bluuebunny/crossref_metadata_2025 huggingface dataset:
Accuracy of Arrhythmia Alarms from a Computer‐Based Arrhythmia Monitoring System
Authors: Hulting Johan , Nygårds Mats‐Erik
Published: August 2010

ABSTRACT. A computer‐based arrhythmia monitoring system has been tested during ten 24‐hour periods in a CCU. Fifty‐five patients were monitored for about 1000 hours. A continuous ECG recording from all patients made it possible to estimate the true incidence of arrhythmias. Five million heart beats were analyzed. The performance of the monitoring system was studied in some defined arrhythmia conditions which were separated into three priority levels. ***‐Alarms included asystole, ventricular fibrillation and ventricular tachycardia. **‐Alarms comprised consecutive ventricular ectopic beats (VBs), ventricular bigeminy, extreme bradycardia and supraventricular tachycardia. *‐Alarms consisted of tachy‐/bradycardia, frequent supraventricular or ventricular beats and multiform VBs. An arrhythmia alarm persisted on the video screen for at least 4 min (alarm time). A number of monitoring status alarms were also produced by the system. The total alarm time for arrhythmias reported by the computer amounted to 122 hours. Top priority alarms constituted only 0.9% of total alarm time, so that performance in these conditions could not be accurately assessed. In the three priority levels, computer alarms were present for 76, 74 and 90%, respectively, of the manually determined alarm time. Out of detected arrhythmia episodes, a correct alarm message was present for 25, 57 and 83% of alarm time in the corresponding priority levels. In the whole study the proportion correct to irrelevant alarms was 8 to 1 and a correct diagnosis was present on 3/4 of all write‐outs for arrhythmias produced by the automated system.
Effects of Glipizide and Food Intake on the Blood Levels of Glucose and Insulin in Diabetic Patients
Authors: Sartor G. , Scherstén B. , Melander A.
Published: August 2010

ABSTRACT. The blood levels of glucose and insulin were monitored in 15 patients with non‐ketotic maturity‐onset diabetes mellitus given a single 5 mg oral dose of a novel sulfonylurea drug, glipizide, together with, and 30 min prior to, a standardized breakfast meal. In addition, the effect of the meal only was examined. The mean preprandial levels of blood glucose and plasma insulin on the three occasions were similar. Following glipizide administration, the early postprandial increment of blood glucose was reduced, and there was a subsequent decrease to values below the preprandial level. Both the decrease and the reduction of the early increase were significantly more marked when the drug was given 30 min prior to than together with the meal. Apparently, this did not result from a stronger effect of the drug on insulin release when given before than together with the meal, as the plasma insulin levels and the corresponding concentration curve areas did not differ. Rather, the difference was due to a more optimal timing between insulin release and the blood glucose increment evoked by the meal. In addition, there seemed to be only a minor interindividual variation in the bioavailability of the drug, as its effect on insulin levels varied rather little. Hence, 5 mg of glipizide three times daily 30 min before meals can be recommended as a standard regimen.
Hypocalcaemia with Zonular Cataract Due to Idiopathic Hypoparathyroidism
Authors: Philipson Bo , Angelin Bo , Christensson Tony , Einarsson Kurt , Leijd Barbro
Published: August 2010

ABSTRACT. A 59‐year‐old woman with idiopathic hypoparathyroidism who had tetany and zonular cataract is described. Twelve years ago she had had a period with cramps and convulsions, followed by an absence of symptoms for several years. Judging from the distance between the opacity of cataract and the surface of the lens, the onset of the cataract was estimated to have occurred 11 years ago and the apparent cessation of cataract development 10 years ago. It is suggested that the absence of hypocalcaemic symptoms during the last 10 years was associated with an increase in serum calcium levels, possibly connected with the onset of menopause. The occurrence of hypocalcaemia was analyzed in a health‐screened population of 15903 persons. Nine of the subjects were found to have a serum calcium level of less than 2.10 mmol/l, giving a prevalence of 0.6%o. None had primary hypoparathyroidism, which illustrates the rarity of this condition.
Complete Reversibility of Paraneoplastic Acanthosis Nigricans after Operation
Authors: Möller H. , Eriksson Sten , Holen O. , Waldenström J. G.
Published: August 2010

ABSTRACT. A patient with widespread acanthosis nigricans is described. No abdominal tumour was found. Explorative thoracotomy disclosed numerous enlarged lymph glands containing squamous cell carcinoma. The left lung was removed but meticulous search did not disclose any tumour. The glands were removed as radically as possible. After the operation the skin improved and the lesions have disappeared completely. The observation time is over three years.
Extreme Hyponatremia in Patients with Myelomatosis
Authors: Bloth B. , Christensson T. , Mellstedt H.
Published: August 2010

ABSTRACT. Three patients with IgG myelomatosis and extreme hyponatremia are described. By isoelectric focusing of the M‐component it is demonstrated that the subnormal sodium value is most likely explained by a cationic effect of the myeloma globulin.
Factors Responsible for Bone Marrow Toxicity after Treatment of Myeloma Patients with Different Alkylating Agents
Authors: Ringborg U. , Lewensohn R.
Published: August 2010

ABSTRACT. Leukopenia and thrombocytopenia were studied after loading doses of melphalan (5 mg/daily for 18–25 days) in 71 myeloma patients. Seventy per cent of the patients developed pronounced leukopenia (white cells <2.0 × 109/1) and/or thrombocytopenia (platelets <100 × 109/1). The patients with pronounced and moderate hematological side‐effects, respectively, were compared for weight and age. The body weight was the same in the two groups, indicating that the patient's weight is of minor importance for the dosage of melphalan. There was a numerical difference in age, on the borderline for statistical significance, indicating that the age of the myeloma patient may be of minor importance for the dosage of melphalan. It is possible that more pronounced age differences may be of greater importance in this respect. Fifteen patients with myeloma were treated with cyclophosphamide. Compared with melphalan, the effect on white cells was the same, while the incidence of thrombocytopenia was statistically significantly lower with cyclophosphamide.
Relapsing Annular Erythema and Myeloma Successfully Treated with Cyclophosphamide
Authors: Krook Gösta , Waldenström Jan G.
Published: August 2010

ABSTRACT. We report the history of a patient, who had recurrent patches of erythema on the trunk and extremities for some years. The diagnosis of erythema elevatum diutinum or annulare centrifugum was discussed. The patient developed a monoclonal IgA lambda fraction and clinical signs of myeloma. Treatment with cyclophosphamide stopped the development of erythema and also caused the M‐component to disappear. This improvement has persisted even without cytostatic treatment. Another patient with prostatic carcinoma and relapsing annular erythema was cured of his skin lesions, when his carcinoma was treated with estrogens. The literature is reviewed.
Osteosclerotic “Plasmocytoma” with Polyneuropathy, Hypertrichosis and Diabetes
Authors: Waldenström Jan G. , Adner Agneta , Gydell Karl , Zettervall Olle
Published: August 2010

ABSTRACT. The combination of osteosclerosis, polyneuropathy, monoclonal immunoglobulin, hypertrichosis, serositis and a number of other symptoms is described. It seems probable that this is a special type of myeloma. Similar cases have been described in Japan and our findings are compared with the Japanese picture. The age of the patients is unusually low. The M‐component in the plasma is small. There is very little Bence Jones protein in the urine and osteolytic lesions in the skull do not seem to have occurred. The polyneuropathy may improve during treatment with cytostatic drugs.
Bleomycin Treatment in a Case of Polyarteritis Nodosa
Authors: Blomgren Henric , Berg J. V. Rebekka , Edsmyr Folke , Norberg Renée , Wasserman Jerzy
Published: August 2010

ABSTRACT. A 65‐year‐old man presented himself with a tumorous mass which had developed during a period of about 4 years. The lesion was similar to a penile carcinoma although no malignant cells were found in biopsies. Accordingly he was treated with local radiotherapy and injections of bleomycin, which resulted in an almost complete regression. The patient, however, died in a state of uremia 2 1/2 months after initiation of the treatment. Hepatitis B surface antigen (HBsAg) could not be demonstrated whereas antibodies against HBsAg were present in the patient's sera before, during and after treatment. A diagnosis of polyarteritis nodosa, localized to the kidneys and genital organs, was revealed by the postmortal histologic examination. Cancer cells, however, were not observed. Before the patient entered treatment his peripheral lymphocytes exhibited weak proliferative responses to phytohemagglutinin (PHA), concanavalin A (ConA) and PPD‐tuberculin in vitro. The frequency of lymphocytes binding sheep erythrocytes, E‐cells (T‐cells), was also subnormal. The Ig levels, C3 and C4 were within normal ranges. Within a few weeks after the start of therapy the reactivity of lymphocytes to ConA and PHA increased sharply. There was also some increase in the PPD reactivity of the lymphocytes and the frequency of E‐cells was normalized. The IgA and IgG levels in serum increased. One explanation for the rapid progression of polyarteritis nodosa could be that the bleomycin treatment corrected the immune deficiency of the patient and thereby accelerated the vasculitis, which is probably of an immunological nature.
Bone Mineral Content in Chronic Renal Failure during Long‐Term Treatment with 1α‐Hydroxycholecalciferol
Authors: Madsen S. , ølgaard K. , Ladefoged J.
Published: August 2010

ABSTRACT. Bone mineral content of the radius (BMC) has been measured by photonabsorptiometry in 22 adults with chronic renal failure before and after on an average 15.4 months of treatment with 1α‐hydroxycholecaiciferol (1α‐HCC). Identical measurements were performed in a control group comprising 26 uremic adults, who did not receive any vitamin D supplements during the study. The BMC was reduced and not significantly different in the two groups of uremic patients at the initial measurement. During treatment with 1α‐HCC the BMC increased significantly in 3 patients, while the total group showed only a small (mean 0.7%), non‐significant increase. In the control group the BMC decreased significantly in 4 patients, while the total group showed a non‐significant decrease (mean 3.5%). However, a comparison of the BMC changes in the two groups revealed a significant difference (p <0.01). The BMC changes in the 1α‐HCC group were uncorrelated to changes in serum calcium, ionized calcium, phosphate, alkaline phosphatases, immunoreactive parathyroid hormone and intestinal calcium abosrption during therapy. The data indicate that cessation of skeletal demineralization in chronic renal failure may be achieved by 1α‐HCC, but re‐mineralization of the skeleton seems to be attainable only in a minority of adult patients.
Electrophysiological Methods in Assessing Cardiac Effects of the Tricyclic Antidepressant Imipramine
Authors: Brorson Leif , Wennerblom Bertil
Published: August 2010

ABSTRACT.The tricyclic antidepressant agent imipramine was tested intravenously in 8 healthy individuals with respect to its effect on sinus recovery time, intervals in His bundle electrograms and the duration of the repolarization in the right atrium and ventricle judged from the refractoriness and monophasic action potential duration. Sinus recovery time was unchanged after the drug. The interval between the His bundle deflection and the start of the QRS complex in the standard lead showed no consistent changes but increased to pathological values in two individuals. The duration of the repolarization decreased in the atrium—an effect which could be arrhythmia‐provoking or arrhythmia‐protecting. The duration increased at the ventricular level. This effect could explain the antiarrhythmic effect on ventricular ectopics observed in other investigations.
The Cardiac Response to a Small i.v. Dose of Dihydralazine, a Safe Drug for Diagnostic Tests?
Authors: Falch D. K. , Norman N.
Published: August 2010

ABSTRACT. Dihydralazine, given in small i.v. doses, has been of great value in diagnostic tests for unilateral renovascular hypertension, where it enhances renin release on the affected side. The acute hemodynamic effects of an i.v. dose of 0.1 mg/kg b.wt. were studied in 14 patients with essential hypertension, using a quantitative renographic technique for determination of effective renal plasma flow and radiocardiographic technique for determination of the parameters in systemic circulation. Cardiac index increased from 4.040 to 6.423 1/min‐m2 (p <0.01), stroke index from 59 to 66 ml/beat.m2 (p <0.05), heart rate from 70.4 to 96.6 beats/min (p <0.01) and left ventricular work index from 1.04 to 1.49 W/m2 (p <0.01), while mean arterial BP decreased from 125 to 110 mmHg (p <0.01) and total peripheral resistance index from 2927 to 1534 105.N.s.m‐3 (p <0.01). Effective renal plasma flow and pulmonary plasma volume were unchanged. Peripheral renin activity increased from 0.5 to 1.6 nmol A1/l‐h (p <0.02). It is concluded that even a small test dose of 0.1 mg/kg of dihydralazine elicits a considerable additional work load on the heart, a circumstance that must be taken into consideration in studies of patients with coronary heart disease.
A Prospective Study of Streptokinase and Heparin in the Treatment of Deep Vein Thrombosis
Authors: Arnesen H. , Heilo A. , Jakobsen E. , Ly B. , Skaga E.
Published: August 2010

ABSTRACT. In a prospective trial, 42 medical patients with a history of deep vein thrombosis of less than five days were allocated at random to treatment with streptokinase or heparin. Only patients with extensive thromboses were included. Streptokinase was given in a loading dose of 250000 IU and a maintenance dose of 100000 IU/hour for 4 days as a mean. Heparin was given in a loading dose of 15 000 IU and a maintenance dose of 20000–50000 IU/day. The therapeutic results were evaluated by phlebography. Significant thrombolysis occurred in 71.4% of 21 patients treated with streptokinase and in 23.8% of the 21 heparin‐treated patients. Using the X2‐test for overall association, this difference was statistically highly significant (p=0.002). Three patients in each treatment group experienced major bleeding, two in each group requiring blood transfusions. Minor bleeding and slight rise in temperature were encountered more often in the streptokinase than in the heparin group. It is concluded that patients with acute deep vein thrombosis with proximal extension of the thrombus beyond the calf veins should be offered a therapeutic trial with streptokinase.
A Family with Thromboembolic Disease Associated with Deficient Fibrinolytic Activity in Vessel Wall
Authors: Johansson Lilian , Hedner Ulla , Nilsson Inga Marie
Published: August 2010

ABSTRACT. Defective fibrinolytic activity is often a contributory factor in deep venous thrombosis. A family with a high incidence of venous thrombosis in association with such a defect is presented. Of 13 family members who had had thrombosis, 12 showed a defective capacity to release fibrinolytic activity from vessel wall after venous occlusion and/or infusion of DDAVP, a vasopressin derivate. The fibrinolytic activator activity of the vessel wall was normal in all cases. This seems to be the first family in which there is evidence of an inherited abnormal fibrinolytic activity.
Left Anterior Hemiblock in Acute Myocardial Infarction
Authors: Otterstad Jan Erik , Gundersen Stein , Anderssen Norman
Published: August 2010

ABSTRACT. The incidence of intraventricular conduction defects was examined retrospectively in 449 consecutive patients with acute myocardial infarction (AMI). The incidence of left anterior hemiblock (LAH), right bundle branch block (RBBB), left bundle branch block (LBBB) and RBBB+LAH was 12.2, 4.2, 3.8 and 2.5%, respectively. At least 24 patients (5.8%) developed LAH as a result of the AMI. LAH was present in 20% (33/164) of patients with anterior infarction, in 14% (18/131) of those with infarction of undetermined localization, and in 3% (4/143) of patients with diaphragmatic infarction. The incidence of complete atrioventricular (AV) block in patients with LAH was 6% and in patients with no intraventricular conduction defects 7%. In patients with RBBB, RBBB+LAH and LBBB, the incidence of complete AV block was 37, 45 and 18%, respectively. Severe pump failure occurred with the same low incidence in patients with LAH as in patients without intraventricular conduction defects, but was much more common in patients with complete bundle branch block (BBB). The mortality rate for patients with LAH was 22% and for patients with no intraventricular conduction defects 21%. In patients with RBBB, RBBB+LAH and LBBB, the mortality rates were 53, 55 and 53%, respectively. Patients with complete BBB had a higher age and a higher incidence of previous AMI than the others. Compared to patients with no intraventricular conduction defects, the presence of LAH did not increase the mortality rate, or the risk of developing severe heart failure or complete AV block, in contrast to the serious prognosis in patients with complete BBB.
Clinical Evaluation of Hepatic Scintigraphy
Authors: Dyrbye Martin
Published: August 2010

ABSTRACT The diagnostic accuracy of liver scintigraphy concerning focal liver diseases was evaluated. Two groups of patients were examined. The first group was examined with a rectilinear scanner and a definite diagnosis was obtained in 176 cases. The predictive diagnostic values of the scintigraphic diagnosis: focal liver lesion present (PV pos.) was 71% (57–83), focal liver lesion not present (PV neg.) was 84% (76–90) (95% confidence limits in brackets).

The second group was examined with a gamma camera and a definite diagnosis was obtained in 41 cases. Here the PV pos. was 56% (21–86) and the PV neg. 97% (84–100). A motion correction devise did not improve the interpretation.

A survey of the literature indicates that the accuracy despite progressive technological development has not improved during the last 6 or 7 years.

Despite its limitations the author finds liver scintigraphy indicated in patients with suspected or proven cancer.
On the pathogenetic role of prostaglandins in Bartter's syndrome.
Authors: Nielsen Ingolf , Hesse Birger , Christensen. Poul
Published: August 2010

Abstract Two patients, one with Bartter's syndrome and one with severe abuse of diuretics, were investigated before and after indomethacin treatment. Before indomethacin the two patients showed a similar pattern of hypokalaemic alcalosis, secondary hyperaldosteronism, and increased urinary excretion of PGE2 and kallikrein. After a few days on peroral indomethacin medication the hypokalaemia was significantly improved, the plasma renin activity, and the urinary excretion of aldosterone, PGE2 and kallikrein were normalized in both patients. It is concluded that the beneficial effect of indomethacin cannot be used as a proof of prostaglandin overproduction as the primary defect in Bartter's syndrome.

Recently Bartter's syndrome (BS) ‐ a condition of hypokalaemic alcalosis, hyperaldosteronism, hyperplasia of the juxtaglomerular apparatus and normal blood pressure without oedema ‐ has been associated with overproduction of renal prostaglandins, and the manifestations of the condition have been successfully treated with agents inhibiting prostaglandin synthesis (4, 6). Consequently it was suggested that prostaglandin overproduction was the primary defect in BS.

In 1973 our group presented a report on three cases of BS (9), two adults and one child. Since then one of the adults died suddenly, presumably of cardiac arrest. We found it of interest to review the remaining two cases in a protocol with measurements of prostaglandin (PGE2) and kallikrein excretion before and after indomethacin treatment.
ULTRASOUND FLUOROSCOPY ‐ WHAT IS IT, AND OUR APPROACH TO YOUR REQUIREMENTS
Authors: MCLAIN J.A.
Published: August 2010

A discussion on Ultrasound Fluoroscopy and how it relates to the traditional Real Time Instrumentation.

This paper covers the various types of Ultrasound Fluoroscopy Instrumentation, a few of the advantages and disadvantages of each and Unirad Corporation's approach to Ultrasound Fluoroscopy. Also detailed discussions on the technical differences between their approach and the traditional Real Time Instrumentation itemizing electronic beam resolution control in some detail as to its advantages, complexity and comparison to Real Time (Non‐focused) and the traditional single element Ultrasound Instruments.
EVALUATION OF THE LEFT VENTRICLE BY TWO‐DIMENSIONAL ECHOCARDIOGRAPHY
Authors: KISSLO J.A.
Published: August 2010

Left ventricular wall motion was assessed in 105 consecutive patients both invasively using biplane cineangiography, and non‐invasively, by a real‐time, phased‐array, two‐dimensional echocardiography system. Ventricular wall motion in five anatomic areas of the ventricle (anterolateral, posterolateral, apical, septal and inferior) was analyzed by both methods in a double‐blind manner. Two‐dimensional echocardiographic images were deemed adequate for analysis in 82% of the regions (430 of 525). Firty‐five discrepancies were noted in the comparison of the remaining 430 regions.

The reasons for discrepancies in interpretation between the two methods were established for 54 during retrospective review: 33 were due to echocardiography (inadequate target visualization, observer error, or tangential echo views). Fifteen were related to angiography (overlay of silhouettes or observer error), and six were due to other reasons including definition problems or spatial orientation difficulties.

Both real‐time, two‐dimensional echocardiography and cineangiography have advantages and disadvantages. The techniques used together could provide more complete information concerning ventricular wall movement than is now currently available.
PULMONARY VALVE MOTION IN VALVULAR PULMONARY STENOSIS IN CHILDHOOD
Authors: REY C. , LABLANCHE J.M.
Published: August 2010

Echocardiography tracings of the pulmonary valve was recorded in 16 patients with pulmonic stenosis (PS) ranging in ages from 6 to 14 years (average 10 years). 11 patients had an isolated PS and 5 had a PS associated with atrial septal defect.

In 2 patients with mild PS (gradient 15 mm Hg) the depth of the “a” wave was normal: 3 and 4 mm.

In 14 patients with moderate or severe PS (gradient 40 mm to 200 mm Hg), the maximal depth of the “a” wave was less than 6 mm in 2 patients, and more than 6 mm in 12 patients (range 7 to 15 mm, average 10 mm). The motion of both anterior and posterior pulmonary valve leaflets was well recorded in 3 patients with severe PS. The “a” wave showed a posterior motion of the posterior leaflets and an anterior motion of the anterior leaflet. This motion is due to the premature pulmonary valve opening.
ECHOCARDIOGRAPHIC FINDINGS IN VENTRICULAR SEPTAL RUPTURE AND ANTERIOR WALL ANEURYSM COMPLICATING MYOCARDIAL INFARCTION
Authors: EGEBLAD H. , HAUNSØ S.
Published: August 2010

Echocardiographic findings in a patient with ventricular septal rupture and anterolateral wall aneurysm complicating myocardial infarction are presented. The findings were confirmed by cardiac catheterization and surgery. Using M‐mode ultrasonocardiography one was able to demonstrate and localize the aneurysm as well as the ventricular septal defect which presented as an oblique interventricular communication appearing only during systole. Thus echocardiography supplemented the invasive examinations in exactly revealing the site of ventricular septal rupture. Other echocardiographic features of ventricular septal rupture were right ventricular dilatation, pathological septal motion and abnormal tricuspid valve motion as recently reported by other authors.
QUANTITATIVE ANALYSIS OF LEFT VENTRICULAR FILLING PHASE BY ECHOCARDIOGRAPHY
Authors: BRUN P. , ODDOU C. , BERALDO E. , KULAS A. , LAURENT F. , PHILIPPON A. , DE VERNEJOUL F.
Published: August 2010

The ultrasonic method was used in an attempt to correlate the different mechanical events occuring during left ventricular rapid filling phase, concerning anterior mitral leaflet, posterior wall and interventricular septal motions.

Signals were recorded on a line scan recorder. The M‐mode records were placed on a digitizing tablet under the control of a minicomputer for continuous measurements throughout the cardiac cycle. Q waves were indicated to identify end‐diastole and heart rate. The left ventricular internal diameter (minor axis) and its rate of change were calculated from anterior and posterior endocardial echos together with posterior wall and septal thickness, external and mid‐wall diameter. The analysis was made on data obtained from 40 normal subjects.

The results suggest that our echographic measurements of the left ventricular internal diameter rate of change and the electromagnetic transmitral flow time variation present a high temporal correlation:

Peak rate of change of the internal diameter lengthening and peak mitral flow occur shortly after the anterior mitral leaflet E wave (echographic data: 26± 30 ms).

In the case of long diastole, rapid lengthening and filling phase ends before, mitral F point (echographic data: 43 ± 37 ms).

The abrupt slope change of the posterior wall occuring during early diastole precedes significantly the end of rapid filling (50 ± 30 ms), which is indicated by an abrupt slope change of the interventricular septum.
Effect of Oral Verapamil on Ventricular Irregularity in Long‐Standing Atrial Fibrillation.
Authors: Khalsa Amrit , Olsson Bertil , Henriksson Bengt‐Åke
Published: August 2010

ABSTRACT. In patients with chronic atrial fibrillation (AF), symptoms and cardiac function may be improved by regularizing the ventricular rhythm, even though the AF persists. This study concerned effects of i.v. and oral verapamil (V) on ventricular regularity. A regularizing effect was observed in 5 out of 10 patients after 0.15 mg of V/kg b.wt. i.v., but in only one patient after 80 mg of V by mouth. V in a dose of 240 mg by mouth resulted in ventricular regularity in 6 out of 10 other patients, 320 mg in a further 2 and 400 mg in the remaining 2 patients. Six patients were given chronic oral therapy in progressively increasing doses. Although ventricular regularity and symptom relief were obtained, intolerable side‐effects precluded the evaluation of subjective long‐term effects of this therapy in all but one patient. Further investigations, particularly concerning the pharmacokinetic mechanisms of V, are needed before the treatment can be recommended for patients with chronic AF.
Decreased Renal Plasma Flow during Propranolol Treatment in Essential Hypertension
Authors: Falch D. K. , Ødegaard A. E. , Norman N.
Published: August 2010

ABSTRACT. The pharmacodynamic effect of propranolol (80 mg b.i.d.) on the renal and systemic circulation was studied after 1 and 8 months of treatment in 13 patients with essential hypertension, using non‐invasive radioisotope techniques. Effective renal plasma flow (ERPF) fell from (mean ± S.E.M.) 244±18 to 208±14 after 1 month and to 187±13 ml/min· m2 after 8 months of treatment. Concomitantly cardiac index (CI) fell from 3.24±0.15 to 2.62±0.11 and 2.75±0.10 1/min· m2, respectively. The coefficient of correlation between the decreases in ERPF and CI was 0.49. Mean arterial blood pressure decreased from 138±5 to 118±5 and 116±4 mmHg, respectively. Left ventricular work was reduced by 30.2 and 27%, while peripheral resistance was unchanged. Total plasma volume was increased from 19.3±0.5 to 20.3±0.6 ml/cm after 1 month, but was within the same range as the control values after 8 months of treatment. Pulmonary plasma volume was unchanged, indicating that there was no pooling of plasma in the pulmonary circulation. The interventricular circulation time was increased from 6.9±0.4 s to 8.4±0.3 s and varied with the change in heart rate. It is concluded that the fall in ERPF might be explained by reduced cardiac output in addition to interference with the hemodynamic autoregulation in the kidney.
Paraplegia in Myelomatosis—A Study of 20 Cases
Authors: Dahlström Ulf , Järpe Sven , Lindström Folke D.
Published: August 2010

ABSTRACT. A retrospective study of 20 cases of multiple myelomatosis and paraparesis treated during 1966–77 is presented. All patients but one had been submitted to decompressive laminectomy. A close correlation between duration of paraparesis before operation and prognosis was found, eight patients with a duration of paraparesis of several days remaining paraplegic. No particular paraparesisprone patient group with respect to duration of myelomatous disease, Ig class or various laboratory findings could be identified. In several instances radionuclide scan was effective in localizing vertebral lesion. In most patients radicular type back pain signalled vertebral damage and subsequent paraparesis. In many cases long survival after operation and excellent to good functional results made surgery a worthwhile procedure. The importance of postoperative radiotherapy and adequate chemotherapy is stressed.
Differences in Metabolic Responses to β‐Adrenergic Stimulation after Propranolol or Metoprolol Administration
Authors: William‐Olsson T. , Fellenius E. , Björntorp P. , Smith U.
Published: August 2010

ABSTRACT.Isoprenaline, or the β2‐agonist terbutaline, was infused in healthy male volunteers and the plasma levels of insulin, glucose and free fatty acids (FFA) were determined. Saline, propranolol, or the selective β1‐receptor antagonist, metoprolol, was administered i.v. prior to the infusion of the β‐stimulants. The two β‐receptor blockers inhibited isoprenaline‐induced increase in chronotropy to about the same extent, while the effects on systolic and diastolic blood pressure were in accordance with a selective β1‐blocking effect of metoprolol and a non‐selective β‐blocking action of propranolol. Quantitative differences were found between metoprolol and propranolol on the metabolic parameters. The effects can best be described in terms of β1‐ or β2‐receptors, where effects on plasma FFA and glycerol levels seem to be mainly β1‐mediated. An apparent β2‐mediated effect was found for insulin release and hepatic glucose output.
The Influence of Sar1 Ala8 Angiotensin II (Saralasin) on Plasma Aldosterone in Hypertensive Patients
Authors: Donker A. J. M. , van Hoogdalem P. , Prat J. J. , Leenen F. H. H.
Published: August 2010

ABSTRACT. The effect of a 4‐hour infusion of the angiotensin II analogue sar1 ala8 angiotensin II (saralasin) on plasma aldosterone concentration (PAC) was assessed in relation to plasma renin activity (PRA) in 12 patients, both on normal sodium intake and after marked sodium depletion. On normal sodium intake the response of PAC to saralasin was variable; following sodium depletion saralasin induced a marked decrease in PAC in 11 of 12 patients. The extent of the change in PAC induced by saralasin correlated closely with log PRA. The data indicate that saralasin is also a competitive antagonist of the effect of the endogenous renin‐angiotensin system (RAS) on the adrenal cortex, with agonistic activity appearing at low levels of PRA. The effect of sodium depletion on PAC appears to be mediated to a major degree by the RAS.
Association of Pancreas Affection and Yersiniosis
Authors: Schulz Tom Benkestok
Published: August 2010

ABSTRACT. A case history of a 25‐year‐old female is reported. She had no diseases predisposing for pancreatic disease. A few days after a familial outbreak of yersinia enteritis, she again became ill and was referred to hospital. Clinical and laboratory examination made it likely that she underwent an acute pancreatic affection, and the serological test proved that she had been through an acute yersiniosis. The coincidental occurrence may of course be by chance, but considering the immunological aspects of secondary yersiniosis, there might also be an etiological link.
Circumstances around the Onset of a Myocardial Infarction
Authors: Sjögren A. , Erhardt L. R. , Theorell T.
Published: August 2010

ABSTRACT. Psychosocial factors, experienced pain and anxiety in relation to patient delay were studied in 100 patients admitted for suspected acute myocardial infarction (AMI). More severe pain was reported by women, by those who had recently consulted a physician, who experienced severe anxiety, who fell ill away from their place of work, or who possessed little medical knowledge. These patients tried to get relief from pain by resting. Patients experiencing more severe anxiety were younger, had not consulted a physician recently, had poor medical knowledge, belonged to lower socio‐economic groups or were impatient. These patients also sought relief from pain by resting. Pain, but not anxiety, was related to delay. Long delay was seen more often in patients who did not believe they had suffered an AMI and who were psychologically inactive prior to the onset of pain. Recent physician consultation, failure to call for help and belonging to lower socio‐economic groups were also related to long delay. Medical knowledge was unrelated to patient delay. Patients with a low degree of pain rarely reported considerable anxiety, whereas several patients with severe pain had little or no anxiety.
Rapid Thrombolysis and Preservation of Valvular Venous Function in High Deep Vein Thrombosis
Authors: Watz R. , Savidge G. F.
Published: August 2010

ABSTRACT. The results of streptokinase and heparin treatment are compared in a 4‐year prospective study with special reference to preservation of high valvular venous function. An objective assessment was based upon phlebographic examinations before, during and 1–2 months after therapy. Complete lysis was demonstrated in 44% of high thromboses treated with streptokinase and in 6% treated with heparin. Retrograde phlebography revealed normal function of the proximal femoral valves in 92% of streptokinase‐treated high thromboses, compared with 13% of those treated with heparin. These phlebographic results were considered to be a valid prognostic indicator of the eventual development of the postthrombotic syndrome. Allergic reactions were seen in 39% and minor haemorrhagic complications in 18% of the streptokinase‐treated cases. The therapeutic benefit of streptokinase therapy in this study was found to outweigh any disadvantages incurred by observed complications.
The Removal of Exogenous Triglycerides in Haemorrhagic Hyperlipidaemia in Rabbits
Authors: Kerttula Yrjö
Published: August 2010

ABSTRACT. Bleedings (15 ml/day/kg b.wt.) on two consecutive days caused a threefold increase in plasma triglycerides (TG) in rabbits. Both in normal and in haemorrhagic rabbits the elimination of injected TGs (fat emulsion) was exponential, the fractional removal rate in the haemorrhagic group being slower than normal. In order to rule out the possible effect of the TG pool in haemorrhagic rabbits and the possible changes in endogenous TGs during the test, the TGs were fractionated by the polyvinylpyrrolidone density gradient method. Again, both in normal and in haemorrhagic rabbits the elimination of exogenous TGs was exponential, the removal rate of haemorrhagic animals being retarded. Accordingly, the changes in endogenous TGs were negligible. The results are regarded as indicative of an elimination defect as one factor in the pathogenesis of haemorrhagic hyperlipidaemia.
Changes in Amylase, Hepatic Enzymes and Bilirubin in Serum upon Initiation of Alcohol Abstinence
Authors: Wadstein J. , Skude G.
Published: August 2010

ABSTRACT. The serum levels of bilirubin, aspartate aminotransferase (ASAT), γ‐glutamyltransferase (GT), and pancreatic isoamylase were determined in 156 alcohol addicts during the first 9 days upon initiation of alcohol abstinence. During this period decreasing activities were recorded for S‐bilirubin and S‐ASAT but patients possessing moderately increased serum activity of GT showed no decrease. Increased activities of S‐ASAT and S‐GT were still frequently seen at the end of the observation period. For S‐pancreatic isoamylase, both decreases and increases from initial activities were frequently found. In patients with low activities initially, the S‐pancreatic isoamylase activity increased during the observation period and thus, pathologically increased activities were recorded more often 9 days after alcohol withdrawal than on arrival at the hospital.
Trauma and Hodgkin's Disease
Authors: Bichel Jørgen
Published: August 2010

ABSTRACT. In two patients, Hodgkin's disease developed apparently after a trauma. The relationship between trauma and Hodgkin's disease is discussed. The trauma may be the initiating factor in the development of the pathological process, or it may be a localizing factor in a patient already suffering from Hodgkin's disease. As long as these questions remain unanswered and a causal relationship cannot be excluded, it will be reasonable, if accident insurance problems are involved, to give the patient the benefit of the doubt.
Evaluation of Indices of Alcohol Intake in a Population of 60‐Year‐Old Men in Uppsala, Sweden
Authors: Waern Urban , Boberg Jonas , Hellsing Krister
Published: August 2010

ABSTRACT. The following indices of alcohol intake were evaluated in a health survey of 60‐year‐old men in Uppsala: medical history of alcohol intake on the day prior to screening, presence of alcohol in urine (U‐alcohol) on the day after screening, registration at the Temperance Board in the community. For 28% of the participants, one or two of the indices pointed to casual or long‐standing habits of alcohol intake. Eighteen per cent considered themselves to be teetotallers. S‐triglycerides, S‐cholesterol, B‐glucose, S‐urate and S‐gammaglutamyl transferase (S‐GT) concentrations were analysed. No significant differences in S‐lipid and B‐glucose concentrations were found between the alcohol index groups and a control group. The mean values of S‐urate and S‐GT, however, were significantly higher in the alcohol index groups and proved to be reasonably discriminatory between them and the control group, in that 63% of the subjects who had S‐GT values of ≤0.70 μkat/l had one or two indices of alcohol intake. The corresponding figure for subjects who had S‐GT values of >0.30 μkat/1 was 22%. U‐alcohol was found in 36 subjects (11%), 14 of whom also had other indices of alcohol intake; the remaining 22 probably represented examples of casual alcohol intake. It is concluded that determinations of U‐alcohol, S‐GT, and S‐urate concentrations could be of diagnostic value in unclear cases in which increased alcohol intake is suspected of being the etiological factor of a disease or a symptom.
A Simple Test for Autonomic Neuropathy in Juvenile Diabetics
Authors: Hilsted J. , Jensen S. B.
Published: August 2010

ABSTRACT. The reproducibility of a simple method for determining the beat‐to‐beat variation during maximal respiration (duration of inspiration = duration of expiration=5 sec), using an ordinary ECG apparatus and a ruler, was tested in 10 normals and 40 insulin‐treated diabetics. The results were reproducible and beat‐to‐beat variation was found to be independent of a 25‐minute period of rest. The method was subsequently applied to 126 insulin‐treated diabetics and the results are in accordance with previous investigations on cardiac vagal neuropathy. The method is applicable as a clinical routine test for cardiac vagal neuropathy.
Effect of Clinical Bed Rest for Seven Days on Physical Performance
Authors: Friman Göran
Published: August 2010

ABSTRACT. Twenty‐two healthy men were confined to bed in a hospital ward (clinical bed rest) for one week. Variables related to physical fitness were measured before and immediately after the bed rest period, as well as one and three months thereafter. As a result of bed rest, maximal oxygen uptake, W170 and total Hb decreased to 94%, and calculated blood volume to 93% of the initial value. Hb concentration and Hct were unaltered. Thus, red cell and plasma volumes were proportionately reduced. No significant orthostatic dysfunction developed. The blood lactate peak at maximum work remained unchanged (14.0 mM/1). The resting excretion of noradrenaline decreased moderately during the bed rest period, whilst that of adrenaline was unchanged. Body weight decreased by a mean of 0.7 kg.
Biochemical Variables Related to Calcium Metabolism in Epileptics
Authors: Dymling John F. , Lidgren Lars , Wallöe Anders
Published: August 2010

ABSTRACT. Five biochemical variables, S‐Ca, U‐ Ca, S‐P, U‐P and S‐ALP, all involved in calcium metabolism, have been investigated in 86 epileptics on long‐term medication. We found hypocalciuria in half of the epileptics and increased S‐ALP in one third. In contrast to earlier reports there was no hypocalcemia, whereas hypercalcemia was found in 7 epileptics. We have previously reported a high frequency of fractures in these epileptics. An increased fracture rate was found in the 13 epileptics with both hypocalciuria and increased S‐ALP, indicating osteomalacia.
Drug‐Induced Blood Dyscrasias
Authors: Böttiger L. E. , Furhoff A. K. , Holmberg L.
Published: August 2010

ABSTRACT. Drug‐induced blood dyscrasias (agranulocytosis, aplastic anemia, hemolytic anemia and thrombocytopenia) in Sweden during a 10‐year period (1966–75) have been analyzed. The overall occurrence is remarkably constant, although marked changes have occurred with regard to offending drugs. Drug‐induced thrombocytopenia and agranulocytosis are about twice as common as hemolytic anemia, which in turn is twice as common as aplastic anemia. There is a marked increase with age in the incidence of all drug‐induced cytopenias. Women predominate and make up close to 70% of the material. With regard to responsible drugs, the most remarkable finding is the high frequency with which sulfonamides appear as responsible for all types of drug‐induced cytopenia.
A Case of Merbromin (Mercurochrome®) Intoxication Possibly Resulting in Aplastic Anemia
Authors: Slee Peter H. Th. J. , den Ottolander Gerard J. , de Wolff Frederik A.
Published: August 2010

ABSTRACT. A patient is described who appeared to be suffering from mercury intoxication caused by local application of merbromin to an operation wound and who developed aplastic anemia, which we ascribed to merbromin.
Aggregation of Deaths from Ischaemic Heart Disease among First and Second Degree Relatives of 108 Males and 42 Females with Myocardial Infarction
Authors: Thordarson Oskar , Fridriksson Sturla
Published: August 2010

ABSTRACT. The occurrence of deaths due to ischaemic heart disease (IHD) among first and second degree relatives of coronary patients and among relatives of an equal number of matched controls was studied on the basis of death certificates. The propositi were 108 males and 42 females, who had developed myocardial infarction (MI), males before 65 years of age and females before 70. When compared with controls, a 1 1/2‐fold higher death rate was found among first degree relatives of the propositi and a lower average age at death. The difference in death rate between second degree relatives was not significant, except for maternal brothers. When compared with the death rate due to IHD in the general population, the increase in risk to first degree relatives of propositi was nearly 3‐fold over the expected value, and 1 1/2‐fold to second degree relatives. The age of the propositi at onset of MI did not affect the risk to relatives, whereas sex‐related influence was significant. To first degree relatives of male propositi the risk increase was up to 5‐fold over the expected value. The risk increase was found to be greatest to first degree male relatives of female propositi, or over 7‐fold to fathers and brothers. Mothers and sisters of both male and female propositi showed a 4–5‐fold risk increase over the expected value. The risk increase to second degree relatives was 2 1/2‐fold over the expected value to maternal brothers of male propositi and 4‐fold to such brothers of female propositi. The relatives of controls showed a coronary mortality close to that of the general population. Familial clustering of coronary deaths was found in 8.7% of the families of the propositi and in 4.7% of the families of the controls. The findings of the present study indicate a substantial genetic component in the overall aetiology of IHD, which is more prominent in families of female propositi but hardly of a magnitude to warrant genetic counseling.
Follow‐up Studies of Joint Complications in Yersiniosis
Authors: Kalliomäki J. L. , Leino R.
Published: August 2010

ABSTRACT. In 1971–73, 60 patients were hospitalized for an infectious disease caused by Y. enterocolitica serotypes III and IX or Y. pseudotuberculosis serotype I. In the spring of 1977 a follow‐up study was carried out with 52 of these patients, one patient having died from intestinal perforation evidently resulting from yersiniosis‐induced amyloidosis and colitis. The follow‐up study showed that two patients had symptoms of sacroilitis, one had developed an apparent rheumatoid arthritis after yersiniosis and one had joint pains and a high serum rheumatoid factor titer with no objective joint changes. All results from kidney and liver studies were normal. No brucellosis antibodies were found in the follow‐up study. Twelve patients had antibody titers against Y. enterocolitica serotype III.
Acquired Factor XII Deficiency in a Patient with Nephrotic Syndrome
Authors: van Royen E. A. , de Boer J. E. G. , Wilmink J. M. , Jenkins C. S. P. , ten Cate Jan W.
Published: August 2010

ABSTRACT. A patient with nephrotic syndrome and an acquired factor XII deficiency associated with a factor XII‐like procoagulant activity in the urine was investigated. The urinary protein with procoagulant activity was isolated and comparative investigations revealed similar properties to plasma factor XII. It is suggested that the acquired coagulation defect may result from an insufficient biosynthetic capacity to compensate for the loss of factor XII in the urine.
Compression of the Inferior Caval Vein—A Rare Complication of a Large Non‐Parasitic Liver Cyst
Authors: Frisell J. , Röjdmark S. , Arvidsson H. , Lundh G.
Published: August 2010

ABSTRACT. A patient with massive edema of the legs and scrotum is presented in whom non‐parasitic cysts of the liver were found. Surgical evacuation of one large lobulated liver cyst completely relieved the patient of his edema. It is concluded that in this patient the peripheral edema was caused solely by cystic obstruction of the inferior caval vein.
Glomerulonephritis and Exposure to Organic Solvents.
Authors: Ravnskov Uffe , Forsberg Björn , Skerfving Staffan
Published: August 2010

ABSTRACT. Fifty patients with biopsy‐proven glomerulonephritis and 100 sex‐ and age‐matched controls (50 patients each with non‐glomerular renal disease or acute appendicitis) were asked by questionnaire and a telephone interview whether they had been exposed to organic solvents. The questioning and the evaluation of the exposure, if any, was made without knowing the diagnosis of the interviewee. Fifty per cent of the patients with glomerulonephritis reported more than slight exposure, but only 20% of the controls. Exposure to organic solvents may often play a role in the causation of glomerulonephritis.
Acute Glomerulonephritis and Exposure to Organic Solvents in Father and Daughter
Authors: Ravnskov Uffe
Published: August 2010

ABSTRACT. A man and his daughter had acute glomerulonephritis, the daughter eight years after the father. Both were exposed to vapours of organic solvents shortly before the onset of nephritis.