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Suzuki T, Sato Y, Okuno Y, Torii Y, Fukuda Y, Haruta K, Yamaguchi M, Kawamura Y, Hama A, Narita A, Muramatsu H, Yoshikawa T, Takahashi Y, Kimura H, Ito Y, Kawada JI. Single-Cell Transcriptomic Analysis of Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis. J Clin Immunol 2024; 44:103. [PMID: 38642164 DOI: 10.1007/s10875-024-01701-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/05/2024] [Indexed: 04/22/2024]
Abstract
Epstein-Barr virus (EBV) infection can lead to infectious mononucleosis (EBV-IM) and, more rarely, EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH), which is characterized by a life-threatening hyperinflammatory cytokine storm with immune dysregulation. Interferon-gamma (IFNγ) has been identified as a critical mediator for primary HLH; however, the detailed role of IFNγ and other cytokines in EBV-HLH is not fully understood. In this study, we used single-cell RNA sequencing to characterize the immune landscape of EBV-HLH and compared it with EBV-IM. Three pediatric patients with EBV-HLH with different backgrounds, one with X-linked lymphoproliferative syndrome type 1 (XLP1), two with chronic active EBV disease (CAEBV), and two patients with EBV-IM were enrolled. The TUBA1B + STMN1 + CD8 + T cell cluster, a responsive proliferating cluster with rich mRNA detection, was explicitly observed in EBV-IM, and the upregulation of SH2D1A-the gene responsible for XLP1-was localized in this cluster. This proliferative cluster was scarcely observed in EBV-HLH cases. In EBV-HLH cases with CAEBV, upregulation of LAG3 was observed in EBV-infected cells, which may be associated with an impaired response by CD8 + T cells. Additionally, genes involved in type I interferon (IFN) signaling were commonly upregulated in each cell fraction of EBV-HLH, and activation of type II IFN signaling was observed in CD4 + T cells, natural killer cells, and monocytes but not in CD8 + T cells in EBV-HLH. In conclusion, impaired responsive proliferation of CD8 + T cells and upregulation of type I IFN signaling were commonly observed in EBV-HLH cases, regardless of the patients' background, indicating the key features of EBV-HLH.
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Affiliation(s)
- Takako Suzuki
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Yoshitaka Sato
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yusuke Okuno
- Department of Virology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuka Torii
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Yuto Fukuda
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Kazunori Haruta
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Makoto Yamaguchi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Asahito Hama
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Aichi Medical Center Nagoya First Hospital, Nagoya, Japan
| | - Atsushi Narita
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hideki Muramatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Hiroshi Kimura
- Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshinori Ito
- Departments of Pediatrics, Aichi Medical University, Nagakute, Aichi, Japan
| | - Jun-Ichi Kawada
- Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
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Kakei Y, Morioka I, Imai T, Itohara K, Yano I, Takahashi N, Yoshikawa T, Moriuchi H, Ito Y, Fujioka K, Oka A. Assessment of patients' characteristics associated with the efficacy and safety of oral valganciclovir treatment for infants with symptomatic congenital cytomegalovirus disease. J Infect Chemother 2024:S1341-321X(24)00081-3. [PMID: 38484931 DOI: 10.1016/j.jiac.2024.03.006] [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: 12/03/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/20/2024]
Abstract
INTRODUCTION Insurance coverage for oral valganciclovir (VGCV) began in Japan in April 2023 on the basis of results, including our clinical trials for symptomatic congenital cytomegalovirus (CMV) disease. The VGCV treatment is available throughout Japan, so clinicians must consider the likelihood of hearing improvement and the possibility of neutropenia before dosing. MATERIALS AND METHODS We performed a substudy of an investigator-initiated, single-arm, prospective, multicenter, clinical trial in which 24 infants with symptomatic congenital CMV disease were orally administered 16 mg/kg VGCV twice daily for 6 months as an intervention. We examined the infants' baseline characteristics associated with improved hearing impairment or a severely reduced neutrophil count. RESULTS Of the 24 patients, 4 had normal hearing on assessment of their ear with the best hearing. Hearing impairment improved in 14 patients and did not respond to VGCV treatment in 6 patients at the 6-month hearing assessment. CMV DNA levels in plasma at baseline were higher in patients in whom hearing did not respond to treatment. A neutrophil count <500/mm3 occurred in 5 (21%) patients for the first 6 weeks and in 8 (33%) patients for the first 6 months. A neutrophil count at screening and the lowest neutrophil count over the 6 months showed the highest correlation (r = 0.477, p = 0.019). CONCLUSIONS Infants with a low plasma viral load at screening tend to have an improvement in hearing impairment. Clinicians should be aware of neutropenia during VGCV treatment particularly in patients with a low neutrophil count during screening.
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Affiliation(s)
- Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan; Clinical and Translational Research Center, Kobe University Hospital, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi, Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.
| | - Takumi Imai
- Clinical and Translational Research Center, Kobe University Hospital, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Kotaro Itohara
- Department of Pharmacy, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Ikuko Yano
- Department of Pharmacy, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Naoto Takahashi
- Department of Pediatrics, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 470-1192, Japan.
| | - Hiroyuki Moriuchi
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan.
| | - Yoshinori Ito
- Department of Pediatrics, Aichi Medical University Graduate School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
| | - Kazumichi Fujioka
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Akira Oka
- Department of Pediatrics, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan; Saitama Prefectural Children's Medical Center, 1-2 Shin-toshin, Chuo-ku, Saitama, Saitama, 330-8777, Japan.
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Kawamura Y, Kozawa K, Koinuma G, Onda T, Cho K, Higashimoto Y, Miura H, Yoshikawa T. A GIRL WITH ADENOVIRUS TYPE 2 INDUCED INTERSTITIAL PNEUMONITIS ACUTELY EXACERBATED WITH PRIMARY HUMAN HERPESVIRUS 7 INFECTION. Pediatr Infect Dis J 2024:00006454-990000000-00776. [PMID: 38451886 DOI: 10.1097/inf.0000000000004312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/09/2024]
Abstract
We encountered a previously healthy 3-year-old girl with interstitial pneumonitis that initially developed due to human adenovirus type 2 infection and exacerbated by primary human herpesvirus 7 infection. A comprehensive serum biomarker analysis showed patterns that differed by viral infection, suggesting that respiratory and lymphotropic viral infections might have different pathophysiology in interstitial pneumonitis.
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Affiliation(s)
- Yoshiki Kawamura
- From the Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
- Department of Pediatrics, Fujita Health University Okazaki Medical Center, Okazaki, Japan
| | - Kei Kozawa
- From the Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Goro Koinuma
- Division of Pulmonology, National Center for Child Health and Development, Tokyo, Japan
| | - Tetsuo Onda
- Department of Pediatrics, Japan Community Healthcare Organization Hokkaido Hospital, Sapporo, Japan
| | - Kazutoshi Cho
- Department of Pediatrics, Japan Community Healthcare Organization Hokkaido Hospital, Sapporo, Japan
| | - Yuki Higashimoto
- Faculty of Medical Technology, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
| | - Hiroki Miura
- From the Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tetsushi Yoshikawa
- From the Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
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Kawamura Y, Komoto S, Fukuda S, Kugita M, Tang S, Patel A, Pieknik JR, Nagao S, Taniguchi K, Krause PR, Yoshikawa T. Development of recombinant rotavirus carrying herpes simplex virus 2 glycoprotein D gene based on reverse genetics technology. Microbiol Immunol 2024; 68:56-64. [PMID: 38098134 DOI: 10.1111/1348-0421.13107] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 02/07/2024]
Abstract
Vaccine development for herpes simplex virus 2 (HSV-2) has been attempted, but no vaccines are yet available. A plasmid-based reverse genetics system for Rotavirus (RV), which can cause gastroenteritis, allows the generation of recombinant RV containing foreign genes. In this study, we sought to develop simian RV (SA11) as a vector to express HSV-2 glycoprotein D (gD2) and evaluated its immunogenicity in mice. We generated the recombinant SA11-gD2 virus (rSA11-gD2) and confirmed its ability to express gD2 in vitro. The virus was orally inoculated into suckling BALB/c mice and into 8-week-old mice. Serum IgG and IgA titers against RV and gD2 were measured by ELISA. In the 8-week-old mice inoculated with rSA11-gD2, significant increases in not only antibodies against RV but also IgG against gD2 were demonstrated. In the suckling mice, antibodies against RV were induced, but gD2 antibody was not detected. Diarrhea observed after the first inoculation of rSA11-gD2 in suckling mice was similar to that induced by the parent virus. A gD2 expressing simian RV recombinant, which was orally inoculated, induced IgG against gD2. This strategy holds possibility for genital herpes vaccine development.
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Affiliation(s)
- Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Department of Pediatrics, Fujita Health University Okazaki Medical Center, Okazaki, Aichi, Japan
| | - Satoshi Komoto
- Department of Virology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Center for Infectious Disease Research, Research Promotion Headquarters, Fujita Health University, Toyoake, Aichi, Japan
- Division of One Health, Research Center for GLOBAL and LOCAL Infectious Diseases (RCGLID), Oita University, Yufu, Oita, Japan
| | - Saori Fukuda
- Department of Virology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Masanori Kugita
- Advanced Medical Research Center for Animal Models of Human Disease, Fujita Health University, Toyoake, Aichi, Japan
| | - Shuang Tang
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Amita Patel
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Julianna R Pieknik
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Shizuko Nagao
- Advanced Medical Research Center for Animal Models of Human Disease, Fujita Health University, Toyoake, Aichi, Japan
| | - Koki Taniguchi
- Department of Virology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Philip R Krause
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
- Independent Consultant, Bethesda, Maryland, USA
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Suzuki T, Michihata N, Hashimoto Y, Yoshikawa T, Saito K, Matsui H, Fushimi K, Yasunaga H. Association between aspirin dose and outcomes in patients with acute Kawasaki disease: a nationwide retrospective cohort study in Japan. Eur J Pediatr 2024; 183:415-424. [PMID: 37917176 DOI: 10.1007/s00431-023-05302-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/25/2023] [Accepted: 10/21/2023] [Indexed: 11/04/2023]
Abstract
This study aimed to identify the appropriate dose of aspirin to be prescribed to patients with acute Kawasaki disease (KD). Using a Japanese national inpatient database, we identified patients with KD treated with intravenous immunoglobulin between 2010 and 2021.The outcomes included the occurrence of coronary artery abnormalities and intravenous immunoglobulin resistance, length of hospital stay, and medical costs. Restricted cubic spline functions were performed to examine the association between aspirin dose and the outcomes. Data of 82,109 patients were extracted from the database. Non-linear associations were observed between aspirin dose and the outcomes. In comparison with an aspirin dose of 30 mg/kg/day, the odds ratio (95% confidence interval) for coronary artery abnormalities was 1.40 (1.13-1.75) at 5 mg/kg/day. An aspirin dose of ≥ 30 mg/kg/day did not significantly change the odds ratio for coronary artery abnormalities. Intravenous immunoglobulin resistance was significantly lower at a dose of 60 mg/kg/day or higher. CONCLUSION The results showed no significant association between aspirin escalation over standard-dose and coronary artery abnormalities in patients with acute KD. High-dose aspirin showed the potential to reduce hospital stay and medical costs without increasing complications. WHAT IS KNOWN • Aspirin is used as a standard treatment together with intravenous immunoglobulin for acute Kawasaki disease (KD). However, few studies have shown the most effective dosage of aspirin to prevent coronary artery abnormalities (CAAs). WHAT IS NEW • There was no significant association between aspirin dose escalation and CAAs in patients with acute KD.
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Affiliation(s)
- Takanori Suzuki
- Department of Pediatrics, Fujita Health University, Aichi, Japan
| | - Nobuaki Michihata
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Yohei Hashimoto
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | | | - Kazuyoshi Saito
- Department of Pediatrics, Fujita Health University, Aichi, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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Kondo Y, Kawamura Y, Hattori F, Nakai H, Saito K, Suzuki D, Kozawa K, Yoshikawa T. Serological analysis of severe acute respiratory syndrome coronavirus 2 infection in children with Kawasaki disease. J Med Virol 2023; 95:e29274. [PMID: 38009251 DOI: 10.1002/jmv.29274] [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: 08/16/2023] [Revised: 11/10/2023] [Accepted: 11/16/2023] [Indexed: 11/28/2023]
Abstract
Multisystem inflammatory syndrome in children (MIS-C) was reported as a severe complication of coronavirus disease 2019; an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and was suggested to be associated with Kawasaki disease (KD) in terms of severe systemic inflammation and mucocutaneous symptoms. Because severe gastrointestinal symptoms and systemic shock are more frequently observed with MIS-C, patients with mild MIS-C might have been diagnosed with KD. In this study, titers of IgG antibodies against the SARS-CoV-2 S (S-IgG) and N proteins (N-IgG) were measured in 99 serum samples collected from patients with KD treated between January 2020 and December 2021 to evaluate the relationship between KD and SARS-CoV-2 infection. S-IgG were detected in only one patient out of 99 patients. This patient had coronavirus disease 2019 (COVID-19) 10 months before KD onset, and was unlikely MIS-C. According to characters of S-IgG and N-IgG, the patients was unlikely infected with SARS-CoV-2 just before the onset of KD. In addition to this study, the 26th Nationwide Survey and previous studies showed an association between KD and SARS-CoV-2 to be unlikely. In conclusion, SARS-CoV-2 infection was not observed in patients with KD until Delta predominance in Japan by the method of detecting SARS-CoV-2 IgG.
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Affiliation(s)
- Yotaro Kondo
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
- Department of Pediatrics, Fujita Health University Okazaki Medical Center, Okazaki, Japan
| | - Fumihiko Hattori
- Department of Pediatrics, Kariya Toyota General Hospital, Kariya, Japan
- Department of Pediatrics, Toyokawa City Hospital, Toyokawa, Japan
| | - Hidetaka Nakai
- Department of Pediatrics, Toyokawa City Hospital, Toyokawa, Japan
| | - Kazuyoshi Saito
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Daijiro Suzuki
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
- Department of Pediatrics, Fujita Health University Okazaki Medical Center, Okazaki, Japan
| | - Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
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7
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Enya Y, Hiramatsu H, Ihira M, Suzuki R, Higashimoto Y, Funato Y, Kozawa K, Miura H, Miyata M, Kawamura Y, Ishihara T, Taniguchi K, Komoto S, Yoshikawa T. Similarities in rotavirus vaccine viral shedding and immune responses in pairs of twins. Fujita Med J 2023; 9:253-258. [PMID: 37554946 PMCID: PMC10405898 DOI: 10.20407/fmj.2022-039] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/14/2022] [Indexed: 08/10/2023]
Abstract
OBJECTIVES Intestinal rotavirus (RV) vaccine replication and host immune response are suggested to be affected by several factors, including maternal antibodies, breastfeeding history, and gut microbiome, which are thought to be similar in pairs of twins. The aim of this study was to determine whether viral shedding from the fecal RV vaccine strain Rotarix® (RV1) and IgG and IgA responses to RV show similarity in pairs of twins. METHODS Quantitative reverse transcription polymerase chain reaction specific to RV vaccine strain RV1 was used to monitor fecal RV1 viral shedding. RV IgG and IgA titers were measured using an in-house enzyme-linked immunosorbent assay. Fecal RV1 viral shedding and immune responses were compared between twins and singletons with mixed effects and fixed effects models. RESULTS A total of 347 stool and 54 blood samples were collected from four pairs of twins and twelve singletons during the observation period. Although the kinetics of fecal RV1 viral shedding and immune responses differed among vaccinated individuals, they appeared to be similar within twin pairs. RV shedding after the first dose (P=0.049) and RV IgG titers during the entire observation period (P=0.015) had a significantly better fit in the fixed effect model that assumed that twins have the same response versus the model that assumed that twins have a different response. CONCLUSIONS The similarity of RV vaccine viral replication in intestine and host immune responses in twin pairs was demonstrated using statistical analysis.
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Affiliation(s)
- Yasuko Enya
- Faculty of Clinical Engineering, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
| | - Hiroyuki Hiramatsu
- Department of Clinical Pharmacy, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Masaru Ihira
- Faculty of Clinical Science for Biological Monitoring, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
| | - Ryota Suzuki
- Department of Clinical Pharmacy, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Yuki Higashimoto
- Faculty of Cellular and Molecular Biology, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
| | - Yusuke Funato
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Kei Kozawa
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Masafumi Miyata
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Takuma Ishihara
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Gifu, Japan
| | - Koki Taniguchi
- Department of Virology and Parasitology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Satoshi Komoto
- Department of Virology and Parasitology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
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Suzuki T, Kono T, Satoshi H, Uchida H, Ota S, Tateya I, Yoshikawa T. Case report: A case of severe retropharyngeal edema after COVID-19 successfully treated with intravenous immunoglobulin. Front Pediatr 2023; 11:1198505. [PMID: 37534196 PMCID: PMC10391543 DOI: 10.3389/fped.2023.1198505] [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: 04/01/2023] [Accepted: 06/30/2023] [Indexed: 08/04/2023] Open
Abstract
Multisystem inflammatory syndrome in children (MIS-C) has been widely reported, mainly in Western countries. The clinical features of MIS-C and Kawasaki disease are similar. The latter is common in Asian countries, including Japan. Meanwhile, the incidence of MIS-C seems to be low in Japan. Retropharyngeal edema is relatively common in older patients with Kawasaki disease and has been reported in a few patients with MIS-C. We describe a case of severe retropharyngeal edema after coronavirus disease 2019 (COVID-19) that improved quickly with high-dose of intravenous immunoglobulin treatment. Onset of retropharyngeal edema was 3 weeks after COVID-19. The patient received appropriate intravenous antibiotics for 5 days, but his symptoms worsened. Therefore, we suspected that his retropharyngeal edema was caused by suspected MIS-C even though he did not have the typical clinical symptoms of suspected MIS-C such as gastrointestinal symptoms and shock. Retropharyngeal edema was refractory to antibiotic therapy but lessened quickly with high-dose immunoglobulin therapy, without other typical clinical manifestations of MIS-C, suggesting that early immunoglobulin therapy might prevent the progression of MIS-C.
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Affiliation(s)
- Takanori Suzuki
- Department of Pediatrics, School of Medicine, Fujita Health University, Aichi, Japan
| | - Toya Kono
- Department of Pediatrics, School of Medicine, Fujita Health University, Aichi, Japan
| | - Hisada Satoshi
- Department of Otorhinolaryngology, School of Medicine, Fujita Health University, Aichi, Japan
| | - Hidetoshi Uchida
- Department of Pediatrics, School of Medicine, Fujita Health University, Aichi, Japan
| | - Seiichiro Ota
- Department of Radiology, School of Medicine, Fujita Health University, Aichi, Japan
| | - Ichiro Tateya
- Department of Otorhinolaryngology, School of Medicine, Fujita Health University, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, School of Medicine, Fujita Health University, Aichi, Japan
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Kozawa K, Kawamura Y, Hattori F, Miura H, Higashimoto Y, Ihira M, Matsunaga M, Ota A, Yoshikawa T. Changes in trends of pediatric β- and γ-herpesvirus infections during the COVID-19 pandemic: A single-center observational study. J Med Virol 2023; 95:e28925. [PMID: 37409636 DOI: 10.1002/jmv.28925] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/16/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023]
Abstract
Nonpharmaceutical interventions (NPIs) to control COVID-19 have decreased the incidence of many pediatric infectious diseases. The epidemiology of β- and γ-herpesvirus infections might have been affected by NPIs. The aim of this study was to elucidate changes in trends in β- and γ-herpesvirus infections and complex febrile seizures (cFS) of viral etiology before and during the COVID-19 pandemic. Between April 2017 and March 2021, febrile children aged ≤5 years were enrolled. Detection of EBV, CMV, HHV-6B, and HHV-7 DNA in serum was performed using real-time PCR. The epidemiology of viral infections and cFS were compared between the prepandemic and pandemic periods. During the observation period, 1432 serum samples were collected. The mean number of febrile children decreased during the pandemic period, but the number of patients with HHV-6B infection increased from 35 (9.3% of all febrile children) per year before the pandemic to 43 (15.5%) during the pandemic. The change in the proportion of patients with primary HHV-6B infection was 6.50% (95% confidence interval [CI], 2.05%-11.3%; p = 0.0047). The mean number of patients with cFS decreased during the pandemic period, but the number of patients with HHV-6B-associated cFS was stable throughout the observation period. Therefore, the change in proportion of patients with cFS caused by primary HHV-6B infection was 49.5% (95% CI, 12.2%-60.5%; p = 0.0048). The disease burden of primary HHV-6B infection among patients in the emergency room remained unchanged, with a significant increase in the relative proportion after the COVID-19 pandemic began.
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Affiliation(s)
- Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Fumihiko Hattori
- Department of Pediatrics, Kariya Toyota General Hospital, Kariya, Aichi, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yuki Higashimoto
- Faculty of Cellular and Molecular Biology, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan
| | - Masaru Ihira
- Faculty of Clinical Science for Biological Monitoring, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan
| | - Masaaki Matsunaga
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Suzuki T, Kawai S, Morihana E, Kawabe S, Iwata N, Saito K, Yoshikawa T, Yasuda K. Association of steroid administration with larger coronary artery abnormalities in patients with Kawasaki disease. Cardiol Young 2023; 33:1112-1116. [PMID: 35833216 DOI: 10.1017/s1047951122002104] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We sought to elucidate the risk profiles of patients with Kawasaki disease who developed coronary artery abnormalities through a retrospective analysis with special reference to steroid treatment. Demographics of the patients were obtained from medical records, and characteristics of the coronary artery abnormalities were evaluated by echocardiography and coronary angiography, which included number, location, size, and length of coronary artery abnormalities (we evaluated by cardiac catheterisation with the American Heart Association classification with segments). We divided the patients into two groups based on steroid use and compared their characteristics and the complications of coronary artery abnormalities and cardiac events. A total of 29 patients were diagnosed with coronary artery abnormalities by echocardiography and coronary angiography during the study period (24 male; median age, 24 months [range: 2-84 months]). Eighteen patients were treated with aspirin and intravenous immunoglobulin (63%, non-steroid group), whereas 11 received aspirin and intravenous immunoglobulin plus steroids (37%, steroid group). No significant differences were found in the number and location of coronary artery abnormalities between the steroid and non-steroid groups. However, the size and number of segments for coronary artery abnormalities were significantly larger and shorter, respectively, in the steroid group (z-score: non-steroid group 6.3 versus steroid group 8.7; p < 0.01). The coronary artery abnormality segments under steroid use were also shorter (non-steroid group versus steroid group, two segments versus one segment; p = 0.02). Coronary artery abnormality size was larger in patients who used steroids than that of non-steroids. This study showed that steroid use significantly affected coronary artery abnormality size in patients with Kawasaki disease. However, cardiac complications from coronary artery abnormalities and cardiac events were comparable between the steroid and non-steroid groups. Further prospective, multicentre studies are needed to confirm these findings.
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Affiliation(s)
- Takanori Suzuki
- Department of Pediatric Cardiology, Aichi Children's Health and Medical Center, Aichi, Japan
- Department of Pediatrics, School of Medicine, Fujita Health University, Aichi, Japan
| | - Satoru Kawai
- Department of Pediatric Cardiology, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Eiji Morihana
- Department of Pediatric Cardiology, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Shinji Kawabe
- Department of Infectious Immunology, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Naomi Iwata
- Department of Infectious Immunology, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Kazuyoshi Saito
- Department of Pediatric Cardiology, Aichi Children's Health and Medical Center, Aichi, Japan
- Department of Pediatrics, School of Medicine, Fujita Health University, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, School of Medicine, Fujita Health University, Aichi, Japan
| | - Kazushi Yasuda
- Department of Pediatric Cardiology, Aichi Children's Health and Medical Center, Aichi, Japan
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11
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Tanaka M, Miura H, Ishimaru S, Furukawa G, Kawamura Y, Kozawa K, Yamada S, Ito F, Kudo K, Yoshikawa T. Future Perspective for ALK-Positive Anaplastic Large Cell Lymphoma with Initial Central Nervous System (CNS) Involvement: Could Next-Generation ALK Inhibitors Replace Brain Radiotherapy for the Prevention of Further CNS Relapse? Pediatr Rep 2023; 15:333-340. [PMID: 37368362 DOI: 10.3390/pediatric15020029] [Citation(s) in RCA: 2] [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: 02/26/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Central nervous system (CNS) involvement in anaplastic large cell lymphoma (ALCL) at diagnosis is rare and leads to poor prognosis with the use of the standard ALCL99 protocol alone. CNS-directed intensive chemotherapy, such as an increased dose of intravenous MTX, increased dose of dexamethasone, intensified intrathecal therapy, and high-dose cytarabine, followed by cranial irradiation, has been shown to improve survival in this population. In this paper, the authors describe a 14-year-old male with an intracranial ALCL mass at onset who received CNS-directed chemotherapy followed by 23.4 Gy of whole-brain irradiation. After the first systemic relapse, the CNS-penetrating ALK inhibitor, alectinib, was applied; it has successfully maintained remission for 18 months without any adverse events. CNS-penetrating ALK inhibitor therapy might prevent CNS relapse in pediatric ALK-positive ALCL. Next-generation ALK inhibitors could be introduced as a promising treatment option, even for primary ALCL with CNS involvement, which could lead to the omission of cranial irradiation and avoid radiation-induced sequalae. Further evidence of CNS-penetrating ALK inhibitor combined therapy for primary ALK-positive ALCL is warranted to reduce radiation-induced sequalae in future treatments.
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Affiliation(s)
- Makito Tanaka
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
| | - Soichiro Ishimaru
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
| | - Gen Furukawa
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
| | - Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
| | - Seiji Yamada
- Department of Diagnostic Pathology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan
| | - Fumitaka Ito
- Department of Radiation Oncology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan
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12
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Higashimoto Y, Ihira M, Kawamura Y, Inaba M, Shirato K, Suzuki T, Hasegawa H, Kageyama T, Doi Y, Hata T, Yoshikawa T. Dry loop-mediated isothermal amplification assay for detection of SARS-CoV-2 from clinical specimens. Fujita Med J 2023; 9:84-89. [PMID: 37234399 PMCID: PMC10206895 DOI: 10.20407/fmj.2022-003] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/15/2022] [Indexed: 05/28/2023]
Abstract
Objectives To establish a point-of-care test for coronavirus disease 2019 (COVID-19), we developed a dry loop-mediated isothermal amplification (LAMP) method to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA. Methods We carried out reverse transcription (RT)-LAMP using the Loopamp SARS-CoV-2 Detection kit (Eiken Chemical, Tokyo, Japan). The entire mixture, except for the primers, is dried and immobilized inside the tube lid. Results To determine the specificity of the kit, 22 viruses associated with respiratory infections, including SARS-CoV-2, were tested. The sensitivity of this assay, determined by either a real-time turbidity assay or colorimetric change of the reaction mixture, as evaluated by the naked eye or under illumination with ultraviolet light, was 10 copies/reaction. No LAMP product was detected in reactions performed with RNA from any pathogens other than SARS-CoV-2. After completing an initial validation analysis, we analyzed 24 nasopharyngeal swab specimens collected from patients suspected to have COVID-19. Of the 24 samples, 19 (79.2%) were determined by real-time RT-PCR analysis as being positive for SARS-CoV-2 RNA. Using the Loopamp SARS-CoV-2 Detection kit, we detected SARS-CoV-2 RNA in 15 (62.5%) of the 24 samples. Thus, the sensitivity, specificity, positive predictive value, and negative predictive values of the Loopamp 2019-CoV-2 detection reagent kit were 78.9%, 100%, 100%, and 55.6%, respectively. Conclusions The dry LAMP method for detecting SARS-CoV-2 RNA is fast and easy to use, and its reagents can be stored at 4°C, solving the cold chain problem; thus, it represents a promising tool for COVID-19 diagnosis in developing countries.
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Affiliation(s)
- Yuki Higashimoto
- Faculty of Medical Technology, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
| | - Masaru Ihira
- Faculty of Clinical Engineering, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Masato Inaba
- Department of Infectious Diseases, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Kazuya Shirato
- Department of Virology III, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Hideki Hasegawa
- Influenza Virus Research Center, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Tsutomu Kageyama
- Influenza Virus Research Center, National Institute of Infectious Diseases, Musashimurayama, Tokyo, Japan
| | - Yohei Doi
- Department of Infectious Diseases, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Tadayoshi Hata
- Faculty of Medical Technology, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
- Department of Clinical Laboratory, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
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13
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Funato Y, Higashimoto Y, Kawamura Y, Sakabe Y, Iwakura M, Ihira M, Shiogama K, Miyata M, Nishizawa H, Sekiya T, Fujii T, Kosugi I, Yoshikawa T. Retrospective immunohistochemical analysis of human cytomegalovirus infection in the placenta and its association with fetal growth restriction. Fujita Med J 2023; 9:90-94. [PMID: 37234388 PMCID: PMC10206905 DOI: 10.20407/fmj.2022-001] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/22/2022] [Indexed: 05/28/2023]
Abstract
Objectives Fetal human cytomegalovirus (HCMV) infection might be involved in fetal growth restriction (FGR). Maternal serostatus and the prevalence of congenital HCMV infection are affected by various factors, such as socioeconomic status and ethnicity. Therefore, the prevalence of congenital HCMV-related FGR should be examined in each region. Methods Seventy-eight cases of FGR with delivery between January 2012 and January 2017 at Fujita Health University Hospital were studied. Twenty-one non-FGR cases were also included as a control group. Placental sections obtained from the FGR and control cases were immunostained with two primary antibodies for detecting immediate early antigens. Results Nineteen placental samples from FGR cases with another etiology were excluded. Finally, 59 placental samples from FGR cases of unknown etiology were included in the pathological analysis. Four of 59 (6.8%) placental samples were positive for HCMV antigen. All four positive cases were stained with the M0854 antibody, and there were no positive case with the MAB810R antibody. Neither maternal nor infantile clinical features were different between the HCMV-positive and -negative FGR cases. A pathological examination showed a hematoma in three of four cases and infarction in two of four cases. Conclusions HCMV antigen was detected in 6.8% of placental samples obtained from FGR cases without an obvious etiology. No remarkable maternal or neonatal clinical features discriminated HCMV-related FGR from FGR due to other causes. Vasculitis and inflammation might play important roles in the pathogenesis of HCMV-related FGR.
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Affiliation(s)
- Yusuke Funato
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Yuki Higashimoto
- Faculty of Medical Technology, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Yoshiko Sakabe
- Department of Obstetrics and Gynecology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Minori Iwakura
- Faculty of Medical Technology, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
| | - Masaru Ihira
- Faculty of Clinical Engineering, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
| | - Kazuya Shiogama
- Faculty of Pathology, Fujita Health University, School of Medical Sciences, Toyoake, Aichi, Japan
| | - Masafumi Miyata
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Haruki Nishizawa
- Department of Obstetrics and Gynecology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Takao Sekiya
- Department of Obstetrics and Gynecology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Takuma Fujii
- Department of Obstetrics and Gynecology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Isao Kosugi
- Department of Regenerative and Infectious Pathology, Hamamatsu University, School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
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14
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Ishimaru S, Michihata N, Kawamura Y, Uda K, Matsui H, Fushimi K, Yasunaga H, Yoshikawa T. Trend in the Numbers of Hospitalized Patients With Varicella, Herpes Zoster, and Ischemic Stroke in Japanese Individuals <20 Years of Age Before and After Implementation of Universal Varicella Vaccination. Pediatr Infect Dis J 2023:00006454-990000000-00395. [PMID: 36996309 DOI: 10.1097/inf.0000000000003907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/01/2023]
Abstract
Several studies have shown an association between varicella-zoster virus infection and ischemic stroke. We analyzed the trends in the numbers of patients with varicella, herpes zoster and ischemic stroke before and after the universal vaccination program using a Japanese database of hospitalized patients. The number of patients with varicella decreased but those of herpes zoster and ischemic stroke did not change.
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Affiliation(s)
- Soichiro Ishimaru
- From the Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Nobuaki Michihata
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshiki Kawamura
- From the Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuaki Uda
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Tetsushi Yoshikawa
- From the Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
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15
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Hayashi K, Tanaka Y, Tsuda T, Nomura A, Fujino N, Furusho H, Sakai N, Iwata Y, Usui S, Sakata K, Kato T, Tada H, Kusayama T, Usuda K, Kawashiri MA, Passman RS, Wada T, Yamagishi M, Takamura M, Fujino N, Nohara A, Kawashiri MA, Hayashi K, Sakata K, Yoshimuta T, Konno T, Funada A, Tada H, Nakanishi C, Hodatsu A, Mori M, Tsuda T, Teramoto R, Nagata Y, Nomura A, Shimojima M, Yoshida S, Yoshida T, Hachiya S, Tamura Y, Kashihara Y, Kobayashi T, Shibayama J, Inaba S, Matsubara T, Yasuda T, Miwa K, Inoue M, Fujita T, Yakuta Y, Aburao T, Matsui T, Higashi K, Koga T, Hikishima K, Namura M, Horita Y, Ikeda M, Terai H, Gamou T, Tama N, Kimura R, Tsujimoto D, Nakahashi T, Ueda K, Ino H, Higashikata T, Kaneda T, Takata M, Yamamoto R, Yoshikawa T, Ohira M, Suematsu T, Tagawa S, Inoue T, Okada H, Kita Y, Fujita C, Ukawa N, Inoguchi Y, Ito Y, Araki T, Oe K, Minamoto M, Yokawa J, Tanaka Y, Mori K, Taguchi T, Kaku B, Katsuda S, Hirase H, Haraki T, Fujioka K, Terada K, Ichise T, Maekawa N, Higashi M, Okeie K, Kiyama M, Ota M, Todo Y, Aoyama T, Yamaguchi M, Noji Y, Mabuchi T, Yagi M, Niwa S, Takashima Y, Murai K, Nishikawa T, Mizuno S, Ohsato K, Misawa K, Kokado H, Michishita I, Iwaki T, Nozue T, Katoh H, Nakashima K, Ito S, Yamagishi M. Correction: Characterization of baseline clinical factors associated with incident worsening kidney function in patients with non-valvular atrial fibrillation: the Hokuriku-Plus AF Registry. Heart Vessels 2023; 38:412. [PMID: 36508013 DOI: 10.1007/s00380-022-02218-5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Yoshihiro Tanaka
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Toyonobu Tsuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Noboru Fujino
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hiroshi Furusho
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Department of Cardiology, Ishikawa Prefectural Central Hospital, 2-1, Kuratsuki-higashi, Kanazawa, Japan
| | - Norihiko Sakai
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Yasunori Iwata
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takeshi Kato
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takashi Kusayama
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Keisuke Usuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Rod S Passman
- Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Takashi Wada
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Masakazu Yamagishi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Osaka University of Human Sciences, Settsu, Osaka, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
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Katsuta T, Aizawa Y, Shoji K, Shimizu N, Okada K, Nakano T, Kamiya H, Amo K, Ishiwada N, Iwata S, Oshiro M, Okabe N, Korematsu S, Suga S, Tsugawa T, Nishimura N, Hishiki H, Fujioka M, Hosoya M, Mizuno Y, Miyairi I, Miyazaki C, Morishima T, Yoshikawa T, Wada T, Ouchi K, Moriuchi H, Tanaka-Taya K, Saitoh A. Acute and Postacute Clinical Characteristics of Coronavirus Disease 2019 in Children in Japan. Pediatr Infect Dis J 2023; 42:240-246. [PMID: 36730047 PMCID: PMC9935236 DOI: 10.1097/inf.0000000000003792] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND The clinical features of coronavirus disease 2019 (COVID-19) in children have been changing because of the emergence and rapid spread of variants of concern (VOC). The increase in cases infected with VOC has brought concern with persistent symptoms after COVID-19 in children. This survey aimed to analyze the clinical manifestations and persistent symptoms of pediatric COVID-19 cases in Japan. METHODS We analyzed the clinical manifestations of pediatric COVID-19 cases reported between February 2020 and April 2022 in Japan, using a dedicated database updated voluntarily by the members of the Japan Pediatric Society. Using the same database, we also analyzed persistent symptoms after COVID-19 in children who were diagnosed between February 2020 and November 2021. RESULTS A total of 5411 and 1697 pediatric COVID-19 cases were included for analyzing clinical manifestations and persistent symptoms, respectively. During the Omicron variant predominant period, the percentage of patients with seizures increased to 13.4% and 7.4% in patient groups 1-4 and 5-11 years of age, respectively, compared with the pre-Delta (1.3%, 0.4%) or Delta period (3.1%, 0.0%). Persistent and present symptoms after 28 days of COVID-19 onset were reported in 55 (3.2%). CONCLUSIONS Our survey showed that the rate of symptomatic pediatric COVID-19 cases increased gradually, especially during the Omicron variant predominant period, and a certain percentage of pediatric cases had persistent symptoms. Certain percentages of pediatric COVID-19 patients had severe complications or prolonged symptoms. Further studies are needed to follow such patients.
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Affiliation(s)
- Tomohiro Katsuta
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yuta Aizawa
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kensuke Shoji
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Naoki Shimizu
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kenji Okada
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Nakano
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
| | - Hajime Kamiya
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kiyoko Amo
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatric Emergency, Osaka City General Hospital, Osaka, Japan
| | - Naruhiko Ishiwada
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Infectious Diseases, Chiba University, Medical Mycology Research Center, Chiba, Japan
| | - Satoshi Iwata
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Makoto Oshiro
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Japanese Red Cross Nagoya First Hospital, Aichi, Japan
| | - Nobuhiko Okabe
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Kawasaki City Institute for Public Health, Kanagawa, Japan
| | - Seigo Korematsu
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Saitama Medical Center, Saitama, Japan
| | - Shigeru Suga
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Infectious Disease Center and Department of Clinical Research, National Hospital Organization Mie National Hospital, Mie, Japan
| | - Takeshi Tsugawa
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Naoko Nishimura
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Konan Kosei Hospital, Aichi, Japan
| | - Haruka Hishiki
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Masashi Fujioka
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Fujioka Pediatric Clinic, Osaka, Japan
| | - Mitsuaki Hosoya
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Yumi Mizuno
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatric infectious diseases and immunology, Fukuoka Children’s Hospital, Fukuoka, Japan
| | - Isao Miyairi
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Chiaki Miyazaki
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Fukuoka-city Social Welfare Agency, Fukuoka, Japan
| | - Tsuneo Morishima
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Aichi Medical University, Aichi, Japan
| | - Tetsushi Yoshikawa
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Fujita Health University School of Medicine, Aichi, Japan
| | - Taizo Wada
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Kanazawa University, Ishikawa, Japan
| | - Kazunobu Ouchi
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
| | - Hiroyuki Moriuchi
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Kanazawa University, Ishikawa, Japan
| | - Keiko Tanaka-Taya
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akihiko Saitoh
- From the The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Japan
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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17
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Higashimoto Y, Hattori F, Kawamura Y, Kozawa K, Hamano A, Kato M, Kato S, Hosokawa A, Enya Y, Ihira M, Yoshikawa T. Analysis of the reliability of rapid diagnostic tests for varicella, including breakthrough cases. J Med Virol 2023; 95:e28569. [PMID: 36762573 DOI: 10.1002/jmv.28569] [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: 11/24/2022] [Revised: 01/28/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023]
Abstract
In the era of universal varicella vaccination, diagnosis of varicella is challenging, especially for breakthrough cases. We sought to clarify the reliability of direct varicella-zoster virus (VZV) loop-mediated isothermal amplification (LAMP) and DermaQuick® VZV using the immunochromatography technique as rapid diagnostic tests for varicella. In addition, the usefulness of saliva as a sample type for direct LAMP was investigated. Among the 46 enrolled patients with suspected VZV infection, 31 patients (67.3%) were positive for the nucleic acid test based on real-time PCR from skin swab samples. Direct LAMP of skin swabs was positive in 29 (63.0%) of 46 patients. DermaQuick® VZV was positive in 25 (54.3%) of 46 patients. VZV DNA was detected in only 48.4% of oral swabs with the direct LAMP method. With real-time polymerase chain reaction (PCR) as the standard for diagnosing varicella, the sensitivity and specificity of DermaQuick® VZV were 80.7% and 100%, respectively. The sensitivity and specificity of direct LAMP from skin swabs were 93.6% and 100%, respectively. The sensitivity and specificity of real-time PCR for DNA extracted from oral swabs were 74.2% and 93.3%, respectively. Thus, oral swab samples are not suitable for breakthrough varicella diagnosis. Although DermaQuick® VZV is considered the most convenient point-of-care test for varicella, its sensitivity and specificity were lower than those of direct VZV LAMP.
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Affiliation(s)
- Yuki Higashimoto
- Department of Cellular and Molecular Biology, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Fumihiko Hattori
- Department of Pediatrics, Kariya Toyota General Hospital, Kariya, Aichi, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Aoi Hamano
- Department of Cellular and Molecular Biology, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Mizuki Kato
- Department of Cellular and Molecular Biology, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Sayaka Kato
- Department of Cellular and Molecular Biology, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Asuka Hosokawa
- Department of Cellular and Molecular Biology, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Yasuko Enya
- Department of Clinical Science for Biological Monitoring, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Masaru Ihira
- Department of Clinical Science for Biological Monitoring, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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18
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Akamatsu M, Kawamura Y, Miura H, Sugimoto E, Okamoto K, Nakajima Y, Kozawa K, Furukawa G, Tanaka M, Kudo K, Yoshikawa T. Systemic herpes simplex virus infection in a child with eczema herpeticum. Pediatr Dermatol 2023; 40:582-583. [PMID: 36682743 DOI: 10.1111/pde.15253] [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: 06/21/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023]
Abstract
Eczema herpeticum (EH) is a disseminated cutaneous infection with herpes simplex virus (HSV) that develops in patients with atopic dermatitis. The kinetics and clinical significance of HSV viremia in EH are poorly understood. Herein, we report HSV DNAemia in a child with EH 12 months after the completion of chemotherapy for Hodgkin lymphoma.
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Affiliation(s)
- Mami Akamatsu
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan.,Department of Pediatrics, Kariya Toyota General Hospital, Kariya, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan.,Department of Pediatrics, Fujita Health University Okazaki Medical Center, Okazaki, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan.,Department of Dermatology, School of Medicine, University of California Davis, Sacramento, USA
| | - Erina Sugimoto
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kaoru Okamoto
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yoichi Nakajima
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Gen Furukawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Makito Tanaka
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
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19
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Torii Y, Morioka I, Kakei Y, Fujioka K, Kakimoto Y, Takahashi N, Yoshikawa T, Moriuchi H, Oka A, Ito Y. Correlation of cytomegalovirus viral load between whole blood and plasma of congenital cytomegalovirus infection under valganciclovir treatment. BMC Infect Dis 2023; 23:31. [PMID: 36658533 PMCID: PMC9850601 DOI: 10.1186/s12879-023-07995-6] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection (cCMV) can cause sensorineural hearing loss and neurodevelopmental disabilities in children. Oral valganciclovir (VGCV) therapy has been reported to improve long-term audiological and neurodevelopmental outcomes in patients with cCMV. The levels of CMV DNA in whole blood have been monitored in previous studies. However, quantitative methods using whole blood have not been standardized. Recently, the plasma viral load has been standardized and widely used in CMV-associated diseases. METHODS CMV viral loads in whole blood and plasma were serially measured in 24 patients with a confirmatory diagnosis of cCMV during oral VGCV therapy using an in-house real-time PCR assay. Plasma samples were assayed using the Cobas 6800 system (Roche Diagnostics) in addition to an in-house assay. RESULTS Plasma CMV viral loads were remarkably decreased at the end of therapy compared to before therapy. A significant correlation of CMV levels between whole blood and plasma was observed (Spearman's ρ = 0.566). The levels of CMV DNA before therapy were significantly correlated with the period of decreasing the viral loads to below the detection limit, not only in whole blood (Spearman's ρ = 0.901) but also in plasma (Spearman, ρ = 0.804). Finally, CMV viral loads between the in-house assay and commercially available standardized assay in 75 plasma samples with positive PCR results for CMV were compared; a significant correlation was observed between the results of both assays. CONCLUSIONS There was a significant correlation between the two assays (Spearman, ρ = 0.882), suggesting that CMV plasma viral loads measured by the standardized assay are widely used to monitor the levels of CMV DNA in patients with cCMV during oral VGCV therapy.
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Affiliation(s)
- Yuka Torii
- grid.27476.300000 0001 0943 978XDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, 466-8550 Japan
| | - Ichiro Morioka
- grid.260969.20000 0001 2149 8846Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi, Kami-cho, Itabashi-ku, Tokyo, 173-8610 Japan
| | - Yasumasa Kakei
- grid.411102.70000 0004 0596 6533Clinical and Translational Research Center, Kobe University Hospital, Kobe, 650-0017 Japan
| | - Kazumichi Fujioka
- grid.31432.370000 0001 1092 3077Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, 650-0017 Japan
| | - Yu Kakimoto
- grid.26999.3d0000 0001 2151 536XDepartment of Pediatrics, The University of Tokyo, Tokyo, 113-8655 Japan
| | - Naoto Takahashi
- grid.26999.3d0000 0001 2151 536XDepartment of Pediatrics, The University of Tokyo, Tokyo, 113-8655 Japan
| | - Tetsushi Yoshikawa
- grid.256115.40000 0004 1761 798XDepartment of Pediatrics, Fujita Health University School of Medicine, Toyoake, 470-1192 Japan
| | - Hiroyuki Moriuchi
- grid.174567.60000 0000 8902 2273Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501 Japan
| | - Akira Oka
- grid.26999.3d0000 0001 2151 536XDepartment of Pediatrics, The University of Tokyo, Tokyo, 113-8655 Japan ,Saitama Prefectural Children’s Medical Center, Saitama, 330-8777 Japan
| | - Yoshinori Ito
- grid.27476.300000 0001 0943 978XDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, 466-8550 Japan ,grid.260969.20000 0001 2149 8846Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi, Kami-cho, Itabashi-ku, Tokyo, 173-8610 Japan
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20
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Nakao H, Nomura O, Yoshihara S, Yoshikawa T, Ishiguro A. Association between residents' scholarly activities and publication requirement policy. Pediatr Int 2023; 65:e15685. [PMID: 37968888 DOI: 10.1111/ped.15685] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/03/2023] [Accepted: 09/15/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Scholarship is recognized as important in residency training worldwide. The Japan Pediatric Society (JPS) enacted a reform in 2017 to require publication of an article as a prerequisite for taking the board certification test, with the goal of increasing scholarly activity. METHODS The purpose of this study was to provide a detailed description of the trends in residents' scholarly activities related to the JPS reform. A secondary analysis was performed on the cross-sectional database of pediatrics residents who took the certification test in 2015-2018. RESULTS The enrolled participants were 2399 residents of which 79.7% passed the test. Publication of any type of article increased significantly (21%-22% to 100%; 0.1 to 0.3/person-year) after the implementation of the JPS reform, whereas academic presentations did not (89% to 91%; 1.2 to 1.3/person-year), both in terms of the percentage of the number of those who created them and the average rate of research production. Not only Japanese articles (11%-13% to 49%-53%; 0.04 to 0.15-0.17/person-year) or case reports (10%-14% to 51%-52%; 0.03-0.05 to 0.16-0.17/person-year), but also English articles (4%-5% to 15%-16%; 0.01-0.02 to 0.05/person-year) and original articles (5% to 11%-17%; 0.01 to 0.03-0.05/person-year) increased significantly. The number of each type of article publication was correlated with success in the board certification test (odds ratio 1.5-1.8). CONCLUSIONS Scholarly activities of pediatrics residents were enhanced by the JPS implementation of the article requirement policy, which is crucial to fostering a scholarly culture. The most efficient measures to promote scholarship need to be persistently investigated.
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Affiliation(s)
- Hiro Nakao
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
- Department of General Pediatrics & Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Osamu Nomura
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
- Department of Health Sciences Education, Hirosaki University, Hirosaki, Japan
| | - Shigemi Yoshihara
- Department of Pediatrics, Dokkyo Medical University, Mibu, Shimotsugagun, Japan
| | | | - Akira Ishiguro
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
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21
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Numaguchi A, Ishii A, Natsume J, Saitoh S, Aoki Y, Yoshikawa T, Isobe I, Okumura A, Seno H, Takahashi Y. Medical records as screening tools for child death review in Japan. Pediatr Int 2023; 65:e15692. [PMID: 37991171 DOI: 10.1111/ped.15692] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/01/2023] [Accepted: 09/21/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Although many child death review (CDR) systems have been developed in Japan, the optimal system is still being identified. The aim of this study is to identify the etiologies of child deaths and to propose a screening method for initiating the CDR process in Japan. METHODS Clinical medical records (CMRs) in hospitals and autopsy records were surveyed for cases of deaths of children aged less than 15 years between 2014 and 2016 in Aichi Prefecture, Japan. The data were analyzed in three steps, and the findings were compared with the vital statistics. RESULTS Of the 695 children whose death certificates were submitted to Aichi Prefecture, 590 could be traced to pediatric care hospitals. The distribution of causes of death was slightly different from the vital statistics, with 11.5% dying of extrinsic causes and 19.7% dying of unknown causes. Maltreatment was suspected in 64 cases, which was much higher than that in government statistics. Overall, 158 (26.8%) deaths were considered preventable. The number of unnatural deaths, which might be screened in, was calculated as 172 (29.2%) in the vital statistics, whereas the survey of CMRs revealed that 241 (40.8%) to 282 (47.8%) should be screened in. CONCLUSIONS Surveying CMRs in hospitals may be a suitable method to detect and screen deaths to start the CDR process in Japan.
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Affiliation(s)
- Atsushi Numaguchi
- Department of Emergency and Intensive Care Medicine, Nagoya University Hospital, Nagoya, Japan
- Department of Pediatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Akira Ishii
- Department of Legal Medicine and Bioethics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Jun Natsume
- Department of Pediatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Department of Developmental Disability Medicine, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Graduate School of Medical Science, Nagoya City University, Nagoya, Japan
| | - Yasuhiro Aoki
- Department of Forensic Medicine, Graduate School of Medical Science, Nagoya City University, Nagoya, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Graduate School of Medicine, Fujita Medical University, Toyoake, Japan
| | - Ichiro Isobe
- Department of Legal Medicine, Graduate School of Medicine, Fujita Medical University, Toyoake, Japan
| | - Akihisa Okumura
- Department of Pediatrics, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Hiroshi Seno
- Department of Legal Medicine, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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22
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Yokoi K, Nakajima Y, Takahashi Y, Hamajima T, Tajima G, Saito K, Miyai S, Inagaki H, Yoshikawa T, Kurahashi H, Ito T. Transport and Golgi organization 2 deficiency with a prominent elevation of C14:1 during a metabolic crisis: A case report. JIMD Rep 2023; 64:3-9. [PMID: 36636595 PMCID: PMC9830013 DOI: 10.1002/jmd2.12275] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 01/16/2023] Open
Abstract
Mutations in transport and Golgi organization 2 homolog (TANGO2) have recently been described as a cause of an autosomal recessive syndrome characterized by episodes of metabolic crisis associated with rhabdomyolysis, cardiac arrhythmias, and neurodegeneration. Herein, we report a case of a one-and-a-half-year-old Japanese girl, born to nonconsanguineous parents, who presented with metabolic crisis characterized by hypoglycemia with hypoketonemia, rhabdomyolysis, lactic acidosis, and prolonged corrected QT interval (QTc) at the age of 6 months. Acylcarnitine analysis during the episode of crisis showed prominent elevation of C14:1, suggesting very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency. In addition, worsening rhabdomyolysis was observed after intravenous administration of L-carnitine. VLCAD deficiency was initially suspected; however, the enzyme activity in lymphocytes was only mildly decreased at the gene carrier level, and no mutation in the VLCAD gene (ADADVL) was detected. Subsequently, acylcarnitine analysis was nonspecific at 17-h fasting and almost normal during the stable phase. Eventually, a trio whole-exome sequencing revealed a compound heterozygous variant of two novel variants in the TANGO2 gene, a missense variant, and a deletion of exon 7. This is the first case of TANGO2 deficiency in Asians. Our case suggests that elevated C14:1 may be seen in severe metabolic crises and that the use of L-carnitine should be avoided during metabolic crises.
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Affiliation(s)
- Katsuyuki Yokoi
- Department of PediatricsFujita Health University School of MedicineToyoakeJapan
- Division of Molecular GeneticsInstitute for Comprehensive Medical Science, Fujita Health UniversityToyoakeJapan
| | - Yoko Nakajima
- Department of PediatricsFujita Health University School of MedicineToyoakeJapan
| | - Yoshihisa Takahashi
- Department of Endocrinology and MetabolismAichi Children's Health and Medical CenterOhbuJapan
| | - Takashi Hamajima
- Department of Endocrinology and MetabolismAichi Children's Health and Medical CenterOhbuJapan
| | - Go Tajima
- Division of Neonatal ScreeningResearch Institute, National Center for Child Health and DevelopmentTokyoJapan
| | - Kazuyoshi Saito
- Department of PediatricsFujita Health University School of MedicineToyoakeJapan
| | - Shunsuke Miyai
- Division of Molecular GeneticsInstitute for Comprehensive Medical Science, Fujita Health UniversityToyoakeJapan
| | - Hidehito Inagaki
- Division of Molecular GeneticsInstitute for Comprehensive Medical Science, Fujita Health UniversityToyoakeJapan
| | - Tetsushi Yoshikawa
- Department of PediatricsFujita Health University School of MedicineToyoakeJapan
| | - Hiroki Kurahashi
- Division of Molecular GeneticsInstitute for Comprehensive Medical Science, Fujita Health UniversityToyoakeJapan
| | - Tetsuya Ito
- Department of PediatricsFujita Health University School of MedicineToyoakeJapan
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23
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Kozawa K, Higashimoto Y, Kawamura Y, Miura H, Negishi T, Hattori F, Ihira M, Komoto S, Taniguchi K, Yoshikawa T. Rotavirus genotypes and clinical outcome of natural infection based on vaccination status in the post-vaccine era. Hum Vaccin Immunother 2022; 18:2037983. [PMID: 35240934 PMCID: PMC9009920 DOI: 10.1080/21645515.2022.2037983] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Rotavirus (RV) is a leading cause of gastroenteritis in children. In Japan, Rotarix (RV1; GlaxoSmithKline), which is a monovalent vaccine derived from human RV (G1P[8]), has been introduced since November 2011, and RotaTeq (RV5; MSD) which is an pentavalent, human-bovine mono-reassortant vaccine (G1, G2, G3, G4, and P1A[8]), has been introduced since July 2012. Long-term follow-up on vaccine efficacy and RV genotypical change should be carried out in order to control RV infection. The RV gastroenteritis (RVGE) outbreak occurred during the 2018/2019 season in Aichi prefecture, Japan. Therefore, the molecular epidemiology of RV among three different groups of RVGE, which were outpatients who received RV1, those who received RV5, and those without vaccination, was explored. Clinical features of RVGE patients were compared among the three patient groups. Children less than 15 years of age with gastroenteritis who visited any of seven pediatric practices between January and June 2019 were enrolled in the study. G, P, and E genotypes were determined by direct sequencing of reverse transcription-polymerase chain reaction products amplified from stool samples. Among 110 patients, there were 27, 28, and 55 in the RV1-vaccinated, RV5-vaccinated, and unvaccinated groups, respectively. The most frequent genotype was G8P[8] (92/110 patients, 83.6%). Genotype distributions did not significantly differ among the three patient groups (P = .125). Mean Vesikari score was significantly lower among RV1-vaccinated (7.1) and RV5-vaccinated patients (6.4) than among unvaccinated patients (10.2) (P < .001). Even in RVGE patients treated in an outpatient clinic, RV vaccine reduced the severity of the disease in this cohort.
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Affiliation(s)
- Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yuki Higashimoto
- Faculty of Medical Technology, Fujita Health University School of Health Sciences, Toyoake, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Takumi Negishi
- Department of Clinical Laboratory, Fujita Health University Hospital, Toyoake, Japan
| | - Fumihiko Hattori
- Department of Pediatrics, Kariya Toyota General Hospital, Kariya, Japan
| | - Masaru Ihira
- Faculty of Clinical Engineering, Fujita Health University School of Medical Sciences, Toyoake, Japan
| | - Satoshi Komoto
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Koki Taniguchi
- Department of Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
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24
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Higashimoto Y, Hattori F, Kawamura Y, Kozawa K, Enya Y, Ihira M, Yoshikawa T. 372. Analysis of the reliability of rapid diagnostic tests for varicella patients, including breakthrough cases. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
In the era of universal varicella vaccination, diagnosis of varicella is challenging, especially for breakthrough cases. We sought to clarify the reliability of direct varicella-zoster virus (VZV) loop-mediated isothermal amplification (LAMP) and DermaQuick® VZV using the immunochromatography technique as rapid diagnostic tests for varicella. In addition, the usefulness of saliva as a sample type for direct LAMP was also investigated.
Methods
Between April 2019 and January 2021, 46 patients suspected VZV infection were enrolled in this study. Written informed consent was obtained from the parents of all participants. This study was approved by the institutional review board of Fujita Health University (No. 15–247). Samples were collected from skin eruptions using two different swabs. one swab which was soaked in 1 mL of isotonic saline was used for direct VZV LAMP and the other swab which was immersed in 500 µL of DermaQuick® VZV reaction buffer was used for DermaQuick® VZV. The isotonic saline solution used to wash the oral swab sample was used for direct VZV LAMP. The DNA extracted from the solutions were used for real-time PCR analysis.
Results
Thirty one patients (67.3%) were diagnosed with varicella based on real-time PCR of skin swabs. Direct LAMP of skin swabs was positive in 29 (63.0%) of 46 patients. DermaQuick® VZV was positive in 25 (54.3%) of 46 patients. The sensitivity for direct LAMP of skin swabs, DermaQuick® VZV, direct LAMP of oral swabs, and real-time PCR of oral swabs was 93.6% (95% confidence interval [CI], 79.3–98.9%), 80.7% (95% CI, 63.7–90.8%), 48.3% (95% CI, 32.0–65.1%), and 74.2% (95% CI, 56.8–86.3%), respectively. The sensitivity and specificity of real-time PCR for DNA extracted from oral swabs was 74.2% (95% CI, 56.8–86.3%) and 93.3% (95% CI, 79.8–99.7%), respectively.
Conclusion
Although DermaQuick® VZV is the most convenient point-of-care test for varicella, the sensitivity and specificity of this method were slightly lower than those of direct VZV LAMP.
Disclosures
All Authors: No reported disclosures.
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Affiliation(s)
- Yuki Higashimoto
- Fujita Health University school of Medical Sciences , Toyoake, Aichi , Japan
| | | | - Yoshiki Kawamura
- Fujita Health University Okazaki Medical Center , Okazaki, Aichi , Japan
| | - Kei Kozawa
- Fujita Health University School of Medicine , Toyoake, Aichi , Japan
| | - Yasuko Enya
- Fujita Health University , Toyoake, Aichi , Japan
| | - Masaru Ihira
- Fujita Health University School of Medical Sciences , Toyoake, Aichi , Japan
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Kawamura Y, Komoto S, Fukuda S, Kugita M, Tang S, Pieknik J, Enya Y, Ihira M, Nagao S, Krause P, Taniguchi K, Yoshikawa T. 2136. Development of Recombinant Rotavirus Vaccine Carrying Herpes Simplex Virus 2 Gene Based on Reverse Genetics Technology. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.1756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
Herpes simplex virus type 2 (HSV-2) can cause genital herpes, which reduces the patient's QOL associated with pain. In addition, genital herpes can increase the risk of human immunodeficiency virus infection. Vaccine development has been attempted for many years, but it has not yet been put into practical use. Meanwhile, rotavirus (RV) is one of the major viral causes of severe gastroenteritis in infants and young children worldwide. Currently, two live attenuated vaccines are widely used to prevent severe RV infection in children. We have developed entirely plasmid-based reverse genetics systems of RV, which allowed the generation of recombinant reassortant RV containing a foreign gene.
In this study, we sought to develop simian RV (SA11), in which HSV-2 glycoprotein D (gD2) gene was inserted by reverse genetics system, as a herpes vaccine, and evaluated its immunogenicity in mice.
Construction of HSV-2 protein expressing rotavirus as a vaccine inducing mucosal immunity
Methods
Artificially synthesized gD2 DNA fragment was inserted into T7 expression NSP1 plasmids (pT7/NSP1-gD2). Using the plasmid, recombinant SA11-gD2 virus (rSA11-gD2) was generated. gD2 protein expression in infected MA104 cells was verified by Western blotting. rSA11-gD2 was orally inoculated into BALB/c suckling mice twice two weeks apart and into eight-week-old mice three times apart four weeks. Diarrhea score was evaluated for seven days after first inoculation in suckling mice. Serum IgG and IgA titers against RV and gD2 were measured by ELISA.
Results
Insertion of the gD2 gene and synthesis of gD2 protein were demonstrated by sequence analysis and Wester blotting analysis, respectively. Diarrhea occurred after the first inoculation of rSA11-gD2 in suckling mice. Although IgG and IgA antibodies against RV were induced, gD2 antibody was not detected in convalescent sera in the suckling mice. Meanwhile, in the eight-week-old mice inoculated with three times of rSA11-gD2, significant increases in not only IgG and IgA against RV but also IgG against gD2 were demonstrated.
Conclusion
Simian RV containing gD2 gene, which was developed by the reverse genetics, induced IgG antibody against gD2 in orally inoculated mice. This strategy can be used to develop genital herpes vaccine.
Disclosures
All Authors: No reported disclosures.
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Affiliation(s)
- Yoshiki Kawamura
- Fujita Health University Okazaki Medical Center , Okazaki, Aichi , Japan
| | - Satoshi Komoto
- Fujita Health University School of Medicine , Toyoake, Aichi , Japan
| | - Saori Fukuda
- Fujita Health University School of Medicine , Toyoake, Aichi , Japan
| | - Masanori Kugita
- Fujita Health University School of Medicine , Toyoake, Aichi , Japan
| | - Shuang Tang
- Food and drug administration , Silver Spring, Maryland
| | | | - Yasuko Enya
- Fujita Health University , Toyoake, Aichi , Japan
| | - Masaru Ihira
- Fujita Health University School of Medical Sciences , Toyoake, Aichi , Japan
| | - Shizuko Nagao
- Fujita Health University School of Medicine , Toyoake, Aichi , Japan
| | | | - Koki Taniguchi
- Fujita Health University School of Medicine , Toyoake, Aichi , Japan
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Manabe M, Fujino M, Kusuki H, Sadanaga T, Hata T, Bouda H, Miyata M, Yoshikawa T. Effect of Hypothermia on Myocardial Depolarization and Repolarization in Neonates with Hypoxic-Ischemic Encephalopathy Due to Asphyxia. Pediatr Cardiol 2022; 43:1792-1798. [PMID: 35670814 DOI: 10.1007/s00246-022-02916-x] [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: 12/31/2021] [Accepted: 04/15/2022] [Indexed: 11/24/2022]
Abstract
Therapeutic hypothermia (TH) is effective for neonatal hypoxic-ischemic encephalopathy (HIE). The combination of abnormal myocardial repolarization and fatal arrhythmia in patients with accidental hypothermia has prompted clinical validation of the proarrhythmic potential of TH. However, to our knowledge, there have been few clinical studies on myocardial depolarization and repolarization abnormalities caused by TH in neonates. Therefore, we investigated the effects of TH on neonatal myocardial depolarization and repolarization by capturing the waveform changes in electrocardiograms (ECGs) associated with body temperature (BT) before and after TH. We included three neonates with HIE diagnosed at birth who were treated with TH in our hospital. The heart rate, RR interval, P wave duration, PR interval, QRS duration, QT interval, corrected QT (QTc) interval by Fridericia's formula, J point-T end (JT) interval, corrected JT (JTc) interval by Fridericia's formula, T peak-T end (Tpe) interval, Tpe/QT, and QRS/QTc were calculated retrospectively using an ECG. The correlations of ECG parameters recorded concurrently with 33 samples in which BT measurements were confirmed were performed. BT and heart rate were positively correlated (R: 0.589, p = 0.0003). BT was negatively correlated with Tpe/QT (R: - 0.470, p = 0.0058), the QTc interval (R: - 0.680, p < 0.0001), and the corrected JT interval (R: - 0.697, p < 0.0001). TH does not affect atrial or ventricular depolarization but prolongs the ventricular repolarization process in a temperature-dependent manner.
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Affiliation(s)
- Masahiko Manabe
- Department of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Masayuki Fujino
- Department of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Hirofumi Kusuki
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan
| | | | - Tadayoshi Hata
- Department of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan. .,Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan.
| | - Hiroko Bouda
- Department of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Masafumi Miyata
- Department of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
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Higashimoto Y, Kozawa K, Miura H, Kawamura Y, Ihira M, Hiramatsu H, Suzuki R, Haga K, Takai-Todaka R, Sawada A, Katayama K, Yoshikawa T. Correlation between anti-S IgG and neutralizing antibody titers against three live SARS-CoV-2 variants in BNT162b2 vaccine recipients. Hum Vaccin Immunother 2022; 18:2105611. [PMID: 36094467 DOI: 10.1080/21645515.2022.2105611] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We analyzed serially collected serum samples from healthy adults who underwent BNT162b2 vaccination to elucidate the association between spike (S)-IgG antibody titers determined by ELISA using the WHO international standard (NIBSC code 20/136) and neutralizing antibody titers against three live SARS-CoV-2 variants. This study included 53 health care workers who received two doses of the BNT162b2 vaccine. S-IgG and nucleocapsid (N)-IgG antibody titers were measured by ELISA. Neutralizing (NT) antibody responses against three variants (Wuhan D614 G: KUH003, Alpha, and Delta) were evaluated before and after the first and second vaccination. N-IgG were not detected in any serum samples. S-IgG antibody titers remarkably increased after two BNT162b2 vaccine doses in all participants. S-IgG antibody titers were strongly correlated with NT titers against three variants of live viruses: KUH003 (r = 0.86), Alpha (r = 0.72), and Delta (r = 0.84). Serum samples from participants after one dose of BNT162b2 neutralized Alpha efficiently (median titer, 113.0), but median NT titers against KUH003 and Delta variants were lower, 57.0 and 28.0, respectively (p < .01). Two doses of the BNT162b2 vaccine elicited a strong immune response in this study. The second dose was required for induction of a strong booster effect. Serum collected from BNT162b2 vaccine recipients contained significantly lower neutralizing activity against Delta than that of against KUH003 (p < .0001) and Alpha (p < .0001). If a new variant emerges, live virus-based NT titers should be examined in serum obtained from vaccine recipients to evaluate vaccine efficacy for protection against infection.
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Affiliation(s)
- Yuki Higashimoto
- Faculty of Medical Technology, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Masaru Ihira
- Faculty of Clinical Engineering, Fujita Health University School of Medical Sciences, Toyoake, Aichi, Japan
| | - Hiroyuki Hiramatsu
- Department of Clinical Pharmacy, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Ryota Suzuki
- Department of Clinical Pharmacy, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Kei Haga
- Laboratory of Viral Infection Control, Department of Infection Control Science and Immunology, Ōmura Satoshi Memorial Institute & Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Reiko Takai-Todaka
- Laboratory of Viral Infection Control, Department of Infection Control Science and Immunology, Ōmura Satoshi Memorial Institute & Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Akihito Sawada
- Laboratory of Viral Infection Control, Department of Infection Control Science and Immunology, Ōmura Satoshi Memorial Institute & Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Kazuhiko Katayama
- Laboratory of Viral Infection Control, Department of Infection Control Science and Immunology, Ōmura Satoshi Memorial Institute & Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Shimohama S, Iizuka T, Takizawa T, Watanabe N, Tezuka T, Matsuda K, Yamanoi K, Kanazawa N, Kawamura Y, Yoshikawa T, Suzuki T, Takao M, Nakahara J, Izawa Y. Anti‐N‐methyl‐D‐aspartate receptor encephalitis with concurrent human herpes virus‐6A deoxyribonucleic acid detection: An autopsy case. Neuropathology 2022. [DOI: 10.1111/neup.12881] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Sho Shimohama
- Department of Neurology Keio University School of Medicine Tokyo Japan
| | - Takahiro Iizuka
- Department of Neurology Kitasato University School of Medicine Sagamihara Japan
| | - Tsubasa Takizawa
- Department of Neurology Keio University School of Medicine Tokyo Japan
| | - Narumi Watanabe
- Department of Neurology Keio University School of Medicine Tokyo Japan
| | - Toshiki Tezuka
- Department of Neurology Keio University School of Medicine Tokyo Japan
| | - Kosuke Matsuda
- Department of Pathology Keio University School of Medicine Tokyo Japan
| | - Kazuhiro Yamanoi
- Department of Pathology Keio University School of Medicine Tokyo Japan
| | - Naomi Kanazawa
- Department of Neurology Kitasato University School of Medicine Sagamihara Japan
| | - Yoshiki Kawamura
- Department of Pediatrics Fujita Health University School of Medicine Toyoake Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics Fujita Health University School of Medicine Toyoake Japan
| | - Tadaki Suzuki
- Department of Pathology National Institute of Infectious Diseases Tokyo Japan
| | - Masaki Takao
- Department of Clinical Laboratory National Center of Neurology and Psychiatry (NCNP) National Center Hospital Kodaira Japan
| | - Jin Nakahara
- Department of Neurology Keio University School of Medicine Tokyo Japan
| | - Yoshikane Izawa
- Department of Neurology Keio University School of Medicine Tokyo Japan
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29
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Ito M, Maeda D, Matsue Y, Shiraishi Y, Dotare T, Sunayama T, Nogi K, Kohsaka S, Yoshikawa T, Saito Y, Minamino T. Increasing the class of foundational medication for heart failure is associated with improved prognosis in hospitalized patients with heart failure with reduced or mildly reduced ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/13/2022] Open
Abstract
Abstract
Aim
To clarify the association between changes in the number of foundational medications for heart failure (FMHF) during hospitalization for worsening heart failure and post-discharge prognosis.
Methods and results
We retrospectively analyzed a combined dataset of three large-scale registries of hospitalized patients with heart failure in Japan (NARA-HF, WET-HF, and REALITY-AHF) and included patients already diagnosed with heart failure with reduced or mildly reduced left ventricular ejection fraction (HFr/mrEF) before admission. Patients were stratified by changes in the number of prescribed FMHF classes, namely angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta blockers, and mineralocorticoid receptor blockers, from admission to discharge. The primary endpoint was defined as the combined endpoint of heart failure rehospitalization and all-cause death within 1-year of discharge. The cohort consisted of 1,113 patients, and 482 combined endpoints were observed. In total, 413 (37.1%) patients were on increased FMHF (increased group), 607 (54.5%) remained unchanged (unchanged group), and 93 (8.4%) had a decreased number of FMHF (decreased group) at discharge compared to the time of admission. In multivariable analysis, the increased group was associated with a significantly lower incidence of the primary endpoint compared with the unchanged group (hazard ratio 0.56, 95% confidence interval 0.45–0.60; P<0.001) and decreased group (hazard ratio 0.58, 95% confidence interval 0.40–0.84; P=0.004).
Conclusion
Increasing the number of FMHF cases during heart failure hospitalization is associated with a better prognosis in patients with HFr/mrEF.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): REALITY registry was funded by the Cardiovascular Research Fund of Japan.WET-HF registry was supported by a Grant-in-Aid for Young Scientists (Y.S. JSPS KAKENHI, 18K15860).
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Affiliation(s)
- M Ito
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - D Maeda
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - Y Matsue
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - Y Shiraishi
- Keio University School of Medicine, Division of Cardiology, Department of Medicine , Tokyo , Japan
| | - T Dotare
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - T Sunayama
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - K Nogi
- Nara Medical University, Department of Cardiovascular Medicine , Nara , Japan
| | - S Kohsaka
- Keio University School of Medicine, Division of Cardiology, Department of Medicine , Tokyo , Japan
| | - T Yoshikawa
- Sakakibara Heart Institute, Department of Cardiology , Tokyo , Japan
| | - Y Saito
- Nara Medical University, Department of Cardiovascular Medicine , Nara , Japan
| | - T Minamino
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
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30
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Matsumura K, Muto J, Tanaka M, Joko M, Yoshikawa T, Hirose Y. Usefulness of three-dimensional computed tomography venography differentiating calvarium subperiosteal hematoma crossing the suture lines due to hair pulling from subgaleal hematoma: case report and review of the literature. Childs Nerv Syst 2022; 38:2017-2020. [PMID: 35380260 DOI: 10.1007/s00381-022-05517-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022]
Abstract
This case showed a 13-year-old boy presented with calvarium subperiosteal hematoma crossing the suture lines caused by hair pulling, and 3D-CTV can differentiate calvarium subperiosteal hematoma crossing the suture lines from subgaleal hematoma. He was treated successfully.
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Affiliation(s)
- Kazuyasu Matsumura
- Department of Neurosurgery, Fujita Health University, Toyoake City, 1-98 Dengakugakubo, Kutsukake, Aichi, Japan
| | - Jun Muto
- Department of Neurosurgery, Fujita Health University, Toyoake City, 1-98 Dengakugakubo, Kutsukake, Aichi, Japan.
| | - Makito Tanaka
- Department of Pediatrics, Fujita Health University, Aichi, Japan
| | - Masahiro Joko
- Department of Neurosurgery, Fujita Health University, Toyoake City, 1-98 Dengakugakubo, Kutsukake, Aichi, Japan
| | | | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University, Toyoake City, 1-98 Dengakugakubo, Kutsukake, Aichi, Japan
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31
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Yokoi K, Nakajima Y, Sudo Y, Mariya T, Kawamura R, Tsutsumi M, Inagaki H, Yoshikawa T, Ito T, Kurahashi H. Maple syrup urine disease due to a paracentric inversion of chr 19 that disrupts
BCKDHA
: A case report. JIMD Rep 2022; 63:575-580. [PMID: 36341163 PMCID: PMC9626657 DOI: 10.1002/jmd2.12333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 11/12/2022] Open
Abstract
Maple syrup urine disease (MSUD) is a rare autosomal recessive inherited disorder of branched‐chain amino acid metabolism caused by mutations in BCKDHA, BCKDHB, and DBT that encode the E1α, E1β, and E2 subunits of the branched‐chain α‐ketoacid dehydrogenase (BCKD) complex. Various MSUD‐causing variants have been described; however, no structural rearrangements in BCKDHA have been reported to cause the classic MSUD phenotype. Here, we describe the classic patient with MSUD with compound heterozygous pathogenic variants in BCKDHA: a missense variant (NM_000709.3:c.757G > A, NP_000700.1:p.Ala253Thr) and a paracentric inversion disrupting Intron 1 of BCKDHA, which was identified by whole‐genome sequencing and validated by fluorescence in situ hybridization. Using the sequence information of the breakpoint junction, we gained mechanistic insight into the development of this structural rearrangement. Furthermore, the establishment of junction‐specific polymerase chain reaction could facilitate identification of the variant in case carrier or future prenatal/preimplantation tests are necessary.
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Affiliation(s)
- Katsuyuki Yokoi
- Department of Pediatrics Fujita Health University School of Medicine Toyoake Japan
- Division of Molecular Genetics Institute for Comprehensive Medical Science, Fujita Health University Toyoake Japan
| | - Yoko Nakajima
- Department of Pediatrics Fujita Health University School of Medicine Toyoake Japan
| | - Yuta Sudo
- Department of Pediatrics Fujita Health University School of Medicine Toyoake Japan
| | - Tasuku Mariya
- Department of Obstetrics and Gynecology Sapporo Medical University School of Medicine Sapporo Japan
| | - Rie Kawamura
- Division of Molecular Genetics Institute for Comprehensive Medical Science, Fujita Health University Toyoake Japan
| | - Makiko Tsutsumi
- Division of Molecular Genetics Institute for Comprehensive Medical Science, Fujita Health University Toyoake Japan
| | - Hidehito Inagaki
- Division of Molecular Genetics Institute for Comprehensive Medical Science, Fujita Health University Toyoake Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics Fujita Health University School of Medicine Toyoake Japan
| | - Tetsuya Ito
- Department of Pediatrics Fujita Health University School of Medicine Toyoake Japan
| | - Hiroki Kurahashi
- Division of Molecular Genetics Institute for Comprehensive Medical Science, Fujita Health University Toyoake Japan
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32
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Kawamura Y, Maesawa S, Numoto S, Saito R, Yoshikawa T, Okumura A. Human herpesvirus 6 DNA was not detected in a brain specimen from a patient with mesial temporal sclerosis after status epilepticus due to human herpesvirus 6 infection. Epilepsia Open 2022; 7:817-821. [PMID: 35916714 PMCID: PMC9712467 DOI: 10.1002/epi4.12634] [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: 05/17/2022] [Accepted: 07/28/2022] [Indexed: 12/30/2022] Open
Abstract
We performed virological analysis of resected brain tissues from a patient with temporal lobe epilepsy associated with mesial temporal sclerosis after febrile status epilepticus caused by human herpesvirus 6 infection. The patient had febrile status epilepticus at 9 months of age associated with human herpesvirus 6 infection. Magnetic resonance imaging revealed reduced water diffusion in the right temporal lobe and hippocampus. Polymerase chain reaction analysis detected 1.6 × 105 copies/μg of human herpesvirus 6 DNA in whole blood, but none in the cerebrospinal fluid. The patient developed temporal lobe epilepsy associated with mesial temporal sclerosis at 67 months of age, necessitating surgical treatment. Anterior temporal lobectomy was performed at 171 months of age. Real-time polymerase chain reaction analysis of resected brain tissues revealed no viral DNA. In our patient, human herpesvirus 6 infection triggered febrile status epilepticus, while direct evidence to prove contribution of HHV-6 to the development of MTS was not obtained.
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Affiliation(s)
- Yoshiki Kawamura
- Department of PediatricsFujita Health University School of MedicineAichiJapan
| | - Satoshi Maesawa
- Department of NeurosurgeryNagoya University Graduate School of MedicineAichiJapan
| | - Shingo Numoto
- Department of PediatricsAichi Medical UniversityAichiJapan
| | - Ryuta Saito
- Department of NeurosurgeryNagoya University Graduate School of MedicineAichiJapan
| | - Tetsushi Yoshikawa
- Department of PediatricsFujita Health University School of MedicineAichiJapan
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33
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Yoshikawa T, Furukawa T, Hashimoto T, Morimoto M, Azuma N, Matsui K. AB0401 THE BASELINE SERUM SOLUBLE TNF RECEPTOR LEVELS ARE ASSOCIATED WITH THE RESPONSE OF RHEUMATOID ARTHRITIS PATIENTS TO JAKinibs. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the multiple joints.The elucidation of the pathogenesis of RA has progressed dramatically in recent decades, and among the many cytokines involved in the pathogenesis of RA, interleukin (IL)-6 and TNF-α are known to be the major pro-inflammatory cytokines that are abundant in the bloodstream and synovial tissue. JAK inhibitors (JAKinibs) such as tofacitinib and baricitinib are used in the treatment of RA by inhibiting JAK, which in turn inhibits the signaling of various cytokines including IL-6. However, predictors of the response to JAKinibs are still required.ObjectivesWe aimed to combine soluble TNF receptor (sTNFR) I, sTNFR II, IL-6, soluble IL-6R (sIL-6R) and soluble gp130 (sgp130) levels to identify groups of JAKinibs responses in RA patients.MethodsThis research is a retrospective study. We reviewed medical records of RA patients initiating JAKinibs between July 2013 and July 2021 in our hospital. The Simplified Disease Activity Index (SDAI) was evaluated at baseline and 3, 6 months after JAKinibs administration. Clinical remission was defined when SDAI decreased ≤ 3.3. Of the 125 patients treated with JAKinibs, 89 patients with 6 months follow-up, valid SDAI and serum available were enrolled. Serum samples were tested for IL-6 (Human IL-6 Quantikine ELISA Kit, R&D systems), sIL-6R (Human soluble IL-6R alpha Quantikine ELISA Kit, R&D systems) and sgp130 (Human soluble gp130 Quantikine ELISA Kit, R&D systems), sTNFR I (Human TNF RI/TNFRSF1A Quantikine ELISA Kit DRT100) and sTNFR II (Human sTNF RII/TNFRSF1B Quantikine ELISA Kit DRT200) using specific ELISAs according to the manufacturer’s instructions. The statistical analyses were performed with EZR 1.55, and p values less than 0.05 were considered significant.ResultsThe median age of patients was 62 (IQR: 51 - 72) years and the median of disease duration was 6.0 (2.0 - 16.0) years. Twenty-seven (30.3%) patients were biologics and Jakinibs naive. The baseline SDAI was median 18.9 (12.7 - 27.9). When comparing SDAI-remission group (clinical remission: CR) and non-remission group, there were no significant differences in any of the baseline clinical parameters. There was no significant difference in the serum levels of IL-6, sIL-6R and sgp130 between the CR and non-CR groups, but the serum levels of sTNFR I and sTNFR II in the CR group were significantly lower than non-CR group. Univariate logistic regression analysis suggested Biologics and JAKinibs naive (odds ratio (OR) 3.58, p = 0.015), baseline Log sTNFR II levels (OR 0.013, P=0.034) as predictors of SDAI remission treated with JAKinibs at 6 months. Although not significant, Stage IV (OR 0.211, P=0.082) and baseline Log sTNFR I serum levels (OR 0.013, P=0.065) were associated with clinical remission.ConclusionRA patients could be easily stratified prior to JAKinibs intervention with serum sTNFR II and sTNFR I levels, not but IL-6 axis cytokines (IL-6, sIL-6R and sgp130).Univariate logistic regression analysis for clinical remission in patients treated with JAKinibs. Odds Ratio[95% C.I.]P ValueAge, year0.973[0.942 - 1.010]0.104Female (%)0.820[0.231 - 2.910]0.759BMI0.968[0.847 - 1.110]0.627Duration, year0.952[0.897 - 1.010]0.110StageIreferrenceII0.857[0.218 - 3.370]0.825III0.444[0.072 - 2.740]0.382IV0.211[0.036 - 1.220]0.082Biologic/JAKi naïve3.580[1.280 - 9.950]0.015JAKi Drug-Baricitinibreferrence-Tofacitinib1.780[0.659 - 4.800]0.256MTX use1.640[0.532 - 5.30]0.390PSL use0.476[0.176 - 1.290]0.143SASP use0.783[0.268 - 2.290]0.654IGU use0.328[0.039 - 2.750]0.304BUC use0.436[0.051 - 3.760]0.450TAC use0.233[0.029 - 1.910]0.1750W IL-6, pg/mL0.991[0.977 - 1.000]0.1980W sIL-6R, ng/mL0.983[0.947 - 1.02]0.3690W sgp130, ng/mL0.998[0.994 - 1.000]0.4440W sTNFR II/I ratio0.808[0.222 - 2.940]0.7460W Log sTNFR II, pg/mL0.002[0.0000653 - 0.634]0.0340W Log sTNFR I, pg/mL0.013[0.000126 - 1.300]0.065Disclosure of InterestsNone declared
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Yoshikawa T, Azuma K, Furukawa T, Hashimoto T, Morimoto M, Azuma N, Matsui K. AB0362 NEUTROPHIL COUNT REDUCTION 1 MONTH AFTER INITIATING SARILUMAB AND BASELINE SERUM SOLUBLE gp130 LEVELS CAN INDEPENDENTLY PREDICT CLINICAL REMISSION WITHIN 3 MONTH IN RHEUMATOID ARTHRITIS PATIENTS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundIL-6 contributes significantly to the chronic inflammatory process of rheumatoid arthritis (RA) and is elevated in serum and synovial fluid of RA patients.Sarilumab (SRL), a human anti-human IL-6 receptor alpha monoclonal antibody that blocks the signaling originated by the IL-6/IL-6R complex like tocilizumab (TCZ),is an effective treatment. Recently, an association between the therapeutic effect of TCZ and neutropenia after TCZ initiation was reported[1]. Neutropenia is a common adverse event of SRL in patients with RA, but the relationship between reduced neutrophil count and clinical response to SRL is still inconclusive. In EULAR 2020, we reported the association between serum soluble gp130 levels before SRL treatment and the efficacy of SRL[2]. It is also unclear whether there is a relationship between IL-6 axis cytokines and SRL-induced neutropenia.ObjectivesThe purpose of this study was to determine whether neutropenia at 1 month by SRL predicts clinical remission within 3 months and whether there is an association between IL-6 axis cytokines levels and SRL-induced neutropenia.MethodsThis research is a retrospective study. We reviewed medical records of RA patients initiating SRL between February 2018 and August 2021 in our hospital. The Clinical Disease Activity Index (CDAI) was evaluated at baseline (before initiating SRL) and 3 months after administration. Clinical remission was defined when CDAI decreased ≤ 2.8. Of the 66 patients treated with SRL, 42 patients with 3 months follow-up, valid CDAI and serum available were enrolled. The ratio of neutrophil counts 1 month after initiating SRL to those at baseline (neutrophil ratio) was also calculated. Serum samples were tested for IL-6 (Human IL-6 Quantikine ELISA Kit, R&D systems), sIL-6R (Human soluble IL-6R alpha Quantikine ELISA Kit, R&D systems) and sgp130 (Human soluble gp130 Quantikine ELISA Kit, R&D systems) using specific ELISAs according to the manufacturer’s instructions. The statistical analyses were performed with EZR 1.55, and p values less than 0.05 were considered significant.ResultsThe median age of patients was 69.0 (IQR: 59.3 - 73.8) years and the median of disease duration was 9.0 (3.0 - 16.0) years. Eighteen (42.9%) patients were biologics and Jakinibs naive. The baseline CDAI was median 16.7 (11.5 - 25.8). When comparing CDAI-remission group (clinical remission: CR) and non-CR group, Patients in the CR group had significantly shorter disease duration, were more Biologic and JAKinib naive, and had greater neutropenia 1 month after starting SRL (0.71 vs 0.94, P=0.0252). There was no significant difference in the baseline serum levels of IL-6, sIL-6R between the CR and non-CR groups, but baseline serum sgp130 levels in the CR group tended to be higher than in the non-CR group (264.9 vs 234.2 ng/mL, P=0.0592). Univariate logistic regression analysis suggested Biologics and JAKinibs naive (odds ratio (OR) 6.68, p = 0.0317), baseline serum sgp130 levels (OR 8.608, P=0.0312) as predictors of CDAI remission treated with SRL at 3 months. Although not significant, neutrophil ratio ≤ 0.8 was associated with achieving remission (OR 6.67, P=0.0537). Univariate logistic regression for neutrophil ratio ≤ 0.8 did not show any relevant factors, including higher baseline serum sgp130 levels (OR 1.25, P=0.782).ConclusionA 20% or greater decrease in neutrophil count after 1 month of SRL treatment and a high baseline serum sgp130 level independently predict clinical remission within 3 months.References[1]Nakajima T, Watanabe R, Hashimoto M, Murata K, Murakami K, Tanaka M, et al. Neutrophil count reduction 1 month after initiating tocilizumab can predict clinical remission within 1 year in rheumatoid arthritis patients. Rheumatol Int. 2021;1rin[2]Yoshikawa T, Furukawa T, Tamura M, Hashimoto T, Morimoto M, Azuma N, et al. FRI0113 THE BASELINE SOLUBLE GP130 IS ASSOCIATED WITH THE RESPONSE OF RHEUMATOID ARTHRITIS PATIENTS TO SARILUMAB. Ann Rheum Dis. 2020;79(Suppl 1):637.1-637.Disclosure of InterestsNone declared
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Kozawa K, Miura H, Kawamura Y, Higashimoto Y, Ihira M, Yoshikawa T. Unremarkable antibody responses against various infectious agents after inoculation with the BNT162b2 COVID-19 vaccine. J Med Virol 2022; 94:4583-4585. [PMID: 35641431 PMCID: PMC9347795 DOI: 10.1002/jmv.27895] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, 4701192, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, 4701192, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, 4701192, Japan
| | - Yuki Higashimoto
- Faculty of Medical Technology, Fujita Health University School of Health Sciences, Toyoake, Aichi, 4701192, Japan
| | - Masaru Ihira
- Faculty of Clinical Engineering, Fujita Health University School of Health Sciences, Toyoake, Aichi, 4701192, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, 4701192, Japan
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Tanita K, Kawamura Y, Miura H, Mitsuiki N, Tomoda T, Inoue K, Iguchi A, Yamada M, Yoshida T, Muramatsu H, Tada N, Matsui T, Kato M, Eguchi K, Ishimura M, Ohga S, Imai K, Morio T, Yoshikawa T, Kanegane H. Case Report: Rotavirus Vaccination and Severe Combined Immunodeficiency in Japan. Front Immunol 2022; 13:786375. [PMID: 35281013 PMCID: PMC8905240 DOI: 10.3389/fimmu.2022.786375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/28/2022] [Indexed: 11/16/2022] Open
Abstract
Severe combined immunodeficiency (SCID) is an inborn error of immunity that occurs in approximately 1 in 50,000 births, mainly due to impaired lymphocyte differentiation. Without curative treatment, such as hematopoietic cell transplantation (HCT) or gene therapy, severe infection in the first year of life could make this condition fatal. The results of HCT are poor when patients have active infections, thus requiring early diagnosis before onset of infection. In five cases of SCID diagnosed in Japan, the oral rotavirus vaccine had been administered before diagnosis. In this study, we demonstrated that the rotavirus from their stools was a vaccine-derived strain. In some cases, severe gastroenteritis triggered the diagnosis of SCID. However, newborn screening for SCID is available before the first rotavirus vaccination using assays for the detection of T-cell receptor excision circles (TRECs). Therefore, to improve the prognosis of patients with SCID in Japan, we should establish a screening system of TRECs for newborns throughout Japan.
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Affiliation(s)
- Kay Tanita
- Department of Pediatrics and Developmental Biology, Graduate School of Medical Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Noriko Mitsuiki
- Department of Pediatrics and Developmental Biology, Graduate School of Medical Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takahiro Tomoda
- Department of Pediatrics and Developmental Biology, Graduate School of Medical Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kento Inoue
- Department of Pediatrics and Developmental Biology, Graduate School of Medical Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Akihiro Iguchi
- Department of Pediatrics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Masafumi Yamada
- Department of Pediatrics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Taro Yoshida
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideki Muramatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norimasa Tada
- Department of Pediatrics, Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Toshihiro Matsui
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuhide Eguchi
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masataka Ishimura
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohsuke Imai
- Department of Community Pediatrics, Perinatal and Maternal Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Graduate School of Medical Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Okamoto K, Nakajima Y, Yoshikawa T, Kondo Y. Serological examination for clinical cross-reactivity between salmon roe and pollock roe in patients with a salmon roe allergy. Fujita Med J 2022; 8:52-58. [PMID: 35520294 PMCID: PMC9069270 DOI: 10.20407/fmj.2021-004] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/19/2021] [Indexed: 11/27/2022]
Abstract
Objectives Fish roe is a common allergen in Japan. We have previously reported that although immunoglobulin (IgE) from patients with salmon roe (SR) or pollock roe (PR) allergies cross-react, 70% of patients with SR allergy can consume PR without developing any symptoms. However, a correlation between clinical cross-reactivity and serological cross-reactivity remains to be demonstrated. Methods Serum samples were collected from 15 patients with SR allergy who had consumed cooked PR previously. Among these volunteers, four had experienced immediate symptoms after consuming cooked PR, while the others had exhibited no symptoms of PR allergy. A competitive enzyme-linked immunosorbent assay (ELISA) was performed to analyze the serological cross-reactivity with SR and PR. Immunoblotting inhibition assays were performed using serum samples that had been pre-incubated with SR or PR extracts. Results In ELISAs, binding to SR was inhibited by >50% when the serum samples from patients with both SR and PR allergies were pre-incubated with PR extract (p=0.0256). In immunoblots, pre-incubation of serum samples with PR extract inhibited detection of the 16-kDa protein, which likely corresponds to the major SR allergen beta' component, significantly more for samples from patients with both SR and PR allergies (100%) than for samples from those with only an SR allergy (18.2%) (p=0.011). Conclusions The superior competitive binding of the sera from patients with both SR and PR allergies to PR compared with that to SR may induce clinical cross-reactivity between SR and PR.
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Affiliation(s)
- Kaoru Okamoto
- Department of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Yoichi Nakajima
- Department of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Yasuto Kondo
- Department of Pediatrics, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
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Suzuki T, Saito K, Yoshikawa T, Hirono K, Hata Y, Nishida N, Yasuda K, Nagashima M. A double heterozygous variant in MYH6 and MYH7 associated with hypertrophic cardiomyopathy in a Japanese Family. J Cardiol Cases 2022; 25:213-217. [DOI: 10.1016/j.jccase.2021.09.011] [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] [Received: 07/19/2021] [Revised: 09/14/2021] [Accepted: 09/23/2021] [Indexed: 11/28/2022] Open
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Yoshikawa T, Arakawa M. Effects of C-factor on dentin bonding using various adhesive systems. Niger J Clin Pract 2022; 25:255-260. [PMID: 35295045 DOI: 10.4103/njcp.njcp_1364_21] [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: 11/04/2022]
Abstract
Aims and Background This study evaluated the effect of C-factor on the bond strength of a resin composite to floor and wall dentin using various adhesive systems. Materials and Methods Four dentin substrates (flat wall, flat floor, cavity wall, or cavity floor) were prepared on human molars. Each specimen was restored with one of three adhesives; Clearfil SE Bond, Single Bond, or Clearfil tri-S Bond followed by buildup or filling using Z100 resin composite. The specimen was cut perpendicular to the bonded surface parallel to the floor or wall to obtain beams after light curing at 24,000 mJ/cm2. The microtensile bond strength to wall specimens or the cavity floor was determined. Data were analyzed. Results All adhesive systems exhibited the highest bond strength to flat wall group (p < 0.05). The bond strength to the cavity group was significantly lower than that to the respective flat group regardless of the bonding system (p < 0.05). There was no significant difference in bond strength with Clearfil SE Bond and Clearfil tri-S Bond between the cavity wall and cavity floor (p > 0.05). Conclusion The findings suggested that the strength of bonding to the cavity floor and cavity wall was affected by C-factor regardless of the adhesive system. Bonding to flat wall was higher than flat floor regardless of the adhesive system. Self-etching system provided uniform bond to the cavity wall and cavity floor dentin. However, total etching system reduced bond to the cavity floor than to the cavity wall.
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Affiliation(s)
- T Yoshikawa
- Department of Cariology and Operative Dentistry, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Yushima, Bunkyo-ku, Tokyo, Japan
| | - M Arakawa
- Department of Dental Hygiene, Chiba Prefectural University of Health Sciences, 2-10-1, Wakaba, Mihama-ku, Chiba-city, Chiba, Japan
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Kawamura Y, Miura H, Saito K, Kanno T, Yokoyama T, Aizawa Y, Yoshikawa T. An atypical case of Kawasaki disease with severe pneumonia in a neonate. BMC Pediatr 2022; 22:132. [PMID: 35287620 PMCID: PMC8918903 DOI: 10.1186/s12887-022-03203-7] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kawasaki disease (KD) is an acute, febrile, systemic vasculitis of unknown etiology that primarily affects the coronary arteries and generally occurs at around 1 year of age. Although the diagnosis of KD is generally not difficult, it is challenging in cases of incomplete KD lacking characteristic clinical manifestations. The incidence of incomplete KD is higher in infants younger than 6 months of age. Pneumonia is an extremely rare complication of KD and can be misinterpreted as atypical pneumonia rather than KD. Herein, we report a neonate with atypical KD and severe pneumonia who required mechanical ventilation. CASE PRESENTATION Japanese one-month-old infant had only fever and rash on admission (day 1), and he was transferred to the intensive care unit for severe pneumonia on day 2. Although pneumonia improved following intensive care, he was diagnosed with KD on day 14 because of emerging typical clinical manifestations such as fever, bulbar nonexudative conjunctival injection, desquamation of the fingers, and coronary artery aneurysm. KD symptoms improved after three doses of intravenous immunoglobulin plus cyclosporine. However, small coronary aneurysms were present at the time of discharge. In a retrospective analysis, no pathogens were detected by multiplex real-time PCR in samples collected at admission, and the serum cytokine profile demonstrated prominent elevation of IL-6 as well as elevation of neopterin, sTNF-RI, and sTNF-RII, which suggested KD. CONCLUSIONS The patient's entire clinical course, including the severe pneumonia, was caused by KD. As in this case, neonatal KD may exhibit atypical manifestations such as severe pneumonia requiring mechanical ventilation.
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Affiliation(s)
- Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 47-01192, Japan.
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 47-01192, Japan
| | - Kazuyoshi Saito
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 47-01192, Japan
| | - Takayuki Kanno
- Department of Pathology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Tadafumi Yokoyama
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8640, Japan
| | - Yuta Aizawa
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98 Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 47-01192, Japan
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Suzuki T, Michihata N, Yoshikawa T, Saito K, Matsui H, Fushimi K, Yasunaga H. Low- versus high-concentration intravenous immunoglobulin for children with Kawasaki disease in the acute phase. Int J Rheum Dis 2022; 25:576-583. [PMID: 35258165 DOI: 10.1111/1756-185x.14309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/05/2021] [Revised: 01/22/2022] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Few studies have compared the effects of low-concentration (5%) and high-concentration (10%) intravenous immunoglobulin (IVIG) preparations for patients with Kawasaki disease (KD) in the acute phase. The purpose of this study was to compare outcomes between low- and high-concentration IVIG preparations in children with KD, using a national inpatient database in Japan. METHOD We used the Diagnostic Procedure Combination database to identify patients with KD treated with IVIG from April 2012 to March 2020. We identified those receiving high- and low-concentration IVIG preparations as an initial treatment. The outcomes included the proportions of patients with coronary artery abnormalities (CAAs) and IVIG resistance, length of stay, and medical costs. Propensity score-matched analyses were conducted to compare the outcomes between the 2 groups. Instrumental variable analyses were performed to confirm the results. RESULT We identified 48 046 patients with KD and created 4:1 propensity score-matched pairs between the low- and high-concentration IVIG groups. There was a significant difference in the percentage with IVIG resistance between the 2 groups (20.6% vs 24.1%; risk difference, 3.5% [95% confidence interval, 2.3-4.7]; P < .001). However, there was no significant difference in CAAs (1.6% vs 1.6%; risk difference, 0.013% [95% confidence interval, -0.34 to 0.37]; P = .953). The instrumental variable analyses showed similar results. CONCLUSIONS The proportion of CAAs did not differ significantly between those receiving low- and high-concentration IVIG. To confirm the results of this study, prospective studies adjusting for duration of IVIG administration and duration of observation are needed.
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Affiliation(s)
- Takanori Suzuki
- Department of Pediatric Cardiology, Aichi Children's Health and Medical Center, Aichi, Japan.,Department of Pediatrics, Fujita Health University, Aichi, Japan
| | - Nobuaki Michihata
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Kazuyoshi Saito
- Department of Pediatrics, Fujita Health University, Aichi, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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Suzuki N, Ihira M, Enya Y, Yumi T, Izuru C, Rie I, Higashimoto Y, Hiroki M, Asaki T, Kaoru F, Kawamura Y, Yoshikawa T. Dynamics of salivary human herpesvirus-6 and -7 shedding in pregnant women. J Med Virol 2022; 94:3359-3367. [PMID: 35243652 DOI: 10.1002/jmv.27692] [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: 12/24/2021] [Revised: 02/09/2022] [Accepted: 02/28/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Reactivation of Betaherpesvirinae (Human herpesvirus 6A: HHV-6A, -6B, HHV-7) may be associated with mental illness and host fatigue. This study aimed to determine whether viral reactivation, measured by monitoring salivary viral DNA load, can be used to monitor depression in pregnant and postpartum women. METHODS Saliva samples were collected from 64 pregnant women at five-point of observation periods. The HHV-6 and HHV-7 specific qPCRs were carried out to measure viral DNA load. When HHV-6 DNA was detected in saliva, nested PCR was used to discriminate between HHV-6A and B. RESULTS In both viruses, a significant correlation was observed between detection frequency and viral DNA load in saliva. In the low-shedding group, HHV-6 DNA was significantly higher in the third trimester (P<0.0001), the time of delivery (P=0.0003), one month after birth (P=0.0023) compared to the first trimester, and HHV-7 was at the time of delivery (P=0.0277) and one month after birth (P=0.0235). Most of detected HHV-6 DNAs in saliva were HHV-6B. Both viral DNA loads were significantly lower (HHV-6:P=0.0101, HHV-7:P=0.0044) in the subjects with abnormal EPDS scores. CONCLUSIONS Detection rate and viral DNA load of both viruses in saliva increased after the third trimester. Salivary virus DNA shedding was significantly lower in subjects with an abnormal EPDS score. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Noriko Suzuki
- Faculty of Health Care and Nursing, Juntendo University, Tokyo, Japan
| | - Masaru Ihira
- Faculty of Clinical Engineering, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan
| | - Yasuko Enya
- Faculty of Clinical Engineering, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan
| | | | | | - Igarashi Rie
- Seibo international Catholic hospital, Tokyo, Japan
| | - Yuki Higashimoto
- Faculty of Medical Technology, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan
| | - Miura Hiroki
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takanashi Asaki
- Faculty of Health Care and Nursing, Juntendo University, Tokyo, Japan
| | - Fujimoto Kaoru
- Department of Nursing Faculty of Health Science Technology, Bumkyo Gakuin University, Tokyo, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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Natsume J, Numaguchi A, Ohno A, Mizuno M, Takahashi Y, Okumura A, Yoshikawa T, Saitoh S, Miura K, Noda M. Death review of children receiving medical care at home. Pediatr Res 2022; 91:1286-1289. [PMID: 34239067 PMCID: PMC8265292 DOI: 10.1038/s41390-021-01606-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/14/2021] [Accepted: 05/20/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Children receiving home medical care need special attention to prevent unexpected death. The aim of this study was to clarify the factors contributing to death in children receiving home medical care from the child death review database. METHODS Children receiving home medical care were enrolled from the child death review database from 2014 to 2016 in Aichi prefecture, Japan, with a population of one million children. Types of medical care and factors contributing to death were examined. RESULTS Of the 631 children who died, 40 children (6%) were receiving home medical care (21: tracheostomy; 19: ventilator; 26: suctioning of naso-oral secretions; 19: oxygen inhalation; 32: tube feeding; 6: urethral catheterization; and 1: peritoneal dialysis). The death rate was 50 times that in the general population of children. Ten children had contributory factors that seemed to be preventable. In four children, the families could not replace the tracheostomy tubes during an accident. In three, oxygen saturation or ventilator alarms were not set appropriately. In two, an oxygen cylinder became empty. One child fell down from a seat in a car. CONCLUSIONS Improvement of devices and correct guidance to caregivers may reduce the death rate in children receiving home medical care. IMPACT Children receiving home medical care, such as tracheostomy care, mechanical ventilation, or tube feeding, need special attention to prevent unexpected death. In this population-based child death review, 6% of children received home medical care, and it was estimated that 1 of 100 children receiving home medical care died per year. One-quarter of the deaths could be preventable by caregiver education or development of devices.
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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. .,Committee on Home Medical Care of Children, Aichi Medical Association, Aichi, Japan.
| | - Atsushi Numaguchi
- Committee on Home Medical Care of Children, Aichi Medical Association, Aichi, Japan ,grid.27476.300000 0001 0943 978XDepartment of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Atsuko Ohno
- Department of Pediatrics, Toyota Municipal Child Development Center, Toyota, Japan
| | - Mihoko Mizuno
- Committee on Home Medical Care of Children, Aichi Medical Association, Aichi, Japan ,Department of Pediatrics, Daido Hospital, Nagoya, Japan
| | - Yoshiyuki Takahashi
- grid.27476.300000 0001 0943 978XDepartment of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihisa Okumura
- grid.411234.10000 0001 0727 1557Department of Pediatrics, Aichi Medical University, Nagakute, Japan
| | - Tetsushi Yoshikawa
- grid.256115.40000 0004 1761 798XDepartment of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Shinji Saitoh
- grid.260433.00000 0001 0728 1069Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kiyokuni Miura
- Committee on Home Medical Care of Children, Aichi Medical Association, Aichi, Japan ,grid.440395.f0000 0004 1773 8175Department of Pediatric Neurology, Aichi Developmental Disability Center, Kasugai, Japan
| | - Masaharu Noda
- Committee on Home Medical Care of Children, Aichi Medical Association, Aichi, Japan
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44
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Katsuta T, Shimizu N, Okada K, Tanaka-Taya K, Nakano T, Kamiya H, Amo K, Ishiwada N, Iwata S, Oshiro M, Okabe N, Kira R, Korematsu S, Suga S, Tsugawa T, Nishimura N, Hishiki H, Fujioka M, Hosoya M, Mizuno Y, Mine M, Miyairi I, Miyazaki C, Morioka I, Morishima T, Yoshikawa T, Wada T, Azuma H, Kusuhara K, Ouchi K, Saitoh A, Moriuchi H. The clinical characteristics of pediatric coronavirus disease 2019 in 2020 in Japan. Pediatr Int 2022; 64:e14912. [PMID: 34233075 PMCID: PMC8446955 DOI: 10.1111/ped.14912] [Citation(s) in RCA: 5] [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: 04/28/2021] [Revised: 06/10/2021] [Accepted: 06/14/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND The COVID-19 pandemic has affected the lives of people of all ages. Most reports on pediatric cases suggest that children experience fewer and milder symptoms than do adults. This is the first nationwide study in Japan focusing on pediatric cases reported by pediatricians, including cases with no or mild symptoms. METHODS We analyzed the epidemiological and clinical characteristics and transmission patterns of 840 pediatric (<16 years old) COVID-19 cases reported between February and December 2020 in Japan, using a dedicated database which was maintained voluntarily by members of the Japan Pediatric Society. RESULTS Almost half of the patients (47.7%) were asymptomatic, while most of the others presented mild symptoms. At the time of admission or first outpatient clinic visit, 84.0% of the cases were afebrile (<37.5°C). In total, 609 cases (72.5%) were exposed to COVID-19-positive household members. We analyzed the influence of nationwide school closures that were introduced in March 2020 on COVID-19 transmission routes among children in Japan. Transmission within households occurred most frequently, with no significant difference between the periods before and after declaring nationwide school closures (70.9% and 74.5%, respectively). CONCLUSIONS COVID-19 symptoms in children are less severe than those in adults. School closure appeared to have a limited effect on transmission. Controlling household transmission from adult family members is the most important measure for prevention of COVID-19 among children.
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Affiliation(s)
- Tomohiro Katsuta
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Naoki Shimizu
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kenji Okada
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Keiko Tanaka-Taya
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takashi Nakano
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
| | - Hajime Kamiya
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kiyoko Amo
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatric emergency, Osaka City General Hospital, Osaka, Japan
| | - Naruhiko Ishiwada
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Infectious Diseases, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Satoshi Iwata
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan
| | - Makoto Oshiro
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Japanese Red Cross Nagoya First Hospital, Aichi, Japan
| | - Nobuhiko Okabe
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Kawasaki City Institute for Public Health, Kanagawa, Japan
| | - Ryutaro Kira
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Seigo Korematsu
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Nakatsu Municipal Hospital, Oita, Japan
| | - Shigeru Suga
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Clinical Research, Infectious Disease Center, National Hospital Organization Mie National Hospital, Mie, Japan
| | - Takeshi Tsugawa
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Naoko Nishimura
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Konan Kosei Hospital, Aichi, Japan
| | - Haruka Hishiki
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Chiba University Hospital, Chiba, Japan
| | - Masashi Fujioka
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Fujioka Pediatric Clinic, Osaka, Japan
| | - Mitsuaki Hosoya
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Yumi Mizuno
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatric infectious diseases and immunology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Mahito Mine
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Mine Pediatric Clinic, Saitama, Japan
| | - Isao Miyairi
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Division of Infectious Diseases, National Center for Child Health and Development, Tokyo, Japan
| | - Chiaki Miyazaki
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Fukuoka-city Social Welfare Agency, Fukuoka, Japan
| | - Ichiro Morioka
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Tsuneo Morishima
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Aichi Medical University, Aichi, Japan
| | - Tetsushi Yoshikawa
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Fujita Health University School of Medicine, Aichi, Japan
| | - Taizo Wada
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Kanazawa University, Ishikawa, Japan
| | - Hiroshi Azuma
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Asahikawa Medical University, Hokkaido, Japan
| | - Koichi Kusuhara
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazunobu Ouchi
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Kawasaki Medical School, Okayama, Japan
| | - Akihiko Saitoh
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroyuki Moriuchi
- The Committee on Immunization and Infectious Diseases, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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45
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Sudo Y, Kawamura Y, Miura H, Yokoi K, Yoshikawa T. Peripheral venous catheter-related candidemia in an immunocompetent child. Pediatr Int 2022; 64:e14883. [PMID: 34847271 DOI: 10.1111/ped.14883] [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: 02/27/2021] [Revised: 05/20/2021] [Accepted: 06/08/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Yuta Sudo
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan.,Department of Pediatrics, Kariya Toyota General Hospital, Kariya, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Katsuyuki Yokoi
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
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46
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Kondoh T, Nakajima Y, Yokoi K, Matsumoto Y, Inagaki H, Kato T, Nakajima Y, Ito T, Yoshikawa T, Kurahashi H. Identification of a Novel Mutation in Carboxyl Ester Lipase Gene in a Patient with MODY-like Diabetes. TOHOKU J EXP MED 2022; 256:37-41. [DOI: 10.1620/tjem.256.37] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Tomomi Kondoh
- Department of Pediatrics, Fujita Health University School of Medicine
| | - Yoko Nakajima
- Department of Pediatrics, Fujita Health University School of Medicine
| | - Katsuyuki Yokoi
- Department of Pediatrics, Fujita Health University School of Medicine
| | - Yuji Matsumoto
- Department of Pediatrics, Fujita Health University School of Medicine
| | - Hidehito Inagaki
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University School of Medicine
| | - Takema Kato
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University School of Medicine
| | - Yoichi Nakajima
- Department of Pediatrics, Fujita Health University School of Medicine
| | - Tetsuya Ito
- Department of Pediatrics, Fujita Health University School of Medicine
| | | | - Hiroki Kurahashi
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University School of Medicine
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47
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Nomura O, Michihata N, Kaneko K, Yoshikawa T, Ishiguro A. Research Publication Experience as a Requirement for Board Examination Acceptance to Promote Scholarly Activities of Pediatric Residents. JMA J 2022; 5:93-98. [PMID: 35224266 PMCID: PMC8827206 DOI: 10.31662/jmaj.2021-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/10/2021] [Accepted: 10/19/2021] [Indexed: 11/09/2022] Open
Abstract
Introduction: Methods: Results: Conclusions:
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Affiliation(s)
- Osamu Nomura
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
- Department of Emergency and Disaster Medicine, Hirosaki University, Aomori, Japan
| | - Nobuaki Michihata
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
- Department of Health Services Research, The University of Tokyo, Tokyo, Japan
| | - Kazunari Kaneko
- Department of Pediatrics, Kansai Medical University, Osaka, Japan
| | | | - Akira Ishiguro
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
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48
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Yoshikawa T, Sadr A. Polymerization Behavior of Composites at Top/Bottom of Cavity Using Different-Lights. Dent Mater 2022. [DOI: 10.1016/j.dental.2021.12.107] [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: 11/26/2022]
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49
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Ishimaru S, Kawamura Y, Miura H, Shima S, Ueda A, Watanabe H, Mutoh T, Yoshikawa T. Detection of human herpesviruses in cerebrospinal fluids collected from patients suspected of neuroinfectious diseases. J Neurovirol 2021; 28:92-98. [PMID: 34970721 DOI: 10.1007/s13365-021-01040-5] [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] [Received: 01/23/2021] [Revised: 11/21/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
The full spectrum of human herpesviruses (HHV)-associated neuroinfectious diseases in immunocompetent adults remains unclear. Hence, we sought to elucidate the epidemiology and clinical features of these diseases. The study subjects were patients over 16 years old suspected of neuroinfectious diseases who underwent spinal tap performed by neurologists in our university hospital between April 2013 and March 2018. The presence of seven HHV DNAs in cerebrospinal fluid (CSF) was determined by real-time PCR. HHV DNAs were detected in 33 (10.2%) of the 322 patients. The most frequently detected herpesvirus was varicella zoster virus (VZV) (19 patients), followed by HHV-6 (four patients), herpes simplex virus (HSV)-1 (three patients), HSV-2 (three patients), and Epstein-Barr virus (two patients). HHV DNAs were detected in CSF collected from patients with various neuroinfectious diseases, including myelitis, peripheral neuritis, encephalitis, and meningitis. All patients with HSV-1 DNA had encephalitis, whereas all patients with HSV-2 DNA had meningitis. Eleven of the 19 patients with VZV DNA had meningitis. Patients with VZV-associated encephalitis (median age, 80 years) were significantly older than non-encephalitis patients (median age, 60.5 years) (P = 0.046). Although post-herpetic neuralgia was observed in seven (54%) of the 13 patients with VZV and without encephalitis, no such neurological sequela was observed in the four encephalitis patients. In conclusion, HHVs were associated with approximately 10% of neuroinfectious diseases in this cohort. VZV was the most common pathogen, probably due to the large number of VZV meningitis patients. In addition, patients with VZV-associated meningitis were significantly younger than patients with VZV-associated encephalitis.
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Affiliation(s)
- Soichiro Ishimaru
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98, Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98, Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 470-1192, Japan.
| | - Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98, Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
| | - Sayuri Shima
- Department of Neurology, Fujita Health University School of Medicine, 1-98, Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
| | - Akihiro Ueda
- Department of Neurology, Fujita Health University School of Medicine, 1-98, Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
| | - Hirohisa Watanabe
- Department of Neurology, Fujita Health University School of Medicine, 1-98, Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
| | - Tatsuro Mutoh
- Department of Neurology, Fujita Health University School of Medicine, 1-98, Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, 1-98, Kutsukake-cho, Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
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50
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Miura H, Taniguchi K, Narita K, Kawamura Y, Kozawa K, Muramatsu H, Takahashi Y, Ihira M, Yoshikawa T. Nosocomial infection with rotavirus vaccine strain in paediatric patients with immunodeficiency. J Hosp Infect 2021; 121:9-13. [PMID: 34915052 DOI: 10.1016/j.jhin.2021.12.009] [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] [Received: 09/27/2021] [Revised: 12/01/2021] [Accepted: 12/08/2021] [Indexed: 11/25/2022]
Abstract
In infants with immunodeficiency, rotavirus (RV) vaccines can be continuously excreted in stool. We analysed nosocomial infection with RV vaccine strain in immunodeficient paediatric patients. RV1 RNAs were detected in stool and serum samples from case A, who was vaccinated with RV1, and case B, who was not. PAGE analysis of serial stool samples of case A revealed several rearrangements of the RV genome. In case B, the only band pattern detected was the same as a rearrangement detected in case A at the same time. In summary, RV vaccination of infants with immunodeficiency poses a risk of nosocomial infections.
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Affiliation(s)
- Hiroki Miura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi; Department of Dermatology, School of Medicine, University of California Davis (UC Davis), Sacramento, California.
| | - Koki Taniguchi
- Virology and Parasitology, Fujita Health University School of Medicine, Toyoake, Aichi
| | - Kotaro Narita
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi
| | - Yoshiki Kawamura
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi
| | - Kei Kozawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi
| | - Hideki Muramatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi
| | - Masaru Ihira
- Faculty of Clinical Engineering, Fujita Health University School of Health Sciences, Toyoake, Aichi
| | - Tetsushi Yoshikawa
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi
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