Publishing type：Research paper (scientific journal)  

DOI： 10.1172/jci.insight.169855

researchmap

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

Invasive neonatal infection with Group B Streptococcus (GBS) is a disease of concern that can lead to neurological sequelae. Guidelines for preventing mother-to-child transmission have been introduced to reduce the incidence of early-onset infection, but guidelines for controlling the late-onset form are lacking. Recently, the trans-breastfeeding route of transmission has been highlighted as an example of late-onset infection, but no consensus on how to manage such infections has been reached. In this report, we describe a case of late-onset bacteremia/meningitis in a neonate suspected to have been infected with GBS via breastfeeding. A vaginal culture test of the mother at 35 weeks' gestation was negative for GBS. Since she had symptoms of mastitis, breast milk and nipple cultures were also tested and found to be positive for the strain of GBS identified in the neonate on genetic analysis. Diagnosis of trans-mammary GBS infection is challenging because breastfeeding-related events are difficult to identify. In our case, the diagnosis was based on the mother's history of mastitis, and the patient was treated without escalation to sequelae. When a neonate develops a fever, physicians should consider GBS infection and examine the mother's medical history to facilitate accurate diagnosis, especially if the history includes mastitis. A breast milk culture should be performed if the mother has mastitis, especially in cases of infection in preterm infants and in recurrent cases.

DOI： 10.1272/jnms.JNMS.2024_91-501

PubMed

researchmap

Language：English  

UNLABELLED: Three patients, aged 2 years 0 months, 2 years 2 months, and 6 years 1 month at the time of plain old balloon angioplasty (POBA), developed an aneurysm in the left anterior descending coronary branch after suffering from Kawasaki disease. POBA was subsequently performed due to 99 % stenosis proximal to the aneurysm. There was no restenosis within a few years after percutaneous coronary intervention, and there was no evidence of ischemia, although 75 % restenosis occurred in two patients after 7 years.Although calcified lesions are more likely to occur 6 years after the onset of Kawasaki disease, none of the patients in this study had calcified lesions within 4 years of Kawasaki disease onset, and good results were obtained with POBA alone. POBA can be safely performed in children and is an effective treatment for improving myocardial ischemia if calcification has not progressed. LEARNING OBJECTIVE: Plain old balloon angioplasty (POBA) can be performed effectively and safely for Kawasaki disease coronary artery stenosis in early childhood if calcification is minimal, with little restenosis for at least several years. POBA is a useful tool in the treatment of coronary artery stenosis in early childhood.

DOI： 10.1016/j.jccase.2023.01.001

PubMed

researchmap

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

Coronary artery bypass grafting (CABG) for severe cardiac sequelae of Kawasaki disease (KD) complicated by myocardial ischemia is feasible even in childhood. However, no report has summarized the prognosis of CABG in preschool-aged children. Therefore, we evaluated the outcomes of seven preschool-aged children who underwent CABG for the cardiac sequelae of KD in our hospital. The median age at KD onset and CABG was 36 and 59 months, respectively. The median period from KD onset to CABG was 12 months. The median post-operative observation period was 108 months. CABG between the left internal thoracic artery and left anterior descending artery was performed in all patients. In all patients, postoperative cardiac catheter examination revealed good graft patency and no anastomotic stenosis. Further, pre-operative abnormality of coronary flow reserve returned to normal after CABG. Currently, only one patient is taking warfarin. Regarding school-life management, no patient has exercise limitations, except for one patient who had acute myocardial infarction before CABG. Further, the risk of graft stenosis or occlusion was evaluated in the included patients. However, no accidents have been reported to date, and myocardial ischemia and school-life management have improved. Thus, CABG is an effective treatment in preschool-aged children.

DOI： 10.3390/jcm11051421

PubMed

researchmap

Publishing type：Research paper (scientific journal)   Publisher：Ovid Technologies (Wolters Kluwer Health)  

DOI： 10.1161/CIRCRESAHA.121.319153

researchmap

Publishing type：Research paper (scientific journal)   Publisher：American Society for Clinical Investigation  

DOI： 10.1172/jci.insight.151981

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

Language：Japanese   Publisher：(NPO)日本小児循環器学会  

researchmap

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

researchmap

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

DOI： 10.1111/cei.13401

researchmap

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

DOI： 10.1111/cei.13314

researchmap

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

DOI： 10.1016/j.immuni.2019.05.021

researchmap

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

BACKGROUND: Coronary artery evaluation by virtual histological intravascular ultrasonography (VH-IVUS) late in Kawasaki disease (KD) shows intimal thickening, calcification, fatty components, and necrosis of regressed coronary artery lesions (CALs). However, it is not clear when these VH-IVUS findings start to occur. Therefore, we evaluated coronary arteries using VH-IVUS in patients with early-stage KD and tried to determine whether these atherosclerotic findings on VH-IVUS were different from that in patients with late-stage KD. METHODS: Eighteen patients with KD aged between 1 and 32 years who had CALs and underwent cardiac catheterization between January 1, 2008 and December 31, 2014 were included. They were divided into 2 groups-those with the disease for <1 year (group A) and those with it for >10 years (group B). VH-IVUS findings were compared between the groups. The coronary arteries were divided based on coronary angiography findings into normal, regressed (dilated CALs regressed to a normal size), and aneurysmal lesions. The Wilcoxon signed-rank test was used in the statistical analysis. RESULTS: In both regressed and aneurysmal lesions, marked intimal proliferation and atherosclerotic findings (fibro-fatty and necrotic core lesions) were observed. In addition, there was no difference in the area percentage of atherosclerosis between the groups. CONCLUSIONS: VH-IVUS revealed that atherosclerotic-like findings exist in CALs in patients with KD, even within a year of onset. The findings were almost the same in those with the disease for >10 years. Because there is no histological evidence of atherosclerosis in KD, these VH-IVUS findings may indicate complex histological findings of KD. Nevertheless, early interventions to help reduce the risk factors of atherosclerosis may be required in these patients.

DOI： 10.1016/j.jjcc.2019.06.015

PubMed

researchmap

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

DOI： 10.1172/jci.insight.126279

researchmap

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

Background: The coronary arterial lesions of Kawasaki disease are mainly dilative lesions, aneurysms, and stenotic lesions formed before, after, and between aneurysms; these lesions develop in multiple branches resulting in complex coronary hemodynamics. Diagnosis of myocardial ischemia and infarction and evaluation of the culprit coronary arteries and regions is critical to evaluating the treatment and prognosis of patients. This study used hybrid imaging, in which multidetector computed tomographic (CT) images for coronary CT angiography (CCTA) and stress myocardial perfusion single photon emission CT (SPECT) images were fused. We investigated the diagnosis of blood vessels and regions responsible for myocardial ischemia and infarction in patients with complex coronary arterial lesions; in addition, we evaluated myocardial lesions that developed directly under giant coronary artery aneurysms.
Methods: The subjects were 17 patients with Kawasaki disease with multiple coronary arterial lesions (median age, 18.0 years; 16 male). Both CCTA using 64-row CT and adenosine-loading myocardial SPECT were performed. Three branches, the right coronary artery (RCA), left anterior descending branch (LAD), and left circumflex branch, were evaluated with the conventional side-by-side interpretation, in which the images were lined up for diagnosis, and hybrid imaging, in which the CCTA and SPECT images were fused with computer processing. In addition, the myocardial lesions directly under giant coronary artery aneurysms were investigated with fusion imaging.
Results: Images sufficient for evaluation were acquired in all 17 patients. In the RCA, coronary arterial lesions were detected with CCTA in 16 patients. The evaluations were consistent between the side-by side and fusion interpretation in 14 patients, and the blood vessel responsible for the myocardial ischemic region was identified in 2 patients. In the left circumflex branch, coronary arterial lesions were confirmed with 3-dimensional CT in 5 patients, and the the culprit coronary arteries for myocardial ischemia/infarction were confirmed with the fusion interpretation but not with the side-by-side interpretation. In the LAD, coronary arterial lesions were present in all patients, and the diagnosis was made with the fusion interpretation in 10 patients. In the LAD, small-range infarct lesions were detected directly under the giant coronary artery aneurysm in 8 patients, but were not confirmed with the side-by-side interpretation.
Conclusion: Fusion imaging was capable of accurately evaluating myocardial ischemia/infarction as cardiovascular sequelae of Kawasaki disease and confirming the culprit coronary arteries. In addition, analysis of fusion images confirmed that small-range infarct lesions were concomitantly present directly under giant coronary artery aneurysms in the anterior descending coronary artery.

DOI： 10.1272/jnms.83.71

Web of Science

researchmap

Language：Japanese   Publisher：公益財団法人 日本心臓財団  

DOI： 10.11281/shinzo.48.1425

researchmap

Language：English   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

researchmap

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

Aims: We evaluated the systolic and diastolic functions of both ventricles from the early neonatal period to adolescence using color tissue Doppler imaging and 2-dimensional tissue tracking echocardiography.
Methods: We examined 100 healthy children (aged 1-5 days, n=20; 1 month, n=20; 1 year, n=20; 6-7 years, n=20; and 12-13 years, n=20). Blood flow velocities in the mitral and tricuspid valves (E) were obtained with pulsed Doppler imaging, and longitudinal systolic (S') and early diastolic (E') peak velocities at the mid free wall segment of both ventricles were obtained with color tissue Doppler imaging. For longitudinal strain imaging, systolic peak values were obtained at the same position. In addition, peak systolic radial strain was obtained from a short-axis view of the left ventricle using the tissue tracking method. The E/E' ratio was calculated.
Results: Regarding systolic indices, S' increased during development and stabilized at 6 to 7 years, and longitudinal strain reached values of the 12- to 13-year-old group at 1 year of age in both ventricles. Like longitudinal strain, radial strain in the left ventricle reached values of the 12- to 13-year-old group at the age of 1 year. Similarly, the E/E' ratio was high at 1 month or younger and decreased by 1 year.
Conclusions: Systolic and diastolic variables change markedly from birth to 1 year of age and show only small changes thereafter.

DOI： 10.1272/jnms.80.260

Web of Science

researchmap

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

researchmap

Language：Japanese   Publisher：日本小児呼吸器学会  

researchmap

Language：English   Publisher：ELSEVIER SCIENCE INC  

DOI： 10.1016/S0735-1097(11)62038-X

Web of Science

researchmap

Language：Japanese   Publisher：The Medical Association of Nippon Medical School  

A 19-year-old man was admitted to our hospital for elective surgery to replace the ascending aorta. The patient's father had died suddenly of aortic dissection associated with Marfan syndrome. Because of the patient's family history and physical findings, we suspected Marfan syndrome and began regular observations of aortic size when he was an infant. When he was 18 years old, magnetic resonance cardiography showed a marked increase in the size of the ascending aorta, replacement of which was indicated. Computed tomography performed before the planned elective surgery incidentally revealed dissection of the ascending aorta, although the patient was asymptomatic. Thus, we failed to prevent the aortic dissection in this patient, although we had regularly observed the aorta since he was an infant. Surgery should have been performed earlier than it was. Our experience suggests more frequent observation and stricter indications for aortic surgery should be considered in Marfan syndrome.<br>

DOI： 10.1272/manms.7.179

researchmap

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

リウマチ熱は本邦においては激減したといわれていたが、近年の米国における小流行から、本邦においても今後流行の可能性が懸念されている。当科においても、新たなリウマチ熱患者は20年以上認められなかったが、比較的短期間に3例を経験した。3例とも発症前に溶連菌感染の病歴が明らかでなく、抗菌薬の投与がされていなかった。またうち2例では発症初期には認められなかった心炎が経過中に認められるようになった。今後の流行の可能性に備えて、リウマチ熱の診断、治療、予防についての再検討が必要と思われる。(著者抄録)

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2009280976

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPANESE CIRCULATION SOC  

Background It was investigated whether edaravone, a potent free radical scavenger, would protect against anthracycline-induced cardiotoxicity and prevent cardiac function deterioration.
Methods and Results Cultured neonatal rat cardiomyocytes were stimulated by daunorubicin 1 mu mol/L either with or without edaravone or superoxide dismutase mimetic Mn(III) tetrakis (1-methyl-4-pyridyl) porphyrin pentachloride (MnTMPyP). Cell viability was estimated by measuring the amount of lactate dehydrogenase (LDH) released into the culture medium. Apoptosis was determined by a caspase-3 activity assay and a histone-DNA complex fragment assay. To investigate whether edaravone interfered with daunorubicin's anti-tumor effect, daunorubicin and edaravone were added to human leukemia K562 cells, and the surviving cells were counted. In addition, edaravone's in vivo effect was evaluated using Sprague-Dawley rats. A total of 15 mg/kg doxorubicin was injected intraperitoneally either with or without simultaneous edaravone injection. Two and 6 weeks after the final injection, left ventricular diastolic diameter and left ventricular fraction shortening were assessed echocardiographically. The LDH assay showed that edaravone significantly inhibited LDH release from cardiac myocytes (p=0.0428). The caspase-3 activity and histone-DNA complex fragment assays demonstrated that edaravone's apoptosis suppression effect was much weaker than that of MnTMPyP. The in vivo study showed that edaravone prevented doxorubicin-induced cardiac deterioration. Finally, edaravone was found to not affect daunorubicin's anticancer effect on K562 cells.
Conclusions Edaravone protects cardiornyocytes from anthracycline-induced cardiotoxicity via an anti-necrotic rather than an anti-apoptotic effect.

DOI： 10.1253/circj.71.1815

Web of Science

researchmap

Language：Japanese   Publisher：Japanese Society of Pediatric Pulmonology  

DOI： 10.5701/jjpp.18.82

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2007335249

Language：English   Publisher：The Medical Association of Nippon Medical School  

We describe an uncircumcised male infant treated for urinary tract infection who exhibited multiple hormonal and electrolyte abnormalities consistent with a diagnosis of transient pseudohypoaldosteronism. Successful treatment of the urinary tract infection was accompanied by the resolution of all hormonal and electrolyte abnormalities, including hyperaldosteronemia, hyperreninemia, hyponatremia and hyperkalemia. Radiographic examination revealed marked left dilatation of the renal pelvis and hydroureter but no vesicoureteral reflux. Owing to the possibilities of future renal scarring, decreased renal function, and hypertension, evaluation of urinary tract malformation and appropriate hormonal studies should be performed in infants with urinary tract infection and hyperkalemia.<br>

DOI： 10.1272/jnms.73.289

researchmap

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

DOI： 10.1007/s00431-005-1697-9

PubMed

researchmap

Language：English   Publisher：Japanese Circulation Society  

CiNii Books

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：English   Publisher：Japanese Circulation Society  

CiNii Books

researchmap

Language：English   Publisher：Japanese Circulation Society  

CiNii Books

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  

13歳男児.黄疸と全身倦怠感を主訴とした.眼球結膜黄染,眼瞼結膜の貧血がみられ,入院時検査にて大球性の高度の溶血性貧血および肝機能障害,血清アルカリフォスファターゼ低値を認めた.ウイルソン病を疑い精査した結果,血清および尿中銅は高値,セルロプラスミン値は低値であり,眼科学的検索にて角膜にKayser-Fleischer ringを確認したためウイルソン病と確定診断した.D-ペニシラミン投与を開始し,その後貧血の改善とともにALP値の上昇を認めた.原因不明の溶血性貧血を伴った肝機能障害症例におけるアルカリフォスファターゼ低値は,ウイルソン病を疑わせる重要な鑑別点と考えられた

CiNii Books

researchmap

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

researchmap

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

researchmap

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

researchmap