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Nishino T, Tomori S, Haruyama M, Takahashi K, Mimaki M. A case of rapid avacopan-induced liver injury in pediatric granulomatosis with polyangiitis. Pediatr Nephrol 2024:10.1007/s00467-024-06376-8. [PMID: 38619581 DOI: 10.1007/s00467-024-06376-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/16/2024]
Abstract
Children with anti-neutrophil cytoplasmic antibody-associated vasculitis benefit immensely from avacopan as it reduces the requirement for steroids. However, descriptions of adverse drug reactions in children are lacking, and the dosage and follow-up intervals are unclear. A 10-year-old boy with initial granulomatosis and polyangiitis presented with diffuse pulmonary hemorrhage. Rituximab and 30 mg avacopan were administered twice daily as induction therapy following methylprednisolone pulse therapy. However, sudden liver function test abnormalities were observed on day 31 of avacopan treatment, despite liver enzyme levels being within the normal range 5 days earlier. A drug-induced lymphocyte stimulation and various infectious disease tests yielded negative results. Discontinuation of rituximab and avacopan resulted in improved liver function; no change in the Birmingham Vasculitis Activity Score during liver function test abnormalities was observed. Avacopan-associated abnormalities in liver function tests suggest that drug-induced liver injury may occur rapidly in children, and appropriate dosing strategies should be reconsidered.
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Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan.
| | - Shinya Tomori
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Mei Haruyama
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan
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Nishino T, Tomori S, Ono S, Takahashi K, Mimaki M. Effect of proteinuria at relapse on shear wave velocity assessed using ultrasound elastography in children with idiopathic nephrotic syndrome. J Med Ultrason (2001) 2024:10.1007/s10396-024-01455-7. [PMID: 38613718 DOI: 10.1007/s10396-024-01455-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/30/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE Shear wave velocity (SWV) is an ultrasound elastography technique that provides much information for kidney disease assessment. However, the factors that alter SWV are not fully understood; it is unclear whether the variation in SWV seen in proteinuria associated with disease progression is due to tissue or proteinuria. This study investigated the effect of proteinuria on SWV. METHODS This prospective observational study compared SWV at remission with SWV at relapse in children treated for idiopathic nephrotic syndrome (INS) between April 2020 and December 2023. All relapses without oral steroids during the observation period were measured. SWV at remission was defined as the date closest to relapse during which repeated measurements were taken approximately every 3 months after steroid discontinuation. RESULTS Eight patients were treated for INS with a median observation period of 21.9 months (11.8-27.1). Of the 15 relapses, five that met the definition were considered for the study. The median interval between the measurement at relapse and remission was 40 days (11-55). SWV was significantly lower at relapse than remission (2.40 ± 0.20 m/s vs. 2.14 ± 0.15 m/s, P < 0.01). CONCLUSIONS SWV decreased in the presence of severe proteinuria at relapse compared to the remission measurements. Although more cases need to be studied, the decrease in SWV may reflect the mechanism by which protein leaks into the urine, not just a direct change caused by the presence of proteinuria.
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Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan.
| | - Shinya Tomori
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Sayaka Ono
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan
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Nishino T, Takahashi K, Ono S, Mimaki M. Pathological Factors Affecting the R2* Values of the Kidney in Blood Oxygenation Level-dependent MR Imaging: A Retrospective Study. Magn Reson Med Sci 2024; 23:153-160. [PMID: 36754388 PMCID: PMC11024711 DOI: 10.2463/mrms.mp.2022-0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/07/2023] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Despite the usefulness of blood oxygenation level-dependent (BOLD) MRI in assessing glomerulonephritis activity, its relationship with histological findings remains unclear. Because glomerulonephritis presents multiple complex injury patterns, analysis of each pattern is essential. We aimed to elucidate the relationship between the histological findings of the kidney and BOLD MRI findings in mesangial proliferative glomerulonephritis. METHODS Children under 16 years of age diagnosed with mesangial proliferative glomerulonephritis by kidney biopsy at our university hospital between January 2013 and September 2022 were included in this study. Cortical and medullary spin relaxation rate (R2*) values were measured using BOLD MRI at 3T within two weeks before and after the kidney biopsy. The R2* values, including the fluctuations with low-dose oxygen administration, were retrospectively examined in relation to the cortical (mesangial proliferation, endothelial cell proliferation, crescent, sclerosis, and fibrosis) and medullary findings (fibrosis). RESULTS Sixteen times kidney biopsies were performed for glomerulonephritis during the study period, and one patient was excluded because of comorbidities; the remaining 14 patients included six boys with a mean age of 11.9 ± 3.5 years at the BOLD examination. None of the patients had medullary fibrosis. Among the kidney tissue parameters, only sclerosis showed a significant correlation with R2* values: medulla with R2* values under atmospheric pressure (r = 0.53, P < 0.05) and cortex with the rate of change in R2* values with low-dose oxygen administration (r = -0.57, P < 0.03). In the multiple regression analysis, only sclerosis was an independent contributor to the change in R2* values with oxygen administration in the cortex (regression coefficient -0.109, P < 0.05). CONCLUSION Since the R2* values reflect histological changes in the kidney, BOLD MRI may facilitate the evaluation of mesangial proliferative glomerulonephritis, potentially reducing the patient burden.
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Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Sayaka Ono
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
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Shimoda K, Iwasaki H, Mizuno Y, Seki M, Mimaki M, Kato M, Shinozaki-Ushiku A, Mori H, Ogawa S, Mizuguchi M. Case Report: Tuberous sclerosis complex-associated hemihypertrophy successfully treated with mTOR inhibitor sirolimus. Front Pediatr 2024; 12:1333064. [PMID: 38455392 PMCID: PMC10919150 DOI: 10.3389/fped.2024.1333064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/12/2024] [Indexed: 03/09/2024] Open
Abstract
Tuberous sclerosis complex (TSC) is an autosomal dominant disorder caused by a mutation in either of the two tumor suppressor genes, TSC1 and TSC2. Due to dysregulated activity of the mammalian target of rapamycin (mTOR) pathway, hamartomas or benign tumors frequently occur in many organs and are often treated with mTOR inhibitors. Hemihypertrophy is a rare complication of TSC. Although not being a tumor, progressive overgrowth of the affected limb may cause cosmetic and functional problems, for which the efficacy of mTOR inhibitors has not been reported previously. We herein report a case of TSC-associated hemihypertrophy. In this case, genetic studies revealed TSC1 loss of heterozygosity as the cause of hemihypertrophy. Clinically, pharmacological treatment with an mTOR inhibitor sirolimus successfully ameliorated cosmetic and functional problems with no intolerable adverse effects.
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Affiliation(s)
- Konomi Shimoda
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Pediatrics, National Rehabilitation Center for Children with Disabilities, Tokyo, Japan
| | - Hiroyuki Iwasaki
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoko Mizuno
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masafumi Seki
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motohiro Kato
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aya Shinozaki-Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Harushi Mori
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Institute for the Advanced Study of Human Biology, Kyoto University, Kyoto, Japan
| | - Masashi Mizuguchi
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Pediatrics, National Rehabilitation Center for Children with Disabilities, Tokyo, Japan
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Nishino T, Hirano S, Takemura S, Tomori S, Ono S, Takahashi K, Mimaki M. Glomeruli Count and Arterial Injury in Real-Time Ultrasound-Guided Needle Kidney Biopsy Specimens: Adequacy of Three Approaches for Pig Kidneys. Am J Nephrol 2023; 54:528-535. [PMID: 37579726 DOI: 10.1159/000533593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/08/2023] [Indexed: 08/16/2023]
Abstract
INTRODUCTION Real-time ultrasound-guided percutaneous kidney biopsy is essential for diagnosis and treatment planning; nonetheless, the optimal puncture approach has yet to be established. In vivo, performing different approaches on the same patient at once is not possible. This study aimed to determine the impact of different approaches on the number of obtained glomeruli and their potential to cause arterial injury using pig kidneys, which are similar to humans. METHODS A total of 120 pig kidneys (60 right-sided kidneys and 60 left-sided kidneys) for research were obtained from a slaughterhouse. The specimens were collected from the lower pole on the sagittal plane of the kidney using three different approaches on the same kidney: caudocranial approach, caudal to cranial; craniocaudal approach, cranial to caudal; and vertical approach, through the surface cortex. Five blinded pediatric nephrologists assessed the number of glomeruli and arterial injuries. RESULTS Overall, 360 specimens were collected from the kidneys through biopsy using a 16-gauge needle (mean vertical kidney length, 11.2 ± 0.7 cm; mean depth, 3.47 ± 0.23 cm). No significant difference in the incidence of arterial injury was observed between the three approaches (caudocranial vs. craniocaudal vs. vertical approaches: 78% vs. 87% vs. 87%, p = 0.14). In contrast, the vertical approach retrieved significantly more glomeruli than the caudocranial and craniocaudal approaches (caudocranial approach: 7.5 ± 2.8, craniocaudal approach: 7.8 ± 2.7, and vertical approach: 8.9 ± 3.3, p < 0.001). CONCLUSIONS Considering its efficacy and safety profile, the vertical approach may be preferred, as more glomeruli can be obtained without increasing the incidence of arterial injury. Although the results cannot be directly extrapolated to humans due to the differences between species, they still offer important insights into the characteristics of each approach.
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Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Sakurako Hirano
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Shin Takemura
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinya Tomori
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Sayaka Ono
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
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Ono S, Nishino T, Takahashi K, Mimaki M. A Case of Shear Wave Velocity Reflecting the Disease Activity in Glomerulonephritis. J Med Ultrasound 2023; 31:235-237. [PMID: 38025002 PMCID: PMC10668900 DOI: 10.4103/jmu.jmu_24_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 12/01/2023] Open
Abstract
Ultrasound elastography can measure tissue elasticity using the shear wave velocity (SWV). Evaluating disease activity with elastography instead of renal biopsy may be less invasive. However, to the best of our knowledge, although there are studies comparing different glomerular diseases using SWV, there are no reports that have measured glomerulonephritis longitudinally from the acute phase of the disease. This study aimed to assess whether SWV reflects disease activity in glomerulonephritis, and we continued to observe children with post-streptococcal acute glomerulonephritis (PSAGN) from the acute phase to over a year later. In this case, a 6-year-old boy diagnosed with PSAGN had impaired renal function, and was admitted and tested. He was placed in a prone resting position and measurements were taken from the back. SWV was measured ≥50 times at each examination, and the mean was calculated when the net amount of effective SWV was ≥50%. The tests were performed once in the acute phase and thrice during the recovery phase for 13 months. SWV was found to be significantly lower in the recovery period than during the disease onset, and continued to stay lower at each test during the recovery period (P < 0.02). In conclusion, this indicated that SWV fluctuated similarly to the disease activity of glomerulonephritis; therefore, we suggest using SWV measurement to estimate the disease activity in glomerulonephritis in children. Although more clinical cases are needed, SWV measurement is a noninvasive and reproducible imaging modality to estimate the disease activity in glomerulonephritis.
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Affiliation(s)
- Sayaka Ono
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
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Ibayashi K, Fujino Y, Mimaki M, Fujimoto K, Matsuda S, Goto YI. Estimation of the Number of Patients With Mitochondrial Diseases: A Descriptive Study Using a Nationwide Database in Japan. J Epidemiol 2023; 33:68-75. [PMID: 33907064 PMCID: PMC9794447 DOI: 10.2188/jea.je20200577] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To provide a better healthcare system for patients with mitochondrial diseases, it is important to understand the basic epidemiology of these conditions, including the number of patients affected. However, little information about them has appeared in Japan to date. METHODS To gather data of patients with mitochondrial diseases, we estimated the number of patients with mitochondrial diseases from April 2018 through March 2019 using a national Japanese health care claims database, the National Database (NDB). Further, we calculated the prevalence of patients, and sex ratio, age class, and geographical distribution. RESULTS From April 2018 through March 2019, the number of patients with mitochondrial diseases was 3,629, and the prevalence was 2.9 (95% confidence interval [CI], 2.8-3.0) per 100,000 general population. The ratio of females and males was 53 to 47, and the most frequent age class was 40-49 years old. Tokyo had the greatest number of patients with mitochondrial diseases, at 477, whereas Yamanashi had the fewest, at 13. Kagoshima had the highest prevalence of patients with mitochondrial diseases, 8.4 (95% CI, 7.1-10.0) per 100,000 population, whereas Yamanashi had the lowest, 1.6 (95% CI, 0.8-2.7). CONCLUSION The number of patients with mitochondrial diseases estimated by this study, 3,269, was more than double that indicated by the Japanese government. This result may imply that about half of all patients are overlooked for reasons such as low severity of illness, suggesting that the Japanese healthcare system needs to provide additional support for these patients.
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Affiliation(s)
- Koki Ibayashi
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Fukuoka, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Fukuoka, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kenji Fujimoto
- Department of Public Health, University of Occupational and Environmental Health, Japan, Fukuoka, Japan
| | - Shinya Matsuda
- Department of Public Health, University of Occupational and Environmental Health, Japan, Fukuoka, Japan
| | - Yu-ichi Goto
- Department of Mental Retardation and Birth Defect Research, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan
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Nishino T, Takahashi K, Tomori S, Ono S, Mimaki M. Association of human leukocyte antigen with IgA vasculitis with nephritis in Japanese children. Pediatr Int 2023; 65:e15422. [PMID: 36413137 DOI: 10.1111/ped.15422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/26/2022] [Accepted: 11/21/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinya Tomori
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Sayaka Ono
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
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Hyodo Y, Akiyama T, Fukuyama T, Mimaki M, Watanabe K, Kumagai T, Kobayashi K. Simultaneous assay of urine sepiapterin and creatinine in patients with sepiapterin reductase deficiency. Clin Chim Acta 2022; 534:167-172. [PMID: 35926683 DOI: 10.1016/j.cca.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Sepiapterin reductase deficiency (SRD) causes central nervous system symptoms due to dopamine and serotonin depletion because sepiapterin reductase plays an important role in tetrahydrobiopterin biosynthesis. SRD cannot be detected by newborn screening because of the absent hyperphenylalaninemia. To diagnose SRD biochemically, confirmation of reduced monoamine metabolites and elevated sepiapterin in the cerebrospinal fluid (CSF) has been considered necessary, because a past study showed no elevation of urine sepiapterin. Recently, however, the elevation of urine sepiapterin in SRD was reported. METHODS We developed a fast method to measure sepiapterin and creatinine simultaneously using high-performance liquid chromatography with fluorescence and ultraviolet detection. Urine sepiapterin and creatinine were measured in three SRD patients, two SRD carriers, four SRD siblings, and 103 non-SRD patients. RESULTS In the three SRD cases, concentrations of urine sepiapterin were 1086, 914, and 575 µmol/mol creatinine (upper limit: 101.7 µmol/mol creatinine), and were markedly higher than those in other groups. CSF sepiapterin concentration was also measured in one SRD case and it was 4.1 nmol/L (upper limit: 0.5 nmol/L). CONCLUSIONS The simultaneous determination of urine sepiapterin and creatinine appears helpful for the diagnosis of SRD. This assay system can also be used to measure sepiapterin in the CSF.
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Affiliation(s)
- Yuki Hyodo
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry, Pharmaceutical Sciences, Okayama, Japan.
| | - Tomoyuki Akiyama
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry, Pharmaceutical Sciences, Okayama, Japan
| | - Tetsuhiro Fukuyama
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Keiko Watanabe
- Department of Pediatrics, Yaizu City Hospital, Yaizu, Japan
| | | | - Katsuhiro Kobayashi
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry, Pharmaceutical Sciences, Okayama, Japan
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Fujisawa C, Kodama H, Sato Y, Mimaki M, Yagi M, Awano H, Matsuo M, Shintaku H, Yoshida S, Takayanagi M, Kubota M, Takahashi A, Akasaka Y. Early clinical signs and treatment of Menkes disease. Mol Genet Metab Rep 2022; 31:100849. [PMID: 35242581 PMCID: PMC8861833 DOI: 10.1016/j.ymgmr.2022.100849] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/18/2022] Open
Abstract
Menkes disease (MD) is an X-linked recessive disorder caused by mutations in ATP7A. Patients with MD exhibit severe neurological and connective tissue disorders due to copper deficiency and typically die before 3 years of age. Early treatment with copper injections during the neonatal period, before the occurrence of neurological symptoms, can alleviate neurological disturbances to some degree. We investigated whether early symptoms can help in the early diagnosis of MD. Abnormal hair growth, prolonged jaundice, and feeding difficulties were observed during the neonatal period in 20 of 69, 16 of 67, and 3 of 18 patients, respectively. Only three patients visited a physician during the neonatal period; MD diagnosis was not made at that point. The mean age at diagnosis was 8.7 months. Seven patients, who were diagnosed in the prenatal stage or soon after birth, as they had a family history of MD, received early treatment. No diagnosis was made based on early symptoms, highlighting the difficulty in diagnosing MD based on symptoms observed during the neonatal period. Patients who received early treatment lived longer than their elderly relatives with MD. Three patients could walk and did not have seizures. Therefore, effective newborn screening for MD should be prioritized.
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Affiliation(s)
- Chie Fujisawa
- Department of Pediatrics, School of Medicine, Teikyo University, Itabashi-ku, Tokyo 173-8606, Japan
- Department of Research Unit, Faculty of Medicine, Toho University, Ota-ku, Tokyo 143-8540, Japan
- Corresponding authors at: Department of Research Unit, Faculty of Medicine, Toho University, Omori-Nishi, Ota-ku, Tokyo 143-8540, Japan.
| | - Hiroko Kodama
- Department of Pediatrics, School of Medicine, Teikyo University, Itabashi-ku, Tokyo 173-8606, Japan
- Graduate School of Health Sciences, Teikyo Heisei University, Toshima-ku, Tokyo 170-8445, Japan
- Corresponding authors at: Department of Research Unit, Faculty of Medicine, Toho University, Omori-Nishi, Ota-ku, Tokyo 143-8540, Japan.
| | - Yasuhiro Sato
- Department of Pediatrics, School of Medicine, Teikyo University, Itabashi-ku, Tokyo 173-8606, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, School of Medicine, Teikyo University, Itabashi-ku, Tokyo 173-8606, Japan
| | - Mariko Yagi
- Department of Childhood Development and Education, Faculty of Human Science, Konan Women's University, Higashinada-ku, Kobe-shi, Hyogo 658-0001, Japan
| | - Hiroyuki Awano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Chuo-ku, Kobe-shi, Hyogo 650-0017, Japan
| | - Muneaki Matsuo
- Department of Pediatrics, Faculty of Medicine, Saga University, Nabeshima, Saga-shi, Saga 840-8502, Japan
| | - Haruo Shintaku
- Department of Pediatrics, Graduate School of Medicine, Osaka City University, Abeno-ku, Osaka-City, Osaka 545-8585, Japan
| | - Sayaka Yoshida
- Department of Pediatrics, Nara Prefecture General Medical Center, Nara-shi, Nara 630-8581, Japan
| | - Masaki Takayanagi
- Department of Pediatrics, Chiba Children's Hospital, Chiba-shi, Chiba 266-0007, Japan
| | - Mitsuru Kubota
- Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Setagaya-ku, Tokyo 157-8535, Japan
| | - Akihito Takahashi
- Department of Pediatrics, Kurashiki Central Hospital, Kurashiki, Okayama 710-8602, Japan
| | - Yoshikiyo Akasaka
- Unit of Regenerative Diseases Research, Division of Research Promotion and Development, Advanced Medical Research Center, Toho University Graduate School of Medicine, Ota-ku, Tokyo 143-8540, Japan
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Yasukawa M, Arai S, Nagura M, Kido R, Asakawa S, Hirohama D, Yamazaki O, Tamura Y, Fujimaki M, Kobayashi S, Mimaki M, Kodama H, Uchida S, Fujigaki Y, Shibata S. Selenium associates with response to erythropoiesis-stimulating agents in hemodialysis patients. Kidney Int Rep 2022; 7:1565-1574. [PMID: 35812286 PMCID: PMC9263417 DOI: 10.1016/j.ekir.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 03/12/2022] [Accepted: 04/04/2022] [Indexed: 10/25/2022] Open
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Nishino T, Takahashi K, Ono S, Mimaki M. Fluctuation of R2* values in blood oxygenation level-dependent MRI during acute and remission phases of IgA vasculitis with nephritis in children. Jpn J Radiol 2022; 40:840-846. [PMID: 35357626 DOI: 10.1007/s11604-022-01267-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/10/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Noninvasive assessment of the kidney using blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) has progressed remarkably; indications have expanded to include the evaluation of glomerulonephritis. However, no longitudinal measurements from acute to post-treatment remission phases have been reported. Hence, this study aimed to investigate spin relaxation rate (R2*) values during acute and remission phases in children with glomerulonephritis. MATERIALS AND METHODS All pediatric patients with IgA vasculitis with nephritis (IgAVN) diagnosed between January 2014 and October 2021 and requiring renal biopsy were retrospectively reviewed; four patients who were observed from onset to remission were included in this study. In total, eight MRIs were performed in the acute and remission phases, and R2* values and fluctuations induced by low-dose oxygen administration were determined from 10 echoes using a 1.5 T MRI system with 4.76-47.6 ms echo times and a 153 ms repetition time. RESULTS The median age of patients undergoing MRI was 8.5 years in the acute phase and 13.9 years in the remission phase. R2* values of the acute phase were higher than those of the remission phase; however, the difference was not significant (cortex; p = 0.32 and medulla; p = 0.052). Oxygen administration did not cause fluctuations in the R2* values in the cortex or medulla during the acute phase (cortex; p = 0.67 and medulla; p = 0.76); however, in the remission phase, the R2* values in the cortex and medulla significantly decreased due to low-dose oxygen administration (cortex; p < 0.01 and medulla; p < 0.01). CONCLUSION The fluctuation in R2* values observed during different phases of IgAVN indicates that BOLD MRI may be used to assess disease activity. Therefore, we propose BOLD MRI with low-dose oxygen administration as a noninvasive method to evaluate the activity of glomerulonephritis.
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Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Sayaka Ono
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
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13
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Sato Y, Isojima T, Takamiya K, Motoyama K, Enkai S, Ogawa E, Kodama H, Yorifuji T, Mimaki M. Longitudinal Glycaemic Profiles during Remission in 6q24-Related Transient Neonatal Diabetes Mellitus. Horm Res Paediatr 2022; 94:229-234. [PMID: 34348302 DOI: 10.1159/000518617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/20/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Transient neonatal diabetes mellitus (TNDM) is a rare condition that is characterized by the presence of diabetes mellitus during the first 6 months of life and remission by 18 months of age. It usually relapses at a median age of 14 years. Hyperinsulinaemic hypoglycaemia is a relatively common complication during remission. Although β-cell function is reported to be impaired at relapse, the clinical course of glycaemic profiles during remission in patients with TNDM remains largely unknown. CASE PRESENTATION Longitudinal glycaemic profiles were investigated annually from remission (185 days) to relapse (14.5 years) in a patient with TNDM due to paternal 6q24 duplication using the oral glucose tolerance test (glucose intake: 1.75 g/kg to a maximum of 75 g). The patient's β-cell function and insulin sensitivity were assessed by calculating the insulinogenic index, homeostasis model assessment of β-cell function (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index, and Matsuda index. Early insulin response to glucose intake was impaired throughout remission, whereas fasting insulin and β-cell function by HOMA-β gradually increased in the first few years since remission, followed by a gradual decline in function. In contrast, HOMA-IR fluctuated and peaked at 6.5 years of age. CONCLUSION This is the first report of annual longitudinal glycaemic profiles in a patient with 6q24-related TNDM during remission. We identified fluctuations in β-cell function and insulin resistance during remission.
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Affiliation(s)
- Yasuhiro Sato
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Tsuyoshi Isojima
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kiyomi Takamiya
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kahoko Motoyama
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Shigehiro Enkai
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Eishin Ogawa
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan.,Minatocho Kodomo Clinic, Kawasaki, Japan
| | - Hiroko Kodama
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan.,Department of Dietetics, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan
| | - Tohru Yorifuji
- Division of Pediatric Endocrinology and Metabolism, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
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14
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Ogata K, Mochizuki Y, Saito T, Sakiyama Y, Mizuguchi M, Kubota M, Mimaki M, Okuno T, Ikeda A, Komori T, Yoneyama A, Mochizuki H. [Perspective on transition from pediatric to adult health care for patients with neurological disease: current situation and issues]. Rinsho Shinkeigaku 2022; 62:261-266. [PMID: 35354722 DOI: 10.5692/clinicalneurol.cn-001676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
An improvement in efficacy treatment and development of the social support system has led to many patients with neurological disease being able to reach adulthood. Therefore health care for life from pediatrics to adulthood has become necessary. The Special Committee for Measures Against Transition from Pediatric to Adult Health Care of the Japanese Society of Neurology officially started to examine the current situation and issues of transition from pediatric to adult health care in July 2020. Pediatric neurologists and adult neurologists have an awareness of this issue of constructing a better transition from pediatric to adult health care. However, there are some tasks that need to be resolved in the medical system. We intend to improve the understanding of transition and assessment of medical service fees for transition in cooperation with the Japanese Society of Neurology and the Japanese Society of Child Neurology.
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Affiliation(s)
- Katsuhisa Ogata
- Department of Neurology/Institute of Clinical Research, National Hospital Organization Higashisaitama National Hospital
| | - Yoko Mochizuki
- Department of Neurology, Tokyo Metropolitan Kita Medical and Rehabilitation Center for the Disabled
| | - Toshio Saito
- Division of Child Neurology, Department of Neurology, National Hospital Organization Osaka Toneyama Medical Center
| | - Yoshio Sakiyama
- Department of Neurology, Jichi Medical University, Saitama Medical Center
| | - Masashi Mizuguchi
- Department of Pediatrics, National Rehabilitation Center for Children with Disabilities
| | - Masaya Kubota
- Department of Pediatrics, Shimada Ryoiku Medical Center for Challenged Children
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine
| | - Tatsusada Okuno
- Department of Neurology, Osaka University Graduate School of Medicine
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine
| | - Tetsuo Komori
- Department of Neurology, National Hospital Organization Hakone Hospital
| | - Akira Yoneyama
- Department of Child Psychiatry, Medical Division, National Medical and Educational Consulting Center for Children with Disabilities
| | - Hideki Mochizuki
- Department of Neurology, Osaka University Graduate School of Medicine
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15
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Yamamoto K, Nakamura K, Shiozawa R, Iwashima S, Mimaki M. First report of familial hemolytic anemia due to hemoglobin Sabine in Asia. Pediatr Int 2022; 64:e15081. [PMID: 35510681 DOI: 10.1111/ped.15081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/26/2021] [Accepted: 11/12/2021] [Indexed: 01/05/2023]
Affiliation(s)
- Kazuna Yamamoto
- Teikyo University Department of Pediatrics, Itabashi, Tokyo, Japan
| | - Kozue Nakamura
- Teikyo University Department of Pediatrics, Itabashi, Tokyo, Japan
| | - Ryosuke Shiozawa
- Chutoen General Medical Hospital Department of Pediatrics, Kakegawa, Japan
| | - Satoru Iwashima
- Chutoen General Medical Hospital Department of Pediatrics, Kakegawa, Japan
| | - Masakazu Mimaki
- Teikyo University Department of Pediatrics, Itabashi, Tokyo, Japan
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16
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Nishino T, Takahashi K, Tomori S, Ono S, Mimaki M. Effects of diurnal variation of bile acids by meal on cyclosporine A absorption. Pediatr Int 2022; 64:e15296. [PMID: 36421923 DOI: 10.1111/ped.15296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/10/2022] [Accepted: 07/08/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Stabilizing blood levels with microemulsified cyclosporine A (CsA), administered in many pediatric kidney diseases, is important for effective immunosuppression and reduced nephrotoxicity. CsA is affected by total bile acids (TBAs); however, no reports have simultaneously measured both. We aimed to elucidate the hypothesized relationship between TBA levels and diurnal variation in CsA in children. METHODS We retrospectively reviewed the medical records of children who were taking oral CsA for the treatment of kidney diseases between January 2016 and July 2021. They consumed four balanced meals and snacks during the day. CsA and TBA were measured twice, in pairs, before and at 0.5, 1, 1.5, 2, 3, and 4 h after oral administration in the morning and evening, and the four-h area under curve (AUC)0-4 of CsA and trough-to-peak ratio (TPR) of TBA were compared. RESULTS Fifty-eight pairs were measured in total; 12 children had idiopathic nephrotic syndrome and 4 children had immunoglobulin A vasculitis with nephritis. The median age at measurement was 7.5 years and the dose of CsA was 3.8 mg/kg/day. The AUC0-4 (ng·h/mL) was significantly lower in the evening than in the morning (1,669 vs. 1,451, P < 0.001). The TPR of TBA was significantly higher in the evening than in the morning (0.14 vs. 0.25, P < 0.001). CONCLUSIONS The low AUC0-4 and slow TBA secretion observed in the evening may be due to pediatric-specific dietary rhythms; thus, snack timing should be considered in children for stabilizing CsA levels.
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Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Shinya Tomori
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Sayaka Ono
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
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17
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Nishino T, Takahashi K, Ono S, Mimaki M. Blood oxygen level-dependent imaging for evaluating C3 glomerulonephritis. Pediatr Int 2021; 63:1386-1388. [PMID: 34324767 DOI: 10.1111/ped.14605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Sayaka Ono
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
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18
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Nishino T, Takahashi K, Tomori S, Ono S, Mimaki M. Cyclosporine A C 1.5 monitoring reflects the area under the curve in children with nephrotic syndrome: a single-center experience. Clin Exp Nephrol 2021; 26:154-161. [PMID: 34559341 DOI: 10.1007/s10157-021-02139-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/18/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The currently used single-monitoring method for drug-blood-level evaluation in cyclosporine A (CsA) treatment for nephrotic syndrome (NS) was established through hourly measurements based on adult organ transplantation. However, the pharmacokinetics may differ due to different concomitant medications, age, and conditions. This study was conducted to determine the measurement timing that best reflects the CsA area under the curve (AUC) in pediatric NS. METHODS This retrospective study included children aged 2-14 years who were started on CsA treatment for idiopathic NS during 2013-2020. AUC0-4 was calculated from 7 points, before and 0.5, 1, 1.5, 2, 3, and 4 h after administration. Mean values at each timing were compared with age-dependent different drug forms. Correlation between AUC0-4 and measurement timing was analyzed. RESULTS There were 13 patients (11 boys) whose median age during testing was 7.3 years, and the total number of measurements was 94. The highest timing of CsA concentrations was found in C1 59.6%. The content liquid used at younger ages had a faster absorption time to peak value and lower blood concentration than those of capsules. Among the significant correlations observed, AUC0-4 and C1.5 showed the strongest significant correlation coefficient (r = 0.93, P < 0.001). CONCLUSION In pediatric NS, CsA metabolism may be faster than that in previous organ transplantation. Compared with C2, C1.5 monitoring may result in better disease control as it can best reflect the AUC0-4 and peak values associated with side effects, which are indicators of therapeutic efficacy.
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Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Shinya Tomori
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Sayaka Ono
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
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19
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Nishino T, Ito N, Shimada S, Kodera M, Morita K, Mimaki M. A Neonatal Case of Extralobar Pulmonary Sequestration with Thymus-Like Shadow. Glob Pediatr Health 2021; 8:2333794X211003435. [PMID: 34409131 PMCID: PMC8366123 DOI: 10.1177/2333794x211003435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/23/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Naoki Ito
- Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Satoshi Shimada
- Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Misaki Kodera
- Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Kiyoko Morita
- Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Masakazu Mimaki
- Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
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20
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Motoyama K, Isojima T, Sato Y, Aihara A, Asakura H, Hiraike H, Hino Y, Mimaki M, Nomura K, Kodama H. Trace element levels in mature breast milk of recently lactating Japanese women. Pediatr Int 2021; 63:910-917. [PMID: 33190386 DOI: 10.1111/ped.14543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/30/2020] [Accepted: 11/11/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Many trace elements are essential for infant growth and development during early life. Their concentrations in breast milk vary depending on social and economic factors. Nonetheless, the present available values in Japan were derived from lactating mothers approximately 15 years ago. METHODS Healthy mothers who gave birth to a single infant after 37 weeks of gestation at Teikyo University Hospital were recruited between July 2016 and December 2017. They were encouraged to collect breast milk samples and a self-administered food frequency questionnaire at 1 and 3 months postpartum. Anthropometric data for the mothers and their infants were also collected. Overall, 79 subjects were analyzed after excluding subjects with inadequate data in the food frequency questionnaire, insufficient breast milk samples, and medication that could affect dietary intakes. Trace element concentrations were determined by inductively coupled plasma mass spectrometry, and their correlation with several factors were investigated. RESULTS Trace element concentrations were widely distributed as previously reported. Median concentrations of Cr, Mn, Fe, Cu, Zn, Se, and Mo were 0.8, 0.8, 98, 50, 272, 2.2, and 0.7 µg/dL at 1 month postpartum and 0.6, 0.7, 55, 33, 177, 2.1, and 0.7 µg/dL at 3 months postpartum, respectively. There were no correlations between trace element concentrations and either mothers' intakes or infants' growth. In contrast, there were significant correlations between several trace elements and macronutrients in addition to inter-element correlations among almost all trace elements. CONCLUSIONS Trace element concentrations in mature breast milk were determined from recently lactating mothers in Japan.
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Affiliation(s)
- Kahoko Motoyama
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Tsuyoshi Isojima
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Yasuhiro Sato
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Ayaka Aihara
- Department of Nutrition, Teikyo University Hospital, Tokyo, Japan
| | - Hitomi Asakura
- Department of Nutrition, Teikyo University Hospital, Tokyo, Japan
| | - Haruko Hiraike
- Department of Obstetrics and Gynaecology, Teikyo University School of Medicine, Tokyo, Japan
| | - Yuko Hino
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kyoko Nomura
- Department of Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiroko Kodama
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan.,Department of Health and Nutrition, Teikyo Heisei University, Tokyo, Japan
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21
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Nishino T, Ito N, Tomori S, Shimada S, Kodera M, Morita K, Takahashi K, Mimaki M. Effects of Temperature and Position Change on Neonatal Brain Regional Oxygen Saturation in Tub Bathing: A Prospective Study. Pain Ther 2021; 10:1269-1282. [PMID: 34263424 PMCID: PMC8279383 DOI: 10.1007/s40122-021-00290-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 06/29/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION A major goal in neonatal medicine is to reduce stress as much as possible in routine care. Bathing is one of the important routine cares for neonates, but it makes a big environmental change for them. We aimed to examine whether water temperature, room temperature, and position changes in tub bathing serve as noxious stimuli to neonates. METHODS This prospective trial was performed in full-term and non-low-birth-weight neonates admitted to the hospital between July 2020 and March 2021. Those with underlying diseases, fetal distress, infection, and other medical conditions were excluded. Measurements were taken during the neonates' first tub bath since birth, which was performed by a trained nurse. Changes in regional oxygen saturation (rSO2), determined using near-infrared spectroscopy, and water and room temperature, were examined at five different time points: upon entering the bath, head washing, position change, exiting the bath, and during the 3 min after bathing. RESULTS In total, 17 neonates were analyzed. No changes in rSO2 due to head washing or position change were observed; however, rSO2 significantly decreased upon entering (78.5 ± 4.1% vs. 75.7 ± 4.1%, p < 0.001) and exiting the bath (75.8 ± 5.7% vs. 74.4 ± 5.4%, p < 0.04). The rate change in rSO2 upon entering the bath showed a significant inverse correlation with water temperature (r = - 0.53, p < 0.03), and there were no significant correlations between rSO2 and water or room temperature upon exiting the bath. There was no change in body skin temperature before and after bathing, but rSO2 gradually decreased during the 3 min after bathing. CONCLUSIONS Neonates may perceive certain temperatures during bathing as noxious stimuli. Therefore, methods to minimize stress associated with bathing should be implemented to reduce the difference between water temperature and room temperature during bathing. TRIAL REGISTRATION This trial has been registered at UMIN repository with the trial number UMIN000041045 ( https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046500 ). The date of the final dataset was April 01, 2021.
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Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Naoki Ito
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Shinya Tomori
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Satoshi Shimada
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Misaki Kodera
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Kiyoko Morita
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
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22
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Bonora E, Chakrabarty S, Kellaris G, Tsutsumi M, Bianco F, Bergamini C, Ullah F, Isidori F, Liparulo I, Diquigiovanni C, Masin L, Rizzardi N, Cratere MG, Boschetti E, Papa V, Maresca A, Cenacchi G, Casadio R, Martelli P, Matera I, Ceccherini I, Fato R, Raiola G, Arrigo S, Signa S, Sementa AR, Severino M, Striano P, Fiorillo C, Goto T, Uchino S, Oyazato Y, Nakamura H, Mishra SK, Yeh YS, Kato T, Nozu K, Tanboon J, Morioka I, Nishino I, Toda T, Goto YI, Ohtake A, Kosaki K, Yamaguchi Y, Nonaka I, Iijima K, Mimaki M, Kurahashi H, Raams A, MacInnes A, Alders M, Engelen M, Linthorst G, de Koning T, den Dunnen W, Dijkstra G, van Spaendonck K, van Gent DC, Aronica EM, Picco P, Carelli V, Seri M, Katsanis N, Duijkers FAM, Taniguchi-Ikeda M, De Giorgio R. Biallelic variants in LIG3 cause a novel mitochondrial neurogastrointestinal encephalomyopathy. Brain 2021; 144:1451-1466. [PMID: 33855352 DOI: 10.1093/brain/awab056] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 11/13/2020] [Accepted: 12/09/2020] [Indexed: 12/11/2022] Open
Abstract
Abnormal gut motility is a feature of several mitochondrial encephalomyopathies, and mutations in genes such as TYMP and POLG, have been linked to these rare diseases. The human genome encodes three DNA ligases, of which only one, ligase III (LIG3), has a mitochondrial splice variant and is crucial for mitochondrial health. We investigated the effect of reduced LIG3 activity and resulting mitochondrial dysfunction in seven patients from three independent families, who showed the common occurrence of gut dysmotility and neurological manifestations reminiscent of mitochondrial neurogastrointestinal encephalomyopathy. DNA from these patients was subjected to whole exome sequencing. In all patients, compound heterozygous variants in a new disease gene, LIG3, were identified. All variants were predicted to have a damaging effect on the protein. The LIG3 gene encodes the only mitochondrial DNA (mtDNA) ligase and therefore plays a pivotal role in mtDNA repair and replication. In vitro assays in patient-derived cells showed a decrease in LIG3 protein levels and ligase activity. We demonstrated that the LIG3 gene defects affect mtDNA maintenance, leading to mtDNA depletion without the accumulation of multiple deletions as observed in other mitochondrial disorders. This mitochondrial dysfunction is likely to cause the phenotypes observed in these patients. The most prominent and consistent clinical signs were severe gut dysmotility and neurological abnormalities, including leukoencephalopathy, epilepsy, migraine, stroke-like episodes, and neurogenic bladder. A decrease in the number of myenteric neurons, and increased fibrosis and elastin levels were the most prominent changes in the gut. Cytochrome c oxidase (COX) deficient fibres in skeletal muscle were also observed. Disruption of lig3 in zebrafish reproduced the brain alterations and impaired gut transit in vivo. In conclusion, we identified variants in the LIG3 gene that result in a mitochondrial disease characterized by predominant gut dysmotility, encephalopathy, and neuromuscular abnormalities.
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Affiliation(s)
- Elena Bonora
- Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, 40138, Italy
| | - Sanjiban Chakrabarty
- Department of Molecular Genetics, Erasmus MC, Rotterdam, 3000 CA, The Netherlands
| | - Georgios Kellaris
- Center for Human Disease Modeling, Duke University, Durham, NC 27710, USA
| | - Makiko Tsutsumi
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Aichi, 470-1192, Japan
| | - Francesca Bianco
- Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, 40138, Italy
| | - Christian Bergamini
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, 40126, Italy
| | - Farid Ullah
- Center for Human Disease Modeling, Duke University, Durham, NC 27710, USA
| | - Federica Isidori
- Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, 40138, Italy
| | - Irene Liparulo
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, 40126, Italy
| | - Chiara Diquigiovanni
- Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, 40138, Italy
| | - Luca Masin
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, 40126, Italy
| | - Nicola Rizzardi
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, 40126, Italy
| | - Mariapia Giuditta Cratere
- Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, 40138, Italy.,Division of Genetics and Cell Biology, San Raffaele Scientific Institute, Milan, 20132, Italy
| | - Elisa Boschetti
- Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, 40138, Italy
| | - Valentina Papa
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, 40123, Italy
| | - Alessandra Maresca
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, 40139, Italy
| | - Giovanna Cenacchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, 40123, Italy
| | - Rita Casadio
- Biocomputing Group, Department of Biological, Geological, Environmental Sciences, University of Bologna, Bologna, 40126, Italy
| | - Pierluigi Martelli
- Biocomputing Group, Department of Biological, Geological, Environmental Sciences, University of Bologna, Bologna, 40126, Italy
| | - Ivana Matera
- IRCCS Istituto Giannina Gaslini, Genova, 16128, Italy
| | | | - Romana Fato
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, 40126, Italy
| | - Giuseppe Raiola
- Department of Paediatrics, Pugliese-Ciaccio Hospital, Catanzaro, 88100, Italy
| | - Serena Arrigo
- IRCCS Istituto Giannina Gaslini, Genova, 16128, Italy
| | - Sara Signa
- IRCCS Istituto Giannina Gaslini, Genova, 16128, Italy
| | | | | | | | | | - Tsuyoshi Goto
- Laboratory of Molecular Function of Food, Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Uji, 611-0011, Japan
| | - Shumpei Uchino
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, 173-8605, Japan.,Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Yoshinobu Oyazato
- Department of Pediatrics, Kakogawa Central City Hospital, Kakogawa, Hyogo, 675-8611, Japan
| | - Hisayoshi Nakamura
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Sushil K Mishra
- Glycoscience Group, National University of Ireland, Galway, H91 CF50, Ireland
| | - Yu-Sheng Yeh
- Laboratory of Molecular Function of Food, Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Uji, 611-0011, Japan
| | - Takema Kato
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Aichi, 470-1192, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Hyogo, 650-0017, Japan
| | - Jantima Tanboon
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, 173-8610, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Tatsushi Toda
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Yu-Ichi Goto
- Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Akira Ohtake
- Department of Pediatrics & Clinical Genomics, Faculty of Medicine, Saitama Medical University, Saitama, 350-0495, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Yoshiki Yamaguchi
- Laboratory of Pharmaceutical Physical Chemistry, Tohoku Medical and Pharmaceutical University, Miyagi, 981-8558, Japan
| | - Ikuya Nonaka
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, 187-8502, Japan
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Hyogo, 650-0017, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, 173-8605, Japan
| | - Hiroki Kurahashi
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Aichi, 470-1192, Japan
| | - Anja Raams
- Department of Molecular Genetics, Erasmus MC, Rotterdam, 3000 CA, The Netherlands
| | - Alyson MacInnes
- Department of Metabolic Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, 1100 DD, The Netherlands
| | - Mariel Alders
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, 1100 DD, The Netherlands
| | - Marc Engelen
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, 1100 DD, The Netherlands
| | - Gabor Linthorst
- Department of Metabolic Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, 1100 DD, The Netherlands
| | - Tom de Koning
- Department of Metabolic Diseases, UMCG, Groningen, 9700 RB, The Netherlands
| | | | - Gerard Dijkstra
- Department of Gastroenterology, UMCG, Groningen, 9700 RB, The Netherlands
| | - Karin van Spaendonck
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, 1100 DD, The Netherlands
| | - Dik C van Gent
- Department of Molecular Genetics, Erasmus MC, Rotterdam, 3000 CA, The Netherlands
| | - Eleonora M Aronica
- Department of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, 1100 DD, The Netherlands
| | - Paolo Picco
- IRCCS Istituto Giannina Gaslini, Genova, 16128, Italy
| | - Valerio Carelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, 40123, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Bologna, 40139, Italy
| | - Marco Seri
- Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, 40138, Italy
| | - Nicholas Katsanis
- Center for Human Disease Modeling, Duke University, Durham, NC 27710, USA
| | - Floor A M Duijkers
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, 1100 DD, The Netherlands
| | - Mariko Taniguchi-Ikeda
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Aichi, 470-1192, Japan.,Department of Pediatrics, Kobe University Graduate School of Medicine, Hyogo, 650-0017, Japan.,Department of Clinical Genetics, Fujita Health University Hospital, Aichi, 470-1192, Japan
| | - Roberto De Giorgio
- Department of Morphology, Surgery and Experimental Medicine, St. Anna Hospital, University of Ferrara, Ferrara, 44124, Italy
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23
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Korematsu S, Miyamoto Y, Muramatsu K, Yamanaka G, Hoshide M, Miyata R, Ito S, Shimokawa S, Mimaki M, Yamanouchi H. A fact-finding survey of the recommendation on sedation during physiological examinations such as electroencephalogram in Japan. Brain Dev 2021; 43:208-213. [PMID: 33069553 DOI: 10.1016/j.braindev.2020.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/12/2020] [Accepted: 09/25/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Seigo Korematsu
- Medical Safety Committee, The Japanese Society of Child Neurology, Japan; Department of Pediatrics, Nakatsu Municipal Hospital, Japan.
| | - Yusaku Miyamoto
- Medical Safety Committee, The Japanese Society of Child Neurology, Japan; Department of Pediatrics, St. Marianna University School of Medicine, Japan
| | - Kazuhiro Muramatsu
- Medical Safety Committee, The Japanese Society of Child Neurology, Japan; Department of Pediatrics, Jichi Medical University, Japan
| | - Gaku Yamanaka
- Medical Safety Committee, The Japanese Society of Child Neurology, Japan; Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Japan
| | - Madoka Hoshide
- Medical Safety Committee, The Japanese Society of Child Neurology, Japan; Department of Pediatrics, Yamaguchi University, Japan
| | - Rie Miyata
- Medical Safety Committee, The Japanese Society of Child Neurology, Japan; Department of Pediatrics, Tokyo-kita Medical Center, Japan
| | - Susumu Ito
- Medical Safety Committee, The Japanese Society of Child Neurology, Japan; Department of Pediatrics, Tokyo Women's Medical University, Japan
| | - Shoko Shimokawa
- Medical Safety Committee, The Japanese Society of Child Neurology, Japan; Department of Neurosurgery, Takagi Hospital, Japan
| | - Masakazu Mimaki
- Medical Safety Committee, The Japanese Society of Child Neurology, Japan; Department of Pediatrics, Teikyo University, Japan
| | - Hideo Yamanouchi
- Medical Safety Committee, The Japanese Society of Child Neurology, Japan; Department of Pediatrics, Saitama Medical University, Japan
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24
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Numoto S, Kurahashi H, Sato A, Kubota M, Shiihara T, Okanishi T, Tanaka R, Kuki I, Fukuyama T, Kashiwagi M, Ikeno M, Kubota K, Akasaka M, Mimaki M, Okumura A. Acute encephalopathy in children with tuberous sclerosis complex. Orphanet J Rare Dis 2021; 16:5. [PMID: 33407677 PMCID: PMC7789140 DOI: 10.1186/s13023-020-01646-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 12/09/2020] [Indexed: 11/10/2022] Open
Abstract
Objective We examined the clinical manifestations of acute encephalopathy (AE) and identify risk factors for AE in children with tuberous sclerosis complex (TSC). Methods The clinical data of 11 children with clinically diagnosed TSC associated with AE and 109 children with clinically diagnosed TSC alone aged 4 years or older were collected from 13 hospitals. Results Of the 11 children with AE, 5 had histories of febrile seizures (FS), and all had histories of febrile status epilepticus (FSE). AE developed within 24 h after fever onset in all children with seizures lasting 30 min or longer. All children developed coma after seizure cessation. Head magnetic resonance imaging (MRI) revealed widespread abnormalities in the cerebral cortex, subcortical white matter, corpus callosum, basal ganglia, and thalamus. One child died; seven had severe neurological sequelae; and the other three, mild sequelae. Logistic regression analysis revealed that a history of FSE was correlated with the development of AE. Significance AE in children with TSC was characterized by sudden onset after fever, followed by coma, widespread brain edema evident on MRI, and poor outcomes. A history of FSE was a risk factor for the development of AE.
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Affiliation(s)
- Shingo Numoto
- Department of Pediatrics, Aichi Medical University, 1-1 Yazako Karimata, Nagakute, Aichi, 480-1195, Japan.
| | - Hirokazu Kurahashi
- Department of Pediatrics, Aichi Medical University, 1-1 Yazako Karimata, Nagakute, Aichi, 480-1195, Japan
| | - Atsushi Sato
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
| | - Masaya Kubota
- Division of Neurology, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Shiihara
- Department of Neurology, Gunma Children's Medical Center, Shibukawa, Gunma, Japan
| | - Tohru Okanishi
- Department of Child Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Ryuta Tanaka
- Department of Child Health, Ibaraki Pediatric Education and Training Station, University of Tsukuba, Mito, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | | | | | - Mitsuru Ikeno
- Department of Pediatrics, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Kazuo Kubota
- Department of Pediatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Manami Akasaka
- Department of Pediatrics, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Akihisa Okumura
- Department of Pediatrics, Aichi Medical University, 1-1 Yazako Karimata, Nagakute, Aichi, 480-1195, Japan
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25
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Hikita T, Hoshino H, Mimaki M. Ramosetron as a Treatment for Cyclic Vomiting Syndrome: A Small-Scale Patient Trial. Glob Pediatr Health 2020; 7:2333794X20969281. [PMID: 33225023 PMCID: PMC7656858 DOI: 10.1177/2333794x20969281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/21/2020] [Accepted: 09/30/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Toshiyuki Hikita
- Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan.,Hikita Pediatric Clinic, Gunma, Japan
| | - Hideki Hoshino
- Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Masakazu Mimaki
- Teikyo University School of Medicine, Itabashi-ku, Tokyo, Japan
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26
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Nagamitsu S, Mimaki M, Koyanagi K, Tokita N, Kobayashi Y, Hattori R, Ishii R, Matsuoka M, Yamashita Y, Yamagata Z, Igarashi T, Croarkin PE. Prevalence and associated factors of suicidality in Japanese adolescents: results from a population-based questionnaire survey. BMC Pediatr 2020; 20:467. [PMID: 33023527 PMCID: PMC7542337 DOI: 10.1186/s12887-020-02362-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 09/28/2020] [Indexed: 11/13/2022] Open
Abstract
Background Suicide is the leading cause of death among Japanese adolescents. However, knowledge gaps regarding contemporary demographics and factors associated with suicidality among Japanese adolescents are a major concern. This study examined the prevalence of suicidality among Japanese adolescents and investigated associated factors. Methods A population-based questionnaire survey investigating general health was administered to 22,419 adolescents aged 13–18 years. The 29-item questionnaire covered emotional status, family function, cyberbullying, suicidality, and stressors (e.g., relationships with parents/friends, school performance, and sexual identity). We conducted multiple logistic regression analysis to identify factors associated with suicidality in this population. Results The prevalence of suicidal ideation was 21.6% in males and 28.5% in females, and that of attempted suicide was 3.5% in males and 6.6% and in females. Bullying and stress related to family relationships had the strongest associations with suicidality. Exposure to cyberbullying had the highest odds ratio for both junior high (3.1, 95% confidence interval [CI] 2.1–4.4) and high school students (3.6, 95% CI 2.5–5.3). Other factors significantly associated with suicidality were sex, emotional status, and stress about relationships with friends, sexual identity, school records, and academic course. Adolescents accessed a variety of resources to cope with stressors, with the Internet being the most common resource consulted. Conclusions Suicidality is commonly experienced among Japanese adolescents. Although there are many associated risk factors, cyberbullying is of particular concern. Recognition of factors associated with adolescent suicidality will inform further research and suicide prevention efforts for healthcare providers and families.
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Affiliation(s)
- Shinichiro Nagamitsu
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi Kurume, Fukuoka, 830-0011, Japan.
| | - Masakazu Mimaki
- Department of Pediatrics, School of Medicine Teikyo University, Tokyo, Japan
| | - Kenshi Koyanagi
- Nagasaki Prefectural Center of Medicine and Welfare for Children, Isahaya, Japan
| | - Natsuko Tokita
- Department of Pediatrics, School of Medicine, Keio University, Tokyo, Japan
| | - Yoriko Kobayashi
- Clinic of International University of Health and Welfare, Otawara, Japan
| | - Ritsuko Hattori
- Faculty of Health Science Naragakuen University, Nara, Japan
| | - Ryuta Ishii
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi Kurume, Fukuoka, 830-0011, Japan
| | - Michiko Matsuoka
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi Kurume, Fukuoka, 830-0011, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, School of Medicine, University of Yamanashi, Kofu, Japan
| | | | - Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, USA
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27
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Kato Y, Takahashi K, Ito F, Suzuki S, Fukui K, Mimaki M, Suzuki K. Novel oseltamivir-resistant mutations distant from the active site of influenza B neuraminidase. J Biomol Struct Dyn 2020; 39:3491-3500. [PMID: 32406800 DOI: 10.1080/07391102.2020.1765872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We performed a neuraminidase sequence analysis of thirty-two pediatric patients with influenza B who visited Teikyo University Hospital from January 2016 to March 2017, and found oseltamivir-resistant samples belonging to the Yamagata and Victoria lineages. Comparison with the neuraminidase sequence of oseltamivir-susceptible B/Brisbane/60/2008 revealed 5 common amino acid substitutions in many of these samples. According to the binding free energy calculation, the N340D and E358K substitutions reduced the affinity of oseltamivir to neuraminidase. Unexpectedly, these substitutions were located distant from the oseltamivir-binding site in neuraminidase. According to the molecular dynamics simulations, the N340D substitution rearranged complicated hydrogen bond networks in an extensive surface region of neuraminidase. The E358K substitution extensively altered the electrostatic potential map of the overall neuraminidase structure. Through these novel mechanisms, the N340D and E358K substitutions indirectly influenced the affinity reduction. These results may be useful for designing drugs for the treatment of oseltamivir-resistant virus infections.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Yusuke Kato
- Institute for Enzyme Research, Tokushima University, Tokushima, Japan.,Asia International Institute of Infectious Disease Control, Teikyo University, Tokyo, Japan
| | - Kazuhiro Takahashi
- Asia International Institute of Infectious Disease Control, Teikyo University, Tokyo, Japan.,Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Fuyu Ito
- Asia International Institute of Infectious Disease Control, Teikyo University, Tokyo, Japan
| | - Shoichi Suzuki
- Asia International Institute of Infectious Disease Control, Teikyo University, Tokyo, Japan
| | - Kiyoshi Fukui
- Institute for Enzyme Research, Tokushima University, Tokushima, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazuo Suzuki
- Asia International Institute of Infectious Disease Control, Teikyo University, Tokyo, Japan
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28
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Tanaka M, Natsume J, Hamano SI, Iyoda K, Kanemura H, Kubota M, Mimaki M, Niijima SI, Tanabe T, Yoshinaga H, Kojimahara N, Komaki H, Sugai K, Fukuda T, Maegaki Y, Sugie H. The effect of the guidelines for management of febrile seizures 2015 on clinical practices: Nationwide survey in Japan. Brain Dev 2020; 42:28-34. [PMID: 31604594 DOI: 10.1016/j.braindev.2019.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/02/2019] [Accepted: 08/26/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the effect of guidelines for management of febrile seizures on the clinical practice, we conducted a nationwide survey in Japan. METHODS The Japanese guidelines for management of febrile seizures 2015 (GL2015) was released in 2015. In 2016, a questionnaire was sent to all 512 certified hospitals (3 pediatricians each) of the Japan Pediatric Society and all 47 prefecture Pediatric Associations (10 private pediatricians each) in Japan asking about management policies for febrile seizures (FSs) during 2013-2014 and 2016. The questionnaires were about the following procedures: (1) lumbar punctures, blood examinations, and diazepam suppositories for children after a first simple FS at emergency departments; and (2) prophylactic diazepam during febrile illnesses in children with two or three past simple FSs, with no known predictors of recurrence. RESULTS A total of 1327 pediatricians (66.2%) answered the questionnaire. Numbers of pediatricians performing lumbar punctures and blood examinations, and giving diazepam suppositories after a first simple FS were less in 2016 than in 2013-2014 (1.2% and 2.0%, 53.1% and 61.3%, and 36.7% and 51.9%, respectively). Pediatricians recommending prophylactic diazepam for children with two and three FSs decreased from 45.7% and 82.4% in 2013-2014 to 31.0% and 65.0% in 2016, respectively. CONCLUSION GL2015 had an effect on the clinical practices of pediatricians. On the other hand, 65% recommended prophylactic diazepam to children with three simple FSs even though GL2015 did not recommend use of diazepam based on number of previous FS. Anxiety about frequent seizures may affect pediatricians' clinical practice.
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Affiliation(s)
- Masaharu Tanaka
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jun Natsume
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Shin-Ichiro Hamano
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Division of Neurology, Saitama Children's Medical Center, Saitama, Japan
| | - Kuniaki Iyoda
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Fukuyama Support Center of Development and Care for Children, Fukuyama, Japan
| | - Hideaki Kanemura
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Masaya Kubota
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Division of Neurology, National Center for Child Health and Development, Tokyo, Japan
| | - Masakazu Mimaki
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Shin-Ichi Niijima
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Department of Pediatrics, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Takuya Tanabe
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Tanabe Children's Clinic, Osaka, Japan
| | - Harumi Yoshinaga
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Department of Child Neurology, Okayama University Graduate Schools of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Noriko Kojimahara
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Hirofumi Komaki
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kenji Sugai
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tokiko Fukuda
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshihiro Maegaki
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Division of Child Neurology, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Hideo Sugie
- Working Group for Guidelines for Management of Febrile Seizures, Japanese Society of Child Neurology, Nagoya, Japan; Faculty of Health and Medical Sciences, Tokoha University Hamamatsu Campus, Hamamatsu, Japan
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29
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Inoue M, Uchino S, Iida A, Noguchi S, Hayashi S, Takahashi T, Fujii K, Komaki H, Takeshita E, Nonaka I, Yoshizawa T, Van Lommel L, Schuit F, Goto Y, Mimaki M, Nishino I. METABOLIC DISTURBANCES IN NEUROMUSCULAR DISEASES. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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30
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Tran DH, Sugamata R, Hirose T, Suzuki S, Noguchi Y, Sugawara A, Ito F, Yamamoto T, Kawachi S, Akagawa KS, Ōmura S, Sunazuka T, Ito N, Mimaki M, Suzuki K. Azithromycin, a 15-membered macrolide antibiotic, inhibits influenza A(H1N1)pdm09 virus infection by interfering with virus internalization process. J Antibiot (Tokyo) 2019; 72:759-768. [PMID: 31300721 DOI: 10.1038/s41429-019-0204-x] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/29/2019] [Accepted: 06/06/2019] [Indexed: 02/07/2023]
Abstract
The pandemic influenza 2009 (A(H1N1)pdm09) virus currently causes seasonal and annual epidemic outbreaks. The widespread use of anti-influenza drugs such as neuraminidase and matrix protein 2 (M2) channel inhibitors has resulted in the emergence of drug-resistant influenza viruses. In this study, we aimed to determine the anti-influenza A(H1N1)pdm09 virus activity of azithromycin, a re-positioned macrolide antibiotic with potential as a new anti-influenza candidate, and to elucidate its underlying mechanisms of action. We performed in vitro and in vivo studies to address this. Our in vitro approaches indicated that progeny virus replication was remarkably inhibited by treating viruses with azithromycin before infection; however, azithromycin administration after infection did not affect this process. We next investigated the steps inhibited by azithromycin during virus invasion. Azithromycin did not affect attachment of viruses onto the cell surface, but blocked internalization into host cells during the early phase of infection. We further demonstrated that azithromycin targeted newly budded progeny virus from the host cells and inactivated their endocytic activity. This unique inhibitory mechanism has not been observed for other anti-influenza drugs, indicating the potential activity of azithromycin before and after influenza virus infection. Considering these in vitro observations, we administered azithromycin intranasally to mice infected with A(H1N1)pdm09 virus. Single intranasal azithromycin treatment successfully reduced viral load in the lungs and relieved hypothermia, which was induced by infection. Our findings indicate the possibility that azithromycin could be an effective macrolide for the treatment of human influenza.
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Affiliation(s)
- Dat Huu Tran
- Department of Health Protection, Graduate School of Medicine, Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan.,Asia International Institute of Infectious Disease Control (ADC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Ryuichi Sugamata
- Department of Health Protection, Graduate School of Medicine, Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan.,Asia International Institute of Infectious Disease Control (ADC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan.,General Medical Education and Research Center (G-MEC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Tomoyasu Hirose
- Kitasato Institute for Life Sciences and Graduate School of Infection Control Sciences, Kitasato University, Shirokane 5-9-1, Minato-ku, Tokyo, 108-8641, Japan
| | - Shoichi Suzuki
- Department of Health Protection, Graduate School of Medicine, Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan.,Asia International Institute of Infectious Disease Control (ADC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan.,General Medical Education and Research Center (G-MEC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Yoshihiko Noguchi
- Kitasato Institute for Life Sciences and Graduate School of Infection Control Sciences, Kitasato University, Shirokane 5-9-1, Minato-ku, Tokyo, 108-8641, Japan
| | - Akihiro Sugawara
- Kitasato Institute for Life Sciences and Graduate School of Infection Control Sciences, Kitasato University, Shirokane 5-9-1, Minato-ku, Tokyo, 108-8641, Japan.,Graduate School of Pharmaceutical Sciences, Tohoku University, Aza-Aoba 6-3, Aramaki, Aoba-ku, Sendai, 980-8578, Japan
| | - Fuyu Ito
- Asia International Institute of Infectious Disease Control (ADC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Tomoko Yamamoto
- Asia International Institute of Infectious Disease Control (ADC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Shoji Kawachi
- Asia International Institute of Infectious Disease Control (ADC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan.,General Medical Education and Research Center (G-MEC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Kiyoko S Akagawa
- Kitasato Institute for Life Sciences and Graduate School of Infection Control Sciences, Kitasato University, Shirokane 5-9-1, Minato-ku, Tokyo, 108-8641, Japan
| | - Satoshi Ōmura
- Kitasato Institute for Life Sciences and Graduate School of Infection Control Sciences, Kitasato University, Shirokane 5-9-1, Minato-ku, Tokyo, 108-8641, Japan
| | - Toshiaki Sunazuka
- Kitasato Institute for Life Sciences and Graduate School of Infection Control Sciences, Kitasato University, Shirokane 5-9-1, Minato-ku, Tokyo, 108-8641, Japan
| | - Naoki Ito
- The Pediatric Department, Teikyo Hospital University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Masakazu Mimaki
- The Pediatric Department, Teikyo Hospital University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Kazuo Suzuki
- Department of Health Protection, Graduate School of Medicine, Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan. .,Asia International Institute of Infectious Disease Control (ADC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan. .,General Medical Education and Research Center (G-MEC), Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan.
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31
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Inoue M, Uchino S, Iida A, Noguchi S, Hayashi S, Takahashi T, Fujii K, Komaki H, Takeshita E, Nonaka I, Okada Y, Yoshizawa T, Van Lommel L, Schuit F, Goto YI, Mimaki M, Nishino I. COX6A2 variants cause a muscle-specific cytochrome c oxidase deficiency. Ann Neurol 2019; 86:193-202. [PMID: 31155743 DOI: 10.1002/ana.25517] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/28/2019] [Accepted: 05/31/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Cytochrome c oxidase (COX) deficiency is a major mitochondrial respiratory chain defect that has vast genetic and phenotypic heterogeneity. This study aims to identify novel causative genes of COX deficiency with only striated muscle-specific symptoms. METHODS Whole exome sequencing was performed in 2 unrelated individuals who were diagnosed with congenital myopathy and presented COX deficiency in muscle pathology. We assessed the COX6A2 variants using measurements of enzymatic activities and assembly of mitochondrial respiratory chain complexes in the samples from the patients and knockout mice. RESULTS Both patients presented muscle weakness and hypotonia in 4 limbs along with facial muscle weakness. One patient had cardiomyopathy. Neither patient exhibited involvement from other organs. Whole exome sequencing identified biallelic missense variants in COX6A2, which is expressed only in the skeletal muscle and heart. The variants detected were homozygous c.117C > A (p.Ser39Arg) and compound heterozygous c.117C > A (p.Ser39Arg) and c.127T > C (p.Cys43Arg). We found specific reductions in complex IV activities in the skeletal muscle of both individuals. Assembly of complex IV and its supercomplex formation were impaired in the muscle. INTERPRETATION This study indicates that biallelic variants in COX6A2 cause a striated muscle-specific form of COX deficiency. ANN NEUROL 2019;86:193-202.
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Affiliation(s)
- Michio Inoue
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Integrated Graduate School of Medicine, Engineering, and Agricultural Science, University of Yamanashi, Yamanashi, Japan.,Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shumpei Uchino
- Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Aritoshi Iida
- Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Satoru Noguchi
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shinichiro Hayashi
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tsutomu Takahashi
- Department of Pediatrics, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Katsunori Fujii
- Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hirofumi Komaki
- Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Eri Takeshita
- Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ikuya Nonaka
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yukinori Okada
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takuya Yoshizawa
- College of Life Sciences, Ritsumeikan University, Kusatsu, Japan
| | - Leentje Van Lommel
- Department of Cellular and Molecular Medicine, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Frans Schuit
- Department of Cellular and Molecular Medicine, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Yu-Ichi Goto
- Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan
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32
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Uchino S, Iida A, Sato A, Ishikawa K, Mimaki M, Nishino I, Goto YI. A novel compound heterozygous variant of ECHS1 identified in a Japanese patient with Leigh syndrome. Hum Genome Var 2019; 6:19. [PMID: 31016024 PMCID: PMC6474858 DOI: 10.1038/s41439-019-0050-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/12/2019] [Accepted: 03/12/2019] [Indexed: 11/25/2022] Open
Abstract
Leigh syndrome (LS) is a heterogeneous neurodegenerative disorder caused by mitochondrial dysfunction. Certain LS cases have mutations in ECHS1, which encodes a short-chain enoyl-CoA hydratase involved in the metabolism of fatty acids and branched-chain amino acids in mitochondria. Using exome sequencing, we diagnosed a Japanese patient with LS and identified the patient as a compound heterozygote for a novel variant of ECHS1, consisting of NM_004092.4:c.23T>C (p.Leu8Pro) and NM_004092.4:c.176A>G (p.Asn59Ser).
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Affiliation(s)
- Shumpei Uchino
- 1Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.,2Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan.,3Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Atsushi Sato
- 3Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Masakazu Mimaki
- 2Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Ichizo Nishino
- 4Medical Genome Center, NCNP, Tokyo, Japan.,5Department of Neuromuscular Research, National Institute of Neuroscience, NCNP, Tokyo, Japan
| | - Yu-Ichi Goto
- 1Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), Tokyo, Japan.,4Medical Genome Center, NCNP, Tokyo, Japan
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33
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Nakagama Y, Hamanaka K, Mimaki M, Shintaku H, Miyatake S, Matsumoto N, Hirohata K, Inuzuka R, Oka A. Leaky splicing variant in sepiapterin reductase deficiency: Are milder cases escaping diagnosis? Neurol Genet 2019; 5:e319. [PMID: 31041399 PMCID: PMC6454308 DOI: 10.1212/nxg.0000000000000319] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/08/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Yu Nakagama
- Department of Pediatrics (Y.N., K. Hirohata, R.I., A.O.), Graduate School of Medicine, The University of Tokyo; Department of Human Genetics (K. Hamanaka, S.M., N.M.), Graduate School of Medicine, Yokohama City University; Department of Pediatrics (M.M.), School of Medicine, Teikyo University, Tokyo; and Department of Pediatrics (H.S.), Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kohei Hamanaka
- Department of Pediatrics (Y.N., K. Hirohata, R.I., A.O.), Graduate School of Medicine, The University of Tokyo; Department of Human Genetics (K. Hamanaka, S.M., N.M.), Graduate School of Medicine, Yokohama City University; Department of Pediatrics (M.M.), School of Medicine, Teikyo University, Tokyo; and Department of Pediatrics (H.S.), Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Masakazu Mimaki
- Department of Pediatrics (Y.N., K. Hirohata, R.I., A.O.), Graduate School of Medicine, The University of Tokyo; Department of Human Genetics (K. Hamanaka, S.M., N.M.), Graduate School of Medicine, Yokohama City University; Department of Pediatrics (M.M.), School of Medicine, Teikyo University, Tokyo; and Department of Pediatrics (H.S.), Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Haruo Shintaku
- Department of Pediatrics (Y.N., K. Hirohata, R.I., A.O.), Graduate School of Medicine, The University of Tokyo; Department of Human Genetics (K. Hamanaka, S.M., N.M.), Graduate School of Medicine, Yokohama City University; Department of Pediatrics (M.M.), School of Medicine, Teikyo University, Tokyo; and Department of Pediatrics (H.S.), Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Satoko Miyatake
- Department of Pediatrics (Y.N., K. Hirohata, R.I., A.O.), Graduate School of Medicine, The University of Tokyo; Department of Human Genetics (K. Hamanaka, S.M., N.M.), Graduate School of Medicine, Yokohama City University; Department of Pediatrics (M.M.), School of Medicine, Teikyo University, Tokyo; and Department of Pediatrics (H.S.), Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Naomichi Matsumoto
- Department of Pediatrics (Y.N., K. Hirohata, R.I., A.O.), Graduate School of Medicine, The University of Tokyo; Department of Human Genetics (K. Hamanaka, S.M., N.M.), Graduate School of Medicine, Yokohama City University; Department of Pediatrics (M.M.), School of Medicine, Teikyo University, Tokyo; and Department of Pediatrics (H.S.), Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Koji Hirohata
- Department of Pediatrics (Y.N., K. Hirohata, R.I., A.O.), Graduate School of Medicine, The University of Tokyo; Department of Human Genetics (K. Hamanaka, S.M., N.M.), Graduate School of Medicine, Yokohama City University; Department of Pediatrics (M.M.), School of Medicine, Teikyo University, Tokyo; and Department of Pediatrics (H.S.), Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Ryo Inuzuka
- Department of Pediatrics (Y.N., K. Hirohata, R.I., A.O.), Graduate School of Medicine, The University of Tokyo; Department of Human Genetics (K. Hamanaka, S.M., N.M.), Graduate School of Medicine, Yokohama City University; Department of Pediatrics (M.M.), School of Medicine, Teikyo University, Tokyo; and Department of Pediatrics (H.S.), Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Akira Oka
- Department of Pediatrics (Y.N., K. Hirohata, R.I., A.O.), Graduate School of Medicine, The University of Tokyo; Department of Human Genetics (K. Hamanaka, S.M., N.M.), Graduate School of Medicine, Yokohama City University; Department of Pediatrics (M.M.), School of Medicine, Teikyo University, Tokyo; and Department of Pediatrics (H.S.), Graduate School of Medicine, Osaka City University, Osaka, Japan
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34
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Ishiyama A, Muramatsu K, Uchino S, Sakai C, Matsushima Y, Makioka N, Ogata T, Suzuki E, Komaki H, Sasaki M, Mimaki M, Goto YI, Nishino I. NDUFAF3
variants that disrupt mitochondrial complex I assembly may associate with cavitating leukoencephalopathy. Clin Genet 2018; 93:1103-1106. [DOI: 10.1111/cge.13215] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/11/2018] [Accepted: 01/12/2018] [Indexed: 01/29/2023]
Affiliation(s)
- A. Ishiyama
- Department of Child Neurology; National Center of Neurology and Psychiatry (NCNP), National Center Hospital; Tokyo Japan
- Department of Neuromuscular Research; National Institute of Neuroscience, NCNP; Tokyo Japan
- Department of Pharmacology, Interdisciplinary Graduate School of Medicine and Engineering; University of Yamanashi; Yamanashi Japan
| | - K. Muramatsu
- Department of Pediatrics; Gunma University Graduate School of Medicine; Gunma Japan
- Department of Pediatrics; Jichi Medical University; Tochigi Japan
| | - S. Uchino
- Department of Mental Retardation and Birth Defect Research; National Institute of Neuroscience, NCNP; Tokyo Japan
- Department of Pediatrics, Faculty of Medicine; Teikyo University; Tokyo Japan
| | - C. Sakai
- Department of Mental Retardation and Birth Defect Research; National Institute of Neuroscience, NCNP; Tokyo Japan
| | - Y. Matsushima
- Department of Mental Retardation and Birth Defect Research; National Institute of Neuroscience, NCNP; Tokyo Japan
| | - N. Makioka
- Department of Pediatrics; Gunma University Graduate School of Medicine; Gunma Japan
| | - T. Ogata
- Department of Pediatrics; Gunma University Graduate School of Medicine; Gunma Japan
| | - E. Suzuki
- Department of Pediatrics; Gunma University Graduate School of Medicine; Gunma Japan
| | - H. Komaki
- Department of Child Neurology; National Center of Neurology and Psychiatry (NCNP), National Center Hospital; Tokyo Japan
| | - M. Sasaki
- Department of Child Neurology; National Center of Neurology and Psychiatry (NCNP), National Center Hospital; Tokyo Japan
| | - M. Mimaki
- Department of Mental Retardation and Birth Defect Research; National Institute of Neuroscience, NCNP; Tokyo Japan
- Department of Pediatrics, Faculty of Medicine; Teikyo University; Tokyo Japan
| | - Y.-I. Goto
- Department of Mental Retardation and Birth Defect Research; National Institute of Neuroscience, NCNP; Tokyo Japan
| | - I. Nishino
- Department of Neuromuscular Research; National Institute of Neuroscience, NCNP; Tokyo Japan
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35
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Shimoda K, Mimaki M, Fujino S, Takeuchi M, Hino R, Uozaki H, Hayashi M, Oka A, Mizuguchi M. Brain edema with clasmatodendrosis complicating ataxia telangiectasia. Brain Dev 2017; 39:629-632. [PMID: 28351596 DOI: 10.1016/j.braindev.2017.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 02/20/2017] [Accepted: 02/24/2017] [Indexed: 11/17/2022]
Abstract
Ataxia-telangiectasia is a chronic progressive disorder affecting the nervous and immune systems, caused by a genetic defect in the ATM protein. Clasmatodendrosis, a distinct form of astroglial death, has rarely been reported in ataxia-telangiectasia. Neuropathology of our patient disclosed diffuse edema of the cerebral and cerebellar white matter with prominent clasmatodendrosis, implicating ATM in the regulation of astroglial cell death.
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Affiliation(s)
- Konomi Shimoda
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Japan. konomi-@mbb.nifty.ne.jp
| | - Masakazu Mimaki
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Japan
| | - Shuhei Fujino
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Japan
| | - Masato Takeuchi
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Japan
| | - Rumi Hino
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Hiroshi Uozaki
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Japan; Department of Pathology, Graduate School of Medicine, The University of Teikyo, Japan
| | - Masaharu Hayashi
- Department of Brain Development and Neural Regeneration, Tokyo Metropolitan Institute of Medical Science, Japan
| | - Akira Oka
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Japan
| | - Masashi Mizuguchi
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Japan; Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Japan
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36
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Natsume J, Hamano SI, Iyoda K, Kanemura H, Kubota M, Mimaki M, Niijima S, Tanabe T, Yoshinaga H, Kojimahara N, Komaki H, Sugai K, Fukuda T, Maegaki Y, Sugie H. New guidelines for management of febrile seizures in Japan. Brain Dev 2017; 39:2-9. [PMID: 27613077 DOI: 10.1016/j.braindev.2016.06.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 06/11/2016] [Accepted: 06/13/2016] [Indexed: 12/01/2022]
Abstract
In 2015, the Japanese Society of Child Neurology released new guidelines for the management of febrile seizures, the first update of such guidelines since 1996. In 1988, the Conference on Febrile Convulsions in Japan published "Guidelines for the Treatment of Febrile Seizures." The Task Committee of the Conference proposed a revised version of the guidelines in 1996; that version released in 1996 was used for the next 19years in Japan for the clinical management of children with febrile seizures. Although the guidelines were very helpful for many clinicians, new guidelines were needed to reflect changes in public health and the dissemination of new medical evidence. The Japanese Society of Child Neurology formed a working group in 2012, and published the new guidelines in March 2015. The guidelines include emergency care, application of electroencephalography, neuroimaging, prophylactic diazepam, antipyretics, drugs needing special attention, and vaccines. While the new guidelines contain updated clinical recommendations, many unsolved questions remain. These questions should be clarified by future clinical research.
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Affiliation(s)
- Jun Natsume
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Shin-Ichiro Hamano
- Division of Neurology, Saitama Children's Medical Center, Saitama, Japan
| | - Kuniaki Iyoda
- Fukuyama Support Center of Development and Care for Children, Fukuyama, Japan
| | - Hideaki Kanemura
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Masaya Kubota
- Division of Neurology, National Center for Child Health and Development, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinichi Niijima
- Department of Pediatrics, Juntendo University Nerima Hospital, Tokyo, Japan
| | | | - Harumi Yoshinaga
- Department of Child Neurology, Okayama University Graduate Schools of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Noriko Kojimahara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Hirohumi Komaki
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kenji Sugai
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tokiko Fukuda
- Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshihiro Maegaki
- Division of Child Neurology, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Hideo Sugie
- Faculty of Health and Medical Sciences, Tokoha University Hamamatsu Campus, Hamamatsu, Japan
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37
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Ohta S, Isojima T, Mizuno Y, Kato M, Mimaki M, Seki M, Sato Y, Ogawa S, Takita J, Kitanaka S, Oka A. Partial monosomy of 10p and duplication of another chromosome in two patients. Pediatr Int 2017; 59:99-102. [PMID: 28102624 DOI: 10.1111/ped.13181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 07/16/2016] [Accepted: 09/23/2016] [Indexed: 11/30/2022]
Abstract
Partial monosomy of 10p is a rare chromosomal abnormality. Common features are hypoparathyroidism, deafness, renal anomalies, distinctive facies, and mental retardation, with phenotypic variability. We report two patients with chromosomal abnormalities identified on single-nucleotide polymorphism (SNP) array analysis. Although patient 1 had common features of monosomy10p, G-banding indicated a normal karyotype. SNP array and fluorescence in situ hybridization (FISH), however, indicated unbalanced translocation of a 10p terminal deletion of 11.7 Mb and a 15q terminal duplication of 8.2 Mb. In patient 2, SNP array and FISH indicated a 10p terminal deletion of 12.6 Mb and a 7q terminal duplication of 1.9 Mb. This is the first case report of monosomy 10p combined with trisomy 15q (patient 1). Because the clinical heterogeneity of the 10p deletion syndrome would be affected by duplication of another chromosome, we emphasize that SNP/microarray analysis is necessary to confirm genotype-phenotype correlation.
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Affiliation(s)
- Sayaka Ohta
- Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Tsuyoshi Isojima
- Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.,Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoko Mizuno
- Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Motohiro Kato
- Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.,Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Masafumi Seki
- Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yusuke Sato
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Junko Takita
- Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Sachiko Kitanaka
- Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Akira Oka
- Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Sato Y, Wakabayashi K, Ogawa E, Kodama H, Mimaki M. Low serum biotin in Japanese children fed with hydrolysate formula. Pediatr Int 2016; 58:867-71. [PMID: 26824516 DOI: 10.1111/ped.12937] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/21/2015] [Accepted: 01/26/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Given that nutritional biotin deficiency in Japanese infants has been reported, a straightforward method for estimating biotin level is needed. The biotin content in infant formula, breast milk, and the sera of infants fed with various types of formula were measured using avidin-binding assay. METHODS A commercially available ELISA kit was used for the measurement of biotin in 54 types of formula, including hydrolysate formulas for milk allergy, as well as in breast milk and in the sera of 27 infants fed with these formulas. RESULTS The biotin content reached the recommended value in only five formulas. All of the hydrolysate formulas and more than half of the special formulas contained biotin <0.1 μg/dL. Serum biotin was low in infants fed only with the hydrolysate formulas, and one of them had alopecia related to biotin deficiency. CONCLUSION While many were asymptomatic, infants fed with formulas lacking biotin are at risk of developing symptomatic disease. The addition of biotin to breast milk substitutes was finally approved in the middle of 2014, however pediatricians in Japan should still be vigilant with regard to nutritional biotin deficiency in infants for the time being.
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Affiliation(s)
- Yasuhiro Sato
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kenji Wakabayashi
- Department of Health Dietetics, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan
| | - Eishin Ogawa
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan.
| | - Hiroko Kodama
- Department of Health Dietetics, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
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Hikita T, Kodama H, Ogita K, Kaneko S, Nakamoto N, Mimaki M. Cyclic Vomiting Syndrome in Infants and Children: A Clinical Follow-Up Study. Pediatr Neurol 2016; 57:29-33. [PMID: 26861170 DOI: 10.1016/j.pediatrneurol.2016.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 12/29/2015] [Accepted: 01/01/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cyclic vomiting syndrome is characterized by recurrent vomiting that is associated with increased adrenocorticotropic hormone and antidiuretic hormone levels during cyclic vomiting syndrome attacks. However, both prognosis and treatment remain unclear. We therefore evaluated the clinical features, prognosis, and effectiveness of the prophylaxis of cyclic vomiting syndrome as well as the relationship between symptoms and adrenocorticotropic hormone/antidiuretic hormone levels. METHODS We included 31 patients with cyclic vomiting syndrome who were admitted to Teikyo University between 1996 and 2008. All patients were diagnosed with cyclic vomiting syndrome based on the criteria of the second edition of the International Headache Classification. The patients (25 of 31) were followed until 2013. RESULTS The median overall duration of the disorder was 66 (3-179) months. Follow-up was completed for 25 patients with cyclic vomiting syndrome, of whom 44% (n = 11) developed migraine. Valproic acid, valproic acid with phenobarbital, phenobarbital, and amitriptyline were effective in nine, four, three, and one patients, respectively. Abnormally high adrenocorticotropic hormone (n = 17) and antidiuretic hormone (n = 18) levels were found among the 25 patients for whom follow-up data were available. The following correlations were significant: attack duration and adrenocorticotropic hormone levels (correlation coefficient: 0.5153, P = 0.0084) and attack duration and antidiuretic hormone levels (correlation coefficient: 0.5666, P = 0.0031). Antidiuretic hormone levels in patients with bilious vomiting were higher than in those without bilious vomiting (P = 0.048). CONCLUSIONS Most patients with cyclic vomiting syndrome recovered completely and benefited from prophylactic therapy, although half of them developed migraines.
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Affiliation(s)
- Toshiyuki Hikita
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan.
| | - Hiroko Kodama
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan
| | - Kaori Ogita
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan
| | - Sono Kaneko
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan
| | - Natsue Nakamoto
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan
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40
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Mimaki M, Shiihara T, Watanabe M, Hirakata K, Sakazume S, Ishiguro A, Shimojima K, Yamamoto T, Oka A, Mizuguchi M. Holoprosencephaly with cerebellar vermis hypoplasia in 13q deletion syndrome: Critical region for cerebellar dysgenesis within 13q32.2q34. Brain Dev 2015; 37:714-8. [PMID: 25454392 DOI: 10.1016/j.braindev.2014.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 10/04/2014] [Accepted: 10/16/2014] [Indexed: 10/24/2022]
Abstract
We describe two unrelated patients with terminal deletions in the long arm of chromosome 13 showing brain malformation consisting of holoprosencephaly and cerebellar vermis hypoplasia. Array comparative genomic hybridization analysis revealed a pure terminal deletion of 13q31.3q34 in one patient and a mosaic ring chromosome with 13q32.2q34 deletion in the other. Mutations in ZIC2, located within region 13q32, cause holoprosencephaly, whereas the 13q32.2q32.3 region is associated with cerebellar vermis hypoplasia (Dandy-Walker syndrome). The rare concurrence of these major brain malformations in our patients provides further evidence that 13q32.2q32.3 deletion, harboring ZIC2 and ZIC5, leads to cerebellar dysgenesis.
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Affiliation(s)
- Masakazu Mimaki
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Japan.
| | | | - Mio Watanabe
- Department of Neurology, Gunma Children's Medical Center, Japan
| | - Kyoko Hirakata
- Department of Ophthalmology, Gunma Children's Medical Center, Japan
| | - Satoru Sakazume
- Clinical Genetics Center, Dokkyo Medical University Koshigaya Hospital, Japan
| | - Akio Ishiguro
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Japan
| | - Keiko Shimojima
- Tokyo Women's Medical University Institute for Integrated Medical Sciences, Japan
| | - Toshiyuki Yamamoto
- Tokyo Women's Medical University Institute for Integrated Medical Sciences, Japan
| | - Akira Oka
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Japan
| | - Masashi Mizuguchi
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Japan; Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo, Japan
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41
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Saitsu H, Fukai R, Ben-Zeev B, Sakai Y, Mimaki M, Okamoto N, Suzuki Y, Monden Y, Saito H, Tziperman B, Torio M, Akamine S, Takahashi N, Osaka H, Yamagata T, Nakamura K, Tsurusaki Y, Nakashima M, Miyake N, Shiina M, Ogata K, Matsumoto N. Phenotypic spectrum of GNAO1 variants: epileptic encephalopathy to involuntary movements with severe developmental delay. Eur J Hum Genet 2015; 24:129-34. [PMID: 25966631 DOI: 10.1038/ejhg.2015.92] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/24/2015] [Accepted: 04/14/2015] [Indexed: 12/11/2022] Open
Abstract
De novo GNAO1 variants have been found in four patients including three patients with Ohtahara syndrome and one patient with childhood epilepsy. In addition, two patients showed involuntary movements, suggesting that GNAO1 variants can cause various neurological phenotypes. Here we report an additional four patients with de novo missense GNAO1 variants, one of which was identical to that of the previously reported. All the three novel variants were predicted to impair Gαo function by structural evaluation. Two patients showed early-onset epileptic encephalopathy, presenting with migrating or multifocal partial seizures in their clinical course, but the remaining two patients showed no or a few seizures. All the four patients showed severe intellectual disability, motor developmental delay, and involuntary movements. Progressive cerebral atrophy and thin corpus callosum were common features in brain images. Our study demonstrated that GNAO1 variants can cause involuntary movements and severe developmental delay with/without seizures, including various types of early-onset epileptic encephalopathy.
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Affiliation(s)
- Hirotomo Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryoko Fukai
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Bruria Ben-Zeev
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel aviv, Israel
| | - Yasunari Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Nobuhiko Okamoto
- Department of Medical Genetics, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Yasuhiro Suzuki
- Department of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Yukifumi Monden
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan
| | - Hiroshi Saito
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan
| | - Barak Tziperman
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Michiko Torio
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Akamine
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Hitoshi Osaka
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan
| | | | - Kazuyuki Nakamura
- Department of Pediatrics, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Yoshinori Tsurusaki
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mitsuko Nakashima
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masaaki Shiina
- Department of Biochemistry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuhiro Ogata
- Department of Biochemistry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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42
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Formosa LE, Mimaki M, Frazier AE, McKenzie M, Stait TL, Thorburn DR, Stroud DA, Ryan MT. Characterization of mitochondrial FOXRED1 in the assembly of respiratory chain complex I. Hum Mol Genet 2015; 24:2952-65. [DOI: 10.1093/hmg/ddv058] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 02/09/2015] [Indexed: 11/12/2022] Open
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43
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Tucker EJ, Mimaki M, Compton AG, McKenzie M, Ryan MT, Thorburn DR. Next-generation sequencing in molecular diagnosis: NUBPL
mutations highlight the challenges of variant detection and interpretation. Hum Mutat 2011; 33:411-8. [DOI: 10.1002/humu.21654] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 10/31/2011] [Indexed: 11/05/2022]
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Takahashi K, Oka A, Mizuguchi M, Saitoh M, Takita J, Sato A, Mimaki M, Kato M, Ogawa S, Igarashi T. Interstitial deletion of 13q14.13-q32.3 presenting with Arima syndrome and bilateral retinoblastoma. Brain Dev 2011; 33:353-6. [PMID: 20728296 DOI: 10.1016/j.braindev.2010.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2010] [Revised: 06/09/2010] [Accepted: 06/21/2010] [Indexed: 11/25/2022]
Abstract
A patient with a large deletion of the distal part of the long arm of chromosome 13 showed severe psychomotor retardation, a characteristic face, nystagmus, retinopathy, cystic kidney disease, and brain malformation with molar tooth sign and cerebellar vermis hypoplasia, a phenotype typical of Arima syndrome. This patient also had bilateral retinoblastoma. Fluorescent in situ hybridization and single-nucleotide-polymorphism genotyping microarray demonstrated an interstitial deletion of 54 Mbp, ranging from 13q14.13 to 13q32.3 and involving the RB1 gene. This patient is the first case of Arima syndrome, or a Joubert syndrome-related disorder, that showed linkage to chromosome 13q.
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Affiliation(s)
- Kan Takahashi
- Department of Pediatrics, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
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45
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Mimaki M, Hatakeyama H, Komaki H, Yokoyama M, Arai H, Kirino Y, Suzuki T, Nishino I, Nonaka I, Goto YI. Reversible infantile respiratory chain deficiency: a clinical and molecular study. Ann Neurol 2011; 68:845-54. [PMID: 21194154 DOI: 10.1002/ana.22111] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To characterize the clinical features and clarify the pathogenicity of "benign cytochrome c oxidase deficiency myopathy." METHODS The study included 8 patients with the phenotype of this disease. Six patients underwent muscle biopsies and all the 8 underwent mitochondrial DNA analyses. To confirm the pathogenicity of the detected mitochondrial DNA mutation, we performed northern blot analysis, using muscle specimens, and blue native polyacrylamide gel electrophoresis and respiratory chain enzyme activity assay of transmitochondrial cell lines (cybrids). RESULTS Clinical symptoms were limited to skeletal muscle and improved spontaneously in all cases; however, 2 siblings had basal ganglia lesions. In all patients, we identified a homoplasmic m.14674T>C or m.14674T>G mitochondrial transfer RNA-glutamate mutation. Northern blot analysis revealed decreased levels of mitochondrial transfer RNA-glutamate molecules. Muscle specimens and cybrids derived from patients showed decreased activity of respiratory complexes IV, and/or I, III; however, this was normal in naive myoblasts. INTERPRETATION Identification of a novel m.14674T>G mutation in addition to m.14674T>C indicated the importance of this site for disease causation. Analyses of cybrids revealed the pathogenicity of m.14674T>C mutation, which resulted in defects of cytochrome c oxidase and multiple respiratory chain enzymes. Furthermore, patients with basal ganglia lesions provided new insights into this disease, in which only skeletal muscle was thought to be affected. Normal respiratory chain enzyme activities in naive myoblasts suggested the compensatory influence of nuclear factors, which may be a clue to understanding the mechanisms of spontaneous recovery and low penetrance in families carrying the mutation.
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Affiliation(s)
- Masakazu Mimaki
- Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
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46
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Tumurkhuu M, Saitoh M, Sato A, Takahashi K, Mimaki M, Takita J, Takeshita K, Hama T, Oka A, Mizuguchi M. Comprehensive genetic analysis of overlapping syndromes of RAS/RAF/MEK/ERK pathway. Pediatr Int 2010; 52:557-62. [PMID: 20030748 DOI: 10.1111/j.1442-200x.2009.03020.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Germline mutations in several members of RAS/RAF/MEK/ERK pathway cause clinically similar genetic disorders, including Noonan syndrome (NS), Costello syndrome (CS) and cardio-facio-cutaneous syndrome (CFC). Each of these syndromes has a wide spectrum of molecular etiology. The aim of the present study was to conduct a comprehensive genetic analysis of RAS/RAF/MEK/ERK pathway in these syndromes. METHODS Three patients with NS and two patients with CS/CFC were examined. Peripheral blood samples were collected from all patients as well as from 100 healthy Japanese volunteers. The protein phosphatase, non-receptor type II (PTPN11), KRAS, HRAS, NRAS, BRAF, RAF1, Son of Sevenless (SOS1) and MEK1genes were analyzed. RESULTS In a patient with a severe Noonan phenotype, a rare PTPN11 mutation was detected: A to G transition at position 172, causing an N58D substitution within the N-SH2 domain. In a CS/CFC patient no HRAS mutations were found, but a novel SOS1 missense mutation was found: A to G transition at position 473, causing a T158A substitution within domain of histone-like fold (HF). CONCLUSIONS A case mimicking CS with SOS1 T158A substitution, which has not been reported previously in CS, revealed the complex relationship between the genotype and phenotype of overlapping syndromes of the RAS/RAF/MEK/ERK pathway.
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Affiliation(s)
- Munkhtuya Tumurkhuu
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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47
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Kato M, Takita J, Takahashi K, Mimaki M, Chen Y, Koh K, Ida K, Oka A, Mizuguchi M, Ogawa S, Igarashi T. Hepatoblastoma in a patient with sotos syndrome. J Pediatr 2009; 155:937-9. [PMID: 19914434 DOI: 10.1016/j.jpeds.2009.06.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Revised: 05/14/2009] [Accepted: 06/17/2009] [Indexed: 11/26/2022]
Abstract
We report a case of hepatoblastoma that developed in a child with Sotos syndrome, an overgrowth syndrome with an increased risk of neoplasms. Genome-wide analysis of copy number alterations showed a gain of chromosome 2, uniparental disomy of 18q, and microdeletion of 5q35.
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Affiliation(s)
- Motohiro Kato
- Department of Pediatrics, Graduate school of Medicine, University of Tokyo, Tokyo, Japan
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48
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Sato A, Mizuguchi M, Mimaki M, Takahashi K, Jimi H, Oka A, Igarashi T. Cortical gray matter lesions in acute encephalopathy with febrile convulsive status epilepticus. Brain Dev 2009; 31:622-4. [PMID: 18848752 DOI: 10.1016/j.braindev.2008.08.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Revised: 08/29/2008] [Accepted: 08/31/2008] [Indexed: 10/21/2022]
Abstract
In acute encephalopathy with febrile convulsive status epilepticus (AEFCSE), subcortical white matter lesions on diffusion-weighted images are sometimes encountered on magnetic resonance imaging (MRI), such as in acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). We report here a severe case of AEFCSE following respiratory syncytial virus infection, with emphasis on the cranial MRI findings. MRI in this patient showed widespread T2-hyperintensity along the cerebral cortical gray matter from day 3 to day 22. Lesions with reduced diffusion were noted on day 3 in the deep zone of gray matter of the left occipito-temporo-parietal cortex, but on day 7 they shifted to the subcortical white matter of both the cerebral hemispheres. These MRI findings provide radiologic evidence for damage to the cortical gray matter in AEFCSE. The serial change of diffusion-weighted images suggests that the cortical gray matter may be injured prior to the involvement of the subcortical white matter.
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Affiliation(s)
- Atsushi Sato
- Department of Pediatrics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
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Abstract
OBJECTIVE We sought to clarify the features of kernicterus in preterm infants. METHODS The subjects of this study were 8 preterm infants with athetoid cerebral palsy whose gestational ages were < or =34 weeks. We retrospectively investigated clinical, laboratory, MRI, and brainstem auditory evoked potential (BAEP) findings. RESULTS Gestational age was < or =26 weeks in 6 of the 8 infants, and birth weight was <1000 g in 5 infants. Serious postnatal complications with systemic deterioration were observed in 3 infants. Total bilirubin levels were measured frequently in the majority of infants; peak values of >15 mg/dL were observed in 3 infants. No infant showed neurologic symptoms characteristic of classical acute bilirubin encephalopathy during the neonatal period. Dystonic posture and abnormal muscle tone were first recognized within 6 months' corrected age in all patients. During infancy, MRI was performed in 7 infants. Abnormal high-intensity areas were observed in the bilateral globi pallidi in all 7 infants. However, MRI during the neonatal period or after 1 year's corrected age showed no abnormal findings. BAEP measurements were abnormal in 7 of the 8 infants. CONCLUSIONS Preterm infants with athetotic cerebral palsy showed rather homogeneous features, similar to term infants with kernicterus, with marked hyperbilirubinemia. This combination of clinical, laboratory, neuroimaging, and neurophysiological data will contribute to the increased recognition of preterm infants with kernicterus.
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Affiliation(s)
- Akihisa Okumura
- Department of Pediatrics, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
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50
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Mimaki M, Hatakeyama H, Ichiyama T, Isumi H, Furukawa S, Akasaka M, Kamei A, Komaki H, Nishino I, Nonaka I, Goto YI. Different effects of novel mtDNA G3242A and G3244A base changes adjacent to a common A3243G mutation in patients with mitochondrial disorders. Mitochondrion 2009; 9:115-22. [PMID: 19460299 DOI: 10.1016/j.mito.2009.01.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Revised: 11/09/2008] [Accepted: 01/12/2009] [Indexed: 10/21/2022]
Abstract
Two novel mitochondrial DNA base changes were identified at both sides of the 3243A>G mutation, the most common mutation associated with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). One was a 3244G>A transition in a girl with MELAS. The other was a 3242G>A transition in a girl with a mitochondrial disorder without a MELAS phenotype. Although the two base changes were adjacent to the 3243A>G mutation, they had different effects on the clinical phenotype, muscle pathology, and respiratory chain enzyme activity. Investigations of the different effects of the 3244G>A and 3242G>A base changes may provide a better understanding of tRNA dysfunction in mitochondrial disorders.
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Affiliation(s)
- Masakazu Mimaki
- Department of Mental Retardation and Birth Defect Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, Japan
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