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Biomedical subjects

Y Futagi

Publications and source records attributed to Y Futagi.

At least 55 records · Page 3Linked to original sources

Cerebral blood flow during ACTH therapy: especially diurnal changes within the first week of therapy.

Changes in cerebral blood flow (CBF) were evaluated in children with epilepsy treated with adrenocorticotrophic hormone (ACTH) by the Doppler ultrasound method. The average maximal blood velocity (A/L) and maximal end-diastolic blood velocity (d) of the internal carotid artery, as indices of CBF, significantly decreased during ACTH therapy. These values had already decreased at 30 minutes after the first injection of ACTH and were hardly restored 24 hours later just before the next injection. Such changes repeatedly occurred for the first four days of therapy so that the reductions in the A/L and d values proceeded in a stepwise manner. These values became minimum at around one week after initiation of the therapy and then gradually increased, returning to the original levels by the 8th week of therapy. Investigation of the changes in cerebral metabolism seemed to be the next step for elucidation of the mechanism underlying the CBF reduction during ACTH therapy.

Adrenocorticotropic Hormone↗

Recovery curve of the H-reflex in normal infants, central coordination disturbance cases and cerebral palsy patients within the first year of life.

The differences in the recovery curve of the H-reflex in the gastrocnemius within the first year of life were evaluated among 81 normal controls, 40 infants with cerebral palsy and 11 infants with central coordination disturbance (CCD). In normal controls, the recoveries for the groups of under 6 months of age were more marked than those for the groups of 6 months and over of age, with interstimulus intervals of 400 msec and less. The results for the infants with cerebral palsy showed more rapid recovery and facilitation of the reflex compared to those in the normal control infants throughout the first year of life. The recovery curves for the infants with CCD were similar to those for the infants with cerebral palsy in part. It was considered that the recovery curve of the H-reflex might provide additional information for evaluating an infant's motor function.

Age Factors↗

Cerebral blood flow and brain shrinkage seen on CT during ACTH therapy.

By means of the Doppler ultrasound method, the cerebral blood flow (CBF) was assessed in 21 children with epilepsy undergoing treatment with adrenocorticotrophic hormone (ACTH). The maximum reduction in the internal carotid velocity, as an index of CBF during therapy, was about 35 percent compared with the values before therapy. Furthermore, sequential computed tomography (CT) examinations of the same subjects were performed to evaluate the change in the area of the intracranial brain parenchyma during therapy. The maximum reduction in the parenchymal area during therapy was about 10 percent. This corresponds to a 20 percent reduction in CBF according to Poiseuille's law, however, the remaining reduction in CBF demonstrated by velocity measurement cannot be explained only by that mechanical vascular factor. From these findings, it is concluded that in order to elucidate the mechanism of the CBF reduction, physiological factors such as changes in metabolism during therapy should also be evaluated in addition to the mechanical and physical causes.

Adrenocorticotropic Hormone↗

The effect of ACTH on cerebral blood flow in children with intractable epilepsy.

Cerebral blood flow was assessed by ultrasound in 12 children with intractable epilepsy who were treated with ACTH. The average maximal blood velocity (A/L) and end-diastolic blood velocity (d) of the internal carotid artery were measured, before, during and after ACTH therapy in each subject. The right and left mean A/L and d values were significantly decreased during ACTH therapy, and these values returned to the previous levels after the treatment. Cerebral function in children treated with ACTH may be affected by a decrease in cerebral blood flow.

Adrenocorticotropic Hormone↗

H-reflex study in normal children and patients with cerebral palsy.

The H-reflex was studied in 53 children with cerebral palsy, and the results were compared with those obtained for 56 normal control subjects. Pairs of identical stimuli were delivered and the time course of recovery of the amplitude of the H-reflex was determined. Recovery of the H-reflex was increased in the normal control group aged 0 to 12 mos compared to that in the normal control group aged 1 to 9 yrs, especially at interstimulus intervals from 100 to 800 msec. In children with spasticity, marked recoveries of the H-reflex were observed in both age groups, 0 to 12 mos and 1 to 9 yrs, compared to those in normal controls. In the cases of athetosis, recovery of the H-reflex was also marked. In children with ataxia, it was not pronounced and similar to that in normal controls. From these findings, an H-reflex study was considered to be useful for evaluation of central nervous system function in childhood.

Ataxia↗

Cerebral blood flow in children with intractable epilepsy.

A good correlation of Doppler internal carotid blood velocity determinations with hemispheric blood flow measurements by the 133-xenon inhalation method was demonstrated in 14 epileptic patients without abnormal CT findings. The highest correlation was seen between the flow of gray matter (F1) and the internal carotid end-diastolic velocity (d) (left side r = 0.841, right side r = 0.817). As end-diastolic velocity (d) well correlated with the value obtained by the 133-xenon inhalation method, the d value was compared between 77 healthy children and 13 patients with intractable epilepsy. The mean d value of both internal carotid arteries in patients was 16.7 +/- 2.9 mm (mean +/- SD), and that of healthy children 20.9 +/- 4.3 mm, the difference being statistically significant. The low cerebral blood flow in patients might be due to multiple antiepileptic drugs administered and/or mental retardation and cerebral hypofunction related to seizures.

Adolescent↗

Cerebral blood flow measured by Doppler flow meter during petit mal seizure.

We measured the cerebral blood flow velocity percutaneously using the Doppler ultrasound method while concurrently recording the EEG during seizures in two patients with petit mal epilepsy. The average maximal blood flow velocity (A/L) and end-diastolic blood flow velocity (d) of the internal carotid artery were measured. Somewhat increased A/L and d values were found at the onset of 3 Hz spike and wave bursts on EEG in one case. However, no increase or even reductions in A/L and d values were found during spontaneous petit mal seizures compared with interictal ones in the other case. These results are opposite to the previous other report.

Cerebrovascular Circulation↗

Internal carotid velocity measurements in children with cerebrovascular disease.

Internal carotid artery flow velocity was evaluated by the Doppler ultrasound method in 32 children with cerebrovascular disease. The average maximal blood velocity (A/L) and end-diastolic blood velocity (d) were compared with each other as indices of blood flow velocity. The right and left mean A/L and d of moyamoya disease were significantly lower than those observed in normal children. The A/L and d of the affected side both in internal carotid artery occlusion and in middle cerebral artery occlusion were also significantly low. In the subarachnoid hemorrhage after rupture, these values were significantly low. In basilar artery occlusion, these values were similar to those in normal children. The results of this study indicate that Doppler ultrasound assessment of internal carotid flow velocity provides noninvasive reliable information for the diagnosis of cerebrovascular disease in childhood.

Basilar Artery↗

A case report of congenital hypomyelination.

A 3 year, 11 month-old Japanese male with congenital hypomyelination is described. Clinical features are delay of motor development, generalized muscle hypotonia and weakness, absent tendon reflexes due to peripheral neuropathy, and normal mental development. Electrophysiologically, nerve conduction velocities could not be measured. Histological examination of the right sural nerve revealed total of absence myelin of most of the myelinated fibers. Electronmicroscopically, there was a concentric network of lamellae formed by double-layered sheets of basement membranes with fragments of Schwann cell cytoplasm around the myelinated fibers, so called "onion-bulbs". These peculiar features were similar to those in the cases reported by Lyon, (1969); Kennedy et al., (1977); Karch et al., (1975); and Anderson et al. (1973).

Biopsy↗

Cerebral blood flow changes in orthostatic dysregulation fainters.

The changes in blood flow of both the internal carotid and the vertebral artery during orthostatic test with or without fainting attack were studied in 25 healthy children and 30 patients with orthostatic dysregulation (OD). In healthy children and non-fainted OD patients, no change in blood flow occurred in either the internal carotid artery or the vertebral artery during orthostatic test. On the other hand, a significant decrease in blood flow of the internal carotid artery and/or the vertebral artery occurred during fainting of OD patients. These data suggest that three mechanisms might be involved in fainting of OD patients; a decrease in blood flow of the internal carotid artery, the vertebral artery and a decrease in blood flow of both these arteries.

Adolescent↗

Internal carotid blood flow velocity in children with cerebral palsy by Doppler Ultrasound method.

Cerebral blood flow assessed noninvasively by Doppler ultrasound technique in 30 children with cerebral palsy. The average maximal blood velocity (A/L) and end-diastolic blood velocity (d) of internal carotid artery were measured before and during brief digital compression of contralateral common carotid artery. Both A/L and d values in children with cerebral palsy were significantly lower than those observed in normal healthy children. In 13 children with spastic hemiplegia, no significant difference in either A/L or d was seen between the non-affected side and affected side both before and during brief digital compression. This data suggests that mean cerebral blood flow decreases in our children with cerebral palsy, and that no lateralization of the decrease in hemispheric cerebral circulation in hemiplegic children may explain by supposing the existence of generalized bilateral brain damage in those subjects.

Adolescent↗

Antiepileptic effects of clobazam in children.

Many benzodiazepines used as anticonvulsants have nitrogen radicals in positions 1 and 4. Clobazam has nitrogen radicals in positions 1 and 5. We studied the antiepileptic effect of clobazam in 36 patients with intractable epilepsies in childhood. Their ages were 1 year 1 month to 16 years 5 months (mean 8 years). The mean initial dose was 0.33 mg/kg of daily doses and increased up to 0.71 mg/kg. Nine cases (primary generalized epilepsy 2/2, secondary generalized epilepsy 7/29) were completely free from seizures, and another 9 (secondary generalized epilepsy 8/29, partial epilepsy 1/5) experienced a decrease of 50% or more in seizure frequency. Seizure frequency did not change in 16, and increased in the other 2 (secondary generalized epilepsy 2/29). The antiepileptic effects were observed on the first day to 10th day after clobazam treatment. There were recurrences of seizures in 4 out of 9 patients with complete control of seizures, 1 month alter in 3 and 10 months later in one. Mean serum clobazam level of 7 improved cases was 73 ng/ml and that of 3 cases with no response was 94 ng/ml. Although mild clinical side effects such as drowsiness were observed transiently in 17 cases, no abnormality was found in laboratory investigations performed.

Adolescent↗