bluuebunny/crossref_metadata_2025 huggingface dataset:
The Long‐term Prognosis for Patients with Sinoatrial Block Treated with Permanent Pacemaker
Authors: Skagen Knud , Hansen Jørgen Fischer
Published: August 2010

ABSTRACT Fifty patients with SA block have been treated with permanent pacing and followed up for 1–14 years. Survival after one, two, five and eight years was calculated to 94, 85, 64 and 48%, respectively. These figures indicate an excess yearly mortality in the first five years of 4–5% compared with a population of the same age and sex. Analysis of the survival curves shows that the excess mortality is caused by coexisting diseases, primarily coronary heart disease with previous myocardial infarction and valvular heart disease.
Sequential Studies of Lymphocytes, Neutrophils and Serum Proteins during Prednisone Treatment
Authors: Clemmensen Ole , Andersen Vagn , Hansen Niels Ebbe , Karle Hans , Koch Christian , Søborg Mogens , Weeke Bent
Published: August 2010

ABSTRACT Seven patients (6 with connective tissue diseases, 1 with bronchial asthma) have been studied before, during, and after prednisone therapy. Maximum dose was 15 mg daily, which was tapered off to zero within three months. All patients showed striking subjective improvement during therapy. The ESR reflected this improvement but the acute phase proteins did not. The serum concentration of prealbumin rose significantly during the period of most intensive steroid treatment. IgE decreased in the patient with bronchial asthma, but otherwise the immunoglobulins did not change, and positive serological tests remained unchanged. Contact sensitization to haptens was induced without impairment during therapy. Prednisone induced rises in blood lymphocyte and neutrophil concentrations. Lymphocyte transformation, both mitogen‐ and antigen‐induced, was not influenced by therapy, but PPD‐induced inhibition of leucocyte migration decreased. Neutrophil phagocytosis was unimpaired, but bactericidal capacity, stimulated nitroblue tetrazolium reduction, and neutrophil and plasma lysozyme concentrations were all depressed during treatment with prednisone.
Iron Absorption in Patients with Chronic Uremia Undergoing Regular Hemodialysis
Authors: Milman Nils , Larsen Lars
Published: August 2010

ABSTRACTGastrointestinal iron absorption has been measured by whole body counting in 17 patients with chronic uremia undergoing regular hemodialysis. Absorption was expressed as whole body retention 14 days after oral administration of 10μCi59Fe together with a carrier dose of 10 mg Fe2+. The percentage incorporation in the total erythrocyte mass of administered59Fe (erythrocyte incorporation) and absorbed59Fe (red cell utilization) was estimated as well. Geometric mean iron absorption was 14.3± 2.0 (S.D.)% and significantly higher than the value obtained in a normal control group (p< 0.03). Geometric mean erythrocyte incorporation was 11.6 ± 2.3 (S.D.) % and arithmetic mean red cell utilization was 84.4 ± 6.0 (S.E.M.)%. Neither of these parameters differed from corresponding values in the control group (p> 0.1 andp> 0.2, respectively). The correlation between iron absorption and erythrocyte incorporation was highly significant (r= 0.94,p<0.001). Patients on regular hemodialysis are subjected to considerable iron loss which should be treated by iron supplementation; oral iron administration is recommended in view of the adequate gastrointestinal absorption.
Mitotic Activity in Acute Promyelocytic Leukaemia and Leukaemoid Reactions
Authors: Sjögren U.
Published: August 2010

ABSTRACT Bone marrow smears from 6 untreated patients with acute promyelocytic leukaemia (APL) and from 6 patients with leukaemoid reactions (LR) have been compared with smears from healthy controls. The mitotic indices of the granulopoietic precursor cells were significantly lower in the APL group and significantly higher in the LR group, both compared with the normals. Mitotic countings seem to be of diagnostic value for distinguishing APL from conditions simulating this disease.
Plasma Renin Activity and Hypertensive Organ Manifestations in 50‐year‐old Males
Authors: Berglund Göran , Aurell Mattias , Wikstrand John , Wallentin Ingemar
Published: August 2010

ABSTRACT From a screening examination in a randomly selected third of the 50‐year‐old male population in Göteborg, Sweden, a 10% subsample was selected as a reference group (n = 80). All untreated persons with SBP > 175 or DBP > 115 mmHg on two separate occasions made up the hypertension group (n = 35). The reference group and the hypertension group were subjected to the same investigations, including BP measurement before and after rest and determination of plasma renin activity (PRA), urinary sodium and norepinephrine excretion and GFR. Plasma renin activity was approximately normally distributed in both the reference and the hypertension group. Mean values were 0.78 ± 0.18 and 0.65 ± 0.17 ng/ml/h respectively, the difference being almost statistically significant (0.10 > p > 0.05). There was no difference with respect to sodium excretion between the reference group and the hypertension group. In the reference group, heart rate was positively correlated to PRA and to urinary norepinephrine excretion during the day. No linear correlation between PRA and BP was found, either in the reference group, or in the hypertension group. Sodium excretion during the day was positively correlated to GFR in the hypertension group, but not in the reference group. Compared to hypertensives with normal or high sodium excretion during the day, the hypertensives with low sodium excretion during the day were characterized by a higher BP, a lower GFR and a reversed diurnal rhythm of urine excretion. Thus, low sodium excretion seemed to indicate more severe hypertension with increased renal resistance during the day. The hypertension group was also divided with regard to sodium excretion into a low, normal and high renin group. The low renin group had the lowest GFR and with rising renin group (from low via normal to high) there was a significant increase in GFR and a significant decrease in resting BP. The results indicate that low renin hypertension is not a more mild, but indeed rather a more severe form of hypertension.
Hemodynamic Effect of Pindolol in Essential Hypertension with Special Reference to the Resistance and Capacitance Vessels of the Forearm
Authors: Atterhög J.‐H. , Dunér H. , Pernow B.
Published: August 2010

ABSTRACT Ten patients, mean age 48 years, with essential hypertension of stage I and II according to the WHO classification, have been studied at rest and during work before and after on average 8 weeks oral treatment with a β‐adrenergic blocking agent, pindolol. The pindolol treatment caused a significant decrease in the systemic systolic and diastolic blood pressure, heart rate and cardiac output both at rest and during work. The systemic vascular resistance and the forearm vascular resistance decreased significantly after and during work, respectively. Forearm venous tone was significantly decreased at rest, during and after work. The plasma renin activity decreased. Three mechanisms seem to be involved in the antihypertensive effect of pindolol: 1) a negative chronotropic effect on the heart, 2) a decrease in peripheral vascular resistance, and 3) an increase in vascular capacitance affecting the venous return.
Detection and Characterization of Middle‐aged Men with Hypertension
Authors: Hedstrand Hans , Åberg Hans
Published: August 2010

ABSTRACT In a health examination survey of more than 2 000 middle‐aged men the prevalence of hypertension, defined as supine DBP ≥ 105 mmHg and including those on treatment, was 7.5 %. Half of the hypertensives were untreated. A satisfactory BP control was present in 27.6% of the total hypertensive population. Untreated hypertensives had a higher relative body weight and a greater skinfold thickness, indicating a greater degree of obesity, than a population sample from the same survey. They also had more hyperuricaemia, hypertriglyceridaemia and hyperinsulinaemia, fasting as well as during i.v. glucose tolerance test. However, when the hypertensives were compared to normotensive, weightmatched controls, most of these differences were eliminated. The findings indicate that the metabolic disturbances in hypertensives are associated with overweight and suggest that weight reduction might be beneficial not only for the BP but also for correcting the metabolic pattern.
Interstitial Nephritis with Acute Renal Failure Following Cardiac Surgery and Treatment with Methicillin
Authors: Olsen Steen , Asklund Mogens
Published: August 2010

ABSTRACT Six patients developed acute renal failure 13–19 days after cardiac surgery with extracorporeal circulation. None of the patients had suffered from postoperative hypotension; slight hemolysis was present for only 1–2 days postoperatively. Acute renal failure lasted for 11–80 days in four patients. In two patients creatinine clearance stabilized at reduced values. Seven renal biopsies from the six patients showed severe acute interstitial nephritis with mononuclear cellular infiltration and distal tubular damage. No immune deposits were detected in glomeruli or tubular basement membrane. All six patients had been treated prophylactically with methicillin and the acute renal disease was probably elicited by this drug.
Liver Biopsies in Epileptics during Anticonvulsant Therapy
Authors: Jacobsen Niels Otto , Mosekilde Leif , Myhre‐Jensen O. , Pedersen Ejner , Wildenhoff K. E.
Published: August 2010

ABSTRACTLiver function tests, performed in 11 epileptics under antiepileptic treatment for 10–35 years, showed a slight increase in serum alanine aminotransferase in six patients and a marked increased level of serum alkaline phosphatases in four. Liver biopsies revealed few uni‐ or paucicellular necroses in five patients. Granulomatous hepatitis was found in one patient in whom sarcoidosis was later diagnosed. None of the biopsies showed signs of permanent liver damage.
Anticonvulsant Osteomalacia Determined by Quantitative Analysis of Bone Changes
Authors: Mosekilde Leif , Melsen Flemming
Published: August 2010

ABSTRACTMaterial has been obtained by biopsy from the right iliac crest of 60 adult epileptic outpatients receiving chronic anticonvulsant therapy with diphenylhydantoin (DPH), either in single‐drug or combined‐drug regime, and of 16 controls with the same distribution by sex and age. Four (7%) of the epileptics were hypocalcemic and 25 (42%) had elevated serum alkaline phosphatase values. A quantitative analysis of the morphological bone changes was performed on decalcified and undecalcified bone, using integrating filters and the point count principle. An increased amount of unmineralized bone was found in 32 (53%) of the epileptics. The trabecular osteoclastic resorption surfaces and the mean volume of periosteocytic lacunae were increased in 36 (69%) and 45 (75%) patients, respectively. The calcification rate was decreased in relation to what is referred to elsewhere as normal. The bone changes suggest a mineralization defect analogous to osteomalacia with secondary hyperparathyroidism. An increased osteoid volume or thickness and decreased calcification rate were correlated to low dietary vitamin D intake, low exposure to sunlight, high hepatic clearance rate of DPH, combined‐drug treatment and the male sex. These parameters should be considered risk factors of anticonvulsant osteomalacia.
Acute Myeloid Leukaemia Appearing in Two Patients after Prolonged Continuous Chlorambucil Treatment for Wegener's Granulomatosis
Authors: Westberg N. Gunnar , Swolin Birgitta
Published: August 2010

ABSTRACT Two patients with Wegener's granulomatosis have been treated with chlorambucil and prednisolone continuously for 3 and 5 years, respectively. This treatment was effective in controlling the disease, but bone marrow toxicity with severe pancytopenia developed in both cases. Both patients died from thrombocytopenia with haemorrhagic pericarditis. In one case, the diagnosis of acute myeloid leukaemia was established from the appearance of myeloblasts in the peripheral blood and from characteristic bone marrow morphology. In the other case this diagnosis was strongly suspected on the basis of the bone marrow morphology alone. It is proposed that this development of acute leukaemia in two patients with a primary non‐neoplastic disease may result from a direct carcinogenic action of chlorambucil in humans.
Chronic Myocardial Disease
Authors: Hatle L. , Stake G. , Storstein O.
Published: August 2010

ABSTRACTHaemodynamic findings in 106 patients with chronic myocardial disease have been related to the course of the disease during a follow‐up period of 2–12 years. A high filling pressure, especially when combined with low cardiac output, suggested a severe development. The worst outlook was noted in patients who in addition had raised pulmonary arteriolar resistance. On the other hand, a low filling pressure even if cardiac output was reduced, was generally associated with a more benign course. An increase in left ventricular wall thickness as determined angiographically suggested a better outlook than normal wall thickness.
Atrial Repolarization in Healthy Males
Authors: Brorson Leif , Olsson S. Bertil
Published: August 2010

ABSTRACT Right atrial effective refractory periods (AERP) and monophasic action potentials (MAP) have been determined in 29 healthy males in four different age groups between 25 and 64 years. One age group (45–54 years) showed a significantly longer AERP than the others, with a mean of 283 msec compared with 230–238 msec in the other groups. However, no age trend was found in the total material. The AERP decreased at higher paced heart rates, the decrease between paced cycle lengths of 800 and 600 msec amounting to 13 msec. When the MAP and the AERP were determined in the same position of the atrium, they showed no statistically significant correlation. A possible explanation is that the cells contributing to the AERP and the MAP are not altogether the same. The MAP and the AERP determinations have a similar degree of reproducibility but possibly mirror different kinds of repolarization phenomenon.
The Sick Sinus Syndrome
Authors: Sauerwein H. P. , Roos J. C. , Becker A. E. , Dunning A. J.
Published: August 2010

ABSTRACT Clinical and electrophysiological characteristics have been investigated in a group of 30 patients with a sick sinus syndrome. No predictable response to exercise or drugs was observed, although a poor response of the sinus rate to atropine was present. Distal conduction abnormalities were found in seven of 14 patients, in whom detailed electrophysiological measurements were made, and sinus node recovery time was abnormal in all except one. Treatment with permanent pacing not only relieved syncope and dizziness, but made drug treatment of associated tachyarrhythmias feasible. The elusive and intermittent nature of the syndrome is stressed. The pathological findings in one case are described at length.
Platelet Adhesiveness in Myocardial Infarction in Relation to Clinical Course
Authors: Bygdeman S. , Eliasch H.
Published: August 2010

ABSTRACT ADP‐induced and whole blood platelet adhesiveness have been studied by repeated measurements during the acute stage of the disease and the following two months in 86 randomly selected patients admitted to a coronary care unit because of acute central chest pain. In the patients who developed ECG and enzyme changes typical of infarction (group 1), platelet adhesiveness was significantly increased on admission compared with the rest of the patients (group 2) and controls (group 3). Patients in groups 1 and 2 showed a secondary increase during the first week, but two months after admission the means had returned to values within the normal range. No correlation was found between platelet adhesiveness and infarction size or fatal outcome of the disease. Platelet adhesiveness did not differ between patients with ECG changes indicating a transmural infarct and those with mainly subendocardial infarction.
Renal Stones and Coronary Heart Disease
Authors: Ljunghall Sverker , Hedstrand Hans
Published: August 2010

ABSTRACT The relationship between risk factors for coronary heart disease (CHD) and renal stone disease has been studied in a population of more than 2 000 middle‐aged men. The only positive association found was a slight increase in diastolic BP among stone formers and a higher stone prevalence in untreated hypertensives. Furthermore, the prevalence of a history of renal stones in male survivors of myocardial infarction (MI) was similar to that found in the population study. An investigation of the vitamin D intake by means of a dietary questionnaire revealed no differences between stone formers, healthy controls and MI survivors. Contrary to other reports, the present study indicates that the risk factor profile for CHD in stone formers is similar to that in the general population.
Maximal Bioavailability of Digoxin from Tablets and Oral Solution in Steady State
Authors: Manninen Vesa , Reissell Pentti , Ojala Kaarina
Published: August 2010

ABSTRACTComparison has been made between the absorption of digoxin from Lanoxin® tablets and the absorption of international chemical reference substance digoxin from an oral solution. Plasma levels, areas under 24‐hour plasma concentration curves and urinary excretion were similar by both formulations in steady state. 78% of the digoxin administered was absorbed from the tablets and 76% from the solution. Rapid dissolution in the intestinal fluids accounts for the high digoxin bioavailability of the tablets.
Antihypertensive Effect and Side‐effects of Bendroflumethiazide and Propranolol
Authors: Berglund Göran , Andersson Ove , Larsson Owe , Wilhelmsen Lars
Published: August 2010

ABSTRACTThe antihypertensive effect and sideeffects during 12 months' treatment with bendroflumethiazide and propranolol have been compared in two randomly selected, equally large groups (n =53) of previously untreated male hypertensives. Systolic BP above 170 or diastolic BP above 105 mmHg on two occasions were defined as hypertension. The same BP reduction was achieved in both groups. During the 12 months' treatment one subject on bendroflumethiazide developed diabetes mellitus and one on propranolol developed cardiac decompensation. None developed gout. Contrary to what had been presumed, glucose tolerance improved during 12 months' treatment with both agents, while there were no changes in fasting blood sugar, insulin or triglyceride concentrations. No changes were found in serum potassium or total body potassium during 12 months' bendroflumethiazide treatment, while serum potassium increased during treatment with propranolol. Uric acid increased slightly during treatment with both agents. Prolongation of the follow‐up to 24 months did not change any of the findings regarding metabolic changes during treatment. The frequency of subjective side‐effects decreased to the same extent during treatment with both drugs. It is concluded that bendroflumethiazide and propranolol are equally useful as antihypertensive agents and that the risk of impairment of glucose metabolism and potassium balance seems to be very slight during treatment with bendroflumethiazide in mild hypertension.
Postvaccinial Lymphadenitis Developing into Hodgkin's Disease
Authors: Bichel Jørgen
Published: August 2010

ABSTRACT In four cases, Hodgkin's disease developed after vaccination against smallpox (three cases) and diphtheria (one case). The cases are reported and may contribute to the discussion on the aetiology and nature of Hodgkin's disease.
Psychological and Social Problems Encountered in Active Treatment of Chronic Uraemia
Authors: Hirvas Juhani , Enckell Mikael , Kuhlbäck Börje , Pasternack Amos
Published: August 2010

ABSTRACT. Sixty‐four kidney donors have been interviewed by a psychiatrist and given the Rorschach test 6 months‐6 years after the transplantation. Twenty‐three of these donors were also interviewed before the operation. In addition, each case was studied in detail at a case conference. On the basis of the data thus obtained, an analysis was made of the central dynamics of the donors' personalities, of how they had experienced the donation, and of how they had adapted to it. No psychic trauma was observed in 20 of the subjects, and in 5 of these the operation had apparently had a beneficial effect on their psychic well‐being. That no trauma was observed in 8 additional donors was due largely to the effects of a multitude of other traumatic life experiences. Mild trauma had been experienced by 24 donors and moderate to severe by 12. In our study, the donation of a kidney to a sibling turned out to be more traumatic than the donation to a child, and a transplantation with an unsuccessful outcome was more often associated with psychic trauma to the donor than was a donation with a successful outcome. Psycho‐social factors that substantially lessened the likelihood of trauma were: good inner resources, flexible defence mechanisms, good mental health and mild compulsive traits. Factors that favoured traumatization were: poor living conditions, interpersonal problems, limited inner resources, low self‐esteem (narcissistic problems) and severe psychic deviancy. The results clearly show 1) that potential donors ought to be given adequate time not only to consider their decision but also to prepare themselves for the actual donation, and 2) that supportive help should be offered, both before and after transplantation, to donors whose psycho‐social profiles reveal them to be vulnerable to traumatization.
Reduction of Isoniazid Bioavailability in Normal Men by Concomitant Intake of Food
Authors: Melander A. , Danielson K. , Hanson A. , Jansson L. , Rerup C. , Scherstén B. , Thulin T. , Wåhlin E.
Published: August 2010

ABSTRACT. The influence of food intake on the bioavailability of isoniazid (INH) has been examined in nine healthy male volunteers. INH was administered as a single oral dose, both in fasting state and together with a standardized breakfast. Numerous venous blood samples were obtained 5 min‐6 hours after the INH ingestion, and the concentrations of unmetabolized INH in serum were assessed by spectrophotometry. The observations indicate that both the peak concentration and the total amount of INH absorbed are greatly reduced when the drug is ingested together with food. Hence it is recommended that, in the treatment of tuberculosis with INH, the drug should be given on an empty stomach. The data may also have some bearing on the use of INH for assessing acetylation rates and estimating dosages of hydralazine and related drugs.
Lactate Production during Fructose Infusion with or without Amino Acids
Authors: Bergström J. , Fürst P. , Gallyas F. , Hultman E. , Vinnars E.
Published: August 2010

ABSTRACT.Lactate production from the liver during fructose infusion was decreased when an amino acid infusion was given simultaneously. The most pronounced decrease was observed when the amino acid infusion was started before the simultaneous administration of fructose and amino acids. The explanation of the phenomenon is thought to be a stimulation of gluconeogenesis by amino acids.
Complication Rates of Selective Percutaneous Transfemoral Coronary Arteriography
Authors: Nitter‐Hauge S. , Enge I.
Published: August 2010

ABSTRACT. A review is presented of 1094 selective coronary artery studies during a 3‐year period in which 7001 coronary artery injections were performed using the percutaneous transfemoral artery approach as described by Judkins. A total of 24 serious complications occurred, including 11 ventricular fibrillations, 5 asystoles or severe bradycardias, 3 acute myocardial infarctions and 5 cerebral vascular accidents. There were 5 deaths, giving an overall mortality rate of 0.46%. Causes of individual complications are analyzed. The incidence of serious cardiac complications did not differ significantly from that reported in the literature with the Sones technique. The Judkins technique is a simple and reliable method for selective coronary arteriography. In our opinion, the incidence of complications can be kept at an acceptably low level by meticulous examination techniques.
Prevalence of Hypercalcaemia in a Health Screening in Stockholm
Authors: Christensson T. , Hellström K. , Wengle B. , Alveryd A. , Wikland B.
Published: August 2010

ABSTRACT. A free health check, offered to 21417 20–63‐year‐old employees of the Stockholm City and County Council in 1971‐73, was accepted by 15903 persons. The examination included a multichannel chemical analysis of a single blood sample. Serum calcium levels ≥11.0 mg/100 ml (2.75 mmol/1) and ≥11.1 mg/100 ml (2.78 mmol/l) were encountered in 3.9% and 1.1% of the population, respectively. Among subjects below 50 years of age, the calcium concentration was significantly higher in males than in females. This difference disappeared in older subjects, essentially because the calcium level decreased with advancing age in the men. To a further investigation were invited 178 subjects with a single serum calcium registration ≥11.1 mg/100 ml (2.78 mmol/l). Of this group, 95 persons (53.4%) exhibited hypercalcaemia (HC) on repeated testing. Twelve had been operated on prior to the actual follow‐up and found to have parathyroid adenomata. Twenty subjects were on continuous treatment with diuretics of the thiazide type and seven had diseases that might induce HC (two had hyperthyroidism, two hypothyroidism, one sarcoidosis, one hypernephroma and one mammary carcinoma). In 56 patients the laboratory and physical examinations did not reveal any obvious cause for the HC except possible hyperparathyroidism (HPT). Eighty (84.2%) of the 95 HC subjects were women, mostly over 50 years. The 95 persons constituted 6%‰ of the total number of health‐screened persons. The highest prevalence, 13 %‰, was recorded for women aged 60–63. The prevalence of HPT in the total material was 3.6%‰, which is higher than that found in several other studies. This is based on surgical findings to date.
Extensive Nodular Infiltration of Extra‐osseous Tissues in Human Myelomatosis
Authors: Bjørkholm M. , Holm G. , Mellstedt H. , Sjøgren A.
Published: August 2010

ABSTRACT. The autopsy findings of a woman with myelomatosis diagnosed half a year before her death are described. She had an IgG‐γ myeloma which initially responded to treatment. However, subsequently she developed a condition characterized by massive soft tissue involvement with increased number of plasma cells in peripheral blood. Rounded hard myeloma infiltrates were disseminated through the body, only sparing the adrenal glands and intracranial structures.
Prolonged Symptoms of Brain Dysfunction— Adverse Effect of Levodopa
Authors: Samuelsson Karin , Änggård Erik
Published: August 2010

ABSTRACT. Symptoms of brain dysfunction occurred in a 67‐year‐old woman with idiopathic parkinsonism on treatment with levodopa. The adverse effect reappeared in a more severe and prolonged form when she was treated one year later with levodopa in combination with the peripheral decarboxylase inhibitor Ro‐4–4602. The symptoms were associated with a markedly altered level of HMPG (a noradrenaline metabolite) in the cerebrospinal fluid.
Disopyramide in Ventricular Tachycardia
Authors: Hulting Johan , Rosenhamer Gunnar
Published: August 2010

ABSTRACT. Administration of disopyramide phosphate (DE) i.v. in two doses, 30 min apart, to a patient with ventricular tachycardia was accompanied by no, or only slight, changes in systemic arterial pressure (SAP), cardiac output (Q), stroke work (SW), and pulmonary artery diastolic pressure (PADP). Heart rate fell from 123 to 103/min. Following reversion to sinus rhythm, which occurred 60 min after the second dose of DE at a serum concentration >4.3 μg/ml, Q and SW showed significant increases above their control values. PADP fell from 20 to 6 mmHg whereas the mean SAP remained largely unchanged. There seemed to be no adverse effects of drug administration. In this patient, recurrent attacks of ventricular tachycardia not responding to conventional antiarrhythmic treatment could be prevented by oral DE in a dose of 800 mg/day.
Therapeutic Implications of Renal Transplantation in a Patient with Fabry's Disease
Authors: Van den Bergh F. A. J. T. M. , Rietra P. J. G. M. , Kolk‐Vegter A. J. , Bosch E. , Tager J. M.
Published: August 2010

ABSTRACT. In a patient with Fabry's disease who had undergone kidney transplantation to correct uremia, the neutral glycosphingolipids and α‐galac‐tosidase activity have been measured in plasma and urine and, 9 months later, after the death of the patient, in autopsy material. After transplantation, there was no significant increase in α‐galactosidase activity in plasma; the activity found never exceeded 3% of the mean control value. A striking parallelism was found during the follow‐up period in the increase and decrease of trihexosylceramide and globoside and also of glucosylceramide and dihexosylceramide. The αgalactosidase activity in spleen and liver was as low as that observed in untreated Fabry hemizygotes. These data and those obtained from autopsy material provide evidence that renal transplantation does not lead to a specific enzymic breakdown of trihexosylceramide in Fabry patients. However, no trihexosylceramide accumulation was observed in the transplanted kidney.
Hyperlipidaemia and Reduced Fibrinolytic Activity Associated with Thromboembolic Complications in a Family
Authors: Andersen P.
Published: August 2010

ABSTRACT.Although not significantly correlated, the occurrence of reduced fibrinolytic activity and capacity in hyperlipidaemics has often been described. Hyperlipidaemia and reduced fibrinolysis might well enhance the possibility of thromboembolism. Such a coincidence of risk factors has probably caused thrombotic disease in a family, as described in this case report and family investigation.
Serum Glucose Determination with Dextrostix and the Eyetone Reflectance Meter
Authors: Hornnes P. , Köhl C.
Published: August 2010

ABSTRACT. A simple, modified procedure for the Dextrostix‐Eyetone system has been evaluated in order to enable the system to measure the concentration of glucose in serum as well as in whole blood. A reduction of the ordinary time of reaction on the Dextrostix from 60 to 45 sec gave serum glucose determinations by the Dextrostix‐Eyetone system that correlated almost perfectly with those obtained by a specific conventional laboratory procedure. Thus, the coefficient of correlation was 0.99 and the regression line very close to the ideal line. As the modification is very simple and does not involve any changes in the adjustment of the instrument, it is recommendable in all cases where only serum samples are available.
Plasma Levels and Effect on Heart Rate and Blood Pressure of Metoprolol after Acute Oral Administration in 12 Geriatric Patients
Authors: Lundborg P. , Steen B.
Published: August 2010

ABSTRACT.Metoprolol, a cardioselective β‐blocking agent, has been given orally to 12 geriatric patients with moderate hypertension. Drug levels of metoprolol as well as the effect of the drug on resting heart rate and BP were studied. Metoprolol was given in a dose of 20 mg, and 8 of the 12 patients also received a 50 mg dose. After the 20 mg dose the peak drug plasma concentration varied between 5 and 80 ng/ml (mean 33), and after the 50 mg dose between 14 and 212 ng/ml (mean 111). This variation is much greater than that seen in earlier studies on healthy volunteers and on a group of non‐geriatric hypertensive patients. Plasma half‐life of metoprolol averaged about 3.5 hours after both the 20 mg and the 50 mg dose; this does not differ from the plasma half‐life in earlier studies in younger age groups. The variability observed in the study might be explained multifactorially, e.g. by different body weight, absorption and/or first‐pass effect of the drug.
The Postinfarction Clinic in Göteborg, Sweden
Authors: Vedin Anders , Wilhelmsson Claes , Tibblin Gösta , Wilhelmsen Lars
Published: August 2010

ABSTRACT. Since Jan. 1, 1968, a Postmyocardial Infarction Clinic has been operating in Göteborg, Sweden. The methods used have been presented previously in this journal. The present study compares 96 male postinfarction cases, 57–67‐year‐old, treated at the Postmyocardial Infarction Clinic and a random sample of 85 patients not treated at the clinic. The mortality did not differ between the groups but there was a significant difference with regard to non‐fatal reinfarction. The reasons for this are only partially explained by better control of accepted cardiovascular risk factors in the group treated at the clinic. Cessation of smoking was vigorously recommended but lipid lowering, antiarrhythmic or anticoagulant drugs were never used in this group. The results indicate that formalized management of homogeneous patient groups may achieve a general reduction of recurrences.
Mortality Pattern among Initial Survivors of Acute Myocardial Infarction Using a Life‐table Technique
Authors: Helmers C. , Lundman T. , Maasing R. , Wester P. O.
Published: August 2010

ABSTRACT. The 5‐year pattern of mortality among 475 immediate survivors of acute myocardial infarction (AMI) (mean age 65 years on entry) is described by a life‐table technique. The risk of death was highest during the early part of the follow‐up. After 3–4 years, the prognostic influence of the AMI seemed to be overshadowed by the age effect. Special attention was paid to the incidence of sudden death, a fictive elimination of which was shown to reduce the risk of death by 9–22% during the different years of the investigation period. The absolute number of sudden deaths was highest during the early part of the follow‐up period but the relative importance of this mode of death was approximately the same during the entire 5‐year period after the AMI.
On the Influence of Concomitant Food Intake on Sulfonamide Bioavailability
Authors: Melander A. , Wåhlin E. , Danielson K. , Rerup C.
Published: August 2010

ABSTRACT. The influence of food intake on the bioavailability of a frequently used short‐acting sulfonamide, sulfaisodimidine (Elkosin®), has been examined in eight healthy volunteers. The drug was administered as a single oral dose, both on an empty stomach and together with a standardized breakfast. Numerous venous blood samples were drawn for the first eight hours after ingestion of the drug, and the concentration of unmetabolized sulfonamide in serum was assessed by spectrophotometry. The observations indicate that concomitant food intake alters neither absorption rate, peak concentration, time to reach peak concentration, elimination rate, nor total amount of sulfonamide reaching the general circulation. Thus, the absorption of orally administered sulfaisodimidine is not at all affected by concomitant intake of food. This finding contrasts with previous observations on some other sulfonamides, and it may signify a therapeutic advantage of sulfaisodimidine. In addition, the amount absorbed showed only a little interindividual variation. This suggests that the use of standardized size and interval of sulfaisodimidine dosage can be recommended. The present findings emphasize that conclusions about the absorption of a certain drug should not be derived from studies with other, albeit chemically related, compounds.
Displacement of endocardial pacemaker electrodes
Authors: JOHANSEN J. KJERSGAARD , ANDERSEN L. HESLET , KEMP A.
Published: August 2010

ABSTRACT. The implantation of a permanent pacemaker has been carried out on 159 patients suffering from Adams‐Stokes seizures. Elema 588 B electrodes were implanted in 119 patients and Chardack 5818 electrodes in 40 patients.

The two types of electrodes differ with regard to both the implantation technique and weight and thickness. No difference was found in the incidence of electrode displacement or survival between the two groups, similarly the experience of the physician with regard to implantation had no influence on the frequency of displacement.

Displacement on the other hand occurred significantly more frequently in those patients suffering from heart disease demonstrable by x‐ray examination.
Complications of transvenous and transthoracic electrodes
Authors: KOSTIAINEN SEPPO
Published: August 2010

ABSTRACT. Electrode complications in a series of 220 patients are presented. At the primary pacemaker implantation, 114 patients received transvenous and 106 transthoracic electrodes. For the transvenous technique the Elema unipolar electrode (EMT 588 and 588 B) was used exclusively and for the transthoracic technique an epicardial disc electrode (EMT 567) was used in 64 per cent and myocardial electrodes (Vitatron MIP 125, Medtronic 5814 and 6913) in 36 per cent. The material was followed up for an average of three years (from 2 to 10 years).

The dislocation frequency of transvenous electrodes was 10.4 per cent/patient‐year, as 21 per cent of the electrodes became dislodged. Of the electrode dislocations, forty per cent occurred within the first post‐implantation month. Exit block at stimulation with transthoracic electrodes was seen in 8.1 per cent/patient‐year. Infections were more common with the transvenous than with the other types of electrodes.

The myocardial electrode was significantly (p < 0.05) more reliable than the transvenous electrode during the follow‐up evaluated in terms of uncomplicated function time of the primary electrode.

As in Helsinki both endocardial and myocardialepicardial pacemaker electrodes have been used it seems to be of interest to report the results from our pacemaker material.
Experiences with a new myocardial electrode for permanent cardiac pacing
Authors: LARSSON STURE
Published: August 2010

ABSTRACT. The first experiences with a new myocardial sutureless screw‐in electrode for cardiac pacing are reported. A brief description of the technique is given. The electrode can be inserted quickly and safely under direct vision through a small anterior thoracotomy using a special inserter tool. The heart can be brought under pacemaker control in less than 5 minutes. The technique was employed in 15 patients. Results to date are promising and it is suggested that this method should be resorted to in cases of unstable pacing or recurrent dislocation of an endocardial lead, or when there are difficulties in the proper positioning of an electrode transvenously.

In Sweden endocardial electrodes for transvenous insertion predominate. In many countries, especially the U. S. A., there is extensive experience of epior myocardial pacing leads (2, 4, 5). Some authors consider epicardial pacemakers safer than endocardial pacemakers for permanent cardiac pacing (8).

We have observed defective or unstable pacing with an endocardial electrode in a high proportion of patients in our series early after the implantation and even after many years of perfect pacing. When there are problems with an endocardial lead an epi‐ or myocardial electrode can be used. This paper reports experiences with a new sutureless myocardial electrode (Medtronic model 6917).
ARTERIAL HYPERTENSION AS A RISK FACTOR FOR ISCHEMIC HEART DISEASE IN WOMEN ‐ RESULTS FROM A RETROSPECTIVE AND FROM A PROSEPCTIVE STUDY
Authors: Bengtsson Calle
Published: August 2010

ABSTRACT. Results from retrospective and prospective studies of women in Göteborg. Sweden indicate that arterial hypertension is a risk factor for ischemic heart disease in women and of similar importance as in men.
HAEMODYNAMIC STUDIES IN YOUNG MEN WITH MILD BLOOD PRESSURE ELEVATION
Authors: Sannerstedt R. , Sivertsson R. , Lundgren Y.
Published: August 2010

Abstract. The cardiac output at rest, and the intra‐arterial blood pressure and hand blood flow at maximal vasodilation were determined in two groups of men aged 18–22 years. 44 patients were referred from a military enlistment centre because of mild blood pressure elevation, and 29 normotensive volunteers were mainly recruited from the same enlistment centre. In addition, in a majority of subjects in both groups the auscultatory blood pressure of both parents was determined.

The patients were characterized by a significantly higher cardiac index at rest, and a significantly higher vascular resistance in the hand blood vessels at maximal vasodilation than the controls, indicating the presence of structural alterations in the resistance vessels of these subjects with only very mild blood pressure elevation.

The tendency to increased vascular resistance in the hand blood vessels at maximal vasodilation was more prominent in patients with a normal cardiac index than in those with a high index. This suggests inclusion in the patient group of tense, anxious individuals with an elevated cardiac index but otherwise normal circulation, but does not exclude the possibility that these patients may develop structural vascular changes later on.

The parents blood pressure was higher in the group of patients, both for patients with a normal and those with a high cardiac index, compared to the parents of the controls.
Plasma renin activity and blood pressure during long term treatment with propranolol and diuretic.
Authors: Nielsen I. , Steiness B. , Hesse B.
Published: August 2010

Abstract. 19 primary hypertensive patients were treated in random succession with diuretic, propranolol and the combination of both. It was found that the diuretic gave a sustained increase in plasma renin activity (PRA). There was a negative correlation between PRA level attained and blood pressure reduction. Propranolo treatment gave a sustained reduction of PRA. There was no correlation between PRA reduction and blood pressure reduction. When diuretic was combined with propranolol, PRA was in average at con trol level, and there was no correlation between the PRA reduction from diuretic value to combination value and the corresponding additional blood pressure fall. It is concluded that propranolol treatment does not transform patients to “low renin hypertensives specifically sensitive to diuretic treatment.

Plasma renin as a patogenic factor in primary hypertension and a paramenter worth measuring to chose therapy has been a controversial subject, since Bühler et al. (2) found that “high renin hypertension” responded hest to propranolol treatment, and there was a significant correlatinn between fall in plasma renin activity and fall in blood pressure. Only very few investigators have been able to reproduce these findings. That plasma renin activity indeed is a blood pressure determinant was supported by Haber et al. (6), who found that normotensives only during salt depletion (with consequently high renin) responded to inhibitor to converting enzyme (impeding angiotensin II production) with blood pressure fall during orthostasis. The observations by Douglas et al. (4) that “low renin hypertensives” responded best to diuretic treatment has added evidence to the contention.

The object of the present study was to establish, whether propranolol could suppress plasma renin activity during diuretic treatment. Further to evaluate whether a possible renin suppression had made the patimt a “low renin hypertensive” with a pronounced additional blood pressure fall during combined propranolol and diuretic treatment.
1α‐Hydroxycholecalciferol in the Treatment of Hypoparathyroidism
Authors: Jørgensen H. , Vogt J. H.
Published: August 2010

ABSTRACT In two patients (father and daughter) with idiopathic hypoparathyroidism, one of whom was resistant to the action of vitamin D2 and AT‐10, lα‐hydroxycholecalciferol (lα‐(OH)D3) in doses of 2–5 μ//day restored the serum calcium concentration to the normal range. The calcemic effect of 1α‐(OH)D3 was in both patients due to an increased intestinal calcium absorption and increased calcium mobilization from bone. In one of the patients 1α‐(OH)D3 also increased the renal tubular calcium reabsorption; in the other it did not have this effect, resulting in hypercalciuria as serum calcium rose. The lack of effect on tubular calcium reabsorption probably accounts for the relative resistance to the action of lα‐(OH)D3 in this patient compared with the other.
Effects of Total Energy Withdrawal (Fasting) on the Levels of Growth Hormone, Thyrotropin, Cortisol, Adrenaline, Noradrenaline, T4, T3, and rT3 in Healthy Males
Authors: Palmblad J. , Levi L. , Burger A. , Melander A. , Westgren U. , von Schenck H. , Skude G.
Published: August 2010

ABSTRACT Ten days of total energy deprivation evoked the following endocrine changes in 12 healthy, normal‐weight males: early and marked reductions and increments in the blood levels of T3 and reverse T3, respectively, with rapid returns to pre‐starvation levels after refeeding; a slight and late decrease in the blood levels of T4; a minute reduction of the blood levels of TSH; a pronounced increase in the blood levels of growth hormone, but a return towards preexposure levels even before discontinuation of starving; a minor and gradual enhancement of the blood levels of cortisol, and an increase in nocturnal urinary adrenaline excretion. It is assumed that these changes reflect a complex regulatory mechanism, the purpose of which is to secure adequate energy supply to vital organs.
Serum and Erythrocyte Magnesium in Normal Elderly Danish People
Authors: Petersen Birte , Schroll Marianne , Christiansen Claus , Transbøl Ib
Published: August 2010

ABSTRACT Serum lipids, blood pressure, and magnesium levels in serum and erythrocytes have been measured in 73 men and women, aged 60. The purpose was to evaluate the relationship between the serum and erythrocyte magnesium and indicators of ischaemic heart disease. The results showed significant inverse correlations between serum magnesium levels and PB, and positive significant correlation between erythrocyte magnesium and serum cholesterol.
Amylase, Hepatic Enzymes and Bilirubin in Serum of Chronic Alcoholics
Authors: Skude G. , Wadstein J.
Published: August 2010

ABSTRACT The serum concentration of bilirubin and the activities of aspartate aminotransferase (ASAT, GOT), alanine aminotransferase (ALAT, GPT), γ‐glutamyltransferase (GT), total amylase and pancreatic isoamylase have been determined in serum of 182 male chronic alcoholics. Twelve per cent had abnormally high levels of bilirubin, 73% increased activity of S‐ASAT, 50% increased S‐ALAT, and 69% increased S‐GT. The highest values were often found after 5–20 years of well documented alcoholism. Some patients with alcoholism of more than 20 years' duration displayed a slight tendency towards normalization of the activities. For all parameters the scatter around the mean was greater in the patients than in the controls. Patients who had had attacks of delirium showed slightly higher S‐ASAT and S‐ALAT than other alcoholics. Determination of S‐ALAT and S‐bilirubin did not add to the cases with abnormal laboratory tests demonstrated by the combination of S‐ASAT and S‐GT. In 14 patients the above mentioned parameters were within normal limits, even though severe alcoholism had lasted for many years. Isoamylase determination disclosed 20% to have decreased activity of pancreatic isoamylases in serum, whereas only 6% had low total serum amylase activity.
Immunoglobulin Levels and Autoantibodies in Epileptics on Long‐term Anticonvulsant Therapy
Authors: Andersen P. , Mosekilde L.
Published: August 2010

ABSTRACT Serum immunoglobulin (Ig) levels and various autoantibodies have been determined in 53 epileptics treated with anticonvulsant drugs for more than 10 years and in 53 controls matched for age and sex. Aberrations in both IgG, IgA and IgM values were demonstrated. The mean IgG concentration was significantly lower in epileptics (1 217 mg/100 ml) than in controls (1 364 mg/100 ml) (p<0.05). The mean IgA value was 161 mg/100 ml in both patients and controls (F‐test, p<0.01), but abnormally low IgA values were found in 17%, and abnormally high values in 11% of the epileptics. The mean IgM concentration was 157 mg/100 ml in epileptics and 117 mg/100 ml in controls (F‐test, p<0.01). Autoantibodies were found significantly more often in epileptics (26.4%) than in controls (3.8%) (2 p<0.002). The occurrence of autoantibodies could not be related to alterations in the Ig levels. Neither was it possible to correlate the occurrence of mitochondrial antibodies, smooth muscle antibodies and antinuclear antibodies to the slightly abnormal biochemical liver parameters found in these patients. Thus, the abnormalities in Ig levels and the autoimmune phenomena observed in epileptics on long‐term anticonvulsant therapy are not intimately related.