ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb01917.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.The left ventricular ejection fraction (EF) obtained by first pass radionuclide angiocardiography was compared with that determined by contrast angiocardiography in 49 patients. In 35 of the patients a comparison with the EF obtained by M‐mode echocardiography was also made. The EF echo was determined in two ways, from the standard cube formula and the regression equation suggested by Teichholz for left ventricular volume calculations. The latter formula gave an average EF closer to the average EF obtained by isotope technique and cineangiography and was therefore used in the comparison study. Measurements of EF by isotope technique and echocardiography correlated well (r= 0.78). The correlation between these two noninvasive methods for EF determination and their cineangiographic counterpart was almost identical (r= 0.72‐0.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb01918.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.A 48‐lead ECG including six extremity leads and seven vertical rows of six chest leads was registered in patients with myocardial infarction (MI) and controls. Patients with Wolff‐Parkinson‐White syndrome, bundle branch block or ventricular hypertrophy were excluded. The control group consisted of 75 healthy persons, aged 21–38, and 37 older patients who had never had MI, as verifed later at autopsy. The R wave amplitude was measured in each of the 42 chest leads and the normalized amplitude difference between each two adjacent leads (“quotient”) was calculated in horizontal and vertical direction. The ranges of these 71 quotients constituted, occasionally after exclusion of an extreme value, the reference to which 192 patients with MI were compared. The MIs were diagnosed by serum enzyme estimations, in 119 patients about one week and in 52 about one year prior to the ECG recording. In another 21 patients the diagnosis was subsequently confirmed at autopsy. The highest number of excluded extreme values in any control was three and, consequently, the presence of 4 quotients or more per ECG falling outside the reference range was used as the MI criterion of the 42 chest leads. Together with common Q wave criteria applied to the extremity leads it detected 70% of the 192 MIs. Fifty‐nine per cent fulfilled the common criteria applied to the 13‐lead ECG included in the 48‐lead recording (extremity leads and CR4R–1–2–3–4–5–7). In order to estimate the specificity of this 48‐lead ECG, the control group was randomly divided into two halves. For one half, new reference ranges for the 71 quotients were estimated. The quotient values of the other half as well as of the MI patients were compared to this new reference range for each quotient. At 70% sensitivity—as found above—the specificity was 95%. The spe

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb01919.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.The regression of the ECG signs of myocardial infarction has been studied in 101 patients. A significant increase in R wave amplitude and decrease in Q wave depth on the standard ECG was observed over three months. In 21% of the patients, Q waves disappeared completely. In inferior infarction, these changes were more apparent in the lateral V leads than in the inferior limb leads. Patients with intraventricular conduction defects were excluded. Two factors associated with the Q and R wave changes have been identified. Lower heart rates appeared to facilitate the recovery of R waves, and smaller infarcts, as assessed by peak LDH, showed greater ECG recovery. This study raises the interesting possibility that modification of the heart rate may affect favourably the healing process after an acute myocardial infarction.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb01920.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Fifty‐three consecutive patients, mean age 63 years, undergoing either peripheral vascular reconstructive surgery (n=40) or lobectomy for bronchial carcinoma (n=13) were examined pre‐ and postoperatively with conventional electrocardiogram (ECG), vectorcardiogram (VCG) and estimation of serum levels of aspartate aminotransferase, alanine aminotransferase, total lactic dehydrogenase and the heat‐stable fraction of lactic dehydrogenase for the diagnosis of per/postoperative myocardial infarction (MI). Six patients (11%) developed signs of acute MI. In 2 patients whose ECG showed only unspecific changes, the VCG was decisive for the diagnosis. The serum enzyme values alone were of limited value in the diagnosis of per/postoperati

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb01921.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.There have been many reasons for hesitating when faced with the decision whether or not to operate upon a renal artery stenosis in an aged person. Arteriosclerotic disease carries a poorer prognosis than does fibromuscular dysplasia, and in old persons arteriosclerosis is the usual cause of renal artery stenosis, and is likely to be generalized. In this study of 24 patients above 60 years of age with renovascular disease, 11 were operated upon; 9 because of renovascular hypertension and 2 with the main aim of arresting the deterioration of renal function. The selection of candidates was mainly determined by the renin secretion pattern. After operation for renovascular hypertension, 67% of the patients improved. In these patients renal function remained stable or recovered. Of the two patients operated upon because of decreasing renal function, one died postoperatively and the other suffered from technical complications resulting in a further impairment of renal function without any beneficial effect on the high blood pressure. Of the 13 patients not operated upon, 4 were clearly renin‐positive and would have been candidates for surgery had it not been for complicating factors. Three of these patients died of coronary disease within one year of the investigation. The results of our and other studies, together reviewing the fate of 56 patients above 60 years of age operated upon for renovascular hypertension, do not indicate that old age per se should be considered a contraindication to surgery when proper attention is paid to co‐existing risk factors. The majority of patients operated upon for renovascular hypertension will benefit from the surgical treatm

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb01922.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Twenty‐four insulin‐dependent, hypertensive diabetic patients were treated with a β1‐selective blocking agent (metoprolol) to evaluate its influence on diabetic state and arterial blood pressure (BP). Two groups were delineated after exclusion of one patient. Twelve patients (group A) obtained normotension with metoprolol alone, whilst 11 (group B) required concomitant treatment with thiazides, 7 of them both with thiazides and hydralazine. BP fell significantly in group B, by 15% (p<0.01), compared with pretreatment levels. Postprandial blood glucose levels, glucose excretion and insulin requirements were unchanged during treatment in all patients. Neither quantitative nor qualitative changes in the recognition of the effects of insulin were observed by 15 diabetics familiar with this sensation. Side‐effects were few. One episode of severe hypoglycaemia, probably unrelated to the β‐blockade, was encountered. We suggest that antihypertensive treatment with metoprolol is a reasonable alternative in the treatment of hypertensive insulin‐dependent diab

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb01923.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Based on the recent pharmacokinetic and clinical studies on hydralazine, this long‐term study has been performed to compare multiple and single daily administration of hydralazine (Slow Apresoline), with special emphasis on the blood pressure (BP) response and simultaneous steady‐state concentration of hydralazine in plasma. Patients treated with conventional Apresoline, combined with β‐blockers with or without diuretics, were selected for inclusion into the study. Eighteen males with persisting hypertension were studied for approximately two years on once‐daily Slow Apresoline medication, preceded by a two‐month period of twice‐daily administration. The results show that the BP control previously achieved with multiple daily doses of conventional Apresoline is maintained with Slow Apresoline, with no discrepancy between once‐ and twice‐daily administration. The BP control during once‐daily treatment tended to improve with time despite a marginal reduction in the daily dose of Slow Apresoline, suggesting secondary adaptation to maintained BP control. No correlation was found between the BP response and stimultaneous plasma concentration of free and “apparent” hydralazine, either in fast or in slow acetylators. The results from this clinical‐pharmacological study support that the elimination of hydralazine from the smooth muscles of the arterioles is considerably slower than from plasma. Furthermore, and in accordance with studies with β‐blockers, the results indicate that the duration of the BP response is considerably longer than the plasma half‐lives of these antihypertensive substances, indicating that plasma half‐life is of little value for determination of the dosage interval in the treatment of hypertension. The good tolerability to once‐daily administration of Slow Apresoline shows that it can be given in larger single doses than are normally given during treatment with conventional Apresoline without any increase

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb01924.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Intramuscular (m. quadriceps) contents of electrolytes, free amino acids and energy‐rich phosphagens were determined in 12 patients (51–81 years of age) with moderate chronic obstructive lung disease. At the time of the study the patients were in their habitual condition. After an overnight rest, 8 patients showed hypoxia and five of these also hypercapnia. Compared to apparently healthy controls of similar age and studied under identical conditions, the patients had increased intramuscular concentrations of sodium, chloride and extracellular water, whereas magnesium was slightly reduced. ATP and phosphocreatine, as well as the ATP/ADP and phos‐phocreatine/total creatine ratios, were reduced. The ATP/ADP ratio correlated significantly to intracellular magnesium. Plasma amino acids were essentially similar in controls and patients but the intramuscular contents of essential amino acids and of the three branched‐chain amino acids were slightly enhanced in the p

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb01925.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY

摘要:

ABSTRACT.Colony‐forming cells (CFU‐C) in peripheral blood and bone marrow and colony‐stimulating activity (CSA) in mononuclear peripheral white blood cells were studied at diagnosis in 87 patients with acute nonlymphoblastic leukemia (ANLL). Absence of CFU‐C in peripheral blood was more frequent in patients who did not enter remission than in those who did, and survival was significantly shorter in CFU‐C‐negative than in CFU‐C‐positive patients. No correlation was found between CFU‐C in the bone marrow and frequency of remission or survival time. Absence of CSA was significantly more frequent in patients who did not enter remission than in those who did. Only 4 of 28 patients who lacked CSA entered remission. Survival was significantly longer in CSA‐positive than in CSA‐negative patients. Thus, CSA synthesis in peripheral mononuclear blood cells appears to be a valuable prog

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1982.tb01926.x

出版商:Blackwell Publishing Ltd    

年代:1982

数据来源: WILEY