Publications by authors named "Ryojiro Tanaka"

Article Synopsis
  • - The study aimed to compare neuronal injury biomarkers in cerebrospinal fluid of pediatric patients experiencing complex febrile seizures (CFS) versus those with infection-triggered acute encephalopathy (AE), specifically looking at the pathogenesis of AE with biphasic seizures.
  • - Researchers analyzed cerebrospinal fluid samples from 63 patients collected within 24 hours of neurological symptoms; results indicated significantly higher levels of the biomarkers S100B and GDF-15 in patients diagnosed with AESD and AE, respectively.
  • - The findings suggest that elevated S100B levels indicate active astrocyte involvement in AESD pathology, while increased GDF-15 points to a stronger defense response linked to more severe neurological injuries in infection-trigger
View Article and Find Full Text PDF

Whether neurologic symptoms due to SARS-CoV-2 differ from those of non-SARS-CoV-2 viral infection is unclear. We aimed to describe these neurological manifestations and compare the clinical characteristics and treatments in children with seizures and fever with or without COVID-19. We retrospectively analyzed data from 105 hospitalized children (<18 years) with clinical seizures and fever between September 2021 and August 2022.

View Article and Find Full Text PDF

Aim: Out-of-hospital cardiac arrest (OHCA) has a poor prognosis in children; however, the annual patterns of prognosis and treatment have not been fully investigated.

Methods: From the Japanese Association for Acute Medicine OHCA registry, a multicenter prospective observational registry in Japan, we identified pediatric patients (zero to 17 years old) between June 2014 and December 2019. The primary outcome was one-month survival.

View Article and Find Full Text PDF

Background: Patients with severe IgA vasculitis with nephritis (IgAVN) typically receive aggressive therapy as an initial approach. We have consistently performed combination therapy including corticosteroids and immunosuppressants as initial therapy for severe IgAVN over a 20-year-plus period, with only minor changes to the treatment protocol. This study seeks to reveal the efficacy of combination therapy for severe IgAVN.

View Article and Find Full Text PDF

Background: Patients with complex febrile seizures (CFS) often display abnormal laboratory results, unexpectedly prolonged seizures, and/or altered consciousness after admission. However, no standardized values have been established for the clinical and laboratory characteristics of CFS in the acute phase, making the management of CFS challenging. This study aimed to determine the clinical and laboratory characteristics of children with CFS during the acute phase.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates how cytokine levels change over 72 hours in children diagnosed with acute encephalopathy (AE) and febrile seizures (FS), focusing on their potential as biomarkers for differentiating the two conditions.
  • Researchers measured levels of 13 different cytokines in serum samples from seven children and found that most cytokines peaked within the first 12-24 hours after onset.
  • The results suggest that cytokine levels are generally higher in AE compared to FS, and highlight the importance of monitoring these levels to guide anti-inflammatory treatment decisions within the first day after symptoms appear.
View Article and Find Full Text PDF

Background: Prehospital termination of resuscitation (TOR) rules can be recommended for adults with out-of-hospital cardiac arrests (OHCAs). This study aimed to investigate whether adult basic life support (BLS) and advanced life support (ALS) TOR rules can predict neurologically unfavorable one-month outcome for pediatric OHCA patients.

Methods: From a nationwide population-based observational cohort study, we extracted data of consecutive pediatric OHCA patients (0-17 years old) from January 1, 2005, to December 31, 2011.

View Article and Find Full Text PDF
Article Synopsis
  • The study focused on understanding pediatric nasal foreign body cases and aimed to find ways to minimize the number of removal attempts necessary for children's comfort.
  • Researchers reviewed cases from a pediatric emergency department over two years, analyzing outcomes of different removal methods used for foreign bodies.
  • Findings showed that while most attempts were ultimately successful, the method used significantly affected the initial outcome, indicating a need for tailored approaches based on the shape of the foreign body.
View Article and Find Full Text PDF

Background: Febrile status epilepticus is the most common form of status epilepticus in children. No previous reports compare the effectiveness of treatment strategies using fosphenytoin (fPHT) or phenobarbital (PB) and those using anesthetics as second-line anti-seizure medication for benzodiazepine-resistant convulsive status epilepticus (CSE). We aimed to examine the outcomes of various treatment strategies for febrile convulsive status epilepticus (FCSE) in a real-world setting while comparing the effects of different treatment protocols and their presence or absence.

View Article and Find Full Text PDF
Article Synopsis
  • Patients with complicated focal IgA nephropathy (focal IgAN) show a better response to combination therapy, including corticosteroids, compared to diffuse IgA nephropathy (diffuse IgAN).
  • In a study of 88 children, 100% of the focal IgAN group achieved proteinuria disappearance within 2 years, significantly faster than the diffuse IgAN group, which had an 83.9% success rate.
  • The study concludes that combination therapy is effective for complicated focal IgAN, with a favorable long-term prognosis and a suggestion to shorten treatment duration to minimize side effects.
View Article and Find Full Text PDF

Background: Rituximab is the standard therapy for childhood-onset complicated frequently relapsing or steroid-dependent nephrotic syndrome (FRNS/SDNS). However, most patients redevelop FRNS/SDNS after peripheral B cell recovery.

Methods: We conducted a multicenter, randomized, double-blind, placebo-controlled trial to examine whether mycophenolate mofetil (MMF) administration after rituximab can prevent treatment failure (FRNS, SDNS, steroid resistance, or use of immunosuppressive agents or rituximab).

View Article and Find Full Text PDF
Article Synopsis
  • - The study aimed to identify early biomarkers, specifically serum GDF-15 levels, that could predict poor outcomes in pediatric patients experiencing status-epilepticus-associated-with-fever (SEF).
  • - Researchers collected blood samples from 37 SEF patients and compared GDF-15 levels during the first 24 hours post-seizure with patients having simple febrile seizures (SFS) and febrile controls, finding significantly higher GDF-15 values in the SEF group.
  • - Results suggest that elevated GDF-15 levels within the first 6 hours after seizure onset may indicate a higher risk of severe outcomes, showcasing its potential as an early predictor for patients with SEF.
View Article and Find Full Text PDF

Background: Although Lowe syndrome and Dent disease-2 are caused by Oculocerebrorenal syndrome of Lowe (OCRL) mutations, their clinical severities differ substantially and their molecular mechanisms remain unclear. Truncating mutations in OCRL exons 1-7 lead to Dent disease-2, whereas those in exons 8-24 lead to Lowe syndrome. Herein we identified the mechanism underlying the action of novel OCRL protein isoforms.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates accidental foreign body ingestion (FBI) and toxic agent ingestion (TAI) in children at a primary emergency center over a four-year period, emphasizing the need for early detection and intervention to improve patient outcomes.
  • A total of 580 children were analyzed, with a significant number (70%) under 2 years old; common ingested items included cigarettes, medicines, and various household products.
  • Findings reveal that few cases required treatment at advanced hospitals, highlighting the need for unified protocols to enhance management strategies for FBI/TAI in emergency settings.
View Article and Find Full Text PDF

Steroid pulse therapy is widely used to treat virus-associated acute encephalopathy, especially the cytokine storm type; however, its effectiveness remains unknown. We sought to investigate the effectiveness of early steroid pulse therapy for suspected acute encephalopathy in the presence of elevated aspartate aminotransferase (AST) levels.We enrolled children admitted to Hyogo Children's Hospital between 2003 and 2017 with convulsions or impaired consciousness accompanied by fever (temperature >38°C).

View Article and Find Full Text PDF

Moyamoya disease (MMD) has long been known to be associated with hypertension. While renal artery stenosis (RAS) is considered one of the causes of hypertension with MMD, most hypertension causes remain unexplained. A boy with MMD was diagnosed with renovascular hypertension (RVH) due to left-sided RAS by angiography.

View Article and Find Full Text PDF

To assess whether target temperature management (TTM) is effective for 1-month survival with favorable neurological outcome among pediatric patients who achieved return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA). The Japanese Association for Acute Medicine-out-of-hospital cardiac arrest (JAAM-OHCA) Registry, a multicenter prospective observational registry in Japan, included OHCA patients aged ≤17 years who achieved ROSC between June 2014 and December 2017. The primary outcome was 1-month survival with favorable neurological outcomes, defined as pediatric cerebral performance category 1 or 2.

View Article and Find Full Text PDF
Article Synopsis
  • * This study examined serum biomarker levels in six patients with HSES, finding that levels of various cytokines and chemokines peaked within the first 24 hours and then declined, with GDF-15 remaining notably elevated.
  • * Results showed that inflammatory markers were significantly higher in HSES patients compared to controls during the initial 24-hour period, providing new insights into the condition’s pathophysiology and suggesting potential biomarkers for diagnosis and monitoring.
View Article and Find Full Text PDF

Background: IgA nephropathy (IgAN) is characterized by predominant mesangial IgA deposition. Some patients with IgAN demonstrate IgA deposition in glomerular peripheral capillaries (cap-IgA). The clinicopathological significance of cap-IgA remains incompletely investigated in children.

View Article and Find Full Text PDF