Biomedical subjects
Publications and source records attributed to R Sulkava.
In four men a severe encephalitis developed one week after the respiratory symptoms during the influenza A outbreak in 1980. Virological studies showed that the patients had had a recent influenza A (H3N2) infection. All patients made a complete recovery.
The histocompatibility antigens of the A, B and C loci were typed for 32 patients with Alzheimer's disease and 35 controls of the same age. The results were also compared to the distribution of HLA antigens in a series of 900 healthy blood donors. No statistically significant differences were found between the Alzheimer patients and the controls. HLA--Cw1 was found significantly less frequently in the group comprising the patients with Alzheimer's disease and their controls together, than in the younger blood group. This leads us to suggest that an age-matched control group may be needed, at least when the patients are elderly.
In 1976, 220 patients over 15 years of age were admitted to the adult medical services of Aurora Hospital, Helsinki, with a provisional diagnosis of pneumonia. All patients had an infiltrate on the chest X-ray. Acute pneumonia was found in 193 patients (87.7%). Other diseases in this series were pulmonary tuberculosis in 14 cases (6.4%), carcinoma of the lung in 6 cases (2.7%), and carcinoma of the lung with acute pneumonia in 5 cases (2.3%), aspergilloma in one case (0.5%) and an eosinophilic infiltrate in one case (0.5%). Previous or associated illnesses in the pneumonia patients were previous pneumonia (40.4%), chronic alcoholism (26.8%) and congestive heart failure (25.8%). The probable infectious aetiology of pneumonia was found in 45 cases (22.7%). The commonest agents were influenza A, 17 cases (8.6%); Pneumococcus, 9 cases (4.6%); and Mycoplasma pneumoniae 8 cases (4.0%). Bacteria were accepted causal if grown from blood cultures; tests for detecting antibodies against Pneumococcus were not used. Sputum cultures were not helpful in the study of bacterial pneumonia. Alcoholism seemed to predispose to pneumococcal pneumonia, but in the alcoholic patients leukocyte counts on admission were not lower than in the other patients. The overall mortality of pneumonia was 5.5%, only 3.5% of patients died during the first 3 weeks.
Chromosomal abnormalities have been reported earlier in Alzheimer-type dementia. Sister chromatid exchange (SCE) was studied in four patients with Alzheimer's disease and five control subjects. The sensitive method to detect chromosomal damage showed no elevated number of SCEs in Alzheimer's disease.
In the present study, we attempted to replicate the finding of an increased frequency of HLA-A2 in men with early-onset (less than or equal to 60 years) Alzheimer disease (AD). HLA data obtained on 167 patients (including 19 men with early-onset AD) from three geographic regions (North Carolina, Great Britain, and Finland) failed to replicate the result. A recent prospective study from Oregon, however, confirmed the association. Studies demonstrating the association suggest its presence in sporadic rather than familial AD. These results indicate a variable HLA/AD association, with some factor such as geographic region or disease familiality contributing to this variability.
Apolipoprotein E genotyping was carried out in a stratified random sample of 52 patients with Alzheimer's disease, 48 patients with vascular or mixed dementia, and 49 nondemented controls in a population-based study of people aged 85 and older (the Vantaa 85+ Study). Our results indicate that the apolipoprotein E epsilon 4 allele is associated with approximately a twofold increase in clinically diagnosed Alzheimer's disease in this very old general population aged 85+. When combined with previous studies, our data also suggest that the association is decreasing with age. In contrast, there appears to be no relation between apolipoprotein E alleles and clinically diagnosed vascular dementia.
The aim of our study was to evaluate the relationship between health-related factors, brain imaging findings and cognitive functioning. We examined 113 neurologically healthy subjects from 55 to 85 years of age. Health-related variables included a clinical health evaluation, cardiovascular diseases, and other systemic diseases. The presence of white matter changes and cerebral and peripheral atrophy were obtained with magnetic resonance imaging. Neuropsychological tests measuring verbal memory, visual memory, intellectual and language functions, visuoconstructional functions, flexibility, and speed and attention were administered. Results showed that overall health status was not related to cognition. Subjects, who had both arterial hypertension and white matter changes had difficulties in flexibility. Cardiac failure and white matter changes were related to impairment in visuoconstructional functions, flexibility and attention. Significant speed and attention deficits were observed in subjects with cardiac failure and central atrophy. In conclusion, this study verifies the relationship between hypertension, white matter changes and cognitive functions. We found also specific patterns in relation with cardiac failure, brain imaging findings and cognitive functioning, the most vulnerable domains were visuoconstructional functions, flexibility and attention.
Magnetic resonance (MR) imaging and CT of three patients with Creutzfeldt-Jakob disease (CJD) showed bilateral cortical atrophy and no apparent white matter changes. Serial examinations revealed the progressive nature of the atrophy, findings compatible with the patients' clinical deterioration. At autopsy some white matter abnormalities were detected in one patient 6 months after MR imaging. The available data suggest that the white matter abnormalities, if present, develop during the final stage of CJD.