bluuebunny/crossref_metadata_2025 huggingface dataset:
Haemodynamic Effects of Saluretic Treatment and β‐receptor Blockade in Patients with Essential Hypertension
Authors: Bevegård Sture , Castenfors Jan , Danielson Mats
Published: August 2010

ABSTRACTThe long‐term haemodynamic effects of treatment with mefruside alone or in combination with alprenolol have been studied in nine patients with essential hypertension. After four months of mefruside therapy alone there was a significant decrease in intraarterial BP both at rest and during standardized leg exercise. Cardiac output and calculated total peripheral vascular resistance (TPVR) showed only minor mean decreases which were not statistically significant. Stroke volume tended to decrease and heart rate to increase. After another four months' treatment with addition of alprenolol there was a further significant decrease in intraarterial BP, related mainly to a further mean decrease in cardiac output which was not statistically significant. Heart rate decreased significantly, stroke volume was not significantly changed. Compared with the pretreatment levels, combination therapy induced a substantial decrease in intraarterial BP and a significant decrease in cardiac output both at rest in supine position and during standardized leg exercise. TPVR decreased slightly both at rest and during exercise but the change was not statistically significant. The results suggest that the decrease in BP after combined therapy with mefruside and alprenolol is mainly related to a decrease in cardiac output, the changes in TPVR being not significant. The additive hypotensive effect of alprenolol seems to be related in part to blocking of the increase in sympathetic activity that was found after treatment with mefruside alone.
Studies on Plasma Lipid and Phospholipid Composition in Pernicious Anemia before and after Specific Treatment
Authors: Wallentin Lars , Berlin Ragnar , Vikrot Olle
Published: August 2010

ABSTRACTPatients with pernicious anemia (PA) have been compared with a reference group concerning the concentration of lipids in plasma before (34 cases) and after (15 cases) treatment with vitamin B12. The lipid parameters in plasma and in postheparin plasma have been measured before and after 6 hours' incubation at 37°C before and after specific treatment. In a limited number of cases the lecithin: cholesterol acyl transfer (LCAT) rate has been determined. In relapse, the PA cases showed increased free fatty acid (FFA) and triglyceride (TG) concentrations but decreased concentrations of total cholesterol (TC), unesterified cholesterol (UC) and all examined phospholipid fractions. After treatment, FFA remained unchanged and TG decreased, while TC and possibly also UC and the phospholipid fractions were in line with reference levels. After incubations, UC and phosphatidylcholine (PC) decreased and lysolecithin (LL) increased. FFA increased and TG decreased. Incubation of postheparin plasma resulted in an augmented decrease in TG and PC and increase in FFA and LL. In relapse, the changes on incubation were less pronounced than after treatment. The LCAT rate was low but within the normal range before treatment in the six cases examined. After treatment, LCAT rates increased but were still normal in relation to the plasma lipid concentrations. The study showed a decreased net esterification of cholesterol and LL formation on incubation of plasma in PA cases in relapse. This finding might be explained by the low concentration of plasma substrates for the LCAT reaction and phospholipases. After treatment the concentration of lipid substrates was restored to normal, with subsequent normal LL formation and cholesterol esterification. The observations could also explain the frequent lack of stabilization of erythrocytes suspended in plasma of PA after incubation, resulting in virtually the same ESR after as before this procedure. Due to low LL formation following the insufficient substrate availability for LCAT and phospholipase, the previously reported critical level of the LL concentration is not reached and cannot achieve its normal reduction of the ESR.
Studies on the Pelger Anomaly in Iceland
Authors: Jensson ölafur , Árnason Kjartan , Jóhannesson Gudmundur M. , Úlfarsson Jakob
Published: August 2010

ABSTRACT An Icelandic family, containing 15 members with Pelger anomaly, is reported. Affected individuals in two branches of the family, living in the south‐east and east of Iceland, have been traced to common ancestors born 200 years ago. The results of scanning of blood films from approximately 20% of the population of Iceland suggest that the Pelger family described contains the only mutation of this kind in Icelanders.
Treatment of Progressive Systemic Sclerosis (Scleroderma, PSS) with a New Drug Influencing Connective Tissue
Authors: Herbai Georg , Blom Berith , Boström Harry
Published: August 2010

ABSTRACT Cyclofenil is a new diphenyl ethylene derivative related to stilboestrol without oestrogenicity but with marked effects on connective tissue metabolism. The drug has been tested, in a daily dose of 200 mgX3, in six patients with progressive systemic sclerosis (PSS) to analyze the expected beneficial effects on the PSS symptoms. The typical skin hardness, joint and muscle rigidity, and reduced breathing capacity were improved to varying degrees. The only side‐effect was a slight transient liver enzyme elevation in 1 out of 6 patients. A slight increase was found in urinary calcium and hydroxyproline excretion. In several cases serum calcium, cholesterol, triglyceride and in some cases the serum uric acid levels were decreased. The ANF titres diminished to varying degrees in 4 out of 6 patients. These results indicate that further detailed clinical and laboratory studies on the therapeutic potential of cyclofenil in PSS and other diseases affecting connective tissue seem to be justified.
Evaluation of the Sulphapyridine Acetylator Phenotyping Test in Healthy Subjects and in Patients with Cardiac and Renal Diseases
Authors: Molin Lilian , Larsson Rutger , Karlsson Erling
Published: August 2010

ABSTRACTThe acetylator phenotype of 35 healthy, drug‐free volunteers and 21 patients with cardiac and/or renal disease has been assessed using oral sulphapyridine. Comparative evaluation of a simplified and a more selective method of sulphapyridine analysis was performed. Thirteen of the patients were also phenotyped by determination of plasma isoniazid half‐life. 81% of the patients were slow acetylators, compared with only 51% of the volunteers. When phenotyping healthy, drug‐free subjects the analytical procedure, involving a direct estimation of sulphapyridine in urine with the Bratton‐Marshall procedure, was satisfactory. On the other hand, in patients receiving concomitant drug therapy the more selective analytical procedure was necessary in order to diminish the risk of methodological interference.
Spontaneous Systemic Lupus Erythematosus and Acetylator Phenotype
Authors: Larsson Rutger , Karlsson Erling , Molin Lilian
Published: August 2010

ABSTRACTFifteen patients with spontaneous systemic lupus erythematosus (SLE) have been phenotyped by determination of plasma isoniazid (INH) half‐life. Seven patients had signs of renal insufficiency. Of the 15 patients, 13 were slow and only 2 rapid acetylators. No correlation was found between the plasma INH half‐lives and the renal function. Thus, there is the same marked predominance of slow acetylators in patients with spontaneous SLE as in patients with the drug‐induced SLE‐like syndrome.
Myelofibrosis and Rapid Thrombocytolysis
Authors: Kutti Jack , Bergström Anna‐Lisa , Ridell Börje
Published: August 2010

ABSTRACT A 69‐year‐old woman was referred to our department because of moderate anemia and thrombocytopenia. On admission the spleen was slightly enlarged. On the basis of histological examination of biopsy specimens from spinal processes the diagnosis of myelofibrosis was made. The subsequent clinical course was progressively downhill. Although splenomegaly was of only moderate degree, severe anemia and thrombocytopenia supervened. Platelet mean life span was dramatically shortened (1.8 hours) and platelet production rate considerably increased (about 18 × normal). Neither corticosteroid therapy nor splenectomy alleviated the thrombocytopenia. Extremely large platelets, with diameters of up to 10 μm, were seen in the peripheral blood. The mean platelet diameter and percentage of mega‐thrombocytes reached peak values about 2 weeks after splenectomy. It is suggested that the immunologic background of the rapid thrombocytolysis is similar to that which governs platelet destruction in idiopathic thrombocytopenic purpura.
Divergent Changes of Serum 3,5,3‘‐Triiodothyronine and 3,3’,5‘‐Triiodothyronine in Patients with Acute Myocardial Infarction
Authors: Westgren U. , Burger A. , Levin K. , Melander A. , Nilsson G. , Pettersson U.
Published: August 2010

ABSTRACT The serum levels of thyroxine (T4), 3,5,3′‐triiodothyronine (T3), 3,3′,5′‐triiodothyronine (reverse T3, rT3), thyroxine‐binding globulin and thyroid‐stimulating hormone have been monitored in 13 patients with acute myocardial infarction. The major changes recorded were a transient decrease in T3 and a transient increase in rT3. They reached a nadir and a peak, respectively, within three days. A conceivable explanation for these alterations is that the monodeiodination of T4 is diverted from the activating pathway (T4 to T3) to the inactivating pathway (T4 to rT3).
Kaliuretic Effect of L‐dopa Treatment in Parkinsonian Patients
Authors: Granérus Ann‐Kathrine , Jagenburg Rudolf , Svanborg Alvar
Published: August 2010

ABSTRACTHypokalemia, sometimes severe, was observed in some L‐dopa‐treated parkinsonian patients. The influence of L‐dopa on the renal excretion of potassium was studied in 3 patients with hypokalemia and in 5 normokalemic patients by determination of renal plasma flow, glomerular filtration rate, plasma concentration of potassium and sodium as well as urinary excretion of potassium, sodium and aldosterone. L‐Dopa intake was found to cause an increased excretion of potassium, and sometimes also of sodium, in the hypokalemic but not in the normokalemic patients. This effect on the renal function could be prohibited by the administration of a peripheral dopa decarboxylase inhibitor. It is not known why this effect occurred in some individuals but not in others, but our results indicate a correlation between aldosterone production and this renal effect of L‐dopa.
Effect of Long‐term Vitamin D2 Treatment on Bone Morphometry and Biochemical Values in Anticonvulsant Osteomalacia
Authors: Mosekilde Leif , Melsen Flemming , Christensen Merete Sanvig , Lund Birger , Sørensen Ole Helmer
Published: August 2010

ABSTRACT Quantitative morphometric analyses of iliac crest biopsies from 20 epileptic patients receiving chronic anticonvulsant therapy have been performed before and after 4–8 months of vitamin D2 treatment with 9000 U per day. Biochemical quantities, including serum 25‐hydroxycholecalciferol (25‐HCC) and serum parathyroid hormone (iPTH), were measured. The anticonvulsant osteomalacia found in the initial bone biopsies was characterized by an increased amount of unmineralized bone, an increased bone resorption and, contrary to vitamin D deficiency, an increased bone mineralization and bone formation. Bone resorption and bone formation were probably equally increased since the amount of cancellous bone was normal. Except for a slight increase in osteoid‐covered surfaces and osteoclastic resorption surfaces, the bone changes were normalized after vitamin D2 treatment, leading to a mean serum level of 25‐HCC 2.4 times above normal. Serum iPTH was normal before and unchanged during D2 therapy. The urinary calcium excretion remained decreased. The investigation characterizes anticonvulsant osteomalacia as a specific bone disease different from that of vitamin D deficiency but induced by abnormalities in vitamin D metabolism or in the effects of vitamin D metabolites on receptor cells.
Urinary Excretion of Ten Plasma Proteins in Patients with Febrile Diseases
Authors: Hemmingsen L. , Skaarup P.
Published: August 2010

ABSTRACTThe 24‐hour urinary excretion of albumin, transferrin, haptoglobin, IgG, IgA, IgM, free lambda and kappa light chains from immunoglobulin, lysozyme, and β2‐microglobulin has been investigated in 22 patients with febrile diseases, using an automated immunoprecipitin reaction. The average excretion of the 10 proteins was significantly increased in the patients compared with a control group. In patients with body temperature ±38.5°C the tubular type of proteinuria was significantly increased compared with those with body temperature <38.5°C. Sequential studies in 10 patients showed that the tubular type of proteinuria occurred in all, whereas the glomerular type was demonstrated in 8. When the fever had subsided, the tubular proteinuria disappeared rapidly i in all patients, while the glomerular proteinuria disappeared in only 4 out of 8. It was shown that tubular proteinuria was caused by fever per se, and it is suggested that glomerular proteinuria might be due to an immune response to antigens, derived from the infectious agents, producing a transient or permanent glomerular injury.
Effect of Sodium Loading and Exercise on Renal Haemodynamics and Urinary Sodium Excretion in Young Patients with Essential Hypertension before and during Propranolol Treatment
Authors: Pedersen E. B.
Published: August 2010

ABSTRACT The effects on renal plasma flow (RPF) and glomerular filtration rate (GFR) of an i.v. sodium load and exercise have been measured in 14 young patients with essential hypertension before and after 3–4 months' treatment with propranolol as well as in 10 normotensive control subjects. In the untreated hypertensive patients, RPF and GFR were significantly reduced during sodium loading and exercise. After propranolol treatment, RPF and GFR were unaffected by sodium loading but decreased during exercise. In the normotensive control group, GFR and RPF were unchanged during sodium loading; RPF decreased during exercise, whereas GFR was not significantly reduced. RPF was significantly lower in the untreated hypertensive patients than in the normotensive control subjects during sodium loading and exercise. Propranolol treatment induced a significant reduction of BP and heart rate. RPF and GFR were not altered by propranolol treatment during sodium loading. During exercise, however, RPF was significantly lower after treatment than before. Urinary sodium excretion during sodium loading was significantly higher in the hypertensive patients than in the control subjects and decreased significantly during propranolol treatment. The reason for the abnormal reduction in renal haemodynamics during sodium loading in patients with essential hypertension is not clarified, but may possibly be related to functional or structural alterations in the renal vascular bed. The lower RPF during exercise after treatment with propranolol is most likely caused by an inhibition of the cardiac output induced by β‐adrenergic blockade. It is conceivable that the reduced urinary sodium excretion during propranolol treatment is attributable to the reduction of BP.
Prolonged Monosymptomatic Fever due to Yersinia Enterocolitica
Authors: Bliddal Johs. , Kaliszan Steen
Published: August 2010

ABSTRACT A previously healthy 14‐year‐old girl showed monosymptomatic hectic fever for over 3 weeks with negative clinical findings. Extensive laboratory investigation revealed only elevated ESR and a high titer of agglutinating antibodies against Yersinia enterocolitica, serotype 0–3. These abnormalities disappeared upon tetracycline therapy, after which she remained in excellent health. This unusual manifestation of yersiniosis, which was of unknown source, demonstrates that Yersinia infection should be considered in patients with prolonged febrile illnesses of obscure etiology.
Carcinoembryonic Antigen in Amniotic Fluid
Authors: Gadler HÅkan , Wahren Britta , Lindsten Jan , Bremme Katarina , Malmqvist Eva
Published: August 2010

ABSTRACT Carcinoembryonic antigen (CEA), a substance which is known to occur in high amounts in the fetal gut and also in certain tumors of the gastrointestinal tract, has been demonstrated in amniotic fluids from different stages of pregnancy. Radioimmunoassays of CEA in amniotic fluids of 91 normal pregnancies showed a decrease from a mean of 53 ng/ml at 19 weeks to 25 ng/ml at the end of gestation. The CEA activity in amniotic fluid was eluted in the same volume as a standard 125I‐CEA on a Sephadex G200 column. Amniotic fluid therefore contains CEA similar in molecular weight to the CEA purified from liver metastases of colonic cancer. Among 17 cases of abnormal pregnancies, CEA elevations were observed in five with anomalous fetuses.
Evaluation of Obstructive Characteristics of Mitral Disc Valve Implants with Ultrasound Doppler Techniques
Authors: Holen Jarle , Nitter‐Hauge Sigurd
Published: August 2010

ABSTRACT Ten adult patients with mitral disc valve implants have been examined on the catheterization table. Non‐invasive ultrasound Doppler data, pulmonary artery wedge pressure and left ventricular pressure were recorded simultaneously. The cardiac output was determined with the direct Fick method. The effective valve area was taken as a measure of the flow obstruction in the disc valve implants. This area was calculated from the ultrasound data and the cardiac output as well as from the manometric data and the cardiac output. The resulting two sets of areas demonstrated a linear correlation coefficient of 0.86. The effective valve areas calculated from the ultrasound data were reasonable when compared with the results of in vitro studies of disc valve performance and demonstrated good agreement with the findings of other investigators.
Computer‐based ECG Analysis in Acute Myocardial Infarction
Authors: Hulting Johan , Blomqvist Peter , NygÅrds Mats‐Erik
Published: August 2010

ABSTRACT A routine bipolar ECG has been recorded on magnetic tape in 12 patients with acute myocardial infarction. The recording was started 2–8 h after the onset of symptoms and lasted for 12 h. Minute‐by‐minute classification from a paper chart write‐out revealed ventricular ectopic beats (VBs) in all the patients. Ventricular tachycardia was seen in 6 patients and 2 had ventricular fibrillation, one of whom died. The tape recordings were analysed by a non‐interactive arrhythmia monitoring system. The accuracies of two different algorithms for detecting ventricular arrhythmias were compared. Program I was based on the comparison of all beats with a running average complex and the correlation of abnormal beats with a typical VB waveform. Program II implied the separation of complexes with different morphology on the basis of a five‐parameter description. The diagnosis of a VB was based on discriminant functions and rhythm criteria. A total of 2775 VBs were diagnosed, out of which programs I and II correctly diagnosed 48 and 60%, respectively. With program I only 34% of the alarm situations due to VBs were recognized, whereas 50% were correctly identified by program II. False positive VBs amounted to 0.21 and 0.07%, respectively, out of a total of 631 200 complexes and gave rise to false alarms corresponding to 3/4 of all alarms with program I and about 1/3 with program II—misdiagnosed alarm situations are not included in these figures. However, one patient with a technically bad recording contributed to more than 50% of the false alarms with both programs. Following this study and after minor modifications, an arrhythmia monitoring system based on program II has been taken into routine use in our Coronary Care Unit.
Pronounced Deficiency in T‐cells and Lymphocyte Chromosomal Aberrations in a Patient with Sarcoidosis, Myelofibrosis and Acute Leukaemia Following Thorotrast Angiography
Authors: Brandt L. , Emanuelsson H. , Mitelman F. , Stenstam M. , Söderström N.
Published: August 2010

ABSTRACT A patient exposed to thorotrast angiography developed sarcoidosis 21 years after the injection and myelofibrosis 13 years later. On the latter occasion an extreme deficiency in circulating lymphocytes forming rosettes with sheep erythrocytes (T‐cells) was observed and a large fraction of the cells had chromosomal aberrations. Acute leukaemia developed 1 year later. The multiple clinical symptoms may be related to radiation‐induced destruction of bone marrow tissue, mutations in haemopoietic cells and depression of cell‐mediated immunity.
Factors Modifying Ischemic Injury in the Isolated Rat Heart
Authors: Waldenström Anders P. , Hjalmarson Åke C.
Published: August 2010

ABSTRACT The extent of ischemic injury has been studied in the isolated working rat heart utilizing an aortic ball valve that reduces the coronary flow. A number of factors were tested including high heart rate, noradrenaline, acidosis, alkalosis, high afterload, β‐blockade, glucose‐insulin‐potassium (GIK), palmitate and methylprednisolone. Mechanical performance, myocardial contents of ATP, creatine phosphate, glycogen and lactate and the leakage of creatine phosphokinase (CK) from the myocardium to the perfusion buffer were measured and used for determination of the ischemic injury. Tachycardia, noradrenaline and palmitate are factors that markedly increase the ischemic injury in this preparation. GIK and probably metoprolol decrease the release of CK compared with the controls.
Swallowing Syncope
Authors: Golf Svein
Published: August 2010

ABSTRACT A previously healthy man complained of syncopes and convulsions during meals. Despite thorough gastroenterologic, neurologic and cardiologic examination, the condition was misinterpreted as a psychiatric disorder for 13 years. Then ambulatory ECG, using a casette recorder, revealed periods of 2nd degree AV block during swallowing. Pacemaker implantation prevented the attacks.
Alcohol Consumption and Hematology
Authors: Myrhed Mårten , Berglund Lena , Böttiger Lars Erik
Published: August 2010

ABSTRACT A number of hematological variables have been investigated and followed during a hospital stay in a group of 34 non‐cirrhotic male alcoholics after acute drinking bouts. The most prominent findings were a rise in reticulocytes, a fall in serum iron and a rise in WBC, especially with respect to the lymphocytes. HB and hematocrit values both fell during hospitalization, while ESR and serum haptoglobin rose. No change was observed in the platelet count. It is concluded that alcohol has marked effects on the hematological system even in subjects without serious liver damage. The results underline the importance of an adequate knowledge of the patient̂s alcohol habits in the investigation of obscure hematologic abnormalities.
Aseptic Necrosis of Bone Following Renal Transplantation
Authors: Nielsen H. E. , Melsen F. , Christensen M. S.
Published: August 2010

ABSTRACT Aseptic necrosis of bone has developed 5–48 months (mean 23) after renal transplantation in 22 (11%) of 195 patients with graft function for more than 6 months. The bone lesions were mainly localized to weight‐bearing cancellous bone areas, most often the femoral heads. The mean duration of hemodialysis was significantly longer in recipients with aseptic necrosis than in those without. The serum concentration of phosphate was reduced and the serum concentration of parathyroid hormone increased in both groups of recipients. Quantitative histological examination of iliac crest biopsies showed a pronounced reduction of spongy bone (osteopenia) in recipients with aseptic necrosis compared with both normals and recipients without aseptic necrosis. Both patient groups showed similar changes in bone remodelling, indicating decreased bone formation. These findings suggest that osteopenia is an important contributory factor in the development of aseptic necrosis of bone after transplantation. The osteopenia may be a consequence of both the uremic bone disease before transplantation and the immunosuppressive treatment after transplantation.
Bone, Calcium, and Hydroxyproline Metabolism in Hyperparathyroidism and after Removal of Parathyroid Adenoma
Authors: Laitinen Ossi
Published: August 2010

ABSTRACT Several laboratory parameters have been followed before and after surgery in a 69‐year‐old woman with parathyroid adenoma and severe skeletal involvement. High preoperative levels of immunoreactive parathyroid hormone rapidly decreased postoperatively, accompanied by a similar fall in the peptide‐bound hydroxyproline (HP) excretion in the urine. Renal clearance of free HP was high both pre‐ and postoperatively, probably because of renal damage associated with the disease. The high serum alkaline phosphatase levels increased slightly after the operation. The patient developed severe postoperative hypocalcaemia, and prolonged calcium supplement therapy was necessary. The results imply a clear correlation between the changes in Ca homeostasis and the breakdown rate of bone collagenous matrix. Postoperative hypocalcaemia was mainly due to the rapid change in the rates of bone formation and destruction.
Screening for and Treatment of Bacteriuria in a Middle‐aged Female Population
Authors: Takala Jorma , Jousimies Hannele , Sievers Kai
Published: August 2010

ABSTRACT Forty‐seven of the 55 subjects with bacteriuria found during a screening of an unselected female population aged 40–64 years (1312 women, 93.2% of whom were examined) have been treated with a systematic 2‐week nitrofurantoin therapy and 77% of them were cured. During a 1‐year follow‐up, urinary tract infection (UTI) recurred in 68% of those cured; thus only 24% of those treated had been cured and remained uninfected for a year. Although the result of treatment in the group with no diabetes, hypertension or chronic rheumatoid arthritis was better (88%) than in the group with these diseases (46%), the cured subjects in both groups had a similar frequency of recurrences. A previous UTI did not appear to have a negative effect on the result of treatment, neither did it increase the number of recurrent UTIs. The fact that even in the group with no complicating diseases only 28% of those treated were cured and remained free from bacteriuria for 1 year proves that, so far, no satisfactory therapy is available for mass use in the treatment of bacteriuria following a systematic screening of middle‐aged nonpregnant women. In addition to the lack of therapeutic methods, the systematic screening for bacteriuria in middle‐aged women was found to suffer from limited resources for further diagnostic examinations: according to the present study, a total of 3% of middle‐aged women need further examinations following the screening for and treatment of bacteriuria.
The Effect of Glucagon on Plasma Cyclic AMP and Glucose Concentrations in Patients with Alcoholic Cirrhosis
Authors: Strange R. C. , Mjøs O. D. , Henden Thale , Jynge P.
Published: August 2010

ABSTRACT Glucagon was infused intravenously into four patients with alcoholic cirrhosis and five healthy subjects and serial measurements were made of plasma cyclic AMP and glucose concentrations. The results in the cirrhotic patients did not differ significantly from those in healthy subjects.
Toxicity of Intravenous Catheters Tested in a Human Bone Marrow Culture System
Authors: Mortensen B. Thing , Jensen Lis E. , Knudtzon Seren , Nissen Nis I.
Published: August 2010

ABSTRACT Nine brands of i. v. catheter were tested for toxicity in a human bone marrow culture system, and content and leaching of plasticizers determined. Three catheters showed toxicity to the culture system and three others leached di‐2‐ethylhexyl‐phthalate in appreciable amounts.
Proteinuria Following Renal Arteriography
Authors: Tejler Lars , Ekberg Mats , Almén Torsten , Holtås Stig
Published: August 2010

ABSTRACT Two patients reacting with transitory, massive proteinuria after diagnostic renal arteriography with a commonly used non‐ionic contrast medium, metrizoate, are described. One of them developed temporary renal failure; the concentration of urinary albumin reached 330 g/g creatinine. It is suggested that intratubular precipitation of proteins, obstructing urinary flow, might be one factor in the development of her renal failure.
Effect of Clofibrate and Calcium in Type II A Hyperlipoproteinaemia
Authors: Lehtonen A. , Viikari J.
Published: August 2010

ABSTRACT In type II A hyperlipoproteinaemia, treatment with cholestyramine (12 g), calcium clofibrate (2 g) and a combination of calcium clofibrate and calcium carbonate (2+2 g) reduced the cholesterol concentration. The combination of calcium and clofibrate was at least as effective as cholestyramine. Calcium clofibrate decreased very low density and low density lipoprotein cholesterol, triglycerides and phospholipids, whereas no changes were found in high density lipoproteins. Cholestyramine decreased low density lipoprotein lipids.
External Carotid Pulse Recordings in Hypertrophic Obstructive Cardiomyopathy
Authors: Nesje Ola Alfred , Enge Ivar
Published: August 2010

ABSTRACT External carotid pulse tracings were examined in 15 patients with hypertrophic obstructive cardiomyopathy (HOCM), the diagnosis being confirmed by catheterization of the left heart. Of 12 patients with intraventricular gradients at rest, 9 had a typical bifid pulse with midsystolic dipping. In one patient without a gradient at rest, midsystolic dipping occurred only in beats following extrasystoles (Brockenbrough phenomenon). The upstroke of the pulse wave was rapid in all the patients, a finding that distinguishes them from patients with valvular aortic stenosis. There was a correlation between the length of the left ventricular ejection time and the intraventricular gradient (r=0.71) but as more than half the patients had normal or shortened ejection times, the diagnosis of HOCM cannot be based on measurements of this parameter. It is concluded that carotid pulse registrations are of considerable diagnostic value in patients suspected of having HOCM. As the pulse changes are correlated to the degree of left ventricular outflow obstruction, it is suggested that repeated pulse tracings may be used as a means for controlling the degree of obstruction once the diagnosis has been established in the individual patient.
The Hepatic Conversion of Vitamin D in Alcoholics with Varying Degrees of Liver Affection
Authors: Lundy B. , Sørensen O. H. , Hilden M. , Lund B.
Published: August 2010

ABSTRACT The seasonal variations in circulating 25‐hydroxycholecalciferol (25‐HCC) were studied in 102 alcoholics with fatty liver disease without histologic signs of cirrhosis and in 35 patients with alcoholic cirrhosis. The mean levels were compared with those of normal persons. Alcoholics had generally lower 25‐HCC values than the controls, particularly in the summer. This was primarily explained by insufficient diet and reduced exposure to sunshine. The ability of the liver to hydroxylate in the 25‐position was studied in three groups of alcoholics with 1) fatty liver disease without cirrhosis, 2) compensated cirrhosis, 3) severely incompensated liver cirrhosis. All three groups exhibited a significant increase in serum 25‐HCC following the peroral administration of cholecalciferol at a dose of 1200 U daily for 7 days. Similar rises were seen 7 days after a single injection of 10000 U cholecalciferol. This indicates a normal intestinal absorption of vitamin D, even in advanced alcoholic liver disease, and is inconsistent with a severely damaged 25‐hydroxylation capacity in these patients. Osteomalacia due to impaired liver hydroxylation of vitamin D can hardly explain the increased fracture rate and the decreased bone mass, which have been described in alcoholics.
Anticoagulant Treatment in Sarcoidosis
Authors: Hedfors Eva
Published: August 2010

ABSTRACT The treatment of sarcoidosis has so far been disappointing. This paper presents a patient in whom persistent disappearance of the pulmonary infiltrations was observed during anticoagulant treatment for venous thrombosis. A possible mechanism for a beneficial effect of anticoagulant treatment in sarcoidosis is discussed.
Electro‐Retinal Abnormalities in Heterozygotes of Renal‐Retinal Dysplasia
Authors: Hogewind Barend L. , Veltkamp Jan J. , Polak Bettine C. P. , van Es Leendert A.
Published: August 2010

ABSTRACT The relatives of two patients with medullary cystic disease associated with retinitis pigmentosa were studied. A new case was found in one of these families, and consanguinity of the parents was established in another. Conventional fundoscopic examination of relatives without renal disease did not show retinal abnormalities, but electro‐ophthalmologic investigation demonstrated retinal dysfunction in three relatives, including two of the four parents who may be considered obligatory heterozygotes under the assumption of autosomal recessive inheritance of this syndrome. Less severe electro‐ophthalmological abnormalities were observed in the other two parents. It is considered highly probable that all three patients are homozygous for a mutant gene causing both the renal and the retinal abnormalities. The results of this study support the view that medullary cystic disease associated with retinitis pigmentosa is transmitted as an autosomal recessive trait, in contrast to the dominant form, which is reported not to be associated with eye abnormalities. With respect to genetic counseling and donation of kidneys by relatives, it is important to establish the mode of inheritance of cystic medullary disease in a given family. Electro‐ophthalmologic examination should therefore be included in the examination of families in which medullary cystic disease occurs.
Angina Pectoris in Young Patients: Clinical Appraisal and Evaluation by Exercise, Atrial Pacing, and Myocardial Lactate Metabolism
Authors: Rajasalmi M. , Takkunen J.
Published: August 2010

ABSTRACT Young patients with a symptom complex of angina pectoris constitute a problematic group in medicine. Many of them require a detailed investigation. By combining electrophysiologic and metabolic measurements with dynamic clinical experiments, one can distinguish with great probability between normal and pathological findings. Exercise ECG, atrial pacing and simultaneous sampling of blood from artery and coronary sinus were undertaken in 57 patients aged 40 or less. Although the patients were selected according to a history of effort angina, results were normal in four and in seven others only one test was pathological. The sensitivity was highest in atrial pacing (78%) and somewhat lower in exercise ECG (75%) and lactate extraction (67%). The specificity of the tests in series was about 53%. Concordant results made a diagnosis of ischemic heart disease highly probable. Discrepancies and probably false negative results in individual cases are evident. The need for angiographic evaluation of coronary arteries and left ventricular function is clear. The stepwise advance from the usual physical examination to more demanding investigations provides a possibility of classifying the patients according to the needs of an accurate medical appraisal.
Controlled Clinical Study on Antihypertensive Treatment with a Diuretic and Methyldopa Compared with a β‐Blocking Agent and Hydralazine
Authors: Hansen Mogens , Hansen Ole Paaske , Lindholm Jörgen
Published: August 2010

ABSTRACT Twenty‐eight previously untreated patients with essential hypertension were included in a randomized double‐blind cross‐over study comparing the results of treatment with the established combination of a thiazide and methyldopa (regimen A) with the combination of a β‐receptor blocker and hydralazine (regimen B). Three patients each developed intolerable side‐effects on each regimen but they were all treated successfully on the alternative regimen. The remaining 22 patients obtained a significant reduction in BP at rest and during exercise on both treatments, with no significant difference between the two schedules. Heart rate was significantly reduced at rest and during exercise with regimen B, while a significant reduction was also obtained following exercise on regimen A. There was no significant difference between the two regimens as to tolerable side‐effects during treatment, which were registered in about 60% of the patients on each scheme. However, 64% of the patients were treated satisfactorily without side‐effects on either regimen. It is concluded that the combination of a β‐blocking agent and hydralazine is without obvious advantages compared with the combination of thiazide and methyldopa in obtaining initial BP control in patients with essential hypertension.
Effects of Beta‐Adrenergic Blockade on Diurnal Variability of Blood Pressure and Plasma Noradrenaline Levels
Authors: de Leeuw P. W. , Falke H. E. , Kho T. L. , Vandongen R. , Wester A. , Birkenhäger W. H.
Published: August 2010

ABSTRACT The effect of propranolol on diurnal variability of BP and plasma noradrenaline levels was assessed in 15 patients with uncomplicated essential hypertension. While total variability and average noradrenaline level remained unaltered, the pressor range (difference between basal and maximum BP readings) was reduced in most patients. An inverse relationship was observed between changes in pressor range and noradrenaline.
Lipoprotein Lipase Activity in Adipose Tissue and in Postheparin Plasma in Human Obesity
Authors: Taskinen Marja‐Riitta , Nikkilä Esko A.
Published: August 2010

ABSTRACTThe mechanism by which obesity influences the metabolism of circulating triglycerides was assessed by determination of lipoprotein lipase (LPL) activity in adipose tissue and in postheparin plasma of 26 normolipidemic obese and 26 normal‐weight subjects. Furthermore, the uptakes of VLDL triglyceride and FFA by adipose tissue in vitro were measured in these two groups. The heparin‐releasable LPL activity per weight unit of adipose tissue was similar in obese and normal‐weight subjects but the LPL activity per fat cell was on an average twice as high in obese as in non‐obese subjects. Also the VLDL triglyceride and FFA uptakes by adipose tissue were similar in obese and non‐obese groups when related to tissue weight but both were increased in obese fat cells compared with those of non‐obese. When expressed per total body fat, all these parameters of adipose tissue lipid uptake were higher in obese than in normal‐weight subjects. In contrast, the obese group did not show any increase in the postheparin plasma LPL activity but rather a tendency for the values to accumulate in the low normal range. Serum triglyceride concentration was not related to any of the LPL activities or to tissue lipid uptake in separate or combined obese and non‐obese groups. Serum basal insulin level and insulin response to glucose were significantly higher in the obese than in non‐obese subjects but in spite of this, the serum triglyceride level was similar in the two groups. Stepwise multiple regression analysis showed that all the measured parameters of adipose tissue were positively correlated to fat cell size but when the latter was held constant, the fat cell VLDL triglyceride uptake was still related to cell LPL activity and to serum insulin concentration. These results suggest that in obesity the adipose tissue has an increased capacity to remove circulating triglycerides.
Effects of Prolonged, Strenuous Exercise on Lipids and Thyroxine in Serum
Authors: Kirkeby Knut , Strömme Sigmund B. , Bjerkedal Inger , Hertzenberg Leif , Refsum Harald E.
Published: August 2010

ABSTRACT Serum lipids and thyroxine were determined in 26 men participating in a 90‐km cross‐country ski race, before, immediately after, and on the following days. Serum cholesterol was unchanged immediately after the race, but then fell significantly and remained low during the observation period. During the race the fatty acid composition of serum free fatty acids changed towards the composition of ordinary adipose tissue. The composition of serum triglycerides showed similar but less pronouced changes. On the following days an increase in the arachidonic, and a decrease in the linoleic acid fraction of the total serum lipids were observed. Total thyroxine and free thyroxine in serum were significantly increased at the end of the race, but had returned to the pre‐race levels during the rest of the observation period. The observations correspond to the findings during acute, severe illness, and are compatible with the hypothesis that some of the changes In serum lipids following severe somatic stress are due to increased thyroid hormone activity.
Patient Compliance
Authors: Åberg Hans
Published: August 2010

Only a minority of all hypertensive individuals are well treated. In few other chronic disorders is the patient compliance to therapy such a challenging task. The reason is that a hypertensive patient is usually free from symptoms. Different methods can be used to study compliance. On the one hand we have simple interview methods and on the other we have sophisticated techniques for measuring the urine content of the drug. The best way of evaluating patient compliance over the years, however, is probably to study the number of drop‐outs from follow‐up or treatment failures with regard to reduction of the blood pressure. In a preventive trial on middle‐aged men, over 3 1/2–6 years of therapy we have had a drop‐out rate of 8% and a mean blood pressure reduction of 30/18. In another study of drug behaviour in a group of hypertensive individuals an acceptable level of compliance, measured as forgotten doses, was found in about 80% of the subjects. In spite of this rather high figure only a few subjects stated that they had received information on their hypertension at the clinic. However, about half of the subjects did not want any more information. The problem of patient compliance to therapy has therefore many aspects, ranging from the psychological background just touched upon to more practically oriented matters such as dosettes etc. and I will review some of them.

Finally, I would like to make some suggestions for improving both the patient's compliance and the doctor's attention to antihypertensive therapy.
Once a Day Treatment of Hypertension
Authors: Frithz Göran
Published: August 2010

Abstract. Two studies are presented on the possibility of treating hypertension with pindolol once daily.

In the first one, patients already treated with multiple doses of pindolol, propranolol or alprenolol were shifted to single dose regime with pindolol, given in the morning. In most cases an adequate blood pressure control could be maintained on a dose of up to 20 mg pindolol.

In the other study, previously untreated patients with mild to moderate hypertension were treated from the beginning with a single dose of pindolol. An adequate pressure control was also obtained in most of these patients with a dose not surpassing 20 mg pindolol once daily. In non‐responders, the addition of a once daily dose of a diuretic resulted in an adequate pressure control.

In both studies side‐effects were few. The absence of sleep disturbances and beta‐blocker induced bradycardia was particularly noteworthy.
New Trends in Pharmacology
Authors: Henning Matts
Published: August 2010

Abstract.Among the factors influencing the arterial blood pressure the neural control through the autonomic nervous system is of paramount significance. The sympathetic division of this system holds a key position in this regard and its neural transmission mechanisms represent a well established target for pharmacological interference aimed at lowering blood pressure. This presentation will first deal with the morphological and physiological basis for blood pressure control through the sympathetic nervous system and the various possibilities for antihypertensive drug action through this system. Special attention will be drawn to recent advances in catecholamine research which may offer new leads in the development of blood pressure lowering agents. A second topic in this review will be some remarks on other pharmacological principles for interference with vascular control apart from the sympathetic system, particularly the vasodilator principle.
The Prevention of Hypertension
Authors: Tibblin Gösta , Eriksson Carl‐Gunnar
Published: August 2010

Abstract. Our way to prevention is to find a list of traits known to be predictors of elevated blood pressure. This list of predictors offers means for the early identification of susceptible persons. Years of experience in preventive work indicate that such identification is always useful for developing preventive programmes, since it gives a focus for action (5).

Most of the predictors show possible ways in which action could be directed towards prevention of hypertension and reduction of elevated blood pressure.

We will focus on salt, control of obesity, physical exercise, and meditation. We would like to discuss preventive aspects of hypertension and the possibility of treating with other methods than drugs.
A New Parallel Plate Dialyser
Authors: Dawids S. , Boe C.
Published: August 2010

Abstract. Using a high efficiency membrane support pattern, described in the previous paper, a prototype of a new parallel plate dialyser has been developed. The new dialyser is designed in such a way that the number of components is reduced to one item per blood layer and the membrane is folded as a continuum. This permits a semiautomatic assembly of the unit, which reduces production costs. Furthermore this technique facilitates aseptic handling of the item. The in vitro performance has been tested and it compares favorably with commercially available disposable parallel plate dialysers.
The mechanism of lincomycin‐induced diarrhoea
Authors: Hoff Stein G. , Schjønsby Henning , Andersen Knut‐Jan
Published: August 2010

ABSTRACT Metabolic studies were performed before and seven days after treating rats orally with lincomycin. Following the treatment the mean faecal weight increased from 30.2 g/72 hr ± 3.8 (S.D.) to 65.5 ± 8.2. The faecal fat excretion was unchanged, and the weight increase was mainly due to increased water content. To find whether the watery diarrhoea was due to bile acid malabsorption, the absorption rate of [14C] ‐taurocholic acid was measured in untreated rats and rats treated with lincomycin using an in vivo perfusion technique. There was no significant difference in bile acid absorption rate measured at three different concentrations of bile acid in the perfusate. Alternative mechanisms of lincomycin‐associated diarrhoea are discussed.
Osteomalacia in the stagnant loop syndrome
Authors: Schjønsby H.
Published: August 2010

ABSTRACT Osteomalacia in a 80‐year old woman with malabsorption due to the stagnant loop syndrome is reported. The osteomalacia was associated with bacterial overgrowth in the small intestine and increased bile salt deconjugation. Although the mechanism of osteomalacia in the stagnant loop syndrome remains uncertain, it is suggested that abnormal flora reduce the absorption of vitamin D by deconjugation of bile salts in the lumen of the small intestine.
Non‐Invasive Assessment of Cardiac Function in Poisoning with Drugs
Authors: Brubakk Oddbjørn , Kalager Tore
Published: August 2010

ABSTRACT. Systolic time intervals (STI) have been used in evaluating cardiac function in 21 patients who had taken an overdose of drugs. Registrations were made in all patients on arrival at the hospital and on the third day. On arrival STI was abnormal in 16 patients (76%). At the second registration it was still abnormal in ten (48%). Prolongations of total electromechanical systole (QS2) and preejection period (PEP) were the most frequent findings. The patients with abnormal STI at the first registration showed a significant improvement in QS2 (p<0.01) and PEP (p<0.05) from the first to the third day. Two of the four patients who had taken amitriptyline in a slow release form showed a prolongation of PEP and an increase in PEP/LVET from the first to the third day, and one patient had a further prolongation on the fifth day. The findings may be explained by a reduction of cardiac contractility caused by the membrane‐stabilizing effect of the drugs.