bluuebunny/crossref_metadata_2025 huggingface dataset:
SUCCESSFULLY TREATED PRIAPISM IN ACUTE MYELOBLASTIC LEUKEMIA COMPLICATING HODGKIN'S DISEASE
Authors: Veenhof C. H. N. , van der Meer J. , Goudsmit R.
Published: August 2010

Abstract. Acute myeloblastic leukemia developed in a 22‐year‐old male patient who had suffered from Hodgkin's disease since his eighth year. In this period of 14 years the patient received radiotherapy (a total of 14 000 rads) and several courses of cytotoxic drugs. During the final admission priapism and bilateral central retinal vein thrombosis developed. Both complications subsided during a combined treatment with cytotoxic drugs and the defibrinating agent ancrod. After 34 days of treatment priapism gradually diminished and eventually sexual function was restored. Notwithstanding serious thrombocytopenia, lowering of the plasma fibrinogen level below 50 mg/100 ml during most of the 60 days of ancrod treatment did not cause hemorrhagic complications.
A CONTRIBUTION TO THE KNOWLEDGE OF THE HYPO‐β‐LIPOPROTEINEMIA
Authors: Rerabek Jaro , Eliasch Harald
Published: August 2010

Abstract. Low density lipoprotein (LDL) deficiency (hypo‐β‐lipoproteinemia) was disclosed on routine examination of a 25‐year‐old man. Clinical examination yielded normal findings. Serum was not devoid of LDL. A slightly reduced absorption capacity was found in the vitamin A test and no acanthocytes could be demonstrated in the peripheral blood smear. The dyslipoproteinemia was characterized by a low concentration of the β‐lipoprotein, which amounted to less than one‐tenth of normal. In addition there was a relative increase in the α‐lipoprotein (HDL) content. An essentially similar electrophoretic pattern was found following intake of food. The electrophoretic pattern was normal in the proband's father, brother and two nephews. In the mother a subnormal content of β‐lipoprotein with a relative increase in the α‐lipoprotein band was found. Analysis of the LDL apoproteins in the proband suggested that the described deficiency could be explained by two defects, i.e. an insufficient biosynthesis of specific LDL apoproteins and insufficient linkage between the apoprotein and the lipid moiety of the LDL. The possible mode of inheritance of the low density lipoprotein deficiency is discussed and a polygenic trait is proposed.
CARBOHYDRATE‐STIMULATED FATTY ACID SYNTHESIS DE NOVO IN HUMAN ADIPOSE TISSUE OF DIFFERENT CELLULAR TYPES
Authors: Sjöström L.
Published: August 2010

Abstract. Fatty acid (FA) synthesis in vitro by human adipose tissue has been determined as glucose incorporation into FA by slices and as the overall enzyme capacity for incorporation of acetyl units into FA from acetate and citrate by an optimal cytoplasmic assay system. Twelve subjects with normal, hypertrophic, hyperplastic or combined hypertrophic‐hyperplastic adipose tissue were examined during basal, weight stable conditions and after 3 and 22 days on a high‐carbohydrate low‐fat chemically defined diet (Vivasorb®) administered in amounts resulting in a moderately negative energy balance. Incorporations obtained with the cytoplasmic assay were several times higher than those with the whole cell technique. During carbohydrate feeding FA synthesis increased 3 and 11 times, respectively, as measured with the subcellular and the whole cell techniques. However, FA synthesis de novo was of little quantitative importance in human adipose tissue even during stimulated conditions. Expressed per g adipose tissue triglyceride (TG), there were no differences in FA synthesis between the four cellular groups before or during high‐carbohydrate feeding. Expressed per cell, large fat cells demonstrated a higher enzyme capacity for FA synthesis than did cells of normal size. The correlation between fat cell size and enzyme capacity for FA synthesis increased during the course of high‐carbohydrate feeding. During but not before high‐carbohydrate feeding there were several correlations between different whole cell and subcellular activities of adipose tissue and also strong correlations between FA synthesis in adipose tissue and serum TG. The latter correlation was most likely not related to a direct dependence between the two factors. Contrary to earlier reports, this investigation indicates the presence of ATP citrate lyase [E.C.4.1.3.8] in human adipose tissue and demonstrates that, in vitro, the enzyme capacity for citrate incorporation is at least as large as the capacity for acetate incorporation into FA if optima! conditions are used for both precursors.
ARRHYTHMIA PROPHYLAXIS WITH PROCAINE AMIDE: PLASMA CONCENTRATIONS IN RELATION TO DOSE
Authors: Collste Per , Karlsson Erling
Published: August 2010

Abstract.Forty patients with suspected or confirmed acute myocardial infarction have been treated with procaine amide orally because of ventricular arrhythmia. The patients were divided into three groups with respect to doses and dosage intervals. Frequent determinations of the concentration of procaine amide in plasma were performed by a fluorometric method. Plasma concentrations between 4 and 6 μg/ml, which have been reported to be the therapeutic range, were achieved only with one of the dose schedules employed, i.e. a total daily dose of 50 mg/kg b.wt., administered in divided doses every 3 hours. However, even a 4‐hour administration interval may give rather acceptable plasma concentrations. In patients with cardiac and renal insufficiency the dose must be individually reduced.
THE EFFECT OF MEFRUSIDE ON PLASMA AND MUSCLE ELECTROLYTES AND BLOOD PRESSURE IN NORMAL SUBJECTS AND IN PATIENTS WITH ESSENTIAL HYPERTENSION
Authors: Bergström J. , Hultman E. , Solheim S. B.
Published: August 2010

Abstract.The effect of mefruside on plasma and muscle electrolytes has been studied in 10 normal subjects and in 8 patients with essential hypertension. The normal subjects, 5 men and 5 women, were given 75 mg (to men) or 50 mg (to women) mefruside daily for one week. The hypertensive patients, who were on normal diet, were treated with 25 mg mefruside daily over a period of 5 months. No extra potassium was supplied. Muscle tissue was obtained by needle biopsy from the m. quadriceps femoris before and after the period of mefruside administration. Tissue samples were analysed for water, sodium, potassium, magnesium, chloride and (in the series of normal subjects) total phosphorus. In the normal subjects a slight hypochloremic, hypokalemic alkalosis was recorded in the plasma; in muscle tissue the total water content decreased, as did the potassium content and the K/P ratio, the decreases averaging 3–4% of the normal mean value. The blood pressure was not changed. Long‐term treatment with mefruside in patients with hypertension resulted in a significant blood pressure reduction. Plasma potassium decreased by 0.7 mEq/l; the muscle potassium content was, however, unchanged and the intracellular potassium concentration (calculation based on the chloride method) was significantly increased. The total water content and the intracellular water content (calculation based on the chloride method) was significantly reduced. There was a correlation between the decrease in total water and the change in extracellular water, sodium and chloride content. We conclude that short‐term treatment in normal subjects with a high daily dose of mefruside during one week causes a slight depletion of intracellular (muscle) potassium, whereas long‐term treatment with a lower dose in hypertensive patients depletes the extracellular fluid potassium without significantly affecting the intracellular content. The reduction in total water and extra‐ and intracellular water recorded in the hypertensive patients may have a casual relation to the antihypertensive effect.
PLATELET COUNTS IN MOTHERS AND THEIR NEWBORN INFANTS WITH RESPECT TO ANTE‐PARTUM ADMINISTRATION OF ORAL DIURETICS
Authors: Jerkner K. , Kutti J. , Victorin L.
Published: August 2010

Abstract. In order to investigate a possible effect of diuretics on maternal and neonatal thrombopoiesis, platelet count was performed on 200 mothers and their offspring. One hundred of the mothers had received treatment with oral diuretics for at least 3 weeks prior to the admission, while the remaining 100 had not received any diuretic agent. Transitory thrombocytopenia (defined as a platelet count below 100 000/mm3) was observed in 6% of treated mothers, 9% of control mothers, 1% of infants born to treated mothers and 7% of control infants. No case of thrombocytopenia was associated with clinical signs of a bleeding tendency. It is concluded that short‐time ante‐partum therapy with oral diuretics in this series did not affect the platelet counts in mothers or their newborn infants.
FATTY LIVER PERSISTING FOR UP TO 33 YEARS
Authors: Hilden M. , Juhl E. , Thomsen Å. Chr. , Christoffersen P.
Published: August 2010

Abstract. Re‐evaluation of 890 consecutive liver biopsy specimens from the period 1938–56 has been done and fatty liver diagnosed in 59 patients. A follow‐up examination was performed on 58 of these patients, their time of observation in respect to long‐time prognosis of fatty liver varying from 16–33 years, half of the patients being alcoholics. Evaluation of the liver was done on the basis of microscopy from repeated biopsy or autopsy (18 cases), on postmortem gross examination (19 cases), on clinical and laboratory findings (4 cases) or on death certificate (17 cases). In the follow‐up period cirrhosis of the liver was diagnosed in two patients only, one being an alcoholic. A certain degree of fatty liver was shown in nearly all cases in which histology had been performed. Our results support the hypothesis that steatosis and cirrhosis represent the various forms of response from the liver rather than coherent stages in the development of alcoholic liver damage.
THE DIAGNOSTIC VALUE OF THE INHIBITORY EFFECT OF ETHANOL ON GALACTOSE ELIMINATION IN LIVER DISEASE
Authors: Lindskov J. , Bach‐Mortensen N.
Published: August 2010

Abstract. The inhibitory effect of ethanol on the galactose elimination as calculated from changes in the galactose elimination capacity and the galactose half‐time was examined in three normal individuals, four patients with cirrhosis and ten patients with steatosis, most of whom were alcoholics. The degree of ethanol inhibition did not differ in patients with cirrhosis from that in alcoholic patients with steatosis. According to these results the ethanol inhibition of the galactose elimination is not a specific diagnostic test for steatosis. The galactose elimination capacity during ethanol administration was of the same order of magnitude in the different groups of patients with liver diseases as well as in the normal individuals. The cause of this phenomenon and the reason why the inhibition of ethanol is smaller in liver disease remain to be elucidated.
CHRONIC CONGESTIVE HEART FAILURE TREATED WITH LONG‐TERM INFUSION OF GLUCAGON
Authors: Forfang Kolbjørn , Falch Dagfinn , Frey Harald M. M. , Fremstad Dag
Published: August 2010

Abstract. Eight patients with severe chronic congestive heart failure (functional classes III‐IV, N.Y.H.A.) have been treated with continuous infusion of glucagon (2–4 mg/h) for 96 hours. During this period all other treatment was kept constant. Mean b.wt. was reduced from 62.8 kg to 61 kg (p<0.02) and there was a slight decrease in the serum concentrations and urinary excretion of sodium, potassium and chloride. Four patients showed a slight improvement in dyspnoea, otherwise no beneficial clinical effects were found. All patients complained of nausea. The possible influence of the metabolic changes induced by long‐term glucagon infusion on chronic congestive heart failure is discussed.
THE EFFECT OF DIFFERENT SERUM CONCENTRATIONS OF ANTIMICROBIAL DRUGS ON THE LACTOBACILLUS LEICHMANNII VITAMIN B12 ASSAY
Authors: Asbjørnsen Gunnar
Published: August 2010

Abstract. The existence of antimicrobial drugs in serum may invalidate microbiological serum assays by inhibiting the growth of the test organism. Sixteen antimicrobial agents have been added to serum in vitro and tested for their ability to influence the vitamin B12 assay by the L. leichmannii method. Seven were found to cause significant inhibition when screened at very high serum levels. On further examination the lowest serum concentrations needed to reduce the estimated vitamin B12 by as much as 25% were 1–2 μg/ml phenoxymethylpenicillin, just below 2.5 μg/ml lincomycin, 5–10 μg/ml ampicillin, 10–25 μg/ml benzylpenicillin, carbenicillin or erythromycin, and 25–125 μg/ml chloramphenicol.
INSULIN RESPONSE TO INTRAVENOUS GLUCOSE DURING LONG‐TERM TREATMENT WITH PROPRANOLOL
Authors: Hedstrand Hans , Åberg Hans
Published: August 2010

Abstract. The early insulin response to i.v. glucose has been studied in 10 patients with primary hypertension before and during long‐term treatment with large oral dosage of propranolol. No change in the early insulin secretion was found.
PROTEINURIA IN NON‐RENAL INFECTIOUS DISEASES
Authors: Jensen Herluf , Henriksen Kirsten
Published: August 2010

Abstract. The urinary excretion of total protein, orosomucoid, albumin, transferrin, and IgG, has been determined in 19 children and 23 adults with various nonrenal infectious diseases. Furthermore urine muramidase was estimated in 39 of these patients (16 children, 23 adults). An often considerably increased urinary protein excretion (“febrile proteinuria”) was found in 74% of the children, with a maximal output of 2283 mg/24 h, and in 83% of the adults, maximal output 3350 mg/24 h. In all cases an increased excretion of orosomucoid was found, but in many cases the excretion of the other proteins determined was increased as well, which excludes a prerenal mechanism as the only factor responsible for the increased protein excretion. The hypothesis is put forward that infections result in an immunological injury of the glomerular and/or tubular basement membrane, which might be of pathogenetic importance in the development of renal diseases.
SERUM URIC ACID LEVELS IN WOMEN
Authors: Bengtsson Calle , Tibblin Elisabeth
Published: August 2010

Abstract. Women in the age strata 38, 46, 50, 54 and 60, 1462 women in all, were submitted to a population study in Göteborg, Sweden. Determination of serum uric acid levels was included in the study. The mean values of serum uric acid increased from 3.6 mg/100 ml in women aged 38 to 4.4 mg/100 ml in women aged 60. The rise in serum uric acid with age seemed to be unrelated to the menopause, as no differences were found between premenopausal and postmenopausal women of the same age. None of the 1462 women studied was found to suffer from clinical gout. When comparing women with high serum uric acid values and women in the general population of corresponding ages, no significant differences were found for joint complaints, serum creatinine, history of cystitis and/or pyelonephritis, history of renal calculi, alcohol consumption or socio‐economic status. Women on saluretic diuretics had significantly raised serum uric acid values compared to the general population of women. The urine concentrating capacity was decreased in hyperuricaemic women, both in those who took and in those who did not take saluretic diuretics. Women with high serum uric acid values had significantly higher values for body weight, subscapular skinfold and Hb. Serum uric acid was raised in women with arterial hypertension, women with a history suggesting angina pectoris and women with ECG changes suggesting ischaemic heart disease. However, these differences were probably caused by an overrepresentation of women on saluretic diuretics in these groups.
OSLER'S DISEASE WITH IMPAIRED ADHESION AND AGGREGATION OF PLATELETS
Authors: Larsson Sten Olle
Published: August 2010

Abstract. In the investigation of haemostasis in a 37‐year‐old woman with Osier's disease the Ivy bleeding time proved to be prolonged. Platelet adhesiveness, measured both by Hellem's and Salzman's methods, was decreased and platelet aggregation was clearly reduced after addition of ADP, but only slightly after collagen and epinephrine. Platelet factor 3 activity was normal, as was clot retraction. The therapeutic consequences of the platelet defect, including the risk of using drugs affecting platelet function, are stressed. It is concluded that in cases of Osier's disease the possibility of functional disorders of platelets should be borne in mind.
HYPERTENSIVE CRISIS FOLLOWED BY ADRENOCORTICAL INSUFFICIENCY AFTER UNILATERAL ADRENAL PHLEBOGRAPHY IN A PATIENT WITH CUSHING'S SYNDROME
Authors: Jørgensen Hans , Stiris Gabriel
Published: August 2010

Abstract. A report is given of a patient with Cushing's syndrome who developed a serious hypertensive crisis later followed by adrenocortical insufficiency after retrograde adrenal venography. It is concluded that this examination should be done only in selected patients who have to be kept under careful observation for hours following the procedure.
JAUNDICE IN PREGNANCY
Authors: Furhoff Anna‐Karin , Hellström Kjell
Published: August 2010

Abstract. In 1955 the late L. Thorling reported on 71 women with jaundice in pregnancy because of cholestasis of pregnancy or infectious hepatitis. A follow‐up of 61 of these women, now 40–60 years of age and living all over Sweden, was performed in 1970. Six women had died and four were unwilling to participate. The study included an interview following a standardized questionnaire, oral cholecystography (unless the anatomical state of the biliary tract was known) and physical and laboratory examinations (44 women). A moderately abnormal bromsulphalein retention not accounted for by known disease was found in 8 women, three of whom had had symptoms compatible with recurrent cholestasis of pregnancy. There were few other indications of liver disease and, in general, the women considered themselves to be in good health. Evidence of earlier (cholecystectomy) or present (abnormal cholecystography) gallbladder disease was found in 31 of the 61 women investigated. The prevalence was higher in women above (67%) than below (47%) 50 years of age. Including the deceased women, the minimal prevalence of gallbladder disease among women with recurrent cholestasis of pregnancy was 57% (16 of 28). Three of the 6 deceased women had had severe kidney disease with uraemia, and 12 surviving women had had symptoms of pyelitis and/or nephrolithiasis. Of the latter, urinary tract disease was most common among those with non‐recurrent jaundice (8 of 25, 32%).
DEFECTIVE DIFFERENTIATION OF MEGAKARYOCYTES IN ACUTE MYELOID LEUKEMIA
Authors: Brandt L. , Levari G. , Mitelman F. , Sjögren U.
Published: August 2010

Abstract. In a patient with acute myeloid leukemia chromosome analysis, using banding technique, revealed an isochromosome 17 in granulopoietic and erythropoietic precursors as well as in polyploid cells, probably megakaryocytes. An abundant number of megakaryocytes in the bone marrow permitted characterization of the ploidy levels of these cells. It is demonstrated that most megakaryocytes were diploid and that polyploidy was not normally developed. The results indicate a defective differentiation of the megakaryocytes and/or their precursors analogous to what has previously been demonstrated in the myeloblasts of acute leukemia.
IODINE‐INDUCED TOXIC DIFFUSE GOITRE
Authors: Liewendahl K. , Gordin A.
Published: August 2010

Abstract. A report is given of iodine‐induced hyperthyroidism and goitre in a patient who ingested seaweed tablets for over two years and lived in an area of iodine sufficiency. There was spontaneous remission of both hyperthyroidism and goitre three months after withdrawal of excess iodine. This case shows that neither pre‐existing iodine deficiency nor goitre are necessary for development of iodine‐induced hyperthyroidism and that a combination of iodine‐induced thyrotoxicosis and goitre can occur. Various theories for the pathogenesis of iodine‐induced hyperthyroidism are discussed briefly.
DRUG‐INDUCED MALABSORPTION OF VITAMIN B12
Authors: Jounela A. J. , Pirttiaho H. , Palva I. P.
Published: August 2010

Abstract. Among 25 diabetic patients on long‐term phenformin therapy, the Schilling test was abnormal in 10. When the test was repeated with intrinsic factor on 6 patients with this abnormality, 5 of them still had abnormally low values. This group had the same mean age, the same duration of diabetes and also the same duration of treatment as the other patients. Discontinuation of treatment with phenformin normalized the Schilling test values in 4 of these 5 patients. Eleven diabetics on long‐term chlorpropamide or tolbutamide acted as a control group. They had normal Schilling test values. The series contained no anaemic patients.
Lp(a) LIPOPROTEIN AND PRE‐β1‐LIPOPROTEIN IN YOUNG ADULTS
Authors: Dahlén Gösta , Berg KÅre , Ramberg Ulla‐Britta , Tamm Allan
Published: August 2010

Abstract.A very strong association between phenotype Lp(a +) and presence of pre‐β1‐lipoprotein has been observed in two series of healthy young adults. The data are in agreement with the view that pre‐β1‐lipoprotein is identical to the lipoprotein carrying the Lp(a) antigen: the Lp(a) lipoprotein. Lp(a) antigen/pre‐β1‐lipoprotein occurred more frequently in persons with a positive than with a negative family history of coronary heart disease, though this trend was not statistically significant. Occurrence of Lp(a) antigen/pre‐β1‐rlipoprotein was not correlated with smoking or with the use of contraceptive pills.
CONGENITAL ABSENCE OF PORTAL VENOUS SYSTEM IN A 50‐YEAR‐OLD WOMAN
Authors: Oiling S. , Olsson R.
Published: August 2010

Abstract. A 50‐year‐old woman is reported who had no portal vein at autopsy, but otherwise the liver histology and function appeared unremarkable. Retrospectively it could be assumed that she had in fact had episodes of portal encephalopathy.
HAEMODYNAMIC EFFECTS OF DIHYDROERGOTAMINE IN PATIENTS WITH POSTURAL HYPOTENSION
Authors: BevegÅrd Sture , Castenfors Jan , Lindblad Lars‐Erik
Published: August 2010

Abstract. In four patients with postural hypotension the effect of i.v. and oral administration of dihydroergo‐tamine (DHE) has been studied. The therapeutic effect of oral administration of DHE has also been compared to the effect of treatment with an antigravity suit. Heart rate, intraarterial BP, cardiac output (dye dilution technique) and central venous pressure were measured in supine position before and during simulated orthostatic stress, induced by application of lower body negative pressure. In three patients forearm blood flow, using venous occlusion plethysmography, was also measured. Measurements were made before and after i.v. injection of DHE (0.01 mg/kg b.wt.). The long‐term effects of oral administration of DHE were evaluated using an orthostatic test on a tilt table before and during medication. Following i.v. administration of DHE, systemic and central venous pressures increased in all cases. The effect on cardiac output was negligible and consequently the calculated total peripheral vascular resistance increased slightly in all cases. Forearm blood flow changed in proportion to cardiac output. Orthostatic tolerance increased in all cases. Following long‐term oral administration an increased orthostatic tolerance was demonstrated in three of four cases. The effect was comparable to that obtained with an antigravity suit. Thus acute and long‐term administration of DHE can increase the tolerance to orthostatic stress in patients with severe postural hypotension. This is probably explained by effects on both capacitance and resistance vessels.
BONE MINERAL IN SARCOIDOSIS
Authors: Tervonen S. , Karjalainen P. , Valta R.
Published: August 2010

Abstract. The uptake of 85Sr in the spine and both the bone mineral linear density (g/cm) and mineral density (g/cm3) of the trabecular radius, midshaft radius and ulnae have been measured in 21 untreated sarcoid patients, using the 241Am γ‐transmission method. The results were compared with control subjects who showed no evidence of bone involvement or disturbances in calcium kinetics. Sarcoidosis was considered to be subacute active in 14 cases (5 male and 9 female), subacute inactive in four (1 male and 3 female) and chronic active in three (1 male and 2 female). The study showed: (a) In women the mean 85Sr uptake in the spine was significantly smaller than in the controls. (b) In the early stages of the disease the 85Sr uptake values were lower than when the disease was prolonged both in men and women. (c) The bone mineral linear density of the trabecular radius in active subacute sarcoidosis was significantly higher than in the controls. The relative difference in mineral density was of the same magnitude. (d) In chronic sarcoidosis neither the 85Sr uptake in the spine nor the bone mineral values differed from the control values. (e) The mineral linear density and density in the midshaft radius and ulnae were at the same level as in the controls. (f) A significant negative correlation was established between the 85Sr uptake in the spine and the bone mineral density in the distal radius. It seems evident from this study that patients in the acute phase of sarcoidosis have an abnormally high bone mineral density and that there is a distinct mineral decrease correlated with the duration of the disease.
RENAL ARTERIOVENOUS FISTULA—A CAUSE OF HEART FAILURE
Authors: Christensson Bo , Ekelund Leif , Lindstedt Eric , Nordenfelt Ivar , Olin Tord
Published: August 2010

Abstract. Two cases of renal arteriovenous fistula are reported in which heart failure was a major symptom. One patient had auricular fibrillation and suspected mitral valve insufficiency. She had observed a thrill over her left flank and a large renal arteriovenous fistula, probably congenital. was disclosed. Blood flow through the fistula was measured by dye‐dilution technique and estimated to be 2.8 l/min. Cardiac output preoperatively was 6.8 l/min. after nephrectomy 4.3 l/min. Heart size diminished from 690 to 450 ml/m2 BSA. The other patient had a large renal carcinoma and considerable arteriovenous shunting in the tumour. Her heart size diminished from 720 to 540 ml/m2 BSA after nephrectomy and her clinical condition improved. About two months after operation she died of acute pulmonary oedema.
RECURRENT ATTACKS OF HEMOLYTIC ANEMIA, THROMBOCYTOPENIA AND UREMIA— HEMOLYTIC UREMIC SYNDROME?
Authors: ølgaard K. , Madsen S. , Jacobsen S. V.
Published: August 2010

Abstract. The case history of a 3‐year‐old boy with 6 relapses of hemolytic anemia, thrombocytopenia and uremia is reported. Between the attacks the glomerular filtration rate was normal and there was no proteinuria. The possible relationship to hemolytic uremic syndrome and thrombotic thrombocytopenic purpura is discussed.
THE EFFECT OF ALPRENOLOL IN ELDERLY PATIENTS WITH RAISED BLOOD PRESSURE
Authors: Eisalo Antti , Heino Arvo , Munter Jussi
Published: August 2010

Abstract A total of 38 patients aged 61 to 89 years, mean age 72 years, were treated with the β‐adrenergic blocking agent, alprenolol, in a dosage of 400 mg daily for three months. Blood pressure decreased significantly. While the systolic blood pressure decreased to a greater extent during the first week of treatment, the diastolic pressure declined continuously. A significant decrease of heart rate occurred. After one week's treatment signs of congestive heart failure appeared in three patients and were compensated by digitalis in two cases. In one case treatment with alprenolol had to be interrupted. No signs of heart failure after alprenolol appeared later during the treatment. The concomitant use of alprenolol with digitalis, diuretics or oral hypoglycemic agents did not cause any negative interaction.
FAMILIAL THYROXINE‐BINDING GLOBULIN DEFICIENCY
Authors: Strunge Poul
Published: August 2010

Abstract. Three Danish pedigrees have been studied with a view to reduced thyroxine‐binding globulin (TBG). The study confirmed that this defect is transmitted by X‐chromosome‐linked dominant inheritance, there being no man‐to‐man transmission, but also that it may occur in two types: deficient TBG and low, non‐zero TBG. Definite changes of TBG and thyroid function tests were found in the hemizygous men, whereas the heterozygous women showed a marked variation in the range between the values for hemizygous men and normal persons. Determination of total thyroxine appears to afford more guidance than the protein‐bound iodine suggested by others. Two of four women on oral contraception exhibited such deviating TBG values that they are assumed to be TBG heterozygous. In all persons free thyroxine proved normal or slightly reduced but all the persons tested were euthyroid. However, the propositus of one family had previously been treated for Graves' disease.
DIURNAL VARIATIONS IN THE CONCENTRATIONS OF BLOOD ACETOACETATE AND 3‐HYDROXYBUTYRATE
Authors: Wildenhoff K. E. , Johansen J. P. , Karstoft H. , Yde H. , Sørensen N. Schwartz
Published: August 2010

Abstract. In six normal persons reduced physical activity during the day did not influence the rise in blood ketone bodies during the evening, which was previously found in normal persons with normal physical activity. This rise, therefore, does not seem to be due to post‐exercise ketosis. During the evening free fatty acids (FFA) and glycerol in serum varied in principle in the same way as did the blood ketone bodies. The rise in blood ketone bodies can therefore be assumed to be due to an increased rate of formation of ketone bodies as a consequence of increased mobilization of FFA from adipose tissue. There was no evidence of a rise in serum growth hormone as trigger mechanism for the rise in blood ketone bodies. The rise in ketone body concentration was completely prevented by constant glucose infusion.
RESPIRATORY DISTURBANCE DURING L‐DOPA TREATMENT OF PARKINSON'S SYNDROME
Authors: Granerus Ann‐Kathrine , Jagenburg Rudolf , Nilsson Nils Johan , Svanborg Alvar
Published: August 2010

Abstract. A 56‐year‐old woman, suffering from postencephalitic parkinsonism for 15 years, developed a respiratory disturbance in connection with L‐dopa therapy. About 2 hours after the medication she often had attacks of irregular breathing, lasting for 2–4 hours. During the attacks apnoeic periods of 2–30 sec appeared, interspersed in a uniform series of vigorous breaths. Arterial oxygen saturation was never below 90%. The intestinal absorption and the elimination from the blood of L‐dopa did not differ from that observed in other patients with parkinsonian symptoms. A single‐blind study confirmed the impression from history and clinical observation that the disturbance is caused by L‐dopa.
URINARY FIBRIN/FIBRINOGEN DEGRADATION PRODUCTS (FDP) AND GLOMERULONEPHRITIS
Authors: Hedner Ulla , Ekberg Mats , Nilsson Inga Marie
Published: August 2010

Abstract.In concentrated 24‐hour urine from 24 patients with incipient glomerulonephritis without uraemia the fibrin/fibrinogen degradation products (FDP) have been studied. In 18 of 19 patients with proliferative glomerulonephritis high molecular weight degradation products (HMWDP) were found, while one patient had D and E products probably due to further degradation of the HMWDP in the lower urinary tract. Only 2 patients of 5 with membranous glomerulonephritis had HMWDP in the urine in low concentrations. All patients with proliferative glomerulonephritis had a selective proteinuria with an excretion predominantly of albumin and transferrin, which makes it improbable that the HMWDP found in the urine from these patients are derived from filtration through the glomeruli. Thus the urinary HMWDP found in these patients most probably originate from lysis of fibrin deposits in the kidney and are excreted in the urine. It is concluded that the FDP may be demonstrated in the urine also in incipient glomerulonephritis provided that the urine is concentrated. These FDP most probably originate from the kidneys.
INCIDENCE OF PREMATURE BEATS AND ECTOPIC TACHYARRHYTHMIAS AND THEIR POSSIBLE INTERRELATION IN ACUTE MYOCARDIAL INFARCTION
Authors: Christiansen Ib , Amtorp Ole , Haghfelt Torben
Published: August 2010

Abstract. In a prospective study of patients with acute myocardial infarction the incidence of supraventricular and ventricular ectopic beats and tachyarrhythmias has been examined with regard to the site of the infarcts and a possible interrelation between the different kinds of dysrhythmias. The material consisted of 356 patients consecutively treated and analysed in a Coronary Care Unit (CCU). The mortality rate was 19%. In 68 patients (19%) no ectopic beats or tachycardia were registered. The mortality rate in this group was 13%. In 288 patients with ectopic arrhythmias (81%) the mortality rate was 21%, highest for anterior infarcts. The site of the infarcts was without influence on the frequency of the different kinds of dysrhythmia apart from sinus tachycardia and atrial fibrillation, which were most common in cases of anterior infarct. The incidence of ectopic beats and tachycardias was equal to that found in other CCUs. Supraventricular tachycardias including atrial fibrillation did not influence the mortality rate unless they were part of a pump failure syndrome. A significantly higher frequency of patients with more than 15% supraventricular ectopic beats was found among patients with supraventricular tachycardia than in patients without. No significant interrelation was found between supraventricular and ventricular ectopic beats. In spite of medical treatment a significantly higher frequency of patients with more than 5% ventricular ectopic beats was found in the group with ventricular fibrillation or ventricular tachycardia than in the group without, a tendency that was accentuated if the ectopic beats came in salvoes.
LEUCOCYTE STIMULATION BY AUTOHOMOGENATE IN SYSTEMIC LUPUS ERYTHEMATOSUS MEASURED WITH FLOW MICROCALORIMETRY
Authors: Levin K. , Thomasson B.
Published: August 2010

Abstract. Flow microcalorimetry has been used to measure heat production (HP) from leucocytes and the effect on the HP of adding homogenate prepared from the subject's own leucocytes. The procedure is named the CAL‐LE test. In normal subjects and in a group of patients with miscellaneous diagnoses very little stimulation was found when homogenate was added. A reference range of ‐30 to + 40% stimulation was obtained. Thirteen out of 14 patients with definite systemic lupus erythematosus (SLE) exhibited an increased stimulation. The highest value obtained was more than 400% stimulation. Two patients out of 16 with rheumatoid arthritis also showed increased stimulation. With 11 patients in borderline diagnostic groups varying results were obtained. The stimulation of leucocyte HP obtained is regarded as an expression of phagocytosis or phagocytosis‐like phenomena taking place upon addition of autohomogenate. The results indicate a relation between the outcome of the CAL‐LE test and the ability of the patient's serum to induce the LE cell phenomenon. A clear relation has also been found between the stimulation obtained with the CAL‐LE test and the activity of the disease in patients with SLE. According to our present experience the CAL‐LE test is a valuable method for the estimation of the degree of SLE activity.
UNUSUAL PATTERN OF HEPATIC ALKALINE PHOSPHATASE ACTIVITY AND RENAL CARCINOMA
Authors: Axelsson Uno , Hägerstrand Inga , Zettervall Olle
Published: August 2010

Abstract. Two cases of renal carcinoma associated with hepatic dysfunction in the absence of hepatic metastasis are presented. A moderately elevated activity of serum alkaline phosphatase was found. Liver biopsy specimens disclosed normal morphology, but an abnormal localization of alkaline phosphatase activity was found adjacent to the canaliculi in the entire hepatic lobules. Serum alkaline phosphatase and platelet levels became normal after extirpation of the tumour. It is concluded that the canalicular phosphatase activity is in some way induced by a humoral tumour agent. It is of clinical importance to realize signs of hepatic dysfunction as a paraneoplastic manifestation and, in known tumour cases, not to interpret them as unequivocal symptoms of liver metastasis.
CLINICAL AND MORPHOLOGICAL STUDIES OF GIANT HYPERTROPHIC GASTRITIS (MÉNÉTRIER'S DISEASE)
Authors: Raotma Heino , Angervall Lennart , Dahl Ingvar , Dotevall Gerhard
Published: August 2010

Abstract. The authors describe four cases of giant hypertrophic gastritis (Ménétrier's disease), which demonstrate that the disease is easily overlooked clinically. In all four cases the definite diagnosis was established after morphological examination of the surgical specimens. The importance of gastroscopy, gastric secretory studies, studies of the protein metabolism and X‐ray investigation of the upper gastrointestinal tract for the clinical diagnosis is emphasized, even if a definite diagnosis seems possible only after examination of full‐thickness surgical biopsy specimens.
CARDIAC ARREST FOLLOWING ACUTE MYOCARDIAL INFARCTION
Authors: Fabricius‐Bjerre N. , Astvad K. , Kjßrulff J.
Published: August 2010

Abstract. During a 38‐month period 1108 cases of acute myocardial infarction have been treated in three medical departments with a joint acute medical admission section containing a coronary care unit (CCU); 285 of them had cardiac arrest (26%). In 209 cases (73% of cardiac arrests) resuscitation was attempted, in 66 cases (23 %) with primary success. Twenty‐five patients (9 %) could be discharged from hospital. Two to four years later 17 were still alive, 14 in heart function class I, 12 with unchanged working ability. Cardiopulmonary resuscitation later than 24 hours after admission to the CCU improved the rate of survival after myocardial infarction by less than 0.5%. In this study the survival after cardiac arrest is somewhat lower than usually reported from CCUs. This is supposed to be due to our treatment of a less selected patient group, and possibly to the untraditional integration of a CCU in an acute medical admission unit. This may lead to a less intensive treatment of the cardiac patients, while it is considered an advantage for the non‐cardiac acute medical patients.
CELLULARITY AND CELL PROLIFERATION RATES IN HUMAN BONE MARROW
Authors: Skårberg Karl Olof
Published: August 2010

Abstract. The total marrow cellularity, using 59Fe as a marrow label, has been measured by an in vivo technique including suppression of radioiron reutilization by inactive iron. The blocking efficacy was studied from the red cell incorporation of 55Fe given after marrow sampling. The error of the method was approximately 16%. The total number of nucleated bone marrow cells averaged 21 × 109/ kg b.wt. There were 13 × 109 granulocyte precursors, 3.4 × 109 nucleated red cells and 0.016 × 109 megakaryocytes. The marrow reticulocytes averaged 4.6 × 109/kg b.wt., or about 20% of the total marrow cells, which was more than in the circulation (3.1 × 109). The transit time of marrow reticulocytes was calculated to be about 50 hours. About 2 red cells and 400 platelets were produced for every granulocyte and each megakaryocyte produces approximately 300 platelets/day. The total volume for erythro‐, granulo‐ and megakaryopoietic marrow cells was approximately 500 ml. The erythroid marrow was calculated to be able to expand maximally by a factor of 10.
CELLULARITY AND CELL PROLIFERATION RATES IN HUMAN BONE MARROW
Authors: Skårberg Karl Olof
Published: August 2010

Abstract. Whole body erythroblast numbers and erythrocyte production have been estimated in 14 patients with hypoproliferative or aregenerative anaemia, 9 with hypocellular or fibrotic bone marrow sections or pure red cell aplasia and 5 with hypercellular bone marrow sections. Numbers and production were calculated on the basis of average bone marrow cell and erythrocyte incorporation of 59Fe. Erythroblast generation times were calculated, based on numbers, production and marrow differential counts. H3TDR labelling of erythroblasts was simultaneously studied in vitro. Patients with hypocellular marrows had a significantly decreased whole body erythroblast number, short generation times and normal labelling indices. It is speculated that the low erythroblast number despite normal or rapid multiplication may be explained by stem cell failure. Patients with hypercellular marrows had almost normal erythroblast numbers, significantly prolonged generation times and significantly decreased labelling indices. It is speculated that accumulation of slowly multiplicating erythroblasts in this form of the disease may be related to its previously demonstrated preleukaemic nature.
RADIOISOTOPE RENOGRAPHY, GLOMERULAR FILTRATION RATE AND EFFECTIVE RENAL PLASMA FLOW IN DONORS WITH NORMAL RENAL FUNCTION AFTER NEPHRECTOMY
Authors: Hansen H. E. , Skov P. E. , Hansen H. H. , Taagehøj‐Jensen F.
Published: August 2010

Abstract. Radioisotope renography with 13I‐hippuran has been undertaken in 14 kidney donors with normal renal function 26–53 months after unilateral nephrectomy. Immediately after renography simultaneous creatinine, 125iothalamate and 131I‐hippuran clearances were determined. Ratios calculated within the first 2.5 min of the renogram could not be correlated to clearance values or to the size of the remaining kidney. There was a statistically significant correlation between clearance values and renal size. The range of the ratios calculated was 5–10%, whereas the range of clearance values was 15–30%. 131I‐hippuran reached the bladder after a minimum of 2.0 min. There was a correlation between transit time and time to the renogram's maximum.
TREATMENT OF OSTEOPOROSIS WITH VITAMIN D
Authors: Buring K. , Huith A. G. , Nilsson B. E. , Westlin N. E. , Wiklund P. E.
Published: August 2010

Abstract. A daily intake of 35000 IU vitamin D2 and calcium supplement for one year could not be demonstrated to influence the bone mineral mass in the forearm of 23 women with osteoporosis.
THE ADHESIVENESS OF HUMAN BLOOD PLATELETS AND THYROID FUNCTION
Authors: Hellem Arvid J. , Segaard Erik , Solem Jan H.
Published: August 2010

AbstractHypothyroidism is associated with severe coronary atherosclerosis. In spite of this the reported incidence of angina pectoris and myocardial infarction in untreated hypothyroidism is small. Since many authors consider the formation of a thrombus in coronary arteries to be the final event of the process which leads to myocardial infarction, changes in the platelet function may explain the paradoxical rarity of myocardial infarction in untreated hypothyroidism. To evaluate this hypothesis, platelet adhesiveness has been estimated before and after treatment in 9 hypothyroid and 16 thyrotoxic patients. In thyrotoxicosis the platelet adhesiveness was significantly increased, but decreased to normal after treatment. In hypothyroidism platelet adhesiveness was abnormally low but increased to normal value after thyroid hormone replacement. This may be an important factor in precipitating myocardial infarction in patients with hypothyroidism and coronary artery atherosclerosis.
THE FREQUENCY OF SECONDARY HYPERTENSION
Authors: Bech Karine , Hilden Tage
Published: August 2010

Abstract In a series comprising 482 patients with hypertension requiring treatment 79% had to be classified as essential hypertension. Bilateral renal disease was found in 9%, unilateral renal disease in 3.3%, but only one patient underwent surgery. Renal artery stenosis was found in 24 patients (5%), but only 5 (1%) were operated on. Two cases of primary hyperaldosteronism and one of phaeochromocytoma were found; in all three surgical intervention was successful. Oral contraceptives had caused the elevated BP in 7 patients (1.5%). It is empahsized that the frequency of curable hypertension is still very low and this should be taken into account when routine examination of patients with hypertension requiring treatment is discussed.
INHIBITION OF ADRENAL FUNCTION IN MAN BY HEPARIN OR HEPARINOID Ro 1‐8307
Authors: Kloppenborg P. W. C. , Casparie A. F. , Benraad Th. J. , Majoor C. L. H.
Published: August 2010

Abstract Heparin and the heparinoid Ro 1‐8307 inhibited the secretory rate of aldosterone in physiological or pathological aldosteronism to the level found in normal subjects on liberal sodium intake. In addition, these compounds inhibited corticosterone biosynthesis, although less markedly than that of aldosterone. Indications of interference with Cortisol production have not been found. During drug treatment angiotensin, in doses of 5–10 ng/kg b.wt./min, did not stimulate aldosterone secretion. ACTH responsiveness of the adrenals—indicated by the fractional increases of both aldosterone and corticosterone secretory rates—remained unchanged. In two studies heparin had no consistent effect on plasma renin activity.
MYOCARDIAL BIOPSY IN A CASE OF CARDIOMYOPATHY AND PARTIAL α‐1 ANTITRYPSIN DEFICIENCY WITH LIVER ENGAGEMENT
Authors: Torp Alf
Published: August 2010

Abstract A case of partial α‐1 antitrypsin deficiency with liver engagement and a biopsy‐verified congestive cardiomyopathy is reported. The possibility of a connection between these two diseases is discussed in view of recent literature.
NICOTINIC ACID AND THE ENDOGENOUS PRODUCTION OF CARBON MONOXIDE
Authors: Lundh B. , Cavallin‐Ståhl E. , Mercke C.
Published: August 2010

Abstract The endogenous production of carbon monoxide (V̇CO) has been followed with the aid of a rebreathing system for 3 hours in four healthy volunteers after i.v. injection of 50 mg nicotinic acid (NA). After an initial slight decrease for 15–30 min in the CO hemoglobin per cent saturation (COHb), a rapid increase was registered for 120 min, whereafter the V̇CO returned to the normal, preinjection level. The amount of “extra” CO produced varied between 4.1 and 2.2 ml, corresponding to 2.9 and 1.6 g Hb or 182 and 98 μmol heme, respectively. These figures are 3–5 times higher than those reported in the literature, calculated from increases in serum iron, bilirubin and COHb (without the use of a rebreathing system). When related to the total body heme (TBH) estimated with the CO dilution technique, the amount of “extra” heme metabolized after NA corresponded to 0.30% (range 0.26–0.32) of the TBH (a fourth of the total daily heme turnover or a third of the daily Hb heme catabolism).
INITIAL SERUM POTASSIUM LEVEL IN RELATION TO EARLY COMPLICATIONS AND PROGNOSIS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors: Dyckner T. , Helmers C. , Lundman T. , Wester P. O.
Published: August 2010

AbstractDuring two years 450 patients with AMI have been treated in the CCU at Serafimerlasarettet. Serum potassium level was determined in 444 patients on admission. Hyperkalemia was a rare finding associated with a bad state on admission and a poor prognosis. Hypokalemia was recorded in 15% of the patients and was associated with previous diuretic treatment, supraventricular bradycardia as well as atrial flutter and fibrillation during the first 24 hours in the CCU. Ventricular ectopic beats and ventricular tachycardia were also seen more frequently in hypokalaemic than in other patients.