Epileptic syndromes in neonates: nosological problems from etiological aspects.
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Biomedical subjects
Publications and source records attributed to K Otani.
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To distinguish hypoplastic myelodysplastic syndrome (MDS) from aplastic anemia (AA), morphological abnormalities of bone marrow hematopoietic cells in 8 patients with MDS and 39 patients with AA were studied. All the patients with MDS and AA showed prolonged plasma iron disappearance time, (PIDT1/2) > 120 min. Five hundred erythroid and myeloid cells, as well as 20 megakaryocytes were counted. Dysplastic changes were defined if morphological changes were present in more than 1.0% cells with only one lineage, or in more than 0.6% cells with more than two lineages. Twenty six of 39 patients with AA showed morphological abnormalities. In MDS cases, morphological abnormalities were prominent in trilineage cells in some cases, in bilineage (erythroid and megakaryocytic or myeloid and megakaryocytic cells), in others, or solely in myeloid cells or in megakaryocytic cells in other cases. Morphological abnormalities seen solely in erythroid cells, especially those with segmented nuclei were considered to be less significant for the diagnosis of MDS. The findings were considered to be useful to distinguish hypoplastic MDS from AA.
1. Ethanol-induced sleep time was significantly longer in F344 than LEW rats. However, there is no difference in barbital-induced sleep time between F344 and LEW. 2. Development of tolerance to ethanol-induced motor impairment was slightly faster in F344 than in LEW rats. While, LEW rats more easily developed tolerance to the impairment by barbital in comparison with F344 rats. 3. F344 and LEW rats were chronically treated with liquid diet containing ethanol or with barbital-admixed food. After the termination of ethanol and barbital treatments, various withdrawal signs occurred in F344 rats, including tremor and convulsions, whereas LEW rats showed no convulsions. Withdrawal scores of ethanol and barbital were significantly higher in F344 than in LEW rats. 4. These results suggest that strain differences in physical dependence on ethanol and barbital may be mainly influenced by the susceptibility to ethanol and the development of tolerance to barbital, respectively.
The effects of zonisamide (3-sulfamoylmethyl-1,2-benzisoxazole), a novel anticonvulsant, on extracellular levels of monoamine and its metabolite in the striatum and hippocampus, and Ca2+ dependent monoamine release in the striatum of freely moving rats were studied by microdialysis. Zonisamide increased dopamine, homovanillic acid and 5-hydroxyindoleacetic acid, and decreased 3,4-dihydroxyphenylacetic acid in the rat striatum. However, zonisamide showed no effect on Ca2+ dependent dopamine release in the rat striatum. In the hippocampus, zonisamide increased dopamine, homovanillic acid, serotonin and 5-hydroxyindoleacetic acid and decreased 3,4-dihydroxyphenylacetic acid. The present results suggest that zonisamide facilitates dopaminergic and serotoninergic neurotransmission but does not affect Ca2+ dependent dopamine release within therapeutic plasma concentrations.
In order to clarify reflex profiles in the first year of life in connection with categories of neurological abnormality, six primitive reflexes, i.e., the crossed extensor reflex, suprapubic extensor reflex, heel reflex, Galant response, asymmetric tonic neck reflex and plantar grasp response, were examined in 458 normal infants, 78 infants with cerebral palsy (CP) and 81 infants with mental retardation (MR), whose diagnoses were confirmed at a later follow-up examination. The change in the mean score for each of these reflexes with age was characteristic for each category or type of neurological abnormality. This implies that a presumptive diagnosis can be made in neurologically high-risk infants by examination of the primitive reflexes. Such reflexes are therefore of specific significance, among other neurological criteria, in infants within the first year of life.
Since 1986 we have performed expansive laminoplasty with reattachment of the spinous processes and extensor musculature in cases of cervical myelopathy, to avoid the late postoperative complications of extensive laminectomy. The operative procedure and results are given in detail. Forty cases (24 men, 16 women) were followed for a mean of 28 months. Postoperative results were satisfactory, with no major complications according to the evaluation criteria of the Japanese Orthopaedic Association. No instability or malalignment was seen on postoperative radiographs.
The main purpose of the present study was to examine the possibility that plasma concentrations of mianserin and its metabolite, desmethylmianserin, might be predicted by recording subjective side effects. In 44 depressed patients, subjective side effects during 3 weeks of treatment with 30 mg of mianserin were evaluated by the UKU Side Effect Rating Scale, and their relationships to plasma concentrations of mianserin and desmethylmianserin were analyzed. There was no significant relationship between plasma concentrations of these compounds and the occurrence of mianserin-induced side effects, except for dryness of mouth during week one. Our study, therefore, suggests that it is difficult to predict plasma concentrations of mianserin and desmethylmianserin based on the occurrence of subjective side effects.
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Single oral, subcutaneous or intravenous administration to mice and rats and oral administration to dogs were performed to investigate the acute toxicity of FUT-187. 1) LD50 values in mice were 4,395 mg/kg for males and 3,626 mg/kg for females orally, 6,284 mg/kg for males and 5,492 mg/kg for females subcutaneously, and 39.4 mg/kg for males and 41.4 mg/kg for females intravenously. In rats, these values were 4,653 mg/kg for males and 3,761 mg/kg for females orally, 6,799 mg/kg for males and 3,343 mg/kg for the females subcutaneously and 21.8 mg/kg for males and 15.8 mg/kg for females intravenously. 2) Death occurred 2 hours after administration in a male dog of the 3,000 mg/kg group just after convulsion and nasal discharge were observed. 3) General symptoms in mice and rats included a creeping gait, convulsion, singultus, cyanosis, decreased locomotor activity, piloerection and salivation which were commonly observed by all routes. All dogs showed vomiting and decreased locomotor activity; the prone or lateral position, crouching, ataxic gait and salivation were also observed in many cases. 4) On autopsy, changes attributable to local irritation by FUT-187 were seen in all species except mice and rats dosed intravenously. For the gastro intestinal-tract (GIT), inflammation of the stomach, adhesions between the stomach and the liver and sclerosis, petechiae or ulcer were observed in mice and rats dosed orally. In the subcutaneous route, retention of the test compound and necrosis at the injection site were observed. Reddening and loss of mucosal smoothness were observed in the GIT of a dog which died; desquamation, congestion, hemorrhage and retention of tested compound in the digestive mucosa were observed on histopathology.
6-Amidino-2-naphthyl 4(-)[(4,5-dihydro-1H-imidazol-2-yl) amino] benzoate dimethanesulfonate (FUT-187) was given orally to pregnant Crj : CD (Sprague-Dawley) rats from days 7 through 17 of gestation at dose levels of 50, 200 and 800 mg/kg/day. In the 800 mg/kg/day group, salivation just after dosing, suppression in body weight gain and decreased food consumption were observed. No external, visceral and skeletal anomalies attributable to FUT-187 were observed in fetuses. From the present result, it is considered that the no-effect dose level of FUT-187 for dams and fetuses are 200 mg/kg/day and 800 mg/kg/day respectively.
Antigenicity study of 6-amidino-2-naphthyl 4(-)[(4,5-dihydro-1H-imidazol-2-yl)amino] benzoate dimethanesulfonate (FUT-187), a new protease inhibitor, was investigated in guinea pigs and mice and the following results were obtained. 1. In guinea pigs immunized with FUT-187 plus adjuvant by intramuscular/subcutaneous routes, ASA, ACA and PCA reactions challenged intravenously or intradermally were positive. 2. In guinea pigs immunized with FUT-187 plus adjuvant by intramuscular/subcutaneous routes, ASA and PCA reactions challenged orally were negative. 3. In guinea pigs immunized with FUT-187 by the oral route, ASA, ACA and PCA reactions were negative. 4. In guinea pigs immunized with IABA and AN plus adjuvant by intramuscular/subcutaneous routes, ASA and PCA reactions were negative. 5. 48-hr PCA reactions were elicited with sera obtained from BALB/c and C3H/He mice immunized with FUT-187 plus adjuvant by the intraperitoneal route, responses were negative. 6. From the results of hapten inhibition tests using anti-FUT-187 guinea pig serum, it is suggested that the antigenicity of FUT-187 is attributable to the its benzoic acid.
A subacute oral toxicity study of 6-amidino-2-naphthyl 4-[(4,5-dihydro-1H-imidazol-2-yl) amino] benzoate dimethanesulfonate (FUT-187), a new protease-inhibiting agent, was carried out in beagle dogs of both sexes. FUT-187 was administered to dogs at daily oral doses of 15, 50 and 150 mg/kg. Dogs in 150 mg/kg group were given twice a day in a.m. and p.m.. The results were as follows: 1. Changes of physical sign attributed to FUT-187, consisted of vomiting, diarrhea, salivation, decrease of locomotor activity, sedation and hyperemia of eye mucosa. These changes expect vomiting vanished within about 2 hours after treatment. One male given 150 mg/kg died on day 19 and two females given 150 mg/kg were sacrificed on day 55 and 67 due to deterioration of systemic conditions. 2. Body weight gain was suppressed in males given 150 mg/kg and females given 50 mg/kg or more. 3. In hematological examinations, some changes suggesting anemia or inflammation were observed in a few animals received 50 mg/kg or more 4. In serum biochemical examinations, dogs given 50 mg/kg or more had decrease of albumin, total protein, A/G ratio and total cholesterol, increase of GPT activity. In liver function test, decrease of function was observed in a few animals in 150 mg/kg group. These changes diminished by the end of recovery period. 5. In autopsy findings, ulcer formation and desquamation of mucosa in the digestive tract were observed in dead or sacrificed animals and survived animals given more than 50 mg/kg. In sacrificed animals, liver was yellow in color and intussusception was seen. 6. Plasma levels of intact FUT-187 and metabolites on the day 37 or 83 were higher than that on the first day of administration. 7. In histopathological examinations, ulcer formation, desquamation, degeneration and/or atrophy of mucosa in the digestive tract were observed in the animals from 50 mg/kg and 150 mg/kg groups. In addition, fatty deposition in hepatocytes was observed in one dead animal and two sacrificed animals.(ABSTRACT TRUNCATED AT 400 WORDS)
"This paper examined the relationship between locus of control and such variables as unmarried woman's sexual activity, wife's experience of premarital conception, female marriage probability, post marital contraception and first-conception probability in present-day Japan...[using data from the 1987] Ninth Japanese National Fertility Survey....[The findings] contradict the general prediction that the internal locus of control is associated with well-planned behaviours...." (SUMMARY IN JPN)
To assess the relative contribution of antiepileptic drugs (AEDS) to occurrence of congenital malformations, we compared two prospective studies. We analyzed data for 14 AEDs for total daily doses (drug score) and eight background factors. From the first study, the drug score and polytherapy--particularly the use of valproate plus carbamazepine--were suspected to be primary factors for increased incidence of congenital malformation. In the other study, the drug score for each case was decreased, and polytherapy--particularly valproate plus carbamazepine--was changed to monotherapy before conception. These changes significantly decreased the incidence of malformations. Among risk factors, only the doses of methylphenobarbital for mothers of infants with malformations were significantly higher than those for mothers of infants without malformations. Statistical differences were seen in drug score, number of AEDs, maternal age at delivery, seizure type, and etiology of epilepsy between the two groups. When data were corrected for seizure type, maternal age at delivery, or etiology of epilepsy, the difference in the incidence of malformations did not disappear, but it did disappear when data were corrected for drug score or number of AEDs. These results support our previous observations that AEDs are primary factors for the increased incidence of congenital malformation in infants of mothers with epilepsy.