We conducted a retrospective case-control study to investigate a possible association between alcohol intake and stroke. Reported recent alcohol consumption and biochemical and hematologic markers of alcohol intake were examined for 230 patients with stroke (20 to 70 years old) and compared with concurrently collected data on controls matched for age, sex, and race. A single estimate of current intake was used as a measure of alcohol consumption. Among men, the relative risk of stroke (adjusted for hypertension, cigarette smoking, and medication) was lower in light drinkers (those consuming 10 to 90 g of alcohol weekly) than in nondrinkers (relative risk, 0.5), but was four times higher in heavy drinkers (consuming greater than or equal to 300 g weekly) than in nondrinkers. Because very few women in our study drank heavily, we were unable to determine whether heavy alcohol intake influenced the risk of stroke in women. With increasing serum concentrations of the biochemical markers of alcohol intake (aspartate aminotransferase, uric acid, and gamma-glutamyl transferase), we observed similar trends in the relative risk of stroke. Only the erythrocyte mean cell volume did not follow this pattern. We conclude that heavy alcohol consumption is an important and underrecognized independent risk factor for stroke in men, but our data are not adequate to settle the issue for women. Our conclusions are qualified by our reliance on reported recent alcohol consumption as the primary measure of intake.

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SUMMARY. A series of experiments are described which show that second derivative spectroscopy can be used to quantify conjugated lipid dienes as markers of lipid peroxidation in heptane extracts of plasma from patients with rheumatoid arthritis, osteoarthritis, and healthy controls. Results obtained by this method gave reasonable agreement with those derived from the measurement of simple absorbance in chloroform/methanol extracts.Two minima were observed in the derivative spectrum of plasma lipid extracts. These minima occurred at 233 and 241 nm and corresponded to absorbance maxima in the conventional UV spectrum. Using a combination of phospholipase hydrolysis, reverse phase high performance liquid chromatography (HPLC) and second derivative spectroscopy we confirmed that these two minima can be attributed to a single fatty acid (9 cis-,ll trans-linoleic acid) shown previously to account for greater than 90% of diene conjugation in human plasma samples. When the biological isomer 9 cis-,ll trans-linoleic acid was separated by reverse phase HPLC from the mixture of other plasma phospholipid-2-esterified fatty acids we observed a change in derivative spectroscopy minima from 233 and 241 nm to 228 and 237 nm. Minima at the latter two wavelengths were also seen with pure preparations of the Paint Research Isomer (9 trans-,ll trans-linoleic acid) which eluted later than biological 9 cis-,ll trans-linoleic acid using reverse phase HPLC, suggesting that the absorbtion spectra of these pure cis-, trans and trans, trans dienes are similar but can be altered by the presence of other fatty acids in the extra~t. Additional key phases: rheumatoid arthritis; 9 cis-, I I trans-linoleic acidThe process of free radical-induced autoxidation of polyunsaturated fatty acids results in double bond rearrangement and conjugated diene products (DC) are generated.' At 233 to 235 nm in UV light DC lipids absorb maximally and this property has been used as the basis for their detection in biological samples by simple absorptiometry. However, several difficulties are encountered when using this technique. The precise wavelength of the absorption maximum is difficult to determine and the contribution to absorbance made by native fatty acid or lipid itself cannot be eliminated since DC absorption represents a small shoulder on the stronger absorption spectrum of the native lipid. Such problems may be eliminated using the technique Correspondence: Dr R D Situnayake, Department of Rheumatology, Dudley Road Hospital, Birmingham BI8 7QH, UK. 258of derivative spectroscopy (DS) which measures the change of absorbance during wavelength scanning. A first derivative spectrum represents change in absorbance units per nanometer of wavelength plotted against wavelength. The second derivative spectrum is the derivative of the first, representing change in absorbance per nrrr' plotted against wavelength. The minima observed in the DS spectrum represent absorbance maxima in the conventional UV spectrum. DS spectra still obey Beer's law, provided the orig...

M. After effects of sleeping drugs. In: Wheatley D, ed. Psychopharmacology of sleep. New York: Raven Press, 1981:177-97. 4 Clayton AB. The effects of psychotropic drugs on driving related skills.