Efficacy of topiramate for intractable childhood generalized epilepsy with epileptic spasms: With special reference to electroencephalographic changes

AbstractPurposeEpileptic spasms (ES) beyond infancy are a highly refractory type of seizures that require the development of an effective treatment. We therefore studied the efficacy and safety of topiramate (TPM), which is a drug that is indicated to be effective for intractable childhood epilepsy, for ES.MethodsOut of 58 children with ES, we enrolled 33 patients treated with TPM at ≤12years of age. The administration of TPM was limited to cases of epilepsies that were resistant to any other potent treatment. We retrospectively investigated the efficacy of TPM for seizures and changes in electroencephalogram (EEG) findings.ResultsThe median age at the start of TPM treatment was 5years, 8months. All patients had ES and 28 also had tonic seizures. As for the efficacy of TPM for all seizures, five patients became seizure-free and two had a ≥50% reduction in seizures. Seizure aggravation was observed in six patients. Of 29 patients whose EEG findings were compared before and during TPM treatment, nine showed EEG improvement with reduced epileptic discharges. Adverse effects were observed in 13 patients and included somnolence, anorexia, and irritability. In general, TPM was well tolerated.ConclusionsTPM can be effective at suppressing very intractable ES in a proportion of patients who do not respond to any other treatment. The efficacy of TPM may be predictable based on EEG changes observed early in the course of treatment. TPM is promising for the treatment of extremely intractable childhood epilepsy and it has largely tolerable adverse effects

A Radioimmunoassay for Rat Serum Corticosterone

A reliable radioimmunoassay for rat serum corticosterone has been developed. 25 μ1 of diluted serum (1:100) was assayed with a specific antiserum raised against corticosterone-21-hemisuccinate conjugated to bovine serum albumin. The within-assay and between-assay coefficients of variation were 7.1% and 13.9%, respectively. The mean serum corticosterone concentration was 65.3±6.0 ng/ml (n=10). The corticosterone level increased to 208.4 ±23.7 ng/ml after ACTH administration, and was suppressed to the limit of assay sensitivity after dexamethasone administration

Steroidogenesis in Isolated Adrenal Cells of Rat

A reliable and reproducible system for the isolation of rat adrenal cells was developed, using 0.25% trypsin for cell dispersion. The suspending cell in Krebs-Ringer bicarbonate buffer containing 0.2% glucose and 0.5% bovine serum albumin was incubated for 120 minutes at 37℃ under 95% 02 and 5% C02. Corticosterone production induced by synthetic 1-24ACTH showed a dose-related increase in decapsular cells. The precision of the inter-experiment of corticosterone production was 5.0% (average coefficients of variation)

Analysis of Human Insulin Analogues in Vitro, Using Gel Chromatographic Method

The incubation medium and incubated human pancreas were gel chromatographed on the Bio-Gel P-30 column after extraction with acid ethanol. The extracted immunoreactive insulin (IRI) was successfully separated into two peaks at the position of 6000 molecular weight region. These two peaks corresponded to those which were detected in human serum. These findings suggest that the two groups of insulin are directly secreted from human pancreatic tissue. But the incorporated [3H] leucine peak into acid-ethanol extractable protein did not elute out at the same position as each insulin peak. Therefore, the measurement of [3H] leucine incorporation into acid-ethanol extractable protein is not a good indicator to evaluate insulin biosynthesis

Distribution and Elimination of Insulin and C-peptide in a Benign Insulinoma Patient

The distribution and elimination of insulin and C-peptide was evaluated in a case of benign insulinoma, using the method of gel chromatography. The significant differences between total Immunoreactive insulin (IRI) level and the level of Peak I plus Peak II of IRI was noticed in splenic vein. This fact suggested that intermediate and/or abnormal IRI could be released from the tumor. In order to diagnose a hypoglycemic patient with completely normal IRI and CPR level in peripheral blood, the gel chromatographic separation of IRI from splenic and/or portal blood could be useful