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Biomedical subjects

Kazuyoshi Watanabe

Publications and source records attributed to Kazuyoshi Watanabe.

At least 37 records · Page 2Linked to original sources
PubMed2005

Comparison of two low dose ACTH therapies for West syndrome: their efficacy and side effect.

In order to clarify the appropriate usage of adrenocorticotropic hormone (ACTH), the efficacy and side effects of two different regimens of low dose ACTH therapy were compared. Thirty-four patients with West syndrome (WS) were treated with ACTH. The dose of synthetic ACTH-Z was 0.015 mg/kg/dose in 18 patients who were treated between 1996 and 1998 (regimen A), and 0.010 mg/kg/dose in 16 patients who were treated between 1999 and 2001 (regimen B). Patients were classified into cryptogenic and symptomatic groups. Efficacy and adverse effects of ACTH were compared between regimens A and B. Similar analyses were performed after stratification into cryptogenic and symptomatic groups. The efficacy of ACTH was not different between regimens A and B. However, among patients with symptomatic WS, the number of ACTH injections and the dose of ACTH until cessation of spasms were significantly smaller in regimen A than in regimen B. There was no significant difference in these variables between the regimens among those with cryptogenic WS. Adverse effects were not different between regimens A and B. 0.010 mg/kg per day of ACTH will be adequate for cryptogenic WS, but 0.015 mg/kg per day of ACTH is recommended for symptomatic WS.

Adrenocorticotropic Hormone↗
PubMed2005

Popliteal angle in preterm infants with periventricular leukomalacia.

The aim of this study is to clarify the usefulness of popliteal angle in infants with periventricular leukomalacia. The popliteal angle was measured at 1, 4, 8, and 12 months of corrected age in 47 infants with periventricular leukomalacia and in 103 control infants with normal development. The popliteal angle was categorized into two groups; tight, when it was < or =120 degrees , and wide, when it was >120 degrees . The severity of diplegia was defined at 2 years as follows: mild, when an infant could walk; moderate, when an infant could sit but could not walk; severe, when an infant could not sit. Tight popliteal angle was more often observed in infants with periventricular leukomalacia than in normal infants at any corrected age. The rate of tight popliteal angle was significantly lower in infants with mild diplegia than in those with moderate or severe diplegia at 8 and 12 months of corrected age. Specificity and positive predictive value were high at 8 and 12 months of corrected age, whereas sensitivity was relatively low. The results of this study suggest that evaluation of popliteal angle is useful for detection of infants with periventricular leukomalacia, although false-negative rate is high during late infancy.

Case-Control Studies↗
PubMed2005

Congenital cytomegalovirus infection diagnosed by polymerase chain reaction with the use of preserved umbilical cord.

We report a patient with congenital cytomegalovirus infection diagnosed retrospectively by real time polymerase chain reaction with the use of a preserved umbilical cord. The patient had mild developmental delay without apparent hearing loss at the diagnosis. Congenital cytomegalovirus infection was suspected on the basis of magnetic resonance imaging that showed abnormal signal intensities in the gray-white matter junction.

Brain↗
PubMed2005

Epilepsies after Pocket Monster seizures.

BACKGROUND: We conducted a 5-year follow-up study in patients with a seizure induced by animated cartoon "Pocket Monster." METHODS: A recurrence of seizures was observed in 25 of 91 patients with a Pocket Monster seizure. The patients were divided into two groups: Epilepsy group of 12 patients with a history of epilepsy and Nonepilepsy group of 13 patients without a history of epilepsy. RESULTS: Age below 12 years and generalized seizures were more often in Nonepilepsy group than in Epilepsy group. Seizure recurrence was earlier in Epilepsy group than in Nonepilepsy group. Photoparoxysmal response was relatively infrequent in Epilepsy group. The majority of patients were classified into idiopathic generalized epilepsies in Nonepilepsy group, whereas most patients were categorized into localization-related epilepsies in Epilepsy group. CONCLUSIONS: Epilepsies after Pocket Monster seizures were different according to the presence or absence of a history of epilepsy. These results will be useful in order to determine the treatment of a patient with a visually induced seizure.

Cartoons as Topic↗
PubMed2005

Growth pattern changes of meningiomas: long-term analysis.

OBJECTIVE: Although tumors are generally expected to grow exponentially, it is not known whether meningiomas retain a constant growth rate or not because of the lack of long-term follow-up. We analyzed the long-term growth pattern of meningiomas. METHODS: Twenty patients with a total of 31 meningiomas were radiologically followed for 4.1 to 18.3 years (median, 10.1 yr). Seven patients (including two neurofibromatosis cases) had incidental tumors. Another 13 patients with symptomatic tumors were followed after surgery. Their volumes were measured, and their time-volume curves were plotted. RESULTS: The growth curves of four atypical meningiomas fitted better to an exponential curve (R > 0.95). Two calcified tumors did not grow. Although the other benign tumors grew exponentially or linearly, their tumor volume doubling times in the initial phase were shorter than those in the later phase in most cases. Meningiomas without calcification tended to grow exponentially, whereas those with calcification were likely to reveal a linear growth pattern (P = 0.002, chi2 test). This was supported by the observation that in two patients, the tumor growth pattern changed from exponential to linear and from linear to no growth with progression of calcification. CONCLUSION: Three growth patterns of meningiomas were demonstrated. Atypical meningiomas grew exponentially. Conversely, benign meningiomas revealed exponential, linear, or no growth. The growth pattern of the latter may change with the appearance of calcification.

Adult↗
PubMed2005

[Subacute encephalitis/encephalopathy with residual cognitive deficit].

We studied clinical features of 5 patients with subacute encephalitis/encephalopathy with residual cognitive deficit. In all patients, impairment of consciousness was mild at the onset, progressed between 4 and 15 days after the onset, and reached its peak at 6-18 days after the onset. Neuroradiological or electrophysiological examinations at the onset showed normal or mildly abnormal findings. In accordance with the clinical deterioration, brain atrophy was detected on cranial magetic resonance imaging (MRI) in 3 patients, and electroencephalogram revealed slowing of the background activities in all patients. Single photon emission computed tomography (SPECT) showed hypoperfusion in the fronto-temporal areas in all patients at the recovery stage. Three patients had severe mental deficits, and the other two had mild cognitive deficit. Motor impairment was observed in one patient.

Atrophy↗
PubMed2005

[Urachal anomalies and tumor: clinical investigation of 14 cases].

Diseases associated with persistent urachus are relatively rare. During the past 9-year period, there have been 14 patients with urachal disease consisting of 10 with urachal abscess and 4 with urachal cancer. The 10 patients with urachal abscess consisted of 7 males and 3 females aged 19-77 years (mean, 46 years). The 4 patients with urachal cancer consisted of 2 males and 2 females aged 48-81 years (mean, 57 years). As symptoms, lower abdominal pain was frequently observed in the patients with persistent urachus with abscess and gross hematuria in those with urachal cancer. Echo and magnetic resonance imaging (MRI) were useful for visualizing the lesion. Computed tomogtaphic (CT) scanning could not visualize the lesion in 2 patients. Nine patients underwent MRI, which visualized the lesion in all of them. As urachal abscess, an umbilical fistula was observed in 3 patients, urachal cyst in 4, and urachal diverticulum in 1. The preoperative diagnosis was urachal cancer in 6 patients, and pathological examination showed 4 patients with adenocarcinoma, 1 with inflammatory granuloma, and 1 with pseudosarcoma. Urachal abscess was treated by resection of the abscess in 6 patients, transurethral resection in 1, and resection of the umbilicus and urachus and total cystectomy in the other. Of the patients with urachal cancer, 1 underwent total cystectomy and the other 3 underwent total urachal resection and partial cystectomy. In 2 patients with persistent urachus with abscess, the differentiation between abscess and malignant tumor was difficult.

Abscess↗
PubMed2004

The evolutionary change of flash visual evoked potentials in preterm infants with periventricular leukomalacia.

OBJECTIVE: The aim of this study was to prospectively investigate flash visual evoked potential (VEP) findings and their chronological changes in preterm infants with cystic periventricular leukomalacia (PVL) during the early neonatal period. METHODS: The subjects of this study were 14 preterm infants with cystic PVL. The patients underwent serial cranial ultrasonography and diagnosed as having cystic PVL. Flash VEPs were diagnosed at least twice within the first 3 weeks of life. RESULTS: All infants had at least one or more flash VEP abnormalities. The most common finding was 'absent VEP', which was seen in 13 infants (93%). 'Delayed latency' was seen in two infants and 'abnormal waveform' was seen in one infant. Concerning the chronological changes, all records were abnormal in 4 infants, and the other 10 had transient normal VEP findings. Among them, flash VEPs changed from normal to abnormal within 10 days after birth in most cases. CONCLUSIONS: Almost all infants with cystic PVL had abnormal flash VEPs within the first 3 weeks of life, but chronological changes of flash VEP findings were seen during the period. SIGNIFICANCE: This manuscript may be useful as a reference to the flash VEPs in preterm infants with cystic PVL.

Cerebral Cortex↗
PubMed2004

Susceptibility of medical students to vaccine-preventable viral diseases: a serological study.

As a measure for the prevention and control of nosocomial infections in medical school students, we examined the students' titers of antibodies to measles, rubella, varicella, and mumps viruses to determine whether vaccination was required. We also analyzed and discussed correlations among antibody titers to the viruses. Subjects were 363 Juntendo University students, ranging from freshmen to seniors. EIA was used to measure IgG antibody titers. Eight subjects (2.2%) had negative titers for measles, 36 (9.9%) for rubella, 8 (2.2%) for varicella, and 10 (2.7%) for mumps. Seronegative subjects were vaccinated against each virus and high seroconversion rates were obtained: 100% for measles and rubella, 67% for varicella, and 89% for mumps. In addition, we used Pearson's test to search for correlations among the antibody titers for each virus. A weak correlation was observed among antibody titers for measles, rubella, and mumps but not for varicella. These results suggest that MMR vaccine might be effective in people with low levels of antibody to measles, rubella, and mumps.

Adult↗
PubMed2004

Non-epileptic pedaling-like movement induced by triclofos.

We reported an otherwise healthy infant with non-epileptic pedaling-like movement induced by triclofos. For the purpose of sedation for head computed tomography, 80 mg/kg of triclofos was administered. Fifteen minutes after the use of triclofos, the infant exhibited pedaling-like movement accompanied by slight upper eye deviations. This movement could be arrested by manual restraint. The pedaling-like movement lasted for about 2 h intermittently. Electroencephalography during this movement revealed physiological activities with semirhythmic theta waves without paroxysmal activities.

Brain↗
PubMed2004

A pilot study on lidocaine tape therapy for convulsions with mild gastroenteritis.

The aim of this study was to clarify the efficacy and safety of lidocaine tape therapy (LDT) in patients with convulsions with mild gastroenteritis (CwG). Twenty-one consecutive episodes of CwG were treated with LDT therapy. The dose of LDT was 36 mg in patients with body weights of <15 kg, 54 mg in those with body weights between 15 and 20 kg, and 72 mg in those with body weights of >20 kg. LDT was attached on the back of each patient every 12 h. Application of LDT was continued for 48 h. The serum levels of lidocaine (LD) were measured 4 h after the first attachment of LDT. The seizures completely ceased in 13 episodes (62%) after the application of LDT, while a recurrence of seizures was observed in the other 8 episodes. Drip infusion of LD was performed in 4 of these 8 episodes. The serum LD levels were only measurable in 6 infants (average, 0.4 microg/ml; range, 0.2-0.5 microg/ml). In the other patients, the serum LD levels were below the lower limit of measurement. Adverse effects of LDT were not observed in any patients. LDT therapy was safe and effective in patients with CwG.

Administration, Cutaneous↗
PubMed2004

Temporal structure of the apparent motion perception: a magnetoencephalographic study.

Humans perceive motion when numerous small dots pattern is followed by one of the same pattern but with all the dots shifted a little in one direction. When the amount of shift exceeds a level humans no more perceive motion even though physical visual information does not change. Using this stimulus, we addressed to elucidate the temporal structure of the neural activity related to this apparent motion perception. The magnetic responses to the random-dot patterns with various amounts of shift were measured while the subjects were performing a direction discrimination task. A significant magnetic response amplitude change occurred with three distinct peaks when the response inducing apparent motion was compared with those inducing no motion without change in the response latencies. The major difference occurred at about 110, 140, 210 ms after the stimulus onset. The response origin was always within the occipitotemporal area. The results indicate that the neural activity for the perception of apparent motion can be measured by MEG that occur at least 110 ms after the stimulus onset possibly in the human MT+. Three distinct peaks in the response difference may represent the sequential multiple neural process proposed theoretically though further study is necessary to prove.

Adult↗
PubMed2004

Popliteal angle of low birth weight infants during the first year of life.

The aim of this study is to clarify the evolutional changes of the popliteal angle in low birth weight infants during the first year of life. The popliteal angle was measured at 1, 4, 8, and 12 months of corrected age on routine physical examination of 204 appropriate-for-date infants who had achieved normal psychomotor development. The popliteal angle was visually determined and categorized into two groups; tight, when it was 120 degrees or less, and wide, when it was more than 120 degrees. The infants were divided into five groups according to their birth weights; Group E, birth weight or=2500 gm. At 4 months of corrected age, the rate of a tight popliteal angle was significantly higher in Groups E + V + L1 than in Groups L2 + N. A tight popliteal angle was rare in all groups at 8 or 12 months of age. The results of this study indicate that the physiologic muscle tone of lower extremities is higher in infants with birth weights of <2000 gm at 4 months of corrected age. One should carefully interpret a tight popliteal angle in low birth weight infants during early infancy. Serial assessment of the popliteal angle is necessary before judging that a low birth weight infant has spastic cerebral palsy.

Biological Evolution↗
PubMed2004

Unconsciousness and delirious behavior in children with febrile seizures.

The aim of this study is to clarify the incidence and clinical features of prolonged unconsciousness and delirious behavior in children with febrile seizures. We studied 213 consecutive febrile seizures during 208 febrile episodes in 203 patients. The seizure manifestations, the duration of seizures, the duration of unconsciousness, and the presence or absence of delirious behavior were determined on the basis of interviews with the parents with the assistance of medical records. The duration of seizures was less than 5 minutes in 90.2% of the seizures. The duration of unconsciousness was less than 30 minutes in 93% of the seizures. Delirious behavior was observed in 2.0% of the patients. Delirious behavior appeared before febrile seizures, and its duration was not long. On multiple regression analysis, nongeneralized seizures, seizures of >/=5 minutes, and intravenous diazepam were demonstrated to be independently associated with prolonged unconsciousness. In conclusion, prolonged unconsciousness and delirious behavior are rare in children with febrile seizures. Careful diagnostic evaluation is necessary when a child with febrile seizures has associated prolonged unconsciousness or delirious behavior.

Child↗
PubMed2004

Diffusion tensor imaging in frontal lobe epilepsy.

We report a 13-year-old female with refractory frontal lobe epilepsy in whom diffusion tensor imaging was useful for exploring subtle cortical malformation. She had frequent simple partial seizures characterized by clonic movement of the right upper extremity. Conventional magnetic resonance imaging was not conclusive. A diffusion tensor imaging revealed an increased apparent diffusion coefficient and reduced anisotropy in the left frontal lobe. Positron emission tomography disclosed hypermetabolism in the adjacent area. We could identify the relatively thick cortex with an indistinct gray-white matter junction in a thin-slice T(1)-weighted image.

Adolescent↗
PubMed2004

Efficacy of antiepileptic drugs in patients with benign convulsions with mild gastroenteritis.

The aim of this study was to clarify the efficacy of antiepileptic drugs during a cluster of seizures in patients with convulsions with mild gastroenteritis (CwG). We retrospectively investigated the details of antiepileptic treatment in 110 consecutive episodes in 103 patients with CwG. The temporal course of the seizures and the use of antiepileptic drugs were investigated in each episode. Drugs were judged as effective when seizure cessation was achieved after administration of the drug. As the first drug, diazepam (DZP)/bromazepam (BZP) was effective in 38%, phenobarbital (PB) in 40%, and lidocaine (LD) in 100%. As the second drug, DZP/BZP was effective in 42%, PB in 69%, and LD in 100%. As the third drug, PB was effective in 70%. When the efficacy of the first doses of PB and LD were compared, the efficacy rate was significantly higher for LD than for PB (P = 0.047). In conclusion, LD was effective for the cessation of seizures in patients with CwG.

Anesthetics, Local↗
PubMed2004

Treatment and outcome in patients with febrile convulsion associated with epileptiform discharges on electroencephalography.

The aim of this study is to determine the efficacy of prophylactic treatment for patients with febrile convulsions (FCs) in whom electroencephalograms (EEGs) revealed epileptiform discharges. We retrospectively investigated 43 patients who met the following criteria: (a) at least one FC during the study period; (b) epileptiform discharges were first recognized; (c) no unevoked seizures before epileptiform discharges were first seen; (d) normal psychomotor development and no neurological abnormality; and (e) follow-up >3 years. The clinical characteristics, treatment, and a later occurrence of FCs or unevoked seizures were studied. EEGs revealed focal epileptiform discharges in 25 patients and generalized ones in 18. There was no significant difference in the rate of recurrence of FC or occurrence of unevoked seizures between those with focal and generalized epileptiform discharges. No prophylaxis was performed in ten patients, 14 patients being treated with intermittent diazepam and 19 with a daily anticonvulsant. The rate of recurrence of FC was not significantly different between patients with and without prophylaxis. Unevoked seizures were only observed in two patients undergoing daily treatment. Intermittent or daily anticonvulsant therapy will not reduce the risk of recurrence of FCs or later development of unevoked seizures in patients with FC with epileptiform discharges.

Anticonvulsants↗