bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Cigarette Smoking a Promoter of the Menopause?
Authors: Andersen F. S. , Transbel I. , Christiansen C.
Published: August 2010

ABSTRACT. All women (n = 11809) aged 44–53 years from a representative district of Denmark were asked by questionnaire about their date of birth, date of latest menstrual bleeding, possible gynaecological operations, smoking habits, and use of medications. A total of 9411 (80%) questionnaires were returned. After exclusions because of incomplete information (n = 275), possible surgical menopause (n = 1270), and treatment with gonadal hormones (n = 2 221), 5 645 women remained suitable for the study. The reproducibility of the information given by these women was excellent as judged by personal interviews of 315 participants. The study population was divided into five 2‐year age groups, and the proportion of postmenopausal women among non‐smokers and heavy smokers was calculated. Differences in respect to the menopausal status were not observable in the oldest and the youngest two age groups comprising just a few per cent of postmenopausal women. However, heavy smokers in the other two age groups had passed the menopause earlier than the non‐smokers (p<0.001). This finding suggests cigarette smoking as a promotor of the menopause.
Fatal Reaction Following Renal Angiography and Biopsy in Diabetic Patients with Azotemia
Authors: Hietala Sven‐Ola , Lindqvist Bengt , Lithner Folke , Wirell Marianne
Published: August 2010

ABSTRACT. Severe reactions to contrast media in two diabetic patients with azotemia are described. Both patients also showed signs of immunopathy. The reaction was fatal in one of them. Little is known about contrast media reactions and their natural history. Patients with diabetes mellitus and impaired renal function should be studied with caution and with careful consideration of the indication for the procedure. If an examination with contrast media is considered unavoidable, all diabetic patients with renal failure should be supervised closely to detect the development of acute renal failure. Dehydration should be avoided. Careful monitoring of blood glucose, serum electrolytes, serum creatinine and blood pressure will aid in the early detection of the adverse reaction.
Oral Zinc Treatment in Primary Biliary Cirrhosis
Authors: Olsson Rolf
Published: August 2010

ABSTRACT. Oral zinc treatment, which has been shown to increase copper excretion and to cause clinical improvement in Wilson's disease, was without detectable value in four patients with primary biliary cirrhosis.
The Effect of Metamucil on Postprandial Blood Glucose and Plasma Gastric Inhibitory Peptide in Insulin‐dependent Diabetics
Authors: Florholmen J. , Arvidsson‐Lenner R. , Jorde R. , Burhol P. G.
Published: August 2010

ABSTRACT. Postprandial hyperglycemia was significantly (p<0.05) reduced during administration of the fibre supplement Metamucil in nine insulin‐dependent diabetics. A similar but less pronounced effect was also found on the plasma gastric inhibitory polypeptide secretion. Six subjects noted an increased frequency of hypoglycemic episodes, and reductions in insulin dosage might have been necessary if the experiment had continued longer.
Circulatory Aspects of Hypertension
Authors: Conway F. James , Lund‐Johansen Per , Hansson Lennart , Andrén Lennart , Eggertsen Robert , Jem Sverker , Sivertsson Ramon , Svensson Anders
Published: August 2010

ABSTRACT. In this seminar the main emphasis was put on hemodynamic and circulatory aspects of hypertension and in particular the initiating mechanisms in hypertension. The importance of external “stress” stimuli and psychological and social factors was dealt with as well as effects of structural adaptation.
Combination of Amikacin and either Ampicillin or Cephalotin as Initial Treatment of Febrile Neutropenic Patients
Authors: Palmblad Jan , Lönnqvist Berit
Published: August 2010

ABSTRACT. A prospective, randomized trial of two antibiotic combinations (amikacin plus either ampicillin or cephalotin) was performed on 39 consecutive episodes of fever in 30 patients with neutropenia and hematological malignancy. Infections were documented as the cause of fever in 37 episodes (95%): in 21 episodes (54%) bacteria or a virus (n=1) were isolated, and in 16 (41% of all episodes) the infection was documented clinically but no pathogen was isolated. The most frequently isolated bacteria were Staph, aureus (38% of all strains), E. coli (13%), and Pseudomonas aeruginosa (13%). Bacteremia occurred in 18% of the febrile episodes. Improvement followed treatment with the combination amikacin plus ampicllin in 73% of 19 cases, and with amikacin plus cephalotin in 55% of 20 cases (p>0.05), giving a total Improvement rate of 64%. Failure of therapy was seen in episodes caused by multiple bacteria or Pseudomonas infections. Mild signs of nephrotoxicity were noted in 13% during both regimens. Audiograms were normal in all but two patients who showed slight high‐frequency hearing loss. A second infection occurred in 7 episodes (18%). Thus, the combination of amikacin plus ampidllin was as efficient (but less expensive) as amikacin plus cephalotin in the initial treatment of febrile episodes in neutropenic patients with hematological malignancies.
Reticulocytes and Insulin Binding to Erythrocytes1
Authors: Ivarsson Sten A. , Thorell Jan I.
Published: August 2010

ABSTRACT. The relationship between erythrocyte insulin receptors and the reticulocytes were studied in a group with a varying degree of reticulocytosis. The maximal 125I‐insulin binding to erythrocytes varied between 6% and 37% and it showed a highly significant positive correlation with the reticulocyte count (r = 0.85). The highest binding was found in a patient with hereditary spherocytosis and very active hematopoiesis (312 × 109 reticulocytes per litre). The results suggest that insulin receptors are predominantly localized to the young erythrocytes, and that further studies are needed to characterize the dependence of the receptor on erythrocyte maturation.
On Some Factors Related to the Pathogenesis of Diabetic Angiopathy
Authors: Almér L. ‐O.
Published: August 2010

ABSTRACT. The deterioration of the circulation in small and large vessels in diabetes seems to be related to abnormalities of the function of the endothelial cells and of the platelets. The endothelial factor VIII R:Ag, enhancing platelet adhesion, is increased, while fibrinolysis is decreased. The balance between thromboxane (platelet‐aggregating) and prostacyclin (desaggregating) is also shifted in a similar way. These changes all favour increased deposition and delayed removal of platelets and fibrin on the intima, and they might contribute markedly to the development of diabetic angiopathy. Some new drugs seem to normalize the endothelial fibrinolytic activity, and long term studies are in progress to evaluate if this improvement is parallelled by a delayed or absent development of vascular complications.
Ambulatory ECG Recording in Patients Referred because of Syncope or Dizziness
Authors: Kala Risto , Viitasalo Matti T. , Toivonen Lauri , Eisalo Antti
Published: August 2010

ABSTRACT. Data are presented on patients referred for ambulatory ECG recording because of syncope or dizziness during a 2‐year period. Of the 272 consecutive patients subjected to the recording, 107 (39.3%) had syncope or dizziness as the main indication for referral. Sixteen of these patients (14.9%) experienced the presenting symptom during the recording, and in 8 (50%) of these the simultaneous ECG finding was interpreted as causative.

In patients who were symptom‐free during the recording, sinus arrests exceeding 2.5 seconds seemed to be a valuable finding to support the cardiac aetiology of the syncopal symptoms, whereas the diagnostic value of second degree AV block with either Wenckebach or Mobitz II like patterns, as such, and of ventricular tachycardia remained mostly unsettled.
Overdrive Pacing as Treatment of Sotalol‐Induced Ventricular Tachyarrhythmias (Torsade de pointes)
Authors: Tötterman K. J. , Turto H. , Pellinen T.
Published: August 2010

ABSTRACT. Four patients with ventricular arrhythmias due to sotalol intoxication were successfully treated with overdrive pacing. In three patients the reason for sotalol overdose was a suicidal attempt and in the fourth patient the reason was unknown. In all cases a prolongation of the Q‐T interval was seen, which is a typical feature of sotalol overdose. Other features of beta‐blocker intoxication like bradycardia were found in all patients and hypotension in two patients. Three of four patients received lidocaine, but with no effect on multiple ventricular premature beats (VPB) or ventricular tachycardia (VT) of »torsade de pointes»‐type. Overdrive pacing abolished immediately VPBs and VTs in three patients, and in the fourth patient there was apparent decrease in dysrhythmia. Temporary overdrive pacing is suggested as treatment of ventricular arrhythmias in association with prolonged Q‐T interval caused by overdose of sotalol.
Plasma Prekallikrein, Kallikrein Inhibitors, Kininogen and Lipids during Gemfibrozil Treatment in Type II Dyslipidaemia
Authors: Torstila Ilkka , Kaukola Sirkka , Manninen Vesa , Virtamo Jarmo , Mälkönen Marjatta
Published: August 2010

ABSTRACT. The effects of gemfibrozil on plasma prekallikrein, kallikrein inhibitors, kininogen and plasma lipids were investigated in 31 male subjects having either type IIA or IIB dyslipidaemia. During gemfibrozil use, plasma prekallikrein and kininogen were increased significantly while kallikrein inhibitors increased only slightly. Total cholesterol and triglycerides decreased while HDL cholesterol was increased. Changes in prekallikrein and HDL cholesterol were correlated, whereas no other significant correlations between changes in lipid and kinin parameters were seen. The observed changes in prekallikrein and kininogen possibly indicate a shift in the thrombo‐haemorrhagic balance in favour for increased fibrinolysis. If so, the effects of gemfibrozil in prevention and management of atherosclerosis would not be solely due to correlation of the dyslipidaemia but also to protection against the accelerated coagulation tendency seen in type II dyslipidaemia.
Myocardial LDH Isoenzyme Patterns in Rats Exposed to Cold and/or Hypobaric Hypoxia
Authors: Kaaja Risto , Are Kristina
Published: August 2010

ABSTRACT. Exposure of rats to hypobaric hypoxia (9.5% O2) for 40 days produced cardiac hypertrophy, increases in the total LDH activity and subunit M percentage of LDH and a significant decrease (50%) in H/M ratio when compared to control rats. An equally long exposure to cold (+ 6°C) did not affect heart weight or total LDH activity, but a significant increase (17.6%) in the H/M ratio developed. Simultaneous exposure to cold (+ 6°C) and hypoxia (9.5% O2) caused a significant decrease in the H/M ratio, but there was no change in the total LDH‐activity when compared to the control group. The poor hypoxic tolerance of the cold‐exposed rats could partly be explained by disadvantageous distribution of LDH isoenzymes leading to impaired glycolytic capacity of such an aerobic organ as the heart.
Trial with Human Leucocyte Interferon and Vidarabine in Herpes Simplex Virus Encephalitis: Diagnostic and Therapeutic Problems
Authors: Koskiniemi M. L. , Vaheri A. , Valtonen S. , Haltia M. , Kaste M. , Manninen V. , Salonen E. M. , Icén A. , Cantell K. ,   Study Group
Published: August 2010

ABSTRACT. A combination therapy of human interferon, vidarabine, and dexa‐methasone was administered to six patients with proven (Patients I‐III) or presumed (Patients IV‐VI) herpes simplex virus encephalitis (HSVE). Interferon combined with dexamethasone was given to one patient with presumed HSVE (Patient VII). Leucopenia and elevated serum transaminase levels appeared in all patients and a diffuse bleeding in one of them. Patients II, III and IV died, 26, 43, and 209 days after the onset of encephalitis, respectively. Patients I, V, VI, and VII were left with moderate brain damage although their physical condition was good. HSV encephalitis presents diagnostic difficulties, complementary diagnostic methods are needed, and current therapeutic trials must be considered as preliminary.
Thyroid hormones and the adrenergic nervous system
Authors: Nilsson Ove R , Karlberg Bengt E
Published: August 2010

ABSTRACTThis paper reviews the various possible relationships between thyroid hormones and the adrenergic nervous system. These concern the sympathetic influence on thyroid hormone secretion, thyroid hormone ‐ induced changes of sympathetic activity or adrenoceptor changes ‐ the effects of catecholamines on thyroid hormone metabolism and, finally, the clinical benefits of β‐adrenoceptor blocking drugs on symptoms and signs of hyperthyroidism.
Adrenergic regulation of renin release and effects on angiotensin and aldosterone
Authors: Karlberg Bengt E
Published: August 2010

ABSTRACTThis survey discloses the main mechanisms regulating renin release from the kidneys. Stimulation or inhibition of renin at least during a normal sodium intake seems to depend mostly on the sympathetic nervous system and be mediated through β1‐adrenoceptors. The suppression of renin release is maintained during long‐term treatment with both selective (β1) and non‐selective (β1+β2)‐adrenoceptor blocking drugs. The role of α‐adrenoceptors on renin release is less clear, both stimulating and suppressive effects having been described after treatment with α1‐adrenoceptor blocking therapy (i.e. prazosin). In certain conditions, i.e. when renal vascular resistance is increased or renal perfusion pressure augmented, renal prostaglandins (PG) especially PGE2, may play an important part in renin release. Angiotensin II (A II) and aldosterone generally follow the shifts in renin release. Thus, a decrease in both A II and plasma aldosterone is seen during long‐term treatment with β‐adrenoceptor‐blockade and may contribute to the blood‐pressure lowering effect of these drugs.
Adrenergic control of lipid metabolism
Authors: Smith Ulf
Published: August 2010

ABSTRACT Adrenergic receptors are ubiquitous and mediate several important effects involving lipid metabolism. Thus, β‐adrenergic stimulation increases lipolysis and inhibits the activity of the lipoprotein lipase. In contrast, α‐adrenergic stimulation inhibits fat cell lipid mobilisation. Unexpectedly, β‐adrenergic blockade increases plasma triglyceride levels and tends to lower the high density lipoprotein (HDL‐cholesterol). These effects seem to be prevented or attenuated by concomitant α‐blockade. Possible mechanisms for the adrenergic effect on lipid metabolism are reviewed.
β‐adrenoceptor blockade and exercise: effects on endurance and physical training
Authors: Juhlin‐Dannfelt Anders
Published: August 2010

ABSTRACTβ‐adrenoceptor antagonists influence almost all haemodynamic and metabolic actions in the body. High levels of sympathetic stimulation accompany aerobic exercise and it is known that β‐blockade results in a decreased working capacity. Furthermore it has also been questioned whether β‐blockade inhibits the normal response to physical training. Although adrenergic mechanisms are involved in muscle and liver glycogen breakdown, β‐blockade does not seem to reduce glycogen utilisation during exercise. Both selective and non‐selective β‐blockade inhibit lipolysis and result in less free fatty acids being available for muscle utilisation. Surgical and chemical sympathectomy in animals has been shown to inhibit the responses to physical training but results are now available showing that β‐adrenergic blockade does not prevent the effect of physical conditioning in patients treated with propranolol. It is concluded that β‐blockade during prolonged exercise a) does not reduce oxygen uptake by the working muscles b) decreases fat metabolism, which secondarily increases the use of carbohydrates, resulting in earlier hypoglycaemia and/or depletion of muscle glycogen with reduction in working capacity c) does not inhibit central and peripheral adaptation to physical conditioning.
Incidence and importance of metabolic side‐effects during antihypertensive therapy
Authors: Elmfeldt Dag , Berglund Göran , Wedel Hans , Wilhelmsen Lars
Published: August 2010

ABSTRACTThree long‐term, randomised trials examining antihypertensive treatment with either diuretics or β‐blockers are in progress. On the basis of these, the following conclusions may be drawn regarding metabolic side‐effects. Diuretics decrease whereas β‐blockers increase serum potassium. Neither drug has any obvious influence on total body potassium. Serum urate increases on both drugs but more so in those taking diuretics. Serum triglycerides increase while total serum cholesterol is unchanged in both treatments. It is still a matter of controversy whether there is a decrease in glucose tolerance and an increase in the incidence of diabetes in patients on diuretics. The possible negative influence of metabolic side‐effects on morbidity and mortality may limit the beneficial effects of blood pressure reduction, especially in patients with low pressures before treatment. Thus, it seems crucial to minimise theses side‐effects. Since they are dose‐related for both diuretics and β‐blockers, the use of low doses and, if needed, combination treatment is preferable.
Neurotrophic effects on the vascular bed
Authors: Folkow Björn
Published: August 2010

ABSTRACTAfter defining truly “neurotrophic” influences, and giving examples from the many studies of such influences on the somatomotor system, current research concerning sympathetic neurotrophic effects on the vascular bed is discussed. Tissue‐culture studies have made it clear that, particularly in early growth phases, local trophic influences are quite important and interdependent between adrenergic neurons and vascular smooth muscle cells. Most experiments aimed at illustrating neurotrophic effects on vascular beds in vivo, however, seem to suggest the dominance of long‐term adaptation processes inherent in the effector cells themselves which, particularly on sustained extrinsic activation however achieved, become increasingly mobilised. This is not to dispute the fact that truly neurotrophic influences seem to be superimposed, facilitating and modulating these essentially intrinsic mechanisms for long‐term effector cell adaptation, but their relative importance is difficult to judge.
The relation between cardiac hypertrophy and hypertension
Authors: Hartford Marianne , Wikstrand John , Wallentin Ingemar , Ljungman Susanne , Berglund Göran
Published: August 2010

ABSTRACT Left ventricular mass determined echocardiographically was related to blood pressure in a stratified random sample (n = 120) of 49‐year‐old men selected from a blood pressure screening and covering a wide range of blood pressures. Only subjects not on antihypertensive treatment were studied. Left ventricular mass was also related to sympathetic activity, the renin‐angiotensin‐aldosterone system and glucose metabolism. A poor correlation between left ventricular mass and blood pressure was found in the entire study group. In the upper blood pressure range only blood pressure during isometric exercise was significantly correlated with left ventricular mass. In this range there were significant correlations between left ventricular mass and 24 hour urinary noradrenaline excretion and plasma aldosterone. In the intermediate blood pressure range there was an association between left ventricular mass and blood glucose and plasma insulin. It is concluded that in mild to moderate hypertension other factors probably modify the hypertrophic response to rising arterial pressure.
Adrenergic control of Na+‐K+‐homoeostasis
Authors: Clausen Torben
Published: August 2010

ABSTRACTCatecholamines induce hypokalaemia via stimulation of β‐adrenoceptors, primarily in skeletal muscle but also in other tissues. This is the result of increased active Na+‐K+‐transport, leading to a rise in the intracellular K+/Na+‐ratio and hyperpolarisation in muscle cells. These effects are mediated by 3′, 5′‐cyclic adenosine monophosphate, can be detected down to physiological concentrations of adrenaline and noradrenaline, and are seen both in vitro and in vivo. Catecholamines released from the adrenal medulla as well as sympathetic nerve endings are of importance in clearing K+from the extracellular water space during K+‐loading or exercise. β2‐adrenoceptor agonists can be used in the treatment of hyperkalaemia, and β‐adrenoceptor blockade may induce hyperkalaemia, in particular during exercise. The effects of catecholamines on the contractile performance of skeletal muscles are partly due to stimulation of the active electrogenic Na+‐K+‐transport across the sarcolemma.
The role of salt in hypertension
Authors: Berglund Göran
Published: August 2010

ABSTRACT Epidemiological data indicate a weak but significant positive correlation between the level of salt intake and blood pressure. It is unclear how this relationship is mediated but some studies indicate that heredity for hypertension is associated with an increased sensitivity to salt. Decrease of the salt intake decreases blood pressure in established hypertension and should be used as a therapeutic adjuvant in mild uncomplicated hypertension much more often than is now the case. Increased salt intake in young subjects with or without heredity for hypertension does not seem to increase the blood pressure during a 4–12 week load. Increased salt intake in middle‐aged men, on the other hand, seem to induce a blood pressure increase irrespective of the presence or absence of a positive family history. The sensitivity to a high salt intake might thus be associated with aging. Increase of the salt intake from the normal level seems to induce an increase in sympathetic nervous activity. The interplay between the level of salt intake and sympathetic nervous activity should be studied in more detail.
Electrocardiographic Findings in Subarachnoid Hemorrhage
Authors: Melin J. , Fogelholm R.
Published: August 2010

The prevalence of ECG abnormalities and their prognostic value in subarachnoid hemorrhage (SAH) were analysed in patients from an epidemiological study on SAH. The analysis was based on ECGs recorded during the first 72 hours after bleeding. An ECG recording was obtained in 29% of patients dying within 7 days after SAH, and in 64 % of those surviving longer. Tachycardia over 100 beats/min, P mitrale, and ST segment depression >1.0 nun or elevation >2.5 mm were statistically significantly more common among patients dying within 7 days after bleeding. ECG changes reflecting myocardial ischemia or a compromised hemodynamic state observed during the first 3 days after SAH seem to have an untoward effect on the prognosis.
Muscle Fibre Composition in Relation to Blood Pressure Response to Isometric Exercise in Normotensive and Hypertensive Subjects
Authors: Frisk‐Holmberg Marianne , Essén Birgitta , Fredrikson Mats , Ström Gunnar , Wibell Lars
Published: August 2010

A positive relationship was demonstrated between the blood pressure and the fibre composition of the vastus muscle at rest in 17 hypertensive and 17 age‐ and sex‐matched normotensive subjects. The hypertensive group had a higher proportion of fast twitch (FT) fibres (p<0.1). The circulatory response was measured during isometric exercise (IE) and cold pressor test (CPT). During IE the blood pressure increase was positively related to the percentage of FT fibres. No such relationship was demonstrated during CPT. It was thus found, particularly in hypertensive subjects, that an individual's muscle fibre profile is of importance for the blood pressure response during IE.
Intellectual and Social Function of Patients Surviving Cardiac Arrest outside the Hospital
Authors: Nielsen J. Rokkedal , Gram Lis , Rasmussen L. Pind , Damsgaard Else Marie , Dalsgaard M. , Richardt C. , Beckmann J.
Published: August 2010

Thirteen survivors of cardiac arrest outside the hospital were examined by clinical and psychological tests 1–3 years after the incidence, and compared to a matched control group of 13 patients with acute myocardial infarction without cardiac arrest. Psychological tests revaled that 7 patients with previous cardiac arrest and 4 control patients had mild‐moderate to moderate‐severe dementia. The demential symptoms were not detectable by a clinical interview. Four patients in each group exhibited pronounced anxiety symptoms. There were no clear differences between the two groups in respect of changes in cardiac function and social status after the incidence.
Rate of Progression of Severity of Valvular Aortic Stenosis
Authors: Jonasson Rune , Jonsson Bengt , Nordlander Rolf , Orinius Erik , Szamosi Alfred
Published: August 2010

Twenty‐six patients with valvular aortic stenosis were followed up for an average period of 9 years after the initial evaluation when the valvular disease had been considered too mild for surgical treatment. The valve area was 0.7–1.9 (mean 1.2) cm2 at the first study and 0.3–2.0 (mean 0.9) cm2 at the second. The mean annual decrease was about 0.1 cm2 in ten and less in the remaining patients. Advanced age and low physical working capacity at the first investigation were associated with rapid progression of the severity of the stenosis, but rapid progression was not predictable. At follow‐up the combination of 1) calcifications of the valve on chest X‐ray, 2) low physical working capacity and 3) negative/biphasic T wave in V6 after exercise was present in 100% of the severe stenoses (≤0.6 cm2) and in 10% of the mild (≥1.0 cm2). The rate of progression of valvular aortic stenosis in adults is usually slow, but moderate stenoses may become severe within a few years.
Increased Total Serum IgE in Alcoholics
Authors: Hällgren R. , Lundin L.
Published: August 2010

Total serum IgE concentrations were measured in 106 male alcoholics with current alcohol abstinence of varying duration. The influence of smoking habits and clinical atopy on IgE levels was considered. The majority (91%) of the alcoholics were smokers and 26 % suffered from possible clinical atopy. The geometric mean IgE in non‐atopic, smoking alcoholics was 42 kU/l and significantly higher than the mean IgE level, 19 kU/l, in age‐matched, smoking, non‐atopic male participants in a general health survey (p<0.001). The IgE levels declined with the length of the alcohol abstinence period. Alcoholics, serially followed after a heavy drinking spree, showed a uniform pattern of declining IgE levels during a fortnight of abstinence (p<0.001). No link was noted between total IgE levels and the extent of liver affection as estimated by various serum variables (bilirubin, aminotransferases, γ‐GT, IgG, IgA and IgM) or galactose tolerance test. The increased IgE levels in alcoholics are suggested to reflect an influence of ethanol on T lymphocytes regulating the IgE synthesis. Such a proposed effect of ethanol on cellular immunity may contribute to certain organic alcohol diseases, but does not appear to influence the frequency of clinical atopy, being similar in our patient group and in the general population of the same geographic area.
Echocardiography in Lone Atrial Fibrillation
Authors: Godtfredsen John , Egeblad Henrik , Berning Jens
Published: August 2010

Twenty‐seven consecutive patients with suspected lone atrial fibrillation were studied by M‐mode echocardiography. Echocardiography disclosed structural or functional cardiac abnormalities in only two (12%) of 17 patients without any sign of underlying heart disease by history or physical examination, whereas an accompanying or underlying cardiac disorder was found in 6 (60 %) of 10 patients with ambiguous clinical findings. It is concluded that echocardiography is of minor value in patients with lone atrial fibrillation if symptoms and signs of other cardiac disorders are totally absent, but the presence of even minor or ambiguous clinical abnormalities seems to be a clear indication for echocardiography in these patients. It is, however, emphasized that echocardiography appears to guide the clinical management in less than 20% of patients with clinically suspected lone atrial fibrillation.
ECG Abnormalities in Patients with Sarcoidosis
Authors: Thunéll M. , Bjerle P. , Stjernberg N.
Published: August 2010

The frequency and type of some abnormal ECG findings in 86 consecutive patients with intrathoracic sarcoidosis were studied and compared with 86 age‐ and sex‐matched healthy controls. Ail ECGs from the patients and controls were mixed and evaluated blindly by one of the investigators. Ectopic beats were seen in 6 patients in the sarcoidosis group and in 3 individuals in the control group. Patients with stage m sarcoidosis had more conduction defects compared with stage I and n patients and with the controls. Repolarization disturbances were found in 17 patients and 6 controls. These disturbances were more common in patients with stage I and II man in those with stage III sarcoidosis. The total number of patients with some ECG abnormality was 27 compared to 12 controls.
Platelets and Coagulation in Patients with Familial Hypercholesterolemia (Type Ha)
Authors: Nordøy Arne , Brox Jan H. , Holme Stein , Killie Jan E. , Lenner Ragnhild Arvidsson
Published: August 2010

Seventeen subjects with hypercholesterolemia (type IIa) were compared with 11 normocholesterolemic family members (controls) with similar dietary habits. The type IIa subjects bad a shorter bleeding time. Beta‐thromboglobulin in plasma and thromboxane B2 and malondialdehyde released from platelets before and after stimulation with collagen or thrombin were similar. No differences in platelet sensitivity to adenosine diphosphate, thrombin or collagen were observed. Gel‐filtered platelets from type IIa subjects had a tendency to spontaneous aggregation and lower procoagulant activity. Platelet sensitivity to prostacyclin was slightly higher in type IIa subjects. No differences in a series of coagulation parameters were observed between the groups. This study has shown some deviations from normal in platelets from subjects with familial hypercholelsterolemia. These changes may contribute to the increased tendency to occlusive vascular diseases in such subjects.
Risk of Myocardial Infarction in Finnish Men in Relation to Fluoride, Magnesium and Calcium Concentration in Drinking Water
Authors: Luoma H. , AromaaProfessor A. , Helminen S. , Murtomaa H. , Kiviluoto L. , Punsar S. , Knekt P.
Published: August 2010

ABSTRACT To study the influence of drinking water composition on the risk of myocardial infarction, the following study was conducted: The cases (C), men 30–64 years of age, had been discharged with a first acute myocardial infarction (AMI) from Kotka Central Hospital. The hospital controls (HC), matched for age and type of community, were selected for each case among surgical patients. Population controls (PC), matched for age and municipality, were drawn for each case from the population register. Subjects submitted a sample of their drinking water and a filled‐in questionnaire. After exclusions, a series of 50 C‐HC and 50 C‐PC pairs was finally constructed. The point estimate of relative risk (RR) for the association between low F (≤0.1 ppm) and increased risk of AMI was 3.0 in the C‐HC series. In the C‐PC comparison, RR was 4.4. RR for low Mg (≤1.2 ppm) was 2.0 in the C‐HC comparison and 4.7 in the C‐PC comparison. The results are consistent with the hypothesis that both a low F and a low Mg intake are conducive to atherosclerosis leading to AMI.
Unsuccessful DTIC treatment of a Patient with Glucagonoma Syndrome
Authors: Hallengren Bengt , Dymling John‐Fredrik , Manhem Per , Tennvall Lena , Tibblin Sten
Published: August 2010

ABSTRACT Various chemotherapeutic modalities have been tried in the treatment of patients with malignant glucagonomas. Promising results have been reported after drug treatment with dimethyl‐triazenoimidazole carboxamide (DTIC). We present a patient with a metastasizing pancreatic glucagonoma, in whom treatment with neither DTIC nor with the combination of streptozotocin and 5‐fluorouracil resulted in any noticeable improvement.
Priapism—Side‐Effect of Prazosin in Patients with Renal Failure
Authors: Ylitalo Pauli , Pasternack Amos
Published: August 2010

ABSTRACT Priapism developed during antihypertensive therapy with prazosin, 3–10 mg daily for 2–4 months, in two young men with severe renal failure. The cases are believed to be associated with α‐adrenoceptor blocking and/or vasodilatory effects of the drug. Renal failure alone unlikely causes priapism, but may be an exposing factor for the episode.
Glucose Intolerance in Patients with Chronic Inflammatory Diseases Is Normalized by Glucocorticoids
Authors: Hällgren R. , Berne C.
Published: August 2010

ABSTRACT Nine of 16 patients with inflammatory connective tissue diseases (rheumatoid arthritis, polymyalgia rheumatica, scleroderma and mixed connective tissue disease) had glucose intolerance defined a a K‐rate less than one but a normal early insulin response to intravenous glucose loading. The degree of the impaired glucose handling was related to the degree of inflammatory activity as defined by acute phase reactants. Glucocorticoid therapy induced within three days an improved and normalized glucose tolerance and an augmented early insulin response (p<0.001). The glucocorticoid effect was still present up to six months of ongoing therapy. It is suggested that glucose intolerance in chronic inflammation is a consequence of a peripheral insulin antagonism and an inhibition of insulin secretion. This inhibition may be mediated directly or indirectly by inflammatory cell products and may be sensitive to glucocorticoids.
Effect of Correction of Hyperglycemia on Left Ventricular Function in Non‐Insulin‐Dependent (Type 2) Diabetics
Authors: Uusitupa Matti , Siitonen Onni , Aro Antti , Korhonen Timo , Pyórälä Kalevi
Published: August 2010

ABSTRACTSystolic time intervals (STI) were recorded in 33 newly diagnosed non‐insulin‐dependent diabetics (19 men, 14 women, aged 44–64 years) before and after 3–8 months' dietary therapy. The mean (±SD) fasting blood glucose was 11.1±2.6 mmol/l before treatment and 7.8±1.8 at the second examination (p<0.001). Concomitantly with the decline in blood glucose concentration, the heart rate corrected pre‐ejection period (PEP) decreased from 139±11.9 to 135±14.4 msec (mean±SD) (p<0.05), the heart rate corrected left ventricular ejection time (LVET) increased from 400 ± 15.1 to 410±20.7 msec (p<0.0025) and the PEP/LVET ratio decreased from 0.39±0.06 to 0.36±0.06 (p<0.005). When the diabetics were divided into two groups according to the degree of the decline in blood glucose concentration, only those whose fasting blood glucose decreased by ≥3 mmol/l showed significant changes in STI. No significant changes were observed in the mean heart rate or systolic blood pressure during the treatment. Cardiac dysfunction occurring in untreated non‐insulin‐dependent diabetics may be caused by metabolic factors and it may be reversed at least partially by correction of hyperglycemia.
Intoxication with Sodium Valproate
Authors: Karlsen Ragnar Lund , Kett Kjell , Henriksen Olaf
Published: August 2010

ABSTRACT Sodium valproate is a relatively new compound in the treatment of epilepsy. A female patient was admitted to the hospital after voluntary intake of 30 g sodium valproate. Her serum concentration was 4 925 μnol/l, but the course of the intoxication was mild and the patient was soporous for only 12 hours after intake of the compound. Biochemical data may suggest a slight transitory liver affection.
Angioleiomyoma of the Common Bile Duct
Authors: Pönkä Antti , Laasonen Leena , Strengell‐Usanov Liisa
Published: August 2010

ABSTRACT An 80‐year‐old woman with angioleiomyoma in the common bile duct is described. Apart from weakness and jaundice, the patient had no signs or symptoms until after endoscopic retrograde cholangiopancreatography, when cholangitis and septicaemia due to Pseudomonas aeruginosa developed. X‐ray during endoscopy revealed a tumour obstructing the common bile duct and was assumed to be malignant. Because the patient was so old and her general condition had deteriorated, no treatment was given. Autopsy revealed a benign angioleiomyoma of the common bile duct and suppurative cholangitis, the latter obviously caused by the endoscopy.
Glycosylated Haemoglobin in Clinical Practice
Authors: Blohmé GÖran
Published: August 2010

ABSTRACT.Glycosylated haemoglobin or HbA, is a valuable instrument and an objective method to evaluate the metabolic state in the management of diabetes mellitus. This paper summarizes the value of HbA1analysis from the clinical point of view, discussing errors and indications. Only 20% of a group of type I diabetic patients had acceptable HbA1niveau indicating that a lot of work has to be done to achieve normoglycaemia in ordinary diabetics outside the remission period and during pregnancy.
Factors of Importance for Residual Beta‐cell Function in Type I Diabetes Mellitus
Authors: Madsbad Sten
Published: August 2010

ABSTRACT. With the development of the C‐peptide assay more systematic studies of the endogenous insulin secretion have been possible in insulin‐dependent diabetes. Several reports now support the view that nearly 100% of patients have functioning beta‐cells at onset of disease. After start of insulin therapy most patients have a transient improvement in beta‐cell function, the remission period, with a maximum found between 2 and 5 months after diagnosis. Thereafter the beta‐cell function declines, but after 2 years duration of disease nearly 100% of the patients still will display residual beta‐cell function. The following years the prevalence of residual beta‐cell function will decrease to about 15% after 10 to 15 years duration, and thereafter no further decline in prevalence seems to occur. At present it is unclear why insulin‐dependent patients have different degree of beta‐cell function after years duration of disease. We have demonstrated that age at onset is of importance the first 10–15 years of disease, where the prevalence was highest in the elder patients. Thereafter the age at onset is without influence on prevalence of residual beta‐cell function. The degree of metabolic control is also of importance for beta‐cell function. Both at onset and in patients past their initial remission period has improvement in glucaemic control resulted in an improved beta‐cell function; but disappointingly this effect has only been transient. Whether poor metabolic control accelerates the destruction of the beta‐cells is not known. The importance of the many abnormal immunological parameters found in insulin‐dependent diabetics still has to be elucidated. Until now none of them have shown correlations to residual beta‐cell function. Therefore, at present it is impossible to predict at diagnose and during the first year of disease, which patients who will display residual beta‐cell function throughout life.
Type I Diabetes and Physical Exercise
Authors: Holm GÖran , StrÖmblad Gunnar
Published: August 2010

ABSTRACT. Metabolic effects of physical exercise in type I diabetes are reviewed. Physical training leads to an increased insulin sensitivity but does not seem to influence the metabolic control. However, the metabolic control is of importance for the exercise results. Patients in a good control do not differ from normal individuals concerning working capacity, recovery after hypoglycemia and hormonal balance. Furthermore, abnormalities in the blood glucose homeostasis during exercise in type I diabetes are discussed as well as potential beneficial effects of physical training in the prevention of cardiovascular disease.
Human Monocomponent Insulin
Authors: Markussen Jan , Damgaard U. , Jørgensen K. H. , Sørensen E. , Thim L.
Published: August 2010

ABSTRACT. The primary structure of different insulins is reviewed and the properties, identification tests, purity, potency and immunogenicity of human insulin are summerized. Novo Research Institute has developed a method, simply using an enzymatic conversion reaction to substitute the B30 alanine of porcine insulin with threonine to manufacture human insulin. This process is basically an extension of the process currently used to manufacture the Novo purified insulins which are commercially available.
Transplantation of Isolated Pancreatic Islets: Current Status and Prospects
Authors: Henriksson Christen
Published: August 2010

ABSTRACT. Complete and permanent reversal of diabetes by transplantation of isolated pancreatic islets has been repeatedly demonstrated experimentally, whereas islet isolation and transplantation in man are associated with largely unsolved problems: the standard isolation procedure including disruption of acini and collagenase digestion is ineffective. Improvement of the islet yield is currently obtained in animal and human trials by using substances selectively acting on exocrine tissue and others protecting the islets at the isolation as well as in tissue culture media. Islet tissue banks and repeated transplantations seem to be realistic also in man. Islets are advantageously implanted intraportally in the liver. They are rejected soon without protection or efficient immunosuppression. Intense research concerns islet‐containing diffusion chambers, macrophage suppression, new immunosuppressive agents and induction of immunological tolerance. A successful solution of the technical and immunological problems will aggravate a shortage of donor tissue, already noticeable in the experimental work: this will make the recipient selection crucial.
Coxsackie B Virus Antibodies in Myocardial Infarction
Authors: NIKOSKELAINEN JUKKA , KALLIOMÁKI J. LENNART , LAPINLEIMU KAISA , STENVIK MIRJA , HALONEN PEKKA E.
Published: August 2010

ABSTRACT. Evidence for the association between Coxsackie B virus infections and myocardial infarction was studied in a prospective follow‐up examination. Using the micro neutralization test, 9 (15%) of 59 patients with acute myocardial infarction and 1 (2.6%) of 38 control patients showed a fourfold, or higher, antibody increase in paired serum samples against Coxsackie B1‐5 viruses. This difference is significant (p≤0.05). None of the patients or controls revealed symptoms of a viral infection during the blood sampling. Virus isolation from throat and feces was negative in all patients and controls. This finding agrees with some previous studies suggesting that the Coxsackie B group may in some cases have a causal role in myocardial infarction, or may act as a triggering factor.
Is there an Association between Serum Cholesterol and Blood Pressure Changes?
Authors: SALONEN JUKKA T. , PUSKA PEKKA
Published: August 2010

ABSTRACT. A community‐based programme to influence the risk factors of coronary heart disease was carried out in North Karelia, Eastern Finland in 1972‐77. The evaluation, based on examination of large cross‐sectional random samples at the outset and at the end of the period, showed a greater reduction in both serum cholesterol and blood pressure levels in North Karelia than in a matched reference area. A random cohort of 293 men and 321 women who were studied both in 1972 and in 1977 did not use antihypertensive drugs on either occasion. Among these people the change in blood pressure was positively associated with the change in serum cholesterol even when age, initial blood pressure, changes in body mass and number of blood pressure measurements were allowed for. This finding supports the hypothesis that changes in fat consumption lead to changes in blood pressure, but this hypothesis needs further investigation.
Reference Lists in Medical Journals—Language and Length
Authors: BÖTTIGER L. E.
Published: August 2010

ABSTRACT. A total of 8251 references from seven medical journals from four language areas (English, French, German and Swedish) have been studied. The mean number of references per article varies from 13 to 27, the range is wide (2–63). Six per cent of the references are more than 25 years old and most of them could probably be omitted. The English language predominates to the degree (91 %) that there is practically no influx from other language areas than those included in the study. A Medline search shows a much higher proportion of references in other languages (English 59%) and makes it likely that non‐English references to a large degree are neglected by authors writing and reading only English. It is concluded that it should be possible to limit the number of references per original article to 20–25.
Amyloid‐Associated Muscle Pseudohypertrophy and Multiple Myeloma in a Man with Hypernephroma
Authors: ELOMAA INKERI , EKBLOM PETER , SOMER TIMO
Published: August 2010

ABSTRACT. Amyloidosis is known to occur both in renal adenocarcinoma and multiple myeloma. This paper describes a 52‐year‐old man who developed multiple myeloma and widespread amyloidosis after surgical removal of a hypernephroma. Multiple myeloma presented with osteolytic bone lesions and slight bone marrow plasmocytosis. Both kappa light chains and monoclonal IgG were secreted. Amyloidosis was seen as muscle pseudohypertrophy with wood‐hard masses of amyloid in shoulders, girdle, buttocks and proximal limbs. Macroglossia was impressive and swelling of submandibular structures and the floor of the mouth was marked. Knowing the peculiar immunological potency of hypernephroma, attention is called to associations between renal carcinoma and monoclonal gammopathies, including amyloidosis.
Plasma High‐Density Lipoproteins and Liver Lipids and Proteins in Man
Authors: LUOMA P. V. , SAVOLAINEN M. J. , SOTANIEMI E. A. , PELKONEN R. O. , ARRANTO A. J. , EHNHOLM C.
Published: August 2010

ABSTRACT.The association of high‐density lipoproteins (HDL) in plasma with liver lipids and proteins was investigated in 28 subjects with diagnostic liver biopsy. Lipids and proteins were evaluated in relation to hepatic histology and microsomal enzyme induction, assessed by liver cytochrome P‐450. Moderate‐severe hepatic parenchymal changes were associated with low liver phospholipids, protein and cytochrome P‐450, low plasma HDL cholesterol (HDL‐C), and high hepatic triglycerides. Liver microsomal induction accompanying anti‐convulsant therapy was associated with high liver phospholipids and protein, high plasma HDL‐C, apoproteins A‐I and A‐II, and high HDL‐C/total cholesterol (T‐C) ratio. HDL‐C, A‐I and the HDL‐C/T‐C ratio were directly proportional to liver phospholipids, protein and cytochrome P‐450, inversely related to hepatic triglycerides. Increases in hepatic phospholipids and protein, characteristic of microsomal induction, may lead to the elevation of plasma HDL apoprotein and HDL‐C levels and HDL‐C/T‐C ratios, and thus reduce the risk of coronary heart disease.
Ketanserin in Hypertension
Authors: ANDRÉN LENNART , SVENSSON ANDERS , DAHLÖF BJÖRN , EGGERTSEN ROBERT , HANSSON LENNART
Published: August 2010

ABSTRACT.Ketanserin, a new 5‐hydroxy‐tryptamine antagonist, was given at three different dosage levels (double‐blind, randomized) in a dose finding study for 2 months to 31 patients with mild to moderately severe essential hypertension. Treatment with ketanserin was then continued until 9 months had been completed. A significant antihypertensive effect was demonstrated at daily dosages of 20 mg t.i.d. or 40 mg t.i.d. The antihypertensive effect was similar to that of previous multiple drug treatment with conventional drugs. However, 60 mg t.i.d. was not acceptable, at least not as initial dosage. At this dose level, 8 out of 10 patients had to be withdrawn from the study during the initial phase due to unwanted effects. It is conceivable that α1‐adrenoceptor blockade may have played a role at this dose level, since postural reactions were observed which was otherwise not the case during this study. Ketanserin is a new and interesting alternative in the treatment of hypertension. At the same time it offers a tool by which the role of 5‐hydroxy‐tryptamine in the regulation of arterial pressure can be investigated.