Biomedical subjects
E Vuori
Publications and source records attributed to E Vuori.
Daime--a ritual herbal potion.
Explore the source record for details and available documents.
Grading rigor mortis with myotonometry--a new possibility to estimate time of death.
Myotonometry has been applied to grade rigor mortis. The myotonometer is a hand-held instrument which gives a mechanical impact against the muscle. The muscle responds with a damped vibration which is registered and treated mathematically. The period and the logarithmic decrement of decay of the vibrations were found to change with the development of rigor mortis. The method gives quantitative information on the muscular stiffness and it can be used when estimating the time of death.
Influence of topical steroid treatment on maxillary sinusitis.
The clinical efficacy and adverse effects of budesonide administered as a nasal aerosol in addition to sinus washings and erythromycin therapy was assessed by comparison with placebo in a randomized, double-blind study of 40 patients with chronic or recurrent maxillary sinusitis. Most of the patients had been referred for operative treatment. Corticosteroid therapy, 400 micrograms daily, or placebo was continued for 3 months. Budesonide and antral irrigations reduced nasal symptoms more effectively than placebo, and there was a significantly greater reduction in facial pain and sensitivity in the budesonide group than in the placebo group. During the treatment period, mucosal thickening as evaluated by radiology decreased more clearly in the budesonide group than in the placebo group, but the difference did not reach statistical significance. The most frequently isolated bacteria were Staphylococcus aureus, Staphylococcus epidermidis and Haemophilus influenzae. Only 2 of 20 Haemophilus strains were beta-lactamase producers. The cellular picture was dominated by neutrophils in all secretions. There was no significant difference in clinical outcome between the two groups. Topical steroid therapy did not cause any adverse effects.
High cyanide level in a homicide victim burned after death: evidence of post-mortem diffusion.
Elevated levels of carbon monoxide and cyanide serve as evidence of intravital burning in fire victims. Hydrogen cyanide is released by combustion of nitrogen-containing organic material such as plastics and wool. We present a case of a man who died of haemopneumothorax caused by a stab wound. According to several eye witnesses the body was wrapped in a plastic sheet and burned 2 days after death with the aid of gasoline. No coal pigment was observed in the mucosa of the upper airways at autopsy. The blood sample taken from the pulmonary vessels 6 days after death disclosed a level of blood carboxyhaemoglobin of 4% and of blood cyanide of 10 mg/l. The low carboxy-haemoglobin level was consistent with the smoking habits of the victim. The thoracic cavity had been opened by burning of the intercostal soft tissue. This allowed hydrogen cyanide gas to enter the thoracic cavity and diffuse into the blood probably causing the high blood-cyanide level.
Facile detection of anatoxin-a in algal material by thin-layer chromatography with Fast Black K salt.
A method for facile high-capacity screening of algal samples for anatoxin-a (ANTX-a), a potent neurotoxin of Anabaena flos-aquae, is presented. The method is based on in situ colour reaction of algal extracts containing ANTX-a on a thin-layer chromatographic plate with the diazonium reagent Fast Black K salt, and subsequent separation of the orange-red product. The product, shown to be a stable 3,3-dialkyltriazene, is derived from a reaction involving the aliphatic secondary amino group of ANTX-a. The detection limit for ANTX-a is 10 micrograms g-1 of lyophilized algal material, which is comparable to earlier methods using more complex instrumentation.
Bacterial findings in middle ear effusion in children.
During 1983-87, tympanostomy tubes were inserted in a total of 4952 ears of 2575 children remitted to the ENT Department of our hospital because of chronic or recurrent otitis media problems. The children were included in a prospective study and referred to one of three groups for comparison of findings. Group 1 included all 6- to 12-month-old infants undergoing primary tube treatment; group 2, all children 1 year or older who had their first ventilation tube(s) inserted in connection with adenoidectomy; and group 3, all children in whom tympanostomy had been performed one or more times previously. Middle ear effusion was aspirated from 2392 ears (48%); 67.6% of all ears were negative for bacteria and 22.1% of the ears with effusion grew pathogenic bacteria. S. pneumoniae was the most frequently cultured pathogen among the 6 to 12 month olds in group 1, but in groups 2 and 3 H. influenzae occurred more frequently than S. pneumoniae. Beta-lactamase-producing strains of pathogenic bacteria were formed in only 4% of all ears with effusion: H. influenzae in 1.2% and B. catarrhalis in 2.8%. Compared with figures from the United states, the frequency of beta-lactamase-producing strains is low in the present series. This is probably explained by differences in antimicrobial treatment practices; in Finland and the Scandinavian countries, penicillin V is the primary drug for acute otitis media. In light of present results, it seems well-suited for treatment of otitis media in young children.
Peripheral zonal hepatic necrosis caused by accidental ingestion of methyl ethyl ketone peroxide.
Fatal massive peripheral zonal hepatic necrosis developed in a 47-year-old man who accidentally ingested a solution of methyl ethyl ketone peroxide (MEKP) in dimethyl phthalate. Such solutions contain about 10% active oxygen. The clinical course was characterized by temporary cardiac arrest, abdominal burns, severe metabolic acidosis, rapid hepatic failure, rhabdomyolysis and respiratory insufficiency. A fatal outcome resulted 4 d afterwards from hepatic coma associated with blood coagulation disorders. Microscopical examination revealed massive periportal hepatic necrosis accompanied by atypical pseudoductular proliferation. The proliferating cells were probably of bile duct origin and exhibited atypia and mitoses. The pathogenetic mechanism may involve lipid peroxidation caused by free oxygen radicals derived from MEKP.
Fatal intoxications in the Nordic countries. A forensic toxicological study with special reference to young drug addicts.
Fatal intoxications in the 15-34 age group in the five Nordic countries during the years 1984 and 1985 (Sweden only in 1984) were investigated. The known drug addicts were studied separately. The highest incidence of intoxications, calculated per 10(5) population, was found in Finland (11.3), followed by Denmark (10.3), Sweden (8.5), Iceland (7.2) and Norway (6.6). The percentage of intoxications caused by drugs was 92 in Denmark, 71 in Norway, 66 in Sweden, 50 in Finland and 17 in Iceland. Ethanol intoxications were seen 5-7 and 2-3 times as frequently in Finland and in Iceland, respectively, than in the other three countries. Carbon monoxide intoxications accounted for two-thirds of all fatal intoxications in Iceland. Drug addicts accounted for 62% of all fatal intoxications in the Danish material. The corresponding figures were 33% in the Norwegian, 16% in the Swedish and 5% in the Finnish material. No deaths in drug addicts were found in Iceland. Most drug addicts in Denmark, Norway and Sweden died of hard drugs and most in Norway and Sweden, from heroin or morphine, whereas in Denmark other strong analgesics, such as methadone, dextropropoxyphene and ketobemidone, accounted for 40% of all hard-drug-related fatal intoxications. To a certain extent the results reflect differences in the legal autopsy routines in the various Nordic countries. However, the ascertainment of drug addicts is assumed to be near-complete in each country.
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.
Serum zinc and copper: associations with cholesterol and triglyceride levels in children and adolescents. Cardiovascular risk in young Finns.
Associations among serum lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides) and levels of serum zinc (S-Zn), serum copper (S-Cu), and their ratio were analyzed in 3373 3-, 6-, 9-, 12-, 15-, and 18-year-old Finnish girls and boys. S-Zn was positively related to total cholesterol, HDL-cholesterol, and LDL-cholesterol; S-Cu related negatively to HDL-cholesterol. Obesity did not affect these relationships. The few exceptionally high lipid levels found were not associated with very low or high S-Zn or S-Cu. S-Zn and S-Cu were related to serum lipids; causality between the variables, however, remains to be studied.
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)
Zinc, copper, and growth status in children and adolescents.
The associations between serum zinc and copper concentrations and anthropometric variables in 3415 3-, 6-, 9-, 12-, 15-, and 18-y-old Finnish girls and boys were investigated to identify groups with low serum zinc or copper concentrations and retarded growth, possibly suggesting deficiencies. Serum zinc levels and height, wt, body mass index, and skinfold thickness were not strongly related. Serum copper levels were negatively correlated with height and positively with wt, body mass index, and skinfold thickness. These relationships were clearest in both sexes between the ages of 9 and 15 y. Height, wt, body mass index, and skinfold thickness in subjects with very low or high serum values were in agreement with the correlations between these anthropometric variables and serum levels. Groups with clear deficiencies of zinc or copper could not be identified. We conclude that copper levels especially are correlated with stature between the ages of 3 and 18 y. In addition, the results suggest that deficiency states affecting growth are not very likely in healthy Finnish children and adolescents.
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.
Effect of exogenous heme on hepatic iron-load and changes induced in hepatic heme metabolism by chronic iron-load.
It has recently been shown that heme arginate treatment can markedly improve blood cell counts in some severely cytopenic patients with a myelodysplastic syndrome (MDS). As MDS is often associated with iron overload, we have now studied in iron-loaded rats the hepatic effects of heme arginate given in a dose of 1.2 mg/100 g intraperitoneally twice a week for a period of 4.5 weeks. The heme injections caused a very marked increase in the mean hepatic iron content of the iron-loaded rats, which was more than twice the total amount of the heme-iron injected per rat. The heme treatment did not significantly affect the activities of the enzymes involved in the heme metabolism. Although no clinical side effects have been found in the MDS patients treated with heme arginate so far, the present study suggests that in iron-load the possible adverse hepatic effects should be taken into account and a minimum therapeutic dose of heme arginate should be used.
[Fatal poisoning in Scandinavia--narcotic addicts are a high-risk group].
This study on fatal intoxications in the Nordic countries indicates an over-representation of drug addicts in Denmark, Norway and Sweden. All cases of fatal intoxications in persons 15-34 years of age submitted to medicolegal autopsy and subsequent toxicological examination in the Nordic countries during 1984-1985 included in the study. A comparison between the Nordic countries is possible because the same definition of a drug addict and classification of drugs are used. The numbers of fatal intoxications among drug addicts per 10(5) population were 6.3 in Denmark, 2.1 in Norway, 1.3 in Sweden, 0.6 in Finland and none in Iceland. About 70 per cent of the drug addicts in Norway and Sweden died from heroin/morphine intoxication. In Denmark only 55 per cent of the drug addicts died from heroin/morphine and 36 per cent died from overdoses of the legal drugs methadone, dextropropoxyphene and ketobemidone.
Hair zinc and copper: relationship to hair type and serum concentrations in children and adolescents.
The zinc and copper serum and hair concentrations of 691 3-18-y-old girls and boys previously determined as a part of the Multicentre Study of Atherosclerosis Precursors in Finnish Children and Adolescents were further analyzed in order to find a possible association between these two zinc and copper indices. The influence of hair color and the diameter of individual hair strands on hair concentrations were studied by the analysis of covariance. Hair color and serum zinc concentrations were found to be associated with hair zinc concentrations in boys. Such an association was not found for zinc and copper concentrations in girls. Hair vs serum concentrations in different age and hair color groups did not show however, a significant relationship either in copper or in zinc concentrations. The subjects with very low or high serum zinc or copper concentrations did not usually have extreme hair concentrations and vice versa. However, there were some subjects with low or high serum concentrations associated with low or high hair concentrations.
Prevalence of hemochromatosis in Finland.
Transferrin saturation was determined in 11,431 men and 10,639 women aged 15 or more drawn from different areas in southern and central Finland and attending a multiphasic health screening examination in 1967-1972. All the 163 men and 66 women with transferrin saturation greater than or equal to 70% at the initial examination and still alive at the end of 1983 were invited to a re-examination. Of the invited persons, 76% attended the re-examination. Transferrin saturation and serum ferritin were the initial screening methods in the re-examination. All persons with suspected hemochromatosis were clinically examined and a laparoscopy was performed. Four men and four women were found with unequivocal hemochromatosis. Only one of these cases was diagnosed beforehand. According to these data the prevalence of hemochromatosis in Finland is about 50/100,000.