bluuebunny/crossref_metadata_2025 huggingface dataset:
DEXTROSTIX REFLECTANCE METER AS AN AID IN DIAGNOSTIC HYPOGLYCEMIA
Authors: Hedner Pavo , Scherstén Bengt , Thulin Thomas
Published: August 2010

Abstract. The Dextrostix Reflectance Meter (DRM) system has been used for monitoring of the blood glucose level during diagnostic hypoglycemia in 16 patients with suspected pituitary insufficiency. In the range 15–40 mg glucose/100 ml blood the reproducibility of the DRM system, + 1.7 mg/100 ml, was as good as that of the reference method. The agreement between values obtained with the DRM and the reference method showed a straight line relationship, the equation for the regression line being y = 1.02x‐ 3.1 and the coefficient of correlation 0.94. The access to immediate and continuous information about the blood glucose level was of value for avoidance of complications and methodological misinterpretations, and permitted the test to be performed in open care.
THE EFFECT OF BENDROFLUMETHIAZIDE ON THE INTESTINAL ABSORPTION OF CALCIUM IN NORMOCALCAEMIC RENAL STONE FORMERS AND IN HYPERPARATHYROIDISM
Authors: Jørgensen F. Schønau , Transbøl Ib
Published: August 2010

Abstract. While the hypocalciuric action of thiazides is well established, their action on the intestinal absorption of calcium has remained a matter of dispute. In the present investigation this action has been studied in man by the measurement of forearm radioactivity in an Armac large volume liquid scintillation counter following separate oral and i.v. administration of 47Ca. Determined in this way duplicate measurements of calcium absorption in the same individual yield a standard deviation of 3.2%. Oral administration of bendroflumethiazide, 10 mg/day, led to a significant increase in fractional calcium absorption in a group comprising patients with hypercalcaemic hyperparathyroidism (n = 7), normocalcaemic renal stone disease (n = 8) and postsurgical hypoparathyroidism (n = 1). The mode of action of thiazides on the intestinal calcium absorption is discussed. Probably thiazides promote in a specific way the transport of calcium through the intestinal as well as through the tubular epithelial cells.
COAGULATION STUDIES IN CHRONICALLY BEDRIDDEN PATIENTS
Authors: Lorentsen E. , Eika C. , Godal H. C.
Published: August 2010

Abstract. Twelve patients without clinically recognized venous thromboembolic disease have been studied. In none of them could obvious signs of hypercoagulability or intravascular coagulation be demonstrated. The clinical implications of these finings are briefly discussed.
MYELOID METAPLASIA IN DISSEMINATED VASCULAR DISEASE
Authors: von Knorring J. , Selroos O. , Wasastjerna C. , Wegelius O.
Published: August 2010

Abstract. Myeloid metaplasia has been demonstrated in a patient after the onset of fulminant obliterative thromboangiitis and in another patient prior to the onset of systemic sclerosis. In regard to the former patient it was suggested that the bone marrow failure had resulted from thrombotic obliteration of the nutrient vessels of the bone marrow. The favourable effect of immunosuppressive treatment upon the peripheral circulation, wound‐healing and anaemia in this patient suggested an immune pathogenetic mechanism with respect to the vessel damage. In the latter patient no relationship was apparent between the myeloid metaplasia and the systemic sclerosis, which became manifest 10 years later. Impaired extramedullar haematopoiesis and further progress of the osteomyelosclerosis by reason of arterial involvement in the spleen and bone marrow may have contributed to rapid progression of the anaemia during the last months of the patient's life.
A HEREDITARY RENAL DISEASE WITH CLINICAL AND HISTOLOGICAL PICTURE AS IN CHRONIC GLOMERULONEPHRITIS
Authors: Thomsen M. , Ladefoged J.
Published: August 2010

Abstract. A family with a hereditary disease with the following characteristics is described: early proteinuria, severe hypertension and progressing renal failure, which as a rule reached the final stage at an age of 30–40 years. Women have been attacked as often as men. Deafness or other defects were not seen. The inheritance was apparently dominant. Histologically, changes were found similar to those in chronic glomerulonephritis with synechia, hypercellularity, mesangial thickening, hyaliniza‐tion of glomeruli and hypertensive vessel changes.
EXTRACORPOREAL IRRADIATION OF THE BLOOD
Authors: Weeke Eva
Published: August 2010

Abstract. The development and duration of lymphopenia in 71 uremic patients undergoing extracorporeal irradiation of the blood (ECIB) have been investigated. The median duration of each ECIB session was 9 1/2 hours, administered at intervals ranging from 1 to 4 days. The median total duration of one series of ECIB was 100 hours. The changes in the lymphocyte concentration during ECIB were analysed by means of the least squares method and could be expressed by the equation Y = B(1)e(‐ B(2) X) + B(3), in which Y is the lymphocyte count in % of pre‐ECIB level and X the number of blood volumes radiated. The development of lymphopenia was then defined by the slope — B(2) and the degree by the intercept B(3). In all patients a rapid reduction of the lymphocyte concentration in peripheral blood to 25–30% of pre‐ECIB level was observed. Continuation of ECIB treatment did not result in a further significant reduction of the lymphocyte concentration. A direct relationship was found between the transit dose and the development and degree of lymphopenia for transit doses between 100 and 500 rads. Variation neither in blood flow rate nor in spacing of the ECIB sessions had any detectable influence on the development and degree of the lymphopenia produced. After cessation of ECIB the lymphocyte concentration was followed in 19 patients within a period of 18 months. An increase in the lymphocyte counts to 35–40% of pre‐ECIB level was observed within the first 5 months after cessation of ECIB, but from the 5th to the 18th month no further increase could be demonstrated.
COMPARISON OF AMPICILLIN AND NALIDIXIC ACID IN THE TREATMENT OF URINARY TRACT INFECTIONS CAUSED BY E. COLI
Authors: Toivonen Seppo , Pentikäinen Pertti , Leirisalo Marjatta , Pyörälä Kalevi
Published: August 2010

Abstract. A comparative study of ampicillin and nalidixic acid in short‐term treatment of urinary tract infections caused by E. coli has been carried out in a series of female out‐patients. Twenty‐six patients were treated with ampicillin at a daily dosage of 2 g and 41 with nalidixic acid at a daily dosage of 4 g. Duration of treatment was 14 days in both groups. The frequency of primary resistance of E. coli to ampicillin was 13/67 (19%), whereas primary resistance to nalidixic acid was not found. Development of secondary resistance to ampicillin during treatment did not occur. Secondary resistance to nalidixic acid developed in only one of the 41 cases. In acute infections the cure rate was 14/15 (93%) in the ampicillin group and 18/19 (95%) in the nalidixic acid group. In patients with chronic infections the cure rates were 9/11 (82%) and 17/22 (77%), respectively. In contrast to previous reports, development of secondary resistance to nalidixic acid was not common. The rather favourable results obtained with nalidixic acid must be weighed against a relatively high frequency of side‐effects in patients treated with this drug.
BODY COMPOSITION AND ADIPOSE TISSUE CELLULARITY IN HUMAN OBESITY
Authors: Sjöström Lars , Björntorp Per
Published: August 2010

Abstract. Body composition, age at onset of obesity, adipose tissue cellularity and metabolic variables have been determined in 137 obese subjects and controls. Weight stability in 34 of the patients could also be judged by a repeated examination after about 10 months. Fat cell number correlated strongly with body fat, while fat cell size increased only within the control range of body fat. Above approximately 30 kg body fat, the fat cell enlargement was equally pronounced at all degrees of obesity. A cross‐sectional analysis of the obese men and women indicated that fat cell size was larger at 30–40 years of age than before and after this age. Cell number was elevated but did not increase with age in the obese group. Groups of younger and older obese women did not differ in adipose tissue cellularity factors. This had the consequence that, in comparisons with age‐ and sex‐matched control groups, obesity depending primarily on enlargement of fat cells seemed to be more frequent in the younger age groups, while in older obese subjects cell number seemed to be a more important factor for contribution to obesity. Fat cell number correlated positively with body cell mass. The earlier the onset of obesity the more fat cells, particularly when obesity could be traced to infancy. Obesity starting at adult age was characterized by larger fat cells. Two types of obesity can be distinguished. One is a hypercellular severe obesity with an early onset and an elevated body cell mass. The fat cells may be enlarged or not. The other type of obesity is characterized by fat cell hypertrophy, moderately increased body fat and a later onset. There is no increase in body cell mass. Plasma insulin was dependent on weight stability. Hypertriglyceridemia in obesity was associated with a decreased glucose tolerance, somewhat elevated insulin values, and elevated serum uric acid.
CELLULARITY AND CELL PROLIFERATION RATES IN HUMAN BONE MARROW
Authors: Skårberg Karl Olof , Cea Ricardo , Reizenstein Peter
Published: August 2010

Abstract. In a group of 12 patients without haemato‐logical diseases the total number of erythroblasts has been estimated with a 59Fe‐dilution technique including the blocking of 59Fe recirculation by carrier‐iron injections. The total number of proerythroblasts, basophilic, polychromatic and orthochromatic erythroblasts, was estimated on the basis of the total erythroblast number and a marrow differential count and was found to average altogether 3.4 × 109/kg b.wt. The total daily erythrocyte production was estimated by the alveolar carbon monoxide method. Based on the above data the generation times for the various erythroblasts were calculated to be about 11 hours for the most immature and 26 hours for the most mature. The transit time of the orthochromatic erythroblasts was estimated to be 20 hours and that of marrow reticulocytes 51 hours. The total marrow transit time from proerythroblast to circulating reticulocyte was calculated to be 124 hours or about 5 days. Simultaneously in vitro labelling of the erythroblasts with tritium labelled thymidine (H3TDR) was studied. Of the basophilic erythroblasts 70% were labelled, but only 30–40% of the proerythroblasts and the polychromatic erythroblasts. No simple parallelism is thus found with this technique between the labelling index and the generation time.
QUANTITATION OF ERYTHROPOIESIS BY A NEW METHOD
Authors: Lockner Dieter , Skårberg Karl Olof
Published: August 2010

Abstract. In new methods for the quantitative estimation of erythropoiesis and bone marrow cellularity using radioiron, inactive iron is given to block reutilization of radioiron. The efficiency of this blocking technique has been studied by giving two radioiron isotopes (59Fe and 55Fe), one before, the other after different doses and forms of inactive iron. It was found that 60 % of the radioiron is definitely destined for erythropoiesis, the remaining 40% may disturb quanti‐tation of erythropoiesis and marrow cellularity by reutilization. About half of this iron is reutilized in spite of blocking. Serum iron and reutilization of radioiron are significantly and inversely related. It is calculated that erythropoiesis is overestimated by 10% if this blocking technique is used.
PRE‐β‐1 LIPOPROTEIN AND EARLY DETECTION OF RISK FACTORS FOR CORONARY HEART DISEASE
Authors: Dahlén Gösta , Ramberg Ulla‐Britta
Published: August 2010

Abstract.Seventy‐five apparently healthy 16–17 year old schoolboys have been studied for the presence of pre‐β‐1 lipoprotein by two separate methods of lipoprotein electrophoresis. Forty‐three per cent of the boys revealed a detectable pre‐β‐1 lipoprotein. The pre‐β‐1 positive group had a higher mean value of total (p< 0.01) and free (p<0.01) cholesterol than the pre‐β‐1 negative group. A higher mean value of total CO2(p<0.02) and a lower chloride value (p<0.05) were also found in the pre‐β‐1 positive group. Six young males with the most prominent pre‐β‐1 lipoprotein fraction also showed a higher value of hematocrit (p< 0.05). These results may provide further explanation for the higher incidence of CHD previously found among pre‐β‐1 positive middle‐aged males.
RELATIONSHIP BETWEEN BLOOD PRESSURE AND PHYSICAL FITNESS, SMOKING AND ALCOHOL CONSUMPTION IN COPENHAGEN MALES AGED 40–59
Authors: Gyntelberg Finn , Meyer Jørgen
Published: August 2010

The separate relationships between BP and age, physical fitness, relative weight, smoking and alcohol consumption have been studied in a cardiovascular survey of 5249 middle‐aged males. Increasing age, relative weight and alcohol consumption were all positively related to the height of BP. In contrast, physical fitness and smoking were negatively related. The separate linear effects of age, relative weight and physical fitness were estimated by means of multiple regression analysis. The BP differences between smokers and non‐smokers and drinkers and non‐drinkers could not be explained by differences between the groups in respect of age, relative weight or physical fitness.
THE EFFECT OF PROPRANOLOL ON PLASMA RENIN ACTIVITY AND BLOOD PRESSURE IN MILD ESSENTIAL HYPERTENSION
Authors: Hansson Lennart , Zweifler Andrew J.
Published: August 2010

Abstract. Fourteen male patients with mild to moderate essential hypertension have been studied with regard to plasma renin activity (PRA) after acute and prolonged β‐adrenergic blockade with propranolol. Initial PRA was determined after four weeks of placebo treatment. Before propranolol was given PRA rose in response to 10 min of 45° head‐up tilt from 151.7 ng/100 ml/h to 248.7 ng/100 ml/h (p<0.01). After acute administration of propranolol 0.22 mg/kg b.wt. i.v. and following repeated tilt for 10 min PRA only rose to 204.7 ng/100 ml/h (n.s.). Following four weeks of oral propranolol treatment at 160–320 mg daily PRA after tilt was 39.0 ng/100 ml/h. Thus a significant reduction of PRA had taken place (p< 0.005) to a level constituting only 15% of the initial PRA after tilt.

The reduction of blood pressure (BP) after four weeks of propranolol treatment was also significant. Diastolic BP was reduced by 19 mmHg(p< 0.001). The changes in BP and tilted PRA were not significantly correlated (r=0.449, p<0.10). These results indicate that propranolol causes a marked reduction of PRA in addition to its hypotensive effect. However, this does not necessarily imply that there is a direct causal relationship between the effect of propranolol on PRA and its effect on BP.
BUMETANIDE IN THE TREATMENT OF HEPATIC ASCITES A Short and Long‐term Study
Authors: Ring‐Larsen Helmer
Published: August 2010

Abstract. A new diuretic agent, bumetanide, has been used in the treatment of ascites in 10 patients with cirrhosis of the liver. In a short‐term study (7 days) the diuretic and natri‐uretic effect of the drug was demonstrated. Patients receiving 2 or 4 mg orally per day had highly significant negative sodium and water balance and an increased potassium excretion. In a long‐term study (198–475 days) the effect on serum electrolytes and the toxicity of the drug were estimated in 6 patients receiving up to 6 mg daily. Except for a significant increase in standard bicarbonate, no change in serum electrolyte status occurred. Azotemia was only seen in two patients with high values prior to therapy. No changes in thrombocyte count, differential WBC, urine specimen or blood glucose levels were observed. One patient developed a Stevens‐Johnson syndrome probably due to the drug. Bumetanide proved to be equal to other potent diuretics already in use in decompensated cirrhosis of the liver in respect to efficacy and side‐effects.
CIRRHOSIS AND MALIGNANT HEPATOMA IN α1‐ANTITRYPSIN DEFICIENCY
Authors: Eriksson Sten , Hägerstrand Inga
Published: August 2010

Abstract. Clinical and laboratory findings in 9 adults with homozygous (Pizz) α1‐antitrypsin (AAT) deficiency and cirrhosis of the liver are described. This clinical entity is characterized by rapidly progressive cirrhosis in non‐alcoholics above 50 years of age, resulting in severe portal hypertension and death in hepatic coma or bleeding. Concomitant emphysema, often subclinical, is usually present and malignant hepatoma is common. Histologically typical PAS‐positive inclusion bodies are always demonstrable. Cholestatic features are not prominent. The entity is not associated with the HAA antigen, and serum “auto‐antibodies” are lacking. In addition to AAT deficiency the serum protein analysis reveals the pattern seen in cirrhosis of other etiology, but in most cases the IgM level was unusually high. The pathogenetic mechanism leading to cirrhosis in a minority, at most 10% of adult patients with the Pizz phenotype remains obscure.
RENAL ARTERY OCCLUSION, MALIGNANT HYPERTENSION AND THROMBOTIC THROMBOCYTOPENIC PURPURA
Authors: Ekberg Mats , Nilsson Inga Marie , Hedner Ulla , Moqvist Ingrid , Bergentz Sven‐Erik , Denneberg Torsten
Published: August 2010

Abstract.A case with unilateral renal artery stenosis and malignant hypertension, complicated with thrombotic thrombocytopenic purpura (TTP), is described. The patient was uraemic due to severe arteriolar sclerosis in the contralateral kidney. A massive consumption of platelets, a decreased fibrinogen value and occurrence of fibrin/fibrinogen degradation products (FDP) in serum and urine were demonstrated. During treatment with heparin the renal function improved, the platelet count rose and the FDP amount in the serum as well as in the urine decreased. Reconstructive surgery of the occluded artery was then performed and the contralateral kidney was removed.
ISOLATED VALVULAR AORTIC STENOSIS: Clinico‐pathological Findings in an Autopsy Material of Elderly patients
Authors: Andersen Johan A. , Hansen Birgit Fischer , Lyngborg Kjeld
Published: August 2010

Abstract In a review of 2557 autopsy reports from a general hospital 20 patients, aged 65 or above, have been found to have severe isolated valvular aortic stenosis. The diagnosis was made or suggested clinically in only 5 cases. The clinical findings were often atypical, e.g. the BP amplitude was above 50 mmHg in 9 patients and 4 had a systolic BP of 180 mmHg or more. Left ventricular hypertrophy as evaluated by ECG was, however, present in all examined cases but one. The main cause of death was cardiac in 17 cases, of whom 2 died suddenly and 4 following non‐cardiac surgery. At autopsy significant coronary arteriosclerosis was found in all but 2 patients. In 9 patients acute myocardial infarction was demonstrated—in 2 cases only through a macroscopic enzyme test (Nitro‐BT method).
DIAGNOSIS OF MEDULLARY CARCINOMA OF THE THYROID BY FINE NEEDLE ASPIRATION BIOPSY
Authors: Söderström Nils , Telenius‐Berg Margareta , Åkerman Måns
Published: August 2010

Abstract Fine needle aspiration biopsy has been evaluated as a diagnostic method for medullary carcinoma of the thyroid (MCT) in 18 patients with verified hereditary or sporadic MCT. The typical MCT cell was asymmetrical, sometimes triangular and often with a characteristic red granulation in May‐Grünwald‐Giemsa staining. Eccentrically positioned, multiple nuclei were common. Amyloid was seen both intra‐ and extracellularly, staining blue‐grey or violet with May‐Grünwald‐Giemsa and with green birefringence in polarized light after staining with alkaline Congo. The method was simple and quick to perform, causing negligible discomfort to the patient. No complications were seen. An adequate bioptic yield was obtained in 15 patients. In 13 of them (87%), including one patient with a normal thyroid at clinical examination, a correct diagnosis was reached.
IDIOPATHIC HYPERTROPHIC SUBAORTIC STENOSIS
Authors: Hansen Jørgen Fischer , Pedersen‐Bjergaard Ole , Stage Poul , Efsen Fritz
Published: August 2010

Abstract The clinical and laboratory findings in 29 patients with idiopathic hypertrophic subaortic stenosis are presented. Dyspnoea during exercise, angina pectoris, syncope combined with left ventricular hypertrophy on ECG and chest X‐ray and a systolic ejection murmur at the apex and the left sternal border are the most important findings. The findings were different in patients below and above 30 years of age. Most of the patients below 30 were in function group I, had a normal heart volume on chest X‐ray, and syncope was related to exercise. All patients above 30 had symptoms, nearly all were in function groups II‐IV and often complained of palpitations, had increased heart volume on chest X‐ray, sign of enlarged left atrium or atrial fibrillation on ECG. Syncope was not related to exercise, but always associated with palpitation in patients above 35 years of age. Pathologic Q waves were found more often in the younger age group. The differential diagnosis is discussed in relation to fixed aortic stenosis, mitral valve disease, ventricular septal defect, coronary artery disease, and hypertrophic cardiomyopathy without outflow tract obstruction.
PORTAL AND CUBITAL SERUM INSULIN DURING ORAL, PORTAL AND CUBITAL GLUCOSE TOLERANCE TESTS
Authors: Lund B. , Schmidt A. , Deckert T.
Published: August 2010

AbstractOral, intracubital, and intraportal glucose tolerance tests have been performed on 7 non‐obese non‐diabetics, and glucose and insulin concentrations have been followed in the peripheral and portal blood. A significant rise in portal glucose and insulin was found 1/2–2 min after oral glucose intake. There was no lag between the rise in insulin and glucose concentrations. The portal glucose concentration after oral glucose intake was significantly higher than after cubital glucose infusion for 45 min, although the peripheral glucose concentrations were identical. In the cubital vein the insulin concentration after oral glucose intake was significantly higher than after i.v. glucose infusion, but in the portal blood there wasnodifference. After portal glucose infusion the cubital insulin concentration did not differ significantly from the concentration after i.v. glucose infusion. Thus, it seems unlikely that a high portal glucose concentration is responsible for the higher peripheral insulin concentration after oral glucose intake. A high portal glucose concentration does not seem to influence the hepatic uptake or release of glucose.
FEVER AND HAEMOLYSIS IN HODGKIN'S DISEASE
Authors: Storgaard L. , Karle H.
Published: August 2010

Abstract One hundred and four patients with Hodgkin's disease have been studied retrospectively in order to evaluate the relationship between fever associated with the disease (Pel‐Ebstein type) and the development of anaemia. In the material 19 episodes of fever were found to be of this type. The mean loss of Hb during a fever period was 14% (range 2–33). From the rate of decrease in Hb it was deduced that this was at least partly caused by an increased destruction of erythrocytes. There was a significant correlation between the thermal exposure (expressed either as the duration of fever, the maximum body temperature during the fever period, or the sum of the temperature maxima) and the degree of erythrocyte loss. The loss of Hb was self‐limited in spite of persistent fever. Furthermore, there seemed to be an inverse relationship between the degree of preexisting anaemia and the fever‐induced relative loss of Hb. A possible explanation is that the older part of the erythrocyte population is more sensitive to the effect of fever.
THE ACUTE EFFECT OF SODIUM CELLULOSE PHOSPHATE ON INTESTINAL ABSORPTION AND URINARY EXCRETION OF CALCIUM IN MAN
Authors: Berstad A. , Jørgensen H. , Frey H. , Vogt J. H.
Published: August 2010

Abstract Intestinal 47Ca absorption has been determined from blood and stool radioactivity after oral administration of the isotope in nine patients before and during cellulose phosphate treatment. Oral administration of 5 g cellulose phosphate concomitant with 47Ca in 100 mg “carrier” calcium as CaCl2 decreased 47Ca absorption by 80%. Cellulose phosphate, 5 g three times daily, decreased urinary excretion of non‐radioactive calcium by 47%. Urinary magnesium excretion decreased by 47%, whereas urinary phosphorus excretion increased by 67%. Calcium and magnesium excretion in urine decreases because cellulose phosphate binds divalent cations within the GI tract. The increased phosphorus excretion is probably due to partial hydrolysis of the substance in the gut.
STUDIES IN ASYMPTOMATIC PRIMARY HYPERLIPIDAEMIA
Authors: Ekelund Lars‐Göran , Olsson Anders G.
Published: August 2010

ABSTRACTOne‐hundred‐and‐sixty male and 123 female subjects with asymptomatic primary hyperlipidaemia (HLP) selected from a health control centre have been studied with a heart rate (HR) controlled exercise test. The serum cholesterol and/or TG at screening were above 350 mg/100 ml and 3.5 mmol/l, respectively. As a reference group 49 male and 60 female age‐matched subjects from the same centre with serum cholesterol below 300 mg/100 ml and TG below 2.00 mmol/l were investigated using the same technique. Quantitative lipoprotein (LP) analyses and typing were performed on all HLP and control subjects. The subjects were divided into two age groups, 36–50 and above 50 years of age. Men with all types of HLP had lower working capacity, expressed in W170or W150, than controls, most pronounced in the younger age group. Younger women with type II A had lower working capacity than their controls. After correction for variation in body weight and age there remained a significantly lower W150, in male types II A (11%) and IV (21 %) and female type II A (11%). There was no difference in systolic BP during exercise between controls and HLP. The total exercise time and final HR did not differ in control and HLP subjects. Dynamic spirometry was performed in 102 of the male subjects and a significantly lower vital capacity was found in HLP subjects compared with controls after correction for variation in age, weight and height. No differences were found in the maximal flow values. The observed differences in working capacity between controls and HLP subjects are explained by a difference in stroke volume. The lower stroke volumes in male types II A and IV and female type II A could be explained by a lower degree of physical fitness, by a common genetic factor resulting in HLP and decreased stroke volume or by a less effective myocardial function in HLP subjects.
CREATINE PHOSPHOKINASE AFTER SUBMAXIMAL PHYSICAL EXERCISE IN UNTRAINED INDIVIDUALS
Authors: Forssell G. , Nordlander R. , Nyquist O. , Orinius E. , Styrelius I.
Published: August 2010

Abstract Serial estimations of total serum creatine phosphokinase (CPK) have been performed before and during 18–49 hours after submaximal physical exercise in 17 untrained individuals, mean age 50 years. The maximal CPK increase after exercise was 32 mU/ml (73%). The serum CPK did not exceed the upper normal limit (130 mU/ml) except in one individual (150 mU/ml). The maximal CPK increase in patients with acute myocardial infarction (AMI) varied between 101 mU/ml (133%) and 2 260 mU/ml (3 790%), mean 900 mU/ml (1 184%). As the maximal CPK elevation in AMI occurs within the same period, it seems that heavy physical work of short duration just before the onset of symptoms will very seldom impair the diagnosis of AMI with the CPK technique used.
GAUCHER'S DISEASE AND BENIGN MONOCLONAL GAMMAPATHY
Authors: Turesson Ingemar , Rausing Alf
Published: August 2010

Abstract A case of chronic non‐neuronopathic Gaucher's disease is presented. The diagnosis was based on the finding of typical Gaucher cells in the bone marrow and spleen. The patient also had a benign monoclonal gammapathy. Immunofluorescence studies of bone marrow and spleen were performed using monospecific antisera against immunoglobulin heavy and light chains. The results indicate a monoclonal plasma cell proliferation in the bone marrow, whereas the distribution of plasma cells in the spleen was polyclonal. The combination of chronic Gaucher's disease and monoclonal gammapathy was also found in the patient's brother.
THE AUTOREGULATION OF THE MICROCIRCULATION
Authors: Crone Christian
Published: August 2010

Abstract. The paper reviews August Krogh's contribution to capillary physiology stressing his formulation of useful new concepts such as “tissue cylinder model”, capillary intermittency and the intimate matching of capillary perfusion and cellular metabolism. Looked upon from a control theory viewpoint, Krogh was very early in considering the microcirculation as an autoregulated system with tissue oxygen tension as the controlled parameter. Recent work on Krogh's theories is briefly summarized.
THE BLOOD OXYGEN TRANSPORT SYSTEM A numerical simulation of capillary‐tissue respiratory gas exchange
Authors: Meldon J. H. , Garby L.
Published: August 2010

Abstract. A theoretical model of the process of respiratory gas exchange between capillary and tissue is described, with special reference to the importance of variations in blood properties. The volume of tissue supplied with oxygen from a single vessel, as a function of the blood flowrate (u), hematocrit (h), and 2, 3 diphosphoglycerate concentration (DPG), is calculated from a solution to the set of equations governing species distributions in the blood and tissue. The results, which are presented in the form of crossplots of the three blood parameters (u, h, and DPG) at a constant oxygen supply rate, show the possible significance of in vivo variations in the oxygen affinity of hemoglobin as a compensatory mechanism. Of further physiological interest is the sharp increase in venous erythrocyte pH in response to decreases in hematocrit, once the hematocrit is below a certain level. These results, and those relating DPG to hematocrit at constant O2 supply, are consistent with experimental observations of elevated DPG and pH levels in anemic individualts, and the dependence of erythrocyte DPG concentration upon pH.
Morphological Effects of Rapeseed Oil in Rats
Authors: ENGFELDT BENGT , BRUNIUS EDVARD
Published: August 2010

In long‐term studies covering up to 160 days young Sprague‐Dawley rats were fed diets containing 40 cal% of fat. The fat component consisted of either conventional rapeseed oil, or Canadian rapeseed oil low in erucic acid, or arachis oil. Myocardial fatty accumulation was demonstrated in light microscopic studies throughout the experiments in rats fed conventional rapeseed oil, but the number of fat droplets decreased with time. The controls fed arachis oil showed no fatty accumulation. In the rats fed conventional rapeseed oil focal myocardial lesions appeared after 40 days on the diet. These consisted of histiocytic infiltration, occurrence of macrophages, myolysis, proliferation of fibroblasts and finally scarring. Such foci were found widely spread in the myocardium of these rats. In the experimental groups given Canadian rapeseed oil from the cultivar Oro no histiocytic foci or scarring were observed. Small myocardial lesions were occasionally found in the control rats. These latter findings were observed on serial sections. It was concluded that this type of lesion is a “normal” finding. The number and size of the foci observed in animals fed conventional rapeseed oil (10 % and 2 % (w/w) erucic acid in the diet) indicate, however, that they have to be considered pathological under such circumstances. The pathogenesis of the myocardial alteration is discussed and it is concluded that the long‐chain fatty acids are responsible. No direct proof has been presented that the described events are of importance in human pathophysiology. However, several circumstances pointing in this direction are discussed. It is concluded that on the basis of our present knowledge a pathological effect of erucic acid and its homologues in man cannot be excluded.
Hypertension and the Coummunity
Authors: READER RALPH
Published: August 2010

Summary. There is now indisputable evidence from therapeutic trials that pharmacologic treatment in symptomatic and pre‐symptomatic subjects can reduce morbidity and mortality from hypertensive disease. Furthermore, there has been a striking fall in national mortality rates from hypertensive diseases. In Australia rates for cerebrovascular disease were rising slowly in the decade befor the introduction of sympatholytic drugs in about 1950. Since then the rate has fallen dramatically. The reversal in trend and its timing, and a consideration of numbers of patients under treatment and the incremental fall in deaths each year are consistent with such a conclusion.

Some 15% of adults in many western communities are hypertensive. In Australia, of 36,000 subjects screened, 16.3% had a diastolic blood pressure of 95 mm or greater on two separate visits, or were on hypotensive therapy. Of these 35% were unaware of the condition and 45% were taking therapy. In 11% of those not on treatment, the diastolic pressure was 110 or systolic pressure was 200 or greater.

In 1973 the cost of drugs in Australia specified for hypertension was $A13,000,000. In addition $A6,000,000 was spent on diuretics and $A400,000 on beta antagonist drugs (assuming that 40% of the cost of diuretics and 20% of the cost of beta antagonists were prescribed for hypertensive patients). The total drug bill was $A19,000,000.

The fall in national mortality rates above suggest that for this annual drug bill, 2,000 lives are now saved each year. If all hypertensives in Australia were on therapy, many more lives would by saved, for an additional cost of drugs of $A17,000,000. The total drug bill for the nation would be $A44,000,000. Other debits would include medical expenses, costs of a national screening progrmme (approximately 60c.per person) and the side effects of therapy. A major problem for health planners if to cut these costs while maintaining the advantages of therapy. Better knowledge of the features and pattern of progression of hypertension in the community is necessary toj permit this, and some aspects of national and internatonal efforts to acquire this knowledge are described.
A Trial of a New Adrenergic β‐receptor Blocker, ICI 66.082, in the Treatment of Hypertension
Authors: Erikssen Jan , Jervell Jak
Published: August 2010

Abstract. From a survey of 1250 males, 40–60 years of age, 25 mildly to moderately hypertensive patients have been offered treatment with the new β‐blocker ICI 66.082. Before and during the trial, data were obtained on resting BP and pulse rate, BP, pulse rate and ECGs during near maximal exercise, and various ventilatory function tests. In 15 patients, satisfactory BP control was obtained with ICI 66.082 alone, 25–100 mg twice daily. In 5 patients, the addition of hydralazine or a diuretic was necessary for satisfactory response. In 2 patients satisfactory control was not achieved and 3 patients were excluded for various reasons. Although BP and maximal pulse rate fell markedly during exercise, the total work capacity was not significantly reduced. No deleterious effect on ventilatory function was noted.
Effects of Medium Chain Triglycerides on Portal and Arterial Levels of Insulin, FFA and Glucose in Patients with Pancreatic Disease
Authors: Röjdmark Sven
Published: August 2010

Abstract. Trioctanoin has been given orally to six patients with pancreatic disease and the effects on the portal and arterial levels of insulin, free fatty acids (FFA) and glucose have been investigated. The serum levels of insulin and FFA rose significantly in portal blood but not in arterial blood after trioctanoin. The glucose level in portal as well as in arterial blood remained unaffected by the fat ingestion. The implications of these findings are discussed.
Carbon Monoxide Production and Reticulocyte Count in Normal Women
Authors: Mercke C. , Cavallin‐Ståhl E. , Lundh B.
Published: August 2010

Abstract. Endogenous production of carbon monoxide (VCO), serum bilirubin (SB) and reticulocyte (retic) count have been followed during the menstrual cycle in 12 women (4 of them smokers) without contraceptive drugs and in 10 women (5 of them smokers) on contraceptive drugs. During the progesterone phase (Pph), VCO in the non‐smokers was 18.2±2.1 μmol/mmol total body heme (TBH) and day (mean ±1 S.E.M.), compared with 10.1±1.0 during the estrogen phase (Eph). In the smokers, VCO was 10.4±1.9 during Pph and 12.5±0.7 during Eph. SB for the non‐smokers was 5.2±1.0 μg/ml during Pph and 3.9±0.5 during Eph, compared with 3.2±0.8 and 3.9±1.2, respectively, for smokers. The retic count for the non‐smokers was 64.1±4.7times103/μl during Pph and 17.7±5.1 during Eph. In the smokers the corresponding counts were 93.6±15.9 and 60.8±7.6. These results confirm earlier reports that VCO is increased during Pph and indicate that the rise could be due to a change in red cell catabolism, since it is concomitant with a significant increase in retic counts, which has not been found in earlier works on VCO, but which is known from reticulocyte studies. Furthermore, the results may indicate that persistent smoking affects the metabolism of CO and/or heme, since the smokers did not react with any change in VCO during Pph. In subjects using contraceptive drugs, VCO was significantly higher (14.9±0.6 on combined estrogen‐gestagen drugs and 14.5±1.1 on continuous gestagens, respectively) than during Eph in nonsmokers (10.1±1.0 μmol/mmol TBH and day), which might be taken as the baseline group. This indicates that the increased VCO in subjects on contraceptive drugs may be related to the activity of gestagens, which were included in all contraceptive drugs tested.
The Di Guglielmo Syndrome: A study of 17 Cases
Authors: Søndergaard‐Petersen Helena
Published: August 2010

Abstract. In 17 patients with Di Guglielmo's syndrome the PAS‐stained erythroblasts in bone marrow smears have been assessed by a scoring system. Most of the PAS scores were either moderately high or very high—much higher than those normally seen in disorders with benign erythropoietic hyperplasia. On the other hand, very low scores were obtained in a few cases. Whereas a high PAS score always lends strong support to a diagnosis of Di Guglielmo's syndrome, a low score, or even a negative reaction, does not exclude this diagnosis. The highest scores were obtained in cases with many pathological erythroblasts. Staining after diastase digestion confirmed that the positive PAS reaction is due to glycogen. In this test, experience showed that a period of at least 2 hours is required for complete digestion of the glycogen.
Liver, Lung and Malignant Disease in Heterozygous (Pi MZ) α1‐antitrypsin Deficiency
Authors: Eriksson Sten , Moestrup Torkil , Hägerstrand Inga
Published: August 2010

Abstract. The occurrence of PAS‐positive, diastase‐resistant, inclusion bodies in hepatocytes has been used as a marker of heterozygous (Pi MZ) α1‐antitrypsin deficiency in order to study the frequency of lung, liver and malignant disease in a consecutive autopsy material from a well defined population. Typical PAS‐positive inclusion bodies were found in the liver in 26 (3.7%) of the 700 cases studied. In these 26 subjects both liver (cirrhosis or fibrosis) and lung disease (emphysema) were significantly more prevalent (p < 0.001) than among PAS‐negative controls. The prevalence of malignant disease did not differ between the groups. The results are consistent with the concept that heterozygous (Pi MZ) α1‐antitrypsin deficiency predisposes to both liver and lung disease but does not influence the survival rate.
Immunodeficiency and Prognosis in Hodgkin's Disease
Authors: Björkholm M. , Holm G. , Mellstedt H. , Johansson B.
Published: August 2010

Abstract. Blood lymphocytes from the majority of 33 unselected and untreated patients with Hodgkin's disease were deficient in T‐lymphocytes and their DNA synthesis induced by concanavallin A mitogen and PPD antigen was impaired. The spontaneous DNA synthesis during the first 24 hours of culture was often raised. The prognostic role of the lymphocyte deficiency was evaluated in a follow‐up 10–22 months after institution of therapy. The lymphocyte functions were more commonly abnormal in patients responding poorly to treatment (incomplete remission, relapse after treatment, or death) than in patients entering complete remission. The lymphocyte deficiency seems to give information about prognosis in Hodgkin's disease in addition to histopathology, clinical stage, B‐symptoms and age.
A Rapid Screening Test for Cushing's Syndrome
Authors: Thorén Marja , Sjöberg Hans Erik , Hall Kerstin , Löw Hans
Published: August 2010

Abstract. A combination test consisting of two parts, a single dose of dexamethasone and a (1–24) ACTH injection, has been used for the diagnosis of Cushing's syndrome. The test was performed by administering 1 mg dexamethasone orally at 11 p.m. on the first day and 25 IU synthetic ACTH i.v. at 8 a.m. on the second day. Plasma Cortisol was determined at 8 a.m. on the first and second day and 1 1/2 and 2 hours after the ACTH injection. The test was performed in 33 patients with Cushing's syndrome and in 114 controls without adrenal disease. After dexamethasone administration alone, Cortisol values frequently overlapped between patients with Cushing's syndrome and controls. The validity of the test was considerably improved by adding ACTH stimulation. The test procedure is recommended as a screening test for Cushing's syndrome in ambulatory practice.
Arterial Calcification and Progressive Peripheral Gangrene after Renal Transplantation
Authors: Hällgren R. , Wibell L. , Ejerblad S. , Eriksson I. , Johansson H. , Grimelius L. , Wilander E.
Published: August 2010

Abstract. Two cases of progressive arterial calcification and peripheral gangrene after successful renal transplantation are presented. Parathyroidectomy was performed and was followed in one case by healing of the peripheral necroses. It is suggested that parathyroidectomy should be considered in similar cases even in the absence of hypercalcemia.
Iron Absorption in Patients with Chronic Renal Failure not Requiring Dialytic Therapy
Authors: Milman Nils , Larsen Lars
Published: August 2010

Abstract. Gastrointestinal iron absorption, by means of whole body counting, has been measured in 15 patients with chronic renal failure, not requiring dialysis. Whole body retention 14 days after oral administration of 10 μCi 59Fe together with a carrier dose of 10 mg Fe2+ was taken as expression of absorption. The percentage incorporation in the total erythrocyte mass of administered 59Fe (erythrocyte incorporation) and absorbed 59Fe (red cell utilization) was estimated as well. Iron absorption was 9.6 ± 2.0 (S.D.)% (geometric mean) and erythrocyte incorporation 7.5 ± 2.3 (S.D.)% (geometric mean) while red cell utilization averaged 80.3 ± 4.8 (S.E.M.)% (arithmetic mean). None of these parameters were significantly different from those obtained in a normal control group (p > 0.5, p > 0.9 and p > 0.2, respectively). The correlation between iron absorption and erythrocyte incorporation was highly significant (r = 1.00, p < 0.001). Iron supplementation is often indicated in the investigated category of patients due to increased blood loss and insufficient iron intake and should be given orally in consideration of the normal gastrointestinal absorption.
EFFECTS OF METABOLIC AND PHARMACOLOGIC INTERVENTIONS ON MYOCARDIAL INFARCT SIZE FOLLOWING CORONARY OCCLUSION*
Authors: Maroko Peter R. , Braunwald Eugene
Published: August 2010

A number of hemodynamic, pharmacologic and metabolic interventions were found to change the extent of acute ischemic injury of the myocardium and subsequent necrosis following experimental coronary artery occlusion. Reduction in myocardial damage occurred by decreasing myocardial oxygen demands (beta‐adrenergic blocking agents, intra‐aortic balloon counter‐pulsation, external counterpulsation, nitroglycerin, decreasing afterload in hypertensive patients, inhibition of lipolysis, and digitalis in the failing heart); by increasing myocardial oxygen supply either directly (coronary artery reperfusion or elevating arterial pO2), or through collateral vessels (elevation of coronary perfusion pressure by alpha‐adrenergic agonists, intra‐aortic balloon counterpulsation); or by increasing plasma osmolality (mannitol, hypertonic glucose); presumably by augmenting anaerobic metabolism (glucose‐insulin‐potassium, hypertonic glucose); by enhancing transport to the ischemic zone of substrates utilized in energy production (hyaluronidase); by protecting against autolytic and heterolytic damage (hydrocortisone, cobra venom factor, aprotinin). Augmentation of myocardial ischemic damage occurred as a consequence of increasing myocardial oxygen requirements (isoproterenol, glucagon, ouabain, bretylium tosylate, tachycardia); by decreasing myocardial oxygen supply either directly (hypoxia, anemia) or through reduction of collateral flow (hemorrhagic hypotension, minoxidil) or by decreasing substrate availability (hypoglycemia). Pilot studies have been carried out in patients with hyaluronidase, nitroglycerin, intra‐aortic balloon counterpulsation, beta‐blocking agents and Arfonad and have shown that these interventions may also reduce myocardial damage, suggesting that the concept of reduction in infarct size following coronary occlusion is applicable clinically.
Diagnosis and Treatment of Acute Gastrointestinal Haemorrhage in a Small District Hospital
Authors: Cronstedt J. , Östberg H. , Carling L. , Lööf L. , Wennerholm M. , Högberg N. , Vogel A.
Published: August 2010

ABSTRACT Ninety‐eight consecutive patients admitted to a small district hospital because of acute gastrointestinal haemorrhage have been studied. Patients with haematemesis and/or melaena were treated with antacids and tranexamic acid from the very beginning and were examined with early panendoscopy. All patients were closely observed in an ordinary medical ward by a staff especially trained to handle acute gastrointestinal bleeding. Seven patients required acute surgery. The overall mortality was 4.1%. It is concluded that acute gastrointestinal haemorrhage can be successfully handled with modern diagnosis and treatment in a small hospital.
Fine‐needle Biopsy of the Liver Complicated with Bile Peritonitis
Authors: Schulz Tom Benkestok
Published: August 2010

ABSTRACT Fine‐needle biopsy has been performed on a healthy subject without any signs of liver disease, especially none of cholestasis. During aspiration, bile appeared in the syringe, and laparotomy was necessary 24 hours later. About 1.5 1 bile was found in the abdominal cavity; no lesions of the biliary system could be seen. Treated with drainage, the further course was uncomplicated.
Premature Ventricular Beats with Narrow QRS Complexes
Authors: Forssell G. , Nordlander R. , Nyquist O. , Orinius E.
Published: August 2010

ABSTRACT A case is presented with premature ventricular beats with narrow QRS complexes. The arrhythmia is discussed on the basis of an ECG recording with 12 simultaneous ECG leads.