Language：Japanese   Publisher：(一社)日本産婦人科感染症学会  

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: Sterile inflammation, initiated by endogenous molecules such as high-mobility group box-1 (HMGB1), has come to be recognized as a critical mechanism in a variety of chronic diseases. To elucidate the involvement of sterile inflammation in neonatal disease, the association between serum HMGB1 levels and the development of bronchopulmonary dysplasia (BPD) was evaluated. STUDY DESIGN: Serum HMGB1 levels were measured in 25 premature infants born before 33 weeks of gestation, excluding any infection cases. Samples were collected at birth, two, and four weeks of age and compared according to BPD status. RESULTS: The serum HMGB1 levels in infants with BPD were maintained up to 4 weeks of age, while those without BPD declined with time. Postnatal cardiopulmonary and nutritional transition was delayed in infants with BPD. CONCLUSION: Sustained elevation of serum HMGB1 levels was associated with the development of BPD, suggesting that prolonged sterile inflammation may contribute to lung injury.

DOI： 10.1080/14767058.2021.1931102

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1111/ped.14335

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

PROBLEM: Acute chorioamnionitis (aCAM) associated with microbial infection is a primary cause of preterm birth (PB). However, recent studies have demonstrated that innate immunity and sterile inflammation are causes of PB in the absence of aCAM. Therefore, we analyzed immune cells in the decidua of early to moderate PB without aCAM. METHOD OF STUDY: Deciduas were obtained from patients with PB at a gestational age of 24+0 to 33+6  weeks without aCAM in pathological diagnosis. The patients were divided into two groups as follows: patients with labor and/or rupture of membrane (ROM) (no aCAM with labor and/or ROM: nCAM-w-LR), and patients without labor and/or ROM (no aCAM without labor and/or ROM: nCAM-w/o-LR). The immune cells and high mobility group box 1 (HMGB1) levels in the decidua were analyzed using flow cytometry. Co-culture of CD56+ cells with dendritic cells (DCs) and macrophages obtained from the decidua was also performed in the presence of HMGB1. RESULTS: The nCAM-w-LR group demonstrated an accumulation of iNKT cells, and increased expression of HMGB1, TLR4, receptors for advanced glycation end products, and CD1d on DCs and macrophages. HMGB1 facilitated the proliferation of iNKT cells co-cultured with DCs and macrophages, which was found to be inhibited by heparin. CONCLUSIONS: Inappropriate activation of innate immune cells and increased HMGB1 expression may represent parturition signs in human pregnancy. Therefore, control of these cells and HMGB1 antigenicity may be represent a potential therapeutic target for the prevention of PB.

DOI： 10.1111/aji.13330

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

In reproduction, inflammatory processes play important roles in the development of many pregnancy complications such as preterm labor/birth, recurrent pregnancy loss, recurrent implantation failure, and preeclampsia. Inflammation can be initiated by both microbial and non-microbial causes. Bacterial infection in the feto-maternal interface and uterus can provoke preterm labor/birth, miscarriage, and chronic endometritis. By contrast, inflammation without infection, or 'sterile inflammation,' can also lead to many kinds of complications, such as preterm labor/birth, miscarriage, or preeclampsia. Aberrant inflammation is facilitated by immune cells such as macrophages, dendritic cells, natural killer cells, and invariant natural killer T cells. In addition, cytokines, chemokines, and several kinds of inflammatory mediators are involved. On the other hand, appropriate inflammation is required for a successful offspring during the progression of the entire pregnancy. Herein, we discuss the relation between pregnancy and inflammation with immunological alterations. Understanding the role of inflammation in complications during pregnancy may establish new perspectives of the progress of normal pregnancy as well as treatments during pregnancy complications.

DOI： 10.1080/25785826.2020.1809951

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: There has been significant progress in reducing perinatal mortality in Japan. However, due to changes in social conditions, the total fertility rate and the number of births are decreasing, whereas the number of low birth weight infants is increasing along with the number of newborn babies that require intensive care. Further, although the number of high-level perinatal medical centers has increased, so has that of infants who need long-term hospitalization. Conversely, the number of regular obstetric facilities has decreased, thus resulting in insufficient beds for neonatal care. To fill this gap, we established a neonatal intensive care unit (NICU) at our hospital. This study aimed to evaluate our new type by comparing the data from ours with that from other facilities. METHODS: The other facilities assessed were two high-level NICU facilities and two regular obstetric facilities. Data, including sex, gestational age, birth weight, Apgar scores at 1 and 5 min, delivery method, and presence of breathing disorders, were extracted from medical records. RESULTS: The birth weight and gestational age distributions were significantly different in the institutions, except in one facility without a NICU. The new NICU saw more infants with low birth weight and respiratory disorders than the regular obstetric facilities. CONCLUSION: The comparison of birth weight and gestational age distributions, cases of respiratory disorders, and delivery methods indicate that our new NICU is positioned as an intermediate facility between a high-level NICU and a regular obstetrics facility.

DOI： 10.1272/jnms.JNMS.2021_88-403

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Transfer of infants who no longer need intensive or specialized care from tertiary to community hospitals or clinics contributes to efficient bed utilization in neonatal intensive care units (NICUs). METHODS: A retrospective analysis of the records of all 1,503 infants admitted to our NICU during the past 6 years (from April 2013 to March 2019) was performed to evaluate the impact of interfacility neonatal transport for convalescent care. RESULTS: During the study period, our NICU accepted 33 infants from other tertiary NICUs and transferred 103 infants to other hospitals or clinics before their home discharge for convalescent care. Our NICU covered 39% of the total hospital days of infants accepted from other NICUs. Of the infants transferred to other facilities, 81% of infants born at our hospital were born to mothers transported to our obstetric department as imminent high-risk deliveries; 94% of infants born at other hospitals were moved back to the referring facility. CONCLUSIONS: Interfacility neonatal transport for, both accepting and transferring infants for convalescent care has become an integral part of NICU practice to bridge the gaps between higher level care facility and home. Establishment of well-defined transfer criteria and appropriate allocation of medical and staff resources among relevant facilities is desirable.

DOI： 10.1272/jnms.JNMS.2020_87-604

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: A right aortic arch is a congenital vascular anomaly that is present in up to 0.1% of pregnancies. The anomaly observed by fetal ultrasonography was recently reported to indicate vascular and chromosomal abnormalities that may complicate postnatal management. CASE PRESENTATION: We report the successful resection of a Kommerell's diverticulum with left subclavian artery transfer to the left carotid artery in a 5-month-old Japanese boy. The patient was prenatally diagnosed as having a right aortic arch, and a vascular ring was confirmed at 4 months of age with enhanced computed tomography. The pathology of the resected aortic wall revealed severe disruption and fragmentation of elastic fibers associated with a disarray of smooth muscle cells in the tunica media, and cystic medial necrosis with mucoid extracellular matrix deposition. CONCLUSION: These abnormal pathological findings supported the resection of Kommerell's diverticulum at this point of time, and division of the ligamentum arteriosus alone was not recommended. Early intervention in this condition once the diagnosis is made may thus be advocated. The fetal diagnosis of a right aortic arch may provide a clue to the possibility of a vascular ring.

DOI： 10.1186/s40792-019-0726-2

PubMed

researchmap

Language：English  

Anhidrotic ectodermal dysplasia (AED) is a rare hereditary disorder with a triad of sparse hair, dental hypoplasia, and anhidrosis. Here we report a case of AED with food allergy and atopic eczema. The patient was a 11-month-old boy admitted to our hospital with pyrexia for 2 weeks. He presented with a history of dry skin, eczema, and food allergy to egg. On clinical examination, his body temperature was 38.8°C, with dry skin and eczema almost all over the body, sparse eyebrows, and scalp hair. Laboratory investigations and physical examination did not show any evidence of infection. Radioallergosorbent test was positive to egg yolk, egg white, ovomucoid, milk, house dust, and house dust mite. As the child did not sweat despite the high fever, we performed the sweat test which revealed a total lack of sweat glands. Genetic examination revealed a mutation of the EDA gene and he was diagnosed as AED. His pyrexia improved upon cooling with ice and fan. His mother had lost 8 teeth and her sweat test demonstrated low sweating, suggestive of her being a carrier of AED. Atopy and immune deficiencies have been shown to have a higher prevalence in patients with AED. Disruption of the skin barrier in patients with AED make them more prone to allergic diseases such as atopic eczema, bronchial asthma, allergic rhinitis and food allergy. Careful assessment of the familial history is essential to differentiate AED when examining patients with pyrexia of unknown origin and comorbid allergic diseases.

DOI： 10.5415/apallergy.2019.9.e3

PubMed

researchmap

Web of Science

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

BackgroundThe developmental process of bronchopulmonary dysplasia (BPD) is not identical between very preterm infants born small for gestational age (SGA) and those born appropriate for gestational age (AGA). In this study, we compared the pattern of the inflammatory response in infants of each group, by measuring urinary 2-microglobulin (U2M) as an alternative, concise, and less-invasive biomarker.
MethodsU2M and clinical details were examined at birth and at 4weeks of age in 146 very preterm infants.
ResultsOf the 57 infants diagnosed with BPD, 18 were SGA, and 39 were AGA. U2M at birth was significantly lower in SGA BPD infants than in AGA BPD infants, but it increased with time. The prevalence of chorioamnionitis (CAM) was significantly lower in SGA BPD infants than in AGA BPD infants, while that of pregnancy-induced hypertension was the opposite.
ConclusionsExposure to prenatal factors other than CAM may sensitize fetal lungs to become vulnerable to postnatal inflammation in very preterm SGA infants with BPD.

DOI： 10.1111/ped.13407

Web of Science

PubMed

researchmap

Language：English   Publisher：ELSEVIER IRELAND LTD  

DOI： 10.1016/j.jri.2017.10.007

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Problem: Acute chorioamnionitis (aCAM) is an important cause of pre-term birth. However, little is known about the pathogenesis of late pre-term birth without aCAM that was the most common category of pre-term birth. Here we analyze the kinetics of immune cells obtained from the decidua of women with late pre-term births with and without aCAM.
Method of study: Deciduas were obtained from women who underwent labor with late pre-term birth without aCAM (PB-n/aCAM) or with aCAM (PB-w/aCAM). The population of DEC-205(+) dendritic cells (DCs), macrophages, invariant natural killer T (iNKT) cells, NK cells, CD8(+) T cells, and CD4(+) T cells were analyzed by flow cytometry.
Results: The number of iNKT cells was higher in the decidua obtained from women with PB-n/aCAM than PB-w/aCAM. DEC-205(+) DCs obtained from women with PB-n/aCAM preferentially induced iNKT cell proliferation.
Conclusion: iNKT cell accumulation with DEC-205(+) DCs in PB-n/aCAM suggests that iNKT cells contribute to the onset of PB-n/aCAM.

DOI： 10.1111/aji.12658

Web of Science

PubMed

researchmap

Language：English   Publisher：ELSEVIER IRELAND LTD  

DOI： 10.1016/j.jri.2016.10.043

Web of Science

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

Peters' plus syndrome is a rare autosomal recessive condition characterized by a combination of typical ocular defects and other systemic abnormalities. We present a case of this uncommon syndrome that we diagnosed during a fetal ultrasonographical examination. Because the patient exhibited microcephaly and anterior staphyloma of the right eye and because impending rupture was feared, we performed ophthalmectomy during the neonatal period. Fetal ophthalmological anomalies are often detected during ultrasonographic examination targeting other systemic abnormalities, with positive family histories providing important diagnostic clues. This case is, to our knowledge, the first to be reported of prenatally diagnosed Peters' plus syndrome in a patient with no known family history in whom total blindness was prevented with an early referral to specialists.

DOI： 10.1272/jnms.83.130

Web of Science

PubMed

researchmap

Language：English   Publisher：W B SAUNDERS CO LTD  

DOI： 10.1016/j.placenta.2015.07.168

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：INFORMA HEALTHCARE  

Objective: Fetal inflammatory response syndrome (FIRS), which induces hypercytokinemia, is important for the outcomes of premature infants. It is necessary to focus on the fetal inflammatory environments.
Methods: A total of 37 premature infants (gestational age <= 32 weeks) were divided into three groups: (1) 15 without chorioamnionitis (CAM) and funisitis; C(-)F(-) group, (2) 15 with CAM but without funisitis; C(+)F(-) group and (3) 7 with CAM and funisitis; C(+) F(+) group. Blood interleukin (IL)-1 beta, IL-6 and IL-8 levels were measured on day 0 (= in umbilical cord blood), 3, 7, 14, 21 and 28.
Results: (1) day 0: Cord blood concentrations of IL-1 beta, IL-6 and IL-8 were significantly higher in the C(+)F(+) group than in the C(+)F(-) group and C(-)F(-) group. On the other hand, they were comparable between the C(+)F(-) group and C(-)F(-) group. (2) Days 3-28: elevated cytokines levels in the C(+)F(+) group with funisitis decreased on day 3 and later.
Conclusions: We suggested that hypercytokinemia in the cord blood in premature infants were greatly related with funisitis. Diagnosis of funisitis would be important to find the premature infants who need to be managed their risk of FIRS. In addition, hypercytokinemia disappeared in a few days after birth; therefore, cord blood data analysis of cytokines and/or inflammation-related proteins concentrations is necessary to evaluate the fetal inflammatory environments in premature infants after birth.

DOI： 10.3109/14767058.2013.867321

Web of Science

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

Objective: The aim of this study was to examine the effects of a newly established neonatal intensive care unit (NICU) on clinical work practice and educational activity at Nippon Medical School Musashikosugi Hospital.
Methods: This retrospective study analyzed the clinical records of all neonates admitted to the NICU from December 2010 through November 2013. Anthropometric data, clinical status, problems, and outcomes of patients and the related obstetrical history were extracted and analyzed.
Results: Of the 568 neonatal admissions, about half were related to preterm birth (49%) and low birth weight (55%). Forty-eight percent of patients were born via caesarean delivery. Maternal hypertension, diabetes, and thyroid disease were found in 8%, 5%, and 2% of cases, respectively. Mechanical ventilatory support was provided for 20% of patients. Neonates from multiple pregnancy and with significant congenital anomalies accounted for 17% and 10% of all patients, respectively. Five patients died during hospitalization. In addition training was provided in the NICU for an average of 10 residents and 20 medical students per year.
Conclusion: Since the NICU was established, closer cooperation beyond the framework of a single department has come to be needed. In addition, NICUs in teaching hospitals are expected to provide opportunities for medical students and residents to observe and participate in multidisciplinary medical care.

DOI： 10.1272/jnms.81.328

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

Group B Streptococcus (GBS) is an important pathogen that causes neonatal sepsis and meningitis, which have high mortality and morbidity. Most cases of infection are early onset, with late onset infections being less common. Moreover, many cases of infection are caused by type III GBS, while type Ib GBS infections are rare. We report a case of late-onset infection by type Ib GBS. A female neonate weighing 574 g was delivered at 27 weeks' gestation. An endotracheal tube was inserted shortly after birth because of respiratory distress syndrome, and ampicillin was administered by the age of 3 days. At the age of 54 days after cardiopulmonary adaptation had been achieved, the patient presented with tachycardia following refractory apnea and bradycardia, and her skin became pale. She was suspected of having sepsis, and intensive treatment, including intubation and administration of catecholamines, was started. Despite these measures, the patient died after 5 hours after the onset of sepsis. Type Ib GBS infection may be more frequent in Japanese infants because of the low concentration of IgG antibodies against type Ib in pregnant Japanese women.

DOI： 10.1272/jnms.80.384

Web of Science

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

BACKGROUND: The aim of the study was to determine factors that affect adverse long-term pulmonary outcome in premature infants. METHODS: This retrospective analysis was done using 306 clinical records of preterm singleton neonates at <32 weeks of gestation. Two definitions of adverse pulmonary outcome were used: chronic lung disease (CLD), defined as a need for supplemental oxygen for at least 28 days after birth; and bronchopulmonary dysplasia (BPD), defined as oxygen dependency for at least 28 days after birth plus at 36 weeks postmenstrual age and/or a need for positive-pressure ventilatory support. Selected perinatal variables were compared between these definitions, and factors related to disease development were identified on multivariate analysis. RESULTS: The incidence of CLD and of BPD were 42% and 17%, respectively. Regardless of the definitions, the incidence of patent ductus arteriosus and of neonatal infection were significantly higher in the patients who met the disease criteria, but that of chorioamnionitis and of small for gestational age (SGA) were significantly higher in the patients only when the BPD definition was applied. Multivariate analysis identified SGA as an independent risk factor for the development of BPD after controlling for gestational age. CONCLUSIONS: Among selected perinatal variables, prenatal risk factors, particularly SGA, contributed to prolonged dependency on oxygen and/or positive-pressure ventilatory support, in combination with neonatal risk factors.

DOI： 10.1111/ped.12151

Web of Science

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Intussusception occurring in premature infants is exceedingly rare and shows substantially different characteristics from that in the typical age group or non-premature neonates. We present a case of intussusception in an extremely premature infant following bacterial sepsis, in which necrotizing enterocolitis was initially suspected. The correct diagnosis was made at 35 days old using abdominal ultrasonography, but the general condition of the infant had deteriorated to the point where surgery could not be performed. The patient died of multiple organ failure, and autopsy revealed ileo-ileal intussusception without a recognizable anatomical leading point. Possible mechanisms for this rare clinical entity are discussed.

DOI： 10.1007/s00431-011-1635-y

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

It is important to identify premature infants with prenatal inflammation as it contributes to short- and long-term complications. Our object was to study how prenatal inflammation affects the urinary beta(2)-microglobulin (beta(2)-MG) level. Preterm neonates were divided based on the presence of chorioamnionitis (CAM) into the CAM (n = 100) and non-CAM groups (n = 117). These were further subdivided into five groups each: 30 preterm neonates of 23-26; 42 neonates of 27-28; 54 neonates of 29-30; 51 neonates of 31-32; and 40 neonates of 33-34 weeks&apos; gestation. The urinary beta(2)-MG level within 48 h of birth was significantly higher in the CAM group than in the non-CAM group among the neonates of 23-26 weeks&apos; gestation (18.3 +/- 6.9 vs 10.0 +/- 5.6 x 10(4) mu g/gCr, p = 0.0018) and the neonates of 27-28 weeks&apos; gestation (16.2 +/- 10.8 vs 8.8 +/- 3.3 x 10(4) mu g/gCr, p = 0.0101). However, there was no difference in urinary beta(2)-MG level between the CAM and the non-CAM group among the neonates a parts per thousand yenaEuro parts per thousand 29 weeks &apos;gestation. Moreover, the elevated urinary beta(2)-MG level in the neonates a parts per thousand currency signaEuro parts per thousand 28 weeks &apos; gestation with CAM had disappeared by 1 week after birth. The reasons for the increase in urinary beta(2)-MG level within 48 h of birth in very preterm neonates (a parts per thousand currency sign 28 weeks&apos; gestation) with CAM are believed to be not only prematurity, but also prenatal inflammation. It is suggested that the urinary beta(2)-MG level during the early postnatal period can identify prenatal inflammation.

DOI： 10.1007/s00467-011-1924-8

Web of Science

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Objective: To evaluate the clinical utility of urinary beta-2-microglobulin (B2M) at birth, an alternative to proinflammatory cytokines, as an indicative marker of fetal inflammatory response and subsequent higher risk of bronchopulmonary dysplasia (BPD) in premature infants.
Study Design: The relationship between urinary B2M at birth and the occurrence of BPD was examined in 96 premature infants with a description of perinatal backgrounds. Constructing a receiver-operating characteristic curve to determine the cutoff value of urinary B2M at birth for the development of BPD, a multivariate logistic regression analysis was performed to evaluate whether elevated urinary B2M at birth can be used as a predictor of BPD.
Results: BPD was diagnosed in 34% (33/96) of the infants. Neonates with BPD had a significantly higher occurrence rate of chorioamnionitis and greater levels of median urinary B2M at birth than did those without BPD. The selected cutoff value of urinary B2M at birth correlated with the development of BPD, even after adjusting for gestational age and other confounding factors.
Conclusions: Elevated urinary B2M levels at birth can be used as an alternative marker of fetal inflammatory response and subsequent higher risk of BPD in premature infants. Journal of Perinatology (2011) 31, 330-334; doi:10.1038/jp.2010.129; published online 2 December 2010

DOI： 10.1038/jp.2010.129

Web of Science

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Idiopathic intrauterine constriction/closure of the ductus arteriosus, which is distinct from that secondary to maternal exposure to non-steroidal anti-inflammatory drugs, such as indomethacin, or structural cardiac defect, is an uncommon event that often results in severe fetal-neonatal morbidity and mortality. We reported a case of idiopathic fetal ductal constriction, in which the diagnosis was confirmed by documentation of an abnormal four-chamber view of the fetal heart at 38 weeks of gestation on obstetric ultrasound examination. A female infant weighing 2,816 g was born by Cesarean section, and her postnatal course was mild; transient tachypnea requiring only several days of supplemental oxygen with spontaneous regression of the abnormal echocardiographic findings by 3 months of age. The incidence of idiopathic constriction/closure of the fetal ductus arteriosus may be underestimated, particularly with a negative history of maternal drug exposure and mild postnatal clinical presentation.

DOI： 10.1007/s00431-010-1295-3

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL PUBLISHING, INC  

Background:
It is clear that inflammation plays an important role in developing chronic lung disease in preterm infants. The purpose of the present study is to investigate changes of serum soluble tumor necrosis factor receptor-1 levels over time in infants with chronic lung disease.
Methods:
The serum levels of soluble tumor necrosis factor receptor-1 were measured after delivery, and at 7, 14, 21 and 28 days of age in 10 infants with chronic lung disease and in 18 infants without chronic lung disease.
Results:
The serum level of soluble tumor necrosis factor receptor-1 was significantly higher in infants with chronic lung disease than in infants without chronic lung disease after delivery. The differences between these two groups remained up to 28 days of age.
Conclusion:
Prenatal inflammation with persistence into postnatal inflammation may be involved in the onset of chronic lung disease.

DOI： 10.1111/j.1442-200X.2009.02954.x

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE  

Full-term cord blood (TCB) hematopoietic stem/progenitor cells (HSC/HPCs) are used for stem cell transplantation and are well characterized. However, the properties of preterm cord blood (PCB) HSC/HPCs remain unclear. In the present study, we compared HSC/HPCs from TCB and PCB with respect to their expression of surface markers, homing capacity and ability to repopulate HSCs in the NOD/Shi-scid mice bone marrow. The proportion of CD34+CD38- cells was significantly higher in PCB. On the other hand, the engraftment rate of TCB CD34+ cells into NOD/Shi-scid mice was significantly higher than PCB CD34+ cells. The expression of VLA4 was stronger among TCB CD34+ cells than PCB CD34+ cells. Moreover, there was a positive correlation between the proportion of CD34+CXCR4+ cells and gestational age. These data suggest that the homing ability of HSCs increases during gestation, so that TCB may be a better source of HSCs for transplantation than PCB. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.bbrc.2009.08.139

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Aim: Chronic lung disease (CLD) is a major component in the morbidity of premature infants suffering from fetal inflammatory response (FIRS). The aim of the present study was to compare the value of measuring neonatal urinary beta(2)-microglobulin (beta(2)-MG) levels with fetal blood interleukin (IL)-6 levels in premature infants at risk of developing CLD.
Methods: Premature infants (gestational age &lt;30 weeks) without CLD (n = 19) and with CLD (n = 10) were enrolled. We measured IL-6 levels in umbilical cord blood and beta(2)-MG levels in urine obtained within 48 h after birth.
Results: IL-6 and beta(2)-MG levels were significantly higher in infants who developed CLD than in those who did not (median IL-6, 54.7 vs 7.6 pg/mL; P &lt; 0.005; beta(2)-MG 17.7 vs 9.3 x 10(4) mu g/gCr; P &lt; 0.05). The sensitivity and negative predictive value of beta(2)-MG at the cut-off value at 10.0 x 10(4) mu g/gCr (0.90 and 0.92) were comparable to IL-6 at 16 pg/mL (0.90 and 0.94).
Conclusion: We suggest that measuring urinary beta(2)-MG in premature infants soon after birth can monitor FIRS and may provide information on the risk of subsequent CLD development that is as clinically important as information derived from umbilical cord blood IL-6.

DOI： 10.1111/j.1447-0756.2008.00988.x

Web of Science

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER HEIDELBERG  

Congenitally corrected transposition of the great arteries (ccTGA) is a rare cardiac defect characterized by the atria connecting with anatomically discordant ventricles and the ventricles connecting with discordant and transposed great arteries, which allows hemodynamic compensation. Most patients with ccTGA have associated intracardiac anomalies, which could be a diagnostic clue, whereas isolated forms are infrequently diagnosed during the neonatal period and in utero. We describe a fetus that was diagnosed with ccTGA and without additional cardiac anomalies at 25 weeks of gestation. The parallel course of the great arteries discovered during a routine obstetric scan indicated this rare cardiac anomaly. Further detailed examination of the ventricular morphology helped to confirm the diagnosis. Despite hemodynamic compensation, the long-term prognosis of ccTGA is uncertain because of the possible development of arrhythmias or heart failure later in life. Our findings showed that fetal echocardiography can detect prenatal ccTGA.

DOI： 10.1007/s00404-008-0739-8

Web of Science

PubMed

researchmap

Language：English   Publisher：WILEY-BLACKWELL PUBLISHING, INC  

The aim of our study was (i) to determine whether chorioamnionitis (CAM) is associated with an elevated soluble tumor necrosis factor receptor I (sTNFR-I) level and (ii) to examine the time course of the concentration of sTNFR-I in preterm infants after birth.
We measured sTNFR-I levels in the cord blood of 112 preterm infants (gestational age &lt;= 34 weeks), and those in peripheral blood of 30 preterm infants on days 7, 14, 21 and 28.
The median value for the sTNFR-I was significantly elevated in 33 infants with CAM at stage 3 (4618 pg/mL) compared with the 52 infants without CAM (2866 pg/mL), or the 13 infants with CAM at stage 1 (3638 pg/mL) and the 14 infants at stage 2 (3242 pg/mL). The severity of CAM is an independent factor for the elevation of cord blood sTNFR-I. The sTNFR-I level on day 0 was significantly higher in eight infants with CAM at stage 3 than in the 22 infants without CAM or with CAM at stage 1 and 2; however there were no significant differences on days 7, 14, 21 and 28. The serum level of sTNFR-I showed a significant gradual decline with time.
We suggest that there is an association between elevated sTNFR-I levels in cord blood and maternal CAM, and this elevation may reflect the fetal inflammation. However the elevation of sTNFR-I could not persist postnatally for a long time.

DOI： 10.1111/j.1447-0756.2008.00949.x

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

We describe an infant with nemaline myopathy accompanied by hypertrophic cardiomyopathy. The patient required long-term, intermittent positive-pressure ventilation after birth owing to muscle weakness, and cardiac failure developed during infancy. We diagnosed hypertrophic cardiomyopathy with outflow tract obstruction, and treated the heart failure with β-adrenergic and angiotensin II receptor blockers. We discuss the prognosis of nemaline myopathy combined with hypertrophic cardiomyopathy.

DOI： 10.1272/jnms.75.350

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

In this case-control study, we examined infants delivered vaginally at 37 weeks or later to identify factors associated with transient tachypnea of the newborn (TTN). We reviewed the obstetric records of all vaginal deliveries at the Japanese Red Cross Katsushika Maternity Hospital from 2005 through 2007. Demographic information and the characteristics of labor were extracted from patient charts. Multivariate analysis identified that the incidence of TTN was significantly associated with nulliparity; a history of infertility therapy, such as in vitro fertilization; augmentation of labor; nonreassuring fetal status; vacuum/forceps delivery; and low Apgar score (<7) at 1 and 5 minutes. In addition, a low Apgar score at 1 minute was the factor most strongly associated with the incidence of TTN (adjusted odds ratio, 20; 95% confidence intervals, 12-34; p<0.001). The present results indicate that the improvement of obstetric surveillance to diminish the frequency of low Apgar scores is important for preventing TTN in infants delivered vaginally at 37 weeks or later.

DOI： 10.1272/jnms.75.269

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

We present a case of fetal tricuspid valve dysplasia, which was diagnosed at 22 weeks of gestation during a routine obstetrical examination. Serial fetal echocardiographic evaluation revealed progressive right ventricular outflow tract obstruction and persistent cardiomegaly. A female infant weighing 1,916 g was delivered by elective cesarean section at 38 weeks of gestation. Longstanding compression of the fetal lungs secondary to the persistent cardiomegaly resulted in severe respiratory distress and cyanosis immediately after birth. Although, mechanical ventilation and continuous infusion of prostaglandin were instituted, the infant died of respiratory failure at 21 days of age. During the pregnancy, the fetus exhibited intrauterine growth restriction, but hydrops did not occur. In regard to the fetal hemodynamics in this cardiac anomaly, transatrial communication is essential for fetal survival. The diameter of the fossa ovalis, which is a marker of transtrial blood flow, was adequate in this case. However, marked enlargement of the right heart associated with regurgitation interfered with left ventricular filling and output, which resulted in restriction of the combined ventricular output and intrauterine fetal growth restriction. © Springer-Verlag 2005.

DOI： 10.1007/s00404-005-0084-0

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JOHN WILEY & SONS INC  

We present a rare case of suprasellar arachnoid cyst discovered incidentally on routine fetal sonographic examination. Serial sonographic and MRI scanning led to a prenatal diagnosis and appropriate endoscopic treatment at 5 months of age. The patient is currently developing normally at 3 years of age. Careful screening of fetal intracranial abnormalities is important in routine prenatal sonographic examination for early intervention, which will prevent irreversible complications such as endocrine disorders and visual impairment. (C) 2006 Wiley Periodicals, Inc.

DOI： 10.1002/icu.20202

Web of Science

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Background: Fetal supraventricular tachycardia confers an increased risk of cardiac failure, hydrops, and eventual intrauterine death. Although protocols for prenatal anti-arrhythmic treatment are now well established, few published reports discuss this condition in the setting of multiple pregnancies. Case report A 20-year-old primigravida woman with a twin pregnancy presented at 31 weeks of gestation for routine obstetrical check-up which revealed simultaneous supraventricular tachycardia in both fetuses. She was treated with oral digoxin, resulting in successful cardioversion in both of the fetuses, which was maintained until they were delivered by caesarian section at 38 weeks gestation. However, several hours after birth, tachyarrhythmias recurred in each of the infants. Combined disopyramide therapy with digoxin was necessary to control their heart rates. Conclusion: The treatment of arrhythmia in fetuses of a multiple gestation presents unique issues, particularly when diagnosed prior to fetal lung maturity. © Springer-Verlag 2004.

DOI： 10.1007/s00404-003-0576-8

Scopus

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Over a five-year period, we reviewed 19 fetuses who were prenatally diagnosed with congenital heart disease, including hemodynamically significant arrhythmias. Five of them had fetal tachyarrhythmias, and 14 had structural heart disease. The outcomes were: six intrauterine deaths, five neonatal deaths, and three infant surgeries. Six of the fetuses had chromosomal abnormalities, four had extracardiac anomalies, and two had hydrops fetalis. Of the 96 neonates with congenital heart disease found during the study period, the overall detection rate was 20%
16% of the neonates with structural cardiac defects and 83% of the neonates with arrhythmias. Some of the complex cardiac defects with normal fetal four-chamber view were difficult to detect prenatally. During the course of the pregnancy, 37% of the fetuses with prenatally diagnosed congenital heart disease were found to have intrauterine growth retardation, and 26% were found to have an abnormal amniotic fluid volume. In view of our findings, a comprehensive screening system should be more frequently considered in order to improve both detection rate and perinatal management.

DOI： 10.1272/jnms.71.328

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY-ELSEVIER  

The urinary beta(2)-microglobulin (MG) concentration on day 0 to 2 was significantly higher in premature infants with chorioamnionitis (CAM) than in infants without CAM and in infants who developed chronic lung disease (CLD) than in those who did not. We propose that an elevated urinary beta(2)-MG can indicate a fetal inflammatory response and identify neonates at risk for the development of CLD.

DOI： 10.1016/S0022-3476(03)00249-X

Web of Science

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

We report an unusual case of perforation of a congenital fibrosarcoma of the jejunum in utero and secondary meconium peritonitis. Prenatal ultrasound showed polyhydramnios and fetal ascites from 25 gestational weeks in the absence of other fetal congenital anomalies. A 2200 g baby girl was born at 34 weeks gestation, presenting with severe generalized edema and respiratory distress immediately after birth. Plain radiography revealed progressive abdominal distension and pneumoperitoneum. The baby subsequently underwent surgery at the age of one day. A perforation of the upper jejunum, which had resulted in meconium peritonitis, was discovered intraoperatively and the perforated section of the intestine was resected and anastomosed successfully. The postoperative course was uneventful. Pathological examination confirmed that the perforation was caused by rupture of a congenital fibrosarcoma originating from the jejunum. Rupture of a malignant tumor is an extremely rare cause of peritonitis in the fetus and neonate.

DOI： 10.1055/s-2003-39560

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

A 23-year-old woman, gravida 1, was referred to our hospital for possible fetal distress at 32 weeks of pregnancy, A fetal cardiotochogram showed a reactive pattern, but mild continuous bradycardia and an intermittent pulse were observed, regarded as a sinus type and a type of A-V block, respectively. The continuous deceleration of the heart rate to 95 bpm was observed frequently at 35 weeks, 3 days of gestation. Thus, an emergent cesarean section was performed and a viable 2,082 g female infant was delivered. The neonate gradually became cyanotic, and an echocardiogram was performed. The neonate was regarded as a right ventricular outflow obstruction with intact ventricular septum. Unlike other cases, the infant revealed a moderately developed right ventricle despite a severely stenotic tricuspid valve. The infant died 27 days after birth and an autopsy established the diagnosis of critical pulmonary stenosis with intact ventricular septum. Right ventricular myocardial sinusoidal-coronary artery connections, one of the major features of this type of heart anomaly, was speculated to be involved in the cause of fetal bradyarrhythmias.

DOI： 10.1007/s00404-002-0307-6

Scopus

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Medical Association of Nippon Medical School  

A characteristic prenatal ultrasonographic finding of patent urachus is described. Routine obstetrical ultrasonography first revealed a cystic mass in the umbilical cord at 16 weeks of gestation. The mass spontaneously decreased in size and was undetectable at full term on serial ultrasound examination. The male newborn infant was delivered uneventfully at 38 weeks of gestation, weighing 2,774 g. He was noted to void urine from the umbilicus soon after birth, and, the diagnosis of patent urachus was confirmed. On the 8 th day of life, complete surgical removal of the urachus was performed, and the postoperative course was uneventful. An umbilical cystic mass which diminishes in size over the course of pregnancy is a sugesstive prenatal sonographic finding for urachal anomalies.

DOI： 10.1272/jnms.70.172

Scopus

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

We describe here the case of a female newborn baby with a bilateral complete transverse facial cleft. Obstetrical ultrasound had revealed an increased amount of amniotic fluid from 28 weeks' gestation without fetal hydrops or congenital anomalies. A 1900-g baby girl born at 36 weeks' gestation presented with bilateral wide facial clefts with macrostomia, microphthalmia, nose, and auricular deformities. Her breathing was dependent on life support, which was discontinued 2 hours after birth. An autopsy revealed no congenital malformations in vital organs but the absence of the olfactory nerves. Polyhydramnios and respiratory arrest after birth were presumed to be due to central disintegration of swallowing and breathing, in this case with brain anomaly.

DOI： 10.1038/sj/jp/7210595

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Mesenchymal stem villous hyperplasia of the placenta is a rare placental anomaly characterized by placental vascular malformation and the appearance of a partial mole. CASE: A multiparous woman presented with fetal growth restriction (FGR) at 35 weeks’ gestation. Ultrasonographic examination showed multiple anechoic lesions on the placental surface. Cesarean delivery was performed at 37 weeks’ gestation, and a healthy 1536-g female was delivered. The placenta had aneurysmal dilatations of the chorionic vessels. Unlike other cases, it also showed subamniotic hemorrhage and had no features of a partial mole. Histologic examination established the diagnosis of mesenchymal stem villous hyperplasia of the placenta with severe thrombosis. CONCLUSION: Fetal growth restriction can be caused by severe thrombosis in this placental anomaly. © 2001 American College of Obstetricians and Gynecologists.

DOI： 10.1016/S0029-7844(01)01512-5

Scopus

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: Our aim was to obtain new information about the relationship between infant responses to surfactant replacement therapy and histopathological changes in vital organs. STUDY DESIGN: To accomplish this, the autopsy findings and clinical backgrounds of 41 very low birth weight infants (gestational week 25.6 +/- 2.3; birth weight 806.4 +/- 251.6g) who had died after receiving surfactant replacement therapy were reviewed, and those who responded to therapy were compared with those who did not. Responders were infants in whom the required FiO(2) declined by > 20% or mean airway pressure declined by > 20% within six hours of instilling surfactant (n=18); non-responders were infants who did not meet those criteria (n=23). RESULT: Gestational age, birth weight and time at treatment were similar in responders and non-responders, but survival was significantly longer in responders. The incidences of hyaline membrane disease, pulmonary interstitial emphysema, hemorrhagic necrosis and parenchymal degeneration of the liver and kidney were all higher in non-responders, whereas the incidences of bronchopulmonary dysplasia and pneumonia were higher in responders. Prior to treatment, acidosis and hypothermia were significantly more severe in non-responders, and perinatal complications, such as fetal distress and intrauterine infection, were observed more often in non-responders. Substantial degradation of vital organs had already occurred during the early post-natal or intrauterine life of the non-responders, which would be expected to interfere with the clinical response to instilled surfactant. CONCLUSION: It is anticipated that in the future improved monitoring of immature fetuses will be indispensable to improve intrauterine fetal management and to achieve better control over the timing and mode of delivery.

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Resistive indices (RI) in the anterior cerebral artery (ACA), basilar artery (BA), middle cerebral artery (MCA) and descending aorta (DA) were obtained in 15 small-for-dates (SFD) infants who were, growth retarded because of maternal pregnancy-induced hypertension and in 20 appropriate-for-dates (AFD) infants matched for gestational age between 24 h and 48 h after birth. The RIs in the MCA, ACA and BA were significantly lower, while the RI in the DA was significantly higher, in the SFD infants than in the AFD infants. These changes in RIs in the SFD infants might be similar to the "brain sparing" effect as reported in growth-retarded fetuses.

PubMed

researchmap

researchmap

researchmap

researchmap

Language：Japanese   Publisher：(一社)日本臨床免疫学会  

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

researchmap

Language：Japanese   Publisher：(公社)日本新生児成育医学会  

researchmap

Language：Japanese   Publisher：(公社)日本新生児成育医学会  

researchmap

Language：Japanese   Publisher：(公社)日本新生児成育医学会  

researchmap

Language：Japanese   Publisher：(株)東京医学社  

researchmap

Language：Japanese   Publisher：(公社)日本小児科学会  

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：(一社)日本臨床免疫学会  

researchmap

Language：Japanese   Publisher：(一社)日本病院薬剤師会  

重症筋無力症は生殖可能年齢の女性に多く発症するため、妊娠・授乳中に発症することがある。免疫グロブリン静注療法は、重症筋無力症の急性増悪時に有効な治療法であるが、妊娠・授乳中の使用に関する報告は乏しく、外来にて免疫グロブリン静注療法を行った報告はない。妊娠23週に重症筋無力症の症状増悪があり、外来にて免疫グロブリン静注療法を施行し、重篤なクリーゼを発症することなく妊娠37週で自然分娩にて健児を出産した。外来にて治療が継続できたことで入院によるストレス軽減や医療費削減にも貢献できる可能性が示唆された。また、薬剤使用による出生児への影響に関する過度な不安に対し、妊娠前、妊娠判明後、母乳栄養開始時に薬剤師からカウンセリングを行った。脳神経内科医師、新生児科医師とともに協議し、薬剤師からカウンセリングを行うことは、薬物療法、妊娠、授乳を継続するうえで、有用な方法であると考えられた。(著者抄録)

researchmap

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J04451&link_issn=&doc_id=20200812230010&doc_link_id=%2Fdg4hppha%2F2020%2F005608%2F010%2F0913-0917%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdg4hppha%2F2020%2F005608%2F010%2F0913-0917%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(株)東京医学社  

＜回答のポイント＞1)出生後間もない新生児の皮膚は、環境変化に即応する準備がまだ十分に整っていない。2)全身の多様な紅斑は、温度・湿度の変化に対する真皮上層の毛細血管網の反応性の未熟さの結果であり、炎症機転を生ずるに至ったものがいわゆる中毒疹として観察される。3)これらはいずれも生理的で一過性の変化なので、特別な処置を要さずとも数日の経過で消褪してゆく。4)一方、症候性の皮疹では感染症の直接・間接的な作用であることが多いが、ごく稀に母体疾患を背景に出現する場合もある。4)病的皮疹の鑑別には、局所所見だけではなく、児のそのほかの全身状態や、母親の妊娠中の合併症・既往歴などについても留意する。(著者抄録)

researchmap

Language：Japanese   Publisher：(株)東京医学社  

＜回答のポイント＞1)医学的にはさまざまな誘引による不随意で反射的に反復する横隔膜の攣縮現象である。2)健康な新生児なら、ほぼ哺乳時の状況や体温変化などの物理的事象に起因すると考えてよい。3)通常は一時的で、数分にわたって持続するようなことがあっても自然に停止する。4)排気を促す、着衣を点検するなどの対処のみでよいことを保護者に説明して安心させる。(著者抄録)

researchmap

Language：Japanese   Publisher：(株)東京医学社  

＜回答のポイント＞1)羊水中にあった皮膚は突然大気にさらされるので、急速に乾燥して表層部が剥離・脱落する。2)正常な適応現象の一つで、新生児の成熟度評価の指標にもなっている。3)腹部や四肢に顕著で、粃糠様あるいは大小の葉状となって落屑する。4)生後1〜2日頃より始まり、数日の経過で収束するので特別な処置は必要としない。(著者抄録)

researchmap

Language：Japanese   Publisher：日本臨床免疫学会  

researchmap

Language：Japanese   Publisher：(一社)日本臨床免疫学会  

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

researchmap

Language：Japanese   Publisher：(公社)日本小児科学会  

症例は在胎37週6日に出生した1828gの女児で、脳梁欠損、脳室拡大の精査目的で日齢0に当院NICUへ入院となった。入院時、口蓋裂、小顎症、耳介低位、両足第二趾の折り重なり、両側の揺り椅子状足底を認めた。超音波では上記の脳所見に加え、小脳低形成、右卵巣嚢腫を認めた。日齢1より経腸栄養を開始したところ、徐々に多呼吸が出現し、乳酸アシドーシスが進行した。血液・髄液ともにL/P比正常の乳酸・ピルビン酸の上昇を認め、遺伝子解析の結果、PDHC欠損症(ピルビン酸脱水素酵素複合体欠損症)の診断が確定した。診断後はケトンフォーミュラの投与を開始し、呼吸状態や乳酸アシドーシスは改善したが、日齢35に突然無呼吸発作が頻発し、フェノバルビタール投与にて症状は消失した。日齢112にはヒプサリスミアを認め、フルスルチアミン、レボカルニチン、ビオチン、ポラプレジンク補充にて症状は改善した。

researchmap

Language：Japanese   Publisher：(公社)日本産科婦人科学会  

researchmap

Language：Japanese   Publisher：神奈川県医師会  

researchmap

Language：Japanese   Publisher：(一社)日本新生児成育医学会  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

症例は日齢2の男児で、在胎38週0日に予定帝王切開にて出生体重3130gで出生した。日齢2の検温時に体温が35.8度まで低下しており、活気がないことに気付かれた。吸気性喘鳴と徐脈が出現した後に呼吸が停止したため、陽圧換気での蘇生を開始しNICUに入室となった。NICUへの移動後も自発呼吸が再開しなかったため、気管挿管および人工呼吸管理を開始した。その後、一旦は呼吸循環ともに安定したものの、入院3時間後に再度SpO2の低下・徐脈が出現し心肺蘇生を再開した。日齢6に提出した新生児マススクリーニングでのアシルカルニチン分析にて中鎖アシルCoA脱水素酵素(MCAD)欠損症が疑われたため、専門機関にMCAD酵素活性および遺伝子解析を依頼し、MCAD欠損症の確定診断に至った。退院に向けた準備として、新生児マススクリーニング対象疾患等診療ガイドライン2015に準じて哺乳間隔の順守、L-カルニチンの内服、両親による血糖測定、哺乳不良やsick dayを指導、日齢80に退院となった。

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本周産期・新生児医学会  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：東京医学社  

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)関東連合産科婦人科学会  

researchmap

Language：Japanese   Publisher：(公社)神奈川県医師会  

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese   Publisher：金原出版  

CiNii Books

researchmap

Language：Japanese   Publisher：日本知的障害者福祉協会 ; 2002-  

CiNii Books

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本産科婦人科学会  

CiNii Books

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese   Publisher：金原出版  

CiNii Books

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

We report a case of intrauterine intestinal volvulus without malrotation in a fetus. A 31-year-old woman was admitted at 33 weeks 3 days&#039; gestation because of decreased fetal movement and a nonreassuring fetal heart rate pattern on cardiotocography. A 1,948-g boy was delivered via emergency cesarean section. After birth, a small-bowel volvulus without malrotation was noted at laparotomy. In this case, the abnormal fetal heart rate pattern might have been caused by the decreased cardiac output associated with intestinal bleeding and distension due to small bowel volvulus.&lt;br&gt;

DOI： 10.1272/manms.9.198

CiNii Books

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本小児科学会  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本小児科学会  

CiNii Books

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese   Publisher：金原出版  

CiNii Books

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

We report on 10 premature infants with acute hemolytic anemia and Heinz bodies treated from 1999 to 2007 and discuss their clinical characteristics. All patients were very low birth weight infants (mean gestational age, 27 weeks; range, 24～30 weeks; mean birth weight, 889g; range, 598～1,412g), and hemolytic anemia developed after cardiopulmonary adaptation had been achieved. Heinz body appeared an average of 20 days after birth (range, 11～25 days), and hemolysis persisted for an average of 9 days (range, 4～16 days) and spontaneously resolved. Hemolytic anemia and jaundice developed suddenly, during which time Heinz bodies were observed on hematologic examination. The affected infants showed refractory apnea just before the onset of hemolytic anemia.&lt;br&gt; The exact cause of these hemolytic episodes remains unclear. However, the immature antioxidant function of the red blood cell membrane against oxygen radicals was a suspected cause, because most of the infants required ventiratory managements with high concentration of supplemental oxygen.&lt;br&gt;

DOI： 10.1272/manms.7.16

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese   Publisher：金原出版  

CiNii Books

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：永井書店  

CiNii Books

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

Despite strict adherence to standard precautionary methods, such as hand washing, isolation precaution, and individual use of various devices, methicillin-resistant Staphylococcus aureus (MRSA) has become epidemic in our neonatal intensive care unit (NICU). To prevent nosocomial MRSA transmission via the hands of hospital personnel, we have worn gloves while caring for neonates since July 2005. The colonization rate of MRSA was calculated as the ratio of the neonates colonized with MRSA to the total number of neonates in our NICU. With the glove precaution, the mean colonization rate has decreased from 20% (April 2004 through June 2005) to 8.8% (July 2005 through June 2006). This study suggests that the glove precaution can significantly reduce the nosocomial transmission of MRSA, although it might be necessary to survey MRSA carriers and search for effective control measures in each NICU.<br>

DOI： 10.1272/manms.4.189

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：東京医学社  

CiNii Books

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

researchmap

Language：Japanese   Publisher：日本産婦人科・新生児血液学会  

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：東京医学社  

CiNii Books

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

Despite strict adherence to standard precautionary methods, such as hand washing, isolation precaution, and individual use of various devices, methicillin-resistant &lt;i&gt;Staphylococcus aureus&lt;/i&gt; (MRSA) has become epidemic in our neonatal intensive care unit (NICU). To prevent nosocomial MRSA transmission via the hands of hospital personnel, we have worn gloves while caring for neonates since July 2005. The colonization rate of MRSA was calculated as the ratio of the neonates colonized with MRSA to the total number of neonates in our NICU. With the glove precaution, the mean colonization rate has decreased from 20% (April 2004 through June 2005) to 8.8% (July 2005 through June 2006). This study suggests that the glove precaution can significantly reduce the nosocomial transmission of MRSA, although it might be necessary to survey MRSA carriers and search for effective control measures in each NICU.&lt;br&gt;

DOI： 10.1272/manms.4.189

researchmap

Language：Japanese   Publisher：日本医科大学医学会  

Coarctation of the aorta without intracardiac structural anomaly is uncommon and is rarely detected during early infancy. We report here a case of simple coarctation of the aorta in a male newborn who was initially treated for postnatal transient tachypnea. A disparity in blood pressure between the upper and lower extremities prompted echocardiographic examination focused on the aortic isthmus. Heart failure due to afterload mismatch was confused with neonatal tachypnea in the first days after admission. Surgical repair was successfully performed, and the postoperative course was uneventful. Careful physical examination was the key clue to the correct diagnosis of this unusual condition in our patient.&lt;br&gt;

DOI： 10.1272/manms.4.15

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：永井書店  

CiNii Books

researchmap

Language：Japanese   Publisher：東京医学社  

CiNii Books

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese   Publisher：東京医学社  

CiNii Books

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本小児医事出版社  

CiNii Books

J-GLOBAL

researchmap

Language：Japanese  

OBJECTIVE: To investigate how the increase in survival rate in extremely low birth weight (a birth weight of 1,000 g or less) infants had affected the incidence of retinopathy of prematurity (ROP) and the frequency of laser treatment. METHODS: We retrospectively reviewed the medical records of 122 surviving premature infants with birthweights less than 1,000 g to determine the severity of ROP observed at 16 neonatal intensive care units in Tokyo between April and October 2002. RESULTS: The survival rate was 85.6%. The mean gestational age was 26.74 weeks and the mean birth weight was 782.25 g. One-hundred-and-five infants (86.1%) developed ROP, fifty (41.0%) received laser treatment, and six (4.9%) had retinal detachment. The median postmenstrual age (gestational age at birth plus chronological age in weeks, PMA) at the onset of ROP was 32.5 weeks, and the first laser treatment was performed at the median PMA of 35.7 weeks. CONCLUSIONS: In these extremely low birth weight infants, there was an increase in the survival rate and in the incidence of severe ROP that progressed to the stage that required treatment.

PubMed

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：English   Publishing type：Rapid communication, short report, research note, etc. (scientific journal)