bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal Venous Output of Kinins in Patients with Hypertension and Unilateral Renal Artery Stenosis
Authors: Hulthén U. L. , Lecerof H. , Hökfelt B.
Published: August 2010

ABSTRACT In four patients with hypertension and angiographically pronounced unilateral renal artery stenosis, kallikrein activity was estimated in each kidney separately by the determination of kinin output in the renal veins. All patients showed suppression of renin release from the kidney with a non‐stenotic artery. Accordingly, plasma flow from the kidney with artery stenosis could be estimated. The ratio of venous output of kinins between the kidney with a non‐stenotic artery and the one with artery stenosis was 2.6–6.5 This indicates that renal artery stenosis leads to diminished intrarenal kinin generation. Reduced kinin formation may explain the low diuresis and natriuresis found in the kidney with artery stenosis.
The Value of Thermography and the Determination of Fibrin‐Fibrinogen Degradation Products in the Diagnosis of Deep Venous Thrombosis
Authors: Byström L.‐G. , Larsson T. , Lundell L. , Åbom P.‐E.
Published: August 2010

ABSTRACTFifty‐one patients with leg symptoms indicating deep venous thrombosis (DVT) were investigated concomitantly with thermography and phlebography. Altogether 26 legs with phlebograpbically proven DVT exhibited a thermographic picture typical of DVT. So, however, did 3 out of 25 legs with no DVT. A 94% agreement was found between phlebography and thermography when applied to legs with suspect DVT. The serum levels of fibrin‐fibrinogen degradation products (FDP) were assayed in 58 patients attending hospital for suspect DVT. These patients were free from other diseases known to be followed by raised FDP levels. With borderline significance, the DVT group had higher FDP values. The usefulness of this laboratory test in the diagnosis of DVT is, however, questioned.
Preliminary Observations on Interventricular Septum Vibrations
Authors: Vukas M. , Wallentin I. , Hjalmarson Å. C.
Published: August 2010

ABSTRACT In previous experimental and clinical studies on aortic valvular stenosis it has been suggested that in addition to the degree of stenosis, other factors, such as the pathoanatomy of the valve and turbulence‐induced vibrations, might be of importance. Using echocardiography, vibrations of the interventricular septum were demonstrated in six consecutive patients with congenital aortic stenosis. In comparable normal subjects no such vibrations could be seen. The clinical significance of ventricular wall vibrations has not yet been established.
The Effects of Four Months' Treatment with Spironolactone on Systemic Blood Pressure, Cardiac Output and Plasma Renin Activity in Hypertensive Patients
Authors: Bevegård Sture , Castenfors Jan , Danielson Mats
Published: August 2010

ABSTRACT The effect of spironolactone on BP, cardiac output, plasma renin activity and urinary excretion of electrolytes has been studied in 12 hypertensive patients. After 1 month of spironolactone therapy there was a significant decrease in arterial BP. Urinary sodium excretion was significantly decreased and plasma renin activity increased. After four months of spironolactone therapy there was no further decrease in arterial BP. Cardiac output, heart rate and stroke volume were unchanged in the supine position, but the calculated total peripheral vascular resistance (TPVR) was reduced, indicating that the lower BP was mainly a result of dilatation of the resistance vessels. During exercise there was still a significant decrease in arterial BP but this was related to a decrease in both cardiac output and TPVR.
Cardiomyopathy after Chloroquine Treatment
Authors: Magnussen I. , Olivarius B. de Fine
Published: August 2010

ABSTRACT A case of cardiomyopathy combined with vacuolar myopathy in the extremity muscles and irreversible retinopathy produced by chloroquine is described.
Studies on Digitalis
Authors: Storstein Ole , Hansteen Viggo , Hatle Liv , Hillestad Leif , Storstein Liv
Published: August 2010

ABSTRACT In a prospective study on digitalis intoxication, low serum magnesium was found in 90 patients, while 388 patients had values above 1.5 mEq/1. Hypomagnesemia was more frequent in women than in men, in those with low body weight and in those with advanced heart failure. More patients with hypomagnesemia than those without had nausea, anorexia, fatigue, flickering of vision and atrial tachycardia with block. Patients with hypomagnesemia also had lower serum potassium than normo‐magnesemic patients. There was, however, no significant difference in the prevalence of digitalis intoxication or in serum digitoxin concentration. Nor was there any correlation between serum digitoxin and serum magnesium levels.
The Effect of Body Temperature on Thyroid Hormone Levels in Patients with Non‐Thyroidal Illness
Authors: Ljunggren Jan‐Gustaf , Kallner Gunnar , Tryselius Monica
Published: August 2010

ABSTRACT During studies on the mechanism underlying the low serum T3 levels in euthyroid patients with various acute and chronic non‐thyroidai illnesses, it became evident that body temperature may be one parameter associated with changes in serum T3 levels. Forty‐nine hospitalized, euthyroid patients with hyperpyrexia caused by various non‐thyroidal illnesses were studied. The levels of serum T3 were found to decrease gradually with increasing body temperature. T3 was already below the normal level ±2 S.D. at a body temperature of around 38°C. Such low T3 levels as were seen at temperatures of above 40°C are observed in thyroid patients only during severe hypothyroidism. The levels of T4 and TSH remained unchanged and within the normal range regardless of body temperature. The levels of reverse‐T3 in the sera analyzed were found to be unchanged in some cases, while in others they paralleled body temperature. It is concluded that the body temperature must be taken into consideration when studying the serum levels of T3.
Treatment of Glomerulonephritis with Drainage of the Thoracic Duct and Plasmapheresis
Authors: Ravnskov Uffe , Dahlbäck Olle , Messeter Lisbeth
Published: August 2010

ABSTRACT Nine patients with various types of severe glomerulonephritis were treated with drainage of the thoracic duct (n=8) and/or plasmapheresis (n=6) without the use of pharmacological immunosuppression. In most of the patients treatment produced a prompt temporary regression of albuminuria and creatininemia. In one patient renal function was substantially improved 8 months after the last period of treatment, in 2 patients the progress of the uremia was probably retarded. In the remaining 6 patients treatment had no obvious effect on the course of the illness. Drainage of the thoracic duct and plasmapheresis may be of benefit in the treatment of glomerulonphritis, but their proper utilization requires further studies.
Sodium Excretion and Blood Pressure of West and East Finns
Authors: Karvonen M. J. , Punsar S.
Published: August 2010

ABSTRACT Altogether 1178 men aged 55–74 were studied at 15‐year re‐examination of two rural cohorts of initially 1711 men from east and west Finland. At the start, 15 years ago, the mean BPs were 148/89 and 140/82 mmHg in the eastern and western populations, respectively. The difference had now disappeared and changed direction for systolic BP (east 147/85, west 155/84 mmHg). Of those with an initial systolic BP of 170 mmHg or higher, 68/118 (58%) in the east and 33/67 (49%) in the west had died in 15 years. A 24‐hour urine sample was collected for Na and K analysis from 20% of the men randomly selected. Men in the east excreted less urine (1.64 vs. 1.801/24 h, p<0.05) but more Na than men in the west (245 vs. 217 mEq/24 h, p<0.05; 3.56 vs. 2.92 mEq/kg b.wt./24 h, p<0.001). Regular medication with diuretics or antihypertensives did not affect the Na excretion. The Na excretion showed a weak negative correlation with diastolic BP in the west (r=–0.22, p<0.05), but no correlation in the east. The mean K excretion was approximately 90 mEq/24 h, with no difference between east and west. The estimated NaCl intake was in the east 16.0, in the west 14.2 g/day. According to international standards, the NaCl intake is high, especially in the east, where male mortality from cardiovascular disease is highest in the world. Energy expenditure and food intake are obvious determinants of Na excretion. Ageing and incapacitation due to illness, including hypertensive disease, reduce food intake. The observed negative correlation between BP and Na excretion can partly be ascribed to such factors, partly to high mortality of individuals sensitive to damage caused by Na.
Long‐term Aspects on Essential Hypertension
Authors: Liljefors Ingvar
Published: August 2010

Abstract. Hypertension has been found to imply a disease entity since the beginning of this century. Effective treatment available in the last two decades has changed the outlook remarkably, especially in malignant hypertension.

There are more and more evidence that less severe forms of hypertension will benefit from keeping the blood pressure under control.
A New Parallel Plate Dialyser
Authors: Dawids S. , Boe C.
Published: August 2010

Abstract.The pattern of membrane support in the dialysate flow path of a dialyser is one of the most important parameters for high utilization of the membrane‐area. 27 different injection moulded membrane support patterns were designed to approximate a pattern with the best overall properties. Only 15 of the patterns had acceptable properties in regard to 1) efficiency, 2) compliance, 3) flow resistance, 4) membrane rupture level, and 5) air retention at low flow values. A pattern with parallel interrupted ridges perpendicular to the direction of dialysate flow showed the best overall results although differences were marginal between the best patterns. The chosen support pattern was approximately 35% better in chloride clearance at low dialysate flow, and approximately 200% better at high flows than the conventional Kiil pattern.
A New Parallel Plate Dialyser
Authors: Dawids S. , Vojnovic S.
Published: August 2010

Abstract.The clinical model of a new parallel plate dialyser with a membrane area of 0.96 m2with cuprophane 150 PM has been tested in more than 2000 dialyses with good clinical results. The simple design permits an aseptic, semiautomatic assembly and makes cheap industrial production possible. Clinical clearance values for urea, creatinine and uric acid are presented as well as data for ultrafiltration, residual blood volume and rupture frequency. The specific efficiency per square meter has been found to be high.
BODY COMPOSITION IN 70‐YEAR‐OLD MALES AND FEMALES IN GOTHENBURG, SWEDEN A POPULATION STUDY
Authors: Steen B. , Bruce Å. , Isaksson B. , Lewin T. , Svanborg A.
Published: August 2010

The objectives of this substudy within the population study “70‐year‐old people in Gothenburg, Sweden” were to determine the body composition of the probands and to clarify possible relationships between results of these body compartment determinations and more simple somatometric variables. The cross‐sectional data will be used as a basis for a prospective longitudinal geriatric/gerontological study. The subsample comprised 66 males and 76 females, of whom 49 males and 56 females underwent a complete examination. The probands examined were considered representative of the 70‐year‐old population in Gothenburg. Total body potassium was estimated by using a whole body counter and total body water with an isotope dilution technique using tritiated water as a tracer. Body cell mass, intracellular and extracellular water, body fat and fat‐free extracellular solids were then calculated from body weight, total body potassium and total body water using certain assumptions, the relevance of which in this age group is discussed. Average values of body weight were 76.2 kg and 66.3 kg, of body cell mass 28.1 kg and 20.3 kg and of body fat 12.5 kg and 18.1 kg in males and females, respectively. It was possible from body weight and subscapular skinfold in males and from body weight, thigh and triceps skinfold in females to reach a proportion of explained variance of body fat of 58 per cent and 76 per cent, respectively. There was a good correlation between body fat and the difference between body weight and “ideal body weight” as defined by Lindberg and collaborators, 1956. A preliminary comparison between the current data and corresponding data from cross‐sectional studies of middle‐aged individuals in Gothenburg showed that the amount of fat was similar in the two age groups. Body cell mass seemed to be of the same order of magnitude in 70‐year‐old as in middle‐aged females, but showed a lesser value in 70‐year‐old than in middle‐aged males.
Obstructive Characteristics of Björk‐Shiley, Hancock, and Lillehei‐Kaster Prosthetic Mitral Valves in the Immediate Postoperative Period
Authors: Holen Jarle , Høie Johan , Semb Bjarne
Published: August 2010

ABSTRACT. The flow obstruction in mitral valve implants was studied in the immediate postoperative period in 19 patients with Björk‐Shiley, Hancock, or Lillehei‐Kaster prosthetic mitral valves. The effective valve area (Ae) was used as a measure of the flow obstruction. The blood velocity in the implants was estimated with a non‐invasive ultrasound Doppler system. The cardiac output was determined with an indwelling thermodilution catheter. The collected data allowed the determination of Ae. Multiple determinations of Ae, at various cardiac outputs and pulse rates were generally performed in each patient during the first 2–3 postoperative days. The investigation demonstrated that the method employed was useful for the study of mitral implant performance. The obtained values of Ae demonstrated that the flow obstruction in prosthetic mitral valve implants is fiequently considerable.
Effect of Nifedipine (Adalat®) on Coronary Haemodynamics in Patients with Coronary Arteriosclerotic Disease
Authors: Simonsen Svein , Nitter‐Hauge Sigurd
Published: August 2010

ABSTRACT. Effects of the new Ca++ antagonist nifedipine (Adalat®) on coronary haemodynamics were studied in 8 patients with documented ischaemic heart disease. The continuous infusion thermodilution technique was used to measure cardiac venous Mood flow. Sublingual application of 10 mg nifedipine caused a significant increase (16%) in myocardial blood flow and a decrease (18%) in coronary arteriolar resistance at rest, but not during a submaximal atrial pacing test. There was no change in coronary arteriovenous oxygen difference, myocardial oxygen consumption, oxygen consumption per unit of heart rate blood pressure index or left ventricular efficiency index, The effects on the coronary haemodynamics are discussed in relation to the simultaneous changes in general haemodynamics. Systolic aortic pressure was slightly reduced, significantly only at rest, while peripheral vascular resistance decreased and cardiac output increased also during atrial pacing. No change in free fatty acid metabolism was observed. It is concluded that nifedipine is a mild coronary vasodilator. No effect was observed on myocardial oxygen demand. The oxygen cost of left ventricular work was unchanged by the drug both at rest and during the submaximal stress test.
Lipoprotein Metabolism in Patients with Chronic Uremia
Authors: Huttunen Jussi K. , Pasternack Amos , Vänttinen Tuomo , Ehnholm Christian , Nikkilä Esko A.
Published: August 2010

ABSTRACT. Lipoprotein metabolism has been studied in six patients with chronic uremia before and during maintenance hemodialysis. Special attention was paid to experimental conditions to control the effect of intermittent heparin administration on various parameters of lipid metabolism. The concentration of VLDL was elevated in five of the six patients before dialysis. During hemodialysis the concentration decreased in these five patients but increased in the patient with an initially normal VLDL level. The concentration of HDL cholesterol was abnormally low before dialysis and increased in all patients after the beginning of dialysis. No consistent changes were observed in the concentration of LDL. The cholesterol/triglyceride ratio of LDL was significantly lower in uremic patients than in controls both before and during dialysis. The activity of postheparin plasma hepatic lipase was markedly decreased in uremic patients both before and during dialysis as compared to age‐matched controls. The activity of postheparin plasma lipoprotein lipase was lower in uremic patients than in controls both before and after the initiation of dialysis, but the difference was statistically significant only before the beginning of the treatment. Hemodialysis did not sect the activity of postheparin plasma lipoprotein lipase or hepatic lipase. The removal constant of i.v. administered lipid emulsion (Intralipid®) decreased in four patients and increased in one patient after the beginning of dialysis. Intermittent heparin administration at two‐day intervals in three healthy volunteers did not influence the acitvity of postheparin plasma lipases. The activity of both enzymes decreased during a long‐term heparin infusion in three patients with deep vein thrombosis. After termination of the heparin treatment the activity of both enzymes gradually returned to the pretreatment level.
Effect of Food on the Bioavailability of Bendroflumethiazide
Authors: Beermann Björn , Groschinsky‐Grind Margaretha , Lindström Björn
Published: August 2010

ABSTRACT. Bendroflumethiazide (BFT), 10 mg, was given orally to eight subjects after fasting overnight and together with a meal. Concentrations of the diuretic in plasma and urine were determined by GLC. As judged by AUC and urinary recovery of BFT, the bioavailability of the diuretic was not influenced by concomitant intake of a meal.
Storage of Polyvinylpyrrolidone (PVP) in Tissues Following Long‐Term Treatment with a PVP‐Containing Vasopressin Preparation
Authors: Christensen M. , Johansen P. , Hau C.
Published: August 2010

ABSTRACT. The parenteral use of polyvinylpyrrolidone (PVP) leads to PVP retention in the human organism. Four case histories dealing with patients on long‐term treatment with a PVP‐containing vasopressin preparation are presented and the possibility of a harmful effect of the PVP storage is discussed. The presence of PVP in serum, demonstrated by lipoprotein electrophoresis, is described. Based on the literature and the present findings, a withdrawal of PVP‐containing preparations for injectional purposes is advocated.
Verapamil and Pulmonary Hypertension
Authors: Landmark Knud , Refsum Anne Mane , Simonsen Svein , Storstein Ole
Published: August 2010

ABSTRACT.We report on the effect of verapamil in 12 patients suffering from pulmonary hypertension. The drug caused a slight, but statistically significant decrease in mean pulmonary artery pressure and in the work performance by the right ventricle. The mean pressure of the right atrium, the end‐diastolic pressure of the right ventricle, the pulmonary arteriolar resistance, the cardiac index and the stroke volume were not significantly changed, however, and there was a wide spread of the values observed. In some patients the drug exerted a marked negative inotropic effect, with a concomitant increase in the pulmonary arteriolar resistance.
Cardiovascular Risk Factor Changes in a Three‐Year Follow‐up of a Cohort in Connection with a Community Programme (the North Karelia Project)
Authors: Puska Pekka , Virtamo Jarmo , Tuomilehto Jaakko , Mäki Juhani , Neittaanmäki Liisa
Published: August 2010

ABSTRACT. A re‐examination after 3 years was done in 1975 in a 20% random subsample (n=1683) of the representative populalon sample (males and females, 25–59 years) that was examined in 1972 in North Karelia (NK), and a matched reference county as the baseline survey for the community programme in NK. The changes in smoking habits, serum cholesterol, dietary fat consumption and systolic BP were more favourable among the subjects in the NK sample than among the reference sample, although the differences were generally small. Results from multivariable analyses are presented to show the variables that predict a favourable risk factor change in the individual. Living in NK is associated in the analysis with a favourable change in each of the three risk factors. The limitation of this method in the evaluation of a community programme is discussed.
Lymphocyte Subpopulations in Chronic Lymphocytic Leukemia (CLL)
Authors: Mellstedt Hakan , Pettersson Dagny , Holm Göran
Published: August 2010

ABSTRACT. The blood lymphocytosis in CLL is caused mainly by a rise of immunoglobulin (Ig)‐bearing leukemic lymphocytes. Most cells carry Fc‐receptors, while the percentage with receptors for human complement is very low with the present technique. The leukemic lymphocytes carry only one of the light chain types, which suggests a monoclonal origin. CLL patients with lymphocytes expressing κ light chains may have a more benign disease than X‐CLL. T‐lymphocyte levels are high during the early course of the disease but decrease with its progression and are low in patients with “active” disease.
The Effect of the Converting Enzyme Inhibitor SQ 20.881 on Kinins, Renin‐Angiotensin‐Aldosterone and Catecholamines in Relation to Blood Pressure in Hypertensive Patients
Authors: Hulthén Lennart , Hökfelt Bernt
Published: August 2010

ABSTRACT. Nine sodium replete hypertensive patients with normal or high plasma renin activity (PRA) were given SQ 20.881, 1 mg/kg intravenously. BP fell significantly within 20 min and reached its lowest level after 60 min. Blood kinins showed a minor but significant decrease after 60 and 105 min. Plasma angiotensin II was markedly reduced after 15 and 60 min. PRA was significantly increased after 15–105 min. Plasma aldosterone was reduced at 60 min in eight patients and slightly increased in one. Plasma noradrenaline increased after 15 min, whereas adrenaline decreased after 60 min. These results indicate that the reduction of BP following inhibition of converting enzyme by SQ 20.881, 1 mg/kg, is not related to reduced degradation of kinins but rather to decreased formation of angiotensin II. Angiotensin II appears to be of importance for the maintenance of BP in sodium replete hypertensive patients with normal or high PRA.
Elevation of High‐Density Lipoprotein in Epileptic Patients Treated with Phenytoin
Authors: Nikkilä Esko A. , Kaste Markku , Ehnholm Christian , Viikari Jorma
Published: August 2010

ABSTRACT.Previous observations have shown that serum alpha (high‐density) lipoprotein (HDL) cholesterol is increased by some agents which also act as liver microsomal inducers. Against this background we measured the serum HDL and other lipoprotein and apolipoprotein A levels in 28 epileptic patients who received phenytoin as the only medication. In comparison with healthy controls of similar age and sex, the phenytoin users had significantly higher HDL cholesterol (p<0.001) and apolipoprotein A‐I (p<0.01) levels. Highest values of both parameters were found in patients whose serum phenytoin concentration was within the therapeutic range. HDL cholesterol levels were above the control mean +2 S.D. in 43% of the phenytoin users. Hypertriglyceridemia was more common among male phenytoin users than in control males (33 vs. 16%). It is suggested that phenytoin increases the secretion of nascent HDL particles (and probably also that of VLDL) by the liver and that this could be associated with the induction of hepatic microsomes. Since HDL is inversely related to risk of coronary heart disease, the observed increase of this lipoprotein may be an example of a beneficial side‐effect of a drug.
Minoxidil in Severe Hypertension
Authors: Oka Martti , Mäkelä Matti
Published: August 2010

ABSTRACT. Minoxidil has been administered to 16 patients with severe hypertension and renal failure. In every patient the indication for minoxidil treatment was resistance to conventional drugs. The final dose of minoxidil was 2.5–30 mg (average 20) and it was combined with a β‐blocking agent and a diuretic (or dialysis). The therapy was given for 1–27 months (average 12). The average supine BP fell from 200/130 to 164/96 mmHg and the upright BP from 200/120 to 152/90 mmHg. No hypotensive reactions occurred. In most patients the progression of hypertensive organ changes was arrested. No major vascular complications have occurred during the 16 years of treatment. Prickling of the skin and hirsutism were common side‐effects. The other side‐effects observed were oedema in five patients and development of latent diabetes in three. In four patients minoxidil treatment was discontinued for following reasons: successful reconstruction of the renal artery after stenosis, renal transplantation, severe oedema and hirsutism. The risk of hirsutism is a contraindication to prolonged minoxidil administration in most female patients. Minoxidil is especially indicated in uncontrolled renal hypertension.
Autoantibodies in Untreated and Treated Essential Hypertension. I
Authors: Kristensen B. østergaard , Andersen P. L.
Published: August 2010

ABSTRACT. Using the indirect immunofluorescence method, autoantibodies (AB) of IgG and IgM classes were investigated in sera from 161 consecutive patients with essential hypertension and compared with those from 78 healthy normotensive subjects of the same composition by age and sex, and without any family history of hypertension. The frequency of one or more AB was as high in 78 untreated (15.3%) as in 83 treated patients (13.0%) and was in the controls 9.0% (n.s.). In the treated patients, the AB were associated with heart involvement (p <0.02). In the untreated patients, antinuclear antibodies of IgG class were associated with BP (p <0.01) and fundus grading (p <0.005). A family history of hypertension was found in 23.5% of the hypertensive males with AB and in 9.0% of the normotensive males (p <0.10). These results are discussed in relation to reports of an association of AB with cardiovascular diseases. It is concluded that the presence of AB in essential hypertension is not necessarily due to drug induction.
Factors Influencing the Occurrence of “on‐off” Symptoms during Long‐Term Treatment with L‐dopa
Authors: Granérus Ann‐Kathrine
Published: August 2010

ABSTRACT.“On‐off” symptoms were found to have developed in 43 of 85 parkinsonian patients who had been treated with L‐dopa for five years or more, the risk of such symptoms apparently being greater the younger the patient had been at the début of the disease and at the start of treatment. The dopa dose had been higher throughout the treatment in the patients developing “on‐off” symptoms than in those maintaining an even effect, and, furthermore, the initial improvement had been more marked and dyskinesia had appeared earlier and in a higher frequency. The clinical observations in the present studies seemed to be related to some pharmacological findings, where different degrees of the nigrostriatal neuron degeneration and the efficacy of the remaining neurons could be of importance for a varying therapeutic response. It also seemed possible that a higher dopa dose could evoke “on‐off” symptoms more easily than a lower one in thereto predisposed individuals. As the patients maintaining an even symptomatology during long‐term treatment with L‐dopa were older, and in particular as they had dementia in a higher frequency than those developing “on‐off” symptoms, the possibility of a more widespread neuron damage, influencing the clinical manifestation in these patients, had to be taken into consideration.
Prognosis for Juvenile Diabetics with Nephropathy and Failing Renal Function
Authors: Andersen Allan Renard , Andersen Jane Kock , Christiansen Jens Sandahl , Deckert Torsten
Published: August 2010

ABSTRACT. A total of 157 consecutive patients with juvenile diabetes (onset before the 31st birthday), diabetic nephropathy, and impaired renal function were followed up until 1.1.1976. All the patients had been admitted to the Steno Memorial Hospital, Copenhagen, between 1934 and 1972. Independently of the patients' age at onset of diabetes, it was found that persistent proteinuria appeared after an average of 19 years, and that death ensued 5–6 years thereafter. Division of the patients into two groups, according to whether the diabetes had set in before or after 1940, showed no signs of an improved prognosis during the past few decades. Once the serum creatinine has started to rise, the prognosis is very grave. Only 50% were alive 21 months after serum creatinine levels of 2–5 mg/100 ml had been ascertained. Among patients whose serum creatinine exceeded 5 mg/100 ml, 50% succumbed in 9 months. It is concluded that renal transplantation, if it is to be done, should be instituted early.
Overweight in Women—Metabolic Aspects
Authors: Noppa Henry , Bengtsson Calle , Björntorp Per , Smith Ulf , Tibblin Elisabeth
Published: August 2010

ABSTRACT. In a population sample of 1462 women aged 38–60 years, those with overweight were studied separately and compared with the women in the total population sample. Overweight was defined as the upper 5% of a weight index in the various ages studied and the weight index as

body weight (kg) * 100/body height (cm)‐100.

Significant differences, with higher values in the overweight women, were found for serum triglycerides, serum uric acid and arterial BP. Smoking was significantly less common in the overweight women. Serum cholesterol was similar in overweight women and in women in the total sample. Higher values for some risk factors for ischaemic heart disease in the overweight group of women thus seemed to be compensated to some extent by a lower number of smokers in this group.
An Arm‐Chair Study of Diagnostic Decision‐Making in Gastroenterological Out‐Patients
Authors: Friis H. , Hansen S. W. , Binder Vibeke , Riis P. , Wulff H. R.
Published: August 2010

ABSTRACT. It is the purpose of this study to evaluate the efficacy of alternative diagnostic strategies in gastroenterological out‐patients. Photocopies were made of the history and physical examination recorded at the first visit of 146 consecutive patients. In each case a senior gastroenterologist was asked to state the most likely diagnosis, indicating his or her confidence in the diagnostic bid, and to state which investigations he or she wanted done. The diagnostic bids were then compared with the actual diagnoses made at the Out‐Patient Department. The chief result was that the diagnostic bid agreed with the actual diagnosis in 81% of the 146 cases. Agreement was more frequent in cases where the gastroenterologist was confident in the diagnostic bid than in those where the prediction was considered less certain. The high proportion of correct diagnoses suggests the adoption of a single‐target strategy in most gastroenterological out‐patients, i.e. a strategy aimed at confirming or excluding only that diagnosis which is considered most likely. A multi‐target strategy, taking into account several diagnostic possibilities, may be reserved for that minority of cases where the primary diagnostic bid proves incorrect. It is suggested that gastroenterological out‐patients may be subjected to fewer investigations if these recommendations are accepted. Only 26% of the items of information recorded in the notes were used for the diagnostic prediction, and, possibly, hospital records contain too much irrelevant information.
Aortic Insufficiency in Chronic Renal Failure
Authors: Storstein Ole , örjavik Ola
Published: August 2010

ABSTRACT. A diastolic decrescendo murmur was heard along the left sternal border in 21 patients with advanced renal failure. Eight patients had organic aortic insufficiency. Among the remaining 13 patients, angiocardiography was carried out in 6; aortic regurgitation was demonstrated in 4, while 2 had stenosis of a coronary artery. Two of the 5 patients with positive angiography have died. At autopsy the aortic ostium was normal. The diastolic murmur in these patients is thought to be functional. It disappears during treatment with hemodialysis and renal transplantation.
Human Leucocyte Response to Migration Inhibitory Activity from Lymphocytes
Authors: Coeugniet E. , Søeberg B. , Bendixen G.
Published: August 2010

ABSTRACT. Human lymphokines can elicit several effects associated with inflammation, e.g. leucocyte migration inhibition and fibrinolysis. These effects can be assessed in vitro by the leucocyte migration agarose technique (LMAT) and the leucocyte migration fibrinolysis technique (LMFT). The present study shows that preincubation of normal leucocytes with aprotinin, tranexamic acid and phenyl‐methylsulfonylfluoride (PMSF) reduces or abolishes their migration inhibition response to leucocyte migration inhibition factor. The compounds exert this effect at non‐toxic concentrations, which do not otherwise interfere with migration or fibrinolysis, and are non‐toxic as estimated by PHA stimulation of lymphocytes. The LMFT is more sensitive to the modifying effect than the LMAT. The effect of aprotinin and tranexamic acid is reversible, the effect of PMSF is irreversible.
Long‐term Effect of Clofibrate on Albumin Turnover and Distribution in Man
Authors: Briem H. , Helgason T. , Gudmundsson T. V.
Published: August 2010

ABSTRACT. The long‐term effect of clofibrate (at least 6 months' treatment) on albumin metabolism was investigated in 7 subjects and the results were compared with those from 15 control subjects. Human albumin labelled with 131I was used as a tracer. A significant difference between the groups was found in the following parameters: The clofibrate‐treated group had a prolonged rapid component (t1 1/2) of the disappearance curve (p <0.05), relatively increased albumin in the extravascular space (i.e. decreased distribution ratio, (p <0.01) and increased extravascular albumin space when corrected for body size by calculating it as per cent of the extravascular bromide space (p <0.01). There was no significant difference between the groups in albumin synthesis, fractional catabolic rate or the slow component (t2 1/2) of the disappearance curve. The results suggest that long‐term treatment with clofibrate causes changes in the intercellular matrix.
Persistent Hypothalamic‐Pituitary Insufficiency Following Acute Meningoencephalitis:
Authors: Hägg Erik , Åström Lennart , Steen Lars
Published: August 2010

ABSTRACT. This report concerns two patients, a 43‐year‐old woman and a 53‐year‐old man, who developed clinical as well as laboratory signs of permanent gonodal and thyroid failure following an acute intracranial infection—in the woman a meningoencephalitis of unknown origin, and in the man an encephalitis caused by Coxsackie B5. Endocrine investigations were compatible with hypothalamicpituitary dysfunction, with some of the results favoring a hypothalamic lesion. Perhaps hormone deficiency of hypothalamic and/or pituitary origin is a more common sequel of acute meningoencephalitis than has hitherto been reported.
Pyoderma Gangraenosum (Dermatitis Ulcerosa) and Monoclonal (IgA) Globulin Healed after Melphalan Treatment
Authors: Möller Halvor , Waldenstrom Jan G. , Zettervall Olle
Published: August 2010

ABSTRACT. Since 1968 we have been treating a patient, who has had a combination of pyoderma gangraenosum (dermatitis ulcerosa) and signs that may indicate early multiple myeloma. She also had carcinoma of the colon, which was successfully operated. The pyoderma healed later after intensive and successful cytostatic treatment of the “myeloma”. The ulcers remain practically healed and the protein pattern is normal in May 1977. Such cases are rare and a search in the literature has not been very rewarding. In our own series of more than 200 cases with myeloma this combination is unique. The literature is discussed in detail with data on the follow‐up on some of the patients.
Urinary Excretion of Basement Membrane Antigen in Normal Persons and Patients with Febrile Proteinuria —Quantitated by Means of Rocket Immunoelectrophoresis
Authors: Henriksen Kirsten , Jensen Herluf
Published: August 2010

ABSTRACT. The urinary excretion of a glomerular basement membrane‐like antigen was quantitated in 19 adult normal subjects and in 15 patients with febrile proteinuria by means of rocket Immunoelectrophoresis. In the normal persons the excretion averaged 59 (S.D. 8.9) U/24 hours' creatinine clearance. An increased excretion was demonstrated in 80% of the patients. There was a significant relation between the urinary excretions of albumin and protein in the patients with febrile proteinuria. The basement membrane antigen was also demonstrated in normal human serum, liver and placenta. No unusual basement membrane antigen could be demonstrated in the urine from patients with febrile proteinuria.
Validity of Casual Blood Pressure in Women
Authors: Thulin Thomas
Published: August 2010

ABSTRACT. In order to assess the prognostic significance of causal BP recordings, 64 women not treated for hypertension were selected from a population survey and their BP was followed for six years. In addition, a number of parameters considered to be of interest in connection with hypertension were examined. The two age‐matched study groups comprised women with pressures above the 95th percentile and those with pressures below the 30th percentile, respectively. The differences in BP between the two groups persisted at repeated casual BP measurements three and six years after the initial examination. Similar differences in BP between the two groups were also found after rest. The casual BP measurement predicted future BP readings with about the same accuracy as the BP measurement after rest. The subjects in the high BP group were significantly more obese and had significantly higher B‐hematocrit, fS‐triglycerides and S‐urate levels than those in the low BP group. The latter differences were not related to the BP level, but to the degree of obesity. The heart rate was significantly higher and codable ST and T wave changes in the ECG were present more often in the group above the 95th percentile. This study has shown that women, like men, with moderately high BPs have significantly higher levels of some parameters considered to be risk factors in connection with hypertension.
Effect of Upright Tilting on Kinins as Compared to Renin Activity in the Renal Venous Blood from Patients with Essential Hypertension
Authors: Hulthén U. L. , Lecerof H. , Hökfelt B.
Published: August 2010

ABSTRACT.The effect of tilting on the release of renal kallikrein as compared to renin was studied by the determination of kinin concentration and plasma renin activity (PRA) in the renal veins in supine position and after 15 min of 45° upright tilting in 10 patients with essential hypertension. Kinin concentration decreased from 0.62 ± 0.05 μg/l (mean ± S.E.M.) in supine position to 0.51 ± 0.05 after tilting (p<0.01), while PRA increased from 2.84 ± 0.39 μg/l/3 h to 4.87 ± 0.66 (p<0.001). These results indicate that tilting diminishes the release of renal kallikrein. It is suggested that decreased intrarenal generation of kinins may be of importance for the reduction of diuresis and natriuresis induced by tilting.
Changes in Plasma Volume and Extracellular Fluid Volume after Addition of Hydralazine to Propranolol Treatment in Patients with Hypertension
Authors: Ibsen H. , Rasmussen K. , Jensen H. Ærenlund , Leth A.
Published: August 2010

ABSTRACT.In 16 patients with hypertension, BP could not be controlled satisfactorily by treatment with propranolol alone (mean dosage 325 mg/day). Plasma volume (PV) (T‐1824) and extracellular fluid volume (ECV) (82Br‐distribution space) were determined in these patients before and after the addition of hydralazine for three months (mean dosage 135 mg/day). After the addition of hydralazine, PV and ECV increased significantly, by 9% and 3%, respectively. Systolic and diastolic BPs decreased, by 15% and 13%. The mechanisms inducing fluid retention during treatment with hydralazine and the clinical significance of the problem are discussed. It is concluded that the addition of a diuretic to propranolol‐hydralazine treatment is often well indicated.
Adverse Reactions with Methyldopa—a Decade's Reports
Authors: Furhoff Anna‐Karin
Published: August 2010

ABSTRACT. During 1966–75 the Swedish Adverse Drug Reaction Committee received some 300 reports of reactions to methyldopa. As the Swedish rules for reporting adverse reactions emphasize the importance of severe and unexpected reactions, the relative incidence of various adverse effects differs greatly from what would be found in an intensive study. The three most commonly reported reactions are fever, hemolysis and hepatic effects. Two‐thirds of these patients were women. The median age of the groups differed, from 57 years (hepatic effects) to 69 years (hemolysis). The clinical picture of the different reactions was consistent, in the main, with what has been described previously. Between 70 and 85% of the patients in these groups were admitted to hospital because of the adverse reaction.
Smoking, Lung Function, Physical Performance and Latent Coronary Heart Disease in Presumably Healthy Middle‐Aged Men
Authors: Erikssen Jan , Enger Sven Chr.
Published: August 2010

ABSTRACT. During a cardiovascular survey comprising 2014 presumably healthy men aged 40–59 years, latent (previously undetected) coronary heart disease (CHD), lung function and physical performance were related to differences in smoking habits. The survey examination classified 1832 individuals as “normals” (without clinical signs/symptoms of CHD). Among the others, a strong suspicion of CHD was found in 115, of whom 105 had diagnostic coronary angiography. No angiography was performed in another 35 individuals with slight, albeit typical angina pectoris. The remaining 42 men were excluded from this presentation for various reasons. The following findings were obtained: 1) In the 69 men with positive coronary angiography, the extent of coronary atheromatosis was positively related to the number of cigarettes smoked. 2) The smoking habits of the 35 individuals with slight angina pectoris but no angiography did not differ from those of the “normals”. 3) Physical performance during a near maximal bicycle exercise test and lung function according to spirometry were strongly and negatively related to smoking (in “normals”). 4) Previous smokers and never‐smokers among “normals” had almost identical lung function and physical performance.
Thrombosis of the Inferior Vena Cava, Disseminated Intravascular Coagulation and Gangrene of the Penis
Authors: Sødal Gunnar , Ly Bernt , Borchgrevink Hans Henrik Chr.
Published: August 2010

ABSTRACT. Gangrene of the penis following thrombosis of the lower segment of vena cava inferior is reported in a patient who also exhibited clinical and laboratory signs of disseminated intravascular coagulation. Development of the gangrene may have been related to thrombotic occlusion of the right spermatic vein.
Post‐Transfusion Purpura Treated with Plasma Exchange by Haemonetics Cell Separator
Authors: Laursen B. , Morling N. , Rosenkvist J. , Sørensen H. , Thyme S.
Published: August 2010

ABSTRACT. A case of post‐transfusion purpura in a 61‐year‐old, multiparous female with a platelet alloantibody (anti‐Zwa) in her serum is reported. The patient was successfully treated with plasma exchange by means of a Haemonetics 30 cell separator and corticosteroids. Compared with other therapeutic measures, plasma exchange seems to shorten the duration of thrombocytopenia. Major surgery was possible in our patient within ten days of development of the syndrome.
The predictive value of myocardial scintigraphy with 99mtechnetium pyrophosphate in diagnosing acute myocardial infarction
Authors: Höilund‐Carlsen P. F. , Badskjær J. , Hertz J. Boëtius , Sørensen O. Helmer , Christiansen I. , Uhrenhoidt A.
Published: August 2010

Myocardial scintigraphy with 99mtechnetium‐pyrophosphate was performed in two selected groups of patients, consisting of 20 who had acute myocardial infarction (AMI) clinically and 18 who had no AMI clinically. The purpose was to estimate the value of this method in the detection or disproof of AMI compared with usual procedures (ECG and serum enzyme determination — GO‐transaminase and α1‐fraction of LDH).

Each of the 20 patients with clinical AMI had positive scintigrams. There were no false‐negative findings. Out of 18 without AMI, 15 had negative scintigrams; in the other 3, scintigraphic findings were false‐positive.

The prevalence of AMI among patients admitted to the cardiological department was 0.39. In this population of patients, the calculated predictive value of a positive scintigram was 0.80, whereas the predictive value of a negative was 1.0. In patients admitted to the coronary care unit, the prevalence of AMI was 0.51; the corresponding predictive values of a positive scintigram was 0.86 and of a negative 1.0.

The identity between scintigraphic and electrocardiographic infarct localization was good. Infarct size estimated by scintigraphy was not significantly correlated to the maximum elevation of serum enzyme concentration.

In patients suspected of having AMI, it is highly probable that a negative scintigram obtained from day 2 to day 6 after the onset of symptoms will rule out the presence of acute myocardial infarction.
TSH and Thyroid Stimulating Antibodies (TSAb) Activate Thyroid Adenylate Cyclase through Different Pathways
Authors: Madsen Stig Nistrup , Bech Karine
Published: August 2010

ABSTRACT Adenylate cyclase activity in human thyroid homogenates was studied after stimulation with thyrotropin (TSH) and thyroid stimulating antibodies (TSAb). The results show:

TSAb prepared from different patients with Graves' disease show different adenylate cyclase activation patterns and a lag phase is frequently observed.

TSH and TSAb appear to cause mutually inhibitory activation of thyroid adenylate cyclase.

The maximal adenylate cyclase activation is higher with TSH than with TSAb, but this could possibly be due to contamination of TSAb preparations with an adenylate cyclase inhibitor.

There is no absolute copurification of TSH sensitive and TSAb sensitive adenylate cyclase in various subcellular fractions of thyroid homogenate.

Incubation of thyroid homogenate with cortisol cause a dose dependent decrease in the adenylate cyclase response to TSAb whereas the response to TSH is either increased or unchanged.

The results indicate that TSH and TSAb activate thyroid adenylate cyclase through different pathways in the plasma membrane.
Impairment of Vitamin D and Bone Metabolism in Patients with Bypass Operation for Obesity
Authors: Hey H. , Lund B. , Sørensen O. H. , Lund Bj. , Christensen M. S.
Published: August 2010

ABSTRACT Thirty‐four patients were studied 2–6 years after jejunoileal bypass for morbid obesity. The serum concentrations of 25‐hydroxyvitamin D (25‐OHD) were reduced and related to the frequency of stools and to the weight reduction. Fifteen patients were not able to normalize serum 25‐OHD following a long‐term regular vitamin D intake. The serum immunoreactive parathyroid hormone concentration (iPTH) and the alkaline phosphatase levels were elevated in this group, indicating a secondary hyperparathyroidism. The mean bone mineral content of the forearm was reduced 3–6 years after the operation, most severely in those with elevated serum iPTH. The desired weight reduction by jejunoileal shunt was obtained at the expense of a severely disturbed vitamin D metabolism. We suggest, that all patients with an intestinal bypass for obesity should receive regular vitamin D supplement, and serum 25‐OHD should be measured in order to monitor the effect of therapy.