bluuebunny/crossref_metadata_2025 huggingface dataset:
Cellular Immunity in Renal Diseases
Authors: Ala‐Houhala Ilpo , Uotila Arja , Pasternack Amos , Krohn Kai
Published: August 2010

ABSTRACT. Cellular immune reactivity was studied in 78 patients with various forms of renal disease by skin testing with four recall antigens and a lymphocyte transformation test with tuberculin PPD and leucoagglutinin. Patients with S‐creatinine ≤230 μmol/l as well as those with chronic pyelonephritis who had S‐creatinine values below 230 μmol/l had significantly lower skin reactions than the controls to streptokinase‐streptodornase, parotitis and PPD. Glomerulonephritic patients with S‐creatinine values below 230 μmol/l had normal skin reactivity. Lymphocyte transformation tests showed decreased reactivity only in patients with S‐creatinine level ≤230 μmol/l. The results suggest an association of chronic pyelonephritis with a defective efferent, nonspecific arm of cellular immunity.
1α‐hydroxyvitamin D3 Treatment of Therapy‐Resistant Symptomatic Hypocalcemia in a Hypoparathyroid Patient with Intestinal Malabsorption
Authors: Hylander Ellinor , Madsen Søren
Published: August 2010

ABSTRACT. The case history of a hypoparathyroid female with short bowel syndrome and long‐standing therapy‐resistant symptomatic hypocalcemia is reported. During treatment with massive doses of the potent vitamin D analog, 1α‐hydroxyvitamin D3(1α(OH)D3), normocalcemia was re‐established and clinical symptoms of hypocalcemia were relieved. Furthermore, significant improvement of intestinal calcium absorption and bone mineral content was observed after three months of treatment with 1α(OH)D3. The data suggest that 1α(OH)D3 may be of therapeutical value in patients with hypoparathyroidism and intestinal malabsorption.
Serum Calcitonin after Renal Transplantation
Authors: Nielsen H. E. , Olsen K. J.
Published: August 2010

ABSTRACT. A prospective study of serum calcitonin was made in 9 patients with chronic renal failure. The patients received a well‐functioning renal transplant. At the time of transplantation serum calcitonin was significantly elevated as compared with the serum concentration in normal controls. During the first 3–5 weeks after renal transplantation serum calcitonin decreased. Afterwards it increased to a level of the same magnitude as the initial value. A significant relationship was found between serum calcitonin and serum phosphorus, whereas no significant correlation was present between serum calcitonin and serum creatinine or between serum calcitonin and serum calcium.
Serum Levels of Testosterone and Luteinizing Hormone in Patients with Chronic Renal Disease
Authors: Krølner Bjørn
Published: August 2010

ABSTRACT. Androgen metabolism has been studied in 33 patients (17 males, 16 females) with chronic renal disease not undergoing dialysis treatment. The mean value of serum testosterone was reduced in both sexes, whereas that of serum luteinizing hormone (LH) was elevated in the males. The parameters became increasingly pathological with decreasing renal function. There was no correlation between serum testosterone and serum LH, indicating an inadequate hypothalamic‐pituitary response to the testicular dysfunction. The clinical significance of this relative hypoandrogenaemia is obscure. A possible relation to the anaemia and bone disease of chronic renal failure is discussed.
Increased Red Cell Content of Zn2+ in Essential Hypertension
Authors: Frithz G. , Ronquist G.
Published: August 2010

ABSTRACT. The zinc content in plasma as well as in erythrocytes was studied in 61 patients with untreated essential hypertension. They displayed an intraerythrocytic mean value of Zn2+ of 128.2 μmoles/l intracellular water, which is significantly higher than the corresponding mean of 101.5 μmoles/l from 42 normal persons. In plasma, on the other hand, the mean zinc value of the hypertensive persons was 15.2 μmoles/l plasma, i.e. well within the normal range of plasma Zn2+. Possible mechanisms underlying the elevated red cell zinc level in hypertension are discussed.
Function of Pituitary‐Thyroid Axis after Surgical Treatment of Non‐Toxic Nodular Goitre
Authors: Blichert‐Toft M. , Egedorf J. , Christiansen C. , Axelsson C. K.
Published: August 2010

ABSTRACT Fifty consecutive patients with benign euthyroid nodular goitre underwent goitre resection. In uninodular goitres a remnant of normal thyroid tissue was left, while in multinodular goitres the remnant presented varying degrees of nodularity. The pituitary‐thyroid function was determined before operation and 3, 6, and 12 months after surgical treatment by measuring serum T4, serum T3, FT4 index, serum TSH, and TSH response to TRH. Moreover, determination of thyroid autoantibodies and 99mTc scintigraphy were carried out. In the uninodular goitre group, removal of a single hypofunctioning adenoma caused a slight but significant increase in thyrotrophic function without significant changes in serum levels of thyroid hormones. The thyrotrophic function showed a more pronounced rise in the multinodular than in the uninodular goitre group. Nonetheless, a decrease in serum levels of thyroid hormones took place. Numerically, the fall was modest, albeit significant. Overt hypothyroidism developed in only one patient. According to the present knowledge of development and maintenance of goitre, our results do not indicate that thyroid replacement therapy is required as a routine measure after nodular goitre resection. Overt thyroid failure or abnormally high TSH levels—conditions in which thyroid substitution should be offered—developed only in the group operated upon for multinodular goitre.
Electrolytes and Whole Body Potassium in Acute Leukemia
Authors: Lantz Bo , Carlmark Björn , Reizenstein Peter
Published: August 2010

ABSTRACT In a consecutive series of 22 patients with acute leukemia, the total body potassium was studied in 18 patients on 39 occasions during relapse and remission. Total body water was also determined. A control group consisting of 88 age‐matched healthy volunteers was also studied. The patients had a significantly lower mean potassium concentration, per kg body weight, per kg lean body mass and per kg water, than the controls (p<0.001). Individually, 11 out of the 18 patients had at least one value below the lower 95% confidence limit. Hypokalemia was frequent both in the patients with low (7/11) and normal (3/6) potassium per kg lean body mass. Five of 13 investigated patients showed laboratory indications of secondary hyperaldosteronism, which might be partly responsible for the hypokalemia. Increased serum or urine levels of lysozyme were found in 62% of the patients.
Work Status after Coronary Bypass Surgery
Authors: Frick M. H. , Harjola P.‐T. , Valle M.
Published: August 2010

ABSTRACT The rate of return to work was assessed in a series of patients with coronary heart disease randomly allocated to medical and surgical treatment groups of 50 patients each. Sixteen of the medical and 19 of the surgical patients were already retired at entry and did not resume work later. Only 9 patients (26%) on medical therapy were working at 2‐year follow‐up in contrast to 18 (60%) working after bypass surgery (p<0.05). Functional classification of angina pectoris and exercise tolerance on ergometry were significantly better in the surgical group, especially in the surgical subgroup at work. Repeated postoperative angiographies of the inserted grafts and native vessels disclosed that completeness of revascularization was related to work status after bypass surgery. The data suggest that a combination of coronary bypass surgery and medical therapy, when indicated, is superior to medical therapy alone in influencing the rate of working in coronary heart disease.
A Controlled Study of Early Discharge after Uncomplicated Myocardial Infarction
Authors: Ahlmark Gösta , Ahlberg Greger , Saetre Helge , Haglund Ingegerd , Korsgren Magnus
Published: August 2010

ABSTRACT Out of 383 myocardial infarction (MI) patients aged below 70 years, 252 (66%) were judged after the third day in hospital to have had uncomplicated infarctions. These patients were allocated at random to two groups, one of which was given treatment for 8 days and the other for 15 days. No significant differences in mortality, morbidity or incapacity for work could be detected during the three‐month period of follow‐up. The findings thus support previous conclusions that early discharge from hospital after uncomplicated MI is not associated with greater risk for the patient than later discharge.
The Effects of a Beta1‐Blocking Agent, Atenolol, on Blood Pressure, Plasma Renin Activity and Prostaglandin F2α Excretion in Patients with Essential Hypertension
Authors: Pitkäjärvi T. , Ylitalo P. , Metsä‐Ketelä T. , Vapaatalo H.
Published: August 2010

ABSTRACT The antihypertensive action ofβ‐blocking agents has been suggested to be associated with the decrease in plasma renin activity (PRA) and can be antagonized by indomethacin, a prostaglandin (PG) synthesis inhibitor. We studied the acute and long‐term effects of aβ1‐blocking agent, atenolol (50 mg b.i.d.), on blood pressure (BP), PRA and urinary PGF2α excretion in 12 male patients (40 years old) with essential hypertension. BP was measured by means of a brachial cuff. PRA and PGF2α were estimated radioimmunologically. One day after the initiation of atenolol treatment, BP fell significantly, the supine values from 159/114 to 143/104 mmHg and the erect from 158/118 to 140/106 mmHg. In six weeks BP decreased further to 135/94 and 134/96 mmHg, respectively. After the cessation of atenolol for three weeks BP rose to the pre‐atenolol level. When the dose was readjusted (25–150 mg daily for 26 weeks), diastolic BP remained at 100 mmHg or higher in only two patients. During the atenolol treatment PRA declined to one‐third of the pre‐atenolol level in one day and to one‐half in six weeks. The urinary excretion of PGF2α was not affected by atenolol. Our results suggest that 1) the antihypertensive action of atenolol and the reduction of PRA are substantial already in one day, and 2) the decrease in BP or PRA is not associated with PGF2α production.
Massive Embolization of Cardiac Myxoma
Authors: Tornvall Gunnar , Olin Christian
Published: August 2010

ABSTRACT A case of left atrial myxoma with massive embolization in a 20‐year‐old woman is described. The initial clinical picture was confusing, but repeated examinations, including enzyme determinations and arteriographies, disclosed the presence of multiple arterial emboli. At embolectomy, histological investigation of embolic masses showed a picture indicating cardiac myxoma. This diagnosis was confirmed by pulmonary angiography and the tumour was removed. Postischaemic oedema of the legs necessitated decompression operations. The peripheral circulation was restored and the final result was excellent. Some aspects of the clinical presentation of this uncommon disease are discussed.
Diastolic Wave Initiating Ventricular Tachyarrhythmias and Suppressible by Lignocaine and Isoprenaline
Authors: Orinius Erik
Published: August 2010

ABSTRACT A patient is described with ventricular tachycardia and premature beats (VPB) probably initiated by a diastolic wave, which—like the VPBs—could be eliminated by lignocaine and isoprenaline.
Myasthenia Gravis and Werlhof's Disease
Authors: Veenhoven W. A. , Oosterhuis H. J. , van der Schans G. S.
Published: August 2010

ABSTRACT A case of Werlhof's disease (immune thrombocytopenia) associated with myasthenia gravis is described. The two disorders developed within a few months of each other. The immunological and practical aspects of the association are discussed.
Aoric Valve Replacement in Elderly Patients
Authors: Storstein Ole , Efskind Leif
Published: August 2010

ABSTRACT During the years 1965‐75, 98 patients more than 65 years of age had aortic valve replacement in our hospital, 24 ball valves and 74 disc valves inserted in their aortic orifice. Actuarial analysis of survival in these patients shows that the operative risk is slightly higher in elder than in younger patients. The survival curve for the following years for those who had disc valve implantation runs parallel to that of younger patients, while those who had ball valve implantation showed a more rapid fall in survival after 3 years. After 10 years, only 30% of patients with ball valve transplantation were alive.
Early Mobilization and Discharge of Patients with Acute Myocardial Infarction
Authors: Lindvall K. , Erhardt L. R. , Lundman T. , Rehnqvist N. , Sjögren A.
Published: August 2010

ABSTRACT Consecutive patients (n = 184) surviving 48 hours in a coronary care unit were divided into one rapidly (RM) (n = 55, 30%) and one conventionally mobilized (CM) group (n = 129, 70%). The selection of RM patients was based on the absence of five early risk indicators (RI), reflecting electrical and mechanical heart dysfunction. During after‐care, five late RIs were evaluated, including a submaximal bicycle exercise test to 50 W, which excluded nine (16%) additional patients from the RM group. After excluding four patients for non‐cardiac reasons, the remaining 42 RM patients were rapidly mobilized and discharged after a mean of nine days, in contrast to a mean of 19 days in the CM group, comprising 121 patients. No RM patient died in hospital and only one patient died during a six‐month follow‐up, compared to 17 (p<0.01) and 28 (p<0.01) patients respectively, in the CM group. Both reinfarction and mortality increased with the number of positive RIs. The early exercise test excluded four patients from the RM group. Altogether 22 of 45 patients showed some abnormality during exercise. Half of these 22 patients were readmitted due to cardiac complications during the follow‐up period. These findings indicate that it is possible to identify a group of patients with AMI suitable for early discharge, and that an early exercise test in selected good risk patients is safe and identifies a group prone to complications during the early follow‐up period.
Changes in Serum Triglyceride and Cholesterol Levels during Long‐Term Phenytoin Treatment for Epilepsy
Authors: Luoma P. V. , Reunanen M. I. , Sotaniemi E. A.
Published: August 2010

ABSTRACTThe effect of long‐term phenytoin therapy on serum triglyceride and cholesterol levels in 20 patients with epilepsy was investigated. In patients followed up for six years, phenytoin treatment was associated with an increase in serum triglyceride and cholesterol levels. The most significant increases in lipid levels were measured during the first months of therapy, whereafter values generally tended to decrease. The elevation in serum triglyceride concentration was relatively greater than that in serum cholesterol level. Cholesterol concentrations, however, remained high for a longer period. The results demonstrate that phenytoin therapy for epilepsy is associated with a rise in serum triglyceride and cholesterol levels, the degree of which seems to be related to the duration of the treatment. The changes presumably reflect phenytoin effects on hepatic lipid metabolism.
Temporal Arteritis and Gangrene of the Tongue
Authors: Arnung Klaus , Nielsen Ida Lind
Published: August 2010

ABSTRACT A 69‐year‐old woman, suspected of having polymyalgia rheumatica, was biopsied from the temporal artery to establish the diagnosis. Six hours after the biopsy, she developed progressive gangrene of the tongue and the floor of the mouth, and intensive steroid therapy was initiated. The histological examination of the biopsy revealed giant‐cell arteritis. Biopsy or other manipulation of the artery is suggested to be the cause of exacerbation of the arteritis locally. Steroid treatment is proposed in all cases prior to the biopsy. Other studies have not shown that the possibility of obtaining a positive histological diagnosis is reduced during or after steroid treatment. A review of the literature on gangrene of the tongue is given.
Myocardial Infarction in Malmö during the 10‐Year Period 1963–1972
Authors: Isacsson Sven‐Olof , Johansson Bengt W.
Published: August 2010

ABSTRACT Myocardial infarctions in Malmö during the 10‐year period 1963‐72 have been studied. The mortality from myocardial infarction decreased significantly among men during this period but not among women. The incidence of hospital‐treated infarction increased significantly among men, mainly due to an increase in primary infarctions. The one‐year survival in this hospital material did not improve during the period. The number of days of sick‐leave during 12 months before primary infarction was significantly higher than expected. The duration of sick‐leave during the year after primary infarction remained unchanged throughout the period. The mortality figures relate to all age groups, comprising 2111 men and 1409 women. The hospital incidence relates to men and women aged 65 years or below and comprises 1323 men and 279 women during the period concerned. The reduced mortality and increased incidence of hospital‐treated infarction are probably explained by the fact that more men seek hospital treatment, leading to a better prognosis. The long duration of sick‐leave after infarction is probably due to causes other than strictly medical factors.
Amino Acid Metabolism in Patients with a Hereditary Myopathy and Paroxysmal Myoglobinuria
Authors: Wahren John , Linderholm Håkan , Felig Philip
Published: August 2010

ABSTRACT Amino acid metabolism of skeletal muscle was examined in two patients with a hereditary myopathy associated with elevated blood levels of lactate and pyruvate and paroxysmal myoglobinuria. Arterial concentrations as well as arm and leg exchange, respectively, of amino acids, lactate, pyruvate and oxygen were studied at rest and during exercise (16 and 33 W) using a bicycle ergometer. The patients' arterial concentrations of amino acids, lactate and pyruvate in the resting state were similar to those of healthy controls. During exercise a marked increase in lactate and pyruvate concentrations was seen in the patients, exceeding the small rise in healthy controls. The arterial alanine concentration rose during exercise in both patients (+120%, +125%), while no change was observed in the controls working at the same work load. No other amino acid showed a consistent rise during exercise. Instead, the arterial levels of the branched chain amino acids (valine, leucine, isoleucine) fell during exercise in the patients but not in the controls. Net release of alanine from the legs in patient 1 rose 2.5‐ and five‐fold during exercise, while no change was seen in the controls. Alanine output from the working arms in patient 2 exceeded that of controls by 50%. In addition, the release of lactate and pyruvate during exercise was much augmented in both patients in comparison to controls. It is concluded that the rate of alanine formation by skeletal muscle during exercise is much increased in patients with this type of myopathy, associated with elevated levels of lactate and pyruvate. These findings lend support to the theory that the carbon skeletons for alanine synthesis by skeletal muscle are derived from muscle glycolysis.
Relief of Pruritus as an Early Sign of Spinal Cord Compression in Hodgkin's Disease
Authors: Olsson H. , Brandt L.
Published: August 2010

ABSTRACT In a patient with advanced Hodgkin's disease (HD) associated with generalized pruritus, an unexpected relief of itching was found to be an early sign of spinal cord compression. Following irradiation of an extradural mass at the Th II level, itching recurred. Although the mechanisms bringing about itching in HD are unknown, the relief and recurrence of the symptom in our patient are in line with a peripheral origin of pruritus in the disease. Spontaneous relief of pruritus in HD despite other signs of active disease should prompt a neurological examination, since early recognition and treatment of spinal cord compression in lymphoma are important to avoid residual neurological disability.
Isovolemic Hemodilution in Erythrocytosis Secondary to Chronic Obstructive Lung Disease
Authors: Danielson Mats , Nordenström Jörgen
Published: August 2010

ABSTRACT Patients with chronic obstructive lung disease often present with a combination of respiratory and circulatory insufficiency. In secondary erythrocytosis (polycythemia) blood viscosity rises and further impairs peripheral oxygenation. Against this background, a patient with acute exacerbation of a chronic respiratory disease with secondary erythrocytosis was treated with isovolemic hemodilution during two periods of hospitalization. During each of these two periods, hemodilution was achieved by removing 1700 and 1750 ml blood, respectively, and replacing this simultaneously by infusing equal volumes of dextran 70 (Macrodex®). The patient's general condition improved, her dependence on supplementary oxygen drastically decreased and the blood gas values improved after hemodilution. The progress of the disease in this case suggests that the raised hematocrit rather than hypervolemia contributed to the patient's poor condition. It also illustrates that too intensive diuretic therapy in cardiac insufficiency with concomitant erythrocytosis can lead to hemoconcentration and thereby add to the strain on an already overloaded circulation.
Stroke Registration in Göteborg, Sweden, 1970–75
Authors: Harmsen Per , Berglund Göran , Larsson Owe , Tibblin Gösta , Wilhelmsen Lars
Published: August 2010

ABSTRACT Strokes occurring among persons between 15 and 65 years of age (population 300 000) have been registered since 1970 in Göteborg, Sweden. Control of the validity showed that less than 10% of all cases of stroke were undetected. During the period Nov. 15, 1970–May 14, 1975, 986 stroke events occurred in 941 patients, giving an annual average incidence rate of 73 (89 for men and 58 for women) per 100 000 individuals 15–65 years of age. The incidence for all ages was estimated to be about 200/100 000. The rates were higher for men than for women in all age groups. There was a female preponderance for subarachnoid haemorrhage but a male preponderance for other types of stroke. Incidence rates increased with age, most rapidly for brain infarcts and unspecified stroke. Fatality rates levelled out 3 weeks after onset of stroke; they were high for subarachnoid and intracerebral haemorrhage and low for cerebral infarction and unspecified stroke. Incidence rates were lower than those found in two similar studies from Denmark and Finland, and even greater variations were found with respect to types of stroke. Fatality rates were similar to those reported by other authors.
Effect of Prolonged In Vivo Administration of Leukocyte Interferon on the Mitogen Responsiveness of Human Lymphocytes
Authors: Einhorn Stefan , Blomgren Henric , Cantell Kari , Strander Hans
Published: August 2010

ABSTRACT Peripheral lymphocytes from patients with osteosarcoma receiving interferon (IF) as adjuvant therapy were tested in vitro for response to various mitogens. Prolonged parenteral administration of IF preparations caused no major change of the mitogen responses. The ability of IF, when added in vitro, to inhibit lymphocyte response to mitogens was not altered to any major extent by in vivo administration of IF.
Disopyramide Plasma Levels in Cardiac Patients on Maintenance Therapy
Authors: Landmark Knud , Storstein Liv , Larsen Anne
Published: August 2010

ABSTRACT The antiarrhythmic agent disopyramide, in a dosage of 200 mg/8 h, was given to 7 cardiac patients. The drug was fairly rapidly absorbed, and the mean peak plasma concentration (3.5 μ/ml) was measured 1 h after administration of the first dose. The mean biological half‐life (7.8 h) was slightly prolonged compared to that reported in normal volunteer subjects. Mean steady state plasma concentrations within the therapeutic range were attained 24–32 h after the start of medication. The fluctuations in the plasma levels were in the order of 30%; however, a wide spread of the values was observed. The drug was well tolerated.
Incidence of Urolithiasis Leading to Hospitalization in Finland
Authors: Juuti Markku , Heinonen Olli P.
Published: August 2010

ABSTRACT The study population consists of 2304 urolithiasis patients discharged from all hospitals in 21 central hospital districts in 1970. The incidence rate was 50 per 100 000 inhabitants per year, 74 for men and 27 for women. The age distribution resembles the Gaussian curve, with a peak between 45 and 49 years for men and between 50 and 54 years for women. The male/female ratio was 2.7 in the entire material, about 1 in the age group 0–24 years, about 3 in the age group 25–74 years and about 1.5 in patients 75 years or older. The standardized incidence was highest in Southeastern Finland and in the archipelago of åland, and lowest in the coastal area of Southwestern Finland. In the area with high incidence, the age distribution of urolithiasis patients differed from that in the rest of the country: in the age groups over 40 the incidence of urolithiasis did not appear to decrease. This difference was attributed to some lifelong environmental exposure. The standardized incidence of urolithiasis leading to hospitalization was higher among urban than rural residents. Seasonal variation in the hospital admissions for urolithiasis was not evident, temporal patterns of admissions were, however, dissimilar in urban and rural areas, and might reflect differences in the physical activities of urban and rural populations.
An Atypical Manifestation of Multiple Myeloma in a 24‐ Year‐Old Male
Authors: Wille L. E. , Wetteland P. , Förre ö. , Hovig T. , Winnem M.
Published: August 2010

ABSTRACT A structurally unusual, B‐cell‐derived malignant tumour is reported in a 24‐year‐old male. The gross autopsy findings were those of classical myelomatosis, with extensive and centrally located skeletal infiltrates and typical myeloma kidneys. The tumour cells were, however, morphologically very unusual. All elements were markedly pyroninophilic, indicating active protein synthesis, but typical plasma cell characteristics were lacking. The cells were ultrastructurally characterized by large and distended vacuoles, often with ribosomal granules attached, and containing an amorphous material. Virtually all tumour elements were found to be heavily loaded with IgG(k) in immunofluorescence studies. IgG paraprotein was also found in serum, and kappa light chains in the urine. It is concluded that the tumour represents an intermediate form between multiple myeloma and a tumour originating from the large pyroninophilic, immunoglobulin‐secreting lymphocytes.
Effect of 24‐Hour Somatostatin Infusion on Glucose Homeostasis and on the Levels of Somatomedin A and Pancreatic and Thyroid Hormones in Man
Authors: Lins P. E. , Efendic S. , Hall K.
Published: August 2010

ABSTRACT In order to investigate whether somatostatin plays a role in the regulation of thyroid hormone secretion we have compared the effects of a prolonged somatostatin infusion on insulin and glucagon levels, on the one hand, with its effect on T4, T3, rT3 and TSH, on the other. Furthermore, the serum levels of somatomedin A were determined. Saline was infused in control experiments. Cyclic somatostatin was given as an i.v. bolus of 200 μ followed by a constant rate infusion of 50μg/h during 24 hours. Somatostatin suppressed basal insulin and glucagon levels as well as insulin responses to meals but did not influence somatomedin A levels. T4, and T3 decreased during the first hour, whether somatostatin was given or not. Thereafter, T4 and T3 remained stable in the control experiments, while they continued to decrease slowly when somatostatin was added. The suppressive effect of somatostatin was significant 11 hours (p<0.05) and 24 hours (p0.005) after the onset of the infusion. In contrast, rT3, and TSH were not suppressed by somatostatin. The fact that basal TSH did not decrease, favors the idea that the suppression of T4 and T3 was mainly due to a direct inhibitory effect of somatostatin on the thyroid gland. Our observation that a low dose of somatostatin decreases peripheral T4, and T3 levels supports the idea that somatostatin plays a role in the regulation of thyroid hormone secretion.
Incidence and Significance of Heartmuscle Antibodies in Patients with Acute Myocardial Infarction and Unstable Angina
Authors: Liem K. L. , ten Veen J. H. , Lie K. I. , Feltkamp T. E. W. , Durrer D.
Published: August 2010

ABSTRACTThe incidence of heartmuscle antibodies was studied prospectively in 136 patients consecutively admitted for acute myocardial infarction (AMI) and in 95 patients with unstable angina. Heartmuscle antibodies were determinted with the indirect immunofluorescence technique on days 1,10,20 and 30 in patients with AMI and on days 1 and 10 in patients with unstable angina. Heartmuscle antibodies were found in 16/136 AMI patients (12%) and in 3/95 (3%) with unstable angina. None of the AMI patients developed post‐myocardial‐infarction syndrome in the 2–4 weeks after infarction or during the one‐year follow‐up. The AMI patients with and without heartmuscle antibodies were comparable with respect to age, sex, site and size of infarction, incidence of early pericarditis and previous infarction.
Hyperparathyroidism Associated with Distal Tubular Dysfunction but Intact Reabsorption of Protein in the Proximal Tubules
Authors: Wibell Lars , Dahlberg Per Anders , Karlsson Anders
Published: August 2010

ABSTRACT The urinary output ofβ2‐microglobulin was measured in ten hypercalcemic patients undergoing surgery because of hyperparathyroidism. In three subjects theβ2‐microglobulin excretion was abnormally increased and in seven patients it was normal before surgery. Three of these seven patients displayed markedly impaired distal tubular function with a reduced urinary concentration capacity. After surgery all patients became normocalcemic and the urinary concentrating capacities improved. Theβ2‐mciroglobulin excretion, on the other hand, remained unchanged. Thus, hypercalcemia per se does not readily affect the proximal tubular function of reabsorbing low molecular weight proteins. “Tubular proteinuria”, if found in patients with hypercalcemia, should be suspected to reflect damage to the kidney by additional mechanisms.
A Study of Stroke Patients Treated in a Non‐Intensive Stroke Unit or in General Medical Wards
Authors: von Arbin M. , Britton M. , de Faire U. , Helmers C. , Miah K. , Murray V.
Published: August 2010

ABSTRACT. To study the representativity and outcome of patients admitted to a stroke unit (SU) (n =269), a comparison was made with all stroke patients treated in general medical wards (GMW) (n =225) in the same hospital during two years. There was no difference between the patient groups regarding sex, age, previous cardiovascular diseases or neurological deficit on admission. As expected, more diagnostic examinations were performed in the SU than in the GMW where a diagnosis of ill‐defined stroke was very frequent. A higher frequency of lumbar puncture with CSF spectrophotometry would have increased considerably the number of specific diagnoses in the GMW. Acute and, particularly, secondary prophylactic treatment was more often given in the SU. There was no difference between the patient groups regarding mortality or length of hospital stay.
Vitamin D Deficiency in Welfare Institutions for the Aged
Authors: Toss G. , Almqvist S. , Larsson L. , Zetterqvist H.
Published: August 2010

ABSTRACT. Serum concentrations of 25‐OH‐D in a group of 47 elderly people (70–94 years old) living in homes for the aged were lower than those in a matched control group living in their homes. No differences between the groups were noted in serum ionized calcium, alkaline phosphatase, inorganic phosphate, magnesium or parathyroid hormone. The low serum concentration of 25‐OH‐D may be due to less outdoor activities and/or a smaller dietary vitamin D intake in the institutionalized group. The importance of preserving an adequate vitamin D status in geriatric patients is emphasized.
Abnormal Pattern of the Rough Endoplasmic Reticulum of Plasma Cells in Multiple Myeloma with Multiple Concentric Lamellar Bodies and “Single Sac Loops”
Authors: Stavem P. , Ly B. , Rørvik T. O.
Published: August 2010

ABSTRACT. A patient with IgG myeloma showed a highly abnormal pattern of the rough endoplasmic reticulum (RER) with multiple concentric lamellar bodies and “single sac loops”. This abnormal pattern might be due to either a complete rearrangement of the architecture within the cell, and/or a pathology in the wall of the sacs of RER.
Cortisone‐Induced Remission of Hypothyroidism in Schmidt's Syndrome
Authors: Petersen Hans Draminsky , Bergman Mozes
Published: August 2010

ABSTRACT.A patient with autoimmune Addison's disease, hypothyroidism and primary gonadal insufficiency is described. Initial treatment with cortisone improved his thyroid function, probably through cortisone suppression of the autoimmune reactions. It was, however, not possible to normalize the thyroid function completely. The decreased testicular function did not improve during the cortisone treatmen.

Schmidt's syndrome
Effect of Long‐Term Treatment with Human Leukocyte Interferon on Various Laboratory Parameters
Authors: Ingimarsson Snorri , Bergström Kurt , Brostrom Lars åke , Cantell Kari , Strander Hans
Published: August 2010

ABSTRACT. Leukocyte interferon was given by i.m. injection as adjuvant therapy to 9 patients with os‐teosarcoma. The dose was 3times 106 standard units daily for one month, and then 3 times a week for the next 17 months. Blood samples were drawn at intervals for a number of routine tests during the 18‐month course of interferon administration and during the subsequent 18 months. On withdrawal of the interferon treatment, the mean Hb concentration rose significantly and the mean ESR fell significantly. There was no significant change in the leukocyte and platelet counts or in the alkaline phosphatase, alanine and aspartate aminotransferase or plasma protein levels.
Immunological Studies on Human Thymus
Authors: Christensson Birger , Matell Georg , Biberfeld Peter
Published: August 2010

ABSTRACT. Suspended cells and tissue sections from myasthenia gravis (MG) and control thymuses were characterized for surface expression and his‐tological distribution of immunoglobulin (Ig) and receptors for sheep erythrocytes (SE), the Fc part of IgG (Feγ) and of IgM (Fcμ) and complement factors C3b and C3d (CR). In sections the cortical areas from both MG and control thymuses expressed SE as well as Feγ receptors, whereas medullary areas only showed weak SE binding. In contrast to control patients, MG thymuses also contained Ig+ cells confined to nodular areas of the thymic medulla. These nodules stained for both IgG and IgM, and were polyclonal with respect to light chains. In several cases IgD was found as well. In addition, the nodular areas were positive for C3b and C3d receptors. In serial sections, these Ig+ CR+ nodules corresponded to morphologically characteristic lymphoid follicles. Such B cell follicles were observed in variable numbers in all MG thymuses, whether hyperplastic or with normal histology. Five thymomas gave heterogeneous results with regard to immunological markers. Comparison of methods showed that receptor and Ig indication on sections was more sensitive than corresponding tests on thymus cells in suspension.
Castle's Test (with Vitamin B12and Normal Gastric Juice) in the Ileum in Patients with Genuine and Patients with Tapeworm Pernicious Anaemia
Authors: von Bonsdorff Bertel , Gordin Ruben
Published: August 2010

ABSTRACT.A mixture of vitamin B12and normal gastric juice, instilled through an intestinal tube into the ileum, produces haematological remission in patients with tapeworm pernicious anaemia. When a similar mixture is administered by mouth, this effect fails to occur. This observation constitutes evidence in favour of the view that Diphyllobothrium latum, attached to the proximal portion (JeJunum) of the intestine, absorbs the vitamin B12contained in the food, thus preventing vitamin bound to the intrinsic factor of the gastric juice from reaching the receptors in the distal portions of the small intestine of the host. In genuine pernicious anaemia, remission results from the administration of vitamin B12+gastric juice both by mouth and into the ileum.
HDL‐Increasing Effect of Cyclofenil
Authors: Persson Bertil , Fex Göran
Published: August 2010

ABSTRACT. Nineteen patients with low levels of HDL as measured by APO‐AI have been treated with cyclofenil (a non‐steroid stilboestrol isomer with very low oestrogenic effects) as the only form of therapy. The therapy elicited a highly significant rise of about 15% in HDL levels. A slight increase in trans‐aminases occurred in 6 patients but was reversible without terminating therapy.
Urinary Zinc Excretion during Treatment with Different Diuretics
Authors: Wester P. O.
Published: August 2010

ABSTRACT. Urinary zinc excretion was studied in a randomized trial in 9 patients during treatment with bendroflumethiazide, chiorthalidone and hy‐drochlorothiazide and in another 9 patients during treatment with bumetanide, furosemide and triam‐terene. During treatment with the thiazides, the zinc concentration rose by 30% and the total amount of zinc excretion increased by 60%. In contrast, during treatment with the loop‐diuretics, urine zinc concentration diminished and the total amount of zinc excretion increased much less than during therapy with the thiazides. With respect to the importance of zinc as an essential element in human metabolism and the frequency of diuretic treatment, the observed increased urinary losses of zinc deserve further attention.
Electrocardiographic Diagnosis of Ventricular Septal Infarction
Authors: Hellerstedt Margareta , Jonasson Rune , Orinius Erik
Published: August 2010

ABSTRACT. To find electrocardiographic criteria for ventricular septal infarction, two series of ECGs were studied, all without fascicular/bundle branch block and complete heart block. One series consisted of the ECGs recorded at thallium‐201 scintigraphy in 49 patients 2–3 weeks after an acute myocardial infarction (AMI); in this series the 14 patients with a defect in the septal wall of the left anterior oblique view were compared with the 35 without. The other series consisted of the last premortal ECGs in 20 AMI patients with and in seven without a septal involvement of the infarct at autopsy. The best criterion from earlier literature was absence of a q wave in lead V6, showing a sensitivity of 53 % in the combined scintigraphy and autopsy series. The predictive value of a positive test was 75%. The very first QRS vector in the frontal plane tended to discriminate better than absence of a q in lead V6. With a similar predictive value, 71 %, the sensitivity of a deviating vector (+120° to ‐60° and ‐120° to ‐180°) was 65% in the combined scintigraphy and autopsy groups. Most of the patients with a deviating vector showed this on admission. The clinical importance of an early diagnosis of septal involvement in AMI remains to be settled.
Membranous Glomerulopathy in a Patient on Captopril
Authors: Hoorntje S. J. , Donker A. J. M. , Prins E. J. L. , Weening J. J.
Published: August 2010

ABSTRACT. This case report describes a patient with essential hypertension in whom captopril during seven months resulted in a nephrotic syndrome. A renal biopsy specimen revealed membranous glomerulopathy stage I. After withdrawal of the drug, urinary protein loss disappeared within ten days. However, a second biopsy three months later still showed granular deposition of IgA, IgG, IgM and C3 in the glomerular basement membrane and unchanged subepithelial electron‐dense deposits on electron microscopy. Glomerular filtration rate remained normal during the observation period.
Effect of Verapamil on Blood Glucose and Serum Insulin in Patients with Hyper‐ and Hypothyroidism
Authors: Andersson D. E. H. , Röjdmark S.
Published: August 2010

ABSTRACT. This investigation was carried out in order to study whether calcium antagonism may affect the basal peripheral venous insulin and/or glucose concentration in patients with abnormal thyroid function. For this purpose verapamil, a calcium blocking agent, was infused i.v. over a period of 180 min into 5 thyrotoxic, 4 hypothyroid and, for comparison 5 healthy controls. In the thyrotoxic group, verapamil induced a significant fall in glucose from 60 min on, whereas it had no significant effect on the concomitant insulin concentration. After 4–9 months, 4 of the 5 patients in this group were reinvestigated when euthyroid due to antithyroid treatment. At that time verapamil was without effect on both insulin and glucose concentrations. In the hypothyroid patients, verapamil brought about a transient but significant increase in insulin. Accordingly, insulin had increased by 93± 14% (p<0.01) after 30 min. From 60 min on it had returned to the control level. The blood glucose concentration tended to fall in response to the infusion, but never reached significantly below the control level. When 3 of the 4 hypothyroid patients were reinvestigated in an euthyroid state after 2–4 months of oral thyroxine substitution, verapamil did not affect either the insulin or the glucose concentration. In the healthy subjects verapamil was without effect on both the insulin and glucose concentrations. This study thus demonstrates an abnormal and different insulin‐glucose response pattern to verapamil infusion in untreated hyper‐ and hypothyroid patients, which can be restored to normal by medical treatment, rendering these patients euthyroid.
Renal Function and Morphology in Long‐Term Lithium and Combined Lithium‐Neuroleptic Treatment
Authors: Bucht G. , Wahlin A. , Wentzel T. , Winblad B.
Published: August 2010

ABSTRACT.Ten patients on long‐term lithium therapy and ten on lithium and neuroleptics (combination therapy) were examined with renal biopsy and tests of renal function. Patients on combination therapy had more pronounced histopathological changes and lower concentrating capacity than patients on lithium alone. Patients on combination therapy had received a larger total dose of lithium and had had higher maximum serum lithium levels than patients on lithium alone. Patients with large daily urine volumes had a low concentrating capacity. There was a negative correlation between degree of histopathological lesions and urinary concentrating capacity. Estimation of urinary concentrating capacity seems to be of value for the assessment of renal lesions in lithium treatment.
Epidemiological Studies in the Upernavik District, Greenland
Authors: Kromann Niels , Green Anders
Published: August 2010

ABSTRACT. An epidemiological survey of several chronic diseases in the Upernavik district, Northwest Greeland, is reported. The study population (ap‐prox. 1 800 inhabitants) is one of the remaining whaling and sealing populations in Greenland. It was observed over the 25‐year period 1950–74 as to the incidence of the diseases, which was based on all cases diagnosed in hospital during this period. The disease pattern of the Greenlanders differs from that of West‐European populations, having a higher frequency of apoplexy and epilepsy but a lower frequency or absence of acute myocardial infarction, diabetes mellitus, thyrotoxicosis, bronchial asthma, multiple sclerosis and psoriasis. The distribution of cancer types differs from that of the Danish population, but the total incidence of cancer is of the same magnitude. Further comparable studies should be performed in Greenlandic districts that are characterized by more profound changes in life style, in order to elucidate the effect of these changes on the disease pattern.

Acta Med Scand 208: 401, 1980.
Aneurysm of the Popliteal Vein as a Cause of Pulmonary Embolism
Authors: Persson Bo G. , Donnér Mikael , Petersson Bo , Eklöf Bo , Wintzell Knut
Published: August 2010

ABSTRACT. A case of recurrent pulmonary embolism, secondary to thrombosis in an aneurysm of the popliteal vein is described. The source of embolism was not obvious clinically, and it was discovered only after venography. The anomaly was amenable to surgical intervention and the patient was cured from his source of embolism. We have found only one similar case in the literature.
Bacteriuria in a Population Sample of Women
Authors: Bengtsson C. , Bengtsson U. , Lincoln K.
Published: August 2010

ABSTRACT.The prevalence of bacteriuria was studied in a population sample of women aged 38–60. Significant (≥ 100 000 bacteria/ml of the same species in two consecutive specimens) or “probable” bacteriuria (≥ 100 000 in the first and 20 000–90 000 bacteria/ml of the same organism in the second specimen) were found in 5% of the women, increasing from 3.5 % in women aged 38 to 8.6% in women aged 60. Escherichia coli predominated (90 % of those with significant bacteriuria), and 91 % of the Escherichia coli strains were sensitive to sulphonamides. About half of the women who were non‐bacteriuric after short‐term treatment had one or more recurrent urinary tract infections during a two‐year follow‐up period. Serum creatinine and urine concentrating capacity did not differentiate women with significant or “probable” bacteriuria from the others. Pathological radiological changes were found in 17% of bacteriuric women who were submitted to i.v. pyelography. When re‐examined six years after the first study, 23% of initially bacteriuric and 5% of initially non‐bacteriuric women had bacteriuria. Patients with renal lesions have been followed for ten years, but none of them has developed progressive renal impairment. Three women with chronic pyelonephritis and acute pyelonephritic attacks in the past were discovered when screening the concentrating capacity in this population sample, but they were non‐bacteriuric when screening for bacteriuria. A study of this kind must be conducted over many years before valid conclusions can be drawn.
Occurrence of Adult Fanconi Syndrome in Benign Monoclonal Gammopathy
Authors: Dahlström U. , Mårtensson J. , Lindström F. D.
Published: August 2010

ABSTRACT. Adult Fanconi syndrome has been described as a manifestation of a latent form of myeloma. Since benign monoclonal gammopathy (BMG) is a latent form of myeloma we studied ten patients with this disease with respect to the adult Fanconi syndrome. These patients were selected from a larger group with BMG because of urinary excretion of monoclonal light chains. In no instance could a complete Fanconi syndrome be shown, but one patient, who also had a diabetic nephropathy, had very high levels of urinary β2‐microglobulins. Two additional patients showed minor features included in the adult Fanconi syndrome. BMG does not seem to be associated with an increased risk of developing adult Fanconi syndrome.
Lymph Node Toxoplasmosis
Authors: Miettinen Markku , Saxén Lauri , Saxén Erkki
Published: August 2010

ABSTRACT. The clinical features, histology and follow‐up of lymph node toxoplasmosis are presented in the light of 237 histologically and serologically verified cases. Lymph node toxoplasmosis is a disease with mild symptoms, and in most patients the enlarged lymph nodes were the only sign. Three fourths of the patients were women and the majority were under 40 years of age. The clinical picture was not specific, but suggestive features included a relatively short history, presence of the nodes in the neck and relative lymphocytosis in peripheral blood. Histologi‐cal changes in the lymph nodes were characteristic. The most important features were strong hyperplasia but preserved general structure with small groups of epithelioid cells both in the paracortical area and in the germinal centers. Strands of monocytoid cells were usually found. 80% of the cases with typical histology also had high antibody titers, and in more than 85 % of the cases with high antibodies, the lymph nodes presented a typical picture of toxoplasmosis. The follow‐up revealed that lymph node toxoplasmosis. The follow‐up revealed that lymph node txo‐plasmosis is a disease without complications, nor is there any connection with malignant lymphomas.
Carditis and Arthritis Associated with Campylobacter Jejuni Infection
Authors: Pönkä A. , Pitkänen T. , Pettersson T. , Aittoniemi S. , Kosunen T. U.
Published: August 2010

ABSTRACT. Three patients who developed carditis after enteritis caused by Campylobacter jejuni are reported. Two had perimyocarditis and one endocarditis. The cardiac sequelae persisted in two patients. Concomitant arthritis appeared in two of these patients, monoarthritis in one and polyarthritis in the other.