A discretized model for enzymatic hydrolysis of cellulose in a fed-batch process.

In the enzymatic hydrolysis of cellulose, several phenomena have been proposed to cause a decrease in the reaction rate with increasing conversion. The importance of each phenomenon is difficult to distinguish from batch hydrolysis data. Thus, kinetic models for the enzymatic hydrolysis of cellulose often suffer from poor parameter identifiability.

[Neurologic indications of botulin in adults].

Botulin is established as first-line treatment in cervical dystonia, blepharospasm, hemifacial spasm and stroke-related spasticity of the distal parts of the upper limb. In addition, many other motor disorders and muscular hyperactivity states and neurologic symptoms and manifestations, in which temporary muscle paralysis, analgesic properties and effects on the functioning of the autonomic nervous system brought about by botulin can be utilized, have become indications for use. With proper dosage, botulin has proven to be safe even in prolonged use, the effect usually lasting for years.

CERAD-neuropsychological battery in screening mild Alzheimer's disease.

Objectives: The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery (nb) is used as an evaluation tool for dementia. In Finland, CERAD-nb was introduced in 1999 and has been proposed to be used in primary health care. However, some of its parts need reassessment and focusing.

[Update on current care guidelines. Parkinson's disease].

Following the diagnosis of Parkinson's disease, treatment may be initiated with MAO-B-inhibitor, even prior to the development of any functional deficit. For patients with a functional deficit who are younger (usually under 75 years of age) and otherwise in good condition, treatment should be started with a dopamine agonist or MAO-B-inhibitor. In other patients, initial treatment with levodopa is recommended.

[Early detection of cognitive changes in memory diseases: new cut-off scores for the Finnish version of CERAD neuropsychological battery].

The evaluation of cognitive functions by using CERAD (Consortium to Establish a Registry for Alzheimer's Disease) is recommended as a tool in basic health care for screening of memory diseases. The reliability of this method, adopted in Finland in 1999, has been impaired by the fact that there have been no comprehensive Finnish norms to serve as the basis for the cut-off limits of the test tasks. This article presents the new, revised cut-off values for the CERAD procedure, based on the comparison of Finnish population-based normative data with those of persons having very mild or mild Alzheimer's disease.

Recurrent falls and mortality in Parkinson's disease: a prospective two-year follow-up study.

Objectives: To evaluate the risk factors for recurrent falling and mortality in Parkinson's disease (PD) in a prospective study design.

Materials And Methods: One hundred and twenty-five PD patients were included in the study. Baseline medical data were collected, and patients were clinically tested for mobility and balance.

Sudomotor dysfunction in patients with optic neuritis.

Objectives: Optic neuritis (ON) is a frequent initial manifestation of multiple sclerosis (MS). Autonomic failure affecting the pupillary function is known to exist in ON patients, and patients with MS are known to have more widespread autonomic dysfunction. For example, sudomotor dysfunction is well known in MS.

Sweating impairment in patients with multiple sclerosis.

Objectives: To measure sweating in patients with multiple sclerosis (MS).

Materials And Methods: Sweating was measured by an evaporimeter after a heating stimulus in 29 MS patients and in 15 healthy control subjects.

Results: The MS patients sweated markedly less than the controls.

Orthostatic hypotension, balance and falls in Parkinson's disease.

Orthostatic hypotension (OH) is a common feature in Parkinson's disease (PD). As the control of balance and gait is already affected by PD per se, OH may further predispose patients to falls and accidents. The study was conducted to evaluate the clinical correlates of OH and its association with mobility and balance in PD.

Mobility and balance in Parkinson's disease: a population-based study.

Background And Purpose: To assess the clinical correlates of mobility and balance, and to identify the risk factors for falls in Parkinson's disease (PD).

Methods: One-hundred and nineteen PD patients underwent clinical examination and tests for mobility and balance using the Timed Up & Go (TUG) test, walking speed, and the measurement of postural sway.

Results: The fallers (35% of the subjects) performed significantly worse in the TUG test than the non-fallers, and they also had a slower walking speed (P = 0.

Sympathetic skin responses in multiple sclerosis.

Objectives: This study assessed the sympathetic skin responses (SSRs) and their correlation with brain lesion volumes in patients with multiple sclerosis (MS).

Materials And Methods: The SSRs were measured in 27 patients with MS and 27 healthy controls. The volumes of the proton density-weighted MS lesions in the brain were measured using MRI.

Postural sway and falls in Parkinson's disease: a regression approach.

A population-based study was designed to evaluate the clinical associates of postural sway and to identify the risk factors for falls in Parkinson's disease (PD). From a total population of 205,000 inhabitants, 215 PD patients were identified of which 120 home-dwelling cases were finally included in the study. Medical data were collected and patients were clinically examined and tested for static balance using an inclinometric device.

Blood pressure and heart rate in parkinsonian patients with and without wearing-off.

Our study aimed to investigate the cardiovascular autonomic regulation related to the wearing-off phenomenon in Parkinson's disease (PD). We measured blood pressure (BP) and heart rate (HR) at rest and during orthostatic test in 16 patients with PD with wearing-off and in 15 patients with PD without wearing-off both before (baseline) and repetitively at 1-h intervals for up to 4 h after the morning PD medication dose. The patients with wearing-off had fluctuation of BP during the observation period, BP increasing when the motor performance worsened and vice versa.

Sweating in Parkinsonian patients with wearing-off.

Disorders of the autonomic nervous system are common in Parkinson's disease (PD). Earlier studies suggest that some nonmotor symptoms may fluctuate with the motor symptoms, but the possible interrelationship between motor phenomena and sweating has not been studied. The authors measured sweating by using an evaporimeter on three different areas of the body (right hand, left hand, chest) immediately before the morning PD medication (baseline), and thereafter hourly up to 4 hour, in 16 PD patients with wearing-off type of motor fluctuations and in 15 patients without clinical motor fluctuations.

Selegiline and blood pressure in patients with Parkinson's disease.

Objectives: Parkinson's disease (PD) frequently affects both the extrapyramidal system and the autonomic nervous system (ANS), the latter also being sometimes disturbed by PD medications. Specifically selegiline is known to disturb cardiovascular ANS functions and may cause or enhance orthostatic hypotension.

Methods: In order to study the effect of the withdrawal of selegiline on the regulation of blood pressure (BP) in advanced PD, an orthostatic test was performed in 14 PD patients with wearing-off before the morning levodopa dose and thereafter repetitively at 1-h intervals for up to 4 h.

Natriuretic peptides and mortality after stroke.

Background And Purpose: Measurement of natriuretic peptides provides prognostic information in various patient populations. The prognostic value of natriuretic peptides among patients with acute stroke is not known, although elevated peptide levels have been observed.

Methods: A series of 51 patients (mean age, 68+/-11 years) with first-ever ischemic stroke underwent a comprehensive clinical examination and measurements of plasma atrial natriuretic peptides (N-ANP) and brain natriuretic peptides (N-BNP) in the acute phase of stroke.

Marked effect of liver and kidney function on the pharmacokinetics of selegiline.

Objectives: The pharmacokinetics of selegiline was investigated in an open study with 4 parallel groups of 10 subjects in each. Patients with liver disease, those receiving a drug that induced hepatic enzyme activity, and those with impaired kidney function were compared with control subjects.

Methods: A single oral 20-mg dose of selegiline was administered after an overnight fast, and blood samples were collected over a period of 48 hours.

Cerebral CT and MRI findings in cervicocephalic artery dissection.

Purpose: To explore the frequency and patterns of brain infarction and other brain manifestations in cervicocephalic artery dissection (CCAD) and to evaluate the correlation between vessel wall findings and infarctions.

Material And Methods: The medical records and films of 136 consecutive CCAD patients diagnosed in Oulu University Hospital during the 20-year period since 1982 were reviewed. Five patients with no brain imaging were excluded.

The generic 15D instrument is valid and feasible for measuring health related quality of life in Parkinson's disease.

Objectives: To test the validity and feasibility of the generic 15D health related quality of life (HRQoL) instrument in Parkinson's disease (PD) and compare parkinsonian patients with the general population. Much effort has gone into developing disease specific HRQoL measures for PD, but only generic measures allow comparisons with the general population. New HRQoL tools are needed for PD because earlier ones have low feasibility in elderly patients.

Heart rate dynamics predict poststroke mortality.

Background: Impaired cardiovascular autonomic regulation assessed by heart rate (HR) variability provides prognostic information in patients with heart disease as well as among elderly. Reduced HR variability has been described in stroke patients, but the prognostic significance of HR variability measures after stroke has not been studied.

Methods: A series of 84 patients (mean age 59 +/- 12 years) with an acute first-ever ischemic stroke underwent a comprehensive clinical investigation, laboratory tests, and 24-hour EKG recordings and were followed up for 7 years (mean 83 +/- 54 months).

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.

Nocturnal cardiac autonomic regulation in Parkinson's disease.

Diminished heart rate (HR) variability has been reported in patients with early phase Parkinson's disease (PD) using standardized cardiovascular reflex tests. However, limited data exist on HR variability during sleep; thus the present study was performed to investigate the characteristics of HR variability during different sleep stages. The HR variability of 21 newly diagnosed and untreated PD patients and of 22 control subjects was evaluated by using time domain, frequency domain and non-linear methods and by analyzing HR reactions to body movements during the different sleep stages (non-REM stages S1-4 and the REM stage).

Pulsatile tinnitus as a symptom of cervicocephalic arterial dissection.

The aim of this study was to investigate pulsatile tinnitus as a presenting symptom in cervicocephalic arterial dissection (CCAD). Of the 136 consecutive patients with confirmed CCAD, 16 presented with pulsatile tinnitus. On admission 10 patients presented with subjective tinnitus and five with objective tinnitus, tinnitus being the only presenting symptom in one case.

Extracranial internal carotid and vertebral artery dissections: angiographic spectrum, course and prognosis.

We reviewed the clinical and radiological findings of 93 consecutive patients with 111 extracranial internal carotid (ICAD) and vertebral artery (VAD) dissections and one concomitant intracranial VAD; 83% of the patients had unilateral and 17% multiple vessel dissections. The diagnosis was made by intra-arterial digital subtraction angiography in 92 patients and MR angiography in one. Follow-up angiography was performed in 77 cases (83%): of 49 initially stenotic arteries, 40 became completely or almost completely normal, while three showed slight improvement.