ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb03159.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Eleven patients concomitantly poisoned with methanol are described. Their whole blood methanol concentration ranged from 137.2 mmol/l (4.39 g/1) to 7.4 mmol/l (0.24 g/1). The clinical course in most patients was mild, which was attributed to the concomitant and subsequent ethanol ingestion and rapid transport to dialysing units. One patient suffered permanent visual impairment of one eye while the others recovered completely. Symptoms of poisoning were most clearly correlated to the degree of metabolic acidosis. All patients were hemodialysed. In two patients the average dialysator clearance of methanol was 157 and 176 ml/min at blood flows of 200 and 215 ml/min, respectively. In the same patients the average dialysator clearance of ethanol was 149 and 164 ml/min. Assuming a volume of distribution of methanol of 0.7 l/kg, the dialysator represented about 89 and 95%, respectively, of the total body clearance of methanol during ethanol therapy. Ethanol in concentrations even lower than usually recommended may be useful as the only treatment of patients with blood methanol concentrations up to 15 mmol/l (0.5 g/l), provided there is no acidosis or visual impairment.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb03160.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Toxicokinetic studies during hemodialysis are presented in two patients with blood ethylene glycol concentrations of 40 and 41 nunol/1, respectively. Treatment involved bicarbonate, ethanol and hemodialysis with a 1.6 m2dialysator. Both patients developed acute renal failure and one was discharged with permanent cerebral impairment. The other made an uneventful recovery. The average dialysator clearance of ethylene glycol at a blood flow of 200 ml/min was 145 and 148 ml/min, respectively. Assuming a volume of distribution of ethylene glycol of 0.7 l/kg, the dialysator represented about 92 and 95%, respectively, of the total body clearance of ethylene glycol during ethanol treatment. During hemodialysis a blood ethanol concentration of about 15 nunol/1 (0.7 g/1) caused a near complete inhibition of ethylene glycol metabolism at ethylene glycol concentrations up to about 25 rhmol/l (1.6 g/l). We recommend prompt hemodialysis in ethylene glycol poisoning to supplement alkali and ethanol treatment.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb03161.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.The diagnostic value of determination of the anion and osmolal gaps was studied in 6 patients poisoned with methanol and in 5 poisoned with ethylene glycol. Increased osmolal gap was present on admission in ail patients, whereas increased anion gap was present in all except one. In the methanol‐poisoned patients the mean blood values were: pH 7.27, anion gap 24 mmol/l, osmolal gap 81 mosmol/ kg H2O, methanol 67 mmol/l, ehtanol 11 mmol/l and in the ethylene glycol‐poisoned patients: pH 6.93, anion gap 38 mmol/l, osmolal gap 35 mosmol/kg H2O and ethylene glycol 24 mmol/l. In the absence of alcoholic acidosis or diabetic coma the finding of a simultaneous increase in both the anion and osmolal gaps indicates methanol or ethylene glycol poisoning. Thus determinations of the anion and osmolal gaps are mandatory whenever facing metabolic acidosis of unknown etiol

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb03162.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Semisynthetic human insulin (Novo) was compared with porcine insulin with regard to absorption from subcutaneous depots, blood glucose control and plasma insulin concentrations in patients, and the binding to insulin receptors of porcine and human origin. The binding affinities of semisynthetic human insulin and porcine insulin were identical with human erythrocyte receptors and receptors on porcine hepatocytes. The subcutaneous absorption of semisynthetic human and porcine125I‐labelled insulin both of soluble and lente type was identical. The metabolic control study was performed as a double‐blind crossover study in eight type I diabetics. They received semisynthetic human insulin and porcine insulin (of soluble as well as lente type) for 10 days each, the last 7 days in each period being the observation period. Blood glucose concentration was measured 9 times per 24 hours. No statistically significant differences were found between mean blood glucose levels at the 9 samplings or in the overall mean blood glucose concentration. Further, the blood glucose control was evaluated as a function of time by a computerized method for time series analysis of a complex dynamic system. This method described adequately each blood glucose value as a linear function of the immediately preceding blood glucose value and that measured 24 hours before. No difference was found between human and porcine insulin when the blood glucose control was assessed by this method. Plasma concentrations of total insulin (IRI) and free IRI before and 3 hours after the morning insulin injection were identical in the two treatment periods. It is concluded that human and porcine insulin can be interchanged in the treatment of diabetics without changing the d

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb03163.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.ECGs of 36 hypokalemic patients (K/s 1.0–3.5 mM/l) were analysed. The sum of the S‐T depression and the U wave amplitude in leads II and V3was used and constituted the uncorrected hypokalemic index. To correct the hypokalemic index, the figure obtained during normokalemia is subtracted from that obtained during hypokalemia. The corrected hypokalemic index gives an approximation of the K/s irrespective of other factors permanently influencing the ECG, such as treatment with antiarrhythmic drugs, coronary insufficiency, and ventricular hypertrophy. The corrected index was ≥4.0 at a K/s of ≤2.0 mM/l. Eight out of nine patients with a K/s 2.1–2.6 had an index of 1.5–3.5. All patients with a K/s>2.6 mM/l had a

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb03164.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.In order to study the interaction of insulin and somatostatin on glucose regulation in the posthypoglycemic phase of a somatostatin infusion we have applied a bolus of i.v. insulin to healthy subjects receiving a continuous infusion of somatostatin. Glucose, insulin and counter regulatory hormones were determined. Somatostatin suppressed the growth hormone and glucagon responses to hypoglycemia but did not augment the hypoglycemic action of insulin. In contrast, theK‐value for the decrease in blood glucose was significantly lower in the presence of somatostatin. Thus, the interaction of insulin and somatostatin on glucose metabolism is complex and time‐dependent. While the peptide potentiates the action of insulin during the first hour of a somatostatin infusion, it counteracts if after two hours. As somatostatin has currently been introduced in the therapy of upper gastrointestinal bleedings, these effects of the peptide must be taken into considerat

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb03165.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.A significantly increased serum level of β‐hexosaminidase was found in an unselected group of 85 diabetics. When the patients were divided into three groups according to type of treatment, increased enzyme levels were found only in patients treated with oral hypoglycemic agents or diet while insulin‐treated patients had normal serum levels of β‐hexosaminidase. There was a positive correlation between β‐hexosaminidase and blood glucose concentration for the entire patient series. When grouped according to treatment, a positive correlation was found only in the insulin‐treated group despite its normal serum activity of β‐hexosaminidase. Serum β‐hexosaminidase of patients with retinopathy did not differ from the mean value of their group. It is concluded that the activity of β‐hexosaminidase in diabetics can produce different results depending on the type of

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb03166.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Plasma levels of platelet factor 4 (PF 4) were determined in 30 patients with recent acute myocardial infarction. Comparisons were made with the levels in 26 age‐matched controls. In another 15 patients, also with recent myocardial infarction, PF 4 plasma levels were determined before and immediately after a standardized exercise stress test. At rest, none of the patients had elevated PF 4 levels. Only one patient demonstrated an increase after exercise. These findings are in conflict with some recent reports. The importance of age‐matched controls, the hazard of in vitro platelet activation and the possible effect of β‐blocking and calcium‐antagonistic drugs on PF 4 plasma levels is discuss

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb03167.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.An early exercise test was performed in 317 patients with acute myocardial infarction (AMI). The long‐term prognosis was assessed after an average follow‐up of 5.7 years. The patients with a small increase in the pressure rate product from rest to maximal exercise and/or with major ventricular arrhythmias constituted a general prognostic high‐risk group. The survival was analyzed further applying the above mentioned exercise parameters in the following clinical subgroups: I) patients with clinical heart failure during hospitalization and/or previous myocardial infarction, II) patients with anterior AMI, III) patients with inferior or indefinite AMI. Within each clinical group there was a highly significant difference in survival between the exercise‐determined high‐risk and low‐risk patients. The exercise parameters were more sensitive and more specific prognostic determinators than the clinical variables. The most striking difference was found in patients with clinical heart failure and/or previous infarction. In this group the exercise‐determined high‐risk patients had a probability of S‐year survival of 0.238 vs. 0.909 in the corresponding low‐risk

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb03168.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY