No To Hattatsu最新文献_第4页

Tuberous sclerosis with infantile spasm and subependymal giant cell astrocytoma. 结节性硬化症合并婴儿痉挛和室管膜下巨细胞星形细胞瘤。

No To Hattatsu Pub Date : 2016-11-01

Toru Yoneda, Masayuki Shimono, Miwa Yoshino, Yasuhiko Takahashi

引用次数: 0

The clinical features of patients suffering from psychogenic non-epileptic seizures with or without epileptic seizures. 心因性非癫痫性发作伴或不伴癫痫性发作患者的临床特点。

No To Hattatsu Pub Date : 2016-11-01

Yuri Narita, Shin-ichiro Hamano, Mai Kuroda, Kenjiro Kikuchi

{"title":"The clinical features of patients suffering from psychogenic non-epileptic seizures with or without epileptic seizures.","authors":"Yuri Narita, Shin-ichiro Hamano, Mai Kuroda, Kenjiro Kikuchi","doi":"","DOIUrl":"","url":null,"abstract":"Objective: We investigated the clinical characteristics of pediatric psychogenic non-epileptic seizures (PNES). Methods: We studied 15 children and adolescents with PNES, who were divided into 3 groups : 1) a group with epilepsy (7 patients), 2) a group without epilepsy and mental retardation (MR) (7 patients), and 3) a group with MR (1 patient), according to the guideline for the diagnosis and treatment of PNES established by the Japan Epilepsy Society. Results: Remission of epilepsy and PNES was achieved in only 2 patients in the group with epilepsy. In the group without epilepsy and MR, antiepileptic drugs (AEDs) could be discontinued entirely in all the patients, however, the treatment for PNES could be completed in only one patient. Treatment of epilepsy and PNES could be completed in the one patient with MR. Conclusions: It is important for pediatric neurologists to explain the good news to the parents of children in the group without epilepsy or MR, that the patient does not have epilepsy and does not require treatment with AEDs. For the group with MR, understanding should be encouraged about the development of the child. Because treatment is difficult in the group with epilepsy and PNES, cooperation among the pediatric neurologists, pediatric psychiatrists and clinical psychologists is more important.","PeriodicalId":39367,"journal":{"name":"No To Hattatsu","volume":"48 6","pages":"425-9"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36313902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ulcers on the epiglottis caused by a nasogastric tube in three adults with severe motor and intellectual disabilities. 在会厌溃疡由鼻胃管引起的三个成人严重运动和智力障碍。

No To Hattatsu Pub Date : 2016-11-01

Sui Sone, Ayako Yoshino, Yukari Kawahara, Yoshiko Takeda, Hiroshi Hamaguchi, Takanori Ezoe, Harumi Saijo, Katsuhito Araki, Kiyoko Kurata

{"title":"Ulcers on the epiglottis caused by a nasogastric tube in three adults with severe motor and intellectual disabilities.","authors":"Sui Sone, Ayako Yoshino, Yukari Kawahara, Yoshiko Takeda, Hiroshi Hamaguchi, Takanori Ezoe, Harumi Saijo, Katsuhito Araki, Kiyoko Kurata","doi":"","DOIUrl":"","url":null,"abstract":"Nasogastric tube feeding is a common method of parenteral nutrition. We observed ulcers on the epiglottis caused by a nasogastric tube in three adults with severe motor and intellectual disabilities (SMID) during examination with a laryngeal fiberscope while swallowing. These ulcers were healed by changing the method of inserting the nasogastric tube. The patients were three men aged 25, 39, and 55 years. The muscle tone of the whole body was increased in all of the patients. Two patients had severe scoliosis, and the other patient had lordosis in the thoracic vertebrae and had received laryngo-tracheal diversion. All of the patients received intermittent or continuous respiratory care. The pharynx of the patients with severe scoliosis became thinner and the feeding tubes ran obliquely. The feeding tube in the patient who received laryngo-tracheal diversion entered the cut and closed trachea through the glottis. Ulcers were observed on the laryngeal side of the epiglottis in all of the patients. The ulcers were healed by preventing feeding tubes from running obliquely or by using the naso-gastric tube made of different materials in the patients with severe scoliosis. In the patient who received laryngo-tracheal diversion, we succeeded in avoiding the glottis by keeping his face forward while inserting the feeding tube. Then feeding tubes were changed with guidewires, and the ulcers were healed. When using nasogastric tube feeding for persons with SMID with a large increase in muscle tone and/or with severe scoliosis, adopting a method of inserting feeding tubes that avoids damaging the epiglottis with a laryngeal fiberscope is required.","PeriodicalId":39367,"journal":{"name":"No To Hattatsu","volume":"48 6","pages":"434-8"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36312476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Study of death with the severely disabled. 对严重残疾死亡的研究。

No To Hattatsu Pub Date : 2016-11-01

Sachiko Onoe, Tokuji Koda, Tatsuro Nobutoki, Makoto Watanabe

{"title":"Study of death with the severely disabled.","authors":"Sachiko Onoe, Tokuji Koda, Tatsuro Nobutoki, Makoto Watanabe","doi":"","DOIUrl":"","url":null,"abstract":"Objective: The characteristics of death in patients with severe mental and physical disabilities include, a short period from the onset of symptoms to death and sudden death in the young. However in recent years, it has not been rare for such patients to live to more than 50 years old. We examined the survival rate and current state of death within 24 hours among this patient population at our center. Methods: We identified 314 deaths from April 1 in 1969 to March 31 in 2013 and a total of 388 survivors during this date range. Based on confirmation, cases of death occurring within 24 hours from onset were extracted. The probability of survival was estimated and graphed using the Kaplan-Meier method, and factors influencing the characteristics of death within 24 hours and/or the survival rate were investigated using medical records after 1995. Results: The median age at survival was 56 years. The need for gastrostomy feeding was associated with a 2.4 times higher mortality rate than oral feeding. The survival estimate at 60 years for the cases of gastrostomy feeding was 34%, and the survival estimate at 70 years for the cases involving severe motor impairment was 34%. The age distribution showed no significant differences between the two groups, i. e.; cases of death within 24 hours and others. In the cases of death within 24 hours, the patients were tracheotomized and/or not followed with a monitor, which suggests that death may occur in all cases, irrespective of the patient’s condition. Conclusions: This study showed that patients with severe motor impairment may survive beyond 70 years of age. Death within 24 hours is not associated with a specific mortality age and can occur in any patient regardless of the severity of their condition, accounting for a relatively high proportion of causes of death, even now.","PeriodicalId":39367,"journal":{"name":"No To Hattatsu","volume":"48 6","pages":"407-12"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36313898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Case study of a spinal muscular atrophy type 1 patient retaining one allele of the SMN1 gene. 1例脊髓性肌萎缩症患者保留SMN1基因等位基因的病例研究。