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Biomedical subjects

M Erkintalo

Publications and source records attributed to M Erkintalo.

At least 19 recordsLinked to original sources
PubMed2007

Adolescent disc degeneration--no headache association.

The objective of the study was to determine whether adolescents with headache have more disc degeneration in the cervical spine than headache-free controls. This study is part of a population-based follow-up study of adolescents with and without headache. At the age of 17 years, adolescents with headache at least three times a month (N = 47) and adolescents with no headache (N = 22) participated in a magnetic resonance imaging (MRI) study of the cervical spine. Of the 47 headache sufferers, 17 also had weekly neck pain and 30 had neck pain less than once a month. MRI scans were interpreted independently by three neuroradiologists. Disc degeneration was found in 67% of participants, with no difference between adolescents with and without headache. Most of the degenerative changes were located in the lower cervical spine. In adolescence, mild degenerative changes of the cervical spine are surprisingly common but do not contribute to headache.

Adolescent↗
PubMed2001

Association between decreased disc signal intensity in preoperative T2-weighted MRI and a 5-year outcome after lumbar minimally invasive discectomy.

A total of 39 patients who had undergone microdiscectomy or percutaneous nucleotomy for lumbar disc herniation were examined after a follow-up of 5 years. The overall outcome was satisfactory in 80% of the patients treated, and only 1 (3%) patient had been reoperated during the follow-up. Clinical signs and symptoms of lumbar instability were detected in 10 (26%) patients. All these 39 patients had been examined with lumbar magnetic resonance imaging (MRI) on the day preceding the operation; the presence of disc degeneration was graded as severe, mild or non-existent depending on the visual brightness of the discs on T2-weighted images, as compared to the signal intensity of the lumbar vertebrae. None of the 12 patients with no preoperative disc degeneration in MRI suffered from postoperative clinical signs and symptoms of instability as compared to 10 (37%) of the 27 patients with mild or severe disc degeneration suffering from instability (p = 0.04). Thus, the results of the present study imply that the grade of the disc degeneration in preoperative T2-weighted MR images significantly predicted the occurrence of postoperative clinical instability.

Aged↗
PubMed1999

Central nervous system involvement in gyrate atrophy of the choroid and retina with hyperornithinaemia.

In gyrate atrophy of the choroid and retina with hyperornithinaemia (GA), a genetically determined deficiency of ornithine delta-aminotransferase activity leads to high ornithine concentrations in body fluids. GA is characterized by centripetally progressing retinal and choroidal destruction and selective atrophy with tubular aggregates in type II skeletal muscle fibres. These findings have been suggested to be mediated by hyperornithinaemia-induced deficiency of high-energy creatine phosphate. As abnormal brain magnetic resonance images and electroencephalograms are found in another disorder of creatine metabolism, guanidinoacetate methyltransferase deficiency, we investigated the central nervous system involvement in GA, which seems to be associated with a milder degree of phosphocreatine deficiency. We compared 23 untreated GA patients with age-matched healthy controls, and with 9 patients who had received creatine or creatine precursor supplementation daily for several years. The mean age of the patients (32 +/- 18 years) was similar to that of the controls (36 +/- 22 years). The MRI or EEG findings of the patients on creatine supplementation did not differ from those of the untreated group. Brain MRI revealed degenerative lesions in the white matter in 50% of the GA patients, and 70% of the patients had premature atrophic changes, with a striking increase in the number of Virchow's spaces. Of the patients whose EEG was recorded, 58% had abnormal slow background activity, focal lesions or high-amplitude beta rhythm (> 50 microV). The EEG findings were not associated with the MRI changes or with the age or the sex of the patients. Early degenerative and atrophic brain changes and abnormal EEG are thus features of GA, in addition to the well-characterized eye and muscle manifestations.

Adolescent↗
PubMed1999

Muscle creatine phosphate in gyrate atrophy of the choroid and retina with hyperornithinaemia--clues to pathogenesis.

BACKGROUND: In gyrate atrophy of the choroid and retina with hyperornithinaemia (GA), inherited deficiency of ornithine-o-aminotransferase leads to progressive fundus destruction and atrophy of type II skeletal muscle fibres. Because high ornithine concentrations inhibit creatine biosynthesis, the ensuing deficiency of high-energy creatine phosphate may mediate the pathogenesis. MATERIALS AND METHODS: Relative concentrations of inorganic phosphate (Pi), creatine phosphate (PCr) and ATP in resting calf muscle were recorded in 23 GA patients and 33 control subjects using 31P-magnetic resonance spectroscopy (MRS). Eight patients with autosomal recessive retinitis pigmentosa with matched control subjects constituted an additional reference group. RESULTS: The PCr/Pi and PCr/ATP ratios (means +/- SD) were lower for the GA patients than for healthy control subjects [4.66 +/- 0.37 vs. 9.75 +/- 2.17 (P < 0.0001) and 2.85 +/- 0.37 vs. 3.70 +/- 0.50 (P < 0.05) respectively]. In retinitis pigmentosa the respective values were 9.12 +/- 2.57 and 4.25 +/- 0.45. Age and stage of the disease had no effect. CONCLUSION: Muscle 31P-MRS spectra were markedly abnormal in all GA patients.

Adenosine Triphosphate↗
PubMed1999

Creatine corrects muscle 31P spectrum in gyrate atrophy with hyperornithinaemia.

BACKGROUND: Eye fundus destruction and type II muscle fiber atrophy in gyrate atrophy of the choroid and retina with hyperornithinaemia (GA) may be mediated by elevated ornithine concentrations which strongly inhibit creatine biosynthesis. This results in deficiency of creatine phosphate (PCr), a key intracellular energy source, as we have demonstrated in skeletal muscle of the patients by 31P magnetic resonance spectroscopy (31P MRS). MATERIALS AND METHODS: Possible correction of the relative PCr deficiency by long-term daily exogenous supplementation of creatine or its precursors was investigated in four GA patients receiving creatine and in five patients treated with guanidinoacetic acid-methionine combination. The relative PCr concentration, expressed as PCr/Pi (Pi; inorganic phosphate) or as PCr/ATP ratios, was compared with the values of untreated GA patients, and matched healthy volunteers. RESULTS: Muscle PCr/Pi ratios (mean +/- SD) of the untreated and creatine supplemented GA patients and controls were 4.9 +/- 1.4, 7.9 +/- 0.4 and 8.4 +/- 1.3. Guanidinoacetate-methionine combination was similarly effective (respective PCr/Pi ratios: 4.9 +/- 0.7, 6.3 +/- 1.1 and 10.7 +/- 2.8). CONCLUSION: Supplementation with creatine or creatine precursors almost normalised low muscle PCr/Pi ratios of patients with GA.

Adolescent↗
PubMed1998

Back extensor and psoas muscle cross-sectional area, prior physical training, and trunk muscle strength--a longitudinal study in adolescent girls.

The association between physical training, low back extensor (erector spinae plus multifidus muscles) and psoas muscle cross-sectional areas (CSA) and strength characteristics of trunk extension and flexion were studied in adolescent girls. A group of athletes (n = 49) (age range 13.7-16.3 years) consisting of gymnasts, figure skaters and ballet dancers was age-matched with non-athletes (n = 17) who acted as a sedentary control group. The CSA of psoas muscles and multifidus plus erector spinae muscles were measured from lumbar axial images by magnetic resonance imaging. Maximal trunk extension and flexion forces were measured in a standing position using a dynamometer and trunk musculature endurance was evaluated using static holding tests. When CSA were adjusted with body mass, the athletes showed significantly greater CSA in both muscles studied (psoas P < 0.001; erector spinae plus multifidus P < 0.05) than the non-athletes. The athletes also had a greater absolute psoas muscle CSA (P < 0.01) and trunk flexion force (P < 0.01) compared to the controls. When the forces were expressed relative to body mass, the athletes were superior both in trunk flexion (P < 0.001) and extension (P < 0.001). There was a significant correlation between muscle CSA and strength parameters, but the force per muscle CSA did not differ significantly between the athletes and the non-athletes. In addition, the athletes showed a better body mass adjusted muscle endurance in trunk flexion (P < 0.05) than the non-athletes. Our study indicated that regular physical training enhances trunk musculature hypertrophy, force and endurance in adolescent girls, and that there is an association between muscle CSA and strength parameters.

Adolescent↗
PubMed1998

Reduced metabolic efficiency of skeletal muscle energetics in hyperthyroid patients evidenced quantitatively by in vivo phosphorus-31 magnetic resonance spectroscopy.

Skeletal muscle energetics of seven hyperthyroid patients were investigated throughout a rest-exercise-recovery protocol using phosphorus-31 magnetic resonance spectroscopy (31P MRS) to quantitatively document in vivo the metabolic bases of impaired muscle performance in hyperthyroidism. The contributions of the main pathways of adenosine triphosphate (ATP) synthesis to energy production and proton efflux were measured and compared with results from normal muscle. At rest, a reduced concentration of phosphocreatine (PCr) was calculated for hyperthyroid patients when compared with controls, whereas pH and concentrations of inorganic phosphate (Pi) and phosphomonoesters (PME) were not different from controls. During exercise, the analysis of changes in pH and PCr concentration demonstrated that (1) at the onset of exercise, the magnitude of glycolysis activation is significantly larger for patients, resulting in a marked pH decrease; (2) the energy cost of exercise is higher for patients as compared with controls performing the same amount of work; and (3) both anaerobic and aerobic pathways are significantly more activated in the hyperthyroid group throughout the 3 minutes of exercise. During recovery, the rates of proton efflux and PCr resynthesis were similar in both groups, excluding any alteration in oxidative function and proton handling as a cause of initial glycolytic hyperactivation. The increased energy cost measured for patients during exercise evidences an increased need for energy, which is (1) probably linked to the existence of additional ATP-consuming mechanism(s), and (2) supported by hyperactivation of both aerobic and anaerobic pathways. These findings imply that, all things equal, a hyperthyroid muscle requires more energy to function than normal, and as a result is potentially more fatiguable.

Adolescent↗
PubMed1997

P-31 magnetic resonance spectroscopy demonstrates unaltered muscle energy utilization in polymyalgia rheumatica.

OBJECTIVE: To characterize muscle metabolic anomalies associated with polymyalgia rheumatica (PMR) using P-31 magnetic resonance spectroscopy (MRS). METHODS: Seventeen patients with PMR and 9 age-matched control subjects were investigated. The forearm flexor muscles were examined by P-31 MRS in a 4.7 T superconducting horizontal magnet (Biospec Bruker 47/30) during a rest-exercise-recovery protocol. The intracellular pH and the relative concentrations of phosphocreatine (PCr), inorganic phosphate (Pi), ATP, and phosphomonoesters were measured every minute during the protocol. Based on the PCr and pH time-dependent changes during exercise and recovery, the rates of ATP production from PCr hydrolysis, glycogenolysis, and aerobic metabolism were calculated for each minute of exercise. RESULTS: At rest, the metabolic parameters [PCr]:[Pi], pH, and [PCr]:[ATP] were not significantly different between the PMR patients and the control subjects. During exercise, the energetic cost and the contribution of anaerobic and oxidative pathways to energy supply were similar in the 2 groups, as were the recovery kinetics of the phosphorylated compounds and pH. CONCLUSION: Muscle MRS does not confirm the findings of histologic and biochemical studies that suggest an alteration of mitochondrial function in PMR. No other modifications in glycolytic or glycogenolytic pathways or in proton handling were found that could indicate an alteration of muscle energetics in patients with PMR.

Adenosine Triphosphate↗
PubMed1997

Age-dependent correlation of low-back pain and lumbar disc regeneration.

The prevalence of lumbar disc degeneration in subjects suffering from low-back pain (n = 207; age range 10-49 years) and in age-matched asymptomatic controls (n = 216) was investigated by magnetic resonance imaging. The percentage of subjects with degenerated discs increased with age; starting from the age of 15 years, this increase was more rapid in subjects with low-back pain. Concurrently, the number of degenerated discs was higher in the pain group than in controls. Lumbar disc degeneration manifests earlier and in a greater percentage of subjects with low-back pain than in asymptomatic controls.

Adolescent↗
PubMed1996

Low-back pain in adolescent athletes.

In this 3-yr longitudinal study we investigated the occurrence of low-back pain and anatomic changes in the low back in relation to loading and injuries among 98 adolescents: 33 nonathletes (16 boys, 17 girls), 34 boy athletes (17 ice hockey, 17 soccer players), and 31 girl athletes (17 figure skaters, 14 gymnasts). During the 3-yr follow-up, low-back pain lasting longer than 1 wk was reported by 29 (45%; 95% CI, 32%-57%) athletes and by 6 (18%; 95% CI, 7%-35%) nonathletes (P = 0.0099). Acute back injury was reported by 17 of 19 subjects who also reported low-back pain (89%; 95% CI, 67%-99%) and by 2 of 63 of those without prolonged low-back pain (3%; 95% CI, 0%-11%) (P < 0.0001). Among 43 girls participating in baseline and follow-up MRI examinations of the lumbar spine, new MRI abnormalities were found in 6 of 8 reporting acute back injury (75%; 95% CI, 35%-97%) and in 8 of the remaining 35 girls (23%; 95% CI 10% to 40%) (P = 0.018). In conclusion, excessive loading that involves a risk for acute low-back injuries during the growth spurt is harmful to the lower back.

Adolescent↗
PubMed1995

Low back pain in the young. A prospective three-year follow-up study of subjects with and without low back pain.

STUDY DESIGN: This was a prospective 3-year follow-up study of randomized matched subgroups of 15-year-old school children with or without low back pain initially. OBJECTIVE: In addition to low back pain and leisure time physical activity, spinal mobility, trunk muscle strength, and early degenerative findings of the lumbar spine were evaluated. SUMMARY OF BACKGROUND DATA: Reliable epidemiologic studies on the prevalence of low back pain and development of early degenerative changes of the lumbar spine in young persons have been sparse. Along with several other characteristics, the relationship of these changes to frequent low back pain in young persons is not known. METHODS: After a questionnaire-based survey was administered, subjects with or without low back pain were examined initially and at follow-up with special reference to leisure time physical activity, anthropometry, spinal mobility, trunk muscle strength, and magnetic resonance imaging findings of the lumbar spine. RESULTS: At baseline and at follow-up, those subjects with initial low back pain were characterized by a low frequency of physical activity and decreased spinal function. During follow-up, the occurrence of disc degeneration increased significantly more in the original group with low back pain than among asymptomatic subjects. Furthermore, disc degeneration at baseline significantly predicted future frequent low back pain. Initial disc protrusion also predicted future frequent low back pain. CONCLUSION: After the rapid physical growth period, there seemed to be a causal relationship between the early evolution of the degenerative processes of the lower lumbar discs and frequent low back pain in several subjects.

Adolescent↗
PubMed1994

Diurnal fluid changes of lumbar discs measured indirectly by magnetic resonance imaging.

The feasibility of magnetic resonance imaging and the magnetization transfer technique for measurement of diurnal fluid changes in lumbar discs was studied with the use of 13 healthy subjects. The diurnal height loss of the subjects ranged from 13 to 21 mm. The disc signal in T2-weighted magnetic resonance imaging increased as much as 25% after overnight bed rest, presumably due to the enhanced influx of water. The change in magnetization transfer parameters also suggested increased hydration of the disc after bed rest. Magnetic resonance imaging techniques can be used for indirect measurement of the changes in fluid content and the interaction of water with macromolecules in the disc.

Adult↗
PubMed1994

Magnetic resonance image changes and clinical outcome after microdiscectomy or nucleotomy for ruptured disc.

Preoperative and postoperative magnetic resonance imaging (MRI) of the lumbar spine was performed on 41 patients treated either microsurgically or with percutaneous nucleotomy for lumbar disc herniation. On the first postoperative day, MRI revealed an edematous mass effect at the level of surgery in 25 (61%) patients. The mass effect caused compression of the anterior dural sac mimicking preoperative disc herniation. After the follow-up of 6 months, the mass effect had disappeared in all patients, and the MRI finding in the operated disc space was that of a prolapse in six (15%) patients and that of a protrusion in 16 (39%) patients. Postoperative scarring was detected in 23 (56%) patients. The amount of the epidural scar tissue was significantly (p = 0.0002) associated with the extent of the early postoperative hemorrhagic changes detected in these patients with MRI. No association was observed between these MRI findings (mass effect, disc herniation, epidural scarring) and the clinical outcome of the patients.

Adult↗
PubMed1994

Postoperative hematomas after successful lumbar microdiscectomy or percutaneous nucleotomy: a magnetic resonance imaging study.

We evaluated the incidence of postoperative extradural hematomas by means of magnetic resonance imaging (MRI) technique in 44 patients who underwent successful surgery for a virgin lumbar disc herniation. Of these patients, 28 were treated with microdiscectomy and 16 with percutaneous nucleotomy. Postoperative hematoma proved to be a universal MRI finding in the microsurgically treated patients: hematomas were found in all patients in the microdiscectomy group. In 12 (43%) patients the hematoma extended into the dural sack. The incidence of hematomas was significantly (p = 0.001) lower in the patients treated with percutaneous nucleotomy: hematomas were detected in only 10 (63%) of the 16 patients in the nucleotomy group. The hematomas in these patients were also smaller in size and none of them connected with the dural sac. Correlation between the hematomas and clinical findings showed that the presence of a hematoma had no obvious effect on the immediate postoperative recovery of a patient.

Adult↗
PubMed1989

Disc degeneration in Scheuermann disease.

Comparison of the radiographic signs of Scheuermann disease and the corresponding disc degeneration on thoracolumbar magnetic resonance (MR) images was made in 21 young patients. Marginal sclerosis, Schmorl nodes and narrowed disc spaces, but not irregular or wedge-shaped end-plates, were significantly associated with disc degeneration. Fifty-five percent of the discs in the patients with Scheuermann disease were abnormal on MRI, compared with 10% in asymptomatic controls. Our study confirms that thoracolumbar disc degeneration is enhanced in 20-year-old patients with low back pain who have radiological evidence of Scheuermann disease.

Adolescent↗
PubMed1989

Magnetic resonance study of disc degeneration in young low-back pain patients.

The correlation of roentgenographic findings, clinical history, and incipient disc degeneration (DD), diagnosed with magnetic resonance imaging, was analyzed in young patients with low-back pain (LBP). One or more lumbar discs were abnormal in 57% of the 20-year-old LBP patients (n = 75) and in 35% of the asymptomatic controls (n = 34) in MRI. Narrowed disc spaces and alterations attributed to lumbar Scheuermann's disease, shown on the radiographs, were always associated with DD in MRI. Such a strong relationship was not observed with transitional vertebrae, spondylolisthesis, spina bifida, or postural abnormalities. However, an increased weight, a positive straight leg raising test, and a reduced lumbar mobility was consistent with an increase in frequency of DD. Magnetic resonance imaging is a safe and sensitive method for studying the presence and etiologic factors of DD.

Adult↗