Natural evolution of snoring: a 5-year follow-up study

Introduction – The natural evolution of snoring was studied in a middle-aged population in Finland. Material and methods – A questionnaire was mailed to a stratified random sample of 1600 people aged 36–50 years in 1985 with a response rate of 75.2%; 53% of them completed also the 5-year-follow-up questionnaire. Clinical examinations (N = 36) and whole-night polygraphic recordings (N = 22) were made to habitual (every or almost every night) snorers and daily sleepy persons. Results – A total of 626 persons completed the 5-year-follow-up questionnaire. The prevalence of habitual snoring among men was 28.3–43.8% and among women 6.3–18.8%, increasing with age. Sleepiness was common: doze-off at the wheel was reported by 23% of snorers and traffic accidents because of sleepiness by 4.5%. Hypertension was clearly more common (p = 0.002) among habitual snorers, but the self-reported rates of strokes and coronary heart disease were not increased in this study. None of the snorers had been investigated because of their snoring or sleepiness during the five years. In polygraphic recordings 11/22 showed an oxygen desaturation index (ODI4) more than 5/h; active treatment was started for 8 of them. The observed prevalence of sleep apnea syndrome with ODI4> 10 was 1.1% in this study. Conclusions – Snorers, even with clear sleepiness, are passive in seeking help for their symptoms. Physicians should actively diagnose this treatable condition impairing the quality of life and increasing the risk of traffic accidents and vascular diseases.     

Macrophages Are a Major Source of Acetaldehyde in Circulating Acetaldehyde-Albumin Complexes Formed after Exposure of Mice to Ethanol

C57BL mice were depleted of macrophages by an intravenous injection of liposome-encapsulated dichloromethylene diphosphonate (DCMDP), and control mice were uninjected or injected with empty liposomes. One day after injection, a proportion of the DCMDP-treated and control mice was continuously exposed to ethanol vapor for 4 days. Albumin fractions were separated from the sera of both ethanol-unexposed and ethanol-exposed animals and tested for cytotoxicity against a monolayer of A9 cells using two indicators of cytotoxicity: detachment of adherent cells and a decrease in the ability of cells to reduce tetrazolium. The results show that, in mice exposed to ethanol, macrophages are a major source of the acetaldehyde in circulating cytotoxic acetaldehyde-albumin complexes and presumably also of free acetaldehyde.     

The gluteal perforator-based flap in repair of pressure sores.

The gluteal perforator-based flap is designed according to the localisation of sacral perforator vessels. These vessels penetrate the gluteus maximus muscle and reach the intrafascial and suprafascial planes, and the overlying skin forming a rich vascular plexus. The gluteal perforator-based flaps described in this paper are highly-vascularised, have minimal donor site morbidity, do not require the sacrifice of the gluteus maximus muscle and rarely lead to post-operative complications. We believe these easy-to-perform flaps might be considered as the first choice in the repair of gluteal pressure sores.     

Angiographic patterns of involvement in renal and perirenal lymphoma

Ten patients with renal lymphoma studied by selective angiography are reported. Seven patients had unilateral and 3 had bilateral involvement. A localized mass was seen in 6 patients and diffuse infiltration in 3. In 1 patient with bilateral nodular involvement, the angiographic findings resembled those of adult-type polycystic kidney disease. In all cases, renal lymphoma was suspected angiographically. The findings included hypovascular mass or masses with fine neovascularity, smooth and diffuse arterial encasement, and faint tumor staining.     

Dynamic aspects of rhodamine dye photosensitization in vitro with an argon-ion laser

Phototoxicity in cultured human bladder carcinoma cells treated by 514.5-nm argon-ion laser irradiation plus rhodamine-123 (R123) or tetrabromo-R123 (TBR) was assessed counting total cell number and percent viability at 1, 24, 48, 72, and 96 h after irradiation. TBR was markedly more efficient than R123 at causing both reversible and persistent phototoxic cytostasis. Furthermore, TBR photosensitization caused net cytocidal effects at 0.5 J/cm2, which were not seen with R123 photosensitization at up to 40 J/cm2. The reduced phototoxic efficiency of R123 as compared to TBR appears, in part, to reflect the presence of a fraction of cells refractory to R123 photosensitization.     

Short-term tranexamic acid treatment in aneurysmal subarachnoid hemorrhage

Antifibrinolytic treatment for 4 weeks after a subarachnoid hemorrhage has been shown to have no effect on outcome since a reduction in the rate of rebleeding was offset by an increase in ischemic events. To determine if a shorter course (4 days) of antifibrinolytic treatment before the expected onset of ischemic complications might reduce the rate of rebleeding yet avoid ischemic complications, we prospectively studied a series of 119 patients with subarachnoid hemorrhage; 479 patients with subarachnoid hemorrhage from our previous randomized double-blind study (238 treated with placebo, 241 with long-term tranexamic acid) served as historical control groups. At 3 months' follow-up, the outcome of patients treated with short-term tranexamic acid was not different from that of patients treated with long-term tranexamic acid. The rate of rebleeding (24 of 119, 20%) was near that with placebo (56 of 238, 24%). In contrast, the rate of cerebral infarction (33 of 119, 28%) was almost identical to that after long-term tranexamic acid (59 of 241, 24%), although mortality from cerebral infarction was reduced. Compared with historical control groups, treatment with tranexamic acid for 4 days fails to reduce the incidence of rebleeding but still increases the rate of cerebral infarction.     

Organophosphate Metasystox-induced Increment of Lipase Activity and Lipid Peroxidation in Cerebral Hemisphere: Diminution of Lipids in Discrete Areas of the Rat Brain

Abstract: The effects of the pesticide, metasystox (O,O-dimethyl-S-2 or Metasystor^® (ethylsulphinyl) ethylthiophosphate), on various lipid fractions in the discrete areas of the brain were studied. The daily intraperitoneal administration of 4 mg/kg body weight of metasystox for 10 days has depleted the levels of total lipids, phospholipids, cholesterol, esterified fatty acids and gangliosides in cerebral hemisphere, cerebellum, brain stem and spinal cord. But the lipase and lipid peroxidation measured in the cerebral hemisphere were significantly increased. It is possible that the inhibition of the lipid levels in the discrete areas of the brain may be due to the increase activity of lipase and lipid peroxidation.     

Conjugation of acrylamide with glutathione catalysed by glutathione-s-transferases of rat liver and brain

Acrylamide, an α,β unsaturated electrophile and a cumulative neurotoxin, was found to react with glutathione giving rise to an S-conjugate of acrylamide. Glutathione S-transferase of rat liver and brain cytosols (active on both acrylamide and 1-chloro 2,4 dinitrobenzene) emerged as a single major peak on elution from Sephadex G-75. The enzymic conjugation of acrylamide with glutathione increased with protein and was dependent on incubation time and pH of medium. Acrylamide inhibited glutathione-S-transferase activity towards 1-chloro 2,4-dinitro-benzene of both liver and brain cytosol, in a concentration and time dependent manner. Enzyme catalyzed conjugation of acrylamide with glutathione was induced significantly by phenobarbital and t-SO (tans-stilbene oxide). The enzymic conjugation of acrylamide increased two fold from neonatal to adult and then showed a decreasing pattern at subsequent ages.