"Obtundation status (Dravet)" caused by complex partial status epilepticus in a patient with severe myoclonic epilepsy in infancy.

PURPOSE: We report a 1-year 7-month-old boy with severe myoclonic epilepsy in infancy (SME) who exhibited complex partial status epilepticus (CPSE), which was confirmed by ictal video-EEG analysis. This boy first had a hemiconvulsion in a hot bath at age 3 months. Thereafter, he exhibited both partial and generalized seizures that were extremely intractable. At age 9 months, he had a prolonged episode of impaired consciousness that fit the "obtundation status in SME" defined by Dravet et al. METHODS AND RESULTS: Ictal EEG revealed persisting irregular spike-and-wave complexes over the left hemisphere, predominantly in the occipitotemporal area, and confirmed CPSE. The EEG abnormalities with decreased level of the consciousness continued approximately 6 h after onset of the symptoms even with AED administration. CONCLUSIONS: Because SME features both generalized and focal seizures, both types of nonconvulsive status may be seen in SME. Although Dravet et al. already reported long-lasting atypical absences in patients with SME as "obtundation status," we demonstrated CPSE in an infant with SME who exhibited a prolonged stuporous state.

Muscle involvement in congenital insensitivity to pain with anhidrosis.

A patient with congenital insensitivity to pain with anhidrosis, who had characteristic clinical features and biopsied sural nerve, is presented. Nerve pathology findings indicated a loss of the small myelinated and unmyelinated fibers. Biopsied muscle disclosed a marked variation in fiber size, some small fibers with central nuclei, and a small number of small angulated fibers, consistent with neurogenic and myogenic changes. Many patients with congenital insensitivity to pain with anhidrosis had muscle weakness and absent or decreased deep tendon reflexes with normal nerve conduction velocity. We confirmed that lack of small myelinated fibers in motor neurons resulted in a striking change of muscle in our patient.

[Clinical effects of terodiline hydrochloride for urinary frequency and sense of residual urine].

The clinical effects of terodiline hydrochloride were evaluated in forty-four patients with urinary frequency and/or sense of residual urine. After a four-week treatment with 24 mg terodiline hydrochloride once daily, subjective symptoms were improved and micturition frequency was decreased significantly. Slight dysuria was reported as a side effect only in one patient. Terodiline hydrochloride is considered to be superiorly effective and safe for the treatment of urinary frequency and sense of residual urine.

T antigen expression in benign hyperplasia and adenocarcinoma of the prostate.

The status of Thomsen-Friedenreich antigen (T antigen), in histological sections of human hyperplasia (30 cases) and adenocarcinoma (45 cases) of the prostate, was investigated by the immunohistochemical method. All benign prostatic hyperplasias were negative for T antigen but positive for cryptic T antigen after neuraminidase digestion. Of the 45 cases of adenocarcinoma of the prostate, 27 (60%) were positive for T antigen, 13 (29%) were negative for T antigen but positive for cryptic T antigen, and 5 (11%) were negative T and cryptic T antigens. The status of T antigen was found to be correlated with the histological grade and bone metastasis. However, there was statistically no definitive correlation between the status of T antigen and survival of patients with adenocarcinoma of the prostate.

Protein profiles of benign hypertrophic prostate: stroma-abundant distribution of BPH-associated nonhistone proteins.

Mechanically isolated epithelium and stroma from benign hypertrophic prostates were highly pure on the basis of histochemical and biochemical criteria. By electrophoretic analyses, whole cellular and nuclear proteins were compared among whole tissues, epithelium, and stroma. The characteristic protein profiles of benign hypertrophic prostates were reflected in the electrophoretic patterns of the stroma. Two-dimensional gel electrophoretic patterns of the epithelium were different from those of the stroma with exception of about 18 major spots that were common to both fractions. Of the protein species separated, 35K/6.7 (molecular weight/pI) and 36K, which was composed of two species with pI of 4.4 and 4.6, were abundant in the epithelium and stroma, respectively. Nuclei prepared from whole tissues of benign hypertrophic prostates contained three kinds of nonhistone proteins (NHP) closely associated with benign prostatic hypertrophy (BPH); 42 K-NHP, 55 K-NHP and 190 K-NHP. Electrophoretic analysis of the nuclear proteins revealed that all the BPH-associated nonhistone proteins were abundantly distributed in the nuclei of the stroma.

[Prophylactic effect of etretinate on the recurrence of superficial bladder tumors--results of a randomized control study].

The recurrence preventing effect of Etretinate on 174 superficial bladder tumors was examined by a randomized study using the envelope method. After transurethral resection of the bladder tumor, the tumor-free patients were divided into two groups, one administered one 10 mg capsule of Etretinate once a day, and the other group untreated (control group). As a rule, the patients were examined for recurrence every 3 months. There were 9 drop outs (9.6%) in the Etretinate group, and 8 (10%) in the control group. Therefore, 85 subjects in the Etretinate group and 72 patients in the control group were analyzed for statistics. The recurrence rate during the observation period of over 2 years was 38% in the control group and 18% in the Etretinate group, the number of relapsing cases in the latter group tending to be decreased (P less than 0.1). The cumulative recurrence inhibition rate for cases observed over one year tested by the Kaplan Meier method tended to be higher in the Etretinate group compared to the control group (P less than 0.1). Etretinate administration had a high recurrence inhibitory effect (P less than 0.05) in the cases of relapse, multiple tumors, and tumors less than 1 cm. Side effects of Etretinate administration were seen in 21 cases (22.3%). The major symptoms were dry lips, cheilitis, stomatitis, dermal desquamation, etc., and drug use was discontinued in 7 cases (7.4%). The symptoms all disappeared after drug administration was discontinued.

[Efficacy of a latex Foley catheter with sustained release of chlorhexidine: 1st report: Clinical trials for the prevention of urinary tract infection].

Seventy five patients requiring urethral catheterization for over 24 hours were treated with a latex Foley catheter with sustained release of chlorhexidine in a closed drainage system. While the catheter was indwelling, urinary concentrations of chlorhexidine were maintained at the level of 1 to 2 micrograms/ml in average in almost all patients. The catheter was highly effective in preventing the acquisition of catheter-associated bacteriuria in patients with initially sterile urine without systemic antimicrobial therapy. The acquisition rate of bacteriuria was 8, 16, 23, 35 and 74% on day 3, 4, 5, 6 and 7 with the catheter indwelling, respectively. The catheter was not effective in eradicating preexisting bacteriuria. Complications of the catheter were minimal.