bluuebunny/crossref_metadata_2025 huggingface dataset:
Albumin Metabolism and Gastrointestinal Loss of Protein in Chronic Renal Failure
Authors: Johansson S. V. , Odar‐Cederlöf I. , Plantin L.‐O. , Strandberg P. O.
Published: August 2010

ABSTRACT The catabolism of albumin labelled with 125I has been studied in 10 patients with advanced renal failure and in 5 with nephrotic syndrome. In 10 patients the gastrointestinal protein loss was studied simultaneously by determining the faecal excretion during 7 days of 51Cr after i.v. administration of 51Cr‐labelled chromic chloride. The results were related to a control group in which 12 subjects were studied with respect to albumin catabolism and 17 with respect to the gastrointestinal protein losses. The results showed that: 1) In the two patient groups the means for serum albumin concentration and the intravascular albumin pool, expressed as g or g/kg b.wt., were significantly decreased compared with those of the control group. 2) The two patient groups had an increased extravascular albumin pool as well as an elevated ratio between extra‐ and intravascular pools. 3) The mean albumin catabolic rate was not increased in the renal insufficiency group, expressed as a percentage of the intravascular pool/24 h or as g/24 h. In the patients with nephrotic syndrome, however, it was significantly increased. 4) The renal insufficiency group had a mean cumulative 51Cr excretion during 7 days of 1.6±0.80% of the given dose, the control group 0.63±0.30%. This difference is highly significant. The patients with nephrotic syndrome did not differ from the control group.
Partial Correction of Hypertension by Angiotensin II Blockade in a Patient with Phaeochromocytoma
Authors: van Hoogdalem P. , Donker A. J. M. , Brentjens J. R. H. , van der Hem G. K. , Oosterhuis J. W.
Published: August 2010

ABSTRACT This case report describes a patient with malignant hypertension and phaeochromocytoma in whom blockade of angiotensin II receptors by the competitive antagonist 1‐sar‐8‐ala‐angio‐tensin II (Saralasin®) resulted in a partial correction of the elevated BP. Plasma renin activity was high and rose further during the blockade. Competitive inhibition of angiotensin II by Saralasin does not abolish the pressor effect of catecholamines. It was therefore interesting to observe that in this patient with phaeochromocytoma, independently, both α‐adrenergic receptor blockade and angiotensin II receptor blockade were effective in lowering BP.
The Urinary Sediment in Hydronephrosis
Authors: Wahlin Anders
Published: August 2010

ABSTRACT Phase contrast microscopy has been used for examination of urinary sediments from 19 patients with hydronephrosis. Casts were seldom seen. A raised number of erythrocytes was seen only in association with catheter, calculi or diabetes. A raised number of leukocytes was seen in patients with bacteriuria. A striking observation was the finding of a great proportion (64%) of histiocyte‐like cells in six out of 12 cases in whom a differential count was performed. The proportion of histiocyte‐like cells was small (14%) in cases with bacteriuria or history of urinary tract infection.
Nephrotoxicity in Combined Cephalothin and Gentamicin Therapy
Authors: Hansen M. Mørk , Kaaber K.
Published: August 2010

ABSTRACT Thirty‐two series of treatment with cephalothin and gentamicin for 5–10 days have been administered to 26 patients. An increase in serum creatinine occurred in 6 series. Important factors for the renal damage were elevated pretreatment serum creatinine, elevated serum gentamicin and probably a high serum cephalothin. In 2 patients the nephrotoxicity was fully reversible; the others died before a dicisive improvement in renal function could be expected. In 11 out of 28 treatment series there was a transient drop in serum potassium. Since the combination of cephalothin and gentamicin as the primary treatment of life‐threatening infection has often proved effective, and since short‐lasting treatment seems to entail only a minute risk of nephrotoxicity in patients with normal pretreatment serum creatinine, we still prefer this treatment in such cases.
Electrocardiographic Changes in Massive Pulmonary Embolism
Authors: Ahonen Antti
Published: August 2010

ABSTRACT A retrospective analysis of ECG changes during lung embolism has been made in 35 patients (16 male, 19 female) who died of massive lung embolism. The presence of lung embolism or infarct was confirmed at autopsy. According to the ECG the mean heart rate increased from 91 to 106. The amplitude of the P wave increased in leads I, II, III and aVL and decreased in all precordial leads. A small increase in the Q wave occurred in leads II, III, aVF, V1, V2 and V6. Only a small decrease in the R wave occurred in leads I, II and aVL. A small increase in the S wave occurred in leads I, II, V2‐V6 when compared with the controls. None of the differences was, however, statistically significant.
Sudden Coronary Death in Scandinavia
Authors: Furberg Curt , Romo Matti , Linko Eino , Siltanen Pentti , Tibblin Gösta , Wilhelmsen Lars
Published: August 2010

ABSTRACT All cases of acute myocardial infarction (AMI) and sudden death due to coronary heart disease have been registered in two Swedish and two Finnish cities during a 1‐year period. The incidence increased steeply with age in both sexes and was in all age groups far higher in males than in females. The age‐related incidence in both Finnish cities was definitely higher than in Gothenburg, Sweden, while the other Swedish register city, Boden, had an intermediate position. The case: fatality rate within one year was 44.2% for males and 37.4% for females. This difference was already apparent in the first hour after the onset of the attack, when the case: fatality rate was 15.5% for males and 9.3% for females. A history of previous cardiovascular disease was much more common in AMI patients than in the general population. It was also slightly more common in subjects who died suddenly than in AMI patients who did not die suddenly.
Intermittent Melphalan and Prednisolone Therapy in Plasma Cell Myeloma
Authors: Mellstedt H. , Björkholm M. , Holm G.
Published: August 2010

ABSTRACT Thirty‐two consecutive, previously untreated patients with plasma cell myeloma were treated with 4‐day courses of melphalan (0.25 mg/kg/day) and prednisolone (2 mg/kg/day) every sixth week. The observation period ranged from 26 to 75 months and the total median survival time was 29 months. 75% of the patients responded to therapy and their median survival time was 42 months. Sex did not influence either the response rate or the survival time. Most patients were treated in an outpatient clinic and required a minimum of check‐ups.
Cellular Immunocompetence in Asymptomatic Paraproteinaemia
Authors: Weits J. , de Gast G. C. , The T. H. , Esselink M. T. , Mandema E.
Published: August 2010

ABSTRACT Several sensitive parameters of cellular immunity were studied in 20 patients with asymptomatic paraproteinaemia as judged after at least 3 years of follow‐up. In vitro lymphocyte transformation by the primary immunogen haemocyanin of Helix pomatia (HPH) following immunization, by PHA, PWM and previously encountered antigens was measured, as was skin sensitization by the primary immunogen dinitrochlorobenzene (DNCB). All 12 patients with low serum paraprotein levels—benign paraproteinaemia according to common criteria— had normal parameters of cellular immunity. However, 5 of 6 patients with high IgG and IgA serum paraprotein levels had a decreased response to HPH; 3 of these 5 also had a decreased PHA response. Two patients with high IgM serum paraprotein levels had normal lymphocyte reactivity. Lymphocyte reactivity by PWM and previously encountered antigens was normal in all patients. Autologous serum culture medium did not influence the results. DNCB skin sensitization was significantly lower in the group with high serum paraprotein levels than in the group with low levels. It is concluded, that in asymptomatic paraproteinaemia, patients with high serum paraprotein levels differ from those with low paraprotein levels in their defective cellular response to primary immunogens. The significance of these findings is discussed.
Effects of Dexamethasone, Desoxycorticosterone, and ACTH on Serum Concentrations of Thyroxine, 3, 5, 3′‐Triiodothyronine and 3, 3‘, 5’‐Triiodothyronine
Authors: Westgren U. , Ahrén B. , Burger A. , Ingemansson S. , Melander A.
Published: August 2010

ABSTRACT The effects of a pure glucocorticoid, dexamethasone, and a pure mineralocorticoid, desoxycorticosterone, on the serum concentrations of thyroxine (T4), 3, 5, 3′‐triiodothyronine (T3), and 3, 3′, 5′‐triiodothyronine (reverse T3, rT3) were compared both in healthy subjects and in athyreotic T4‐substituted patients. In addition, the effect of exogenous ACTH was examined in healthy subjects. Both in healthy subjects and in T4‐substituted athyreotic patients, administration of a single oral dose of dexamethasone caused a rapid and sharp decrease in the serum concentration of T3, and a corresponding increase in the serum concentration of rT3. The T4 concentration was not changed. A single oral dose of desoxycorticosterone evoked no significant changes in the serum concentrations of T3, rT3, or T4 either in healthy subjects or in T4‐substituted athyreotic patients. Like dexamethasone, ACTH (two i.v. injections of 60 IU each, at a 6‐hour interval) evoked a serum T3 reduction and a serum rT3 increase. Hence, it appears that both endogenous and exogenous glucocorticoids, but not mineralocorticoids, may partially divert the deiodination of T4 from the activating (T4←T3) to the inactivating (T4←rT3) pathway.
Studies on Replacement and Suppressive Dosages of l‐Thyroxine
Authors: Nilsson G. , Pettersson U. , Levin K. , Hughes R.
Published: August 2010

ABSTRACT Serum thyrotropin (TSH) levels were studied in 55 hypothyroid patients in order to determine adequate replacement and suppression dosages of l‐thyroxine (T4). In accordance with previous reports it was found that most patients had normal TSH levels and were clinically euthyroid at daily doses of 0.10–0.15 mg T4. None of the patients required a dose exceeding 0.20 mg. When the TSH levels normalized, serum thyroxine and serum triiodothyronine also fell to levels within their normal ranges. The effectiveness of various doses of T4 in suppressing the temporary rise in serum TSH concentration normally induced by thyrotropin‐releasing hormone was examined in 57 patients treated with T4 for atoxic goitre or after subtotal surgical removal of such a goitre. The rise in TSH was not usually inhibited by a T4 dose of less than 0.20 mg, a finding which at least theoretically has implications for the adequate suppressive dose of T4.
The Liver in Sarcoidosis
Authors: Lehmuskallio Eero , Hannuksela Matti , Halme Helena
Published: August 2010

ABSTRACT Needle biopsies of the liver were performed in 121 cases of sarcoidosis. Granulomas compatible with sarcoidosis vere seen in 24% of the cases. Liver function tests (serum alkaline phosphatase, serum aspartate aminotransferase, serum alanine aminotransferase, and bromsulphthalein clearance test) were performed on 325 patients with sarcoidosis and on 132 with non‐sarcoid erythema nodosum (EN). Pathological findings were seen especially in patients with extensive EN, without any correlation with the disease responsible for the eruption. Hepatic granulomas were found more often in patients with sarcoid changes in lung parenchyma than in those with bilateral hilar adenitis only. There were no other definite correlations between hepatic granulomas and other clinical and laboratory findings. The incidence of pathological results in this study was clearly lower than, e.g., in the USA, thus reflecting the good prognosis of sarcoidosis in the Scandinavian countries.
Lactoferrin and Lysozyme in Arthritic Exudates
Authors: Malmquist Jörgen , Thorell Jan I. , Wollheim Frank A.
Published: August 2010

ABSTRACT Lactoferrin (LF) has been assayed by radioimmunoassay in plasma and arthritic exudates and compared with lysozyme (LZ) levels and leukocyte counts. The mean LF concentration in 38 rheumatoid arthritis (RA) exudates was 9.1 mg/l (range 0.02–39.2). In 30 non‐RA exudates LF was 3.3 mg/l (range 0.01–14.6). The corresponding LZ levels were 7.4 mg/l (range 2.5–18.5) in RA and 4.7 (range 1.0–12.5) in non‐RA fluids. Exudate/plasma ratios were much higher for LF than for LZ and higher in RA than in non‐RA exudates, whereas leukocyte counts did not differ. The LF/leukocyte count ratio was significantly higher in RA than in the non‐RA group. The data suggest a more prominent release of neutrophilic granulocyte components in RA than in non‐RA arthritis.
Deleterious Effects of Cardiac Pacing in a Patient with Mitral Insufficiency
Authors: Edhag O. , Fagrell B. , Lagergren H.
Published: August 2010

ABSTRACT A 70‐year‐old, artificially paced woman with dizziness and extremely low physical capacity exhibited a systolic BP varying from one moment to another; in standing position it was not measurable. With the aid of a strain gauge technique, the amplitude of the pulse wave of her left thumb was recorded and shown to vary widely. The variations were correlated to synchrony or asynchrony between atrial and ventricular activity. Pronounced decreases in stroke volume and peripheral pulse volume were recorded with pacemaker‐induced beats compared with idioventricular beats. With artificial stimulation at a rate of 45/min, thus avoiding competition but still protecting her from syncopes, she was free from symptoms.
Intravenous Glucose Tolerance Test in Middle‐Aged Men with and without Latent Coronary Heart Disease
Authors: Erikssen Jan , Enger Sven Chr.
Published: August 2010

ABSTRACT During a cardiovascular survey, aimed at detecting cases of latent coronary heart disease (CHD), glucose elimination was studied after i. v. loading in 1970 presumably healthy men aged 40–59 years. The aim was to throw light on the importance of deranged glucose tolerance for the development of CHD. Of the 1970 individuals, 1798 were defined as “normals”, 33 had chronic, non‐anginal chest pain, 34 had slight albeit typical angina pectoris. The remaining 105 had various symptoms/signs strongly suggestive of CHD, and underwent diagnostic coronary angiography (69 angiopositive, 36 angionegative). Plasma insulin was determined in relation to the test in 249 of the subjects. The following conclusions were reached: 1) Mean k‐values were similar in all subgroups (p0.10). 2) Low and borderline k‐values were significantly more frequent in angiographed individuals compared with the group of normals (p<0.025). However, an almost identical frequency was seen in angiopositive and angionegative cases. 3) K‐values did not change with age between 40 and 59 years. 4) K‐values were unrelated to the severity of angiographic findings in individuals with proven CHD. 5) Significantly lower k‐values were found in individuals with a positive diabetic heredity, and 6) in individuals with a high insulin response. 7) The i. v. glucose loading did not influence an exercise ECG recorded in relation to a near‐maximal bicycle exercise test.
The Possible Relation between Postpartum Exacerbation of Hyperthyroidism and Neonatal Thyrotoxicosis
Authors: Serup Jørgen , Petersen Sten
Published: August 2010

ABSTRACT Hyperthyroidism is generally considered to be ameliorated during pregnancy, and there appears to be a high incidence of postpartum exacerbation. These phenomena have to our knowledge not been related to neonatal thyrotoxicosis, a transient hyperthyroidism seen only in newborns of previous or current hyperthyroid mothers. The first of two siblings of a previously thyrotoxic mother had marked symptoms of neonatal thyrotoxicosis and high levels of thyroid hormones. The mother had not received antithyroid treatment during her first pregnancy. During her next pregnancy she was treated with propylthiouracil from the second trimester. This infant had only minimal thyrotoxic signs but almost as high levels of thyroid hormones during the neonatal period as the elder. The mother had no signs of postpartum exacerbation but her thyroid hormones were significantly elevated in the postpartum period analogous to the infants. Neither the mother nor the infants presented any increase in thyroid‐stimulating hormone and long‐acting thyroid stimulator during the hyperthyroid periods. The possibility is discussed, that postpartum exacerbation of hyperthyroidism and neonatal thyrotoxicosis may be related. They could be the result of a changed balance between a thyroid stimulator and an inhibitor after birth.
Transient Changes of Sensory Nerve Functions in Uraemia
Authors: Lang A. H. , Forsström J.
Published: August 2010

ABSTRACT The neurophysiological parameters (conduction velocity, amplitude and rise time of the compound action potential) of two sensory nerves of the lower limb (N. suralis and peronaeus superficialis) were determined bilaterally in five patients. Measurements were carried out at least twice in each subject during a time of great metabolic change. Two patients were recovering from acute renal failure (a single haemodialysis had to be performed on one of them) and three were under chronic maintenance haemodialysis. In the case of the haemodialysis patients, measurements were performed on two successive days, before and after one haemodialysis session. All the neurophysiological parameters showed significant improvement in successive measurements. In one patient the follow‐up after acute renal failure revealed a delayed deterioration of the nerve functions, but after one year the values were normal. From the results it seems probable that an acute metabolic disturbance may cause transient inhibition of nerve functions without morphological changes in the nerve fibres.
Treatment of Hypertension in the Community
Authors: Berglund Göran , Andersson Ove , Wilhelmsen Lars
Published: August 2010

Abstract. The feasibility and efficacy of antihypertensive treatment within the Primary Preventive Trial against myocardial infarction and stroke in Göteborg, Sweden, are described. The study group consisted of 9967 men aged 47–54 years, chosen at random from the general population. 75% of them participated in a screening examination including a blood pressure (BP) measurement. Hypertension defined as BP above 175 mm Hg systolic or 115 mm Hg diastolic on two separate occasions or antihypertensive treatment was found in 9%.

The drop‐out rate was 6.5% during the first year and 3.6% during the second year of treatment. The percentage of hypertensive subjects with uncontrolled BP decreased from 83% at screening to 16% after one year and to 9% after two years of treatment. The frequency of side‐effects of such severity as to cause withdrawal of drugs, was 16% during the first year and 7% during the second year.

The morbidity in coronary heart disease and stroke in those hypertensives (n=696) treated at the Hypertension Clinic was compared with that of an untreated control group (n=330). The incidence of death and fatal plus non‐fatal myocardial infarction was significantly lower in the treated group than in the untreated comparison group, in spite of lower initially predicted risk of myocardial infarction in the comparison group. The findings indicate that antihypertensive treatment prevents the occurrence of coronary heart disease.
Effect of Alcohol on Chemotaxis, Adherence and Phagocytosis of Human Polymorphonuclear Leucocytes
Authors: Hallengren Bengt , Forsgren Arne
Published: August 2010

ABSTRACT. In view of the presumed increased susceptibility of chronic alcoholics to infectious diseases, the influence of alcohol in vitro on leucocyte adherence, neutrophil chemotaxis, phagocytosis and intracellular killing was investigated with highly standardized methods. A significant inhibitory influence on these leucocyte functions was found only at alcohol concentrations in excess of those obtained clinically. An interesting observation not reported before was increased adherence, phagocytosis and chemotaxis at low to moderate concentrations of alcohol.
Mild Phosphate Diabetes in Adults
Authors: Lundberg Erik , Bergengren Harald , Lindqvist Bengt
Published: August 2010

ABSTRACT. Phosphate diabetes has been considered as rare and to occur almost exclusively in children. Upon examination of adult patients with rheumatic or kidney diseases it has, however, been found that the combination of hypophosphataemia and hyperphosphaturia is not so rare. This paper deals with 24 adult patients of this type, whom we have found during 6 months. Their mean serum phosphorus concentration was 0.7 mmol/1 (range 0.5‐0.8). Mean phosphate clearance was 31 ml/ min/1.73 m2 (range 16–51). The diagnoses were myalgia, dorsalgia (n = 7), papillitis calcificans (n = 5), prostatitis or prostate accretions (n = 4), dizziness (n=2), kidney stones, tubular defect, interstitial nephritis, medullary sponge kidney (1 case each), two patients had transplanted kidneys. Asthenia was a common additional diagnosis. The patients' complaints have been pain in the muscles, joints, bones (18 cases), tiredness (10 cases), dizziness (8 cases), shakyness, numbness, burning sensation (7 cases), tenderness in the muscles and bones (“the princess‐on‐the‐pea syndrome”) (7 cases). The most common findings upon examination were bone tenderness (13 cases), reduced manual power (8 cases), positive Romberg test (3 cases), slight muscle atrophy (2 cases), waddling gait (2 cases). The most common findings encountered in the laboratory, besides hypophosphataemia and hyperphosphaturia, were high pH in the urine, hyperaminoaciduria, and phosphate crystals in dried urine.
Idiopathic Acquired Panmyelopathy in Pregnancy
Authors: Samsom J. P. , Brouwers Th. M. , Huisjes H. J. , van der Schans G. S. , Nieweg H. O.
Published: August 2010

ABSTRACT. A case of idiopathic acquired pan‐myelopathy (aplastic anaemia) in pregnancy in a 32‐year‐old woman is presented. The outcome for mother and child was favourable. Special attention is paid to the management of the delivery. Another aspect of interest is the haematologic status of the child. In panmyelopathy an immunologic mechanism may operate as indicated by the finding of platelet membrane associated immunoglobulins, which were also present in our patient. If the bone marrow lesions in this disease are indeed due to immunological injury, they are mediated by immune complexes or by a cellular mechanism, for it is well known that IgG antibodies may pass through the placenta and induce lysis of circulating blood cells in the newborn. There was no evidence of bone marrow damage in the infant. This is in accordance with the cases mentioned in the literature.
Hypertensive Eye Ground Changes
Authors: Svärdsudd Kurt , Wedel Hans , Aurell Elisabeth , Tibblin Gösta
Published: August 2010

ABSTRACT. As part of a prospective population study of cardiovascular disease, ophthalmoscopic examination was performed in 855 randomly selected 50‐year‐old men in 1963. The examination was repeated four years later, in 1967. On both occasions haemorrhages, exudates and papillary aedema were rarely seen. Attenuating arterioles, focal narrowing, crossing phenomena and broadened light reflex were all related to BP but attenuating arterioles and/or focal narrowing discriminated BP best. Isolated broadened reflex and/or crossing phenomena were not related to BP. The change in BP over four and ten years was the same in those who had and those who did not have hypertensive eye ground changes at the initial examination, indicating that eye ground changes do not precede hypertension. Mortality data and the morbidity in myocardial infarction and stroke were followed up until 1975. The importance of the separate eye ground variables for these mortality and morbidity end‐points was analyzed, taking into account the importance of BP, serum cholesterol and smoking. Focal narrowings were of importance for mortality, regardless of its cause, for stroke and for death from malignancy. Crossing phenomena were of importance for mortality, regardless of cause, for fatal coronary heert disease, for stroke and for deaths other than cardiovascular and cancer deaths. The eye ground variables are thus of differing importance for different end‐points. Grouping them as in Keith and Wagener's or other classification systems, means a loss of information and should be avoided.
Ectopic Secretion of Calcitonin
Authors: Mulder H. , Hackeng W. H. L.
Published: August 2010

ABSTRACT. In 7 out of 25 unselected patients (28%) with a malignant disease, the circulating calcitonin level had increased. Pentagastrin i.v. gave no elevation of the calcitonin level comparable to the response in patients with medullary carcinoma of thyroid.
Drug‐Induced Neutropenia in the Stockholm Region 1973‐75: Frequency and Causes
Authors: Arneborn Per , Palmblad Jan
Published: August 2010

ABSTRACT. The records of 133 patients, discharged with a diagnosis of agrauulocytosis (i.e. blood neutrophil levels <1.0times109/l) during the years 1973‐75 in the Stockholm county region, were reviewed. In 45 cases the neutropenia was probably caused by drugs other than cytostatics, giving an annual incidence of drug‐induced neutropenia of 0.01%***o. The most common drugs were thenalidine, sulfonamides and thyreostatics. Only one of the 45 patients died during the neutropenic phase. It is concluded that the pattern of drugs causing neutropenia has changed in Sweden compared with studies from the latter half of the 1960s, and only about 40% of the cases have been reported to the authorities.
Whipple's Disease
Authors: Tauris Palle , Moesner Jørgen
Published: August 2010

ABSTRACT. A case of Whipple's disease involving the small intestine, bone marrow and peripheral lymph nodes diagnosed one year after the initial arthritic symptoms by peroral jejunal biopsy and rapidly responding to treatment with sulphamethoxa‐zole‐trimethoprim, is described. The effectiveness of therapy was monitored by clinical evaluation of the patient's condition, repeated intestinal biopsies, determination of body weight, faecal lipid excretion and haematological values. Clear‐cut clinical remission was induced promptly; and after nine months' treatment, the patient was in perfect health. The drug was well tolerated and folate deficiency did not occur. After four months of antibiotic therapy, bacterial capsular remnants could still be demonstrated in the bone marrow aspirate. The characteristic small bowel mucosal PAS‐positive macrophages, visualized in the jejunal biopsy specimens, persisted in reduced number after nine months of treatment.
Thallium Intoxication Treated with Long‐term Hemodialysis, Forced Diuresis and Prussian Blue
Authors: Pedersen Robert Smith , Olesen Anders Schou , Freund Leif Gade , Solgaard Per , Larsen Elfinn
Published: August 2010

ABSTRACT. A 56‐year‐old woman, who ingested 2 g of thallium sulfate, was successfully treated with long‐term hemodialysis for 200 hours during ten days, combined with forced diuresis and Prussian blue. The effect of the artificial kidney dialysis was determined by repeated analysis of the thallium concentration in the dialysis bath and in blood samples. During the first 120 hours of hemodialysis, 143 mg of thallium was eliminated via the artificial kidney and 110 mg via the urinary tract. The present case of acute thallium intoxication is the first in which long‐term hemodialysis has been used in the acute phase together with forced diuresis and Prussian blue. The data obtained are compared to those obtained from cases treated with hemodialysis in the past. It is concluded that treatment with hemodialysis should be considered as an important supplement to treatment with forced diuresis and Prussian blue in cases of thallium intoxication.
Interferon Therapy in Neoplastic Disease
Authors: Christophersen Ivan Strøyer , Jordal Robert , Osther Kurt , Lindenberg John , Pedersen Poul Hjortkjßr , Berg Kurt
Published: August 2010

ABSTRACT. The treatment of 10 patients having neoplastic disease with exogenous i.m. interferon therapy is described. The interferon given is partially purified interferon produced from human leukocytes. Sendai virus is used as interferon inductor. The patients reported in this paper have been on treatment for periods of 2–28 months. Apart from initial periods of fever, no side‐effects have been recorded. Patients suffering from bladder papillomas have shown partial regression after a few months of therapy. The other cases treated are too few to warrant any conclusions, but the therapy does seem to have been beneficial.
Embolism in Sinoatrial Disease
Authors: Bathen J. , Sparr S. , Rokseth R.
Published: August 2010

ABSTRACT. Among a series of consecutive patients treated with permanent pacemaker between 1965 and 1976, 43 had sinoatrial disease with paroxysmal tachycardia (group A), 30 sinoatrial disease without tachycardia (group B) and 165 atrioventricular block (group C). A retrospective study showed systemic vascular events compatible with embolism in 35%, 7% and 10% in groups A, B and C, respectively. The groups were comparable as regards age, other diseases and duration of pacemaker therapy. Because of the high incidence of embolism in group A, anticoagulant therapy should be evaluated in patients with the brady‐tachycardia syndrome.
Electrocardiographic Changes during Total Energy Deprivation (Fasting)
Authors: Theorell T. , Kjellberg J. , Palmblad J.
Published: August 2010

ABSTRACT. The effect of 10 days of total energy deprivation (fasting) on ECG reactions was evaluated in 14 healthy normal‐weight males. The heart rate and the ratios between QRS and T wave amplitudes in leads I and II decreased significantly, as did body weight and blood glucose levels. The urinary excretion of adrenaline increased. It is concluded that other hormonal (e.g. thyroidal), neural and metabolic mechanisms are of greater significance for the heart than the sympatho‐adreno‐medullary activity during fasting. T wave abnormality without an abnormal Q wave and without other clinical symptoms was noted in one subject on the 8th day of starvation and remained abnormal for more than a year.
Electroencephalographic Prediction of Anoxic Brain Damage after Resuscitation from Cardiac Arrest in Patients with Acute Myocardial Infarction
Authors: Møller M. , Holm B. , Sindrup E. , Nielsen B. Lyager
Published: August 2010

ABSTRACT. The short‐term prognostic value of routine electroencephalography (EEG), carried out on the days after cardiac arrest, was evaluated in a consecutive study of 185 patients with acute myocardial infarction together with an episode of clinical cardiac arrest. The individual EEGs were classified on a 5‐grade scale. Of the 89 patients who survived, 18 had signs of anoxic brain damage; 96 patients died, 76 as a result of cerebral anoxia. Only 2 patients survived out of the total of 72 for whom the first EEG was classified as grades III‐V. The EEGs of both these patients were recorded within a few hours after the cardiac arrest. None of the patients with an EEG of grade I died of cerebral anoxia, while all degrees of brain damage were otherwise observed in connection with EEGs of both grades I and II. It is concluded that an EEG of grades III‐V indicates a fatal outcome, provided it has been recorded more than 24 hours after the cardiac arrest. A grade III‐V EEG that is recorded within 24 hours after a cardiac arrest should be repeated some days later. It is not possible, on the basis of a single EEG, to predict the extent of the anoxic brain damage.
Third Degree Atrioventricular Block, Chronic Progressive External Ophthalmoplegia and Pigmentary Degeneration of Retina
Authors: Petersen Erik la Cour
Published: August 2010

ABSTRACT. A woman was noted to have chronic progressive external ophthalmoplegia, pigmentary degeneration of retina and third degree AV block. She was admitted to hospital because of syncopes and was successfully treated with a permanent pacemaker. Since 1958, 12 similar cases have been noted. Three of 7 patients without pacemaker treatment died, and 5 were successfully treated with pacemaker. The disturbances in AV conduction are not thought to be a mere coincidence to the ocular disorder. Cardiomyopathy has been suggested.
Increased Serum Levels of Immunoglobulins in Untreated and Treated Essential Hypertension
Authors: Kristensen Bent østergaard
Published: August 2010

ABSTRACT. In 164 consecutive patients with essential hypertension, serum immunoglobulin (Ig) levels of IgA, IgG and IgM classes were determined, using single radial diffusion techniques, and compared with 80 healthy normotensive subjects without any family history of hypertension. Of 80 untreated and 84 treated patients, IgA and/or IgG were significantly increased in 40% and 37%, respectively. IgG correlated positively to BP in untreated patients (p <0.0008), as well as in insufficienctly treated males (p <0.004). No correlations were found between Ig and duration of hypertension. The increase in Ig was not associated with any particular drugs. A family history of hypertension was found in 19.6% of the patients with elevated Ig and in 9.7% of those with normal Ig (p <0.10). The study provides further evidence for involvement of immune mechanisms in essential hypertension, and suggests a possible genetic predisposition.
Four Cases of Long‐Standing Diarrhoea and Colic Pains Cured by Fructose‐Free diet—A Pathogenetic Discussion
Authors: Andersson Dan E. H. , Nygren Arne
Published: August 2010

ABSTRACT. Four patients with a long history of abdominal swelling, colic pains and diarrhoea were cured by a fructose‐free diet. They were all given an oral load of (14C) fructose and their expiratory excretion of 14CO2 was found to be significantly lower than that of control patients with similar symptoms. It is concluded that the patients cured by a fructose‐free diet might have a partial fructose malabsorption.
Listeria Encephalitis in Five Renal Transplant Recipients
Authors: Niklasson Per‐Magnus , Hambraeus Anna , Lundgren Göran , Magnusson Gösta , Sundelin Pär , Groth Carl‐Gustav
Published: August 2010

ABSTRACT. Listeria encephalitis has occurred recently in 5 renal transplant recipients at the Transplantation Unit in Stockholm. Symptoms from the central nervous system, such as coma, hemiparesis and cranial nerve paresis, dominated the clinical picture. Listeria monocytogenes was isolated from the blood of all the patients, from the cerebrospinal fluid in two, from the urine in one and post mortem from the brain in one patient. Pleocytosis never exceeded 200 leucocytes/mm3 and the glucose ratio was normal or near normal. Complement fixation test for Listeria was negative in all 5 patients. Four patients expired in spite of treatment with large doses of penicillin and other antibiotics to which the isolated strains were sensitive in vitro. At autopsy, inflammation and necrosis were observed in the brain, especially the brain stem, and there was mild lymphocytic infiltration of the meninges. The surviving patient was treated with a combination of chloramphenicol and ampicillin.
Acute Interstitial Nephritis during Treatment with Penicillin and Cephalothin
Authors: Milman Nils
Published: August 2010

ABSTRACT. A case of non‐oliguric acute interstitial nephritis during treatment with ampicillin, benzylpenicillin and cephalothin is reported. There were symptoms of drug hypersensitivity, including fever, exanthema, eosinophilia and elevated serum IgE. Renal biopsy showed marked interstitial edema and infiltration with numerous eosinophils, some mononuclear cells and giant cells, and scattered tubular damage, but normal glomeruli and vessels. There was no pathological deposition of immunoglobulins or complement in the renal tissue. Renal function recovered after withdraval of antibiotics and treatment with steroids. The findings suggest a drug‐induced, hypersensitivity‐mediated pathogenesis of the renal lesions, with participation of both humoral and cell‐mediated immunological reactions.
Clinical Features of Patients with a Serum M Component
Authors: Peltonen Soila , Wasastjerna Curt , Wager Odd
Published: August 2010

ABSTRACT. The series comprised 169 patients with a serum M component (MC). Their mean age was 67.9 years. Eighty patients (47.3%) had a primary malignant lymphocytic or plasmacellular disease (68 myeloma, 6 macroglobulinaemia, 4 lymphoma, 2 chronic lymphocytic leukaemia). In 88 patients the MC was considered secondary and in one patient it was probably primary benign. In the group with a secondary MC the most common diagnoses were cardiovascular disease, an immunological disorder, infection, diabetes, and carcinoma. The possibility of a causal relation between cancer or prolonged antigenic stimulation and emergence of M components is discussed. Among 14 patients with definite myeloma the mean serum concentration of MC was 35.7 g/l, among 32 with secondary MC 12.9 g/l. Of the 68 patients with myeloma, 60% had an IgG MC, 22% an IgA MC and 18% an MC composed only of light chains. Of the patients in whom this paraprotein was secondary, it was IgG in 77%, IgA in 14% and IgM in 9%. One patient in this group had Bence Jones proteinuria; none had a pure light chain MC. Among patients with IgG or IgA myeloma or with a secondary MC and in whom the light chain type was identified, the kappa:lambda ratio was 1.5: 1. Of the 11 patients with demonstrated light chain myeloma, the MC was of the kappa type in 4 and of the lambda type in 7. The levels of “background” immunoglobulins were depressed in 88% of patients with a lymphocytic or plasmacellular neoplasia and in 38% with a secondary MC. Of the 91 patients whose serum samples were assayed for antibody activity, high titres were observed in 10.
Macroglobulinaemia in an Icelandic Family
Authors: Björnsson Ólafur Grímur , Ámason Alfreo , Gudmunosson Sigurour , Jensson Ólafur , Ólafsson Snorri , Valdimarsson Helgi
Published: August 2010

ABSTRACT. Macroglobulinaemia in an Icelandic family is presented. A woman had Waldenström's macroglobulinaemia, and two of her brothers had monoclonal macroglobulinaemia of the benign form. One was asymptomatic, but the other had polyneuropathy and IgM deposits in peripheral nerves. A third brother of these siblings died of a lymphoreticular disease, which presented with a widespread neuropathy. A second sister had polyclonal increase in serum IgA and two other brothers of this sibship had IgM slightly elevated. A study of all descendants (45 in all and 19 spouses) revealed seven individuals with elevated IgM levels. No other immunoglobulin abnormalities were detected.
Cytostatic Treatment of Glomerular Diseases
Authors: Balsløv J. T. , Brun C. , Jørgensen F. , Jørgensen H. E. , Larsen M. , Larsen S. , Lorenzen I. , Thomsen Å. C.
Published: August 2010

ABSTRACT. Sequential statistical testing of the development of the disease in the single patient was used in the assessment of immunosuppressive treatment of renal glomerular diseases. After an initial period of prednisone (P) treatment, this was supplemented first by azathioprine (A) and later in addition by cyclophosphamide (C). The time of transition from one treatment to another was determined by the result of the current statistical testing of the correlation between serum creatinine concentration and proteinuria on the one hand and the time and the varying doses of the drugs on the other. Twenty‐nine patients entered the study. Thirteen were withdrawn, eight for technical reasons, three due to side‐effects and two on account of renal deterioration and transfer to dialysis treatment. Eight patients were cured, one during P treatment, five during P + A, and two during the combination of P, A and C. Eight patients completed treatment without being cured. In the overall material no statistically significant change in serum creatinine was noted, whereas the proteinuria decreased during P + A and P + A + C. No dose‐dependent therapeutic effect of the drugs was demonstrated. In conclusion, this combined treatment with P, A and C did not seem to yield any major therapeutic progress. The technic of sequential statistical testing may be a useful tool in clinical research.
Rocket Immunoelectrophoresis of myoglobin in urine in patients with myocardial infarction
Authors: Kølendorf K. , Pedersen F. , Christiansen E. , Gad I.
Published: August 2010

A rocket immunoelectrophoretic method with prepared antisera to rabbit myoglobin has been developed to study the urinary myoglobin excretion in patients with acute myocardial infarction. The method is able to detect a minimum urinary myoglobin concentration of 1—2 mg/l. Urine specimens from 156 patients admitted to the coronary care unit with a provisional diagnosis of acute myocardial infarction were analysed. Seventysix patients proved to have documented myocardial infarction. Twelve of them had at least one positive determination. Four of the 80 without infarction had myoglobinuria. 15 hours elapsed from the time of the initial event of chest pain to the first positive urine specimen. No statistically significant difference could be demonstrated in the mortality in patients with infarction with and without myoglobinuria.

The present authors were unable to confirm the high incidence of myoglobinuria in acute myocardial infarction, described previously in other works. The possibility of renal tubular reabsorption of myoglobin as an explanation of this descrepancy is mentioned. Our preliminary results with the estimate of myoglobin in serum with a radioimmunoassay seem to valuable as an index of infarct size.
Development of Ketonemia in Fasting Patients with Hyperthyroidism
Authors: Bartels Paul D. , Kristensen Lars Østergaard , Heding Lise G. , Sestoft Leif
Published: August 2010

ABSTRACT Concentrations of ketone bodies, free fatty acids, glycerol, lactate, glucose, insulin, glucagon and cortisol were determined 6‐hourly during 36 hours of fasting in 4 hyperthyroid patients and in 4 euthyroid controls. The concentrations of ketone bodies were elevated in hyperthyroid patients from the beginning and increased during fasting more rapidly and to higher values as compared to the controls. After 6 hours of fasting the blood ketone concentrations were 1.1‐1.8 mM in hyperthyroid patients and 0.3‐0.6 mM in the controls. After 36 hours the concentrations had increased to about 3.5 mM and 1.4 mM in hyperthyroid and control subjects, respectively. The concentrations of free fatty acids were identical in the groups compared postprandially, but increased significantly more in the hyperthyroid patients than in the controls during fasting. The glycerol concentration was higher in the hyperthyroid group throughout the observation period.

The concentrations of insulin were slightly higher in the hyperthyroid group than in the control, whereas the concentrations of the “ketogenic” hormones, glucagon and cortisol were identical in the compared groups.

It is concluded that hyperthyroidism leads to an increased tendency to ketosis, that is partly explained by increased concentrations of free fatty acids and that might also involve a direct action of long term thyroid hormone excess on enzyme activities (e.g. carnitine acyltransferase in liver).
The Effect of Repeated intramuscular Gonadotrophin‐Releasing Hormone Injections on Luteinizing Hormone, Follicle‐Stimulating Hormone, Testosterone, Oestrogens, Dehydroepiandrosterone and Dehydro‐epiandrosterone Sulfate in Normal Men
Authors: Jørgensen Fritz Schønau , Bennett Paul , Hansen Jens Mølholm , Johnsen Svend G. , Kampmann Jens P. , Nielsen Kirsten Storm
Published: August 2010

ABSTRACT The endocrine response to three daily intramuscular injections of 500 μg LH‐RH was measured in 9 normal men during a period of 3 days. A marked but declining response in LH was seen in addition to a significant increase in the serum concentration of FSH, testosterone, oestradiol and the urinary excretion of oestrogenic substances. No change could be demonstrated in the DHA, DHAS or cortisol secretion which confirms our previous results of a direct effect of clomiphene on adrenal steroidogenesis.
Cardiac Rupture in Acute Myocardial Infarction
Authors: Rasmussen Sten , Leth Arne , Kjøller Erik , Pedersen Asger
Published: August 2010

ABSTRACT. The occurrence of rupture of the external cardiac wall (CR) in a consecutive series of 2 244 admissions with confirmed acute myocardial infarction (AMI) has been analysed. The series comprises the unselected admissions to a single department, evaluated according to uniform criteria, with postmortem examination in 95% of fatal cases. The incidence of CR was 3.2% af all cases of AMI, and 12.6% of all deaths. CR was significantly more frequent in women than in men, and in both sexes significantly more frequent after the age of 60, though the age distribution did not differ significantly from that of the patients dying from other causes. Moreover, CR was significantly more frequent in anterior wall infarctions, and in patients with no previous AMI. The majority of CR (84%) occurred within the first week, and a considerable part (32%) within the first 24 hours after the onset of infarction. According to findings at autopsy, CR was accompanied particularly often (in 71%) by complete occlusion of a major coronary artery. Autopsy findings gave no evidence that attempts at resuscitation, including external cardiac massage (65 patients), as well as intracardial injections (55 patients) and transthoracic introduction of a pace catheter (3 patients), could have any connection with the development of CR. The usual strict immobilization of the patients was applied during the first part of the series, but in the latter half (1 337 admissions) the patients were allowed to be out of bed from the first day with no imposed immobilization at all. The incidence of CR did not change significantly throughout the period, and the indication for maintaining the traditional immobilization of patients with AMI is questioned.
Treatment of Refractory Anemias with Methenolone
Authors: Lockner Dieter
Published: August 2010

ABSTRACT. A therapeutic trial with methenolone (Primobolan®) in 19 consecutive patients with different types of refractory anemia is reported. The remission frequencies were: pancytopenia 3/6, bicytopenia 2/4, refractory anemia with hyperplastic marrow 1/5, myelofibrosis 1/4. There was no obvious prolongation of survival in the patients responding. Side‐effects were negligible.
Analgesic Treatment with Levomepromazine in Acute Myocardial Infarction
Authors: Davidsen Otto , Lindeneg Ole , Walsh Mark
Published: August 2010

ABSTRACT. The efficacy of a non‐narcotic analgesic is evaluated in a double‐blind randomized series of patients with acute myocardial infarction (AMI). Levomepromazine or pethidine were given in 328 consecutive cases to 316 patients within 24 hours after the onset of symptoms. Levomepromazine, 12.5 mg, appeared as effective as pethidine, 50 mg, in the alleviation of pain, though the initial dose had to be higher. Nausea and vomiting were half as frequent in the levomepromazine group as in the pethidine group (p<0.001). The incidences of arrhythmias, lung oedema, hypotension and thromboembolic complications did not differ between the groups. The mortality rate in the first 4 weeks was 22% in the levomepromazine group and 37% in the pethidine group (p<0.005), and after one year 39 and 50% (p<0.05), respectively. It is concluded that levomepromazine is better tolerated than pethidine in AMI. This suggests that the present management of pain in AMI should be reconsidered.
Impact of a Mobile Coronary Care Unit on the Sudden Coronary Mortality in a Community
Authors: Siltanen Pentti , Sundberg Stig , Hytönen Inari
Published: August 2010

ABSTRACT. A 6‐month feasibility study on a mobile coronary care unit (MCCU) was implemented in an urban community provided with a WHO Acute Ischemic Heart Disease Register. MCCU was able to reach in time less than 5% of all cases of unexpected cardiac arrest in the community. For cases of myocardial infarction and cardiac arrest transported by MCCU, a pair‐matched control series was obtained from a period of 2–8 months before the beginning of the MCCU activity. No difference was found in the first 28 days' mortality rate between MCCU and control groups. The operation of MCCU did not induce any reduction of the patient delay time in the community.