bluuebunny/crossref_metadata_2025 huggingface dataset:
ITCHING IN PREGNANCY
Authors: Furhoff Anna‐Karin
Published: August 2010

Abstract. All pregnancies in 89 women wo had had itching during pregnancy have been characterized on the basis of a personal interview and available hospital records. Most of the non‐cholecystectomized women underwent an oral cholecystography. The majority of the women were between 35 and 55 years old. The study was performed approximately 15 years after their last complicated pregnancy. Itching had recurred during subsequent pregnancies in 34 of the 71 women with more than one full‐term pregnancy. Delivery tended to occur earlier in pregnancies with itching (median 40th week) than in uncomplicated ones (median 41st week). Children born at deliveries with itching were somewhat lighter than those born after uncomplicated pregnancies (median 3 365 and 3 500 g). Meconium staining of the amniotic fluid was observed in 27% of deliveries with itching and in 9% of those without. Four children born to women with recurrent itching died from asphyxia at or shortly after birth. Two of the pregnancies had been complicated by itching. Evidence of earlier (cholecystectomy) or present (abnormal cholecystography) cholelithiasis was found in 35 women. The minimal prevalence was higher in women with recurrent itching (59%) than in the remainder (27%). The combined evidence from this and a previous study indicates that the minimal prevalence of cholelithiasis in women 35–60 years old with a history of recurrent cholestasis of pregnancy is 58%. The figure is significantly higher (p<0.001) than that encountered in women of comparable age in two Swedish autopsy series.
REMOVAL OF EXOGENOUS PLASMA TRIGLYCERIDES IN SPLANCHNIC VISCERA IN MAN DURING ANESTHESIA
Authors: Freyschuss Ulla , Hallberg Dag , Johnsson Lennart , Rössner Stephan
Published: August 2010

Abstract.The role of the splanchnic viscera and the liver in removal of an artificial fat emulsion lntralipid® has been studied in anesthetized man. Ten males and six females were studied. During operation for cholecystectomy catheters were placed into an artery, the portal and the hepatic veins. During a constant i.v. infusion of lntralipid® the concentration of the fat emulsion was determined by nephelometry in blood plasma sampled at intervals from these three vessels. Splanchnic plasma flow was estimated simultaneously. During the infusion a constant concentration of lntralipid® was found in the blood. The splanchnic flow was not affected by the infusion of the fat emulsion. The difference in mean arterio‐portal concentration of lntralipid® was 69±15 μmol/1 at 20 and 31 min, corresponding to a removal of 5.3±1.2% of the arterial concentration (p< 0.001). The amount of infused lntralipid® removed per minute was 35±8 μmol. corresponding to 25±6% of the infused quantity (p<0.001). No significant changes of mean concentration were observed between the portal and the hepatic veins.
THE EFFECT OF A LONG‐ACTING GLUCAGON PREPARATION ON ENDOCRINE AND METABOLIC RESPONSES IN ACUTE MYOCARDIAL INFARCTION
Authors: Arstila Matti , Iisalo Esko , Kallio Veikko , Nousiainen Risto , Viljanen Matti
Published: August 2010

Abstract.In acute myocardial infarction (AMI) the availability and the insulin‐dependent transportation of glucose can possibly influence the extent of myocardial damage and the incidence of arrhythmias. Glucose metabolism is affected by several endocrine changes in connection with an AMI. Some of these changes have been studied in 43 patients with an uncomplicated AMI. A slight hyperglycemia was seen, with an increased catecholamine excretion and growth hormone secretion but with no reduction in the basal insulin secretion. The treatment of 27 of the patients with a zinc‐protamineglucagon (ZPG) suspension, s.c. 8 mg t.i.d., changed the natural response to an AMI only through a slight increase in the plasma growth hormone and insulin levels. The clinical course was not affected by ZPG, which was tolerated without side‐effects. It is concluded that treatment with ZPG is not indicated inuncomplicatedcases of AMI.
ACID‐BASE PATTERN OF CEREBROSPINAL FLUID AND ARTERIAL BLOOD IN BACTERIAL MENINGITIS AND IN ENCEPHALITIS
Authors: Hansen E. Lyders , Kristensen H. Sund , Brodersen P. , Paulson O. B. , Möllertz S. , Jessen O.
Published: August 2010

Abstract. The acid‐base status of cerebrospinal fluid (CSF) and arterial blood has been investigated in sequential samples from 25 patients with bacterial meningitis and 8 with acute encephalitis. Patients with bacterial meningitis hyperventilated spontaneously throughout the first week to median values for arterial carbon dixoide tension of about 30 mmHg. The pH in CSF was less than 7.30 in 17 cases, within the normal range in 5 and above 7.34 in 7. On admission the following CSF median values were observed: clactate=9 mmol/1, chydrogen carbonate=14 mmol/1 and pH=7.23. The concentration of lactate and pH in CSF approached normal values within a week. Patients with acute encephalitis also hyperventilated, but pH values in CSF were close to normal. Only severe cases of encephalitis had elevated lactate concentrations in the CSF. Even in the presence of spontaneous hypocapnia artificial hyperventilation may be beneficial in cases where arterial carbon dioxide tension rises without a simultaneous clinical improvement.
EPSTEIN‐BARR VIRUS (EBV) INFECTIONS IN ARMY RECRUITS
Authors: Nikoskeiainen Jukka , Salmi Heikki A. , Laine Matti J. , Vuori Martti J. , Halonen Pekka E.
Published: August 2010

Abstract. Serum specimens collected from 477 recruits entering military service have been studied for fluorescent IgG antibodies to Epstein‐Barr virus (EBV). Only 40 men (8.5%) were negative and 91.5% had antibodies to EBV. During the 8–11 months' military service repeated serum specimens were taken from 35 antibodynegative men and at every infection of the upper respiratory tract. During this follow‐up period 4 negative men (11.4%) had seroconversion. One of them had a typical heterophil antibody‐positive infectious mononucleosis, two had had tonsillitis 3 and 4 weeks before the specimens with seroconversion were taken; none of these three men had heterophil antibodies. The fourth man reported no illness. Serum specimens from all four recruits with seroconversion were studied also for fluorescent IgM, gel‐precipitating and complement‐fixing antibodies to EBV. These tests confirmed the diagnosis of EBV infection.
A CIRCULATING ANTICOAGULANT AGAINST FACTOR V
Authors: Nilsson Inga Marie , Hedner Ulla , Ekberg Mats , Denneberg Torsten
Published: August 2010

Abstract.A 65‐year‐old man who developed a potent circulating anticoagulant directed against factor V is described. After prostatectomy he went into a septic shock and received treatment with cephalothin. After 12 days' treatment he developed severe bleedings and signs of drug allergy. Coagulation studies showed a factor V level of 0% and a circulating anticoagulant against factor V in high titre. The anticoagulant belonged to the IgG class. After treatment with cyclophosphamide in large doses and withdrawal of cephalothin the bleedings stopped and the anticoagulant successively decreased, and after 5 weeks he had a normal factor V level. In this case the anticoagulant probably developed as a consequence of the cephalothin therapy.
THE PERIPHERAL NERVE FUNCTION IN CHRONIC RENAL FAILURE
Authors: Nielsen V. Kamp
Published: August 2010

Abstract. Serial determinations of the sensory and motor nerve conduction, and of the vibratory perception threshold (VPT), and serial clinical neurological examinations have been performed in 16 patients during progressive renal failure and/or regular hemodialysis. During progressive renal failure a gradual and almost equal slowing of the nerve conduction was observed in lower as well as in upper extremities, although clinical neuropathy was prevalent in the lower extremities. In contrast to the gradual slowing of the nerve conduction, clinical findings usually developed abruptly, the first indication being a sudden rise in VPT. During regular hemodialysis there was no further slowing of the nerve conduction, nor was there any significant improvement. Despite this fact a marked decrease in VPT occurred within the first months, followed by a somewhat slower remission of other clinical findings. The present study thus confirms and adds further evidence to an existing dissociation between clinical findings and nerve conduction data, demonstrated in a previous study based on single observations in a larger material of patients with varying degree of renal failure. With the aim of preventing clinical neuropathy, VPT is advocated as the most valuable and simple method among the neurological variables studied for the selection of the optimal time for institution of regular hemodialytic treatment.
DOSAGE, PLASMA CONCENTRATION AND ANTIARRHYTHMIC EFFECT OF PROCAINAMIDE IN SUSTAINED‐RELEASE TABLETS
Authors: Arstila M. , Katila M. , Sundquist H. , Anttila M. , Pere E. , Tikkanen R.
Published: August 2010

Abstract.A new sustained‐release tablet of procainamide has been found to have a mean biological half‐life of 6.7 hours as compared with 3.2 hours in ordinary tablet form. The dosage of 1.2 g t.i.d. yielded averaged plasma concentrations of 3.2–5.4 mg/1 after 24 hours. Ventricular premature beats were abolished for about 5 hours in most of the 47 patients studied. These findings suggest 1.0 g q.i.d. to be the optimum for an average patient. Because of great individual differences the determination of procainamide plasma levels in clinical use is recommended.
A CLINICAL SYNDROME WITH INBORN DEFECT IN ERYTHROPOIESIS, DYSPLASTIC KIDNEYS, EYE LESIONS, MALFORMATION OF THE TEETH AND IMPAIRED HEARING
Authors: Jacobsen Carl Ditlef , Brodwall Erling Kruge
Published: August 2010

Abstract. A 28‐year‐old woman is described, having defective erythropoiesis, kidney dysplasia, minor skeletal defects, progressive loss of vision, abnormal development of the teeth and slight impairment of hearing. Her disease is most probably inherited. It started in the first years of life with thirst and weakness. From the age of 20 she had to be given blood transfusions. Kidney function has deteriorated very slowly. For many years the only feature of impaired renal function was a low specific gravity of the urine. Serum creatinine is now 2.6 mg/100 ml. Loss of vision of the left eye was noticed very early and this eye was removed when she was 12 years old because of secondary glaucoma. The other eye was later affected, and she is now blind. Very recently a slight neurogenic loss of hearing has occurred on the left side. Dental development was abnormal. The skeletal defects of genu valgum and pes excavatus were moderate. The mental, endocrine and sexual development have been normal. Her father and mother are healthy, but they have a reduced PAH and inulin clearance, indicating a slight impairment of renal function. Renal biopsy from the patient revealed kidney dysplasia with smooth muscle in the parenchyma and a lack of Henle's loop. The cause of this syndrome and the mechanism by which all these different organ disorders can be linked together is completely unknown. To our knowledge this syndrome has not been reported previously.
PROGNOSIS AFTER FIRST MYOCARDIAL INFARCTION
Authors: Thygesen K. , Dalsgaard P. , Nielsen B. Lyager
Published: August 2010

Abstract. The study includes 404 patients with their first myocardial infarction, admitted to a Coronary Care Unit within 24 hours of the onset of symptoms. Sixty‐two patients (15%) died during the first month following admission. A follow‐up examination was carried out of the remaining patients after a minimum observation time of 12 months and a maximum of 38 months. It was possible to demonstrate, using the life‐table method, that patients with their first myocardial infarction have a significantly poorer survival rate than the normal population. In patients still living one month after the acute attack of first myocardial infarction it was shown: 1) that there is a poorer survival rate with increasing age, 2) that women have a poorer survival rate than men, partly because the average age of the women is higher and partly because the old women (≥ 70 years) have a considerably higher mortality rate than the old men, 3) that the site of the infarction, the magnitude and duration of the ST elevation in standard ECG leads in the acute phase are of no prognostic importance for long‐term survival.
CELLULARITY AND CELL PROLIFERATION RATES IN HUMAN BONE MARROW
Authors: Skårberg Karl Olof , Cea Ricardo , Reizenstein Peter
Published: August 2010

Abstract. Overproduction of red cells in primary and secondary polycythaemia could be due to each erythroblast (eb) dividing more often than normally or to the number of eb being increased but their dividing at a normal or perhaps even at a slower rate than normally. The generation times of the eb have been calculated from their total number and from the daily erythrocyte production. Simultaneously the in vitro uptake of H3TDR has been studied. Polycythaemia vera (PCV) patients had a significant increase in the number of eb (7.7 × 109/kg b.wt.) in comparison with controls (3.4 × 109/kg) and secondary polyglobulias (4.6 × 109/kg). The generation times of the eb in PCV were significantly longer than in controls and patients with secondary polyglobulia (PS). The high erythrocyte production in PCV thus seems to result from an increased eb population dividing no more often than normally. This could be caused in part by a stem cell abnormality, which possibly also explains the significant increase of granulocyte precursor cells and megakaryocytes. Labelling indices in immature PCV—and mature PS—erythroblasts differ significantly from normal indices, indicating a disturbance of their generation cycle. However, no simple linear relationship could be demonstrated between the calculated generation times and the in vitro labelling indices.
PACEMAKER‐VENTRICULAR BLOCKS
Authors: Forssell G. , Nordlander R. , Nyquist O. , Orinius E.
Published: August 2010

Abstract. Three patients are presented with pacemaker‐ventricular (P‐V) or ventricular‐pacemaker (V‐P) block. All patients had ischemic heart disease and severe heart failure and were treated with transvenous endocardial pacing because of high degree AV block and periods of asystole. One patient had a 1st degree P‐V block for several days before the endocardial electrode was replaced and the P‐V block disappeared. Another patient was in the terminal phase of an acute myocardial infarction when she developed a 1st degree V‐P block. The retrograde latency in the conventional leads corresponded to the time difference between a bipolar intra‐ventricular and a bipolar precordial lead. The third patient was in the terminal phase of myocardial failure when he developed 1st degree P‐V block followed by 2nd degree P‐V block type I and type II and finally high degree P‐V block. The mechanism of P‐V blocks is discussed.
EFFECTS OF DOPAMINE ON HEMODYNAMICS AND RENAL FUNCTION
Authors: Abrahamsen A. M. , Storstein L. , Westlie L. , Storstein O.
Published: August 2010

Abstract.In 10 patients hemodynamics and renal function have been examined before and during i.v. infusion of dopamine. Oxygen consumption was unchanged, but cardiac output increased significantly on account of a significant reduction of arteriovenous oxygen difference during infusion. On an average cardiac output rose by a significant increase in heart rate and a slight rise in stroke volume. The pressures in the pulmonary artery, wedge position and end‐diastolic pressure in the left ventricle were essentially unchanged, but the systolic pressure in the left ventricle increased significantly. Systemic arteriolar resistance fell significantly, pulmonary arteriolar resistance revealed a trend to reduction. A very significant increase in dp/dt was found. Renal extraction of PAH fell slightly, PAH clearance increased significantly, while the clearance of inulin showed only a minimal rise. Renal plasma and blood flow, and the excretion of sodium in the urine, all increased significantly. There was a slight rise in urine flow and reabsorption of sodium. The results indicate that dopamine may have a favourable effect in shock, also in patients with oliguria.
PENICILLAMINE TREATMENT OF CYSTINURIA
Authors: Ekberg M. , Jeppsson J.‐O. , Denneberg T.
Published: August 2010

Abstract. Seven patients with cystinuria have been treated with D‐penicillamine for 4–52 months. Excretion of free cystine in urine has been quantified regularly by ion‐exchange chromatography. A specially short programme on an automatic amino acid analyser has been developed for this purpose. The chelating properties of D‐penicillamine are responsible for loss of trace metals, and therefore zinc and copper in urine and zinc and ceruloplasmin in plasma were measured. Thus the dose of D‐penicillamine can be reduced and trace metals can be substituted if there is any tendency to depletion. These corrections will presumably eliminate some of the drawbacks in D‐penicillamine treatment of cystinuria.
CORTISOL AND CORTISONE ACETATE IN PARENTERAL GLUCOCORTICOID THERAPY?
Authors: Kehlet H. , Madsen S. Nistrup , Binder C.
Published: August 2010

Abstract. Intramuscular cortisol and cortisone acetate have been administered to six patients with adrenocortical insufficiency. Plasma cortisol determinations during the following four hours showed a pronounced increase after injection of cortisol, but virtually no increase in five and only a moderate increase in one patient after injection of cortisone acetate. It is therefore recommended not to use cortisone acetate in parenteral glucocorticoid therapy.
INSULIN DEFICIENCY ASSOCIATED WITH HYPOGLYCEMIA AND GOOD GLUCOSE TOLERANCE IN HYPOPITUITARISM
Authors: A Nikkilä Esko , Pelkonen Risto , Taskinen Marja‐Riitta , Aro Antti
Published: August 2010

Abstract. A female patient with active acromegaly and latent insulin‐deficient diabetes suffered pituitary apoplexy after which the markedly elevated plasma growth hormone decreased to non‐detectable levels and did not respond to hypo‐glycemia. Simultaneously the clinical signs of acromegaly progressively subsided and the adrenocortical function became subnormal. However, in spite of an almost total absence of insulin secretion the fasting blood glucose decreased to slightly hypoglycemic range and the previously diabetic glucose tolerance was improved in spite of blunted insulin response. Adequate cortisone substitution did not influence either glucose tolerance or insulin secretion. These findings suggest that in the absence of growth hormone glucose assimilation may be rapid in spite of nearly complete lack of insulin.
CLINICAL FINDINGS IN PATIENTS WITH HYPERCALCAEMIA A Final Investigation Based on Biochemical Screening
Authors: Stenström Gunnar , Heedman Per‐Axel
Published: August 2010

Abstract. Ninety patients with hypercalcaemia (serum calcium 5.6 mEq/l or more) found in the course of 9 months in 1970‐71, when a multiphasic procedure was applied for the first time, have been reexamined 2 1/2 years later. According to clinical data the patients were divided into six groups: 1) verified primary hyperparathyroidism, 2) probable primary hyperparathyroidism, 3) possible primary hyperparathyroidism, 4) hypercalcaemia of other known cause, 5) hypercalcaemia of unknown cause, and 6) no disturbance of calcium metabolism. The frequency of hyperparathyroidism seems to be higher than in other studies probably because biochemical profiling was applied for the first time to the population in this area. Hyperparathyroidism was the most common cause of hypercalcaemia (28/100 000 in‐hab./y.), closely followed by thiazides (21/100 000 in‐hab./y.) and malignant diseases (16/100000 inhab./y.). Of patients treated with thiazides 0.44% have been found to have hypercalcaemia. When screening procedure is used regularly over a longer period, it seems likely that the most common cause of hypercalcaemia will be found to be thiazides. However, from a clinical point of view the diagnosis of hyperparathyroidism remains the main problem.
THE EFFECT OF EXTRACORPOREAL IRRADIATION OF THE BLOOD IN NECROKIDNEY TRANSPLANTATION
Authors: Weeke Eva , Thaysen Jørn Hess
Published: August 2010

Abstract. Sixty‐nine patients received extracorporeal irradiation of the blood (ECIB) as pretreatment and as regular follow‐up treatment in connection with necro‐kidney transplantation. Seventy‐four patients did not receive ECIB. Both groups were treated with azathio‐prine and prednisone according to conventional standards. The results were evaluated by the cumulative fraction of patients without rejection, the cumulative graft survival and the graft function. An intergroup analysis showed that the ECIB‐treated patients had significantly fewer rejection episodes (p<0.001), whereas a 10% improvement in graft survival was insignificant (p>0.10) and graft function identical. An intragroup analysis showed a 25% improvement in graft survival after 1 year in 26 patients who had received a sufficient treatment with ECIB as compared to 27 insufficiently treated patients and to the untreated group. Also this result was, however, not significant in the small groups under study. Despite a well documented quantitative and qualitative effect on human lymphocytes, ECIB, as it can be administered in practice on a large scale, is of little, if any, value in necrokidney transplantation. On the other hand the results do not permit the conclusion that ECIB is entirely ineffective in humans, and certain possibilities for improvement of the method are discussed.
ACUTE INTOXICATION
Authors: Larsson Sten Olle , Sundkvist Göran
Published: August 2010

Abstract. Investigation of cases of acute intoxication, admitted to the Department of Internal Medicine, Helsingborg Central Hospital, in 1951, 1961 and 1971 revealed that the number of cases had increased from 42 in 1951 to 230 in 1971, and that the frequency of cases per total number of inpatients at the Department had increased from 2.2% to 7.6% during the same time. Intoxication with more than one agent had become more common, as had the combination medical drug+alcohol. The duration of hospital care was roughly the same in 1951 and 1961 but shorter in 1971. The number of single intoxications was high, but a small group of patients had a very high frequency of recurrences.
CHANGES IN CERTAIN IRON METABOLISM VARIABLES AFTER A SINGLE BLOOD DONATION
Authors: Liedén Gudrun , Höglund Sverker , Ehn Lars
Published: August 2010

Abstract Signs of iron deficiency have been studied after the first blood donation in 11 healthy men. Six were given 100 mg iron daily, and five received placebo tablets. The total iron‐binding capacity and iron absorption remained raised for more than 26 days, but had almost returned to the initial values after 70 days. A significant decrease in the stainable bone marrow iron could be shown in all subjects after 26 days; later some restitution was seen in subjects given iron supplements, but not in those given placebo. As the restitution times are long, the interval after blood donation must be taken into account when judging iron metabolism variables in active donors.
IRON SUPPLEMENT TO BLOOD DONORS
Authors: Liedén Gudrun
Published: August 2010

Abstract A series of 58 male blood donors has been studied with regard to stainable bone marrow iron, des‐ferrioxamine test, sideroblasts, total iron‐binding capacity, serum iron, and haemoglobin values. With one conventional blood donation every second month the storage iron was found to be significantly decreased after four blood donations both when placebo and oral ferrous iron in doses of up to 2000 mg were given over a period of two weeks after each blood‐letting. The iron state in donors given 2000 mg was superior to that in donors given 1000 mg, and better in the latter group than when placebo was given. A moderate increase in the total iron‐binding capacity could be discerned in subjects treated with placebo or only 1000 mg iron after each donation, but no changes in serum iron or haemoglobin were noted. A smaller series of 13 donors was also investigated after six donations and was found to show essentially the same pattern in the iron state variables as after four donations. When the interval between donations was four months and 2000 mg ferrous iron was given over two weeks after each donation, all variables including the amount of bone marrow iron and the desferrioxamine test remained unchanged in ten subjects after four donations. Two subjects showed a moderate decrease in the stainable bone marrow iron, but it did not disappear completely.
STUDIES OF URINARY BLADDER DYSFUNCTION IN AMYLOIDOSIS WITH POLYNEUROPATHY
Authors: Andersson Rune , Bjerle Per
Published: August 2010

Abstract Eight male patients with amyloid polyneuropathy, seven of whom had symptoms of dysfunction of the urinary bladder, were studied by cystometry and micturition analysis and compared with eight male controls. Most of the patients with amyloidosis had an increased bladder capacity. The need to micturate was reduced, and urine retention was common. In most of them detrusor function could not be demonstrated. The maximal flow rate was usually diminished and the resistance to flow elevated. In some of the patients there was increased rigidity of the bladder wall.
LUPUS‐LIKE SYNDROME ASSOCIATED WITH PULMONARY REACTION TO NITROFURANTOIN: Report of Three Cases
Authors: Selroos Olof , Edgren Johan
Published: August 2010

Abstract A systemic lupus erythematosus‐like syndrome developed simultaneously with pulmonary reactions of the chronic type in three female patients after treatment with nitrofurantoin for 12, 27 and 38 months, respectively. The syndrome was characterized by elevated ESR, polyclonal hypergammaglobulinemia, the presence of IgG anti‐nuclear antibodies and a positive latex‐fixation test. Two patients had severe arthralgia and one of them peripheral lymphadenopathy. Pleural effusion and a chronic active hepatitis were present in the third patient, in whom interstitial cystitis also developed. All signs and symptoms of the lupus‐like syndrome disappeared, without corticosteroid or other medication, when nitrofurantoin was omitted. The diminution of pulmonary infiltrates and the reversal of interstitial cystitis also appeared to be directly related to cessation of nitrofurantoin therapy. Our findings indicate that long‐term medication with nitrofurantoin may cause, in addition to pulmonary changes, a simultaneous lupus‐like syndrome. Our data also raise the possibility that interstitial cystitis may occur as an adverse reaction to nitrofurantoin therapy.
COMPLEMENT SYSTEM STUDIES IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)
Authors: Teisberg P.
Published: August 2010

Abstract Complement system involvement has been studied in 16 patients with systemic lupus erythematosus (SLE). Circulating conversion products of C3 were observed in 4 cases. Low mean values of C4 and C3 were found, while C3 proactivator (properdin factor B) levels were low in only a few of the patients. The levels of C4, C3 and C3 proactivator were not lower in the 4 patients in whom C3 conversion products could be demonstrated than in the others. It is concluded that the low complement values found in SLE may be caused mainly by deficient synthesis. Signs of complement activation are in this patient material demonstrated early in the disease, and chiefly in patients not receiving immunosuppressive therapy.
DIAZEPAM IN CARDIOVERSION
Authors: Forssell G. , Nordlander R. , Nyquist O. , Orinius E.
Published: August 2010

Abstract Diazepam has been used to an increasing extent in cardioversion, since avoiding general anaesthesia simplifies the procedure. The present study concerns the effect of diazepam on BP and blood gases in 13 cases of cardioversion. A moderate fall of both systolic and diastolic BP occurred. The arterial pO2 and pCO2 did not change significantly.
RENAL EXCRETION OF VANCOMYCIN IN KIDNEY DISEASE
Authors: Nielsen H. E. , Hansen H. E. , Korsager B. , Skov P. E.
Published: August 2010

Abstract The renal elimination of vancomycin has been determined in 18 patients. In 4 anuric patients in intermittent haemodialysis the dosage of vancomycin necessary to treat infections with penicillin‐resistant strains of Staphylococcus aureus was determined. In 14 patients with varying degrees of renal insufficiency vancomycin, creatinine and 125iothalamate clearances were measured and found to be closely correlated. After administration of the initial vancomycin dose and attainment of the serum concentration desired, the maintenance dose can be calculated on the basis of the GFR.
MONOCLONAL IMMUNOGLOBULINAEMIA ASSOCIATED WITH GLOMERULOPATHY
Authors: Jensen Herluf , Wiik Allan
Published: August 2010

Abstract Four patients with benign monoclonal immunoglobulinaemia and associated glomerulopathy are described. Immunohistochemical investigations of the immunoglobulin‐containing cells in the bone marrow revealed an unexpectedly pronounced predominance of monoclonal over polyclonal cells as typically seen in macroglobulinaemia and multiple myeloma, but in contrast to the malignant plasma cell proliferations the percentage of immunoglobulin‐containing cells only constitued 6–12% of the nucleated cells. The possible pathogenetic mechanisms relating monoclonal immunoglobulinaemia and glomerulopathy are unknown. The sera did not contain antibodies to glomerular basement membrane, cryoglobulins, antinuclear factors or antiglobulins. The immunohistochemical technique certainly offers a clear advantage over conventional bone marrow cytology in the study of patients with monoclonal immunoglobulinaemia.
THERAPEUTIC EFFECT OF LEO 1031, AN ALKYLATING CORTICOSTEROID ESTER, IN LYMPHOPROLIFERATIVE DISORDERS
Authors: Brandt L. , Könyves I. , Möller T. R.
Published: August 2010

Abstract Leo 1031, a chlorambucil ester of pred nisolone, has been administered orally to 15 patients with chronic lymphocytic leukaemia (CLL) continuously for 1–29 months (mean 12.5). Seven patients were previously untreated and eight had been treated with prednisolone, radiotherapy and/or alkylating agents. The initial daily dose was generally 8–16 mg and the maintenance dose was 6–8 mg. Allopurinol was given concurrently. In 14 of 15 patients a reduction of the leucocyte count was observed and a reduction, in most instances, of lymphadenopathy or splenomegaly, or both. In seven patients the Hb concentration was improved. Significant toxic effects on bone marrow function have been observed in one patient. Two patients developed urticaria. Our study suggests that the drug is effective in the treatment of CLL.
TURNOVER OF PLASMA CHOLESTEROL IN PATIENTS WITH CHOLESTEROL GALLSTONES
Authors: Pedersen L. , Arnfred T. , Thaysen E. Hess
Published: August 2010

Abstract Following the i.v. injection of about 30 μCi of 1‐α‐2‐α‐3H‐cholesterol, the specific activity decay of plasma cholesterol has been analysed in terms of a 2‐pool model in eight patients with radiolucent gallstones and two healthy controls. In each subject some kinetic parameters were calculated, including the input into and the size of the rapidly exchangeable cholesterol pool. The results were compared with those in 16 controls from another study. Statistical analysis failed to demonstrate significant differences in any of the parameters between the gallstone patients and the combined controls, indicating that patients with cholesterol gallstones have normal input into and size of the rapidly exchangeable cholesterol mass. This conclusion is discussed in relation to similar studies, and it is speculated that gallstone patients may have decreased absorption of exogenous cholesterol.
ANOREXIA NERVOSA AND THE FREQUENCY OF SEX CHROMATIN‐POSITIVE CELLS
Authors: Wålinder Jan
Published: August 2010

Abstract Five consecutive cases of anorexia nervosa in women have been investigated for variations in the frequency of sex chromatin‐positive cells. The results showed a statistically significant relation between body weight and the frequency of sex chromatin‐positive cells, the amount of sex chromatin increasing with rising body weight. These findings are difficult to explain but the results might conceivably be used, at least in some cases, as an index of changing basal biological functions in anorexia nervosa.
ADULT TYPE OF POLYCYSTIC KIDNEY DISEASE IN A NEW‐BORN CHILD
Authors: Bengtsson Ulla , Hedman Lars , Svalander Christian
Published: August 2010

Abstract A case of polycystic kidney disease in a newborn child is reported. Renal cortical necrosis due to asphyxia was the cause of death. The histopathological picture and a heavy family history support the rare diagnosis of polycystic kidney disease of adult type in a new‐born child.
DIPPING PROCEDURE FOR BLOOD GLUCOSE DETERMINATION WITH DEXTROSTIX AND THE EYETONE REFLECTANCE METER
Authors: Kühl C.
Published: August 2010

Abstract A dipping procedure for blood glucose determination with the Dextrostix‐Eyetone system has been evaluated. The procedure involves the immersion of the Dextrostix reagent area for 1 min in a tube of whole blood followed by wash, blotting and reading as in the regular procedure. Sixty‐five blood samples, covering a wide glucose concentration range, were estimated for their glucose content in random order both by the dipping procedure and a conventional Dextrostix‐Eyetone procedure. An almost perfect agreement between the two methods was found, the coefficient of correlation being 0.99 and the regression line very close to the ideal line. The presence of a Dextrostix reagent area in the blood was found to bring about glycolysis. Except at high blood glucose levels, this glycolysis, however, was insignificant if the strip was correctly removed after 1 min. The dipping procedure overcomes the main technical problem of conventional procedures: the inconsistency of the drop application on the reagent area. As it is easy to perform and a reliable alternative to conventional procedures, it is recommendable in all cases where blood samples are available.
Studies in Asymptomatic Primary Hyperlipidaemia
Authors: Olsson Anders G. , Ekelund Lars‐Göran , Carlson Lars A.
Published: August 2010

Abstract. Among approximately 20000 apparently healthy subjects whose serum cholesterol and triglyceride (TG) values were screened at a health examination, those with the most pronounced hyperlipidaemia have been selected for further studies. Thus 188 males and 126 females, aged 30–65 years, with asymptomatic primary hyperlipoproteinaemia (HLP) and 59 male and 69 female controls with non‐elevated serum lipids were studied with regard to frequency of ST segment depressions during exercise to near maximal heart rate. Furthermore, the concentrations of cholesterol and TG were determined in the lipoprotein (LP) classes very low (VLDL), low (LDL) and high (HDL) density LP, separated by preparative ultracentrifugation. From the LP analysis each subject's HLP was classified according to the typing system of HLP recommended by the WHO. The frequency of ST depressions (Minnesota code 4.1–4.3 as well as 4.1–4.4) increased with age, was higher in females than in males and was increased in all types of HLP in males. The percentage frequencies of ST depressions 4.1–4.4 in the various types of HLP were (male/female, p against controls): controls 16/36, type IIA 50 (p<0.01)/56, type IIB 64 (p<0.01)/75 (p<0.05), type III 67 (p<0.01)/33 and type IV HLP 40 (p<0.01)/53. There was no significant difference in the frequencies of ST depressions in subjects with “high” and “low” BP (hypertensives were excluded from the study) or in subjects with “high” and “low” k‐value for the i.v. glucose tolerance. Non‐smokers had a tendency to higher frequencies of ST depressions than smokers. The association between different LPs and other “risk factors” and the occurrence of ST depressions in HLP were studied further with multiple regression analysis. Invariably age was the best predictor of ST depressions. The LP fraction giving the highest correlation coefficient was LDL cholesterol in both sexes. VLDL TG and LDL TG were also positively and significantly associated with ST depressions. HDL cholesterol was negatively but insignificantly correlated to ST depressions. When age and LDL cholesterol had been entered into the multiple regression, the only factor giving further significance was VLDL TG in males. Probability tables for the occurrence of ST depressions considering age and different levels of LDL cholesterol and VLDL TG were given. The importance of simultaneous consideration of both VLDL TG and LDL cholesterol in ST segment depression was evident from the tables. Of other “risk factors” (BP, glucose tolerance, smoking, ESR) entered into the regression together with only age or with age and the LPs, only ESR contributed with borderline significance to ST depressions.
Myxoedema Coma
Authors: Lindberger Kerstin
Published: August 2010

Abstract. Myxoedema coma is a medical emergency, which must be treated immediately. Otherwise the mortality is high. It is important to administer L‐triiodothyronine and corticosteroids early. If hypoventilation occurs, artificial respiration may be necessary. In the two cases described here the outcome was successful, probably owing to quick substitution. The causes of myxoedema and the symptomatology are discussed.
The Lipoprotein and Lipid Pattern in Xanthomatosis
Authors: Heiberg Arvid
Published: August 2010

Abstract. The relation between xanthomatosis and plasma lipid and lipoprotein concentrations has been studied in 336 subjects (172 males and 164 females) with xanthomatosis. With a few exceptions, these patients were either born or lived in Østfold county, which has a population of about 220 000. Xanthomas had made their first appearance in half the subjects by the age of 48 years. The most frequent localizations of xanthomas were the extensor finger and the Achilles tendons, the former site being more common in males and the latter in females. Tuberotendinous xanthomas were found in 7% of the cases, whereas only one subject had tuberous xanthomas without tendinous involvement. Xanthelasmas were found in 1/3 of the females and 1/6 of the males. The size of xanthomas and the number of xanthoma sites increased with age and cholesterol levels. Cholesterol concentrations were (or had been) increased in 5/6 of the subjects with xanthomathosis. Normal cholesterol was combined with increased triglyceride values in 5% of the individuals. A further 6% had normal cholesterol and triglyceride values together with raised LDL cholesterol concentrations, whereas the remaining subjects had normal lipid levels. There was no evidence of homozygosity for the gene(s) for type II hyperlipoproteinaemia. The type III hyperlipoproteinaemia pattern was not seen. Type IIA and IIB electrophoretic patterns were seen in 68 and 13% of those tested, respectively. Changes in lipoprotein patterns with treatment were frequent, especially in males, and the “original” frequency of type IIA is probably higher.
Studies on the Serum Lipid and Lipoproteins in Steatosis of the Liver
Authors: Hilden M. , Clausen J.
Published: August 2010

Abstract. In a medical department, specialized in liver diseases, 45 patients (33 men and 12 women) suffering from steatosis of the liver have been examined with reference to serum lipid abnormalities. Twenty‐eight of the patients were chronic alcoholics. Annual check‐ups, including biopsy of the liver, were made to evaluate the development of the steatosis. The patients did not receive treatment with drugs or diet. Thirteen patients showed hypercholesterolemia, 16 increased serum triglyceride and 8 increased serum phosphorus lipid. Two showed a type I lipoprotein anomaly and 33 a type II‐like pattern, defined as increased β‐lipoprotein, but normal serum cholesterol. The type II lipoprotein anomaly, defined as increased β‐lipoprotein associated with increase of serum cholesterol, was found in four cases. Three had a type III and three a type IV abnormal pattern, with increased pre‐β‐lipoprotein and serum triglyceride levels. Correlation analysis revealed correlations between pre‐β‐lipoprotein and serum triglyceride as well as between serum triglyceride and serum free fatty acid levels.
Drug‐induced Febrile Mucocutaneous Syndrome
Authors: Böttiger L. E. , Strandberg I. , Westerholm B.
Published: August 2010

Abstract. A retrospective investigation of 89 cases of the Stevens‐Johnson and/or Lyell's syndrome showed that 77 patients (87%) had been treated with drugs, 2/3 of them for symptoms of respiratory and/or urinary infections. The most frequent drugs were longterm sulfonamide preparations, penicillins, butazones and antiepileptics. Mycoplasma pneumoniae and Staphylococcus aureus were the most common infective agents of those reported. More than 40% of the patients were below 20 years of age. There were more women than men. The mortality was 1–2% for the Stevens‐Johnson syndrome and 4 of 11 patients for Lyell's syndrome. It must be pointed out that, in the individual patient, it can be difficult to determine the etiology, especially in cases with infections.
Predictable Reduction in Anticoagulant Activity of Warfarin by Small Amounts of Vitamin K
Authors: Andersen P. , Godal H. C.
Published: August 2010

Abstract.After withdrawal of warfarin (Marevan), 48–72 hours are required to raise the Thrombotest values from a therapeutic level (range 5–10%) to 12% or higher. By i.v. administration of 1 mg vitamin K1 (Konakion®) and without changing the dose of the anticoagulant, this effect could be obtained within 24 hours. Furthermore, the effect of vitamin K vanished within 2–5 days. The use of small amounts of vitamin K may therefore be a simple and reliable way of obtaining a rapid, temporary reduction in anticoagulant effect.
Thyroid Carcinoma after 131I Treatment for Hyperthyroidism
Authors: Wiener Jan D. , Thijs L. G. , Meijer Sybren
Published: August 2010

Abstract. A case of anaplastic thyroid carcinoma is described, occurring in a 71‐year‐old woman, 8 1/2 years after treatment with 8 mCi 131I for hyperthyroidism.
Treatment of Sinoatrial Syndrome with Permanent Cardiac Pacing in 90 Patients
Authors: Härtel Gottfried , Talvensaari Taisto
Published: August 2010

Abstract. Out of a pacemaker population of 392 patients, 90 (23%) have been found to have sinoatrial syndrome. Their ages ranged from 22 to 86 years, and averaged 66 for men and 70 for women. The male‐to‐female ratio was 1: 1.6. Before pacemaker implantation, syncopal attacks had occurred in 54%, dizziness without syncope in 31% and tachyarrhythmias in 57%. Atrial or paroxysmal supraventricular tachycardia had been recorded in 33%, atrial fibrillation or flutter in 28%, and ventricular tachycardia in 11%. First and/or second degree AV block was found in 36%. Coronary heart disease was present in 61% and 20% had had myocardial infarction. Cardiomyopathy and previous carditis were other associated heart diseases. Sinoatrial syndrome was the only manifestation of heart disease in 20%. Follow‐up time after pacemaker implantation ranged from 3 months to 7 years, mean 23 months. Syncopal attacks were stopped in 48 of 49 patients, dizziness was relieved in all 28 patients and tachyarrhythmias were controlled by combined drug treatment in 43 of 51 patients. Nineteen patients died during the follow‐up, most of them of cerebrovascular events or myocardial infarction. Associated coronary heart disease was especially frequent in this group. The death of one patient was caused by a run‐away pacemaker. Other pacing failures were due to electrode movement or premature battery exhaustion. There was no mortality associated with pacemaker implantations or replacements. These results strongly support the view that pacemaker treatment most effectively controls symptoms of sinoatrial syndrome when drug treatment fails.
Catecholamines in Plasma and Urine in Patients with Essential Hypertension Determined by Double‐Isotope Derivative Techniques
Authors: Pedersen E. B. , Christensen N. J.
Published: August 2010

Abstract. Employing double‐isotope derivative techniques, noradrenaline and adrenaline have been determined in plasma and in urine and dopamine in urine in 21 patients with essential hypertension as well as in 32 controls. Plasma noradrenaline rose with age in both groups of subjects. No differences were observed in plasma noradrenaline and plasma adrenaline in the resting supine position and in urinary excretion of noradrenaline and dopamine in hypertensive patients as compared to control subjects. Urinary excretion of adrenaline was somewhat lower in the hypertensives than in the controls. Treatment with alprenolol, a β‐adrenergic blocking agent, did not influence noradrenaline and adrenaline in plasma in the basal state or the urinary excretion of the three catecholamines. The combined treatment with alprenolol and hydralazine was followed by a significant rise in plasma noradrenaline. It is concluded that the adrenergic activity evaluated by circulating catecholamines is normal in most patients with essential hypertension.
Survival of Patients on Hemodialysis after Renal Graft Failure
Authors: Attman Per‐Ola , Gustafsson Åke , Ahlmén Jarl
Published: August 2010

Abstract. The influence of kidney graft failure on the survival rate after reentering maintenance hemodialysis has been studied in 63 patients. Twenty‐eight patients were observed for at least 12 months after a primary graft failure and 35 had a second transplant some time during this period. Patient survival 12 months after graft failure was 57%. This result was compared with the 1‐year survival of 82% in 150 patients dialyzed prior to the first transplantation. The majority of the deaths on dialysis after graft failure were caused by infectious complications probably related to the immunosuppressive treatment. It is suggested that survival on dialysis after graft failure may be improved by an early reduction of the immunosuppressive treatment in patients with failing grafts.
Plasma Myeloperoxidase and Lactoferrin Measured by Radioimmunoassay: Relations to Neutrophil Kinetics
Authors: Hansen Niels Ebbe , Malmquist Jörgen , Thorell Jan
Published: August 2010

Abstract. In 31 patients, covering a wide range of blood neutrophil counts and turnover rates, the plasma concentrations of myeloperoxidase and lactoferrin have been measured with radioimmunoassays and compared to neutrophil kinetic parameters, measured with DF32P‐labeled neutrophils. It was found that the plasma concentrations of both proteins correlated significantly with the total number of neutrophils in the blood (TBGP=total blood granulocyte pool) as well as with the neutrophil turnover rate (GTR=granulocyte turnover rate), which is evidence that neutrophilic granulocytes are the main suppliers of myeloperoxidase and lactoferrin to the plasma. In contrast to the previously demonstrated better relationship between the GTR and plasma lysozyme, a protein also originating in neutrophil granules, both myeloperoxidase and lactoferrin correlated better with the TBGP. These differences may reflect differences in the mode of release of intragranular proteins from neutrophils to the plasma. The correlation of the plasma lactoferrin concentration with the TBGP was so good as to suggest its use in the clinical assessment of the TBGP.
Effects of Long‐term Treatment with Procaine Amide
Authors: Henningsen Nels Chr. , Cederberg Åke , Hanson Arne , Johansson Bengt W.
Published: August 2010

Abstract.During 1970–75 a total of 42 patients have been subjected to long‐term treatment with procaine amide (PrA) because of different cardiac arrhythmias and have been observed up to over 5 years. Among these patients 35 (83%) developed a significantly increased titer of ANF and of these, 12 patients (29%) developed a “classical” drug‐induced SLE syndrome. In the SLE group all but 2 improved rapidly after cessation of PrA, and the ANF titer decreased continuously but slowly in both groups. Acetylation test with sulphamidine and/or isoniazid in 11 patients among the SLE cases showed 8 slow and 3 fast acetylators. Among 12 patients who also had received PrA for a long time, but had not shown any signs of an SLE syndrome, there were 10 fast and 2 slow acetylators.