Effects of intravoxel velocity distributions on the accuracy of the phase-mapping method in phase-contrast MR angiography.

The phase-mapping method of phase-contrast magnetic resonance angiography is shown to be based on an implicit assumption that the intravoxel velocity distribution is symmetric about its mean velocity. The effect of asymmetric distributions on the accuracy of quantitative average velocity measurements is determined analytically and verified experimentally. An explicit formulation is developed for the estimated average velocity in a voxel as a function of the true average velocity and the asymmetry of the distribution about the true average velocity. Worst-case distributions are determined for unidirectional and bidirectional flow, and the special case of laminar flow is also investigated. Computer simulations and phantom imaging experiments demonstrate the accuracy of the analysis. For voxels with unidirectional flow, the phase-mapping method produces accurate estimates of average velocity, while results for bidirectional flow indicate possible large errors unless the aliasing velocity is increased, which decreases the signal-to-noise ratio in the resultant velocity map image.

Incidence and survival rate in cases of biopsy-proven temporal arteritis.

In the population of the city of Tampere, Finland, 66 patients with histologically verified temporal arteritis were identified during the 20-year period from 1969 to 89. The cases were followed up to March 31st in 1991. The annual age- and sex-adjusted incidence of temporal arteritis per 100,000 population aged 50 or older was 4.5 in 1970-79 and 9.2 in 1980-89. The patients showed excess mortality although this was not statistically significant. After excluding hypertensive disease, angina pectoris and congestive heart disease the survival of the remaining subgroup did not differ from the control population.

Annual injection of vitamin D and fractures of aged bones.

In order to investigate the effect of a supplementation of vitamin D in the prophylaxis of fractures of the bones of aged people, an annual intramuscular injection of ergocalciferol (150,000-300,000 IU) was given to two series of aged subjects: first to 199 (45 male) of 479 subjects (110 male) aged more than 85 years who were living in their own home, and second to 142 (29 male) of 320 (58 male) subjects aged 75-84 and living in a home for aged people. This prospective series was divided into treatment groups according to month of birth. These injections were given annually from September to December in the years 1985-1989, two to five times to each participant. The fracture rates, laboratory values, vitamin D levels, possible side effects, and mortality were followed until October 1990. A total of 56 fractures occurred in the 341 vitamin D recipients (16.4%) and 100 in 458 controls (21.8%) (P = 0.034). The fracture rate was about the same in both outpatient and municipal home series. Fractures of the upper limb were fewer in the vitamin D recipients, 10/341 = 2.9% (P = 0.025), than in the controls, 28/458 = 6.1%, during the follow-up. A similar result was obtained in fractures of ribs, 3/341 = 0.9% and 12/458 = 2.6%, respectively. Fractures of the lower limbs occurred almost as frequently, 31/341 = 9.1%, among the vitamin D recipients as among the controls, 49/458 = 10.7%. The fracture rate was higher in females (22.2%) than in males (9.5%). The fractures were fewer in the vitamin D recipients only in females.(ABSTRACT TRUNCATED AT 250 WORDS)

Serum vitamin D level after an annual intramuscular injection of ergocalciferol.

An annual intramuscular injection of ergocalciferol (150,000 IU) normalized low serum (25(OH)D concentrations in elderly people for 1 year. The treatment had a slight effect on serum 24,25(OH)2D levels but no effect on 1,25(OH)2D levels.

Body weight and the three-year prognosis in very old people.

We studied prospectively the three-year prognosis of persons aged 84-88 years living in their own homes in the city of Tampere, Finland in 1981-84. Out of the target population 722 persons (64 per cent), 181 of them male (25 per cent), participated in the initial survey. A re-examination was carried out annually for the next three years. Increased mortality was observed for subjects with body mass index less than or equal to 22.0 kg/m2, statistically significantly in women but not in men. Mortality was not increased in those with body mass index greater than or equal to 30.0 kg/m2 in either sex. Low body mass index was associated with mortality due to stroke. Low body mass index was related to permanent hospitalization and also to failure to cope with living at home. On average, body weight was somewhat reduced during the follow-up period. Both a loss and a gain in weight by two kilograms or more during the first follow-up year were associated with increased mortality but not with institutionalization during the next two years.

Blood pressure in the very old.

Seven hundred and twenty-four people (541 female, 183 male), aged 84-88 years and living at home in the city of Tampere, Finland, accepted our invitation to be examined in the outpatient department of the local geriatric hospital. These subjects were re-examined annually, and their fate was followed for 3 years. The blood pressure level was a prognostic sign for mortality during the first year after its measurement. The lowest mortality rate was found among those subjects with systolic blood pressure between 140 and 169 mmHg and diastolic blood pressure between 70 and 99 mmHg. Blood pressures outside of these ranges were associated with increased mortality rates, particularly cardiac and coronary mortality. The mortality rate was especially high among those whose systolic blood pressure had decreased to low levels in the year before, but was lower in those whose systolic blood pressure had decreased from high to middle levels (140-169 mmHg) than in those with consistently high systolic blood pressure. Eventual institutionalization was more common in those with low systolic blood pressure.

Treatment of chronic constipation with lactitol sweetened yoghurt supplemented with guar gum and wheat bran in elderly hospital in-patients.

The faecal output of 33 elderly hospitalized patients was followed daily for 4 weeks. After an observation period of 1 week 18 patients received during the following 2 weeks a 150 ml portion of yoghurt containing lactitol, guar gum and wheat bran (fibre yoghurt group) twice daily. Fifteen control patients received the same volume of yoghurt without lactitol, guar gum or wheat bran (control yoghurt group). The study design was randomized double-blind. The mean faecal output increased 1.6-fold in patients receiving fibre yoghurt, while the corresponding value for control patients was 1.2 (p less than 0.05). About 50% of the fibre yoghurt group and 25% of the controls considered the treatment effective. Some in the fibre yoghurt group experienced meteorism and loose stools. No significant changes were observed in blood glucose, serum cholesterol or triglyceride values, body weights or faecal pH values in either group.

Blood glucose and diabetes mellitus predicting mortality in persons aged 85 years or above.

The population aged 85 years or over (n = 674) living in Tampere, Finland was surveyed in 1977-1978. In an investigation of the prognostic survival of new and previously diagnosed diabetic patients, the levels of blood glucose were analysed in 558 persons, 99 men and 459 women. The relative sex- and age-adjusted survival rates were evaluated at the 5-year follow-up. The mortality after 5 years of the 17 new diabetics at home did not differ significantly from that of the 225 non-diabetics at home. The mortality of 30 patients with previously diagnosed diabetes mellitus was higher than that of the non-diabetics. The survival prognosis of the diabetics on antidiabetic medication did not differ from that of those on diet. An increased risk of mortality was found in this series in previously diagnosed diabetics and--most unexpectedly--in non-diabetics with the lowest fasting blood-glucose levels.

Living conditions and health of a population aged 85 years or over: a five-year follow-up study.

The population aged 85 years or over (n = 674) living in Tampere, Finland was surveyed in 1977-78. Altogether 561 persons (83%), 99 men and 462 women, were examined. A re-examination of 170 persons, 23 men and 147 women, was carried out in 1982 by the same procedure as in 1977-78, The results were compared with those of the same people and with those of over-90s five years before. Of the group followed, in the initial survey 65% were living at home and 25% in old people's homes, 10% being hospitalized. The percentage of hospital in-patients had increased threefold during the five-year follow-up. The functional capacity of the subjects had deteriorated as regards mental function and ability to walk. The mean values of blood samples (apart from ESR) were still in normal ranges, although the levels of haemoglobin and haematocrit had fallen significantly. Dementia or confusion, anaemia, femoral-neck fracture and cataract were significantly increased.

Mortality and high haematrocrit in the very aged.

A series of 543 people, aged 85 years or more was studied and divided into groups according to haematocrit value. The mortality of the subjects was followed over the next 5 years. The mortality in the lowest haematocrit groups was highest during the whole observation period. Further, in the haematocrit bracket greater than or equal to 0.48, the mortality in the first year was higher than in those with haematocrit 0.40-0.47. In the second year this increased mortality had disappeared and in the third-fifth years decreased mortality was found with high haematocrit. Initially high haematocrit also decreased during the observation period. Since the increased mortality associated with high haematocrit disappeared it cannot be based on any chronic disease but on some disappearing factor, e.g. simply the high haematocrit itself.

Electrocardiogram, clinical findings and chest x-ray in persons aged 85 years or older.

Persons aged 85 years or more (n = 674) living in Tampere, Finland, were surveyed in 1977 and 1978. Five hundred fifty-nine persons (83%) were examined. Electrocardiographic findings, classified according to the Minnesota code, were compared with reported cardiac symptoms, clinical congestive heart failure, clinical coronary heart disease and relative cardiac volume on chest radiograph. Electrocardiographic items had a poor association with cardiac symptoms. ST-segment depression, T-wave inversion, ventricular premature complexes and atrial fibrillation were related statistically highly significantly to clinical congestive heart failure, as were ST-segment depression and T-wave inversion to clinical coronary heart disease. High left R waves, ventricular premature complexes and atrial fibrillation showed a significant association with cardiac enlargement (over 500 ml/m2) and pulmonary congestion in chest radiographs.