研究者詳細 - 津川　毅

論文 - 津川　毅

分割表示 91 件中 61 - 80 件目／全件表示 >>

Long-term sensor-augmented pump therapy for neonatal diabetes mellitus: a case series.

Yuya Fukuda, Akira Ishii, Hotaka Kamasaki, Shintaro Fusagawa, Kojiro Terada, Lisa Igarashi, Masaki Kobayashi, Shigeru Suzuki, Takeshi Tsugawa

Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology 31 ( 3 ) 178 - 184 2022年 [査読有り] [国内誌]

担当区分：最終著者

Neonatal diabetes mellitus (NDM) is a rare metabolic disorder that is mainly present in the first 6 months of life and necessitates insulin treatment. Sensor-augmented pump (SAP) therapy has been widely used in children with type 1 diabetes mellitus, but its use in patients with NDM is limited. We report three patients with NDM who received SAP therapy using the MiniMed™ 640G system starting in the neonatal period. Two patients were treated for 3 months, and one patient continued treatment up to an age of 22 mo. The MiniMed 640G system can automatically suspend insulin delivery (SmartGuard™ Technology) to avoid hypoglycemia when the sensor glucose level is predicted to approach the predefined threshold. We suggest that SmartGuard Technology is particularly useful for infants in whom hypoglycemia cannot be identified. The MiniMed 640G system automatically records the trends of sensor glucose levels and the total daily dose of insulin, which can make the management more accurate and reduce the family's effort. SAP therapy for patients with NDM automatically prevents severe hypoglycemia and is useful for long-term management; however, attention should be paid to its application.

Detailed Evolutionary Analyses of the F Gene in the Respiratory Syncytial Virus Subgroup A.

Mariko Saito, Hiroyuki Tsukagoshi, Mitsuru Sada, Soyoka Sunagawa, Tatsuya Shirai, Kaori Okayama, Toshiyuki Sugai, Takeshi Tsugawa, Yuriko Hayashi, Akihide Ryo, Makoto Takeda, Hisashi Kawashima, Nobuhiro Saruki, Hirokazu Kimura

Viruses 13 ( 12 ) 2021年12月 [査読有り] [国際誌]

We performed evolution, phylodynamics, and reinfection-related antigenicity analyses of respiratory syncytial virus subgroup A (RSV-A) fusion (F) gene in globally collected strains (1465 strains) using authentic bioinformatics methods. The time-scaled evolutionary tree using the Bayesian Markov chain Monte Carlo method estimated that a common ancestor of the RSV-A, RSV-B, and bovine-RSV diverged at around 450 years ago, and RSV-A and RSV-B diverged around 250 years ago. Finally, the RSV-A F gene formed eight genotypes (GA1-GA7 and NA1) over the last 80 years. Phylodynamics of RSV-A F gene, including all genotype strains, increased twice in the 1990s and 2010s, while patterns of each RSV-A genotype were different. Phylogenetic distance analysis suggested that the genetic distances of the strains were relatively short (less than 0.05). No positive selection sites were estimated, while many negative selection sites were found. Moreover, the F protein 3D structure mapping and conformational epitope analysis implied that the conformational epitopes did not correspond to the neutralizing antibody binding sites of the F protein. These results suggested that the RSV-A F gene is relatively conserved, and mismatches between conformational epitopes and neutralizing antibody binding sites of the F protein are responsible for the virus reinfection.

Stereotyped Upper Limb Movement in MECP2 Duplication Syndrome.

Tomohiro Wakabayashi, Shinobu Fukumura, Satoru Takahashi, Kenji Kurosawa, Shuichi Miyamoto, Kosuke Tsuchida, Shinsuke Kato, Takeshi Tsugawa, Yoshiyuki Sakai, Yukihiko Kawasaki

Neurology 97 ( 2 ) 92 - 94 2021年07月 [査読有り] [国際誌]

The clinical characteristics of pediatric coronavirus disease 2019 in 2020 in Japan

Tomohiro Katsuta, Naoki Shimizu, Kenji Okada, Keiko Tanaka‐Taya, Takashi Nakano, Hajime Kamiya, Kiyoko Amo, Naruhiko Ishiwada, Satoshi Iwata, Makoto Oshiro, Nobuhiko Okabe, Ryutaro Kira, Seigo Korematsu, Shigeru Suga, Takeshi Tsugawa, Naoko Nishimura, Haruka Hishiki, Masashi Fujioka, Mitsuaki Hosoya, Yumi Mizuno, Mahito Mine, Isao Miyairi, Chiaki Miyazaki, Ichiro Morioka, Tsuneo Morishima, Tetsushi Yoshikawa, Taizo Wada, Hiroshi Azuma, Koichi Kusuhara, Kazunobu Ouchi, Akihiko Saitoh, Hiroyuki Moriuchi

Pediatrics International ( Wiley ) 64 ( 1 ) e14912 2021年07月 [査読有り] [国際誌]

BACKGROUND: The COVID-19 pandemic has affected the lives of people of all ages. Most reports on pediatric cases suggest that children experience fewer and milder symptoms than do adults. This is the first nationwide study in Japan focusing on pediatric cases reported by pediatricians, including cases with no or mild symptoms. METHODS: We analyzed the epidemiological and clinical characteristics and transmission patterns of 840 pediatric (<16 years old) COVID-19 cases reported between February and December 2020 in Japan, using a dedicated database which was maintained voluntarily by members of the Japan Pediatric Society. RESULTS: Almost half of the patients (47.7%) were asymptomatic, while most of the others presented mild symptoms. At the time of admission or first outpatient clinic visit, 84.0% of the cases were afebrile (<37.5°C). In total, 609 cases (72.5%) were exposed to COVID-19-positive household members. We analyzed the influence of nationwide school closures that were introduced in March 2020 on COVID-19 transmission routes among children in Japan. Transmission within households occurred most frequently, with no significant difference between the periods before and after declaring nationwide school closures (70.9% and 74.5%, respectively). CONCLUSIONS: COVID-19 symptoms in children are less severe than those in adults. School closure appeared to have a limited effect on transmission. Controlling household transmission from adult family members is the most important measure for prevention of COVID-19 among children.

Children's decision making in cancer therapy: A long-term observational study.

Ryoko Michinobu, Masaki Yamamoto, Tsukasa Hori, Takahiro Mikami, Keita Igarashi, Kotoe Iesato, Akira Takebayashi, Takeshi Tsugawa, Yukihiko Kawasaki, Hiroyuki Tsutsumi

Pediatrics international : official journal of the Japan Pediatric Society 64 ( 1 ) e14700 2021年03月 [査読有り] [国際誌]

BACKGROUND: The survival rate of children with cancer has increased substantially in recent years. Shared decision making (i.e., the ability of children with cancer to express their will and share it with medical personnel) has become a particularly important issue. The nature and developmental processes of children's decision making in hospital should be understood. There is, however, a lack of research in this area. METHODS: From January 2016 to March 2018, we conducted a longitudinal qualitative observational study, within the context of medical anthropology, in a hospital pediatric ward in Japan. We investigated the nature and development of decision making among seven children aged 5-12 years with hematologic cancers. We recorded their everyday behaviors, interactions, narratives, and events in the ward. The recording was conducted systematically and thematically analyzed using both variable-oriented and process-oriented modes to assess causal relationships between the phenomena. RESULTS: The thematic analysis identified three thematic scenes in which children developed their will regarding cancer treatment: (1) adjusting to hospital life, (2) forming friendships with other children, and (3) communicating with medical personnel. Sharing information, building trusting relationships, and sharing treatment goals with medical personnel were identified as forms of children's participation in medical decision making. Through cultivated friendships, children's peer groups were sources of resilience and strength in overcoming difficulties in hospital life. CONCLUSIONS: The development of children's decision making in a pediatric oncology ward was based on various rich human relationships. Such relationships should be promoted to substantially improve shared decision making.

Transient Angioedema of the Small Bowel because of Intravenous Nonionic Iodinated Contrast Media.

Tomohiro Wakabayashi, Yuta Sasaoka, Yoshiyuki Sakai, Shuichi Miyamoto, Takeshi Tsugawa, Yukihiko Kawasaki

The Journal of pediatrics 230 264 - 265 2021年03月 [査読有り] [国際誌]

Editorial for the Special Issue: Molecular Epidemiology, Diagnostics and Management of Respiratory Virus Infections.

Hirokazu Kimura, Yuriko Hayashi, Mitsuru Sada, Haruyuki Ishii, Takeshi Tsugawa, Akihide Ryo

Microorganisms 8 ( 12 ) 2020年12月 [国際誌]

Effect of a vaccine information statement (VIS) on immunization status and parental knowledge, attitudes, and beliefs regarding infant immunization in Japan.

Aya Saitoh, Akihiko Saitoh, Tomohiro Katsuta, Mahito Mine, Hajime Kamiya, Isao Miyairi, Naruhiko Ishiwada, Makoto Oshiro, Ryutaro Kira, Naoki Shimizu, Shigeru Suga, Takeshi Tsugawa, Masashi Fujioka, Chiaki Miyazaki, Ichiro Morioka, Seigo Korematsu, Takashi Nakano, Keiko Tanaka-Taya, Tetsushi Yoshikawa, Satoshi Iwata, Koichi Kusuhara, Hiroshi Azuma, Hiroyuki Moriuchi, Nobuhiko Okabe, Mitsuaki Hosoya, Hiroyuki Tsutsumi, Kenji Okada

Vaccine 38 ( 50 ) 8049 - 8054 2020年11月 [査読有り] [国際誌]

BACKGROUND: Because of the overabundance of vaccination information on the internet, in the media, and on social media, providing clear and correct information on immunization is critical for parental decision-making. In 2018, the Japan Pediatric Society created and distributed a Vaccine Information Statement (VIS) to provide appropriate immunization information to caregivers. The objectives of the present study were to evaluate the effect of the VIS on immunization rates, adherence to schedule, and parental understanding of immunization in Japan. METHODS: This cross-sectional study was conducted at 18 centers in 2 prefectures in Japan. Caregivers were assigned to an intervention group, which received the VIS and a questionnaire when their child reached the age of 1 month, and a control group, which received only the questionnaire. Using the self-reported questionnaires, we evaluated vaccination rates and schedule adherence at age 2 months, and parental knowledge, attitudes, and beliefs regarding immunization. Three months later, the questionnaires were returned, and the findings were compared between the 2 groups. RESULTS: We contacted 422 and 428 persons in the intervention and control groups, respectively, and 111/422 (26.3%) and 119/428 (27.8%) returned the surveys. Vaccination rates and adherence rates for the first dose of 4 recommended vaccines did not differ significantly (P > 0.25); however, there were some positive effects on items related to vaccine knowledge (P = 0.03), perceived benefits (P = 0.02), perceived barriers (P < 0.001), and perceived behavioral control (P = 0.01). CONCLUSION: The VIS improved parent comprehension of infant immunization. Future studies should examine if the effects of such an intervention persist and affect vaccine uptake throughout childhood.

Detailed Molecular Interactions of Favipiravir with SARS-CoV-2, SARS-CoV, MERS-CoV, and Influenza Virus Polymerases In Silico.

Mitsuru Sada, Takeshi Saraya, Haruyuki Ishii, Kaori Okayama, Yuriko Hayashi, Takeshi Tsugawa, Atsuyoshi Nishina, Koichi Murakami, Makoto Kuroda, Akihide Ryo, Hirokazu Kimura

Microorganisms 8 ( 10 ) 2020年10月 [査読有り] [国際誌]

Favipiravir was initially developed as an antiviral drug against influenza and is currently used in clinical trials against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection (COVID-19). This agent is presumably involved in RNA chain termination during influenza virus replication, although the molecular interactions underlying its potential impact on the coronaviruses including SARS-CoV-2, SARS-CoV, and Middle East respiratory syndrome coronavirus (MERS-CoV) remain unclear. We performed in silico studies to elucidate detailed molecular interactions between favipiravir and the SARS-CoV-2, SARS-CoV, MERS-CoV, and influenza virus RNA-dependent RNA polymerases (RdRp). As a result, no interactions between favipiravir ribofuranosyl-5'-triphosphate (F-RTP), the active form of favipiravir, and the active sites of RdRps (PB1 proteins) from influenza A (H1N1)pdm09 virus were found, yet the agent bound to the tunnel of the replication genome of PB1 protein leading to the inhibition of replicated RNA passage. In contrast, F-RTP bound to the active sites of coronavirus RdRp in the presence of the agent and RdRp. Further, the agent bound to the replicated RNA terminus in the presence of agent, magnesium ions, nucleotide triphosphate, and RdRp proteins. These results suggest that favipiravir exhibits distinct mechanisms of action against influenza virus and various coronaviruses.

疲労骨折を契機に炎症反応と乖離した再燃を認めた慢性再発性多発性骨髄炎(Chronic recurrent multifocal osteomyelitis:CRMO)の1例

木澤敏毅, 稲澤奈津子, 伊藤希美, 東舘義仁, 長岡由修, 石井玲, 津川毅, 鎌崎穂高, 要藤裕孝, 川崎幸彦

小児リウマチ ( (一社)日本小児リウマチ学会 ) 10 ( 1 ) 38 - 43 2019年 [査読有り]

発症3年後より血清の炎症反応と臨床症状に乖離を認めた慢性再発性多発性骨髄炎の女児を経験した。症例は発症時9歳女児。反復する多発性の骨痛を認め当院に紹介。採血で臨床症状に一致した炎症反応の上昇と画像にて骨髄炎を確認でき、骨生検にて悪性疾患、感染症を否定できたことからChronic recurrent multifocal osteomyelitis(CRMO)と診断し、NSAIDsやステロイドにて寛解していた。発症3年後に認めた疲労骨折を契機に炎症反応の上昇を認めないにも関わらず、右脛骨の疼痛が増悪し痛みのため歩行困難となった。MRI及び骨シンチを行ったところ、右脛骨部に骨髄炎の残存を確認し、炎症反応陰性のCRMOと診断した。これまでの治療に加え、ビスフォスフォネート製剤を開始するも無効であり、院内倫理委員会許可のもとTNF阻害剤であるInfliximab(IFX)を開始したところ臨床的寛解を認め、通常の生活が可能となった。(著者抄録)

Tetanus in a partially immunized child.

Yusuke Akane, Takeshi Tsugawa, Tsukasa Hori, Atsuo Togashi, Yuko Yoto, Natsuko Inazawa, Nozomi Ito, Ryoko Kyan, Mitsutoshi Senoh, Haru Kato, Hiroyuki Tsutsumi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy ( Elsevier B.V. ) 24 ( 12 ) 980 - 982 2018年12月 [査読有り] [国際誌]

A case report of cutaneous polyarteritis nodosa in siblings.

Toshitaka Kizawa, Yuko Yoto, Miyako Mizukami, Takeshi Tsugawa, Takako Takeuchi, Hotaka Kamasaki, Yasue Ishii-Osai, Toshiharu Yamashita, Kazushige Nagai, Tsukasa Hori, Hiroyuki Tsutsumi

Modern rheumatology 28 ( 6 ) 1049 - 1052 2018年11月 [査読有り] [国際誌]

Cutaneous polyarteritis nodosa (CPAN) is characterized by a necrotizing vasculitis of small and medium-sized arteries in the skin, which can be associated with fever, arthralgia, myalgia, and neuropathy, but, unlike polyarteritis nodosa (PAN), there is no visceral involvement. CPAN is rare in childhood. We report two siblings who developed CPAN during childhood. Interestingly, both had Mediterranean fever gene (MEFV) mutation, i.e. heterozygous E148Q. They also shared HLA-A24, -DR15 alleles. Simultaneous occurrence of MEFV mutation and HLA alleles with CPAN has never been reported in Japan. These cases could provide some hereditary clue for the development of CPAN.

Adrenocortical carcinoma characterized by gynecomastia: A case report.

Takako Takeuchi, Yuko Yoto, Akira Ishii, Takeshi Tsugawa, Masaki Yamamoto, Tsukasa Hori, Hotaka Kamasaki, Kazutaka Nogami, Takanori Oda, Akihiro Nui, Sachiko Kimura, Takuya Yamagishi, Keiko Homma, Tomonobu Hasegawa, Maki Fukami, Yoko Watanabe, Hidehiko Sasamoto, Hiroyuki Tsutsumi

Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology ( Jeff Corporation Co. Ltd ) 27 ( 1 ) 9 - 18 2018年 [査読有り] [国内誌]

We present a 4-yr-old boy with adrenocortical carcinoma (ACC), diagnosed due to the appearance of gynecomastia as the presenting symptom. Six months prior to admission, an acute growth spurt along with the development of bilateral breast swelling was observed. He did not present any features of virilization, including enlargement of the testes, increase in testis volume, and penis size. Laboratory investigations showed gonadotropin-independent hypergonadism, with low LH/ FSH levels and elevated estradiol/testosterone levels. Abdominal computed tomography revealed a large heterogeneous mass adjacent to the right kidney and below the liver. Pathological investigations of the biopsy specimen demonstrated that the tumor was an ACC. Pre- and post-operative combination chemotherapy with mitotane was administered and surgical resection was carried out. Post-surgery, the elevated estradiol/testosterone concentrations reverted to within the reference range. Urinary steroid profile and tissue concentration analysis of estradiol and testosterone indicated the presence of estrogen in the ACC tissue. An investigation for TP53 gene aberrations revealed the presence of a germline point mutation in exon 4 (c.215C>G (p.Pro72Arg)). In ACC, the most common symptom is virilization, and feminization, characterized by gynecomastia, is very rare. However, a diagnostic possibility of ACC should be considered when we encounter patients who have developed gynecomastia without the influence of causative factors such as obesity or puberty, and do not present with the typical signs of virilization.

Virus infection and children

Hiroyuki Tsutsumi, Yuko Yoto, Tsukasa Hori, Takeshi Tsugawa, Masaki Yamamoto

Sapporo Medical journal ( Sapporo Medical University ) 86 ( 1-6 ) 1 - 8 2017年12月

Following the lead of Dr. Toru Nakao and Emeritus Professor Shunzo Chiba, we have conducted epidemiological and virological research on viral infections frequently observed in children. The present report is an overview of the research we have conducted. Amongst our research, we have demonstrated that the genetic evolution of the respiratory syncytial virus (RSV) undergoes both geographical and temporal clustering. Additionally, we have shown that the cytomegalovirus (CMV), a DNA virus, is widely disseminated under very stable genetic conditions. We have also clarified the situation concerning the genetic evolution of rotaviruses collected in Sapporo. In addition, we have attempted to identify the virulence-associated genome mutations of murine and human rotaviruses. Furthermore, we have indicated how the considerable genetic mutations of human parvovirus B19 could be associated with outbreaks of exanthema infectiosum every few years. Finally, we have examined viral reactivation in patients who underwent allogeneic hematopoietic stem cell transplantation and identified human herpesvirus 6 as a prominent pathogen causing important clinical events in these patients.

Pneumococcal vaccination reduces the risk of community-acquired pneumonia in children.

Junko Hasegawa, Mitsuru Mori, Hirofumi Ohnishi, Takeshi Tsugawa, Tsukasa Hori, Yuko Yoto, Hiroyuki Tsutsumi

Pediatrics international : official journal of the Japan Pediatric Society ( WILEY ) 59 ( 3 ) 316 - 320 2017年03月 [査読有り] [国際誌]

BACKGROUND: The seven-valent pneumococcal conjugate vaccine (PCV7) was introduced to Japan in 2009, after which there was a rapid decline in invasive pneumococcal disease. There are few data, however, on the effectiveness of PCV7 against community-acquired pneumonia (CAP). We conducted an ambispective cohort study among children aged 0-6 years old who attended day-care centers. METHODS: A total of 624 children at 10 day-care centers in Sapporo, Japan participated in the study. The parents reported whether their child had received PCV7 one or more times, as well as the exact dates of vaccination from records in maternal and child health handbooks marked by pediatricians. Each CAP event was reported by parents according to doctor diagnosis. A Cox proportional hazards regression model was used to calculate the hazard ratio (HR) and 95%CI of CAP incidence reduced by PCV7 inoculation. RESULTS: During the observational period, 94 subjects contracted CAP. After adjusting for potentially confounding variables, inoculation with PCV7 was significantly associated with a reduced risk of CAP (HR, 0.22; 95%CI: 0.13-0.34). On stratified analysis by age, PCV7 was significantly associated with a reduced risk of CAP in both children aged <3 years (HR, 0.31; 95%CI: 0.14-0.71), and those ≥3 years (HR, 0.20; 95%CI: 0.09-0.43). CONCLUSION: PCV7 is highly effective in reducing the risk of CAP in children attending day-care centers.

Genomic changes detected after serial passages in cell culture of virulent human G1P[8] rotaviruses.

Takeshi Tsugawa, Hiroyuki Tsutsumi

Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases ( ELSEVIER SCIENCE BV ) 45 6 - 10 2016年11月 [査読有り] [国際誌]

担当区分：筆頭著者 , 責任著者

Serial passages of a virulent mouse rotavirus in cell cultures caused a loss of virulence in mice. To gain insight into the genomic mutations in human rotavirus during cell culture and its attenuation in humans, we serially passaged three wild type human G1P[8] rotavirus strains (Wa, DC3695, DC5685) derived from diarrheal stool samples up to 60 times in two different cell cultures (human colon adenocarcinoma cell line: HT29, and primary African green monkey kidney cells: primary AGMK). We sequenced the whole genomes of 60 times-passaged strains and compared them with those of the original viruses. Most substitutions were detected in VP4, followed by substitutions in VP7 and NSP4 genes. Substitution at amino acid 385 in the putative VP4 fusion domain and substitution T45M in NSP4 genes were detected in all AGMK-passaged strains, respectively. These genomic changes are likely to correlate with a loss of rotavirus virulence in humans.

An adolescent case of familial hyperparathyroidism with a germline frameshift mutation of the CDC73 gene.

Takako Takeuchi, Yuko Yoto, Takeshi Tsugawa, Hotaka Kamasaki, Atsushi Kondo, Jiro Ogino, Tadashi Hasegawa, Naoya Yama, Sawa Anan, Shinya Uchino, Aki Ishikawa, Akihiro Sakurai, Hiroyuki Tsutsumi

Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology ( Jeff Corporation Co. Ltd ) 24 ( 4 ) 185 - 9 2015年10月 [査読有り] [国内誌]

A 13-yr-old boy who complained of persistent nausea, vomiting and weight loss had hypercalcemia and an elevated intact PTH level. Computed tomography confirmed two tumors in the thyroid gland. The tumors were surgically removed and pathologically confirmed as parathyroid adenoma. Because his maternal aunt and grandmother both had histories of parathyroid tumors, genetic investigation was undertaken for him, and a germline frameshift mutation of the CDC73 gene was identified. CDC73 gene analysis should be done on individuals who are at risk of familial hyperparathyroidism, including those who are asymptomatic, and they should be followed for potential primary hyperparathyroidism and associated disorders including resultant parathyroid carcinoma.

Pneumococcal vaccination reduced the risk of acute otitis media: Cohort study.

Junko Hasegawa, Mitsuru Mori, Satoko Showa, Aiko Matsushima, Hirofumi Ohnishi, Takeshi Tsugawa, Yuko Yoto, Hiroyuki Tsutsumi

Pediatrics international : official journal of the Japan Pediatric Society ( WILEY-BLACKWELL ) 57 ( 4 ) 582 - 5 2015年08月 [査読有り] [国際誌]

BACKGROUND: Seven-valent pneumococcal conjugate vaccine (PCV7) was introduced to Japan in 2009, and after that invasive pneumococcal disease has gradually decreased. There are few data, however, on the effectiveness of PCV7 against acute otitis media (AOM) in Japan. METHODS: From 10 daycare centers in Sapporo, Japan, 614 parents participated in the survey. Each parent reported whether their child subject had received one or more doses of PCV7, and, if so, the exact dates of receiving PCV7 were verified by reviewing their maternal and child health handbooks marked by a pediatrician. AOM was diagnosed by otorhinolaryngologist or pediatrician. Cox's proportional hazard model was used for calculating the hazard ratio (HR) of AOM incidence reduced by PCV7 inoculation. RESULTS: Inoculation of PCV7 significantly reduced the risk of AOM (crude HR, 0.63; 95%CI: 0.50-0.79). Adjusting for potentially confounding variables reduced the risk further (adjusted HR, 0.32; 95%CI: 0.23-0.44). On stratification by subject age on 30 April 2012, PCV7 was significantly associated with a reduced risk of AOM in both infants < 3 years old, and in children ≥ 3 years. CONCLUSION: PCV7 is effectiveness in reducing the risk of AOM both in infants < 3 years old, and in young children ≥ 3 years in Japan.

Ankyloblepharon-ectodermal-defects-cleft lip/palate症候群(AEC症候群)の1例

重冨浩子, 白石真大, 野口聡子, 石川淑, 浅沼秀臣, 新飯田裕一, 木澤敏毅, 津川毅, 竹内孝子, 鎌崎穂高, 要藤裕孝, 堤裕幸

臨床小児医学 ( (財)小児愛育協会 ) 62 ( 1-6 ) 32 - 34 2014年12月 [査読有り]

日齢0男児。出生時に広範囲の皮膚剥離と口唇口蓋裂を認め、生後1時間で当院NICUに搬送となった。入院時、眼瞼癒着と口唇口蓋裂、頭部・背部・四肢を中心に全身の30%に表皮剥離を認め、発赤とびらんを伴っていた。日齢2に皮膚生検を実施し、遺伝子解析にてTP63遺伝子の変異を確認し、Ankyloblepharon-ectadermal-defects-cleft lip/palate症候群の診断に至った。体幹と四肢の皮膚剥離は清拭やワセリン塗布、シートによる保護で順調な上皮化が得られたが、頭皮は浸出液が持続した。日齢29に口蓋裂の外科治療目的で転院となったが、この時点でも頭皮の皮膚病変は完全な上皮化が得られなかった。なお、眼瞼癒合はその後自然軽快した。

Quantitation of human parvovirus B19 DNA in erythema infectiosum and aplastic crisis.

Aki Ishikawa, Yuko Yoto, Takeshi Tsugawa, Hiroyuki Tsutsumi

Journal of medical virology ( WILEY-BLACKWELL ) 86 ( 12 ) 2102 - 6 2014年12月 [査読有り] [国際誌]

Several publications concerning the methods of real-time PCR for human parvovirus B19 (B19V) have appeared and some case reports mention B19V DNA loads. However, no large-scale study quantitating levels of B19V DNA in common or representative B19V manifestations such as erythema infectiosum and aplastic crisis has been performed. Consequently, using the TaqMan PCR assay, the B19V load in a large sample of subjects with erythema infectiosum or aplastic crisis was quantitated. Sixty-five subjects in the acute phase of erythema infectiosum were involved, and in addition 22 serum samples from seven subjects with B19V-associated aplastic crisis complicating chronic hemolytic anemia were also analyzed. In the acute phase of erythema infectiosum the median B19V DNA load in the serum samples from the acute phase of erythema infectiosum was 7.63 × 10(5) genomes/ml, (range from 4.48 × 10(3) to 8.31 × 10(6) genomes/ml). The serum B19V DNA load during the acute phase of aplastic crisis complicating chronic hemolytic anemia was extremely high, that is 10(10) -10(13) genomes/ml, and decreased gradually to around 10(5) genomes/ml over 1-2 months. Although all subjects followed an almost uniform and typical clinical course of erythema infectiosum, there was a large individual variation of B19V DNA loads, that is differences of over 1,000 times. Extremely high B19V loads were observed in subjects with aplastic crisis. This study is the first large scale report of studies of the B19V DNA loads in subjects with erythema infectiosum and aplastic crisis, the most common and significant clinical manifestations by B19V infections.

　前のページ - 次のページ　

1
2
3
4
5

このページの先頭へ▲