Kouji Takekuma

Diagnostic and predictive value of CSF d-ROM level in influenza virus-associated encephalopathy.

The aim of this study was to assess the validity of serum and CSF oxidative status of patients with IE in their initial stage through the d-ROM (Diacron-Reactive Oxygen Metabolites, Italy) test, compared to those with other neurological diseases. The study was conducted on the following four groups: (1) influenza virus-associated encephalopathy (IE, n = 8), including four patients showing neurological sequelae or mortal; (2) influenza virus-associated febrile seizures (IFS, n = 11); (3) febrile convulsion (FC, n = 10): (4) enterovirus-associated encephalopathy (EE, n = 4), including one patient with neurological sequelae. The CSF d-ROM levels in the IE group were significantly higher than those in the IFS and the FC groups but not in the EE group. In addition, general laboratory findings such as leukocytes, platelets, C-reactive protein, aspartate aminotransferase, creatinine, creatinine kinase and LDH, including interleukin-6 (IL-6), were analyzed in each group. The CSF d-ROM levels in the IE group were significantly higher than those in the IFS and FC groups but not in the EE group. As for the serum d-ROM levels and general laboratory findings, with the exception of CSF IL-6 levels in IE, no significant differences were detected compared with the other groups. In patients with IE, the CSF d-ROM levels could be a valid predictive biomarker of the severity, and oxidative stress may be related to the pathogenesis of IE.

Combined Treatment of Steroids and Cyclosporine in Kimura Disease

Kimura disease is a rare but distinctive chronic eosinophilic inflammatory disorder that is characterized by tumor-like lesions in the soft tissue and lymph nodes of the head and neck or parotid gland. Recently, many immunopathogenetic features of underlying T lymphocytes and related cytokines have been noted in Kimura disease. However, few previous studies have investigated the serial levels of cytokines in children. In this report we describe an 11-year-old Japanese boy with relapsing Kimura disease. Before the diagnosis of Kimura disease, the patient had a swelling on his left neck. Steroids were effective, but the tumor relapsed within a few months as the steroids were tapered. He was treated with steroids and cyclosporine. This treatment was done by measuring serial levels of serum soluble interleukin-2 receptor, interleukin-4, interleukin-5, and eosinophil cationic protein. These results suggest the activation of T-helper cells and T-helper 2 cytokines, that after activated B cells and eosinophilic infiltration play an important role in Kimura disease, and that cyclosporine suppresses the activity of this disease.

Detection of mumps virus genome directly from clinical samples and a simple method for genetic differentiation of the Hoshino vaccine strain from wild strains of mumps virus.

A simple and sensitive method was developed for the differentiation of the Hoshino vaccine strain from wild strains with a restriction fragment length polymorphism (RFLP) analysis in the part of hemagglutinin‐neuraminidase (HN) gene. The virus genome was amplified by using a reverse transcriptase‐polymerase chain reaction (RT‐PCR) directly from clinical samples. The PCR product of the Hoshino vaccine strain was cleaved into 2 fragments after digestion with Sca I and Afl II. All wild strains showed 2 RFLP profiles, A and B, different from that of vaccine strain. Wild A strains were cut into 2 fragments after digestion with Sca I only, while wild B strains were cleaved neither with Sca I nor Afl II. This molecular approach provides an effective method for differentiation of the Hoshino vaccine strain from wild strains of mumps virus in patients after vaccination. J. Med. Virol. 52:195–199, 1997.

High concentration of serum nitrite/nitrate obtained from patients with influenza‐associated encephalopathy

According to a marked decrease in the vaccination rate of influenza virus in Japan during the last 10 years, it has become evident that a number of patients with a new type of influenza-associated encephalopathy is increasing. 1 The onset of the seizures and unconsciousness is abrupt, usually within 12–24 h after the first symptoms, that is severe fever, and findings of severe brain edema by brain computed tomography (CT) scanning which is characteristic but not the specified localization of necrosis and bleeding. Virus isolation from serum and cerebrospinal fluid is not always successful and the viremic condition is not always demonstrated. 2,3 High levels of cytokines in the serum or central nervous system of influenza patients were reported from several institutes. 4,5 In such cytokines, tumor necrosis factorα (TNFα ) is thought to be one of the cause of neural damage. Additionally, one of the biological gases, nitric oxide (NO), elicits the immune response related to the cytokine network under inflammatory condition. However, these pathophysiological correlations are actually still unknown. In this study, we measured the nitrite/nitrate (NOx) levels in serum of influenza patients in order to evaluate the correlation between the NO production and the process of influenza-associated encephalopathy assessed by the sensitive high-performance liquid chromatographyultra violet (HPLC-UV) system. Study subjects

PRIMARY BIOMARKERS IN CEREBRAL SPINAL FLUID OBTAINED FROM PATIENTS WITH INFLUENZA-ASSOCIATED ENCEPHALOPATHY ANALYZED BY METABOLOMICS

In order to search for the specific biomarkers of patients with influenza-associated encephalopathy this article analyzed all metabolites in cerebrospinal fluid (CSF) by using metabolome analysis. In all metabolites, the peaks of two molecular weights, 246.0092 and 204.0611, were significantly higher than those in other diseases including influenza without convulsion (p < .05). The peak of a molecular weight 228.0247 in all of the patients except one was less than that in other patients. These results indicate that the new metabolites detected in CSF would be primary markers for the diagnosis of influenza-associated encephalopathy.

A case of intractable epilepsy positive for the detection of measles virus genome in the cerebrospinal fluid and peripheral mononuclear cells using reverse transcriptase-polymerase chain reaction.

We report a rare case of intractable frontal lobe epilepsy with mental deterioration, in which the measles virus gene was detected from the cerebrospinal fluid (CSF) and peripheral mononuclear cells (PBMC) obtained 9 years after the first epileptic episode using reverse transcriptase-polymerase chain reaction (RT-PCR). The patient had been immunized with an attenuated measles vaccine and had no history of clinically apparent acute measles infection. However the analysis of the sequence of the PCR product from CSF showed the circulating wild strain genotype at the time when the patient complained of his first epileptic episode.

Cytomegalovirus DNA among children attending two day‐care centers in Tokyo

Abstract Background : In the USA, a high prevalence rate of cytomegalovirus (CMV) excretion among children in day‐care centres was reported. However, there is no research about the prevalence rate of CMV among children in day‐care centres in Japan.

Production of chemokines in respiratory syncytial virus infection with central nervous system manifestations

Respiratory syncytial virus (RSV) infection in children can be associated with acute encephalopathy. However, the roles of cytokines in the cerebrospinal fluid (CSF) of such patients remain unevaluated. In this study, a profile of 17 cytokines was determined for eight RSV-infected children with neurological complications. In one patient with high levels of 13 cytokines, a cytokine storm was considered to have occurred. Interleukin (IL)-6, IL-8, monocyte chemoattractant protein (MCP)-1, and macrophage inflammatory protein (MIP)-1β levels were also high in other patients. These data suggest that chemokines in CSF play roles in neurological complications in RSV-infected children.

Rapid diagnosis of bacterial meningitis by using multiplex PCR and real time PCR

Abstract Background : The purpose of the present study was to improve a method for a rapid identification of bacteria in bacterial meningitis by using multiplex polymerase chain reaction (PCR).

Squamous cell carcinoma-related antigen in children with atopic dermatitis.

dermatitis (AD) has increased. Children who show exanthema over the entire body with severe itching are not rare. However, the severity of AD is not completely correlated with the levels of IgE and eosinophil counts. Soluble E-selection is now considered a good marker.1 However, the assay is not easy to carry out. There is no clinical good marker reflecting the severity of atopic dermatitis. Squamous cell carcinoma (SCC)-related antigen has been purified from human uterine cervical SCC and developed to be a tumor marker, mainly for cervical squamous cell cancer.2 The antigen is also present and expressed in normal epithelium and epithelial tissues. Squamous cell carcinomarelated antigen has been reported to be elevated in several benign lesions, including lung and skin diseases.3 In the present study, we have shown that SCC-related antigen is useful to evaluate the severity of AD in children.