bluuebunny/crossref_metadata_2025 huggingface dataset:
Spectral Imaging Microscopy Can Define Hyperchromasia in Small Lymphoid Cells
Authors: McNutt N.S. , Levenson R.M. , Peters S.B.
Published: August 2010

Spectral Imaging Microscopy (SIM) is a technique for performing image‐enabled spectroscopic analysis using a standard light microscope. We employed a prototype to a current, commercially available, spectral imaging system (NuanceTM, CRI, Inc.) that electro‐optically selects narrow bands of light to be collected by a cooled, monochrome CCD camera. For each sample, images were taken every 10 nm from 420 nm to 720 nm to create a spectral image “stack.” Analysis of the images with a prototype to the Nuance TM Analyze software (CRI, Inc.) gave both standard color (RGB) and spectral information at each pixel of the images. A representative 40x field was spectrally imaged from H&E slides of 104 biopsy specimens of mycosis fungoides (MF). Optical densities and spectral properties of small lymphocytes were determined. Hyperchromatic cells were pseudocolored to show their distribution. In addition to the important architectural features of MF, SIM can define whether hyperchromatic or normochromatic small lymphocytes are epidermotropic in the lesion by setting appropriate threshold values. Hyperchromasia can be attributed to increased nuclear eosinophilia or basophilia. These differences are difficult to estimate by eye. Since lymphoblasts have enlarged nuclei with dispersed chromatin, a combination of spectral and spatial data is required for their analysis.
Porokeratosis‐like Changes in Chondrodermatitis Nodularis Helicis:Consequence or Coincidence?
Authors: Page R.N. , King R. , Googe P.B.
Published: August 2010

Background:  Chondrodermatitis nodularis helicis (CNH) is a condition with known predisposing factors, but of unknown etiology. A variety of opinions exist as to the cause of this condition, without consensus. Design: We reviewed 111 cases of CNH from 103 patients at our laboratory. p53 immunohistochemical staining, which is over expressed in basilar epidermal cells of porokeratosis, was performed in a representative sample of CNH cases. Histologic changes characteristic of porokeratosis were qualified as a 1) parakeratotic column of keratinocytes 2) an attenuated to absent granular layer, and 3) adjacent or underlying dyskeratosis of keratinocytes, present in columns or aggregates. Results: Porokeratosis‐like changes were identified in 77 of 111 cases. p53 staining was noncontributory. Conclusion: The presence of these porokeratosis‐like changes in 69% of cases is intriguing. It is not clear whether or not this could possibly represent a causative mechanism or, perhaps, an otherwise coincident histologic change. The presence of porokeratosis‐like changes in CNH provides a possible hypothesis in relationship to its etiology, at the very least, it could provide some histologic clue as to the presence of this deep dermal process in superficial biopsies.
Multifocal Infantile Fibromatosis
Authors: Pham T. , Madden J. , Selim M.A. , Herman C.
Published: August 2010

Infantile fibromatosis (IF) is an uncommon childhood disorder characterized by solitary or muticentric tumors involving skeletal muscle, skin, bones, or viscera. There is a wide morphologic spectrum reflecting various stages of fibroblastic differentiation. We present the clinical and histopathologic findings of a rare case of IF. A seven month old female presented with firm masses over the right elbow (2 × 3 cm.) and right distal clavicle (3 × 4 cm.). Magnetic resonance imaging demonstrated increased T2 signal within the soft tissues of the right axilla, supraclavicular region, and distal humerus. However, there was no evidence for bony involvement. Incisional biopsy of the supraclavicular mass showed a white fibrous grossly appearing tumor. Histologic examination revealed clusters of adipocytes and infiltration of skeletal muscle fibers by a moderately cellular proliferation of ovoid within a fibrous background. There was no atypia, necrosis, or increased mitotic activity. The tumor cells showed diffuse immunoreactivity for vimentin and weak focal positivity for smooth muscle actin. No reactivity was seen with S100. In addition, none of the tumor cells exhibited nuclear estrogen receptor expression by image cytometry. This case is reported in an effort to better define the clinical and histopathologic features of infantile fibromatosis.
Laminin‐5 Expression in Melanocytic Lesions of the Skin
Authors: Ramirez J.A. , Diaz L.K. , Guitart J.
Published: August 2010

Background: Laminin‐5 is a basement membrane constituent that functions as an anchoring filament to integrin‐derived hemidesmosomes, and has been detected at the invasive front (tumor‐stromal interface) in many types of carcinomas. Our goal was to analyze laminin‐5 expression in melanocytic lesions and evaluate its role in tumor progression. Design: Immunohistochemical staining for laminin‐5 was performed on 101 cutaneous melanocytic lesions including 41 nevi, 31 primary melanomas, and 29 metastatic melanomas. A standard immunoperoxidase technique (ABC) was used with DAB chromagen and a primary monoclonal antibody to the laminin‐5 gamma2 chain (clone D4B5, 1:50, Chemicon International, Temecula, CA). Any degree of staining in melanoma cells or at the tumor‐stromal interface was considered positive. Results: Positive staining for laminin‐5 was observed in three of the primary melanomas (10.7%), three of the metastatic melanomas (10.3%), and none of the nevi. In primary melanomas, staining was observed predominately at the tumor‐stromal interface. In metastatic lesions, staining was observed around individual melanoma cells and melanoma cell nests.Conclusion: Expression of laminin‐5 was detected in a small percentage of primary and metastatic melanomas and in none of the nevi studied. Laminin‐5 expression does not appear to be essential for the development of melanomas or their metastases.
The Role of Ki‐67 in Predicting Prognosis of Malignant Melanoma of the Vulva
Authors: Reutter JC , Hoang M , Vollmer RT , Groben PA , Thomas DB , Selim MA
Published: August 2010

Background: Malignant melanoma of the vulva (MMV) accounts for 2% of all melanomas in women with 5‐year survival rate of 47%. Lymph node involvement predicts survival in these patients. Ki‐67 expression has been correlated with lymph node status in cutaneous melanomas. The aim of this study was to evaluate whether Ki‐67 correlates with lymph node metastasis in MMV. Methods: Histomorphology and clinical information of 25 MMV were reviewed. The database was divided in MMV with metastasis (M+) and without lymph node metastasis (M‐). A MMV subset was stained for Ki‐67 and scored as a percentage (7 patients M+ and 9 patients M‐). Results: The age range was 36–88 years‐old (mean 63 years‐old). The tumor thickness mean was 3.14 mm. The mean Ki‐67 expression was 23% for M‐ and 42.5% for M+(p = 0.07). Correlation of tumor thickness and Ki‐67 expression also has a p value of 0.07. Logistic regression analysis was obtained.Conclusions: This study shows that Ki‐67 expression is associated with lymph node metastasis in MMV. However, when Ki‐67 expression is compared to a classic prognostic indicator such as tumor thickness, it appears to have little or no additional predictive value. Larger studies are needed to confirm these results.
Akt/PKB and Melanocytic Proliferations
Authors: Robbins Jason B. , Boyd Alan S. , Ellis Darrel L. , Nanney Lillian , Richmond Ann
Published: August 2010

Distinguishing among the various melanocytic proliferations remains one of the biggest challenges in dermatopathology. New insights into tumor proliferation may lead to the discovery of helpful immunohistochemical markers. Akt/PKB is a serine/threonine kinase which is a core component of the PI3K signalling pathway. Activation of Akt is seen in many human cancers. This study evaluated Akt activation (phospho‐Akt) by immunohistochemistry on 18 intradermal nevi, 8 dysplastic nevi, 9 Spitz nevi, and 27 melanomas. Immunostaining was graded 0 (no staining), 1 (slightly positive), 2 (moderately positive), and 3 (highly positive). The mean immunostaining scores were as follows: intradermal nevi 1.16, dysplastic nevi 1.25, Spitz nevi 2.11, and melanomas 2.15. Spitz nevi exhibited significant pAkt immunoreactivity. Increased pAkt immunoreactivity is seen in melanomas and Spitz nevi as compared to benign intradermal nevi and dysplastic nevi.
Bulls‐Eye Cutaneous Infarct of Zygomycosis
Authors: Rubin A. , Grossman M. , Rabinowitz A.
Published: August 2010

A seventy‐year‐old woman with a history of chronic lymphocytic leukemia was admitted to the hospital for change in mental status. She had a splenectomy five years prior to admission. The white blood cell count was 154,000 cells/microliter with 95% lymphocytes and 4% neutrophils. Blood cultures grew Salmonella enteritidis and Candida krusei. She developed a wrist lesion at the site of a previous arterial line. The lesion had a striking resemblance to a bulls‐eye, with three distinct concentric zones. A bedside touch preparation rapidly processed with Periodic Acid Schiff staining demonstrated a single intact aseptate broad hypha. Punch biopsy specimens demonstrated broad, aseptate hyphae throughout the dermis and subcutis invading both blood vessels and interstitum. A skin biopsy specimen sent for fungal culture grew Rhizopus arrhizus. Cutaneous zygomycosis is a rare, devastating disease that can occur in both immunocompromised and immunocompetent hosts. This case illustrates a distinct morphology, which we have coined the “bulls‐eye infarct of cutaneous zygomycosis”. Recognition of this unique appearance allows a rapid bedside diagnosis of this life threatening infection. To our knowledge, this morphology has been reported only twice in the medical literature.
Cutaneous Necrotizing Sarcoidosis
Authors: Spoonemore K. , Neil Crowson A. , Cornelison R.
Published: August 2010

A 33‐year‐old African American woman presented with a 2 year history of skin lesions on her legs. Skin biopsy demonstrated interstitial and focally confluent reticular dermal histiocytic infiltrate consistent with granuloma annulare. She was treated with high‐potency topical steroids and returned 14 months later with diffuse papular lesions, 80 lb. weight loss, and dyspnea. Repeat skin biopsy showed similar distribution of interstitial and sheet‐like histiocytopathy, accompanied by fibrinoid necrosis, cell‐poor lymphocytic interface dermatitis and thrombogenic vasculopathy. Stains for fungi (AB – PAS and GMS) and mycobacterial species (Ziehl‐Neelsen, Fite and auramine‐rhodamine immunofluorescence) were negative. No foreign material was evident under polarized light. A diagnosis of cutaneous necrotizing sarcoidosis was made. Necrotizing sarcoidosis is a well‐recognized pulmonary entity, but is rarely reported in the skin. Diagnostic features include granulomata with regional necrosis, often with a granulomatous vasculitis, in the absence of demonstrable microbial pathogens. Patients are typically adult women who present with pulmonary symptoms, fever, weight loss and fatigue. The etiology of sarcoidosis remains obscure. One proposed mechanism is an id reaction to an as yet unidentified pathogen, with circulating microbial antigens leading to an occlusive and infarctive vasculopathy. Such a mechanism could explain the pathologic changes seen with our patient.
Nodular Vascultitis in Association with Primary Biliary Cirrhosis
Authors: Winfield H. , Rosenberg A. , Smoller B.
Published: August 2010

BACKGROUND: Nodular vasculitis is a disorder that can be associated with several disease states, including infection, medications, malignancy, and collagen vascular disorders. The pathogenesis is unknown, but may be related to immune complex deposition, leading to subsequent vascular damage. METHODS: We report a case of nodular vasculitis occurring in a 40‐year‐old African‐American woman with end‐stage liver disease and a 3 month history of ulcerating lesions on her lower extremities. Although these lesions were both clinically and histologically consistent with erythema indratum, all studies directed at determining a mycobacterial etiology were negative. RESULTS: Biopsy of the skin lesions revealed a neutrophil‐predominant vasculitis in the setting of a lobular panniculitis. The histopathology of the liver biopsies, and the patient’s clinical course were consistent with auto‐immune cholangitis. A course of oral prednisone was initiated, which resulted in improvement of the lower extremity lesions. CONCLUSION: In this case report we document a case of nodular vasculitis occurring in the setting of auto‐immune cholangitis. The pathogenesis of this condition remains obscure, however possible causes include immune complex deposition or a delayed‐type hypersensitivity reaction.
Einige Erfahrungen betreffs Schicks Reaktion
Authors: HUSS R. , ÖSTLING K.
Published: August 2010

Wir haben durch unsere Untersuchungen die allgemein gewonnene Erfahrung bestätigen können, dass die Anzahl Schickpositiver am grössten während der ersten Lebensjahre ist, um dann allmählich abzunehmen, im Anfang rascher, danach langsamer. Der Umstand, dass eine Diphtherieepidemie den Untersuchungen vorausgegangen ist, scheint die Proportion Schickpositiver in verschiedenen Altersgruppen nur in der Weise beeinflusst zu haben, dass eine deutliche Abnahme der Anzahl Schick‐positiver in der Altersgruppe hat beobachtet werden können, die das Durchschnittsalter der Erkrankten umfasst.

Es hat sich gezeigt, dass die Anzahl Schickpositiver unter gesunden Bazillenträgern relativ niedriger ist als unter den übrigen nicht erkrankten Personen.

Die Berechtigung, die Pseudoreaktion als eine allergische Reaktion aufzufassen, wird durch unsere Beobachtungen bestätigt, da sie hauptsächlich bei älteren Personen vorkommt und frequenter unter denjenigen ist, die Diphtherie gehabt haben, als unter den übrigen.

Die mit Schicks Reaktion gewonnenen Resultate haben uns die Möglichkeit gegeben, zu beurteilen, ob die Epidemie durch eine Milchinfektion bedingt gewesen ist, und endgültig zu entscheiden, dass das nicht der Fall hat sein können. Eine positive Antwort auf die Frage nach der Verbreitungsweise hat dagegen auf diesem Wege nicht erhalten werden können.
Nouvelle orientation sur la gymnastique médicale(hygiénique)1
Authors: FABER ARNE
Published: August 2010

Entre les traitements de maladie est le massage employé un peu trop et la gymnastique médicale (hygiénique) trop peu.

Par nouvelle orientation dans la gymnastique médicale c'est possible d'obtenir plus d'effet dansle traitement. Par »les exercices avec résistance» et les exercices avec résistance par soiměme (»auto‐tension») = Selbsthemmungsübungen) nous avons des remédes techniques bonnes.

Une revue historique et physiologique dans la question est ici présentée.
2. Report: Clinical Experiences as to Dietary Diseases and Dietetic By‐effects.
Authors: Hanssen O.
Published: August 2010

(Not submitted for publication.)
Spontane Diurese
Authors: GERRITZEN F.
Published: August 2010

Ausgehend von der Hypothese Forsgrens, dass die Leber eine rhythmische Funktion mit abwechselnder Assimilation und Dissimilation habe, hat Verfasser Dieses an 42 gesunden Versuchspersonen 50 Belastungsproben angestellt, die bezweckten zu untcrsuchen, ob diese rhythmische Leberfunktion in der Diurese erkennbar werde, wenn die Flussigkeitszufuhr konstant gehalten wird.

Diese Versuche haben ausser 3 Ausnahmeii alle 24 Stunden gedauert; 6 wahrten 48 Stunden, wahrend bei 2 Versuchspersonen die Probe 60 Stunden durchgefiihrt wurde.

Als Hesultat ist hervorzuheben, dass sich ein deutlicher Unterschied zwischen den Perioden von 1–13 Uhr und 14–24 Uhr vorfindet.

In der ersten Periode ist die Harnmenge entschieden grösser als in der zweiten, was eine ungezwungene Deutung in der Forsgrenschen Hypothese findet. während die Versuchsergebnisse wieder diese Hypothese stutzen.

Als Erklärung sind weder Wasserbilanz, Körperhakung, zeiten, Schlaf, Fehler noch Temperatur oder klimatische Fak anzunehmen, während die Schwankungen nicht mit Verändegen des Blutdruckes in Zusammenhang stchen.

Diese sponfane Diurese ist in erster Linie von der rhythmischen Leberfunktion bedingt und zeigt eine überraschende Übereinstimmung mit dem 24Stunden‐Blutzuokergehaltverlauf bei Diabetes.

Verfasser Dieses ist genötigt, eine Hyperinsulinämie in der Periode von 7‐9‐9 Uhr bis 14 Uhr auch bei gesunden Personen anzunehmen.
Das Wesen der essentiellen renalen Glykosurie und ihre Beziehung zum Diabetes mellitus, unter besonderer Berücksichtigung der Erblichkeitsfrage.
Authors: SCHNELL ANNEMARIE
Published: August 2010

1. Der Begriff des Diabetes renalis tritt in der Literatur in zweifacher Form auf:

Einmal bezeichnet man damit sämtliche Glykosurien, die nicht oder nicht restlos aus einer bestehenden Hyperglykämie erklärt werden können.

Zum andern versteht man darunter eine besondere, erbliche Anomalie, bei der ohne ersichtliche Ursache zeitweise oder ständig Glukose durch die Nieren ausgeschieden wird.

2. Diese beiden Begriffe können nicht auf einen Nenner gebracht werden.

3. Der Diabetes renalis im engeren Sinne hat einen dominant mendelnden Vererbungsgang.

4. Der Diabetes mellitus vererbt sich recessiv mendelnd, wie am eigenen Material und der vorhandenen Literatur nachgewiesen werden konnte.

5. Irgend ein Zusammenhang zwischen den beiden Melliturien kann auf Grund des verschiedenen Vererbungsgangs nicht angenommen werden, insbesondere wegen der grossen Seltenheit der dominant mendelnden renalen Glykosurie im Vergleich zur Häufigkeit des recessiven Diabetes mellitus.
Ein Beitrag zu der Frage, ob Ascorbinsäure im Überschuss beim Menschen Pellagra auslösen kann
Authors: ALWALL NILS
Published: August 2010

In der Literatur wird ein Fall mitgeteilt, bei welcheni im Anschluss an Behandlung mit Ascorbinsäure »im Überschuss» dermatitische Veränderungen vom Typus einer Pellagra auftraten.

In der vorliegenden Arbeit wird ein Fall mit den klassischen Symptomen der Pellagra beschrieben.

Nachdem die Pellagrasymptome durch Nikotinsäurebehandlung zum Weichen gebracht worden waren, bekam die Patientin 62 Tage lang durchschnittlich über 1.6 g Ascorbinsäure pro Tag, d. i. eine viermal so grosse Dosis während viermal so langer Zeit, wie bei dem besagten, im Schrifttum referierten Falle. Trotzdem die Patientin sich in der Sonne aufhielt und schliesslich auch mit Quarzlicht behandelt wurde, traten weder während noch nach der Behandlung Symptome von Pellagra auf.

Das Ergebnis stützt also nicht die Annahme, dass Ascorbinsaure, auch in sehr grossen Dosen und während langer Zeit verabreicht, Pellagra hcrvorrufen könne.
Über den Glykogengehalt des Blutes
Authors: BRUMMER PEKKA
Published: August 2010

Als Zusammenfassung des Obigen kann festgestellt werden, dass der Glykogengehalt im Blut der Gesunden sehr niedrig ist und auf nur ein paar mg % steigt. Nach Zuckerbelastung und Insulin‐injektion können in den Glykogenwerten des Blutes keine Veränderungen festgestellt werden, ebensowenig in nennenswertem Masse im Zusammenhang mit dem Diabetes, so dass dem Glykogen des Blutes offenbar keine Bedeutung im Kohlehydratstoffwechsel zukommt. Gesteigerte Glykogenwerte wurden in Material eigentlich nur bei Pneumonie besonders bei kroupöser, festgestellt. Der Verfasser ist jedoch der Ansicht, dass dieser Anstieg mit grosser Wahrscheinlichkeit nicht auf der Erhöhung des Glykogengehaltes, sondern möglicherweise auf den Bakterienpolysacchariden beruht.
EFFECT OF A NEW ADRENERGIC β‐BLOCKING AGENT, H 56/28, ON NERVOUS HEART COMPLAINTS
Authors: Nordenfelt I. , Persson S. , Redfors A.
Published: August 2010

AbstractThe effect of a new adrenergic β‐receptor blocking agent H 56/28 has been studied in fourteen patients with nervous heart complaints, mainly palpitations. Organic heart disease and hyperthyroidism were excluded. The investigation was performed as a double blind test. During a first treatment period half of the patients received H 56/28 and the other half placebo‐tablets; during the second period the treatment was reversed. The patients were also studied during repeated exercise tests. The heart rate during exercise was significantly reduced by H 56/28 and there was also a slight, though not significant, decrease of the systolic blood pressure. In addition to the immediate effect, H 56/28 treatment seemed to have a more prolonged lowering effect on the heart rate. No side effects of the drug worth mentioning were seen. All but three patients preferred H 56/28 to placebo. The β‐blocker was especially effective in relieving palpitations. It is concluded that β‐blocking agents might be of value in treating patients with nervous heart complaints.
AN EVALUATION OF DC SHOCK TREATMENT OF ATRIAL ARRHYTHMIAS
Authors: Bjerkelund Christopher , Orning Otto M.
Published: August 2010

Abstract A total of 1098 DC shocks were given in 572 attempts at reversion of permanent atrial arrhythmias in 437 patients. Of these, 348 (80%) reverted to sinus rhythm during the first attempt.

Complications of the DC shock itself were infrequent. Ventricular arrhythmias and bradycardia occurred, usually of short duration. Eight patients developed ventricular fibrillation, and in one instance the episode was dramatic. Digitalis toxicity disposed patients to some of the ventricular arrhythmias. No deaths, considered due to the DC shock, were observed.

Thirteen patients (3%) developed an embolic episode 6 hours‐6 days after reversion. Only two of these were among the 228 patients who were on anticoagulant therapy, as against 11 among the 209 who were not. Quinidine syncope, caused by ventricular fibrillation, was observed in eight patients.

The 290 patients first treated were followed up after the first attempt at reversion until relapse of the atrial arrhythmia or for a minimum of two years. After this period, 23% of the patients treated were in sinus rhythm. The sinus rhythm attained was most stable in the patients with operated mitral stenosis, atrial septal defect and thyrotoxicosis that received treatment. The stability gradually decreased with increasing duration of the preceding arrhythmia, but was little influenced by the heart size and even less by functional classification. Good long‐term results were obtained in individual patients with all etiological and anatomical types of heart disease.

Simple criteria can hardly be given for selection of patients who will benefit from reversion of atrial arrhythmia; and careful evaluation of the individual patient is required.
PROPRANOLOL (INDERAL) IN THE LONG TERM PROPHYLAXIS OF VENTRICULAR ARRHYTHMIAS
Authors: Wennevold Alf , Sandøe Erik
Published: August 2010

Abstract The results of prophylactic treatment for more than 2 1/2 years with propranolol in four patients with attacks of ventricular tachyarrhythmia are reported. Two of the patients are children.

Good results were obtained in three of the patients, who lead a satisfactory life with no or rare attacks of tachycardia. In one patient the treatment has only decreased the frequency of the severe attacks somewhat.

The growth and development of the two children have been normal. In one patient more pronounced bradycardia with drowsiness has been encountered, as well as symptomless thrombocytopenia. In another patient the medical treatment had to be supplemented by a pacemaker.
THE LATE CARDIAC PROGNOSIS AFTER ACUTE CARBON MONOXIDE INTOXICATION
Authors: Orinius E.
Published: August 2010

Abstract A follow‐up study of 23 hospitalized cases of acute carbon monoxide poisoning showed, 2–23 years after the event, ECG changes in five cases to be the only abnormal cardiologic finding.
THE GROWTH HORMONE DEPENDENT SULFATION FACTOR IN SERUM FROM PATIENTS WITH VARIOUS TYPES OF DIABETES
Authors: Yde Hans
Published: August 2010

Abstract The growth hormone dependent sulfation factor is low in serum from diabetics. There is no difference between the values obtained from obese and non‐obese diabetics. Nor is there any difference between the values obtained from recently diagnosed, untreated cases and long‐term diabetics with severe diabetic angiopathy. In non‐obese, untreated diabetics a negative correlation obtains between the fasting serum sulfation factor and the serum glucose. One hour after ingestion of glucose the sulfation factor falls. In obese diabetics no correlation was observed between serum sulfation factor and serum glucose.
MALIGNANT LYMPHOGRANULOMATOSIS AND ANTICONVULSANT THERAPY
Authors: Rausing Alf , Trell Erik
Published: August 2010

Abstract. A case is described of a woman who, after three years of diphenylhydantoin therapy because of epilepsia, developed a rapidly lethal condition which at autopsy proved to have the histopathological picture of malignant lymphogranulomatosis. Reticulum cell hyperplasia of the type which has been described as a complication of hydantoin therapy was also present. Malignant lymphoma in a few patients receiving diphenylhydantoin medication has been described earlier. This is the first such case in which microscopically verified malignant changes in liver, spleen and bone marrow have been reported.
URINARY PROTEINS AND PLASMA RENIN ACTIVITY DURING TOTAL STARVATION
Authors: Kjellberg Jan , Piscator Magnus , Castenfors Jan
Published: August 2010

Abstract. Fifteen overweight patients, aged 19–65 years, have been treated by total starvation for 2–9 weeks. In six patients urinary protein patterns of tubular type were found as shown by paper electrophoresis and gel filtration, accompanied by increased excretion of ribonuclease. In two cases, followed weekly, potassium substitution therapy normalized the tubular patterns. The results indicate that starvation induces a reversible tubular protein‐uria, probably secondary to potassium deficit. Plasma renin activity in the three patients studied showed varying changes during and increased values after the starvation period in two of them.
THE CONCENTRATION OF 21 SERUM PROTEINS IN NORMAL CHILDREN AND ADULTS
Authors: Weeke B. , Krasilnikoff P. A.
Published: August 2010

Abstract By means of Laurell quantitative immunoelectrophoresis albumin, IgG, IgA and IgM have been examined in 258 sera from normal children and adults, while a further 17 serum proteins have been determined in 208 of these sera. In comparison with the adults, the children showed lower mean concentrations of pre‐albumin, α1‐lipoprotein, α1‐antitrypsin, easily precipitable glycoprotein, α1‐antichymotrypsin, Gc protein, haptoglobin, hemopexin, β‐lipoprotein, IgG, IgA and IgM, and higher concentrations of ceruloplasmin, α2‐macroglobulin, pseudocholinesterase, complement C'3 and transferrin. Furthermore several proteins showed higher variations of values in comparison with adults. The indication of normal ranges separately for children and adults is therefore necessary. During shorter or longer periods of life, men showed a higher concentration than women in respect of prealbumin, albumin, ceruloplasmin, β‐lipoprotein, transferrin and IgA and, vice versa, a higher concentration was found in women for α1‐lipoprotein, α1‐antitrypsin, ceruloplasmin, α2‐macroglobulin, pseudocholinesterase, hemopexin and IgM. In these periods of life normal ranges for the mentioned proteins should therefore be used for either sex. The variation of the proteins according to sex throughout life is evaluated on the basis of the present knowledge of their function in the organism.
THE CALCIUM INFUSION TEST IN PRIMARY HYPERPARATHYROIDISM
Authors: Mosekilde L. , Andersen P.
Published: August 2010

Abstract The calcium infusion test as described by Kyle et al. (10), which involves measurement of forenoon phosphate clearance before and after a calcium infusion, has been performed in 10 patients with primary hyperparathyroidism (PHP), 4 with non‐parathyroid hypercalcemia and in 12 control patients together with 11 patients with other diseases (kidney stone, peptic dyspepsia, and normocalcemic sarcoidosis). The fall in phosphate clearance (F%) indicated the degree to which the parathyroid glands could be suppressed. F% did not completely differentiate patients with PHP from normocalcemic patients because of a marked overlap. Only values less than 10% were indicative of PHP. In patients with non‐parathyroid hypercalcemia a low F% was also found and was dependent upon the degree of hypercalcemia. In normocalcemic patients F% was found to be dependent upon the increase in serum calcium concentration which could be achieved during infusion. This correlation was not found in patients with PHP. No relationship was found between the degree of adenoma activity, expressed by the serum calcium concentration, and F%. Whether forenoon phosphate clearance was suited as a criterion for differential diagnosis of PHP was also studied. This did not appear to be the case.
CYTOSTATIC TREATMENT OF GLOMERULAR DISEASES
Authors: Balsløv J. T. , Brun C. , Jensen K. Birger , Jørgensen F. , Jørgensen H. E. , Larsen M. , Lorenzen I. , Thomsen Å. Chr.
Published: August 2010

Abstract Forty‐six patients with chronic glomerular diseases have been treated with azathioprine for up to 84 months. The importance of the variables sex, age, clinical diagnosis, histological glomerular changes, arterial hypertension, treatment with prednisone and initial values of serum creatinine and proteinuria was investigated. In 22 patients the renal state as estimated by serum creatinine, proteinuria and urinary sediment was normalized or improved. The renal state was unchanged in 9 patients and deteriorated in 12. The clinical diagnoses glomerulonephritis and idiopathic nephrotic syndrome, normal arterial BP and normal initial serum creatinine concentration were correlated to the improvement. Five of 26 patients deteriorated after withdrawal of azathioprine. Eighteen patients died during the study, 7 from uremia, 2 from side‐effects of the cytostatic treatment and 9 from other diseases. Initial serum creatinine concentration was the only variable correlated to survival.
CYTOSTATIC TREATMENT OF GLOMERULAR DISEASES
Authors: Balsløv J. T. , Brun C. , Jensen K. Birger , Jørgensen F. , Jørgensen H. E. , Larsen M. , Lorenzen I. , Thomsen Å. Chr.
Published: August 2010

Abstract Urine and serum proteins have been determined by the Mancini technique in 33 patients with histologically verified glomerular diseases subjected to 12 months' treatment with azathioprine. A statistically significant decrease in the urinary excretion of albumin, IgG, IgA and transferrin was demonstrated during the treatment period. The excretion of α2‐macroglobulin and IgM was often zero or trace. Correspondingly, increases of serum concentrations of albumin, transferrin and IgG were observed. Also decreases in clearance of albumin, IgG and IgA were demonstrated. The level of selectivity index before treatment could not be correlated significantly to various clinical characteristics, but the histological subgroups showed statistically significant differences. Patients with the highest selectivity generally responded best to the cytostatic treatment. During treatment certain subgroups showed increasing selectivity. This applied to patients treated with prednisone, patients without hypertension and those with membranoproliferative glomerular lesions. IgA was the protein fraction showing the greatest number of significant correlations between excretion or clearance and clinical or histological diagnosis. However, the differentiated examinations of the excretion of plasma proteins gave little more information concerning the result of treatment than did total proteinuria.
PYURIA: DEPOSIT IN HIGH‐POWER MICROSCOPIC FIELD—WBC/HPF—VERSUS WBC/mm3 IN COUNTING CHAMBER.
Authors: Alwall Nils
Published: August 2010

Abstract. The methodological study with a defined technique presented in this paper gave the result that the number of WBC/HPF in the sediment corresponded to approximately 11% of the number of cells/mm3 in the sample. The correlation appears to be satisfactory. Thus the criterion of >4 WBC/HPF for pyuria corresponds to roughly >40 cells/mm3 under the methodological conditions obtaining here.
HEMODYNAMIC CHANGES AT REST AND DURING EXERCISE IN LONG‐TERM β‐BLOCKER THERAPY OF ESSENTIAL HYPERTENSION
Authors: Lund‐Johansen Per
Published: August 2010

Abstract. In 10 men with untreated early essential hypertension oxygen consumption and central hemodynamics have been studied before and after one year on alprenolol, 400–800 mg daily. The most important changes (at rest and during exercise) induced by therapy were: marked reduction in heart rate and cardiac index, moderate reduction in arterial blood pressure and no change or increase in calculated total peripheral resistance. No subject demonstrated an unequivocal change in hemodynamic pattern towards reduction in total peripheral resistance without decrease in cardiac output.
THE INTRAVENOUS FAT TOLERANCE TEST IN SUBJECTS WITH MASSIVE OBESITY
Authors: Rössner S. , Backman L. , Hallberg D.
Published: August 2010

Abstract. The i.v. fat tolerance test (IVFTT), in which the elimination rate of the fat emulsion Intralipid® is determined, has been performed in 60 patients with massive obesity. These patients were compared with a control group of matched subjects of normal weight with the same plasma TG concentrations. The hyperbolic correlations which were found between the plasma TG concentration and the IVFTT value did not differ between the two groups. The IVFTT value was correlated rather to the plasma TG value than to total body weight. The IVFTT values were higher in women of both groups. Twenty‐three obese patients were studied with IVFTT before and after a jejuno‐ileal bypass operation. Concomitant with a mean weight reduction from 129 to 104 kg, plasma TG was significantly reduced from 1.92 to 1.40 mmol/l. The IVFTT value rose significantly from 3.99 to 5.83 %/ min. However in the individual cases the pattern was highly variable, as some patients lost weight considerably without major effects on the IVFTT value, whereas others had a marked fall of plasma TG and rise of IVFTT value concomitant with a very moderate weight loss. The results suggest that the reduced IVFTT values in massive obesity are of the same order as seen in primary hyper‐lipidaemia and that the removal sites for the Intralipid® emulsion are not proportionate to the amount of adipose tissue. Other factors than weight loss, such as changes of blood flow in the splanchnic region, could possibly account for the increased IVFTT values after jejuno‐ileal bypass operations.
Hypothyroidism with Subacute Pseudomyotonia – an Early Form of Hoffmann's Syndrome?
Authors: Cronstedt Jean , Carling Lasse , Östberg Henrik
Published: August 2010

Abstract. A 25‐year‐old man was admitted to the hospital because of painful muscle cramps and action myospasms of subacute onset and of 6 weeks' duration. No myotonia could be demonstrated objectively and his deep tendon reflexes showed no prolongation of the relaxation phase. Serum creatinine was raised but creatinine clearance was normal. Serum levels of aldolase, CPK, ASAT and ALAT were increased but ordinary light microscopy revealed no histological signs of muscle disease in a quadriceps biopsy. ECG showed a prolonged PQ interval and flat T waves in the left precordial leads. Laboratory tests of thyroid function revealed intensive hypothyroidism, and high titers of circulating thyroid antibodies were demonstrated. During 21/2 months of thyroid therapy, the muscle symptoms gradually disappeared completely and the patient could return to work. By that time the serum enzymes and the ECG had normalized. Despite the lack of objective signs of myotonia, we consider that the very dominant subjective muscle symptoms, severe enough to prevent the patient from performing his ordinary manual work and completely reversible on thyroid therapy, justify the designation of hypothyroid myopathy. The question is raised whether the case represents an early form of Hoffmann's syndrome.
Pyoderma Gangrenosum Associated with Regional Enteritis
Authors: Brandt L. , Gärtner I. , Nilsson P. G. , Olofsson T.
Published: August 2010

ABSTRACT A defective uptake of oxygen by peripheral blood granulocytes during phagocytosis, indicating a subnormal phagocytic capacity, has been found in a patient with regional enteritis complicated by pyoderma gangrenosum (PG). During administration of clofazimine the granulocyte function normalized and the skin lesions healed. It is possible that a defective granulocyte function may sometimes be involved in the pathogenesis of PG and that a clofazimine‐induced improvement in the function will favour healing of the lesions. The result of treatment in our patient and in other cases recently published indicates that the drug may be worth trying in PG.
Membrane Filtration in Microscopical Examination of Urinary Sediment
Authors: Iversen B. M. , Andersen K.‐J. , Willassen Y. , Ofstad J.
Published: August 2010

ABSTRACT Microscopical examination of the urinary sediment has been performed after membrane filtration and after routine centrifugation, and the results were compared. Various quantities of urine were filtered through a membrane with pore size of 3 μm, stained with Shorr stain and made translucent with xylol. All granular and cellular casts were counted on a trimmed membrane, 15times20 mm. The routine centrifugation was carried out on 10 ml urine at 1500 rpm for 3 min. Among 11 patients with glomerulonephrits and recurrent hematuria, casts were found in 9 after filtration but in only 2 after routine centrifugation. Casts were detected by the filter method in the urine after angiography of the kidneys in 8 of 12 patients, after centrifugation in only one of them. No casts were found in 6 patients with hematuria due to urological disorders and in 21 healthy persons. The diagnostic sensitivity of microscopical examination of urine was greatly increased by the filter method. This may be due to larger amount of urine examined by the filter method, but an additional cause may be that routine centrifugation destroys red cell casts.
ECG Aberrations, Latent Coronary Heart Disease and Cardiopulmonary Fitness in Various Age Groups of Norwegian Cross‐Country Skiers
Authors: Lie Håkon , Erikssen Jan
Published: August 2010

ABSTRACT. To assess the prevalence of possible, latent coronary heart disease (CHD) among physically active men, 149 elite cross‐country skiers in three age groups (26–33, 43–50 and 58–44 years) were invited for an examination which included clinical examination, Vitalogram, resting ECG, and a near maximal bicycle test. Of the invited men, 122 participated, i.e. 81.8%. The following findings were made: Normal clinical findings in all except 2, low resting heart rate, lung function parameters of about normal mean; voltage signs of left ventricular hypertrophy in resting ECG in 61/122, incomplete right bundle branch block in 14/122, codable Q waves (Minnesota Code, MC) in 5/87 from the highest age groups, ischaemic exercise ECG changes of MC 4.1 or 4.2 types in 11/87 vs. 1/35 in the two oldest vs. the youngest age group. Physical performance was very high in all age groups, but regular training did not seem to inhibit the normal age‐dependent decline in physical performance. The resting and exercise ECG data in the two oldest age groups did not differ favourably from similar data obtained in sedentary men of the same age from approximately the same geographic area. Thus, it is possible that regular strenuous exercise and training may not protect against the development of CHD. The implications of such a view are briefly discussed.
Peripheral Neuropathy in Monoclonal Gammapathy with Cryoglobulinemia and Arteritis
Authors: Häggblom O. , von Schéele C.
Published: August 2010

ABSTRACT. We report a patient with IgM gammapathy, cryoglobulinemia, Raynaud's phenomena, purpura hyperglobulinemica of the legs and polyneuropathy. Endoneural vasculitis with infiltrations of eosinophilic and neutrophilic granulocytes and an extensive loss or Wallerian degeneration of myelinated nerve fibers were seen on histopathologic examination of a sural nerve biopsy specimen. The microscopic picture differed somewhat from that observed previously in cryoglobulinemic vasculitis. Although vasculitis is most often believed to represent an immunologically mediated lesion, we propose an alternate explanation, namely, that the disease manifestations in the present case were secondary to cold‐induced effects of the cryoglobulin on the microcirculation.
Small Cell Carcinoma of the Lung: Relation of Calcitonin to Bone Marrow Metastases, Parathormone and Gastrin
Authors: Hansen Mogens , Rehfeld Jens F. , Stadil Flemming
Published: August 2010

ABSTRACT The relations of calcitonin concentrations to the presence of bone marrow metastases and to the concentrations of calcium, parathormone and gastrin in serum were investigated in 74 untreated patients with small cell carcinoma of the lung. Calcitonin concentrations were enhanced in two thirds of the patients, while serum calcium concentrations were normal in all. In 19 of 57 patients parathormone concentrations were slightly above the normal range, but the concentrations of parathormone and calcitonin were not correlated. Bone marrow metastases had no influence on the concentration of serum calcitonin. Finally, a small inverse correlation between the concentrations of gastrin and calcitonin in serum was observed. The results resemble those of the calcitonin‐producing medullary carcinoma of the thyroid, supporting the suggestion of an ectopic source of hypercalcitoninemia in small cell carcinoma of the lung.
The Relationship between Marginal Bone Loss and Serum Zinc Levels
Authors: Frithiof L. , Lavstedt S. , Eklund G. , Söderberg U. , Skårberg K. O. , Blomqvist J. , Åsman B. , Eriksson W.
Published: August 2010

ABSTRACT. Serum was analyzed for zinc in 51 patients of varying age and with varying degrees of alveolar bone loss as recorded on roentgenograms. There was a reversed correlation between marginal alveolar bone loss and serum zinc levels. The observations are discussed in relation to the physiological functions of zinc.
Hypokalemia—Clinical Spectrum and Etiology
Authors: Steen Bertil
Published: August 2010

This paper is intended to give a review of the etiology and symptoms of potassium deficiency in man, as an introduction to the section on potassium and cardiac arrhythmias of this symposium. A review is given of different conditions where hypokalemia and /or total potassium deficiency is or might be part of the clinical picture, such as conditions with insufficient dietary intake, gastrointestinal potassium losses (e.g. vomiting, fistulas, malabsorption, abuse of laxatives and diarrhea), and renal potassium losses (e.g. primary and secondary hyperaldosteronism, Cushing's syndrome, intake of licorice, diabetic coma, renal disease, diuretic treatment and l‐dopa treatment). Common symptoms of hypokalemia and/or potassium deficiency are reviewed as well, such as general and unspecific symptoms (e.g. tiredness, lack of concentration, lack of appetite and vomiting), and symptoms from the heart, kidneys and skeletal muscle.
NATURAL HISTORY OF MYOCARDIAL INFARCTION ‐ RELEVANCE FOR SECONDARY PREVENTION
Authors: Julian D. G.
Published: August 2010

Numerous variables have been identified as having prognostic value after infarction. The significance of each of these depends both on the time after the event when the observation is made and the length of follow‐up. Although much prognostic information has been published, its validity is difficult to establish because the criteria for infarction have seldom been stated, the effect of treatment has been ignored and the case material has been either ill‐defined or atypical.

Most of the most powerful predictors of medium and long‐term prognosis are not susceptible to correction, e.g. age, previous myocardial infarction, cardiomegaly, enzyme levels, intraventricular conduction defects and indices of left ventricular dysfunction. Others, e.g. «warning arrhythmias» may be treatable but there is, as yet, no evidence that suppressing them improves prognosis.

The most clinically relevant prognostic factors are those which are of relatively high predictive value but are potentially correctable. These include smoking, hypertension, diabetes, life‐threatening arrhythmias, and exercise‐induced ischaemia, as manifested by angina and ST changes.

Secondary prevention is most likely to be successful if appropriate approaches are aimed at specific subsets. Thus, beta‐blockade, anti‐arrhythmic therapy, platelet active agents, and surgery may each be beneficial in different although possibly overlapping sub‐sets. Even if it is shown that any one of these forms of therapy produces a statistical benefit when given to the whole post‐infarct population, it does not follow that it should be given to all members of such a population.
Post Exercise T Wave Changes in Patients with Normal and Abnormal Coronary Arteriogram
Authors: Forssell Gunilla , Jonasson Rune , Landou Christian , Orinius Erik
Published: August 2010

ABSTRACT. The pre‐ and postexercise ECGs of those with normal (n=15) and those with abnormal (n=66) coronary arteriogram (diameter reduction ≥50% regarded as significant) were compared in a series of 81 patients with effort angina. ECGs with other known causes of ST‐T changes had been excluded. The ECGs 2 and 4 min after a bicycle exercise test were studied for an abnormal ST reaction, and the change in the T wave amplitude in lead V2 from before to 2 min after exercise was measured when there was no q wave, QS complex or negative T at rest in this lead. None of the 15 patients in the normal arteriogram group had abnormal ST reaction post exercise and 1 of 13 evaluable ECGs showed a reduction of T in V2 ≥20%. In the abnormal arteriogram group, 37 of the 66 patients had an abnormal reaction and 17 of the remaining 26 evaluable ECGs showed a reduction of T in V2 ≥20%. The sensitivity of an abnormal ST reaction for significant coronary obstructions was 56% at a specificity of 100%. Addition of an alternative criterion of a reduction of the T amplitude in lead V2 ≥20% from before to 2 min post exercise increased the sensitivity to 82% and decreased the specificity to 92%. Thus, it seems worthwhile to study the T V2 reaction in angina patients who do not show an abnormal ST reaction post exercise.
Very Early Changes in Circulating T3 and rT3 during Development of Metabolic Derangement in Diabetic Patients
Authors: Madsbad Sten , Laurberg Peter , Weeke Jørgen , Ørskov Hans , Faber Ole K. , Binder Christian , Krarup Thure , Regeur Lisbeth
Published: August 2010

ABSTRACT. Alterations in circulating iodothyronines were studied in 15 juvenile type diabetic patients during the development of metabolic derangement after withdrawal of insulin. By means of measurements of circulating C peptide, one group of patients with and one without residual β‐cell function had been selected. In both groups there was a gradual decrease in serum T3 during the 12‐hour period studied after withdrawal of insulin, while an increase in serum rT3 was observed after 4–6 hours. The alterations in serum T3 and the metabolic derangement were significantly more pronounced in patients without than with residual β‐cell function.