bluuebunny/crossref_metadata_2025 huggingface dataset:
THE COMBINED DIURETIC ACTION OF QUINETHAZONE AND FUROSEMIDE IN CONGESTIVE HEART FAILURE
Authors: Olesen Knud H. , Dupont Bo , Flensted‐Jensen E.
Published: August 2010

Abstract. The combined diuretic action of quinethazone and furosemide has been studied in 24 patients with congestive heart failure maintained on a constant diet. The study was performed as a permutation trial test in which the error variance is reduced while permitting the examination of drug effects separate from the variations due to different patients and varying sequence of administration of drugs. The diuretic response to single drugs and to the combination of drugs in half doses showed exactly the same trend in 12 patients with slight to moderate degree of sodium retention as in 12 patients with severe sodium retention given double doses of diuretics. The results obtained indicate an additive effect of the combination of diuretics in terms of osmolal clearance, urinary sodium and chloride output as well as in terms of the development of hypochloraemic, hypokalemic alkalosis. The diuretic action of furosemide differed significantly from that of quinethazone. The renal tubular response to furosemide was characterized by: (a) a larger increase in natriuresis with rising doses; (b) a significant decrease of tubular reabsorption of solute free water; and (c) a shorter duration of action. Apparently the combined effect of the two drugs is most easily explained when it is assumed that the two diuretics, at least in part, inhibit renal tubular sodium reabsorption at different sites in the nephron. The combination of quinethazone and furosemide may prove useful in the treatment of refractory cardiac oedema when precautions are taken to avoid serious electrolyte disturbances.
INTENSIVE CARE OF MYOCARDIAL INFARCTION
Authors: Linko E. , Koskinen P. J. , Ruosteenoja R. , Kauranen O. , Hakala T.
Published: August 2010

Abstract. An analysis of 329 cases with acute myocardial infarction (AMI) treated in an intensive care unit for internal medicine (ICU) during a two‐year period is presented. The series comprises 44% of all hospitalized AMI cases within this period. 191 patients were admitted directly via the emergency department, 138 were transferred from medical wards to the ICU. In principle only the most severe cases were admitted to the ICU.

The “direct” and “transfer” groups are compared as to: (a) the clinical severity of the disease, (b) delay between onset of symptoms and arrival in hospital, and (c) incidence and prognostic effect of shock, congestive heart failure and arrhythmias.

Special attention is directed to cardiac arrest. In the case of primary ventricular fibrillation occurring in the ICU patients the results were very good. In the case of complicating ventricular fibrillation the results were rather good. Half of the 69 patients with ventricular fibrillation left the hospital alive. In contrast, the results of resuscitation in asystole were very poor.

The results obtained very much support the opinion that the AMI patients need special surveillance and possibilities for qualified intensive measures during their stay in hospital, especially in the early phase of their disease.
STUDIES IN SUBJECTS WITH POSITIVE POSTPRANDIAL CLINISTIXr̀ TEST
Authors: Lundquist Ingmar , Nordén Åke , Scherstén Bengt
Published: August 2010

Abstract. In a diabetes detection survey based on postprandial Clinistixr̀ testing, 2477 out of 228,833 participants (1.08%) reacted positively. In 2180 a 3‐hour oral glucose tolerance test was performed. Diagnostic criteria for diabetes were established in a random sample from the same population matched in age and sex. The controls were healthy and had no known heredity for diabetes. The requirement for a diagnosis of diabetes was that all 10 capillary blood sugar values during the tolerance test should exceed the corresponding mean plus 3 S.D. for the control group. Likewise a normal tolerance was only considered present when none of the 10 values reached the mean plus 2 S.D. for the control group.

A diagnosis of diabetes was made in 538 subjects, i.e. 0.2% of the population under study.

Fasting SILA values in 16 normal men less than 50 years of age showed a mean of 94 μU per ml. and in 12 men more than 50 a mean value of 83 μU per ml was found. Fasting SILA values in eight normal women less than 50 showed a mean of 34 μU per ml, and in nine women more than 50 a mean of 75 μU per ml was found. The low value in women less than 50 was significantly different (p <0.001) from the male group and also from values found in women more than 50 years of age (p<0.01).

Fasting SILA in 16 men and 14 women with newly discovered diabetes and age more than 50 showed all values in the normal range. Three diabetic women less than 50 had 50, 61, and 146 μU per ml.

SILA during the glucose tolerance test in six patients with diabetes showed a subnormal response in all of them.

SILA during the glucose tolerance test in five subjects considered diabetics by conventional criteria, but not according to our criteria, showed a normal response.

Fasting serum corticosteroids in six diabetic subjects were significantly higher than in five controls.

Serum corticosteroids during the glucose tolerance test dropped to the same base level both in the diabetic and in the normal group.
A SMALL OUTBREAK OF COXSACKIE B5 INFECTION WITH TWO CASES OF CARDIAC INVOLVEMENT AND ORCHITIS FOLLOWED BY TESTICULAR ATROPHY
Authors: Freij L. , Norrby R. , Olsson B.
Published: August 2010

Abstract. An outbreak of Coxsackie B5 infection in a group of six male students is reported. Four of the patients had the symptoms of an uncomplicated enterovirus infection with fever, chills, muscular pains etc. In two cases there was, however, marked cardiac involvement with severe chest pains and ECG changes. In addition these two patients had orchitis with secondary testicular atrophy.

Immunoglobulin separation and demonstration of IgMantibodies against Coxsackie B5 was used for the confirmation of the virological diagnosis in three of the cases. The value of this technique is discussed in the paper.
KIDNEY PRESERVATION WITH HYPOTHERMIA AND HYPERBARIC OXYGEN
Authors: Løkkegaard H. , Fernandes A. , Gyrd‐Hansen N. , Hansen R. Iversen , Hasselager E. , Kemp E. , Lund F. , Rasmussen Folke
Published: August 2010

Abstract. Preservation of kidneys for 24 hours by means of hypothermia (5°C) and hyperbaric oxygen (50, 25 or 15 ATA) has been studied in experiments on pigs.

At none of the oxygen pressures used was survival of the pigs achieved when contralateral nephrectomy was performed in conjunction with transplantation. Use of 50 and 25 ATA oxygen pressure caused greater damage to the tissue than 15 ATA. With postponement of contralateral nephrectomy for three weeks after the transplantation, the function of the kidney stored at 15 ATA oxygen pressure was determined by means of inulin, endogenous creatinine, urea and PAH clearances 10, 31, 52, 73 and 94 days after contralateral nephrectomy. The renal function was reduced in all experiments when compared to a control group of autotransplanted, not long‐term preserved pig kidneys.
THE INFLUENCE OF INFECTION ON THE DEGREE OF BONE MARROW INSUFFICIENCY
Authors: Wijnja L. , Koopmans R. K. , Nieweg H. O.
Published: August 2010

Abstract. The clinical significance of infection in bone marrow failure has been demonstrated in the case histories of five patients with panmyelopathy. In these patients the development of infections was associated with a hematologic relapse. With successful treatment of infections a marked improvement of the hematologic status occurred, characterized by at least a decrease in transfusion requirement and sometimes an increase in leucocyte count and the number of platelets. In one case (no. 1) a complete remission occurred. Apparently infection may lead to acute bone marrow failure in patients with panmyelopathy, possibly by increasing the load on a damaged organ which is already working at the maximum of its limited capacity. Adequate treatment and prevention of infections is therefore of major importance for the hematologic status of those patients.
SURVIVAL AND MORTALITY IN MALIGNANT (GRADE IV) AND GRADE III HYPERTENSION
Authors: Hood B. , Örndahl G. , Björk S.
Published: August 2010

Abstract. A series of malignant and other severe hypertensives (grade IV, 128 subjects, grade III, 177 subjects, according to the classification of Keith, Wagener and Barker) were submitted to energetic antihypertensive treatment, starting in October 1950. The patients have been followed from 5 to 17 years. Overall five‐year survival rates were in grade IV 50%, in grade III 61%. These results compare favorably with the results reported by other investigators.

Subdividing the material into four consecutive patient groups, as regards the start of treatment, the most striking increase in five‐year survival in comparison with earlier untreated control material was observed already in the first group, starting treatment in the early fifties. The tendency to further improvement was rather slight. However, more advanced age and signs of more severe vascular damage in vital areas in the later patient groups might partly explain this, patients without such unfavorable factors showing a better prognosis in the last two groups.

Of the four major causes of death, congestive failure was most markedly suppressed, cerebro‐vascular lesions and uremia clearly lowered, while myocardial infarction remained virtually unaffected.

Measures discussed for further improving prognosis were active tracing and energetic treatment of less advanced stages of hypertensive disease, improved detection of impaired renal function, prophylactic measures against pyelonephritis and an aggressive approach to simultaneous control of other “coronary and cerebro‐vascular high risk factors” as defined by prospective studies.
PHEOCHROMOCYTOMA
Authors: Hillestad Leif , Brodwall Erling
Published: August 2010

Abstract. In a series of ten patients a total of 14 pheochromocytomas have been removed. All the tumors were located in the adrenal glands, except for one situated in the organ of Zuckerkandl. In one man two tumors were removed from the right adrenal gland with an interval of five years. Bilateral pheochromocytoma was found in three of five young women. In two of them the second tumor appeared as late as seven and ten years respectively after removal of the first. A woman got her second pheochromocytoma during pregnancy. She was treated with alphamethyldopa and went through an uncomplicated delivery. A fortnight later the tumor was removed. Two men suffering from “diabetes mellitus” were ultimately diagnosed as having pheochromocytoma. Removal of the tumor led to cure. The same applied to two young women suffering from “acute” and “chronic nephritis” respectively. In two instances the urinary output of catecholamines was normal, while the excretion of metabolites was significantly elevated. In another instance the excretion of vanillin mandelic acid was normal, whereas the remaining biochemical outputs were increased.
EXERCISE‐RELEASED VENTRICULAR FIBRILLATION IN HYPERTROPHIC SUBAORTIC STENOSIS TREATED WITH PROPRANOLOL
Authors: Hilty‐Tammivaara Ritva , Cullhed Ingemar
Published: August 2010

Abstract. A 22‐year‐old woman was controlled for two‐and‐a‐half years after surgical treatment for hypertrophic subaortic stenosis. Exercise tests at identical loads (200 and 400 kpm/min) were performed before and after treatment with propranolol, which had been instituted because of angina pectoris. After propranolol there was subjective improvement of the chest pain, and the heart rate at rest and during exercise was lower. After 4 min at 400 kpm/ min (heart rate 154/min) an irregular ventricular tachycardia appeared which changed into several short periods of ventricular fibrillation. The patient became unconscious but continued spontaneous breathing during external heart massage, given until sinus rhythm spontaneously returned after 3 min. The further clinical course was uneventful. The possible causal role of propranolol in this arrhythmia is discussed.
LACTULOSE TREATMENT OF CHRONIC HEPATOPORTAL ENCEPHALOPATHY
Authors: Rorsman Gunne , Sulg Ilmar
Published: August 2010

Abstract. Current treatment of chronic hepatoportal encephalopathy with dietary protein restriction is not always sufficient, and long‐term administration of antibiotics may lead to some undesirable side‐effects. The present study of three patients with encephalopathy and surgical portacaval shunt demonstrates the favourable effect of a synthetic disaccharide (lactulose, Duphalac). This study also demonstrates clearly that there is a close interrelation between the EEG and the metabolism of the brain. Thus the EEG analysis can be used as a method for checking the effects of therapy in hepatic encephalopathy.
NECROTIC PHAEOCHROMOCYTOMA WITH GASTRIC HAEMORRHAGE, SHOCK, AND UNCOMMONLY HIGH CATECHOLAMINE EXCRETION
Authors: Nyman Dag , Wahlberg Peter
Published: August 2010

Abstract. A 43‐year‐old man who was admitted to hospital for gastric haemorrhage had a necrotic phaeochromocytoma. The blood loss was corrected, but the patient died in irreversible shock 4 days after admission. There was adrenergic myocardiopathy. The catecholamine excretion was 19,200 μg/24 h, vanilmandelic acid excretion 398 mg/24 h. Values of this magnitude have not been found elsewhere. The autopsy showed necrotic phaeochromocytoma, atrophic gastritis with mucosal necrosis, and myocardiopathy. It is suggested that the tumour necrosis took place as a result of malignant growth within a firm capsule. Very high catecholamine excretion values may indicate the need for emergency surgery in phaeochromocytoma.
FISTULA OF THE THORACIC DUCT AS IMMUNOSUPPRESSIVE TREATMENT IN RHEUMATOID ARTHRITIS
Authors: Wegelius O. , Laine V. , Lindström B. , Klockars M.
Published: August 2010

Abstract. Six patients with severe, progressive classical rheumatoid arthritis and one with progressive polyarthritis of an active juvenile type have been treated by drainage of the thoracic duct. The lymph was kept flowing for seven days in four patients. In one case the drainage tube was occluded after five days, and in another the lymph flow had to be stopped after three days because of a psychical reaction. The total volume of lymph drainage ranged from 2.1–14.5 1, the cell mass from 400–1,400 × 108. The immediate response to treatment was good in three patients, fairly good in two, while no effect was obtained in the patient showing the juvenile type of the disease. In four out of six patients the remission lasted for several months as shown by follow‐up examination. Cytostatic treatment was administered when these patients showed obvious exacerbation. All four responded well to the treatment.
HEMODYNAMIC EFFECTS OF COMPLAMIN®
Authors: Abrahamsen Arne M. , Bay Gunnar , Müller Carsten
Published: August 2010

Abstract. Twelve normal persons and 12 patients with mitral stenosis have been examined with heart catheterization before and during intravenous infusion of Complamin®, 510 mg on an average. There were no significant changes in the following ten parameters: oxygen consumption, arteriovenous oxygen difference, cardiac index, pulmonary arteriolar resistance, systemic arteriolar resistance, pulmonary capillary venous pressure, pressure in the pulmonary artery and systolic arterial pressure, heart rate and stroke volume. There was a trend to reduction in the systolic arterial pressure. No rise of the mean pressure in wedged position and in the pulmonary artery was observed in normal persons or in patients with mitral stenosis. This study gives no support for the opinion stated by the manufacturer that Complamin® is contraindicated in patients with mitral valvular disease.
THE EFFECT OF IRON SUPPLEMENTATION ON THE PHYSICAL WORK CAPACITY IN THE ELDERLY
Authors: Ericsson Per
Published: August 2010

Abstract. The effect of a high oral iron supplementation (120 mg day) on the physical work capacity has been studied in a group of apparently healthy men and women of ages 58–71 years, and this effect was correlated with the initial values of and changes in some variables constituting usual clinical estimates of the state of iron nutrition. The increase in physical work capacity was about 4% higher in men and about 12% higher in women in the group supplemented with iron than in the control (placebo) group. In the control group there was a positive correlation between increase in physical work capacity and initial value for stainable iron in the bone marrow, and a negative correlation between increase in physical work capacity and decrease in the value for stainable iron in the bone marrow; it is pointed out that these findings should not be expected in the iron‐supplemented group, where variations in the depot iron will be of less influence. In the iron‐supplemented group the total iron binding capacity decreased significantly, while the remaining variables constituting estimates of the state of iron nutrition showed no significant changes. The increase in physical work capacity in the iron‐supplemented group did not appear to be correlated to the initial value either for haemoglobin concentration or for other variables estimating the state of iron nutrition. It is concluded that in apparently healthy people the increase in physical work capacity during moderate training is related to the availability of iron.
RENAL EXCRETION OF GENTAMYCIN IN CHRONIC PYELONEPHRITIS
Authors: Bergan Tom , Brodwall Erling K. , øyri Audun
Published: August 2010

Abstract. The renal handling of gentamycin has been studied in nine patients with chronic pyelonephritis. It was found that the clearance of gentamycin was markedly below the creatinine clearance in eight patients with reduced kidney function, yielding a considerable apparent tubular reabsorption of gentamycin. In one patient with a normal kidney function the amount of apparent reabsorption was negligible, giving an excretion ratio of 0.94. The dependence of log gentamycin clearance on creatinine clearance was found to be highly significant (p < 0.001). The possibility that gentamycin is fairly inert in relation to tubular function, as has been implied by previous studies in dog and man with normal renal function, seems unlikely. It is therefore reasonable to assume that the apparent reabsorption noted with reduced kidney function in chronic pyelonephritis may be a consequence of a reduced secretion of gentamycin due to tubular damage. An interdependence of log10 serum half‐life (T 1/2) of gentamycin and log10 creatinine clearance (Cer) was found and expressed by the regression line Y = 1.3416 — 0.4655x. The relationship between T 1/2 and Cer was found to be significant (P < 0.05).
THE EFFECT OF REPLENISHMENT OF IRON STORES AFTER PHLEBOTOMY THERAPY IN PORPHYRIA CUTANEA TARDA
Authors: Lundvall Ove
Published: August 2010

Abstract. In a previous study phlebotomy therapy was consistently effective in porphyria cutanea tarda, causing clinical and biochemical remission in all. In 13 patients observed for periods of 1 to 3 1/2 years after treatment and who were not given iron, relapse occurred in only one patient. The latter had reaccumulated iron stores of considerable size spontaneously. In the present study the effect of replenishment of iron stores after phlebotomy‐induced remission was investigated. Five patients (4 men and 1 woman) were included, in four of whom the initial iron stores (before phlebotomy) had been of normal size. In one of them a moderate iron overload had been present. Iron stores were replenished by oral administration of iron sulphate in four and by intravenous administration of iron dextrin in one. After replenishment of iron stores biochemical relapse occurred in each patient. The skin disease remained in remission, except in the woman who noted an increased hair growth on the face. They were again subjected to repeated phlebotomy. Biochemical remission occurred in all and the hypertrichosis in the woman vanished. It is concluded that phlebotomy probably exerts its effect by reduction of iron stores, and that even normal amounts of storage iron may provoke deterioration of porphyrin metabolism in subjects with latent disease.
PERMANENT ENDOCARDIAL PACING
Authors: Inberg M. V. , Kallio V. , Linna M. I. , Wendelin H.
Published: August 2010

Abstract. Forty‐nine patients have been treated with permanent pacing, 48 of them with endocardial electrode. In four patients the pacing was begun with epicardial electrodes, which were later substituted by endocardial electrodes in three of them. Altogether 101 impulse generators were implanted. The early postoperative mortality was 2% (1/48). The cumulative survival rates at one, two and three years were 90, 69 and 63%, respectively. The battery life‐time was 15.2 months on the average. The commonest complication was dislocation of the endocardial electrode, which happened in five patients as an early complication and in three patients later during the follow‐up period. This complication was treated successfully in all instances. The advantages of endocardial in comparison to epicardial electrode technique are discussed.
FEMORAL NECK FRACTURE DURING AND AFTER SURGERY
Authors: Honkonen Kirsti , Tarkkanen Leena , Julkunen Heljo
Published: August 2010

Abstract. An analysis has been made of 166 patients (31 men, 135 vomen, mean age 71.9 years) with fractures of the femoral neck. Of these patients 150 were operated on, using three types of anaesthesia: general, spinal, or combined spinal and general anaesthesia. There was a correlation between increasing age and concurrent diseases (especially cardiac insufficiency, aortic stenosis, hypertension and pulmonary insufficiency), on the one hand, and complications during and after surgery on the other. There was a higher percentage of complications and a greater postoperative mortality in the two spinal anaesthesia groups than in the general anaesthesia group, but when all factors influencing the choice of anaesthesia are taken into account, no type of anaesthesia could be regarded as superior to the others in this series. Of the preoperative examinations, the respiratory peak flow value seemed most closely related to the occurrence of complications and could possibly be used to predict the likelihood of difficulties during the operation. There was a high incidence of postoperative pneumonia, and the importance of close postoperative surveillance and breathing exercises is stressed.
POST‐TRANSPLANT HYPERCALCEMIA DUE TO MOBILIZATION OF METASTATIC CALCIFICATIONS
Authors: Hornum Ib
Published: August 2010

Abstract. A case of transient hypercalcemia in a 29‐year‐old female, who received a renal transplant from her homozygotic twin‐sister, has been examined by a 47‐calcium tracer study and traditional calcium and phosphorus balance techniques. Parathyroid activity was evaluated by measuring the tubular reabsorption of calcium and the tubular maximum capacity of glucose. The study revealed a pronounced negative balance due to a pronounced hypercalcuria and a low intestinal absorption of calcium in a functionally hypoparathyroid patient. It is concluded that the hypercalcemia was caused by a mobilization of metastatic calcifications deposited in the terminal phase of uremia and during hemodialyses. It is suggested that other calcium metabolic disturbances may have a similar pathophysiological mechanism, including some cases of post‐transplant hypercalcemias, which have hitherto invariably been considered to be due to so‐called tertiary hyperparathyroidism.
HUMAN EXPOSURE TO MERCURY FROM GOOSANDER EGGS CONTAINING METHYL MERCURY
Authors: Wahlberg Peter , Karppanen Eeva , Henriksson Kurt , Nyman Dag
Published: August 2010

Abstract. A woman living in the Åland Islands in the Baltic had symptoms and signs which caused suspicion of mercury poisoning. She was found to be exposed to mercury, and the mercury was traced to goosander (Mer‐gus merganser L.) eggs which she had consumed every year. Goosander eggs, 36 in all, were collected from various parts of the islands and were found to contain between 0.3 and 3.5 mg/kg of mercury (mean 1.4 mg/kg). Between 0.5 and 5.8 mg/kg was found in the whites (mean 1.9) and between 0.2 and 1.8 mg/kg in the yolks (mean 0.7 mg/kg). The main part of the mercury (mean 78% of the total mercury) was in the form of methyl mercury. The mean weight of the eggs without shell was 71.1 g. The fish in the waters of the Åland Islands have been found to contain only negligible amounts of mercury, whereas the fish in the birds' winter quarters (the Danish sounds and southern Baltic) have been found to be contaminated with this metal. It is concluded that the birds are contaminated in their winter quarters and carry the mercury to their summer quarters, where contaminated eggs are consumed by the inhabitants. To the best of the author's knowledge, this is the first report of migratory birds carrying pollutants from their winter quarters and causing risk of human exposure to the pollutant in the summer quarters.
MYELOFIBROSIS WITH MYELOID METAPLASIA AND PANCYTOPENIA AFTER THOROTRAST INJECTION
Authors: Bastrup‐Madsen Poul , Jensen Bjørn Nordentoft
Published: August 2010

Abstract. Twenty‐two years after an injection of thorotrast, myelofibrosis with extramedullary metaplasia of the spleen and lymph nodes developed in a man aged 50 years. Pancytopenia with erythroblasts and poikilocytes in the blood was present. The clinical picture was characterized by anaemia, infections and haemorrhages, which ultimately led to death. The case is remarkable owing to the absence of splenomegaly. Both the spleen and the lymph nodes were the site of marked follicular atrophy, presumably evoked by radiation from the deposited thorium dioxide, which was also present in the liver and bone marrow. This radioactive material, which is assumed to have induced the myeloproliferative disorder, is also likely to have accentuated the pancytopenia. It is pointed out that some of the cases which are described in the literature as aplastic anaemia after thorotrast injection had morphological changes in the red blood picture of the same type as in myelofibrosis. This diagnosis may be overlooked if the thorium radiation induces splenic atrophy instead of the splenomegaly which is otherwise a characteristic feature.
SINGLE CORONARY ARTERY
Authors: Hillestad Leif , Eie Harald
Published: August 2010

Abstract. Three cases of single coronary artery are reported. All had bicuspid aortic valves and one case also a ventricular septal defect. A 24‐year‐old woman had suffered from angina pectoris from the age of 16. Over the last years electrocardiographic signs of progressive myocardial ischemia and an additional right bundle branch block have developed. Angiography has shown the presence of a single left coronary artery and bicuspid aortic valves. A 65‐year‐old woman with aortic stenosis and insufficiency has a single right coronary artery and bicuspid aortic valves. The ECG reveals the presence of a left bundle branch block. A man aged 34 years with a single left coronary artery, bicuspid aortic valves and a ventricular septal defect had a subacute bacterial endocarditis with rapid development of aortic insufficiency. He died from intractable heart failure. Emphasis is laid upon the recognition of single coronary artery as the potential cause of severe heart disease such as subacute bacterial endocarditis, aortic valvular disease and premature myocardial ischemia.
SURVIVAL TIME IN CARDIOGENIC SHOCK
Authors: Lunde M. , Nordenstam H. , Nyquist O. , Orinius E.
Published: August 2010

Abstract. Thirty consecutive patients with an acute myocardial infarction and cardiogenic shock have been classified at autopsy as having or not having right ventricular hypertrophy (RVH). The RVH group had a significantly longer survival time after onset of shock than those without RVH. The finding is discussed.
AGRANULOCYTOSIS ASSOCIATED WITH AJMALIN THERAPY
Authors: Wilson J. H. P. , Cazemier Trijn , Nieweg H. O.
Published: August 2010

Abstract. The case reports of five patients who developed agranulocytosis while taking the antiarrhythmic drug ajmalin are presented. All five responded rapidly to withdrawal of the drug and, in four of the five, antileucocyte ajmalin‐dependent activity was demonstrated in the serum by means of a leucocytotoxicity test.
POLYMORPHISM OF PLASMA TRIGLYCERIDE KINETICS IN NORMAL HUMAN ADULT SUBJECTS
Authors: Nikkilä Esko A. , Kekki Matti
Published: August 2010

Abstract. Plasma triglyceride turnover has been measured in 34 adult healthy human volunteers selected on the basis of normal serum cholesterol and triglyceride concentrations and a normal b.wt. The circulating triglyceride was labelled in vivo with tritiated glycerol and the disappearance of radioactivity was followed up to 24 h. The descending part of the slope was divided into exponential components with the aid of a computer and the one‐exponential resolutions were used for analysis. The enzymatic nature of the triglyceride removal mechanism was confirmed. When it was assumed that all subjects have a common maximal removal velocity (Vmax) level, calculation of Km values indicated that the population under study is definitely composed at least of two and perhaps of three groups. The next analysis was therefore carried out without any presumptions and the conventional enzyme kinetic plots were drawn. These revealed that the two groups differ in regard to Vmax but not to Km. Two of the subjects did not fit into either of these groups. Group I with a higher Vmax had a significantly higher turnover rate than group II, which showed a rather uniform distribution of both turnover rate and concentration. The two groups had identical age, sex and b.wt. distribution. There was a definite difference in the triglyceride kinetics between males and females. Both had identical turnover rates, but females showed a lower Km and, correspondingly, a lower plasma concentration of triglyceride. The well known difference in plasma triglyceride concentration between men and fertile‐aged women is thus accounted for by the more efficient removal system in the latter. It is concluded that the plasma triglyceride concentration in any individual and under any conditions is determined by three factors: (1) the turnover (synthesis) rate, (2) the maximal removal velocity (Vmax), and (3) the Michaelis constant (Km) of the removal enzyme(s). All of these may be influenced by factors like diet, hormones, metabolites and drugs, but obviously the first two are also genetically determined. It is suggested that any classification of hypertriglyceridemias should include an enzyme kinetic analysis, and this will be attempted in the studies in progress.
TRACE ELEMENT BALANCES IN TWO CASES OF PANCREATIC INSUFFICIENCY
Authors: Wester P. O.
Published: August 2010

Abstract. Balance studies in two patients with pancreatic insufficiency have been performed with respect to the following trace elements: Ag, As, Au, Br, Cd, Ce, Co, Cu, Fe, Hg, La, Mo, Rb, Sb, Sc, Se, Sm, W and Zn. The method consisted in neutron activation analysis combined with a recently developed ion exchange technique. The results suggest that the metabolism of trace elements with both known, suspected and unknown biological function is influenced by exocrine pancreatic enzymes.
THE ELECTROCARDIOGRAPHIC PATTERN AND MORTALITY RISK IN POST‐MYOCARDIAL INFARCTION PATIENTS
Authors: Leren Paul , Hjermann Ingvar , Björnson Jan
Published: August 2010

Abstract. Electrocardiograms of 412 male post‐myocardial infarction patients have been recorded 1–2 years after their first infarction and classified according to the Minnesota code in groups of possible prognostic significance: A: with major Q changes, B: with Q and T changes, C: a mixed group with hypertrophy, conduction defects and arrhythmias, and “O”: a reference group with normal or fairly normal ECGs. The 11‐year incidence of subsequent fatal myocardial infarction was significantly increased with a pathologic ECG at entry. The incidence of sudden death was also increased with a myocardial injury ECG pattern. The present study and a previous 5‐year follow‐up study which correlated non‐fatal as well as fatal coronary relapses to the same ECG changes seem to justify the following conclusion: The predictive value of the post‐myocardial infarction ECG is limited with regard to the risk of suffering a new infarct. However, the risk of coronary death seems to be increased when there is persistent ECG evidence of myocardial injury.
HEPATIC LIPOGENESIS IN TWO CASES WITH INSULIN‐PRODUCING TUMOR OF THE PANCREAS
Authors: Scherstén T. , Nilsson Sv. , Jönsson Jane
Published: August 2010

Abstract. The incorporation rate of glycerol‐1.3‐14C and fructose‐U‐14C into glycerides and into the fatty acid moiety of glycerides has been determined in liver slices obtained from liver biopsies taken at operation of two patients with insulin‐producing tumor of the pancreas. Both of these patients had high plasma concentration of insulin. The results were compared with the corresponding incorporation rate in liver slices obtained from fasting controls and controls pretreated with 400 g fructose on the day before operation (gallstone patients). In the insuloma cases the incorporation rate and the distribution of label amongst liver lipids was in conformity with the fasting controls. A changed distribution of label with an increased incorporation of glycerol as well as fructose into the fatty acid moiety of glycerides was found in the patients pretreated with fructose. The results suggest that chronic hyperinsulinemia without increased concentration of plasma glucose does not promote hepatic lipogenesis in man.
VIRUS ANTIBODY LEVELS IN RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Laitinen Ossi , Vesikari Timo , Vaheri Antti
Published: August 2010

Abstract Sera from 30 patients with rheumatoid arthritis (RA), 10 with systemic lupus erythematosus (SLE) and 99 healthy control subjects have been studied for several viral antibodies by haemagglutination inhibition (HI) and complement fixation (CF). Measles HI antibodies were significantly increased in both RA and SLE. The geometric mean of the measles antibody titres, expressed as log2 of the reciprocal mean antibody titre, where 1.00 equals a titre of 1: 10, was 1.17 in the controls, 2.45 in patients with RA (p<0.01), and even higher, and 3.80 (p<0.01), in patients with SLE. The measles CF antibody titres of SLE patients, but not of RA patients, also differed significantly from those of controls. In addition, the mean rubella HI titre was slightly increased in SLE (p<0.02). The significantly elevated measles antibody levels in RA and SLE may be due to altered immuno‐logical reactivity in these diseases, but a viral aetiology cannot be excluded.
THE RENAL EXCRETION AND TUBULAR REABSORPTION OF CITRIC ACID IN RENAL TUBULAR ACIDOSIS
Authors: Brodwall E. K. , Westlie L. , Myhre E.
Published: August 2010

Abstract Three patients with renal tubular acidosis (RTA) have been examined during metabolic acidosis and after correction of the acidosis. Citrate (Ci) clearance was decreased in all patients during acidosis and was not normalized after correction of the acidosis. Renal metabolism of Ci was in the normal range except in one patient in whom the metabolism probably was decreased because of impaired renal function. Tubular reabsorption of Ci was increased independent of the degree of acidosis. We suggest this might be due to decreased tubular synthesis and secretion of Ci.
IMMUNE PHAGOCYTOSIS IN VIVO OF HUMAN MALIGNANT MELANOMA CELLS
Authors: The T. H. , Eibergen R. , Lamberts H. B. , Oldhoff J. , Ploeg E. v. d. , Koops H. Schrafford , Nieweg H. O.
Published: August 2010

Abstract Phagocytosis of tumour cells has been observed in imprint preparations from a lymph node metastasis removed from a patient with malignant melanoma. This observation was made when the patient developed a relapse after a spontaneous remission lasting nearly three years. Material from 37 other melanoma patients without a history of tumour remission was studied. Only four showed some degree of tumour phagocytosis. It could be demonstrated by means of the immunofluorescence technique that the freshly biopsied tumour cells were covered with immunoglobulins. After these immunoglobulins had been eluted from the tumour into solution with citrate buffer, pH 3.2, they could react when tested by the indirect immunofluorescence technique with cultured melanoma cells. Furthermore these eluted antibodies were shown to induce phagocytosis in vitro of cultured autologous melanoma cells by heterologous macrophages. The failure of immune elimination of tumour cells and the significance of macrophages in this phenomenon will be discussed in relationship to the observed development of a diminished skin reactivity to dinitrochlorobenzene and a normal response of patient's lymphocytes to phytohaemagglutinin in vitro.
POTENTIAL SOURCES OF CADAVERIC KIDNEYS FOR TRANSPLANTATION IN A GENERAL HOSPITAL
Authors: Friedberg Michael , Larsen Niels A. , Larsen Svend
Published: August 2010

Abstract An investigation, based on autopsy findings, has been made of the number of theoretically available cadaveric kidney donors among 1 400 patients dying in 1968 at our 900‐bed hospital. Patients on whom no autopsy was performed were excluded from the investigation. Criteria for exclusion were: age above 70 years, cancer, septicaemia or proven bacteriaemia, active tuberculosis, systemic disease, renal disease, hypertension, and terminal hypotension exceeding one hour. Among 1 185 patients dying from natural causes 45 suitable donors (3.8%) were found. Out of 56 patients dying from accidents, suicide and homicide ten (18%) would have been suitable kidney donors. Although most of the donors in the group dying from natural causes were older than 60 years, histological changes due to aging were only slight. Donors suffering from renal disease, cancer or active tuberculosis could be excluded with reasonable certainty by clinical evaluation and macroscopical examination of the kidneys. The investigation shows that, although the percentage of theoretically available kidney donors among patients dying from natural causes is only 3–4%, the great number of patients in this group makes it an important, albeit hitherto underestimated, source of cadaveric kidneys.
SIGNIFICANCE OF GLUCOSE LOAD IN ORAL GLUCOSE TOLERANCE TESTS
Authors: Christensen Niels Juel , Örskov Hans , Hansen Aage Prange
Published: August 2010

Abstract Blood glucose, serum insulin, growth hormone and free fatty acids (FFA) have been measured in eight young healthy subjects after oral glucose loads of 25, 50, 100 and 200 g. While the blood glucose areas only quadrupled, the insulin areas rose by a factor of 16 through the eightfold increase in oral glucose load. In the early part of the tests blood glucose was the same after high and low doses, while serum insulin was much higher after large doses. The significance of the I/G ratio in oral glucose tolerance tests is discussed in the light of the results. The serum growth hormone suppression phase increased with increasing glucose loads in male as well as in female subjects. In female subjects, however, this regular pattern was obscured by intermittent peaks. The serum FFA suppression phase also increased as glucose loads increased. Serum FFA patterns were identical in male and female subjects.
REHYDRATION AS A DIAGNOSTIC AND THERAPEUTIC MEASURE IN HYPERCALCEMIA
Authors: Andersen Margrethe
Published: August 2010

Abstract Two patients in a hypercalcemic crisis received fluid replacement therapy, which sufficed to control their condition. Both of them developed a marked polyuria even before they were clinically rehydrated and large amounts of calcium were demonstrated in the urine. A third patient, who clinically presented with the most pronounced symptoms of hypercalcemia, did not produce polyuria or hypercalciuria when rehydrated. It is suggested that the presence or absence of polyuria upon rehydration may serve to distinguish between hypercalcemic crisis sensu strictu and hypercalcemia with less rapid calcium mobilization. When the two first mentioned patients had been brought into a steady state with a stable, but elevated serum calcium and a constant, but abnormally high daily excretion of calcium in the urine, porcine calcitonin was administered. One patient responded with a drop in serum calcium and phosphaturia, both parameters reverting to pretreatment values upon cessation of the drug. In the other patient serum calcium was abruptly normalized, urinary excretion diminished and the effect was sustained.
DOUBLE‐BLIND TRIAL WITH INCREASING DOSES OF SALBUTAMOL AND TERBUTALINE AEROSOLS IN PATIENTS WITH REVERSIBLE AIRWAYS OBSTRUCTION
Authors: Simonsson Bo G. , Stiksa J. , Ström Berit
Published: August 2010

AbstractIn a double‐blind trial we have tested the effects of inhaling increasing doses of salbutamol and terbutaline aerosol. In 12 patients with reversible airways obstruction we assessed the effects on the airways obstruction by dynamic spirometry and repeated measurements of peak expiratory flow rate (PEFR) over a period of 5 hours after inhalation of 0.10+0.20 mg salbutamol and 0.25+0.50 mg terbutaline. A similar and significant bronchodilation occurred up to 2 hours, with a 50% maximum increase after 1 hour. After 3–4 hours the effect declined, but was still significant. The ventilatory effect of terbutaline was significantly larger than that of salbutamol after 3–5 hours. No consistent significant changes or differences between the drugs were noted concerning pulse rate, BP or subjective side‐effects.
HEMODYNAMIC EFFECTS OF NOREPINEPHRINE IN SEVERE HYPNOTIC DRUG POISONING WITH ARTERIAL HYPOTENSION
Authors: Hulting J. , Thorstrand C.
Published: August 2010

Abstract The hemodynamic response to infusion of norepinephrine (NE) has been measured in 12 patients with severe hypnotic drug poisoning. All patients had a mean arterial blood pressure (B.P.) of 70 mmHg or less initially. As evaluated from central venous pressure no marked hypovolemia was present. Cardiac output (C.O.) was determined by the dye dilution method and right heart catheterization by a “floating” catheter technique. Following infusion of NE the arterial B.P. and C.O. increased. The increase in C.O. resulted from increases in stroke volume and to a less extent also in heart rate (HR). There was no significant change of peripheral vascular resistance index (PVRI), in contrast to the NE effect in cardiogenic, hemorrhagic and septic shock states. The increase in arterial B.P. was accompanied by an increase in HR, which implies a disturbed function of the high pressure baroreceptor system. The rise in B.P. is primarily due to the increase in C.O. No adverse effects were noted during the NE infusion. It is concluded that NE is beneficial in the treatment of severe hypnotic drug poisoning complicated by hypotension.
ON CORTICOSTEROID AND AZATHIOPRINE TREATMENT OF GLOMERULAR RENAL DISEASES
Authors: Alwall N. , Halldorson T. , Kjellstrand C. M. , Lindholm T. , Ahlström C. G.
Published: August 2010

Abstract The results after corticosteroid and azathioprine treatment of glomerular renal disease were assessed in a series of 90 patients. Forty‐five (59%) of 76 patients treated solely with corticosteroids for at least one month showed an improvement, while 20 were unchanged and 11 deteriorated. Azathioprine was given to 37 patients, 31 of whom were treated with corticosteroids as well. In this group of patients, who were more severely ill than those treated only with corticosteroids, 12 (32%) improved. The hypertensive patients had a worse prognosis than the normotensive, but otherwise it was not possible from the clinical data and the light microscopy examination of renal biopsies to predict which of the patients would react favourably to the treatment. Without a real control series it is impossible to get a clear evaluation of such treatment, but the results in individual cases appeared so good that we feel it ethically impossible to refuse a badly ill patient a treatment which may be of benefit.
CONCENTRATIONS AND FATTY ACID COMPOSITION OF SERUM LIPID FRACTIONS FOLLOWING ACTH IN RABBITS
Authors: Kirkeby Knut , Bjerkedal Inger
Published: August 2010

Abstract In a group of rabbits injection of ACTH over 5 days caused a rise in cholesterol, phospholipids and triglycerides (TG) in serum. Concomitant changes in fatty acid composition included an increase in linoleic acid in cholesterol esters and phospholipids, a lowering of oleic acid in all three fractions, and an increase in palmitic acid in TG. The changes in fatty acid composition may be accounted for by increased lipolysis of adipose tissue effected by ACTH with an increased influx to the liver of free fatty acids (FFA), rich in palmitic and linoleic acid, and relatively poor in oleic acid. Furthermore, inhibition by ACTH of fatty acid synthesis may have favoured the incorporation of linoleic acid at the expense of fatty acids synthetized in the liver. It is concluded that the changes in lipid concentrations and fatty acid composition after injecting ACTH in rabbits are quite different from those observed following serious illness in man. This may indicate that the degradation of low density lipoproteins, with lowering of cholesterol and phospholipids following serious illness in man, is not caused by ACTH or corticosteroids.
AVAILABILITY OF IRON SORBITOL FOR HEMOGLOBIN FORMATION
Authors: Olsson K. Sigvard
Published: August 2010

Abstract The availability of iron sorbitol for hemoglobin synthesis has been studied in six young, healthy male volunteers made anemic by repeated venesections. The rate of Hb production from iron sorbitol was compared to that after oral iron therapy and was found to be of the same order except for the first week of treatment, when iron sorbitol gave a slower response. This delay was thought to be due to processing of the iron sorbitol complex before iron could be delivered to the erythroid marrow. In another group of six male volunteers, made iron deficient by phlebotomy, iron stores were created by iron sorbitol of a size as encountered in normal men. The availability of these iron stores for Hb production was studied by means of quantitative phlebotomy. The amount of iron mobilized from the iron sorbitol stores averaged 94% of the calculated store of 727 mg. No significant residual iron deposits could be demonstrated after completed venesections. The urinary iron excretion after desferrioxamine (DF) in subjects treated with iron sorbitol was found to be significantly higher than in subjects with normal iron stores of corresponding size. It was suggested that this was due to localization of a fraction of iron sorbitol to tubular cells of the kidneys where DF reaches a high concentration.
METABOLIC EFFECTS OF DIETARY FRUCTOSE IN INSULIN DEPENDENT DIABETES OF ADULTS
Authors: Pelkonen Risto , Aro Antti , Nikkilä Esko A.
Published: August 2010

Abstract. The metabolic effect of an isocaloric replacement of 75 grams of dietary starch by fructose was studied in 10 insulin‐dependent diabetic patients. Body weight, urinary excretion of glucose, diurnal variation of blood glucose, plasma free fatty acids (FFA) and plasma immunoreactive growth hormone (IRGH) and fasting levels of plasma cholesterol and triglyceride were determined during three successive dietary periods. During the first and third period starch was the main carbohydrate given while during the second period 75 grams of starch was replaced by fructose. Fructose feeding did not alter diurnal blood glucose or urinary output of glucose but a tendency to an increase of plasma triglyceride and FFA levels was observed during the fructose period. Plasma levels of cholesterol and IRGH were unaffected by fructose.

The results suggest that in controlled insulin‐dependent diabetes moderate amounts of fructose can be included in the diet without any adverse effects on the glucose balance. However, it seems likely that triglyceride metabolism of diabetics is influenced by dietary fructose even in moderate doses.