bluuebunny/crossref_metadata_2025 huggingface dataset:
ESTIMATION OF THE SEVERITY OF AORTIC INCOMPETENCE FROM PROLONGATION OF THE LEFT VENTRICULAR EJECTION TIME
Authors: Luomanmäki Kimmo , Heikkilä Juhani
Published: August 2010

Abstract. The regurgitant fraction of the total left ventricular stroke index was estimated by a new method in 30 patients with pure aortic incompetence and compared with cineaortographic findings. The total stroke index was derived from the left ventricular ejection time, heart rate, and aortic diastolic pressure. The assumption was made that the interrelationships between the four variables in aortic incompetence are not different from those, found by others, in normal subjects at rest and during exercise. The forward stroke index was determined by Fick's method. The regurgitant fractions varied between 0 and 75% and showed a close correlation to the angiographic severity of aortic incompetence. The correlation exceeded that offered by prolongation of the ejection time alone, aortic diastolic pressure alone, or aortic pulse pressure. The method seems suitable for estimation of aortic incompetence in the absence of significant aortic valve obstruction and even in the case of failing left ventricle. It is simple to apply, as all the variables are easily determined at routine cardiac catheterization without using any additional equipment.
PLATELET PHOSPHOLIPIDS AND THEIR FUNCTION IN PATIENTS WITH ISHEMIC HEART DISEASE
Authors: Nordøy Arne , Rødset Johanne Margrete
Published: August 2010

Abstract. Platelet factor‐3 activity and availability, platelet phospholipids and their fatty acid and aldehyde composition have been examined in males with non‐acute ischemic heart disease and in a control group. Increased platelet factor‐3 activity was present in platelet‐rich but not in platelet‐poor plasma from the patients. No difference in the increase of activity after exposure of PRP to ADP, kaolin or freezing and thawing three times was observed compared with the controls. Estimated per 10° platelets, increased amounts of ethanolamine glycerides, serine phosphoglycerides, choline phosphoglycerides, sphingomyeline and total lipid phosphorus were found in the patient group. The phospholipid: protein ratio was also increased. Only small changes were observed in the fatty acid pattern of the various phospholipids. A slight decrease in palmitic acid and a slight increase in oleic acid were found in most fractions.
PRIMARY LYMPHOEDEMA COMBINED WITH HEREDITARY RECURRENT INTRAHEPATIC CHOLESTASIS
Authors: Sigstad H. , Aagenæs Ø. , Bjørn‐Hansen R. W. , Rootwelt K.
Published: August 2010

Abstract. Five related cases of primary lymphoedema combined with recurrent cholestasis are reported. The cholestasis was of intrahepatic origin with defective excretion of conjugated bilirubin, bile salts and lipids. During the cholestasis malabsorption was demonstrated and the patients were jaundiced and complained of severe itching. From prepuberty the patients developed massive oedema in the legs, enamel defects and discoloration of the teeth. Severe pathology was demonstrated by lymphangiography in the lower extremities in three of the patients. In the non‐icteric periods the biochemical parameters were normal, but the peripheral oedema persisted. Liver histology showed only slight degeneration of some of the parenchymal cells, but no progressive fibrosis. Hepatic radionuclide lymphography with colloidal 198Au was performed in one patient. No lymphatic drainage was found suggestive of changes of the lymphatics in the liver. It is proposed that disturbed lymph flow of the liver is the main aetiological factor in the production of the recurrent intrahepatic cholestasis.
POISONING WITH ETHYLENE GLYCOL MONOMETHYL ETHER
Authors: Nitter‐Hauge Sigurd
Published: August 2010

Abstract.The clinical and laboratory features of two patients with ethylene glycol monomethyl ether poisoning are presented. By accident, both patients concomitantly had ingested about 100 ml of the toxic agent. After a symptom‐free interval of 8–18 hours, they became mentally confused and complained of general weakness and nausea. In addition, a deep and frequent respiration together with a profound metabolic acidosis was found. One of the patients, in whom a marked oxaluria was demonstrated, initially had a transitory rise in the serum creatinine level. Both cases made an uneventful recovery. The similarities between the clinical picture described and that of poisoning with pure ethylene glycol and also methanol are emphasised and might support the assumption that ethylene glycol monomethyl ether is hydrolysed in man with formation of the two former compounds.
FAMILIAL LECITHIN:CHOLESTEROL ACYLTRANSFERASE DEFICIENCY
Authors: Norum Kaare R. , Børsting Sigurd , Grundt Inger
Published: August 2010

Abstract. A family with two patients, a brother and a sister, afflicted with familial lecithin:cholesterol acyltransferase deficiency is described. The patients had corneal infiltration, normochromic anemia, and proteinuria. No lecithin:cholesterol acyltransferase activity could be demonstrated in their plasma. They had high plasma concentration of unesterified cholesterol, lecithin and triglyceride, and low concentration of cholesteryl ester, which acyl groups were mainly saturated and mono‐unsaturated. Paper electrophoresis of plasma lipoproteins showed absence or highly reduced levels of α‐ and pre‐β‐lipoproteins. The erythrocytes contained increased amounts of cholesterol and lecithin, and decreased amounts of sphingomyelin and phosphatidylethanolamine. Post‐heparin lipolytic activity, tested in one of the patients, showed values within the normal range. No relevant abnormalities were found in the parents of the patients or in their only sib, a healthy female.
ALPRENOLOL IN THE TREATMENT OF ARRHYTHMIAS IN ACUTE CORONARY PATIENTS
Authors: Kreus K.‐E. , Salokannel S. J. , Isomäki H. , Waris E. K.
Published: August 2010

Abstract.Alprenolol, a beta‐receptor blocking agent with a slight intrinsic beta‐receptor stimulating effect, has been given to 15 acute coronary patients intravenously for treatment of acute arrhythmias. The results were successful in one case out of three with atrial fibrillation, in none of the three cases with ventricular tachycardia, in three cases out of four with supraventricular tachycardia, in three cases out of four with ventricular ectopic beats, and unsuccessful in the only atrial flutter case. In four cases the injection of 2.5–5.0 mg of alprenolol resulted in sudden circulatory collapse and clinical shock. In all these cases the blood pressure was readily restored with metaraminol or noradrenaline infusion without complications. It is evident that the beta‐receptor stimulating effect is not sufficient to compensate the drawbacks of beta‐blockade in this drug. Alprenolol cannot be recommended in the treatment of arrhythmias in acute coronary patients.
THYROID ANTIBODIES AND THYROGLOBULIN‐LIKE PRODUCTS IN SERUM DURING ANTITHYROID THERAPY
Authors: Hjort T. , Lauridsen U. Birk , Persson I.
Published: August 2010

Abstract. In hyperthyroidism thyroid antibodies (thyroglobulin antibody and/or microsomal antibody) have been found in 30% of 44 patients examined before treatment was started, in 22% of 41 patients treated with antithyroid drugs, and in 21% of 34 patients who had previously undergone partial thyroidectomy. In a few patients there was a rather abrupt fall in the concentration of thyroglobulin antibody during treatment with antithyroid drugs. As this might possibly have been due to a neutralization of the antibody in vivo, a number of sera which did not contain thyroglobulin antibody were investigated for circulating thyroglobulin. This investigation revealed thyroglobulin activity in the sera of 11 out of 18 patients who were receiving antithyroid drug therapy and in five out of 11 patients from whom antithyroid therapy had been withdrawn, but only in two out of 18 patients who had previously undergone partial thyroidectomy. Isolation experiments would suggest that the substance demonstrated might be genuine thyroglobulin, but—at least in some cases—with a lower iodine content than normal thyroglobulin. It is discussed whether the presence of this iodine‐poor thyroglobulin‐like protein and its breakdown products might not provide an explanation of the low PBI concentrations which are occasionally seen in patients during treatment with antithyroid drugs, once they have reached the euthyroid state.
HAEMODYNAMIC RESPONSES TO SUSTAINED HAND‐GRIP IN PATIENTS WITH HYPERTENSION
Authors: Hoel B. L. , Lorentsen E. , Lund‐Larsen P. G.
Published: August 2010

Abstract. The haemodynamic responses to sustained handgrip were studied in 15 hypertensive patients. The response pattern was found to be similar to that in normotensive subjects, and was characterized by marked increase in systolic, diastolic and mean arterial pressure, moderate increase in heart rate and cardiac output, and no change in central venous pressure, stroke volume or total peripheral resistance. Mean arterial blood pressure was found to be higher in our patients than it is in normotensive subjects during static muscular contraction, and higher than it is in hypertensive subjects during dynamic exercise.
EXOCRINE PANCREATIC FUNCTION IN PORPHYRIA CUTANEA TARDA
Authors: Dehlin Ove , Hallgren Bo , Lundvall Ove
Published: August 2010

Abstract. Pancreatic exocrine function has been studied in 18 patients with porphyria cutanea tarda by determination of trypsin concentration in duodenal aspirate after a standardized test meal. The results were compared with those obtained in a group of 22 healthy subjects and in a group of 18 chronic alcoholics without a history of pancreatic disease. There were no statistically significant differences between the means of the groups studied. Furthermore, no patient with porphyria cutanea tarda had a value below the range of the group of healthy non‐alcoholic controls. In the group of chronic alcoholics one had a value below the normal range.
SERUM FRACTIONS OF CALCIUM AND PHOSPHORUS IN URAEMIA
Authors: Weeke E. , Friis Th.
Published: August 2010

Abstract.Serum concentration of total calcium, protein‐bound calcium, complexbound calcium, ionized calcium, total inorganic phosphorus, and ultrafiltrable phosphorus has been determined in 20 normal persons and in 30 uraemic patients. A positive correlation between creatinine clearance and total serum calcium and protein‐bound calcium and a negative correlation between clearance and the relation ionized calcium/total calcium were demonstrated. The calcium binding ability of the serum proteins decreased with increasing renal failure. Concerning serum phosphorus, a negative correlation to clearance was demonstrated. The ultrafiltrable fraction was identical in normal persons and in uraemic patients expressed in percentages (88%). The ionized calcium × ultrafiltrable phosphorus product was found to be increased in uraemic subjects and negatively correlated to clearance. However, no mutual correlation between the two factors was demonstrated. Eighteen of the 30 uraemic patients had halisteresis. Fourteen of them had an elevated serum concentration of alkaline phosphatase. Of the 12 uraemic patients who did not have changes of the bones, only three had an increased level of alkaline phosphatase.
INDIVIDUAL PLASMA PHOSPHOLIPIDS IN HYPERCHOLESTEROLEMIA
Authors: Vikrot Olle , Berlin Ragnar , Oldfelt Carl Olof
Published: August 2010

Abstract. Individual phospholipids were determined in the plasma of 24 hypercholesterolemic subjects and in 13 healthy controls. In the hypercholesterolemic group total phospholipids were increased, as were the absolute amounts of lecithin and especially sphingomyelin. Expressed as percentage of total phospholipids, sphingomyelin was increased and lecithin decreased. The absolute amount of lysolecithin was unchanged and the percentage lower than normal. Phosphatidylethanolamine was not changed. The findings are compatible with an increase of beta‐lipoproteins of normal composition in hypercholesterolemia. It is speculated whether the alteration in the phospholipid pattern may be of importance for the tendency to atherosclerosis in hypercholesterolemia.
PACEMAKER SOUND DUE TO STIMULATION OF THORAX MUSCLES BY CARDIAC PACEMAKERS
Authors: Grendahl Helge , Rasmussen Knut
Published: August 2010

Abstract. Patients with pacemaker sound due to stimulation of thoracic muscles from cardiac pacemakers are described. The pacemaker sound can be recorded immediately after the pacemaker impulse. The contractions of the intercostal muscles can be recorded on an apex cardiogram. The intensity of the pacemaker sound will in different patients vary from very weak to equal to the loudest heart sound. In some patients pacemaker sound is intermittent, often related to respiration or posture. The incidence in 38 consecutive patients on unipolar endocardial pacing was 26%. Pacemaker sound may indicate current leak or electrode perforation in patients on bipolar endocardial pacing, although the pacemakers seem to function well in the majority of such patients. The disappearance of a previously permanent pacemaker sound may indicate battery exhaustion. The muscular contractions associated with pacemaker sound will be felt as unpleasant by some patients.
SERUM AND URINARY CREATINE AND CREATININE IN PARALYTIC POLIOMYELITIS
Authors: Kuhlbäck Börje , Pasternack Amos
Published: August 2010

Abstract. Serum and urinary creatine and creatinine have been studied in eight patients with paralytic poliomyelitis. The serum and urinary creatine concentrations were strikingly high, while the corresponding creatinine concentrations were extremely low. The creatine/creatinine ratio showed an obvious change in both the serum and urine as compared to normal control values. The cause of the changes observed and their clinical implications are discussed.
MEDICAL ASPECTS IN THE TREATMENT OF FEMORAL NECK FRACTURE
Authors: Julkunen Heljo , Honkonen Kirsti , Tarkkanen Leena
Published: August 2010

Abstract. The aim of the study was to discover the diseases associated with fracture of the femoral neck treated in a surgical‐orthopaedic hospital and, by systematic study, to find the complications of the conservative, surgical and anaesthesiological methods of therapy. The material consisted of 166 patients, 135 of whom were females. The mean age was 71.9 years. In 20 cases the accident had occurred in other hospitals or in nursing homes. The mean duration of hospital treatment was 32 days. Medical examination, laboratory studies, ECG and chest X‐ray were done in all cases immediately after admission and 7–10 days later or after operation. Additional diseases were found in 145 cases, the most important of which were heart failure in 72, an old myocardial infarction in 27, hypertension in 24, aortic stenosis in 21, diabetes mellitus in 16, and rheumatoid arthritis in 13. Metabolic alkalosis was found in 46. Respiratory function was measured in all cases. All patients over 60 were digitalized, and anticoagulants were given in 97 selected cases during the first week after the accident. Embolism was found in 10 cases, and pneumonia in 44 (27%). A myocardial infarction occurred during hospital treatment in 8 cases. Mortality was 9%, 7% in 150 operated cases, and 31% in the conservatively treated group. It varied in the different groups of additional diseases. Some new information for better medical therapy in cases of femoral neck fracture was obtained.
CARDIOVASCULAR EFFECTS OF GLUCAGON
Authors: Westlie Lars , Andersen Anders , Jervell Jak , Rasmussen Knut , Storstein Ole
Published: August 2010

Abstract.Glucagon, 50 μg/kg, was given as a bolus injection into the pulmonary artery to ten patients with severe heart disease. In all patients an increase in cardiac output was found, those with highest initial output increasing most. Oxygen consumption was unaltered, systemic vascular resistance decreased, potassium levels fell, whereas glucose and insulin levels rose. No effect was observed on heart rate. In four other patients the same registrations were made after infusion of 90 ml 30% glucose with 8 IU insulin. No effect on cardiac output was observed, although glucose levels increased and potassium levels fell to the same extent as after glucagon injection. In the same patients the cardiac output increased after glucagon injection. The investigation supports previous reports that glucagon might be a useful therapeutic agent in low output failure.
THE DIAGNOSTIC VALUE OF SERUM LDH ISOENZYMES AND HEAT‐STABLE AND UREA‐STABLE LDH MEASUREMENTS
Authors: Auvinen Samuli , Konttinen Aarne
Published: August 2010

Abstract. Serum heat‐stable and urea‐stable LDH measurements have been found to detect acute myocardial infarction more sensitively than the separation of LDH1 or LDH2 isoenzymes with agar gel electrophoresis. On the other hand, serum heat‐stable and urea‐stable LDH tests gave better information of myocardial damage if the serum LDH pattern was confused by simultaneous augmentations of liver‐originated LDH isoenzymes. The simple heat‐stable and urea‐stable LDH measurements thus seem to give more accurate confirmation of myocardial damage than the more complicated electrophoretic separation of LDH isoenzymes.
HAS THE PREVALENCE OF CORONARY SCLEROSIS AND CORONARY HEART DISEASE INCREASED?
Authors: Brummer Pekka , Brummer Pentti
Published: August 2010

Abstract. Evidence for the increase of coronary sclerosis and angina pectoris is lacking. On the contrary many facts contradict this. If the incidence of cardiac ruptures is used as a measure for the incidence of myocardial infarction, it is uncertain whether this has increased since the last century either.
AUTOIMMUNE HEMOLYTIC ANEMIA IN ULCERATIVE COLITIS, CURED BY COLECTOMY
Authors: Arner O. , Brohult J. , Engstedt L. , Karlson R. , Sällström T.
Published: August 2010

Abstract. A case of severe Coombs' positive hemolytic anemia in a 42‐year‐old woman with fulminant ulcerative colitis is described. Conservative treatment failed, total colectomy was performed on vital indication, and all symptoms disappeared. Coombs' test also became negative.
ACUTE MYOCARDIAL INFARCTION IN THE COPENHAGEN AREA IN NOVEMBER 1968
Authors: Haghfelt Torben
Published: August 2010

Abstract. On the basis of a study performed in Copenhagen in November 1968, an account is given of the initial course of acute myocardial infarction (a.m.i.), of the mortality rate, and of the incidence in the population of the Copenhagen area (i.e. the Copenhagen‐Frederiksberg municipalities). In that month a total of 338 cases of a.m.i. occurred, corresponding to an incidence of 0.4%. Compared with previous studies, it seems as if the incidence has been on the increase in recent years. In total, the mortality rate was 56% in this series; about 70% of the deaths occurred outside hospital, while 15% occurred in ambulances taking the patients to hospital. Among the hospitalized patients, the mortality rate was 22% for patients in coronary‐care units, 29% for patients in combined intensive‐care departments, and 39% for patients in general medical departments. About 70% of deaths occurred within the first hour following onset of the disease; about 85% occurred within 12 hours after onset. On an average, the time interval between occurrence of the first symptoms and admission of the patients was two hours if patients were taken to hospital in “emergency ambulances” without a medical officer first being called for, whereas the interval was about 10 hours if patients were admitted by medical officers and taken to hospital in an “ordinary ambulance”. The fact that it might take some time before patients called for a doctor or an ambulance when initial symptoms of acute heart disease became manifest is the main reason why this latent period was relatively protracted. The study shows beyond doubt the value of having intervals as short as possible between onset of acute attack and hospitalization of patients if the risk of a fatal outcome of a.m.i. is to be avoided; the findings also support the idea of having a mobile coronary‐care unit introduced in Copenhagen.
BENEFITS OBTAINED BY THE INTRODUCTION OF A CORONARY‐CARE UNIT
Authors: Christiansen Ib , Iversen Kurt , Skouby Arne P.
Published: August 2010

Abstract. During the period Nov. 24, 1967, to Dec. 31, 1968, a prospective study was performed, comparing the mortality among patients with acute myocardial infarction treated in a coronary‐care unit and patients treated in departments of general medicine. All patients suspected of having acute myocardial infarction were accepted, without any limitation, in the coronary‐care unit if a bed with monitoring apparatus was unoccupied. If the four monitored beds were occupied, the patients were admitted direct to one of the other two departments of general medicine of the same hospital, serving as control departments. A total of 328 patients were admitted to the coronary‐care unit and 484 to the control departments as suspected of acute myocardial infarction. In accordance with firmly established criteria, the diagnosis could be confirmed in about 50% of the cases in both groups, viz. in 171 patients in the coronary‐care unit and in 244 in the control departments. The two groups were comparable in respect to the majority of important parameters, but there was a preponderance of patients with obesity. congestive heart failure, short duration of symptoms, and anterior‐wall infarctions in the coronary‐care unit group. The overall mortality in the coronary‐care unit group was 17.6% as compared with 41.4% in the control group. Within the various age groups the mortality was consistently lower in the coronary‐care group. It is concluded that the better results obtained in the coronarycare unit seem to be due to a selective, individualized prophylaxis based upon intensive observation, early detection and treatment of arrhythmias, and a schedule for slow reduction of drug therapy under close observation to detect the slightest signs of relapse.
FOUR CASES OF MASSIVE DIGITALIS POISONING
Authors: Asplund J. , Edhag O. , Mogensen L. , Nyquist O. , Orinius E. , Sjögren A.
Published: August 2010

Abstract. Four cases of massive digitalis poisoning are described. One of the patients died. Potentially fatal arrhythmias were seen in all four cases. Failing response to conventional drug therapy was observed. Pacemaker treatment was applied in three cases and defibrillation in the fourth. Three of the four cases were thus successfully treated. The value of handling these patients in a unit capable of providing intensive cardiac care is underlined. The role of hyperkalemia in digitalis poisoning, its prognostic significance and position in the therapeutic discussion is ventilated.
REATMENT OF ANGINA PECTORIS WITH BETA‐RECEPTOR BLOCKING AGENTS
Authors: Björntorp Per
Published: August 2010

Abstract. Nine patients with angina pectoris had been treated between two and three years with the beta blocking agent alprenolol when they agreed to withdrawal of treatment and introduction of a double‐blind cross‐over trial with placebo. All had more attacks on placebo than on alprenolol. Six patients had no attacks on alprenolol, but angina pectoris returned when they were on placebo. The same nine patients, one year later, compared the ordinary tablet of alprenolol (100 mg × 4) and sustained release tablets (200 mg × 2). No significant difference was found in frequency of attacks of angina pectoris or in subjective ranking of these two drugs. It is concluded that β‐receptor blockade as treatment of angina pectoris cannot be withdrawn even after a long period of treatment. Furthermore, the sustained release tablets were effective against angina pectoris, because they showed no difference from alprenolol in ordinary tablet form, and the latter were much more effective than placebo in the same patients.
METHOXAMINE INJECTIONS IN THE DIAGNOSIS OF MITRAL INSUFFICIENCY DURING ROUTINE RIGHT HEART CATHETERIZATIONS
Authors: Grendahl Helge , Abrahamsen Arne M. , Müller Carsten
Published: August 2010

Abstract.The effect of methoxamine on PCV pressure has been examined in 47 cases (24 with mitral valvular disease, 2 with aortic insufficiency, 12 with congenital heart disease, and 9 with no organic heart disease). The rise in v‐peak pressure related to the elevation in systemic arterial pressure (Δv/ΔA ratio) after methoxamine injection was measured. The ratio usually was higher in patients with mitral insufficiency than in other cases, but a marked overlapping was seen between the different patient groups. The methoxamine test during routine cardiac catheterization is therefore of limited value in the diagnosis of mitral insufficiency. A marked bradycardia was seen after methoxamine infusions in most cases. Four patients had transient conduction disturbances, but no serious complications were encountered. The effect of methoxamine on cardiac output was recorded in 13 cases. Methoxamine did not influence cardiac output significantly.
FIBRINOLYTIC ACTIVITY IN HEMIPLEGIC PATIENTS
Authors: Karaca Mustafa , Nilsson Inga Marie
Published: August 2010

Abstract. The fibrinolytic activity after venous occlusion of the arms and the legs for 20 min has been studied in 19 patients with hemiplegia. The patients were divided into three groups according to degree of mobilization. In normals the fibrinolytic activity induced by venous occlusion is markedly higher (4 to 6 times) in the arms than in the legs. A marked fibrinolytic activity developed after venous occlusion of the arms in all but one of the patients. In contrast with normals, the patients confined to bed had almost the same fibrinolytic activity in the legs as in the arms, while in patients who were partly mobilized the activity of the legs, compared with that of the arms, decreased with increasing degree of mobilization. No difference was found between paralysed and non‐paralysed arms and legs. The lower local fibrinolytic activity after venous occlusion of the legs, compared with that of the arms in normals, may therefore be due to emptying of the activator from the vessel wall, as a consequence of the habitually vertical position of human beings, a position favouring venous stasis.
ACUTE ERYTHRAEMIA (DI GUGLIELMO'S SYNDROME) AFTER THOROTRAST INJECTION
Authors: Bastrup‐Madsen Poul , Nielsen Kai , Mose C. B.
Published: August 2010

Abstract. Fifteen years after an injection of thorotrast a typical acute Di Guglielmo erythraemia developed in a man aged 65 years. Death occurred a few months after the onset of the initial symptoms. Autoradiography revealed signs of alpha radiation in the liver and spleen. The role of thorium dioxide in the aetiology of the disease is discussed.
CYTOLOGICAL IDENTIFICATION OF PRIMARY HEPATIC CARCINOMA CELLS
Authors: Ekelund Paul , Wasastjerna Curt
Published: August 2010

Abstract. Cytological specimens obtained by fine‐needle puncture from the liver of 3 patients with primary hepatic carcinoma and 12 patients with liver metastases of various tumours have been stained for the demonstration of naphthylamidase (N‐ase) and by the MGG method. The N‐ase staining method has earlier been shown to stain bile canaliculi in cytological liver preparations. In cases of primary hepatic carcinoma, bile canaliculi or canalicular fragments were recognisable among the tumour cells in preparations stained for N‐ase. In two cases of bile duct carcinoma the tumour cells showed a granular cytoplasmic reaction when stained for N‐ase. In the remaining cases the tumour cells were N‐ase‐negative. Consequently, staining for the demonstration of N‐ase seems quite helpful when interpreting cytological liver preparations from patients suffering from neoplastic disease of the liver.
EFFECT OF LB 46, A NEW BETA‐ADRENERGIC ANTAGONIST, IN HYPERTHYROIDISM
Authors: Runeberg Lars , Kreus K.‐E.
Published: August 2010

Abstract. The effect of oral administration of a single dose of 5 mg (6 patients) and 10 mg (6 patients) of LB 46 (Sandoz Ltd., Basel), a new β‐adrenergic antagonist, or placebo (3 patients), on the heart rate and blood pressure at rest and during exercise on a bicycle ergometer has been studied in patients with untreated hyperthyroidism. The two doses had essentially similar effects and decreased the heart rate by about 20% both at rest and during work. There was a marked increase in the calculated physical working capacity at 170 heart beats/min (PWC170) but no significant change in the actual physical working capacity. There was a slight but statistically insignificant decrease in blood pressure. Five mg of LB 46 was given every 8 h for 1 to 3 weeks without any other medication, and the exercise test was then repeated with essentially similar results. Two patients developed transient disturbances of cardiac rhythm during ergometry after 10 mg of LB 46, but all the patients did well during the subsequent continuous administration of the drug. It is concluded that LB 46 is effective in decreasing tachycardia in hyperthyroidism and, mainly in this way, it increases the PWC170.
BETA‐ADRENERGIC BLOCKADE IN THE TREATMENT OF LEFT‐SIDED HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY (HOCM)
Authors: Rookmaker W. A. , Nieveen J. , Kruizinga K. , Blickman J. R.
Published: August 2010

Abstract. The surgical treatment of left‐sided HOCM is difficult and disappointing. Favourable results of treatment of this disease with beta‐adrenergic blocking drugs have been reported. Therefore the effects on left ventricular haemodynamics of acute and/or long‐term treatment with a beta‐adrenergic blocking drug were studied in eight patients. In some patients only a minor decrease of the left ventriculo‐aortic pressure gradient was found. From these results we concluded that long‐term administration of propranolol in patients with HOCM is of no practical use. One patient, who had been operated upon earlier and was also submitted to the experiments, as hardly any improvement took place after the operation, did improve on treatment with propranolol. From these experiments it was concluded that operation is still the treatment of choice for this disease, bearing in mind however that HOCM is a diffuse myocardiopathy. Treatment with propranolol after operation might improve the effect of operative therapy.
ON COAGULATION AND FIBRINOLYSIS IN URAEMIC PATIENTS ON MAINTENANCE HAEMODIALYSIS
Authors: Larsson Sten Olle
Published: August 2010

Abstract. Twenty cases of chronic uraemia, on maintenance haemodialysis, have been examined in respect of their coagulation and fibrinolytic status immediately before, 18 and 42 hours after a routine haemodialysis (mean duration 6.4 hours). In two of the cases the same determinations were made also after a prolonged (10 hours) dialysis. The examinations before dialysis showed, as in conservatively treated cases, a prolonged Ivy bleeding time, increased content of factor VIII, P & P and fibrinogen, low fibrinolytic activity and increased content of inhibitors of plasminogen activation in high frequency. After dialysis one fourth of the cases showed transient shortening of the bleeding time, and about half of the cases an increase of factor VIII, fibrinogen and inhibitors of plasminogen activation, while the low fibrinolytic activity remained unchanged. The platelet adhesiveness, which was primarily low in five cases, increased in four. In both of the two cases treated with dialysis for 10 hours the Ivy bleeding time was normal 18 hours after dialysis. It is concluded that the presence of haemorrhagic diathesis in uraemia indicates an intensification of treatment with haemodialysis and that the tendency to clotting in certain cases with an external shunt is probably due largely to local endothelial damage, with release of thromboplastic substances, in combination with the generally low fibrinolytic activity in uraemia.
CLINICAL EXPERIENCE WITH DETERMINATION OF FIBRINOGEN DEGRADATION PRODUCTS
Authors: Hedner Ulla , Nilsson Inga Marie
Published: August 2010

Abstract.Sera from 3 075 patients with various diseases and urine from 75 of them have been examined for fibrinogen degradation products (FDP) by the quantitative immunochemical method of Niléhn. Such products were found inserumin cancer (61%), chronic renal disease (37%), acute renal disease (78%), shock due to sepsis (100%) or postoperative bleedings (100%), acute stage of thromboembolism (72%) and in the acute stage of collagen diseases (38%). In patients with toxemia or hepatosis or other complications of pregnancy FDP were found in 61% and 81% respectively. FDP were found in theurinein almost the same frequency as in the serum in chronic renal disease (urine 39%, serum 37%) and in acute renal disease (urine 57%, serum 78%). FDP in serum were rarely found in liver diseases (< 25 %) and in the chronic stage of thromboembolism (3%). Uncomplicated hemorrhage did not seem to result in any FDP. These findings appear to warrant the conclusion that repeated demonstration of FDP by our method indicates the presence of some disease requiring further investigation, and secondly that the method might prove a useful diagnostic screening tool.
ANALYSIS OF ERRORS IN ELECTRONIC BLOOD CELL COUNTING
Authors: Talstad Ingebrigt
Published: August 2010

Abstract. The present work is based on the use of purified blood cells in analysing possible errors in electronic counting. In counting of erythrocytes, no great errors occurred. In counting of platelets a primary diluting fluid prepared from Isopaque® was found useful to obtain constant separation and to avoid correction for hematocrit. In counting of leucocytes the composition of the diluting fluid was essential; saponin caused complete hemolysis and reduced the interference from platelets. A new method was used for calibrating the electronic particle counter, which simplified the technique and reduced the interference from other cells.
THE MECHANISM OF THE ERYTHROCYTE SEDIMENTATION RATE (ESR)
Authors: Talstad Ingebrigt
Published: August 2010

Abstract. The relation between the erythrocyte sedimentation rate (ESR) and aggregation has been studied by applying different aggregating substances. In normal autologous plasma the ESR increased with the cell concentration due to increased rouleaux formation reaching a maximum size of ESR. At high cell concentrations the ESR was retarded, probably due to formation of a network of rouleaux, which may explain the remarkably small normal ESR. The elevated ESR and the shape of the ESR curves were found to depend on the aggregating capacity present in the fluid, which determines the formation of “clumps of rouleaux” and adhesions between such clumps.
BLOOD LACTATE AND KETONE BODIES IN DIABETIC KETOACIDOSIS
Authors: Strandgaard Svend , Nielsen Poul Ebbe , Bitsch Vibeke , Lyngsøe Jens
Published: August 2010

Abstract. Arterial blood lactate, pyruvate, plasma β‐hydroxybutyrate and acetone have been followed in 12 patients with diabetic ketoacidosis during the initial 24‐hour treatment period. In all cases the acidosis was fully explained by the accumulation of ketone bodies, and blood lactate and pyruvate never exceeded normal values. A slight rise was, however, observed in blood lactate in some patients during the treatment. Some possible explanations of this phenomenon are discussed. β‐hydroxybutyrate was cleared from the plasma much faster than acetone, and the ratio between the ketone bodies was constantly changing during treatment of the acidosis.
THE INFLUENCE OF DIETARY FATS ON PLATELETS IN MAN
Authors: Nordøy Arne , Rødset Johanne Margrete
Published: August 2010

Abstract. Two groups, each of 10 subjects, have been given isocaloric diets for 21 days. The diets were identical with the exception of their fat content. One group was given 40% of the calories as soybean oil, and the other the same amount as MCT oil. Platelet and serum lipids and platelet function tests were evaluated before and after the dietary period. The platelet lipid analysis included estimation of total cholesterol and phospholipids, fractionation of phospholipids by thin layer chromatography and gas liquid chromatographic estimation of the fatty acid and aldehyde composition of the various phospholipids. Platelet function tests included platelet factor‐3 (PF‐3) activity and availability, platelet aggregation induced by collagen, ADP and thrombin and platelet electrophoresis. In subjects given a soybean oil diet a significant reduction in serum total cholesterol and phospholipids occurred. No changes were observed in the platelet cholesterol and phospholipid levels, whereas a significant increase of linoleic acid in choline, ethanolamine and serine phosphoglycerides took place. The relative increase of linoleic acid was most marked in the choline phosphoglycerides. A moderate decrease in palmitic and oleic acids was seen in most phospholipid fractions. PF‐3 activity in platelet‐rich plasma showed a consistent decrease in these subjects, whereas the other platelet function tests showed insignificant changes. In subjects given MCT oil diet no significant changes were observed in serum or platelet lipids, including the phospholipid fatty acids. Increased PF‐3 activity in platelet‐rich plasma exposed to ADP was the only functional disturbance observed in this group.
IMMUNOGLOBULIN STUDIES IN GASTROINTESTINAL DYSFUNCTION WITH SPECIAL REFERENCE TO IgA DEFICIENCY
Authors: Bjernulf A. , Johansson S. G. O. , Parrow A.
Published: August 2010

Abstract. The concentrations of the five immunoglobulins G, A, M, D and E have been studied in 34 adults with gastrointestinal dysfunction. Four patients lacked detectable amounts of IgA as determined by gel precipitation methods. The mean levels of the other four immunoglobulins were practically normal. It is doubtful whether there is any relation between IgA deficiency and gastrointestinal dysfunction.
THE PERIPHERAL NERVE FUNCTION IN CHRONIC RENAL FAILURE
Authors: Nielsen V. Kamp
Published: August 2010

Abstract. A material consisting of 109 patients with chronic renal failure has been examined for the presence of clinical symptoms and signs indicating a peripheral neuropathy. Symptoms were reported by 84 patients (77%). Cramps and the restless legs syndrome were reported most frequently. However, several clinical observations raised doubt whether these symptoms do at all reflect a peripheral neuropathy. Paresthesia (31%) and dysesthesia (18%) were the most common sensory symptoms, whereas actual pain and the burning feet syndrome were rare complaints. Clinical signs of a neuropathy were recorded in 56 patients (51%). This came close to the over‐all incidence in previously reported materials. Impaired vibration sense and reflex disturbances were the earliest and the most frequent findings. As a rule other signs occurred late in the course of chronic renal failure, and they were late manifestations of neuropathy as well.
THE PERIPHERAL NERVE FUNCTION IN CHRONIC RENAL FAILURE
Authors: Nielsen V. Kamp , Winkel P.
Published: August 2010

Abstract. A material of 109 patients with varying degrees of chronic renal failure has been divided into two groups according to the presence (56 patients) or absence (53 patients) of clinical signs of neuropathy. A relationship between the primary renal diseases and neuropathy could not be demonstrated either in females or males. In both groups the two sexes were comparable with respect to age, renal function, and degree of azotemia. There was a significant predominance of males among patients with neuropathy. A multivariate discriminant analysis comprising age, creatinine clearance, serum creatinine and urea, and serum sodium and potassium levels, failed to demonstrate any significant difference between females with and without neuropathy. In male patients a significant difference was present. The creatinine clearance and the age were ranked as the most significant discriminating variates. The combined use of all six variates did not improve the discriminative effectiveness, but the creatinine clearance could be replaced by the serum creatinine concentration. It is concluded that the biological variates, sex and age greatly influence the breakthrough of clinical signs of neuropathy at any given degree of renal failure.
MECHANICAL FRAGILITY OF ERYTHROCYTES IN NORMALS AND IN PATIENTS WITH HEART VALVE PROSTHESES
Authors: Dale Jon , Myhre Erik
Published: August 2010

Abstract. Hemolysis following insertion of heart ball valves shows great individual differences. Besides the mechanical properties of the prosthetic valves, individual variations in the mechanical fragility (MF) of the erythrocytes might be important in this respect. The MF has been studied with the hemoresistometer of Fleisch and Fleisch, which exposes the cells to a standardized trauma by rotation of the blood in a cylindrical chamber. The MF is defined as the amount of heme liberated. A normal material is presented, and the error of the method and the normal variation of the MF are estimated, using two different rotors. The hemoresistometer seems to be a valuable tool for evaluation of the MF, offering several advantages compared to other methods. Reference has been made to a material of nine consecutive patients with heart valve disease examined before and after prosthetic ball valve implantation. All had a normal MF before the operation, and the mean MF remained normal in spite of moderate intravascular hemolysis developing in all but one patient postoperatively. In four patients with valve prostheses readmitted for hemolytic anemia the plasma heme concentrations were markedly increased, but the MF was normal. The question whether a lowered MF may be the cause of the severe intravascular hemolysis developed by some patients remains unsettled, but the present study suggests that individual differences in MF are of minor importance for the development of severe hemolytic anemia in these patients.
POST‐GAMMA PROTEIN IN URINARY PROTEIN
Authors: Hansen Niels Ebbe , Karle Hans , Axelsen Nils Holger
Published: August 2010

Abstract. In an examination of 3 200 urinary proteins a postgamma fraction has been found in 13 patients. These patients constituted two groups, one with leukemias of the myeloid (acute or chronic) or monocytic types (8 patients), and one with nephropathies (5 patients). Eight patients were reexamined with simultaneous urinary protein paper electrophoresis and urinary muramidase (lysozyme) determinations. In four of these patients both post‐gamma protein and elevated urinary muramidase activity were found, muramidase activity being localized to the post‐gamma fraction. In the remaining four patients neither post‐gamma protein nor grossly elevated muramidase activity could be demonstrated (probably attributable to treatment). The appearance of post‐gamma protein in urinary protein paper electrophoresis is thus a rare occurrence, should prompt examination for muramidase activity, and may indicate either leukemia of the myeloid or monocytic type and/or nephropathy.
LIPOLYSIS AND GLUCOSE TOLERANCE IN OBESE SUBJECTS DURING PROLONGED STARVATION
Authors: Kjellberg Jan , Östman Jan
Published: August 2010

Abstract. Parameters reflecting the rate of synthesis and breakdown of triglycerides have been studied in subcutaneous adipose tissue removed under local anesthesia from eight subjects submitted to prolonged fasting in the treatment of obesity. The fasting period varied from 12 to 30 days and the mean daily loss of weight was approximately 0.5 kg. Sections of subcutaneous adipose tissue were incubated in albumin containing glucose‐free Krebs‐Henseleit bicarbonate buffer and in plasma obtained from the donor at the time of biopsy. Adipose tissue removed after fasting liberated glycerol into both types of medium twice as rapidly as tissue obtained before the fasting period. From the data on the uptake of radioactive palmitate and the re‐esterification of FFA in tissue incubated in plasma, it can be assumed that the synthesis of triglycerides was rather well preserved during prolonged fasting. In spite of the increased lipolysis in subcutaneous adipose tissue in vitro, the plasma levels of FFA and glycerol at the time of the biopsies were almost the same before and during fasting. In a separate series of investigations, in which five obese subjects were submitted to one week's fasting, it was shown that the maximal glycerol production in subcutaneous adipose tissue exposed to isopropylnoradrenaline, dibutyrylcAMP and theophylline was the same before the start and at the end of this period. These findings indicate that the lipase activity and the response to beta‐adrenergic agonism of adipose tissue were unchanged by one week's fasting. In contrast, noradrenaline had a definite antilipolytic effect at the end of the fasting period. Addition of the α‐adrenergic blocking agent phentolamine to noradrenaline‐containing medium resulted in a glycerol release similar to those evoked by dibutyrylc‐AMP and the other lipolytic agents used. Therefore, it may be assumed that the α‐effect of noradrenaline, which inhibits lipolysis, is more pronounced in adipose tissue removed after prolonged fasting. For three subjects who initially had low k‐values (≤0.90% min), as well as for three additional subjects with normal k‐values before the fasting, the intravenous glucose tolerance increased with fasting. This improvement of the glucose tolerance could be explained by an increased peripheral utilization of glucose resulting from either higher sensitivity of peripheral tissue to insulin or from increased availability of insulin for tissues more sensitive to insulin than adipose tissue. The fall in plasma FFA and glycerol after glucose loading was less pronounced following fasting, an observation consistent with previous findings of decreased insulin secretion in the fasting state, although other mechanisms might coexist.
LEFT‐TO‐RIGHT SHUNT IN ATRIAL SEPTAL DEFECT AT REST AND DURING EXERCISE
Authors: Bay Gunnar , Abrahamsen Arne M. , Müller Carsten
Published: August 2010

Abstract.The pulmonary and systemic flow has been calculated at rest and during exercise in 16 patients with atrial septal defects. In 14 of these patients there was a normal pulmonary arterial pressure at rest. Remarkably many of the patients showed only a slight increase in the systemic flow during exercise. The pulmonary flow increased during exercise in most of the patients. The absolute left‐to‐right shunt fell in 5 patients, was unchanged in 1 and moderately increased in 10 patients. No correlation was found between the magnitude of the shunt and the variation in the pulmonary blood flow during exercise. The pulmonary flow ratio decreased in all patients except 3 during exercise.
AZATHIOPRINE (IMUREL®) THERAPY IN CROHN'S DISEASE
Authors: Fausa Olav , Gjone Egil
Published: August 2010

Abstract. Nine patients with Crohn's disease have been treated with azathioprine for periods ranging from 3 1/2 to 12 months. The majority of them had postoperative recurrences, and all had extensive lesions. Treatment was followed by improvement in seven patients. Healing of fistulae occurred in two of three cases. It is suggested that azathioprine may be useful in treatment of selected cases of Crohn's disease.
A CONTROLLED STUDY OF PERORAL GLUCOSE, INSULIN AND POTASSIUM TREATMENT IN MYOCARDIAL INFARCTION
Authors: Hjermann Ingvar
Published: August 2010

Abstract. A double blind trial has been carried out in order to evaluate the possible effect of peroral glucose/ potassium and insulin treatment in patients with acute myocardial infarction. One hundred and two and 96 patients were allocated to the treatment and control groups respectively, and treated for ten days. There was a statistically significant difference in arrhythmias and conduction disturbances in favour of the treated group, whereas the mortality in the treatment group was not significantly lowered. An effect of the treatment in patients with previous myocardial infarction was also noted.