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

Tracheo-innominate artery fistula (TIF) is a serious, life-threatening complication following tracheostomy. We report a fatal TIF in a 15-year-old girl with Pelizaeus-Merzbacher disease. She received a tracheostomy for prolonged translaryngeal intubation due to acute respiratory failure without a trial of noninvasive ventilatory support before intubation. Severe hemorrhage from the TIF occurred 6 months after tracheostomy; immediate resuscitation failed. Antemortem fiberoptic bronchoscopy showed tracheal stenosis accompanied by granulation tissue, and postmortem examination revealed TIF with ulcerative granulation. Preventive intervention is required to avoid catastrophic TIF due to its high mortality rate. Moreover, to avoid prolonged translaryngeal intubation leading to tracheostomy, noninvasive ventilatory support before translaryngeal intubation, if applicable, is beneficial. (J Nippon Med Sch 2012; 79: 274-279)

DOI： 10.1272/jnms.79.274

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

Background: A global pandemic influenza A (H1N1) outbreak occurred in 2009. Rapid progress of respiratory distress is one of the characteristic features of pandemic influenza A (H1N1) infection. The physiologic mechanism causing hypoxia in pandemic influenza A (H1N1) infection, however, has not been elucidated.
Methods: The serum levels of KL-6 and surfactant protein D (SP-D) were evaluated in 21 cases of pandemic influenza A (H1N1) infection associated with chest radiographic abnormality in order to estimate alveolar involvement. The clinical features were also analyzed.
Results: All of the patients had high fever, and rapidly progressed to respiratory distress within several days of disease onset. Despite mild radiographic abnormality in these patients, dyspnea was severe and they had low blood oxygen saturation levels. Many of the patients had a history of allergic diseases including asthma. Serum KL-6 and SP-D levels on admission were 191 1 69 U/mL and 32.6 1 18.9 ng/mL, respectively. These two levels were still below the upper normal limit 1 week later. There were no clear relationships between specific clinical symptoms and KL-6 or SP-D levels. All patients were treated with oseltamivir and/or zanamivir, and improved without mechanical ventilation management.
Conclusion: KL-6 and SP-D elevation were not significant in pandemic influenza A (H1N1) infection associated with chest radiographic abnormality. In pandemic influenza A (H1N1) infection, alveolar involvement was estimated to be little, and severe respiratory distress was probably caused by obstruction of peripheral bronchi.

DOI： 10.1111/j.1442-200X.2011.03398.x

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

Streptococcus pyogenes. or group A Streptococcus (GAS), causes superficial infections of the upper respiratory tract that manifest as diseases such as pharyngitis and tonsillitis. T serotypes, emm genotypes, and the antimicrobial susceptibility of GAS isolated from the pharynges of patients with pharyngitis and tonsillitis were studied. The two most common T serotypes were T12 (10/25: 40%) and T1 (7/25: 28%), and the two most common emm genotypes were emm12 (12/27: 44%) and emm1 (7/27: 26%). Good correlation was observed between these T serotypes and emm genotypes. (J Nippon Med Sch 2011; 78: 174-177)

DOI： 10.1272/jnms.78.174

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DOI： 10.1272/jnms.78.2

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

We report an 8-year-old boy with left vertebral artery dissection featuring cerebellar ataxia in which congenital vertebral artery hypoplasia was suspected as a predisposing factor in the dissection. The patient suddenly suffered from vertigo and vomiting while swimming, and he was brought to our department. The initial brain Computed Tomography (CT) demonstrated no abnormalities, and his symptoms disappeared the next morning. However, one month after onset, brain Magnetic Resonance Imaging (MRI) revealed ischemic changes (infarction) in the left cerebellum. Transfemoral angiography showed complete occlusion at the C2 portion of the left vertebral artery, suggesting dissection and diffuse narrowing of the proximal segment of the occlusion site. Three-dimensional CT angiography also revealed diffuse narrowing of the left vertebral artery from the bifurcation of the subclavian artery. He has since been living daily life without any difficulties. The detailed etiology of cerebral artery dissection remains unknown, but arterial anomalies should be considered as a predisposing factor. (C) 2008 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.braindev.2008.07.004

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BLACKWELL PUBLISHING ASIA  

Background : Nearly 30% of childhood cases of chronic renal failure in Japan are attributed to congenital anomalies of the kidney and urinary tract ( CAKUT), and the number is increasing. Urine screening at school facilitates early diagnosis and treatment of glomerulonephritis, but early screening for anomalies is currently not in practice. The authors evaluated the value of early abdominal ultrasonography screening in 1- month- old infants.
Methods : The following characteristics of kidneys were assessed: presence versus absence, size, symmetry of size, position, separation of the central echo complex ( CEC), abnormal echogenicity, and other abnormal findings. The bladder and ureter were checked for abnormalities in bladder shape and wall, as well as retrovesical ureteral dilation. Criteria for abnormalities included kidney length of less than or equal to 35 mm, or greater than or equal to 60 mm; a difference in length of left and right kidneys of 10 mm or more; and CEC separation of Society for Fetal Urology ( SFU) grade 2 or higher.
Results : Beginning in April 1994 and continuing until September 2001, screening of 5700 1- month- old infants yielded 198 positive cases ( 3.5%) of CAKUT. Most frequent was abnormal CEC separation ( approximately 60% of all abnormalities), followed by abnormal renal size or size asymmetry ( 30%). Further investigation yielded a specific diagnosis in 32 cases ( 0.6%) of all subjects. Most prevalent was obstructive uropathy ( 15 cases); 8 children underwent surgery. Small kidneys and vesicoureteral reflux were next in frequency.
Conclusions : Ultrasonograpy was effective for early detection of renal and urinary tract anomalies. Ultrasound screening in early infancy may permit early treatment, that can prevent renal dysfunction.

DOI： 10.1046/j.1442-200X.2003.01780.x

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

Serum KL-6 reflects alveolar damage and regeneration of type II pneumocytes, indicating disease activity in various interstitial lung diseases, We conducted a descriptive and observational multiple case-control study to determine the distribution of serum KL-6 levels in pediatric patients with or without respiratory diseases. Subjects were recruited from the patients of a teaching hospital in the suburb of Tokyo. A consecutive series of 401 children (0-16 years old) underwent blood sampling for many clinical reasons. They comprised the following four groups: pneumonia (n=96), bronchial asthma (n=101), measles (n=102), and nonrespiratory diseases (n=102) as a control group.
Standard upper limits of serum KL-6 in a group of children with nonrespiratory disease were 250 U/mL, or half the adult level, No gender or age differences were observed. Elevated serum KL-6 concentrations were observed in severe pneumonia, acute exacerbations of asthma, and measles pneumonia. In the measles group, KL-6 values reflected the presence and severity of complicating pneumonia.
We conclude that serum KL-6 levels exceeding 250 U/mL were rarely observed in children without respiratory diseases. In contrast, a substantial proportion of children with common respiratory diseases showed mild to moderate increases in serum KL-6 levels. Elevated serum KL-6 in these children may reflect the presence of alveolar damage, followed by regeneration of type II pneumocytes. However, in order to use serum KL-6 as a marker of interstitial lung diseases in children, a cutoff level should be determined separately. (C) 2002 Wiley-Liss, Inc.

DOI： 10.1002/ppul.10044

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

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水痘は感染力が強く保育園などの集団の中で流行性耳下腺炎とともに広く流行する疾患であり、ワクチンによって予防しうる疾患(VPD:Vaccine Preventable Disease)の一つである。保育園での水痘の流行状況、ワクチンの接種状況、水痘のワクチン接種児と非接種児との臨床症状の比較、罹患後の併発症等について保護者に質問紙調査を行い、241名から回答を得た。保護者の水痘に対する意識や水痘の流行状況、ワクチンの接種状況について検討したところ、保護者の意識調査では、症状が軽いから自然に罹患したほうがいいとする意見も32.8%にみられた。しかし、質問紙回答者のうちワクチン接種者は45.5%(46/101)が水痘に罹患していた。水痘ワクチン接種の有無によって水痘罹患時の症状について、罹患年齢、発熱期間、最高体温、回復までの期間、発疹数を比較したところ、罹患年齢と回復までの期間はワクチン接種群で有意に罹患年齢が高く、また回復までの期間は短かった。最高体温、発熱期間も接種群では程度が軽かった。発疹数について比較したところ、ワクチン接種群で発疹が50個以上の児は少なく、非接種群で有意に多かった。さらに罹患後の併発症としてのアトピー性皮膚炎の増悪や伝染性膿痂疹などの皮膚症状が、ワクチン接種群では非接種群に比べて少数であった。今回の調査では、水痘のワクチン接種を2回行っていた児は水痘に罹患していない1名のみであった。1回接種では感染に対する予防効果が十分得られず、水痘ワクチン接種後罹患が多く認められた。しかし、その症状はワクチン非接種児に比べ軽微であり、皮膚症状などの併発症を起こす割合が少なかった。(著者抄録)

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Language：Japanese   Publisher：(一社)日本感染症学会  

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小児の喀血は稀である。とくに基礎疾患の明らかでない喀血の症例に遭遇した場合、その対応に苦慮することが多い。我々は、大量の喀血を繰り返し、気管支動脈造影により原発性気管支動脈蔓状血管腫と診断した2例を経験した。気管支動脈蔓状血管腫の特徴的所見は、気管支動脈の著明な拡張、屈曲、蛇行、細小血管の増生であり、しばしば気管支動脈と肺動脈との異常吻合も見られる。症例1は11歳の女児、症例2は7歳の女児で、ともに気管支動脈塞栓術を行い症状は消失した。気管支動脈蔓状血管腫は小児の喀血の原因として重要な疾患の一つであると考えられるが、国際的に認知された診断名とは言い難い。今後国際的に統一された疾患概念ならびに診断名が確立される必要がある。(著者抄録)

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Language：Japanese   Publisher：(公社)日本薬学会  

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.50.286_3

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

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.49.279_3

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Language：Japanese   Publisher：(一社)日本アレルギー学会  

DOI： 10.15036/arerugi.48.1040_3

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Language：Japanese   Publisher：(一社)日本アレルギー学会  

DOI： 10.15036/arerugi.48.953_3

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Language：Japanese   Publisher：(一社)茨城県医師会  

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DOI： 10.15036/arerugi.48.372_4

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Language：Japanese   Publisher：(一社)日本アレルギー学会  

DOI： 10.15036/arerugi.48.376_4

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.48.372_4

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.48.953_3

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.48.1040_3

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.48.376_4

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Language：Japanese   Publisher：医歯薬出版(株)  

活動期の慢性活動性EBウイルス感染症患者の末梢血T細胞にはEBウイルスが感染している.全例でCD3+分画よりEBV-genomeが検出され,その陽性バンドが内部標準に匹敵するほどの強いintensityを示した

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アトピー性皮膚炎(AD)患者群並びに気管支喘息(BA)を合併するAD患者群の血中Zn濃度をADの重症度でグループ分けして検討すると,健常対照群に比し中等症群,重症群で有意に低値であり,しかも重症ほど低値であった.そこで,AD患者ないしBAを併発するAD患者において,血中Zn濃度を健常者の-1 SDとされる80μg/dl以上群と未満の群に分けてIgEの値を比べると,80μg/dl未満の群が80μg/dl以上群よりも高値を示す傾向にあった.AD患者ないしはBAを併発するAD患者のADの重症度と血中Zn濃度の関係を見ると,重症群は血中Zn濃度80μg/dl未満の群に多かった.一部の症例で経口Znの投与により皮膚症状の軽快が認められた.更に,AD患者ないしはBAを併発するAD患者は対照群の健常者に比し,毛髪中のZn濃度が有意に低値であった.それ故,ADの成立にZnが何らかの形で関与している可能性が示唆された

DOI： 10.3388/jspaci.12.244

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Language：Japanese   Publisher：(一社)茨城県医師会  

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Language：Japanese   Publisher：日本小児血液学会  

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Language：Japanese   Publisher：埼玉県医学会  

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DOI： 10.15036/arerugi.47.335_3

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The role of zinc in the production of atopic dermatitis (AD) was studied, and no significant differences were observed in Zn levels among patients of both AD and bronchial asthma (BA), patients with BA alone, and healthy control group.<br>In our comparative studies, no significant differences in IgE levels were observed between patients with serum Zn≥80μg/dl and those with levels<80mμg/dl.<br>However, most of severe cases of AD were found among patients with Zn blood level than 80μg/dl. In some cases, dermatological symptom disappeared when Zn was administrated orally. Moreover, in the comparative studies on Zn levels in hair the levels were significantly lower (p<0.01) in the AD group than in the healthy control group.<br>These results suggest that Zn may play some role in pathogenesis of AD.

DOI： 10.3388/jspaci.12.244

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Language：Japanese   Publisher：日本小児感染症学会  

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Language：Japanese   Publisher：THE JAPANESE SOCIETY OF PEDIATRIC ALLERGY AND CLINICAL IMMUNOLOGY  

We studied effects of cell wall constituents of Staphylococcus aureus, peptideglycan (PG) and N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP: muramyl didpeptide) on IL-4 induced IgE synthesis, interleukin 6 (IL-6) and interferon γ (IFN γ) production in peripheral blood mononuclear cells (PBMCs) from patients with atopic dermatitis (AD). PBMCs from patients with AD whose IL-4 induced IgE synthesis was low (<2U/ml) showed an elevated IgE production by the addition of PG or MDP (P<0.45), while PMBCs from patients with AD whose IL-4 induced IgE synthesis was high (≥2U/ml) showed a suppressed IgE synthesis by the addition of PG, whereas IgE synthesis was enhanced with MDP. But PBMCs from healthy children showed no significant changes in IgE synthesis when PG or MDP were added. Both PBMCs from AD and healthy children showed mild increase in IL-6 generation by the addition of PG or MDP. The IFN-γ generated from PBMCs showed a significant increase (P<0.05) by the addition of PG, and not by the addition of MDP in both healthy and AD groups.<br>These results indicated that Staphylococcal cell wail constituents (PG or MDP) elevate IL-4 induced IgE synthesis in patients with atopic dermatitis which lead to exacerbation of skin lesion.

DOI： 10.3388/jspaci.11.86

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Language：Japanese   Publisher：日本小児アレルギー学会  

IgE産生は,AD患児のうちIL4誘導IgE産生が低値(2U/ml未満)であった群では,PGまたはMDP添加により有意(P&lt;0.05)に増強された.IL4誘導IgE産生が高値であった群(2U/ml以上)ではPG添加によりIgE産生はむしろ抑制され,MDP添加時には上昇傾向にあった.対照群ではPGまたはMDP添加による有意な変化は認められなかった.IL6の産生はAD群,対照群共に,PGまたはMDP添加時に著明な増加を示した.又,IFNγ産生は,AD群ではPG添加時に産生の増加があったが,MDP添加時には変化は見られなかった.対照群でもPG添加時にIFNγ産生の増加が見られたが,MDP添加時には変化は見られなかった

DOI： 10.3388/jspaci.11.86

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DOI： 10.15036/arerugi.46.211_3

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Publisher：日本小児アレルギー学会  

We studied effects of cell wall constituents of &lt;i&gt;Staphylococcus aureus&lt;/i&gt;, peptideglycan (PG) and N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP: muramyl didpeptide) on IL-4 induced IgE synthesis, interleukin 6 (IL-6) and interferon &amp;gamma; (IFN &amp;gamma;) production in peripheral blood mononuclear cells (PBMCs) from patients with atopic dermatitis (AD). PBMCs from patients with AD whose IL-4 induced IgE synthesis was low (&lt;2U/ml) showed an elevated IgE production by the addition of PG or MDP (P&lt;0.45), while PMBCs from patients with AD whose IL-4 induced IgE synthesis was high (&amp;ge;2U/ml) showed a suppressed IgE synthesis by the addition of PG, whereas IgE synthesis was enhanced with MDP. But PBMCs from healthy children showed no significant changes in IgE synthesis when PG or MDP were added. Both PBMCs from AD and healthy children showed mild increase in IL-6 generation by the addition of PG or MDP. The IFN-&amp;gamma; generated from PBMCs showed a significant increase (P&lt;0.05) by the addition of PG, and not by the addition of MDP in both healthy and AD groups.&lt;br&gt;These results indicated that &lt;i&gt;Staphylococcal&lt;/i&gt; cell wail constituents (PG or MDP) elevate IL-4 induced IgE synthesis in patients with atopic dermatitis which lead to exacerbation of skin lesion.

DOI： 10.3388/jspaci.11.86

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Language：Japanese   Publisher：(株)北隆館  

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Language：Japanese   Publisher：THE JAPANESE SOCIETY OF PEDIATRIC ALLERGY AND CLINICAL IMMUNOLOGY  

As part of an attempt to clarify adverse effects of cockroachs and mites upon children suffering from bronchial asthma, measurement has beeen taken of IgE antibodies specific to two cockroach subspecies (Perplaneta fulginosa and Blattella germanica) and a mite (Dermatophagoides farinae) as for 20 asthmatic children.<br>Its results indicated that the rates of positivity were 25% (5/20) for Periplanate fulginosa, 30% (6/20) for Blattella germanica, and 95% (19/20) for Dermatophagoides farinae in the sera from the children as they were analyzed under Pharmacia's CAP system.<br>In nine of the cases, detection attempts were made for allergen in the children's houses, where major allergen of Periplanata fulginosa (Per f1) were actually detected in four cases but major allergen of Blattella germanica (Bla g2) were not detected.<br>Of nine cases in which both IgE antibodies specific to cockroaches and allergens were detected, there was only one case where the antibodies and allergens were positive.<br>A comparison of the volume of allergens among the positive group of IgE antibodies specific to cockroaches, its negative counterpart, and Dermatophagoides farinae (Der 1) revealed no significant differences among the children's room, kichins and living rooms.

DOI： 10.3388/jspaci.10.37

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.45.903_4

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DOI： 10.15036/arerugi.45.294_2

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Publisher：日本小児アレルギー学会  

As part of an attempt to clarify adverse effects of cockroachs and mites upon children suffering from bronchial asthma, measurement has beeen taken of IgE antibodies specific to two cockroach subspecies (Perplaneta fulginosa and Blattella germanica) and a mite (Dermatophagoides farinae) as for 20 asthmatic children.&lt;br&gt;Its results indicated that the rates of positivity were 25% (5/20) for Periplanate fulginosa, 30% (6/20) for Blattella germanica, and 95% (19/20) for Dermatophagoides farinae in the sera from the children as they were analyzed under Pharmacia&#039;s CAP system.&lt;br&gt;In nine of the cases, detection attempts were made for allergen in the children&#039;s houses, where major allergen of Periplanata fulginosa (Per f1) were actually detected in four cases but major allergen of Blattella germanica (Bla g2) were not detected.&lt;br&gt;Of nine cases in which both IgE antibodies specific to cockroaches and allergens were detected, there was only one case where the antibodies and allergens were positive.&lt;br&gt;A comparison of the volume of allergens among the positive group of IgE antibodies specific to cockroaches, its negative counterpart, and Dermatophagoides farinae (Der 1) revealed no significant differences among the children&#039;s room, kichins and living rooms.

DOI： 10.3388/jspaci.10.37

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Language：Japanese   Publisher：(NPO)日本気管食道科学会  

主として気管支喘息患児ら138例を対象に,AlaSTATとMASTで16項目のアレルゲン検索を行った. 1)各年齢群で全項目のアレルゲンにおいて,MASTに比べAlaSTATで高い陽性率が得られた. 2)両測定法のクラス間では良好な相関関係がみられたが,MASTで陰性,AlaSTATで陽性の症例が多く認められた. 3)同一患児における陽性アレルゲン数の平均はAlaSTATで5.47項目,MASTで2.32項目であった. 4)AlaSTATは感度が高く,アレルゲンの一次スクリーニング検査に有用であると考えられた

DOI： 10.2468/jbes.46.476

CiNii Books

J-GLOBAL

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Language：Japanese   Publisher：特定非営利活動法人 日本気管食道科学会  

Using AlaSTAT, a screening test was performed on 138 patients with bronchial asthma, mostly children, for various allergens (16 items). The relative rates of positive reaction to specific IgE antibodies were &lt;I&gt;Dermatophagoides farinae&lt;/I&gt; &gt; house dust 2 &gt; cat epithelium &gt; Japanese cedar &gt; egg white &gt; fungus. When AIaSTAT and MAST values were compared with skin test results (12 items), AlaSTAT and MAST were superior with respect to sensitivity and specificity, respectively. The mean number of positive allergens was 5.47 for AlaSTAT and 2.32 for MAST. Of 115 samples, 20 tested negative for allergens with MAST, while the corresponding number was 5 with AlaSTAT. These results indicate that AlaSTAT should be the primary clinical screening test.

DOI： 10.2468/jbes.46.476

CiNii Books

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.44.993_3

CiNii Books

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.44.398_2

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Language：Japanese   Publisher：(一社)日本アレルギー学会  

DOI： 10.15036/arerugi.43.1064_1

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.43.1064_1

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.43.342_4

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Language：Japanese   Publisher：一般社団法人 日本アレルギー学会  

DOI： 10.15036/arerugi.43.957_2

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