Ayumi Matsumoto

Molecular epidemiology of norovirus gastroenteritis in Soma, Japan, 2001–2003

Background: The aim of the present paper was to investigate the molecular epidemiology of norovirus gastroenteritis in Japan using polymerase chain reaction (PCR) and subsequent phylogenetic analysis.

Outcome of fetal echocardiography: A 17 year single-institution experience in Japan

Background:  The aim of this retrospective study was to evaluate the influence of prenatal diagnosis on perinatal outcomes of congenital heart disease (CHD) over a 17 year period at a single center.

Efficacy of steroid pulse, plasmapheresis, and mizoribine in a patient with focal segmental glomerulosclerosis

There have been few reports on successful treatment for focal segmental glomerulosclerosis (FSGS) complicated by leukoencephalopathy. We report the efficacy of the steroid pulse and mizoribine (MZB) combined with plasmapheresis (PP) for a case of FSGS with leukoencephalopathy induced by cyclosporine (CyA). The patient was a 4-year-old boy with FSGS who presented with steroid-resistant nephrotic syndrome (NS) and was treated with CyA. On the 7th day after starting CyA, he complained of one visual disorder, and hypertension and tonic convulsions were observed. Electroencephalography (EEG) revealed generalized slow waves, and magnetic resonance imaging (MRI) disclosed high signal intensity in the white matter. A diagnosis of leukoencephalopathy induced by CyA was made on the basis of these findings with the improvement in clinical manifestations upon discontinuation of CyA. We treated the patient with steroid pulse therapy and MZB combined with PP, and the proteinuria gradually decreased and only microscopic hematuria remained. We report that steroid pulse and MZB combined with PP may be an effective treatment in a patient with FSGS complicated by CyA-induced leukoencephalopathy.

The trend of drug-resistant Streptococcus pneumoniae from nasopharynx of children

We investigated the trend of the carriage of drug-resistant Streptococcus pneumoniae in nasopharynx of children. The 202 isolates from pediatric outpatients and their previous antibiotic use was investigated from 2004 to 2006. The total rate of patients medicated with antibiotics was 47.5%, a 6.9% decrease compared with our previous study performed from 2001 to 2003. There were 56 (27.7%) penicillin-susceptible, 83 (41.1%) penicillin-intermediate, and 63 (31.2%) penicillin-resistant strains by the susceptibility breakpoints used during the previous study period. There were 196 (97%) susceptible, 5 (2.5%) intermediate, and 1 (0.5%) resistant strains by breakpoints in this study, which were introduced in 2008 by the Clinical Laboratory and Standards Institute. The rate of strains with a single altered pbp gene was 21.8% (44), with 2 altered pbp genes was 21.8% (31), and with 3 altered pbp genes was 53.5% (108). The total rate of strains with altered pbp gene(s) was 90.1% (183). We found the emergence of strains with pbp1a and 2b and the higher rate of strains with pbp2x. There was obvious association between amoxicillin use and the carriage of altered pbp gene(s). These results might suggest that amoxicillin was not a safe alternative to prevent the emergence of resistant strains. We need to reassess a beneficial approach for the treatment of pediatric outpatients.