bluuebunny/crossref_metadata_2025 huggingface dataset:
Probleme der Ketose in der klinischen Praxis
Authors: RYSHOW P. W.
Published: August 2010

1. Hohe Ketose kann bei chirurgischen Kranken vorhanden sein, unabhängig von. Schwankungen der Alkali‐Säurereserven.

2. Negative Reaktion des Harns auf Azeton bedeutet nicht Fehlen von Hyperketonämie.

3. Zur Bestimmung der Ketose sind quantitative ketonämische Exponenten zu verwerten.

4. Die Zunahme der Ketonämie verläuft hauptsächlich auf Kosten der β‐Oxybuttersäure. Beim Anstieg des Ketonurie nimmt das präformierte Azeton stark zu und übersteigt in mehreren Fällen die Menge der β‐Oxybuttersäure.

5. Das Vorhandensein von Hyperketonämie weist auf starke Stoffwechselstörungen hin und kann infolgedessen von prognostischer Bedeutung sein.

6. Bei chirurgischen Schmerzen fanden vir erhöhte Ketose in 73.2% aller Fälle, bei Schmerzen visceralen Ursprungs häufiger als bei solchen peripheren Ursprungs.

Bei Schmerzen zentraler Herkuhft war keine Hyperketose zu beobachten.

7. Die Zunahme der Ketose ist direkt abhängig von der Intensität des Schmerzreizes, jedoch bilden die Schmerzen nur eine der Ursachen, die Hyperketose hervorrufen können.

8. Hyperketose bei visceralen Schmerzen kann (mutmasslich) als Resultat einer Depression der Leberfunktion aufgefasst werden, wodurch die Oxydation der Buttersäure auf der Stufe der β‐Oxybuttersäure aufgehalten wird.

9. Hyperketose ist nicht spezifisch für irgendeine bestimmte Art chirurgischer Erkrankungen; in den meisten Fällen hängt ihr Anstieg vom Allgemeinzustand des Patienten ab.

10. Bluttransfusion setzt die Ketose herab.

11. Die Ketonkörper lassen sich in der Cerebrospinalflüssigkeit sowohl bei hohen Graden von Ketonämie feststellen als auch bei normalem Ketonkörpergehalt des Bluts. Die Bedingungen, unter denen die Ketonkörper die Blutgehirnschranke passieren, sind offensichtlich rein individuell und hängen nicht von der Höhe der Ketonämie ab.
Pellagra und Geisteskrankheit
Authors: LÖFVENDAHL HILLEVI
Published: August 2010

Untersuchungen hinsichtlich der Nikotinsäureaussonderung im Urin sind unter Anwendung der Porjéschen Methode in 85 Fällen von Geisteskranken ausgeführt worden. In 58 Fällen lag die Aussonderung unter 1.2 mg, welches als der niedrigst normale Wert angesehen wird; in 20 dieser Fälle war keine Aussonderung zu verzeichnen. — Beschreibung von vier Fällen, die im Geisteskrankenliaus gepflegt worden sind, wo Pellagra mit der Entstehung von Geisteskrankheit einen Zusammenhang liaben dürfte und wo die Anwendung von Nikotinsäureamid guten Erfolg hatte. — Literaturangaben über die Anwendung der Nikotinsäure in Fällen von Geisteskrankheit, verursacht durch Pellagra. —
Die Untersuchung der Lungenfunktion
Authors: DIRKEN M. N. J. , KRAAN J. K. , OOSTINGA H. , WOUDSTRA S.
Published: August 2010

Untersucht ist die Folge des Einatmens von 21, 17 und 15 % Sauerstoff auf die arterielle Sauerstoffsättigung bei Normalen und bei Patienten mit Lungen‐ und Herzkrankheiten.

Aus den an Normalen erhaltenen Daten ist ein Vergleichsskala zur Beurteilung der bei Patienten gefundenen Werte aufgestellt.

Besprochen werden die Resultate der Belastungsprobe bei Patienten mit Pneumothorax, Lungentuberkulose, Pleuritis, chron. Bronchitis, krup. Pneumonie und Herzabweichungen.

Hieraus ergibt sich, dass sich unterschieden lässt zwischen einerseits den Fällen, bei welchen kleinere oder grössere Teile der Lunge ausgefallen sind, die so einen Eindruck von der noch vorhandenen Blutdurchströmung durch diese Gebiete (Kurzschlüsse) gewären, und andererseits den Fällen, in denen die Sauerstoffzufuhr zum Blut gestört ist, entweder in Folge unzureichender Ventilation der Alveolen oder erschwerter Diffusion durch die Lungenwand.
Die Ausscheidung des Bilirubins im Harn und ihre Abhängigkeit vom Serumbilirubin
Authors: WITH TORBEN K.
Published: August 2010

Die Literatur wird besprochen; Untersuchungen mit zuverlässigen Analysemethoden sind erforderlich. Es wird über Serum‐ und Urinuntersuchungen mit Jendrassik und Gróf's Methode in 23 Hepatitisfälle und 9 Fälle von Okklusionsikterus berichtet. Weiter werden Serumbestimmungen in 5 Fällen von hämolytischem Ikterus sowie Untersuchungen über die Tagesvariation des Serumbilirubins in 5 Hepatitisfällen vorgelegt.

Der Schwellenwert für Bilirubinurie variierte zwischen 3 und 9, am häufigsten 3–6 mg pro 100 ml. Für Ikterus neonatorum betruger doch 18 mg pro 100 ml. Es wurde im Ham 15–75 %, am häufigsten 25–50 % der im Serum vorgefundenen Konzentration beobachtet; nur in einem Fall (cancer pankreatis) wurden Werte von ca. 100 % beobachtet. Es bestand kein sicherer Unterschied zwischen Okklusionsikterus und parenchymatösem Ikterus. Bei Ikterus neonatorum wurde im Harn nur ein Par Prozent der Serumkonzentration vorgefunden.

Die direkte Reaktion wird besprochen; sie kann keine Bedeutung für die Bilirubinsusscheidung im Harn haben. Die Hypothese über die fehlende Harnfähigkeit des indirekten Bilirubins wird diskutiert und als überflüssig und ungenügend begründet gefunden.

Bilirubin scheint nicht eine Schwellenwertsubstanz im eigentlichen Sinne zu sein, da andere Faktoren als die Serumkonzentration entscheidende Bedeutung für die Ausscheidung im Harn haben müssen.
Kreislaufstörungen bei Krampfanfällen epileptischen Typs
Authors: NYMAN E. , SILFVERSKIÖLD B. P.
Published: August 2010

Von früheren Erfahrungen ausgehend wird die Möglichkeit erörtert, dass die Kreislaufstörungen beim Elektroschock eine gleichartige Genese haben können wie die beim Valsalvaschen Versuch beobachteten. Elektrokardiogramme zweier Serien von je 13 Fällen mit Elektrokrampf und Valsalvaschem Versuch werden miteinander verglichen und weisen grosse Übereinstimmungen auf. In beiden Fällen findet man bei der Mehrzahl der Kurven eine Höhenzunahme der P‐ und Höhenabnahme der R‐Zacken. Die T‐Zacken verhalten sich mehr wechselnd, lassen aber nichtsdestoweniger in der Mehrzahl der Fälle in beiden Serien eine grössere Höhe erkennen. Da zuvor nachgewiesen worden ist, dass beim Elektrokrampf eine hochgradige Drucksteigerung in der Brust‐ und Bauchhöhle zustande kommt, macht es den Anschein, als ob die Ekgveränderungen beim Elektroschock im wesentlichen gleichen Ursprungs und Wesens wären wie diejenigen, welche nach dem Valsalvaschen Versuch auftreten.
Über die Wirkung des Bariums auf das Herz auf Grund zweier Vergiftungsfälle.
Authors: HIRVONEN MARTTI
Published: August 2010

In der Arbeit sind zwei charakteristische. Bariumvergiftungsfälle mitgeteilt, von denen der eine im Lauf von 6 Tagen vollständig genas, der andere dagegen 14 Stunden nach der Vergiftung starb. Bei der Obduktion und der sich daran anschliessenden chemischen Untersuchung konnte mit Sicherlieit festgestellt werden, dass eine Bariumvergiftung vorlag.

Besondere Aufmerksamkeit wurde der das Herz betreffenden Wirkung des Bariums auf Grund elektrokardiographischer Untersuchungen zugewandt. Es wurden folgende Beobachtungen gemacht:

In dem leichten Vergiftungsfall trat anfangs extrasystolische Allorrliythmie des Bigeminietypus auf, die sich schon 10 Stunden nach der Vergiftung in langsamen Sinusrhythmus oder in Nodalrhythmus verwandelt hatte, denn die P‐Welle war da in der II. und III. Ableitung negativ, während die PQ‐Zeit andauernd normal war. Die QRS‐Zeit war bei einigen Untersuchungen vielleicht ein wenig verkürzt. In QRSI wurden einmal Knoten konstatiert. Die T‐Welle war in alien Ableitungen sehr flach. Die relative QT‐Zeit war andauernd normal. Eine deutliche U‐Welle trat in alien Ableitungen auf. Alle diese Veränderungen waren 6 Tage nach der Vergiftung verschwunden.

In dem schweren Vergiftungsfall bestand fortwährend Sinusrhythmus. Die P‐Velle war während der ganzen Zeit in alien Ableitungen positiv. Die PQ‐Zeit war wahrscheinlich etwas verlängert, ebenso die QRS‐Zeit im Anfang. Die T‐Welle war in alien Ableitungen positiv. Die Strecke ST war fortwährend stark erniedrigt, und die relative QT‐Zeit war immer deutlich verlängert.
Über das Vorkommen von Malaria in Finnland
Authors: RENKONEN K. O.
Published: August 2010

Es werden statistische Angaben über die Malaria in Finnland angegeben. Die monatliche Verteilungskurve zeigt, dass in Finnland die Malaria ein wenig später als in schweden auftritt. Em kalter Frühling scheint mehr Malariafälle im Norden zu prädisponieren als der wärmere. Auf die Schwierigkeit diese Beobachtung mit der Theorie von langer Inkubationszeit zu erklären wird hingewiesen. Das stufenweise Verschwinden der Malaria aus den verschiedenen Teilen Finnlands wird mit dem Wohlstand und der Kultur der Provinzen verglichen.
The Type of Respiration in Severe Hypoglycemia
Authors: LUNDBÆK KNUD
Published: August 2010

A description is given of a characteristic type of respiration which occurs during severe hypoglycemia and which it has been possible to register in connection with metabolic experiments. This type of breathing is characterised by the occurrence of varying depth of respiration, jerky exspirations and post‐inspiratory and post‐expiratory pauses. The pathogenesis of this form of respiration is discussed. It is empared with other forms of abnormal respiration in animal experiments and in the clinic. The conclusion is drawn that it is due to a general hypo‐oxidation in the cerebrum possibly of a special kind owing to the special conditions in hypoglycemia. The diagnostic significance of this type of respiration is discussed.
SIDE‐EFFECTS OF ORAL IRON THERAPY A double‐blind study of different iron compounds in tablet form.
Authors: HALLBERG LEIF , RYTTINGER LARS , SÖLVELL LENNART
Published: August 2010

Using a double‐blind and placebo technics, the side‐effects of tablets containing different iron compounds were compared in 1496 subjects. Three separate series, all of which included placebo and ferrous sulphate tablets were studied. The agreement between the results obtained in different series was very good.

Ferrous sulphate, ferrous gluconate, ferrous fumarate, and ferrous glycine sulphate had almost the same incidence and type of side‐effects. The incidence was significantly higher than when placebo tablets were given.
RENAL FUNCTION DURING CARDIAC PACEMAKING
Authors: Alestig Kjell , Bojs Göran , Larsson Sture
Published: August 2010

Abstract A hemodynamic and renal study was carried out on eight pacemaker‐treated patients with complete heart block. At the time of study the patients were normotensive and well compensated. Cardiac output, brachial arterial pressure, inulin‐ and PAH‐clearances as well as the excretion of electrolytes were determined on two or three selected heart rate levels between 45–118 for each patient during four to six 20‐minute periods. A change of the ventricular rate from low to high level gave a significant decrease of stroke volume and pulse pressure, but cardiac output, GFR and RPF were unchanged. The most interesting result was the finding of a significantly increased sodium excretion and sodium/potassium quotient on high heart rates. Possible explanations of the mechanisms responsible for this action are discussed.
PRIMARY AND LATE RESULTS OF OPEN CORRECTION OF FALLOT'S DISEASE
Authors: Bjernulf A. , Cullhed I. , Hallén A. , Michaëlsson M.
Published: August 2010

Abstract During the period 1959–1966 total correction was performed on 56 consecutive cases of Fallot's anomaly. Acyanotic cases were not included. The primary mortality was 30%. Factors involving increased risk at operation are, among others, severe cyanosis, age at operation less than five years, and supravalvular changes of the pulmonary artery. The post‐operative follow‐up examination showed a definite improvement in the surviving cases.
THE OBSERVER VARIATION IN THE MEASUREMENT OF ARTERIAL BLOOD PRESSURE
Authors: Eilertsen E. , Humerfelt S.
Published: August 2010

Abstract Observer errors and observer variation have been studied in a survey of blood pressure covering about 70,000 subjects in Bergen, Norway, carried out by 19 specially trained nurses under conditions standardized as much as possible. Substantial differences were found between extreme observers concerning the mean values of the readings in age and sex groups, while the majority only showed insignificant differences. Reading characteristics were supposed to be the reason for individual observers keeping the same ranking position vis‐à‐vis the others from age group to age group in both sexes. A number of observers had, however, a different ranking in systolic from that in diastolic readings. Terminal digit preference in the readings was found only to a small degree, and only in a few of the observers. The special apparatus of the London School of Hygiene was found to reduce, but not to eliminate this error. When the results obtained with the latter apparatus were compared to standard apparatus results, no differences in the reading characteristics were found related to the sex, age and blood pressure level of the subjects examined.

Conclusion: observer variation in blood pressure examination may be substantial and may affect the mean values found in population surveys, even if the observers are carefully selected and thoroughly trained.
STUDIES OF THE CLINICAL AND METABOLIC EFFECTS OF PHLEBOTOMY TREATMENT IN PORPHYRIA CUTANEA TARDA
Authors: Lundvall O. , Weinfeld A.
Published: August 2010

Abstract The size of the iron stores and the effect of phlebotomy treatment has been evaluated in twelve patients with porphyria cutanea tarda. Clinical and biochemical remission was obtained in all patients. The mean treatment period was 4½ months in patients who were phlebotomized frequently and were not given iron. In two patients who received iron supplements in conjunction with phlebotomy treatment remission was not obtained until the iron administration was stopped. In two other patients iron administration after induced remission was associated with relapses. No relapse was seen in the others. The effect of the treatment is probably due mainly to the reduction of the iron stores. Beside the disappearance of active skin symptoms and strongly diminished porphyrin excretion, the treatment was associated with improved liver function tests.
ON THE PREVALENCE OF ADRENOCORTICAL ADENOMAS IN AN AUTOPSY MATERIAL IN RELATION TO HYPERTENSION AND DIABETES
Authors: Hedeland Hans , Östberg Görel , Hökfelt Bernt
Published: August 2010

Abstract A prospective study was performed on an autopsy material consisting of 739 consecutive cases over 20 years of age (391 females, 348 males) during a period of six months. The material included about 70% of the deaths in the city of Malmö (approximately 250,000 inhabitants). The adrenals were specially observed at autopsy for adenomas and hospital records were searched for hypertension and diabetes mellitus.

In the total material the frequency of adrenocortical adenomas was 8.7%, which was considerably higher than previously reported figures. In patients with essential hypertension the adenoma frequency was 12.4% as against 7.9% in normotensives. This difference was not statistically significant. The adenoma frequency in men with secondary hypertension was remarkably high but the significance is not clear. In patients with hypertension the frequency of diabetes was 17.6% as compared to 9.0% in normotensives. This difference was statistically probably significant.

In patients with diabetes the frequency of adrenocortical adenomas was 16.5%, in non‐diabetics 7.7%. The difference was probably significant.
SYSTEMIC ARTERIAL HYPERTENSION
Authors: Hillestad Leif
Published: August 2010

Abstract Among 301 cases of unselected hypertension 45% proved to be of the essential and the remaining 55% of the secondary type. A sex difference was present in that the essential type was found in 53% among men against 33% among women. The major causes of secondary hypertension were chronic pyelonephritis and nephritis, Cushing's disease and allied disorders and aortic coarctation. In a series of 177 patients with selected hypertension 76% maintained the diagnosis of essential hypertension. No significant sex difference was observed. All the cases of secondary hypertension were of renal origin, chronic pyelonephritis being responsible for more than 50% of the cases. Of the techniques employed urography with early sequential exposures seemed to be the method of choice for screening purposes. Renal biopsy was similarly helpful in obtaining the correct diagnosis. Renal angiography also proved to be of great significance, and its use should clearly be extended. The presently available methods for evaluating systemic arterial hypertension are discussed.
MECHANICAL HEMOLYTIC ANEMIA IN UNOPERATED AORTIC VALVE DISEASE
Authors: Dupont Bo , Wennevold Alf
Published: August 2010

Abstract A case is presented with combined aortic stenosis and aortic insufficiency. A hemolytic anemia was demonstrated preoperatively. After replacement of the aortic valve with a homograft, the hemolysis subsided. A prospective study was made of possible hemolysis in 102 hospitalized patients with rheumatic and congenital heart disease. Hemolysis was found in seven patients with aortic valve disease; two of the patients had in addition slight mitral valve disease. Four of the patients had anemia, while the hemolysis was compensated for in the remaining three patients. There were no signs of hemolysis in any of the patients with isolated mitral valve disease or congenital heart disease apart from aortic valve disease. A review of previously published cases seems to substantiate our findings that isolated mitral valve disease does not give rise to mechanical hemolysis.
IDIOPATHIC SCOLIOSIS IN OLD AGE
Authors: Freyschuss U. , Nilsonne U. , Lundgren K.‐D.
Published: August 2010

Abstract Lung function was studied in a group of 14 female patients, between the ages of 57 and 63, who had been diagnosed as idiopathic scoliotics about 50 years ago. The examinations comprised spirometry and determination of ventilation and the alveolar gas exchange at rest and during work. Roentgenological measurements were used to determine the degree of scoliosis; the cases being divided into two groups according to the degree of deformity. The moderately deformed group contained seven patients with an angle of less than 60°, while the other seven patients made up the severely deformed group with an angle of more than 60°. The latter group had significantly lower total and vital capacities, maximum ventilation and forced expiratory volume in one second, and also a significantly higher respiratory rate and tidal volume. The two cases with the most severe degree of scoliosis had an impaired alveolar gas exchange; the one with the largest angle (102°) presenting signs of respiratory insufficiency, with retention of carbon dioxide during oxygen inhalation.

The results thus suggest that the degree of deformity in scoliosis is correlated with lung function.
CEREBRAL BLOOD FLOW AND OXYGEN CONSUMPTION IN BARBITURATE POISONING
Authors: Malmlund Hans‐Olof
Published: August 2010

AbstractCerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRo2) have been determined by the nitrous oxide method in five cases of severe barbiturate poisoning (blood barbiturate level 2.2−15.2 mg/100 ml). All cases needed prolonged artificial ventilation (IPPV) to survive. Mean CBF was 30±9 ml/100 g/min and mean CMRo2was 1.5±0.4 ml/100 g/min. Within the temperature range studied, 31.7°C−37.8°C, body temperature (BT) was correlated to CMRo2according to the equation BT = 6.6 × CMRo2+ 25, the correlation coefficient being 0.96 (p<0.01). A similar correlation was found between CBF and BT (r=0.93,p<0.05). The cerebral arteriovenous oxygen difference was normal and rather constant in spite of generally low values for arterial Pco2. There was no indication of inadequate oxygen supply to the brain.
PREDNISONE‐GLUCOSE TOLERANCE AND SERUM LIPIDS IN SURVIVORS OF MYOCARDIAL INFARCTION
Authors: Jakobson Theodor , Kahanpää Asko , Mäenpää Voitto J.
Published: August 2010

Abstract Glucose tolerance has been examined by means of a prednisone‐glucose tolerance (PGT) test in 41 patients with clinically documented myocardial infarction 3 to 4 weeks after the attack and in age‐matched control subjects without clinical evidence of cardiovascular disease. In addition serum cholesterol and triglyceride levels have been determined and free fatty acid (FFA) concentrations measured prior to the PGT test and after administration of the glucose load.

Abnormal glucose tolerance curves were obtained in 53.6% of the patients 3 to 4 weeks after the infarction and in 25.8% of the controls. Seventeen patients were retested approximately six months after the first test and glucose tolerance in seven patients with initially abnormal PGT curves was found to be within normal limits, while further impairment was observed in only four cases. A significant correlation between the PGT tests and serum cholesterol levels was found to exist only in patients over the age of 60, while no correlation could be observed between prednisone‐glucose tolerance and serum triglycerides or fasting levels of FFA. The mean decrease of FFA 1 hour after the administration of glucose was slightly less in the patients with myocardial infarction than in the controls, while a decrease of FFA to levels below 200 μEq/1 was observed in approximately one third of the patients 1 and/or 3 hours after the glucose load.

It is concluded that the impairment of glucose tolerance which frequently can be observed after recent myocardial infarction is probably due only in a minority of cases to a latent diabetic condition and that other factors which are known to influence carbohydrate metabolism must be taken into consideration in explaining the observed disturbances of glucose homeostasis.
THE DEVELOPMENT OF CELLULAR HYPERSENSITIVITY IN MAN AFTER A PRIMARY IMMUNIZATION
Authors: Søborg Mogens
Published: August 2010

Abstract The development of cellular and humoral hypersensitivity was followed during a primary immunization with brucella bacteria in 15 persons. Both types of hypersensitivity were detected by in vitro techniques, thereby enabling repeated recordings of the degree of hypersensitivity in each individual. Cellular hypersensitivity as measured by the leucocyte migration test developed in two phases separated by a shorter period of non‐reactivity. The first phase was present as early as two days after the immunization. Humoral hypersensitivity measured as agglutinating antibodies followed the usual pattern with rising titers after a latent period of 6–8 days. Cellular hypersensitivity thus seemed to develop earlier than humoral hypersensitivity, and apparently no correlation seemed to exist between these two parameters. The mechanism of the biphasic occurrence of cellular hypersensitivity, especially the possible analogy with the so‐called Jones‐Mote's reactivity and the interrelationship between cellular and humoral hypersensitivity, is discussed.
CLINICAL USE OF HIGH DOSES OF FUROSEMIDE (LASIX®) IN THE TREATMENT OF RESISTANT NEPHROTIC EDEMA
Authors: Silverberg Donald S. , Kjellstrand Carl‐Magnus
Published: August 2010

Abstract Four cases of the nephrotic syndrome are reported in which furosemide was administered in doses higher than those usually prescribed. In three cases merely raising the dose of furosemide to levels up to 600 mg/day promoted a diuresis. In one patient furosemide in doses up to 1200 mg/day failed to produce a diuresis but the addition of a thiazide succeeded in producing one. Hypokaliemia was seen in three patients and was treated by reduction of the drug dose, oral administration of potassium chloride and spironolactone. In cases of edema resistant to the usual doses of furosemide, the use of higher doses alone or in combination with other diuretic agents may produce a satisfactory diuretic response.
CIRCULATORY STUDIES DURING PHYSICAL EXERCISE IN MENTALLY DISORDERED PATIENTS. I
Authors: Carlsson Carl , Dencker Sven J. , Grimby Gunnar , Häggendal Jan
Published: August 2010

Abstract 1. Nine patients who were not given chlorpromazine (mean age 29 years), and eight patients (mean age 30 years) who received large doses of chlorpromazine (1500–3600 mg/day) were studied, with determination of oxygen uptake, ventilation, cardiac output, arterial blood pressure and arterial blood lactate, pyruvate and noradrenaline concentrations at rest supine, and when cycling in the sitting position on a bicycle ergometer with successively increasing work loads. The heart volume was measured roentgenologically with the patient prone. 2. Four patients were studied before, and 1.5–5 months after, the beginning of chlorpromazine treatment. They maintained their physical performance during that period. 3. All patients had a low physical working capacity on the bicycle ergometer; and most of them had a reduced stroke volume in relation to the heart volume. 4. The patients treated with chlorpromazine tended to show further reduction in stroke volume and lower cardiac output during exercise than those who did not receive such treatment. 5. The arterial blood pressure at rest was largely the same in the two groups of patients, but was reduced during exercise in those treated with chlorpromazine. Chlorpromazine did not cause a significant change in peripheral vascular resistance. 6. A high blood noradrenaline level was recorded during exercise after treatment with chlorpromazine. 7. A small stroke volume, especially in patients treated with chlorpromazine, and the fall in arterial blood pressure in this group, are factors that limit physical performance. The importance is stressed of exercise tests in clinical routine in the activation of patients receiving phenothiazines, at least for those receiving large doses.
CIRCULATORY STUDIES DURING PHYSICAL EXERCISE IN MENTALLY DISORDERED PATIENTS. II
Authors: Carlsson Carl , Dencker Sven J. , Grimby Gunnar , Häggendal Jan
Published: August 2010

Abstract 1. Circulatory studies were performed on four schizophrenics (mean age 27 years) not treated with chlorpromazine and on five (mean age 30 years) treated with large doses of this drug (1800–3600 mg/day), before and after 1.5–4 months of physical training. 2. The physical training consisted of strenuous exercise on a bicycle ergometer for three 6‐minute periods five times a week. 3. After training, all the patients, except two, could cycle with a larger work load for 6–10 minutes. 4. In the drug‐free patients the heart rate and arterial blood lactate decreased with training. This training effect was less consistent in the patients treated with chlorpromazine. 5. The stroke volume was small in relation to the heart volume before training. It tended to become normal in five of eight patients after training. 6. In the patients treated with chlorpromazine, the blood noradrenaline level was high during exercise, and fell in all the patients, except one, after training. In the drug‐free patients, this level was not as high, and there was a further decrease with training in all four patients.
PAROXYSMAL NOCTURNAL HAEMOGLOBINURIA
Authors: Hansen Niels Ebbe , Killmann Sven‐Aage
Published: August 2010

Abstract Case reports of eight patients with the PNH defect are presented.

The diagnostic criteria applied are discussed: Ham's and Crosby's tests, the sucrose haemolysis test, acetylcholine esterase activity of the red cells, and signs of intravascular haemolysis with emphasis on the determination of lactate dehydrogenase activity in blood and bone marrow.

The diversity of the presentation of PNH is outlined. One patient presented with attacks of abdominal pain for two years before diagnosis, three patients had longstanding pancytopenia with few clues to the diagnosis, two patients presented as cases of aplastic anaemia with initially negative Ham's tests, and two patients had concomitant myelofibrosis. The relationship of PNH to other blood diseases is discussed, and a possible connection with myelofibrosis is suggested. It thus appears that the PNH erythrocyte defect is encountered not only in the clinically classical PNH syndrome, but also in a variety of pancytopenias which are difficult to classify, and finally in some better defined conditions such as aplastic anaemia and myelofibrosis. This could be interpreted in several ways: 1. PNH is a nosological entity with an extremely wide clinical spectrum; 2. PNH is not a nosological entity, but erythroid cell lines carrying the PNH defect may be set up under many conditions when haemopoiesis is afflicted by a primary haematological disorder; 3. PNH exists (a) as a primary disorder, the clinically classical PNH syndrome, and (b) as a secondary defect in a variety of other haematological disorders. It is not yet possible to determine which of these possibilities, if any, is the right one, although at the present time the second interpretation would appear to be the most likely one.

Clinical features are mentioned, particularly hypercoagulability and the occurrence of thromboses. An interesting aspect is that the majority of patients had an abnormal EEG. The significance of this remains to be determined. The multiple mechanism of anaemia in PNH is emphasized, including marrow hypoplasia, haemolysis, iron deficiency, autoimmunity, and folic acid deficiency.

The value of blood transfusions, iron, adrenocorticoid and anabolic steroids in the management of PNH is discussed.
AN INTRAVENOUS GALACTOSE TOLERANCE TEST AND ITS USE IN HEPATOBILIARY DISEASES1
Authors: Tengström Bertil
Published: August 2010

Abstract The paper describes an intravenous galactose tolerance test performed by a single injection of 350 mg of galactose per kg body weight. Galactose in the blood was determined by a specific galactose oxidase method.

The disappearance of the galactose from the blood mainly occurs by hepatic metabolism which is rate‐limited. The course of the elimination curve, however, is also influenced by extrahepatic factors. The curve was found to be most easily described as a straight line in a semilogarithmic system, the T 1/2 value for galactose being found to be 12.0 ± 2.6 min in normal adults. The galactosuria was reasonably small and constant in different clinical conditions and was therefore disregarded.

The T 3/2 value was elevated in 84% of cases of liver cirrhosis, and the elevation appeared to be a good measure of the degree of liver damage. Abnormal test results were obtained in 58% of patients with acute infectious hepatitis. Among patients with an abnormal T 1/2 value more than three weeks after the onset of jaundice a long duration of the disease was generally seen, the development of cirrhosis was demonstrated in one isolated case, and one patient died. In patients with cancer metastases of the liver the test result was abnormal in 50%. The T 1/2 value was normal in 93% of cases of biliary obstruction.

The galactose test was found to give valuable diagnostic and prognostic information in liver cirrhosis and in hepatitis, and also to be useful in differentiating between obstructive and parenchymatous jaundice.
VIBRATORY PERCEPTION THRESHOLD AND MOTOR CONDUCTION VELOCITY IN DIABETICS AND NON‐DIABETICS
Authors: Gregersen G.
Published: August 2010

Abstract The vibratory sense measured by biothesiometry was found to be correlated to age and sex in non‐diabetics.

In diabetics the vibratory sense was correlated to the duration of the diabetes both on the upper and lower extremities. No difference was found between the sexes.

It was possible to demonstrate a reduction of the vibratory sense already within the first year of diabetes in younger patients with a well‐defined onset of the disease. The same fact has been demonstrated previously with regard to the motor conduction velocity.

In young diabetics motor and sensory nerve functions diminish in parallel.
EFFECTS OF REPEATED WORK TESTS AND ADRENERGIC BETA‐BLOCKADE ON ELECTROCARDIOGRAPHIC ST AND T CHANGES
Authors: Furberg Curt
Published: August 2010

AbstractThe effect of a number of repeated work tests on different electrocardiographic ST and T changes has been studied and the effect compared with that after an adrenergic beta‐receptor blockade.

In subjects with different ECG changes but without any apparent organic heart disease there was a normalization of the ST and T changes during the period of repeated work tests. The normalizing effect was almost identical to that after adrenergic blockade. Different patterns of ST and especially T depressions on the ECG at rest, in the standing position and during and after work are described.

In patients with organic heart diseases the repeated work tests generally had no effect on the ECG patterns typical of coronary insufficiency and myocarditis. In one patient with signs of a vasoregulatory disturbance there seemed to be ST and T changes of different origin, probably both functional and organic. The effect of the adrenergic blockade was almost identical to that of the repeated work tests.

The study gives support to the results of a previous investigation in which the possibility of using an adrenergic blockade for differentiating between ECG changes of functional and organic origin was pointed out.

The normalization effect of 4–6 work tests over a period of 4–6 days on functional ST and T changes on the ECG is supposed to be due to a physical and psychic adaptation to the work tests and to the examination situation.
INVESTIGATION OF PATIENTS WITH MILD THROMBASTHENIA—A HAEMORRHAGIC DISORDER WITH PROLONGED BLEEDING TIME PROBABLY DUE TO A PRIMARY PLATELET DEFECT
Authors: Cronberg Stig , Nilsson Inga Marie
Published: August 2010

Abstract Fifteen families with a haemorrhagic disorder are reported. The patients had a bleeding tendency characterized by easy bruisability, nose bleeding, menorrhagia and bleeding after tooth extractions, accidents or surgery. Laboratory investigation showed prolonged Ivy bleeding time and usually decreased platelet adhesiveness, as measured by Hellem's whole blood method, Salzman's method and occasionally Hellem's plasma‐ADP method. Factor VIII and other coagulation factors were normal. The prothrombin consumption test was mostly normal and there was no pathologic fibrinolysis. The inheritance was probably dominant, but the penetrance weak. The disease was probably caused by a primary platelet defect, especially since a similar syndrome was found among relatives of a family with severe thrombasthenia of Glanzmann's type. We call the condition mild thrombasthenia.
HAEMOGLOBIN LEVEL AND RENAL FUNCTION IN PATIENTS WITH AND WITHOUT HYPERTENSION
Authors: Hilden Mogens , Hilden Tage
Published: August 2010

Abstract A comparison has been made between the haemoglobin level in normotensive and hypertensive patients with impaired renal function.

Because of a higher daily production of creatinine, the renal function, assessed on the basis of the creatinine clearance, is higher in hypertensive than in normotensive patients in relation to their serum creatinine concentration.

Hypertensive patients have a considerably higher haemoglobin level than normotensive patients with the same degree of impairment of renal function.
PYELONEPHRITIS‐LIKE LESIONS AS A LATE EFFECT OF DIFFUSE INTRAVASCULAR COAGULATION
Authors: Brentjens J. R. H. , Vreeken J. , Feltkamp‐Vroom Thea , Helder A. W.
Published: August 2010

Abstract A short episode of diffuse intravascular coagulation caused a range of severe kidney alterations in rabbits which did not die immediately with renal cortical necrosis. Histology resembled that of chronic pyelonephritis. The rabbits exhibited a steep but completely reversible rise in blood creatinine level, and ultimately no abnormalities of the urine. Blood pressure remained normal. It is supposed that comparable situations may arise in human pathology.
THE LATE CARDIAC PROGNOSIS AFTER NON‐PENETRATING CHEST TRAUMA
Authors: Lidström P. , Lindholmer C. , Orinius E.
Published: August 2010

Abstract Fourteen patients with radiologically diagnosed sternal fractures have been studied after 1/2 to 16 years for the possibility of persistent cardiac damage. In no case were there cardiac findings which could be definitely attributed to the non‐penetrating chest trauma.
IRON‐FORTIFIED BREAD
Authors: Vellar Odd D. , Borchgrevink Christian , Natvig Haakon
Published: August 2010

Abstract The increase in serum iron two hours after test‐meals in fasting subjects was taken as an expression of iron absorption in three series of experiments. All the individuals, most of them young, healthy, female nurses acted as their own controls. Tests were performed with white wheaten and wholemeal bread fortified with ferrous sulphate or ferrum reductum to 40 mg iron per 100 g. Some experiments with unenriched white bread were also included.

It was found that ferrous sulphate gave a more pronounced increase in serum iron than ferrum reductum. The increase was higher after fortified white bread than after fortified wholemeal bread. This was probably due to the inhibitory effect, although only partial, of dietary phytate on iron absorption.

Because of the relative uncertainty of the performed absorption experiments, a controlled clinical trial with ferrous‐sulphate‐enriched white and wholemeal bread to 8 mg iron per 100 g was conducted in 146 adult female patients of a mental hospital. The 12 weeks' trial was completed in 77 subjects in the experimental group and in only 20 in the control group.

In the experimental group the mean Hb value showed a significant increase to 14.32 g%, which is equivalent to the mean optimal value for adult Norwegian women. A concomitant rise in the mean Hct and MCHC values was recorded. The results in the control group are difficult to interpret. The mean increase in Hb concentration after 12 weeks, however, was not statistically significant.

The present study indicates that ferrous sulphate baked into bread is better absorbed than ferrum reductum, and is easily available for hemoglobin synthesis.

A long‐term community‐based feeding trial, however, may be necessary before a final conclusion regarding the future Norwegian iron‐fortification policy is reached.
EFFECT OF BRIEF CAROTID SINUS PRESSURE ON DIGITAL VASCULAR TONE
Authors: Heyman Folke
Published: August 2010

Abstract 1. Brief carotid sinus pressure produced a rapidly occurring and passing volume variation of the digits as recorded by digital plethysmography in healthy subjects. The first phase of the response was an increase in volume, the second a decrease. 2. The brachial arterial pressure was not affected by the pressure on the carotid sinus. 3. The reaction was sometimes also elicited peripheral to an obstruction of the circulation in the arm. 4. It is concluded that the response is probably due to a reflexly induced tonus variation of the vascular bed in the finger. 5. The short latency of the reflex effect may denote a coordination between the heart beat and the peripheral vascular tone.
FAMILIAL PROTEIN INTOLERANCE WITH DEFICIENT TRANSPORT OF BASIC AMINO ACIDS
Authors: Kekomäki M. , Toivakka E. , Häkkinen V. , Salaspuro M.
Published: August 2010

Abstract An adult patient suffering from protein intolerance with deficient transport of basic amino acids is described. The early history of the patient was typical of this inborn disorder of amino acid metabolism: weaning was followed by prolonged diarrhea, spontaneous restriction of protein in the diet, and by slow growth. Abandonment of the carbohydrate‐fat diet at the age of 18 years was followed by an increased growth rate and, in a very few months, by mental changes. The timing of these three incidents suggests a causal relationship between them. It therefore seems that both normal body growth and normal cerebral function are possible in protein intolerance; in the individual patient, however, they seem to be mutually exclusive. Analogous considerations in other inborn metabolic disorders of urea synthesis have been presented (2, 5).
BODY COMPOSITION IN HEART DISEASE
Authors: Olesen Knud H.
Published: August 2010

Abstract In order to define the alterations in body composition in cardiac patients with hyponatraemic hypochloraemia, the chloride space, total exchangeable chloride, sodium space, total exchangeable sodium and total exchangeable potassium were measured in 12 subjects with hyponatraemic hypochloraemia and in 12 patients with normonatraemia. The groups were selected to be comparable with regard to average body weight, mean age and sex distribution.

Statistical analysis defined the pattern of body composition in the hyponatraemic hypochloraemic group in the light of the findings in the normonatraemic group as follows: 1. A significant and parallel decrement of serum chloride and serum sodium concentrations; 2. An unchanged chloride space and sodium space; 3. A parallel decrement of total exchangeable chloride and total exchangeable sodium, although not statistically significant; 4. A normal or increased total exchangeable chloride and sodium in relation to predicted normal values; 5. A normal distribution of sodium in relation to chloride space; and 6. A significant rise in serum potassium concentration and a tendency to decrease of total exchangeable potassium.

While the interrelations between chloride space and sodium space and between total exchangeable chloride and total exchangeable sodium were the same in the two groups, the ratios of Cle/Na and Nae/Cl space were significantly lowered in the hyponatraemic hypochloraemic group.

It is concluded that, although it is likely that a deficit of total exchangeable chloride in relation to total exchangeable sodium, associated with metabolic alkalosis and decreased total exchangeable potassium, may account in part for the hypochloraemia seen in both groups, the major cause of the marked hypochloraemia in the hyponatraemic group is apparently a dilution of chloride in an expanded extracellular phase caused by the water retention responsible for the hyponatraemia.
DIRECT CURRENT COUNTERSHOCK COMPLICATIONS
Authors: Åberg Hans , Cullhed Ingemar
Published: August 2010

Abstract Conversion with direct current countershock was attempted in 215 patients with arrhythmias, the majority of whom (81.9%) had atrial fibrillation. There was a fairly high frequency of complicating ventricular arrhythmias (2.5%), probably due to medication with digitalis and/or quinidine. Thromboembolism was only noted in one case, and pulmonary edema in three cases.
MUSCLE AND SKIN CLEARANCE OF ANTIPYRINE FROM EXERCISING ISCHEMIC LEGS BEFORE AND AFTER VASODILATING TRIALS
Authors: Zetterquist Staffan
Published: August 2010

Abstract In a series of patients with intermittent claudication, antipyrine labelled with iodine isotopes was deposited in the calf muscle and skin of the lower leg. The disappearance rates of the tracers were utilized to evaluate changes in the regional blood flow in connection with exercise on a foot ergometer. The clearance curves suggested that, besides an increase of muscle blood flow, there was a gradual diversion of blood flow from the skin during exercise, with a transitory period without any removal of tracer from the skin depot towards the end of exercise but particularly immediately afterwards. The duration of this latter period was correlated to the degree of arterial obliterative disease in the leg and was considered useful in the diagnosis of incipient peripheral ischemia.

The ability of conventional vasodilating drugs to influence the behaviour of these clearance curves during exercise was tested in acute clinical experiments. It was found that, irrespective of the pharmacological mode of action, parenteral administration of the drugs used was accompanied by a significant decrease in clearance rate from the active muscles as compared with that registered during exercise of identical intensity before the therapeutic trial. Simultaneously there was a tendency to a delayed elimination of the skin tracer. The deleterious effect of the drugs on the clearance rates and thus presumably on the peripheral blood flow in the presence of arterial insufficiency seemed to be related to their depressive influence on the mean arterial blood pressure, brought about by an extensive dilation of healthy vascular beds.
HAEMODYNAMICS IN ACUTE PULMONARY OEDEMA IN CORONARY PATIENTS
Authors: Knutsen Brostrup , Broch Ole Jacob
Published: August 2010

AbstractStudies have been made of the haemodynamics in seven coronary patients with acute pulmonary oedema without shock. Five of the patients had acute myocardial infarction. The first examination was made 3–9 hours after the appearance of pulmonary oedema. During the examination evident signs of pulmonary congestion and dyspnoea could be demonstrated. The examination was made after treatment with oxygen, Cedilanide®, aminophyllin and Pethidin®. The second examination was made 8–13 days later, after all signs of pulmonary congestion had subsided. In the acute state tachycardia, reduced stroke volume and increased systematic blood pressure at a normal cardiac output were demonstrated. The difference between the two examinations was an increase of stroke volume, a reduction of the heart rate and systemic blood pressure, and an increase of the relation between stroke volume and central blood volume.
CHROMOSOME STUDIES IN POTENTIALLY LEUKAEMIC MYELOID DISORDERS
Authors: Jensen Mogens Krogh
Published: August 2010

Abstract Fifteen patients suffering from various “non‐leukaemic” myeloid disorders have been cytogenetically investigated. Evidence is presented that chromosome abnormalities may be present in both the erythrocytic and granulocytic precursors of the bone marrow. On the basis of a review of the literature it is suggested that myeloid disorders with abnormal stemlines in the bone marrow should be considered neoplastic conditions. It is concluded that the abnormal chromosome complements may be present at a very early stage of the leukaemic process and that the emergence of the abnormal stem‐lines occurs prior to and is unrelated to the blastic transformation of the granulocytic precursors characteristic of myeloblastic leukaemia.
THE EFFECT OF SHORT‐TERM EXERCISE ON PLASMA VOLUME AND BLOOD PRESSURE IN GUANETHIDINE‐TREATED HYPERTENSIVES
Authors: Hansen Jacob
Published: August 2010

Abstract Short‐term exercise produced a decrease in plasma volume and a rise in B.P. in normotensives and untreated hypertensive patients. The decrease in plasma volume is presumably due to an increased intra‐capillary pressure in the contracting muscles. In guanethidine‐treated patients there was no change in plasma volume during exercise, probably because of vasodilatation and decreased intra‐capillary pressure in the contracting muscles. In several of the guanethidine‐treated patients B.P. fell during and after exercise, in some cases so markedly that symptoms of cerebral ischemia developed.
ENDOCARDIAL PACING IN ACUTE MYOCARDIAL INFARCTION
Authors: Grendahl Helge , Sivertssen Egil
Published: August 2010

Abstract From 1964 to 1968 seventy‐seven patients in Ullevål Hospital with acute myocardial infarction were treated with endocardial pacing. Sixty of these patients had A‐V‐block, 53 complete, and 7 A‐V‐block of second degree.

Indication for pacing in the patients with A‐V block was Adams‐Stokes attack in 23 patients, bradycardia in 14, and in 23 “prophylactic pacing” was performed. Thirty‐three patients (55%) survived and 27 (45%) died. Mortality was higher in patients with anterior myocardial infarction (69%) than in patients with posterior myocardial infarction (13%). All the patients with both anterior and posterior myocardial infarction died. Patients with bundle branch block had a higher mortality (68%) than patients with narrow QRS complexes (21%).

Two patients died during positioning of the electrode and 19 during treatment with pacemaker. Among the 19 fatalities during pacing 5 were due to ventricular fibrillation, 1 to heart rupture and 13 to shock or cardiac failure.

In 17 patients pacing was started on indications other than A‐V block and 13 of the latter (76%) died.

Better results in the treatment of A‐V block in acute myocardial infarction will probably be achieved by the use of “on demand” pacemakers in order to avoid pacemaker‐induced ventricular fibrillation, and by prophylactic pacing before serious complications after Adams‐Stokes attacks or bradycardia have developed.