Publications by authors named "Shigemi Yoshihara"

108 Publications

Kawasaki Disease with Mild Encephalitis/Encephalopathy with Reversible Splenial Lesion in a 2-Year-Old Girl.

Indian J Pediatr 2021 May 3. Epub 2021 May 3.

Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan.

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http://dx.doi.org/10.1007/s12098-021-03779-5DOI Listing
May 2021

Protein-losing enteropathy in an infant with severe atopic dermatitis.

BMJ Case Rep 2021 Apr 22;14(4). Epub 2021 Apr 22.

Department of Pediatrics, Dokkyo Medical University, Shimotsuga, Tochigi, Japan.

Severe atopic dermatitis (AD) may lead to various complications such as hypoproteinaemia. We describe the case of a 7-month-old male infant with severe AD complicated with protein-losing enteropathy (PLE). He was diagnosed with AD at 2 months of age; however, because of familial steroid phobia, topical corticosteroids were not administered. At 7 months of age, he was admitted to our hospital for decreased feeding, diarrhoea, reduced urine volume and recurrent vomiting. Class 3 topical corticosteroid treatment was initiated. On day 3, eczema had almost resolved. However, serum protein levels had not improved; oliguria persisted and oedema worsened. Serum albumin scintigraphy revealed radioisotopes in the distal duodenum, leading to PLE diagnosis. Systemic prednisolone and albumin were administered, with no PLE relapse after discontinuation. To our knowledge, only two infant PLE cases associated with AD were reported to date. PLE should be considered in patients with severe AD and persistent hypoproteinaemia.
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http://dx.doi.org/10.1136/bcr-2020-241057DOI Listing
April 2021

Umbilical Cord Ulcerations with Naked Umbilical Artery.

J Pediatr 2021 Apr 20. Epub 2021 Apr 20.

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1016/j.jpeds.2021.04.006DOI Listing
April 2021

Type 3 antenatal Bartter syndrome presenting with mild polyuria.

BMJ Case Rep 2021 Apr 7;14(4). Epub 2021 Apr 7.

Department of Pediatrics, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.

Bartter syndrome (BS) is a well-recognised inherited tubular dysfunction that causes polyuria, metabolic alkalosis and hypokalaemia. Among BS cases, antenatal/neonatal BS (ABS) usually shows distinct polyhydramnios prenatally and presents features of BS in the early neonatal period. We encountered a premature infant with type 3 ABS presenting with mild polyuria and discuss the pathogenesis of mild polyuria in type 3 ABS. A male infant was born at 31 weeks' gestation. His mother received amniocentesis because of polyhydramnios. Hyponatraemia and hypokalaemia appeared within 3 days after birth. Metabolic alkalosis, hyperreninaemia and hyperaldosteronism were also identified. Temporary polyuria developed at 1 month after birth; however, the mean urine output during hospitalisation was within the normal range. compound heterozygous mutations were confirmed. Polyuria of type 3 ABS may be less severe than in other types of ABS. Lower urine sodium loss may be a characteristic feature of type 3 ABS.
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http://dx.doi.org/10.1136/bcr-2021-242086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030685PMC
April 2021

An atypical type of alveolar capillary dysplasia in a 3-month-old infant.

Pediatr Int 2021 Mar;63(3):350-352

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1111/ped.14426DOI Listing
March 2021

[THE JAPANESE RESPIRATORY SOCIETY GUIDELINES 2019 FOR REFRACTORY ASTHMA IN CHILDREN].

Arerugi 2021 ;70(2):95-99

Department of Pediatrics, Dokkyo Medical University.

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http://dx.doi.org/10.15036/arerugi.70.95DOI Listing
January 2021

The Japanese respiratory society guidelines for the management of cough and sputum (digest edition).

Respir Investig 2021 May 26;59(3):270-290. Epub 2021 Feb 26.

Tokyo Women's Medical University, Japan.

Cough and sputum are common complaints at outpatient visits. In this digest version, we provide a general overview of these two symptoms and discuss the management of acute (up to three weeks) and prolonged/chronic cough (longer than three weeks). Flowcharts are provided, along with a step-by-step explanation of their diagnosis and management. Most cases of acute cough are due to an infection. In chronic respiratory illness, a cough could be a symptom of a respiratory infection such as pulmonary tuberculosis, malignancy such as a pulmonary tumor, asthma, chronic obstructive pulmonary disease, chronic bronchitis, bronchiectasis, drug-induced lung injury, heart failure, nasal sinus disease, sinobronchial syndrome, eosinophilic sinusitis, cough variant asthma (CVA), atopic cough, chronic laryngeal allergy, gastroesophageal reflux (GER), and post-infectious cough. Antibiotics should not be prescribed for over-peak cough but can be considered for atypical infections. The exploration of a single/major cause is recommended for persistent/chronic cough. When sputum is present, a sputum smear/culture (general bacteria, mycobacteria), cytology, cell differentiation, chest computed tomography (CT), and sinus X-ray or CT should be performed. There are two types of rhinosinusitis. Conventional sinusitis and eosinophilic rhinosinusitis present primarily with neutrophilic inflammation and eosinophilic inflammation, respectively. The most common causes of dry cough include CVA, atopic cough/laryngeal allergy (chronic), GER, and post-infectious cough. In the last chapter, future challenges and perspectives are discussed. We hope that the clarification of the pathology of cough hypersensitivity syndrome will lead to further development of "pathology-specific non-specific therapeutic drugs" and provide benefits to patients with chronic refractory cough.
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http://dx.doi.org/10.1016/j.resinv.2021.01.007DOI Listing
May 2021

Preciousness: A reply to haiku with haiku.

J Paediatr Child Health 2021 02;57(2):298

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1111/jpc.15339DOI Listing
February 2021

Effectiveness of Ursodeoxycholic Acid in the Treatment of Primary Sclerosing Cholangitis with Ulcerative Colitis: A Pediatric Case.

Tohoku J Exp Med 2021 02;253(2):109-112

Department of Pediatrics, Dokkyo Medical University.

Primary sclerosing cholangitis is a rare disease with poor prognosis that potentially leads to liver cirrhosis and is often complicated by inflammatory bowel disease. Although ursodeoxycholic acid is the most commonly used drug to treat primary sclerosing cholangitis, its effectiveness in treating primary sclerosing cholangitis has not yet been established. An 11-year-old girl had a fever, upper and lower abdominal pain, and bloody stools. Colonoscopy revealed ulcerative colitis. She also had elevated hepatobiliary enzyme levels and C-reactive protein levels, indicating cholangitis after starting food intake, and primary sclerosing cholangitis was diagnosed with endoscopic retrograde cholangiography. Her hepatobiliary enzyme levels gradually improved after ursodeoxycholic acid was started, and symptoms did not recur after food intake. Primary sclerosing cholangitis should be considered if patients, even children, with inflammatory bowel disease, have upper abdominal pain with elevated biliary enzyme levels. The clinical guidelines for primary sclerosing cholangitis treatment have recommended that ursodeoxycholic acid should not be actively used. However, there are some recent reports stating its effectiveness for primary sclerosing cholangitis. In this patient, ursodeoxycholic acid may have been effective for the normalization of the hepatobiliary enzymes. However, it is unknown whether ursodeoxycholic acid improves long-term prognosis. Hence, further evidence regarding the effectiveness of ursodeoxycholic acid in the treatment of primary sclerosing cholangitis needs to be established.
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http://dx.doi.org/10.1620/tjem.253.109DOI Listing
February 2021

Endoplasmic reticulum stress and collagenous formation anomalies in vascular-type Ehlers-Danlos syndrome via electron microscopy.

J Dermatol 2021 Apr 1;48(4):481-485. Epub 2021 Feb 1.

Department of Dermatology, Dokkyo Medical University School of Medicine, Mibu, Japan.

Vascular-type Ehlers-Danlos syndrome (vEDS) is an autosomal-dominant inherited disorder caused by a deficit in collagen III. It results from heterogeneous mutations in the α1 collagen III gene (COL3A1) and is associated with life-threatening complications, even in younger patients. However, the details of the pathogenesis underlying the COL3A1 mutation causing vEDS remain unclear. Here, we focus on anomalies in collagen fiber size and the endoplasmic reticulum (ER) stress response in patients with vEDS using electron microscopy (EM). We discovered that although the infants did not have vEDS, collagenous formations were similar to their samples in vEDS. Moreover, we examined the expression of activating transcription factor 6 (ATF6) as an ER stress marker and cartilage oligomeric matrix protein (COMP) as a binding partner protein for collagen fibrils in the dermis and COL3A1. The expression levels of ATF6 in the vEDS group were significantly higher than in infants and controls; COMP and COL3A1 levels were significantly lower. The fragile collagen fibrils in vEDS might form as a result of ER stress and that small, newly formed collagen fibrils may appear. This research revealed a novel prospect regarding an issue that has been unclear for a long time, which is the reason for the abnormal sizes of collagenous fibrils in vEDS.
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http://dx.doi.org/10.1111/1346-8138.15766DOI Listing
April 2021

Pneumatosis intestinalis caused by intussusception.

Postgrad Med J 2020 Dec 11. Epub 2020 Dec 11.

Radiology, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.

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http://dx.doi.org/10.1136/postgradmedj-2020-139397DOI Listing
December 2020

Fulminant type 1 diabetes mellitus in a child with SMID leading to hypovolemic shock.

Pediatr Int 2021 Jan 5;63(1):108-109. Epub 2020 Dec 5.

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1111/ped.14357DOI Listing
January 2021

Incidence rate of vitamin D deficiency and FGF23 levels in 12- to 13-year-old adolescents in Japan.

J Bone Miner Metab 2021 May 18;39(3):456-462. Epub 2020 Nov 18.

Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan.

Introduction: The incidence rate of vitamin D deficiency is increasing throughout the world. We measured the incidence rate of vitamin D deficiency and fibroblast growth factor 23 (FGF23) levels in 12- to 13-year-old adolescents in Japan.

Materials And Methods: A total of 492 adolescents (247 boys and 245 girls) from Japanese community enrolled in this study. 25 hydroxyvitamin D (25(OH)D) was measured with radioimmunoassay. In the subjects with low 25(OH)D levels (≦ 20 ng/ml), intact parathyroid hormone (iPTH), calcium (Ca), phosphorus (P), albumin (Alb), alkaline phosphatase (ALP) and FGF23 were measured.

Results: 25(OH)D levels were significantly lower in girls (20.9 ± 3.1 ng/ml) than in boys (22.2 ± 3.3 ng/ml) (p < 0.0001). Fifty-five boys (22.3%) and 83 (33.9%) girls showed vitamin D deficiency (< 20 ng/ml). One-hundred eighty-six (75.3%) boys and 162 (66.1%) girls showed vitamin D insufficiency (≧ 20 ng/ml, < 30 ng/ml). In the subjects whose 25(OH)D levels were ≦ 20 ng/ml, the levels of iPTH, Ca, P, Alb, ALP and FGF23 were 22.3 ± 9.0 pg/ml, 9.5 ± 0.4 mg/dl, 4.7 ± 0.6 mg/dl, 4.6 ± 0.3 g/dl, 920.8 ± 339.3 U/l and 42.6 ± 26.0 pg/ml, respectively. There was a significant negative association between serum 25(OH)D levels and iPTH [r =  - 0.290 (p < 0.0001)]. There was no significant association between serum 25(OH)D levels and FGF23.

Conclusion: We show that 28% of Japanese 12- to 13-year-old early adolescents suffer from vitamin D deficiency. Findings from this study indicate that vitamin D deficiency requires close oversight in public health during adolescence to ensure proper bone health.
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http://dx.doi.org/10.1007/s00774-020-01173-3DOI Listing
May 2021

Oral Symptoms Caused by Toxic Plants Containing Calcium Oxalate.

J Pediatr 2021 03 6;230:258-259. Epub 2020 Nov 6.

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1016/j.jpeds.2020.11.001DOI Listing
March 2021

Pediatric fulminant type 1 diabetes with glutamic acid decarboxylase antibody.

Pediatr Int 2020 Dec 4;62(12):1388-1389. Epub 2020 Nov 4.

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1111/ped.14291DOI Listing
December 2020

Magnetic resonance imaging diagnosis of acute focal bacterial nephritis with MERS.

Pediatr Int 2020 Sep;62(9):1121-1122

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1111/ped.14315DOI Listing
September 2020

[DIAGNOSIS AND TREATMENT FOR ASTHMA IN PRESCHOOL CHILDREN].

Arerugi 2020;69(8):652-657

Department of Pediatrics, Dokkyo Medical University.

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http://dx.doi.org/10.15036/arerugi.69.652DOI Listing
January 2021

Tracheal Buckling in a Young Child.

J Pediatr 2020 12 6;227:316-317. Epub 2020 Aug 6.

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1016/j.jpeds.2020.08.009DOI Listing
December 2020

Retropharyngeal abscess in a 2-month-old boy presenting with intermittent stridor.

Pediatr Int 2020 Sep 3;62(9):1103-1105. Epub 2020 Aug 3.

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1111/ped.14236DOI Listing
September 2020

Effectiveness of stenting with an intubation tube for a subglottic mass in an infant.

BMJ Case Rep 2020 06 30;13(6). Epub 2020 Jun 30.

Department of Pediatrics, Dokkyo Medical University, Shimotsuga, Tochigi, Japan.

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http://dx.doi.org/10.1136/bcr-2020-235904DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328735PMC
June 2020

Usefulness of Non-Contact Infrared Thermometer for Early Neonatal Period Using Bland-Altman Analysis.

Iran J Public Health 2020 Feb;49(2):411-413

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231706PMC
February 2020

Increased MUC1 plus a larger quantity and complex size for MUC5AC in the peripheral airway lumen of long-term tobacco smokers.

Clin Sci (Lond) 2020 05;134(10):1107-1125

Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

There is little information on mucins versus potential regulatory factors in the peripheral airway lumen of long-term smokers with (LTS+) and without (LTS-) chronic obstructive pulmonary disease (COPD). We explored these matters in bronchoalveolar lavage (BAL) samples from two study materials, both including LTS+ and LTS- with a very similar historic exposure to tobacco smoke, and healthy non-smokers (HNSs; n=4-20/group). Utilizing slot blot and immunodetection of processed (filtered and centrifuged), as well as unprocessed BAL samples from one of the materials, we compared the quantity and fraction of large complexes of mucins. All LTS displayed an enhanced (median) level of MUC5AC compared with HNS. LTS- displayed a higher level of large MUC5AC complexes than HNS while LTS+ displayed a similar trend. In all LTS, total MUC5AC correlated with blood leukocytes, BAL neutrophil elastase and net gelatinase activity. Large mucin complexes accounted for most MUC5B, without clear group differences. In all LTS, total MUC5B correlated with total MUC5AC and local bacteria. In the same groups, large MUC5B complexes correlated with serum cotinine. MUC1 was increased and correlated with BAL leukocytes in all LTS whereas MUC2 was very low and without clear group differences. Thus, the main part of MUC5AC and MUC5B is present as large complexes in the peripheral airway lumen and historic as well as current exposure to tobacco smoke emerge as potential regulatory factors, regardless of COPD per se. Bacteria, leukocytes and proteinases also constitute potential regulatory factors, of interest for future therapeutic strategies.
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http://dx.doi.org/10.1042/CS20191085DOI Listing
May 2020

Relationship between early pubertal maturation and asthma.

Allergy 2020 04;75(4):998

Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Japan.

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http://dx.doi.org/10.1111/all.14063DOI Listing
April 2020

Typical MRI Imaging with Clinically Mild Encephalitis/Encephalopathy of a Reversible Splenial Lesion (MERS) Caused by Influenza A Virus.

Iran J Public Health 2020 Jan;49(1):191-192

Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152623PMC
January 2020

[THE JRS GUIDELINES 2019 FOR THE MANAGEMENT OF REFRACTORY ASTHMA IN CHILDREN].

Arerugi 2020;69(2):100-104

Department of Pediatrics, Dokkyo Medical University.

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http://dx.doi.org/10.15036/arerugi.69.100DOI Listing
July 2020

Contribution of Transferrin and Ceruloplasmin Neurotransmission and Oxidant/Antioxidant Status to the Effects of Everolimus: A Case Series.

Cureus 2020 Feb 8;12(2):e6920. Epub 2020 Feb 8.

Department of Pediatrics, Dokkyo Medical University Hospital, Mibu, JPN.

Tuberous sclerosis complex (TSC) is a genetic disorder with a high prevalence of associated autism spectrum disorder (ASD). The pathophysiology of TSC mainly involves the hyperactivation of mammalian target of rapamycin (mTOR) induced by TSC1 (hamartin) and TSC2 (tuberin) heterozygosity. The mTOR inhibitor, everolimus, is a therapeutic target for TSC-related ASD. The efficacy of everolimus may be affected by iron and copper neurotransmission and oxidant-antioxidant systems. Creatine has an antioxidant activity related to the cytoprotective paradigm. Additionally, TSC-related epileptic activity may influence the development of autistic symptoms. This case series examined the efficacy of everolimus in relation to the serum levels of the iron mediator (transferrin (Tf)), the copper mediator (ceruloplasmin (Cp)), the oxidant marker (oxidized low-density lipoprotein (oxLDL)), the antioxidant marker (total antioxidant power (TAP)), and creatine in four cases of TSC accompanied with autism. Everolimus improved autistic symptoms with increased serum Cp and Tf levels in all four cases. Serum TAP and creatine levels showed positive correlations with decreased total Aberrant Behavior Checklist (ABC) and Social Responsiveness Scale (SRS) scores, respectively. As everolimus regulates iron homeostasis and increased copper levels suppress mTOR signaling, everolimus improved autism symptoms with increased serum levels of Cp and Tf via homeostatic control of mTOR activity, accompanied with the considerable overlap of oxidant-antioxidant systems, such as TAP and creatine. Everolimus had no effect on TSC-related epileptiform discharges; thus, the autistic symptoms and epileptic activity may be two independent end results of a common central nervous system including mTOR hyperactivity.
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http://dx.doi.org/10.7759/cureus.6920DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008795PMC
February 2020