No to hattatsu. Brain and development
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Neuroscience has advanced markedly through the 20th century; material processes of brains have been analyzed in detail, and information processes approached as well. Clarification of the material processes has brought about three major strategies to cure and prevent neurological and psychiatric diseases: creation of new drugs, regeneration and transplantation therapy, and gene therapy. ⋯ Cognitive and computational neuroscience will also aim at the clarification of information processes of brains. Neuroscience will exert great influence on pediatrics, in particular on the studies of mental development in childhood.
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Clinical Trial
[Efficacy of continuous intravenous infusion of midazolam in the treatment of status epilepticus in children].
Midazolam infusion was tried as the treatment for 48 episodes of refractory status epilepticus or a cluster of seizures in 16 children. The mean age of patients was 3.5 years (range, 1 month to 18 years). Nine children had epilepsy, one purulent meningitis, one encephalitis, one acute cerebral infarction, and the remaining four had acute phase of hypoxic ischemic encephalopathy. ⋯ The mean duration of the treatment was 4.1 days. None of the patients had serious changes in the blood pressure or respiratory status attributable to the use of midazolam. In conclusion, midazolam infusion is an effective and safe therapeutic approach for the management of childhood status epilepticus.
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We report a 7-year-old girl with severe Guillain-Barré syndrome (GBS) who showed dramatic improvement after immunoabsorption therapy. She had progressive muscle weakness with resultant respiratory failure. On the 7th day of the illness, she was nearly quadriplegic and dependent on mechanical ventilation. ⋯ She regained normal muscle power without any sequelae. The immunoabsorption therapy caused hemolysis and decrease of serum fibrinogen, but no serious complications. The clinical course of this patient suggests the efficacy of immunoabsorption therapy in GBS.
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We report a 25-year-old male with multiple pterygium syndrome (Escobar) complicated with a horseshoe kidney. He had clinical characteristics of Escobar syndrome, including palpebral ptosis, auricular anomalies, pterygia with contracture of the elbow and knee joints, syndactyly and polydactyly of the feet, and growth failure. ⋯ Neither brain MRI and CT nor SPECT demonstrated any abnormalities. Further neurophysiological and neuroradiological studies are necessary to elucidate neurological deficits in this syndrome.
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We report a 10-month-old boy with heat stroke because he was left in a car. He showed hyperthermia, coma and convulsions at the time of his admission. Liver dysfunction and coagulopathy were observed, but they were improved after several days. ⋯ Cranial CT showed brain edema until the 7th hospital day. Cranial MRI on the fortieth hospital day showed the finding of cortical laminar necrosis in the vascular boundary zones. This finding suggest that brain ischemia was related with the neurological involvement of heat stroke.