Publications by authors named "Hiroyuki Torisu"

Background: Therapeutic drug monitoring-informed teicoplanin dosage adjustments are recommended for safe and effective use. The authors' group previously reported that only half of children reached the recommended blood concentration range at the standard teicoplanin loading dose. It has been suggested that higher loading doses are necessary; however, the usefulness and safety of high-dose loading in pediatric patients in clinical practice are unknown.

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  • The Shank3 gene, linked to autism, has several isoforms (Shank3a-f) and knockout mice lacking Shank3a/b show heightened seizure susceptibility.
  • Researchers conducted a proteomic analysis that identified 348 proteins interacting with the N-terminal and ankyrin repeat domains of Shank3a/b, highlighting significant associations with RNA-binding proteins and components involved in splicing and ribosomes.
  • The interaction between Shank3 and the protein Nono was validated, and knockout mice also displayed abnormal splicing of autism-related genes, suggesting Shank3 regulates RNA-binding protein interactions and gene expression in the developing brain.
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Microglia play versatile roles in progression of and protection against neuroinflammatory diseases. Little is known, however, about the mechanisms underlying the diverse reactivity of microglia to inflammatory conditions. We investigated how human induced microglia-like (iMG) cells respond to innate immune ligands.

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Unlabelled: Myelin oligodendrocyte glycoprotein antibody (MOG-Ab) is an autoantibody associated with acquired demyelinating syndrome (ADS) in childhood and adults. The pathogenic roles of MOG-Ab and long-term outcomes of children with MOG-Ab-associated disease (MOGAD) remain elusive. We investigated the clinical features of children with ADS during follow-up in our institute.

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  • Epileptic seizures are common in children with autism spectrum disorder (ASD), suggesting a link between the two due to hyperactive neurons.
  • This study focuses on the role of the ASD-related gene Shank3 in the development of thalamocortical neurons, finding unique expression patterns after birth.
  • Mice lacking Shank3 showed increased seizure susceptibility and reduced signaling in specific brain regions, indicating Shank3's role in preventing hyperexcitability in these neurons during early development.
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Objectives: To determine the neurodevelopmental outcomes of very-low-birth-weight infants (VLBWIs, birth weight <1,500 g) after 9 years of follow-up.

Methods: This study prospectively recruited 224 VLBWIs born from 2003 to 2009 in Kyushu University Hospital, Japan. Comorbidities of neurocognitive impairment, epilepsy, and autism spectrum disorder or attention-deficit hyperactivity disorder (ASD/ADHD) were assessed at age 3, 6, and 9 years.

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  • - The study aimed to analyze the neurophysiological aspects of acute flaccid myelitis (AFM) and its effects on motor skills in patients, focusing on limb strength outcomes.
  • - Out of 49 AFM patients, nerve conduction studies revealed that many showed serious muscle action potential reductions early on, with abnormalities increasing over the first two weeks; weaker muscle strength was linked to lower action potential levels.
  • - The findings suggest that AFM displays distinct neuronopathy characteristics and highlight the potential of nerve conduction studies in diagnosing and assessing AFM.
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Subacute sclerosing panencephalitis (SSPE) is a slow virus infection associated with mutant measles virus (MeV). The long-term outcome of antiviral treatments remains to be determined. We herein present a Japanese boy who was diagnosed with SSPE at 10 years of age.

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Polymicrogyria is a common malformation of cortical development whose etiology remains elusive. We conducted whole-exome sequencing for 124 patients with polymicrogyria and identified de novo variants in eight patients. Mutated causes functional brain diseases, including alternating hemiplegia of childhood (AHC), rapid-onset dystonia parkinsonism (RDP), and cerebellar ataxia, areflexia, pes cavus, optic nerve atrophy, and sensorineural deafness (CAPOS).

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Objective: To elucidate the clinical characteristics of Japanese pediatric patients with acquired demyelinating diseases (ADS), positive for myelin oligodendrocyte glycoprotein antibody (MOG-IgG), we conducted a nation-wide survey.

Methods: Information about pediatric patients under 18 years old with ADS was solicited with surveys sent to 323 facilities. In an initial survey, we asked whether the center had any patients with ADS, and the MOG-IgG serostatus of the patients.

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  • The study examines the long-term motor outcomes and disability levels in children affected by acute flaccid myelitis (AFM) linked to the 2015 enterovirus D68 outbreak.
  • A nationwide follow-up assessed motor function and daily living activities at various stages (acute, recovery, chronic) in 33 pediatric patients.
  • Despite many showing persistent motor deficits, overall disability levels improved significantly over three years, with better outcomes for non-motor neurological symptoms.
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  • The study focused on understanding clinical features related to PRRT2 mutations in Japanese patients suffering from benign infantile epilepsy (BIE) and paroxysmal kinesigenic dyskinesia (PKD).
  • Out of 135 patients analyzed, mutations in the PRRT2 gene were found in 104 individuals, with a higher prevalence in familial cases compared to sporadic ones, and certain mutations were identified as more common.
  • The research concluded that 68% of patients with BIE or PKD had PRRT2 mutations, and the characteristics of the epilepsy observed were consistent with clinical diagnoses.
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While the basic definition of vaccination-associated acute disseminated encephalomyelitis (ADEM) is relatively clear and easily understandable, it is often difficult to diagnose ADEM based on clinical findings alone. ADEM is actually a heterogeneous clinical syndrome that can be approximately characterized by encephalomyelitis with multiple inflammatory demyelination, autoimmune causes, and relationship with a preceding infection or vaccination. The differential diagnosis of ADEM should exclude the possibility of infectious or other autoimmune encephalitis.

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Objecive: To clarify the neuroimaging findings of children with acute flaccid myelitis during an outbreak of EV-D68 infection.

Methods: We performed a detailed review of the spinal and cranial MRI results of 54 children with acute flaccid myelitis. We focused on the range of longitudinal lesions, the localization and appearance of lesions within a horizontal section, Gadolinium-enhancement, and changes over time.

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  • Cardio-facio-cutaneous syndrome (CFCS) is a rare genetic disorder linked to cardiovascular issues, distinct facial features, and developmental delays, often caused by mutations in the BRAF gene and related pathways.
  • A case study of a 3-year-old boy with CFCS revealed he developed acute encephalopathy following a seizure, leading to severe epilepsy and cognitive decline despite intensive care.
  • The findings suggest that hyperactive ERK signaling due to BRAF mutations may increase the risk of acute encephalopathy and subsequent epilepsy in children with CFCS.
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Background: Japanese encephalitis (JE) is the leading cause of viral encephalitis with high mortality and morbidity in Asia. In Japan, however, the active recommendation of JE vaccine was retracted in 2005 because of the potential risk of acute disseminated encephalomyelitis. We aimed to determine the recent incidence of childhood-onset JE after the domestic change of vaccination policy in Japan, and to analyze the clinical features of affected children.

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Background: Leucine-rich alpha-2 glycoprotein (LRG) is a novel biomarker for inflammatory diseases. We evaluated the levels of LRG, interleukin (IL)-6, and tumor necrosis factor (TNF)-α in the cerebrospinal fluid (CSF) of children with meningitis.

Methods: CSF samples from 10 patients with bacterial meningitis (BM) and 10 with aseptic meningitis (AM) were evaluated.

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  • Advancements in exome-wide sequencing are helping to identify numerous genes linked to early-onset epileptic encephalopathy and neurodevelopmental disorders, suggesting common molecular pathways for these conditions.
  • A case study of a 45-year-old woman with neurofibromatosis type 1 and severe developmental issues revealed de novo mutations and potential interactions between NF1 and the MAGEL2 gene.
  • Research indicates that neurons derived from patients with NF1 show significantly reduced expression of specific genes, implying that mutations can disrupt the regulation of other genes involved in neurodevelopmental disorders.
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Mutations in the X-linked gene CDKL5 cause early-onset epileptic encephalopathy and severe developmental delay. Because this disorder predominantly affects females, the full clinical spectrum of male patients remains elusive. We herein report a 16-year-old boy, who suffered from intractable seizures 20 days after birth.

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  • WAGR syndrome is a rare genetic disorder linked to deletions of specific genes (WT1, PAX6, BDNF) on chromosome 11p13, leading to symptoms like kidney tumors, vision issues, genital anomalies, and cognitive delays.* -
  • A case study of a 5-year-old girl with WAGR syndrome highlighted significant growth and developmental delays but no obesity, along with a large deletion involving the aforementioned genes, and recurring hypoglycemic episodes.* -
  • Current findings suggest that the growth delays in WAGR syndrome may involve unexplained mechanisms, and more research is needed to understand the role of epigenetic factors and growth-related genes in these patients.*
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  • Acute flaccid myelitis (AFM) is a rare paralysis syndrome linked to spinal motor neuron damage, and a study conducted during a 2015 enterovirus D68 (EV-D68) outbreak in Japan identified 59 cases, primarily affecting young children with various paralysis patterns.
  • The investigation revealed a strong correlation between AFM cases and EV-D68 detection, with the virus found in several patients through different biological specimens, signaling a potential causal relationship.
  • Key prognostic factors for better outcomes included higher manual muscle strength scores before treatment, normal nerve function indicators, and negative EV-D68 status, indicating that immune responses may play a role in AFM susceptibility.
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  • Paroxysmal sympathetic hyperactivity (PSH) is a condition linked to brain injuries, particularly common in children with traumatic brain lesions, but specific features in kids with intrinsic brain lesions are less understood.
  • A case of a 3-year-old boy with cerebral palsy and epilepsy who experienced severe health issues after a respiratory infection is discussed, highlighting the progression of his brain injury and symptoms.
  • The boy showed signs of PSH along with altered autonomic function during his acute encephalopathy phase, but these symptoms subsided after receiving therapeutic hypothermia, indicating a potential link between PSH and the acute dysautonomia phase.
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  • * A case study describes a 6-year-old girl with HD and two siblings with DRPLA, highlighting the impact of these disorders in young patients.
  • * Neuroimaging and EEG studies reveal that as the diseases progress, children experience prominent brain activity changes, such as periodic epileptiform discharges, indicating severe brain function deterioration.
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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.

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Background: Alternating hemiplegia of childhood (AHC) is a rare neurological disorder that manifests recurrent attacks of hemiplegia, oculogyric, and choreoathetotic involuntary movements. De novo mutations in ATP1A3 cause three types of neurological diseases: AHC; rapid-onset dystonia-Parkinsonism (RDP); and cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss (CAPOS) syndromes. It remains to be determined whether or not a rare mutation in ATP1A3 may cause atypical phenotypes.

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