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10. A Case of Kawasaki Disease with Intussusception

Author

Ueharu, Koji, Asano, Takeshi, Fukunaga, Ryohei, Matsui, Ryosuke, Yoshida, Keishi, Miyatake-Sudoh, Chiharu, Abe, Masanori, Fujita, Atsushi, Itoh, Yasuhiko, Koji, Ueharu, Takeshi, Asano, Ryohei, Fukunaga, Ryosuke, Matsui, Keishi, Yoshida, Chiharu, Miyatake-Sudoh, Masanori, Abe, Atsushi, Fujita, and Yasuhiko, Itoh

Subjects
Male, Abdominal pain, medicine.medical_specialty, Erythema, Colon, Prednisolone, Mucocutaneous Lymph Node Syndrome, Colonic Diseases, hemic and lymphatic diseases, Intussusception (medical disorder), medicine, Humans, skin and connective tissue diseases, Aspirin, business.industry, Age Factors, Immunoglobulins, Intravenous, General Medicine, medicine.disease, Dermatology, Rash, Treatment Outcome, Child, Preschool, Etiology, Kawasaki disease, medicine.symptom, business, Intussusception, medicine.drug
Abstract

Kawasaki disease is a systemic vasculitis of unknown etiology and is known to be associated with various digestive disorders, though only a few cases of intussusception associated with Kawasaki disease have been reported. The case of a 3-year-old boy with intussusception followed by Kawasaki disease is reported. The patient was admitted to our hospital due to severe abdominal pain. Because the target sign was seen on ultrasonography, intussusception was diagnosed, and hydrostatic reduction was performed. On the second day after admission, he developed a high-grade fever (38 oC) and an irregular rash on the whole body. On the fourth day after admission, his high-grade fever continued, and bilateral non-exudative conjunctivitis, erythema of the lips and oral mucosa, strawberry tongue, indurated edema of the dorsum of his hands and feet, and a diffuse erythema of his palms and soles appeared, and he was finally diagnosed as having Kawasaki disease. He was treated with intravenous immune globulin 2 g/kg, aspirin 30 mg/kg/day, and prednisolone 2 mg/kg/day. The high-grade fever, as well as the other clinical symptoms, resolved immediately after the start of treatment. There was no relapse of Kawasaki disease symptoms after initial treatment, and periungual desquamation was observed on the tenth day after admission. He was discharged on the 15th day and showed no abnormalities, such as coronary dilatation, three months after the onset of the symptoms of Kawasaki disease. Age distribution (≥ 3 years old vs < 3years old) between cases with intussusception and Kawasaki disease was clearly older than that with intussusception only. In addition, location of intussusception with Kawasaki disease was mainly colonic, not ileocolic. If intussusception precedes the appearance of the characteristic clinical symptoms of Kawasaki disease, the diagnosis of Kawasaki disease may be delayed. We must be aware of the diagnosis of Kawasaki disease in cases of intussusception in over three years old and colonic location of intussusception.

Published
2020

11. Drug Resistance in Cancer Therapy and the Role of Epigenetics

Author

Asano, Takeshi and Takeshi, Asano

Subjects
Epigenomics, Drug export, DNA Repair, DNA repair, medicine.drug_class, Gene Expression, Antineoplastic Agents, Drug resistance, Methylation, Histones, 03 medical and health sciences, 0302 clinical medicine, Immune system, Antigens, Neoplasm, Neoplasms, Humans, Medicine, Molecular Targeted Therapy, Epigenetics, biology, business.industry, Membrane Transport Proteins, Acetylation, General Medicine, medicine.disease, Leukemia, Histone, Drug Resistance, Neoplasm, 030220 oncology & carcinogenesis, biology.protein, Cancer research, 030211 gastroenterology & hepatology, business, Topoisomerase inhibitor
Abstract

Effective leukemia treatment is seriously hampered by drug resistance, and the potential role of epigenetic mechanisms in cancer drug resistance has recently been investigated. With conventional anticancer drugs, including alkylating drugs, anti-metabolite drugs, topoisomerase inhibitors, and microtubule inhibitors-which have been available for half a century-drug resistance often develops because of decreased expression of target enzymes, in conjunction with increased expression of drug export pumps. Alterations of target gene expression and increased export pump function might be caused by epigenetic changes, such as alterations in methylation status, as well as by changes in histone acetylation status. In addition, newly developed anticancer drugs, including small-molecule drugs, such as kinase inhibitors, antibody drugs, and immune modulatory drugs, also resulted in development of drug resistance within 1 year, although these drugs showed significant effectiveness for patients resistant to conventional anticancer drugs. The resistant cells exhibited increased expression of bypass pathways, activation of downstream cascades, decreased expression of antigens of tumor cells, increased DNA repair activity, and increased expression of drug export pumps, which also suggests the presence of epigenetic changes. This article reviews drug resistance in cancer therapy and the possible roles of epigenetic mechanisms.

Published
2020

15. Growth Hormone Treatment at Nippon Medical School Chiba Hokusoh Hospital

Author

Kuramochi, Eri, Mae, Kazuya, Ohtomo, Yuuka, Kamada, Reina, Sugano-Tajima, Hanako, Asano, Takeshi, Eri, Kuramochi, Kazuya, Mae, Yuuka, Ohtomo, Reina, Kamada, Hanako, Sugano-Tajima, and Takeshi, Asano

Subjects
Male, Pediatrics, medicine.medical_specialty, Time Factors, Adolescent, Turner Syndrome, Short stature, Severity of Illness Index, Growth hormone deficiency, Hospitals, University, Japan, Turner syndrome, medicine, Humans, Child, Dwarfism, Pituitary, Growth Disorders, Schools, Medical, business.industry, Medical school, Age Factors, Infant, General Medicine, medicine.disease, Body Height, Growth hormone treatment, Treatment Outcome, Child, Preschool, Growth Hormone, Noonan syndrome, Small for gestational age, Female, medicine.symptom, business, GH Deficiency, Follow-Up Studies
Abstract

Background Since 2002, the Department of Pediatrics of Nippon Medical School Chiba Hokusoh Hospital has offered educational activities for children with short stature. We analyzed outcomes of growth hormone (GH) treatment for children with short stature treated at our hospital, particularly outcomes after the growth spurt. Methods We analyzed data from children aged 0 to 17 years who were treated with recombinant GH during the period from 2000 through 2016 and were followed for at least 2 years after the start of treatment. Results Among children with short stature, 85 had GH deficiency, 5 had Turner syndrome, 9 were small for gestational age, and 1 had Noonan syndrome. The outcomes of GH treatment was similar to those previously reported in Japan. Children with GH deficiency who started GH treatment before the growth spurt exhibited marked height catch-up until the second year, but the effect decreased after 3 years. The effect of treatment for GH deficiency that was started after the growth spurt continued for 4 to 5 years after the start of treatment. Conclusions Improvement in height standard deviation score was similar when treatment was started before and after the growth spurt.

Published
2021

18. Combination of extracorporeal membrane oxygenation and high-frequency oscillatory ventilation saved a child with severe ARDS after pulmonary resection

Author

Hashiba, Eiji, Kimura, Futoshi, Suzuki, Yasuyuki, Asano, Takeshi, Ono, Tomoko, Okawa, Hirobumi, Tsubo, Toshihito, Ishihara, Hironori, and Hirota, Kazuyoshi

Subjects
Nitric oxide, Surgery, Diuretics, Health
Abstract

We report a case in which a 2-year-old girl who underwent a right middle and lower lung lobectomy for congenital cystic adenomatoid malformation suffered massive bleeding and developed acute respiratory distress syndrome (ARDS) during the operation. She was ventilated with a high level of [F.sub.I][O.sub.2] (0.75-1.0), PEEP (10-20 cm[H.sub.2]O), and PIP (33-55 cm[H.sub.2]O) to maintain SP[O.sub.2] (>90%). Following transfer to the ICU, continuous hemodialysis was introduced to reduce excessive blood volume. However, pulmonary oxygenation did not improve, and marked subcutaneous emphysema occurred on postoperative day 3 (POD 3). We introduced venovenous (V-V) extracorporeal membrane oxygenation (ECMO) to rest the lung, and V-V ECMO was changed to right and left atrial ECMO because of unsatisfactory oxygen support on POD 23. A CT scan showed almost the entire lung had collapsed, even though we had administered diuretics, steroids, nitric oxide, sivelestat, and surfactant for ARDS. We applied high-frequency oscillatory ventilation (HFOV) with a mean airway pressure of 20 cm[H.sub.2]O, frequency of 9.2 Hz, and amplitude of 38 cm[H.sub.2]O on POD 45. The collapsed lung was then gradually recruited, and pulmonary oxygenation improved (P/F ratio = 434). ECMO was successfully weaned on POD 88. The patient required a tracheostomy, but she was able to function without a ventilator on POD 142. Although HFOV has failed to show a mortality benefit in ARDS patients, the unique lung recruitment by HFOV can be a useful therapeutic option for severe ARDS patients in combination with sufficient lung rest produced by ECMO. Keywords Extracorporeal membrane oxygenation * High-frequency oscillatory ventilation * ARDS * Postpneumonectomy pulmonary edema, Introduction Lung injury following pulmonary resection with no identifiable cause, especially after pneumonectomy, has been termed postpneumonectomy pulmonary edema, and has alarmed both anesthesiologists and thoracic surgeons because of its [...]

Published
2011
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25. Effects of flood flow on flood plain soil and riparian vegetation in a gravel river

Author

Toda, Yuji, Ikeda, Syunsuke, Kumagai, Kentaro, and Asano, Takeshi

Subjects
Floodplains -- Analysis, Sediment, Suspended -- Analysis, Engineering and manufacturing industries, Science and technology
Abstract

Field observations were performed to determine the effects of flood flow on the geometrical and chemical characteristics of flood plain soil and the distribution of riparian vegetation in a gravel river. The results of the observations show a decrease in the amounts of the particulate nutrients in the flood plain soil during fairly large flood, because the fine sands that serve as a nutrient source were removed by the flood flow. Numerical simulations for the transport of suspended sediments were performed by varying the peak discharge of the flood, and the change of the particulate nutrients in flood plain soil was estimated by using the results of the simulations. The numerical analysis predicts the reduction of the particulate nutrients in the flood plain soils well. The particulate nutrients on the flood plains decrease if the discharge exceeds the flood of approximately 2 year return period in the observation area. DOI: 10.1061/(ASCE)0733-9429(2005)131:11(950) CE Database subject headings: Nutrients; River flow; Suspended sediments; Flood plains; Vegetation; Floods.

Published
2005

50. Isolation of extracellular 28- and 42-kilodalton beta-1,3-glucanases and comparison of three beta-1,3-glucanases produced by Bacillus circulans IAM1165

Author

Aono, Rikizo, Hammura, Masahiro, Yamamoto, Mami, and Asano, Takeshi

Subjects
Bacillus (Bacteria) -- Research, Microbial enzymes -- Research, Biological sciences
Abstract

Standard techniques help purify the extracellular 28- and 42-kDa beta-1,3-glucanases produced by Bacillus circulans IAM1165. A comparative study of the characteristics of these enzymes with previously isolated 91-kDa enzymes reveals that the 42-kDa enzyme is the most effective in lysing fungal cell walls. The 28- and 42-kDa beta-1, 3-glucanases exhibit similar enzymatic characteristics and are the members of endo type 1,3-beta-D-glucan glucanohydrolases. At 60 degrees Celsius these enzymes exhibit optimum activity.

Published
1995

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