bluuebunny/crossref_metadata_2025 huggingface dataset:
Relative Reference Values for Clinical Chemical and Haematological Quantities in ‘Healthy’ Elderly People
Authors: Dybkær R. , Lauritzen M. , Krakauer R.
Published: August 2010

ABSTRACT. A search of the literature revealed a paucity of data on reference values for clinical chemical and haematological quantities in reasonably ‘healthy’ ambulant persons above 65 years of age. On the basis of 90 papers, concerning 37 different types of quantities, the median values for men and for women at 30, 50, 65, and 80 years are calculated relative to the value in men at 30 years. This transformation reduces influences of analytical and demographic factors that have caused considerable systematic differences in the original data. The reference distribution is described as regards symmetry and the change in dispersion with age. The results are given in a table and show four types of changes with age: no significant variation, a fall, an increase or a maximum somewhere between 30 and 80 years; the type of change often depends on sex.
Inheritable Molecular Variants of Moderate and Mild Hemophilia A
Authors: Ljung Rolf , Holmberg Lars , Nilsson Inga Marie
Published: August 2010

ABSTRACT. Factor VIII clotting activity (VIII: C) and factor VIII clotting antigen (VIII: CAg) were investigated in 54 patients with hemophilia A of moderate or mild severity. The patients belonged to 28 kindreds. The study showed a genetically determined molecular variation within hemophilia A of both moderate and mild forms. Each form can be classified into 3 types according to the content of demonstrable VIII: CAg. Type I has no demonstrable VIII: CAg, type IIa has VIII: CAg in an amount smaller than, or approximately equal to, that of VIII: C and type IIb has a larger amount of VIII:CAg than VIII:C. Affected members of one and the same kindred always have the same type of the disease.
Pituitary Function in Patients with Enlarged Sella Turcica and Primary Empty Sella Syndrome
Authors: Ekblom Marja , Ketonen Leena , Kuuliala Ilkka , Pelkonen Risto
Published: August 2010

ABSTRACT. The pituitary function in 20 patients with primary empty sella syndrome has been evaluated. The only endocrine symptom was secondary amenorrhoea in four patients. In half of the patients, pituitary function tests showed minor abnormalities, the most common being impaired growth hormone response to glucagon. In addition to the empty sella, other intracranial abnormalities such as pituitary tumour and hydrocephalus were found in four patients. Although commonly a benign condition, the empty sella may occasionally be associated with clinically important endocrine dysfunction, pituitary tumours and other intracranial abnormalities.
Determination of Oxalic Acid Clearance and Plasma Concentration by Radioisotope Infusion
Authors: Prenen J. A. C. , Boer P. , Mees E. J. Dorhout , Endeman H. J. , Yoe Oei Hong
Published: August 2010

ABSTRACT. The renal clearance of 14C‐oxalate was studied in a family with two children suffering from primary hyperoxaluria. The 14C‐oxalate/creatinine clearance ratio ranged from 1.8 to 2.6 (mean 2.0) and appeared to be independent of the glomerular filtration rate. The calculated plasma oxalate concentrations in the three normo‐oxaluric subjects ranged from 0.1 to 0.9 μmol/l, whereas values of 3.2 and 16.3 μmol/l were found in the two hyperoxaluric subjects. In the latter patient, the oxalate production decreased and the clearance increased after vitamin B6 treatment, resulting in a drop in the oxalate plasma level to 5.3 μmol/l. The apparent distribution volumes, expressed as percentage of body weight, ranged from 30 to 47 % (mean 35). The mean biological half‐life of 14C‐oxalate was 2.7 hours in the subjects with normal renal function and increased with impairment of renal function. The recovery of 14C in the urine ranged from 87 to 112% (mean 101); all 14C activity was recovered as oxalate.
Hereditary Hemorrhagic Telangiectasia (Osler‐Weber‐Rendu Disease) Complicated by Pulmonary Arteriovenous Fistula and Brain Abscess
Authors: Härkönen Mauno
Published: August 2010

ABSTRACT. A man who developed two brain abscesses was later found to have hereditary hemorrhagic telangiectasia with a pulmonary arteriovenous fistula. Brain abscess is a known complication of pulmonary arteriovenous fistulas. About 15 % of patients with hereditary hemorrhagic telangiectasia develop such a fistula during their lives. Surgical resection of pulmonary arteriovenous fistulas is recommended because of the risk of severe neurological sequelae.
Praecordial ECG Mapping in Acute Anterior Myocardial Infarction
Authors: Thygesen K. , Hørder M. , Petersen P. Hyltoft , Nielsen B. Lyager
Published: August 2010

ABSTRACT. Praecordial ECG mapping (42 leads) was carried out in 16 patients with anterior myocardial infarction, admitted up to 3 hours after the onset of symptoms. The mappings were performed according to a set time schedule throughout the acute phase and one year after the infarction. For each ECG map the number of leads with ST elevation ≥ 1.5 mm (NST) and the sum of these (σST) were calculated. In addition, the sum of Q amplitudes (σQ) and R amplitudes (σR) were determined. On average, the initial σST elevation decreased from 2 to 8 hours. A secondary increase, occurring in 14 patients, was maximal during days 2–5. Based on the appearance function of creatine kinase in plasma and the QRS alterations, it is suggested that this re‐elevation of the ST segment was due to infarct extension (5 pats.) or expansion (9 pats.). The course of the average NST was similar to σST. σQ began to develop at 3 hours, the maximum deflection being reached after about 24 hours (range 8–45). σR was falling at 2 hours; the maximum rate of decrease occurred, on average, within the first 24 hours (range 12–54). One year after the infarction, both σQ and σR had the same level as at 8 hours. The ST elevation at 4 hours was related to the development of Q and R waves within 24 hours, but only a weak or no correlation was found. Thus, there was very little value in predicting the development of QR changes from the ST elevation at 4 hours.
Hyperlipoproteinaemia and Reduced Fibrinolytic Activity in Healthy Coronary High‐Risk Men
Authors: Andersen P. , Arnesen H. , Hjermann I.
Published: August 2010

ABSTRACT. One hundred and four consecutive men from the non‐symptomatic hyperlipoproteinaemic group of the Oslo Study were examined with regard to their fibrinolytic response to venous occlusion of the arm. Sixty‐eight per cent showed reduced fibrinolytic activity as compared to 24% of 21 age‐matched healthy coronary low‐risk men. In the hyperlipoproteinaemic group, 55 individuals had been on a moderate lipid‐lowering diet for about 3 years, whereas the other 49 had not (controls). The diet group showed a marked tendency towards normalization of their lipoprotein patterns, but this was not significantly associated with normalization of the fibrinolytic activity. Out of 20 men with type IV hyperlipoproteinaemia, 95% showed reduced fibrinolytic activity. The association between hypertriglyceridaemia (type IV hyperlipoproteinaemia) and reduced fibrinolytic activity might possibly be explained by a reduced lipoprotein lipase activity in these individuals.
Bone Mineral Content before and after Intestinal Bypass Operation in Obese Patients
Authors: Rickers H. , Balslev I. , Foltved H. , Rødbro P.
Published: August 2010

ABSTRACT.With the aim of investigating bone mineral loss after intestinal bypass operation, bone mineral content (BMC) was measured by two‐dimensional scanning photon absorptiometry on the distal part of the forearm in 23 consecutive patients who had undergone intestinal bypass operation for obesity. Eleven patients (group 1) were investigated before and 12 months after operation, and 12 (group 2), who had been operated on 2–7 years earlier, were investigated two times at an interval of 12 months. No patient received therapeutic calcium or vitamin D supply. The predominant biochemical findings postoperatively were decreased serum values of calcium, magnesium, albumin, and total protein; there was no change in inorganic phosphate or alkaline phosphatase. Mean BMC was normal in both groups postoperatively as well as in group 1 before operation; there was no significant change in mean BMC during 12 months of observation. However, in BMC measurements on extremely obese subjects, a correction for the excessive fat layer on the forearm was necessary because of different attenuation properties of fat and soft tissues. Neglect of this problem will give a systematic underestimation of BMC, and may lead to false conclusions in cross‐sectional as well as longitudinal studies.
On the Size and Tumor Involvement of the Spleen in Hodgkin's Disease
Authors: Askergren J. , Björkholm M. , Holm G. , Johansson B. , Sundblad R.
Published: August 2010

ABSTRACT. Fifty‐four untreated patients with Hodgkins's disease (HD) subjected to splenectomy were studied with respect to preoperatively assessed spleen size compared to postoperative findings. Before splenectomy, nine patients had “normal sized” spleens, 18 patients had spleens weighing ≥ 200 g and 14/39 spleens were tumor‐involved. Nine patients had “enlarged” but impalpable spleens. Eight of these weighed >200 g and 3/9 spleens showed tumor involvement. Six patients with preoperatively palpable spleens showed tumor involvement, their spleens weighed >660 g. The results confirm the inaccuracy of non‐invasive procedures in prediction of spleen size and tumor involvement in HD.
Simultaneous Occurrence of Clinical Manifestations of Myeloma and Waldenström's Macroglobulinemia with Monoclonal IgG Lambda and IgM Kappa in a Single Patient
Authors: Fine J. M. , Gorin N. C. , Gendre J. P. , Petitpierre J. C. , Labro‐Bryskier M. Th. , Lambin P.
Published: August 2010

ABSTRACT.This paper reports a rare case of a patient with biclonal gammopathy IgMk and IgGΛ corresponding to the simultaneous occurrence of the clinical manifestations of Waldenström's macroglobulinemia and multiple myeloma. Two cellular populations derived from the B lymphocyte cell line can be observed in this patient. Bone marrow aspiration revealed abnormal plasma cells with inclusions and lymph node aspiration showed immature lymphoid cells containing μ heavy chains.
Surgical Treatment of Bacterial Endocarditis
Authors: Anker Erik , Thaulow Erik , Forfang Kolbjørn , Rostad Hans
Published: August 2010

ABSTRACT. Prosthetic valve implantation was performed in 36 patients with bacterial endocarditis. Thirty‐two of them were in functional class III or IV (NYHA). The early mortality rate was 16.7%. In six patients perivalvular fistulas occurred and were of haemodynamic significance in three of them. At follow‐up after 44 months on average, the clinical condition was excellent (functional class I or II) in 20 of the 26 survivors. The results encourage an active attitude towards surgical intervention in patients with valvular insufficiency due to bacterial endocarditis.
Biochemical and Circulatory Parameters during Purely Mental Stress
Authors: Danner Sven A. , Endert Erik , Koster Rudolph W. , Dunning Arend J.
Published: August 2010

ABSTRACT.In order to evaluate biochemical and circulatory parameters during purely mental stress, 20 healthy medical students were studied before, during and at the end of an important written medical examination. Plasma catecholamines and diastolic blood pressure rose significantly during the examination, whereas systolic blood pressure did not change and heart rate declined. Continuous ECG recording in 12 of the subjects showed a high peak in heart rate at the start of the examination, quickly followed by a rapid decline to values seen on the previous day. It is suggested that in mental stress without physical effort, the enhanced sympathetic activity triggers an increase in parasympathetic activity which overrides the circulatory effects of the former.
Delay of Onset of Second Degree Pacemaker Block by Beta‐Blockade in Patients with P‐Synchronous Pacemakers
Authors: Storstein Liv
Published: August 2010

ABSTRACT. Second degree pacemaker block is a safety mechanism of the synchronous pacer at atrial rates above 120–130. The aim of the present study was to determine the work level at which pacemaker block occurred before and after β‐blockade. Seven patients (mean age 53 y.) were submitted to graded, submaximal exercise on a bicycle ergometer without drug and after 0.8 mg pindolol i.v. (6 pats.) or alprenolol orally (1 pat.). Pacemaker block developed at much higher total work after β‐blockade in 3 patients (5800 vs. 1900 kpm, p > 0.0005), while 4 patients had to stop work due to exhaustion before pacemaker block occurred. Total work increased significantly after β‐blockade (p > 0.0005). Lack of a stable i.v. atrial electrode has delayed the extensive use of the synchronous pacemaker. The design of the generator, however, is not optimal as the upper escape rate at which pacemaker block occurs is too low for a number of patients. β‐Blockade effectively delays the occurrence of pacemaker block and can be of therapeutic value. It is suggested that the P‐synchronous pacer should be redesigned with a programmable basic rate (50–70 beats/min) and a programmable upper rate (130–180 beats/min) to ensure that the obvious physiologic advantages of the atrial triggered pacemaker can be maintained both at rest and during physical exercise.
A Retrospective Clinico‐Pathologic Study of Non‐Hodgkin's Lymphomas Classified According to the Nomenclatures of Lennert and of Rappaport
Authors: Cavallin‐Ståhl Eva , Landberg Torsten , Lindberg Lars Göran , Åkerman Måns
Published: August 2010

ABSTRACT. The survival of 88 patients treated for non‐Hodgkin's lymphoma 1972–73 have been reviewed. In 49 patients it was possible to do a re‐classification of the lymphomas according to Rappaport's and Lennert's classifications. The main obstacle to the classification according to Lennert was inadequacy of the cyto‐pathological material. The correlation between survival and pathology was studied and a comparison between the two classifications was made. Lennert's classification was found to have a good reproducibility and to be more accurate than Rappaport's in separating lymphomas with favourable prognosis from those with unfavourable.
An Immunofluorescence Study of the Skin in Diabetes Mellitus
Authors: Wallach D. , Cottenot F. , Pelbois G. , Passa P.
Published: August 2010

ABSTRACT. The clinically normal skin of the lower back of 30 patients with diabetes mellitus was examined, using the direct immunofluorescence technique. No deposit of immunoglobulins or complement (C3) could be demonstrated, while other authors have previously reported lupus‐like deposits in diabetes mellitus. As other discrepant studies of skin immunofluorescence have been published, it is suggested that the standards of the various immunopathology laboratories are different. This may explain why the actual value of the lupus band test remains controversial.
Studies on Kidney Function in Subjects Exposed to Organic Solvents
Authors: Askergren Alf , Allgén Lars‐Göran , Karlsson Christine , Lundberg Ingvar , Nyberg Elisabet
Published: August 2010

ABSTRACT. The urine of 134 subjects, exposed to different organic solvents, and 48 unexposed subjects has been analysed with reference to albumin and β‐2‐microglobulin excretion. The exposed subjects excreted significantly larger quantities of albumin than the unexposed. Those exposed to styrene excreted the largest amounts. No significant difference in β‐2‐microglobulin excretion could be demonstrated between the groups.
The Uremic Dyslipoproteinemia: Its Characteristics and Relations to Clinical Factors
Authors: Norbeck Hans Erik , Carlson Lars A.
Published: August 2010

ABSTRACT. Fasting concentrations of cholesterol and triglycerides were determined in total serum and in serum fractions of very low (VLDL), low (LDL) and high (HDL) density lipoproteins in 141 patients with chronic renal failure (CRF) of different etiologies. They were grouped according to sex and degree of renal failure. The characteristic dyslipoproteinemia of uremia, viz. hypertriglyceridemia, raised VLDL and low HDL, cholesterol enrichment of VLDL and triglyceride enrichment of LDL, was present already in the mildest, asymptomatic group (creatinine 140–400 μmol/l), highly significant for men (n=28) but not statistically significant for women (n=7). There was a negative correlation between creatinine and LDL cholesterol concentrations and between creatinine and the cholesterol/triglyceride ratio in LDL in males, otherwise the degree of renal insufficiency did not influence the dyslipoproteinemia. Neither different etiologies of CRF, nor treatment with β‐adrenergic blocking agents or thiazides did seem to influence lipoprotein levels orderly. Males on antacids had lower serum and LDL cholesterol levels, which is probably explained by the negative relation between LDL cholesterol and creatinine, as antacids are more often administered in advanced uremia. Males treated with protein‐poor diet differed from other groups by not having elevated VLDL triglycerides. It is concluded that the lipoprotein abnormalities found in uremia are present already at an early stage of renal impairment and, except for LDL cholesterol in males, fairly uninfluenced by the degree of renal function and etiology of the disease. It is suggested that the dyslipoproteinemia of CRF is caused by effects on several mechanisms in lipoprotein metabolism, e.g. deficiency of different apolipoproteins.
Use of Hypnosis in Studies of the Effect of Stress on Cardiovascular Function and Hormones
Authors: Adlercreutz Herman , Kuoppasalmi Kimmo , Närvänen Sakari , Kosunen Kari , Heikkinen Risto
Published: August 2010

ABSTRACT. In an attempt to separate the somatic and mental components of stress, groups of young male volunteers underwent running exercises and sauna baths, and roughly one year later had the same experiences recalled under hypnosis. In addition, experiments involving mental stress in the form of mental arithmetic were performed. A variety of physiological and biochemical parameters was measured on each occasion.

Results for cardiovascular responses, reninangiotensin–aldosterone, Cortisol, testosterone, androstenedione, prolactin and growth hormone are reported. It is concluded that the mental component of combined mental and somatic stress may be separated from the somatic component by hypnotic suggestion. The response during hypnotic suggestion of the stress is usually of less but sometimes of the same magnitude as that obtained during the actual stress. Occasionally the response goes in the opposite direction during hypnotic suggestion as compared to the real situation. The individual responses vary considerably between individuals. The hormones most sensitive to mental stress are growth hormone, androstenedione, Cortisol, renin and angiotensin II. In the present study, mental stress had a depressing effect, if any, on plasma prolactin. Hypnosis in itself has no effect on plasma hormones in unstressed subjects compared to the normal diurnal variations.
Effect of Diazepam on Endothelial Permeability, Plasma Lipids and Lipoproteins in Cholesterol Fed Rabbits
Authors: Mänttäri M. , Mälkönen M. , Manninen V.
Published: August 2010

ABSTRACT. In order to investigate the effect of diazepam in reducing the incidence and severity of cholesterol induced atherosclerosis in rabbits, 3 treatment groups were compared. The control Group I received the laboratory diet alone. Group II received cholesterol (1 gm daily, given by syringe). Animals in Group III additionally received diazepam (3 mg/kg/day) orally, again by syringe.

After 21 days, animals were injected with Evans blue and 3 hours later their aortas were removed and examined for permeability changes. Serum was assayed for various lipid and lipoprotein components.

Cholesterol feeding produced a 10–fold increase in serum cholesterol values in Groups II and III compared to the control Group I. The aortic uptake of Evans blue was significantly increased in animals treated with cholesterol but not in those which simultaneously received diazepam. Thus, diazepam prevented the increased endothelial permeability produced by hypercholesterolaemia, but it is not yet clear whether this effect involves the central nervous system or is a consequence of some more local membrane stabilizing action.
Psychosocial Stress and Sociodemographic Differentials in Mortality from Ischaemic Heart Disease in Finland
Authors: Valkonen Tapani
Published: August 2010

ABSTRACT. This report describes differences in mortality from ischaemic heart disease (IHD) and other selected causes of death according to region, marital status, language group (Finnish vs Swedish), social group and rural–urban divisions in Finland. The data include all deaths in Finland during 1971–75 in the cohorts of men aged 35–64 and women aged 35–74 on January 1st 1971 (33, 862 IHD deaths). The sociodemographic characteristics of the deceased were obtained through computerized linkage from the records of the 1970 census by means of personal identification codes. IHD mortality was found to be higher than average in Eastern Finland, in the Finnish speaking population and in lower social groups. There was a higher mortality in non–married than in married categories among men, but among women the differences were smaller. The findings are discussed in the light of differences in stressrelated mortality.
Self–Control of Interbeat Interval and Pulse Transit Time at Rest and During Exercise. A Preliminary Report
Authors: Johnston D. W. , Lo C. R. , Marie G. V. , Van Jones J.
Published: August 2010

ABSTRACT. Attempts were made to establish self–control of interbeat interval (IBI) and pulse transit time (PTT) by providing appropriate biofeedback information to volunteers at rest and during dynamic and isometric exercise. Product feedback (IBI × PTT) was found more reliable than simple instruction in allowing subjects to reduce heart rate (HR) and systolic blood pressure (SBP) during dynamic exercise. It also produced greater increases in IBI and PTT than did habituation or relaxation under the same conditions. Product feedback was also superior to the use of other techniques at rest, but PTT feedback did not produce significant control of pressor responses during isometric exercise. Possible reasons for this failure are discussed. Preliminary results of feedback training given to 7 anginal patients suggest that such procedures might help to lower nitroglycerin consumption, decrease the frequency of anginal attacks and increase exercise tolerance.
Adrenergic Receptors: Classification, ligand binding and molecular properties
Authors: Wikberg Jarl E. S.
Published: August 2010

ABSTRACT.The interaction of catecholamines and drugs with adrenergic receptors leads to a set of biochemical reactions which ultimately results in a physiological response. A brief review is given of the classification of adrenergic receptors into subtypes and the use of ligand binding techniques for the identification and characterization of these receptors. Recent advances in the biochemistry of adrenergic receptors are reviewed with special reference to the interaction of the βand α2–receptors with guanine nucleotide regulatory proteins and adenylate cyclase. The role of calcium and phos–phoinositides in the function of the α1–receptor is also discussed.
Effects of labetalol and propranolol on the peripheral circulation in hypertensive patients
Authors: Nyberg Gunnar , Berglund Goran
Published: August 2010

ABSTRACT. Eleven patients with essential hypertension participated in a double–blind cross–over comparison of labetalol (L) and propranolol (P). Each drug was given for 5–8 weeks. The dose reducing the supine diastolic blood pressure when given b.d. to or below 90 mm Hg was titrated out. At the end of each period, isometric exercise (sustained handgrip) and calf plethysmography were performed.

L (mean daily dose 636 mg) was slightly more effective in lowering supine and standing blood pressure than P (mean dose 276 mg). There was no significant difference between the drugs in their effect on the blood–pressure response to handgrip. However, compared with no treatment, L attenuated the blood–pressure rise at near–maximal handgrip; this has not been reported with other β–blockers. Resting vascular resistance and basal vascular tone were significantly lower (20%, p < 0.05) during treatment with labetalol than when the patients were taking propranolol. – The differences may be explained by the α–receptorblocking action of labetalol.
Peripheral vasospasm during β–receptor blockade – a comparison between metoprolol and pindolol
Authors: Eliasson Keith , Lins Lars–Eric , Sundqvist Kerstin
Published: August 2010

ABSTRACT. Ten men reported vasospastic symptoms in their hands during metoprolol treatment. They had no signs of occlusive arterial disease. The temperature reaction to local cooling was measured and no improvement was found after changing to pindolol. Vasospastic symptoms during β–receptor blockade may arise in predisposed individuals irrespective of the type of β–receptor antagonist used.
Labetalol in resistant hypertension
Authors: Hedstrand Hans
Published: August 2010

ABSTRACT. In 12 patients with resistant hypertension labetalol was added to existing therapy. The average dose was 1333 mg (range 400–3600). The subjects were followed up for three and a half years. Mean supine blood pressure (BP) was reduced from 202/123 to 163/103 mm Hg and mean standing BP from 193/127 to 144/100 mm Hg. Mean BP after exercise was 134/93 mm Hg. The main side–effect was postural hypotension during exercise, causing withdrawal of labetalol in two subjects.

In patients with severe hypertension, resistant to several combinations of antihypertensive drugs, the addition of labetalol may lead to satisfactory BP reduction, especially when combined with a potent diuretic.
Treatment of hypertension in the elderly with labetalol
Authors: Eisalo A. , Virta P.
Published: August 2010

ABSTRACT.The response of elderly hypertensive patients to labetalol, possessing α– and β–blocking properties, was studied. The dosage was first titrated out and assessed in a double–blind cross–over trial. Altogether 24 patients were treated for one year. The dosage established during the titration period maintained its efficacy. In most cases 200 mg labetalol daily gave satisfactory result. The side–effects were few. The only reason for discontinuance of the drug was gastrointestinal discomfort. Because of the low dosage, the typical side–effects of β–blockade were lacking and α–blockade seemed to be well tolerated. The normal precautions in the treatment of elderly hypertensive patients should be observed.
Labetalol, a combined α– and β–blocker, in hypertension of pregnancy
Authors: Lunell Nils–Olov , Fredholm Bertil , Hjemdahl Paul , Lewander Rolf , Nisell Henry , Nylund Lars , Persson Bengt , Sarby Bert , Wager Jan
Published: August 2010

ABSTRACT. Labetalol was given to women with hypertension of pregnancy in their last trimester to study its acute effect on circulation and metabolism. Seven women were given 50 mg labetalol i v. There was a significant decrease of blood pressure from a mean of 143/101± 4/2 (SEM) to 127/88 ± 5/2 mm Hg. Maternal heart rate fell significantly from 77 ± 5 to 68 ± 3 beats per min. These changes persisted during a three–hour observation period. The hypotensive response was accompanied by a significant increase in plasma noradrenaline from 1.54 ± 0.16 to 2.37 ± 0.41 nmol/l, suggesting sympathetic activation. Plasma cyclic AMP, which is increased by β2–adrenoceptor stimulation, was significantly elevated after labetalol. This supports the hypothesis of partial β–agonist activity of labetalol. Lipid metabolism, as judged from measurements of plasma FFA, glycerol and 3–hydroxybuturic acid, showed little change.

The acute effect of labetalol on uteroplacental blood flow was determined in eight women with pregnancy hypertension using a gammacamera on line with a computer. 0.5 mCi indium–113m was given i v before and 30 min after labetalol was administered i v in a dose of 1 mg per kg body weight. After the injections of indium–113m, serial scintigrams were recorded during 10 s periods for 240 s. By computerized summation of the scintigrams, an image was obtained in which the placenta could be outlined for time–activity analysis of the isotope accumulation curve. From this curve a uteroplacental blood flow index could be calculated. Labetalol induced a significant drop of mean arterial blood pressure from114 ± 2 mm Hg to 100 ± 3 mm Hg after 30 min in this group of women. However, the uteroplacental blood flow index did not change. As we have earlier shown with this technique that uteroplacental blood flow can be severely impaired in hypertension of pregnancy, the Finding of substained uteroplacental blood flow simultaneously with a decrease in blood pressure should be of clinical importance.

Taken together with other studies of clinical effects, these results indicate that labetalol is useful in the treatment of hypertension of pregnancy
Basic pharmacological properties of prenalterol
Authors: Mattsson H. , Hedberg A. , Carlsson E.
Published: August 2010

The cardiac selectivity of prenalterol as an agonist was demonstrated in the anaesthetised cat, in which the heart rate was dose dependently increased without any effect on peripheral vascular resistance. When doses of prenalterol, isoprenaline (non–selective) and terbutallne (β2–selective) were adjusted to give the same increase in heart rate, prenalterol displayed a significantly higher inotropic effect than the other two agonists.

It is generally accepted that cAMP acts as a second messenger in β–mediated responses. Prenalterol induced an inotropic effect in the cat heart, which at its maximum was 80% of that of isoprenaline without, however, any significant increase in cAMP content. In tissue homogenate from cat left ventricle, prenalterol caused only a minor activation of the adenylate cyclase activity. These results may indicate that only a small increase of the adenylate cyclase activity and cAMP level is sufficient for a maximal inotropic response or that production of cAMP is not essential for the positive inotropism produced by prenalterol.

In isolated electrically driven rabbit papillary muscle prenalterol induced a positive inotropic response, which was inhibited by the β1–antagonist metoprolol but not by the α–blocker phentolamine or the β2–blocker IPS 339. This indicates that the contractile effect of prenalterol in the heart is mediated via β1–adrenoceptors and that α– or β2–adrenoceptors are not involved. An interindividual variation in intrinsic activity of prenalterol in rabbit papillary muscle was found to be correlated to the sensitivity to isoprenaline.

Binding experiments have shown that prenalterol binds with equal affinity to both β1– and β2–adrenoceptors. Prenalterol did not affect subtetanlc contractions in soleus muscle, which indicates a lack of β2–agonistic activity of prenalterol in the skeletal muscle. When the cardiostimulatory effect of prenalterol was compared with the β2–blocking effect in the anaesthetised dog, the results revealed that the β2–blocking effect of prenalterol is produced at doses higher than those inducing cardiac stimulation.
Clinical experiences with prenalterol as an antidote to β–adrenoceptor blockade
Authors: Kulling P.
Published: August 2010

The cases presented in this paper suggest that prenalterol is useful in the treatment of myocardial depression due to β–blockade. According to its pharmacological properties, prenalterol might even be the drug of choice in these situations. It is wellknown that massive β–blocker overdosage may be difficult to manage and as the therapeutic guidelines in these cases have not yet been definitely stated, it is obvious that prenalterol In this context will be of utmost Importance. What remains to be solved is the dosage level. So far, experience has shown that high doses, widely exceeding the recommended initial dose of 50–100 μg/kg, are necessary to restore normal circulation in massive β–blocker overdosage.

Prenalterol has been introduced as an antidote to counteract unwanted cardiac effects of β–blockade [l, 2]. In this paper examples will be given where prenalterol has been successfully used to reverse unwanted cardiac effects (like hypotension and/or cardiac failure) in chronic therapeutic β–blockade (Figures 1–2), in acute therapeutic β–blockade (Figure 3) and in intentional overdosage with β–blockers (Figures 4–6).
Haemodynamic effects of intravenously administered prenalterol in patients with severe heart failure
Authors: Waagstein F. , Estrada–Yamamoto M. , Reiz S. , Reyesl C. , Hjalmarson Å.
Published: August 2010

The acute haemodynamic effects of prenalterol 75–225 μg/kg i.v. were studied at rest and during exercise in the supine position in 12 patients with chronic congestive heart failure secondary to myocardial infarction (6 pts), chronic valvular disease with valvular replacement (4 pts), ischaemic cardiomyopathy (1 pt) and post myocarditis (1 pt). In 5 of the b AMI patients the effect of prenalterol on myocardial oxygen consumption at rest was measured. Pulmonary artery end–diastolic pressure decreased significantly from 17 to 10 mm Hg at rest and from 31 to 21 mm Hg during exercise. Resting heart rate increased from 78 to 90 at rest but was unchanged during exercise. MVO2 in the 5 patients was unchanged or lower in 4 patients and increased in one in whom angina developed after prenalterol. In general, dyspnoea and angina during exercise were less pronounced after prenalterol. The calculated triple product was lower after prenalterol, especially during exercise, indicating lower myocardial oxygen consumption and probably less myocardial lschaemia.

It can be concluded that prenalterol may be of value for treatment of chronic congestive heart failure in addition to digitalis and diuretics even in the presence of ischaemic heart disease and effort angina.
Effects of i.v. prenalterol in patients with severe cardiac failure at rest and during exercise
Authors: Doering W. , Wauer B. , Isbary J.
Published: August 2010

Prenalterol administration (150 μg/kg i.v.) exerted beneficial effects on resting and/or exercise cardiac performance in patients with congestive cardiomyopathy (n=12) and 1 patient with hypertensive heart disease (=group I, n = 13), while the haemodynamic response in patients with severe coronary heart disease (n = 3) or cor pulmonale (n = l) was non–uniform. At rest mean right and left ventricular filling pressures decreased by 26 and 19% (p < 0.02 and p < 0.02), respectively, while stroke volume increased by 8% (p < 0.05), cardiac index by 25% (p < 0.01) and heart rate by 15% (p < 0.005) 5 min after prenalterol administration in group I. During exercise there was no further Increase in heart rate, while filling pressures decreased and cardiac index increased significantly compared to control exercise. This typical inotropic response to prenalterol was observed in fully digitalised patients. Maximal effects occurred about 15 min after i.v. administration.
Bone Mineral Content in Myelomatosis
Authors: Ingeberg Steen , Deding Aage , Jensen Mogens Krogh
Published: August 2010

ABSTRACT. Bone mineral content (BMC) was determined by photon absorptiometry on both forearms in 28 patients with myelomatosis. Nineteen patients had received intermittent treatment with cytostatic agents and prednisone. No significant reduction of BMC was found between the patients with myelomatosis and an age‐ and sex‐matched normal population. Neither was any significant decrease in BMC with the duration of the disease demonstrated. In 16 patients, routine X‐ray indicated osteoporosis, but their BMC was not reduced compared to the patients without osteoporosis on X‐ray. However, the former patients were significantly older than the latter. Provided the term “generalized osteoporosis” implies reduced mineral content in all bones, the study indicates that patients with myelomatosis have not generalized osteoporosis.
Variable Interpretation of Liver Scintigraphy in Malignancy as an Aid in Clinical Decision‐Making
Authors: Christensen Mogens , Ingeberg Steen , Brøchner‐Mortensen Jens , Rødbro Paul
Published: August 2010

ABSTRACT. Despite technical progress in liver radioisotope scintigraphy, the overall accuracy in detecting metastases has not improved. It has been suggested that a fixed scintigram interpretation in reply to changing clinical problems is partly responsible. An evaluation of the possibilities of improving the clinical value of the test by using six cutoff levels in the scintigraphic interpretation is presented. The test population is a prospectively planned consecutive series of 185 patients strongly suspected of having gastric or colo‐rectal malignancies. The incidence of liver metastases was 15%. The relationship between the predictive value of a positive test and the false negative ratio at different incidences of metastases is demonstrated graphically. To improve the clinical value of liver scintigraphy, a close cooperation between clinicians and physicians in nuclear medicine to define the clinical problem and the appropriate scintigraphic cutoff level is necessary.
Effects of Beta‐Adrenergic Blockade on Serum Parathyroid Hormone in Normal Subjects and Patients with Primary Hyperparathyroidism
Authors: Ljunghall Sverker , Rudberg Claes , Åkerström Göran , Wide Leif
Published: August 2010

ABSTRACT. Recent experimental studies suggest that the autonomous nervous system can affect the secretion of parathyroid hormone (PTH) and that these effects could be of physiological importance. The short‐term effects of propranolol were investigated in 13 patients with primary hyperparathyroidism (HPT) and 6 normal subjects. During a 2‐hour infusion there were no changes in serum PTH or calcium concentrations in any of the individuals studied. During long‐term treatment of HPT patients with β‐blocking agents for 2–6 months no reduction of raised PTH levels was detected and the hypercalcaemia was unaffected. These findings question the importance of the adrenergic system for the normal regulation of serum PTH levels and its role for hormone hypersecretion in primary HPT. Our experience does not support the use of propranolol as an alternative to surgery in patients with primary HPT.
Angiotensin‐Converting Enzyme in Hypercalcaemic Disorders
Authors: Rømer Frode K.
Published: August 2010

ABSTRACT. Serum angiotensin‐converting enzyme (SACE) was elevated (mean ± S.D. 55.2±19.8 U/ml) in 11 patients with hypercalcaemia due to sarcoidosis, whereas it was within the normal limits (20.0±5.2 U/ml) in 23 patients with other hypercalcaemic conditions. Among these, 16 had primary hyperparathyroidism and a SACE level of 18.6±4.7 U/ml, significantly lower than in healthy controls (24.4±6.2 U/ml). In 7 patients with hypercalcaemia due to malignancies or prolonged immobilization SACE was 21.8±5.9 U/ml. A weakly positive correlation was found between SACE and S‐calcium in hypercalcaemic sarcoidosis patients but not in the other patients or in a control group of 144 consecutive sarcoidosis patients. Sarcoidosis with hypercalcaemia seems to be associated with a very high prevalence of elevated SACE. Especially when sarcoidosis is suspected to be the cause of hypercalcaemia, SACE measurement may be useful as a rapid diagnostic guide.
Beta2Microglobulin in Pleural Effusions
Authors: Riska Henrik , Pettersson Tom , Fröseth Bertil , Klockars Matti
Published: August 2010

ABSTRACT. Beta2microglobulin (β2m) concentrations in serum and pleural fluid from 64 patients with pleural effusion were studied. The level of β2m in pleural fluid was generally twice that in serum. The ratio of pleural fluid β2m to serum β2m in patient groups defined according to the final diagnosis showed an interestingly high value in tuberculous pleuritis and in patients with rheumatoid arthritis with pleural effusion. There was a positive correlation between the β2m and lysozyme contents in pleural fluid, suggesting local and simultaneous activation of different cell lines when the pleura is involved. We suggest that pleural fluid and concomitant serum β2m measurements should be taken into consideration when pleural effusion of tuberculous origin is suspected. Furthermore, β2m determination might help to differentiate between rheumatoid pleural fluid and pleural involvement due to other systemic diseases.
Spontaneous Pneumomediastinum
Authors: Pellinen T. J. , Karjalainen J. E.
Published: August 2010

ABSTRACT. Spontaneous pneumomediastinum (SPM) is a rare entity in which free air is found within the mediastinum usually as a complication of respiratory diseases and conditions associated with increased intra‐alveolar pressure. We report a case of unusual asymptomatic SPM caused by an attack of asthma.
Left‐Sided Pleural Effusion Secondary to Continuous Ambulatory Peritoneal Dialysis
Authors: Nässberger Lennart
Published: August 2010

ABSTRACT. A young woman with diabetes mellitus and subsequent renal insufficiency developed a massive left‐sided pleural effusion secondary to continuous ambulatory peritoneal dialysis (CAPD). There was no increase in weight, and she was free from oedema and fever. Thoracocentesis yielded a clear, yellow fluid with isolated leucocytes and mesothels, but no atypical cells. A cannulogram via a Tenckhoff catheter showed a satisfactory catheter function and position. CAPD, even when properly performed with correct catheter position, may result in massive pleural effusion.
Diagnostic Imaging of Focal Nodular Hyperplasia of the Liver Developing during Nitrofurantoin Therapy
Authors: Anttinen Henrik , Ahonen Aapo , Leinonen Aaro , Kallioinen Matti , Heikkinen Erkki S.
Published: August 2010

ABSTRACT. An asymptomatic palpable liver tumor developed in a six‐year‐old girl seven months after commencement of prophylactic nitrofurantoin therapy for recurrent urinary tract infections. The tumor was examined by 99mTc colloid radionuclide scan, compound ultrasonography and angiography. Ultrasonography demonstrated a large, solid tumor (5times 5x8 cm) in the right lobe of the liver which had an echogenic central core surrounded by an area giving low‐amplitude echoes. Angiography disclosed that the tumor was well demarcated and hypervascular, containing large tortuous arteries. The uptake of radionuclide in the tumor was normal. The tumor was resected and the pathological findings were typical for focal nodular hyperplasia (FNH) of the liver. The combination of the findings of these three diagnostic imaging methods is probably specific for uncomplicated FNH, a benign and innocuous tumor of the liver.
Prevalence of Intermittent Claudication and Its Effect on Mortality
Authors: Reunanen Antti , Takkunen Heikki , Aromaa Arpo
Published: August 2010

ABSTRACT. The prevalence of symptoms of intermittent claudication and their association with 5‐year mortality were examined in a population study in Finland. A number of 5738 men and 5224 women, aged 30–59 years, from 4 geographic areas of the country were studied. According to a structured interview, 2.1% of the men and 1.8% of the women reported typical symptoms of intermittent claudication. Claudication was most prevalent in East Finland and among persons with agricultural occupations. The symptoms were more frequent in diabetics and persons with symptoms and signs of coronary heart disease (CHD) than in persons without these diseases. High serum cholesterol and smoking were associated with these symptoms but high blood pressure was not. The risk of death from cardiovascular causes was nearly 3‐fold in men with claudication compared to men without claudication. Symptoms of chest pain and smoking increased significantly the mortality risk of male claudicants. The validity of symptoms was poorer in women than in men and they were also less reliable predictors of death in women. A small part of the effect of claudication on mortality was due to its association with conventional CHD risk factors. However, after adjusting for symptoms and signs of CHD, claudication had no independent effect on mortality in men.
Serum Levels of Calcium and Parathyroid Hormone after Subtotal Thyroid Resection for Graves' Disease
Authors: Aagaard J. , Blichert‐Toft M. , Christiansen C.
Published: August 2010

ABSTRACT. The following serum constituents were measured in 19 patients operated on for Graves' disease: calcium, protein, parathyroid hormone (PTH), alkaline phosphatase, thyroxine, triiodothyronine, free thyroxine index, and thyroid‐stimulating hormone. Blood was sampled systematically on the day before and 5 days, 1 month, 2, 3, 4 and 6 months after operation. All patients were pretreated with antithyroid drugs, and 2 months before surgery levothyroxine was added. The study showed that the thyroid function was impaired for 3 months postoperatively. Serum calcium level was lowered in the same period. Serum PTH increased with decreasing serum calcium, and vice versa. The results support the theory that the transient fall in serum calcium level is due to lowered PTH sensitivity in bone tissue caused by temporary impaired thyroid function after surgery. On the other hand, a direct action of lowered thyroid hormone on bone tissue is also a possible explanation.
The Level of Angiotensin‐Converting Enzyme as Indicator of 2‐Year Prognosis in Untreated Pulmonary Sarcoidosis without Erythema Nodosum
Authors: Rømer Frode K.
Published: August 2010

ABSTRACT. In order to evaluate the prognostic significance of elevated serum angiotensin‐converting enzyme (SACE) in pulmonary sarcoidosis, the 2‐year prognosis was studied in 33 untreated patients without erythema nodosum. Elevated SACE was found in 19 patients among whom total regression or improvement was noted in 42%, against 86% in 14 patients with normal SACE in serial measurements. The groups with and without elevated enzyme levels were not different with respect to sex, age, pulmonary changes, or extrathoracic manifestations. Thus, the finding of elevated SACE in this category of sarcoidosis patients may have some prognostic significance, pointing toward a greater risk of a chronic course.
Idiopathic Chronic Active Hepatitis in Iceland
Authors: Bjarnason Ingvar , Magnusson Bjarki , Bjornsson Sigurdur
Published: August 2010

ABSTRACT. An epidemiological study of idiopathic chronic active hepatitis in Iceland during 1970‐79 is described. Patients were identified by examining all request forms for surgical specimens (117 141) sent to the Department of Pathology in that period. The diagnosis was established by a review of clinical records and liver biopsies. The patients were interviewed if clinical or serological information was lacking. Although 33.9% of all deaths in Iceland were autopsied during this period, no previously undiagnosed case of idiopathic chronic active hepatitis was found among the deceased. Eighteen new cases were found, 17 females and one male. The mean age at the time of diagnosis established by liver biopsy was 53 years (range 3–79). The most common symptoms were fatigue and/or malaise (89%) and jaundice (61%) and the prevalence of immunological markers was high. The average annual incidence was 0.83/100000 and the prevalence 8/100000. Because of the ethnic origin of Icelanders, these figures might possibly apply to Norway and the British Isles.