bluuebunny/crossref_metadata_2025 huggingface dataset:
A high pretreatment plasma oestradiol level is associated with a low risk of acute myocardial infarction in parenteral oestrogen therapy for locally advanced prostate cancer
Authors: Mikkola Arto K.K. , Aro Jussi L.V. , Rannikko A.S. Sakari , Ruutu Mirja L. ,   on Behalf of the Finnprostate Group
Published: April 2008

OBJECTIVE

To evaluate the relationship of pretreatment plasma oestradiol (ppE2) and testosterone (ppT) level to acute myocardial infarction (AMI) in patients with locally advanced prostate cancer primarily treated with parenteral polyoestradiol phosphate (PEP) or orchidectomy, considering the effect of age, performance status, pretreatment diseases and medication, and tumour stage and grade.

PATIENTS AND METHODS

The present Finnprostate 6 study comprised 234 patients randomized to oestradiol or intramuscularly administered PEP (240 mg/month) therapy. Each patient was followed until the end of the primary therapy (up to 10 years) or until the first AMI (lethal or not).

RESULTS

The risk of AMI, when the PEP and orchidectomy groups were analysed together, was lower in patients with a high ppE2 level, and this risk was independent of the ppT level, pretreatment diseases, medication, age, performance status, disease stage or grade. In the PEP therapy group the risk of AMI was statistically significantly lower in patients with a high ppE2 level (≥93 pmol/L) than in those with a low ppE2 level (<93 pmol/L; risk ratio 0.28, 95% confidence interval 0.10–0.84, P = 0.022). There was no such difference in the orchidectomy group. The ppT level had no association with the risk of AMI.

CONCLUSIONS

A high ppE2 level is associated with a low risk of AMI in patients with locally advanced prostate cancer treated with PEP; there was no such association for ppT level. In the orchidectomy group the ppE2 or ppT level was not statistically significantly associated with the risk of AMI.
A phase II study of mifepristone (RU‐486) in castration‐resistant prostate cancer, with a correlative assessment of androgen‐related hormones
Authors: Taplin Mary‐Ellen , Manola Judith , Oh William K. , Kantoff Philip W. , Bubley Glenn J. , Smith Matthew , Barb Diana , Mantzoros Christos , Gelmann Edward P. , Balk Steven P.
Published: April 2008

OBJECTIVE

To evaluate mifepristone (RU‐486) in patients with castration‐resistant prostate cancer (CRPC), with a correlative assessment of serum androgens and androgen metabolites

PATIENTS AND METHODS

The androgen receptor (AR) is critical in the development and progression of prostate cancer, but available antiandrogens incompletely abrogate AR signalling. Mifepristone is a potent AR antagonist that functions by competing with androgen, preventing AR coactivator binding and by enhancing binding of AR corepressors. Patients with CRPC were treated with mifepristone 200 mg/day oral until disease progression. Testosterone, dihydrotestosterone (DHT), androstenedione, dihydroepiandrosterone sulphate and the testosterone metabolite 3α‐diol G, were measured at baseline and during therapy.

RESULTS

Nineteen patients were enrolled between April and August 2005; they were treated for a median (range) of 85 (31–338) days. The median prostate‐specific antigen (PSA) level at enrolment was 22.0 (3.0–937.2) ng/mL. No patient had a PSA response (>50% reduction in PSA). Six patients had stable disease for a median of 5.5 months. After 1 month, adrenal androgens were increased and testosterone and DHT increased by 91% and 80%, respectively, compared to baseline.

CONCLUSION

Mifepristone had limited activity in patients with CRPC, and stimulated a marked increase in adrenal androgens, testosterone and DHT. We hypothesise that inhibition of glucocorticoid receptor by mifepristone resulted in an increase in adrenocorticotropic hormone and subsequent increase in adrenal androgens, and that their conversion by tumour cells to testosterone and DHT probably limited the efficacy of mifepristone. These data emphasize the continued importance of alternative androgen sources in AR signalling in CRPC.
Personality Dominance and Preferential Use of the Vertical Dimension of Space
Authors: Moeller Sara K. , Robinson Michael D. , Zabelina Darya L.
Published: April 2008

Previous research has shown that dominant individuals frequently think in terms of dominance hierarchies, which typically invoke vertical metaphor (e.g., “upper” vs. “lower” class). Accordingly, we predicted that in spatial attention paradigms, such individuals would systematically favor the vertical dimension of space more than individuals low in dominance. This prediction was supported by two studies (total N = 96), which provided three tests involving two different spatial attention paradigms. In all cases, analyses controlling for speed of response to horizontal spatial probes revealed that more dominant individuals were faster than less dominant individuals to respond to probes along the vertical dimension of space. Such data support the metaphor-representation perspective, according to which people think in metaphoric terms, even in on-line processing tasks. These results have implications for understanding dominance and also indicate that conceptual metaphor is relevant to understanding the cognitive-processing basis of personality.
The Representation of Simple Ensemble Visual Features Outside the Focus of Attention
Authors: Alvarez George A. , Oliva Aude
Published: April 2008

The representation of visual information inside the focus of attention is more precise than the representation of information outside the focus of attention. We found that the visual system can compensate for the cost of withdrawing attention by pooling noisy local features and computing summary statistics. The location of an individual object is a local feature, whereas the center of mass of several objects (centroid) is a summary feature representing the mean object location. Three experiments showed that withdrawing attention degraded the representation of individual positions more than the representation of the centroid. It appears that information outside the focus of attention can be represented at an abstract level that lacks local detail, but nevertheless carries a precise statistical summary of the scene. The term ensemble features refers to a broad class of statistical summary features that we propose collectively make up the representation of information outside the focus of attention.
Indigenous Peoples in International Environmental Cooperation: Arctic Management of Hazardous Substances
Authors: Selin Henrik , Selin Noelle Eckley
Published: April 2008

This article reviews the international legal framework on hazardous substances, with an emphasis on the Arctic and the roles of indigenous peoples. Persistent organic pollutants (POPs) and heavy metals pose significant risks to Arctic indigenous populations, mainly through the consumption of traditional foods. Treaties of particular relevance include the Protocols on Heavy Metals and POPs to the Convention on Long‐Range Transboundary Air Pollution (1998) and the Stockholm Convention on POPs (2001). Arctic indigenous groups have exerted considerable influence on hazardous substance management through lobbying of national governments, participation in domestic and international scientific assessments, and direct advocacy in regional and global political fora. Their engagement on environmental issues has also helped to shape circumpolar consciousness and political activism among different indigenous groups. At the same time, there remain important limitations on the independent authority and ability to act of indigenous groups. Challenges for Arctic indigenous groups and States include continuing collaborative abatement work targeting many POPs and heavy metals, as well as addressing linkages between hazardous substances and climate change, which is another issue of great Arctic concern.
Effects of induced stress on experimental pain sensitivity in chronic tension‐type headache sufferers
Authors: Cathcart S. , Petkov J. , Pritchard D.
Published: April 2008

Background and purpose:  It has been proposed that stress may contribute to chronic tension‐type headache (CTH) through hyperalgesic effects on already sensitized pain pathways in CTH sufferers. This hypothesis could be partially tested by examining effects of stress on mechanical and thermal pain sensitivity in CTH sufferers. Such examinations have not been reported to date.

Materials and methods:  In the present study, we measured cephalic and extra‐cephalic pressure [pressure‐pain threshold (PPT)] and cold‐pain thresholds (CPT) in CTH sufferers (n = 8 females, n = 8 males) and healthy control subjects (n = 8 males, n = 7 females) recruited from the general population before and after exposure to a 15‐min stressful mental task.

Results:  Results indicated that PPT’s at head and hand were lower in the CTH compared with control group both before and after task exposure. PPT’s and CPT’s decreased from pre‐ to post‐task in both groups, with a significantly greater pre‐ to post‐task reduction in cephalic PPT in the CTH compared with control group. Subjective stress increased from pre‐ to post‐task in both groups and did not differ between groups. In the CTH group, stress reactivity was negatively correlated with PPT’s, whilst absolute stress levels were positively correlated with pre‐ to post‐task decrease in PPT’s.

Conclusions:  The main finding is an enhanced hyperalgesic effect of stress on cephalic pressure‐pain sensitivity in the CTH sufferers compared with the healthy controls. The results support the hypothesis that stress may contribute to CTH through hyperalgesic effects on already sensitized pain pathways in CTH sufferers.
The manufacture and some quality characteristics of kurut, a dried dairy product
Authors: KAMBER UFUK
Published: April 2008

This study was designed to investigate the microbiological and chemical characteristics of kurut, a dairy product obtained by drying yogurt under the sun in rural areas of Turkey. For this purpose, 50 randomly collected kurut samples from the Kars Region were analysed for determination of their microbiological and chemical characteristics. Analysis of kurut samples showed that kurut contained on average 4.52 log10 cfu/g of aerobic mesophilic bacteria, 2.78 log10 cfu/g of aerobic mesophyl spores, 3.60 log10 cfu/g of lactic acid bacteria, 3.60 log10 cfu/g of Lactococcus, 3.94 log10 cfu/g of mould and yeast, 2.13 log10 cfu/g of Enterobacteriaceae, l.51 log10 cfu/g of sulphite‐reducing clostridia, and 1.81 log10 cfu/g of coagulase‐positive staphylococci. Coliform bacteria and enterococci bacteria were not detected in any of the kurut samples. Furthermore, chemical characteristics of the kurut were as follows: pH 4.2, acidity (lactic acid) 2.9, moisture 12.1%, fat 45.9% protein 25.5%, salt 6.7% and ash 10.0%. The quality characteristics of kurut presented here may help create a different perspective for new products to be produced in the dairy sector.
Interrelationship between splanchnic and leg exchange of glucose and other blood‐borne energy metabolites during abdominal surgical trauma
Authors: Stjernström Hans , Jorfeldt Lennart , Wiklund Lars
Published: April 2008

Summary. In eight patients undergoing cholecystectomy, measurements of leg blood flow, splanchnic blood flow and arterio‐venous differences in oxygen, glucose, lactate, pyruvate, glycerol, 3‐hydroxybutyrate and alanine were made. Splanchnic glucose release averaged 1 1 mmol/min. The uptake of glucose into leg tissue was low. The rise in arterial glucose concentration was about I mmol/h during surgery. At the end of surgery splanchnic oxygen uptake was increased by 70% and the alanine uptake into the same region was comparable to that described in patients with septic complications of surgery. The plasma insulin concentration was low compared with the arterial glucose level.

The data suggest that during abdominal surgery (a) increase in arterial glucose concentration can be fully accounted for by slightly increased splanchnic glucose release and a low peripheral utilization; (b) release of gluconeogenic substrates from peripheral tissues is balanced by splanchnic uptake; (c) disturbed relation between glucose and insulin, enhanced gluconeogenesis, increased splanchnic oxygen uptake and fat‐mobilizing lipolysis are in accordance with a raised sympatho‐adrenergic activity.
Physical training in elderly men with special reference to quadriceps muscle strength and morphology
Authors: Aniansson A. , Gustafsson E.
Published: April 2008

Summary.Physical training, including strength training of the lower extremities, was performed three times per week for 12 weeks by twelve 69–74‐year‐old men with no cardiovascular or locomotor symptoms. Only body weight was used as resistance. The training was considered to be moderately intense for this age‐group. After training, the heart rate was significantly lower at submaximal loads, demonstrating a conditioning effect of the training programme. The static and dynamic (isokinetic) muscle strength in the quadriceps muscle increased significantly with the training. Muscle biopsies were obtained from the vastus lateralis muscle for fibre, capillary and enzyme activity analysis. The fibre composition was altered after training, with a significantly higher proportion of Type II fibres, mainly due to an increase of Type II A fibres. The relative area of the Type IIA fibres increased significantly with training. There was no change in total body cell mass or capillarization. There was also enzymatic evidence of training adaptation, with a significant increment in myokinase activity. It is concluded that the ageing human skeletal muscle remains trainable and that the training response is similar to that seen in younger age‐groups.
Effect of intra‐arterially induced OC ‐ receptor blockade upon resistance in collateral arteries in patients with occlusion of the superficial femoral artery
Authors: Agerskov K. , Henriksen O.
Published: April 2008

Summary. The effect of intra‐arterially phentolamine inducing a‐receptor blockade upon the resistance in collateral arteries bypassing an occulusion of the femoral artery was studied in five patients. The patients were placed on a tilt table and the measurements were performed with the patients in supine position and tilted 40o (head‐up). Arterial blood pressure was measured directly in the brachial–common femoral–and popliteal artery. Relative blood flow was calculated as the relative change in arterio‐venous oxygen saturation.

Head‐up tilt caused a decrease in blood flow of about 35% corresponding to an increase in total vascular resistance of 38%. Resistance in collateral arteries increased by 45%. In supine position a‐receptor blockade reduced collateral resistance by 17%. However, the tilt‐induced constriction of the collateral arteries was blocked by 87%.

The results indicate that the constriction of the collateral arteries bypassing an occlusion of the superficial femoral artery is mainly mediated via sympathetic adrenergic vasoconstrictor fibres.
Influence of abdominal surgical trauma and intraoperative infusion of glucose on splanchnic glucose metabolism in man
Authors: Stjernström Hans , Jorfeldt Lennart , Wiklund Lars
Published: April 2008

Summary. Abdominal surgery increases blood glucose concentration and peripheral release and splanchnic uptake of gluconeogenic substrates, including alanine. During trauma or sepsis, infusion of glucose fails to depress alanine conversion to glucose. The effect of intra‐operative glucose infusion on splanchnic metabolism was examined in the present study. In eight patients undergoing elective cholecystectomy, splanchnic glucose metabolism was investigated before, during and immediately after surgery. Glucose was infused at a constant rate of 1 mmol/min. Splanchnic blood flow and arterio‐hepatic venous differences of oxygen, glucose, lactate, glycerol, 3‐hydroxybutyrate and alanine were measured. Eight other patients, who received saline instead of glucose, served as a control group.

Infusion of glucose resulted in total inhibition of splanchnic glucose release before as well as during and immediately after surgery. This was observed, even before surgery, at an arterial glucose level which was lower than that in the control group at the end of and immediately after surgery, at which no decrease of the splanchnic glucose release was recorded. Changes in neuronal and hormonal factors due to the surgical trauma are considered responsible for this difference in glucose homeostasis. Splanchnic alanine uptake increased during surgery in both groups, but tended to be somewhat lower in the glucose group. The arterial glycerol concentration and splanchnic uptake, as well as the arterial concentration and splanchnic release of 3‐hydroxybutyrate, were reduced. It is concluded that an intravenous infusion of glucose at a rate of 1 mmol/min during abdominal surgery (a) increases the arterial blood glucose level and abolishes splanchnic glucose release, (b) reduces, but does not totally prevent the increase in splanchnic uptake of gluconeogenic substrates, and (c) diminishes lipolysis and the formation of 3‐hydroxybutyrate.
Significance of skeletal muscle oxidative enzyme enhancement with endurance training
Authors: Gollnick Philip D. , Saltin Bengt
Published: April 2008

Summary. A theoretical model is proposed to explain how the increase in mitochondrial protein concentration, and therefore of the oxidative enzymes, that occurs with endurance training could operate to alter the choice of substrate during submaximal exercise in a manner such that the oxidation of fatty acids increases, glycogen depletion and lactate production are reduced, and work capacity is enhanced. The model is based on the control of enzyme activities both by enzyme and substrate concentrations. The effect of altering enzyme concentration on reaction velocities is presented on the basis of standard Henri‐Michaelis‐Menten kinetics. It is shown that the reaction velocity at a given substrate concentration is a function of total enzyme concentration. With an increase in total enzyme concentration there is a parallel increase in reaction velocity at the same substrate level. This would have its greatest impact at substrate levels below the Km of the enzyme. It would have an effect of enhancing fatty acid flux through the oxidative pathways while inhibiting the Embden‐Meyerhof pathway. The model, as proposed, is consistent with known alterations in metabolism as they occur in man during submaximal exercise following endurance training.
Local regulation of subcutaneous blood flow in normal subjects and in migraine patients before and after single‐dose ergotamine tartrate
Authors: Eickhoff J. H. , Tfelt‐Hansen P.
Published: April 2008

Summary. Local blood flow regulation of the foot was studied in 15 normal subjects and in nine migraine patients. Changes in arterial and venous pressures were induced by lowering and elevation of the limb. Changes in blood flow were estimated from the changes in the wash‐out rate of a subcutaneous 133‐Xenon depot.

The local vasoconstrictor response to increased venous pressure elicited during lowering was identical in the normal subjects and in the migraine patients. During elevation, however, an abnormality in the autoregulation of blood flow could be demonstrated, as a decrease in blood flow during elevation to +40 cm was more pronounced in the patients than in the normal subjects (P=0·04).

About 3 h after 0·5 mg ergotamine tartrate/70 kg body weight i.v. the local regulation of blood flow had markedly changed in normal subjects as well as in migraine patients. During elevation to +20 and to +40 cm, blood flow increased significantly (P=0·01 and P=0·02). In two subjects the isotope depot was infiltrated with lidocaine and the ergotamine‐induced increase in blood flow during elevation was blocked. The results may indicate that the veno‐receptor of the veno‐arteriolar reflex underlying the local vasoconstrictor response is a tension receptor, which due to the veno‐constrictor effect of ergotamine is triggered even at heart level.
Osteoporosis and normality: how to express the bone mineral content of lumbar vertebrae
Authors: Krølner Bjørn
Published: April 2008

Summary. Bone mineral content of the 2nd, 3rd, and 4th lumbar vertebrae (lumbar BMC) was measured in 70 normal women (aged 19–88 years) and 72 post‐menopausal women (aged 58–89 years) with primary osteoporosis using dual‐photon (153Gd) absorptiometry. The inter‐individual variation of lumbar BMC was 26·7% in normal women. This figure could be reduced to 13·9%, if lumbar BMC was normalized to age (or years after the menopause), body height, body weight, and vertebral size according to multiple regression analysis. The reduction thus obtained of the inter‐individual variation in normal post‐menopausal women was statistically insignificant, however, and it appeared that other variables were of importance as to lumbar BMC of older women.

Mean lumbar BMC of the osteoporotic women was 41% lower than that of normal pre‐menopausal women. The separation between normal and osteoporotic individuals became less clear, if lumbar BMC was normalized as mentioned. The data suggest that spinal osteoporosis is predominantly a condition of normal small old women with diminutive vertebrae and early menopause.

It is recommended that lumbar BMC is expressed as the total mineral mass of the bones measured, the normal range being BMC of healthy pre‐menopausal women. Normalization to age, body height, body weight, and vertebral size seems rather speculative.
Augmentation of exercise ventilation by medroxyprogesterone acetate
Authors: Robertson H. T. , Schoene R. B. , Pierson D. J.
Published: April 2008

Summary. The influence of medroxyprogesterone acetate (MPA) on exercise performance was studied in a double‐blind cross‐over trial using six normal males to compare the exercise performance changes to those observed in a previous study of exercise responses of female subjects during the follicular and luteal phase of the menstrual cycle. A maximal progressive work exercise test on a cycle ergometer was performed after 2 weeks of placebo or MPA administration. Although five of six subjects spontaneously complained of increased exertional dyspnoea on MPA, no significant decreases were documented in maximal exercise time or in maximal oxygen consumption. A mean increase in exercise ventilation of 19% at low levels of exertion and 26% at high levels of exertion was documented, but no subject demonstrated evidence of ventilatory limitation. The increases in exercise ventilation observed in these male subjects after MPA administration were larger than those observed in the previous study comparing exercise ventilatory responses during follicular and luteal phases of the menstrual cycle. It seems possible that some other exercise‐related modulator of the ventilatory response to exercise under the influence of progesterone is present in either male subjects receiving MPA or women with normal hormonal cycles.
Subcutaneous blood flow during insulin‐induced hypoglycaemia: studies in juvenile diabetics with and without autonomic neuropathy and in normal subjects
Authors: Hilsted J. , Madsbad S. , Sestoft L.
Published: April 2008

Summary. Subcutaneous blood flow was measured preceding insulin‐induced hypoglycaemia, at the onset of hypoglycaemic symptoms and 2 h later in juvenile diabetics with and without autonomic neuropathy and in normal males. In all groups subcutaneous blood flow decreased at the onset of hypoglycaemic symptoms compared with pre‐hypoglycaemic flow. Two hours after onset of hypoglycaemic symptoms, subcutaneous blood flow was still significantly decreased compared with pre‐hypoglycaemic flow. In normal subjects local nerve blockade had no effect on blood flow changes during hypoglycaemia, whereas local alpha‐receptor blockade abolished the vasoconstrictor response. We suggest that circulating catecholamines stimulating vascular alpha‐receptors are probably responsible for flow reduction in the subcutaneous tissue during hypoglycaemia.
Resting ECG in athletic and non‐athletic adolescent boys: correlations with heart volume and cardiorespiratory fitness
Authors: Sundberg S. , Elovainio R.
Published: April 2008

Summary. Resting ECG was recorded in 59 endurance trained athletic and 81 non‐athletic boys aged 10–17 years and the findings were correlated with heart volume and cardiorespiratory fitness. The two groups were physically similar, but the athletes had significantly higher maximal oxygen uptake and the 15–17‐year‐old athletes had larger heart volumes. ECG findings were rather similar in both groups, the major differences being a lower heart rate in the athletes than in the controls (71 vs 82 beats/min) and a longer PQ interval (0·151 vs. 0·140 s) and a greater sum of SV2 and RV4 (59 vs.50 mm) in the 15–17‐year‐old athletes. In the controls no correlation existed between precordial voltage criteria for ventricular hypertrophy and heart volume or between heart volume and cardiorespiratory fitness. Contrary to this, in the athletes both SV2+RV5 and SV2+ RV4 correlated significantly (r about 0·40) with relative heart volume, and relative heart volume with both maximal oxygen uptake per kg (r = 0·41) and calculated work at heart rate 170 beats/min expressed per kg (r = 0·61). Our findings seem to indicate that as a consequence of endurance training the high level of cardiorespiratory fitness becomes related to a large heart volume. It is obvious that ECG changes due to relative vagal dominance develop earlier in the adolescent athletes than those attributable to anatomical changes.
Left ventricular function at rest and during exercise in coronary insufficiency — A simultaneous evaluation by means of radionuclide angiocardiography and catheterization
Authors: Dahlström J. A. , Lilja B. , Ohlsson O. , Torp A.
Published: April 2008

Summary. Left ventricular function was assessed simultaneously with heart catheterization and equilibrium radionuclide angiocardiography at rest and during supine exercise in ten patients with effort angina. At rest all had normal haemodynamics. During exercise all developed angina with signs of left ventricular dysfunction in the form of high left ventricular filling pressure, 31±2 mm Hg (mean±SEM) and pathological decreases in left ventricular ejection fraction (11 ± 1 % units). Left ventricular end‐systolic volume increased significantly (43 ± 7%), but the increase in left ventricular end‐diastolic volume (13 ± 7%) was not significant. The discordance between the changes in left ventricular filling pressure and the changes in left ventricular end‐diastolic volume is discussed. Radionuclide angiocardiography revealed left ventricular dysfunction as frequently as did heart catheterization.
Determination of the subcutaneous tissue to blood partition coefficient in patients with severe leg ischaemia by a double isotope washout technique
Authors: Bjerre‐Jepsen K. , Faris I. , Henriksen O. , Tønnesen K. H.
Published: April 2008

Summary. Knowledge of the tissue to blood partition coefficient (λ) is essential for calculation of the perfusion coefficient in a single tissue based on measurements of the washout of locally injected isotopes. No measurements of λ for Xenon in subcutaneous tissue in the leg have been done in patients with occlusive arterial disease. In 12 patients with occlusive arterial disease in the legs λ for Xenon was determined in subcutaneous tissue in the calf region and foot as the ratio between the washout rate constant of 131I‐Antipyrine and 133Xe. A mixture of the two indicators was injected subcutaneously laterally on the calf and in the first interosseous space on the foot. The time until the curves followed a monoexponential course varied between 15 and 45 min in the calf and 5 and 45 min in the foot.

The calculated λ for Xe showed a great variance between individuals in calf as well as foot. Mean value was 3·7 ml · g‐1 (range: 1·7–10·7) in the calf and 2·7 ml· g‐1 (range: 1·2–4·9) in the foot.

It is concluded that λ measurements are necessary for determination of subcutaneous blood flow from 133Xe washout curves in these patients. Determination of λ is especially important when comparisons are made between individuals.
Response of finger systolic blood pressure to cold provocation in cases with hypertension and diabetes
Authors: Thulesius Olav , Valminxy Klas , Todoreskov Radivoj
Published: April 2008

Summary. Finger systolic blood pressure during cooling was determined in 21 hypertensive, 22 diabetics and 18 control individuals. Blood pressure determination was made using a miniature tourniquet on the middle phalanx and a strain‐gauge flow sensor on the finger tip. Pressure was measured at 35°C and upon stepwise local cooling down to 5°C. With this technique the following observations were made:

(1) Systolic blood pressure declined slightly in controls.

(2) The reduction of finger systolic blood pressure was significantly more pronounced in patients with essential hypertension and diabetes, 17 and 23% at 5°C compared to control level at 35°C.

(3) These changes may be explained simply on the basis of physical factors such as altered wall composition resulting in decreased and retarded compliance.
Splanchnic galactose uptake in patients with cirrhosis following single injection
Authors: Ranek L. , Lindskov J. , Tygstrup N. , Medical K. Winkler
Published: April 2008

Summary. The galactose elimination capacity is used as a quantitative liver function test and is supposed to express the functioning liver cell mass. Clinical observations indicate, however, that the galactose elimination capacity overestimates functioning liver cell mass, and we therefore compared hepatic (splanchnic) and extrahepatic, extrarenal galactose elimination after a single injection of galactose in 23 patients with reduced liver function.

The galactose elimination capacity was consistently greater than the hepatic (splanchnic) galactose elimination rate, estimated during liver vein catheterization. The difference was on the average 0·68 mmol min1 (SD ±0·19,P < 0·001) or about 40% of the galactose elimination capacity.

If this difference, partly or fully, is due to extrahepatic extrarenal elimination, the clinical test for galactose elimination needs a correction (of the order of magnitude of 0·7 mmol min1) to serve as an absolute measure of the hepatic functional capacity, but since the hepatic uptake rate may be underestimated following a single injection, the correction may be smaller.
Effect of propranolol on the tone of collateral arteries in patients with occlusion of the superficial femoral artery
Authors: Agerskov K.
Published: April 2008

Summary. The effect of administration of 0·5 mg propranolol into the femoral artery in eight patients with lower limb ischaemia and superficial femoral artery occlusion on collateral arterial resistance was studied in supine and tilted head‐up position. Mean blood pressures were recorded directly from the femoral and popliteal artery and femoral blood flow was measured by an indicator dilution technique. After β‐receptor blockade in the supine position the collateral arterial resistance increased by 7±2%, femoral blood flow decreased 10±4%, and popliteal artery pressure increased by 4 mmHg (8±3%). During head‐up tilt there was no change in femoral blood flow and collateral arterial resistance after propranolol. The peripheral vasoconstrictor effect of propranolol, therefore, seems not to be harmful to patients with vascular disease.
The effects of chloroquine on the electrocardiogram and heart rate in anaesthetized dogs
Authors: Sofola O. A.
Published: April 2008

Summary. The effects of intravenous administration of chloroquine on the electrocardiogram (ECG) and heart rate were studied in anaesthetized dogs. Prolongation of the PR interval on the ECG and bradycardia occurred from a dose of 4 mg kg‐1. Prolongation of the QRS interval occurred from 6 mg kg‐1. Pacing the heart at a constant rate or administration of atropine had no effect on the cardiac changes observed during chloroquine administration. Administration of propranolol potentiated the effects of chloroquine on the ECG intervals and heart rate, whereas adrenaline opposed these effects. It is suggested that prolongation of the ECG intervals is not secondary to the reduction in heart rate, whilst beta‐adrenergic blockade renders the heart more vulnerable to the actions of chloroquine.
Regional extra vascular lung density and fractional pulmonary blood volume in patients with chronic pulmonary venous hypertension
Authors: Wollmer P. , Modes C. G. , Allan R. M. , Maseri A. , Fazio F.
Published: April 2008

Summary. Using a technique based on positron transmission and emission tomography, we measured regional extravascular lung density (lung tissue and interstitial water per unit thoracic volume) and fractional pulmonary blood volume (volume of blood per unit thoracic volume) in normal subjects and in patients with cardiomyopathy and chronic pulmonary venous hypertension.

We found an increase in extravascular lung density in the patients. Extravascular density was increased in all parts of the lung studied, but higher values were seen in the dorsocaudal portion than in the ventrocaudal portion of the lung (average 151% and 130% of normal, respectively). Fractional blood volume was markedly reduced in the dorsocaudal part of the lung (mean 74% of normal).

The increase in extravascular density probably reflects structural changes in the lung as well as accumulation of interstitial fluid. The distribution of extravascular density is consistent with previous radiological and morphological studies, and may reflect a higher tendency to oedema formation in the dependent parts of the lung. The measurements of fractional blood volume suggest that intrapulmonary blood volume is reduced in chronic pulmonary venous hypertension. This may reflect a decrease in the distensibility of the pulmonary vessels due to structural abnormalities, as well as functional changes in the pulmonary vasculature.
Skin perfusion pressure measured by isotope washout in legs with arterial occlusive disease: Evaluation of different tracers, comparison to segmental systolic pressure, angiography and transcutaneous oxygen tension and variations during changes in systemic blood pressure
Authors: Holstein P. , Trap‐Jensen J. , Bagger H. , Larsen B.
Published: April 2008

Summary. The skin perfusion pressure (SPP) measured as the isotope washout cessation external pressure is valuable in selection of major amputation level. Five methodological investigations important to clinical use were carried out: (1) In five normal legs and 10 legs with arterial occlusive disease (AOD), 131I‐antipyrine (1311‐‐a.p.) was compared to Na(131I‐) and 99Tcm‐I pertechnetate (99Tcm). The average SPP by 131I‐a.p. and by 131I‐ were approximately equal, 57·0 mmHg (range 18–93) compared to 56·3 mmHg (range 13–88) (P > 0·1). The average SPP by 99Tcm was just slightly higher, 60·3 mmHg (range 18–98) (P < 0·02). The average washout constant for the three different tracers were approximately equal and correlated statistically significant with the SPP; (2) In 59 legs with AOD, segmental SPP was compared to segmental systolic blood pressures on the thigh, calf, ankle and first digit (strain gauge technique). The two different methods correlated statistically significant at all four levels, but the systolic blood pressures were higher than the SPP in particular in diabetic legs; (3) Angiograms in 35 legs with AOD showed that the SPP on the ankle was only consistently decreased in legs with arterial occlusions at two levels or more; (4) In 47 legs with AOD, the SPP on the calf or on the thigh was compared with transcutaneously measured PO2. The two different methods correlated statistically significant, but the scatter was great; (5) During induced variations in systemic blood pressure in seven patients (12 legs with AOD), the segmental SPP and the segmental systolic blood pressure were found on average to vary in proportion with the intra‐arterial mean and systolic pressure respectively; however, this proportional relationship was not valid for the individual leg. It is concluded that 99Tcmis as suitable as the 131I‐labelled tracers in estimating the SPP. The SPP is significantly correlated to skin blood flow, to systolic blood pressure, to tc PO2 and to angiographic findings. Correction of SPP for systemic blood pressure changes can be made in proportion with the measured variations in systemic mean blood pressure. but only for groups of patients.
Relationship between local and total body bone mineral in epileptic patients and normal subjects
Authors: Tjellesen Lone , Gotfredsen Anders , Borg Jens , Christiansen Claus
Published: April 2008

Summary. Total body bone mineral (TBBM), measured by dual photon absorptiometry, and local body bone mineral content (BMC), measured by single photon absorptiometry, in both forearms were determined in 49 epileptic patients, 19 receiving phenytoin and 30 receiving carbamazepine, and in 55 controls. A highly significant correlation was found between BMC and TBBM in the patients (r = 0·81, SEE = 10·6%), as well as in the controls(r = 0·78, SEE = 9·9%). Furthermore, the intercepts and the slopes were virtually of the same order. The patients on phenytoin had a mild generalised osteomalacia, independent of method used, whereas the patients on carbamazepine did not have this side‐effect. It is concluded that BMC of the forearm can be used as a valid estimate of total body bone mineral in groups of epileptic patients and in normal subjects.
Pedal blood flow and transcutaneous PO2 in normal subjects and in patients suffering from severe arterial occlusive disease
Authors: Bongard O. , Krahenbuhl B.
Published: April 2008

Summary. Pedal transcutaneous partial pressure of oxygen (tcPo2) has been measured by polarographic method, heating the skin at 44°C. In 50 normal subjects, mean tcPo2 measured 54 · 5 ± 7 mmHg. Among 43 patients suffering from chronic ischaemia of lower limbs, mean tcPo3 measured 40·8±8 mmHg in patients with from claudication and 16·1±15 mmHg in patients suffering from rest pain and/or gangrene. The variability of repeated tcPo2 measurements, expressed as 1 SD of the mean, was 4·5 mmHg in normal subjects and 2·9 mmHg in patients.

The relationships between pedal subcutaneous blood flow measured in xenon‐133 clearance method and pedal tcPo2 have been studied in nine normal subjects and in five patients suffering from severe chronic ischaemia of lower limbs (rest pain and/or gangrene). There was a positive correlation between blood flow and tcPo, in normal subjects (r=0·77, P< 0·001). In patients suffering from severe ischaemia, there was no correlation between these two parameters, but measured blood flow was sometimes very high in areas where tcPo2 was low. It is likely that 133Xe clearance method considerably overestimates local blood flow in these patients, because there is considerably less fat in subcutaneous tissue of chronic severely ischaemic areas. Thus, partition coefficient should be determined in each patient. However, tcPo2 may constitute an index of nutritional circulation, while 133Xe clearance actually measures total subcutaneous blood flow.
Diabetes and reactivity of isolated human saphenous vein
Authors: Cardwell Robert J. , Webb R. Clinton
Published: April 2008

Summary. Helical strips of saphenous veins from diabetic (n=8) and non‐diabetic (n= 18) humans were studied in vivo for their responsiveness to several vasoactive agents. Following application of passive force (˜20·0 mN), venous strips from non‐diabetic humans often developed spontaneous phasic contractile activity (12 out of 18 patients; 2–5 contractions/min). These intrinsic changes in force were seen in venous strips from only one diabetic patient. The phasic contractions were not altered by treatment with phentolamine, whereas the calcium channel blocker, D‐600, and calcium‐free solution (1·0 mM EGTA) inhibited the phasic contractions. Saphenous veins from diabetic patients developed less maximal, active tension in response to norepinephrine than those from non‐diabetic patients. Contractile responses to serotonin, angiotensin II, and elevated potassium concentration in saphenous veins from diabetic patients were not different from those in veins from non‐diabetic patients. These observations demonstrate attenuated development of active tension in response to alpha‐adrenergic receptor activation and reduced spontaneous contractile activity in venous smooth muscle from diabetic patients.
Cardiovascular effects of haemorrhagic shock in spleen intact and in splenectomized dogs
Authors: Horton Jureta W. , Longhurst John C. , Coln Dale , Mitchell Jere H.
Published: April 2008

Summary. Cardiac performance was evaluated during haemorrhagic shock in 27 dogs with spleens intact, 24 splenectomized, and 23 splenectomized transfused dogs that were given a volume of packed red blood cells simulating splenic contraction. Contractile changes were evaluated by calculating dP/dt at 20 mmHg developed pressure (dP/dt DP20), and by relating stroke work to left ventricular end‐diastolic volume measured by biplane cinefluorography. Although heart rate increased comparably during early shock, cardiac output, stroke volume, maximal dP/dt, dP/dt DP20, and arterial blood pressure decreased more in splenectomized and splenectomized transfused dogs than in those with spleens intact. During shock dP/dt DP20 was more depressed in the splenectomized and splenectomized transfused dogs than in those with spleens intact. In addition, an increase in left ventricular end‐diastolic volume was accompanied by an increase in left ventricular stroke work in dogs with spleens intact. In contrast, stroke work remained depressed in both splenectomized groups despite increased left ventricular volume. Progressive acidosis and decreased left ventricular blood flow were similar in all dogs during haemorrhage. The greater reduction in left ventricular performance during haemorrhagic shock in the splenectomized and splenectomized transfused dogs was not related to excess lactate, changes in plasma volume, or red blood cell mass. Decreased left ventricular performance, despite improved ventricular filling, indicates greater cardiac dysfunction during haemorrhagic shock. This study suggests that, in dogs, the spleen maintains left ventricular performance during haemorrhage by mechanisms other than autotransfusion.
The relative isometric strength of type I and type II muscle fibres in the human quadriceps
Authors: Young Archie
Published: April 2008

Summary. In isometric contractions, the type II fibres of animal muscle may have a greater specific strength than the type I fibres. This paper reports two retrospective analyses of the influence of fibre‐type composition on the ratio of the voluntary isometric strength of the quadriceps to its cross‐sectional area at mid‐thigh.

In 15 normal quadriceps, the ratio of the muscle's strength to its cross‐sectional area was weakly correlated with the percentage contribution of type II fibres to a biopsy from the lateral mass of the muscle (r = 0·55, P<0·05). Linear regression suggested that type II fibres might have about three times the specific strength of type I fibres.

Measurements of the atrophied quadriceps of 11 patients with unilateral knee injury/immobilization were standardized by comparison with the contralateral muscles. Strength/cross‐sectional area was again correlated with the percentage area as type II fibres (r = 0·62, P<0·05). The data suggested that type II fibres might have about twice the specific strength of type I fibres.

Despite the wide confidence limits of each of the analyses, they agree that, in isometric contractions, the type II fibres of the human quadriceps seem stronger, for their cross‐sectional area, than the type I fibres.
Calculation of 51Cr‐EDTA clearance in children from the activity in one plasma sample by transformation of the biexponential plasma time‐activity curve into a monoexponential with identical integral area below the time‐activity curve
Authors: Groth Steffen
Published: April 2008

Summary. The relation between 51Cr‐EDTA clearance and plasma 51Cr‐activity in children was analysed introducing the functions s(t) and g(t) for transformation of the biexponential plasma time‐activity curve to a monoexponential with identical area below the time‐activity curve. The theory of s(t) and g(t) were discussed and the variation of g(t) with time was determined empirically. The functions s(t) and g (t) were used to derive a formula for the calculation of 51Cr‐EDTA clearance in children from one single plasma sample (ClST) withdrawn between 90 and 150 min after the injection. ClST and 51Cr‐EDTA clearance calculated by means of a standard method were almost identical (r = 0·991). It is concluded that the formula may prove useful for calculation of 51Cr‐EDTA clearance in children.
Fibre types, capillary supply and enzyme activities in human intercostal muscles
Authors: Mizuno Masao , Secher Niels H. , Saltin Bengt
Published: April 2008

Summary. The relative occurrence of slow twitch (ST) and fast twitch (FTa and FTb) fibres, fibre size, capillary supply, and glycolytic and oxidative enzyme activities in external (EXT) and internal (INT) intercostal muscles was determined on biopsies obtained during thoracotomy from the mid‐axillary line in six patients with normal lung function. EXT and INT showed a similar occurrence of ST fibres. Both FTa and FTb fibres were seen in EXT while only FTa fibres were seen in INT. The size of the three fibre types in EXT was similar. In INT the fibre size was larger for FTa than for ST (P < 0–05). INT appeared to have a larger number of capillaries per fibre than EXT (P < 0–05). A positive correlation was demonstrated between variables measured during spirometry and fibre size in INT only. No difference in glycolytic and oxidative enzyme activities between EXT and INT was observed. The histochemical characteristics suggest that, in the mid‐axillary line, INT are more used than EXT, though this conclusion did not appear to be confirmed by the enzyme activities determined.
Reflex inhibition of the quadriceps after meniscectomy: lack of association with pain
Authors: Shakespeare D. T. , Stokes M. , Sherman K. P. , Young A.
Published: April 2008

Summary. We have examined the severity and duration of reflex inhibition of quadriceps activation after arthrotomy and meniscectomy, its relationship with pain, and the effect of local anaesthesia on this relationship.

Fourteen men, on completion of medial meniscectomy by arthrotomy, received either 10 ml (BIO group) or 15 ml (B15 group) of 0–5% bupivacaine hydrochloride (‘Marcaine Plain’) into the knee, or no injection (control group). Reflex inhibition of quadriceps was measured as the percentage reduction, from the ipsilateral preoperative value, in the integrated surface electromyogram recorded during maximal voluntary isometric contractions with the knee in extension. Pain during each contraction was recorded on a linear analogue scale.

Unoperated limbs showed no evidence of quadriceps inhibition. In the operated limbs, at 1–2 h post‐operatively, controls had both severe inhibition (median = 62%) and severe pain on attempting a maximal quadriceps contraction. The BIO group had similar inhibition but less pain (P= s 0–005, Wilcoxon 2‐sample, 1‐tailed test). In the B15 group both inhibition (P 0–05) and pain (P 0–01) were less than in the controls. These effects of bupivacaine had been lost by 4–5 h post‐operatively.

At 3–4 days, inhibition was still severe (median=75%) in all three groups of patients but pain was only mild or absent. At 10–15 days, median inhibition was still 35%, but there was little or no pain.

We conclude that postmeniscectomy inhibition is not simply due to perceived pain but is due, at least in part, to stimuli from the knee.