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Biomedical subjects

V Myllylä

Publications and source records attributed to V Myllylä.

At least 19 recordsLinked to original sources
PubMed2006

Patient satisfaction with switching to Stalevo: an open-label evaluation in PD patients experiencing wearing-off (Simcom Study).

OBJECTIVES AND METHODS: This study investigated the ease with which 52 Parkinson's disease patients already receiving adjunct entacapone to traditional levodopa were switched to Stalevo (levodopa/carbidopa/entacapone). RESULTS: The switch to Stalevo was straightforward for most patients taking standard-release levodopa with 86% of these patients being able to replace their entire regimen without having to change the amount of levodopa taken. The majority of patients (54%, P = 0.162) preferred Stalevo; 31% preferred their prior treatment regimen; 15% had no preference. Patients found Stalevo more simple to dose (94%), more convenient to use (84%), easier to handle (84%), easier to remember (67%) and easier to swallow (59%), compared with their previous medication. CONCLUSIONS: Stalevo was well tolerated, with a low incidence of adverse events. The study shows that Stalevo is an effective, preferred and well-tolerated means of delivering levodopa/carbidopa/entacapone in one easy-to-use tablet.

Adult↗
PubMed2004

Cardiovascular autonomic dysfunction correlates with brain MRI lesion load in MS.

OBJECTIVE: The aim of the present study was to investigate the cardiovascular autonomic control in clinically definite multiple sclerosis (MS) patients with a standardised battery of cardiovascular tests and to correlate these findings with the brain magnetic resonance imaging (MRI) lesion load. METHODS: Fifty-one patients with MS and 50 healthy controls were studied. Brain MRI was performed in all patients showing typical MS lesions. The cardiovascular tests were carried out using a standardised battery. RESULTS: Heart rate (HR) responses to deep breathing (P < 0.05) and tilt table testing (P < 0.001) were significantly decreased in MS patients when compared to those of the controls. Blood pressure (BP) responses in the tilt table test were also impaired in MS patients (diastolic P < 0.001, systolic P < 0.05). Of the different brain areas investigated the total volume of the midbrain MRI lesions (P < 0.05) was the one most clearly associated with the impaired BP responses. CONCLUSIONS: MS results in both reduced HR variation and decreased BP reactions indicating disturbed cardiovascular regulation. In particular, the midbrain lesions found in MS are associated with cardiovascular dysfunction.

Adult↗
PubMed2000

Heart rate variability in patients with untreated Parkinson's disease.

The aim of this study was to evaluate cardiovascular responses as a marker of autonomic nervous system (ANS) disturbances in patients with untreated Parkinson's disease (PD) and to assess the relationship between them and the clinical characteristics of PD. The ANS functions were investigated in 50 patients with PD and 55 healthy subjects by measuring standard cardiovascular autonomic reflexes and heart rate variability (HRV) at rest using spectral analysis (the autoregressive model and the fast Fourier transformation), the percentage of the counts of beat-to-beat variation greater than 50 ms and the fractal dimension. Significantly attenuated HRV and deficient blood pressure reaction to tilting were found in the PD patient group. The patients with hypokinesia/rigidity as the initial symptom of PD had a more pronounced HRV deficit than those with tremor onset. Untreated PD patients suffer significant failure in cardiovascular nervous system regulation, and in patients with hypokinesia/rigidity as their initial disease manifestation the risk of this ANS dysfunction is high. However, in the early stages of PD these changes did not reach significance at individual level.

Adult↗
PubMed1999

Founder mutations and the high prevalence of myotonia congenita in northern Finland.

OBJECTIVE AND BACKGROUND: To find an explanation at the molecular level for the high prevalence of myotonia congenita in northern Finland and the exceptional pattern of inheritance of the disease in many families, and to study genotype-phenotype correlation in the patients. METHODS: Forty-six patients with myotonia congenita and 16 unaffected relatives from 24 families were studied. All 23 exons and their flanking regions of the gene for the chloride channel protein (ClC-1) were sequenced from at least one patient from all families. RESULTS: There were three different mutations of ClC-1 in the patients: one in exon 11, a T-to-G transversion that resulted in the substitution of cysteine for phenylalanine at amino acid position 413 (F413C); one in exon 15, a C-to-T transition that resulted in the substitution of valine for alanine at amino acid position 531 (A531V); and one in exon 23, a C-to-T transition that resulted in the substitution of a stop codon for an arginine codon at amino acid position 894 (R894X). CONCLUSIONS: Molecular studies showed that even in families with apparent dominant inheritance, the actual mode of inheritance was autosomal recessive. This was explained not only by the observed consanguinity in some families but by an enrichment of three different mutations of the ClC-1 gene and a consequent high number of compound heterozygotes in the population. One of the mutations is unique to northern Finland. The conspicuous enrichment of the mutations is likely due to the founder effect and isolation by distance, as in other diseases in the Finnish heritage.

Adolescent↗
PubMed1998

Safety of selegiline (deprenyl) in the treatment of Parkinson's disease.

Selegiline (deprenyl), a selective, irreversible inhibitor of monoamine oxidase type B (MAO-B) is widely used in the treatment of Parkinson's disease. As the first MAO-B inhibitor approved for the treatment of Parkinson's disease, concerns were raised about the safety of the drug based on the adverse effect profiles of older, nonselective MAO inhibitors. Unlike the nonselective MAO inhibitors, selegiline does not significantly potentiate tyramine-induced hypertension (the 'cheese effect') at the dosages (5 to 10 mg daily) used for the treatment of Parkinson's disease. Selegiline has been well tolerated when given alone. The most frequent adverse events seen during monotherapy have been insomnia, nausea, benign cardiac arrhythmias, dizziness and headache. When combined with levodopa, selegiline can potentiate the typical adverse effects of levodopa, if the dose of levodopa is not reduced sufficiently. Thus, the most common adverse effects associated with this combination are nausea, dizziness, fatigue, constipation and insomnia. At the later stages of Parkinson's disease when fluctuations in disability occur, peak dose dyskinesias, psychiatric complications like hallucinations and insomnia, and orthostatic hypotension are further potentiated by selegiline. Mortality was recently reported to be increased when selegiline and levodopa were given together in comparison with treatment with levodopa alone, but a large meta-analysis of 5 long term studies and 4 separate studies did not support this conclusion. Selegiline seems to be generally well tolerated in combination with other drugs. However, when pethidine (meperidine) has been given to patients who are receiving selegiline therapy, severe adverse effects have been reported. Thus, the concomitant use of these drugs is not recommended. A low tyramine diet is recommended if selegiline is used together with nonselective MAO inhibitors or the selective, reversible MAO-A inhibitor, moclobemide. Several adverse effects have been reported when fluoxetine and selegiline have been used together. A recent survey revealed that the incidence of a true serotonin syndrome is, however, very low with this combination. Concomitant use of selegiline and other selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs) like citalopram, which have generally less interactions than fluoxetine, seems to be well tolerated. Nevertheless, caution is advised when combining a SSRI or a tricyclic antidepressant and selegiline.

Antiparkinson Agents↗
PubMed1997

Myelitis associated with influenza A virus infection.

We report a patient presenting with myelitis after respiratory symptoms. A high level of antibodies to influenza A virus was measured in serum and cerebrospinal fluid (CSF), and the serum/CSF antibody ratio was 1.7, suggesting specific antibody production in the central nervous system. Magnetic resonance imaging of the spinal canal showed a contrast-enhanced swelling on the cervical medulla. Such a case would have warranted the use of antiviral therapy and calls to mind the neurotropic potential of influenza A viruses.

Antibodies, Viral↗
PubMed1996

Duplex US of the external carotid artery.

The ratio between the systolic peak velocities of the internal and common carotid arteries (vpICA/vpCCA), vpICA and grey-scale imaging measurement are generally used to evaluate internal carotid stenosis against known flow criteria in order to differentiate non-significant from significant stenosis. The same criteria are also used for evaluating the external carotid artery (ECA). Our data on 707 normal or stenotic ECA nevertheless showed that the systolic peak velocity of the normal ECA (vpECA) and its ratio to the systolic velocity of the CCA (vpECA/vpCCA) are higher than vpICA and vpICA/vpCCA. vpECA/vpCCA is about 2 in > 0-49% ECA stenosis. Only in severe stenosis are the peak velocities almost comparable. The ratio between the peak end diastolic velocities (edvECA/edvCCA) and edvECA proved to be unreliable, as did grey-scale imaging measurement of the external carotid stenosis. In addition, ipsi-lateral internal carotid stenosis greatly affects the non-stenotic external carotid flow values, and probably has the same effect on the flow values of a stenotic external artery. Thus, external carotid flow values must be considered carefully.

Adult↗
PubMed1996

The value of herniography in the diagnosis of unexplained groin pain.

Herniographies were performed on 106 outpatients with obscure groin pain. A total of 39 hernias were found in 38 patients (36%) and the 46 patients either operated on (40 patients) or who had undergone laparoscopy (six patients), included one false positive and two false negative ones. All three cases were inpatients who had earlier undergone surgery for inguinal hernia 27% of the patients with a normal clinical finding (19/70), 67% of those with previous inguinal herniotomy (8/12) and 50% of those with symptoms suggestive of hernia (12/24) had diagnostic findings on herniography. Thirteen out of the 48 women (27%) and 25 of the 58 men (43%) had positive finding at herniography. The valve of herniography was that 56 patients were spared subsequent surgical exploration because of normal herniographic finding. Our results indicate that herniography is a useful tool for the examination of patients with unexplained groin pain.

Adult↗
PubMed1995

Myotonia congenita: quantitation of different aspects of motor performance.

In order to quantitatively assess the motor performance characteristics of 14 patients with congenital myotonia, the reaction time, speed of movement, synergy of different muscle groups and accuracy were measured. The Human Performance Measurement/Basic Elements of Performance device was used for recordings. Warned simple and choice reaction times (SRT, CRT) were significantly longer in the myotonic patients than in the controls. SRTs, consisting of one constant visual stimulus followed by a single movement response of the upper extremities (patients vs. controls) were 218 +/- 48 ms (mean +/- SD) and 172 +/- 12 (p = 0.0038). In the lower extremities the corresponding results were 293 +/- 46 and 239 +/- 24 (p = 0.0018). 1-CRTs, consisting of the upper extremities response to one randomized light signal (patients vs. controls) were 265 +/- 45 and 218 +/- 26 (p = 0.0069), and those of the lower extremities 337 +/- 73 and 279 +/- 39 (p = 0.0107), respectively. 2-CRTs, consisting of two possible visual stimuli in randomized order followed by a movement response of the upper extremities (patients vs. controls), were 308 +/- 54 and 249 +/- 33 (p = 0.0018), and those of the lower extremities 387 /+- 53 and 323 /+- 46 (p = 0.0028), respectively. We did not find any significant difference between the patient and the control groups in speed of movement, synergy of different muscle groups or accuracy. Nor was any significant correlation between the motor performance disability and the disease severity found.

Adult↗
PubMed1992

Autotraction stress roentgenography for demonstration anterior and inferior instability of the shoulder joint.

A form of stress roentgenography is presented for the diagnosis of anterior and inferior shoulder instabilities. Stress is induced by anterioinferior traction concentrated on the shoulder during extension of the flexed hip, when patients hold their legs on the side being examined, with both hands. The anterior and inferior shifts of the humeral head in relation to the glenoid fossa then are measured from anteroposterior and modified axillary roentgenograms. This method was employed in 16 shoulders with recurrent anterior dislocation, 11 recurrent anterior subluxations, nine multidirectional instabilities, and 19 control shoulders. Mean anterior translations were 3 mm and 5 mm, and inferior translations were 7 mm and 10 mm for the control and recurrent dislocation groups, respectively. There were statistically no significant differences between those groups. In the recurrent anterior subluxations, the corresponding translations were of a completely different order, 21 mm and 19 mm, respectively, allowing the distinction from the controls and recurrent anterior dislocations in most cases. The shifts found in multidirectional instabilities, averaging 27 mm and 26 mm, respectively, were significantly greater than for the recurrent subluxations, but the differences were not great enough for accurate differential diagnosis in individual cases. Autotraction stress roentgenography of the shoulder may be of use in the diagnosis of recurrent anterior subluxations and anteroinferior multidirectional instabilities. It also gives good general views of the looseness of the glenohumeral joint.

Adolescent↗
PubMed1991

Aminoterminal propeptide of type III procollagen in cerebrospinal fluid. Variation with age and in childhood leukemia.

Analyses of the aminoterminal propeptide of type III procollagen (PIIINP) in the cerebrospinal fluid (CSF) of 55 children and five young adults without any structural central nervous system (CNS) lesion are reported. The concentration was age-dependent, in that infants and small children had quite high values, whereas the concentration remained relatively constant after the age of 1.5 years. The concentrations of PIIINP in the CSF of 44 children with acute lymphoblastic leukemia (ALL) were prospectively determined at the time of diagnosis and during treatment, since deposition of type III collagen is known to occur during fibroproliferative responses triggered by inflammation. Chemical arachnoiditis is known to be associated with intrathecal methotrexate therapy in children with leukemia. The mean concentration in these children at diagnosis (5.8 micrograms/l +/- SD 2.8 micrograms/l) did not differ from that in age-matched controls (6.7 micrograms/l +/- SD 3.2 micrograms/l). Depending on type of the disease, the children were treated according to two different protocols. PIIINP concentrations were significantly higher during the therapy phases which included intrathecally administered methotrexate (P less than 0.001) than at diagnosis of the disease. Corticosteroid treatments were always associated with a significant decrease in PIIINP concentrations (P less than 0.01 and P less than 0.001 in the two groups, respectively), irrespective of the therapy phase. The results suggest that an increase in PIIINP concentration in the CSF of children with ALL is an indicator of a fibroproliferative response in the arachnoid. Corticosteroids may repress this response and possibly also prevent the development of adhesions in the arachnoid.

Adolescent↗