研究者総覧

小佐見 光樹 (コサミ コウキ)

  • 公衆衛生学部門 助教
Last Updated :2021/12/07

研究者情報

ホームページURL

Researcher ID

  • AAE-8873-2019

J-Global ID

研究キーワード

  • 疫学   公衆衛生   

研究分野

  • ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含む

研究活動情報

論文

  • Hiroya Masuda, Ryusuke Ae, Taka-Aki Koshimizu, Masami Matsumura, Koki Kosami, Kanako Hayashida, Nobuko Makino, Yuri Matsubara, Teppei Sasahara, Yosikazu Nakamura
    Clinical rheumatology 2021年08月 
    INTRODUCTION/OBJECTIVES: Hyponatremia is a potential risk factor for the development of coronary artery lesions (CALs) identified after acute Kawasaki disease (KD). However, the serum sodium distribution corresponding to the reference intervals differs between infants (< 1 year of age) and older children. We hypothesized the association of serum sodium level with CAL complications differs between infants and older patients with KD. METHODS: We analyzed 21,610 population-based patients who developed KD throughout Japan during 2013-2014. We performed multivariable logistic regression analyses to evaluate the association between serum sodium and CAL complications. Additionally, we stratified the serum sodium distribution associated with CAL complications by infants and older patients. RESULTS: CALs were identified in 158 (3.6%) infants and 302 (1.8%) older patients. Infants were more likely to develop CALs when within the normal sodium range compared with older patients (75% vs. 29%), whereas most older patients developed CALs with a sodium level lower than the reference interval. Serum sodium ≤ 130 mEq/L indicated significantly higher risk for development of CALs in both groups (adjusted odds ratio [95% confidence intervals] = 3.21 [1.65-6.25] in infants and 1.74 [1.18-2.57] in older patients). CONCLUSIONS: Serum sodium distribution associated with CAL complications differed greatly between infants and older patients. Older patients developed CALs with sodium levels lower than the reference interval; however, among infants, hyponatremia was not necessarily a risk factor for developing coronary artery lesion. When considering risk assessments for CALs using serum sodium levels, infants with KD should be distinguished from older patients. Key Points • Hyponatremia is a potential risk factor for the development of coronary artery lesions (CALs) among patients with Kawasaki disease. • However, the serum sodium distribution corresponding to the reference intervals differs between infants (< 1 year of age) and older children. • Most infants developed CALs within the normal sodium range, whereas older patients developed at a range lower than the reference interval. • These findings highlight that when considering risk assessments for CALs using serum sodium levels, infants should be distinguished from older patients.
  • Ryusuke Ae, Yoshihide Shibata, Koki Kosami, Yosikazu Nakamura, Hiromichi Hamada
    The Journal of pediatrics 2021年07月 
    OBJECTIVE: To assess the epidemiologic association between Kawasaki disease and common pediatric infectious diseases (PIDs) identified during the coronavirus disease 2019 (COVID-19) pandemic period to confirm whether the infection-triggered theory is a plausible hypothesis for the pathogenesis of Kawasaki disease. STUDY DESIGN: A retrospective epidemiologic study was conducted using datasets obtained from Web-based surveillance of Kawasaki disease and PIDs in Japan. We compared weekly numbers of patients who developed Kawasaki disease and specific PIDs between 2020 and 2017-2019 and evaluated the association between the percent reduction in the number of patients with these diseases. RESULTS: A total of 868 patients developed Kawasaki disease in 2020. During the social distancing period in 2020, the number of patients with Kawasaki disease was approximately 35% lower than in 2017-2019. Time from the onset of Kawasaki disease until the first hospital visit did not differ significantly among the examined years. The proportion of older children with Kawasaki disease decreased more than that of infants with Kawasaki disease (age <1 year), resulting in a significant difference in the proportion of infant patients between 2020 and 2017-2019 (24% vs 19%; P < .01). The number of patients with incomplete Kawasaki disease was unchanged from that of previous years. The weekly percent reduction in patient numbers differed between Kawasaki disease and PIDs during 2020, with no strong correlation between the 2 diseases. CONCLUSIONS: Our data indicate that parents of patients with Kawasaki disease did not avoid hospital visits during the COVID-19 pandemic period. The findings indicate the possibility that triggering Kawasaki disease might be associated with presently unidentified respiratory pathogen(s) that potentially might be acquired from both within and outside the household.
  • Haruki Takikawa, Ryusuke Ae, Yuri Matsubara, Daisuke Matsubara, Nobuko Makino, Koki Kosami, Masanari Kuwabara, Teppei Sasahara, Yosikazu Nakamura
    Archives of disease in childhood 106 7 669 - 673 2021年07月 
    OBJECTIVE: To investigate whether redness and crusting at the bacille Calmette-Guérin inoculation site (BCGitis), identified during acute illness owing to Kawasaki disease (KD), is an independent risk factor for development of cardiac complications. DESIGN: Retrospective cohort study using data from the nationwide KD survey in Japan. SETTING: Survey respondents included hospitals specialising in paediatrics and hospitals with ≥100 beds and a paediatric department throughout Japan. PATIENTS: We included 17 181 patients with KD across Japan during 2005-2006. MAIN OUTCOME MEASURES: BCGitis and cardiac complications resulting from KD. RESULTS: BCGitis was identified in 7549 (44%) patients with KD. Compared with patients without BCGitis, those with BCGitis were younger, more likely to be male, less likely to have recurrent status and visited a hospital and underwent initial intravenous immunoglobulin (IVIG) treatment earlier after KD onset. In the unadjusted model, patients with BCGitis were significantly less likely to have cardiac complications (crude OR 0.81, 95% CI 0.71 to 0.92). However, after including treatment factors (days of illness at initial IVIG and treatment responsiveness) in the adjusted model, the association was no longer significant (adjusted OR 0.89, 95% CI 0.77 to 1.03), indicating that BCGitis was not an independent factor associated with cardiac complication and might be confounded by treatment factors. CONCLUSIONS: BCGitis was identified in comparatively early illness stages of KD. Our findings indicated that BCGitis was not an independent factor associated with developing cardiac complications but was confounded by prompt initial IVIG administration, which might result in successful treatment and prevention of cardiac complications.
  • Kanako Hayashida, Ryusuke Ae, Hiroya Masuda, Koki Kosami, Masami Matsumura, Nobuko Makino, Yuri Matsubara, Teppei Sasahara, Yosikazu Nakamura
    The Pediatric infectious disease journal 40 6 531 - 536 2021年06月 
    BACKGROUND: Some patients with Kawasaki disease (KD) have siblings who developed the same disease. Using a large-scale epidemiologic dataset, the present study aimed to determine the clinical characteristics of this population. METHODS: We analyzed 89,725 patients diagnosed with KD during 2011-2018 who were registered in the nationwide Japanese KD survey database. Multivariable logistic regression analyses were performed to determine factors associated with sibling history of KD. RESULTS: Of the 89,725 patients, 1777 (2%) had sibling history of KD. Annual prevalence ranged from 1.5% to 2.3% during the study period and showed a tendency toward an increasing trend. Patients with recurrent KD and parental history of KD were significantly associated with sibling history of KD (adjusted odds ratio [95% confidence interval] = 2.15 [1.82-2.54] and 2.64 [2.02-3.47], respectively). Although patients with a sibling history of KD were significantly associated with initial intravenous immunoglobulin treatment resistance (1.14 [1.02-1.28]), no significant association was found between sibling history and coronary artery abnormality development. Among patients with a sibling history of KD, male patients were less likely to have recurrent KD than female patients (0.68 [0.49-0.96]). CONCLUSIONS: The significant association between sibling history and parental history may indicate genetic susceptibility to KD onset. Among those with a sibling history, recurrent KD was more likely to occur in female patients. Further studies focusing on this population may contribute toward identification of the cause of KD onset.
  • Ryusuke Ae, Ryan A Maddox, Joseph Y Abrams, Lawrence B Schonberger, Yosikazu Nakamura, Masanari Kuwabara, Nobuko Makino, Koki Kosami, Yuri Matsubara, Daisuke Matsubara, Teppei Sasahara, Ermias D Belay
    Journal of the American Heart Association 10 7 e019853  2021年04月 
    Background Detection of coronary artery lesions (CALs) at initial echocardiography can aid in diagnosing Kawasaki disease (KD) and inform primary adjunctive treatments. We aimed to characterize patients with KD with CALs detected at initial echocardiography. Methods and Results We analyzed data from the nationwide Japanese KD survey that contained information on 103 222 population-based patients diagnosed with KD across Japan during 2011 to 2018. Patients with CALs detected at initial echocardiography were assessed by age, day of illness, and number of principal KD signs (≥3). Multivariable logistic regression analysis was performed to evaluate factors independently associated with CAL detection. Overall, 3707 (3.6%) patients had CALs detected at initial echocardiography. Patients aged <12 and ≥60 months were associated with CAL detection (adjusted odds ratio [95% CI], 1.28 [1.18‒1.39] and 1.32 [1.20‒1.45], respectively; reference, 12‒59 months). Patients with delayed hospital visits were increasingly at higher risk for CAL detection (days 7‒8, 1.84 [1.63‒2.08]; days 9-10, 4.30 [3.58-5.15]; and days ≥11, 9.12 [7.63‒10.90]; reference, days 1-4). Patients with 3 or 4 principal KD signs were independently associated with CAL detection (1.75 [1.63‒1.88]). These patients were significantly more likely to be aged <12 months but were not associated with delayed hospital visit. Younger patients visited at earlier days of illness. Conclusions Timely diagnosis could be beneficial for patients with KD. However, even when the hospital visit occurred early in the course of illness, patients with 3 or 4 principal KD signs, especially younger patients, were at higher risk of CAL detection at initial echocardiography.
  • Hiroya Masuda, Ryusuke Ae, Taka-Aki Koshimizu, Masami Matsumura, Koki Kosami, Kanako Hayashida, Nobuko Makino, Yuri Matsubara, Teppei Sasahara, Yosikazu Nakamura
    Pediatric cardiology 42 4 969 - 977 2021年04月 
    A giant coronary artery (CA) aneurysm is a potentially fatal cardiac complication resulting from Kawasaki disease (KD). We aimed to identify epidemiologic characteristics and potential risk factors associated with giant CA aneurysms identified after acute KD. We analyzed 90,252 patients diagnosed with KD from 2011 to 2018, using data obtained in nationwide KD surveys conducted in Japan. Multivariable logistic regression analyses were performed to evaluate potential risk factors associated with subsequent giant CA aneurysm complications (defined as lumen size ≥ 8 mm), adjusting for all potential factors. Giant CA aneurysms were identified in 144 patients (0.16%) after acute KD. The annual prevalence ranged from 0.07 to 0.20% during the study period. In the multivariate analyses, male sex (adjusted odds ratio 2.09 [95% confidence interval 1.41-3.11], recurrent KD (1.90 [1.09-3.33]), IVIG administration at 1-4 days of illness (1.49 [1.04-2.15]) and ≥ 8 days after KD onset (2.52 [1.38-4.60]; reference, 5-7 days), detection of CA dilatations and aneurysms at initial echocardiography (4.17 [1.85-5.41] and 46.5 [28.8-74.8], respectively), and resistance to IVIG treatment (6.09 [4.23-8.75]) were significantly associated with giant CA aneurysm complications identified after acute KD. The annual prevalence of giant CA aneurysms identified after acute KD did not increase during the study period. Patients with larger CA abnormalities detected at initial echocardiography were independently associated with progression to giant CA aneurysm complications after acute KD regardless of the number of days from onset at treatment initiation.
  • Teppei Sasahara, Koki Kosami, Akio Yoshimura, Ryusuke Ae, Dai Akine, Masanori Ogawa, Yuji Morisawa
    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 2 329 - 335 2021年02月 
    INTRODUCTION: Hand hygiene is crucial for infection control in long-term care facilities for elderly (LTCFEs), because it can be easily implemented in the low-resource settings of LTCFEs. This study investigated the actual status of hand hygiene adherence in LTCFEs, identified the factors inhibiting its appropriate implementation, and evaluated the effectiveness of a hand hygiene promotion program. METHODS: In this before-and-after study, participants were staff members (n = 142) at two LTCFEs in Gunma Prefecture, Japan. We modified the World Health Organization's "five moments for hand hygiene" and assessed participants' hand hygiene adherence rates in four situations: (1) Before touching around a resident's mucous membrane area; (2) Before medical practice or clean/aseptic procedures; (3) After body fluid exposure/risk or after touching around a resident's mucous membrane area; and (4) After touching a resident's contaminated environments. The study was divided into four phases. In Phase 1, participants self-assessed their hand hygiene adherence using a questionnaire. In Phase 2, we objectively assessed participants' pre-intervention adherence rates. In Phase 3, an intervention comprising various hand hygiene promotion measures, such as education and hands-on training on hand hygiene practices and timings, was implemented. In Phase 4, participants' post-intervention adherence rates were objectively measured. RESULTS: Although most participants reported high hand hygiene adherence rate in the self-assessment (93.1%), the pre-intervention evaluation revealed otherwise (16.8%). Participants' post-intervention adherence rates increased for all four situations (77.3%). CONCLUSION: The intervention program helped increase participants' hand hygiene adherence rates, indicating its effectiveness. Similar interventions in other LTCFEs may also improve adherence rates.
  • 全国サーベイランスに基づくわが国のプリオン病の記述疫学(1999-2020)
    小佐見 光樹, 阿江 竜介, 中村 好一, 牧野 伸子, 青山 泰子, 松原 優里, 浜口 毅, 山田 正仁, 水澤 英洋
    Journal of Epidemiology 31 Suppl. 110 - 110 (一社)日本疫学会 2021年01月
  • Teppei Sasahara, Ryusuke Ae, Akio Yoshimura, Koki Kosami, Kazumasa Sasaki, Yumiko Kimura, Dai Akine, Masanori Ogawa, Kenji Hamabata, Shuji Hatakeyama, Longzhu Cui
    BMC geriatrics 20 1 481 - 481 2020年11月 
    BACKGROUND: A high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization has been reported among residents in geriatric long-term care facilities (LTCFs). Some studies indicate that MRSA might be imported from hospitals into LTCFs via resident transfer; however, other studies report that high MRSA prevalence might be caused by cross-transmission inside LTCFs. We aimed to assess which factors have a large impact on the high MRSA prevalence among residents of geriatric LTCFs. METHODS: We conducted a cohort study among 260 residents of four geriatric LTCFs in Japan. Dividing participants into two cohorts, we separately analyzed (1) the association between prevalence of MRSA carriage and length of LTCF residence (Cohort 1: n = 204), and (2) proportion of residents identified as MRSA negative who were initially tested at admission but subsequently identified as positive in secondary testing performed at ≥2 months after their initial test (Cohort 2: n = 79). RESULTS: Among 204 residents in Cohort 1, 20 (9.8%) were identified as positive for MRSA. Compared with residents identified as MRSA negative, a larger proportion of MRSA-positive residents had shorter periods of residence from the initial admission (median length of residence: 5.5 vs. 2.8 months), although this difference was not statistically significant (p = 0.084). Among 79 residents in Cohort 2, 60 (75.9%) were identified as MRSA negative at the initial testing. Of these 60 residents, only one (1.7%) had subsequent positive conversion in secondary MRSA testing. In contrast, among 19 residents identified as MRSA positive in the initial testing, 10 (52.6%) were negative in secondary testing. CONCLUSIONS: The prevalence of MRSA was lower among residents with longer periods of LTCF residence than among those with shorter periods. Furthermore, few residents were found to become MRSA carrier after their initial admission. These findings highlight that MRSA in LTCFs might be associated with resident transfer rather than spread via cross-transmission inside LTCFs.
  • Google APIを用いた位置座標特定による川崎病クラスターの抽出(1989-1998)
    佐野 尭, 牧野 伸子, 阿江 竜介, 小佐見 光樹, 松原 優里, 中村 好一
    日本公衆衛生学会総会抄録集 79回 323 - 323 日本公衆衛生学会 2020年10月
  • 色素性乾皮症全国疫学調査
    石川 鎮清, 小佐見 光樹, 松原 優里, 阿江 竜介, 青山 泰子, 牧野 伸子, 錦織 千佳子, 中村 好一
    日本公衆衛生学会総会抄録集 79回 411 - 411 日本公衆衛生学会 2020年10月
  • Tameto Naoi, Mitsuya Morita, Koki Kosami, Takafumi Mashiko, Tomoaki Kameda, Shunich Okada, Yuka Hayashi, Tadataka Kawakami, Ryota Tanaka, Shigeru Fujimoto
    Journal of Stroke and Cerebrovascular Diseases 29 10 105183 - 105183 2020年10月
  • Ryusuke Ae, Joseph Y Abrams, Ryan A Maddox, Lawrence B Schonberger, Yosikazu Nakamura, Masanari Kuwabara, Nobuko Makino, Yuri Matsubara, Koki Kosami, Teppei Sasahara, Ermias D Belay
    Journal of the American Heart Association 9 17 e015308  2020年09月 
    BACKGROUND Randomized controlled trials previously provided different conclusions about the superiority of adding corticosteroids to initial intravenous immunoglobulin treatment for the prevention of coronary artery abnormalities in patients with Kawasaki disease (KD). To further assess this issue, we analyzed large-scale data from nationwide KD surveys in Japan, where combination treatment (corticosteroids added to initial standard intravenous immunoglobulin treatment) has become commonly used for patients at high risk for KD. METHODS AND RESULTS Standard intravenous immunoglobulin treatment and combination treatment were compared using data from time periods with and without combination treatment. Outcome measures were coronary artery abnormalities and initial intravenous immunoglobulin treatment failure. Hospitals where ≥20% of patients received combination treatment were identified, and treatment and control groups were selected via matching by age, sex, illness day at initial treatment, and KD recurrence. Matched group selection and subsequent analyses were conducted 1000 times to minimize sampling bias and potential confounders (bootstrapping). From 115 hospitals, 1593 patients with KD in the treatment group and 1593 controls were selected for each of the 1000 sample iterations. The median proportion of patients who developed coronary artery abnormalities among the treatment group and controls were 4.6% (95% CI, 3.8%-5.8%) and 8.8% (95% CI, 7.5%-10.0%), respectively: an estimated risk ratio of 0.53 (0.41-0.67). A median of 14.1% (95% CI, 12.4%-15.9%) of the patients in the treatment group and 21.7% (95% CI, 19.8%-23.4%) in the controls had treatment failure: an estimated risk ratio of 0.65 (0.56-0.75). CONCLUSIONS Combination treatment reduced coronary artery abnormality risk by an estimated 47% and treatment failure by 35%. Multiple-dose corticosteroids may provide benefit in selected patients at high risk for KD.
  • 松原 優里, 青山 泰子, 小佐見 光樹, 阿江 竜介, 牧野 伸子, 石川 鎮清, 中村 好一
    日本小児科学会雑誌 124 8 1224 - 1233 (公社)日本小児科学会 2020年08月 
    栃木県の調査データを二次利用し、在宅医療的ケア児の生活状況について分析した。医療的ケア児は県内に約300人、20歳未満人口1000人対0.91みられ、年齢分布では6歳未満が50%を占め、寝たきりや座位の児が50%、歩行や走ることが可能な児が31%であった。サービスについては人工呼吸器使用者で「送迎がない」「利用できるサービスの量が不足」「費用負担が大きい」などの項目が有意に高かった。また、介護者で睡眠5時間未満の者は児に経管栄養がある場合において有意に高かった。以上、これらの結果からも、在宅医療的ケア児の運動・知的機能には個人差があり、個々に応じたサービスの提供が必要であると考えられた。
  • Ryusuke Ae, Joseph Y Abrams, Ryan A Maddox, Lawrence B Schonberger, Yosikazu Nakamura, Masanari Kuwabara, Nobuko Makino, Yuri Matsubara, Daisuke Matsubara, Koki Kosami, Teppei Sasahara, Ermias D Belay
    American heart journal 225 120 - 128 2020年07月 [査読有り][通常論文]
     
    BACKGROUND: Previous studies demonstrated that coronary artery lesions (CALs) resulting from Kawasaki disease (KD) can improve over time. However, limited information is available on sub-acute outcomes of CALs detected at admission during KD illness. METHODS: The nationwide Japanese KD survey contained substantial information on KD patients with CALs detected at admission and who received standard IVIG treatment within 10 days of disease onset. Coronary outcomes were evaluated by changes in CALs from admission to the first assessment at 30 days from disease onset in three categories: improved, unchanged, and progressed. Ordinal logistic regression analysis was performed to evaluate factors associated with the outcomes. RESULTS: Of 2024 patients with CALs detected at admission, improved, unchanged, and progressed outcomes were found in 1548 (76.5%), 390 (19.3%), and 86 (4.2%), respectively. Over 80% of patients with coronary artery (CA) dilatations had improved outcome. Independent factors associated with worse outcomes were larger-size CALs (adjusted ORs [95% CIs]: CA aneurysm = 5.13 [3.65-7.22] and giant CA aneurysms = 7.49 [3.56-15.72] compared with CA dilatation, respectively), age ≥ 60 months (1.45 [1.08-1.94] compared with 12-59 months), recurrent KD (1.57 [1.07-2.29]), parental history of KD (2.23 [1.02-4.85]), and delayed admission (8-10 days from disease onset: 1.76 [1.21-2.57] compared with 1-4 days). CONCLUSIONS: KD patients with larger CALs, ≥60 months old, and with recurrent status or parental history may require more rigorous treatment. In addition, delayed admission may result in worse coronary outcome, indicating that prompt diagnosis and treatment are required.
  • Ryusuke Ae, Nobuko Makino, Koki Kosami, Masanari Kuwabara, Yuri Matsubara, Yosikazu Nakamura
    The Journal of pediatrics 2020年05月 [査読有り][通常論文]
     
    OBJECTIVE: To report the epidemiologic characteristics, treatments, and cardiac complications of KD, using data from the nationwide survey in Japan. STUDY DESIGN: The nationwide KD survey in Japan has been conducted biennially since 1970. The most recent survey was completed in 2019, obtaining information for patients who developed KD during 2017-2018. Survey respondents were hospitals specializing in pediatrics and those with ≥100 beds and a pediatric department throughout Japan, where patients with Kawasaki disease were eventually hospitalized. RESULTS: The survey identified 32528 patients with Kawasaki disease, which consisted of 15164 (46.6%) in 2017 and 17364 (53.4%) in 2018. The highest annual incidence rate was recorded in 2018 (359 per 100,000 children aged 0-4 years). After 1982, patients with ≤4 principal KD signs gradually increased, resulting in 6847 (21.1%) patients diagnosed during 2017-2018. Among 30784 patients receiving initial intravenous immunoglobulin administration, 6061 (19.7%) did not respond. Within 30 days of KD onset, 9.0% of patients were diagnosed with cardiac complications, and consequently, 2.6% of patients developed cardiac sequelae after the acute illness. CONCLUSIONS: The annual number of patients developing KD in Japan increased from 1970 through 2018, while the proportion of patients with Kawasaki disease with cardiac complications decreased in the most recent two decades. Early diagnosis of KD as well as advances in initial treatments could explain these findings.
  • Yuri Matsubara, Daisuke Matsubara, Ryusuke Ae, Koki Kosami, Yasuko Aoyama, Mayumi Yashiro, Nobuko Makino, Shigeki Matsubara, Yosikazu Nakamura
    Pediatrics international : official journal of the Japan Pediatric Society 62 4 444 - 450 2020年04月 [査読有り][通常論文]
     
    BACKGROUND: Some patients with Kawasaki disease (KD) develop cardiac sequelae, which increase the risk of subsequent ischemic heart events. Knowing the cumulative incidence (CI) of KD with cardiac sequelae may contribute to developing health policies to prevent subsequent ischemic events in these patients. METHODS: Study participants consisted of 254 984 patients aged 0-9 years with KD who were registered in nationwide surveys in Japan from 1991-2016. We calculated the incidence probabilities by dividing the number of patients with KD aged 0-9 years by the population used in vital statistics of each calendar year. We calculated the cumulative proportion of those not affected by KD, by multiplying each probability in patients aged from age 0-9 years. The CI of KD was obtained by subtracting this value from 1. We also calculated the number of patients in each birth cohort (BC). The same was done to calculate the CI of KD-related cardiac sequelae. RESULTS: The CIBC steadily increased from 0.005067 in males and 0.003668 in females in 1991 to 0.011431 in males and 0.0088253 in females in 2007. The CIBC of KD with cardiac sequelae decreased from 0.000478 in males and 0.000213 in females in 1997 to 0.000339 in males and 0.000169 in females in 2007. CONCLUSION: The increasing CIBC of KD indicates an increased susceptibility to KD in accordance with birth year. The decreasing CIBC of cardiac sequelae suggests the efficacy of KD treatment.
  • Ryusuke Ae, Joseph Y Abrams, Ryan A Maddox, Lawrence B Schonberger, Yosikazu Nakamura, Asuka Shindo, Masanari Kuwabara, Nobuko Makino, Yuri Matsubara, Koki Kosami, Teppei Sasahara, Ermias D Belay
    The Pediatric infectious disease journal 39 3 197 - 203 2020年03月 [査読有り][通常論文]
     
    BACKGROUND: Platelet count is considered as a biomarker for the development of coronary artery abnormalities (CAAs) among Kawasaki disease (KD) patients. However, previous studies have reported inconsistent results. We addressed the controversial association of platelet count with CAAs using a large-scale dataset. METHODS: A retrospective cohort study was conducted using KD survey data from Japan (2015-2016; n = 25,448). Classifying patients by intravenous immunoglobulin (IVIG) responsiveness, we described the trends in platelet count using the lowest and highest values along with the specific illness days. Multivariate logistic regression analysis was performed to evaluate the association between platelet count and CAAs, adjusting for relevant factors. RESULTS: Platelet counts rapidly decreased from admission, reached the lowest count at 6-7 days, and peaked after 10 days. Platelet counts in IVIG non-responders decreased with a lower minimum value than IVIG responders, but subsequently rebounded toward a higher maximum. Compared with patients with normal platelet counts (150-450 × 10/L), patients with abnormally high platelet counts (>450 × 10/L) were more likely to have CAAs at admission (adjusted odds ratio: IVIG responders, 1.50 [95% confidence interval 1.20-1.87] and non-responders, 1.46 [1.01-2.12]). By contrast, IVIG non-responding patients whose counts were below normal (<150 × 10/L) after hospitalization were at higher risk for developing CAAs (2.27 [1.44-3.58]). CONCLUSIONS: Platelet count varied widely by illness day and was confounded by IVIG responsiveness, which might have contributed to previous inconsistent findings. KD patients with abnormally high platelet counts at admission or abnormally low counts after hospitalization were at higher risk for CAAs.
  • Teppei Sasahara, Masanori Ogawa, Itaru Fujimura, Ryusuke Ae, Koki Kosami, Yuji Morisawa
    Biocontrol science 25 4 223 - 230 2020年 
    Tap water contamination is a growing concern in healthcare facilities, and despite chlorination, tap water in these facilities contains several pathogenic microorganisms causing healthcare-associated waterborne infections or nosocomial outbreaks. Shower units are particularly prone to contamination as they are conducive for bacterial growth and can even produce bioaerosols containing pathogenic bacteria. Shower units coupled with point-of-use (POU) water filters are a simple and safe option; however, their efficacy has been under-reported. Therefore, we determined the efficacy of showerheads attached with a POU filter capsule in preventing infections in our hospital. We investigated the presence of pathogenic bacteria in water sampled from three shower units. After replacing the original shower units with new ones incorporated with a sterile-grade water filter capsule (0.2 µm; QPoint™), the water samples were analyzed for up to 2 months. The POU filters removed several pathogenic bacteria (Mycobacterium, Pseudomonas, Stenotrophomonas, Aeromonas, and Klebsiella spp.). Filter effectiveness depends on regional water quality and we believe that effective tap water treatment combined with the use of POU filters (introduced at a reasonable cost in healthcare facilities) can considerably minimize waterborne diseases in hospitals and improve patient care.
  • Tsuneari Takahashi, Ryusuke Ae, Kensuke Minami, Meiwa Shibata, Tatsuya Kubo, Koki Kosami, Katsushi Takeshita
    Geriatric orthopaedic surgery & rehabilitation 11 2151459320979974 - 2151459320979974 2020年 
    Background: There is no report yet on the application of telemedicine in orthopedic practice in Japan. With a focus on patients with KOA, we investigated the willingness of patients to use telemedicine by assessing factors such as the patient's age, smartphone possession, hospital visiting time, and severity of KOA. Methods: Data of patients who regularly consulted orthopedic surgeons at our institutions from April 2020 to June 2020 were retrospectively analyzed using an electronic medical database. The patients were diagnosed with KOA according to clinical and radiological findings, according to the Kellgren-Lawrence (KL) classification. included were patients with KOA with KL classification above grade 2. All patients were asked: 1) whether they were willing to use telemedicine (Yes or No), 2) the reason why they answered Yes, 3) the reason why they answered No, 4) if they possessed a smartphone, 5) their numeric rating scale for pain at their last outpatient visit after the Sars-CoV-2 epidemic emerged, and 6) the time required for visiting hospital from their house. Patients were stratified into 2 groups depending on whether they answered Yes (Group Y) or No (group N). Comparisons between the groups concerning smartphone possession, NRS pain, hospital visiting times, and distribution of KL grade were made. Results: Only 36.7% of the patients with KOA said they were willing to use telemedicine. The average age of group Y was significantly younger than that of group N (67.9 ± 9.1 vs 73.1 ± 8.0, P = 0.0026) and the cutoff age was 70.0 years. In addition, the rate of smartphone possession was significantly higher in group Y than in group N (82.5% vs 34.5%, P < 0.001). Hospital visit times and the severity of KOA did not differ between the groups. Conclusion: Age is a barrier to the adoption of telemedicine.
  • 地域剥奪指標と東京・大阪における川崎病発生率との関係(1993-1998)
    佐野 尭, 牧野 伸子, 青山 泰子, 小佐見 光樹, 松原 優里, 中村 好一
    日本公衆衛生学会総会抄録集 78回 309 - 309 日本公衆衛生学会 2019年10月
  • Yokota N, Ae R, Amenomori M, Kitagawa K, Nakamura T, Yokota T, Masato K, Sasahara T, Matsubara Y, Kosami K, Nakamura Y
    Journal of general and family medicine 20 4 139 - 145 2019年07月 [査読有り][通常論文]
  • Shinji Kido, Ryusuke Ae, Koki Kosami, Yuri Matsubara, Nobuko Makino, Teppei Sasahara, Masanari Kuwabara, Yasuko Aoyama, Mayumi Yashiro, Hiroshi Yanagawa, Yosikazu Nakamura
    Pediatrics International 2019年 [査読有り][通常論文]
  • Internal Medicine 2019年 [査読有り][通常論文]
  • Nobuko Makino, Yosikazu Nakamura, Mayumi Yashiro, Koki Kosami, Yuri Matsubara, Ryusuke Ae, Yasuko Aoyama, Hiroshi Yanagawa
    Pediatrics International 61 4 397 - 403 2019年 [査読有り][通常論文]
  • 日本全国におけるPM2.5値と川崎病発生との関連(2011年4月-2016年3月)
    佐野 尭, 牧野 伸子, 青山 泰子, 阿江 竜介, 松原 優里, 小佐見 光樹, 中村 好一
    日本公衆衛生学会総会抄録集 77回 318 - 318 日本公衆衛生学会 2018年10月
  • 栃木県における医療的ケア児の生活状況と課題
    松原 優里, 青山 泰子, 小佐見 光樹, 阿江 竜介, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 77回 460 - 460 日本公衆衛生学会 2018年10月
  • 栃木県における医療的ケア児及び重症心身障害児を支える資源調査結果
    青山 泰子, 松原 優里, 小佐見 光樹, 阿江 竜介, 牧野 伸子, 中村 好一
    日本公衆衛生学会総会抄録集 77回 460 - 460 日本公衆衛生学会 2018年10月
  • Nobuko Makino, Yosikazu Nakamura, Mayumi Yashiro, Takashi Sano, Ryusuke Ae, Koki Kosami, Takao Kojo, Yasuko Aoyama, Kazuhiko Kotani, Hiroshi Yanagawa
    Pediatrics International 60 6 581 - 587 2018年06月 [査読有り][通常論文]
     
    Background: The etiology of Kawasaki disease (KD) is unknown. In Japan, the number of patients and incidence rate of KD has increased continuously since its discovery. The aim of this report was to analyze the latest nationwide epidemiological survey of KD in Japan. Methods: The 23rd nationwide survey of KD was conducted in 2015. To report on all patients diagnosed with KD in 2013 and 2014, a questionnaire was sent to hospitals with ≥100 beds containing pediatric departments, as well as specialized pediatric hospitals. Results: The number of KD patients reported was 15 696 in 2013 and 15 979 in 2014, resulting in an annual incidence rate of 302.5 and 308.0 per 100 000 population aged 0–4 years, respectively. The number of patients and incidence rate of KD in 2014 were the highest ever recorded in Japan. The number of patients diagnosed per month peaked in January, and a gradual increase in summer was also observed. Eight patients died of KD in 2013 and 2014. Conclusions: The number of patients and incidence rate of KD in Japan continue to increase. Continued surveillance of epidemiological trends of KD is therefore required.
  • Tsuneaki Kenzaka, Ayako Kumabe, Koki Kosami, Yuki Ueda, Takeshi Takahashi, Yuya Yamamoto, Yurika Hayashi, Akihito Kitao, Masanobu Okayama
    Clinical Interventions in Aging 13 895 - 901 2018年05月 [査読有り][通常論文]
     
    Purpose: The aim of this study was to investigate whether the day of starting oral intake affects the clinical course of patients with aspiration pneumonia. Patients and methods: We conducted a retrospective cohort study of 392 patients who were hospitalized for aspiration pneumonia but tolerated oral intake. Patients were divided into two groups according to the day of starting oral intake: Monday to Friday (midweek group) and Saturday or Sunday (weekend group). Underlying diseases, severity of pneumonia, time to oral intake, hospital duration, discontinuation of oral intake, and death during hospitalization were compared between the groups. Multivariate analysis was performed using hospital duration and discontinuation of oral intake due to aspiration as the dependent variables. Results: The cohort comprised 244 men and 148 women with a mean age of 79.3 ± 13.1 years. The weekend (n = 98) and midweek (n = 294) groups exhibited similar age, sex, and underlying diseases. There were no significant differences in pneumonia-related factors, such as CURB-65 score, A-DROP score, extent of shadow on chest radiograph, incidence of bacteremia, and ventilator use. The weekend group exhibited a significantly shorter time to oral intake and hospital duration, as well as a significantly lower incidence of discontinuation of oral intake than the midweek group. Multivariate analysis revealed that starting oral intake on the weekend was independently associated with a lower incidence of discontinuation of oral intake due to aspiration. Conclusion: The weekend group exhibited a shorter total hospital duration and a lower incidence of discontinuation of oral intake due to aspiration.
  • Tsuneaki Kenzaka, Ayako Kumabe, Koki Kosami, Yasufumi Matsuoka, Kensuke Minami, Daisuke Ninomiya, Ayako Noda, Shinsuke Yahata
    Respiratory Investigation 56 2 150 - 157 2018年03月 [査読有り][通常論文]
     
    Background: Clinical practice guidelines for nursing- and healthcare-associated pneumonia (NHCAP) were developed for pneumonia caused by drug-resistant bacteria and pneumonia in elderly patients, particularly aspiration pneumonia. The identification of pathogenic bacteria and implementation of efforts to prevent the recurrence of aspiration pneumonia are very important in clinical practice. This study examined the extent to which clinicians have established bacteriological testing and recurrence prevention efforts for NHCAP and aspiration pneumonia. Methods: Questionnaire surveys were mailed to the heads of internal medicine and respiratory medicine departments at 2490 Japanese hospitals. The questionnaire evaluated bacteriological testing for NHCAP or aspiration pneumonia and prevention of the recurrence of aspiration pneumonia. Results: A total of 350 hospitals responded. These hospitals were grouped on the basis of whether a pulmonologist provided medical care for aspiration pneumonia and whether the hospital employed an infectious disease specialist. For hospitals in which pulmonologists treated aspiration pneumonia, the response rates for “is done in nearly all cases” were 70.0%, 84.7%, 31.6%, and 48.9% for sputum gram staining, sputum culture tests, blood culture tests, and pneumococcal vaccination, respectively. In hospitals that employed an infectious disease specialist, the response rates for “is done in nearly all cases” were 72.8% and 41.3% for sputum gram staining and blood culture tests, respectively. Recurrence prevention for aspiration pneumonia (other than pneumococcal vaccination) was not actively implemented. Conclusions: Sputum gram staining, sputum culture tests, and other bacteriological tests were implemented quite actively. However, physicians who treat aspiration pneumonia should implement efforts to prevent pneumonia recurrence more actively.
  • Ryusuke Ae, Yosikazu Nakamura, Hiroshi Tada, Yumi Kono, Eiko Matsui, Kazuo Itabashi, Masanori Ogawa, Teppei Sasahara, Yuri Matsubara, Takao Kojo, Kazuhiko Kotani, Nobuko Makino, Yasuko Aoyama, Takashi Sano, Koki Kosami, Maho Yamashita, Akira Oka
    Journal of Epidemiology 28 6 300 - 306 2018年 [査読有り][通常論文]
     
    BACKGROUND: Globally, few published studies have tracked the temporal trend of dioxin levels in the human body since 2000. This study describes the annual trend of dioxin levels in human breast milk in Japanese mothers from 1998 through 2015. METHODS: An observational study was conducted from 1998 through 2015. Participants were 1,194 healthy mothers following their first delivery who were recruited annually in Japan. Breast milk samples obtained from participants were analyzed using gas chromatography and mass spectrometry for dioxins, including polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and coplanar polychlorinated biphenyls (PCBs). RESULTS: Mean age was 29.5 years, and 53% of participants were 20-25 years old. A declining trend in total dioxin levels was found, from a peak of 20.8 pg toxic equivalence (TEQ)/g fat in 1998 to 7.2 pg TEQ/g fat in 2014. Data from the last 5 years of the study indicated a plateau at minimal levels. In contrast, an increasing trend was found in the mean age of participants during the last 5 years. Although significantly higher dioxin levels were observed in samples from older participants, an upward trend in dioxin levels was not observed, indicating that dietary and environmental exposure to dioxins had greatly diminished in recent years. CONCLUSIONS: Dioxin levels in human breast milk may be approaching a minimum in recent years in Japan. The findings may contribute to global reference levels for environmental pollution of dioxins, which remains a problem for many developing countries.
  • Tsuneaki Kenzaka, Ayako Kumabe, Koki Kosami, Yasufumi Matsuoka, Kensuke Minami, Daisuke Ninomiya, Ayako Noda, Masanobu Okayama
    GERIATRICS & GERONTOLOGY INTERNATIONAL 17 5 810 - 818 2017年05月 [査読有り][通常論文]
     
    Aim: To investigate the items that are considered by physicians when making decisions regarding the resumption of oral intake among patients with aspiration pneumonia who have undergone short-term fasting. Methods: We surveyed 2490 Japanese hospitals that had internal medicine and respiratory medicine departments. We mailed questionnaires that contained 24 items related to oral intake resumption after aspiration pneumonia to the head of the department at each hospital. Cronbach statistics, principal component analysis and cluster analysis were used to analyze the results. Results: We received responses from 350 hospitals; 89.7% of the respondents answered that they "Strongly agree" that "level of consciousness" is a useful criterion for resuming oral intake. Furthermore, 66%, 66%, 63.4%, 58.5% and 51% of the respondents answered that they "strongly agree" regarding the use of SpO(2), the discretion of the attending physician, body temperature, swallowing function test results, mental state and respiratory rate, respectively. In the cluster analysis, level of consciousness, body temperature, SpO(2), respiratory rate, mental state and the discretion of the attending physician belonged to the first cluster. The second cluster consisted of the patient's request, the family's request, the opinions of the medical staff and non-physician healthcare providers, and performance status. Conclusions: Physicians consider several criteria during decision-making regarding oral intake resumption, which can be assigned to two clusters. Future studies are required to develop generalizable and objective criteria.
  • Kenzaka T, Takeshima T, Kosami K, Kumabe A, Ueda Y, Takahashi T, Yamamoto Y, Hayashi Y, Kitao A, Okayama M
    Clinical interventions in aging 12 283 - 291 2017年 [査読有り][通常論文]
  • Tsuneaki Kenzaka, Taro Takeshima, Koki Kosami, Ayako Kumabe, Yuki Ueda, Takeshi Takahashi, Yuya Yamamoto, Yurika Hayashi, Akihito Kitao, Masanobu Okayama
    CLINICAL INTERVENTIONS IN AGING 12 283 - 291 2017年 [査読有り][通常論文]
     
    Purpose: To assess the factors involved in oral intake discontinuation in elderly patients with recurrent aspiration pneumonia. Patients and methods: This study included patients with pneumonia who were treated at Jichi Medical University Hospital between 2007 and 2013, at Toyooka Public Hospital between 2011 and 2013 and at Yuzawa Community Medical Center between 2010 and 2012. We consecutively enrolled patients with aspiration pneumonia. The primary study point was oral intake discontinuation after the initiation of oral intake during hospitalization in cases of recurrent aspiration. Various parameters were recorded at admission, at the initiation of intake, and during hospitalization; these parameters were statistically evaluated. Results: A total of 390 patients were assigned to either a "no reaspiration of intake" group (n=310) or a "reaspiration of intake" group (n=80), depending on whether intake was discontinued owing to aspiration during hospitalization. At admission, the following items significantly differed between the groups: level of consciousness, respiratory rate, oxygen saturation, CURB-65 score, extent of infiltration/opacity on chest radiography, albumin levels, blood urea nitrogen levels, and application of swallowing function assessment. At the initiation of intake, level of consciousness, pulse rate, and albumin levels significantly differed between the groups. The following items did not significantly differ between groups: systolic blood pressure, pulse rate, C-reactive protein, bacteremia, use of ventilator at admission, oxygen administration, respiratory rate, and systolic blood pressure at initiation of intake. Multivariate analysis revealed that application of swallowing function assessment, level of consciousness at the initiation of intake, and extent of infiltration/opacity on chest radiography were significant predictive variables for discontinuation of intake. Conclusion: A low level of consciousness at the initiation of intake and a greater extent of infiltration/opacity on chest radiography and the application of a swallowing function are important factors. These factors may be helpful to determine a suitable timing for resumption of oral intake.
  • Tsuneaki Kenzaka, Koki Kosami, Yasufumi Matsuoka, Ayako Noda, Ayako Kumabe
    TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE 240 3 227 - 233 2016年11月 [査読有り][通常論文]
     
    In Japan, aspiration pneumonia is common among the elderly and patients are often treated by temporary discontinuation of meals. However, there are few published studies on the fasting duration for aspiration pneumonia treatment. Therefore, we conducted the present study to assess the opinions of clinicians regarding the fasting duration for the treatment of patients with aspiration pneumonia and the actual medical practice with regard to oral ingestion in hospitalized patients with aspiration pneumonia. We targeted hospitals with internal medicine and respiratory medicine departments across Japan. A questionnaire regarding the fasting duration for aspiration pneumonia treatment and oral ingestion in hospitalized patients with aspiration pneumonia was mailed to physicians treating patients with pneumonia at 2,490 hospitals. We received appropriate responses from 350 facilities (response rate, 14.1%). Most clinicians (78.3%) responded that it best to keep the fasting duration for treatment as short as possible and considered that fasting is absolutely unnecessary. Regarding oral ingestion in hospitalized patients, more than 25% of clinicians restricted oral intake for a certain number of days. The majority of these clinicians (53.3%) preferred prolonged fasting for 3 to 7 days. Although most physicians preferred the fasting duration to be as short as possible, there was a difference between the ideal and actual scenarios in reintroducing oral intake early in patients with aspiration pneumonia. Improving physicians' knowledge and experience will bridge the gap between the ideal situation and what currently occurs. Further studies should investigate the acceptable fasting duration for the treatment of aspiration pneumonia.
  • Ryusuke Ae, Koki Kosami, Shinsuke Yahata
    OSTOMY WOUND MANAGEMENT 62 9 52 - 55 2016年09月 [査読有り][通常論文]
     
    Hypergranulation tissue formation around a gastrostomy tube insertion site is a common feeding tube-related complication that affects patients who receive long-term enteral nutrition. Some clinicians recommend use of a topical corticosteroid in patients with gastrostomy tube insertion site hypergranulation. However, documentation is scant regarding appropriate treatment for this condition. This case report describes a 67-year-old bedridden man with spinocerebellar degeneration who presented with hypergranulation at the site of the gastrostomy tube, inserted 1 week earlier. The tissue was raw and inflamed, with bleeding and exudation. The gastrostomy site was gently cleansed with gauze dampened with tap water, and topical 0.05% clobetasol propionate ointment was applied directly to the hypergranulation tissue twice daily. After 4 days of treatment, the hypergranulation tissue almost completely disappeared, redness markedly decreased, and bleeding and exudation ceased, with no recurrence observed during the 6 months of follow-up. This case study supports other reports that short-term corticosteroid treatment may be a safe, quick, noninvasive, and effective treatment for hypergranulation at the gastrostomy tube insertion site. Further studies are needed to evaluate the safety, effectiveness, appropriate dosage, and duration of topical corticosteroid for the treatment of hypergranulation tissue.
  • Hiromi Sekiguchi, Koki Kosami, Jun Suzuki, Kozue Murayama, Yu Yamamoto, Shuji Hatakeyama, Masami Matsumura
    JOURNAL OF GENERAL INTERNAL MEDICINE 31 S723 - S723 2016年05月 [査読有り][通常論文]
  • Ayako Kumabe, Shuji Hatakeyama, Koki Kosami, Tadahiro Suzuki, Yu Yamamoto, Masami Matsumura
    JOURNAL OF GENERAL INTERNAL MEDICINE 31 S598 - S599 2016年05月 [査読有り][通常論文]
  • Koki Kosami, Tsuneaki Kenzaka, Yuka Sagara, Kensuke Minami, Masami Matsumura
    BMC INFECTIOUS DISEASES 16 2016年04月 [査読有り][通常論文]
     
    Background: Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a mild encephalopathy caused by various pathological processes, but encephalopathy due to bacteria is rare. Case presentation: We report the case of a 45-year-old Japanese woman who on receiving chemotherapy for advanced breast cancer developed an altered mental status and dysarthria soon after fever from infection of a subcutaneous implantable port. Staphylococcus aureus was detected in her blood cultures. Magnetic resonance imaging (MRI) revealed an ovoid lesion in the central portion of the splenium of the corpus callosum (SCC). Although hypotension was not observed, we diagnosed probable toxic shock syndrome (TSS) based on fever (temperature: >38.9 degrees C), altered mental status, erythema, desquamation, thrombocytopenia, liver dysfunction, and creatine phosphokinase elevation. We administered antimicrobial therapy and her neurological symptoms improved gradually. The lesion in the SCC completely disappeared on MRI 7 days after disease onset. Conclusions: We diagnosed this case as MERS caused by S. aureus bacteremia with TSS. This is the first report of such a case, and we suggest that when a TSS patient presents with neurological symptoms, the possibility of MERS should be considered.
  • Tsuneaki Kenzaka, Ken Kato, Akihito Kitao, Koki Kosami, Kensuke Minami, Shinsuke Yahata, Miho Fukui, Masanobu Okayama
    PLOS ONE 10 8 2015年08月 [査読有り][通常論文]
     
    Objectives The present study investigated the incidence of hyperammonemia in urinary tract infections and explored the utility of urinary obstruction relief and antimicrobial administration to improve hyperammonemia. Methods This was an observational study. Subjects were patients who were diagnosed with urinary tract infection and hospitalized between June 2008 and June 2009. We measured plasma ammonia levels on admission in patients who were clinically diagnosed with urinary tract infection and hospitalized. We assessed each patient's level of consciousness on admission using the Glasgow Coma Scale (GCS) and performed urine and blood cultures. We also assessed hearing prior to hospitalization using the Eastern Cooperative Oncology Group performance status (ECOG-PS). In cases with high ammonia levels on admission, plasma ammonia and GCS were measured 24 hours and 5-7 days later. Results Sixty-seven candidates were enrolled; of these, 60 cases (89.6%) with bacterial cell counts >= 10(4) CFU/mL were studied. Five cases (8.3%) presented with high plasma ammonia levels. Cases with hyperammonemia were significantly more likely to present with low GCS scores and urinary retention rate. All five cases received antimicrobial therapy with an indwelling bladder catheter to relieve urinary retention. The case 5 patient died shortly after admission due to complicated aspiration pneumonia; in the remaining cases, plasma ammonia levels were rapidly normalized and the level of consciousness improved. Conclusions The occurrence of hyperammonemia in urinary tract infections is not rare. The cause of hyperammonemia is urinary retention obstruction. Therefore, along with antimicrobial administration, relief of obstruction is important for the treatment of hyperammonemia caused by this mechanism.
  • Yasushi Adachi, Koki Kosami, Noritoshi Mizuta, Mitsuhiro Ito, Yuki Matsuoka, Mami Kanata, Hajime Akiyama, Tomoko Murao, Ming Li, Ryuji Ieki, Susumu Ikehara
    ONCOLOGY LETTERS 7 6 2003 - 2006 2014年06月 [査読有り][通常論文]
     
    Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of B-cell lymphoma characterized by selective growth of clonal B-cells in the lumen of the small vessels of various organs including the liver, spleen, lungs, skin, brain, and kidney. An 86-year-old male presented with weight loss, fever and night sweats (known as B symptoms). Blood examination revealed pancytopenia, high lactate dehydrogenase and high soluble interleukin-2 receptor, suggesting hematopoietic malignancy. However, there were no abnormal hematopoietic cells in the peripheral blood. No lymph node swelling was identified on examination by whole-body computed tomography scan. Therefore, IVLBCL was suspected, and random skin biopsies and a skin biopsy from a senile hemangioma were carried out. A small number of large atypical lymphoid cells resided in the small blood vessels in the deep dermis and subcutaneous tissue of the random skin biopsies, and numerous atypical lymphoid cells were identified in the small vessels of the senile hemangioma. These results suggest the usefulness of skin biopsy from senile hemangiomas in the diagnosis of IVLBCL.
  • 吉池理恵, 谷田和代, 高橋秀子, 陣在佳子, 河崎雄司, 原田智也, 武田賢一, 山崎章, 清水英治, 阿江竜介, 廣谷茜, 小佐見光樹, 松岡学
    月刊地域保健 44 3 50 - 56 2013年03月 [査読有り][通常論文]

MISC

  • 医原性中枢神経感染症 日本国内発症PMLサーベイランス疫学調査と解析
    三浦 義治, 中道 一生, 小佐見 光樹, 阿江 竜介, 濱口 毅, 中村 好一, 西條 政幸, 山田 正仁 NEUROINFECTION 24 (2) 133 -133 2019年09月 [査読無し][通常論文]
  • 日本全国におけるPM2.5値と川崎病発生との関連(2011年4月-2016年3月)
    佐野 尭, 牧野 伸子, 青山 泰子, 阿江 竜介, 松原 優里, 小佐見 光樹, 中村 好一 日本公衆衛生学会総会抄録集 77回 318 -318 2018年10月 [査読無し][通常論文]
  • 栃木県における医療的ケア児の生活状況と課題
    松原 優里, 青山 泰子, 小佐見 光樹, 阿江 竜介, 牧野 伸子, 中村 好一 日本公衆衛生学会総会抄録集 77回 460 -460 2018年10月 [査読無し][通常論文]
  • 栃木県における医療的ケア児及び重症心身障害児を支える資源調査結果
    青山 泰子, 松原 優里, 小佐見 光樹, 阿江 竜介, 牧野 伸子, 中村 好一 日本公衆衛生学会総会抄録集 77回 460 -460 2018年10月 [査読無し][通常論文]
  • 阿江竜介, 古城隆雄, 小佐見光樹, 南建輔, 坪井聡, 桑原政成, 中村好一 日本プライマリ・ケア連合学会学術大会抄録集 5th 279 2014年 [査読無し][通常論文]


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