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Higashidate N, Sakamoto S, Saikusa N, Koga Y, Masui D, Nakahara H, Nakamura M, Saikusa M, Kinoshita M, Kaji T. Tubular intestinal duplication extending from the stomach to the ileum associated with multiple intestinal atresia and situs inversus: a case report. Surg Case Rep 2023; 9:141. [PMID: 37556040 PMCID: PMC10412515 DOI: 10.1186/s40792-023-01728-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/06/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Duplication of the alimentary tract can occur in any of its parts. For duodenal duplication, complete resection is particularly difficult when the ampulla of Vater is on the duplicated lumen and a deliberate management is necessary. CASE PRESENTATION A 0-day female baby was referred to our department due to abdominal distention. The X-ray examination showed dextrocardia and opacity of the liver on the left side and abdominal ultrasonogram revealed remarkable intestinal dilatation. Therefore, urgent laparotomy was performed on the day of birth. Complete situs inversus of the abdominal organs was revealed, and the origin of the jejunum was on the left side and was accompanied by tubular intestinal duplication. The origin of the duplicated intestine was at the pancreatic head's dorsal area. There were two points of type Шa atresia on the ileum. Therefore, we spared the duplicated intestine with a length of 3 cm to secure the passage of the biliary and pancreatic juices by a functional-side-to-side anastomosis with a 45-mm Endo-GIA™ camel load (Medtronic, Minneapolis, MN, USA). The ileum was transected at the distal side of the atresia point, and end-to-end jejunoileostomy was performed. Postoperative gastrointestinal series revealed remnants of the duplicated alimentary tract on the dorsal area of the stomach. CONCLUSIONS Identifying the position of the ampulla of Vater is crucial in the surgery of alimentary tract duplication with duodenal involvement. However, in the present case, it was difficult to identify whether the ampulla of Vater was on the true or duplicated lumen, and we had to spare the duplicated duodenum. Stapler anastomosis could be performed safely even in neonatal cases.
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Affiliation(s)
- Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Misa Nakamura
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Mamoru Saikusa
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Masahiro Kinoshita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Tatsuru Kaji
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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Unno M, Morisaki T, Kinoshita M, Saikusa M, Iwata S, Fukaya S, Yamashita Y, Nakayama M, Saitoh S, Iwata O. Validation of actigraphy in hospitalised newborn infants using video polysomnography. J Sleep Res 2021; 31:e13437. [PMID: 34263949 DOI: 10.1111/jsr.13437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/04/2021] [Accepted: 06/21/2021] [Indexed: 11/28/2022]
Abstract
Actigraphy has been established as a reliable sleep assessment tool in adults; however, its utility in newborns remains unknown. Validation of actigraphy in newborns may provide a significant insight into the physiological and pathological acquisition process of mature diurnal sleep patterns and subsequent morbidities in both newborns and their mothers. Thus, the present study aimed to evaluate the accuracy of sleep-wake detection by overnight actigraphy in a cohort of newborns. Simultaneous recording of polysomnography and actigraphy data was performed in 40 newborns admitted to a tertiary neonatal intensive care unit (NICU). A mixed-effects logistic regression model to explain the sleep state identified by polysomnography was employed using the actigraphic activity score as a fixed independent variable and the individual newborn's identity as a random effect. To evaluate the usefulness of the actigraphic activity score as a surrogate marker of sleep, a receiver operating characteristic (ROC) curve analysis was performed using the variables that were used in the mixed-effects logistic regression model, and the area under the curve (AUC) was assessed. The results showed that polysomnography-determined sleep epochs were associated with a smaller activity index on actigraphy (odds ratio per 10 activity indices increase 0.81, 95% confidence interval [CI] 0.79-0.84). The AUC for the ROC curve was 0.87 (95% CI 0.87-0.88, range 0.54-0.99). An activity score of 124 showed the maximum overall accuracy (90.2%, 95% CI 87.7-92.1). Our present study suggests that sleep-wake states of NICU-hospitalised newborns can be precisely determined using actigraphy on the ankle.
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Affiliation(s)
- Mitsuaki Unno
- Department of Neonatology, St. Mary's Hospital, Kurume, Japan
| | - Toshihiro Morisaki
- Department of Environmental Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan
| | - Mamoru Saikusa
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan
| | - Sachiko Iwata
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.,Department of Pediatrics and Neonatology, Center for Human Development and Family Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoko Fukaya
- Department of Pediatrics and Neonatology, Center for Human Development and Family Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yushiro Yamashita
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan
| | - Meiho Nakayama
- Department of Otolaryngology, Good Sleep Centre, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Center for Human Development and Family Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Osuke Iwata
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.,Department of Pediatrics and Neonatology, Center for Human Development and Family Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Saikusa M, Kinoshita M, Tsuda K, Hisano T, Okada J, Iwata S, Fujino H, Maeno Y, Yamashita Y, Iwata O. Revisions of clinical protocols using the Plan Do Check Act cycle improved outcomes of extremely preterm infants at 2 years. Acta Paediatr 2021; 110:2100-2109. [PMID: 33711173 PMCID: PMC8360062 DOI: 10.1111/apa.15840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 11/28/2022]
Abstract
AIM Clinical quality improvement is often cumbersome due to established protocols. We aimed to investigate whether outcomes of preterm infants improve with protocol revisions using iteration cycles. METHODS Preterm infants born <28 weeks gestation between January 2006 and December 2015 were retrospectively analysed. Protocols were revised using Plan Do Check Act cycle. Death and serious adverse events at term were reviewed in six-monthly quality improvement meetings. Adverse outcome of death or motor/sensory impairments at two years was compared before and after two major protocol changes, which were implemented in January 2008 and January 2012. RESULTS Based on the appraisal for period 2006-2007, strategies for surfactant, narcotics, parenteral nutrition, respiratory gas humidity and prophylactic indomethacin and antibiotics were changed for period 2008-2011. For period 2012-2015, stabilisation of infants was accelerated via very early catheterisation. Of 162 infants (84 males, 25.5 ± 1.5 weeks gestation) within the whole cohort, 63 developed adverse outcomes, which were fewer for periods 2008-2011 (p = 0.013) and 2012-2015 (p = 0.035) compared with period 2006-2007 (adjusted for gestational age, Apgar scores and sex). CONCLUSION Careful bottom-up revisions of protocols using iteration cycles, accounting for local settings, successfully improved the outcomes of preterm infants.
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Affiliation(s)
- Mamoru Saikusa
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Kennosuke Tsuda
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
- Center for Human Development and Family ScienceDepartment of Pediatrics and NeonatologyNagoya City University Graduate School of Medical SciencesNagoyaAichiJapan
| | - Tadashi Hisano
- Center for Human Development and Family ScienceDepartment of Pediatrics and NeonatologyNagoya City University Graduate School of Medical SciencesNagoyaAichiJapan
| | - Junichiro Okada
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Sachiko Iwata
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
- Center for Human Development and Family ScienceDepartment of Pediatrics and NeonatologyNagoya City University Graduate School of Medical SciencesNagoyaAichiJapan
| | - Hiroshi Fujino
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Yasuki Maeno
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Yushiro Yamashita
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Osuke Iwata
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
- Center for Human Development and Family ScienceDepartment of Pediatrics and NeonatologyNagoya City University Graduate School of Medical SciencesNagoyaAichiJapan
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Shimizu T, Yokomine M, Yoshizato T, Araki K, Higashidate N, Saikusa M, Ushijima K. Difficulty in prenatal diagnosis of the volvulus of the small intestine: A peculiar clinical course of two cases with massive bowel dilatation and loss of peristalsis. J Obstet Gynaecol Res 2021; 47:1903-1908. [PMID: 33590600 DOI: 10.1111/jog.14706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/25/2021] [Accepted: 01/30/2021] [Indexed: 11/27/2022]
Abstract
We report two cases of fetal intestinal volvulus (jejunum in case A, ileum in case B) with massive bowel dilatation and loss of peristalsis, which suddenly appeared in the third trimester. The bowel was dilated to different sizes and there were various echogenic patterns of the intestines in case A and a sausage-like appearance in case B. Case A developed polyhydramnios, whereas case B did not. Among 47 cases of fetal intestinal volvulus (29 articles) in which 32 were diagnosed prenatally, almost all cases with a prenatal diagnosis showed "whirlpool sign" or "coffee bean sign" by sonography and/or findings indicating intestinal hemorrhage. Even without these findings, the presence of dilatation of the intestines and loss of peristalsis occurring in the third trimester were diagnostic clues. The presence of different sizes and various patterns of bowel dilation and hydramnios may be helpful for predicting the involved site of intestinal volvulus.
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Affiliation(s)
- Takahiro Shimizu
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Masato Yokomine
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Toshiyuki Yoshizato
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Kenshiro Araki
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, School of Medicine, Kurume University, Kurume, Japan
| | - Mamoru Saikusa
- Department of Pediatrics, School of Medicine, Kurume University, Kurume, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, School of Medicine, Kurume University, Kurume, Japan
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Okada J, Hisano T, Unno M, Tanaka Y, Saikusa M, Kinoshita M, Harada E, Iwata S, Iwata O. Video-call based newborn triage system for local birth centres can be established without major instalment costs using commercially available smartphones. Sci Rep 2020; 10:7552. [PMID: 32371906 PMCID: PMC7200688 DOI: 10.1038/s41598-020-64223-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/10/2020] [Indexed: 11/25/2022] Open
Abstract
Neonates often develop transition problems after low-risk birth, precise assessment of which is difficult at primary birth centres. The aim of this study was to assess whether a video triage system can be established without a specially designed communication system between local birth centres and a tertiary neonatal intensive care unit in a region with a population of 700,000. 761 neonates who were referred to a tertiary neonatal intensive care unit were examined. During period 1 (April 2011-August 2015), only a voice call was available for consultations, whereas, during period 2 (September 2015-December 2017), a video call was additionally available. The respiratory condition was assessed based on an established visual assessment tool. A video consultation system was established by connecting personal smartphones at local birth centres with a host computer at a tertiary neonatal intensive care centre. During period 2, video-based triage was performed for 42.4% of 236 consultations at 30 birth centres. Sensitivity and specificity for predicting newborns with critical respiratory dysfunction changed from 0.758 to 0.898 and 0.684 to 0.661, respectively. A video consultation system for ill neonates was established without major instalment costs. Our strategy might improve the transportation system in both high- and low-resource settings.
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Affiliation(s)
- Junichiro Okada
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
| | - Tadashi Hisano
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Mitsuaki Unno
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
| | - Yukari Tanaka
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
| | - Mamoru Saikusa
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Masahiro Kinoshita
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Eimei Harada
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Sachiko Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Osuke Iwata
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan.
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.
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Harada E, Kinoshita M, Iwata S, Saikusa M, Tsuda K, Shindou R, Sahashi T, Kato S, Yamada Y, Saitoh S, Iwata O. Visual function scale for identification of infants with low respiratory compliance. Pediatr Neonatol 2019; 60:611-616. [PMID: 30905442 DOI: 10.1016/j.pedneo.2019.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/02/2018] [Accepted: 02/26/2019] [Indexed: 11/18/2022] Open
Abstract
AIM Precise estimation of respiratory function is essential to optimise neonatal respiratory care. However, current clinical scores have not been validated with quantitative measures of respiratory function. The aim of this study was to develop a physiological scoring system to predict low respiratory dynamic compliance of <0.6 ml/cmH2O/kg. METHODS Forty-four newborn infants were studied before (dynamic compliance) and shortly after scheduled extubation (physiological signs). A novel scoring system was developed based on the association between physiological signs and dynamic compliance. RESULTS The respiratory rate was identified as the primary independent variable for dynamic compliance in the univariate analysis. The prediction score for low dynamic compliance comprised the presence of nasal flaring, see-saw respiration, suprasternal/intercostal retraction, and the respiratory rate ranks (0-3). The area under the receiver-operating characteristics curve of the composite score had discriminatory capability of 0.86 (95% confidence interval: 0.75-0.97) to predict low dynamic compliance with the optimal cut-off value of ≥3 (sensitivity, 0.882; specificity, 0.667). CONCLUSION Our novel scoring system might help predict newborn infants with low dynamic compliance, who may require escalation of respiratory support, or transfer to higher level units.
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Affiliation(s)
- Eimei Harada
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Sachiko Iwata
- Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Mamoru Saikusa
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kennosuke Tsuda
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Ryota Shindou
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takeshi Sahashi
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Division of Neonatology, Ichinomiya Municipal Hospital, Ichinomiya, Aichi, Japan
| | - Shin Kato
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Yasumasa Yamada
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Perinatal and Neonatal Center, Aichi Medical University, Nagakute, Aichi, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Osuke Iwata
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
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Iwata S, Kinoshita M, Okamura H, Tsuda K, Saikusa M, Harada E, Saitoh S, Iwata O. Intrauterine growth and the maturation process of adrenal function. PeerJ 2019; 7:e6368. [PMID: 30746307 PMCID: PMC6368969 DOI: 10.7717/peerj.6368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 12/28/2018] [Indexed: 11/20/2022] Open
Abstract
Backgrounds Environmental factors during early life alter the hypothalamus-pituitary-adrenal (HPA) axis regulation and increase the risk of diseases in later life. However, adrenal function at each developmental stage has not fully been investigated in relation to pathological antenatal conditions. Cortisol levels of newborns with intrauterine growth restriction (IUGR) are elevated during the neonatal period; however, when studied during early childhood, cortisol levels are reduced compared with their peers, suggesting that the HPA axis regulation might be altered from activation to suppression, the timing of which remains uncertain. Aim The aim of this study was to assess the presence of an interaction between intrauterine growth and postnatal age on cortisol levels in newborns hospitalised at a neonatal intensive care unit. Methods We performed a secondary analysis using a dataset from saliva samples of 62 newborns collected between 30 and 40 weeks corrected age. Interactions between postnatal age and clinical variables with regard to cortisol levels were assessed. Results The z-score of the birth weight and IUGR showed significant interactions with postnatal age on cortisol levels; cortisol levels were higher ≤5 days of birth and lower >14 days of birth than those in their peers without IUGR. Conclusion The adrenal function of newborns with IUGR might be altered from activation to suppression within the first several weeks of life. Longitudinal studies need to address when/how IUGR alters adrenal functions, and how these responses are associated with diseases during adulthood.
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Affiliation(s)
- Sachiko Iwata
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Masahiro Kinoshita
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hisayoshi Okamura
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Mamoru Saikusa
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Eimei Harada
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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Kinoshita M, Iwata S, Okamura H, Tsuda K, Saikusa M, Harada E, Yamashita Y, Saitoh S, Iwata O. Feeding-Induced Cortisol Response in Newborn Infants. J Clin Endocrinol Metab 2018; 103:4450-4455. [PMID: 30085188 DOI: 10.1210/jc.2018-01052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/31/2018] [Indexed: 02/13/2023]
Abstract
CONTEXT Understanding the biological rhythms and stress response in sick newborns is important to minimize the negative effects of intensive care. Salivary cortisol has been used as a noninvasive surrogate marker of adrenal function; however, understanding of its control variables is insufficient. OBJECTIVE To investigate the presence of feeding-induced cortisol response and its control variables in newborns. DESIGN, SETTING, AND PATIENTS Fifty-three newborn infants, who were between 30 and 40 weeks' corrected age and were on 3-hourly regular oral/enteral feeding, were recruited between January 2013 and June 2014. MAIN OUTCOME MEASURE Saliva samples were collected before and 1 hour after regular feeding. Dependence of cortisol levels (adjusted for postnatal age) and their feeding-related elevation on clinical variables was assessed by using generalized estimating equations. RESULTS Higher cortisol levels were associated with corrected age ≥37 weeks and saliva samples collected after feeding (both P < 0.001). Oral feeding was associated with a greater feeding-induced cortisol response compared with exclusive enteral feeding (P = 0.034), whereas a prolonged feeding duration (≥30 minutes) was associated with a reduced cortisol response compared with brief feeding (<30 minutes) (P < 0.001). Gestational age, corrected age, antenatal/postnatal glucocorticoids, type of milk, and daily feeding volume had no effect on cortisol response. CONCLUSIONS Feeding-induced cortisol response was observed in newborns. The cortisol response was more prominent following oral feeding and was reduced with prolonged feeding. Future studies may investigate whether feeding-induced cortisol response plays a role in the acquisition of adrenal ultradian and diurnal rhythms.
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Affiliation(s)
- Masahiro Kinoshita
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Sachiko Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Hisayoshi Okamura
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Mamoru Saikusa
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Eimei Harada
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Yushiro Yamashita
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Osuke Iwata
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
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Yoshizuka T, Kinoshita M, Iwata S, Tsuda K, Kato T, Saikusa M, Shindou R, Hara N, Harada E, Takashima S, Takeshige N, Saitoh S, Yamashita Y, Iwata O. Estimation of elevated intracranial pressure in infants with hydroce-phalus by using transcranial Doppler velocimetry with fontanel compression. Sci Rep 2018; 8:11824. [PMID: 30087390 PMCID: PMC6081432 DOI: 10.1038/s41598-018-30274-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/24/2018] [Indexed: 11/09/2022] Open
Abstract
For infants with acute progressive hydrocephalus, invasive drainage of cerebrospinal fluid (CSF) is performed until a ventriculo-peritoneal shunt can be inserted. Surrogate markers of intracranial pressure (ICP) may help optimise the timing of invasive procedures. To assess whether RI with/without fontanel compression helps distinguish between infants with normal (<5 cmH2O), mild (5-11 cmH2O), and moderate (>11 cmH2O) ICP elevation, 74 ICP measures before/after CSF removal and 148 related Doppler measures of the middle cerebral artery were assessed. Higher RI was associated with fontanel compression, elevated ICP, and their interaction (all p < 0.001). Without compression, differences in RI were observed between normal and moderate (p < 0.001) and between mild and moderate ICP elevation (p = 0.033). With compression, differences in RI were observed for all pairwise comparisons among normal, mild, and moderate ICP elevation (all p < 0.001). Without compression, areas under the receiver-operating characteristic curve for prediction of mild and moderate ICP elevation were 0.664 (95% confidence interval (CI), 0.538-0.791; p = 0.020) and 0.727 (95% CI, 0.582-0.872; p = 0.004), respectively, which improved to 0.806 (95% CI, 0.703-0.910; p < 0.001) and 0.814 (95% CI, 0.707-0.921; p < 0.001), respectively, with compression. RI with fontanel compression provides improved discrimination of infants with absent, mild, and moderate ICP elevation.
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Affiliation(s)
- Teiko Yoshizuka
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Sachiko Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Takenori Kato
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Mamoru Saikusa
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Ryota Shindou
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Naoko Hara
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Eimei Harada
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Sachio Takashima
- Yanagawa Institute for Developmental Disabilities, International University of Health and Welfare, Fukuoka, Japan
| | - Nobuyuki Takeshige
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Yushiro Yamashita
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
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Kurata T, Iwata S, Tsuda K, Kinoshita M, Saikusa M, Hara N, Oda M, Ohmae E, Araki Y, Sugioka T, Takashima S, Iwata O. Physiological and pathological clinical conditions and light scattering in brain. Sci Rep 2016; 6:31354. [PMID: 27511644 PMCID: PMC4980768 DOI: 10.1038/srep31354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/18/2016] [Indexed: 11/15/2022] Open
Abstract
MRI of preterm infants at term commonly reveals subtle brain lesions such as diffuse white matter injury, which are linked with later cognitive impairments. The timing and mechanism of such injury remains unclear. The reduced scattering coefficient of near-infrared light (μs’) has been shown to correlate linearly with gestational age in neonates. To identify clinical variables associated with brain μs’, 60 preterm and full-term infants were studied within 7 days of birth. Dependence of μs’ obtained from the frontal head on clinical variables was assessed. In the univariate analysis, smaller μs’ was associated with antenatal glucocorticoid, emergency Caesarean section, requirement for mechanical ventilation, smaller gestational age, smaller body sizes, low 1- and 5-minute Apgar scores, higher cord blood pH and PO2, and higher blood HCO3− at the time of study. Multivariate analysis revealed that smaller gestational age, requirement for mechanical ventilation, and higher HCO3− at the time of study were correlated with smaller μs’. Brain μs’ depended on variables associated with physiological maturation and pathological conditions of the brain. Further longitudinal studies may help identify pathological events and clinical conditions responsible for subtle brain injury and subsequent cognitive impairments following preterm birth.
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Affiliation(s)
- Tsuyoshi Kurata
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan.,Community Medical Support Institute, Saga University School of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Sachiko Iwata
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Kennosuke Tsuda
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan.,Division of Neonatology, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Mamoru Saikusa
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Naoko Hara
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Motoki Oda
- Central Research Laboratory, Hamamatsu Photonics K.K., 5000 Hirakuchi, Hamakita-ku, Hamamatsu, Shizuoka, 434-8601, Japan
| | - Etsuko Ohmae
- Central Research Laboratory, Hamamatsu Photonics K.K., 5000 Hirakuchi, Hamakita-ku, Hamamatsu, Shizuoka, 434-8601, Japan
| | - Yuko Araki
- Faculty of Informatics, Shizuoka University, 3-5-1 Johoku Naka-ku, Hamamatsu, Shizuoka, 432-8011, Japan
| | - Takashi Sugioka
- Community Medical Support Institute, Saga University School of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Sachio Takashima
- Yanagawa Institute for Developmental Disabilities, International University of Health and Welfare, 218-1 Tano-machi Mitsuhashi-machi, Yanagawa, Fukuoka, 832-0813, Japan
| | - Osuke Iwata
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
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11
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Tanaka S, Iwata S, Kinoshita M, Tsuda K, Sakai S, Saikusa M, Shindo R, Harada E, Okada J, Hisano T, Kanda H, Maeno Y, Araki Y, Ushijima K, Sakamoto T, Yamashita Y, Iwata O. Use of Normothermic Default Humidifier Settings Causes Excessive Humidification of Respiratory Gases During Therapeutic Hypothermia. Ther Hypothermia Temp Manag 2016; 6:180-188. [PMID: 27167667 DOI: 10.1089/ther.2016.0005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adult patients frequently suffer from serious respiratory complications during therapeutic hypothermia. During therapeutic hypothermia, respiratory gases are humidified close to saturated vapor at 37°C (44 mg/L) despite that saturated vapor reduces considerably depending on temperature reduction. Condensation may cause serious adverse events, such as bronchial edema, mucosal dysfunction, and ventilator-associated pneumonia during cooling. To determine clinical variables associated with inadequate humidification of respiratory gases during cooling, humidity of inspiratory gases was measured in 42 cumulative newborn infants who underwent therapeutic hypothermia. Three humidifier settings of 37-default (chamber outlet, 37°C; distal circuit, 40°C), 33.5-theoretical (chamber outlet, 33.5°C; distal circuit, 36.5°C), and 33.5-adjusted (optimized setting to achieve 36.6 mg/L using feedback from a hygrometer) were tested to identify independent variables of excessively high humidity >40.7 mg/L and low humidity <32.9 mg/L. The mean (SD) humidity at the Y-piece was 39.2 (5.2), 33.3 (4.1), and 36.7 (1.2) mg/L for 37-default, 33.5-theoretical, and 33.5-adjusted, respectively. The incidence of excessive high humidity was 10.3% (37-default, 31.0%; 33.5-theoretical, 0.0%; 33.5-adjusted, 0.0%), which was positively associated with the use of a counter-flow humidifier (p < 0.001), 37-default (compared with 33.5-theoretical and 33.5-adjusted, both p < 0.001) and higher fraction of inspired oxygen (p = 0.003). The incidence of excessively low humidity was 17.5% (37-default, 7.1%; 33.5-theoretical, 45.2%; 33.5-adjusted, 0.0%), which was positively associated with the use of a pass-over humidifier and 33.5-theoretical (both p < 0.001). All patients who used a counter-flow humidifier achieved the target gas humidity at the Y-piece (36.6 ± 0.5 mg/L) required for 33.5-adjusted with 33.5-theoretical. During cooling, 37-default is associated with excessively high humidity, whereas 33.5-theoretical leads to excessively low humidity. Future studies are needed to assess whether a new regimen with optimized Y-piece temperature and humidity control reduces serious respiratory adverse events during cooling.
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Affiliation(s)
- Shoichiro Tanaka
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Sachiko Iwata
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Masahiro Kinoshita
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Kennosuke Tsuda
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Sayaka Sakai
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Mamoru Saikusa
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Ryota Shindo
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Eimei Harada
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Junichiro Okada
- 2 Division of Neonatology, St. Mary's Hospital , Fukuoka, Japan
| | - Tadashi Hisano
- 2 Division of Neonatology, St. Mary's Hospital , Fukuoka, Japan
| | - Hiroshi Kanda
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Yasuki Maeno
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Yuko Araki
- 3 Department of Informatics, Graduate School of Integrated Science and Technology, Shizuoka University , Shizuoka, Japan
| | - Kazuo Ushijima
- 4 Department of Anaesthesiology, Kurume University School of Medicine , Fukuoka, Japan
| | - Teruo Sakamoto
- 5 Advanced Emergency Medical Service Centre, Kurume University Hospital , Fukuoka, Japan
| | - Yushiro Yamashita
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Osuke Iwata
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
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12
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Saikusa M, Yatsuga S, Tonan T, Koga Y. Glycogenic hepatopathy and non-alcoholic fatty liver disease in type 1 diabetes patients. Pediatr Int 2013; 55:806-7. [PMID: 24330296 DOI: 10.1111/ped.12235] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 07/19/2013] [Accepted: 10/08/2013] [Indexed: 12/13/2022]
Affiliation(s)
- Mamoru Saikusa
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan
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13
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Iwata O, Okamura H, Saitsu H, Saikusa M, Kanda H, Eshima N, Iwata S, Maeno Y, Matsuishi T. Diurnal cortisol changes in newborn infants suggesting entrainment of peripheral circadian clock in utero and at birth. J Clin Endocrinol Metab 2013; 98:E25-32. [PMID: 23150686 DOI: 10.1210/jc.2012-2750] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the rodent and human fetus, a diurnal cortisol rhythm is observed that is entrained in antiphase to the maternal rhythm. However, after birth, the adrenal circadian rhythm becomes unsynchronized with the clock time, and an adult-type, 24-h rhythm is observed only after a few months. Little is known about when and how the fetal adrenal circadian rhythm is synchronized with the day-night cycle. METHODS To investigate the function of adrenal circadian clock in the newborn infant, eight serial saliva samples were collected every 3 h over 24 h (starting at 0900 h) in 27 newborn infants. RESULTS Cortisol levels were higher during the period 1500 to earlier than 2100 h than during 0900 to earlier than 1500 h and 0300 to earlier than 0900 h (both P < 0.05). Salivary cortisol levels collected during 0 to <6, 6 to <12, and 12 to <18 hours after the clock time at birth (birth time) were higher than those collected during 18 to <24 hours after the birth time (P < 0.005, 0.05, and 0.05, respectively). The acrophase of salivary cortisol was linearly correlated with the birth time within the first 5 d of life (P < 0.005) but not thereafter. CONCLUSION In the newborn infant, diurnal increase in cortisol was observed in the late afternoon and in correspondence with the birth time. The adrenal circadian rhythm acquired in utero may be reentrained by endocrinological events at birth. Such complex regulation of the adrenal circadian clock may inhibit a swift synchronization of the circadian clock to the day-night rhythm.
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Affiliation(s)
- Osuke Iwata
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011 Japan.
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14
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Munemura T, Saikusa M, Kawakami C, Shimizu H, Oseto M, Hagiwara A, Kimura H, Miyamura T. Genetic diversity of enterovirus 71 isolated from cases of hand, foot and mouth disease in Yokohama City between 1982 and 2000. Arch Virol 2003; 148:253-63. [PMID: 12556991 DOI: 10.1007/s00705-002-0920-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Enterovirus 71 (EV71) is known as one of the major causative agents of hand, foot and mouse disease (HFMD) and is also associated with neurological manifestations such as aseptic meningitis, polio-like paralysis and encephalitis. Recently, large HFMD outbreaks, involving severe neurological complications, have been experienced in Malaysia, Taiwan and some other countries in the Western-Pacific region. To investigate the genetic diversity of EV71 isolates in a single community in Japan, nucleotide sequences of the VP4 region of 52 EV71 isolates in Yokohama City from 1982 to 2000 were determined and the phylogenetic relationship was compared with other referential EV71 strains in Japan and in the world. There were two major genotypes of EV71 in Yokohama City through the 1980's and 1990's. Six EV71 isolates in the early 1980's in Yokohama City were closely related to those from HFMD outbreaks in Japan and from outbreaks of polio-like paralysis in Europe in the 1970's. During recent HFMD outbreaks in 1997 and 2000, two distinct genotypes of EV71 were co-circulating in Yokohama City as in HFMD outbreaks in Malaysia and Taiwan. However, the genetic diversity of EV71 in Yokohama City was not directly correlated with the severity of HFMD. The results confirmed the circulation of two distinct genotypes of EV71 over the past 20 years in Japan.
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Affiliation(s)
- T Munemura
- Yokohama City Institute of Health, Yokohama, Japan.
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15
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Kawakami C, Shimizu H, Watanabe S, Saikusa M, Munemura T, Mitamura K, Sugaya N, Imai M. [Evaluation of immunochromatography method for rapid detection of influenza A and B viruses]. Kansenshogaku Zasshi 2001; 75:792-9. [PMID: 11605188 DOI: 10.11150/kansenshogakuzasshi1970.75.792] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We have evaluated a new rapid detection kit for influenza A and B viruses, known as the QuickVue Influenza test (Quidel Coporation, USA); which is based on immunochromatography using virus isolates and clinical specimens. Twelve strains of influenza A and B were tested for evaluate the reactivity and detection limits of this test. The QuickVue Influenza test showed a positive result for all twelve strains of influenza virus and a negative result for fourteen different kinds of other respiratory viruses. The detection limits for six strains were 5 to 30 pfu/ml for a cell culture, 1.0 x 10(3) to 6.0 x 10(4) pfu/ml for 1st PCR, 1 to 50 pfu/ml for nested PCR, 3.0 x 10(5) to 6.0 x 10(5) pfu/ml for the QuickVue Influenza test, 1.5 x 10(5) to 1.0 x 10(6) pfu/ml for the Directigen Flu A, and 7.5 x 10(5) to 5.0 x 10(6) pfu/ml for the FLU OIA. Furthermore, the QuickVue Influenza test were clinically evaluated using 92 throat swab specimens collected from patients with influenza-like illnesses. By cell culture, influenza viruses were detected in 49 of the 92 specimens (AH1N1: 20, AH3N2: 7, B: 22); the titers of the influenza viruses were between 2.5 pfu/ml and 7.0 x 10(5) pfu/ml. Compared to cell culture, the QuickVue Influenza test showed a sensitivity of 75.5%, a specificity of 93.0%, a positive predictive value of 92.5%, a negative predictive value of 76.9%, and an efficiency value of 83.7%. On the other hand, influenza viruses were detected in 54 of the 92 specimens (AH1N1: 19, AH 3N2: 10, B: 25) by RT-PCR. Compared to RT-PCR, the QuickVue Influenza test showed a sensitivity of 72.2%, a specificity of 97.4%, a positive predictive value of 97.5%, a negative predictive value of 71.2%, and an efficiency value of 82.6%. Overall, only one throat swab specimen produced a false positive result using the QuickVue Influenza test; thus, this test appears to have a high specificity. We conclude that the QuickVue Influenza test is a simple one-step test with a sensitivity and specificity equivalent to those of other conventional diagnostic kits. The test is useful and suitable for the diagnosis of influenza and for identifying influenza patients requiring antiviral therapy.
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Takase T, Kohno S, Saikusa M, Fujii T, Sakata S, Ishino T, Ohtsubo T, Iwamoto M, Inoue Y, Kaku M. [Yearly changes of isolated organisms from the respiratory tract in Hokusho Central Hospital]. Kansenshogaku Zasshi 1995; 69:105-13. [PMID: 7751728 DOI: 10.11150/kansenshogakuzasshi1970.69.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Isolated organisms from the respiratory tract have been studied in our hospital from 1986 to 1993. The total number of samples were 18,345 and samples which showed 10(5) cfu/ml organisms were 8648 in our hospital for 8 years. Enterobacteriacae, Pseudomonas aeruginosa, Haemophilus influenzae, Streptococcus pneumoniae, and glucose nonfermenting gram-negative rods were major isolates in 8 years. Haemophilus influenzae, which used to be the commonest isolate, decreased from 10.9% in 1993 while Enterobacteriacae increased from 8.9% in 1986 to 17.6% in 1993. S. pneumoniae and H. influenzae were major isolates from out-patients consisting of 50%, followed by Enterobacteriacae, P. aeruginosa and MSSA. Enterobacteriacae and P. aeruginosa were major isolates from in-patients, followed by MRSA and beta-Streptococcus. Streptococcus agalactiae, Serratia marcescens and Corynebacterium spp. prevailed especially in the geriatric ward. S. pneumoniae, H. influenzae and M. catarrhalis were major isolates from patients with pneumoconiosis, especially in winter.
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Affiliation(s)
- T Takase
- Laboratory of Microbiology and Internal Medicine, Hokusho Central Hospital
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