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Biomedical subjects

J Oki

Publications and source records attributed to J Oki.

At least 55 records · Page 3Linked to original sources

[Higher cortical dysfunctions and image diagnosis in a 9-year-old girl with complex partial epilepsy caused by focal neural migration disorder].

A 9-year-old right-handed girl was admitted because of complex partial seizures, left-right disorientation and finger agnosia. At the age of 2 years, she began to have seizures, which were exacerbated by carbamazepine and diazepam. Subsequently she was treated with phenytoin and phenobarbital, and remained seizure-free for four years. After age 7, she began to have attacks of alteration of consciousness, which lasted 10 seconds and occurred every two or three months. At age 9, neuropsychological testing revealed borderline intellectual functioning (WISC-R:FSIQ 83, VIQ 94, PIQ 73), but selective deficits were found in tests of calculation and spatial-figural relationships. Axial spin echo (3,000/22) image showed an abnormal high signal intensity in the left temporo-parieto-occipital lobe, in which interictal IMP-SPECT demonstrated decreased cerebral blood flow. These results seemed to explain the relationship between clinical findings and focal migration disorder. It is important to detect a focal migration disorder in patients with intractable focal epilepsy or higher cortical dysfunctions.

Agnosia↗

[Exacerbation of seizures by carbamazepine in four children with symptomatic localization related epilepsy].

We treated one hundred and seventy-eight epileptic children with carbamazepine (CBZ) for eight years. Among them, four children with symptomatic localization-related epilepsy, aged 11 months to 12 years, developed exacerbation of seizures. Their epilepsies were associated with hypoxic ischemic encephalopathy, head injury and ectopic gray matter. Despite the serum levels of CBZ (7.0 approximately 9.5 micrograms/ml) being within the therapeutic range, all of them had more frequent and severe partial seizures than before taking CBZ and one developed new atonic seizures. Diffuse irregular spike-wave complexes appeared on EEG in two children. Following discontinuation of CBZ in addition to replacement with phenytoin, their seizures became well-controlled and EEG findings improved except for residual focal spikes. Although CBZ is a widely used and effective antiepileptic drug for partial seizures, it should be kept in mind that CBZ may exacerbate seizures in children with symptomatic localization-related epilepsy.

Carbamazepine↗

[A longitudinal study of children with language delay at 3 years of age; later WPPSI and school attendance].

Ninety-four children (eighty-three boys and eleven girls), who were delayed in verbal expression (expressive language less than two-thirds of the standard for their chronological ages) at the age of three years, were evaluated for school attendance and intelligence at the age of six. The Yamada's Check List for Language Development and Wechsler Preschool and Primary Scale of Intelligence (WPPSI) were used to assess language problems and the intelligence quotient (IQ). Thirty children (32%) were delayed in verbal expression only, and sixty-four (68%) were delayed in both: verbal expression and comprehension were less than two-thirds of the standard for their chronological ages. Of children with delay in verbal expression only, 36% of them had low full-scale IQs (less than 70), and 27% had required special tutoring. Of children with delayed development of verbal expression and comprehension, 85% had low full-scale IQs, and 89% had required special tutoring or had attended schools for mentally retarded children. In expressive and comprehensive language delay, forty-one children avoided personal relations at the age of three years. Later thirty of these children were diagnosed as suffering from infantile autism. Poor mental outcome could be predicted by the delay of expressive and comprehensive language at the age of three years. The high prevalence of developmental disorders at later stages for the children in this study suggests the need for close monitoring of children with delayed language.

Child, Preschool↗

Hypocalcemic focal seizures in a one-month-old infant of a mother with a low circulating level of vitamin D.

We present a case of a one-month-old infant with hypocalcemia and rickets, with symptoms of focal seizures. The ictal EEG showed left occipital spikes spreading over all of the left hemisphere. From the laboratory studies, we concluded that a low maternal circulating level of vitamin D would cause infantile hypocalcemia and rickets, while immature renal response to parathyroid hormone and transient hypoparathyroidism in infancy would induce hyperphosphatemia. Hypocalcemia may be an important factor in the cause of focal seizures which start even after the age of one month. Further, investigation of maternal vitamin D levels should be done in infantile hypocalcemia.

Adult↗

Pharmacological activities of the prenylcoumarins, developed from folk usage as a medicine of Peucedanum japonicum THUNB.

In connection with the chemical structure of coumarin 1 (a mixture of acetylangeloylkhellactone and acetyltigloylkhellactone), a compound isolated from Peucedanum japonicum THUNB., we synthesized eight coumarin compounds (3-10) and performed pharmacological studies on these nine compounds, as well as on another coumarin, praeruptorin A (= Pd-Ia) (2), a compound isolated from Peucedanum praeruptorum DUNN. We studied the effects of compounds 1-5 on isolated smooth muscle and of compounds 1-10 on the cardiovascular system. These compounds showed dose-related antagonistic effects on histamine- and Ca(2+)-induced contractions in smooth muscle and the potencies were in the order 2 greater than 1 greater than seselin (3) greater than xanthyletin (4) = 2.2.10-trimethyl-2H,8H-benzo[1,2-b: 3,4-b']dipyran-8-one (5). All the compounds except 7-geranyloxy-4-methylcoumarin (10) produced a dose-related increase in vertebral, carotid and femoral blood flow. Compounds 1, 5, and 4-methyl-7-(3-methyl-2-butenyloxy)coumarin (8) caused an increase in blood pressure, but 3 and 4 caused a slight decrease. Compounds 2, 3, 4, 5, and 8 increased heart rate. Jatamansinone (6) and jatamansinol (7) caused only slight changes in blood pressure. All the compounds except 10 increased heart rate. Compound 1 also increased blood flow in the cerebral cortex. Thus, compound 1 was confirmed to have an inhibitory effect on contraction in isolated smooth muscle and an action increasing arterial blood flow. Among the compounds tested in this study, 3, as well as 6 and 7 synthesized on the basis of 3, showed actions similar to those of Ca2+ blockers and some compounds had papaverine-like activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[A case of Menkes' kinky hair disease with a renal calculus and diverticula of the bladder].

Menkes' kinky hair disease is a poor prognostic congenital disease with X-linked recessive inheritance. This disease is clinically characterized by seizures, friable hair, growth failure, mental retardation and others. Recently it has been known that this disease is also characterized by multiple diverticula of the bladder and other urological abnormalities. A 6-year-old boy was diagnosed as having Menkes' kinky hair disease at another hospital several weeks after birth because of seizures, friable hair and low serum copper level. He voided by Credé's maneuver by the nurse because he could not void for himself. He was referred to our hospital for macrohematuria and micturition pain on October 8, 1989. Right renal staghorn calculus and multiple diverticula of the bladder were found by roentgenographic examination. He has been treated conservatively after discharge because of his poor condition.

Child↗

[Exacerbation of partial seizures in a case with heterotopic gray matter using antiepileptic drugs].

A two-year-old, right-handed girl was admitted to our hospital with a history of partial seizures. The first seizure, conjugated eye movements and head turning to the right, occurred at the age of 24 months. Later, she suffered from several seizures daily at the age of 34 months. At the age of 35 months, she was admitted to our hospital. On admission her neurological examination was normal. EEG showed a left parietal spike focus. A computed tomographic scan showed a small hyperdense area in the left parietal lobe without contrast enhancement. She was treated with carbamazepine (CBZ : 6 mg/kg/day). When seizures occurred several times within an hour, intravenous or rectal administration of diazepam (DZP : 0.3 mg/kg/dose) was added. However, she complained of sleepiness. The seizures occurred more frequently than before, 50 to 80 times daily, and became secondarily generalized. We thought that the exacerbation of the seizures resulted from the somnolence caused by DZP and CBZ. Consequently, these drugs were discontinued, and phenytoin was begun. She has since been free of seizures for two years. Approximately one year after the discontinuance of DZP and CBZ, heterotopic gray matter and abnormal gyri involving the left parieto-temporal lobe were found by magnetic resonance imaging (MRI). MRI is useful for detecting small heterotopic gray matter. To summarize this case, one should consider the possibility that excessive polytherapy induces seizures, particularly in patients with structural brain abnormalities such as heterotopic gray matter.

Brain↗

[Response to haloperidol and analysis of growth curve in hereditary progressive dystonia with marked diurnal fluctuation].

A case of 10-year-old female with hereditary progressive dystonia with marked diurnal fluctuation (HPD) was described. Her development was normal. Then at the age of eight, she developed dystonia of the left lower extremity that became noticeable toward evening but subsided after taking sleep. And the velocity of height gain decreased at the age of nine (from 5 cm to 3.6 cm per year). Before the diagnosis of HPD, small doses of haloperidol (0.015 mg/kg/day) were given to her. Thereafter she developed progressive dystonia of all extremities and could not walk. Administration of haloperidol was discontinued, and an attempt to reverse the dystonia with L-Dopa was made. Prior to treatment with L-Dopa, a reduced concentration of cerebrospinal fluid homovanillic acid (10 ng/ml) was found. And her height was 130.5 cm (-1.33 SD) at the age of ten. Treatment with L-Dopa (18 mg/kg/day) markedly improved her symptoms within four days. This improvement has been maintained for six years without a need for increasing the doses and without neurological side effects. At the age of sixteen her height was 162.3 cm (+1.0 SD). These findings suggest a diminished dopaminergic activity and a increased susceptibility to dopamine receptor blockade in HPD.

Body Height↗

[Clinical results of 9, 3"-diacetylmidecamycin dry syrup in the pediatric field (author's transl)].

9, 3"-Diacetylmidecamycin (MOM), a new macrolide antibiotic, was administered to 28 patients: 6 with pharyngitis caused by Group A beta-Streptococcus, 2 with lacunar tonsillitis, 8 with upper respiratory tract infection, 6 with acute bronchitis, 3 with Mycoplasma pneumonia, 1 with primary atypical pneumonia, 1 with pneumonia caused by H. influenzae and 1 with whooping cough. MOM in the form of fine granules was administered at a daily dose of about 20-30 mg/kg divided into 3 doses. Isolated group A beta-Streptococcus strains were eradicated in only 1 out of 6 strain S. One strain of H. influenzae was eradicated. The clinical results could be obtained with 21 cases and the response was excellent in 1 case, good in 7, fair in 3 and poor in 10. Although diarrhea was found in 3 cases during the administration of MOM, it was not clear whether these phenomena were caused by MOM, because of the prevalence of diarrhea among the children treated by us at that time.

Adolescent↗