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シンボウ サイドウ アブレーション ニ セイコウシタ ヒンミャク ユウハツセイ シンキンショウ カンジャ ニタイスル ベータ シャダンヤク カイヒ オ ヨソク シウル インシ
Full text link鳥取大学Tottori University博士（医学
Studies on Storage Quality and Removal of Astringency in Japanese Persimmon
No full text鳥取大学Tottori University博士（農学
サシツ ドジョウ ニオケル ショクブツ ヨウブン キュウシュウ ト ドジョウ カガク ヘンカン ノ カンテン カラ ミタ サクモツ セイサンセイ コウジョウ ノ タメノ クリンカーアッシュ ニ カンスル ケンキュウ
No full text鳥取大学Tottori University博士（農学
Use of Gabapentin for Paroxysmal Sympathetic Hyperactivity in Three Children with Severe Motor and Intellectual Disability due to Neonatal Hypoxic Ischemic Encephalopathy
No full textParoxysmal sympathetic hyperactivity (PSH) is a clinical syndrome characterized by recurrent episodes of sympathetic overactivity, including hypertonia, tachycardia, hypertension, and hyperthermia, typically following severe brain injury. While PSH is well documented in adult populations, reports on pediatric patients, particularly those with severe motor and intellectual disabilities (SMID), remain limited. Here, we report three pediatric patients with SMID due to neonatal hypoxic-ischemic encephalopathy (NHIE) who developed PSH. All patients presented with characteristic PSH symptoms and were diagnosed according to the Pediatric Clinical Practice Guidelines based on the 2014 consensus criteria. Gabapentin (GBP) was initiated at low doses (5–10 mg/kg/day) in all patients, resulting in the rapid resolution of PSH symptoms. In two patients, symptoms partially recurred within several months but were controlled through GBP dose adjustment and the addition of clonidine or other agents. No severe adverse events were observed. To our knowledge, this is the first report describing the short-term efficacy of GBP in pediatric patients who developed PSH with SMID status due to NHIE. Our findings suggest that GBP is a valuable and well-tolerated therapeutic option for the management of PSH in children with these conditions
Associations Between Developmental Disorders, Early Seizure Onset, and Polytherapy in Childhood Epilepsy
No full textBackground : Epilepsy patients often exhibit symptoms of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). This study aimed to compare the clinical characteristics of epilepsy in patients comorbid with ADHD/ASD and those diagnosed with ADHD/ASD after epilepsy onset. Methods : We retrospectively reviewed patients under 18 years of age with epilepsy who visited Tottori University Hospital’s Child Neurology Department during 2013–2022. Eligible patients had at least 2 years of follow-up after epilepsy onset and were taking antiseizure medication (ASM). We excluded those with epileptic encephalopathy, abnormal perinatal history, imaging abnormalities, or intellectual disabilities. We compared clinical characteristics between epilepsy patients with and without ADHD/ASD. Results : Data were collected from 28 patients with ADHD/ASD and 87 without. Patients with ADHD/ASD had an earlier seizure onset (6.6 ± 3.9 vs. 8.7 ± 4.1 years, P = 0.018) and were more likely to receive ASM polytherapy (39% vs. 16%, P = 0.010). Seizure outcomes did not differ between the two groups. Of the 28 patients with ADHD/ASD, 11 were diagnosed after epilepsy onset, and these patients were more likely to require multiple ASMs than those without ADHD/ASD(45% vs. 16%, P = 0.035). Conclusion : Patients comorbid with ADHD/ASD tend to have earlier seizure onset and require more ASM, while those diagnosed with ADHD/ASD after epilepsy onset also often need polytherapy. These findings suggest that severe early epilepsy can lead to developmental disorders, though long-term seizure outcomes are not necessarily poor in these patients
Utilization of Explainable Artificial Intelligence (XAI)-Powered Computer-Aided Detection (CAD) System on Chest X-Ray Abnormalities in Health Check-Ups
No full textBackground, We designed a single-center retrospective study comparing the performance of commercially explainable artificial intelligence (XAI)-powered computer-aided detection (CAD) system of abnormal findings on chest X-rays (CXR) with that of non-experts, and pulmonology experts. Methods, A total of 1,262 images of 1,262 subjects (mean age 49 years; 52% female) and 1,252 images of 1,252 subjects (mean age 51 years; 51% female) were obtained from DICOM formats in Hakuai Hospital Health Check-up Center, in the pre-and post-implementing XAI-powered CAD period, respectively. The ultimate decision of abnormality on CXR was made by two pulmonology experts. The diagnostic accuracy metrics were measured accuracy and negative predictive value (NPV) for detecting abnormality on CXR. Results, XAI-powered CAD systems achieved an accuracy of 0.84 (95% confidential interval [CI] 0.82–0.86) and NPV of 1.00 (95% CI 0.99–1.00) to detect the abnormality on CXR. For determining nodular shadows, it was found to be non-inferior to the pulmonology experts with an accuracy of 0.94 (95% CI 0.92–0.95), and NPV of 1.00 (95% CI 0.99–1.00). It tended to overestimate the abnormality of heart enlargement and pleural thickening with a tendency for lower sensitivity. Conclusion, It seems likely that in the future, the most accurate screening CXR will be a double check combining with the pulmonology experts with XAI-powered CAD systems