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Biomedical subjects

E Kinnunen

Publications and source records attributed to E Kinnunen.

At least 37 records · Page 2Linked to original sources
PubMed1990

MS and SLE in twins of successive generations.

During a nationwide twin study on multiple sclerosis (MS) in Finland a dizygotic pair discordant for MS was found. The affected co-twin had dizygotic twin daughters. The affected co-twin of the second generation had systemic lupus erythematosus (SLE). Both pairs were thoroughly examined. No evidence of CNS involvement in the healthy co-twins was found. In pairwise comparisons, virus-specific IgG antibodies to measles and mumps were significantly increased in the MS patient whereas the same was true for rubella in the SLE patient. Both MS and SLE patient expressed HLA alleles most often found to be associated with these disorders. Reversed CD4/CD8 ratios were observed in both MS and SLE patient. No difference in interleukin-2 receptor expression were found but gamma-interferon secretion in the MS patient showed marked increase whereas that of the SLE patient was of the same magnitude as in the healthy members. A different triggering stimulus rather than the dissimilarity in the immunogenetic predisposition may be decisive as to whether or not they develop MS or SLE.

Adult↗
PubMed1989

Myasthenia gravis associated with multiple sclerosis. Epidemiological survey and immunological findings.

Patient registers on myasthenia gravis (94 patients) and multiple sclerosis (991 patients) from a population of 1.5 million were reviewed to find patients with both diseases. Seven potential candidates were found, but both diagnoses were confirmed in 2 women only. The first patient had also iritis, the second patient had, besides MG and MS, bronchial asthma and polyarthritis. Both neurological diseases had a relatively mild clinical course. Thymectomy relieved MG symptoms in both patients. Cerebrospinal fluid studies during the follow-up indicated immunoactivation within the central nervous system. Changes in cellular immunity were also noted. The HLA types were different. The combination of these two diseases appears to be more common than expected.

Adolescent↗
PubMed1989

Immunological studies on patients with optic neuritis without evidence of multiple sclerosis.

We studied 6 patients with idiopathic optic neuritis (ON) after a mean follow-up period of 12 years. No evidence of multiple sclerosis (MS) was found on clinical grounds, nor by magnetic resonance imaging (MRI) or evoked responses. Levels of spontaneous proliferation, serum gamma-interferon (IFN-gamma) and lymphocyte MHC locus II antigen were similar in ON and in 6 patients with progressive MS, but different in healthy controls. This suggests that similar immunological conditions in vivo prevail after an idiopathic ON and in MS. A normal PHA-induced interleukin-2 receptor expression and lymphocyte proliferation but a low IFN-gamma secretion and MHC locus II antigen expression were observed. This suggests that an ON and MS defect is expressed after an interleukin-2 receptor ligand but before IFN-gamma secretion. Our findings also suggest that immunological factors do not explain the neuropathological confinement of the lesions in ON but the protective influence may rather be exerted by some as yet undefined genetic influence or may be explained by the different etiology of ON and MS.

Adult↗
PubMed1989

Serum selenium concentration, glutathione peroxidase activity and lipid peroxides in a co-twin control study on multiple sclerosis.

Serum selenium concentration, glutathione peroxidase activity and lipid peroxides were determined in patients with multiple sclerosis (MS). The series consisted of 13 same-sexed twin pairs derived from the Finnish Twin Cohort of 15,815 pairs. Fourteen subjects had a definite and 1 a probable MS, and their 11 co-twins showed no evidence of central nervous system disease. No statistical differences were observed, but the 3 patients with active progressive MS had a higher mean level of lipid peroxides than the rest of the patients. We suggest that serum lipid peroxidation may be involved in the activity of MS.

Adult↗
PubMed1989

Multiple sclerosis and occupational exposure to chemicals: a co-twin control study of a nationwide series of twins.

From the Finnish Twin Cohort (n = 27,100 pairs with known zygosity) all cases of diagnosed multiple sclerosis (MS) were reviewed and those with clinically verified MS were invited for further examinations at the Institute of Occupational Health, Helsinki, with their co-twins. Twenty one cases (19 pairs, of which 17 were discordant) fulfilled the strict criteria of MS. Detailed occupational history showed exposure to a mixture of solvents in six subjects, to lead in one, and to trichloroethylene in one. Of these seven, two monozygotic twins had MS whereas the other five cases were healthy co-twins. These results do not support a causal association between occupational exposure to chemicals and the aetiopathogenesis of MS.

Adult↗
PubMed1989

Incidence of Guillain-Barré syndrome during a nationwide oral poliovirus vaccine campaign.

Concomitant with a nationwide oral poliovirus vaccine (OPV) campaign in Finland in 1985, an unexpected rise in the number of patients hospitalized with the Guillain-Barré syndrome (GBS) occurred. An analysis based on hospital records covering a population of 1.17 million and 6 years revealed a significantly increased incidence of GBS coinciding with the OPV campaign. We carefully examined 10 cases with onset of GBS within 10 weeks after immunization. Only 4 patients could recall recent symptomatic infection, and we found no specific agent in these cases. Our study suggests that live-attenuated polioviruses may, like other infectious viruses, sometimes trigger the GBS.

Adolescent↗
PubMed1988

Genetic susceptibility to multiple sclerosis. A co-twin study of a nationwide series.

The problems of differentiation between environmental and genetic influences on the development of multiple sclerosis are well known. Twin studies may provide valuable information on this question. However, most published twin series are selected and no through clinical twin studies based on epidemiologic series have been carried out. In this study, all available same-sex twin pairs with clinically definite multiple sclerosis derived from the Finnish Twin Cohort of 15815 pairs were studied by clinical evaluation, magnetic resonance imaging, and visual and auditory evoked responses. The mean length of follow-up of the pairs after the onset of symptoms of multiple sclerosis was 20 years. Two of the seven monozygotic pairs were concordant; one was definitely so, and in the other, the co-twin of the index case had, in addition to clinical findings, white matter changes suggestive of multiple sclerosis in magnetic resonance imaging and abnormal visual evoked responses. All six dizygotic pairs were discordant. The frequency of the HLA antigen DR2 in probands (69%) was significantly increased, but the distribution among the healthy subjects and patients showed nonsignificant differences. The results indicate a genetic influence on the susceptibility to multiple sclerosis, although still unknown genetic determinants are possible involved.

Adult↗
PubMed1988

Placebo-controlled double-blind trial of pirprofen and an ergotamine tartrate compound in migraine attacks.

Sixty-one patients, 16 with classic and 45 with common migraine, were treated during three subsequent attacks with pirprofen, a new inhibitor of prostaglandin synthesis; an ergotamine tartrate compound; or placebo, in a randomized, double-blind multicentre study. Pain relief after a single dose and reduction of the attack intensity occurred most often with pirprofen in patients who needed more than one dose. Among them, however, the duration of attack was shortest with ergotamine. Working ability was well preserved with pirprofen, especially among patients with common migraine, and this treatment was ranked highest by the patients. However, no statistically significant differences were found between pirprofen and ergotamine. No serious side effects were observed with pirprofen. This study establishes the usefulness of pirprofen in the treatment of acute migraine.

Adolescent↗
PubMed1988

Pleuropulmonary involvement during bromocriptine treatment.

The use of bromocriptine in the treatment of Parkinson's disease is increasing. More than 20 cases of suggested drug-induced pleuropulmonary disorders during bromocriptine therapy have been reported. We describe four male parkinsonian patients taking bromocriptine in whom pleuropulmonary abnormalities were discovered in a pulmonary hospital during a one-year period. In only one case were the roentgenographic changes reversible after withdrawal of the drug. Pleural fluid from two patients was analyzed and showed lymphocyte-predominant chronic inflammatory changes. Raised erythrocyte sedimentation rate (ESR) and C-reactive protein values decreased after cessation of bromocriptine. Lung function studies demonstrated volume restriction with normal or high CO transfer coefficient. The frequency of pleuropulmonary changes during bromocriptine therapy may be greater than assumed, and such patients may initially present with nonrespiratory symptoms. Follow-up of patients during bromocriptine treatment by ESR, C-reactive protein, and chest roentgenogram is recommended.

Aged↗
PubMed1988

Peripheral nerve injury and Raynaud's syndrome following electric shock.

A truck driver was injured by a high-voltage line of 10,000 volts when holding a metallic bar in both hands. Initially no neurological abnormalities were found, but during the following few weeks increasing sensory and minor motor symptoms developed in the right upper extremity. After one year numbness of the right thigh and leg appeared, as well as attacks of white finger in both hands. Repeated examinations showed progressive abnormalities of the median and ulnar nerves in both hands. No other cause for Raynaud's syndrome was discovered. The late high-voltage effects, presumably indirect, are suggested to be of multifactorial etiology.

Adult↗
PubMed1987

Acute transverse myelopathy successfully treated with plasmapheresis and prednisone in a patient with primary Sjögren's syndrome.

We report a case of acute transverse myelopathy in a patient with primary Sjögren's syndrome of 3 years duration. Our patient's acute transverse myelopathy developed within 1 week and resulted in complete paraparesis below the mamillary level. Extensive laboratory investigation ruled out viral, bacterial, and fungal etiology, Guillain-Barré syndrome, poliomyelitis, and multiple sclerosis. At diagnosis, treatment was initiated immediately with prednisone (80 mg/day) and plasmapheresis, which was performed as a first-aid measure. Improvement was noted as early as 10 days after the start of therapy. Within 5 1/2 months of the first symptoms of paralysis, the patient walked without difficulty and returned to her normal activities. A causal relationship between plasmapheresis/prednisone therapy and recovery has not been proven but merits further consideration.

Acute Disease↗
PubMed1987

Activated T lymphocytes in patients with multiple sclerosis in clinical remission.

Activation state and proliferation of lymphocytes of 6 patients with definite multiple sclerosis in clinical remission were studied. Lymphocytes carrying MHC class II coded Ia antigen, glycoprotein gp 40/80 and interleukin-2 receptor were significantly higher in patients with MS in remission than in normal healthy controls. The entrance of T cells into the G1 and S phase of the cell cycle was studied using [3H]thymidine autoradiography in combination with immunocytochemistry (cell markers). The proportion of T cells in the S phase of the cell cycle in the peripheral blood was similar in the MS patient and in the control group.

Autoradiography↗
PubMed1987

Evaluation of central nervous system involvement in uncomplicated optic neuritis after prolonged follow-up.

Magnetic resonance imaging (MRI), multimodal evoked responses (ER) and HLA antigens were examined in 10 patients with idiopathic acute optic neuritis (ON) without any clinical symptoms or signs of multiple sclerosis (MS) during 9-14 years. In MRI, abnormalities compatible with MS were seen in 4 patients. In spite of clinically unilateral ON, a bilateral abnormality in visual evoked responses (VER) was seen in 3 of 9 cases. Brain stem auditory evoked responses (BAER) were normal in all cases, short latency somatosensory evoked response (SER) in all but one. The cerebrospinal fluid at time of ON showed signs of demyelination in one case only. The frequency of HLA antigens DR2 (78%) and B18 (40%) was significantly increased in comparison to healthy controls. MRI seems to be the most sensitive method in the detection of cerebral lesions of MS, especially in mild or asymptomatic forms of the disease. The present techniques are, however, mostly unable to demonstrate optic nerve lesions which more reliably can be evaluated by VERs. The question whether idiopathic ON represents a form of MS solely, cannot be resolved.

Adult↗