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A case of mumps-related acute encephalopathy with biphasic seizures and late ...
A case of mumps-related acute encephalopathy with biphasic seizures and late ...Takashi Shiihara
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This case report describes a 3-year-old boy who developed acute encephalopathy with biphasic seizures after experiencing fever and parotitis due to a mumps infection. Brain imaging showed changes consistent with acute encephalopathy with biphasic seizures and late reduced diffusion. The patient received steroid treatment and was discharged nearly a month after onset with impaired development and autism spectrum disorder. This is the first reported case of mumps-related acute encephalopathy with this pattern of seizures and imaging findings. The case suggests mumps infection should be considered a potential cause of this type of encephalopathy and that routine mumps vaccination may help prevent related complications.小児の気管切开ケアとカニュレ交换の実际
小児の気管切开ケアとカニュレ交换の実际Takashi Shiihara
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小児の気管切开ケアとカニュレ交换の実际
日本小児科学会ホームページ内から引用
http://www.jpeds.or.jp/uploads/files/public_manual.pptx
「日本小児医療保健協議会小児在宅医療実技講習会マニュアルより」
スライド内動画は再生できないようなので
https://youtu.be/YYaDD71fBiY にあります。
Thunderbird alert
Thunderbird alertTakashi Shiihara
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Thunderbird 異なるフォルダの未読メッセージに移動するときにいちいち確認が出るのを抑制
確認 受信トレイ内の次の未読メッセージを開きますか？ 音ありMucolipidosis type4 case report
Mucolipidosis type4 case reportTakashi Shiihara
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1. This case report describes a Japanese boy with a mild form of Mucolipidosis IV (MLIV), which is typically associated with intellectual disability, corneal opacities, and motor delays.
2. Serial MRI findings in the boy showed thinning of the corpus callosum, white matter volume reduction, and signal abnormalities. Exome sequencing revealed compound heterozygous mutations in the MCOLN1 gene associated with MLIV.
3. Unique features in this case included a relatively mild course, novel mutations, and elevated serum gastrin levels. Serial MRI also showed signs of cerebellar atrophy and iron accumulation over time. Whole exome sequencing was important for correctly diagnosing this rareProtein-Losing Enteropathy As A Rare Complication Of The Ketogenic Diet: A Ca...
Protein-Losing Enteropathy As A Rare Complication Of The Ketogenic Diet: A Ca...Takashi Shiihara
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This case report describes a rare case of a 9-year-old girl who developed protein-losing enteropathy during treatment with the ketogenic diet for intractable epilepsy. The ketogenic diet was started on day 15 of her illness to control seizures. Over time she experienced weight loss and developed hypoproteinemia, hypoalbuminemia, and hypogammaglobulinemia. An albumin scintigraphy revealed tracer accumulation in the small intestine and colon, consistent with protein-losing enteropathy. Her condition improved after discontinuing the ketogenic diet. This represents a rare complication of the ketogenic diet beyond common side effects like hypoproteinemia and its underlying causes require further study.惭搁滨上缓徐な髄鞘化の进行を认めた未报告笔尝笔1遗伝子変异を伴う軽症笔别濒颈锄补别耻蝉-惭别谤锄产补肠丑别谤病の一例蔼小児神経学会2014浜松
惭搁滨上缓徐な髄鞘化の进行を认めた未报告笔尝笔1遗伝子変异を伴う軽症笔别濒颈锄补别耻蝉-惭别谤锄产补肠丑别谤病の一例蔼小児神経学会2014浜松Takashi Shiihara
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浜松で発表したポスター
ただいま論文投稿中
地味な一例報告です
What a wonderful world
What a wonderful worldTakashi Shiihara
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C Dm C Dm
The song describes the beauty of nature and human relationships, seeing trees, skies, and colors that make the world wonderful. It notes hearing babies cry and watching them grow, learning more than the singer knows. The refrain expresses the thought that this is truly a wonderful world.Country roads
Country roadsTakashi Shiihara
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The document provides the chords for John Denver's song "Country Roads" over three verses. It describes the beauty of West Virginia with references to the Blue Ridge Mountains, Shenandoah River, and life being older than the trees. The singer expresses nostalgia for their home in West Virginia and longing to return to the place they belong.
Amazon
AmazonTakashi Shiihara
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Amazon entered the Japanese e-book market with its Kindle devices but Japanese customers often have to pay more for e-books compared to customers in other countries like the United States. While Amazon tries to provide low prices, book publishers in Japan maintain control over pricing which leads to higher costs for Japanese readers. The disparity in pricing shows the challenges for global companies operating in different country markets with unique business and cultural norms.
Icncaoccn 2012 poster shiihara t
Icncaoccn 2012 poster shiihara tTakashi Shiihara
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This study measured biomarkers (S100B, NSE, tau protein) in the serum and cerebrospinal fluid of patients with either febrile seizures or acute encephalopathy with biphasic seizures and late reduced diffusion. Biomarker levels were significantly higher in acute encephalopathy patients, even early in the illness. CSF levels of S100B and tau protein best distinguished acute encephalopathy from febrile seizures and could help with early diagnosis. Combining CSF S100B and tau levels achieved good sensitivity and specificity for identifying acute encephalopathy. The results suggest acute encephalopathy is associated with damage to astrocytes, neurons and axons from the early stages.
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What a wonderful world
What a wonderful worldTakashi Shiihara
?
C Dm C Dm
The song describes the beauty of nature and human relationships, seeing trees, skies, and colors that make the world wonderful. It notes hearing babies cry and watching them grow, learning more than the singer knows. The refrain expresses the thought that this is truly a wonderful world.Country roads
Country roadsTakashi Shiihara
?
The document provides the chords for John Denver's song "Country Roads" over three verses. It describes the beauty of West Virginia with references to the Blue Ridge Mountains, Shenandoah River, and life being older than the trees. The singer expresses nostalgia for their home in West Virginia and longing to return to the place they belong.Amazon
AmazonTakashi Shiihara
?
Amazon entered the Japanese e-book market with its Kindle devices but Japanese customers often have to pay more for e-books compared to customers in other countries like the United States. While Amazon tries to provide low prices, book publishers in Japan maintain control over pricing which leads to higher costs for Japanese readers. The disparity in pricing shows the challenges for global companies operating in different country markets with unique business and cultural norms.Icncaoccn 2012 poster shiihara t
Icncaoccn 2012 poster shiihara tTakashi Shiihara
?
This study measured biomarkers (S100B, NSE, tau protein) in the serum and cerebrospinal fluid of patients with either febrile seizures or acute encephalopathy with biphasic seizures and late reduced diffusion. Biomarker levels were significantly higher in acute encephalopathy patients, even early in the illness. CSF levels of S100B and tau protein best distinguished acute encephalopathy from febrile seizures and could help with early diagnosis. Combining CSF S100B and tau levels achieved good sensitivity and specificity for identifying acute encephalopathy. The results suggest acute encephalopathy is associated with damage to astrocytes, neurons and axons from the early stages.West ACTH療法について
- 1. ウエスト症候群における 副腎皮質刺激ホルモン(ACTH)療法 群馬県立小児医療センター 神経内科 椎原 隆 2013 年 5 月 27 日 主にウエスト症候群の治療に用いられるが、他の難治性てんかんで用いられることもある。 一般名: 酢酸テトラコサクチド亜鉛注 商品名: コートロシン Z 注 投与量?投与法 投与量を少なくしても、効果は変わらず副作用が減る事がわかってきたため最近は、従来より少 ない量で投与される事が一般的になってきている。当院では、0.0125 mg/kg/日で治療している。 投与法は筋肉内注射（大腿部）。 投与期間 当院では今のところ、連日 2 週間、隔日 2 週間、週二回２週間（計 6 週間）を原則にしているが、 治療効果や副作用を見ながら治療期間や投与量を変更。 効果 West 症候群において、多施設で行った研究報告によると、ACTH 終了時点で 発作消失 70%、発作減少 20%、無効 10% 程度。 West 症候群以外ではまとまったデータはない。 副作用 ほぼ必発だが投与量減量で徐々に改善する物 不機嫌、不眠、肥満、脳退縮 時に起こり、随時治療が必要な物 感染、高血圧、心肥大、電解質異常、肝機能障害 極稀だが重度な物 頭蓋内出血、重症感染 随時検査（採血?レントゲン?頭部画像等）しながら、副作用があれば適宜対処。