Publications by authors named "Motohiko Okano"

38 Publications

[Successful treatment with cyclosporine in a patient with rituximab-refractory thrombocytopenic purpura].

Rinsho Ketsueki 2021 ;62(3):176-179

Department of Hematology and Oncology, Mie University Hospital.

Acquired thrombotic thrombocytopenic purpura (aTTP) is a life-threatening systemic thrombotic microangiopathy characterized by the presence of anti-ADAMTS13 antibodies (inhibitor). Here we report the case of a patient with refractory aTTP successfully treated with cyclosporine. A 69-year-old man presenting with hematuria and petechiae was referred to our hospital; he was disoriented and febrile. Laboratory results revealed Coombs-negative hemolytic anemia, thrombocytopenia, and renal failure. Undetectable ADAMTS13 activity and presence of anti-ADAMTS13 antibodies (inhibitor) confirmed the diagnosis of aTTP. Despite performing plasma exchange and administering prednisolone and rituximab (375 mg/m), we were unable to restore his platelet counts to the normal level. Therefore, he was treated with cyclophosphamide (500 mg/bodyweight), vincristine (1.4 mg/m), bortezomib (1.3 mg/m), and cyclosporine (2.5 mg/kg). After the cyclosporine therapy, his platelet counts gradually normalized. Continuous cyclosporine maintenance therapy led to complete disappearance of the inhibitor. Therapeutic strategies for refractory aTTP have not yet been established. Further investigations are warranted to establish a therapeutic strategy for refractory aTTP.
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http://dx.doi.org/10.11406/rinketsu.62.176DOI Listing
April 2021

Genetic characterization of a novel recombinant echovirus 30 strain causing a regional epidemic of aseptic meningitis in Hokkaido, Japan, 2017.

Arch Virol 2020 Feb 11;165(2):433-438. Epub 2019 Dec 11.

Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo, 060-0819, Japan.

A regional epidemic of aseptic meningitis caused by echovirus 30 (E30) occurred in Hokkaido, Japan, during the period of August-December 2017. To investigate their phylogenetic relationship to other human enteroviruses, we determined the complete genomic nucleotide sequences of isolates from this outbreak. Phylogenetic analysis of the viral capsid protein 1 gene showed that the strains were most closely related to E30 strains detected in Germany, France, and Russia in 2013. In contrast, the region encoding the viral protease and the RNA-dependent RNA polymerase had a close phylogenetic relationship to non-E30 enteroviruses detected in the United Kingdom and Switzerland in 2015-2017, suggesting that a recombination event had occurred.
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http://dx.doi.org/10.1007/s00705-019-04484-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223842PMC
February 2020

Outbreak of aseptic meningitis caused by echovirus 30 in Kushiro, Japan in 2017.

J Clin Virol 2019 07 6;116:34-38. Epub 2019 May 6.

Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan.

Background: Echovirus 30 (E30) is one of the most common causative agents for aseptic meningitis.

Objectives: In the autumn of 2017, there was an outbreak caused by E30 in Kushiro, Hokkaido, Japan. The aim of this study was to characterize this outbreak.

Study Design: Fifty-nine patients were admitted to the Department of Pediatrics, Kushiro Red Cross Hospital (KRCH) with clinical diagnosis of aseptic meningitis. Among those, 36 patients were finally diagnosed as E30-associated aseptic meningitis by the detection of viral RNA using reverse transcription-polymerase chain reaction (RT-PCR) and/or the evidence of more than four-fold rise in neutralizing antibody (NA) titers in the convalescent phase relative to those in the acute phase. We investigated these 36 confirmed cases.

Results: The median age was 6 years (range: 6 months-14 years). The positive signs and symptoms were as follows: fever (100%), headache (94%), vomiting (92%), jolt accentuation (77%), neck stiffness (74%), Kernig sign (29%), and abdominal pain (28%). The median cerebrospinal fluid (CSF) white cell count, neutrophil count, and lymphocyte count were 222/μL (range: 3-1434/μL), 144/μL (range: 1-1269/μL), and 85/μL (range: 2-354/μL), respectively. Although the detected viral genes demonstrated same cluster, they were different from E30 strains observed in Japan between 2010 and 2014.

Conclusion: We mainly showed clinical and virological features of the E30-associated aseptic meningitis outbreak that occurred in Kushiro. To prevent further spread of E30 infection, continuous surveillance of enterovirus (EV) circulation and standard precautions are considered essential.
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http://dx.doi.org/10.1016/j.jcv.2019.05.001DOI Listing
July 2019

Evaluation of a Novel Immunochromatographic Assay for Detection of Human Adenoviruses from Throat Swab Samples Compared with Real-time PCR.

Clin Lab 2018 Oct;64(10):1777-1781

Background: The aim of this study was to determine the sensitivity and specificity of a novel immunochromatographic assay (ICA) kit, ALSONIC® Adeno (Alfresa Pharma Co., Osaka, Japan), for the detection of human adenovirus (HAdV) from throat swab samples based on the results of real-time PCR. The incubation time required for the novel assay kit (5 minutes) is shorter than that required for other ICA kits that are available in Japan.

Methods: Throat swab samples were taken from 151 patients aged 6 months to 15 years who were suspected of having respiratory tract infections caused by HAdV.

Results: The sensitivity and specificity of the ICA for detection of HAdV were 92.2% (83/90) and 95.1% (58/61), respectively, and the assay showed positive and negative predictive values of 96.5% (83/86) and 89.2% (58/65), respectively.

Conclusions: ALSONIC® Adeno is suitable as a diagnostic tool in the acute phase of HAdV infection.
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http://dx.doi.org/10.7754/Clin.Lab.2018.180420DOI Listing
October 2018

Genetic characterization of hemagglutinin protein of measles viruses in Hokkaido district, Japan, 2006-2015.

Microbiol Immunol 2018 Jun;62(6):411-417

Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan.

Strains of measles virus of genotypes D5, H1, D4, D8, and B3 were detected among epidemic, endemic, imported and import-associated cases in Hokkaido district, Japan, during 2006-2015. In the present study, their antigenic features were evaluated by determining the complete nucleotide sequences of their hemagglutinin proteins, which are a major target for neutralizing antibodies, and their amino acid sequences deduced. It was found that the hemagglutinin proteins of these strains had several novel amino acid changes in some functional regions. Although these strains have not caused further infections thus far, these antigenic changes should continue to be monitored to maintain their elimination status.
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http://dx.doi.org/10.1111/1348-0421.12594DOI Listing
June 2018

[A Case of Poorly Differentiated Carcinoma of Unknown Primary Site with Risk of Choriocarcinoma Syndrome Effectively Treated with Reduced Bleomycin,Cisplatin ,Etoposide Combination Regimen(BEP Regimen)].

Gan To Kagaku Ryoho 2018 Apr;45(4):643-645

Dept. of Hematology and Oncology, Mie University Hospital.

A 64-year-old man visited his physician complaining of bilateral gynecomastia and left shoulder pain. Chest X-ray showed multiple bilateral masses in the lung, and he was referred to our hospital. Radiographical findings, elevation of serum total hCG, and histological findings of the cervical lymph node revealed multiple pulmonary, nodal, and brain metastases of poorly differentiated carcinoma of an unknown primary site with choriocarcinoma components. He was administered a regimen of reduced bleomycin, cisplatin, etoposide combination(reduced BEP regimen)to reduce the risk of acute respiratory failure with intra-alveolar hemorrhage related to post-chemotherapy early tumor necrosis. After chemotherapy, the tumor marker hCG levels were almost restored to normal levels, and radiography showed he had achieved a clinical partial response.
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April 2018

[Atypical hemolytic uremic syndrome with C3 p.I1157T missense mutation successfully treated with eculizumab].

Rinsho Ketsueki 2018;59(2):178-181

Department of Hematology and Oncology, Mie University Graduate School of Medicine.

A 23-year-old man from Mie Prefecture, Japan, with past and family history of hematuria was diagnosed with influenza A and admitted to our hospital on the following day because of hemoglobinuria. He was diagnosed with thrombotic microangiopathy and was suspected of having atypical hemolytic uremic syndrome (aHUS). C3 p.I1157T missense mutation, which we had previously reported in eight aHUS patients from six families in Mie Prefecture, was identified. The laboratory findings and symptoms of our patient promptly improved after administering eculizumab. Little information is available on abnormalities of the complement system in aHUS or on mutation-specific outcomes of eculizumab therapy. Eculizumab was effective for treating our aHUS patient with C3 p.I1157T missense mutation.
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http://dx.doi.org/10.11406/rinketsu.59.178DOI Listing
February 2019

Hepatitis E outbreak at a nursing home for aged people in Hokkaido, Japan, between February and March 2016.

J Clin Virol 2018 04 31;101:23-28. Epub 2018 Jan 31.

Hokkaido Institute of Public Health, Sapporo, Japan.

Background: Infection with hepatitis E virus (HEV) genotypes 3 and 4 are usually asymptomatic but can occasionally result in life-threatening acute hepatitis. To date, only sporadic cases together with a few outbreaks have been documented. Seroprevalence studies with assays for the detection of HEV IgG antibodies, suggest that HEV is more prevalent than previously thought, even in non-endemic regions.

Objectives: The aim of this study was to characterize an outbreak of hepatitis E (HE) in a nursing home for aged people between February and March 2016.

Study Design: After the identification of two cases living in the same nursing home, the presence of antibodies against HEV and HEV RNA were examined in serum samples collected from the other residents and staff members to identify any additional cases. An epidemiological investigation was also carried out.

Results: Only 4 patients showed mild symptoms such as anorexia, abdominal pain and fatigue. Among the 125 persons tested, 28 residents and one dietitian were confirmed positive for anti-HEV IgA or IgM antibodies, and/or HEV RNA. Eight samples had only IgG antibodies. Finally, 22 cases were notified with HE on the basis of the presence of IgA antibodies. All HEV isolates obtained were 99.8-100% identical and belonged to genotype 3.

Conclusion: HEV infections seem to be under-reported or underestimated possibly due to cases being generally asymptomatic. Testing for the presence of both anti-HEV antibodies and HEV RNA would be beneficial for both the comprehensive diagnosis of HE infections and the prevention of further infections.
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http://dx.doi.org/10.1016/j.jcv.2018.01.009DOI Listing
April 2018

Isolated thrombocytosis in chronic myeloid leukemia without significant leukocytosis.

Rinsho Ketsueki 2017 ;58(7):766-771

Department of Hematology and Oncology, Mie University Hospital.

Chronic myeloid leukemia (CML) typically causes leukocytosis rather than thrombocytosis. We encountered two women in their thirties with remarkable thrombocytosis, whose platelet counts were over 3,000×10/µl, and without significant leukocytosis. Although their clinical findings resembled that of essential thrombocythemia (ET), they were diagnosed with CML because of the presence of Philadelphia chromosome. JAK2, CALR, and MPL were unmutated. On fluorescence in situ hybridization analysis, only 19.8% of granulocytes in case 2 were found to be BCR/ABL positive in peripheral blood (PB). We reviewed 11 CML cases whose platelet counts were over 2,000×10/µl, but their WBC counts were not significantly elevated (<12,000/µl). Most of them were young females with a normal or a high neutrophil alkaline phosphatase score and without immature myeloid cells in PB. These findings suggested that there is a subgroup of CML patients with marked thrombocytosis and without significant leukocytosis, which may be misdiagnosed as ET.
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http://dx.doi.org/10.11406/rinketsu.58.766DOI Listing
December 2017

Detection of Measles Virus Genotypes B3, D4, D5, D8, and H1 in the Surveillance System in Hokkaido, Japan, 2006-2015, the Last Decade toward the Elimination.

Jpn J Infect Dis 2017 May 22;70(3):317-319. Epub 2016 Dec 22.

Hokkaido Institute of Public Health.

Measles is an acute and highly contagious disease caused by measles virus (MeV). The government of Japan, following the last epidemic in 2007 and 2008, which was caused by genotype D5 strains, introduced a catch-up-vaccination program for teenagers during Japan fiscal years 2008-2012 and a mandatory case-based reporting system for the nationwide elimination. Furthermore, laboratory confirmation of measles cases by genotyping of isolates has been performed to clarify the source of infection and support the interruption of measles cases. Owing to these preventive measures, the number of measles cases has been steadily decreasing after the last epidemic. In March 2015, Japan was internationally verified as having achieved measles elimination by the World Health Organization Regional Office for the Western Pacific. The continuous elimination of measles and high levels of vaccination coverage for MeV have been maintained nationally. However, imported or import-associated cases of measles have sporadically occurred during this time. After the last nationwide epidemic, 17 imported or import-associated measles cases (MeV strains identified as genotypes H1, D4, D8, and B3) were reported in Hokkaido, the northern islands of Japan. In this study, we present the occurrence of measles and surveillance activities in Hokkaido during 2006-2015.
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http://dx.doi.org/10.7883/yoken.JJID.2016.253DOI Listing
May 2017

Evaluation of sensitivity of TaqMan RT-PCR for rubella virus detection in clinical specimens.

J Clin Virol 2016 07 17;80:98-101. Epub 2016 May 17.

Department of Virology III, National Institute of Infectious Diseases, Tokyo 208-0011, Japan.

Background: An easy and reliable assay for detection of the rubella virus is required to strengthen rubella surveillance. Although a TaqMan RT-PCR assay for detection of the rubella virus has been established in Japan, its utility for diagnostic purposes has not been tested.

Objectives: To allow introduction of the TaqMan RT-PCR into the rubella surveillance system in Japan, the sensitivity of the assay was determined using representative strains for all genotypes and clinical specimens.

Study Design: The detection limits of the method for individual genotypes were examined using viral RNA extracted from 13 representative strains. The assay was also tested at 10 prefectural laboratories in Japan, designated as local reference laboratories for measles and rubella, to allow nationwide application of the assay.

Results: The detection limits and amplification efficiencies of the assay were similar among all the representative strains of the 13 genotypes. The TaqMan RT-PCR could detect approximately 90% of throat swab and urine samples taken up to 5days of illness. These samples were determined positive by a highly sensitive nested RT-PCR.

Conclusions: The TaqMan RT-PCR could detect at least 10 pfu of rubella virus. Although the sensitivity was somewhat lower than that of the conventional nested RT-PCR, the TaqMan RT-PCR could be more practical to routine tests for rubella laboratory diagnosis and detection in view of the rapid response and reducing risks of contamination.
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http://dx.doi.org/10.1016/j.jcv.2016.05.005DOI Listing
July 2016

Recent Concise Viewpoints of Chronic Active Epstein-Barr Virus Infection.

Authors:
Motohiko Okano

Curr Pediatr Rev 2015 ;11(1):5-9

Hokkaido Institute of Public Health, 1-1, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan.

Chronic active Epstein-Barr virus infection (CAEBV) is characterized mainly by prolonged or intermittent fever, lymphadenopathy and hepatosplenomegaly without definite underlying diseases at the diagnosis. Patients with CAEBV also may have various life-threatening conditions including hematological, neurological, pulmonary, cardiac, digestive tract, ocular and/or dermal disorders. Additionally, during the course of illness, they often develop hematological malignancies such as T cell, NK cell or B cell lymphoproliferative disorder (LPD) and/or lymphoma. No causative pathogenetic mechanisms have been sufficiently clarified, and additionally no promising efficacious treatment was demonstrated except for the hematopoietic stem cell transplantation (HSCT) in cases who develop T cell or NK cell LPD or lymphoma. This minireview outlines the recent development for the comprehensive viewpoints of CAEBV mainly regarding to virological, immunological, pathological and therapeutical progresses.
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http://dx.doi.org/10.2174/1573396311666150501002809DOI Listing
September 2016

Fusarium falciforme infection in a patient with chronic granulomatous disease: Unique long-term course of epidural abscess.

Pediatr Int 2015 ;57(1):e4-6

Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Chronic granulomatous disease (CGD) is a primary immunodeficiency disease characterized by recurrent life-threatening bacterial and fungal infections with granuloma formation. Species of the genus Fusarium are opportunistic environmental microorganisms that are rarely pathogenic in humans. We report here the first case of X-linked CGD complicated with epidural abscess caused by Fusarium falciforme infection. The abscesses extended along the dura mater for >7 years and finally resulted in fatal meningitis and cervical myelitis. Early intervention with hematopoietic stem cell transplantation should be considered, especially in patients with severe CGD, before the development of serious infectious complication.
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http://dx.doi.org/10.1111/ped.12458DOI Listing
December 2016

Epidemiology and laboratory diagnoses of rubella in Hokkaido district during the Nationwide Outbreak in Japan, 2011-2013.

Jpn J Infect Dis 2014 ;67(6):479-84

Hokkaido Institute of Public Health.

We report the epidemiology and laboratory diagnostic results of rubella cases from 2011 to 2013 in Hokkaido district, Japan. A total of 150 cases were officially reported as rubella; 102 (68%) involved males and 48 (32%) involved females. The highest proportion of cases were notified in 40-49-year-old age group among males and the 20-29-years-old age group among females. Forty-six cases (25 males and 21 females) had not been vaccinated, and 17 had been vaccinated, whereas 87 had the unknown vaccination status. Eighty-three cases (55.3%) showed the 3 typical principal rubella symptoms (fever, rash, and lymphadenopathy). Seven, 11, 92, and 40 cases were identified in the northern, eastern, central, and southern areas of Hokkaido district, respectively. In the central and southern areas of Hokkaido district, endemic rubella transmissions were indicated by both the epidemiological survey and molecular analyses. However, these outbreaks terminated spontaneously and did not expand to other areas of Hokkaido district. Fortunately, no congenital rubella syndrome (CRS) cases were reported during this observation period. However, to control virus transmission, prevent CRS, and maintain the routine vaccination program, the immediate introduction of an immunization strategy is required for susceptible individuals, particularly young adults.
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July 2015

Recent progress toward measles elimination in Hokkaido, Japan, during 2011-2012.

Jpn J Infect Dis 2014 ;67(4):311-4

Hokkaido Institute of Public Health.

Laboratory diagnoses for measles were performed in a total of 97 cases in Hokkaido, Japan, during 2011-2012. Two patients were confirmed to be positive for measles virus (MV), both of whom lived in the Iburi district of Hokkaido. Molecular analysis of the nucleotide sequences of the nucleoprotein (N) gene revealed that these 2 strains had high homology with each other and belonged to the genotype D8. The onset interval of these cases and epidemiological data suggested that MV transmission had occurred between them and then terminated. Phylogenetic analysis of the N gene revealed that the strains identified in Hokkaido were classified into a cluster that contained many genotype D8 strains that were detected within a large area of Japan. Eventually, 9 cases were officially reported as measles. However, other than the abovementioned 2 cases, no genetic information regarding MV was obtained. In future, further active surveillance combined with the genetic investigation should be required in all suspected measles cases to verify the elimination status.
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http://dx.doi.org/10.7883/yoken.67.311DOI Listing
April 2015

Genomic characterization of echovirus 6 causing aseptic meningitis in Hokkaido, Japan: a novel cluster in the nonstructural protein coding region of human enterovirus B.

Arch Virol 2013 Apr 22;158(4):775-84. Epub 2012 Nov 22.

Center for Infectious Diseases Control, Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo, 060-0819, Japan.

We determined four complete nucleotide sequences of echovirus 6 (E6) isolated from an epidemic of aseptic meningitis (AM) in Hokkaido, Japan, in 2011. Phylogenetic analysis of the genes encoding viral capsid protein 1 revealed that the strains were closely related to E6 strains isolated in China in recent years, but they were distantly related to E6 strains isolated from patients with AM in Osaka Prefecture, Japan, in 2011. The genes encoding the viral protease and RNA-dependent RNA polymerase (3CD) were closely related to those of several non-E6 strains of the species Human enterovirus B isolated in China, South Korea, and Australia from 1999 to 2010, resulting in a novel cluster in the phylogenetic tree. These results suggest that the incidence of AM in Japan in 2011 was caused by at least two lineages of E6 strains, and a lineage of the 3CD gene was interspersed among different serotypic strains isolated in Western Pacific countries.
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http://dx.doi.org/10.1007/s00705-012-1535-0DOI Listing
April 2013

An isolated incidence of rubella outbreak at a workplace in Hokkaido, Japan.

Jpn J Infect Dis 2012 ;65(1):94-7

Center for Infectious Diseases Control, Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo, Japan. miyo@iph.pref.hokkaido.jp

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May 2012

Usefulness of the rapid determination system of viral genome sequences in human stool specimens.

J Virol Methods 2012 Jan 23;179(1):256-60. Epub 2011 Nov 23.

Center for Infectious Diseases Control, Hokkaido Institute of Public Health, North 19 West 12, Kita-ku, Sapporo 060-0819, Japan.

The rapid determination system of viral genome sequences (the RDV method) consists of detecting and determining the nucleotide sequences of viral genomes without using specific primers. To evaluate the usefulness of the RDV method, the detection of human norovirus (NV) genomes in stool specimens was investigated. In addition, the effect of nuclease treatment of the process was examined. A total of 23 human stool specimens were used, all of which were collected from patients with acute viral gastroenteritis, and were shown to contain NV genomes and also determined the cDNA copy numbers by the real-time reverse transcriptase-polymerase chain reaction. NV genomes were detected by the RDV method with nuclease treatment in nine specimens containing cDNA copies ranging between 6.2×10(9) and 9.8×10(11)/g stool. In contrast, NV genome was found by the method in 15 specimens without nuclease treatment and the number of NV cDNA copies ranged between 1.2×10(6) and 9.8×10(11)/g stool. These results suggest that the RDV method has potential for detecting viral genomes in stool specimens. The procedure without a step of nuclease treatment appears to be sensitive.
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http://dx.doi.org/10.1016/j.jviromet.2011.11.013DOI Listing
January 2012

Acute or chronic life-threatening diseases associated with Epstein-Barr virus infection.

Am J Med Sci 2012 Jun;343(6):483-9

Center for Infectious Diseases Control, Hokkaido Institute of Public Health, Sapporo, Japan.

Infectious mononucleosis (IM) is one of the representative, usually benign, acute diseases associated with primary Epstein-Barr virus (EBV) infection. IM is generally self-limiting and is characterized mostly by transient fever, lymphadenopathy and hepatosplenomegaly. However, very rarely primary EBV infection results in severe or fatal conditions such as hemophagocytic lymphohistiocytosis together with fulminant hepatitis designated as severe or fatal IM or EBV-associated hemophagocytic lymphohistiocytosis alone. In addition, chronic EBV-associated diseases include Burkitt's lymphoma, undifferentiated nasopharyngeal carcinoma, Hodgkin lymphoma, T-cell lymphoproliferative disorder (LPD)/lymphoma, natural killer-cell LPD including leukemia or lymphoma, gastric carcinoma, pyothorax-associated lymphoma and senile B-cell LPD as well as chronic active EBV infection and LPD/lymphoma in patients with immunodeficiency. The number of chronic life-threatening diseases linked to the EBV infection is increasingly reported and many of these diseases have a poor prognosis. This review will focus on the historical, pathogenetic, diagnostic, therapeutic and prophylactic issues of EBV-associated life-threatening diseases.
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http://dx.doi.org/10.1097/MAJ.0b013e318236e02dDOI Listing
June 2012

Progress toward measles elimination between 2008 and 2010 in the Hokkaido district, Japan.

Jpn J Infect Dis 2011 ;64(5):445-7

Hokkaido Institute of Public Health, Sapporo 060-0819, Japan. nagano@iph.pref.hokkaido.jp

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January 2012

Different genotypic sapoviruses detected in two simultaneous outbreaks of gastroenteritis among schoolchildren in the same school district in Hokkaido, Japan.

Jpn J Infect Dis 2010 Jan;63(1):75-8

Division of Enteric Virology, Department of Microbiology, Center for Infectious Diseases Control, Hokkaido Institute of Public Health, Sapporo, Japan.

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January 2010

A 5-year-old boy with unicentric Castleman disease affecting the mesentery: utility of serum IL-6 level and (18)F-FDG PET for diagnosis.

J Pediatr Hematol Oncol 2009 Sep;31(9):693-5

Department of Pediatrics, Graduate School of Medicine, Japan.

Castleman disease (CD) is a rare lymphoproliferative disorder of unknown etiology. It is quite difficult to diagnose CD without typical localized signs or symptoms. We present a 5-year-old boy with unicentric plasma cell CD in the mesentery, which was too small to be detected by any conventional imaging. (18)F-fluorodeoxyglucose positron emission tomography image and a serum cytokine profile prompted us to perform a curative surgical excision, confirming his diagnosis. Our case also supported an important role of interleukin-6 in the pathophysiology of plasma cell CD.
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http://dx.doi.org/10.1097/MPH.0b013e3181b2708fDOI Listing
September 2009

Epidemiological and molecular studies of measles at different clusters in hokkaido district, Japan, 2007.

Jpn J Infect Dis 2009 May;62(3):209-11

Center for Infectious Diseases Control, Hokkaido Institute of Public Health, Sapporo 060-0819, Japan.

In 2007 eight epidemic clusters (more than 15 cases in each) and other sporadic cases of measles occurred in Hokkaido district, Japan. A total of 850 cases were identified. Approximately half of them were > or = 15 years of age, resulting in a huge public health problem in the community associated with school closings, and 31% of the cases reported that they already had a history of vaccination. Of 28 isolates of the measles virus detected, all were identified as genotype D5, identical to the type isolated in other areas of Japan, suggesting that a highly homologous measles virus circulated in Japan. The occurrence pattern of measles patients and molecular epidemiology indicated that the measles virus that spread in Hokkaido district might not be indigenous.
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May 2009

Sensitive and rapid detection of norovirus using duplex TaqMan reverse transcription-polymerase chain reaction.

J Med Virol 2008 May;80(5):913-20

Division of Enteric Virology, Department of Microbiology, Hokkaido Institute of Public Health, Sapporo, Japan.

Conventional reverse transcription-polymerase chain reaction (RT-PCR) to detect norovirus (NV) is a complex of multi-step procedure that requires gel electrophoresis as well as hybridization or sequencing to confirm the final diagnosis. A duplex TaqMan RT-PCR was developed to detect and classify genogroup (G) I and GII of NV. The primers and TaqMan probes for this assay were selected from the region of open reading frame (ORF) 1-ORF2 junction. A total of 796 stool specimens from 103 outbreaks of gastroenteritis, and a series of 46 stool specimens containing most NV genotypes was used for this study. For these specimens from 103 outbreaks, NV was detected and classified by the duplex TaqMan RT-PCR in 536 of the 541 specimens tested previously to be positive using the conventional RT-PCR. Two hundred fifty-one of the 255 specimens that were negative by the conventional RT-PCR were also negative by the TaqMan RT-PCR. No false positive result was observed for other enteric RNA viruses such as rotavirus and sapovirus. This is the first report on the development of a duplex TaqMan RT-PCR end-point assay for detection and differentiation of GI and GII of NV strains simultaneously followed by genotyping. These results suggest the practical application of this duplex TaqMan RT-PCR is useful for the detection of NV in clinical specimens.
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http://dx.doi.org/10.1002/jmv.21142DOI Listing
May 2008

Advanced therapeutic and prophylactic strategies for Epstein-Barr virus infection in immunocompromised patients.

Expert Rev Anti Infect Ther 2007 Jun;5(3):403-13

Department of Microbiology, Center for Infectious Diseases Control, Hokkaido Institute of Public Health, Kita-ku, Sapporo, Japan.

Epstein-Barr virus (EBV) is an ubiquitous human herpesvirus. Primary infection is generally subclinical but in certain circumstances, such as in patients with either hereditary or secondary immunodeficiency, EBV infection may cause overt disease that is often lethal. Strategies for the prophylaxis and treatment of these potentially life-threatening complications of EBV infection have advanced dramatically. They include immunological-based approaches targeted at EBV-infected cells, as well as improvement in the treatment of the underlying and predisposing disease. This review will discuss EBV biology and immune events that occur in both immunocompetent and immunocompromised individuals and introduce the novel prophylactic and therapeutic strategies for EBV-associated life-threatening diseases.
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http://dx.doi.org/10.1586/14787210.5.3.403DOI Listing
June 2007
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