Morbidity and Mortality in Relation to Blood Pressure and Antihypertensive Treatment

ABSTRACT Morbidity and mortality in cardiovascular and cerebrovascular diseases and total mortality have been studied in a longitudinal population study initially comprising 1462 women representative of the general female population. When related to the initial blood pressure (BP) levels of women not on antihypertensive drugs (hypertensives and non-hypertensives), the distributions of women with myocardial infarction (MI) and stroke during the 12-year follow-up period seemed to be U-shaped, with the highest incidences in women with the lowest and the highest BP levels. Women recognized as untreated hypertensives in the initial study were offered regular control by the study team during the whole 12-year period and were treated when treatment was considered indicated. They were found to be similar to the non-hypertensives with regard to the incidence of MI and stroke and total mortality. Our encouraging results may be explained by continuity of medical care, the antihypertensive treatment per se or the types of antihypertensive drugs administered.     

Viability of human periodontal ligament cells after storage in milk or saliva

The prognosis of replantation of traumatically exarticulated teeth is very much influenced by the conditions under which the teeth have been kept before replantation. Saliva has been recommended as the most suitable storage medium but there are no studies where saliva has been compared with other possible storage media. Milk is such an easily available storage medium. The purpose of the present investigation was to compare the storage effect of milk with that of saliva on human periodontal ligament cells. Milk was superior to saliva as storage medium with respect to number of viable cells, cell size, ability to recover and to heal experimentally produced wounds. The osmolality of milk seems to be the most important factor.     

Biological tests of a silicophosphate cement

The biological compatibility of a silicophosphale cement (Fluoro-Thin®) and a zinc phosphate cement (de Trey's Improved®) has been assessed in in vitro (cell culture) and in vivo (monkey teeth) tests. In the in vitro tests both materials were toxic when freshly prepared, In experiments with prolonged cell-material contact time, with set specimens of the materials, the zinc phosphate cement appeared to be non-toxic, whereas the silicophosphate cement was clearly toxic. The in vivo experiments confirmed that a possible pulp reaction caused by zinc phosphate cement is of a mild nature. The silicophosphate cement, however, caused a moderate or severe reaction in the pulp after 8 days of observation, and there was chronic inflammation in most teeth after 36 or 72 days. It was concluded, therefore, that Fluoro-Thin should not be used as a luting agent or for restorative purposes in direct contact with vital dentine.     

Autonomic Denervation After the Maze Procedure

LÖNNERHOLM, S., et al .: Autonomic Denervation After the Maze Procedure. The Maze III procedure is a surgical operation for curative treatment of AF. The procedure is extensive, however, with multiple incisions in both atria, and its effects on autonomic regulation of the heart rhythm are not known. This study comprises 17 patients, 10 with paroxysmal AF and 7 with chronic AF, who had no concurrent cardiac disease known to affect heart rate variability (HRV). A 24-hour Holter recording was performed preoperatively and 2 months (early) and 7 months (late) after surgery, for analysis of HRV in the time and frequency domains. Early after the Maze procedure all HRV components were markedly reduced compared to baseline (mean ± 1 SD): SDNN   73 ± 13   versus   148 ± 50   (ms), total power   168 ± 126   versus   560 ± 1567   (ms²), low frequency (LF) power   47 ± 67   versus   826 ± 677   (ms²), high frequency (HF) power   47 ± 40   versus   678 ± 666   (ms²), and LF:HF   1.22 ± 0.9   versus   2.55 ± 1.4   . Late after the Maze procedure all variables were still reduced. Only total power increased significantly between early and late follow-up (   168 ± 126   vs   496 ± 435   ms²). Late after Maze surgery, values of the different HRV components did not differ between the patients with paroxysmal AF and chronic AF. Early after the Maze procedure there is a marked decrease of all HRV components, which is maintained 7 months after surgery, a pattern consistent with denervation of the heart. (PACE 2003; 26[Pt. I]:587–592)     

The effects of sodium nitroprusside on cerebral blood flow and cerebral venous blood gases

Abstract. Cerebral blood flow (CBF) and cerebral venous blood gases were studied in seven patients before, during and after intravenous sodium nitroprusside infusion. The ¹³³Xe intra-arterial injection method was used for the CBF measurements. A dose of sodium nitroprusside (mean 1·0 mg, mean infusion time 20 min), which reduced mean arterial blood pressure by a mean of 17%, resulted in a 13% decrease in CBF ( P <0·05). Measurements obtained 5 and 20 min after termination of the sodium nitroprusside infusion showed no signs of a hyperaemic rebound effect. Arterial PCO₂, metabolic rate of oxygen, arterio-venous oxygen difference and venous PO₂ remained unchanged during and after infusion. It is concluded that sodium nitroprusside has a minor effect on cerebral haemodynamics, an effect that might be mediated by the sympathetic nervous system.     

Toxic activity of the CdtB component of Haemophilus ducreyi cytolethal distending toxin expressed from an adenovirus 5 vector

Wising C, Magnusson M, Ahlman K, Lindholm L, Lagergård T. Toxic activity of the CdtB component of Haemophilus ducreyi cytolethal distending toxin expressed from an adenovirus 5 vector. APMIS 2010; 118: 143–9. The Haemophilus ducreyi cytolethal distending toxin (HdCDT) catalytic subunit CdtB has DNase‐like activity and mediates DNA damage after its delivery into target cells. We constructed a replication‐deficient adenovirus type 5 (Ad5) vector expressing CdtB and investigated the toxic properties of this vector on HeLa cells. Ad5CdtB caused loss of cell viability, morphologic changes, and cell cycle arrest, findings similar to HdCDT intoxication. This confirmed that CdtB is responsible for the toxicity of the holotoxin when expressed in cells following transduction by an adenoviral vector, and indicated a possible potential of this novel strategy in studies of activity of intracellular products and in gene therapy of cancer.     

Reactive lymphadenopathy in Ugandan patients and its relationship to EBV and HIV infection

In Uganda, a large number of biopsied enlarged lymph nodes is diagnosed as reactive lymphoid hyperplasia (RLH) not indicative of a specific etiologic agent. The aim of this study was to examine the spectrum of RLH in lymph node biopsies in Ugandan patients and their possible association with HIV and EBV infection. Ninety biopsies were retrieved and included in the study. The predominant RLH type was follicular, found in 45 (50.0%) of the cases. Positive staining for LMP‐1 was found in six cases (6.7%), EBNA‐1 in 36 cases (40.0%) and HIV1‐p24 in 15 cases (16.7%), respectively. A combination of EBV and HIV positivity was found in 46 (52.2%) of the cases. EBV infection was associated with hyperplastic germinal centers (p<0.01). HIV1‐p24 positive staining was associated with follicle fragmentation (p<0.01) but not hyperplastic GC (p=0.08). In conclusion, RLH in Ugandan patients is frequently associated with EBV and HIV infection. The histologic features of the lymph nodes are not specific for any individual infection, but a high number of EBV‐positive cases are associated with hyperplastic GC, and follicular fragmentation is characteristic of HIV infection.     

Echocardiographic-determined Left Ventricular Wall Characteristics in Insulin-dependent Diabetic Patients

Abstract. Left ventricular wall mass, thickness and movement were investigated by echocardiography in 80 insulin-dependent diabetic patients with no signs of ischaemic heart disease and in 40 healthy controls. In diabetics with a disease duration of >30 yr, urinary albumin excretion rate >200 μg/min (clinical nephropathy), proliferative retinopathy or autonomic neuropathy, both the posterior wall thickness and the septal thickness were increased compared to controls. The posterior wall thickness and the septal thickness were positively correlated to blood pressure (p<0.001), disease duration (p<0.001), urinary albumin excretion rate (p<0.001), and negatively correlated to the heart variation during deep respiration (p<0.01). The left ventricular wall mass was correlated to both blood pressure (p<0.01) and urinary albumin excretion rate (p<0.01). By multiple regression analysis urinary albumin excretion rate, disease duration and heart rate variation during deep respiration did not add significantly to the correlation between left ventricular wall mass/wall thickness and blood pressure. The septal movement was reduced in diabetics with proliferative retinopathy or clinical nephropathy. In conclusion, left ventricular wall thickness and wall mass were closely related to blood pressure in insulin-dependent diabetics. Signs of impaired cardiac function, such as reduced septal movement, were seen only in patients with severe microvascular disease.     

Vitality of periodontal ligament cells after storage of monkey teeth in milk or saliva

Vitality of die periodontal ligament (PDL) is necessary for a successful healing after replantation of exarticulated teeth. In the present investigation newly extracted teeth from monkeys were stored in saline, milk or saliva for 1–3 h. Freeze sections were made and the vitality of the PDL was determined histochemically. Milk seemed to provide better storage conditions than saliva or saline.