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Biomedical subjects

Toru Kato

Publications and source records attributed to Toru Kato.

At least 19 recordsLinked to original sources
PubMed2007

Ictal EEG in benign partial epilepsy in infancy.

The aim of this study is to further clarify ictal electroencephalographic findings of patients with benign partial epilepsy in infancy in order to better understand its neurophysiologic features. The study group consisted of 13 infants with definite benign partial epilepsy in infancy, in whom ictal electroencephalograms were recorded and its benignity was confirmed at 8 years or more. The seizure manifestation was reviewed on the basis of video findings in eight patients in whom simultaneous video-electroencephalography recording was available. In the other five patients, the seizure manifestations were determined according to the observations of physicians, nurses, or technicians. Thirteen seizures from eight patients were complex partial, and six seizures from six patients were secondarily generalized ones. Ictal discharges at the onset of a seizure were focal in all seizures. The site of the origin of seizures was in the temporal area in 10 of 13 complex partial seizures, whereas it was in the parietal or occipital area in all 6 secondarily generalized seizures. Among 13 complex partial seizures, paroxysmal discharges remained focal throughout the seizures in 6 seizures, whereas they spread to one hemisphere in the other 7 seizures. Motion arrest or decreased responsiveness was uniformly observed. Lateral eye deviation was commonly recognized in complex partial seizures, whereas head rotation was observed only in seizures in which hemispheric propagation of ictal discharges was observed. Ictal electroencephalographic findings of patients with benign partial epilepsy in infancy were relatively uniform, suggesting the homogeneity of patients with benign partial epilepsy in infancy.

Aged↗
PubMed2006

Visual evoked potential in the newborn: does it have predictive value?

We reviewed studies on the predictive value of visual evoked potentials (VEPs) in the newborn. VEPs demonstrated a good correlation with neurodevelopmental outcome in full-term infants with birth asphyxia. However, their prognostic value in preterm infants is controversial. In preterm infants, most studies showed high specificities for neurodevelopmental outcome, but some studies demonstrated lower sensitivities.

Electroencephalography↗
PubMed2006

Mild oliguria in preterm infants who later developed periventricular leukomalacia.

The aim of this study is to determine whether or not renal involvement was present during the early neonatal period in preterm infants with PVL. We conducted a case-control study. The following items were evaluated; urine output, serum levels of sodium (Na), potassium (K), chloride (Cl), urea nitrogen (UN), and creatinine (Cr). The factors that could influence the urine output were also compared between the PVL and the control group. The mean urine output during the first 24h in the PVL group was 19.8ml/kg/day, and was significantly lower than in the control group (28.8ml/kg/day, p<0.05). The mean UN and Cr were not significantly different between the two groups. The minimal serum Na and Cl levels in the PVL group were significantly lower (128.3 and 94.3mEq/l) than those in the control group (134.8 and 100.7mEq/l, p<0.01 each). The maximal serum K level was significantly higher in the PVL group (6.47mEq/l) as compared to the control group (5.57mEq/l, p<0.05). There were no differences in any postnatal variables between the two groups. The preterm infants who later developed PVL had mild but significant oliguria during the first 24h of life. This suggests that preterm infants with PVL will have renal involvement immediately after birth.

Adult↗
PubMed2006

ACTH therapy for generalized seizures other than spasms.

PURPOSE: We reviewed our experience with ACTH for the treatment of intractable generalized seizures other than spasms. METHODS: Efficacy and adverse effects of ACTH against intractable generalized seizures other than spasms were retrospectively investigated in 15 patients treated between 1991 and 2003. The median age of the patients at ACTH therapy was 42 months. The targeted type of seizure was brief tonic in 6, atypical absence in 6, atonic in 2, and myoclonic in 1. The dose of ACTH was 0.01-0.015 mg/kg in most patients. The effect of ACTH was determined at the end of ACTH therapy, and 3 months and 1 year after ACTH therapy. RESULTS: Seizure freedom was obtained in 13 of 15 patients. However, 6 of them had a recurrence of seizures within 3 months after ACTH therapy. ACTH was the most effective in patients with atypical absence seizures. Statistical analysis showed that the number of injection and total dose of ACTH were smaller in patients with atypical absence seizures than in those with brief tonic seizures. Adverse effects were frequent but serious one was not observed. CONCLUSION: ACTH therapy was effective in patients with intractable generalized seizures other than spasms. However, its efficacy was often transient. ACTH can be useful for generalized seizures other than spasms but its limitation should be considered.

Adrenocorticotropic Hormone↗
PubMed2006

Antiepileptic treatment against clustered seizures in benign partial epilepsy in infancy.

We performed detailed review of clinical course of clustered seizures in patients with benign partial epilepsy in infancy in order to determine the optimal treatment during the acute period. We retrospectively investigated the details of antiepileptic treatment for clustered seizures in 20 patients with benign partial epilepsy in infancy. The temporal course of seizures and the use of antiepileptic drugs were investigated in each patient. Drugs were judged as effective when seizure cessation was achieved after administration of the drug. As the first drug, diazepam/bromazepam was effective in 14% and phenobarbital in 60%. As the second drug, diazepam/bromazepam was effective in 13% and phenobarbital in 40%. As the third drug, phenobarbital was effective in 56%. The efficacy rate of the first dose of phenobarbital was relatively higher than that of diazepam/bromazepam. Persistence of seizures after treatment was relatively shorter and the number of seizures after treatment was relatively smaller in patients treated with PB as the first 2 drugs. In conclusion, the efficacy of diazepam/bromazepam or phenobarbital was insufficient for the cessation of clustered seizures in benign partial epilepsy in infancy.

Anticonvulsants↗
PubMed2006

Amplitude spectral analysis of theta/alpha/beta waves in preterm infants.

The aim of this study is to clarify the usefulness of amplitude spectral analysis for the evaluation of maturational changes of theta, alpha, and beta activities in preterm infants. We chose 10 healthy infants, who were born without complications other than prematurity, who were 29-30 weeks, 31-32 weeks, and 33-34 weeks of postconceptional age, respectively, at time of electroencephalogram recordings. Fast Fourier transform algorithm was applied for amplitude spectral analysis. The analyzed data were divided into five frequency bands: theta 1 4-6 Hz, theta 2 6-8 Hz, alpha 8-13 Hz, beta 1 13-20 Hz, and beta 2 20-30 Hz. The average amplitude of six segments with continuous patterns with high-voltage slow waves of preterm infants was calculated in each frequency band. A significant reduction of the amplitude along with postconceptional age was present in all leads in theta 1 and theta 2 bands. On the other hand, a significant correlation with postconceptional age was not observed in alpha, beta 1, or beta 2 bands. In conclusion, maturational electroencephalographic changes assessed by amplitude spectral analysis were prominent in theta activities and were not remarkable in alpha or beta activities.

Brain↗
PubMed2006

Long-term follow-up of patients with benign partial epilepsy in infancy.

PURPOSE: The aim of this study was to investigate the long-term outcome of children with benign partial epilepsy in infancy (BPEI). METHODS: A telephone-interview survey using a structured questionnaire was conducted with patients who were diagnosed as having possible BPEI at age 2 years and who were 8 years or older at the time of the survey. The data from 39 of 48 patients were available. The median age at the time of the survey was 11.3 years; 18 boys and 21 girls were included. RESULTS: Three patients had a recurrence of unprovoked seizure beyond age 2 years. Four patients had cognitive problems (mild mental retardation in three and Asperger syndrome in one). An association of paroxysmal kinesigenic choreoathetosis was observed in three patients, and another three had experienced seizures associated with mild gastroenteritis. Major behavioral problems were not recognized in any patients. Four patients were excluded from having definite BPEI at age 5 years, and another two were excluded for having definite BPEI at the last follow-up. Eventually, 33 of 39 patients were categorized as having definite BPEI beyond 8 years of age. CONCLUSIONS: A large majority of patients diagnosed as possibly having BPEI at age 2 years did not have a recurrence of unprovoked seizures and cognitive problems beyond 8 years of age.

Age Factors↗
PubMed2006

Short-term passive smoking causes endothelial dysfunction via oxidative stress in nonsmokers.

Recent studies have shown that passive smoking impairs vascular endothelial function and induces oxidative stress in humans. However, in most of the previous human data regarding tobacco-induced pathophysiology, vascular endothelial dysfunction and oxidative stress have been separately assessed. This study was designed to determine the association between the acute effect of passive smoking on vascular endothelial function and in-vivo oxidative stress status. We studied 30 healthy male Japanese volunteers (32 +/- 7 years) including 15 habitual smokers and 15 nonsmokers. After baseline echocardiographic, hemodynamic recording, and blood sampling, subjects were exposed to passive smoking for 30 min. Endothelium-dependent vasodilation was measured by using % flow-mediated vasodilation (%FMD) of the brachial artery and plasma levels of 8-isoprostane was measured by enzyme immunoassay before and after the passive smoking exposure. Baseline %FMD was lower (4.3% +/- 1.2% vs. 10.9% +/- 3.1%, p < 0.001) and baseline plasma 8-isoprostane level was higher (41.5 +/- 5.8 pg/mL vs. 26.9 +/- 5.4 pg/mL, p < 0.001) in smokers than those in nonsmokers. The %FMD and 8-isoprostane level did not change after passive smoking in smokers. In nonsmokers, however, the %FMD decreased (to 5.0% +/- 1.9%, p < 0.001) and the 8-isoprostane level increased (to 37.8 +/- 9.6 pg/mL, p < 0.001) significantly after 30 min passive smoking exposure, equivalently to the levels of smokers. Sixty corrected samples before and after passive smoking exposure in all patients showed a significant negative correlation between the % FMD and the plasma 8-isoprostane levels (n = 60, r = -0.69, p < 0.001). Even 30 min of passive smoking rapidly impairs vascular endothelial function, which is associated with oxidative stress. Our data provide the pathophysiological insight for the recent epidemiological evidence about the increased risk of coronary heart disease among nonsmokers exposed to passive smoking.

Adult↗
PubMed2006

Popliteal angle in infants with west syndrome.

The aim of this study was to clarify the relationship between neurologic findings and outcome of patients with West syndrome, focusing on the popliteal angle. The complete neurologic examination, including an assessment of the popliteal angle and muscle tone, was performed on 45 patients with West syndrome. A tight popliteal angle was determined when it was 120 degrees or less. In all 45 patients, abnormal muscle tone was not correlated with any variables. A tight popliteal angle was correlated with seizure persistence, cerebral palsy, and abnormality on magnetic resonance imaging (MRI), as well as severe developmental delay. When limited to the patients with developmental delay, a tight popliteal angle was correlated with severe developmental delay, cerebral palsy, and MRI abnormality, although abnormal muscle tone was not correlated with any items. In the delay group, eight patients had a tight popliteal angle with normal muscle tone. Among them, severe developmental delay was seen in seven (88%), seizure persistence in five (63%), and MRI abnormality in five (63%). These results suggest that a tight popliteal angle might be an indicator of poor neurologic outcome in patients with West syndrome.

Female↗
PubMed2006

Low-density lipoprotein subfractions and the prevalence of silent lacunar infarction in subjects with essential hypertension.

Recent lipid research has focused on low-density lipoprotein (LDL) subfractions as new markers for cardiovascular risk. However, the clinical significance of measurement of LDL subfractions in subjects with essential hypertension is yet to be established. We studied the association between the prevalence of silent lacunar infarction (SLI) and LDL subfractions in patients with essential hypertension. We performed brain MRI to detect SLI and measured LDL subfractions in 100 asymptomatic non-diabetic middle-aged subjects with essential hypertension (mean age, 62 years). We fractionated LDL into three parts, LDL-1, LDL-2, and LDL-3, with LDL-3 being the oxidized subfraction. Of the 100 study subjects, 24 (24%) had one or more SLIs, while the remaining 76 (76%) were considered as a non-SLI group. The LDL-3 levels were significantly higher in the SLI group than in the non-SLI group (8.3 +/- 4.4 mg/dl vs. 6.3 +/- 2.0 mg/dl, p = 0.006). Multiple logistic regression analysis showed that LDL-3 levels alone were an independent predictor of SLI (odds ratio [OR]: 1.380; 95% confidence interval [CI]: 1.113-1.663; p = 0.003). When subjects were divided into quartiles based on LDL-3 levels, the prevalence of SLI was significantly higher in the highest LDL-3 level group than in the lowest LDL-3 level group (p = 0.0036). The present study suggests that LDL-3 levels are associated with the prevalence of SLI in subjects with essential hypertension.

Adult↗
PubMed2006

Stent-induced neutrophil activation is associated with an oxidative burst in the inflammatory process, leading to neointimal thickening.

Activation of leukocytes plays an essential role in the mechanism of restenosis. Prior research has focused on monocytes and little is known about the role of neutrophils in this process. Neutrophils are known to contribute to tissue injury through oxygen-derived free radicals that nitrate tyrosine. This study was designed to elucidate clinically the role of neutrophil-mediated oxidative burst in the regulation of the post-stent inflammatory process. In 36 patients undergoing coronary stenting, we serially measured serum levels of glycosyl-phosphatidil-inositol-anchored protein (GPI)-80,a modulator of Mac-1 on the surface of neutrophils, in samples of coronary sinus as well as peripheral blood. We also simultaneously measured the serum 3-nitrotyrosine/tyrosine ratio as an index of oxidative stress. The GPI-80 level and the 3-nitrotyrosine/tyrosine ratio increased in the coronary sinus after coronary stenting in a time-dependent manner; with the maximum increase of GPI-80 level (3.1 +/- 2.9 to 8.6 +/- 4.3 ng/ml, P < 0.01) at 48 hours, and 3-nitrotyrosine/tyrosine ratio at 24 hrs (5.2 +/- 4.8 to 28.4 +/- 13.2 x 10(-4), P < 0.01), more strikingly than in the peripheral blood. In the coronary sinus blood, the 3-nitrotyrosine/tyrosine ratio was correlated with GPI-80 levels at 24 hr (R = 0.58, P < 0.001) and at 48 hr (R = 0.41, P < 0.01). Multiple regressions analysis showed that the maximum responses of GPI-80 level and 3-nitrotyrosine/tyrosine ratio were independent predictors of angiographic late lumen loss. Our results may support a hypothesis that Mac-1-dependent activation of neutrophils causes oxidative burst in the post-stent inflammatory process, possibly leading to restenosis.

Amidohydrolases↗
PubMed2006

[High incidence of fatal cytokine-related disease among children with sequelae of perinatal hypoxic-ischemic encephalopathy].

Children with sequelae of perinatal hypoxic-ischemic encephalopathy (HIE) occasionally suffer from cytokine-related disease. We investigated 12 children with perinatal HIE sequelae, who died in childhood, concerning (1) the incidence of cytokine-related disease as the cause of death, and (2) the characteristics of the cytokine-related disease. Six (50%) of the 12 patients died from cytokine-related disease:two had virus-associated hemophagocytic syndrome (VAHS) ; one had acute encephalopathy;one had systemic inflammatory response syndrome (SIRS); and two had severe pneumonia/acute respiratory distress syndrome (ARDS). These six patients presented with increased liver transaminase, LDH, and CK, and decreased platelet count and albumin. This study shows the high incidence of cytokine-related disease as the cause of death in children with perinatal HIE sequelae. Further investigation is needed to clarify the pathogenesis of this disease.

Basal Ganglia Diseases↗
PubMed2006

Postprandial hyperglycemia is a possible contributor to paroxysmal atrial fibrillation: a case report.

Atrial fibrillation, a major risk factor for stroke, is believed to occur first as paroxysmal episodes, gradually becoming more persistent, and finally progressing to chronic atrial fibrillation. Treatment of paroxysmal atrial fibrillation is an important target to prevent chronic atrial fibrillation. We describe a very unique case with postprandial hyperglycemia and obesity associated with drug-refractory paroxysmal atrial fibrillation. A 73-year-old Japanese woman with postprandial hyperglycemia suffered from drug-refractory paroxysmal atrial fibrillation. A 1600 kcal/day diet and walking three times/day for more than 30 min eliminated paroxysmal atrial fibrillation after 6 months. Diet and exercise should be considered as the initial therapy in patients with paroxysmal atrial fibrillation who also have postprandial hyperglycemia. This case suggests that postprandial hyperglycemia and insulin resistance might be one of the possible underlying mechanisms of paroxysmal atrial fibrillation.

Aged↗
PubMed2005

Efficacy and adverse effects of rectal thiamylal with oral triclofos for children undergoing magnetic resonance imaging.

We studied the efficacy and adverse effects of rectal thiamylal in combination with oral triclofos in sedation for pediatric magnetic resonance imaging. Five hundred forty-six children underwent MRI examination from January of 1997 to December of 2001. Among them, 10mg/kg of rectal thiamylal was administrated after oral triclofos in 378 children. Successful sedation was obtained in 321 of 378 patients (85%) after a single rectal administration of thiamylal. Totally, 369 children (98%) could undergo MRI examination completely under successful sedation. Adverse effect was observed only in one patient showing respiratory depression. Rectal thiamylal is effective for sedation for MRI in children. Adverse effect was rare in our patients. Although the risk of side effect was considered to be rare, we should follow principles for the sedation of children.

Administration, Oral↗
PubMed2005

An appropriate indication for the initiation of beta-blocker therapy in dilated cardiomyopathy.

BACKGROUND: Although long-term treatment with beta-blockers has been shown to improve morbidity and mortality in dilated cardiomyopathy (DCM), patient responses are heterogeneous. METHODS: To establish the appropriate indication for the initiation of beta-blocker therapy, we retrospectively analyzed 38 DCM patients treated with beta-blockers (metoprolol or carvedilol) and examined differences in baseline profiles between patients who could continue the therapy (responders) and those who could not (non-responders). RESULTS: In 13 non-responders, the duration from onset of symptoms to beta-blocker initiation was longer (p < 0.05), systolic blood pressure was lower (p < 0.001), serum sodium concentration was lower (p < 0.05), left ventricular posterior wall thickness was thinner (p < 0.05), left ventricular end-diastolic pressure was higher (p < 0.05) and left ventricular wall stress was lower (p < 0.05) than in 25 responders. In 19 patients receiving carvedilol, 5 non-responders showed higher levels of human atrial natriuretic peptide (p < 0.05) and brain natriuretic peptide (p < 0.01) than 13 responders. Discriminant analysis with a linear discriminant function showed the following equation predicted response to beta-blocker therapy: h = 0.004 x systolic blood pressure - 0.002 x brain natriuretic peptide + 0.667 (R2 = 0.67, p < 0.001). The probability of predicting the response was 94.1% with h > or = 0.5. CONCLUSION: We conclude that h > or = 0.5 is the appropriate indication for the initiation of beta-blocker therapy in DCM.

Adrenergic beta-Antagonists↗
PubMed2005

Local release of C-reactive protein from vulnerable plaque or coronary arterial wall injured by stenting.

OBJECTIVES: The purpose of this study was to assess local release of C-reactive protein (CRP) from atherosclerotic plaques or the vessel wall injured by stenting. BACKGROUND: Recent research has focused on the local production of CRP, especially in inflammatory atherosclerotic plaques. METHODS: The study consisted of two separate protocols. In protocol 1, we measured serum high-sensitivity-CRP (hs-CRP) levels in coronary arterial blood sampled just distal and proximal to the culprit lesions in 36 patients with stable angina and 13 patients with unstable angina. In protocol 2, we measured serial serum hs-CRP levels and activated Mac-1 on the surface of neutrophils in both coronary sinus and peripheral blood in 20 patients undergoing coronary stenting. RESULTS: In protocol 1, CRP was higher in distal blood than proximal blood in both stable (p < 0.05) and unstable angina (p < 0.01). The translesional CRP gradient (distal CRP minus proximal CRP, p < 0.05) as well as the proximal CRP (p < 0.05) and distal CRP (p < 0.05) was higher in unstable angina than in stable angina. In protocol 2, the transcardiac CRP gradient (coronary sinus minus peripheral blood) and activated Mac-1 increased gradually after stenting, reaching a maximum at 48 h (p < 0.001 vs. baseline for both). There was a positive correlation between the transcardiac CRP gradient and activated Mac-1 at 48 h (r = 0.45, p < 0.01). CONCLUSIONS: C-reactive protein is an excellent marker for plaque instability or poststent inflammatory status, and its source might be the inflammation site of the plaque or the coronary arterial wall injured by stenting.

Aged↗
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↗