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Biomedical subjects

K Iinuma

Publications and source records attributed to K Iinuma.

At least 91 records · Page 5Linked to original sources
PubMed1998

Improved survival of children with advanced tumors by myeloablative chemotherapy and autologous peripheral blood stem cell transplantation in complete remission.

Five children with neuroblastoma (NB) stage IV and five children with rhabdomyosarcoma (RMS) stage III were treated with myeloablative chemotherapy and autologous peripheral blood stem cell transplantation (MCT/PBSCT) in the state of complete remission (CR) achieved by conventional therapy. PBSCs were collected in CR status using a cell separator with blood access through a double-lumen central venous catheter. PBSCs with 1.9+/-0.8x10(5) of CFU-GM per patient weights (kg) were infused following MCT after a period of conventional therapy for 11.1+/-2.1 or 9.7+/-0.9 months in NB or RMS patients, respectively. Regimen-related toxicity of MCT was tolerable and peripheral white blood cell count recovered beyond 1.0x10(3)/microl 10-12 days after infusion of PBSCs in all patients. All of RMS patients and three of five NB patients survived for an average of 31.6 months (ranged 10.8-58.1). The survival rate of these patients was improved as compared with our historical controls, and presumably, with that of conventional chemotherapy previously reported. Despite a limited number of patients, it appears that MCT/PBSCT may be effective in improving survival by preventing relapse which may occur thereafter if treated with conventional therapy alone. Furthermore, MCT/PBSCT reduced the duration of treatment, as compared with that of conventional chemo-therapy. Therefore, this study may suggest the feasibility and promise of the therapy including MCT/PBSCT for children with advanced stages of NB and RMS.

Antineoplastic Agents↗
PubMed1998

Primary cutaneous T-cell lymphoma involving the cheek: an infant case with a unique clinicopathologic feature.

We report a clinicopathologic feature of primary cutaneous T-cell lymphoma (CTCL) in a five-year-old boy with increasing swelling of his cheek since two years of age. Histologically, an infiltrate of atypical lymphoid cells with mature T-cell phenotype and clonality was prominent from the dermis to the subcutaneous tissue of the cheek. Although little effect was seen with aggressive multidrug-combined chemotherapy, therapy with interferon-alpha and steroids achieved a prolonged remission. This patient may provide important clues to understanding the clinicopathologic feature of rare primary CTCL in young children.

Cheek↗
PubMed1998

Long-term effects of zonisamide in the treatment of epilepsy in children with intellectual disability.

Zonisamide is a new drug with broad-spectrum antiepileptic activity against partial as well as generalized seizures. The purpose of the present study was to compare the long-term efficacy of zonisamide in the treatment of epilepsy in children with intellectual disability (ID) with those with normal intelligence (NI). One hundred and thirty children (74 ID, 56 NI) were included in the study. Fifteen of the subjects were eliminated from the study because of adverse effects or aggravation of seizures. The remaining 115 children (66 ID, 49 NI) were followed up for more than one year. Twenty-eight children (6 ID, 22 NI) were in zonisamide monotherapy. The mean numbers of different antiepileptic drugs were 4.5 and 3 for the ID and NI groups, respectively. The overall improvement rates, defined as a >50% reduction in the number of seizures, were 41% (ID) and 67% (NI) (P<0.01). Side-effects were observed in 27% and 30% of subjects in the ID and NI groups, respectively. However, in the monotherapy group, side-effects were observed in 50% (ID) and in 27% (NI). In conclusion, the effectiveness of zonisamide was weaker in children with ID than those with NI. This is in agreement with the known phenomenon that epileptic children with ID are likely have more intractable seizures than those with NI.

Adolescent↗
PubMed1998

Agreement between predicted risk and prevalence of Down syndrome in second-trimester triple-marker screening in Japan.

Based on 9350 pregnant Japanese women who were screened by serum triple-marker determination, accuracy of predicted risk for Down syndrome was examined using 24 Down syndrome cases detected either prenatally or postnatally. The correlation is statistically very high (r = 0.98) between the predicted risks and the prevalence of Down syndrome cases. Here we emphasize that this could be accomplished only by an extensive follow-up study, implemented in our prospective intervention programme.

Amniocentesis↗
PubMed1997

Prognostic value of visual evoked potentials (VEP) in infants with visual inattentiveness.

Visual evoked potentials elicited by strobe flash (fVEPs) were recorded in 56 infants (3 months to 15 months of age) with visual inattentiveness but without prechiasmal problems. Their visual status was reexamined one or more years later when 41 children were found to be visually competent (Group NB) and 15 were blind (Group B). We also evaluated a group of 32 age-matched children who had no visual symptoms (Group C). It was found that well organized VEP waveforms over one or both hemispheres (Types U and S), or those with a characteristic negative shift (Type N) suggest favorable prognosis. Integrated voltage of the VEP correlated well with long-term prognosis for visual recovery. The vertex VEP also (had) provided some predictions for visual prognosis. Overall results indicate good prognosis if related to sufficient voltage and complexity of the VEP components.

Blindness↗
PubMed1997

Therapeutic doses of theophylline exert proconvulsant effects in developing mice.

We studied the effect of therapeutic doses of theophylline on electrically-induced convulsions in developing mice. A theophylline dose as small as 3 mg/kg increased seizure susceptibility of 21-day-old mice, but not of 42-day-old mice. These findings were consistent with clinical reports that theophylline at the therapeutic blood concentrations occasionally induced convulsions in children. The age-dependent proconvulsant effect of theophylline was well inhibited by phenobarbital (PB), dose-dependently, but not by other well-established antiepileptic drugs (AEDs). PB may be a good choice of AED in patients with bronchial asthma and seizure disorders, if PB is indicative for their seizure types. The proconvulsant effect of theophylline in 21-day-old mice was counteracted by not only an adenosine A1 agonist, but also an NMDA antagonist and a histamine H3 antagonist. Several studies have established that the proconvulsant effect of theophylline intoxication is mainly due to the blockade of adenosine A1 receptors. The present findings suggested that the proconvulsant properties of therapeutic doses of theophylline in developing period were different from those of theophylline intoxication. Combination of therapeutic doses of theophylline and centrally-acting histamine H1 antagonists showed proconvulsant effects even in 42-day-old mice, suggesting that peripherally acting histamine H1 antagonists, such as astemizole, evastine and epinastine, were much safer than centrally acting histamine H1 antagonists for patients with both allergy and seizure history.

Aging↗
PubMed1997

Acute myelogenous leukaemia with t(8;21) translocation of normal cell origin in mosaic Down's syndrome with isochromosome 21q.

We report a 13-year-old girl with Down's syndrome (DS) having a mosaic karyotype of 46,XX/46,XX, -21,+i(21q), who developed acute myelogenous leukaemia (AML) (FAB M1). The t(8;21) translocation generating a AML1/MTG8 chimaeric gene of her blasts was demonstrated by cytogenetic analysis and reverse transcription-polymerase chain reaction. Interestingly, the leukaemic clone with t(8;21) did not have isochromosome 21q, indicating that the blasts were of normal cell origin. These findings suggest that, in older patients with DS, 21 trisomy cells have no greater predisposition to develop AML than normal karyotypic cells.

Adolescent↗
PubMed1997

Tetralogy of Fallot with absent pulmonary valve: evaluation with magnetic resonance imaging.

Two infants with tetralogy of Fallot with absent pulmonary valve were studied with electrocardiographically gated magnetic resonance imaging using a 1.5 T imaging system. In each case, imaging was performed successfully. The magnetic resonance imaging clearly demonstrated a rudimentary pulmonary valve, an aneurysmal pulmonary artery, and compression of the mainstem bronchi. Cine MRI revealed phasic compression of the bronchi by an aneurysmally dilated pulmonary artery. Magnetic resonance imaging produced high quality images and provided all of the anatomic information required for preoperative evaluation.

Bronchi↗
PubMed1997

[Status of severely mentally and physically handicapped children of school age in Nagano prefecture].

Prevalence rate and etiology were studied in severely handicapped children of school age in Nagano prefecture as of July, 1994. Severely retarded children were defined as those whose IQ's were lower than 35 and who were unable to walk. The total number of severely retarded children was 165. The prevalence rate was 0.71/1000, 90% of them being in class 1 or 2 of Oshima's classification (bedridden or unable to sit alone and with IQ less than 20), and 26% being cared for at home. Their average gestational age was 38.5 weeks, and the average birthweight 2,772 g. At birth none of them had extremely low birth weight. Etiology of the handicaps was classified as follows; congenital 26.1%; maternal infection 3.0%; prenatal 3.6%; perinatal 27.3%; postnatal 13.9% and unknown 26.1%. Asphyxia decreased gradually but the number of low birth weight premature infants increased. When postnatal etiologies were excluded, the patients with unknown etiology occupied 30.3%, 23.3% of them being light-for-dates baby. The examination of the case histories revealed that causes of unknown etiology are prenatal. If we add unknown etiology to congenital, maternal infection, and prenatal etiology, the prenatal origin is 68%.

Persons with Disabilities↗
PubMed1997

[The relationship between MR images and clinical findings in neuronal migration disorders].

Among the variable manifesting conditions of neuronal migration disorders, mental retardation, motor disturbance and epilepsy are the main features of developmental disabilities. We analyzed the relationship between clinical symptoms and magnetic resonance (MR) images, including surface anatomy scan (SAS). Thirty nine patients (23 males, 16 females; mean age 6.1 years) with neuronal migration disorders were studied. The diagnoses were cerebral palsy in 23 cases, mental retardation in 4. West syndrome in 4, Fukuyama type congenital muscular dystrophy (FCMD) in 6. Walker-Warburg syndrome in 1 and Dubowitz syndrome in 1. Cortical dysplasias were classified into the following 7 groups, mainly based on the SAS findings: complete agyria (AG 1), mixture of agyria and pachygyria (AG 2), bilateral complete pachygyria (BP 1), diffuse pachygyria with marked widening of the bilateral superior frontal gyrus (BP 2), unilateral pachygyria with hemispheric atrophy or hemimegalencephaly UP), focal cortical dysplasia (FP) and other findings such as solitary schizencephaly (Others). Most cases of AG 1 and AG 2 showed spastic quadriplegia (6/7) and symptomatic generalized epilepsy (5/7), whereas cases of BP1 showed spasticity only in 1/8 and epilepsy in 7/8. Hemiplegia was observed in 6/7 of UP, 2/8 of FP and 2/4 of Others. Partial epilepsy was observed in 2/7 of UP and 1/8 of FP. Intellectual level was variable in BP 1, UP, FP and Others, but all cases showed severe mental retardation in AG 1, AG 2 and BP 2. BP 2 was observed in all cases of typical FCMD (5/5). The birth weight was less than 2,500 g in 6/7 of UP. The structural findings well correlated with clinical symptoms and epileptic seizure types. The surface anatomy scan was a very useful technique for detecting cortical dysplasias.

Adolescent↗
PubMed1997

[Factors associated with the prognosis of bacterial meningitis in children].

Treatment of bacterial meningitis depends on its severity. The signs, symptoms, and laboratory values of 51 patients with bacterial meningitis admitting to the Department of Pediatrics at Sendai City Hospital from January 1985 to December 1994 were analyzed in order to evaluate their prognostic value. The overall mortality rate was 3.9%. The incidence of neurological deficit on discharge was 31.4%. According to their prognoses, patients were divided into two groups: those who recovered with no detectable disabilities (good prognosis) and those who died or were left with neurological deficits (poor prognosis). An analysis of these groups using Fisher's exact probability test revealed that the following risk factors were associated with poor prognosis: 1) duration of fever (including the periods of relapse) for more than 10 days ; 2) abnormal findings on brain imaging, such as cerebral infarction, cerebral hemorrhage, cerebral abscess and subdural effusion: 3 initial serum CRP value above 16 mg/dl; 4) initial CSF glucose value below 12 mg/dl; and 5) initial CSF LDH value above 220 IU/l. Streptococcus pneumoniae infection carried the worst prognosis: the causal organism of both the two fetal cases was S. pneumoniae. The incidence of poor prognosis was also high in S. pneumoniae meningitis (60.0%), compared to those by Hemophilus influenzae (46.7%) and group B streptococcus (25.0%). In the cases in which causal agents were not detected, this incidence was as low as 10 percent, showing significant difference from cases in which causal agents were identified. In order to improve the prognosis of bacterial meningitis, factors associated with poor prognosis should be recognized at early stages of the illness.

Adolescent↗
PubMed1996

Centrally acting histamine H1 antagonists promote the development of amygdala kindling in rats.

We studied the effect of histamine H1 antagonists on the development of amygdala kindling, an experimental model of epilepsy, in rats. The centrally acting histamine H1 antagonists including pyrilamine (mepyramine) and ketotifen showed an acceleration in the rate of electrical stimulation to develop fully kindled convulsive seizures. On the contrary, epinastine, a histamine H1 antagonist which scarcely enters the brain, showed no acceleration. These findings suggest that the central histaminergic neuron system plays an inhibitory role on the seizure development through central histamine H1 receptors.

Amygdala↗
PubMed1996

Triple marker screening in native Japanese women.

Prenatal screening using the maternal serum markers alpha-fetoprotein, human chorionic gonadotropin, and unconjugated oestriol was investigated in a native Japanese population. Comparison with a Caucasian U.S. population revealed differences which led to modification of the generally used equations for risk calculations. Prenatal screening was shown to be clinically useful.

Adult↗
PubMed1996

Reye's syndrome with cortical laminar necrosis: MRI.

Serial MRI findings are described in two patients with Reye's syndrome, demonstrating diffuse cortical and white matter changes. In the acute stage, T2-weighted images showed subtle but definite laminar high signal and contrast-enhanced T1-weighted images laminar enhancement, along the entire cerebral cortex bilaterally. In the chronic stage, unenhanced T1-weighted images showed diffuse cortical laminar high signal. These characteristic MRI features seemed very similar to those of laminar cortical necrosis in hypoxic brain damage. MRI also displayed delayed white matter changes with cerebral atrophy.

Atrophy↗
PubMed1996

Pulmonary interstitial emphysema during piston-type high-frequency oscillatory ventilation.

We retrospectively reviewed data on high frequency oscillatory ventilation (HFOV) settings and pulmonary function in 14 extremely low birth weight infants who were treated with piston-type HFOV immediately after birth for severe respiratory distress to investigate the cause of pulmonary interstitial emphysema (PIE) associated with HFOV. PIE developed a mean of 23 hr after the initiation of HFOV in 6 infants. Eight infants did not develop PIE and served as the control group. The lowest mean airway pressure (MAP) in the PIE group, which occurred immediately before disease onset was 5.2 cm H2O. The lowest MAP in the control group was 7.5 cm H2O (p < 0.01), which occurred immediately before the ventilatory mode was changed from HFOV to conventional mechanical ventilation for weaning from mechanical ventilation. Respiratory system compliance (Crs) 12 hr after birth was below normal in both groups and there was no significant difference between groups. These results suggest that an unusually low MAP may contribute to PIE during piston-type HFOV in the presence of low Crs. It is therefore important to maintain a high MAP during HFOV until pulmonary compliance becomes normal.

Blood Gas Analysis↗