[Occurrence of renal artery stenosis in patients with peripheral arteriosclerosis and hypertension]. / Forekomst af nyrearteriestenose hos patienter med perifer arteriosklerose og hypertension.

The aim of this study was to evaluate the prevalence of renal artery stenosis in patients with clinical signs of peripheral vascular disease and hypertension. One hundred patients, mean age 69 years (range 45-88) with symptoms and clinical signs of severe peripheral ischaemia, underwent aortography to determine the degree of peripheral vascular disease and possible renal artery stenosis. History of claudication and measurement of systolic distal blood pressure and calculation of the Ankle Brachial Index was used to define the severity of peripheral vascular disease. Thirty-one percent had renal artery stenosis (14% greater than 50% reduction in luminal diameter). In a subgroup of patients with hypertension and peripheral vascular disease (n = 74), 34% had renal artery stenosis. In the subgroup of patients with renal artery stenosis, 81% had hypertension. Among patients with renal artery stenosis and lumen reduction of more than 50%, 93% had hypertension (p < 0.001). In conclusion this study shows that the combination of peripheral vascular disease and hypertension is an important clinical clue for renovascular disease. Examination for renovascular disease in this population should be considered, since the prevalence of the condition is high. Furthermore, examination for renal vascular disease in this population is mandatory, before treatment with angiotensin converting enzyme inhibitors is initiated, since treatment might lead to serious renal function impairment.

Long-term results of the Stamey Bladder-neck suspension procedure and of the Burch colposuspension.

This retrospective study compares the long-term results of the Stamey bladder-neck suspension and the Burch colposuspension following operation for urinary incontinence in women. A total of 182 women underwent operation for urinary incontinence: 83 by Stamey bladder-neck suspension and 99 by Burch colposuspension. The case records were perused and questionnaires were sent to the 169 women who were still alive: 129 women had no previous operation for urinary incontinence. At follow-up in this group a median of 7 years after the operation, 32% were completely continent and 39% had improved after the Stamey method, as against 33% and 29%, respectively, after Burch (p > 0.05). The Stamey operation was associated with a lower complication rate (12%) and a lower rate of re-operation (16%) than the Burch operation (23% and 22%, respectively) (p > 0.05). Previous incontinence surgery and mixed type of incontinence was associated with poor outcome in the Stamey group.

Prevalence of renal artery stenosis in patients with peripheral vascular disease and hypertension.

The aim of this study was to evaluate the prevalence of renal artery stenosis in patients with clinical signs of peripheral vascular disease and hypertension. One hundred patients, mean age 69 years (range 45-88) with symptoms and clinical signs of severe peripheral ischemia, underwent aortography to determine the degree of peripheral vascular disease and possible renal artery stenosis. History of claudication, and measurement of systolic distal blood pressure (BP) and calculation of the Ankle Brachial Index was used to define the severity of peripheral vascular disease. A total of 31% had renal artery stenosis (14% greater than 50% reduction in luminal diameter). In a subgroup of patients with hypertension and peripheral vascular disease (n = 74), 34% had renal artery stenosis. In the subgroup of patients with renal artery stenosis, 81% have hypertension. Patients with renal artery stenosis and lumen reduction of more than 50%, 93% have hypertension (P < or = 0.001). In conclusion this study shows that the combination of peripheral vascular disease and hypertension is an important clinical clue for renovascular disease. Examination for reno-vascular disease in this population should be considered, since the prevalence of the condition is high. Furthermore examination for renal vascular disease in this population is mandatory, before treatment with angiotensin converting enzyme (ACE) inhibitors is initiated, since treatment might lead to serious renal function impairment.

Perioperative blood transfusion does not promote recurrence and death after mastectomy for breast cancer. The Danish Breast Cancer Cooperative Group.

Several reports suggest that perioperative blood transfusion promotes recurrence and death after cancer surgery. We studied the effect of transfusion in 1599 patients who had mastectomy for carcinoma of the breast. In 228 transfused patients the disease recurred in 110 (48 per cent), compared with 647 (47 per cent) of 1371 non-transfused patients (P = 0.85). The 5-year recurrence-free survival rate was 0.54 in the transfused patients and 0.60 in the non-transfused group (P = 0.44). The transfused patients had a higher prevalence of risk factors than the non-transfused patients. Cox's multiple regression analysis confirmed that perioperative blood transfusion was of no importance. The study does not support the hypothesis that perioperative blood transfusion promotes recurrence after operation for breast cancer.

Pulmonary disease and antipyrine clearance.

We investigated hepatic microsomal enzyme activity by the one-sample saliva test for antipyrine clearance determination in 35 homozygous, alpha 1-antitrypsin-deficient outpatients with chronic pulmonary disease. Twenty-five outpatients with chronic obstructive lung disease and comparable lung function impairment and 31 healthy volunteers served as controls. Antipyrine clearance did not differ significantly between the two groups of patients with pulmonary disease. However, the clearance was 18% lower in these two groups than in the healthy volunteers (P less than 0.01). Antipyrine clearance was lowest in patients with severe lung function impairment (P less than 0.01).

Duration of delayed-type autoimmunity against arterial vessel-wall antigens following acute hypertensive damage to arterial vessels in rats.

Acute hypertensive damage to small arteries and arterioles in rats was induced by intravenous injections of Hypertensin. The in vitro immunological method of the agarose migration technique was used to demonstrate delayed-type autoimmunity against arterial vessel-wall antigens. By this technique the autoimmunity could be demonstrated for about 16 weeks after the acute hypertensive damage to the arterial vessels. The results of the autoimmunity were given as migration indices. These were lowest during the first 4-5 weeks after the damage to the vessels whereupon they showed higher and higher values, and finally the migration indices were identical with those of the control rats after about 16 weeks.

Further evidence of the development of delayed-type autoimmunity against arterial vessel-wall antigens following acute hypertensive damage to arterial vessels in rats.

Acute hypertensive damage to arterial vessels was induced by intravenous injections of hypertension. The in vitro immunological method of the agarose migration technique was used for demonstration of delayed-type autoimmunity against arterial vessel-wall antigens following the damage of the arterial vessels. By means of this technique it was demonstrated that the migration indices from the rats with induced hypertension differed significantly from the control rats, P less than 0.005. This means that an autoimmunity of the delayed type had developed after the hypertensive damage to the arterial vessels. The autoimmunity was tissue specific.