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Biomedical subjects

H Koponen

Publications and source records attributed to H Koponen.

At least 37 records · Page 2Linked to original sources
PubMed1995

Abnormal regional benzodiazepine receptor uptake in the prefrontal cortex in patients with panic disorder.

The neuroanatomical networks involved in the initiation of panic attack and the maintenance of panic disorder are poorly understood. This study aimed to elucidate the possible abnormalities in benzodiazepine receptor uptake in the brain of patients with panic disorder. Seventeen unmedicated patients with panic disorder were investigated using 123I-iomazenil single photon emission tomography (SPET). Seventeen healthy age- and sex-matched volunteers served as controls. The SPET scan was taken 90 min after injection of tracer. Eleven of 17 patients (65%) showed an increased (> 2 S.D. higher than the mean of the controls) right-to-left ratio of benzodiazepine receptor uptake in the prefrontal cortex. Also, the mean right-to-left ratio of benzodiazepine receptor uptake in all 17 patients with panic disorder was higher than in the controls (P < 0.001). Our SPET study demonstrated focally altered benzodiazepine receptor uptake in the prefrontal cortices in patients with panic disorder. Magnetic resonance imaging indicated that the affected region was located in the right middle and inferior frontal gyri. The deterioration in information processing in the right prefrontal cortex may be implicated in the generation of panic disorder.

Female↗
PubMed1995

A prospective three-year follow-up study of borderline personality disorder inpatients.

Prospective long-term follow-up studies on patients with borderline personality disorder (BPD) have been uncommon. Clinical data suggest that their treatment is highly demanding and that short-term results are sometimes limited. In this study, changes in symptoms and social management were monitored during a hospitalization period of 91 days (mean, range 21-296 days) and during a 3-year follow-up period in 62 patients admitted during 1989 to an open ward specializing in the psychotherapeutic treatment of BPD. The patients were thoroughly evaluated, using various rating scales, at the beginning and at the end of the index admission and after the follow-up period. Forty-two patients (70%) participated in the follow-up evaluation. Most patients suffered from overt anxiety and depressive symptoms at the beginning of hospitalization, and these declined significantly during hospital treatment. At the end of the follow-up period, depressive and anxiety symptoms were at the same level as on discharge, as assessed by the Beck Depression Inventory and Hamilton Depression Rating Scale. Although treatment response was otherwise maintained, the patients often showed suicidal behavior. During the follow-up period the sample clearly differentiated in two groups: those continually fit for work (33%) and those chronically incapable of working (46%).

Adult↗
PubMed1995

Citalopram, a selective serotonin reuptake inhibitor, in the treatment of aggression in schizophrenia.

The aim of this double-blind cross-over study was to investigate whether treatment with the selective serotonin reuptake inhibitor, citalopram reduces aggressiveness in chronically violent schizophrenic inpatients. Initially 19 patients were enrolled into this double-blind cross-over study in which the patients were treated for 24 weeks with placebo and 24 weeks with citalopram (20-60 mg/day) as a supplement to their previous neuroleptic medication. Fourteen patients completed the entire study, but sufficient data on 15 patients could be used in the end-point analysis of efficacy. Psychiatric assessments (Brief Psychiatric Rating Scale, Clinical Global Impression Scale for Severity of Illness, Social Dysfunction and Aggression Scale and the Global Aggression Scale) and side effects (UKU Side Effect Scale) were recorded at baseline and 4 times during both periods. Aggressive incidents (Staff Observation Aggression Scale) were recorded throughout the study. During citalopram treatment, the frequency of aggressive incidents was significantly lower and the mental state did not deteriorate. Patients either experienced no side effects or else side effects were equally mild during both periods.

Adolescent↗
PubMed1994

Testing for mutations in exon 17 of the beta-amyloid precursor protein gene in Finnish Alzheimer patients and normal subjects.

Mutations in the beta-amyloid precursor protein gene on chromosome 21 were shown to cause a small proportion of Alzheimer's disease. We studied the occurrence of the point mutations in exon 17 of the beta-amyloid precursor protein gene in a sample of Finnish familial Alzheimer patients and nondemented controls using polymerase chain reaction and a single strand conformation polymorphism technique. In addition, mutations in familial Alzheimer's disease patients were studied by sequencing the amplified products. Interestingly, two probable polymerase chain reaction errors were detected in codons 717 and 693 of the exon 17. However, no mutations in the exon 17 were confirmed adding the study to the body of literature that mutations in the exon 17 are a rare cause of familial Alzheimer's disease.

Age of Onset↗
PubMed1994

Sleep in panic disorders.

Panic disorder is a common anxiety disorder, which has relatively often its onset during adolescence. Besides panic attacks and avoidance behavior the patients often have sleep disturbances. They suffer from insomnia, nocturnal panic attacks, fear of going to bed or falling asleep and drug- or alcohol-related symptoms such as withdrawal phenomena.

Adult↗
PubMed1994

Serum mianserin and ageing.

1. Mianserin is a tetracyclic antidepressant with relatively few anticholinergic and cardiovascular side-effects. Its clinical efficacy is comparable to that of tricyclic antidepressants. It is widely used in Europe, especially in elderly outpatients. 2. In the present studies, the authors have evaluated the efficacy of mianserin as well as the effects of ageing and concomitant psychotropic drugs on serum mianserin concentrations in 169 depressive psychiatric inpatients. 3. In the patients the mean serum mianserin concentrations or their interindividual variations did not differ between the old, middle-aged, and young age groups. Furthermore, elderly women and men did not differ from each other for their dose-related drug concentrations. Neither were any differences found in serum mianserin concentrations between the older (> or = 75 years) and younger elderly (65-74). As is the case with TCAs, the co-administration of neuroleptics increased serum mianserin concentrations in the elderly. When comparing the therapeutic response and serum mianserin concentrations the authors found that the patients with good clinical improvement had higher mean serum mianserin concentrations than those without efficacy. 4. There seem to be no clinically important changes in the pharmacokinetics of mianserin with advancing age. The present results do not support the claim that the therapeutic profile of this drug is altered with advancing age. Mianserin can be regarded as an antidepressant with relatively few side-effects in the elderly.

Adult↗
PubMed1994

Citalopram in the treatment of social phobia: a report of three cases.

Social phobia is a chronic and disabling anxiety disorder. Although its pharmacological treatment has not been extensively studied, recent reports suggest that social phobia may be treated with monoamine oxidase inhibitors, beta-blockers, tricyclic antidepressants, and alprazolam. A recent study has shown that fluoxetine is also effective in social phobia, and preliminary results suggest that the same may apply to other serotonin reuptake inhibitors, too. In this paper we describe the results of citalopram treatment in three patients with social phobia.

Adult↗
PubMed1994

A 12-week double-blind multi-centre study of paroxetine and imipramine in hospitalized depressed patients.

Fifty-seven inpatients with major depression (DSM-III-R) entered a 12-week study comparing paroxetine and imipramine. Trends (not reaching statistical significance) in favour of paroxetine were seen on the Hamilton Depression Rating Scale (HDRS) and the Montgomery-Asberg Depression Rating Scale (MADRS). The UKU Side Effect Rating Scale showed a significant difference in favour of paroxetine on reduced salivation. Global evaluation of side effect symptoms showed that significantly more paroxetine patients had no side effects, both in the investigators' and the patients' opinion. These results are in line with previous findings of paroxetine being an effective and well tolerated antidepressant.

Adult↗
PubMed1993

Can severe cardiorespiratory dysregulation induced by clozapine monotherapy be predicted?

Severe orthostatic and cardiorespiratory dysregulation may occur during institution of clozapine therapy both during concomitant benzodiazepine medication and on reinstitution of clozapine after a washout period. Extensive medical and neurological workup before and after the trials can nevertheless be normal. The absence of similar previous reactions to other drugs, adhering to monotherapy with clozapine, increasing dosage slowly or performing a single test for orthostatic reactions after initiating clozapine are insufficient precautionary measures. Cardiorespiratory complications can occur without the challenge of assuming an erect position but appear to otherwise run an initial course similar to that of severe orthostatic reactions. A significantly abnormal response to testing for orthostatic reactions may be established, but only during the period of vulnerability to cardiorespiratory dysregulation. Repeated testing for this predisposition during the first weeks of clozapine therapy is suggested.

Adult↗
PubMed1993

Delirium during fluoxetine treatment. A case report.

The correlation between high serum tricyclic antidepressant concentrations and central nervous system side effects has been well established. Only a few reports exist, however, on the relationship between the serum concentrations of selective serotonin reuptake inhibitors (SSRIs) and their toxic effects. In some cases, a high serum concentration of citalopram (> 600 nmol/L) in elderly patients has been associated with increased somnolence and movement difficulties. Widespread cognitive disorders, such as delirium, have not been previously linked with high blood levels of SSRIs. In this report, we describe a patient with acute hyperkinetic delirium connected with a high serum total fluoxetine (fluoxetine plus desmethylfluoxetine) concentration.

Aged↗
PubMed1992

[Current and future work roles of hospital nursing directors].

This study has three aims: 1) to examine the present role of hospital nurse directors; 2) to find out what changes will occur in their role in the near future; and 3) to explore what their future role should be. The data were collected by a means of a mail questionnaire in winter 1990 from 50 nurse directors and 42 chief physicians of departments and 50 head nurses of wards from five Finnish university hospitals and from five other large acute hospitals. The nurse directors assessed their present role as being the most active and the head nurses as the least active in the examined 27 leadership functions. Largest differences were found in the evaluation of the hospital nurse directors' present role between the nurse directors themselves and the head nurses. However, in respect to the future work role the head nurses and nurse directors had rather similar expectations. Both emphasized research and development of the nursing staff and nursing care. The chief physicians thought that nurse directors should concentrate more on the internal leadership functions of the hospitals such as personnel management, solving the conflicts between the staff and performing routine functions of personnel management. The nurse directors themselves emphasized the external functions of hospitals in their present and future work role, such as networking and negotiations outside the hospitals and financial management. The differences in the evaluations of the present role and in the expectations concerning the future role of nurse directors indicate conflicting views between the the three groups. All respondents perceived nurse directors as being important and needed in hospitals. They also considered that non-nurses cannot function as directors of nursing services.

Clinical Nursing Research↗
PubMed1991

A longitudinal study of cerebrospinal fluid acetylcholinesterase in delirium: changes at the acute stage and at one-year followup.

Cerebrospinal fluid acetylcholinesterase (CSF AChE) was determined for elderly delirious patients during the acute stage and after a 1-year followup, and the AChE levels were compared with those of age-equivalent controls. At the acute phase, the AChE levels of the delirious patients were in the same range as those of the control group, but during the followup, a slight declining trend was observed. These results do not unambiguously support the previously suggested role of cholinergic dysfunction in the pathogenesis of acute delirium, although the augmented striatal release of AChE in hyperkinetic and mixed delirium may mask the involvement of cholinergic neurons.

Acetylcholinesterase↗