bluuebunny/crossref_metadata_2025 huggingface dataset:
HEART VOLUME AND ITS RELATION TO MEASURES OF CIRCULATORY FUNCTION IN HEALTHY YOUNG MEN
Authors: Bergström Kjell , Bäcklund Lars , Erikson Uno , Gustafsson Bertil
Published: August 2010

Abstract.Several roentgenological methods for determination of the heart volume have been presented. In order to evaluate the influence of different projections and body positions on two of these methods, the relationship between the heart volume and different measures of the circulatory function capacity was studied in a series of healthy 20‐year‐old subjects. In the heart volume determination seven different projections and positions were used and two formulae were applied. For each of the 14 methods of calculation, the regression line and residual variance were calculated, as well as the coefficients of correlation for the different function parameters. Special attention was paid to the relationship between the work load at a pulse rate of 170 per min (W170) and the heart volume. The regression equations obtained deviated considerably from those described previously. A high correlation was found, however, between the heart volume and (a)W170and (b) the oxygen pulse, among other parameters.
URINARY EXCRETION OF FREE AND CONJUGATED HISTAMINE IN VARIOUS GASTROINTESTINAL DISORDERS
Authors: Sjaastad Ottar
Published: August 2010

Abstract.In order to evaluate the specificity of the increased urinary excretion of conjugated histamine in myotonic dystrophy, patients with various gastrointestinal disorders have been studied. Occasionally the urinary excretion of conjugated histamine in urine was elevated in patients with idiopathic steatorrhoea, coeliac disease and gastritis/peptic ulcer. When determined, the histamine‐like activity in the stools was augmented in cases with increased urinary output of conjugated histamine.

A significantly increased urinary excretion of conjugated histamine was found in cases of chronic pancreatitis. The increased faecal histamine‐like activity indicated an intestinal origin of the urinary conjugated fraction in this disorder.
EXTRACORPOREAL IRRADIATION OF THE BLOOD
Authors: Weeke Eva , Thaysen Jørn Hess
Published: August 2010

Abstract The clinical results of necro‐kidney transplantation after extracorporeal irradiation of the blood (ECIB) are presented. The patient material consists of 91 consecutively transplanted patients; only first necro‐kidney grafts are considered. Thirty‐seven patients received ECIB before as well as immediately following transplantation (group I), 54 patients did not receive ECIB (group II). The clinical results are evaluated from the number and severity of rejection episodes, the graft survival and the clinical rank. In group I the total number of rejection episodes was significantly reduced within the first 2 months (p<0.01) and the number of patients without rejection during a total observation period of 26 months was significantly higher (p <0.01). The graft survival after 6 months was increased by 25% (p<0.05); after 12 months the number of observations was too small to permit a reliable analysis. The clinical rank after 6 months was better in group I (p <0.05) but indistinguishable after 12 months. There was no significant difference between the two groups regarding the number of complicating severe infections caused by bacteria, virus or fungi.
SURVIVAL OF DF32P‐LABELLED ERYTHROCYTES IN URAEMIC PATIENTS DURING EXTRACORPOREAL IRRADIATION OF THE BLOOD
Authors: Weeke E. , Andersen V. , Dige‐Petersen H. , Karle H.
Published: August 2010

Abstract. The survival time of erythrocytes labelled with 32P‐diisopropylfluorophosphate (DF32P) was investigated in uraemic patients on chronic dialysis treatment. Twelve patients were studied; eight survival studies were performed in patients not undergoing extracorporeal irradiation of the blood (ECIB), and 7 survival studies were made in connection with ECIB treatment. The mean erythrocyte survival time was calculated by linear regression analysis of the results obtained 5–36 days after labelling and extrapolation of the curve to the time of zero activity. In all the patients the erythrocyte survival was shortened; in patients not undergoing ECIB the median survival time was 55 days (range 44–62). The survival curves indicated an accelerated and predominantly age‐dependent erythrocyte destruction. ECIB was generally given from day 18 to day 36 after labelling of the erythrocytes. The accumulated radiation dose given to the blood ranged from 46 500 to 70 000 rads. There was no demonstrable influence of ECIB on red cell survival as estimated from the slopes of the individual survival curves before and during ECIB. However, the reduced life span of the erythrocytes in these uraemic patients made it difficult to evaluate a superimposed haemolytic component. The fact that the median Hb concentration in the blood decreased slightly but significantly in a further 15 patients during ECIB indicates that ECIB may induce a slight reduction in red cell survival in severely uraemic patients. This has, however, few clinical consequences.
THE FUNCTIONAL PATTERN IN PATIENTS WITH RENAL DISEASE
Authors: Skov Poul Erik , Hansen Hans Erik
Published: August 2010

Abstract. The glomerular filtration rate (GFR), the effective renal plasma flow (ERPF), and the filtration fraction (FF) have been studied in 38 patients with different renal diseases and varying degrees of renal insufficiency. All diagnoses were verified by percutaneous renal biopsy. Eighteen living kidney donors comprised a control material. In 10 patients in terminal uremia no characteristic functional pattern was found. Twelve patients with interstitial nephritis had a significantly increased FF, 9 with the nephrotic syndrome had a significantly decreased FF, whereas 7 with glomerulonephritis without the nephrotic syndrome did not demonstrate FF values different from those found in normals. A good correlation was found between the size of the FF and the concentration of serum albumin. Creatinine clearance overestimated the true GFR in patients with renal disease. The FF was not significantly increased in hypertensive patients.
Towards Prevention and Health
Authors: MORRIS J. N.
Published: August 2010

Summary. We have come to the end of a road with our strategy for health based so largely on treatment and medical care. There are possibilites of improving health by changes in everday behaviour, in exercise, smoking and weight‐control for behaviour, in exercise, smoking and weight‐control for example. The balance of medicine shuld be turned in this direction whjich offers a more hopeful long‐term future. There is need to develop an epidemiology of health.
Studies on the Haematologic and Cytogenetic Effect of Lithium
Authors: Bille Peter Erik , Jensen Mogens Krogh , Jensen Jens Peter Kaalund , Poulsen Jens Christian
Published: August 2010

Abstract. The corpuscular elements of the peripheral blood and the morphology and chromosome constitution of bone marrow cells have been studied in patients before and during lithium therapy as well as in patients who had received lithium for a substantial period. Lithium therapy produced elevated total white cell, granulocyte, eosinophil and thrombocyte counts and a lymphocytopenia, whereas no effect was seen on the erythrocyte and reticulocyte counts. There were no morphological or cytogenetic changes in the bone marrow aspirates. Neither were toxic doses of lithium able to produce chromosome abnormalities in rats.
Renal Function in Normo‐ and Hypertensive 50‐year‐old Males
Authors: Berglund Göran , Aurell Mattias , Wilhelmsen Lars
Published: August 2010

ABSTRACTRenal function, measured as glomerular filtration rate (GFR), sodium excretion and osmolality after thirst, has been determined in untreated (n= 35) and treated (n= 22) hypertensives and in a reference group (n= 80), all derived from a random population sample of 50‐year‐old men. Renal function was related to casual and resting BP and to relative body weight. Hypertension was defined as SBP > 175 or DBP > 115 mmHg on two separate occasions or current antihypertensive treatment. Mean GFR was 100 ± 11.7 ml/min in the reference group and significantly lower, 94 ± 15.7 ml/min, in the hypertension group. In the hypertension group, 20% had a reduced GFR, although the standard diagnostic procedure, serum creatinine, demonstrated only 4%. Hypertensives with reduced GFR were characterized by higher BP, lower urinary sodium excretion, reversed diurnal rhythm of salt and water excretion and a higher relative body weight, which was, however, explained by the correlation of BP to relative body weight. GFR was negatively correlated to DBP at rest and positively correlated to urinary sodium excretion. Untreated hypertensives with persistent high BP after rest had lower GFR, lower urinary sodium excretion and reversed diurnal rhythm of salt and water excretion, indicating high renal resistance. The results suggest that subjects with relatively severe hypertension as judged by BP and renal function have an increased renal vascular resistance.
Vectorcardiographic‐Hemodynamic Correlations in Adult Aortic Stenosis
Authors: Rasmussen Knut , Simonsen Svein
Published: August 2010

ABSTRACT Thirty‐nine vectorcardiographic (VCG) data from 45 patients with pure adult aortic stenosis have been tested as to their ability to reflect quantitatively the peak systolic left ventricular pressure (LVPSP), the left ventricular end diastolic pressure (LVEDP), and the X‐ray estimated heart volume. VCG was recorded with the axial lead system and simple and multiple linear regression analyses were applied. Eight VCG data correlated significantly (p < 0.001) with LVPSP, the best indicator being the maximum posterior dislocation in the Z lead (r = 0.65). Through multiple regression analysis a formula was derived which gave a correlation coefficient between observed and calculated pressures of 0.82. The best indicator of LVEDP was the maximum positive P amplitude in the X lead (r = 0.41). The relationship was, however, too poor to have practical significance. A good correlation was found between ST segment dislocation and heart volume (r = 0.65), in good accordance with previous observations as to the effect of right ventricular dilatation on the ECG. The study illustrates how ventricular volume and pressure exert different effects on the ECG, and how all the important hemodynamic aspects in aortic stenosis to some degree are reflected. Only the pressure correlations have, however, practical importance.
A Nitrofurantoin‐induced Disorder Simulating Chronic Active Hepatitis
Authors: Fagrell B. , Strandberg I. , Wengle B.
Published: August 2010

ABSTRACT A 78‐year‐old woman with liver damage resembling chronic active hepatitis and occurring during long‐term nitrofurantoin treatment is described. On admission to hospital she displayed jaundice, ascites and high serum levels of GOT, GPT, bilirubin and γ‐globulin as well as high titres of ANF and antibodies against smooth muscle cells. After withdrawal of nitrofurantoin the clinical and laboratory picture normalized without corticosteroid treatment, suggesting that the liver reaction was drug‐induced.
Resumption of Work after Acute Myocardial Infarction
Authors: Kjøller Erik
Published: August 2010

ABSTRACTA total of 644 patients, admitted to the Coronary Care Unit of a district hospital on account of acute myocardial infarction, have been discharged during a 3‐year period. Of these patients, 71% had been employed at the time of the infarction and more than 80% of this group returned to work. Among the long‐term survivors (LTS) aged less than 65 years who had been employed at the time of infarction, 87% of the male and 74% of the female patients had resumed work some time afterwards. Among 347 LTS age was found to be the main factor to determine whether or not patients would be able to resume work, whereas the number of experienced infarctions as well as signs and/or symptoms of heart failure during the acute phase were of no consequence. The occurrence of additional symptoms of ischaemic heart diseases (recurrences of infarction, presence of angina pectoris, demand for drugs) was of prognostic importance for whether or not patients would have to abandon work. The ability of patients to resume their previous work depended on the character of the latter, i.e. its type and the physical strain involved. About 80% of the LTS resumed work within three months. Patients in whom heart failure had occurred during the acute phase tended to return to work later than those without this complication. No more than half of the LTS who had abandoned work declared that cardiac symptoms had been the reason.
Interference with Cardiac Pacemaker Function
Authors: OHM OLE—JØRGEN
Published: August 2010

ABSTRACT. A survey is given of the factors affecting cardiac pacemaker function. Whereas it was earlier considered that external interference was a frequent cause of pacemaker failure, more recent studies indicate that this is of minor importance.

It would appear that failure of pacemaker function due to changes in the QRS‐complex, i. e. voltage change, intraventricular conduction defects and frequency changes, are more important. A lesser known cause of failure in demand function is the inhibition which arises from skeletal muscle potentials. This appears to be a major problem in some types of pacemaker.

Manufacturing defects are unavoidable, and it can still be assumed that electronic component defects may develop in 1 of 1000 pulse generators. Cases with the problem of early run‐away pacemaker are still being reported and two such cases are discussed. In one of the patients the run‐away phenomenon was intermittent, and was accompanied by a variation in run‐away frequency. This possibility should thus always be taken into consideration in a pacemaker patient presenting with syncope. In a patient with a QRS‐inhibited pacemaker a double stimulation phenomenon has been observed.

Various causes of pacemaker failure due to the condition of the electrode are reviewed.
Hypercalcemia and Parathyroid Function after Renal Transplantation
Authors: Christensen Merete Sanvig , Nielsen Hans Egon , Tørring Susanne
Published: August 2010

ABSTRACT Hypercalcemia after renal transplantation (post‐T hypercalcemia) has been detected in 29 (16.7%) of 174 long‐term survivors. The mean time of onset of hypercalcemia was 69 days after renal transplantation (range 3–210). In 18 patients the hypercalcemia was mild and resolved spontaneously (transient) from 2–65 months (mean 19) after onset. In 4 patients serum calcium normalized concurrently with rejection episodes. In 7 patients the hypercalcemia was more pronounced (permanent), being terminated by subtotal parathyroidectomy in 5 and persisting in 2 recipients. The hypercalcemia was asymptomatic except in one patient, who developed calculi in the graft and a fall in graft function, all of which disappeared after parathyroidectomy. At operation the parathyroid glands showed hyperplasia, except in one case with an adenoma in one of the hyperplastic glands. Serum phosphorus was markedly decreased, to the same extent in transiently and permanently hypercalcemic recipients. Serum parathyroid hormone (S‐PTH) was increased in all of 5 patients with permanent and in 3 of 8 with transient post‐T hypercalcemia. In normocalcemic and in transiently hypercalcemic recipients the mean S‐PTH was identical, but significantly lower than in the permanently hypercalcemic recipients. S‐PTH was suppressed to the same extent during an i.v. calcium in fusion in patients with post‐T hypercalcemia and with primary hyperparathyroidism.
Lymphocytic Thyroiditis
Authors: Maagøe Henrik , Reintoft Ingermarie , Christensen Hans Ewald , Simonsen Jørn , Mogensen Erik F.
Published: August 2010

ABSTRACT Thirty‐two patients with goitre and lymphocytic thyroiditis were followed for 1 1/2–19 years (average 7) after open surgical biopsy. Treatment with thyroid hormone was started when myxoedema was diagnosed. Five patients (group A) regained normal glandular size, remained euthyroid and had elevated antibody titres. Six patients (group B) continued to have goitre and elevated antibody titres and remained euthyroid. Thirteen patients (group C) developed myxoedema, while 8 (group D) demonstrated myxoedema at the time of biopsy. The patients in groups C and D had a higher average age and their biopsies showed more marked fibrosis compared with groups A and B. The goitre disappeared during treatment in 62% of the patients and the microsomal antibody titre also decreased in them, whereas the thyroglobulin antibody titre decreased in all treated patients. The results indicate that the degree of fibrosis in the thyroid gland is of overall importance for the prognosis with regard to glandular function. It seems evident that the treatment with thyroid hormone influences the autoimmune process so that the activity decreases.
Bone Mineral Loss during Maintenance Hemodialysis
Authors: Rickers H. , Nielsen A. H. , Pedersen R. Smith , Rødbro P.
Published: August 2010

ABSTRACT. With the aim of investigating bone mineral loss during maintenance hemodialysis (MHD), bone mineral content (BMC) was measured by means of two‐dimensional scanning photon absorptiometry in 47 chronic renal failure patients on MHD 13 females (age range 22–50 years, mean dialysis duration 189 days) and 34 males (age range 23–69 years, mean dialysis duration 449 days). Measurements were carried out in most patients three times at an interval of 6 months. Initial mean BMC values were for both sexes significantly lower than normal, but did not correlate to duration of MHD. The longitudinal measurements demonstrated a highly significant decrease in BMC with time: the mean BMC values after 6 and 12 months, respectively, were for females 95.8 and 93.4% and for males 97.3 and 94.4% of the initial values with no significant differences between sexes. The fall in BMC did not correlate to duration of MHD, initial BMC value, or age. In some of the patients a substantial loss of BMC was observed, and it is suggested that these patients in particular may develop severe bone disease. A BMC method with high precision is mandatory for selection of such patients.
The Relation between Extra‐ and Intracellular Electrolytes in Patients with Hypokalemia and/or Diuretic Treatment
Authors: Dyckner Thomas , Wester P. O.
Published: August 2010

ABSTRACT. The relation between extra‐ and intracellular electrolytes has been studied by means of percutaneous muscle biopsies in 107 patients with hypokalemia and/or treatment with diuretics. No relation was found between the extra‐ and intracellular concentrations of Na or Mg. The serum and muscle contents of K correlated weakly. The correlation coefficient tended to be stronger when S‐creatinine was normal, total carbonate was between 25 and 30 mmol/1, muscle Mg content was ≤3.95 mmol/100 g fat free dry solids, and when no treatment was given with digitalis and/or diuretics.
Smouldering Acute Myelogenous Leukemia
Authors: Evensen Stein A. , Stavem Per
Published: August 2010

ABSTRACT. Among 195 patients with variants of acute myelogenous leukemia (AML), a minimum of 11 met our criteria of smouldering AML: patients with less than 30% of blast cells plus promyelocytes in the bone marrow at the time of diagnosis who were observed without specific antileukemic therapy for a period of at least 6 months without entering a fulminant stage of the disease. These patients were older than other patients with AML, they had initially relatively few infections, bled rarely, and did not enter the fullblown clinical picture typical of acute leukemia until the last months of life. For these 11 patients the median survival time was 29 months from the time of diagnosis. Patients with smouldering leukemia shall be observed carefully and not be given specific antileukemic therapy, at least not before they flare into a blast crisis. Transfusions, antibiotics and a small dose of prednisone should be given when necessary.
Exposure to Organic Solvents—A Missing Link in Poststreptococcal Glomerulonephritis?
Authors: Ravnskov Uffe
Published: August 2010

ABSTRACT. Fifteen patients with evidence of acute poststreptococcal glomerulonephritis were asked about their contact with vapours of organic solvents. Six patients reported brief exposure shortly before the onset of glomerulonephritis, 4 fairly long exposure, and 5 none or insignificant. At the latest follow‐up, 3 of 4 patients who were still exposed to such solvents had proteinuria and a low glomerular filtration rate (GFR), and 2 were hypertensive. Of the 11 patients who had never been or were no longer exposed, the GFR was insignificantly decreased in 2, none had proteinuria and none were hypertensive. Fifteen age‐ and sex‐matched controls, who had been infected with group A β‐hemolytic streptococci, T type 12, had not been exposed, or the exposure was insignificant and not related to the streptococcal infection. Exposure to organic solvents or other nephrotoxic agents may be the condition which determines the outcome of an infection with nephritogenic streptococci.
ACCURACY AND USEFULNESS OF ECHOVENTRICULOGRAPHY IN ACUTE MYOCARDIAL INFARCTION
Authors: NIEMINEN M.S. , HEIKKILÄ J.
Published: August 2010

Echoventriculography is a noninvasive and three‐dimensional ultrasonic technique capable to assess in detail the regional performance of the left ventricle. Therefore the mechanical performance of the left ventricle after myocardial infarction is informatively assessed by the composite contributions made by in‐farcted and noninfarcted segments. Its reliability has been confirmed by direct cineangiographic and autopsy correlations. In clinical decision making such direct information is of great value both for diagnosis and therapeutic selection. In the coronary care unit echoventriculography provides most information obtained by the less feasible invasive cineangiographic examinations.
Ultra‐Microcrystals in Pyrophosphate Arthropathy
Authors: Bjelle Anders , Crocker Peter , Willoughby Derek
Published: August 2010

ABSTRACT. A patient with pyrophosphate arthropathy is reported who had no calcifications on joint radiographs, and no crystals were found in polarized light microscopy of the synovial fluid. Using techniques for identification of crystals at the ultrastruc‐tural level, abundant small (≤1μ) pyrophosphate crystals were recognized and identified. The possibility of “ultramicrocrystal depositions”, including pyrophosphate arthropathy, is important to consider in acute arthritides since small crystals might cause more intense inflammation and be the cause of arthritides, hitherto not possible to classify.
Nonsecretory Myeloma Associated with Nodular Glomerulosclerosis
Authors: Sølling K. , Selling J. , Jacobsen N. O. , Thomsen O. Frakjær
Published: August 2010

ABSTRACT. A patient with nonsecretory multiple myeloma in association with nodular glomerulosclerosis is reported. The clinical course was characterized by rapidly progressing renal insufficiency terminating in uremia within three months. Histological investigation of the kidney revealed extensive nodular formations in the mesangial areas consisting of basement membrane‐like material, in places with content of fibrils. Immunofluorescence demonstrated deposition of kappa chains. Amyloid was not present. Routine methods for investigation of serum and urine showed severe hypogammaglobulinemia without M‐components. Using a sensitive radioimmunoassay for free light chains, an abnormal non‐dissociable kappa chain polymer with a molecular weight of 55000 was found in serum and urine. The findings support the hypothesis that mesangial accumulation of paraproteins induce an increased synthesis of basement membrane material leading to formation of the nodules. Abnormal polymerization of kappa chains might provoke the formation of the glomerular nodules.
Insulin‐Requiring Diabetes Mellitus of Sixty Years' Duration without Significant Late Manifestations
Authors: Brechter Carl , Malmquist Jörgen
Published: August 2010

ABSTRACT. The report concerns a man with onset of diabetes in 1921 and treated with insulin since 1922. In 1981, at the age of 75, he is in excellent health, with no signs of significant diabetic organ injuries. Among other factors, this benign course may be due to retention, until now, of some endogenous insulin production.
Non‐Infarction Coronary Care Unit Patients
Authors: Areskog Magnus , Tibbling Lita , Wranne Bengt
Published: August 2010

ABSTRACT. Among 55 consecutive coronary care unit (CCU) patients with chest pain of unknown origin at discharge from hospital, signs of oesophageal dysfunction (OD) were found in 58 % and signs of ischaemic heart disease (IHD) in 35 % within 2–6 months. At a three‐year follow‐up, signs of OD were found in 62% and signs of IHD in 28%. Forty‐six patients (84%) had experienced a pain similar to that which caused the CCU admission (i.e. the CCU chest pain). OD was regarded as the cause of the CCU chest pain in seven patients (13%) and as a possible cause in another nine (16%). IHD was regarded as the cause of the CCU chest pain in 17 patients (31%), four of whom had died from acute myocardial infarction during the follow‐up period. All ten patients who developed coronary events, such as myocardial infarction or progressive angina pectoris, during the follow‐up period had an ischaemic ECG reaction at exercise test 2–6 months after discharge from the CCU. IHD was found to be the predominant disease in terms of severity of symptoms and prognosis and was also recorded as the most common single cause of the CCU chest pain. Since OD was common and even caused severe chest pain in some patients, oesophageal origin should be considered in the differential diagnosis of chest pain in non‐infarction CCU patients.
Erythrocyte and Total Body Potassium in Untreated Primary Hypertension
Authors: Ericsson Folke , Carlmark Björn , Eliasson Keith
Published: August 2010

ABSTRACT. In a study of total body and erythrocyte potassium in mild hypertension we found decreased intracellular potassium concentrations in 41 hypertensives compared to controls but no correlation between intracellular potassium, measured by whole body counting, and erythrocyte potassium. A total body potassium corresponding to an intracellular potassium of 85% or less of the expected value was found in 44 % of the patients, the decrease being more marked in females. In the hypertensives, a negative correlation existed between serum and erythrocyte potassium. No correlation was found between potassium decrease and urinary aldosterone or plasma renin level. An inhibition of the active sodium‐potassium exchange at the cellular level is proposed as an explanation of these findings.
Psychological Correlates of Some Cardiac Pain Syndromes of IHD
Authors: Zaitsev V. P.
Published: August 2010

ABSTRACT. In four series of observations, 563 males with verified diagnoses of ischaemic heart disease (HID) were examined. Assessment of the patients' psychological status was carried out using the Minnesota Multiphasic Personality Inventory (MMPI) and a clinical rating scale. A close correlation was established between cardiac pain syndromes and the psychological state of IHD patients. The most severe psychological changes were found in association with combined cardiac pain syndromes (angina pectoris and cardialgia). In cardialgia they were more prominent than in angina pectoris. In frequent anginal attacks, and in angina both at rest and on effort, psychological disturbances were observed much more frequently and were of a more profound nature (depression, hypochondria), than in rare attacks of angina, or in angina on effort alone. The least marked psychological changes were observed in IHD running a painless course. Possible cause and effect interrelations underlying these correlations are discussed. Attention is drawn to the necessity for a systematic approach to the treatment of IHD patients, including the use of psychotherapy and psychopharmacotherapy.
Therapeutic Equivalence of Sulfaisodimidine 2 g Twice Daily and 1 g Four Times Daily in Lower Urinary Tract Infections
Authors: Melander A. , Bitzén P.‐O. , Olsson S.
Published: August 2010

ABSTRACT. The serum concentrations and clinical effects of sulfaisodimidine given during 12 days were examined in two groups of patients with uncomplicated lower urinary tract infection. Group I (n = 12) received the drug in a conventional dosage, 1 g four times daily, and group II (n = 14) in a dose of 2 g twice daily. The serum concentrations of sulfonamide at steady state (day 7) and one day after cessation of therapy (day 13) did not differ significantly between the groups. With the exception of one patient in group I, both subjective and objective symptoms vanished during treatment and remained absent for at least 4 weeks thereafter. Two patients in each group developed signs of sulfonamide allergy. Thus, the two regimens seemed to be equally efficient, and the risk of therapy failure due to low blood concentrations of sulfaisodimidine should not be greater when the drug is given in a dosage of 2 g twice daily than when it is administered in the conventional way. Hence, the latter, simpler regimen can be recommended.
Plasma Lipids and Lipoproteins in Long‐Term Beta‐Adrenergic Blockade
Authors: Jürgensen Hans J. , Meinertz Hans , Færgeman Ole
Published: August 2010

ABSTRACT. The effect of long‐term β‐adrenergic blockade on plasma lipids and lipoproteins was studied in 68 consecutive patients enrolled in a double‐blind controlled trial of alprenolol in myocardial infarction. Thirty‐three patients were treated with 200 mg alprenolol twice daily for one year, and 35 patients received placebo. Neither plasma cholesterol, plasma triglycerides nor plasma lipoproteins were significantly influenced by alprenolol.
Serum Concentration of Cathodic Trypsin‐Like Immunoreactivity and Pancreatic Isoamylase in Insulin‐Dependent Diabetes Mellitus
Authors: Møller‐Petersen Jens , KjærgÅrd Jens‐Jørgen , Mourits‐Andersen Hans Torben , Svendsen Kai Naundrup , Dideriksen Klaus , Ditzel Jørn
Published: August 2010

ABSTRACT. The relationship between diabetes mellitus and the exocrine pancreatic function was evaluated in 29 patients with insulin‐dependent diabetes mellitus by measuring cathodic trypsin‐like immunoreactivity (TLI) and the enzymatic activity of pancreatic isoamylase in serum before and 90 min after breakfast and insulin. Thirty healthy subjects served as reference group. Median fasting serum concentrations in the diabetic subjects were significantly lower than in the reference subjects: for TLI 143 and 299 μg trypsin standard/I and for pancreatic isoamylase 43 and 101 U/I, respectively (p<0.001 for both). A positive correlation between TLI and pancreatic isoamylase was present in the diabetics (Sperman's rho=0.56, p<0.01). The serum concentrations of TLI and pancreatic isoamylase were not related to the duration of diabetes, daily insulin dose or glycemic control measured by blood glucose and total glycosylated hemoglobins. Cathodic TLI and pancreatic isoamylase in serum were not influenced by food and insulin.
How Should Functional Impairment in Mitral Valve Disease Be Evaluated?
Authors: Niemelä Kari
Published: August 2010

ABSTRACT. To compare maximal exercise testing with the NYHA functional criteria in grading symptomatic severity in mitral valve disease, a symptom‐limited bicycle exercise test was performed by 40 patients undergoing right and left heart catheterization. In the group as a whole (r=‐0.50) and in patients with combined valvular lesion (r=− 0.72), peak O2 uptake (VO2) correlated with the NYHA criteria, whereas exercise duration failed to demonstrate such a relationship. In each hemodynamic subgroup large individual variations in peak VO2 were seen, particularly in NYHA class II and if the lesion was less severe. Unusually high O2 cost at peak work load was observed in almost half the patients. However, assuming that patients with an aerobic capacity of ≤ 16 ml/kg per min were severely symptomatic (NYHA class III or IV), an agreement between VO2 and the NYHA criteria was seen in 30 patients (75%). In the remaining 10 patients the NYHA criteria were more often predictive of the severity of the lesion. In “pure” mitral stenosis, however, a total VO2 of <1.11/min was more likely (r=0.62) to reveal significant valvular narrowing (≤1.5 cm2). Neither peak VO2 nor the NYHA criteria revealed impaired left ventricular performance or the degree of mitral regurgitation at rest. Rather then being superior, maximal exercise testing seemed to be complementary to the symptom‐rated appraisal. Recognizing the potential limitations of exercise testing, which mainly appeared to be attributable to variations in the threshold of perceived exertion and in the non‐cardiac component of VO2, measurement of peak VO2 is likely to provide a basic estimate of the degree of impairment, particularly in the presence of mitral valve obstruction.
Fibrinogen Derivatives and Recurrent Myocardial Infarction
Authors: Löfmark Rurik
Published: August 2010

ABSTRACT. Plasma fibrinogen, soluble fibrin monomer complexes (FMM) in plasma and fibrin degradation products (FDP) in serum were studied in 31 patients with acute myocardial infarction (MI) during their stay in hospital. The ECGs of 15 patients indicated a high risk of recurrent MI. Seven patients had a recurrent MI within three months. No correlation could be found between plasma fibrinogen or FMM and reinfarction, but FDP was increased in six of the seven patients with reinfarction compared to six of the 24 without (p <0.01).
Increased cardiac output and lowered peripheral resistance during metoprolol treatment
Authors: Wikstrand John , Trimarco Bruno , Buzzetti Giuliano , Ricciardelli Bruno , de Luca Nicola , Volpe Massimo , Condorelli Mario
Published: August 2010

ABSTRACTEchocardiography was performed at every six months in hypertensives well controlled on metoprolol, 100 mg twice a day. After six months' treatment blood pressure was reduced from 177/110 mm Hg to 147/88 (p <0.02). LV wall thickness (septum + posterior wall) was unchanged 2.10 cm (2.14), and a significant drop in cardiac output (CO) to 5.0 1/min (6.1, p <0.02) was recorded (pretreatment values in brackets). After 24 months' treatment LV wall thickness was reduced to 1.94 cm (p <0.02), total peripheral resistance (TPR) to 17.3 mm Hg/1/min (23.4, p <0.02) and CO increased to 6.7 1/min (6.1, n.s.). After six months' treatment, there was thus a drop in BP with a significant drop in CO and unchanged TPR. After 24 months' treatment, however, CO was back to the pretreatment level and the drop in BP was entirely caused by a drop in TPR which was probably secondary to a reduction in the wall thickness of the arterial resistance vessels as judged by the relationship between the reduction in wall thickness in the LV and the reduction in TPR during the treatment.
Fasting Serum Cholesterol and Triglycerides in a Ten‐Year Prospective Study in Old Age
Authors: AGNER ERIK , HANSEN PER FROM
Published: August 2010

ABSTRACT. In a ten‐year prospective study of a population of men and women aged exactly 70 at entry and otherwise selected only according to geography, the predictive values of serum cholesterol and serum triglycerides were evaluated concerning total mortality and cardiovascular disease (CVD) and cancer manifestations in the eighth decade. Both high and low cholesterol values at 70 were associated with excess total mortality in men, the former showing excess CVD mortality, the latter excess cancer mortality. In men, high values of triglycerides at 70 were associated with increased CVD mortality as well as CVD development. In women, high values of triglycerides at 70 were associated with excess hospitalization for cerebrovascular incidence alone.
Visual Disturbances and Occipital Brain Infarct Following Acute, Transient Hypotension in Hypertensive Patients
Authors: STRANDGAARD SVEND , ANDERSEN GERT STEEN , AHLGREEN PREBEN , NIELSEN POUL EBBE
Published: August 2010

Abstract In four hypertensive patients, acute lowering of blood pressure by therapeutic or diagnostic procedures caused visual disturbances ranging from transient visual hallucinations to severe, long‐lasting visual impairment. These symptoms were associated with occipital lobe cerebral infarcts that tended to occur in the border zones between the major cerebral arteries. The infarcts may be seen as the combined result of a “watershed” effect during acute hypotension and the presence of structural hypertensive vascular adaptation. When a hypertensive patient complains of visual disturbances during acute blood pressure lowering, the pressure should be allowed to settle at a level somewhat above normal.
Cardiac Disease in Patients with Reversible Cerebral Ischemic Events
Authors: SCHEIBEL MORTEN , SØRENSEN PER SOELBERG , MØGELVANG JENS , PEDERSEN HOLGER , GODTFREDSEN JOHN
Published: August 2010

ABSTRACT The establishment of a possible association between ischemic cerebral attacks and prolapsing mitral valve has been studied in 45 consecutive patients aged 60 years or less with transient cerebral ischemic attacks and reversible ischemic neurological deficits. The study comprised cardiac history, auscultation, electrocardiography and echocardiography. We found only one patient (2%) with mitral valve prolapse but 19 patients (42%) with cardiac abnormalities. Two of the patients with cardiac abnormalities had a flail posterior mitral leaflet, one had ventricular septal defect and one had sclerotic aortic valves. We conclude that all patients with transient cerebral ischemic attacks should be subjected to heart examination, if possible including echocardiography.
Circulatory Manifestations and Risk Factors in Patients with Acute Cerebrovascular Disease and in Matched Controls
Authors: VON ARBIN M. , BRITTON M. , DE FAIRE U. , TISELL Å.
Published: August 2010

ABSTRACT. The occurrence of various circulatory manifestations and risk factors was evaluated in a consecutive series of 209 patients admitted for acute cerebrovascular disease (CVD) and 209 control patients admitted for acute surgical disorders. Old and recent myocardial infarction, atrial fibrillation, congestive heart failure and reduced arterial blood pressure in the big toe were all much more frequently noted in CVD patients than in their matched controls. Hypertension, diabetes mellitus, overweight, high haemoglobin values, were also overrepresented in the CVD patients. Male CVD patients had a higher alcohol consumption than their controls. These findings implicate that CVD in old age is strongly related to both hypertension and a generalized atherosclerosis. The heavy accumulation of primary risk factors, many of which are considered to be primarily associated with atherosclerosis among elderly stroke victims, may indicate their contribution to a progressive atherosclerotic process still in operation.
Thermography and Plethysmography in the Diagnosis of Deep Venous Thrombosis—a Comparison with Phlebography
Authors: ANDERSSON STAFFAN
Published: August 2010

ABSTRACT. Ninety‐two patients with suspected unilateral deep venous thrombosis (DVT) in the lower limb were examined by thermography, plethysmography and phlebography. ROC analysis (Receiver Operating Characteristics) was used to evaluate discrimination thresholds and to compare thermography and plethysmography (four variables) with phlebography. The sensitivity of thermography, 85% (94% for out‐patients), was higher than that of plethysmography (58–79%) for the discrimination thresholds chosen. The specificity of thermography was low, 39% (42% for out‐patients) or 55%, if obvious relevant clinical findings were included in the evaluation. The specificity of plethysmography was much higher (80–97%). Optimum combination of the four plethysmographic variables showed predictive values of 93–94%, while combination of thermography and plethysmographic variables showed higher predictive values (95–97%), mostly because of a higher sensitivity of thermography for distal DVT. A possible reduction of the number of phlebographic examinations by at least 50% and a cost reduction of 25% could have been obtained without any appreciable loss of diagnostic accuracy. A follow‐up study of 112 consecutive patients, examined according to the recommended screening method, showed a reduction of phlebographic examinations by 62%.
Misleading T3‐test Values in Psychiatric Patients Treated with Orphenadrine
Authors: MOBERG ERIK , HÄGG ERIK , ASPLUND KJELL , GRANKVIST KJELL
Published: August 2010

ABSTRACT Thyroid laboratory tests were assessed in 74 psychiatric patients without clinical evidence of overt thyroid disorder. In a first screening of 42 patients, 13 were found to have elevated levels of triiodothyronine uptake test (T3‐test) by a Sephadex method. Ten of these patients also had an elevated free thyroxine index (fT4‐index). Of the 13 patients with increased T3‐test values, 10 were on orphenadrine (Disipal®) treatment or had recently stopped taking the drug. In a second study, thyroid function tests were compared in 15 pairs of matched psychiatric patients treated with orphenadrine or other anticholinergic drugs. Values of T3‐test and free thyroxine index were significantly higher among patients treated with orphenadrine. Finally, orphenadrine was instituted in four patients and withdrawn in six patients. T3‐test values and free thyroxine indices increased gradually after orphenadrine treatment had been initiated and decreased gradually when it was withdrawn.
Predictors of Stroke in the Elderly
Authors: HIMMELMANN ANDERS , HANSSON LENNART , SVENSSON ANDERS , HARMSEN PER , HOLMGREN CHRISTINA , SVANBORG ALVAR
Published: August 2010

Abstract.Hypertension, diabetes mellitus, coronary heart disease and cigarette smoking have repeatedly been identified as risk factors for stroke in young and middle‐aged individuals. In order to find predicting factors for stroke in the elderly we assessed health characteristics in 55 stroke victims in the age range 65–75 years (mean 70.7±2.7) allocated to our stroke unit at Östra University Hospital in Gothenburg. For comparison we used data from 2009 individuals participating in the ongoing longitudinal population study “70‐year‐old people in Gothenburg, Sweden”. Among the stroke victims we found a higher prevalence of hypertension (63.5% vs. 27.8%,p<0.001), diabetes mellitus (21.8% vs. 6.2%,p<0.001) and a history of previous myocardial infarction (12.7% vs. 4.8%,p<0.01), thus confirming previous findings. There was no difference with regard to smoking habits (32.7% vs. 27.5%, NS), which is at variance with findings in the young and middle‐aged.
Antilipolytic Effect of Insulin in Non‐insulin‐dependent Diabetes Mellitus after Conventional Treatment with Diet and Sulfonylurea
Authors: BOLINDER JAN , ARNER PETER
Published: August 2010

Abstract. Insulin‐induced antilipolysis was investigated in fat cells obtained after an overnight fast and 60 min after glucose ingestion in seven non‐obese patients with non‐insulin‐dependent diabetes mellitus (NIDDM). The study was performed before and after long‐term therapy with diet and glibenclamide. After treatment, the antilipolytic potency of insulin in fat cells was threefold enhanced (p<0.05) in the fasting state and remained unaltered after glucose ingestion. In untreated NIDDM oral glucose induced a significant (p<0.01) increase in insulin sensitivity. In consequence, in the glucose‐fed state insulin sensitivity was similar before and after therapy. Adipocyte insulin receptor binding was comparable before and after therapy, both in the fasting state and following glucose intake. In untreated NIDDM, despite relative hypoinsulinemia, plasma glycerol was markedly reduced after oral glucose. After therapy, plasma glycerol was significantly reduced both in the fasting state and following glucose ingestion. At the same time, fasting and glucose‐stimulated circulating insulin were significantly (p<0.01) increased. It is concluded that conventional antidia‐betes therapy in NIDDM mediates a suppression of adipose tissue lipolysis. This seems to be due to an improvement in insulin secretion in combination with a potentiation of the antilipolytic effectiveness of insulin in fat cells in the fasting state, the latter being secondary to post‐binding alterations in insulin action.
Prediction and verification of possible reef‐fish spawning aggregation sites in Los Roques Archipelago National Park, Venezuela
Authors: Boomhower J. , Romero M. , Posada J. , Kobara S. , Heyman W.
Published: August 2010

This study attempts to predict and verify possible spawning aggregation sites and times in the Los Roques Archipelago National Park, Venezuela, based on physical reef characteristics and the knowledge of experienced local fishermen. Three possible aggregation sites were selected for monitoring based on satellite images, low‐cost bathymetric mapping and interviews with experienced local fishermen. Abundances and sizes of 18 species that are known to form reproductive aggregations were monitored at these sites using underwater visual census for 7 days after each full moon from February to August, 2007. While spawning events were not observed, possible indirect evidence of spawning aggregations was found for Lutjanus analis at Cayo Sal and Boca de Sebastopol, Lutjanus apodus at Cayo Sal, Lutjanus cyanopterus at Cayo Sal and Piedra La Guasa and Epinephelus guttatus at Bajo California and Cayo de Agua. Additionally, indirect evidence was identified for the past existence of a spawning aggregation of Epinephelus striatus in the northern part of the archipelago, which may have been eliminated by overfishing c.15 years ago. Bathymetric mapping showed that the shelf edge at sites monitored in this study was shallower than at spawning aggregation sites in other parts of the Caribbean, and that sites were not proximal to deep water. While this study does not prove the existence or locations of spawning aggregations of reef fishes in the archipelago, it does add insight to a growing understanding of generalities in the relationship between seafloor characteristics and the locations of transient reef‐fish spawning aggregations in the Caribbean.
Direct and indirect effects of temperature on the population dynamics and ecosystem functioning of aquatic microbial ecosystems
Authors: Beveridge Oliver S. , Petchey Owen L. , Humphries Stuart
Published: August 2010

1. While much is known about the direct effect that temperature can have on aquatic communities, less is known about its indirect effect via the temperature dependence of viscosity and temperature‐dependent trophic interactions.

2. We manipulated the temperature (5–20 °C) and the viscosity (equivalent to 5–20 °C) of water in laboratory‐based bacteria–protist communities. Communities contained food chains with one, two or three trophic levels. Responses measured were population dynamics (consumer carrying capacity and growth rate, average species population density, and the coefficient of variation of population density through time) and ecosystem function (decomposition).

3. Temperature, viscosity and food chain length produced significant responses in population dynamics. Temperature‐dependent viscosity had a significant effect on the carrying capacity and growth rates of consumers, as well as the average density of the top predator. Overall, indirect effects of temperature via changes in viscosity were subtle in comparison to the indirect effect of temperature via trophic interactions.

4. Our results highlight the importance of direct and indirect effects of temperature, mediated through trophic interactions and physical changes in the environment, both for population dynamics and ecosystem processes. Future mechanistic modelling of effects of environmental change on species will benefit from distinguishing the different mechanisms of the overall effect of temperature.