Journal of the Oslo city hospitals最新文献

{"title":"Myocardial potassium balance during adrenergic stimulation.","authors":"O Ellingsen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>1) The primary receptor mechanism of catecholamine-induced myocardial potassium uptake is beta 1-adrenoceptor stimulation. Thus, K+ uptake seems to be a general effect of beta-adrenergic stimulation, dominated by beta 1-receptors in heart and by beta 2-receptors in skeletal muscle according to subtype preponderance in either tissue. In the myocardium there is also an effect of alpha 1-adrenoceptor stimulation which causes a significantly smaller uptake and requires higher catecholamine concentrations. 2) Both humoral and nervous adrenergic stimulation of the heart induce a significant potassium uptake which transiently reduces coronary sinus K+ concentration. It is likely that these changes affect cardiac functioning in vivo. During intense endogenous sympathetic activity and by high dose pharmacological interventions, the magnitude of change in coronary sinus concentration suggests that the reduction in extracellular K+ within the myocardium could be up to 1 mM. Under vulnerable conditions like hypokalemia and localized ischemia such changes might contribute to the risk for malignant arrhythmias. 3) Presumably net myocardial K+ accumulation is accompanied by a reciprocal reduction of intracellular Na+ concentration, which tends to reduce myocardial contractility and contribute to impaired cardiac function after a period of strong adrenergic stimulation. In vivo the negative inotropic effect could not be detected as long as catecholamines were supplied, but it occurred after stimulation was stopped. 4) In the intact beating heart beta-adrenergic stimulation increases Na,K-pumping 2.5 fold, from 15% of the maximum possible pump rate in control to 40% of maximum at high inotropy. These findings imply the presence of a substantial spare Na,K-pump capacity of the non-ischemic myocardium, even during intense sympathetic activity. Comparison of changes in pump rate and accumulated ionic shifts indicates that catecholamine-induced stimulation of Na,K-ATPase might be due to increased sensitivity for intracellular sodium.</p>","PeriodicalId":76055,"journal":{"name":"Journal of the Oslo city hospitals","volume":"39 4-5","pages":"39-51"},"PeriodicalIF":0.0,"publicationDate":"1989-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13691910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The frequency of alcoholism and alcohol related brain disorders in various regions of Oslo city. An autopsy study.","authors":"C F Lindboe,&nbsp;E M Løberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The autopsy materials from the 5-year period 1983-1987 from Ullevål and Aker Hospitals in Oslo were reviewed. All cases with alcoholism were recorded and the histological sections were re-examined with regard to the presence of Wernicke's encephalopathy and alcoholic cerebellar atrophy. The two materials were compared statistically in order to see whether any difference in the frequency of alcoholism and alcohol related brain disorders could be demonstrated between the geographic areas served by these two hospitals. The study revealed a significantly higher percentage of alcoholics in the Aker material which also had a higher proportion of alcoholics with cerebellar atrophy and Wernicke's encephalopathy, although not significant for the latter condition. These results indicate that alcoholism is particularly frequent in the north-eastern part of Oslo city and that this region also has a relatively high proportion of heavy drinkers.</p>","PeriodicalId":76055,"journal":{"name":"Journal of the Oslo city hospitals","volume":"39 4-5","pages":"63-6"},"PeriodicalIF":0.0,"publicationDate":"1989-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13901133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interplay among cardiac chambers. Left and right ventricular performance during changes in contractility, afterload and during simultaneous atrio-ventricular contraction.","authors":"O A Vengen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>1. Only a slight increase in stroke volume is observed during a selective left-sided inotropic stimulation of the in situ pig heart. Decreased left ventricular preload during left-sided inotropic stimulation reduces activation of the Frank-Starling mechanism and hence explains the rather small increase in stroke volume. We suggest that left-sided inotropic stimulation redistributes blood from the pulmonary circulation toward the systemic circulation causing a fall in pulmonary artery pressure and increased right ventricular output because of this afterload-reduction. 2. A rise in stroke volume during selective right-sided inotropic stimulation is not attenuated by a concomitant reduction in right ventricular preload. On the contrary, right ventricular preload rises in response to inotropic stimulation of the right atrium. Right-sided inotropic stimulation redistributes blood toward the pulmonary vascular bed and the left side of the heart. Left ventricular function is improved by this redistribution. 3. Both left ventricular end-systolic and end-diastolic volumes are better maintained by thoracic aortic occlusion during left-sided inotropic stimulation than at control inotropy. The concomitantly better preserved dimensions in the right ventricle can be explained by reduced pressure in the pulmonary circulation and a decrease in right-ward septal bulging. The rise in stroke volume by aortic occlusion during intravenous isoproterenol infusion is mainly due to a greater redistribution volume than at control inotropy. 4. Prolongation of the diastolic interval may reduce the end-diastolic pulmonary artery pressure to such an extent that right atrial contraction could eject blood into the pulmonary artery during late ventricular diastole.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":76055,"journal":{"name":"Journal of the Oslo city hospitals","volume":"39 4-5","pages":"53-61"},"PeriodicalIF":0.0,"publicationDate":"1989-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13810679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamics and blood flow distribution in experimental shock. The effect of noradrenaline and isoproterenol.","authors":"H Dedichen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiac output, regional blood flow and other hemodynamic variables were observed on dogs in hemorrhagic and in endotoxin shock. In hemorrhagic shock, a redistribution of cardiac output from other vascular beds to the coronary circulation was seen. This was induced by vasoconstriction in all vascular regions except the coronary arteries. In endotoxin shock, vascular resistance increased in some regions and decreased in others. A redistribution in favor of the mesenteric and femoral regions was seen. The coronary circulation was relatively well maintained in either shock models. Increased oxygen extraction was seen in all vascular beds. Blood pH was decreased corresponding to the degree and duration of the shock. Only small regional variations were observed in these variables. Noradrenaline increases vascular resistance in all regions except the coronary arteries. Isoproterenol reduces vascular resistance in all areas. Both drugs have cardiotropic effects. The same response was seen in normal as well as in shocked dogs. In addition to principal shock treatment, there may still be a place for the judicious use of these drugs in shock therapy.</p>","PeriodicalId":76055,"journal":{"name":"Journal of the Oslo city hospitals","volume":"39 3","pages":"23-9"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13863645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatalities in a stroke unit.","authors":"T Dahl,&nbsp;C F Lindboe,&nbsp;P M Sandset,&nbsp;B Rostad,&nbsp;U Abildgaard","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>During the first 4 years of the CV unit the mortality rate among 464 patients was 5.2 per cent. The records of the 24 fatalities were reviewed. In the 10 patients submitted to autopsy the clinician's opinion of the cause of death was confirmed in 6 cases. In 4 cases autopsy revealed brain abscess, pulmonary embolism, acute myocardial infarction and pneumonia, respectively. Other significant findings not registered clinically were made in 4 cases. Twenty-three patients underwent a cerebral CT scan which showed positive findings in 19 cases. In one patient a brain abscess was misinterpreted as a brain infarction and in 2 other patients with a negative CT scan, autopsy revealed a small pontine and hemispheric infarction, respectively. Apart from the misdiagnosis of the brain abscess the accuracy of the CT scan was acceptable. Extracranial complications as a cause of or contributing to death in stroke patients are common. Prevention, early detection and treatment of these complications are important. The findings underscore the importance of autopsy in the evaluation of stroke patients.</p>","PeriodicalId":76055,"journal":{"name":"Journal of the Oslo city hospitals","volume":"39 3","pages":"31-7"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13863646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Water-soluble contrast media in obstructed in ischemic small intestine. A clinical and experimental study.","authors":"A Stordahl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this study the attention was focused on the possible application of the new low-osmolar water-soluble contrast media in already existing routines for radiologic diagnostic work-up and management of the abdominal emergencies of simple intestinal obstruction and ischemia: Iohexol was a good, or better, alternative to sodium diatrizoate regarding taste acceptance and patient reactions: Seventy-five per cent of patients characterized the taste of iohexol as good or neutral, while 52% gave sodium diatrizoate similar scores. The scores were also consistently in favor of iohexol as compared with sodium diatrizoate for the other chosen criteria; nausea, vomiting and diarrhea, but a larger number of patients may be needed for conclusive evaluation. Water-soluble media may have therapeutic effects on intestinal obstruction when preceded by conventional gastric suction using a short gastric tube: Twenty-three of 25 patients with subtotal small bowel obstruction due to peritoneal adhesions improved following the ingestion of either iohexol or sodium diatrizoate. Hyperosmolar contrast media might stimulate peristalsis and dilute the bowel contents, hence, easing the passage through a subtotally obstructed bowel. In rats, a direct relationship was found between contrast medium osmolality and the degree of intestinal distension, fluid influx to the bowel lumen and the speed of contrast medium progression. The water-soluble, low-osmolar contrast media seem promising as diagnostic aids in examination of the gastrointestinal tract: The low-osmolar contrast media gave better intestinal details on films than both barium sulphate and sodium diatrizoate in rats with intestinal obstruction or ischemia when high volumes of radiopaques were employed. Also in patients iohexol retained its radiographic density in the small bowel better than sodium diatrizoate. The diagnostic efficacy of the water-soluble radiographic media varied directly with their osmolality and the resulting fluid influx to bowel lumen. Hyperosmolality stimulated contrast medium progression and bowel distension, and reduced the radiographic density of the contrast media and the alignment to the bowel wall. Water-soluble contrast media may aid the diagnosis of bowel ischemia and the evaluation of the degree of ischemic injury: No bladder opacification, following absorption of water-soluble contrast media from the simply obstructed bowel, was observed in the majority of the animals and was only faintly present in 8%. Distinct radiographic opacification of the urinary bladder in rats with intestinal ischemia was demonstrated as early as 1-2 hours after the administration of contrast medium.(ABSTRACT TRUNCATED AT 400 WORDS)</p>","PeriodicalId":76055,"journal":{"name":"Journal of the Oslo city hospitals","volume":"39 1-2","pages":"3-22"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13792505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laser Doppler flowmetry in evaluation of lower limb atherosclerosis.","authors":"K Kvernebo","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76055,"journal":{"name":"Journal of the Oslo city hospitals","volume":"38 11-12","pages":"127-36"},"PeriodicalIF":0.0,"publicationDate":"1988-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14199954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic laser Doppler flowmetry in evaluation of human gastric blood flow.","authors":"O C Lunde","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76055,"journal":{"name":"Journal of the Oslo city hospitals","volume":"38 11-12","pages":"113-26"},"PeriodicalIF":0.0,"publicationDate":"1988-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14042969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of the nonstress test.","authors":"O H Jensen,&nbsp;H Jenssen","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76055,"journal":{"name":"Journal of the Oslo city hospitals","volume":"38 10","pages":"97-102"},"PeriodicalIF":0.0,"publicationDate":"1988-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14323068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small intestinal obstruction or ischemia. A comparison between water soluble contrast media and barium in rats.","authors":"A Stordahl,&nbsp;F Laerum","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76055,"journal":{"name":"Journal of the Oslo city hospitals","volume":"38 10","pages":"103-11"},"PeriodicalIF":0.0,"publicationDate":"1988-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14323067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}