Urara Kohdera

Improved outcome in the treatment of pediatric multifocal Langerhans cell histiocytosis: Results from the Japan Langerhans Cell Histiocytosis Study Group-96 protocol study.

The treatment outcome of multifocal childhood Langerhans cell histiocytosis (LCH) has not been satisfactory and has resulted in poor therapeutic responses with high mortality and a high incidence of reactivation with late sequelae. To overcome these issues, the Japan LCH Study Group‐96 (JLSG‐96) protocol was conducted prospectively from 1996 to 2001 in Japan.

Enterovirus 68 in Children with Acute Respiratory Tract Infections, Osaka, Japan

Enterovirus 68 strains were detected in 14 specimens from children with respiratory tract infections and 1 specimen from a child with febrile convulsions during 2010 in Osaka, Japan. These strains had deletions in the 5′ untranslated region and were genetically different from reported strains. This virus is associated with respiratory tract infections in Japan.

Co-Infection of Human Metapneumovirus with Adenovirus or Respiratory Syncytial Virus among Children in Japan

Human metapneumovirus (hMPV) is one of the etiological agents of acute respiratory tract infections. From June 2005 to May 2006, we collected 185 clinical specimens from children in Osaka City, Japan, and detected 41 hMPV RNA. Of the 41 specimens, four (9.8%) also contained other viruses (3 with adenovirus [AdV] and 1 with respiratory syncytial virus [RSV]). The clinical symptoms of patients co‐infected with AdV were indistinct from those of patients mono‐infected with hMPV. The symptoms of the one patient co‐infected with RSV were clinically severe. Further research is needed to clarify the effect of hMPV on other respiratory viruses or vice versa.

Pediatric hospitalizations with influenza A infection during the 2009–2010 pandemic in five hospitals in Japan

Background:  The aim of this study was to identify the clinical characteristics of hospitalized children with the 2009 pandemic influenza virus infection in Japan.

Detection of measles virus RNA on SYBR green real-time reverse transcription–polymerase chain reaction

Background:  As the coverage rate of the measles vaccine increases, not all patients present the typical symptoms of measles after exposure to the measles virus (MV). The virus loads in clinical specimens from patients with vaccine‐modified non‐typical measles are expected to be low compared with those of primary MV infection. A rapid and sensitive laboratory procedure is required for diagnosis of measles.

Seasonal variations of respiratory viruses and etiology of human rhinovirus infection in children

Abstract Background Using the polymerase chain reaction (PCR) method it is possible to detect uncultivable viruses and discover multiple viral infections. However, the clinical importance of these findings in relation to symptoms is not known. Objectives The seasonal fluctuations of respiratory viruses and the clinical outcomes of single infections and dual infections were investigated. Study design Nasal aspirate samples were obtained from outpatients and inpatients of a children’s hospital and these samples were subjected to real-time PCR to detect 16 respiratory viruses. Seasonal variations of the 16 viruses and the clinical outcomes such as wheezing, the need for oxygenation and prolonged hospitalization of patients with single viral infections and multiple infections were determined for the 5 most often detected viruses. Results Among 512 specimens analyzed, one or more viruses were detected in 424 (83%) specimens. Two or more viruses were detected in 160 samples (31% of all samples). The epidemic peaks of the viruses did not coincide with each other. Rhinoviruses were the most frequently detected viruses and their coinfection rates were also higher. However, the disease severity in the lower respiratory tract did not differ in most respiratory viral infections regardless of whether there was single infection or dual infection with a rhinovirus and other respiratory virus. Conclusions Seasonal distribution was seen for each virus. There were no significant differences in clinical symptoms in the children studied. Because the infection of rhinoviruses is the common occurrence in children, it is hypothesized that the factors related to disease severity are mainly the underlying conditions of the children.

Health-related quality of life in Japanese children with acute lymphoblastic leukemia during and after chemotherapy

Quality of life (QOL) as a treatment outcome has not yet been evaluated among patients receiving a specific treatment regimen by treatment phase in a consistent manner. This exploratory cross‐sectional study evaluated the QOL of children with acute lymphoblastic leukemia (ALL) receiving one of the most popular treatment regimens in Japan (Japan Association of Childhood Leukemia Study ALL‐02 revised protocol).

Distinct genetic clades of enterovirus D68 detected in 2010, 2013, and 2015 in Osaka City, Japan

The first upsurge of enterovirus D68 (EV-D68), a causative agent of acute respiratory infections (ARIs), in Japan was reported in Osaka City in 2010. In this study, which began in 2010, we surveyed EV-D68 in children with ARIs and analyzed sequences of EV-D68 strains detected. Real-time PCR of 19 respiratory viruses or subtypes of viruses, including enterovirus, was performed on 2,215 specimens from ARI patients (<10 years of age) collected between November 2010 and December 2015 in Osaka City, Japan. EV-D68 was identified in 18 enterovirus-positive specimens (n = 4 in 2013, n = 1 in 2014, and n = 13 in 2015) by analysis of viral protein 1 (VP1) or VP4 sequences, followed by a BLAST search for similar sequences. All EV-D68 strains were detected between June and October (summer to autumn), except for one strain detected in 2014. A phylogenetic analysis of available VP1 sequences revealed that the Osaka strains detected in 2010, 2013, and 2015 belonged to distinct clusters (Clades C, A, and B [Subclade B3], respectively). Comparison of the 5′ untranslated regions of these viruses showed that Osaka strains in Clades A, B (Subclade B3), and C commonly had deletions at nucleotide positions 681–703 corresponding to the prototype Fermon strain. Clades B and C had deletions from nucleotide positions 713–724. Since the EV-D68 epidemic in 2010, EV-D68 re-emerged in Osaka City, Japan, in 2013 and 2015. Results of this study indicate that distinct clades of EV-D68 contributed to re-emergences of this virus in 2010, 2013, and 2015 in this limited region.

Novel Isolation of Mycoplasma amphoriforme from a Pediatric Patient with Protracted Bronchitis in Japan

1Department of Infectious Diseases, Osaka Prefectural Institute of Public Health, Osaka 537-0025; 2Asai Childrens Clinic, Osaka 534-0016; 3Aiwa kids Clinic, Osaka 545-0053; 4Nakano Childrens Hospital, Osaka 535-0022; 5Department of Clinical Laboratory, Kishiwada Tokushukai Hospital, Osaka 596-8522; 6Department of Pediatrics, Aizenbashi Hospital, Osaka 556-0005; 7Takeda Pediatric Clinic, Osaka 558-0041; 8Hata Pediatric Clinic, Osaka 558-0003; 9GG Kids Clinic, Osaka 591-8023; 10Matsushita Kids Clinic, Osaka 571-0030; and 11International University of Health and Welfare, Tochigi 329-2763, Japan