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Biomedical subjects

K Iwase

Publications and source records attributed to K Iwase.

At least 145 records · Page 8Linked to original sources
PubMed1983

Prognostic factors of convulsive disorders in the first year of life.

Prognostic factors for mental and physical development and seizure control were investigated in 194 patients with convulsive disorders in the first year of life, excluding infantile spasms, neonatal convulsions and occasional convulsions. Thirty-three patients with febrile convulsions were included in the study. All patients were followed up to age six or older. The cases were subdivided into five etiologic groups; prenatal, perinatal, postnatal, doubtful and cryptogenic. Those with delayed development before the onset of seizures, or neurological abnormalities at the first visit had significantly less chance of being seizure-free and attaining normal mental and physical development. The prognosis for seizures and mental and physical development was much better in the patients with brief, symmetric, generalized tonic and/or clonic convulsions. This was also true with cryptogenic cases. There was a significant correlation between the initial EEGs and the long-term prognosis for mental and physical development and seizure control. Normal EEG was associated with a good prognosis. From these data, the neurodevelopmental status before the onset, the clinical features of convulsions and EEG findings in the infantile period were demonstrated to be important prognostic factors in addition to etiology.

Electroencephalography↗
PubMed1983

Etiologic factors and long-term prognosis of convulsive disorders in the first year of life.

Etiological factors and long-term prognosis were studied in 562 cases with convulsive disorders in the first year of life; 114 (20.3%) were prenatal, 114 (20.3%) perinatal, 24 (4.3%) postnatal, and 257 cases (45.7%) were cryptogenic. The remaining 53 (9.4%) patients were doubtful cases. The mortality before six years of age of the pre- and perinatal cases at 17.6% and 15.7%, respectively was significantly higher than in the other etiologic groups. The incidence of a family history of epilepsy or other convulsive disorders was highest in the cryptogenic cases (23.5%), and lowest in the prenatal cases (10.4%) (p less than 0.05). The onset of seizures was very early in the pre- and perinatal groups and they decreased in number after four months of age, whereas cryptogenic cases increased after four months of age. With regard to the seizure types in the first year of life, infantile spasms occurred most frequently as the initial seizures in the prenatal (62.8%) and doubtful (50.9%) group, and generalized motor seizures in the cryptogenic (78.8%) group. The prognosis of seizures and mental and physical development was much better in cryptogenic cases. More than 80% of cases with cryptogenic etiology became seizure-free, mentally and physically normal, whereas in other etiologic groups the rate was much lower.

Age Factors↗
PubMed1983

Long-term prognosis of convulsive disorders in the first year of life: mental and physical development and seizure persistence.

A follow-up study was made on 304 children (164 boys, 140 girls) with convulsive disorders, excluding occasional convulsions, in the first year of life. All patients except 45 who died were followed until 6 years of age or older. At the final follow-up, the subjects were divided into six groups according to the degree of mental and physical development (groups I-VI). Seizures were regarded as absent if the patient had been seizure free for more than 3 years. At the final follow-up, seizures had ceased in 57.7%, and 43.4% had normal mental and physical development (group I). As to the initial diagnosis, the percentage of group I at the final follow-up was 81.8% with febrile convulsions and 37.6% with epilepsy. In patients without seizures it was 69.7% with febrile convulsions and 55.8% with epilepsy. Some 80.6% of patients with unclassified generalized motor seizures, 11.5% of those with infantile spasms, 2.9% of those with secondary generalized epilepsy other than infantile spasms, 46.4% of those with partial seizures, and 25.0% of those with hemiconvulsive seizures were finally placed in group I. The percentage of patients without seizures was 81.4, 33.0, 34.4, 57.7, and 100%, respectively. As has been suggested, among the first-year epilepsies, a subgroup with a more favorable prognosis may exist. Further studies regarding the etiology, ictal EEGs, and effectiveness of treatment and long-term prognosis of these cryptogenic benign infantile convulsions are needed to provide a firm basis for understanding convulsive disorders in the first year of life.

Female↗
PubMed1981

Prognostic factors of infantile spasms from the etiological viewpoint.

We investigated the prognostic factors for mental and physical development and seizure control by dividing the subjects into various etiologic groups in 200 patients with infantile spasms, all of whom (except 48 who died) were aged six years or older. The results were as follows: 1) Intermediate (4-12 mos) onset was found to be a favorable prognostic factor for seizure control in cryptogenic cases, although there was no relation between the age of onset and prognosis in other etiologic groups. 2) There was a significant correlation between the treatment lag and long-term prognosis for mental and physical development only in cryptogenic cases. A short treatment lag (0-2 mos) was associated with a good prognosis. All cryptogenic patients who had no relapse after ACTH therapy developed normally, although in symptomatic cases, there was no correlation between the relapse and the outcome.

Adrenocorticotropic Hormone↗
PubMed1981

Long-term prognosis after infantile spasms: a statistical study of prognostic factors in 200 cases.

A follow-up study was made on 200 children (115 boys, 85 girls) who had had infantile spasms, in order to compare their present condition over the age of six years with various prognostic factors. 48 of the children (30 males and 18 females) had died, and all the rest were aged six years or older at the time of final follow-up. 139 of the children had received ACTH therapy: at final follow-up, spasms had ceased in 43.5 per cent, and about the same proportion showed normal physical development; 23 per cent had normal mental development and 15.4 per cent were attending ordinary schools. Complete recovery (normal mental and physical development and attending ordinary schools) was achieved in only 19 cases (9.5 per cent). Of the cryptogenic cases, 44.4 per cent had made a full recovery. The poor prognostic factors for continuing seizures were evolution into other types of fits, relapse of seizures after ACTH therapy, seizures concomitant with spasms, and convulsions before the onset of spasms. Poor prognostic factors for physical development were delayed development before the onset of spasms, neurological abnormalities, PEG abnormality, symptomatic aetiology, neonatal convulsions, low birthweight, perinatal asphyxia and being female. Poor prognostic factors for mental development were delayed development before the onset of spasms, neurological abnormalities, PEG abnormality, prenatal and perinatal aetiology, relapse after initial ACTH therapy, laughing attacks, and evolution into other types of fits. Only in the cryptogenic cases was there significant correlation between the delay in treatment and the long-term prognosis for mental development. Poor prognostic factors for educability were very similar to those for mental development. In spite of conflicting views as to the long-term effects of ACTH, prompt treatment seems to be mandatory, at least in cryptogenic cases of infantile spasms.

Achievement↗
PubMed1979

A new assay of X-prolyl dipeptidyl-aminopeptidase activity in human serum with glycylproline p-phenylazoanilide as substrate.

A new assay procedure for X-prolyl dipeptidyl-aminopeptidase activity in human serum was developed with glycylproline p-phenylazoanilide tosylate as substrate. p-Phenylazoaniline liberated by the enzyme reaction was measured photometrically at 493 nm after stopping the reaction with acid. This assay was simple and sensitive, and less than 50 microliter of human serum was required for the assay. Km value was 2.5 mM and the optimum pH was 8.7. After disc gel electrophoresis of human serum, the enzyme activity could be distinctly observed as a reddish band on the gel when the gel was incubated with this substrate.

Dipeptides↗
PubMed1979

Comparison of X-prolyl dipeptidyl-aminopeptidase activity in human cerebrospinal fluid with that in serum.

X-Prolyl dipeptidyl-aminopeptidase activities in cerebrospinal fluid and serum from the same patients without neurological diseases, undergoing surgery under lumbar anesthesia, were assayed fluorometrically with a newly synthesized fluorogenic substrate, 7-glycylproline-4-methylcoumarinamide; the values were 129.1 +/- 19.5 nmoles/min/l and 54.17 +/- 3.11 mumoles/min/l (mean +/- SEM, n = 23), respectively, and there was no correlation between both activities (r = 0.0894).

Dipeptides↗
PubMed1979

Sleep and EEG features of newborns with 18 and 13 trisomy syndromes.

Serial polygraphic recordings of two to three hours duration were made in five full-term newborns with trisomy 18 and one full-term newborn with trisomy 13 syndrome. The newborns with 18 trisomy syndrome were poor sleepers with long periods of wakefulness and/or drowsiness. There were no consistent abnormalities in the sleep profile characteristic of 18 or 13 trisomy syndrome. These infants had some difficulty in organizing a stable sleep cycle especially during the immediate neonatal period. There was poor correlation between EEG patterns and states. After one to two weeks, cyclic organization of sleep showed some tendency towards normalization, although there were more trace alternant and fewer high voltage slow patterns in quiet sleep even around and after 44 weeks conceptional age. Other abnormal features of sleep often observed were an increase of indeterminate sleep, a decrease of quiet sleep, and an increase or decrease of active sleep in some records.

Cerebral Cortex↗
PubMed1979

Correlation between X-prolyl dipeptidyl-aminopeptidase and serum amine oxidase in serum of patients with post-burn keloids.

Activities of X-prolyl dipeptidyl-aminopeptidase (EC 3.4.14.1) and amine oxidase (EC 1.4.3.6) in serum were assayed in two groups of patients, children two to nine years old and adults 23 to 60 years old, with hypertrophic scars after severe burn. The peptidase activity tended to be low initially for several months after the burn, but then returned to normal after six months. These changes were marked in the child group, less so in the adult group. Similar but less-pronounced changes were also observed in serum amino oxidase activity. The two serum enzyme activities showed a significant positive correlation (r = 0.668, p less than 0.001, n = 27) in the patients.

Adolescent↗
PubMed1977

Electroclinical studies of seizures in the newborn.

Electroclinical features of neonatal seizures were studied in 215 neonates who developed seizures during the first three weeks of life. In 62 of them, clinical fits occurred during the actual polygraphic recording. The electro-clinical correlations were very variable, although there were some statistically significant associations between certain types of seizures and electrical discharges. The relation between seizures and sleep states was investigated in 40 infants who had more than three fits during the recording. The state in which more than 70% of seizures occurred was active sleep in 28% of the cases, quiet sleep in 13%, indeterminate sleep in 8%, and wakefulness in 8%. In 50%, seizures did not tend to occur in a given state. The authors thank Professor Suzuki for his continued interest and encouragement.

Cortical Synchronization↗
PubMed1976

The evolution of neurophysiological features in holoprosencephaly.

The evolution of EEG, visual and auditory evoked responses (VER and AER) and sleep is described in three cases of semilobar holoprosencephaly. During the neonatal period, the waking EEG was characterized by almost continuous high amplitude rhythmic alpha-theta activity in case 1 and 2, which became discontinuous during quiet sleep. Moderate amplitude rhythmic alpha-theta waves were seen in case 3. This rhythmic alpha-theta activity gradually disappeared with increasing age, being replaced by non-specific slow dysrhythmia. In case 3, the subsequent EEGs were characterized by focal spikes at 4 months, multifocal spikes at 5 and 6 months, hypsarrhythmia at 8 months and bisynchronous diffuse sharp and slow wave discharges at 2 years and 7 months. Ictal EEGs were characterized by desynchronization and/or rapid synchronization, epileptic recruiting rhythm and postical high amplitude slow waves. Definite but mostly abnormal VERs or AERs were obtained in all three cases. In two cases, the evoked responses showed a progressive decrease in amplitude and VERs were abolished finally. No sleep cycle could be identified during the neonatal period probably because of frequent seizures. In two cases no circadian rhythm of sleep developed, although almost normal REM-NREM sleep cycle was present.

Abnormalities, Multiple↗