| 1. |
Kiwamu Hatakeyama, Yuji Shono, Takuma Hashimoto, Taiki Sakamoto, Masaaki Nishihara, Takeshi Iyonaga, Soichi Mizuguchi, Takafumi Sakamoto, Jun Maki, Tomohiko Akahoshi, Emphysematous pyelonephritis with ST elevation accompanied by reciprocal changes mimicking acute coronary syndrome., The American journal of emergency medicine, 10.1016/j.ajem.2023.06.038, 70, 208.e5-208.e7, 2023.08, Patients with infectious diseases including sepsis can develop ST segment changes on an electrocardiogram (ECG) in the absence of coronary artery disease. However, ST elevation with "reciprocal ST segment depression (RSTD)", which is recognized as a specific finding for ST-elevated myocardial infarction, is rare in such patients. Although a small number of cases have reported ST-segment elevation in gastritis, cholecystitis, and sepsis, regardless of coronary artery disease, none presented with reciprocal changes. Here, we describe a rare case of a patient with emphysematous pyelonephritis complicating septic shock who developed ST elevation accompanied by reciprocal changes with no coronary occlusion. Emergency physicians should consider the possibility of acute coronary syndrome mimicking, and choose non-invasive diagnostic procedures when investigating the causes of ECG abnormalities associated with critically ill patients.. |
| 2. |
Yuko Ichimiya, Soichi Mizuguchi, Yoshitomo Motomura, Yuhki Koga, Noriyuki Kaku, Nobuhiro Hata, Koji Yoshimoto, Ayumi Sakata, Satoshi O Suzuki, Toru Iwaki, Yasunari Sakai, Shouichi Ohga, Acute-phase electroencephalography for an infantile atypical teratoid/rhabdoid tumor., Clinical neurology and neurosurgery, 10.1016/j.clineuro.2021.106922, 209, 106922-106922, 2021.10, BACKGROUND: Primary brain tumor is a leading cause of death in cancer-bearing children. Acutely progressive patterns of electroencephalography (EEG) remain to be investigated for children with rapidly growing brain tumors. CASE REPORT: A 14-month-old boy was transferred to our department for prolonged seizures and unrecovered consciousness on his fifth day of illness. The EEG recording on admission showed highly disorganized background activity with high-voltage rhythmic delta waves. Serial EEG monitoring revealed a rapid transition of the background activity to the suppression-burst pattern, and then to generalized suppression of cortical activity within a few hours after admission. Magnetic resonance imaging detected a midline tumor at the pineal gland extending to the midbrain and pons. The tumor was pathologically confirmed as atypical teratoid/rhabdoid tumor (AT/RT) with absent expression of SMARCB1. He died of tumor progression on the 20th day after admission. CONCLUSION: AT/RT is an additional category of brain tumors that cause the clinically and electro-physiologically critical condition in a few days after the onset.. |
| 3. |
Soichi Mizuguchi, Kazuhito Gotoh, Yuya Nakashima, Daiki Setoyama, Yurie Takata1, Shouichi Ohga and Dongchon Kang, Mitochondrial Reactive Oxygen Species Are Essential for the Development of Psoriatic Inflammation, Frontiers in Immunology, 10.3389/fimmu.2021.714897, 12, 2021.08. |
| 4. |
Kazuhito Gotoh, Yurie Takata, Yuya Nakashima, Soichi Mizuguchi, Keishi Komori, Dongchon Kang, Metabolic analysis of mouse bone-marrow-derived dendritic cells using an extracellular flux analyzer., STAR protocols, 10.1016/j.xpro.2021.100401, 2, 2, 100401-100401, 2021.06, Dendritic cell (DC) maturation induced by Toll-like receptor (TLR) agonists requires the activation of downstream metabolic changes. Here, we provide a detailed protocol to measure glycolysis, mitochondrial respiration, and fatty acid oxidation in mouse bone-marrow-derived DCs with the Seahorse XF24 extracellular flux (XF) analyzer. XF analysis with the Seahorse bioanalyzer has become a standard method to measure bioenergetic functions in cells, and this protocol can be adapted to other immune cells. For complete information on using this protocol, please refer to Gotoh et al. (2018).. |
| 5. |
Kenichi Tetsuhara, Noriyuki Kaku, Yuka Watanabe, Masaya Kumamoto, Yuko Ichimiya, Soichi Mizuguchi, Kanako Higashi, Wakato Matsuoka, Yoshitomo Motomura, Masafumi Sanefuji, Akio Hiwatashi, Yasunari Sakai, Shouichi Ohga, Predictive values of early head computed tomography for survival outcome after cardiac arrest in childhood: a pilot study., Scientific reports, 10.1038/s41598-021-91628-y, 11, 1, 12090-12090, 2021.06, Predicting outcomes of children after cardiac arrest (CA) remains challenging. To identify useful prognostic markers for pediatric CA, we retrospectively analyzed the early findings of head computed tomography (CT) of patients. Subjects were non-traumatic, out-of-hospital CA patients |
| 6. |
Kazuhito Gotoh, Yuya Kunisaki, Soichi Mizuguchi, Daiki Setoyama, Kentaro Hosokawa, Hisayuki Yao, Yuya Nakashima, Mikako Yagi, Takeshi Uchiumi, Yuichiro Semba, Jumpei Nogami, Koichi Akashi, Fumio Arai, Dongchon Kang, Mitochondrial Protein Synthesis Is Essential for Terminal Differentiation of CD45- TER119-Erythroid and Lymphoid Progenitors., iScience, 10.1016/j.isci.2020.101654, 23, 11, 101654-101654, 2020.11, p32/C1qbp regulates mitochondrial protein synthesis and is essential for oxidative phosphorylation in mitochondria. Although dysfunction of p32/C1qbp impairs fetal development and immune responses, its role in hematopoietic differentiation remains unclear. Here, we found that mitochondrial dysfunction affected terminal differentiation of newly identified erythroid/B-lymphoid progenitors among CD45- Ter119- CD31- triple-negative cells (TNCs) in bone marrow. Hematopoietic cell-specific genetic deletion of p32/C1qbp (p32cKO) in mice caused anemia and B-lymphopenia without reduction of hematopoietic stem/progenitor cells. In addition, p32cKO mice were susceptible to hematopoietic stress with delayed recovery from anemia. p32/C1qbp-deficient CD51- TNCs exhibited impaired mitochondrial oxidation that consequently led to inactivation of mTORC1 signaling, which is essential for erythropoiesis. These findings uncover the importance of mitochondria, especially at the stage of TNCs during erythropoiesis, suggesting that dysregulation of mitochondrial protein synthesis is a cause of anemia and B-lymphopenia with an unknown pathology.. |
| 7. |
Soichi Mizuguchi, Yoshitomo Motomura, Jun Maki, Rieko Baba, Yuko Ichimiya, Kentaro Tokuda, Noriyuki Kaku, Hidetoshi Takada, Yoshihiko Maehara, Shouichi Ohga, Tracheal Size and Morphology on the Reconstructed CT Imaging, PEDIATRIC CRITICAL CARE MEDICINE, 10.1097/PCC.0000000000001996., 20, 8, e366-e371, 2019.08. |
| 8. |
Soichi Mizuguchi, Yoshitomo Motomura, Jun Maki, Rieko Baba, Yuko Ichimiya, Kentaro Tokuda, Noriyuki Kaku, Hidetoshi Takada, Yoshihiko Maehara, Shouichi Ohga, Tracheal Size and Morphology on the Reconstructed CT Imaging., Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 10.1097/PCC.0000000000001996, 20, 8, e366-e371, 2019.08, OBJECTIVES: To characterize the real size and morphology of tracheas in childhood for the optimal selection of endotracheal tube. DESIGN: A retrospective cohort study of pediatric patients who received CT scan of the cervical spine from July 2011 to March 2018. Cross-sectional CT images vertical to trachea were reconstructed and the accurate tracheal diameters were measured. The validity of the traditional age-based formula for predicting the endotracheal tube size was assessed for the best fit to trachea. SETTING: Tertiary Emergency and Critical Care Center of Kyushu University Hospital. PATIENTS: Children, who are 1 month to 15 years old, received CT scan of the cervical spine. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We enrolled 86 children with median age of 53 months. The cross-sectional shape of pediatric trachea was circular at the cricoid level and elliptical at the infraglottic level. The narrowest part of pediatric trachea was the transverse diameter at the infraglottic level at any age. Significant positive correlation between age and the narrowest diameter was observed. When compared the transverse diameter at the infraglottic level with the outer diameter of endotracheal tubes, uncuffed endotracheal tubes selection based on the traditional age-based formula ran a significant risk of oversized endotracheal intubation until 10 years old compared with cuffed endotracheal tubes selection (60.0% vs 23.8%; p |
| 9. |
Kazue Moon, Muneyuki Takeuchi, Kazuya Tachibana, Soichi Mizuguchi, Shinya Hirano, Accuracy of Reported Tidal Volume During Neonatal Ventilation With Airway Leak: A Lung Model Study., Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 10.1097/PCC.0000000000001752, 20, 1, e37-e45, 2019.01, OBJECTIVES: To determine the accuracy of tidal volume reported by neonatal ventilators, with and without leak compensation, in invasive and noninvasive ventilation modes in the presence of airway leak; and, to determine what factors have a significant effect on the accuracy of tidal volume reported by ventilators with leak compensation in the presence of airway leak. We hypothesized that ventilators with a leak compensation function that includes estimation of tidal volume could accurately report tidal volume in the presence of airway leak, but that the accuracy of reported tidal volume may be affected by variables such as the identity of the ventilator, lung mechanics, leak size, positive end-expiratory pressure level, and body size. DESIGN: In vitro assessment of ventilator volume delivery was conducted for seven acute care ventilators using a passive lung simulator. SETTING: Laboratory-based measurements. INTERVENTIONS: The error of reported tidal volume was calculated under three ventilation modes (noninvasive-pressure-control, invasive-pressure-control, and invasive-dual-control ventilation), three models of lung mechanics (normal and restrictive and obstructive lung disease), a range of airway leak values, two positive end-expiratory pressure values, and two body weights for each ventilator. Ventilators with and without leak compensation were studied. MEASUREMENTS AND MAIN RESULTS: In the absence of airway leak, all ventilators reported tidal volume accurately. In the presence of airway leak, the error of reported tidal volume increased for all ventilators without a leak compensation algorithm while ventilators with leak compensation that included estimation of tidal volume accurately reported tidal volume. In the presence of airway leak, clinically significant effects on the error of reported tidal volume by ventilators with leak compensation were associated with the choice of ventilator in all modes and with lung mechanics in invasive ventilation modes. CONCLUSIONS: Reported tidal volume is affected by the presence of airway leak, but in many ventilators a leak compensation algorithm that includes estimation of tidal volume can correct for the discrepancy between actual and reported tidal volume. However, even in ventilators with leak compensation, choice of ventilator and lung mechanics in invasive ventilation modes have a significant effect on error of reported tidal volume.. |
| 10. |
Masafumi Sanefuji, Yuko Ichimiya, Noriyuki Kaku, Momoko Sasazuki, Kosuke Yonemoto, Michiko Torio, Soichi Mizuguchi, Yoshitomo Motomura, Mamoru Muraoka, Sooyoung Lee, Haruhisa Baba, Kazuhiro Ohkubo, Yuri Sonoda, Yoshito Ishizaki, Yasunari Sakai, Shouichi Ohga, Vascular pathomechanism in acute encephalopathy with biphasic seizures and late reduced diffusion., Journal of the neurological sciences, 10.1016/j.jns.2018.10.007, 395, 141-146, 2018.12, Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a childhood-onset encephalopathy, but the precise pathophysiology remains unclear. We encountered a child with Moyamoya syndrome and AESD. He exhibited left-predominant stenosis of the middle cerebral artery (MCA), and later developed broad lesions in the left hemisphere, raising the possibility that insufficient blood supply relates to formation of the lesions. To test the hypothesis, we investigated the relationship between MCA volume and lesion extent in seven AESD children without preexisting diseases. The MCA volume and lesion extent were quantified with time of flight images for construction of magnetic resonance angiography and apparent diffusion coefficient maps, respectively. Lateralization indices ([right - left]/[right + left]) of the MCA volume and lesion extent were calculated. We found that the lateralization indices were negatively correlated (r = -0.786, p = .036), that is, when the MCA volume was smaller in one side than the other side, the lesions were likely to develop more extensively in the ipsilateral side than the contralateral side. This indicates the association of insufficient blood supply with the lesions. The present study provides the first observation to suggest the involvement of vascular mechanism in AESD and has potential implications for novel therapeutic approach.. |
| 11. |
Kazuhito Gotoh, Takafumi Morisaki, Daiki Setoyama, Katsuhiko Sasaki, Mikako Yagi, Ko Igami, Soichi Mizuguchi, Takeshi Uchiumi, Yoshinori Fukui, Dongchon Kang, Mitochondrial p32/C1qbp Is a Critical Regulator of Dendritic Cell Metabolism and Maturation., Cell reports, 10.1016/j.celrep.2018.10.057, 25, 7, 1800-1815, 2018.11, Dendritic cell (DC) maturation induced by Toll-like receptor agonists requires activation of downstream signal transduction and metabolic changes. The endogenous metabolite citrate has recently emerged as a modulator of DC activation. However, the metabolic requirements that support citrate production remain poorly defined. Here, we demonstrate that p32/C1qbp, which functions as a multifunctional chaperone protein in mitochondria, supports mitochondrial metabolism and DC maturation. Metabolic analysis revealed that the citrate increase induced by lipopolysaccharide (LPS) is impaired in p32-deficient DCs. We also found that p32 interacts with dihydrolipoamide S-acetyltransferase (E2 component of pyruvate dehydrogenase [PDH] complex) and positively regulates PDH activity in DCs. Therefore, we suggest that DC maturation is regulated by citrate production via p32-dependent PDH activity. p32-null mice administered a PDH inhibitor show decreased DC maturation and ovalbumin-specific IgG production in vivo, suggesting that p32 may serve as a therapeutic target for DC-related autoimmune diseases.. |
| 12. |
Yuko Ichimiya, Noriyuki Kaku, Masafumi Sanefuji, Michiko Torio, Soichi Mizuguchi, Yoshitomo Motomura, Mamoru Muraoka, Sooyoung Lee, Haruhisa Baba, Yuri Sonoda, Yoshito Ishizaki, Momoko Sasazuki, Yasunari Sakai, Yoshihiko Maehara, Shouichi Ohga, Predictive indicators for the development of epilepsy after acute encephalopathy with biphasic seizures and late reduced diffusion., Epilepsy research, 10.1016/j.eplepsyres.2018.04.006, 143, 70-74, 2018.07, Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a newly defined clinicoradiologic syndrome characterized by biphasic seizures and altered consciousness followed by restricted diffusion in the white matter on magnetic resonance imaging in acute phase. Intractable epilepsy commonly occurs as the late complication. This study aimed to search predisposing factors to the development of epilepsy after AESD. Consecutively treated 22 patients with AESD in our institution from 2006 to 2016 were grouped into those with post-encephalopathic epilepsy (PEE, n = 10) or without PEE (n = 12). There was no difference between two groups in age at the onset of AESD, duration of the initial seizures, or the follow-up periods after discharge. PEE group patients more frequently showed coma or involuntary movements during the course of AESD than non-PEE group patients (36% vs. 8%, p = 0.008). The quantitative analysis of apparent diffusion coefficient (ADC) map revealed that PEE group showed broader areas with reduced diffusion in the posterior lobes at the onsets of AESD than non-PEE group (0.113 vs. 0.013, p = 0.035). On the other hand, the atrophy on day 30-ADC map did not correlate with the development or control of epilepsy. These results suggest that the clinical severity and ADC profiles in acute phase, rather than the brain atrophy in convalescent phase, may predict the development of post-AESD epilepsy.. |
| 13. |
Yuko Ichimiya, Noriyuki Kaku, Yasunari Sakai, Fumiya Yamashita, Wakato Matsuoka, Mamoru Muraoka, Satoshi Akamine, Soichi Mizuguchi, Michiko Torio, Yoshitomo Motomura, Yuichiro Hirata, Yoshito Ishizaki, Masafumi Sanefuji, Hiroyuki Torisu, Hidetoshi Takada, Yoshihiko Maehara, Shouichi Ohga, Transient dysautonomia in an acute phase of encephalopathy with biphasic seizures and late reduced diffusion., Brain & development, 10.1016/j.braindev.2017.03.023, 39, 7, 621-624, 2017.08, Paroxysmal sympathetic hyperactivity (PSH) is a dysautonomic condition that is associated with various types of acquired brain injuries. Traumatic brain lesions have been documented as the leading cause of PSH. However, detailed clinical features of pediatric PSH caused by intrinsic brain lesions remain to be elusive. We present a 3-year-old boy, who had been diagnosed as having cerebral palsy, developmental delay and epilepsy after perinatal hypoxia-induced brain injury. He developed status epilepticus with fever on the third day of respiratory infection. Whereas the seizure was terminated by systemic infusion of midazolam, consciousness remained disturbed for the next 48h. Serial magnetic resonance imaging studies revealed that acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) evolved on 3days after the seizure. Therapeutic hypothermia was immediately introduced, however, the brain lesion extended to the whole subcortical white matters on day 8. The intermittent bilateral dilation of pupils with increased blood pressure and tachycardia were observed until day 12. Real-time monitoring of electroencephalograms ruled out the recurrent attacks of seizures. The abnormal signs of autonomic nervous system gradually ceased and never relapsed after recovery from the hypothermia. PSH or a transient condition of dysautonomia may emerge and persist during the acute phase of AESD.. |
| 14. |
Sooyoung Lee, Masafumi Sanefuji, Michiko Torio, Noriyuki Kaku, Yuko Ichimiya, Soichi Mizuguchi, Haruhisa Baba, Yasunari Sakai, Yoshito Ishizaki, Hiroyuki Torisu, Ryutaro Kira, Toshiro Hara, Shouichi Ohga, Involuntary movements and coma as the prognostic marker for acute encephalopathy with biphasic seizures and late reduced diffusion., Journal of the neurological sciences, 10.1016/j.jns.2016.09.018, 370, 39-43, 2016.11, Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) occurs in children associated with infection. It is characterized by a prolonged febrile seizure in the first phase, and a cluster of seizures, deterioration of consciousness and the white matter lesions with reduced diffusion in the second phase. The patients often have severe neurological sequelae, but the prognostic indicators remain unknown. The present study aimed to clarify the characteristics of AESD patients who subsequently exhibited severe neurological sequelae. We retrospectively analyzed the clinical and laboratory findings along with the brain imaging in patients who had severe (n=8) and non-severe neurodevelopmental outcomes (n=12). Severe group more frequently showed coma (p=0.014) or involuntary movements including dystonia and oral dyskinesia (p=0.018) before the second phase than non-severe group. Severe group exhibited higher levels of serum alanine aminotransferase than non-severe group (p=0.001). Quantitatively assessed MRI in the second phase revealed that severe group had more extensive lesions than non-severe group, in the anterior (p=0.015) and posterior parts (p=0.011) of the cerebrum and basal ganglia (p=0.020). Early appearing involuntary movements or coma might account for the extension of acute brain lesions and the poor neurological outcomes in AESD patients.. |
