Wei-Te Lee

The long-term effect of listening to Mozart K.448 decreases epileptiform discharges in children with epilepsy

Mozarts Sonata for Two Pianos in D major, K.448 (Mozart K.448), has been shown to improve mental function, leading to what is known as the Mozart Effect. Our previous work revealed that epileptiform discharges in children with epilepsy decrease during and right after listening to Mozart K.448. However, the duration of the effect was not studied. In the study described here, we evaluated the long-term effect of Mozart K.448 on epileptiform discharges in children with epilepsy. Eighteen children with epilepsy whose seizures were clinically well controlled with antiepileptic drugs were included. For each child, EEGs had revealed persistent epileptiform discharges for at least 6 months. These patients listened to Mozart K.448 for 8 minutes once a day before bedtime for 6 months. Epileptiform discharges were recorded and compared before and after 1, 2, and 6 months of listening to Mozart K.448. All of the children remained on the same antiepileptic drug over the 6 months. Relationships between number of epileptiform discharges and foci of discharges, intelligence, epilepsy etiology, age, and gender were analyzed. Epileptiform discharges significantly decreased by 53.2±47.4, 64.4±47.1, and 71.6±45.8%, respectively, after listening to Mozart K.448 for 1, 2, and 6 months. All patients except those with occipital discharges showed a significant decrease in epileptiform discharges. Patients with normal intelligence and idiopathic epilepsy had greater decreases than those with mental retardation and symptomatic epilepsy. Age and gender did not affect the results. We conclude that long-term listening to Mozart K.448 may be effective in decreasing epileptiform discharges in children with epilepsy in a chronologically progressive manner.

Mozart K.448 acts as a potential add-on therapy in children with refractory epilepsy

Mozarts Sonata for two pianos in D major, K.448 (Mozart K.448), has been shown to improve mental function, leading to what is known as the Mozart effect. Our previous work revealed that epileptiform discharges in children with epilepsy decreased during and immediately after listening to Mozart K.448. In this study, we evaluated the long-term effects of Mozart K.448 on children with refractory epilepsy. Eleven children with refractory epilepsy were enrolled. All of the patients were diagnosed as having had refractory epilepsy for more than 1 year (range =1 year to 6 years 4 months, mean =3 years 11 months) and had been receiving at least two antiepileptic drugs (AED). During the study period, they listened to Mozart K.448 once a day before bedtime for 6 months. Seizure frequencies were recorded 6 months before they started listening to this music and monthly during the study period. All of the patients remained on the same AEDs during the 6-month study period. Frequencies of seizures were compared before and after listening to Mozart K.448. Eight of eleven patients were seizure free (N=2) or had very good responses (N=6) after 6 months of listening to Mozart K.448. The remaining three (27.3%) showed minimal or no effect (effectiveness <50%; unmodified or worsened seizure frequency). The average seizure reduction was 53.6 ± 62.0%. There were no significant differences in seizure reduction with IQ, etiology, or gender. We conclude that Mozart K.448 should be further studied as a potential add-on therapy in the treatment of children with refractory epilepsy.

Ectopic Pancreatic Tissue Presenting as an Umbilical Mass in a Newborn: A Case Report

The case of an ectopic pancreatic mass at the umbilicus in an 8‐day‐old male neonate is reported, the youngest patient with this condition ever reported in an English‐language journal. The patient was healthy except for a protruding mass with intermittent mucous discharge at the base of the umbilical stump. Surgical intervention was performed under the impression of the umbilical mass. Pathology diagnosed an ectopic pancreas with acute hemorrhage. To the best of our knowledge, only one case of ectopic pancreas presenting as an umbilical mass with intermittent mucous discharge has previously been reported.

LOWER PLASMA NEUROPEPTIDE Y LEVEL IN PATIENTS WITH ATYPICAL FEBRILE CONVULSIONS

Febrile convulsion (FC) is the most common neurological disease in children. Cases with seizures that persist for more than 15 minutes or recurrent seizures within the same febrile illness are considered to be atypical and may have a different prognosis. Neuropeptide Y (NPY), an endogenous anticonvulsant that is widely distributed throughout the central nervous system, including the hippocampus, is known to prevent seizures by increasing the seizure threshold. Based on our previously finding that patients with atypical FC have lower concentrations of NPY, we hypothesized that the concentration of NPY may play a role in the development of atypical FC. To investigate this hypothesis, we used a radioimmunoassay to measure the plasma NPY concentration of 60 children with FC (typical FC, n = 46; atypical FC, n = 14) and 56 age‐matched controls. The atypical FC group had significantly lower concentrations of NPY than children with typical FC and controls (66.47 ± 19.11 pmol/L vs. 88.68 ± 28.50 pmol/L and 86.82 ± 22.66 pmol/L, respectively). Very low NPY levels were found in two patients; one patient (NPY level: 44.75 pmol/L) experienced prolonged seizures lasting for up to 1 hour and the other had recurrent seizures (three seizures) during the same febrile illness (NPY level: 33.53 pmol/L). These results suggest that patients with inadequate NPY inhibitory activity are more susceptible to atypical FC.

Salmonella/rotavirus coinfection in hospitalized children

This studys aim was to analyze the characteristics and severity of acute gastroenteritis related to infection with rotavirus (group R), nontyphoid Salmonella (NTS; group S), and infection with both rotavirus and Salmonella (group B) in children in southern Taiwan in order to improve diagnosis and expedite appropriate management. The medical records of children admitted between October 2002 to September 2008 for acute gastroenteritis related to rotavirus, NTS, or coinfection were collected and analyzed.Among 2040 reviewed medical records, 40 patients were infected with both pathogens, while 501 cases were infected with rotavirus alone and 189 were infected with NTS alone. There were no significant differences between the three groups in terms of age at admission or sex. The age distribution of the reviewed cases revealed that children between the ages of 12–24 months comprised the largest proportion of cases in each group. Higher concentrations of fecal leukocytes and fecal pus cells and longer hospitalizations were observed in group B in comparison with groups S and R (p < 0.05). Clinical severity was significantly higher in groups B and S than group R (p < 0.05). A proportional association was found between the monthly case number of rotavirus infections and the mean monthly temperature difference in southern Taiwan (r = 0.9248; p < 0.0001). In summary, concomitant rotavirus infection with NTS infection did not affect the clinical manifestations of the reviewed patients. Rotavirus infection was less severe in most clinical manifestations, but vomiting was more severe in rotavirus‐infected patients. Positive fecal leukocytes and positive fecal pus cells were more frequent during coinfection. There was a strong positive relationship between the incidence of rotavirus gastroenteritis and the mean monthly temperature difference.

Postnatal Changes in Tibial Bone Speed of Sound of Preterm and Term Infants during Infancy

This study aimed to evaluate changes in tibial bone speed of sound (SOS) over time, in preterm and term infants during infancy, in addition to identifying factors influencing the development of tibial SOS during infancy. Preterm (n = 155) and term (n = 65) infants were enrolled in this study. Tibial bone SOS was measured using quantitative ultrasonography (QUS) on the left tibia of newborn infants after birth (within 7 days), at 1 month old, and then every 2 months until subjects were approximately 12–15 months old. Follow-up checks included anthropometric measurements and tibial bone SOS. Mean tibial bone SOS at birth was significantly higher in term infants (mean ± SD, 2968.5 ± 99.7 m/s) than in preterm infants (2912.2 ± 122.6 m/s). Values of follow-up tibial bone SOS declined for the first 4 months, and then increased gradually until 12–15 months old. This increasing trend was greater in preterm infants after 2 months of corrected age than in term infants. There were no significant differences by 12–15 months of age between preterm and term infants. A longitudinal mixed-effect model controlling for internal correlations and other covariates in the two groups showed that age and the SOS value at birth were important factors affecting the tibial bone SOS in both preterm and term newborn infants during infancy. There are significant differences in the pattern of change in tibial bone SOS values between preterm and term infants during the first 12–15 months of life. Age and SOS value at birth were important factors affecting the pattern of tibial bone SOS change in both preterm and term newborn infants during infancy.

Eosinophilia in Hospitalized Newborn Infants

To evaluate the incidence of and conditions associated with eosinophilia (absolute eosinophil count (AEC)≥ 1000×10^6/L) in hospitalized newborn infants, the medical records of patients presenting with eosinophilia during hospitalization were retrospectively studied. There were 270 cases enrolled and 69 patients (34 boys and 35 girls) had eosinophilia during hospitalization, for an incidence rate of 25.6%. Conditions associated with eosinophilia included infectious disease (39.1%), establishment of an anabolic state (24.6%), congenital heart disease (10.1%), and others (26.2%). Peak eosinophil counts in 62 of the 69 patients ranged from 1,000 to 2,000×10^6/L. A higher peak AEC was noted in patients with establishment of an anabolic state. In this group, a highly significant positive correlation (r=0.593, p＜0.05) was found between the time at which peak eosinophilia occurred and the time at which birth weight was regained. The AEC returned to normal (＜700×10^6/L) from the peak count within 9.11±9.92 (mean±standard deviation, SD) days. A significant negative correlation (r=-0.42, p＜0.05) was found between birth weight and the time at which peak AEC returned to normal. None of the infants received bone marrow aspiration, and no specific treatment was given. In conclusion, eosinophilia is a frequent finding in hospitalized newborn infants. Eosinophilia is sometimes clinically unimportant with regard to morbidity and requires no specific treatment.