bluuebunny/crossref_metadata_2025 huggingface dataset:
Privatisation in Developing Countries: Performance and Ownership Effects
Authors: Boubakri Narjess , Cosset Jean‐Claude , Guedhami Omrane
Published: April 2008

Over the last twenty years, privatisation, defined as the transfer of public assets (firms) from the government to private investors, has been on the reform agenda of more than 120 developing countries. The switch of ownership induces major changes in the corporate governance of firms, and in their incentives to restructure and improve efficiency and performance. This article evaluates this experience, focusing on its impact on corporate performance and governance, identifying several issues yet to be resolved.
Registration: The Cornerstone of REACH
Authors: Hansen Bjorn , Blainey Mark
Published: April 2008

The EC Regulation on Registration, Evaluation, Authorization and Restriction of Chemicals (REACH) came into force on 1 June 2007, marking the end of three years of intense negotiations between the Council and the European Parliament. One of the most hotly debated topics was the registration of substances, where the original Commission proposal sparked an extensive debate about the volume‐based structure proposed. Risk‐based prioritization was a concept proposed by both industry and academia to replace this, but due to its own fundamental lack of workability, its inclusion was rejected. However, a lightening of the low tonnage levels was agreed, along with the practical implementation of the ‘one substance, one registration’ principle. Overall, it can be seen that despite the many changes proposed, analyzed, discussed and accepted during the three years of intense negotiations, the basic architecture that the Commission proposed remains and registration will provide an enforceable framework for companies and will ensure a level playing field for chemicals across Europe.
Immunological profiles of immune restoration disease presenting as mycobacterial lymphadenitis and cryptococcal meningitis
Authors: Tan DBA , Yong YK , Tan HY , Kamarulzaman A , Tan LH , Lim A , James I , French M , Price P
Published: April 2008

Objectives

A proportion of HIV patients beginning antiretroviral therapy (ART) develop immune restoration disease (IRD). Immunological characteristics of IRD were investigated in a cohort of HIV patients beginning therapy in Kuala Lumpur, Malaysia.

Methods

Peripheral blood mononuclear cells were collected at weeks 0, 6, 12, 24 and 48 of ART from five patients experiencing IRD [two with cryptococcal and three with Mycobacterium tuberculosis (Mtb) disease], eight non‐IRD controls who had begun ART with CD4 T‐cell counts of <100 cells/μL and 17 healthy controls. Leukocytes producing interferon‐gamma (IFNγ) were quantified by enzyme‐linked immunospot assay after stimulation with purified protein derivative (PPD), early secretory antigenic target‐6 (ESAT‐6), Cryptococcus neoformans or Cytomegalovirus antigens. Plasma immunoglobulin (IgG) antibodies reactive with these antigens were assessed by enzyme‐linked immunosorbent assay. Proportions of activated (HLA‐DRhi) and regulatory (CD25 CD127lo and CTLA‐4+) CD4 T‐cells were quantified by flow cytometry.

Results

Plasma HIV RNA declined and CD4 T‐cell counts rose within 8–27 weeks on ART. Mtb IRD patients displayed elevated IFNγ responses and/or plasma IgG to PPD, but none responded to ESAT‐6. Cryptococcal IRD occurred in patients with low baseline CD4 T‐cell counts and involved clear IFNγ and antibody responses to cryptococcal antigen. Proportions of activated and regulatory CD4 T‐cells declined on ART, but remained higher in patients than in healthy controls. At the time of IRD, proportions of activated CD4 T‐cells and regulatory CD4 T‐cells were generally elevated relative to other patients.

Conclusions

Cryptococcal and Mtb IRD generally coincide with peaks in the proportion of activated T‐cells, pathogen‐specific IFNγ responses and reactive plasma IgG. IRD does not reflect a paucity of regulatory CD4 T‐cells.
Cross‐reactivity between pollen allergens from common Pooideae grasses and rye
Authors: Hrabina M. , Sieber J. , Gouyon B. , Bergmann K‐C.
Published: April 2008

In Germany, specific pollen extracts are currently used for immunotherapy of rye (Secale cereale) allergy. Like most common grasses, S. cereale belongs to the Pooideae subfamily. Using sera from grass pollen‐allergic patients, immunoblotting and ELISA inhibition studies demonstrate that a five‐grass allergenic extract from Anthoxanthum odoratum, Dactylis glomerata, Lolium perenne, Poa pratensis and Phleum pratense inhibits over 90% of IgE binding to rye allergens. This result confirms the high degree of homology between allergens from S. cereale and common grass species. We conclude that a five‐grass pollen mixture is appropriate for desensitization of patients who are allergic to rye pollen without the need for additional rye pollen extracts.
Effect of physical exercise on the digoxin concentrations in skeletal muscle and serum in man
Authors: Jogestrand Tomas , Sundqvist Kerstin
Published: April 2008

Summary. Seven healthy men performed an exercise on a bicycle ergometer during one hour after 2 weeks intake of digoxin and with the last dose taken 24 hours before the exercise. Blood samples and skeletal muscle biopsies (m. quadriceps femoris, vastus lateralis) were taken before and after the exercise for analysis of serum and skeletal muscle digoxin concentrations. A percutaneous needle biopsy technique was used for muscle sampling and digoxin was analysed by radioimmunoassay. One minute after completion of the exercise a significantly higher digoxin concentration was found in the thigh muscle than before exercise, indicating an increased digoxin binding in this muscle. Serum digoxin concentration decreased significantly during exercise. After exercise serum digoxin concentration increased again but was still, 30 min after exercise, significantly lower than before exercise.
Dissimilar effects of prostacyclin on cardiac output and forearm blood flow in healthy men
Authors: Eklund B. , Joreteg T. , Kaijser L.
Published: April 2008

Summary. Cardiac output, heart‐rate, stroke volume, pressures in the brachial artery, right ventricle and pulmonary artery, forearm blood flow and in addition arterial concentrations of lactate, glucose and free fatty acids were measured in eight healthy male volunteers during i.v. infusion of prostacyclin in doses corresponding to 2 ng, 6 ng and 12 ng min‐1 kg‐1 b.w. The highest dose almost doubled cardiac output and this was achieved by similar increases in stroke volume and heart‐rate. Arterial diastolic and mean pressures decreased slightly while systolic pressure was unaffected. The calculated total systemic vascular resistance decreased to half the initial level. However, forearm blood flow increased insignificantly and forearm vascular resistance was not significantly altered. Pulmonary artery pressure rose only minimally, which in the presence of a great increase in cardiac output indicates pulmonary vasodilatation.

Arterial lactate and glucose concentrations were not significantly altered while free fatty acid concentration increased slowly during the infusion period to a similar degree as previously shown in fasting individuals undergoing catheterisation.

It is concluded that prostacyclin decreases both pulmonary and total systemic vascular resistance but unlike the most potent vasodilator of the ‘classical’ prostaglandins, PGE17 it has dissimilar vasoactive potency in different systemic vascular beds as evidenced by the insignificant decrease in forearm, simultaneous with the pronounced decrease in total systemic vascular resistance.
Comparison of 133Xenon radiospirometry with quantitative 99mTecnnetium‐macroaggregated albiimin perfusion scintigraphy
Authors: Vitting Karen , Nielsen Steen Levin , Munck Ole , Rasmussen Erik
Published: April 2008

Summary. Radiospirometry with 133Xenon and perfusion scintigraphy with 99mTech‐netium‐labelled macroaggregated albumin were compared in 22 patients with lung diseases scheduled for surgery. The tracers were given intravenously and, with a gamma camera coupled to a computer, regional lung function was obtained from the count rate in the upper and lower halves of the lungs.

There were no significant differences in regional lung function as estimated from the 99mTc perfusion scintigraphy and from the 133Xe method taking perfusion as well as ventilation into account. When the initial lMXe distribution alone was employed, the regional perfusion was underestimated in the right lower lung region and overestimated in the left lung. This is probably due to difficulties in placing the regions of interest.

When a gamma camera is used, perfusion scintigraphy with “Technetium macro‐aggregated albumin is easy to perform aad has good counting statistics. This method is therefore advocated for the pre‐operative assessment of regional lung function.
Influence of everyday physical activity on the serum digoxin concentration in digoxin‐treated patients
Authors: Jogestrand Tomas
Published: April 2008

Summary. Thirteen patients admitted to hospital because of known or suspected cardiac disease who had been treated with digoxin within, at least, the previous month were investigated. Blood samples for serum digoxin analysis by radioimmunoassay were taken before and after 40 min rest in supine in the ward and later in the outpatient clinic, all samples taken about 24 h after the last dose of digoxin. The serum digoxin concentration measured before rest in the outpatient clinic was significantly lower than those measured in the ward before and after rest. This is possibly related to physical activity prior to blood sampling since after 40 min rest in the outpatient clinic the serum digoxin concentration had increased and the concentration after rest was not significantly different from the concentrations measured in the ward. In analogy with a previous finding of a decrease in serum digoxin concentration during exercise in healthy subjects ingesting digoxin, the present results suggest that everyday physical activity affects the serum digoxin concentration. This must be taken into account when interpreting the results of serum digoxin measurements.
Noradrenaline and adrenaline concentrations in various vascular beds in patients with cirrhosis Relation to haemodynamics.
Authors: Henriksen Jens H. , Christensen Niels Juel , Ring‐Larsen Helmer
Published: April 2008

Summary. Plasma noradrenaline (NA) and adrenaline (A) concentrations were related to various haemodynamic parameters in fifteen patients with cirrhosis. In supine position at rest plasma NA and A in peripheral venous blood were significantly higher in patients with cirrhosis than in normal subjects. Mean plasma NA averaged 0–66 and 0–21 ng/ml, respectively (P<0–01). The corresponding values for plasma A were 0–14 and 005 ng/ml (P<0 03). Splanchnic arterial‐hepatic venous extraction ratio of NA in patients with cirrhosis averaged 0–46 (P<0–01). The right kidney released NA into the systemic circulation. Renal venous plasma NA exceeded arterial concentration by 38% (P<0–01). NA concentrations in femoral vein and ascitic fluid were not different from that of arterial plasma. Plasma NA was positively correlated to wedged hepatic vein pressure (r= 0–86, P<0–001) and to heart rate (r= 0–61, P<002), but inversely correlated to plasma volume (r=–0–83, P<0–01) in cirrhotic patients. Arterial blood pressure was reduced in these patients compared to controls (P<0–02), but not significantly correlated to plasma NA. The increased plasma NA indicates that sympathetic nervous activity is enhanced in patients with cirrhosis. Based on the above positive correlation between NA and heart rate and the significant release of NA from the kidney, it may be hypothesized that the increased sympathetic nervous activity especially involves heart and kidney. This response may be mediated by baro‐ and volume receptors.
Flow‐volume curves in healthy non‐smokers and in smokers
Authors: Hedenstierna Göran , Jorfeldt Lennart , Bygdeman Stellan
Published: April 2008

Summary. Maximum expiratory flow‐volume curves were recorded in lung healthy non‐smokers and in smokers. Multiple linear regression analysis was performed with regard to sex, age, height and weight. The regressions for maximum expiratory flow at 50% and 25% of vital capacity (MEF50 and MEF25, respectively) on age were significantly different for non‐smokers and smokers, in males as well as females, but the large scatter around the regression line resulted in more than 50% of presently studied smokers to fall within 1 SD of the reference values for non‐smokers. A skew distribution of MEF25 around the mean was observed at ages above 60 years and so set an upper limit for the linear regression. Above 60 years no linear age dependence was found for MEF25. There was a minor reduction (2%) in the residual standard deviation of the peak expiratory flow (PEF), MEF50 and MEF25 regressions when height was added as an independent variable besides age, while the addition of weight did not reduce the scatter. We conclude that the inter‐individual variability in MEF^ and MEF25 is relatively large even when sex and age are accounted for and that there is no further benefit in including height or weight in the regression equations. The discriminating ability of the MEF50 and MEF25 variables is small, indicated by considerable overlapping between non‐smokers and smokers.
Reference values for respiratory function tests in males: prediction formulas with tobacco smoking parameters
Authors: Fridriksson Hrafn V. , Malmberg Per , Hedenström Hans , Hillerdal Gunnar
Published: April 2008

Summary. Prediction equations for respiratory function tests were obtained by multiple regression of data from 263 healthy males. The material was evenly distributed in the ages 20–70 years, about one third each of non‐smokers, smokers and ex‐smokers. Measurements were done of lung volumes (with body plethysmograph), airways resistance, ventilatory capacity including flow‐volume registration, gas distribution and closing volume, transfer factor and static elastic recoil pressures of the lung with calculation of static compliance. The parameters age, height, weight, years of tobacco smoking and grams of tobacco smoked each day showed significant correlation with the outcome of the test in most of the respiratory function tests. Therefore a set of basic regression equations including these parameters were calculated. In addition an ‘extended’ set of equations was calculated for prediction of some tests with inclusion of nonlinear terms and the parameter ‘years of abstinence from smoking.’ The reduction in variance which followed inclusion of tested parameters was moderate (20–69%). There were significant differences between results of the present study and several previously published regression formulas.
Central and peripheral haemodynamic effects of prenalterol in patients with coronary heart disease
Authors: Svendsen T. L. , Carlsen J. E. , Hartling O. J. , Trap‐Jensen J.
Published: April 2008

Summary. The acute haemodynamic effects of prenalterol, a selective adrenergic beta‐1‐receptor agonist were studied in eight patients with coronary heart disease. Prenalterol was administered intravenously in four increasing doses to a cumulative dose of 5.6 mg. Fifteen minutes after the last dose of prenalterol two doses of the selective adrenergic beta‐1‐receptor antagonist metoprolol were administered intravenously to a cumulative dose of 17.5 mg. Ten minutes after each dose cardiac output, heart rate, arterial blood pressure, pulmonary artery pressure, systolic time intervals and forearm blood flow were determined.

Haemodynamic effects of prenalterol: cardiac index and heart rate increased maximally by 38% and 39% respectively. Stroke index was increased by 6–9% after the first and second dose. Mean blood pressure was increased by 9‐8 mmHg. Total peripheral resistance index was reduced by 19%. The mean pulmonary artery pressure decreased by 3–8 mmHg and pulmonary resistance index was reduced by 48%. Systolic time intervals were all reduced significantly after the second dose, which reflected the positive inotropic effects of prenalterol. Forearm blood flow increased by 29% and forearm vascular resistance was decreased by 20%.

Haemodynamic effects of metoprolol: the haemodynamic changes induced by prenalterol were stepwise counteracted by metoprolol. After the second dose all the haemodynamic variables had returned to the control levels.

It is concluded that prenalterol possesses a considerable positive inotropic as well as positive chronotropic effect on the myocardium. Both the chronotropic and inotropic effect of prenalterol was counteracted by metoprolol.
Free fatty acids and the electrophysiology of the dog heart in situ: effects of isoprenaline, nicotinic acid and lipid emulsion with heparin
Authors: Platou Eivind S. , Myhre Eivind S. P. , Refsum Helge , Mjøs Ole D.
Published: April 2008

Summary. The study was carried out to examine whether high plasma concentrations of free fatty acids (FFA) alone have cardiac electrophysiological effects, and whether the electrophysiological effects of isoprenaline are dependent on elevated plasma FFA. Experiments were performed in sixteen intact, healthy, pentobarbital anaesthetized dogs. Atrial, atrioventricular nodal and ventricular conduction times and refractoriness, and sinus node function were studied by His bundle electrography combined with programmed electrical stimulation. Elevation of plasma FFA by Intralipid and heparin from a median value of 363 to 1780 u‐moM‐1 did not induce any changes in cardiac electrophysiology. Intravenous infusion of isoprenaline (0.15 μg‐min_1‐kg‐1) increased median plasma FFA from 410 to 2254 μmol‐l‐1. This rise in plasma FFA could be prevented by administration of nicotinic acid. The electrophysiological effects of isoprenaline were similar before and after inhibition of lipolysis. The study indicates that the cardiac electrophysiological effects of isoprenaline in the intact, healthy heart are independent of changes in plasma FFA concentrations.
Biotelemetric detection of the disappearance of subcutaneously injected 125I‐NPH insulin
Authors: Kølendorf K. , Bojsen J.
Published: April 2008

Summary. A biotelemetric method with Geiger‐Müller (GM) detectors fixed to the skin surface was used for continuous registration of the disappearance rate of subcutaneously injected 126I‐NPH insulin. Methodological problems concerning counting geometry were investigated by comparing the disappearance of radioactivity, measured with GM‐ and NaI‐detectors, respectively, and by scanning of the radioactive source. The size and position of the subcutaneous depot was unchanged throughout the study. Movement artifacts could be avoided. The coefficient of variation for distribution of ratios between count rates for GM‐ and NaI‐detectors was 3·0%±1·1 (SD) (range 0·9‐4·0%) over periods of 24 h. It is concluded that the biotelemetry technique proved to be a clinically useful procedure for insulin absorption studies.
Hyperinflation on hyperventilation—a simple test to detect early airway disease
Authors: Jorfeldt Lennart , Wranne Bengt
Published: April 2008

Summary. The hypothesis was raised that an increased end‐expiratory lung volume when switching over from normal to hyperventilation (positive ΔFRC) can be used as a criterion of early obstructive lung disease. In 20 normal subjects and in 24 patients with suspect or manifest lung disease ΔFRC at breathing frequencies of 40, 60 and 80 min‐1, forced expiratory volume in one second (FEV1), vital capacity (VC), maximal expiratory flow at 50 and 25% of VC (MEF50 and MEF26) and closing volume (CV) were determined. FEY% (FEV1·VC‐1· 100) and CV% (CV·VC‐1· 100) were calculated. ΔFRC40, correlated negatively with FEV%, MEF50 and MEF25 for normals and patients separately with no difference between the groups. The residual standard deviation of ΔFRC40 on FEV% was significantly reduced when MEF50 and MEF25 was included. ΔFRC40, did not correlate with CV or CV%. ΔFRC60 and ΔFRC80 did not correlate with MEF60 and MEF25. The reproducibility of ΔFRC40, was of the same order as the other variables studied. A ΔFRC40 of +0·3 1 corresponded to MEF50 and MEF25 values 2 SD below the reference value. This suggests that a positive ΔFRC40 of more than 0·31 indicates airway obstruction.
Variability, reproducibility and observer difference of body plethysmographic measurements
Authors: Teculescu D. B. , Bohadana A. B. , Peslin R. , Pino J. , da Silva J. M. Jansen
Published: April 2008

Summary. The variability (coefficient of variation of five consecutive measurements), reproducibility (difference of results at 1 h and 24 h), and interobserver difference (independent reading of the tracings by two observers) of airways resistance (Raw) and static lung volumes (residual volume, functional residual capacity, total lung capacity) using a body plethysmograph were assessed in 14 healthy subjects and in 25 patients with various respiratory disorders. The variability was low for TLC (4–5%), moderate for FRC (74%) and high for Raw (28%). No significant changes of Raw or lung volumes were found for the groups at 1 h and 24 h. Between observers, a slight difference existed for FRC and Raw in normal subjects; the difference was higher (4·5% for FRC and 11 % for Raw) and became significant in patients. The overestimation of Raw by observer 2 as compared to observer 1 was more important at larger values. The present findings call for caution when pooling results obtained by several observers in large‐scale studies, or when comparing figures obtained by different technicians in the pulmonary function laboratory.
Electrophysiological and mechanical effects of sulphinpyrazone on isolated rat atria
Authors: Kristiansen O. , Refsum H. , Hotvedt R.
Published: April 2008

Summary. Clinical trials suggest that sulphinpyrazone reduces the incidence of sudden death in patients having suffered a myocardial infarction. To investigate possible direct antiarrhythmic properties of sulphinpyrazone, we carried out experiments on spontaneously beating and electrically stimulated isolated rat atrial preparations. Dose‐response curves for electrophysiological and mechanical effects of sulphinpyrazone were obtained. Increasing doses of sulphinpyrazone decreased the spontaneous atrial frequency, prolonged the sinus node recovery time after overdrive pacing, slightly increased the electrical threshold for excitation and decreased the contractile force. Although the mechanism by which sulphinpyrazone may reduce the incidence of sudden cardiac death is still not settled, the present study demonstrates direct electrophysiological and mechanical effects of the drug at high concentrations.
Subcutaneous blood flow over 24‐hour periods in patients with severe leg ischaemia
Authors: Bjerre‐Jepsen K. , Faris I. , Henriksen O. , Lassen N. A.
Published: April 2008

Summary. This paper describes a method for studying the clearance of 133Xenon from the subcutaneous tissue of the calf and foot over 24‐h periods. The average blood flow over this period can be estimated from the clearance constant obtained. Two series of measurement of the radioactivity are made, the first 2 h after the injection of 1–2 mCi 133Xenon in saline and the second 18–24 h later. The distance between the detector and the depot is reproduced using a cylinder 20 cm long. The median washout rate of the isotope (k) in 25 patients was 2–57 × 10‐3 min‐1 for the calf and 2·39 × 10‐3 min‐1 for the foot. The median difference between repeated measurements in the same patient was 0·24 × 10‐3 min‐1 in the calf and 0·43 × 10‐3 min‐1 in the foot.

This method, which can be used to estimate the average blood flow over 24 h while the patient undertakes his normal activities, should be useful in assessing the effect of therapy on the blood flow to the limb.
Stimulation of β‐adrenoceptors in the exercising human forearm
Authors: Hartling O. J. , Trap‐Jensen J.
Published: April 2008

Summary. In order to study the effects of local stimulation of β‐adrenoceptors on limb blood flow during exercise and on muscle metabolism, the non‐selective β‐adrenoceptor agonist, isoprenaline, was infused intra‐arterially into the forearm of six healthy, young subjects. Isoprenaline caused a marked increase in forearm blood flow not only at rest but also during dynamic forearm exercise. The forearm release of lactate increased considerably during drug infusion whereas glucose uptake decreased. The net uptake of free fatty acids during exercise decreased. There were no systemic effects of isoprenaline. These findings suggest that the resistance vessels are responsive to p‐adrenergic vaso‐dilatation also during muscle exercise. The increase in blood flow through the exercising forearm may be secondary to an increased muscle metabolism. The increased lactate release from the exercising muscles indicates an increased muscle glycogen breakdown during P‐adrenoceptor stimulation.
Density dependence of maximal expiratory flows in normal subjects: influence of sex, age, body build and spirographic variables
Authors: Teculescu D. B. , Hannhart B. , Peslin R. , Pino J.
Published: April 2008

Summary. We studied the correlation between density‐dependence parameters (ΔHe, volume of isoflow) and age, body build, spirography and forced expiratory flows in 69 healthy non‐smokers (16 females) aged 18 to 51 years. Density dependence variables showed no significant differences between young (less than 35 years) males and females. Volume of isoflow per cent of forced vital capacity (Viso V̇% FVC) was poorly significantly related to age (r=+ 0·25 P < 0·05) and weight (r =+ 0·27 P <0·05). Significant correlations were found between density dependence at low lung volume and the FEV1/VC ratio (r = 0·31, P= 0·01 for ΔHe 25%; r=‐0.40, P < 0·001 for Viso V̇% FVC) or the forced expiratory flows with air (Viso 0% FVC vs. FEF 25% r=‐0.42, P<0·001). These correlations were closer in females as compared to males. Volume of isoflow was well related to ΔHe 25%r= 0·64, P<0·001), but the relationship with ΔHe 50% was weaker (r=‐0·38; P< 0·01).
Effect of terbutaline on lung mechanics and morphology in the preterm rabbit neonate
Authors: Bergman B. , Freyschuss U. , Grossmann G. , Hedner T.
Published: April 2008

Summary. Lung morphology, surface properties of fetal pulmonary fluid, and lung mechanics during spontaneous breathing were studied in preterm newborn rabbits after antenatal administration of terbutaline (0 1 mg). The histological evaluation of lung sections revealed increased amounts of granular eosinophilic and sudanophilic material in the terminal airspaces. The amount of fetal pulmonary fluid was decreased in terbutaline‐treated animals; the fetal pulmonary fluid also showed improved surface properties, evaluated by the pulsating bubble technique. Increased dynamic lung compliance without altered air‐way resistance was found in terbutaline‐treated animals during the first 30 min after onset of breathing. This report demonstrates that terbutaline has an initial beneficial influence on the preterm neonatal lung, probably due to release of preformed surfactant into the alveolar spaces and to dehydration of the lung.
Effect of digoxin on physical performance in healthy man
Authors: Sundqvist Kerstin , Berglund Bo , Jogestrand Tomas
Published: April 2008

Summary. The effect of digoxin on the maximal oxygen uptake, the heart rate reaction during submaximal and maximal bicycle exercise and the isokinetic skeletal muscle strength in the thigh was investigated in nine well‐trained healthy young men. A daily dose of digoxin of 0·50 mg for 2 weeks, giving a steady state serum digoxin concefltration of 1·0 ± 0·2 nmol/l, did not significantly change maximal oxygen uptake or isokinetic muscle strength. However, the heart rate at rest and during exercise, both at submaximal and maximal levels, decreased significantly during digoxin administration.
Pulmonary angiotensin II production in respiratory failure
Authors: Wiberg‐Jørgensen F. , Klausen N. O. , Hald A. , Qvist J. , Giese J. , Nielsen M. Damkjær
Published: April 2008

Summary. Plasma angiotensin II concentration gradients across the pulmonary vascular bed, plasma renin concentration and serum converting enzyme activity were measured in 19 patients. The majority of the patients were critically ill. Nine patients had septicemia with acute respiratory failure, six patients had severe chronic lung disease and four patients had other serious disorders requiring haemodynamic monitoring. Pulmonary angiotensin II generation rates were calculated as the products of the pulmonary plasma flow and the angiotensin II concentration gradient across the lung.

Several patients had a highly activated renin‐angiotensin system. There was a strictly linear correlation between the plasma angiotensin II concentrations in mixed venous blood and in systemic arterial blood across a wide range, the concentration in arterial blood being 14·1·5 times that in mixed venous blood in each of the three groups of patients. Serum converting enzyme activity was not different from the level observed in a group of control patients above 50 years of age, but lower than in younger normal individuals. The maximal angiotensin II production rates in the pulmonary vascular bed of patients with life‐endangering pulmonary disease were similar to the rates previously measured in hypertensive patients with renovascular or renal parenchymal disease. In conclusion, the process of angiotensin I conversion in the lung operates without impediment in spite of severe pulmonary injury.
Effect of cigarette smoking on reactive hyperaemia in the human finger
Authors: Carlsson Inger , Wennmalm Åke
Published: April 2008

Summary. The effect elicited by cigarette smoking on the reactive hyperaemia that develops following release of arterial occlusion in human skin was investigated, and compared to the corresponding effects elicited by oral administration of indomethacin (an inhibitor of the prostaglandin‐forming enzyme cyclo‐oxygenase) or nicotine, or by smoking of nicotine‐free cigarettes. Finger blood flow was determined in human volunteers, using venous occlusion plethysmography, in the basal state and after 5 min of arterial occlusion. All subjects were studied before and after they had smoked two tobacco cigarettes, two herbal (nicotine‐free) cigarettes, or chewed a nicotine chewing gum. The determinations before and after tobacco smoking were repeated after administration of indomethacin. In separate series, the effects of smoking on heart rate and systemic blood pressure were recorded.

The basal finger blood flow was significantly (P< 0·05) diminished following cigarette smoking, by about 35%, and so was the reactive hyperaemia (P<0·05), by about 55%. The reactive hyperaemia after administration of indomethacin in combination with cigarette smoking did not differ from that obtained after cigarette smoking alone. The reactive hyperaemia was not affected by oral administration of nicotine, or by smoking of two herbal cigarettes. Cigarette smoking elicited increases in heart rate and systemic blood pressure that were of similar magnitude before and after indomethacin.

From these data, we conclude that cigarette smoking elicits an inhibitory effect on the reactive hyperaemia in the human finger. This effect is probably not caused by nicotine, and seems to act via blockade of the vascular relaxation normally mediated by locally formed cyclo‐oxygenase products.
NADH and NADPH in human skeletal muscle at rest and during ischaemia
Authors: Sahlin K.
Published: April 2008

Summary. A method for determining the content of NADH and NADPH in biopsy specimens from human skeletal muscle is described. It is based on the bioluminescent technique, utilizing oxidoreductases specific for NADH and NADPH, respectively. Muscle samples were taken from the lateral portion of the quadriceps muscle in the basal state and following local circulatory occlusion. In resting human skeletal muscle, the content of NADH was 91±6 μmol/kg dry muscle (mean ± SE, n = 11) and the NAD/NADH ratio was 18·8±1·3. The content of NADPH determined in four subjects was 108±2 μmol/kg dry muscle. After 5 min of circulatory occlusion, NADH had risen about 100% and a further increase was found after 10 and 20 min, to a plateau about 150% above the basal value. The muscle content of NADPH also increased but to a minor extent (about 30% above the basal value). The changes in muscle lactate after 5 and 10 min occlusion were not uniform between subjects but an increase was obtained in all subjects after 20 min occlusion. No relation was found between the ratios pyruvate/lactate and NAD/NADH and the latter ratio was smaller than the estimated value, calculated from the LDH equilibrium in the cytoplasm. The results indicate that the major part of NADH in muscle tissue is confined to the mitochondrial compartment. It is concluded that measurement of NADH provides information primarily about the mitochondrial redox state rather than the cytosolic and that changes in NADH precede lactate formation and thus are a more sensitive index of tissue hypoxia than increases in lactate.
Effect of antacids on intragastric pH in healthy subjects and duodenal ulcer patients. Influence of the size of the antacid dose and of anticholinergics
Authors: Uusitalo A. , Keyriläinen O.
Published: April 2008

Summary. Different doses of two liquid antacids, alone and combined with an anti‐cholinergic agent, were studied with respect to the duration of antacid action. The studies were performed in healthy subjects with MAO <30 mmol/h and in duodenal ulcer patients with MAO > 35 mmol/h. Gastric pH was recorded using radiotelemetric technique (Heidelberg capsule). In the healthy subjects, there was no significant difference in the duration of action with the different doses but in duodenal ulcer patients a tenfold increase of the antacid dose resulted in a doubling of the duration of action. Combined treatment with an anticholinergic and antacids enhanced the antacid effects in both groups. It is concluded that an antacid dose should be so great that it binds secreted acid before the dose leaves the stomach. Further increase of the dose will not increase the duration. Concomitant use of an anticholinergic agent increases the duration of antacid action.
A telemetric technique for studies of venous pressure in the human leg during different positions and activities
Authors: Noddeland Harald , Ingemansen Roald , Reed Rolf Kåre , Aukland Knut
Published: April 2008

Summary. The pressure in the saphenous vein of the lower leg was monitored by ordinary ECG telemetry equipment supplied with a pressure transducer, a chopper and an extra filter. In eight healthy volunteers venous pressure averaged 802 5 (SD) mmHg in the standing position and 21210 (SD) mmHg during slow walking. When the subjects were occupied with laboratory work in upright position the mean venous pressure was 40–50 mmHg, similar to that obtained sitting at a desk: 48 ± 5 (SD) mmHg.
Respiratory and circulatory adaptation to isometric and dynamic exercise in chronic lung disease
Authors: Schrijen Francine , Ravez Paul , Candina‐Villar Roberto
Published: April 2008

Summary. Changes at the beginning of isometric and dynamic low level exercise were studied in 23 patients with chronic lung disease. Ventilation, oxygen consumption and vascular pressures in systemic and pulmonary circulation were continuously monitored, and cardiac output was measured by thermodilution every minute. Circulatory changes took place suddenly at the beginning of isometric exercise and gradually during dynamic exercise. Ventilatory changes followed almost the same progressive pattern in both types of exercise. Ventilation increase in relation to oxygen uptake was slightly smaller during isometric exercise. Pulmonary artery pressure showed no further increase after the initial change, although ventilation was still rising.
A simplified evaluation of vital capillary microscopy for predicting skin viability in patients with severe arterial insufficiency
Authors: Fagrell B. , Lundberg G.
Published: April 2008

Summary. In the present study the predictive value of a simplified VCM (Vital Capillary Microscopy) classification in assessing the development of skin necrosis was investigated in 69 patients with severe peripheral arterial obliterative disease (AOD) of the leg. The arterial circulation of the foot was evaluated by systolic blood pressure (SBP,). The structure and blood filling of the skin capillaries of all toes and forefeet were evaluated by an ordinary stereo‐microscope at a magnification of 10 to 40 times. A three stage classification was used for evaluating the nutritive skin capillaries: Stage A, B and C. The individual patient was classified according to the worst stage found in the foot. The predictive value for the SBP, measurements with regard to the development of skin necrosis was for the best group (21–30 mmHg) 6%, for the middle group (11–20 mmHg) 58% and for the worst group (0–10 mmHg) 56%. The predictive values for the VCM Stages A, B and C were 5, 16 and 93% respectively. The sensitivity with the borderline between Stage A and B + C was 97% and the specificity 53%. With the borderline between Stage A + B and C the sensitivity and specificity became 87% and 95% respectively. It may be concluded that the VCM classification with three stages used in the present study seems to be very useful for predicting the risk of skin necrosis in patients with severe AOD.
Effects of glucose on alanine‐derived urea synthesis
Authors: Vilstrup Hendrik
Published: April 2008

Summary. The effect of glucose on alanine‐stimulated urea synthesis was studied in six healthy volunteers during 6 h of constant alanine infusion, 2·8 mmol h‐1 kg‐1 b. wht., and during 12 h of constant glucose infusion, 4·0 mmol h‐1 kg‐1 b. wht., with superimposed alanine infusion. The urea nitrogen synthesis rate (UNSR) was determined at intervals of 2 h as urinary excretion rate corrected for accumulation and intestinal hydrolysis. UNSR depended on the blood alanine and glucagon concentration, but was not correlated with glucose, lactate. or insulin concentrations. The slope of the linear relation between UNSR and alanine concentration (the ‘Functional Hepatic Nitrogen Clearance’) was on the average 24·4 1 h‐1 and decreased to 12·8 1 h‐1 by glucose (mean difference k SE of the difference 10·6±7·3, P<0·01). The relation between glucagon and alanine concentration was linear, and the slope was decreased to 40 per cent by glucose (P<0·05). The slope of the linear relation between UNSR and glucagon was not changed by glucose. Thus the catabolism of alanine nitrogen is decreased by glucose because of a reduction of the urea synthesis. Data suggest that this may be due to a depression of the glucagon response to alanine.
Plasma volumes, noradrenaline levels and renin activity during posture changes in end‐stage renal failure
Authors: Koomans H. A. , Geers A. B. , Boer P. , Mees E. J. Dorhout
Published: April 2008

Summary. In nine normal subjects and nine patients with end‐stage chronic renal failure (CRF) we studied the effect of prolonged (110 min) postural changes on the plasma volume, intrathoracic volume, plasma noradrenaline concentration, haemodynamic variables, and plasma renin activity (PRA). Upon standing, plasma volume decreased rapidly by about 11% in both groups as measured from the control volume and changes in haematocrit. This was accompanied by identical increments of plasma colloid osmotic pressure. The changes in intrathoracic volume (monitored by measurement of the electrical impedance of the thorax), as well as the alterations in plasma noradrenaline, blood pressure, and heart rate, were also comparable in the two groups. These similarities were in contrast with divergent responses of PRA. The increase in PRA on standing was significantly blunted in the CRF patients compared with the normal response (to 1.4±0‐ 4 fold of the supine value in CRF v. 6.0±3.2 fold in the normals, P < 0.0004). It is concluded that the attenuated increase in PRA upon standing in patients with CRF is not a consequence of diminished sympathetic stimulation or an altered response of the intravascular volume. Second, the unabated decrease in plasma volume upon standing pleads against a decrease of tissue compliance in CRF.
Effect of exercise training on plasma catecholamines and haemodynamics of adolescent hypertensives during rest, submaximal exercise and orthostatic stress
Authors: Hagberg James M. , Goldring David , Heath Gregory W. , Ehsani Ali A. , Hernandez Antonio , Holloszy John O.
Published: April 2008

Summary. Twelve adolescents with essential hypertension were studied to determine the effect of exercise training on plasma catecholamine concentrations, blood pressure and cardiovascular haemodynamics at rest and during submaximal exercise and orthostatic stress. Maximal oxygen consumption (V̇O2max) increased 13% with training while body weight and body fat did not change. Resting systolic and diastolic blood pressures decreased significantly with training, while plasma norepinephrine and epinephrine levels were unchanged. The increase in systolic blood pressure in response to standing was significantly lower after training, while the plasma catecholamine response was not significantly different. At the same absolute work rate after training, the subjects' systolic and diastolic blood pressures, heart rates, and plasma norepinephrine and epinephrine levels were significantly lower than before training. At the same relative work rate after training, the blood pressure response was the same as before training despite significantly higher plasma norepinephrine levels. Thus, the training‐induced changes in resting blood pressures and blood pressure responses to orthostatic and submaximal exercise stress cannot be attributed to decreases in plasma catecholamine levels.
Effect of exercise training on plasma high‐density lipoprotein cholesterol level at constant weight
Authors: Higuchi Mitsuru , Hashimoto Isao , Yamakawa Kikue , Tsuji Etsuko , Nishimuta Mamoru , Suzuki Shinjiro
Published: April 2008

Summary. Previous investigations have demonstrated an increase of plasma high‐density lipoprotein cholesterol (HDL‐Chol) and a decrease in the ratio of low density lipoprotein (LDL)‐Chol/HDL‐Chol (Atherogenic Index; AI) as a result of exercise training. The question of whether elevation of HDL‐Chol was a consequence of weight reduction or physical training itself was unsolved. The present study was designed to prevent the weight reduction that is associated with exercise training. Five healthy and mildly active male volunteers, aged 28–31 years, participated in a 4‐week training programme. They ran on a treadmill at 140–160 m/min at 0% grade for 50 min, 5 times a week, equivalent to an energy expenditure of 9 kcal/kg body weight/day. Subjects maintained their body weights by increasing calorie intake to match increased energy expenditure. No changes were observed in mean body weight, skinfold thickness, basal metabolism, and maximal oxygen uptake after the training programme. The HDL‐Chol level increased from 54 to 73 mg/dl (P < 0.05), and the reduction of A1 was 30.8% (P < 0.05) in response to the exercise training. However, the exercise training did not induce changes in plasma total cholesterol and triglyceride (TG) levels. The results of this experiment suggested that moderate physical training itself can be a potent factor for the regulation of HDL‐Chol level and improvement of the A1 in the absence of alterations in body weight.
Topical magnetic resonance for the study of muscle metabolism in human myopathy
Authors: Edwards R. H. T. , Griffiths R. D. , Cady E. B.
Published: April 2008

Summary. The role of changes in energy metabolism are obvious in the myopathies with described enzyme defects, but the ability afforded by topical magnetic resonance spectroscopy to study these changes repeatedly and non‐invasively helps provide an understanding of the alterations in energy metabolism seen in muscle complaints of which the aetiologies are still unclear. Attention is focused on interpreting the findings with particular regard to Duchenne muscular dystrophy.
PULMONARY BLOOD FLOW DETERMINATION WITH SELECTIVE REBREATHING OF CO2
Authors: Linnarsson Dag , Larsson Hans
Published: April 2008

A new CO2‐based non‐invasive method for pulmonary blood flow has been developed. Selective rebreathing of CO2 was obtained in an open‐circuit system by measuring the expired instantaneous CO2 flux in the expired air and by mixing pure CO2 into the inspired air. The time course of the inspired PCO2 was altered so that end‐tidal PCO2 changed as a linear function of time (ramp). Pulmonary blood flow was computed as the ratio between the rate of change in net CO2 elimination (or uptake) and the concomitant rate of change of estimated arterial CO2 content. In comparison to simultaneous ly determined cardiac output by means of the O2 Fick method, the proposed CO2 ramp method underestimated cardiac output by some 20 per cent in 22 supine sedated patients with valvular heart disease.

Differences in PCO2 between end‐tidal gas and the gas in perfused alveoli are thought to be the main cause of this underestimation.
Influence of body composition on insulin clearance
Authors: Yki‐Jarvinen H. , Koivisto V. A. , Karonen S.‐L.
Published: April 2008

Summary. . The effect of body composition on clearance of infused insulin was studied in 21 young normal weight (relative body weight 107±2%, of ideal meanæM) healthy subjects. In each subject, the per cent of body weight made up of muscle and fat tissue (% muscle and % fat) were determined. Clearance of insulin was estimated during infusion of insulin at the rate of 40 mU/m2/min under maintenance of normoglycaemia using the euglycaemic clamp technique. Steady‐state plasma insulin levels (92.6±3.2 mU/litre) correlated negatively with % muscle (r‐=‐0.60, P<0–01), and positively with % fat (r=0–55, P<0–01). Clearance of insulin was directly related to % muscle (r=‐0.60, P<0.01), and inversely related to % fat (r=‐0–48, P<0–01). Steady‐state plasma insulin levels or insulin clearance did not correlate with relative body weight. Multiple linear regression analysis revealed a significant multivariate correlation between the rate of insulin clearance versus % muscle and % fat (r=0.62, P<0–02). The changes in % muscle and % fat could predict 37% of the observed interindividual variance of insulin clearance. These results indicate that insulin clearance depends on body composition and is higher in muscular than in adipose subjects. This difference may reflect either a greater distribution space of insulin in muscular as compared to adipose subjects or an influence of body composition on insulin catabolism.