Autopsy-verified Causes of Death after Stroke

ABSTRACT. In a population-based sample of 409 stroke patients, autopsy was performed in 82 of the 95 patients who died during the first three months and in 61 of the 128 patients dying thereafter. The dominant causes of death, as verified by autopsy, were cerebrovascular disease in the first week (90%), pulmonary embolism in the second to fourth week (30%), bronchopneumonia during the second and third months (27%) and cardiac disease, mainly myocardial infarction, later than three months after the stroke (37%). Death was attributed to causes other than the brain lesion in 59% of the patients with ischemic and in 24% of the patients with hemorrhagic stroke (p<0.01). Age and sex had little influence on the distribution of causes of death. Fatal pulmonary embolism and bronchopneumonia surprisingly often occurred in ambulatory patients. An intracardiac thrombus was present in 20% of deceased patients with atrial fibrillation, and in 17% of cases with a history of myocardial infarction. When attempts are made to reduce mortality (and morbidity) after stroke, there would seem to be a considerable potential for prevention and early treatment of complications, such as pulmonary embolism, bronchopneumonia and cardiac disorders.     

Characteristics of-neutral proteases present in inflamed human gingiva

Abstract – The existing forms of neutral proteases present in inflamed human gingiva were examined. Neutral 2 M KCl extracts of inflamed human gingival tissue were fractionated by gel filtration on Sephacryl S-200 and the fractions were assayed for collagenase, trypsin-, chymotrypsin-, and elastase-like proteases. Apparent molecular weights of 80–85 kDa were obtained for trypsin-, chymotrypsin-, and elastase-like proteases, and 70–75 kDa for latent collagenase. Further fractionation of high molecular weight proteases on Con A-Sepharose revealed that, unlike collagenase, chymotrypsin-, and elastase-like proteases, the trypsin-like protease was bound by the affinity column. Native human placental type IV (basement membrane) collagen was degraded by chymotrypsin-like and elastase-like proteases but not by the trypsin-like protease. This degradation was inhibited by phenylmethyl sulfonyl fluoride and EDTA. The serine proteases also degraded efficiently denatured type I collagen. No correlation of the activities of trypsin-like protease and the other proteolytic enzymes was found in extracts of 18 individual gingival specimens. Significant correlation, however, was noted between collagenase and gelatinase. The gingival culture studies showed that, while the highest activity of the trypsin-, chymotrypsin-, and elastase-like enzymes were measured in medium during first days of the culture, collagenase and gelatinase activities increased up to the fourth day of culture and stayed high until the end of the culture. These results suggest that the neutral proteases that may participate in the periodontal tissue destruction are produced by different cell types of gingiva.     

Magnetocardiographic QT Interval Dispersion in Postmyocardial Infarction Patients with Sustained Ventricular Tachycardia: Validation of Automated QT Measurements

T dispersion is a measure of heterogeneity in ventricular repolarization. Increased ECG QT dispersion is associated with life-threatening ventricular arrhythmias. We studied if magnetocardiographic (MCG) measures of QT dispersion can separate postmyocardial infarction patients with and without susceptibility to sustained VT. Manual dispersion measurements were compared to a newly adapted automatic QT interval analysis method. Ten patients with a history of sustained VT (VT group) and eight patients without ventricular arrhythmias (Controls) were studied after a remote myocardial infarction. Single-channel MCGs were recorded from 42 locations over the frontal chest area and the signals were averaged. QT dispersion was defined as maximum — minimum or standard deviation of measured QT intervals. VT group showed significantly more QT and JT dispersion than Controls. QT_apex dispersions were 127 ± 26 versus 83 ± 21 ms (P = 0.004) and QT_end dispersions 130 ± 37 versus 82 ± 37 ms (P = 0.013), respectively. Automatic method gave comparable values. Their relative differences were 9% for QT_apex and 27% for QT_end dispersion on average. In conclusion, increased MCG QT interval dispersion seems to be associated with a susceptibility to VT in postmyocardial infarction patients. MCG mapping with automated QT interval analysis may provide a user independent method to detect nonhomogeneity in ventricular repolarization.     

ACUTE ETHANOL INTOXICATION DOES NOT INFLUENCE GONADOTROPIN SECRETION IN POSTMENOPAUSAL WOMEN

Acute effects of ethanol ingestion (1.0 g per kg body weight)on the serum levels of LH, FSH and prolactin were studied in10 postmenopausal women. Ethanol was administered during thefirst 3 hr of the experiment and the hormone concentrationswere monitored for 10 hr. Each subject served as her own controlin an identical experiment without ethanol. Blood alcohol concentrationreached its maximum 1.18 ± 0.02 g/l (mean ± S.E.M.)3hr after the start of the drinking. No changes were found inthe levels of LH and FSH during the experimental period. Theincrease of 80% in the mean concentration of prolactin at 4hrafter the start of drinking was not statistically significant.On the basis of these and previous results we conclude thatalcohol has no acute effects on the secretion of gonadotropinsin women.     

Determinants of teenage smoking, with special reference to non-standard family background

The prevalence of teenage smoking in a cohort of 12 058 subjects born in northern Finland in 1966 is discussed in terms of its social and family determinants, especially in “non-standard” families (with one or more of the parents absent for at least pan of the child's upbringing). The prevalence of experimental or daily smoking was 67.4%, the rate being 65.5% in the standard, two-parent families and 75.5% in the non-standard families, the difference being statistically significant (p<0.001). The corresponding prevalence of daily smoking was 6.4%, but the rate was 5.1% in standard families and 12.1% in non-standard families (p<0.001). An elevated risk of smoking existed among adolescents who had experienced death of their father or divorce of their parents and among girls who had experienced death of their mother. Maternal smoking during pregnancy and maternal age under 20 years at the time of delivery increased the risk, while being the first-born child reduced it. Among family factors existing in 1980, paternal smoking increased the risk for both sexes, while more than three siblings, mother's unemployment or gainful employment (i.e. not a housewife) were associated with smoking by the boys as was urban living, and for the girls migration by the family to a town. The results suggest that juvenile smoking may be a kind of indicator of possible problems experienced by the parents and/or the adolescents themselves with respect to parenthood and family development.     

Copper in human subgingival calculus

Abstract – The Cu concentration as well as the Ca, Mg, Fe, Pb, Zn, and F concentrations were determined in subgingival calculus and the relation of Cu to Zn, Ca, Mg and Fe described. Samples of human subgingival calculus of 60 pieces from 60 subjects were ashed in an acid solution and the cation concentrations were determined with atomic absorption spectrophotometry. The F content was analyzed with an ion-selective electrode. The data was analyzed using the multiple linear regression analysis. The mean ±SD of the Cu concentration in the subgingival calculus was 48.4 ±59.0 μg/g. Four elements, Zn, Ca, Fe and Mg, explained 41.1% of the Cu content. Zn explained 25.5% and the correlation was positive, whereas Ca (10.4%) had a negative correlation with the Cu content. The results showed such a high Cu content that it could affect the mineralization of calculus.     

Comparison of the Levels of Cardiovascular Risk Factors between Eastern and South-western Finland in 1982

ABSTRACT. Altogether 6523 persons aged 25–64 years were studied in eastern and south-western Finland to determine their cardiovascular risk factor levels. Among men, smoking was more prevalent in the south-western area (41 vs. 37%), serum cholesterol levels were higher in the eastern area (6.2 vs. 6.0 mmol/l) and blood pressure levels were the same in both areas (145/86 in the east vs. 14/86 in the south-west). Among women, smoking was also more common in the south-western area (24 vs. 16%) and serum cholesterol levels were higher in the eastern area (6.1 vs. 6.0 mmol/l) as well as blood pressure levels (142/84 vs. 138/81 mmHg). Among both genders, prevalence of hypertension and proportion of persons on antihypertensive drug therapy was higher in eastern Finland. The comparison of these findings with the results from previous studies carried out among men in these two areas indicates that the risk factor levels have been decreasing in both areas and that the previously observed differences in risk factor levels between eastern and south-western Finland (the levels used to be higher in the east) have levelled off. The favourable development in eastern Finland may be a result of the North Karelia Project.