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M Kaste

Publications and source records attributed to M Kaste.

At least 145 records · Page 8Linked to original sources

Risk of brain infarction in familial hypercholesterolemia.

We followed 54 subjects with heterozygous familial hypercholesterolemia for an average of 10 (range 3-14) years. Half were treated surgically with partial ileal bypass and the other half (matched for age, sex, coronary heart disease, blood pressure, diabetes mellitus, smoking, obesity, and serum cholesterol concentration) were treated conservatively with diet and hypolipidemic drugs. The mean decrease in serum cholesterol concentration from the average value of 522 mg/dl on entry into the study was 32% in the surgically treated group and 10% in the conservatively treated group. One quarter of the subjects (14 of 54) had symptomatic cerebrovascular disorders and one tenth (six of 54) suffered a brain infarction at a mean age of 43 (range 30-57) years. Two thirds of the brain infarctions occurred during follow-up. The method of treatment of familial hypercholesterolemia did not affect the number of new cerebrovascular events. The incidence of brain infarction was 7.4/1000/yr. The risk of brain infarction in these subjects with familial hypercholesterolemia was at least 20 times higher than in the general population. We conclude that symptomatic subjects with familial hypercholesterolemia have not only a high risk of coronary heart disease but also a high risk of cerebrovascular disorders.

Adult↗

[Brain death].

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Angiography↗

Mortality from ischaemic heart disease among patients using anticonvulsive drugs: a case-control study.

Patients who use phenytoin and some other anticonvulsive drugs have been shown to have raised concentrations of plasma high density lipoprotein. As this lipoprotein is known to be inversely associated with the incidence of ischaemic heart disease the causes of death of all patients with epilepsy known to be taking anticonvulsive drugs who died during 1978-80 were studied. Of 1399 deaths of anticonvulsant users, 258 (18.4%) were caused by ischaemic heart disease. This was significantly less (p less than 0.001) than the 382 deaths from ischaemic heart disease (27.3%) observed among paired controls matched for sex, age, and date of death. The total cardiovascular mortality was also lower among patients with epilepsy than among controls (p less than 0.02) despite there being more deaths due to cerebrovascular disease among patients. The difference in mortality from ischaemic heart disease was significant for both sexes and was not accounted for by excess deaths due to any other single cause. Users of phenytoin, carbamazepine, and barbiturates (alone or in combination) showed 29% less mortality due to ischaemic heart disease than respective controls (p less than 0.001).

Aged↗

Thromboembolism in patients with atrial fibrillation.

On retrospective review of records of 150 patients with atrial fibrillation (AF), 31% experienced a stroke or peripheral embolism. The AF was not associated with cardiac valvular disease in 80% of the 150 patients. Most of the cerebral infarcts were large, disabling, and unheralded by transient ischemic attack. The thromboembolism typically occurred in patients whose AF was undetected prior to the infarction. Half of the patients with an ischemic event suffered multiple events, with one fourth of the recurrences arising within two weeks.

Adult↗

Visual and spectral EEG analysis in the evaluation of the outcome in patients with ischemic brain infarction.

Serial EEGs were recorded in 15 patients with acute cerebral infarctions in order to study clinical and prognostic correlations. The EEG was recorded within 48 h from the first symptoms and thereafter weekly for 4 weeks. The EEGs were analyzed both visually and with a computerized spectral analysis. Eight of the patients recovered fully and seven had permanent neurological deficits. On admission, 87% of the patients had an abnormal EEG by visual analysis. The spectral parameters correlated well with visual findings, especially the delta and alpha bands. The spectral analysis was superior to visual in predicting the correct laterality of the lesion. It showed the correct side of the lesion in 87%, while the visual did it in only 54% of the cases. The first EEG records reliably predicted the outcome of the patients. The degree of background abnormality was most important in visual EEG analysis. In spectral analysis, parameters from single derivations were superior to the average of all derivations. A high proportion of delta or low proportion of alpha power were reliable indicators of poor outcome.

Adult↗

Effect of ethanol on blood viscosity and erythrocyte flexibility in healthy men.

The effects of ethanol on blood rheology were studied in twelve healthy male volunteers each serving as his own control. They drank 1.5 g (33 mmol) of ethanol per kg body weight in fruit juice over 2.5 h under controlled laboratory conditions. Blood and plasma viscosity, packed cell volume and erythrocyte flexibility were measured before and 3, 12 and 16 h after ethanol ingestion began, and again during a second session equal volumes of fruit juice were consumed. Packed cell volume varied similarly after ingestion of juice with or without ethanol. Blood viscosity remained almost unchanged after ethanol, while drinking of juice caused an initial decrease followed by a significant (P less than 0.05) increase from 4.04 (SEM 0.06) to 4.32 (SEM 0.18) mPa.s. The juice also caused more significant fluctuations in erythrocyte rigidity (whole blood) than ethanol, which had parallel but insignificant effects. We conclude that a blood ethanol concentration of 28 mmol l-1 failed to induce any marked changes in blood rheology.

Adult↗

Can ethanol intoxication affect hemocoagulation to increase the risk of brain infarction in young adults?

We studied the effects of acute ethanol intoxication on platelet function, coagulation factors, and fibrinolytic activity in 12 healthy men. During the ethanol session, 10 of the 12 developed a transient decrease in fibrinolytic activity. Ethanol ingestion increased factor VIII coagulant activity. VIII-related antigen, and VIII-ristocetin cofactor. The highest levels were detected 16 hours after beginning ethanol ingestion (p less than 0.001), and the bleeding time decreased at 12 hours (p less than 0.01). Ethanol had no effects on platelet count, beta-thromboglobulin, antithrombin III, ethanol gelation, or fibrin/fibrinogen degradation products. Decreased fibrinolytic activity, increased factor VIII complex, and shortened bleeding time may explain why ethanol intoxication increases susceptibility to cerebral thrombosis.

Adult↗

Serial nuclear magnetic resonance (NMR) imaging in patients with cerebral infarction.

Seven patients with supratentorial infarction were studied by means of serial nuclear magnetic resonance imaging using saturation recovery (SR) and proton density (PD) sequences. The earliest changes were visible in the more sensitive T1 dependent images (SR) and may reflect the cytotoxic component of ischemic brain edema. Further progress was also clearly discernible in the PD images and may mainly reflect the slower vasogenic component of ischemic brain edema. Nuclear magnetic resonance imaging seems to provide a new approach to early diagnosis of ischemic brain infarction. Furthermore, it may elucidate some aspects of the pathophysiology of ischemic stroke in man.

Adult↗

Is chronic brain damage in boxing a hazard of the past?

Of fourteen boxers with a mean age of 31 years who had been Finnish, Scandinavian, or European champions, only one showed deficits in neurological status and he and one other had had episodes of inappropriate behaviour which were attributed to boxing. However, computed tomography revealed pathological findings attributable to brain injury in four of six professional and one of eight amateur boxers. Two of the professionals and four of the amateurs had electroencephalographic abnormalities which may have been caused by brain injury. Twelve of the boxers had psychological test results which suggested brain injury, although only two professionals had definite deviation from normal. The results indicate that modern medical control of boxing cannot prevent chronic brain injuries but may create a dangerous illusion of safety. The only way to prevent brain injuries is to disqualify blows to the head.

Adolescent↗

Effects of ethanol intoxication and hangover on plasma levels of thromboxane B2 and 6-keto-prostaglandin F1 alpha and on thromboxane B2 formation by platelets in man.

We detected a significant decrease in plasma thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) levels together with a significant increase in plasma 6-keto-PGF1 alpha/TXB2 ratio in young healthy non-alcoholic male volunteers after acute ingestion of ethanol (1.5 g/kg). Paradoxically, during ethanol intoxication and the following hangover a significant increase in ADP-induced formation of TXB2 by the platelet rich plasma could be observed, which suggests that ethanol intoxication via some unknown mechanism sensitized platelets to produce TXB2. Whether these observations contribute to the increased risks of subarachnoid haemorrhage or ischaemic brain infarction among occasional heavy drinkers recently described by us remains to be proved.

Adenosine Diphosphate↗