論文 - 津川　毅

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]

　概要を見る

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]

　概要を見る

A 13-year-old boy developed tetanus, although he had protective antitoxin antibody raised by three doses of tetanus toxoid vaccine. Four days after injury, he presented with muscle rigidity of his posterior neck, excessive diaphoresis, and risus sardonicus and was subsequently diagnosed with tetanus. Tetanus is rare in developed countries, particularly during childhood, but must be promptly diagnosed based on clinical symptoms.

DOI PubMed

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]

　概要を見る

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.

DOI PubMed

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]

　概要を見る

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.

DOI PubMed

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

　概要を見る

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.

DOI

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]

　概要を見る

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.

DOI PubMed

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

　概要を見る

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.

DOI PubMed

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]

　概要を見る

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.

DOI PubMed

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]

　概要を見る

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.

DOI PubMed

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]

　概要を見る

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.

DOI PubMed

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]

　概要を見る

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。

Longitudinal analysis of VP7 gene of group A human rotavirus G2P[4] strains circulating in the pre-vaccine era in Sapporo, Japan from 1991 to 2011.

Masatoshi Tatsumi, Yoshinobu Nagaoka, Takeshi Tsugawa, Yuko Yoto, Tsukasa Hori, Hiroyuki Tsutsumi

Microbiology and immunology ( WILEY-BLACKWELL )  58 ( 9 ) 540 - 4  2014年09月  [査読有り]  [国際誌]

　概要を見る

Sequence analysis of the VP7 gene in 23 group A human rotavirus G2P[4] strains obtained during 1991-2011, that is, the pre-vaccine era, in Sapporo, Japan showed considerable genetic diversity, mainly in variable regions. Recent G2P[4] epidemic strains were located in sublineage IVa with a distinctive substitution of D96N. This study provides background data on the genetic variability of G2P[4] rotavirus-VP7 gene prior to the widespread use of rotavirus vaccines in Japan.

DOI PubMed

Rhabdomyolysis associated with human parvovirus B19 infection in a patient with Fukuyama-type congenital muscular dystrophy.

Aki Ishikawa, Yuko Yoto, Kazuhiro Ohya, Takeshi Tsugawa, Hiroyuki Tsutsumi

Journal of child neurology ( SAGE PUBLICATIONS INC )  29 ( 7 ) 977 - 9  2014年07月  [査読有り]  [国際誌]

　概要を見る

Patients with Fukuyama-type congenital muscular dystrophy sometimes experience transient exacerbations of muscle weakness. We took care of a 9-year-old boy with Fukuyama-type congenital muscular dystrophy who presented with acute respiratory failure and decreased exercise ability with marked elevation of serum creatine kinase indicating rhabdomyolysis. At that time, his younger sister suffered from erythema infectiosum. Although he had no particular symptoms, he was tested and proven to have acute human parvovirus B19 infection based on detection of anti-B19 IgM and parvovirus B19 DNA in his serum. His acute rhabdomyolysis was possibly triggered by human parvovirus B19 infection.

DOI PubMed

trisomy8が診断の一助となった小児期発症腸管Behcet病の1例

木澤 敏毅, 津川 毅, 竹内 孝子, 鎌崎 穂高, 要藤 裕孝, 五十嵐 敬太, 山本 雅樹, 堀 司, 畠山 直樹, 斉藤 淳人, 東海林 黎吉, 堤 裕幸

小児リウマチ ( (一社)日本小児リウマチ学会 )  5 ( 1 ) 52 - 56  2014年06月  [査読有り]

　概要を見る

腸管Behcet病と診断した12歳男児を経験した。児は幼少時より非周期的に反復する発熱、口腔内アフタを呈し、血液検査では炎症反応の上昇を認めていたが各種培養は陰性であった。不明熱、周期性発熱としてCT、MRI、シンチグラムに加え、骨髄穿刺を施行したところ、染色体検査でtrisomy 8と判明した。trisomy 8の存在から腸管Behcet病を疑い内視鏡検査を実施したところ、食道下部及び回盲部に円形の潰瘍を複数個所に認めたため、trisomy 8に伴う腸管Behcet病と診断した。trisomy 8に伴う骨髄異形成症候群(myelodysplastic syndrome:MDS)の報告が散見されているが、血球系には異常を認めなかった。不明熱の診断過程にて骨髄染色体の異常が診断につながった希有な症例であり、腸管Behcet病の発症機序を考えるうえで非常に興味深い症例と考えられた。(著者抄録)

Virulence-associated genome mutations of murine rotavirus identified by alternating serial passages in mice and cell cultures.

Takeshi Tsugawa, Masatoshi Tatsumi, Hiroyuki Tsutsumi

Journal of virology ( AMER SOC MICROBIOLOGY )  88 ( 10 ) 5543 - 58  2014年05月  [査読有り]  [国際誌]

担当区分：   筆頭著者  , 責任著者

　概要を見る

UNLABELLED: Although significant clinical efficacy and safety of rotavirus vaccines were recently revealed in many countries, the mechanism of their attenuation is not well understood. We passaged serially a cell culture-adapted murine rotavirus EB strain in mouse pups or in cell cultures alternately and repeatedly and fully sequenced all 11 genes of 21 virus samples passaged in mice or in cell cultures. Sequence analysis revealed that mouse-passaged viruses that regained virulence almost consistently acquired four kinds of amino acid (aa) substitutions in VP4 and substitution in aa 37 (Val to Ala) in NSP4. In addition, they gained and invariably conserved the 3' consensus sequence in NSP1. The molecular changes occurred along with the acquisition of virulence during passages in mice and then disappeared following passages in cell cultures. Intraperitoneal injection of recombinant NSP4 proteins confirmed the aa 37 site as important for its diarrheagenic activity in mice. These genome changes are likely to be correlated with rotavirus virulence. IMPORTANCE: Serial passage of a virulent wild-type virus in vitro often results in loss of virulence of the virus in an original animal host, while serial passage of a cell culture-adapted avirulent virus in vivo often gains virulence in an animal host. Actually, live attenuated virus vaccines were originally produced by serial passage in cell cultures. Although clinical efficacy and safety of rotavirus vaccines were recently revealed, the mechanism of their attenuation is not well understood. We passaged serially a murine rotavirus by alternating switch of host (mice or cell cultures) repeatedly and sequenced the eleven genes of the passaged viruses to identify mutations associated with the emergence or disappearance of virulence. Sequence analysis revealed that changes in three genes (VP4, NSP1, and NSP4) were associated with virulence in mice. Intraperitoneal injection of recombinant NSP4 proteins confirmed its diarrheagenic activity in mice. These genome changes are likely to be correlated with rotavirus virulence.

DOI PubMed

【小児内分泌学の進歩2015】カルシウム代謝 副甲状腺腫の確定までに長期間を要した原発性副甲状腺機能亢進症の1例

竹内 孝子, 鎌崎 穂高, 津川 毅, 要藤 裕孝, 近藤 敦, 山 直也, 荻野 次郎, 堤 裕幸

ホルモンと臨床 ( (有)医学の世界社 )  62 ( 5 ) 431 - 434  2014年05月  [査読有り]

Characterization of the NSP4 gene of group A human rotavirus G1P[8] strains circulating in Sapporo, Japan from 1987 to 2000.

Masatoshi Tatsumi, Yoshinobu Nagaoka, Takeshi Tsugawa, Yuko Yoto, Tsukasa Hori, Hiroyuki Tsutsumi

Journal of medical virology ( WILEY-BLACKWELL )  86 ( 2 ) 354 - 9  2014年02月  [査読有り]  [国際誌]

　概要を見る

The genetic diversity of the NSP4 gene of rotavirus G1P[8] strains obtained in Sapporo was analyzed, Japan from 1987 to 2000. Sixty-four strains, which were distributed across the whole study period, were included. All G1P[8] NSP4 genes detected in this study belonged to genotype E1, which divided into at least three lineages. The Sapporo rotavirus G1P[8] isolates were found in each lineage. The mean estimated substitution rate was 1.40 × 10(-3) nucleotide substitutions per site per year, which was comparable to that of the G1P[8] VP7 gene. Comparison of the deduced NSP4 amino acid sequences showed genetic diversity at the center of antigenic site II, but not in the enterotoxic domain. This report represents the first investigation of the genetic diversity and evolution of group A rotavirus NSP4 genes in Asia.

DOI PubMed

Phylogenetic and computational structural analysis of VP7 gene of group a human rotavirus G1P[8] strains obtained in Sapporo, Japan from 1987 to 2000.

Yoshinobu Nagaoka, Masatoshi Tatsumi, Takeshi Tsugawa, Yuko Yoto, Hiroyuki Tsutsumi

Journal of medical virology ( WILEY-BLACKWELL )  84 ( 5 ) 832 - 8  2012年05月  [査読有り]  [国際誌]

　概要を見る

Many studies indicate that G1P[8] genotypes are the most prevalent rotavirus strains worldwide. Although two vaccines have been licensed and their value proven in many countries, continuous surveillance for genetic evolution of circulating rotavirus strains before and after the introduction of the vaccines is desirable. G and P typing were carried out on all field strains isolated during 1987-2000 in Sapporo, Japan. Phylogenetic analysis for the VP7 gene of rotavirus G1P[8] strains was performed. Amino acid substitutions were mapped on the predicted three-dimensional VP7 protein image. G1P[8] genotype predominated. One hundred thirteen strains with G1P[8] genotype were analyzed. Phylogenetic studies of the VP7 gene classified these strains into three lineages. The mean estimated substitution rate was 7.25 × 10(-4) nucleotide substitutions per site per year. One predominant lineage contained the mutant strains which had VP7 amino acid substitutions at residue 91 and 212 that is in the neutralization domains. They were estimated to locate in or near intersubunit boundary of VP7 trimer. It is suggested that the most prevalent G1P[8] lineage strains in Sapporo obtained some survival advantages by changing the neutralization domains of VP7.

DOI PubMed

Detection of enteric viruses in rectal swabs from children with acute gastroenteritis attending the pediatric outpatient clinics in Sapporo, Japan.

Kaori Nakanishi, Takeshi Tsugawa, Shinjiro Honma, Shuji Nakata, Masatoshi Tatsumi, Yuko Yoto, Hiroyuki Tsutsumi

Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology ( ELSEVIER SCIENCE BV )  46 ( 1 ) 94 - 7  2009年09月  [査読有り]  [国際誌]

　概要を見る

BACKGROUND: Gastroenteritis is a world-wide disorder. Numerous studies to identify causative viral agents have been reported for hospitalized patients but there are only a few for outpatients with mild symptoms who are usually managed in the outpatient clinics. OBJECTIVES: Our aim was to clarify the epidemiological and clinical characteristics of acute gastroenteritis in children who visited the outpatient clinics with various complaints suggestive of gastroenteritis. STUDY DESIGN: From December 2003 to December 2005, 877 rectal swabs were collected from patients attending outpatient clinics in Sapporo, Japan. Viral genomes of major five enteric viruses (rotavirus, norovirus, adenovirus, astrovirus and sapovirus) and bocavirus were investigated by RT-PCR or PCR. RESULTS: At least one viral agent was found in 326 (37.2%) cases of the 877 studied. Rotaviruses were the most prevalent and were detected in 143 (16.3%) followed by norovirus in 116 (13.2%), adenovirus in 42 (4.8%), astrovirus in 40 (4.6%) and sapovirus in 15 (1.7%) cases. Bocavirus was detected in only 4 (0.5%) cases. Frequent diarrhea and frequent vomiting were prominent in rotavirus and norovirus infection, respectively. CONCLUSIONS: The prevalence of each enteric virus in outpatients resembled that previously estimated in hospitalized patients, although the detection rate of rotavirus was slightly low. The contribution of bocavirus appears to be small.

DOI PubMed

Guillain-Barre syndrome with meningoencephalitis after Campylobacter jejuni infection.

Takeshi Tsugawa, Koki Nikaido, Toshiaki Doi, Michiaki Koga, Keiichiro Susuki, Tomoki Kubota, Hiroyuki Tsutsumi

The Pediatric infectious disease journal ( LIPPINCOTT WILLIAMS & WILKINS )  23 ( 10 ) 966 - 8  2004年10月  [査読有り]  [国際誌]

担当区分：   筆頭著者

　概要を見る

A 14-year-old boy presented with progressive ascending muscle weakness, urinary retention and disturbed consciousness. Initially his cerebrospinal fluid showed pleocytosis, and protein-cellular dissociation developed later. Campylobacter jejuni was isolated from his stool and serum anti-ganglioside antibodies were positive. Our case suggests that coexistence of meningoencephalitis at an early stage of illness does not necessarily exclude the diagnosis of Guillain-Barre syndrome.

DOI PubMed