bluuebunny/crossref_metadata_2025 huggingface dataset:
A Controlled Clinical Trial of the Immunosuppressive Effect of Extracorporeal Irradiation of the Blood in Renal Allotransplantation
Authors: Birkeland S. A.
Published: August 2010

ABSTRACT The immunosuppressive effect of extracorporeal irradiation of the blood (ECIB) in renal allotransplantation (RAT) has been investigated in a controlled clinical trial. A series of 101 uremic patients undergoing intermittent hemodialysis in preparation for RAT were allocated randomly to two groups; a treated group + ECIB (n = 55), and a control group 0‐ECIB (n = 46). ECIB treatment was given in the form of a fixed dose, with a transit dose of 400 rad and a cumulative dose of approximately 50000 rad, both before and after RAT. A selective long‐term lymphocytopenia was usually obtained, with no effect on immunoglobulins, complements or plasma proteins. Erythrocyte count was reduced in the majority of cases, but this had no limiting effect on the implementation of treatment. The shortest survival times and most deaths occurred in the + ECIB group. The first rejection episode occurred later in the + ECIB group, but there was no difference between the groups in the number of rejections during the first two months or during the whole observation period. There were more cases with two or more rejection episodes in the + ECIB than in the 0‐ECIB group. There was no difference in graft survival, but shortest patient survival and most deaths after RAT occurred in the + ECIB group. It must therefore be concluded that the immunosuppressive effect of ECIB has no practical clinical relevance in RAT, and that ECIB given in the manner described involves the possibility of side‐effects so serious that the method cannot be recommended.
Sarcoidosis
Authors: Rasmussen Stig Munkgaard , Neukirch Frits
Published: August 2010

ABSTRACTIn a 10‐year review of the records of 146 young male patients suspected of sarcoidosis on the basis of radiographic intrathoracic changes, the chest X‐ray findings have been analysed in relation to the results of different biopsies. Most of the patients were military men, and almost all were apparently unaffected by the disease. Sixty‐six per cent had bilateral hilar lymphadenopathy (BHL) only, 12% had isolated pulmonary lesions and 22% had both BHL and pulmonary lesions. In all patients at least one biopsy was performed, in most cases a scalene fat pad biopsy and/or a liver biopsy. Epithelioid cell granulomas were demonstrated in 86 biopsies from 64 of the 146 patients. Granulomas were obtained more frequently by scalene fat pad biopsies than by liver biopsies in the same group of patients. During the first 4–5 years of the 10‐year period the scalene fat pad biopsies were done in local anesthesia in different general surgical departments without special experience of this biopsy procedure. In the last 5–6 years the scalene fat pad biopsies were done in general anaesthesia in a head and neck surgical department specially trained in this biopsy technique. Granulomas were obtained more frequently in the latter than in the former group. The highest frequency of granulomas was found among patients with both BHL and pulmonary lesions. Of the 71 patients in whom liver biopsy was performed, 43% had granulomas in the liver. A few patients had signs —although only slight—of liver affection. The results of the different biopsies are discussed in relation to the clinical picture. It is concluded that scalene fat pad biopsy in some cases can still be of some diagnostic aid in patients with radiographic intrathoracic changes suspected of sarcoidosis, although this type
Pattern of Enzyme Activity Following Acute Myocardial Infarction with Special Reference to γ‐Glutamyl Transpeptidase
Authors: Säwe Urbain , Erhardt Leif R. , Sjögren Andreas
Published: August 2010

ABSTRACT The present study on 55 consecutive patients with acute myocardial infarction (AMI) draws attention to the relationship between different enzyme maxima in AMI, with special reference to serum γ‐glutamyl transpeptidase (S‐GT). In more than 60% of the patients the S‐GT was increased during the hospital stay. The S‐GT rise nearly always began during the first days, reached a maximum within 5–8 days and normalized within 2–3 weeks. We failed to find the late increase in S‐GT reported by others. The rise of S‐GT is particularly common in patients with inferior infarction, with or without right ventricular involvement. We conclude that S‐GT activity is not a useful early or late indicator of AMI but a very sensitive test for hepatic dysfunction in patients with AMI.
Treatment of Hypertension in Middle‐aged Men
Authors: Hedstrand Hans , Åberg Hans
Published: August 2010

ABSTRACT In a health examination survey of 2322 middle‐aged men the prevalence of hypertension, defined as supine DBP ≥ 105 mmHg and including those on treatment, was 7.5%. All untreated and those inadequately treated were invited to a hypertension clinic. One year's treatment in 86 men achieved a BP reduction of 29/17 mmHg in supine and 27/16 mmHg in erect position. This reduction was maintained for a three‐year period and considered satisfactory in 80% of subjects. Propranolol, alone or in combination with other agents, was used in more than 80% of the cases. Special considerations in treating asymptomatic individuals are discussed.
The Urinary Excretion of Ten plasma proteins in Long‐term Renal Transplant Patients
Authors: Hemmingsen L. , Jensen H. , Skaarup P.
Published: August 2010

ABSTRACT Using an automated immunoprecipitin reaction, the urinary excretion of albumin, transferrin, haptoglobin, IgM, IgG, IgA, free lambda and kappa light chains from immunoglobulin, lysozyme and β2‐microglobulin has been investigated in 40 long‐term bilaterally nephrectomized renal transplant patients. The excretion of the proteins, except lysozyme, was significantly increased in 21 of the patients with Albustix®‐negative urine. In patients with glomerulonephritis prior to the transplantation, the excretion of albumin, transferrin, and IgG was significantly increased compared with the other patients. The IgM excretion was significantly increased in patients who had received C and D matches compared with those with A and B matches. Patients with severe surgical complications in the postoperative period had a tubular proteinuria, and in patients surviving more than 60 months after transplantation the excretion of several proteins was significantly increased compared with patients surviving less than 60 months.
Recurrent and Reversible Cerebellar Ataxia with Concomitant Episodes of Hyperthyroidism
Authors: Åberg Hans E. , Herbai Georg L. , Westerberg Carl‐E.
Published: August 2010

ABSTRACT A new disorder with possible autoimmune background is described in a 67‐year‐old man. He had experienced episodes of cerebellar ataxia induced by infections over the last 40 years. In 1963 he had thyrotoxicosis. The patient underwent bilateral subtotal thyroidectomy. Recently it has been possible to detect involvement also of his remaining thyroid gland, with findings compatible with hyperthyroidism concomitant with his cerebellar ataxia.
Cutaneous Reactions to Propranolol (Inderal®)
Authors: Jensen H. Ærenlund , Mikkelsen H. I. , Wadskov S. , Søndergaard J.
Published: August 2010

ABSTRACT Six patients with psoriasiform cutaneous eruptions that developed during long‐term therapy with propranolol (Inderal®) have been studied. The cutaneous changes closely resembled those seen during treatment with practolol (Eraldin®). The duration of treatment before the rash was recognized averaged 10 months, which is about the same latency period as in patients with practolol‐induced exanthe‐mas. The exanthemas disappeared gradually within 1–5 weeks after treatment with propranolol had been stopped. In 4 of 5 patients the skin eruptions reappeared within 2–4 days after oral challenge with propranolol. In the fifth patient, who developed a rash after challenge with practolol and severe abdominal colics after challenge with oxprenolol, no further provocation tests with propranolol were attempted. Skin biopsies obtained from 3 patients showed a microscopical picture similar to that seen in practolol exanthemas. The pathogenetic mechanism responsible for these adverse cutaneous reactions is unknown. However, since the possibility exists, that these changes may be caused by blockade of the epidermal β‐receptors, it is recommended that all patients receiving β‐blocking drugs should be examined carefully for similar adverse reactions. Special attention should be drawn to the reversible skin changes, since during treatment with practolol these have often preceded serious complications from other organs.
Chronic Myocardial Disease
Authors: Hatle L. , Örjavik O. , Storstein O.
Published: August 2010

ABSTRACT The prognosis in chronic myocardial disease is not well defined, partly because of a wide spectrum of clinical courses, and partly because of relatively short observation periods. This paper describes 106 patients followed for 2–12 years. Development or worsening of symptoms after intercurrent infections was associated with a more severe outlook than an insidious debut. The ability to develop myocardial hypertrophy appeared to be an important factor in deciding the prognosis. Pump failure was the cause of death in 80% of the patients, while 16% died suddenly. A favourable course was often noted in patients with ECG signs of left ventricular hypertrophy. This was also the case in patients who developed systemic hypertension. The presence of low voltage, especially in combination with left atrial enlargement, was associated with a malignant development.
Immunofluorescent Demonstration of the Presence of Protein HC on the Surface of Human Lymphocytes
Authors: Tejler Lars , Grubb Anders O. , Turesson Ingemar
Published: August 2010

ABSTRACT Indirect immunofluorescence was used to demonstrate the presence of protein HC on the surface of a large percentage of normal human peripheral blood lymphocytes. Protein HC is a recently described charge heterogeneous, complex‐forming glycoprotein normally present in human plasma, urine and cerebrospinal fluid. The synthesis of protein HC by lymphocytes was indicated by the removal of the glycoprotein from the cell surfaces on trypsinization of the cells followed by the reappearance of the protein on continued cultivation of the cells.
Determination of Pressure Gradient in Mitral Stenosis with a Non‐invasive Ultrasound Doppler Technique
Authors: Holen Jarle , Aaslid Rune , Landmark Knud , Simonsen Svein
Published: August 2010

ABSTRACT A 2 MHz continuous waveform noninvasive ultrasound doppler system has been used in the present investigation. With the aid of the audio signals of the frequency shifts, the ultrasound probe was positioned on the external chest so that the axis of the incident ultrasonic beam coincided with the direction of the maximum velocity vectors of the mitral jet. The frequency shifts due to the mitral jet were frequency analyzed and the time course of the maximum frequency shift was determined. The time course of the maximum mitral jet velocity was then determined from the doppler equation and the time course of the mitral pressure gradient from an orifice equation. The usefulness of the technique was evaluated by studying 25 patients with mitral stenosis and 10 without heart disease. The patients with mitral stenosis were studied during cardiac catheterization and the ultrasound data, the pulmonary artery wedge pressure, and the left ventricular pressure were recorded simultaneously. A table is presented where the gradient determined with the ultrasound technique, ΔPU, is compared with the gradient determined from the pressure tracings, ΔPM. Averaged over the 25 patients studied, ΔPU was 1.7 mmHg smaller than ΔPM at 0.08 sec diastolic time and 1.8 mmHg smaller at 0.25 sec diastolic time. The findings in the patients without heart disease differed distinctly from those in the patients with mitral stenosis. The investigation demonstrated that the non‐invasive ultrasound technique can be used with confidence to gain an impression of the magnitude of the mitral pressure gradient. The findings also suggest that ΔPU represents the actual pressure gradient more accurately than ΔPM Another investigation is proposed to assess the accuracy of the technique more completely.
Interferon Therapy in Hodgkin's Disease
Authors: Blomgren Henric , Cantell Kari , Johansson Bo , Lagergren Curt , Ringborg Ulrik , Strander Hans
Published: August 2010

ABSTRACT The treatment of a case of Hodgkin's disease (lymphocyte predominance, stage IVB) with exogenous i.m. interferon therapy is described. B symptoms disappeared, diseased nodes and pulmonary infiltrations decreased in size, and laboratory values normalized. Clinical improvement was associated with increased mitogenic responsiveness of the patient's lymphocytes towards various stimuli in vitro. After almost half a year's treatment tumour progression and a decreased mitogenic response were again observed. Interferon treatment was then abandoned and combined cytostatic courses were instituted. Partial remission was achieved after 6 months of cytostatic therapy, i.e. 1 year after the start of treatment.
Acute Myeloma
Authors: Almér Lars‐Olof
Published: August 2010

ABSTRACT This patient had an acute onset of myeloma, with hypercalcemia, a high M‐component in the plasma, Bence Jones proteinuria, and 37% plasma cells in the bone marrow sample. After melphalan treatment (210 mg totally) he seems to have a complete cure, with total disappearance of the M‐component, Bence Jones proteinuria, myeloma cells, hypercalcemia and elevated ESR for almost three years.
Clofibrate in Type II Hyperlipoproteinemia
Authors: Ditzel Jørn , Bang Hans Olaf
Published: August 2010

ABSTRACT. As part of a double‐blind randomized study, the safety and the lipid‐ and uric acid‐lowering effect of clofibrate have been evaluated in 28 patients with type II hyperlipoproteinemia (HLP). A highly significant reduction of serum cholesterol occurred in type II a and of serum triglyceride and cholesterol in type IIb HLP throughout the 60‐week observation period (p<0.01). Of the patients with types IIa and lib HLP, 65% had at least a 25% reduction of serum cholesterol. Uric acid was significantly reduced only during the first period of treatment (p<0.05). In the laboratory measurements concerning safety, a persistent, slight reduction was observed in Hb, hematocrit and alkaline phosphatase. No significant clinical side‐effects were noted. Clofibrate is considered effective as a lipid‐lowering agent in many cases of type II HLP.
Studies on Subclinical Hypothyroidism with Special Reference to the Serum Lipid Pattern
Authors: Nilsson G. , Nordlander S. , Levin K.
Published: August 2010

ABSTRACT. Subclinical hypothyroidism is an example of the impact of technology on the concept of a disease. It denotes a condition in which laboratory findings, at least including a raised serum thyrotropin (s‐TSH), indicate hypothyroidism in the absence of clinical signs or symptoms of this disease. One reason for attention to cases of subclinical hypothyroidism is the publication of reports, from the time before introduction of the s‐TSH assay, that hypercholesterolemia precedes other evidence of thyroid failure with attendant risks of ischaemic heart disease and other atherosclerotic manifestations. The present investigation, which concerned the lipid pattern in subclinical hypothyroidism, offered no support for such a concept of hypercholesterolaemia as a premonitory sign of hypothyroidism. Furthermore, no significant differences were found between the serum levels of cholesterol and triglycerides before and after the administration of a thyroxine dose, necessary to suppress the s‐TSH into a normal range, in cases of subclinical hypothyroidism. Nor were there any changes during this therapy in body weight, ECG, or Hb levels, which represent important parameters often found to be abnormal in overt hypothyroidism. From a practical point of view, subclinical hypothyroidism probably can be regarded as a state in which reduction of thyroid activity has been compensated by an increased s‐TSH secretion to maintain a clinically euthyroid state. When no goitre is found, the rationale of treatment of this condition remains to be proved.
Three‐year Follow‐up of Middle‐aged Men with Low Blood Pressure
Authors: Hedstrand Hans , Åberg Hans
Published: August 2010

ABSTRACT. The blood pressure (BP) development in 142 middle‐aged men with BP within the lower region of the BP distribution (supine BP≤ 120/70 mmHg) has been studied. Over a 3‐year period there was a moderate but significant rise in supine systolic BP but not in supine diastolic BP. However, no subject developed hypertension defined as supine BPs≥175/105 mmHg. These findings support the assumption that among middle‐aged men the hypertensives are recruited from the upper part of the BP distribution. Subjects with low BP may be rescreened at longer intervals, if at all.
Hereditary Hepatic Porphyrias in Finland
Authors: Mustajoki Pertti , Koskelo Pentti
Published: August 2010

ABSTRACT. The occurrence of hepatic porphyrias —acute intermittent porphyria (AIP) and variegate porphyria (VP)—in Finland has been studied. During a period of 9 years 107 patients with AIP and 45 patients with VP were found. The prevalence of hereditary hepatic porphyrias was calculated to be 3.4 per 100 000 inhabitants. The patients belonged to 42 different families. Eighty‐nine patients (59%) had had acute attacks, whereas 63 were symptomless latent cases. Precipitating factors, symptoms and excretion of porphyrins and their precursors did not significantly differ from what has been reported earlier from other parts of the world. A slight fragility of the skin on the back of the hands was noted in some 50% of VP patients. Abnormal sensitivity to sunlight could not be seen in a single case. However, about 50% of patients with VP showed an abnormal reaction when irradiated with artificial ultraviolet light. The difference in the skin symptoms in South African and Finnish VP patients is discussed.
Clinical and Hemodynamic Findings Following Prosthetic Valve Replacement for Mitral Valve Disease
Authors: Nitter‐Hauge Sigurd , Frøysaker Tor , Hall Karl Victor
Published: August 2010

ABSTRACT. Clinical and hemodynamic results have been evaluated 12–24 months after mitral valve replacement with the new Björk‐Shiley tilting disc valve prosthesis. After operation, most patients were improved symptomatically and were classified as I‐II (N.Y.H.A.). No patient became worse. Hemodynamic status at rest showed significant reduction in pulmonary capillary venous pressure, pulmonary arterial pressure and significant increase in cardiac output when compared with the preoperative values, but postoperative hemodynamic abnormalities remained. Exercise produced a rise in pressures in the pulmonary circuit and in cardiac output. The increase in cardiac output was less than expected from the increase in oxygen consumption, with a few exceptions. Apparently, there was no close relationship between the symptomatic improvement and the hemodynamic results. Thus, the present study points to the importance of hemodynamic data in the objective assessment of the results of cardiac surgery.
A Validation of Cause‐of‐death Certification in 1 156 Deaths
Authors: de Faire Ulf , Friberg Lars , Lorich Ulla , Lundman Torbjörn
Published: August 2010

ABSTRACT.Swedish twins have been followed for mortality since 1961, when the Swedish Twin Registry was formed. During the years 1961‐73 there were 1290 deaths among twins born in 1901‐25. In 1 156 cases the cause of death could be established from collected records and classified according to the 1965 revision of ICD. Using the review of records as the standard, rates of detection and confirmation relating to the death certificate diagnoses were calculated. It is concluded that Swedish death certificate data are fairly valid for use in epidemiological studies and mortality statistics with regard to most cancer forms, cerebrovascular disease, ischemic heart disease, bronchitis, asthma and emphysema, accidents and suicides, but not for diabetes mellitus, alcoholism, mental diseases, rheumatic heart diseases and other heart diseases. However, in selected clinical—epidemiological studies it is often necessary to collect all available documents prior to judging the cause of death.
The Effects of Different Dose Regimens of Niceritrol on Serum Lipid Concentrations in Man
Authors: Rössner Stephan , Olsson Anders G. , Orö Lars
Published: August 2010

ABSTRACT. The lipid‐lowering effects of 3 g of the nicotinic acid derivative pentaerythritoltetranico‐tinate (niceritrol) given either 1 gx3 or 1.5 gx2 have been evaluated in 18 subjects with hyperlipoprotein‐aemia. When 1 g niceritrol was given three times daily, the serum TG concentration fell from 3.14+ 0.48 to 1.86+0.18 mmol/l (41% reduction) and the serum cholesterol concentration from 282+9 to 227+11 mg/100 ml (20% reduction). The same daily dose, given 1.5 g twice, did not significantly lower the serum TG concentration, and serum cholesterol was lowered by only 12 %. Niceritrol tablets prepared with a dissolution time of 60 or 90 min had identical lipid‐lowering properties. Although patients may find it practical to take niceritrol only twice daily, such a dose regimen has considerably less effect on elevated serum lipids than a thrice‐daily regimen.
Extreme Elevation of Transaminase Levels in Acute Heart Disease—a Problem in Differential Diagnosis?
Authors: Bloth Björn , de Faire Ulf , Edhag Olof
Published: August 2010

ABSTRACT. Five patients admitted to the Coronary Care Unit at the Department of Medicine, Serafimerlasarettet, who developed extreme elevation of transaminase levels, are discussed in terms of problems in differential diagnosis. All five had manifest right ventricular failure on admission and four also had hypotension. Three of the patients died, two survived. The three post‐mortem examinations showed extensive infarctions of the left ventricle and septum. The two survivors had had a prolonged ventricular tachycardia and a probable silent infarct, respectively. It is concluded that the extremely high transaminase levels sometimes seen in acute cardiac disease are predominantly due to sizeable amounts released by the liver as a result of central necrosis of the liver cells. The probable prerequisite for the development of central necrosis of the liver in acute cardiac disease is usually the combination of right ventricular failure and hypotension, which in turn are most often due to extensive left ventricular infarcts.
Microcalorimetric Measurements of Heat Production in Human Erythrocytes
Authors: Monti M. , Wadsö I.
Published: August 2010

ABSTRACT. Heat production has been measured in erythrocytes of 17 hyperthyroid patients both before treatment and when the patients had become clinically euthyroid. The decrease in heat effect during treatment was significant. The initial mean value was significantly higher than the corresponding value for normal subjects. A good correlation was found between heat effect values and the clinical condition. Measurement of heat production in erythrocytes can provide useful information about the peripheral effect of thyroid hormones.
Clinical Diagnosis in Patients with Smooth Muscle Antibodies
Authors: Lidman K.
Published: August 2010

ABSTRACT. Out of 17109 sera tested for autoantibodies by indirect immunofluorescence, 236 contained smooth muscle antibodies (SMA) with a titre of ≥1/25. The majority of these sera, from 190 patients, reacted both with smooth muscle and renal glomerull and the specificity of these SMA is against actin. 91% of high‐titred sera (≥1/100) with IgG antibodies giving this staining pattern were derived from patients with chronic inflammatory liver disease, mainly chronic active hepatitis. In the group with a titre of 1/25, non‐liver diseases such as joint diseases were more common and liver conditions occurred only in 55%. Sera with SMA of IgM class were mostly derived from patients with acute viral hepatitis.
Extreme Digitalis Intoxication
Authors: Ahlmark Gösta
Published: August 2010

ABSTRACT. A case of massive digoxin intoxication is described. The concentration of digoxin in plasma, 15.5 ng/ml, is one of the highest observed in an individual not having heart disease who survived the intoxication. During the first two days there was complete heart block but only moderate hyperkalaemia. The advantage of temporary pacemaker treatment under these conditions is emphasized.
Removal of Exogenous Triglycerides in Subjects with Massive Obesity before and after Jejunoileal Shunt Operation
Authors: Rössner S. , Hallberg D.
Published: August 2010

ABSTRACT. The fractional removal rate of exogenous triglycerides (TG) in 12 obese subjects with a mean body weight of 132+5 kg (S.E.M.) has been studied before a jejunoileal shunt operation. The study was repeated postoperatively at stable body weights 30–54 months later. The weight loss ranged from 13 to 65 kg (mean weight reduction 27%). In 8 patients, 0.3–6.0 kg of skin and subcutaneous tissue were removed surgically for cosmetic reasons during the weight reduction period. Serum cholesterol fell from 220+8 to 141+11 mg/100 ml (p<0.001). The serum TG reduction was not significant, 1.80+0.25 before and 1.50+0.19 mmol/I after operation. The fractional removal rate of exogenous TG, determined by the intravenous fat tolerance test (IVFTT) with the Intralipid® fat emulsion, was not significantly changed. The IVFFT k2 value was 3.5+0.5%/min before and 4.3+0.6 after surgery (p>0.05). Previous studies have shown that a major part of Intralipid® is removed initially in skeletal muscle. The unchanged fractional removal rate of Intralipid, despite the marked reduction in the amount of adipose tissue, supports the concept that the adipose tissue may play a minor role in the initial elimination of exogenous TG from the bloodstream.
Serum Lipid and Lipoprotein Concentrations in Chronic Uremia
Authors: Norbeck Hans‐Erik , Orö Lars , Carlson Lars A.
Published: August 2010

ABSTRACT. The concentrations of triglycerides and cholesterol have been determined in total serum and in the three major serum lipoprotein classes—very low (VLDL), low (LDL) and high (HDL) density lipoproteins—after an overnight fast in 39 patients with chronic uremia of more than 2 years' duration and with serum creatinine above 350 μmol/I. The values were compared with data from healthy male and female controls. The findings were similar for male and female uremics. Hypertriglyceridemia was common while serum cholesterol tended to be normal or subnormal. With the conventional typing system for hyperlipidemia, types II A, III and IV were present in 6, 9 and 30%, respectively. The triglyceride and cholesterol concentrations in VLDL were increased, while their normal relation for this lipoprotein class was maintained. In LDL the concentration of triglycerides was increased, while that of cholesterol was low. The LDL composition, therefore, was changed to be more triglyceride‐rich than normal. The changes in concentration and composition of LDL indicated that the levels of LDL, were raised and of LDL2 decreased in chronic uremia. Increased levels of LDL triglycerides occurred more frequently (40%) than increased levels of VLDL triglycerides (33%). The most striking and consistent lipoprotein abnormality was a low HDL cholesterol, which was not related to high VLDL levels. The HDL triglycerides, on the other hand, tended to be somewhat high. The importance of the raised levels of the triglyceride‐rich VLDL and LDL1 and the decreased levels of HDL cholesterol for the rapid development of atherosclerotic vascular diseases which occur in chronic uremia is discussed. It is of interest in this context that both total cholesterol and LDL cholesterol were low. The possible mechanisms underlying the lipoprotein abnormalities in chronic uremia are discussed and it is suggested that they are complex.
The Renin‐Aldosterone System and Renal Hemodynamics in Patients with Posttransplant Hypertension
Authors: Pedersen E. B. , Kornerup H. J.
Published: August 2010

ABSTRACT. Plasma renin concentration (PRC), plasma aldosterone concentration (PAC), renal plasma flow (RPF) and glomerular filtration rate (GFR) have been studied in 19 patients who had received a renal allotransplant. Group 1 consisted of 7 normotensive and group 2 of 12 hypertensive patients. Bilateral nephrectomy was performed in all patients; all were on a fixed daily sodium intake, and no antihypertensive agents were given. No significant differences were found between the groups in age, time after transplantation or dosages of prednisone. PRC and PAC were normal in all but one patient in group 1 and two in group 2. In these three patients a slight elevation of PRC was measured. After one hour in the erect position, a significant increase was measured in PAC, but not in PRC in both groups. After 6 days on a 10 mEq sodium diet, PRC and PAC increased significantly in both groups. After a further 6 days on the diet plus 150 mEq sodium daily, significant decreases in PRC and PAC were measured in both groups. No differences were detected in PRC or PAC between groups 1 and 2 either before or after the two dietary periods. RPF was significantly lower in the hypertensive group, whereas no significant difference was found in GFR between the groups. No significant relationship could be demonstrated between blood pressure (BP) and PRC or PAC, and PRC and PAC were not correlated to each other. RPF was significantly correlated to mean BP and PRC in the normotensive group but not in the hypertensive. It is concluded that PRC and PAC are normal in most patients with posttransplant hypertension, whereas the RPF is decreased. It is suggested that an abnormal regulation of renin secretion plays a role in the sustained elevation of BP after renal allotransplantation.
Permanent endocardial pacing
Authors: HAVIA T. , ARSTILA M. , WENDELIN H. , HEINONEN R.
Published: August 2010

ABSTRACT. Primary results and follow‐up observations in 90 patients with permanent endocardial pacing–covering the period from 1970 to June 1974–are reported. The primary mortality was 3% (3/90), and late mortality 4% (4/90). Electrode complications were the most common problem and occurred in 20% of implantations. Early or late dislocation of the electrode tip was seen in 12%. With the improved technique is was possible to decrease it significantly through the period. The mean battery life time of Siemens‐Elema pacemakers was 26 months. 10% of the failed batteries were replaced urgently. So far the rather high frequency of electrode complications diminishes the advantages of the pacemaker treatment.
Pacemaker wires and electrodes.: A follow‐up study
Authors: GRENDAHL HELGE , SIVERTSSEN EGIL
Published: August 2010

ABSTRACT. In 362 patients on permanent pacing, a follow up with regard to pacemaker electrode function time and connection to pulse‐generators has been carried out. In 12 patients Elema epicardial electrode were used with an average function time of 3.8 years. 232 Elema EMT 588 endocardial electrodes were used in 216 patients. Average observation time for the electrodes was 3.3 years. Sixty‐eight electrodes have been followed for more than 5 years. Early electrode complications comprise 10 per cent of displacements before implantation of the pulse‐generator and another 6 per cent of electrode displacements within the first 3 months after implantation. Eleven per cent of the electrodes had to be corrected due to high threshold value before implantation and another 6 per cent during the first 3 months after implantation of pulse‐generator.

On hundred and fifty‐five unipolar electrodes of the types Cordis, Medtronic, Eletna EMT 282, and Stanium were implanted in 149 patients. Average observation time for the electrodes was 1.2 years. During the first 3 months after pacemaker implant 7 per cent of the electrodes were dislocated, 5 per cent failed due to high threshold value. Three perforations of the right ventricle occurred, without serious complications. Late complications i. e. after 3 months, for the EMT 588 electrode included 4 percent electrode dislocations, 4.5 per cent failure due to high threshold, 3 cases of wire break and 4 defects in the insulation. Many of the late electrode complications were probably caused by replacement operations for pulse‐generators. The most frequent late complications for the conventional unipolar electrode was wire break which occurred in 5 cases.
Complications from the pacemaker pocket
Authors: CASTBERG THOMAS
Published: August 2010

ABSTRACT. 281 patients who had permanent pacemaker implanted between 1961‐73 have been checked at 4 month intervals over a period of 1 to 13 years. Complications from the pacemaker pocket comprises haematoma, skin necrosis, infection of the pocket, allergic reaction to the pulse generator, pacemaker twiddlers syndrome, and muscle contractions. The causes for and treatment of 11 cases with haematoma, skin necrosis or infection are dealt with in detail.
Disturbance in rhythm in 2 patients with a permanent pacemaker and two endocardial electrodes
Authors: JOHANSEN J. KJERSGAARD
Published: August 2010

ABSTRACT. Rhythm disturbances are described in 2 patients with an implanted permanent pacemaker. Both patients had nonfunctioning electrodes retained after previous complications. It was possible to observe, in both patients, during fluoroscopic examination that the electrodes occasionally touched each other.

The etiology of the rhythm disturbances are discussed on the basis of the technical specifications of the pacemakers.

The interpretation of rhythm disturbances in patients with implanted pacemakers presents special problems. Disturbances in rhythm can be spontaneous and have no relation to, but possibly modified, by the implanted pacemaker. However, the rhythm disturbances can also result from the technical specifications of the implanted pacemaker or from defects in the same.

The following case histories describe disturbances in rhythm in two patients, who both had 2 endocardial electrodes of which only one was connected to the implanted pacemaker.
SYNTHESIS OF RENIN INHIBITORS A REVIEW
Authors: Poulsen Knud , Burton James , Haber Edgar
Published: August 2010

This short review describes how competitive inhibitors were synthesized and how the solubility was increased in order to make them effective at physiological pH. Their use for in vitro and in vivo inhibition of renin is discussed and their use for purification of renin demonstrated.
Counter Regulation of Basal Insulin Secretion during Alcohol Hypoglycemia in Hypercalcemic and Normocalcemic Man
Authors: Röjdmark Sven
Published: August 2010

ABSTRACT In seven normocalcemic subjects, fasted for 48 hours, alcohol hypoglycemia has been accompanied by a significant decline in basal insulin secretion. In another six healthy subjects, fasted for two days, infusion of calcium also induced a significant fall in basal secretion of insulin. However, when six healthy volunteers, fasted for two days, were infused with calcium and given alcohol simultaneously, no significant fall in insulin was recorded, even though the hypoglycemia, following this combined load, was of the same magnitude as in the subjects given alcohol alone. The implications of these findings are discussed.
Tubular Reabsorption and Urinary Excretion of Acetoacetate and 3‐Hydroxybutyrate in Normal Subjects and Juvenile Diabetics
Authors: Wildenhoff K. E.
Published: August 2010

ABSTRACT The renal handling of acetoacetate (AA) and 3‐hydroxybutyrate (3‐HB) has been examined in 8 normal subjects and 7 insulin‐treated juvenile diabetics before and after i.v. infusion of sodium DL‐3‐hydroxybutyrate. In both normals and diabetics the ketone bodies were reabsorbed. At low filtration rates of AA and 3‐HB the reabsorption was nearly complete. With increasing filtration rate both the tubular reabsorption rate and the urinary excretion rate of AA and 3‐HB increased linearly. A maximal tubular reabsorption rate could not be demonstrated. In spite of higher filtration rates of AA and 3‐HB in the diabetics, the mean reabsorption percentage of either ketone body did not differ from that found in the normals.
Determination of Effective Orifice Area in Mitral Stenosis from Non‐invasive Ultrasound Doppler Data and Mitral Flow Rate
Authors: Holen Jarle , Aaslid Rune , Landmark Knud , Simonsen Svein , østrem Tønnes
Published: August 2010

ABSTRACT Ten patients with mitral stenosis, but without mitral insufficiency, have been studied during cardiac catheterization. The mitral orifice blood velocities, the mitral pressure gradient, and the mitral flow rate were determined with ultrasound, manometry, and the direct Fick method, respectively. The effective orifice area was calculated from the ultrasound data and the mitral flow rate. The geometric orifice area was calculated from the pressure gradient and the mitral flow rate, using a revised Gorlin formula. A comparison of the two methods showed a correlation coefficient of 0.975. The investigation demonstrated that the ultrasound method represents an alternative to the conventional catheterization methods used for the quantification of mitral flow obstruction.
Right Atrial Monophasic Action Potential in Patients with Paroxysmal Supraventricular Tachyarrhythmias
Authors: Brorson Leif , Olsson S. Bertil
Published: August 2010

ABSTRACT Thirteen patients with paroxysmal atrial tachyarrhythmias (six atrial supraventricular tachycardia, six atrial fibrillation, and one atrial flutter) have been investigated by recording of monophasic action potentials (MAP) during a period free from arrhythmias. None of the patients differed from healthy individuals with respect to any of the MAP variables. Occasional recordings showed values not found in healthy individuals, such as prolonged duration of the MAP or slow phase 4 depolarization. The atrial effective refractory period (AERP) was determined in two patients. One AERP was short compared with values found in healthy individuals. Thus some MAP recordings gave a possible explanation for the mechanism behind the arrhythmias, while other recordings showed no differences from results in healthy individuals.
Regional Coffee Consumption and Mortality from Ischemic Heart Disease in Finland
Authors: Hemminki Elina , Pesonen Terttu
Published: August 2010

ABSTRACT In Finland the mortality from ischemic heart disease is highest in North Karelia and lowest in Southwest Finland. In this study the consumption of coffee has been measured from the total sales in the different areas of Finland to see if it correlates with the mortality from heart disease. North Karelia had higher coffee sales per inhabitant than Southwest Finland. This finding reinforces the view that carefully controlled dietary studies are needed to establish the role of coffee in the mortality from ischemic heart disease.
Pleuroperimyocarditis Caused by Immunization with Anticatarrh Vaccine
Authors: Bloth B. , Lundman T.
Published: August 2010

ABSTRACT A case of pleuroperimyocarditis caused by immunization with anticatarrh vaccine is described. During the most acute phase, circulating immune complexes were demonstrated in the patient's serum. The possibility that these complexes represent a pathogenic mechanism in the illness and the value of anticatarrh vaccination are discussed.
Prolonged Induction of Germfree Bile Acid Pattern in Conventional Rats by Antibiotics
Authors: Gustafsson Bengt E. , Gustafsson Jan‐Åke , Carlstedt‐Duke Bodil
Published: August 2010

ABSTRACT Male conventional rats have been treated for five days with benzylpenicillin, neomycin, kanamycin, erythromycin, bacitracin+neomycin, succinylsulfathiazole or metronidazole. Total fecal bile acids were analyzed in samples collected during periods of three days during the pretreatment period and during the eight weeks following drug treatment. Metronidazole or succinylsulfathiazole had no or minor effects on the conventional bile acid pattern and the “bile acid index” (ratio β‐muricholic acid/deoxycholic acid) remained low. Benzylpenicillin, neomycin or kanamycin induced a germfree bile acid pattern, i.e. increased the relative amounts of α‐ and β‐muricholic acid in feces and eliminated deoxycholic acid and hyodeoxycholic acid from feces. The high bile acid index was normalized within three weeks after termination of drug treatment but the excretion of α‐ and β‐muricholic acid was not normalized until a normal flora had been established by giving an enema with intestinal contents from intact, conventional rats. Treatment with erythromycin or bacitracin+neomycin also produced a germfree bile acid pattern. In these cases, the bile acid index was not back to normal until after five to eight weeks and the excretion of the muricholic acids was not normalized until an enema with intestinal bacteria had been given. It is suggested that these long‐lasting effects of antibiotics on the metabolism of bile acids in the intestinal tract should be considered after short‐term antibiotic therapy in humans.
Determination of 58Co‐Vitamin B12 Absorption in Pernicious Anemia by Use of Whole‐body Counting: Reproducibility and Control of Gut Transit Time
Authors: Hjelt K. , Rasmussen P. Attrup , Munck O.
Published: August 2010

ABSTRACT In 15 patients with pernicious anemia, the fractional retention of 58Co‐cyanocobalamin (FRB12) without administration of intrinsic factor (IF) averaged 4.9% (range 0–12.7). With administration of IF, FRB12 averaged 32.7% (range 26.6–42.3) in the patients and 65.6% (range 38.8–84.6) in 16 control subjects. The gut transit time for vitamin B12 was evaluated from the excretion of radiopaque pellets given concomitantly with the 58Co‐vitamin B12. The retention of the pellets was positively correlated to that of the non‐absorbed 58Co‐B12. Control of the gut transit time is recommended at each examination of FRB12 in order to avoid falsely high values due to the retention of non‐absorbed 58Co‐B12. We found a good reproducibility of FRB12 when determined in fasting subjects, and it is therefore unnecessary to give the patients a B12‐free meal prior to the examination. As the FRB12 in all probability is only a little lower than the fractional absorption, the present method is applicable for the determination of B12 absorption.
Comparison between Serum Thyroxine and Triiodothyronine Estimation and the TRH Test in the Routine Diagnosis of Hyperthyroidism
Authors: Tryselius Monica , Kallner Gunnar , Ljunggren Jan‐Gustaf
Published: August 2010

ABSTRACT Serum T3 and T4 levels have been determined by a radioimmunoassay technique and the TRH test has been performed in 50 patients in whom hyperthyroidism could not be ruled out by the first clinical examination alone. Each patient was then further evaluated in order to establish the state of the thyroid function. The extent to which the determination of T3 or T4 could replace the TRH test in the routine diagnosis of hyperthyroidism was evaluated. The results showed that 26 of the 50 patients had normal thyroid function and 24 had hyperthyroidism. No patient in the normal group and all but one in the hyperthyroid group had T3 levels above the upper normal limit (2 S.D.). Two of the patients in the normal group and 19 in the hyperthyroid group had T4 levels above the upper normal limit (2 S.D.). Twenty of the patients in the normal group showed a normal TSH response to TRH (increment >3.0 μU/ml); the remaining 6 showed an impaired or absent response. Twenty of the hyperthyroid patients had no response and four had a slightly positive response to TRH. No hyperthyroid patient had a TSH response exceeding 3.0 μU/ml. It is concluded that the determination of T3 is superior to both the determination of T4 and the TRH test for the laboratory discrimination between eu‐ and hyperthyroidism.
Hypomagnesaemia and Muscle Electrolytes and Metabolites
Authors: Stendig‐Lindberg G. , Bergström J. , Hultman E.
Published: August 2010

ABSTRACT Ten patients, aged 39–61 years, with hypomagnesaemia due to chronic alcoholism (7 cases) or malabsorption (3 cases), have been investigated by assessing the maximum isometric voluntary contraction force (MVC) of the quadriceps femoris muscle (7 cases), laboratory screening (9 cases) and estimating the electrolyte and metabolite content of biopsy specimens from the quadriceps femoris muscle. The MVC ranged from 0.5 to 34 kp and was significantly lower than in 12 apparently healthy normo‐magnesaemic controls (p<0.001). The results of the laboratory screening, apart from a significant lowering of the serum magnesium concentration (p<0.01), were mainly within the range of normal values, apart from signs of liver damage, such as an elevated activity of S‐OCT (3 cases), alkaline phosphatase (3 cases), S‐ALAT (1 case) and an elevation of bilirubin and blood ammonia (2 cases). Low serum iron‐binding capacity occurred in 4 cases, a finding reported in protein‐calorie malnutrition. Muscle magnesium content was significantly lower than in healthy controls (p<0.001). Muscle sodium and chloride contents were significantly increased (p<0.05). Total H2O content and the extracellular H2O content were both significantly increased (p<0.05). Pyruvate and lactate values were within the normal range. The apparent equilibrium constant for creatine kinase differed significantly (p<0.01). ATP values were within the normal range, but there were slight decreases for ADP (p<0.05) and creatine phosphate (p<0.01), which is of interest in view of the lowering of the MVC and the diminished capacity for sustained muscular effort in hypo‐magnesaemic patients reported earlier.
Prediction of Cardiovascular Deaths and Non‐fatal Reinfarctions after Myocardial Infarction
Authors: Vedin Anders , Wilhelmsen Lars , Wedel Hans , Pettersson Björn , Wilhelmsson Claes , Elmfeldt Dag , Tibblin Gösta
Published: August 2010

ABSTRACT The present study concerns the development and validation of a logistic multivariate prognostic function in patients followed for two years after myocardial infarction. The patients studied constituted at least 90 % of all cases in a total community—the City of Göteborg, Sweden. Using a multivariate logistic function with 7 variables, based on 30 cardiovascular deaths during two years after discharge from hospital among 292 men with first infarction, breathlessness at onset of symptoms of infarction, SGOT quartile, left heart failure, relative heart size, atrial fibrillation, a history of hypertension, and AV block recorded during the hospital phase were the most important variables. The first five of these variables made significant contributions (p<0.01) to the predictive power. The predictive capacity was confirmed in an independent series of 195 men with first infarction, among whom 17 cardiovascular deaths occurred. Around 60% of the total cardiovascular mortality was concentrated in the highest risk quintile. Deaths from non‐cardiovascular causes were predicted less efficiently. Nonfatal recurrences could not be predicted by the present model. Thus, the function can predict the excess risk of mortality but not the excess risk of reinfarction during two years among men after an initial myocardial infarction.