Katsutoshi Nakano

Fluoroscopic angles should be individualised when performing myocardial biopsies in children

Koichi Takamizawa, Katsutoshi Nakano, Hideki Doi, Yui Ozawa et autres

BACKGROUND: Ventricular perforation is a serious complication of percutaneous myocardial biopsy. Accurate orientation of the biopsy forceps toward the ventricular septum under fluoroscopy is essential to minimise this risk. However, in paediatric patients, variations in ventricular septal orientation complicate proper forceps alignment. …

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A rare case of wheat-dependent exercise-induced anaphylaxis induced by exercise 5 hours after wheat ingestion.

Tomoki Yaguchi, Katsutoshi Nakano, Tadayuki Kumagai

A rare case of wheat-dependentexercise-induced anaphylaxis induced by exercise 5 hours after wheat ingestion.Tomoki Yaguchi1, Katsutoshi Nakano1, Tadayuki Kumagai1Department of Pediatrics, Yaizu City Hospital, Shizuoka, JapanCorresponding authorTomoki Yaguchi, 1000, Dobara, Yaizu-shi, Shizuoka 425-0055, Japan. Phone: +81-54-623-3111, Fax: +81-54-624-9103, E-mail: ravvvvish@gmai.l.comWord Count for …

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Identification of Peripheral Blood Cells Infected with Epstein–Barr Virus: A Practical Method for Choosing the Initial Treatment for Post-Transplantation Lymphoproliferative Disease

Seijiro Ishibashi, Katsutoshi Nakano, Susumu Urata, Ryo Nakagawa et autres

移植後リンパ増殖性疾患（post transplantation lymphoproliferative disease: PTLD）の治療において，リツキシマブの適応は一般的に臨床像および生検結果に基づいて決定する．今回，末梢血のEpstein–Barr（EB）ウイルス感染細胞同定解析に基づき，生検結果が判明するよりも早くリツキシマブの適応があるかを調べられたPTLDの症例を経験した．本症例は2歳男児で，心臓移植の3か月後に発熱・気道症状・下痢症状でPTLDを発症し入院した．入院中に行った末梢血のEBウイルス感染細胞同定解析により，感染細胞がB細胞由来で，リツキシマブの適応があることがわかった．これに基づき，生検結果が判明するより先にリツキシマブを投与開始できた．末梢血のEBウイルス感染細胞同定解析は，生検結果が判明するまで待てないPTLD症例において，リツキシマブの適応があるかを早期に把握する有効な手立てとなる可能性がある．

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Poor Myocardial Compaction in a Patient with Recessive MYL2 Myopathy

Ayaka Monoi Tamamitsu, Yu Nakagama, Yukako Shintani‐Domoto, Kenichi Yoshida et autres

Recessive mutations in the Myosin regulatory light chain 2 (MYL2) gene are the cause of an infantile-onset myopathy, associated with fatal myocardial disease of variable macromorphology. We here present the first Japanese family affected with recessive MYL2 myopathy. Affected siblings manifested typical …

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Current global situation of SARS-CoV-2 variants circulation and future actions required in Japan

Katsutoshi Nakano, Kenzo Takahashi

Intra-Peritoneal Migration of an Epicardial Pacemaker Causing Recurrent Vomiting

Hiroki Kitaoka, Hiroko Asakai, Katsutoshi Nakano, Urata Susumu et autres

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[A Case of Advanced Rectal Cancer with the Metastatic Abdominal Aortic Bifurcation Lymph Node Performed by Laparoscopic Surgery after Chemotherapy].

Yoshiyuki Motoki, Keishi Sugimoto, Katsunori Matsushita, Hideki Sakisaka et autres

A 63-year-old underwent examination for constipation and was found to have an unresectable advanced rectal cancer. Metastatic abdominal aortic bifurcation lymph node and lung metastasis were suspected upon CT(cT3N3M1a[PUL1], cStage Ⅳa), and chemotherapy was administered(CapeOX plus Bmab). After 4 courses of chemotherapy, …

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[Palliative Laparoscopic Operation for an Extremely Elderly Patient with Cecum Cancer].

Hideki Sakisaka, Yoshiyuki Motoki, Katsunori Matsushita, Katsutoshi Nakano et autres

Symptomatic colorectal cancer in extremely elderly patients is difficult to treat. A 97-year-old woman was initially suspected of having appendicitis because of worsening right lower abdominal pain with persistent fatigue. After antimicrobial therapy, advanced cecum cancer with lymph node involvement was found. …

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[A Case of Laparoscopic Surgery for Advanced Rectal Cancer with Lateral Lymph Node Metastasis Resected after Neoadjuvant Chemotherapy].

Yoshiyuki Motoki, Keishi Sugimoto, Hideki Sakisaka, Katsutoshi Nakano et autres

A 62-year-old man with diarrhea and metastases was found to harbor 2 rectal cancers. Both lateral lymph nodes were suspected based on CT and PET-CT(cT3N3M0, cStage Ⅲb). We planned to administer neoadjuvant chemotherapy(NAC) (CapeOX plus Bmab). After 4 courses of NAC, the …

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Vascular ring associated with d-transposition of the great arteries: when should we suspect aortic arch anomalies?

Katsutoshi Nakano, Taiyu Hayashi, Hiroshi Ono

A male neonate with d-transposition of the great arteries was diagnosed with the concomitant anomaly of left circumflex aortic arch and right-sided ductus arteriosus, which formed a vascular ring. Initial postnatal echocardiography had demonstrated an obscured aortic isthmus mimicking coarctation of the …

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Early-onset Marfan Syndrome Caused by a Splicing Mutation of FBN1 Exon 29: A Case Report

Yôsuke Ogawa, Katsutoshi Nakano, Takahiro Shindo, Yoichiro Hirata et autres

FBN1遺伝子の第24–32番エクソンの変異は重症かつ早期発症型のMarfan症候群を呈することが多いことが知られている．症例は4歳男児．新生児期より蜘蛛状指，大動脈弁輪拡張症（AAE），大動脈弁逆流症（AR）を呈し，4歳時にAAEの著明な進行とARに伴う心不全を認めたため当院Marfan外来に紹介され，4歳7か月時にDavid手術を施行された．遺伝学的検査でFBN1遺伝子にde novoの既報変異［IVS29＋1G＞A］を認め，転写産物の解析により本変異がスプライシングの異常によるin-flameの第29番エクソンの欠失を来すことを同定した．近年，Marfan症候群の発症メカニズムはdominant negative effectとhaploinsuffciencyの二つに大別して論ぜられているが，スプライシング異常に伴う変異の場合はそのどちらの形式もとりうるため，遺伝子産物の質的・量的な評価が必要となる．本症例では，FBN1遺伝子の第29番エクソンという変異の「位置」のみならず，スプライシング異常という変異の「形式」もまた，その大動脈病変の重症度に大きく寄与したと考えられた．

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Heart failure in dilated cardiomyopathy mimicking asthma triggered by pneumonia

Kenichi Tetsuhara, Satoshi Tsuji, Katsutoshi Nakano, Mitsuru Kubota

Heart failure is a rare cause of wheezing and may develop into a critical condition in children. Few cases report patients with heart failure, secondary to dilated cardiomyopathy, with high fever. A 23-month-old girl visited the emergency department with high fever, cough, …

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