記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Downfolding of the epiglottis into the laryngeal inlet is considered to be a rare complication of tracheal intubation. We describe a case of epiglottic downfolding during tracheal intubation using a McGrath videolaryngoscope (McGRATHTM MAC). CASE PRESENTATION: A 44-year-old female was scheduled for breast reconstruction surgery. Intubation was performed using a McGrath videolaryngoscope. After intubation, videolaryngoscopy revealed that the epiglottis was inverted and folded down into the laryngeal inlet. We elevated the larynx anteriorly using the McGrath videolaryngoscope, enabling the downfolded epiglottis to be pulled out from the laryngeal inlet and restored to its original position. After surgery, the patient was extubated without any complications. CONCLUSIONS: When using the McGrath videolaryngoscope, both glottic exposure similar to that achieved with the Macintosh laryngoscope and careful observation of the epiglottis should enable the prevention, detection, and treatment of epiglottic downfolding into the laryngeal inlet.

DOI： 10.1186/s40981-020-00349-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: We estimated influenza vaccine effectiveness (VE) in 2015-2016 season against medically attended, laboratory-confirmed influenza, when quadrivalent inactivated vaccine (IIV4) was first introduced in Japan, using test-negative case-control design. Influenza A(H1N1)pdm09 cocirculated with B/Yamagata and B/Victoria during the study period in Japan. METHOD: We based our case definition on two laboratory tests, real-time reverse transcription polymerase chain reaction (RT PCR), and virus isolation and compared VEs based on these tests. In addition, VE was evaluated by rapid diagnostic test (RDT). Nasopharyngeal swabs were collected from outpatients who visited clinics with influenza-like illness (ILIs) in Hokkaido, Niigata, Gunma and Nagasaki prefectures. RESULTS: Among 713 children and adults enrolled in this study, 578 were influenza positive by RT PCR including, 392 influenza A and 186 influenza B, while 135 were tested negative controls. The adjusted VE by RT PCR for all ages against any influenza was low protection of 36.0% (95% confidence interval [CI], 3.1% to 58.6%), for influenza A was 30.0% (95% CI: -10.0% to 55.5%), and influenza B was moderate 50.2% (95% CI: 13.3% to 71.4%). Adjusted VE for virus isolation for A(H1N1)pdm09 was 37.1% (95% CI: 1.7% to 59.7%), Yamagata lineage 51.3% (95% CI: 6.4% to 74.7%) and Victoria lineage 21.3% (95% CI: -50.0% to 58.9%). VE was highest and protective in 0-5 years old group against any influenza and influenza A and B/Yamagata, but the protective effect was not observed for other age groups and B/Victoria. RDT demonstrated concordant results with RT PCR and virus isolation. Sequencing of hemagglutinin gene showed that all A(H1N1)pdm09 belong to clade 6B including 31 strains (88.6%), which belong to clade 6B.1 possessing S162N mutations that may alter antigenicity and affect VE for A(H1N1)pdm09. CONCLUSIONS: IIV4 influenza vaccine during 2015-2016 was effective against A(H1N1)pdm09 and the two lineages of type B. Younger children was more protected than older children and adults by vaccination.

DOI： 10.1016/j.jvacx.2019.100011

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Neuraminidase inhibitors (NAIs) effectively treat influenza. The clinical effectiveness of four NAIs (oseltamivir, zanamivir, laninamivir, and peramivir) was evaluated against influenza A/H1N1pdm09, A/H3N2, and B viruses. Additionally, fever duration in patients infected with oseltamivir-resistant influenza A/H1N1pdm09 with the H275Y mutation was evaluated. METHODS: Patients aged <20 years who visited outpatient clinics in Japan with influenza-like illnesses were enrolled during 4 influenza seasons from 2012/2013 to 2015/2016. After obtaining informed consent, patients who tested positive for influenza with rapid tests received one of the four NAIs. Patients recorded their body temperature daily for 8 days from the first visit. The influenza strain was identified using real-time polymerase chain reaction. Univariate and multivariable analyses were used to evaluate factors influencing fever duration. In children aged ≤5 years treated with oseltamivir, fever duration in oseltamivir-resistant A/H1N1pdm09-infected patients was compared to that in oseltamivir-sensitive A/H1N1pdm09-infected patients. RESULTS: Of the 1,368 patients analyzed, 297 (21.7%), 683 (49.9%), and 388 (28.4%) were infected with influenza A/H1N1pdm09, A/H3N2, and B, respectively. In multivariable analysis factors associated with significantly prolonged fever duration included: treatment with laninamivir (hazard ratio [HR]: 0.78, p = 0.006, compared to oseltamivir), influenza B (HR: 0.58, p<0.001, compared to influenza A/H1N1pdm09), and a higher body temperature at the clinic visit (HR: 0.87 per degree Celsius, p<0.001). Increasing age was associated with a significantly shorter duration of fever (HR: 1.31 for 6-9 years old, p<0.001; and HR: 1.65 for 10-19 years old, p<0.001, respectively, compared to 0-5 years old). Following treatment with oseltamivir, fever duration was significantly longer for oseltamivir-resistant A/H1N1pdm09-infected patients (n = 5) than for oseltamivir-sensitive A/H1N1pdm09 infected patients (n = 111) (mean, 89 versus 40 hours, p<0.001). CONCLUSIONS: Our results revealed characteristic information on the effectiveness of the four NAIs and also on oseltamivir-resistant viruses that may affect patients' clinical care.

DOI： 10.1371/journal.pone.0224683

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We investigated the circulation patterns of human influenza A and B viruses in Myanmar between 2010 and 2015 by analyzing full HA genes. Upper respiratory tract specimens were collected from patients with symptoms of influenza-like illness. A total of 2,860 respiratory samples were screened by influenza rapid diagnostic test, of which 1,577 (55.1%) and 810 (28.3%) were positive for influenza A and B, respectively. Of the 1,010 specimens that were positive for virus isolation, 370 (36.6%) were A(H1N1)pdm09, 327 (32.4%) were A(H3N2), 130 (12.9%) B(Victoria), and 183 (18.1%) were B(Yamagata) viruses. Our data showed that influenza epidemics mainly occurred during the rainy season in Myanmar. Our three study sites, Yangon, Pyinmana, and Pyin Oo Lwin had similar seasonality and circulating type and subtype of influenza in a given year. Moreover, viruses circulating in Myanmar during the study period were closely related genetically to those detected in Thailand, India, and China. Phylogeographic analysis showed that A(H1N1)pdm09 viruses in Myanmar originated from Europe and migrated to other countries via Japan. Similarly, A(H3N2) viruses in Myanmar originated from Europe, and disseminated to the various countries via Australia. In addition, Myanmar plays a key role in reseeding of influenza B viruses to Southeast Asia and East Asia as well as Europe and Africa. Thus, we concluded that influenza virus in Myanmar has a strong link to neighboring Asian countries, Europe and Oceania.

DOI： 10.1371/journal.pone.0210550

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Influenza B viruses of both the Yamagata and the Victoria lineages are implicated in a large proportion of the morbidity and mortality associated with influenza outbreaks. In this study, we characterized the full genomes of 53 influenza B viruses isolated during 2012-2015 in three Asian countries: Japan, Myanmar, and Vietnam. Analysis of the hemagglutinin (HA) genes revealed co-circulation of both the Yamagata and Victoria lineages within the same season in these countries. Our analysis revealed, that a large proportion of viruses circulating during 2013-2014 in Japan and Vietnam were mismatched to the vaccine supporting the rationale for using quadrivalent vaccines. Molecular analysis of the neuraminidase (NA) genes did not reveal any of the previously reported substitutions associated with reduced susceptibility to neuraminidase inhibitors (NAIs). However, one isolate from Nagasaki displayed reduced inhibition by NAIs, associated with an NA-M426I substitution (N2-numbering). Phylogenetic analysis of the eight genome segments identified a 6 + 2 reassortant strain belonging to the Victoria lineage that circulated in Japan during the 2013-2014 season. This strain appears to have evolved from a descendent of a B/Brisbane/60/2008-like strain in an intra-lineage reassortment event involving the nucleoprotein (NP) and nonstructural (NS) genes. Therefore, influenza B strains circulating worldwide continue to evolve via complex reassortment events, which contribute to their survival and the emergence of new strains. These findings highlight the need for ongoing genome-wide studies of circulating viruses and assessing the implications of these evolutionary events on the vaccines.

DOI： 10.1016/j.meegid.2018.04.016

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We investigated the genetic diversity, the circulation patterns, and risk for hospital admission of human respiratory syncytial virus (HRSV) strains in Japan between 2012 through 2015. During the study period, 744 HRSV-positive cases were identified by rapid diagnostic test. Of these, 572 samples were positive by real-time PCR; 400 (69.9%) were HRSV-A, and 172 (30.1%) were HRSV-B. HRSV-A and -B alternated as the dominant strain in the subsequent seasons. Phylogenetic tree analysis of the second hyper-variable region of the G protein classified the HRSV-A specimens into NA1 (n = 242) and ON1 (n = 114) genotypes and the HRSV-B specimens into BA9 (n = 60), and BA10 (n = 27). The ON1 genotype, containing a 72-nucleotide duplication in the G protein's second hyper-variable region, was first detected in the 2012-2013 season but it predominated and replaced the older NA1 HRSV-A in the 2014-2015 season, which also coincided with a record number of HRSV cases reported to the National Infectious Disease Surveillance in Japan. The risk of hospitalization was 6.9 times higher for the ON1 genotype compared to NA1. In conclusion, our data showed that the emergence and predominance of the relatively new ON1 genotype in Japan was associated with a record high number of cases and increased risk for hospitalization.

DOI： 10.1371/journal.pone.0192085

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report five cases of community- and hospital-acquired infections with oseltamivir- and peramivir-resistant A(H1N1)pdm09 viruses possessing the neuraminidase (NA) H275Y mutation during January-February 2016 in Japan. One case was hospitalized and was receiving oseltamivir for prophylaxis. The remaining four cases were not taking antiviral drugs at the time of sampling. These cases were geographically distant and epidemiologically unrelated. The five viruses showed ~300-fold rise in IC50 values against oseltamivir and peramivir, defined as highly reduced inhibition according to the WHO definition. Overall, the prevalence of the H275Y A(H1N1)pdm09 viruses was 1.8 % (5/282). The resistant viruses possessed the V241I, N369 K, and N386 K substitutions in the NA that have been previously reported among A(H1N1)pdm09 to alter transmission fitness. Analysis of Michaelis constant (Km) revealed that two of the isolates had reduced NA affinity to MUNANA, while the other three isolates displayed a slightly decreased affinity compared to the sensitive viruses. Further studies are needed to monitor the community spread of resistant viruses and to assess their transmissibility.

DOI： 10.1007/s11262-016-1396-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The current School Health and Safety Act in Japan states that children with influenza infection should stay home until day 6(th) after symptoms onset. This was an amendment of a previous version recommending school return on day 3 after defervescence. Here, we investigated the duration of fever and virus shedding after laninamivir treatment in 7 children infected with influenza A(H3N2) virus and 21 children with influenza B virus in relation to the school return timing recommended by the School Health and Safety Act during the 2011-2012 influenza season. Nasal discharge was collected on the first, second, and third hospital visits and virus titers were assessed by virus culture and real-time PCR. Duration of fever after laninamivir treatment was 1 day longer for influenza B than for influenza A(H3N2). Virus detection rates with 50% tissue culture infectious dose and viral RNA were highest at the first visit and gradually decreased at subsequent visits. Virus positivity rates were detectable at the time of defervescence in less than half of the enrolled patients (14.3-42.9%). Virus shedding rates were similarly low (0.0-19.0%) on day 3 or later from defervescence and on day 6 or later from fever onset (school return dates per the old and current School Health and Safety Act) regardless of the influenza type. In conclusion, despite the higher efficacy of laninamivir against A(H3N2) viruses than B viruses, viral shedding is low after return to school for both types, regardless of the version of the School Health and Safety Act.

DOI： 10.1620/tjem.238.113

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Influenza A viruses evolve at a high rate requiring continuous monitoring to maintain the efficacy of vaccines and antiviral drugs. We performed next generation sequencing analysis of 100 influenza A/H3N2 isolates collected in four Asian countries (Japan, Lebanon, Myanmar, and Vietnam) during 2012-2015. Phylogenetic analysis revealed several reassortment events leading to the circulation of multiple clades within the same season. This was particularly evident during the 2013 and 2013/2014 seasons. Importantly, our data showed that certain lineages appeared to be fitter and were able to persist into the following season. The majority of A/H3N2 viruses continued to harbor the M2-S31N mutation conferring amantadine-resistance. In addition, an S31D mutation in the M2-protein, conferring a similar level of resistance as the S31N mutation, was detected in three isolates obtained in Japan during the 2014/2015 season. None of the isolates possessed the NA-H274Y mutation conferring oseltamivir-resistance, though a few isolates were found to contain mutations at the catalytic residue 151 (D151A/G/N or V) of the NA protein. These variations did not alter the susceptibility to neuraminidase inhibitors and were not detected in the original clinical specimens, suggesting that they had been acquired during their passage in MDCK cells. Novel polymorphisms were detected in the PB1-F2 open-reading frame resulting in truncations in the protein of 24-34 aminoacids in length. Thus, this study has demonstrated the utility of monitoring the full genome of influenza viruses to allow the detection of the potentially fittest lineages. This enhances our ability to predict the strain(s) most likely to persist into the following seasons and predict the potential degree of vaccine match or mismatch with the seasonal influenza season for that year. This will enable the public health and clinical teams to prepare for any related healthcare burden, depending on whether the vaccine match is predicted to be good or poor for that season.

DOI： 10.3389/fmicb.2016.00262

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記述言語：日本語   出版者・発行元：(一社)日本ペインクリニック学会  

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記述言語：日本語   出版者・発行元：(一社)日本外来小児科学会  

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記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

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記述言語：英語   出版者・発行元：(公社)日本小児科学会  

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記述言語：日本語   出版者・発行元：(一社)日本感染症学会  

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記述言語：日本語   出版者・発行元：(一社)日本感染症学会  

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記述言語：日本語   出版者・発行元：(一社)日本感染症学会  

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記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

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記述言語：日本語   出版者・発行元：(一社)日本感染症学会  

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記述言語：日本語   出版者・発行元：(公社)日本化学療法学会  

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記述言語：日本語   出版者・発行元：(株)最新医学社  

新潟大学では,ミャンマーにてヒトインフルエンザの調査を10年以上にわたり行ってきた.これまで,ヤンゴン,ネピドー,ピンウールインの3つの都市に研究拠点を形成し,約2,000件のインフルエンザウイルスを分離し,ミャンマーでは雨季にインフルエンザが流行することが判明した.我々は若手の人材育成にも力を入れており,受け入れ研修や,現地に出向いて技術研修を行い,ミャンマーにおけるインフルエンザ研究のレベルアップを図ってきた.(著者抄録)

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2015&ichushi_jid=J00516&link_issn=&doc_id=20150415070013&doc_link_id=%2Fap7saisa%2F2015%2F007004%2F014%2F0773-0778%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fap7saisa%2F2015%2F007004%2F014%2F0773-0778%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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出版者・発行元：医薬ジャーナル社  

DOI： 10.20837/2201412096

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記述言語：日本語   出版者・発行元：(株)医薬ジャーナル社  

わが国では抗インフルエンザ薬として、M2阻害薬、ノイラミニダーゼ(NA)阻害薬、RNAポリメラーゼ阻害薬が認可されている。M2阻害薬、NA阻害薬はともに1～2日間の有熱期間の短縮効果があるが、耐性株の出現が問題となっている。現在、ヒトに感染する、A/H1N1pdm09、A/H3N2、A/H7N9はすべてM2阻害薬に耐性である。NA阻害薬については、A/H1N1でNAタンパク275位の変異による耐性株が出現しやすい。わが国では2013-2014年シーズンに札幌を中心にA/H1N1pdm09耐性株の地域流行がみられ、注目を集めている。2014年、世界に先駆け、RNAポリメラーゼ阻害薬のファビピラビル(アビガン)が条件付きで承認となった。今後も新規薬剤の開発が進むものと考えられる。(著者抄録)

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記述言語：日本語   出版者・発行元：医薬ジャーナル社  

インフルエンザウイルスのノイラミニダーゼ(NA)阻害剤への耐性は、ウイルスのNA蛋白の1アミノ酸変異により生じる。薬剤耐性ウイルスの検出には、感受性検査と、遺伝子型検査の二通りがある。最近、世界保健機関(WHO)により耐性の定義が統一され、基準株に対する50%阻止濃度(IC50)の上昇度により耐性を判定することとなった。薬剤投与後に留まらず、近年、A型H1N1亜型の市中株でNA阻害剤の耐性株が流行し、大きな問題となっている。2007～2008年にA型H1N1ソ連型の耐性株(H275Y変異株)の世界的な流行が起こり、2011年にはオーストラリアで、そして2013～2014年シーズンには、日本においてH1N1pdm09のH275Y耐性株の流行が起こった。今後も耐性株のサーベイランスを続けるとともに、新しい機序の薬剤の開発が望まれている。(著者抄録)

DOI： 10.20837/12014102451

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2014&ichushi_jid=J00065&link_issn=&doc_id=20141010120008&doc_link_id=10.20837%2F12014102451&url=https%3A%2F%2Fdoi.org%2F10.20837%2F12014102451&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：大阪 : 医薬ジャーナル社  

DOI： 10.20837/1201410101

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その他リンク： https://ndlsearch.ndl.go.jp/books/R000000004-I025844757

記述言語：日本語   出版者・発行元：東京 : 日本医事新報社  

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その他リンク： https://ndlsearch.ndl.go.jp/books/R000000004-I025692811

記述言語：日本語   出版者・発行元：(一社)日本外来小児科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外来小児科学会  

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記述言語：日本語   出版者・発行元：新潟県医師会  

Respiratory Syncytial Virus(RSV)の流行状況について、国立感染症研究所の6シーズン分の感染症発生動向調査結果を用い、気象条件との関連について検討した。2007～08シーズンから2010～11シーズンまでは、どの地域でも流行は10月頃から始まり12月にピークを迎えていたが、2011～12シーズン以降は、九州や南海では8月より始まり、11月頃には全国的にピークとなった。南日本(沖縄)では5月末～7月に流行が大きかった。気候区分ごとの毎週のRSV定点あたり報告数と週平均気温の関係は、沖縄以外では負の相関を、沖縄では正の相関を示した。RSV報告数と週平均相対湿度の関係は、沖縄では正の相関を示し、他の地域では相関がなかった。RSV報告数を目的変数、平均気温および相対湿度を説明変数とした線形回帰モデルを地域ごとに作成したところ、沖縄では気温、湿度とも正の関連、沖縄以外ではそれぞれ負、正の関連があった。

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記述言語：日本語   出版者・発行元：(一社)日本外来小児科学会  

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