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Biomedical subjects

A Penttilä

Publications and source records attributed to A Penttilä.

At least 91 records · Page 5Linked to original sources
PubMed1990

Arteriovenous malformation of the brain: imaging by postmortem angiography.

Arteriovenous malformation (AVM) of the brain, detected in 0.06% of medicolegal autopsies in Helsinki, was imaged in four cases by postmortem angiography using contrast medium which vulcanised at room temperature. Postmortem angiography visualized the location, extent and type of the malformation as well as its feeding vessels. Angiography was also useful in differentiating between AVM and cerebral artery aneurysm as a cause of haemorrhage and in identifying vascular complications following neurosurgical resection of malformations.

Aged↗
PubMed1990

Medicolegal findings among rape victims.

A survey was done of 249 female victims of alleged sexual offences (mostly rapes) examined at the Department of Forensic Medicine, University of Helsinki in 1978-1984. The judicial outcome of 150 cases of the same material examined in 1978-1981 (annual prevalence 7.8 in Helsinki) was related to the pattern of injuries and to the presence of spermatozoa. Review of medicolegal reports indicated that victims were often quite young, workers and students, who mostly had consumed alcohol and were taken by force by strange offenders often in a remote place, at night and at the weekend. In most cases the offender had used physical violence causing minor injuries to the victim. Apparently, physical injury is not an inevitable consequence of being raped. A vaginal intercourse had mostly occurred. However, spermatozoa were found in just under half the cases. An unconditional imprisonment (usually 0.5-2.5 years) and the withdrawal of the charge was the consequence in one-third of the cases, respectively. There was little correlation between judicial outcome and the severity of injuries and/or the presence of spermatozoa in vaginal samples. Results suggest that the offence should be reported to the authorities as soon as possible so that more medicolegal evidence can be obtained.

Adolescent↗
PubMed1990

[Accidents with fatal outcome in Finnish leisure boating 1986-1988].

All 291 fatal accidents (510 persons on board, 318 drowned) in water traffic in Finland in 1986-1988 were investigated by specific teams. Only some data of this extensive investigation are presented in this study. Staggering and falling in boat because of drunkenness, falling over and sinking of boat were the main causes of getting into water of the people aboard. Only 3.5% of the drowned had used life jackets and 9.7% of them could not swim. The reduced ability to swim because of alcohol and the exhaustion were in about half of the drowned the actual cause and the cold water in one third the background factor for drowning. The results indicate that fatal accidents in water traffic are a major problem of males (95.9%) and give important information for countermeasures.

Cause of Death↗
PubMed1990

[Occasion and risk for detecting driving in alcoholic intoxication].

Detection of offenders driving while intoxicated (DW) (mandatory BAC limit at 0.50%) in Finland was investigated. Almost every fifth offender was detected at road blocks and every tenth of them because of abnormal driving. Compared to the local police the national traffic police had arrested much more offenders for traffic violation (38% vs. 11%) but much less because of accidents (12% vs. 23%). The reason of detection was in a significant way dependent on the following variables: BAC, stage of inebriation, vehicle, day of week and hour of day. The risk of detection is very low, i.e. about 1 to 300. However, the risk has doubled from 1979 to 1984, but thereafter slightly declined. The study provides information for the strategy of the police in traffic supervision.

Accidents, Traffic↗
PubMed1990

Validity of post-mortem alcohol reports.

The drinking behaviour of 95 consecutive men subjected to medicolegal autopsy in Helsinki was studied by interviewing a relative or friend of the deceased. Sufficient data for estimating the daily alcohol dose were obtained in 61 (64%) of the cases. Of these men, 21 (34%) were reported to drink at least an average of 80 g of alcohol daily. The validity of post-mortem alcohol reports was assessed by comparing the occurrence of alcohol-related diseases, toxicological data as well as the cause and manner of death with the reported alcohol consumption. Men whose reported daily alcohol consumption exceeded 80 g (mean 230 g) differed from men reported to drink less than 10 g (mean 3 g) in their more common incidence of positive post-mortem alcohol test (P less than 0.0005), fatty liver (P less than 0.001), enlarged liver (P less than 0.01), alcoholic hepatitis (P less than 0.05), chronic pancreatitis (P less than 0.01), and in their lower rate of death from cardiovascular diseases (P less than 0.05). The present results indicate that interviews with relatives or friends provide reliable data on the drinking behaviour of the deceased. At autopsy, the most sensitive tests coinciding with high consumption of alcohol in post-mortem alcohol reports but not with each other were positive post-mortem blood alcohol and the occurrence of fatty liver.

Adult↗
PubMed1989

Diagnostic postmortem angiography of fatal splenic artery haemorrhage.

The site of fatal haemorrhage from the splenic artery, caused in one case by a ruptured aneurysm and in another case by an intracystic haemorrhage of a postoperative pancreatic pseudocyst, was revealed by postmortem angiography. Radiopaque silicone rubber vulcanizing at room temperature was used as contrast medium. In the latter case, the dissection was seriously hampered by tight postoperative intestinal adhesions following four abdominal operations to control bleeding into the gastrointestinal tract. The results indicate the usefulness of postmortem angiography with contrast medium vulcanizing at room temperature for postmortem diagnosis of rare causes of gastrointestinal haemorrhage.

Adult↗
PubMed1989

Blood alcohol in sudden and unexpected deaths.

Blood alcohol concentration was determined in 1672 sudden and unexpected natural and non-natural out-of-hospital deaths. The material covered all medicolegal autopsies in the province of Uusimaa which has a population of approximately 1.1 million inhabitants. In general, the prevalence of cases with alcohol in the blood at the time of death was high but varied considerably according to sex, age, and the cause and manner of death. The blood alcohol result was positive in 36% of the male and in 15% of the female material. In 59% of the alcohol-positive male and in 54% of the alcohol-positive female cases the actual concentrations were at least 1.5%. Acute use of alcohol was regarded as a significant condition contributing to death in 23% of the whole male and in 8% of the whole female material. These gross results and the details presented indicate that the acute use of excess alcohol is a factor contributing to non-natural but also to sudden and unexpected natural deaths to an extent that is not generally known. The results also emphasize that simple blood alcohol determination should be a routine procedure in the autopsy praxis of all sudden and unexpected natural and non-natural out-of-hospital deaths.

Adolescent↗
PubMed1989

Diagnostic angiography in postoperative autopsies.

Postmortem angiography was used as a diagnostic tool to rule out surgical malpractice in 227 medicolegal autopsies following postoperative deaths in Finland. Of the cases, 111 involved neurosurgical patients or patients undergoing operations on the carotid arteries, 62 involved coronary bypass patients, and 54 patients died following abdominal surgery. A portable perfusion device for postmortem angiography at the autopsy table involves attaching quick couplings to a compressed airline. Permanent cast and three-dimensional topographic assessment of vascular anatomy are achieved using solidifying silicone rubber with lead oxide as a contrast medium and stereopair radiographs. This technique can be performed by experienced autopsy technicians and can be linked to normal autopsy services. In our experience, postmortem angiography is useful in investigating all complicated deaths following surgical operations.

Angiography↗
PubMed1989

Methanol as a marker of alcohol abuse.

Serum methanol levels were studied in 16 skid-row alcoholics, 16 alcoholics entering a detoxification unit, 193 drunken drivers, and 50 social drinkers, all of whom had a blood-ethanol concentration exceeding 5 mmol/liter at the time of sampling. Highest mean serum methanol level was found in alcoholics entering detoxification (636 +/- 68 mumol/liter, p less than 0.001 as compared to social drinkers), followed by skid-row alcoholics (567 +/- 105 mumol/liter, p less than 0.001), drunken drivers (231 +/- 11 mumol/liter, p less than 0.001) and social drinkers (127 +/- 10 mumol/liter). During 2 days heavy drinking mean serum methanol concentration in 10 nonalcoholic volunteers increased from 177 +/- 15 mumol/liter 1 h after the beginning of drinking to 322 +/- 29 mumol/liter 42 h after the beginning of drinking (p less than 0.001). In 70 of the drunken drivers urinary methanol concentration was determined as well and a fairly good correlation (r = +0.56, p less than 0.001) between serum and urinary methanol levels were found. Our results suggest that methanol determined either from serum or urine can be used as a biological marker of alcohol abuse.

Adult↗
PubMed1989

Fatal poisonings with antidepressants in Finland 1985-1987.

In Finland the majority of the users of antidepressants are women and old age people. In the 80's the number of fatal poisonings has increased. During the years 1985-1987 58% of these poisonings were women who belonged to the younger age group of the users. The older tricyclic drugs are known to be more toxic, at least in overdose, than the newer antidepressants especially when they are compared to mianserin. Of the latter, however, lately more serious side effects have been reported. For this reason the use of the different kinds of antidepressants in Finland had changed: the sales of doxepin and amitriptyline have increased and those of maprotiline and mianserin have decreased. To study the role of antidepressants in sudden and unexpected deaths the fatality ratio (defined as fatalities divided by defined daily doses per 1000 inhabitants/day) was calculated for four most prescribed antidepressants. As to the sales, amitriptyline has to be considered to be the leading antidepressant followed by doxepin, mianserin and maprotiline. As a detection in the forensic toxicological screening the sales related ratios showed that maprotiline was most commonly found followed by doxepin, amitriptyline and mianserin. When an antidepressant was the cause of death the fatality ratio was highest for doxepin (6.4) followed by maprotiline (4.3), amitriptyline (4.0) and mianserin (1). In cases of established suicides the order was the same again.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

The possibility of using celiac trunk branches as coronary artery bypass grafts.

The internal mammary artery has proved to be superior to the saphenous vein for coronary artery bypass grafting, because of its arterial nature and closer approximation in size to the coronary arteries. But the internal mammary artery cannot reach the posterior surface of the heart as a pedicled graft. Two suitable intra-abdominal grafts can reach that surface, viz. the right gastroepiploic artery and the splenic artery. In experiments on eight dogs (weight 9-13.5 kg), the gastroepiploic artery was found to be too small for coronary artery anastomosis, and therefore the splenic artery was used. The size approximation with coronary artery (diameter less than 1 mm) was good. Four dogs survived the month of the study. In two of them the anastomosis was patent, in another the splenic artery was patent despite occlusion of the anastomosis, and in the fourth dog both anastomosis and graft were thrombosed. The possibility of using visceral arterial grafts in coronary surgery is discussed.

Anastomosis, Surgical↗
PubMed1989

Fatal intoxication by Remoxipride.

The case history and toxicologic findings of a 23-year-old woman who committed suicide with Remoxipride are described. Remoxipride is a recently developed neuroleptic drug of the benzamide type. Remoxipride was detected in the liver, stomach content, blood, and urine. The concentration of Remoxipride in the blood was 230 mg/L. The recommended therapeutic level for Remoxipride should not exceed 7 to 8 mg/L. The victim had no blood alcohol, but an ethanol concentration of 0.048 g/100 L was detected in the urine. The mechanism of death from Remoxipride intoxication is not known. In clinical studies, sinus bradycardia and infrequent supraventricular and ventricular ectopic beats have been noted.

Adult↗
PubMed1989

[Alcohol consumption in males with sudden unexpected death in Helsinki].

The consumption of alcohol during the preceding year before death was investigated in 400 consecutive sudden and unexpected natural and non-natural out-of-hospital deaths in males aged 35-69 years in Helsinki. Information about the consumption of alcohol was obtained by interviewing the next kind or a good friend of the deceased (84.5%), or only from the police protocols (13.3%). In the whole material the consumption of alcohol was as follows; the proportion of teetotallers was 6.8%, that of moderate users 35.0% and that of heavy users/alcoholics 56.0%. In addition, there were few undefined cases (2.3%). In general, the consumption of alcohol was heavy in all categories of deaths. However, it was not so heavy among the deceased with a heart disease as the cause of death (the proportion of heavy users/alcoholics 42.9%) as in the other groups of deceased (63.0-85.4%). The results indicate that the heavy chronic consumption of alcohol is common in a large proportion of males who die suddenly and suggest that in addition to the acute consumption also the chronic use of alcohol is an important risk factor in many deaths among middle-aged Finns.

Accidents↗
PubMed1989

[Unexpected natural death in street traffic].

All natural deaths of motor vehicle drivers and bicyclists in traffic were retrospectively studied from the police and forensic autopsy protocols in the province Uusimaa in 1982-1985. Of the cases 57 were males and 3 females. The annual prevalence of natural deaths at wheel greatly increased with the age and was 260 and 231 per 1 million drivers and bicyclists aged 60-69 years, respectively. The most common underlying cause of death was chronic ischaemic heart disease, often known before (42%), and often combined with acute myocardial infarction (62%). In about half of the cases there were injuries. However, only in 5 cases the injuries had contributed so death. The presence of alcohol and drugs did not play any role. These deaths differed significantly by the event and demography of the parties from those killed in traffic accidents. The results suggest that sudden deaths at wheel are not very common in Finland. However, in all kinds of traffic deaths the police investigation should be completed by the forensic autopsy.

Accidents, Traffic↗
PubMed1988

Effect of fat on human liver selenium concentration.

Liver samples from 94 adult men and eight fetuses were obtained at autopsy from the Helsinki region. After lyophilization, the samples were analyzed for selenium (Se) both before and after extraction of fat with hexane/isopropanol. An inverse exponential relationship (R2 = 0.63) existed between unextracted adult liver Se concentration and the corresponding liver fat concentration. The relationship ceased to exist when Se was determined on the defatted tissue. The mean defatted adult liver Se concentration, 16.8 microM/kg dry wt, was significantly higher (p less than 0.001) than that of unextracted samples, 12.1 microM/kg. The Se concentration of fetal liver was not affected by the fat extraction. An age relationship (p less than 0.01) was found between subjects under 25 y and those over 40 y when the Se concentration was expressed per unextracted liver tissue but when expressed per defatted liver tissue the difference between age groups widened to comprise subjects over 60 y. Hepatic fat (mean Se concentration 2.7 microM/kg) thus constitutes a diluting factor. We conclude that the Se concentration of fatty human liver results in an underestimation of the selenium status of subjects who have an unphysiologically high liver fat concentration.

Adult↗