PubMed Health⌕ Search

Biomedical subjects

R Raininko

Publications and source records attributed to R Raininko.

At least 73 records · Page 4Linked to original sources
PubMed1993

White matter changes in healthy elderly persons correlate with attention and speed of mental processing.

OBJECTIVE: To evaluate the association between white matter changes (leukoaraiosis [LA]) seen on magnetic resonance imaging and cognitive functions. DESIGN: Survey of cohorts of neurologically healthy elderly subjects derived consecutively from a population-based random sample. SETTING: General community, the Helsinki (Finland) Aging Brain Study. SUBJECTS: Cohorts of neurologically healthy subjects aged 55, 60, 65, 70, 75, 80, and 85 years (n = 20, 18, 19, 18, 17, 17 and 11 subjects, respectively; total N = 120). MEASURES: Leukoaraiosis was rated in the periventricular areas (0 to 24) and the centrum semiovale (0 to 24); also, a total LA score was obtained (0 to 48). The neuropsychological test battery covered memory, verbal intellectual and constructional functions, language, speed and attention, and speed of mental processing, as well as simple psychomotor speed. RESULTS: Low age-related LA scores and deterioration of cognitive functions were obtained in the normal subjects. When controlling for age, we found that speed and attention, together with the speed of mental processing measured by the Trail Making A and the Stroop tests, correlated with the total LA score. However, there was wide variation between subjects. Comparing groups with and without LA proved the association of LA with Trail Making A time, Stroop test result (words/time and difference/time), and the compound score of speed and attention. Presence of periventricular LA was especially related to speed of mental processing. CONCLUSION: Leukoaraiosis could explain some of the intellectual impairment in the elderly, especially that of slowing of distinct motor and attentional functions, as well as slowing of mental processing. Mild LA in normal aged subjects could also signal brain at risk for further cognitive impairment.

Aged↗
PubMed1993

Is the signal intensity of cerebrospinal fluid constant? Intensity measurements with high and low field magnetic resonance imagers.

The signal intensity of cerebrospinal fluid (CSF) was studied by measuring the intensity of nine samples of CSF using various routine pulse sequences with 1.0 T and 0.1 T magnetic resonance imagers. The observed signal intensity differences between the CSF samples were small, as were the differences between the CSF samples and distilled water, although two of the samples were pathological with an elevated protein content. Signal intensity did not correlate with the protein content, and the location of the sample in the coil (head coils were used) caused more variation in the results than did the composition of the sample. The same results were obtained with both imagers. Our results suggest that CSF may be suitable for an intensity reference in routine patient studies in regions where the flow and pulsatile movement of CSF are slow enough not to affect the signal intensity, but further studies are needed to determine such regions in the CSF system.

Cerebrospinal Fluid↗
PubMed1993

Cognitive performance in HIV-1 infection: relationship to severity of disease and brain atrophy.

We examined cognitive performance in 72 HIV-1 infected patients and 34 controls. None of the patients had opportunistic infections or unusual neoplasms of the central nervous system (CNS). Factors other than HIV-1 known to cause cognitive decline were excluded from both groups. Cognitive functioning analysed with special emphasis on the severity of HIV infection was related to neuroradiological and immunological findings. In patients with AIDS-related complex (CDC IVa) or AIDS (CDC IVc,d), a deterioration of memory as well as cognitive speed and flexibility was detected. Furthermore, memory deficits were associated with central cerebral and infratentorial atrophy in those patients, while no association was found between cognitive deficits and immunological abnormalities. Patients at CDC stages II or III showed slight association between altered cognitive speed and flexibility and elevated leukocyte count, suggesting a subclinical CNS disease already at early stages of HIV infection.

AIDS Dementia Complex↗
PubMed1993

CSF follow-up in HIV-1 infection: intrathecal production of HIV-specific and unspecific IGG, and beta-2-microglobulin increase with duration of HIV-1 infection.

Ninety-nine sequential cerebrospinal fluid (CSF) samples from 28 human immunodeficiency virus-1 (HIV-1)-infected patients were analyzed during the follow-up of 9 months to 4 years. Intrathecal synthesis of HIV-antibodies and IgG (p < 0.01), and the levels of beta-2-microglobulin (beta 2m) in the CSF (p < 0.05) and serum (p < 0.01) increased with duration of HIV-1 infection. No effect of duration of HIV-1 infection was observed on the individual CSF white cell counts and the levels of blood-brain-barrier (BBB) permeability. In 13 patients with HIV-1-associated central nervous system (CNS) disease, the effect of duration was seen as an increase of the individual beta 2m levels in serum (p < 0.01). Moreover, 7 of 9 patients who developed neurological disease or showed its progression during the study increased the level of beta 2m in the CSF. All of them increased the level of beta 2m in serum. In 15 neurologically healthy subjects, the effect of duration was expressed as an increase of the level of individual beta 2m in CSF (p < 0.05) and intrathecal IgG synthesis (p < 0.01). In the AIDS group, the level of beta 2m in the CSF increased, but in less severe stages the dependency of the individual CSF parameters on disease duration was not found. Our results indicate that elevated levels of beta 2m in CSF and serum appear to predict progression of neurological and systemic diseases, respectively. Elevated beta 2m in the CSF of clinically intact individuals may indicate subclinical neurological disease caused by HIV-1.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS Dementia Complex↗
PubMed1993

Magnetic resonance imaging findings associated with cardiac arrest.

BACKGROUND AND PURPOSE: The frequency and prognostic significance of neuroradiological findings after cardiac arrest are unknown. Using healthy volunteers as control subjects, we studied the magnetic resonance imaging (MRI) findings associated with cardiac arrest, adjusted for confounding factors. METHODS: The presence of cerebral infarcts, leukoaraiosis, atrophy, and edema on ultra-low-field MRI was assessed in 88 community volunteers and 52 cardiac arrest survivors enrolled in a placebo-controlled, randomized, double-blind trial of nimodipine in out-of-hospital ventricular fibrillation. RESULTS: Cardiac arrest was an independent risk factor for the presence of infarcts in a logistic regression model adjusted for age, sex, and history of myocardial infarction, stroke, coronary heart disease, cardiac failure, and hypertension (odds ratio, 3.6; 95% confidence interval, 1.3 to 9.9; P = .01). Leukoaraiosis was associated with increasing age but not with cardiac arrest. Adjusted for age, the delay of advanced life support had an inverse correlation with the degree of atrophy in placebo-treated patients (r = -.62, P < .0001) but not in patients treated with nimodipine (r = -.10, P = .43). Lack of age-related atrophy, possibly implicating the presence of brain edema, predicted poor outcome after cardiac arrest (odds ratio, 4.6; 95% confidence interval, 1.4 to 15.8; P = .01). CONCLUSIONS: Cardiac arrest was associated with deep cerebral infarcts but not with leukoaraiosis. MRI findings did not predict the functional outcome at 1 year. Nimodipine treatment had no significant effect on the MRI findings, but delayed resuscitation was associated with probable brain edema only in placebo-treated patients.

Adult↗
PubMed1993

Risk factors for cervical atherosclerosis in patients with transient ischemic attack or minor ischemic stroke.

BACKGROUND AND PURPOSE: Our purpose was to study potential determinants of the presence and the severity of cervical atherosclerosis in patients with transient ischemic attack or minor ischemic stroke. METHODS: Two hundred ninety-four patients up to 60 years of age were included in this cross-sectional study. The male to female ratio was 171/123. Atherosclerosis was defined as the presence of any visible atherosclerotic lesion in anteroposterior or left oblique views of cervical arteries in aortic arch angiograms. The severity of atherosclerosis was assessed using three scores, which were computed separately for the total thickness and length of all plaques as well as for the percent stenosis of the vessels. RESULTS: Atherosclerosis was present in 180 patients (61.2%). In a multiple stepwise logistic regression analysis, age, serum triglycerides, smoking history for more than 20 years, arterial hypertension (defined as systolic or diastolic blood pressure values at least 150 or 100 mm Hg, respectively, or the use of antihypertensive medication), regular light alcohol consumption (inversely), and body mass index (marginal inverse association) were independent determinants of the presence of atherosclerosis; the respective odds ratios were 1.1/1 y, 1.8/1 mmol/L, 3.3, 2.4, 0.3, and 0.9/1 kg/m2. In multiple linear regression models, age was associated positively and the ratio of high density lipoprotein to total cholesterol was associated negatively with the severity of atherosclerosis regardless of the scoring method, whereas current smoking and female sex were predictors only of the percent stenosis and the length of the lesions. Arterial hypertension showed a significant association only with the length of the lesions. CONCLUSIONS: Age, cigarette smoking, and arterial hypertension contribute substantially to atherosclerosis in cervical arteries, but this study also confirms the independent associations of lipid or lipoprotein variables with atherosclerotic disease. An independent inverse association of regular light consumption of alcohol with cervical atherosclerosis was also observed.

Adult↗
PubMed1993

Clot formation in angiographic catheters--an in vitro comparative study. Effects of heparin and protein coating of the catheter.

Clot formation was compared in 6 brands of angiographic catheters, each of which was tested in 3 states: untreated, heparinized, and albumin-coated. Forty-six samples of each brand in each state (in total 828) were filled with blood from 23 donors and incubated at +37 degrees C for 5 or 15 min. Physiologic saline was then injected through the catheters at a flow rate of 5 and 50 ml/s, respectively, and any expelled clots identified on a filter. Heparinization reduced the number of clotted catheters at 5 min, but not at 15 min. The only significant difference related to catheter brands was found between the heparinized nylon and polyurethane catheters at 5-min incubation with fewer clotted polyurethane catheters. This difference was not found between the same materials made by two other manufacturers. Albumin coating had no effect on clot formation, but clots were more easily expelled by low-flow injections in albumin-coated and, to a lesser degree, in heparinized than in untreated catheters.

Albumins↗
PubMed1992

Radiological study of the brain at various stages of human immunodeficiency virus infection: early development of brain atrophy.

One hundred and one persons infected with human immunodeficiency virus (HIV-1), in whom other central nervous system infections or diseases were excluded, underwent brain CT and/or MRI at various stages of HIV-1 infection: 29 were asymptomatic (ASX), 35 had lymphadenopathy syndrome (LAS), 17 had AIDS-related complex (ARC), and 20 had AIDS. A control group of 32 HIV-1-seronegative healthy persons underwent brain MRI. The most common finding was brain atrophy, found in 9% of controls, and 31% of ASX cases, 29% of LAS, 59% of ARC and 70% of AIDS. Even the difference between the ASX or LAS groups and controls was significant. The changes were bilateral and symmetrical, and they were more severe at later stages of infection. Infratentorial atrophy was seen in the early stages; supratentorial atrophy became more pronounced at ARC, and generalized atrophy was typical of AIDS. Non-specific small hyperintense foci were found on MRI in 13% of controls and 6-15% of the infected groups. Larger, diffuse, bilateral white matter infiltrates were detected in 4 demented patients with AIDS. Four patients with AIDS and 1 with LAS had focal hyperintense lesions in the internal capsules, lentiform nuclei or thalamus, often bilateral on MRI. One patient with AIDS, examined with CT only, had low density in the lentiform nucleus. Loss of brain parenchyma can occur at an early stage of HIV-1 infection, and the atrophic process becomes more intense at later stages (ARC and AIDS). Parenchymal infiltration, seen as hyperintense areas on MRI, is most often associated with severe clinical symptoms, in the later stages of the disease.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Diffusion of contrast media in cerebrospinal fluid: comparison of iohexol, iopamidol and iotrolan in vitro.

Diffusion of iohexol (300 and 240 mgI/ml), iopamidol (300 and 200 mgI/ml), and iotrolan (300 and 240 mgI/ml) in the cerebrospinal fluid (CSF) of 16 patients was studied in vitro. Test tubes containing CSF were kept in a waterbath at 37 degrees C. Contrast medium was injected along the wall into the tubes, and diffusion of contrast media in the tubes was followed with repeated computed tomography for 5 h. The contents of the tubes were then mixed by shaking, and the tubes were scanned immediately and 8 h later. The contrast media first settled in the bottom of the tubes and then diffused upwards. Iotrolan diffused more slowly than the other media, but the difference was only significant at a concentration of 300 mgI/ml. The difference between iohexol and iopamidol was minimal. In general, diffusion was slower in CSF samples with an elevated protein content, but the difference in the diffusion of contrast medium in normal and pathological CSF was seldom statistically significant, perhaps owing to the small number of samples (5) with an elevated protein content. All contrast medium-CSF mixtures remained homogeneous after mixing. These experiments showed measurable differences in the diffusion of contrast media in CSF, but it does not seem very likely that these would be significant in clinical practice.

Cerebrospinal Fluid Proteins↗
PubMed1992

Encephalopathy and neuropathy in end-stage liver disease before and after liver transplantation.

The nervous system involvement of 8 patients with end-stage liver disease was evaluated by means of clinical neurological, neuropsychological, neurophysiological and neuroradiological investigation before and 6-12 months after a successful liver transplantation. Preoperatively, all subjects (7 women, 1 man; mean age 40 years, range 30-54 years) exhibited decreased muscle strength and 2 patients manifested clinical signs of polyneuropathy. In neuropsychological tests, slight visuoconstructive apraxia, and disturbances of verbal memory and cognitive function were observed. Magnetic resonance imaging (MRI) revealed cerebral lesions in two patients. After transplantation, muscle strength reverted to normal in all patients, polyneuropathy improved and in all but 2 patients recovery of neuropsychological functioning was observed. Clinical signs of encephalopathy had disappeared. All patients were emotionally better adjusted after transplantation. Four subjects showed new, albeit mild changes in neurophysiological and neuropsychological tests postoperatively. We conclude that the majority of neurological impairment disappeared after liver transplantation. We want to stress that evaluation of neurological sequelae of liver transplantation needs to be based on assessments both before and after liver transplantation.

Adult↗
PubMed1992

MRI of the brain, EEG sleep spindles and SPECT in the early diagnosis of infantile neuronal ceroid lipofuscinosis.

Two patients with infantile neuronal ceroid lipofuscinosis are presented whose clinical diagnosis was based on the typical clinical picture, together with absent sleep spindles and MRI findings (hypointense thalami and hyperintense periventricular white matter) as early as 18 months in one girl. In addition to a flat cortical SEP, these abnormalities appeared earlier than the typical ERG and VEP findings used previously for clinical diagnosis of this condition. MRI of the other patient showed the same changes and EEG sleep spindles were absent by two years.

Brain↗
PubMed1991

The spectrum of Jansky-Bielschowsky disease.

A series of five patients with a variant type of Jansky-Bielschowsky disease is presented. The disease initiated between four and a half and seven years with mental and slight motor symptoms. The additional neurological symptoms and signs, i.e. visual failure, retinal degeneration, ataxia, myclonia and epilepsy developed in all children before the age of ten years. The present series differs from our previous series of 16 cases especially in regard of neurophysiological findings (photic spikes, high visual evoked potential, VEP and high somatosensory evoked potential, SEP). VEP became abnormally high between 8.0 and 9.5 years instead of being an early finding as in the previous series. Photic spikes appeared also later in the present series. Electromicroscopic investigation revealed cytosomes with fingerprint profiles (FP) in the autonomic ganglion cells and cytosomes with both FP and curvilinear (CP) profiles in many extraneural cells including smooth muscle, Schwann cells, capillary endothelium and macrophages. In the light of our 21 Finnish patients and the literature, the spectrum of Jansky-Bielschowsky disease seems to be much wider than previously assumed. The diagnosis should be based on clinical, ophthalmological, neurophysiological and ultrastructural findings. Repeated neurophysiological studies may be necessary.

Age Factors↗
PubMed1990

Mild brain atrophy in early HIV infection: the lack of association with cognitive deficits and HIV-specific intrathecal immune response.

Brain MRI and/or CT were performed on 72 HIV-infected patients at various stages of the disease, and on 34 controls. The neuroradiological findings were related to duration of the infection, neurological symptoms, and cognitive abnormalities as well as to immunological findings in the CSF and blood. All types of brain atrophy were more severe and more frequent in HIV-infected subjects than in controls. Patients with neurological symptoms, those with advanced HIV infection, and patients with a duration of HIV infection of more than 4 years showed the most severe and most frequent neuroradiological abnormalities, including central and cortical atrophy, brain stem atrophy, and cerebellar atrophy. Subjects with cognitive defects exhibited more severe central atrophy than cognitively intact patients. However, slight brain atrophy and/or parenchymal lesions were found in 57% of cognitively intact HIV-seropositive individuals. Patients with brain atrophy and those with radiologically normal brain, both showed increased intrathecal synthesis of total IgG, and intrathecal HIV-antibody synthesis. However, a declined general immune response and a lowered CSF leukocyte count were seen predominantly in patients with brain atrophy. The results suggest that subcortical, neurologically "silent" areas of brain white matter are an early target of HIV infection.

AIDS Dementia Complex↗
PubMed1990

CT findings in neuronal ceroid lipofuscinoses.

Forty patients suffering from neuronal ceroid lipofuscinosis, 33 of the juvenile type (JNCL) and 7 of the infantile type (INCL), underwent a brain CT. All INCL patients showed severe atrophic changes which were most pronounced supratentorially and in the brainstem. The white matter was hypodense and markedly reduced and the cortical gray matter was quite thin in the oldest patients. The CT signs appeared early and can be used in differential diagnosis. In the JNCL group, CT findings were normal under the age of nine, but in the older patients (n = 28) atrophic changes were detected in all but two. Both supra- and infratentorial atrophy was detected and the severity of the alterations increased with age. No abnormal densities in the brain parenchyma were detected on CT. The severity of the cerebellar atrophy correlated positively with disturbances in motor functions, balance, co-ordination and EEG.

Adolescent↗