bluuebunny/crossref_metadata_2025 huggingface dataset:
DISTURBANCES IN SERUM LIPIDS AND IN THEIR FATTY ACID COMPOSITION FOLLOWING ACUTE MYOCARDIAL INFARCTION
Authors: Kirkeby Knut
Published: August 2010

Abstract Disturbances in serum lipids and in their fatty acid composition have been studied during the early phase of acute myocardial infarction. A rise in free fatty acids was observed within 2–6 hours after onset of pain, and on the 3rd‐4th day a decline in concentrations of cholesterol and phospholipids together with changes in their fatty acid composition. Linoleate percentages decreased, while arachidonate and palmitate increased. For triglycerides elevations in palmitate and oleate and a decline in lino‐leate were observed in the same period. It is concluded that an increase in β‐lipoprotein degradation—and not a decline in their synthesis—is the mechanism responsible for lowering of cholesterol and phospholipids. Various endocrine factors occurring in response to stress may be involved in the mechanisms leading to lipoprotein degradation, but thyroxine is the only hormone having nearly the same effect on lipid metabolism as that of acute serious illness. It is postulated that alterations in the free thyroxine level contribute more to the homeostatic response to serious illness than has been generally believed hitherto, and that thyroxine is the main cause of the changes in β‐lipoproteins observed after myocardial infarction.
CARDIOVASCULAR COMPLICATIONS IN MALIGNANT THYMOMA
Authors: Trell Erik , Rausing Alf
Published: August 2010

Abstract A case of malignant thymoma with multiple cardiovascular complications is described, and clinical and hemodynamic features, in particular pulmonary hypertension, are briefly discussed in relation to the pertinent literature.
INTESTINAL METABOLISM OF FRUCTOSE
Authors: Herman Robert H. , Stifel Fred B. , Greene Harry L. , Herman Yaye F.
Published: August 2010

Abstract. The metabolism of fructose by the small intestine can be analyzed in terms of the following scheme: 1) hydrolysis of fructose containing saccharides especially sucrose; 2) movement of fructose into the intestinal cell; 3) transformation of fructose into glycolytic metabolic intermediates; 4) formation of fructose from glucose via sorbitol; 5) adaptive regulation of fructose metabolizing enzymes; 6) adaptive responses of other enzymes to fructose. The hydrolysis of sucrose is dependent upon the brush border enzyme sucrase which shows an adaptive response to sucrose diets. The entrance of fructose into the small intestine and the intermediary metabolism of fructose is reviewed. Fructose metabolizing enzymes, fructokinase and fructose‐1‐phosphate aldolase, are regulated by the presence or absence of fructose, folic acid and drugs. Fructose causes adaptive changes in small intestine glycolytic enzymes and decreases the gluconeogenic enzyme fructose‐1,6‐diphosphatase. Actinomycin D inhibits the adaptive effect of fructose on glycolytic enzymes which suggests that fructose acts via the protein synthetic mechanism.
HEREDITARY ALTERATIONS OF FRUCTOSE METABOLIZING ENZYMES
Authors: Schapira F. , Nordmann Y. , Gregori C.
Published: August 2010

Abstract. Two hereditary alterations of fructose metabolizing enzymes are known. We have shown that in essential fructosuria, there is in fact a deficiency of fructokinase activity. We have shown that in hereditary fructose intolerance (HFI) some abnormal properties of aldolase in liver are related to aldolases A (muscle type) and C (brain type) which are normally synthesized by embryo, and which persist without change. In livers with HFI, we have found a protein immunologically related to aldolase B (liver adult type), the enzymatic activity of which is about 3 per cent of the normal value. Its Michaelis constant for fructose‐1‐phosphate is greatly increased.

We conclude that, in hereditary fructose intolerance, there is a mutation of the structural gene.
Chapter IX NUMBER OF PREGNANCIES, USE OF ORAL CONTRACEPTIVES AND MENOPAUSAL AGE IN WOMEN WITH ISCHAEMIC HEART DISEASE, COMPARED TO A POPULATION SAMPLE OF WOMEN
Authors: Bengtsson Calle , Rybo Göran , Westerberg Hans
Published: August 2010

Abstract. The number of childbirths had been significantly greater in women with angina pectoris or ECG changes suggestive of ischaemic heart disease than in women of the general population. A similar tendency was found for women with myocardial infarction. Spontaneous and/or legal abortions had been significantly more common in women with myocardial infarction. None of the women with myocardial infarction, angina pectoris or ECG changes suggestive of ischaemic heart disease had ever used oral contraceptives. Eight women who had a myocardial infarct before the age of 48 were all still menstruating when they had the infarct. A retrospective comparison revealed that significantly more women who had suffered myocardial infarction were postmenopausal at the ages of 45 and 50 than women in the general population. Menopause at the age of 50 or earlier had also taken place significantly more often in women with angina pectoris and in women with ECG changes suggestive of ischaemic heart disease. Postmenopausal 50‐year old women had higher serum cholesterol and serum triglyceride values than 50‐year old women still menstruating but blood pressure was lower than in the latter group of women. These differences in serum lipids and blood pressure between premenopausal and postmenopausal women were statistically significant.
INVESTIGATIONS ON CORRELATIONS BETWEEN SERUM ENZYMES AND HISTOLOGICAL FINDINGS IN LIVER DISEASE
Authors: Trip J. A. J. , van Dam J. , Eibergen R. , Que G. S.
Published: August 2010

Abstract Correlations between liver cell necrosis in biopsy specimens and the serum levels of SGOT, SGPT and urocanase were studied in 186 patients. Because urocanase is a specific liver enzyme, its appearance in serum may be expected to be representative of liver cell necrosis. The results demonstrate that urocanase measurements have no advantage over transaminase determinations. This applies to the whole patient group as well as to smaller groups of patients with different types of liver disease.
HYPERCALCEMIA IN ADRENOCORTICAL INSUFFICIENCY
Authors: Jørgensen Hans
Published: August 2010

Abstract Serum calcium has been examined in 4 patients with Addison's disease and in 5 with symptoms of manifest adrenocortical insufficiency after adrenalectomy for Cushing's syndrome. In each group hypercalcemia was found in 3 patients, and the incidence of hypercalcemia was the same as that of hyponatremia. Hypercalcemia alone occurred in 3 patients, as also did hyponatremia. Hypercalcemia without other disturbances of serum electrolytes led, in one of the patients, to surgical exploration of the neck in the search for a parathyroid adenoma. Determination of serum calcium should be a routine procedure in patients with suspicion of adrenocortical insufficiency, and this diagnosis should not be forgotten in cases with hypercalcemia. Possible mechanisms for the hypercalcemia in adrenocortical insufficiency are discussed.
ACQUIRED HAEMOLYTIC ANAEMIA
Authors: Böttiger L. E. , Westerholm B.
Published: August 2010

AbstractForty‐five cases of drug‐induced haemolytic anaemia have been reported to the Swedish Adverse Drug Reaction Committee during the 5‐year period 1966–70. Methyldopa was responsible in 21 cases (47%) and caused the only two deaths. Sulfonamide preparations for long‐term use induced haemolysis in 10 patients.
ARRHYTHMIAS IN DIFFERENT TYPES OF ACUTE CORONARY HEART DISEASES
Authors: Skjæggestad öyvind
Published: August 2010

Abstract The incidence of arrhythmias has been investigated in 100 patients with intermediate coronary syndrome (ICS), in 42 with small acute myocardial infarction (AMI) and in 147 with frank AMI. A continuous ECG has been monitored from admission until at least 48 hours after the onset of symptoms. Bradyarrhythmias, atrial flutter and fibrillation and short‐lasting ventricular tachycardia were significantly more often seen among patients with small and frank AMI than among patients with ICS. Complete AV block was seen in one patient with small AMI, otherwise no patients with small AMI or ICS had AV block, ventricular tachycardia or fibrillation. Serious arrhythmias did not start more than 48 hours after onset of symptoms in patients with small AMI or ICS as opposed to patients with frank AMI. Serious arrhythmias were more often seen in patients with pre‐existing CHD than in patients without. The results suggest that the observation period in monitored beds can be short, and in case of need omitted, without taking any great risks in patients with small AMI and ICS. This is in contrast to patients with frank AMI, who certainly need these beds and often for more than 48 hours.
THE STUDY OF WOMEN IN GOTHENBURG 1968–1969 —A POPULATION STUDY
Authors: Bengtsson Calle , Blohmé Göran , Hallberg Leif , Hällström Tore , Isaksson Björn , Korsan‐Bengtsen Kristoffer , Rybo Göran , Tibblin Elisabeth , Tibblin Gösta , Westerberg Hans
Published: August 2010

Abstract A population study of women in Gothenburg, Sweden, is presented. The women were representative of the total female population in Gothenburg in the age strata 38, 46, 50, 54 and 60 years. Altogether 1 462 women participated in the examination, the participation rate being 90.1%. Social data of participants and non‐participants are given. The performance of the examination is described and research projects are outlined. It is concluded that the selection of a strictly representative sample, together with careful uniformity of performance and high participation rate, will make it possible to draw valid conclusions about the total population of middle‐aged women in Gothenburg.
DIABETES MELLITUS WITH OPTIC ATROPHY—THALASSEMIA‐LIKE SIDEROBLASTIC ANEMIA AND WEAK ISOAGGLUTININS—A NEW GENETIC SYNDROME?
Authors: Järnerot Gunnar
Published: August 2010

Abstract This paper reports two cases: a young man with Klinefelter's syndrome and his sister. Both siblings have diabetes mellitus, heredoataxia with optic atrophy, a thalassemia‐like sideroblastic anemia, weak isoagglutinins and bone defects. A sister who died in early childhood suffered from an obscure anemia. The possibility of one or several genes influencing each other's penetrance is considered.
SCREENING FOR HYPERTENSION IN AN EPIDEMIOLOGICAL STUDY
Authors: Gyntelberg Finn
Published: August 2010

Abstract Screening for hypertension has been done in an epidemiological study of a large group of 5 200 Copenhagen men aged 40–59. Men having BP readings above the limits systolic ≥ 165 mmHg and diastolic 105 mmHg, and ≥ diastolic 110 mmHg alone, were subjected to further study. 196 men were untreated and had BPs above the arbitrary limit set up, 150 of whom were included in the present study. One‐third of the patients had manifestations of high BP in heart or eyes. Blood values of cholesterol, uric acid, quantitative lipoprotein electrophoresis, Hb and haematocrit were compared with normotensive controls. No differences between patients and controls were found. All patients had their BP measured twice by one observer, the value being lower in the second than in the first measurement, but in only two patients was the second BP below 140–90 mmHg. Few of the patients had earlier been to see their doctor because of symptoms. The results of the study indicate that hypertension is a common and symptomless abnormality or disease and, as shown in this and other studies, involves an increased risk of cardiovascular complications.
FACTORS AFFECTING THE RELIABILITY OF SCREENING TESTS FOR BACTERIURIA
Authors: Alwall Nils , Lohi Aarne , af Ekenstam Jan
Published: August 2010

Abstract Urine specimens have been tested in parallel by conventional culture, Urnitest®, BM Test Nitrite®, BM Test 4®, Griess' test, and Uriglox®. The following values were obtained for the sensitivity and the specificity (figures within parentheses) of the chemical tests: for the nitrite tests in the said order 74.0 (99.7)%, 71.2 (99.8)%, 69.9 (99.7)%, 76.7 (99.6)%, and for Uriglox 52.1 (99.8)%. The variations with respect to positive, false positive, and false negative specimens were analysed. We based our comparison on the results of the cultures and of each of the chemical tests and studied the results from the other specimens. The figures seem to be of interest, in that they give an idea of the numerical magnitude of the afore mentioned variations. A similar comparison was made between the results from the various chemical tests in the screening of 3 988 persons. 3 731 urine specimens were examined by the Urnitest, partly by the subjects themselves in their homes and partly at our laboratory. Out of 3 592 tests assessed as negative at home, 99.6% were also negative at the laboratory and 0.4% were positive. Out of 139 specimens assessed as positive at home, only 53.2% were positive at the laboratory. The test may therefore be suitable for excluding bacteriuria by the person at home, but there is the risk of over‐diagnosis. It should be stressed, however, that at most 70% of the bacteriuric cases in our series were picked up by the nitrite tests.
WALDENSTROM'S MACROGLOBULINAEMIA WITH XANTHOMATOSIS AND HYPERCHOLESTEROLAEMIA
Authors: Petersen Helena Søndergaard
Published: August 2010

Abstract Even though most cases of M‐globulinaemia reveal low serum cholesterol values, a few cases are on record in which hypercholesterolaemia and/or xanthomatosis have been associated with IgG or IgA para‐proteinaemia. In most of the latter cases a familial origin of the disease was not disclosed, and a causal relationship between the paraproteinaemia and the lipoid disease was therefore assumed. A report is presented of a case associated with Waldenström's macroglobulinaemia—a combination which does not seem to have been described before. This case probably represents a fortuitous coincidence of the two diseases, as electrophoresis of the serum lipoproteins in the patient's sister revealed lipoid changes, although this sister had no xanthomata and her serum cholesterol level was only at the upper limit of normal. Thus a familial genesis can be excluded only by an analysis of serum lipoids in members of the family.
RENAL PELVIC CARCINOMA AFTER THOROTRAST PYELOGRAPHY
Authors: Westin Jan , Lanner Lars‐Olof , Weinfeld Aleksander , Zettergren Lennart
Published: August 2010

Abstract. A case of renal pelvic carcinoma, developing in a kidney with remaining deposits of thorotrast contrast medium after a retrograde pyelography 37 years earlier, is described. The patient, a 77‐year‐old man, appeared clinically as an advanced uraemia, caused by chronic pylelonephritis and prostatic hyperplasia, but died within one year with signs of a disseminated malignant tumour. An X‐ray of the abdomen had shown dense material in the right kidney. Microscopic studies revealed that the contrast was located in carcinomatous tissue in this kidney and autoradiography confirmed that the remaining contrast still emitted α‐particles.
VENTILATORY FUNCTION AND RESPIRATORY‐LIMITED EXERCISE TOLERANCE IN PULMONARY TUBERCULOSIS
Authors: Kokkola Keijo
Published: August 2010

Abstract. Correlations of respiratory‐limited physical working capacity with FEV1.0, VC and airways obstruction have been studied in a series of 170 male and 38 female patients with pulmonary tuberculosis. Statistically significant positive correlation was established for exercise tolerance with FEV1.0 and VC. Exercise tolerance displayed significant correlation with airways obstruction in such a way that the obstructive patients of both sexes showed, on average, a better working capacity than the non‐obstructive patients when the material was FEV1.0‐standardized. This was attributed to probable bronchial relaxation and shift of the respiratory midposition towards higher lung volumes among the obstructive patients in exercise. Significant negative correlation with airways obstruction was established in a VC‐standardized male group.
RENAL INVOLVEMENT IN ESSENTIAL CRYOGLOBULINEMIA
Authors: Skrifvars Bo , Tallqvist Gustav , Törnroth Tom
Published: August 2010

Abstract. A report is presented on five patients, three female and two male, who exhibited cryoglobulinaemia and symptoms of renal involvement. Four of the patients had a purpuric eruption during some phase of their illness. These five cases may be characterized as essential cryoglobulinaemia, since the conditions associated with secondary cryoglobulinaemia could be ruled out. Glomerular and vascular lesions were demonstrated by light‐microscopic studies of percutaneous renal biopsy specimens. Immunofluorescent microscopy revealed nodular deposits of immunoglobulin and complement in the glomerular capillary walls. Two biopsy specimens were investigated by electron‐microscopic means, and in one case subepithelial discrete deposits were demonstrated. These deposits were identical with the “humps” observable in acute post‐streptococcal glomerulonephritis. Two patients completely recovered from the renal disease and two died.
MASSIVE DIGOXIN INTOXICATION
Authors: Bertler Å. , Gustafson A. , Redfors A.
Published: August 2010

Abstract. Two patients who had ingested digoxin in great doses with suicidal intent are presented. They reached plasma digoxin levels of 8.1 and 14.4 ng/ml respectively. The urinary excretion, and for one of them the successive loading of tissue digoxin, were followed. Discrepancies were found due to one of the patients being previously undigitalized, the other having for many years been on digitalis treatment. During the first days of intoxication atrial arrhythmias and A‐V block predominated. No ventricular arrhythmias were seen. At a level less than 2 ng/ml the digitalis‐induced dysrhythmias disappeared.
PORPHYRIA CUTANEA TARDA—A GENETIC DISEASE?
Authors: Dehlin Ove , Enerbäck Lennart , Lundvall Ove
Published: August 2010

Abstract. The siblings of patients with clinically manifest porphyria cutanea tarda (PCT) have been investigated by chemical analysis of urinary and faecal porphyrin excretion and by fluorescence microscopical examination of smears from fine needle biopsy specimens of the liver. Four families and one alcoholic and one non‐alcoholic control group were studied. In two families red porphyrin fluorescence was demonstrated in 5 out of 15 asymptomatic siblings, and one sibling who refused liver biopsy was found to have a clinically manifest PCT. In the two other families no porphyrin abnormality could be demonstrated in the 7 asymptomatic siblings. In the control group comprising 36 non‐alcoholic subjects no porphyrin fluorescence could be demonstrated, but in the alcoholic control group of 59 subjects liver porphyrin fluorescence was found in two. Alcoholic abuse was common in the two families in which several members had porphyrin abnormalities indicating latent PCT. In the group of alcoholics liver porphyrin fluorescence was uncommon. Hence the present results indicate that PCT might be a genetic disease.
PROPRANOLOL GIVEN TWICE DAILY IN HYPERTENSION
Authors: Berglund Göran , Andersson Owe , Hansson Lennart , Olander Rolf
Published: August 2010

Abstract.Two small series of hypertensive patients are accounted for. They were treated with propranolol orally twice daily instead of the common administration of 3–4 doses a day. In the first series of 10 patients on a 2‐dose regimen the maintenance of blood pressure control was tested by repeated BP measurements. No significant changes of BP were recorded during a 10‐hour observation period after the morning dose. Sublingual application of nitroglycerine in order to test the degree of adrenergic β‐receptor blockade did not show a significant increase of the pulse rate at the end of the observation period. The second series consisted of 39 previously untreated patients with mild to moderate hypertension. Propranolol given twice daily gave adequate BP control (<170/<100) in 32 patients, while 7 had to be given additional hydralazine. In 6 of the latter the maximum propranolol dose did not exceed 400 mg daily. The side‐effects were few and their frequency did not seem to be influenced by the 2‐dose regimen.
EFFECT OF NICOTINIC ACID ON MUSCLE LIPID CONCENTRATION IN MAN
Authors: Fröberg Sven O. , Castenfors Hans
Published: August 2010

Abstract. Muscle biopsies have been taken by needle blopsy from the femoral muscle of 12 subjects with hyperlipidemia before and during nicotinic acid treatment. No consistent changes were observed in the muscle triglyceride (TG) concentration during nicotinic acid treatment when all subjects were regarded as a group. In subjects with high initial TG values in muscle (40.0–76.1 μmole/g, n=5), however, a decrease and in subjects with initial low values (8.9–14.3 μmole/g, n=7) an increase was observed during nicotinic acid treatment.
PROGNOSIS IN SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Authors: Damsgaard Torsten , Kok‐Jensen Axel
Published: August 2010

Abstract. The prognosis of 187 patients with severe chronic obstructive pulmonary disease has been evaluated by use of the life table method. All patients had a FEV1 less than 60% of VC and below 1.5 1. The observation time ranged from 4 years and 4 months to 7 years and 4 months. The cumulative survival rate in the whole material was 71 % after 3 years and 47% after 6 ýears, results which are very close to the survival found by other authors. Calculations are presented of the survival of FEV1 subgroups and of clinical functional groups separately and combined. These two classifications have a good correlation to survival, and it is demonstrated that the combination of functional group and FEV1 subgroups adds more information regarding the prognosis than that obtained through FEV1 alone. Among patients with earlier pulmonary tuberculosis the prognosis was related only to the degree of pulmonary obstruction. The expected increase in lethality with advancing age was demonstrated, but the mortality was relatively higher in the younger age group when compared to the general population of the same age. The prognosis of patients with cor pulmonale was considerably worse than of patients without cor pulmonale, even when the higher degree of severe airway obstruction was considered.
ON A FAMILY WITH COEXISTENCE OF PHENOTYPES II AND III HYPERLIPOPROTEINEMIA
Authors: Mariën K. J. C. , Hulsmans H. A. M. , Van Gent C. M.
Published: August 2010

Abstract. Two brothers with xanthomata and coronary heart disease presented all the clinical and lipid‐chemical characteristics of a type III hyperlipoproteinemia. Preparative ultracentrifugation at density 1006 revealed β‐migrating lipoproteins in the supernatant fraction, and paper electrophoresis showed a “broad β band”. Not only palpebral xanthelasmata and tendinous and tuberous xanthomata but also xanthochromia striata palmaris, so far only seen in types III and IV hyperlipoproteinemia, were present. However, the family history indicated a genetic type II, because 6 of the 8 sibs of the probands showed a genuine type IIa hyperlipoproteinemia. The implications of these observations are discussed.
COLONY‐FORMING AND COLONY‐STIMULATING CELLS IN RELATION TO PROGNOSIS IN LEUKEMIA
Authors: Granström M. , Gahrton G.
Published: August 2010

Abstract. In order to assess the prognostic significance of colony‐forming cells (CFC) and colony‐stimulating cells (CSC), peripheral white blood cells from patients with leukemia were cultured in agar. Before treatment CFC were found in eight of 12 patients with acute myeloblasts or acute undifferentiated leukemia. The four patients who went into complete remission belonged to this group with CFC initially. Four patients without CFC initially died without remission. The CFC persisted during treatment, except in the event of severe drug‐induced leukopenia. The colony morphology was of the large normal or the small abnormal type initially; in remission the colonies were only of the large normal type. Cells with colony‐stimulating ability were found in six of the 12 patients before treatment; there was no change as a rule during treatment. These six patients included the four with complete remission. All the six patients without CSC died without remission. Since all the four patients with complete remission but only one of those without had both CFC and CSC initially, it seems that this combination may be a favorable prognostic sign in acute leukemia, while the absence of CFC and/or CSC may indicate a poor prognosis.
PRE‐EXCITATION IN YOUNG MEN
Authors: Ahlborg Björn , Atterhög Jan‐Henrik , Ekelund Lars‐Göran , Ericsson Gunnar
Published: August 2010

Abstract. Sixteen young men with pre‐excitation found at an enlistment medical examination of conscripts (giving an incidence of 1/1 000) have been compared with 112 randomly selected healthy men of the same age. None in the pre‐excitation group had any signs of organic heart disease or history of tachycardial bouts. Those with pre‐excitation were significantly shorter and had a slightly higher BP than the controls, but did not differ regarding physical work capacity (W170) or heart volume (HV). No difference was found in these respects between types A and B pre‐excitation. W170 was. when adjusted for differences in HV, significantly higher in 8 subjects, whose ECG were totally or partially normalized during exercise, than in 8 subjects in whom no normalization occurred.
HEART FAILURE AS COMPLICATION OF LITHIUM TREATMENT
Authors: Swedberg Karl , Winblad Bengt
Published: August 2010

Lithium has been used in the treatment of psychiatric disorders since 1949 (2), but as early as in 1907 there was a warning in The Practitioner (11) against “depression and dilatation of the heart”. Few cardiac side‐effects have since been reported. Temporary ECG changes with flattening of the T waves have been described (3, 6), as have frequent ventricular extrasystoles in association with therapeutic concentrations (10). One fatal case of interstitial myocarditis has been described by Tseng in 1971 (12). The lithium determinations in the latter case have been criticized by Schou (5). We report a fatality probably due to prolonged lithium treatment
INVOLVEMENT OF CHROMOSOMES 8, 9, 19 AND 22 IN PH1 POSITIVE AND PH1 NEGATIVE CHRONIC MYELOCYTIC LEUKEMIA IN THE CHRONIC OR BLASTIC STAGE
Authors: Gahrton G. , Lindsten J. , Zech L.
Published: August 2010

Abstract. Chromosome 9 had additional chromosomal material at the end of the long arm in 15 of 16 patients with Ph1 positive CML. The remaining patient had a normal chromosome 9but additional material on 19. The amount of additional material was approximately the same as that lacking on chromosome 22. Translocations between 9 and 22, and 19 and 22, respectively, are therefore suggested. One patient with Ph1 negative CML had no detectable additional chromosomal material on any chromosome including chromosome 9, which gives further support to the view that there is indeed a translocation in Ph1 positive patients. Extra chromosomes appeared in two of three Ph1 positive patients in the blastic stage. Both patients had extra number 8 chromosomes and double Ph1, and one patient had further extra chromosomes, i.e. 7, 11, 12, 16, 17 and 19.
IMMUNOGLOBULIN ANALYSIS IN FAMILIES OF MYELOMA PATIENTS
Authors: Odeberg HÅkan , Johansson Bengt G. , Berlin Sven‐Olof
Published: August 2010

Abstract. The electrophoretic plasma protein pattern (in search for M‐components) and the immunoglobulin (IgG, IgA and IgM) levels have been studied in 24 members of two families with known familial occurrence of myeloma and in 124 relatives of ten patients with myeloma but without known familial occurrence of the disease. Immunoglobulin levels were also determined in a control material composed of 54 blood donors of both sexes. In one of the families with multiple occurrence of myeloma a mother and her son had the disease. In the other family two sibs had myeloma and one sib had an asymptomatic M‐component. No further M‐component was found among the 24 investigated relatives in these two families. In two of the other ten myeloma families an M‐component was disclosed in an asymptomatic relative. The number of M‐components found in the present study cannot be considered unduly high, as the prevalence of M‐components in an adult population is about 1/100. The distribution of immunoglobulin levels among relatives differed little from that of controls and very few markedly deviating immunoglobulin levels were found. The study thus did not indicate a defective regulation of the immunoglobulin production within myeloma families. Apparently myeloma differs in this respect from Waldenstrom's macroglobulinemia, which disease has been found preferentially to develop within families in which the immunoglobulin (IgM) producing cell system is improperly regulated and therefore presumably predisposed to neoplastic transformation.
LONG‐TERM CONSERVATIVE THERAPY OF CHRONIC AV BLOCK
Authors: Hatle L. , Sæterhaug A. , Rokseth R.
Published: August 2010

Abstract. Thirty‐six of 98 patients with chronic advanced AV block have been treated conservatively by us, during the 5‐year period 1966–70. Follow‐up studies were made until Aug. 1973. When oral test doses of isoprenaline increased the heart rate without side‐effects, long‐term isoprenaline abolished syncope in most patients both with normal and with widened QRS complexes. Eighteen patients died during the observation period, but death was in most cases unrelated to block. The study shows that conservative therapy may be used with fair sucess in selected patients.
FATAL POISONING WITH DEXTROPROPOXYPHENE‐CONTAINING ANALGETICS‐SUICIDE OR NOT?
Authors: Sundkvist Lennart , Petrovics Jenö
Published: August 2010

Abstract. Among 63 cases of fatal poisoning with analgetics containing dextropropoxyphene alone or in combination with ethyl alcohol and/or other drugs suicide could be proved in only 20 cases. In a consecutive group of 63 cases of fatal poisoning with barbiturates 42 were regarded as suicide. Thus the number of other deaths turned out to be much higher in the dextropropoxyphene series. The uncharacteristic clinical course and the absence of specific pathoanatomical findings at autopsy mean that such intoxications can easily be overlooked.
CHRONIC INTERSTITIAL PNEUMONITIS WITH FIBROSIS DURING LONG‐TERM TREATMENT WITH NITROFURANTOIN
Authors: Strandberg I. , Wengle B. , Fagrell B.
Published: August 2010

Abstract. Chronic pulmonary lesions in conjunction with prolonged nitrofurantoin treatment have occurred in 15 patients with symptoms in the form of dyspnoea, cough, fever, and sometimes loss of weight. The onset was insidious after 6 months to 6 years of continuous or intermittent treatment. X‐rays of the lungs showed streaky or patchy infiltrations bilaterally, most pronounced basally. Spirometry revealed restrictive ventilatory reduction in 8 of 10 patients. The time during which the patients continued with nitrofurantoin after the onset of symptoms appears to be important but not decisive for the prognosis. Observation of symptoms from the respiratory tract and regular X‐rays during nitrofurantoin treatment are recommended.
SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Eyrich Raili , Borulf Birgitta
Published: August 2010

Abstract.Forty‐one definite and 25 suspected cases of SLE, 66 cases in all, have been investigated at the County Hospital, Halmstad in 1957–71. The occurrence of SLE and related diseases was studied as well as the most common clinical manifestations of SLE. The population in the area of uptake was 95127 in 1957 and 111707 in 1971. The incidence during 1957–64 was 17.6/year/1 mill. inhabitants for definite SLE and 16.2 for suspected SLE. During 1964–71 the incidence of definite SLE was 29.7 and of suspected SLE 12.2/year/ 1 mill. inhabitants. The increasing incidence of definite SLE is probably due to improved laboratory diagnosis, but the possibility that SLE may have become more common cannot be disregarded.
A COMPARATIVE STUDY OF ALPRENOLOL AND α‐METHYLDOPA RESPECTIVELY IN COMBINATION WITH CHLORTHALIDONE IN HYPERTENSION
Authors: Tuomilehto Jaakko , Puska Pekka , Mustaniemi Harri
Published: August 2010

AbstractFifty‐one patients with essential hypertension (WHO stage 1 and 2) were randomly allocated to two groups. One group of 27 patients was treated for six months with chlorthalidone (25 mg) in combination with alprenolol (400–800 mg). The other group, consisting of 24 patients was treated with chlorthalidone combined with α‐methyldopa (750‐1,500 mg). A significant and approximately similar reduction of the blood pressure was observed in both groups. In one patient in the alprenolol group the treatment was interrupted due to inadequate reduction of the blood pressure. Six patients in the α‐methyldopa group discontinued the treatment due to side‐effects. The results indicate that alprenolol is a good alternative to α‐methyldopa when combined with saluretic diuretics in the treatment of hypertension.
THE EFFECT OF ALPRENOLOL IN COMBINATION WITH HYDRALAZINE IN ESSENTIAL HYPERTENSION
Authors: Pape Jan
Published: August 2010

Abstract Seventeen patients with moderate essential hypertension were included in a double‐blind crossover study, comparing the antihypertensive effect of a combination of alprenolol and hydralazine to that of alprenolol and placebo. Both treatments resulted in a significant decrease in blood pressure compared to initial values. The effects of the combination of alprenolol and hydralazine were significantly more pronounced than those of alprenolol alone.

After the crossover study the patients were followed up for 12 months and despite dose reductions of the two drugs in several patients the blood pressure remained virtually unchanged, compared to the values of the crossover study.

It is concluded that the combination of alprenolol and hydralazine is a good alternative to other drug treatment in hypertension.
THE VALUE OF THE EFFECTIVE THYROXINE RATIO COMPARED WITH OTHER COMMON THYROID TESTS
Authors: Timonen T. , Haapalahti J. , Reinilä M. , Vuopala U.
Published: August 2010

Abstract. The purpose of the present work was to compare the reliability of the new in vitro thyroid test, ETR, with that of the other commonly used thyroid tests in three different ways. 1. Comparison of the test results with the clinical picture obtained by a doctor on the basis of anamnesis and status. 2. Investigation of the correlation of ETR with the other thyroid tests. 3. Investigation of the ability of the tests to discriminate between states of hypo‐, hyper‐ and euthyroidism. The material examined consisted of 62 patients. The results showed ETR to be the best of the laboratory tests according to all three criteria. ETR correlated with the clinical picture obtained on the basis of anamnesis and status in 95% of the cases. ETR correlated highly significantly with the other thyroid tests used (T4 T3 (= T3 uptake), FT4 index, PBI, cholesterol and radioiodine test). The discriminative capacity of ETR was highly significant in all the states, while the ability of the T3 test to distinguish hypothyroidism was not statistically significant.
ANTIDIURETIC RESPONSES TO HYPERTONIC SALINE INFUSION, WATER DEPRIVATION, AND A SYNTHETIC ANALOGUE OF VASOPRESSIN IN PATIENTS WITH HEREDITARY, HYPOTHALAMIC DIABETES INSIPIDUS
Authors: Andersson K.‐E. , Arner B. , Fürst E. , Hedner P.
Published: August 2010

Abstract. Eight patients with previously untreated hereditary, hypothalamic diabetes insipidus have been investigated. Infusion of hypertonic saline produced no significant antidiuresis in any of seven patients tested. In two, however, urine osmolality increased to values exceeding plasma osmolality. During water deprivation (818 h) urine osmolality increased in all patients, but only in three were values exceeding plasma osmolality reached. Administration of a new, long‐acting analogue of vasopressin, 1‐deamino‐8‐D‐arginine vasopressin (DDAVP), effectively decreased urine volumes and increased urine osmolality in all the patients. The peptide was used for long‐term treatment in seven cases. The results are discussed in relation to the pathogenesis of the disease.
GLOMERULAR FILTRATION RATE, RENAL PLASMA FLOW AND FILTRATION FRACTION IN LIVING DONORS BEFORE AND AFTER NEPHRECTOMY
Authors: Skov Poul Erik , Hansen Hans Erik
Published: August 2010

Abstract. Simultaneous inulin, 125iothalamate, creatinine, PAH and 131I‐hippuran clearances have been performed in 18 prospective living kidney donors. Good correlation was found between inulin and 125iothalamate and between PAH and 131I‐hippuran clearances as well as between the above mentioned clearances and renal size. In 13 instances 125iothalamate, creatinine and 131I‐hippuran clearances were carried out before and 26–53 months after unilateral nephrectomy. An increase was found in 125iothalamate, creatinine and 131I‐hippuran clearances of 66, 67 and 31%, respectively. These increases were independent of the age (range 19–65 years) and sex of the donor. Clearance values were however well correlated to the size of the remaining kidney. Pattern of kidney function changes, the filtration fraction being significantly greater postoperatively.
DC ELECTROCONVERSION OF PATIENTS WITH ATRIAL FIBRILLATION ADMITTED TO A CORONARY CARE UNIT
Authors: Edhag O. , Hofvendahl S. , Lundman T. , Nordlander R. , Nyquist O. , Sjögren A.
Published: August 2010

Abstract. A retrospective study of patients admitted to a coronary care unit (CCU) because of suspected acute myocardial infarction (AMI) and subjected to DC electroconversion for atrial fibrillation (AF) is presented. DC electroconversion was resorted to in 35 patients. In 19 a diagnosis of an AMI was made. All but two of the 16 remaining patients had findings or symptoms of ischaemic heart disease. The two patient groups, i.e. those with and without a diagnosis of AMI, behaved similarly as regards response to DC electroconversion. Twenty‐nine of the 35 patients (83%) developed sinus rhythm (SR) at electroconversion. However, AF again developed in the unit in 11 of these 29 patients and occurred in 7 within a few minutes of DC electroconversion. Without further attempts at DC electroconversion 80% of the 35 patients were in SR at time of discharge from the CCU. The most striking benefits were observed in patients in whom hypotension was the major reason for resorting to DC electroconversion. The only complication observed was one instance of ventricular fibrillation, apparently caused by the DC shock, which responded to defibrillation.
THE PERIPHERAL NERVE FUNCTION IN CHRONIC RENAL FAILURE
Authors: Nielsen V. Kamp
Published: August 2010

Abstract. Sensory and motor nerve conduction parameters have been studied before and after a successful renal transplantation in 22 patients, 13 of whom had moderate to severe clinical neuropathy. The observation period ranged from 5 weeks to 31 months. The earliest postoperative examination was made after 6.2 + 0.8 weeks, and 10 patients were studied for more than two years. Before transplantation a general slowing of the nerve conduction was present. After transplantation the conduction velocity increased in all patients. The remission was two‐phasic with an early rapid and a late slow phase. The recovery was more rapid and complete in distal than in proximal segments, where the conduction velocity was still significantly slowed after two years. Sensory action potentials (median nerve) became resynchronized and the amplitude was normal after 6 (wrist) and 12 months (elbow). Signs of reinnervation of distal muscles were observed after one month. The amplitude of muscle action potentials increased and in most patients the electro‐myogram at maximal effort became normal, though in severely affected muscles the recovery was incomplete or absent. The uniform degree of impairment and the pattern of recovery in distal and proximal nerve segments appeared incompatible with an ascending segmental de‐myelination and axonal degeneration as the only pathophysiological factor of uremic neuropathy.
RETICULUM CELLS AND ERYTHROBLASTS IN THE BONE MARROW OF ANAEMIC PATIENTS
Authors: Cavallin‐Ståhl E. , Berg B. , Brandt L.
Published: August 2010

Abstract. Reticulum cells surrounded by erythroblasts, i.e. erythroblastic islands, were found to be uncommon in bone marrow from haematologically normal persons. Less than 1% of the erythroblasts were connected with reticulum cells. From a consecutive series of bone marrow smears examined in routine diagnostic work, 16 patients with an impressive occurrence of erythroblastic islands were selected. Nine of the 16 patients had malignant diseases or diseases associated with inflammatory lesions of various types, and their Hb concentration was low compared to the controls. In the patient group there was also an abnormally large proportion of basophilic erythroblasts within the erythropoietic series. Bone marrow from 5 patients was incubated in autochthonous plasma at 37°C for 1 hour. A reduction of the proportion of erythroblasts connected with reticulum cells was then noted and during the same period there was an increase of the proportion of reticulum cells containing Feulgen‐positive cell debris. It is suggested that reticulum cells may engulf and destroy erythroblasts and that this phenomenon occurs frequently in patients with anaemia associated with malignancy and infections. The phagocytosis of erythroblasts may indicate an ineffective erythropoiesis.
QUINIDINE INTOXICATION TREATED WITH HEMODIALYSIS
Authors: Woie Leik , Øyri Audun
Published: August 2010

Abstract.A case is described in which the ingestion of 20 g quinidine produced lethargy, respiratory distress, hypotension, anuria, loss of P waves in ECG and broadening of QRS complex. The highest serum quinidine concentration was 13.5 mg/1. Vasopressor drugs were not effective in restoring BP, and hemodialysis with low concentration of potassium in dialysis fluid was done with impressive effect on the clinical state.
HOSPITAL MORTALITY AFTER MITRAL VALVE REPLACEMENT
Authors: Simonsen Svein , Forfang Kolbjørn , Andersen Anders , Efskind Leif
Published: August 2010

Abstract. One hundred consecutive cases of mitral valve replacements have been retrospectively reviewed. The prognostic significance of preoperative clinical and hemodynamic factors for the early postoperative period has been evaluated. The hospital mortality was 21%. Of the patients above 60 years 42% died compared to 14% of the patients below this age (p < 0.005). The mean pulmonary arteriolar resistance was 446 dyn/sec cm‐5 in the patients who died and 286 in the survivors (p < 0.05). The mortality was markedly increased, 62%, in the patients with pulmonary arteriolar resistance above 600 dyn/sec cm‐5, compared with the rest of the patients (p < 0.0025). The other factors reviewed (functional class NYHA, heart volume measured roentgenologically, pressure data, cardiac index, number of valves replaced and type of prostheses used) showed no statistically significant differences between the survivors and the early deaths. The main mode of death was found to be heart failure and sudden arrhythmia.
ERYTHROPOIESIS IN PATIENTS WITH BONE MARROW METASTASES
Authors: Sjögren U. , Brandt L.
Published: August 2010

Abstract. The erythropoietic part of the bone marrow has been morphologically analysed in 16 anaemic patients with bone marrow metastases and in 16 healthy controls. The proportion of erythroblasts within the blood‐forming tissue was identical in the two groups. In the patients with bone marrow metastases the percentage of basophilic erythroblasts was abnormally high and elevated mitotic indices of the erythropoietic precursor cells were recorded. A threefold increase of “erythroblastic islands”, i.e. erythroblasts in contact with reticulum cells, was found in the patient group. The results indicate that anaemia was not due to a reduced amount of erythropoietic tissue caused by the tumour infiltration of the bone marrow. Nor were there any signs of an impaired proliferative activity of the erythroblasts. It is suggested that “erythroblastic islands” are signs of intra‐medullary phagocytosis of erythroblasts by reticulum cells and that the impressive occurrence of such formations in the patient group may indicate an ineffective erythropoiesis caused by the malignant disease.
HYDRALAZINE‐INDUCED LUPOID SYNDROME
Authors: Blumenkrantz N. , Christiansen A. Hein , Ullman S. , Asboe‐Hansen G.
Published: August 2010

Abstract. A patient suffering from generalized scleroderma. who was on treatment with hydralazine (Hy), has been followed up biochemically and immunologically before, during and after the onset of a lupoid syndrome. A serum precipitation test, which was strongly positive in the acute phase of the condition, is presented. No precipitation was obtained using sera of other patients with scleroderma or SLE or of controls. Low urinary values of sodium, potassium, calcium, phosphate and urea were noticed in relation to the crisis. A steep increase of the urinary output of acid mucopolysaccharides coincided, while no significant changes in collagen metabolites were noticed. Urinary creatinine values were normal. Increased IgM and IgG were found in the solubilized precipitate of patient serum and the Hy‐DNA complex after removal of DNA with protamine sulphate. In the skin biopsy obtained during the crisis, IgM and small quantities of complement were demonstrated by the direct immunofluorescence technique. By immunodiffusion the presence of precipitating antibodies against DNA was shown.
THALASSAEMIA MINOR: Twelve Patients in two Norwegian Families
Authors: Jakobsen E. , Godal H. C. , Kierulf P.
Published: August 2010

Abstract Thalassaemia minor has been diagnosed in 12 members of two Norwegian families. Haematological data from 23 family members are reported. The diagnosis was based on estimation of Hb A2 by polyacrylamide gel disc electrophoresis. All patients having high Hb A2 levels had confirmatory evidence of thalassaemia minor (hypochromic anaemia, marked variation in size and shape of the red cells, target cells, basophilic stippling, decreased osmotic fragility, normal or high serum iron level). The majority of the patients had previously been treated with iron without effect.
DEATHS FROM ISCHAEMIC HEART DISEASE IN HELSINKI IN THE YEARS 1959–1968: Vital Statistics and Medico‐legally Autopsied Sudden Deaths
Authors: Rissanen Viljo , Tenhu Martti , Uotila Unto
Published: August 2010

Abstract According to the official vital statistics, altogether 10910 deaths from ischaemic heart disease (IHD) occurred in persons resident in Helsinki during the 10‐year period 1959–68. A significant increase was found in the incidence of IHD deaths in both sexes even though changes in the structure of the population were taken into account. The increase in the age‐dependent incidence of IHD deaths was most conspicuous at middle age in both sexes and in young males. Altogether 3044 IHD deaths occurring unwitnessed or within 24 hours of the onset of the fatal attack were autopsied medico‐legally during the 10‐year period of the study. The medico‐legally autopsied cases obviously represented a high proportion of sudden IHD deaths occurring outside hospitals in Helsinki. A clear male preponderance was found in the autopsy material as compared with all IHD deaths. The prevalence of cases of acute myocardial infarction varied in different years from 27 to 49% at medico‐legal autopsies. No significant change occurred during the 10‐year period in the distribution of the medico‐legally autopsied IHD deaths into social groups, in the suddenness or place of death. The home was the most common place of death. From 1963 onwards the patients dying from an ischaemic heart attack during transportation to hospital or in an outpatient department constituted 6–7% of all annual IHD deaths.