and all nutrients. The mean protein intake calculated indirectly from the urinary nitrogen excretion came close to the figures calculated from the dietary histories in four out of the five age groups. The energy intake and, consequently, the intake of most nutrients calculated from the dietary histories were higher than generally ascribed to Swedish women, as most previous data have been obtained by 24‐hour dietary recall interviews. Most women (71–89% in the different age groups) consumed too much fat and most women of fertile age (80–92%) consumed too little iron. A significant decrease in the mean energy intake was apparent only in the age group 60, i. e. 1870 kcal versus 1965–2105 in the other groups.