Search PubMed⌕ Search

Biomedical subjects

M Iivanainen

Publications and source records attributed to M Iivanainen.

At least 55 records · Page 3Linked to original sources
PubMed1989

Acute phase response in cerebral infarction.

The serum concentrations of the acute phase proteins, C-reactive protein, serum amyloid A protein, and alpha-1-antichymotrypsin were determined in 50 young and middle aged patients with cerebral infarction and in sex and age matched community controls. Of 46 case control pairs, 11 cases but only one control had raised acute phase protein concentrations simultaneously (p less than 0.01); four case control pairs were excluded because of an infectious complication following infarction and an acute phase response. Seven of the 11 patients (64%) with raised acute phase protein concentrations had a history of bacterial infection in the preceding month but of the remaining 35 patients without raised concentrations only four (11%) had such a history (p less than 0.01). In general, the acute phase response was less pronounced and occurred less often than has been reported in patients after acute myocardial infarction. The results suggest that a positive acute phase response is associated with a preceding bacterial infection or with an infectious complication after cerebral infarction. Measurement of acute phase proteins, therefore, could be used to evaluate the possible role of preceding bacterial infection in the development of cerebral infarction and also in the management of these patients as an early indicator of possible infectious complications.

Acute-Phase Reaction↗
PubMed1988

Diagnosis of acute herpes simplex encephalitis by brain perfusion single photon emission computed tomography.

Brain perfusion was studied in 14 patients with acute encephalitis by use of 123I-iodoamphetamine or 99mTc-hexamethylpropyleneamine oxime and single photon emission computed tomography (SPECT), the first examination being made 4-11 days after onset of encephalitis symptoms. All 6 patients with herpes simplex virus encephalitis (HSVE) had strongly increased accumulation of radiotracer in the affected temporal lobe; in the remaining 8 results were normal. At the time of the first SPECT conventional CT images were normal in all patients. The SPECT abnormality in HSVE gradually converted over 4-10 weeks from increased tracer accumulation to greatly subnormal accumulation. Brain perfusion SPECT may be helpful in the early diagnosis of HSVE.

Acute Disease↗
PubMed1988

Preceding infection as an important risk factor for ischaemic brain infarction in young and middle aged patients.

The role of preceding infection as a risk factor for ischaemic stroke was investigated in a case-control study of 54 consecutive patients under 50 years of age with brain infarction and 54 randomly selected controls from the community matched for sex and age. Information about previous illnesses, smoking, consumption of alcohol, and use of drugs was taken. A blood sample was analysed for standard biochemical variables and serum cholesterol, high density lipoprotein cholesterol, triglyceride, and fasting blood glucose concentrations determined. Titres of antimicrobial antibodies against various bacteria, including Staphylococcus, Streptococcus, Yersinia, and Salmonella and several viruses were determined. Febrile infection was found in patients during the month before the brain infarction significantly more often than in controls one month before their examination (19 patients v three controls; estimated relative risk 9.0 (95% confidence interval 2.2 to 80.0)). The most common preceding febrile infection was respiratory infection (80%). Infections preceding brain infarction were mostly of bacterial origin based on cultural, serological, and clinical data. In conditional logistic regression analysis for matched pairs the effect of preceding febrile infection remained significant (estimated relative risk 14.5 (95% confidence interval 1.9 to 112.3)) when tested with triglyceride concentration, hypertension, smoking, and preceding intoxication with alcohol. Although causality cannot be inferred from these data and plausible underlying mechanisms remain undetermined, preceding febrile infection may play an important part in the development of brain infarction in young and middle aged patients.

Adolescent↗
PubMed1988

Effect of interferon-gamma on biogenic amine metabolism, electroencephalographic recordings, and transient potentials.

For assessment of the underlying central mechanisms of interferon (IFN), measurements have been made of the neurotoxicity, cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) concentrations, along with electroencephalographic (EEG) recordings and visual evoked potentials (VEP) during recombinant IFN-gamma therapy. Interferon-gamma was administered intravenously to 14 patients with non-small-cell lung cancer as 2 mg/m2 (48 X 10(6) IU/m2) three times weekly with 4 h infusion for 12 weeks. The cerebrospinal fluid (CSF) samples were taken by means of lumbar puncture prior to treatment and during the end of the second week of IFN-gamma infusions. During the course of treatment, CSF 5-HIAA diminished from 129.6 +/- 10.9 to 84.5 +/- 10.4 nmol/L (p less than 0.001), while no significant changes were observed in HVA, EEG, and VEPs. These results suggest that IFN-gamma has an effect on the central serotonergic neurotransmission.

Biogenic Amines↗
PubMed1988

Cognitive changes as early signs of HIV infection.

Neuropsychological examination was performed on 13 patients and 10 matched controls to assess the brain involvement of patients with human immunodeficiency virus (HIV) infection. HIV-infected patients showed a significant decline in visuomotor, visuoconstructive and practical abilities as well as in motor-free visuospatial performance and repeating a long sentence. These findings could not be explained by the concomitant mental depression of these patients. Neither were they associated with any particular stage of HIV infection. The results suggest that mild cognitive changes may be detected even in the early stages of HIV infection, when examined by appropriate neuropsychological methods.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Anticardiolipin response and its association with infections in young and middle-aged patients with cerebral infarction.

Antibodies binding to solid-phase cardiolipin (anticardiolipin antibodies, ACA), which are closely associated with lupus anticoagulant activity, have been found in patients with thrombosis. ACA are often seen also in patients after acute infections. To study further our recent observation on the association between infection and cerebral infarction in young and middle-aged patients we measured anticardiolipin response (IgG, IgM, IgA) in paired sera from 54 consecutive patients with cerebral infarction under 50 years of age and in 54 community controls matched for sex and age. An elevated IgG-class ACA level or a significant change in level as observed in 2 serial samples occurred in 15 (28%) patients, but in only 4 (7%) controls (P less than 0.02). These ACA levels were only slightly elevated, and there were no patients with levels approaching values commonly seen in lupus anticoagulant-positive patients. Neither were there any patients with systemic lupus erythematosus (SLE) as an underlying disease. The combination of IgG-class ACA positivity and preceding probable bacterial infection (based on clinical, cultural or serologic data) was found in 10 patients (18%) but in only 2 controls (4%) (P less than 0.05). There were no significant differences in IgM- or IgA-class ACA between the patients and their controls. These results suggest that IgG-class ACA response associated with preceding probable bacterial infection is more common in patients with cerebral infarction than in their community controls. However, slightly elevated ACA are probably only indirect indicators of preceding infection and not directly involved in the pathogenesis of thrombosis itself.

Adolescent↗
PubMed1988

Behavioral assessment of patients treated with alpha-interferon.

To document behavioral effects of interferon (IFN) with daily consecutive assessments we developed an easily administered procedure for bedside testing. It included assessment of mental control and affective behavior, and a self-assessment questionnaire. The method was evaluated in 9 lung cancer patients before and during the treatment with alpha-IFN and the results were supplemented with those obtained by a neuropsychological test battery of one of the patients. The latter tests covered memory, visuoperceptual, visuoconstructional, speech, language, intellectual and psychomotor functions, reading, writing, and calculation. The bedside method was capable of revealing the essential effects of IFN on human behavior, i.e. irritability, slowing of behavior, dyscoordination, and motor perseveration. Consequently, the bedside testing method is recommended for frequently repeated clinical assessments of aberrant behavior of patients treated with IFN, while neuropsychological test batteries serve better for testing situations requiring more detailed and quantified data of localization value.

Aged↗
PubMed1988

Dementia-like, largely reversible syndrome after cranial irradiation and prolonged interferon treatment.

An elderly man with small cell lung cancer developed a largely reversible, dementia-like syndrome after cranial irradiation and prolonged treatment with interferon (IFN). The development of the symptoms started 2 months after cranial irradiation following more than 2 years of IFN treatment. The behavioral impairment did not suggest any specific brain localization. The dementia-like behaviour may be due to a combined effect of irradiation and IFN.

Aged↗
PubMed1987

Effect of phenytoin on the mental and physical function of patients with Baltic myoclonus epilepsy.

Progressive myoclonus epilepsy (PME) without Lafora bodies, or Baltic myoclonus epilepsy, is characterized by stimulus-sensitive myoclonus, generalized tonic-clonic seizures, and an irregularly progressive course beginning between 6 and 15 years of age. The EEG displays spike-and-wave paroxysms with irregular dominant activity. Baltic myoclonus epilepsy is a single-gene disorder inherited in an autosomal recessive pattern. Early cases were reported from Estonia, and many are now found in Finland, suggesting that the gene frequency is increased in those sharing the Finno-Ugric linguistic base. The use of phenytoin should be avoided in this disorder since its continued administration alone or with other antiepileptic drugs is associated with intellectual and motor deterioration, aggressive behavior, increasing ataxia, and even death. Treatment with valproate and the concomitant elimination of phenytoin have been associated with marked improvement in most cases. Baltic myoclonus epilepsy must be distinguished from Lafora body PME, which is relentlessly progressive and invariably fatal, but can usually be differentiated on clinical grounds.

Electroencephalography↗
PubMed1987

CSF protein and cellular profiles in various stages of HIV infection related to neurological manifestations.

CSF protein and cellular profiles were studied in 28 HIV-infected patients. Twenty of them had neurological complaints, but only 6 patients had objective neurological deficits such as dementia, ocular motility disorders or polyneuropathy. The serum/CSF HIV antibody ratio was on average lowest in acquired immunodeficiency syndrome (AIDS) (4 patients) and highest or almost normal in lymphadenopathy syndrome (LAS) (11) and asymptomatic seropositivity (ASX) (7), while it varied between these extremes in AIDS-related complex (ARC) (6). However, low values of the ratio were also found in the HIV-infected patients free of neurological symptoms and even in one ASX patient. The CSF IgG index was elevated in all these 4 general stages of HIV infection without any significant differences between them. The CSF/serum albumin ratio was slightly increased in patients with neurological deficits, but this ratio showed no association with any other clinical factor analysed. CSF leucocytes were increased in the early stages of the disease, but later the cellular reaction subsided. HIV was isolated from post mortem brain tissue of two AIDS patients and from the CSF of one of them. The results suggest increased intrathecal virus-specific IgG synthesis, not only in patients with neurological deficits and at advanced stages of infection, but also in neurologically symptom-free subjects and at early infection. The lack of correlation between the increased virus-specific IgG synthesis within the CNS and the presence of neurological symptoms suggests that neurologically "silent" areas of brain white matter are often affected in HIV infection.

AIDS-Related Complex↗
PubMed1987

Immunoactivation in the central nervous system in myasthenia gravis.

To assess signs of immunoactivation within the central nervous system in myasthenia gravis (MG) we examined the cerebrospinal fluid (CSF) of 44 MG patients for certain immunological parameters. Altogether 73% of the patients had some protein and/or cellular abnormality in their CSF. 22 (50%) out of 44 patients had a lymphoid reaction, i.e. a pathologically elevated proportion of enlarged lymphoid cells, in their CSF. In 15 (37.5%) out of 40 patients an enrichment of anti-acetylcholine receptor antibodies in the CSF was observed in relation to serum antibodies. Our findings suggest involvement of the central nervous system in many myasthenia gravis patients.

Adolescent↗
PubMed1987

Camptocormia, a new side effect of sodium valproate.

A mentally retarded 23-year-old woman with myoclonic astatic epilepsy developed an abnormal posture of extreme forward flexion, called camptocormia, during valproate monotherapy. Camptocormia occurred concomitantly with an increase of the plasma valproate level from about 330 mumol/l up to 530 mumol/l. Four weeks earlier she had developed hepatopathy during a regimen of carbamazepine, lynestrenol and sodium valproate. Hepatopathy subsided after the cessation of carbamazepine and lynestrenol. Camptocormia improved within a week after the reduction of the plasma valproate level to about 300 mumol/l. Four months later reversible camptocormia was manifested again concomitantly with about the same plasma valproate levels as above. Accordingly, camptocormia is a dose-dependent side effect of valproate.

Adult↗
PubMed1987

Sleep apnoea and daytime sleepiness in acromegaly: relationship to endocrinological factors.

Sleep history and pituitary function were studied and sleep polygraphy performed in 11 acromegalic patients before and after pituitary surgery. Excessive daytime sleepiness or habitual snoring or both together, as well as an elevated fasting level of serum GH occurred in all the patients. In five men but in none of the women an abnormal number of episodes of sleep apnoea were observed. Pituitary adenomectomy improved the apnoea frequency in one patient, whereas in the others the abnormality was still present 1 year later. After operation the fasting level of serum GH became normal in eight patients, two of them with persisting sleep apnoea. The sleep apnoea syndrome is common and clinically important in acromegaly. Its early diagnosis using polygraphic monitoring is emphasized, as it is a treatable disorder.

Acromegaly↗