記述言語：英語   掲載種別：研究論文（学術雑誌）  

Socioeconomic status and smoking are reportedly associated with underweight and obesity; however, their associations among pregnant women are unknown. This study aimed to investigate whether socioeconomic factors, namely educational attainment, household income, marital status, and employment status, were associated with pre-pregnancy body mass index (BMI) categories, including severe-moderate underweight (BMI ≤ 16.9 kg/m2), mild underweight (BMI, 17.0-18.4 kg/m2), overweight (BMI, 25.0-29.9 kg/m2), and obese (BMI ≥ 30.0 kg/m2) among Japanese pregnant women using data from the Japan Environment and Children's Study (JECS). In total, pregnant women were included 96,751. Age- and parity-adjusted multivariable multinomial logistic regression analyses assessed socioeconomic factors and smoking associations with falling within abnormal BMI categories (normal BMI as the reference group). Lower education and lower household were associated with overweight and obesity, and, especially, lowest education and household income had relatively higher point estimate relative ratios (RRs) of 3.97 and 2.84, respectively. Regarding the risks for underweight, however, only junior high school education had a significantly higher RR for severely to moderately underweight. Regarding occupational status, homemakers or the unemployed had a higher RR for severe-moderate underweight, overweight, and obesity. Unmarried, divorced, or bereaved women had significantly higher RRs for mildly underweight status. Quitting smoking early in pregnancy/still smoking had higher RRs for all four not having normal BMI outcomes; however, quitting smoking before pregnancy had a higher RR only for obese individuals. Lower educational attainment and smoking are essential intervention targets for obesity and severe-moderate underweight prevention in younger women. Lower household income is also a necessary target for obesity.

DOI： 10.1371/journal.pone.0304844

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記述言語：日本語   出版者・発行元：(株)メディカルドゥ  

先天性筋強直性ジストロフィー(congenital myotonic dystrophy:CDM)は筋強直性ジストロフィー1型の最重症型であり,CDMの児の両親のどちらかが病的バリアントをもつ。他覚的には発症しているが,自覚症状のない例に対する遺伝学的検査は発症前診断に相当すると考えられ,予防法・治療法のない疾患では心理・社会的問題が大きく,検査前に遺伝医療部門での専門的な遺伝カウンセリングが必須である。今回遺伝学的に確定診断されたCDMの児の両親に対して遺伝医療の専門家による遺伝カウンセリングが行われないまま遺伝学的診断を行い,どのように告知するかが問題となった事例を経験した。結果告知前に遺伝カウンセリングを行ったことで告知を受容できた例を報告する。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Pathogenic variants of HECW2 have been reported in cases of neurodevelopmental disorder with hypotonia, seizures, and absent language (NDHSAL; OMIM #617268). A novel HECW2 variant (NM_001348768.2:c.4343 T > C,p.Leu1448Ser) was identified in an NDHSAL infant with severe cardiac comorbidities. The patient presented with fetal tachyarrhythmia and hydrops and was postnatally diagnosed with long QT syndrome. This study provides evidence that HECW2 pathogenic variants can cause long QT syndrome along with neurodevelopmental disorders.

DOI： 10.1038/s41439-023-00245-w

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記述言語：日本語   出版者・発行元：(一社)日本周産期・新生児医学会  

動脈管早期閉鎖(premature closure of ductus arteriosus:PCDA)は胎児期に動脈管が閉鎖し,右心不全や新生児遷延性肺高血圧をきたす病態で,予後良好とする報告が多い一方で,稀に乳頭筋断裂による三尖弁閉鎖不全を合併し重篤な経過を辿ることもある.症例は在胎38週6日,体重2,924g,経腟分娩で出生した男児.妊娠28週までの胎児心エコーで異常を認めなかったが,生後全身チアノーゼが遷延し当院へ緊急搬送された.心エコーでPCDAと診断し,乳頭筋断裂,重度三尖弁逆流も認めた.鎮静下での人工呼吸管理,一酸化窒素吸入療法,循環作動薬投与等で急性期を脱したが,三尖弁逆流は退院時にも残存した.PCDAに乳頭筋断裂による三尖弁閉鎖不全を合併した重症例では速やかに三次医療機関で集中治療を開始し,急性期を脱した後も長期間のフォローアップが必要である.(著者抄録)

DOI： 10.34456/jjspnm.59.1_77

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J04116&link_issn=&doc_id=20230524470012&doc_link_id=%2Fdy1jspnm%2F2023%2F005901%2F012%2F0077-0081%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdy1jspnm%2F2023%2F005901%2F012%2F0077-0081%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: Multimorbidity is defined as the coexistence of two or more chronic physical or psychological conditions within an individual. The association between maternal multimorbidity and adverse perinatal outcomes such as preterm delivery and low birth weight has not been well studied. Therefore, this study aimed to investigate this association. METHODS: We conducted a prospective cohort study using data from the Japan Environment and Children's Study of pregnant women between 2011 and 2014. Those with data on chronic maternal conditions were included in the study and categorised as having no chronic condition, one chronic condition or multimorbidities. The primary outcomes were the incidence of preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA). Adjusted logistic regression was performed to estimate ORs (aORs) and 95% CIs. RESULTS: Of the 104 062 fetal records, 86 885 singleton pregnant women were analysed. The median maternal age and body mass index were 31 years and 20.5 kg/m2, respectively. The prevalence of pregnant women with one or more chronic conditions was 40.2%. The prevalence of maternal multimorbidity was 6.3%, and that of PTB, LBW, and SGA were 4.6%, 8.1%, and 7.5%, respectively. Pre-pregnancy underweight women were the most common, observed in 15.6% of multimorbidity cases, followed by domestic violence from intimate partner in 13.0%. Maternal multimorbidity was significantly associated with PTB (aOR 1.50; 95% CI 1.33-1.69), LBW (aOR 1.49; 95% CI 1.35-1.63) and SGA (aOR 1.33; 95% CI 1.20-1.46). CONCLUSION: Maternal multimorbidity was associated with adverse perinatal outcomes, including PTB, LBW and SGA. The risk of adverse perinatal outcomes tends to increase with a rise in the number of chronic maternal conditions. Multimorbidity becomes more prevalent among pregnant women, making our findings important for preconception counselling.

DOI： 10.1136/bmjopen-2022-069281

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

This study aimed to document the complication status of infants with orofacial clefts born between 2011 and 2014 in Japan. This was a descriptive study using data from the Japan Environment and Children's Study. Among 103 060 pregnancies, 248 infants with orofacial clefts were included (livebirth, 239; stillbirth, 4; miscarriage, 5). The items of interest were complication status of orofacial clefts: isolated (typical orofacial clefts only); multi-malformed (orofacial clefts with unrelated major defects); syndromic (orofacial clefts with a syndrome or a chromosomal defect). Regarding the cleft subtypes, of 248 infants with orofacial clefts, 104 had cleft lip with cleft palate (CLP) (41.9%), 68 had cleft lip without cleft palate (CL) (27.4%), 58 had cleft palate without cleft lip (CP) (23.4%), and 18 were nonclassified (7.3%). In infants with CLP, the proportions of isolated, multi-malformed, and syndromic phenotypes were 73.1%, 15.4%, and 11.5%, respectively. In infants with CL, the proportions were 79.4%, 16.2%, and 4.4%, respectively. In infants with CP, the proportions were 69.0%, 13.8%, and 17.2%, respectively. The most frequently associated congenital anomaly was congenital heart disease. In infants with syndromic CLP, 41.7% had trisomy 13. In infants with syndromic CP, 80.0% had the Pierre Robin sequence. Congenital heart disease could be the most frequently associated congenital anomaly. The most frequently associated syndrome could be trisomy 13 in those with CLP and Pierre Robin sequence in those with CP.

DOI： 10.1111/cga.12496

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: In Japan, the mortality rate of extremely low birth weight (ELBW) infants is notably low in comparison with other developed countries, but the prevalence of chronic lung disease (CLD) and retinopathy of prematurity (ROP) is relatively high. This study aimed to estimate the mortality and morbidity of ELBW infants born in 2015 who were admitted to neonatal intensive care units (NICUs) in Japan and to examine the factors that affected the short-term outcomes of these infants. We also compared the mortality of ELBW infants born in 2005, 2010, and 2015. METHODS: We analyzed the mortality, morbidity, and factors related to short-term outcomes of ELBW infants, using data from 2782 infants born in 2015 and registered at NICUs in Japan. RESULTS: The mortality rates during NICU stays were 17.0%, 12.0%, and 9.8% for ELBW infants born in 2005, 2010, and 2015, respectively. Among ELBW infants born in 2015, multiple logistic regression analysis showed that short gestational age and low birthweight Z-score contributed to the increased risk of death. Births by cesarean section and antenatal corticosteroid administration were significantly associated with a reduced risk of death. Among infants who survived, CLD was observed in 53.1% and ROP requiring treatment was observed in 30.4%. CONCLUSIONS: Mortality in ELBW infants decreased significantly from 2005 to 2015. As CLD and ROP may affect quality of life and long-term outcomes of infants who survived, prevention strategies and management for these complications are critical issues in neonatal care in Japan.

DOI： 10.1111/ped.15493

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Urinary cotinine concentration (UCC) reflects smoking status. However, in pregnant women, its association with adverse birth outcomes related to fetal growth is not widely known. Thus, we aimed to explore this relationship by focusing on dose-response relationships. We investigated 86,638 pregnant women enrolled between 2011 and 2014 in a prospective cohort study in Japan and observed three birth outcomes (preterm birth, low birth weight, and small-for-gestational age). We measured UCC in the second or third trimester, and categorized the participants using cut-off values (negative cotinine concentration, passive cotinine concentration, and active cotinine concentration corresponding to non-smokers, passive smokers, and active smokers, respectively). Logistic regression analyses were conducted to evaluate the risks, and dose-response relationships were visualized using restricted cubic spline curves. Analyses based on self-reported smoking status were also performed. We found that in low active and highly active cotinine concentrations, the adjusted odds ratios (aORs) of birth outcomes were significantly increased (preterm birth, 1.24 [95% CI 1.06-1.46], 1.39 [95% CI 1.19-1.62]; low birth weight, 1.40 [95% CI 1.24-1.58], 2.27 [95% CI 2.05-2.53]; small-for-gestational age, 1.35 [95% CI 1.19-1.52], 2.39 [95% CI 2.16-2.65]). Restricted cubic spline curves demonstrated risk elevations in the active cotinine concentration range. Our research revealed dose-response relationships between UCC during pregnancy and the risks of preterm birth, low birth weight, and small-for-gestational age. Measurement of UCC to ascertain smoking status during pregnancy may be a useful approach for predicting the risks of these birth outcomes.

DOI： 10.1016/j.envres.2022.114302

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The extremes of maternal pre-pregnancy body mass index (BMI) are known to be risk factors associated with obstetric and adverse perinatal outcomes. Among Japanese women aged 20 years or older, the prevalence of underweight (BMI < 18.5 kg/m2) was 11.5% in 2019. Maternal thinness is a health problem caused by the desire to become slim. This study aimed to investigate the association between the severity of maternal low pre-pregnancy BMI and adverse perinatal outcomes, including preterm birth (PTB), low birth weight (LBW), and small-for-gestational age (SGA). METHODS: We conducted a prospective cohort study using data from the Japan Environment and Children's Study, which recruited pregnant individuals between 2011 and 2014. Pre-pregnancy BMI was categorized as severe-moderate underweight (BMI < 16.9 kg/m2), mild underweight (BMI, 17.0-18.4 kg/m2), low-normal weight (BMI, 18.5-19.9 kg/m2), high-normal weight (BMI, 20.0-22.9 kg/m2), overweight (BMI, 23.0-24.9 kg/m2), and obese (BMI ≥ 25.0 kg/m2). The high-normal weight group was used as the reference for statistical analyses. Adjusted logistic regression was performed to evaluate the association between pre-pregnancy BMI and PTB, LBW, and SGA. RESULTS: Of 92,260 singleton pregnant individuals, the prevalence was 2.7% for severe-moderate underweight, 12.9% for mild underweight, and 24.5% for low-normal weight. The prevalence of adverse outcomes was 4.6% for PTB, 8.1% for LBW, and 7.6% for SGA. The adjusted odds ratios (aORs) for PTB were 1.72 (95% confidence interval [CI], 1.46-2.03) for severe-moderate underweight and 1.26 (95% CI, 1.14-1.39) for mild underweight. The aORs of LBW were 2.55 (95% CI, 2.27-2.86) for severe-moderate underweight, 1.64 (95% CI, 1.53-1.76) for mild underweight, and 1.23 (95% CI, 1.16-1.31) for low-normal weight. The aORs of SGA were 2.53 (95% CI, 2.25-2.84) for severe-moderate underweight, 1.66 (95% CI, 1.55-1.79) for mild underweight, and 1.29 (95% CI, 1.21-1.38) for low-normal weight. CONCLUSIONS: A dose-response relationship was found between the severity of low pre-pregnancy BMI and PTB, LBW, and SGA. Even low-normal BMI (18.5-19.9 kg/m2) increased the risk of LBW and SGA. This study provides useful information for pre-conception counseling in lean individuals.

DOI： 10.1186/s12884-022-04418-3

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/ped.14984

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Iron deficiency during infancy is associated with poor neurological development, but iron overload causes severe complications. Appropriate iron supplementation is therefore vital. Reticulocyte hemoglobin content (RET-He) provides a real-time assessment of iron status and chracterezes hemoglobin synthesis in preterm infants. However, the existing literature lacks detailed reports assessing chronological changes in RET-He. The aim of this study was to assess the chronological changes in RET-He during oral iron dietary supplementation, and concomitant therapy with recombinant human erythropoietin (rHuEPO) in preterm very low birthweight infants. METHODS: Very low birthweight infants, admitted to our neonatal intensive care unit were analyzed retrospectively. Hemoglobin (Hb), reticulocyte percentage (Ret), mean corpuscular volume, RET-He, serum iron (Fe), and serum ferritin were recorded. Data at birth (T0), the initial day of rHuEPO therapy (T1), the initial day of oral iron supplementation (T2), 1-2 weeks (T3), 3-4 weeks (T4), 5-6 weeks (T5), and 7-8 weeks (T6) from the initial day of oral iron supplementation were extracted, and their changes over time were examined. RESULTS: Reticulocyte hemoglobin content was highest at birth and declined rapidly thereafter, especially after starting rHuEPO therapy. There was no upward trend in RET-He after the initiation of oral iron supplementation, with a slower increase during 5-6 weeks after the initiation of iron therapy. CONCLUSIONS: During the treatment of anemia of prematurity, low RET-He levels may be prolonged. Anemia of prematurity should therefore be assessed and treated on a case-by-case basis, while considering the iron metabolic capacity of preterm infants.

DOI： 10.1111/ped.15330

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/ped.14855

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/ped.14625

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/ped.14583

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DOI： 10.21203/rs.3.rs-530936/v1

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記述言語：日本語   出版者・発行元：眼科臨床紀要会  

背景:小児特発性頭蓋内圧亢進症(PIIH)は思春期以前に発症する、頭部画像にて脳圧亢進所見や占拠性病変を認めない頭蓋内圧亢進症である。症例:6歳女児。VATER症候群。低身長に対して成長ホルモン(GH)治療中。健診で内斜視を指摘され受診。精神発達遅滞のため、視力測定困難。眼位は20Δ内斜視で、調節麻痺下屈折値は両眼に強度の遠視、眼底検査でうっ血乳頭を認めた。MRIで脳圧亢進所見や占拠性病変は認めないが、脳脊髄圧は260mmH2Oと高値。PIIHと診断し、アセタゾラミド内服を開始した。2ヵ月後、脳脊髄圧は160mmH2Oと正常化し、2年後うっ血乳頭は改善を認めた。眼位は間欠性内斜視に改善した。結論:内斜視の指摘を契機に受診しPIIHと診断し、治療によりうっ血乳頭改善を認めた。自覚症状を聴取できず診断が難しい症例だが、乳頭所見と髄液圧にて診断可能であった。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Although imatinib is the first-line of therapy for Philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML), in Japan, it is recommended by the manufacturer that lactating women treated with imatinib mesylate for CML should discontinue breastfeeding their infants. CASE: A 32-year-old pregnant patient was diagnosed with Ph-positive CML at 13 weeks of gestation. She received imatinib (400 mg/day) after 28 weeks of gestation. A female infant was delivered at a gestational age of 35 weeks and 3/7 days after preterm premature rupture of membranes. It was decided to feed only colostrum to the infant and formula feeding was done subsequently because of the risk of the transfer of imatinib to breast milk. The milk/plasma (M/P) ratio and the relative infant dose (RID) for imatinib were calculated to be 0.35 and 1.4%, respectively at 5 days of life. Moreover, the serum level of imatinib in the child of age 5 days was 27 ng/mL, which was much lower than the target trough value for CML (1000 ng/mL). CONCLUSION: The M/P ratio and RID values for maternally administered imatinib were within the safe range for breastfeeding, as reported in previous studies. In addition, it was found that the serum concentration of imatinib in the child was relatively low during short-term breastfeeding.

DOI： 10.1177/1078155220948942

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Clinical diagnosis of transient abnormal myelopoiesis (TAM) relies on the detection of characteristic blasts and leukocytosis in peripheral blood. We report two patients of trisomy 21 with TAM with hypereosinophilia, who had neither circulating blasts nor leukocytosis. Genetic testing of polymorphonuclear leukocytes isolated from whole blood revealed heterozygous mutations in GATA1, suggesting that the mutations were harbored in increased eosinophils. Both patients had direct hyperbilirubinemia and one died of liver fibrosis. Our findings emphasize the importance of screening for GATA1 mutations in neonatal infants with Down syndrome and hypereosinophilia even if blasts are not detected in peripheral blood smears.

DOI： 10.1080/08880018.2020.1826070

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記述言語：日本語   出版者・発行元：(株)診断と治療社  

在胎38週3日、出生体重3,128gで出生した男児。出生時より吸気性喘鳴があり啼泣時に陥没呼吸、酸素化不良を認め、精査より先天性両側声帯麻痺と診断。閉塞性無呼吸や哺乳不良も認めたが日齢13にhigh flow nasal cannula(HFNC)装着後、症状軽減し哺乳量は増加した。しかしHFNCでは通院移動を含めた在宅管理が困難であり、日齢77にnasal continuous positive airway pressure(NCPAP)へ変更。経管栄養併用し、日齢104に退院。重篤な呼吸障害のない先天性両側声帯麻痺に対し非侵襲的陽圧換気療法が治療選択肢となりうる。(著者抄録)

DOI： 10.34433/j00642.2021054057

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2020&ichushi_jid=J00642&link_issn=&doc_id=20201117090023&doc_link_id=%2Fae4shond%2F2020%2F008312%2F024%2F1813-1816%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fae4shond%2F2020%2F008312%2F024%2F1813-1816%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：日本小児臨床薬理学会  

高緯度・寒冷な地理的条件によりビタミンD(VitD)欠乏のリスクが高い北海道道北地域にて、早産児を含む新生児・乳児延べ137名の臍帯血および血清25-hydoroxyvitamin D(25OHD)値を評価し、一部の早産児に対しVitDサプリメントの効果を検討した。早産児60名を含む新生児106名の臍帯血25OHD値は在胎週数、出生体重・プロポーション、季節にかかわらず著しく低値であり、全体の99%が12ng/mL未満の欠乏状態、52%は測定感度未満であった。また生後5ヵ月までの乳児期においても大半がVitD欠乏状態であった。VitD 400単位/日を投与した早産児13例の多くは20ng/mL以上まで上昇したが、3例では十分な上昇がみられなかった。当地域における新生児のVitD欠乏は深刻であり、積極的なVitD投与が必要である。一方、その至適投与量についてはさらなる検討が必要である。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Basal meningoceles are rare congenital defects and often clinically occult until they result in life-threatening complications. Therefore, it is important to know the diagnostic clues to early diagnosis. CASE PRESENTATION: We describe three cases of congenital basal meningocele in a 3-year-old Japanese boy, a 1-month-old Japanese baby boy, and a 10-month-old Japanese baby girl. One of our patients died of sepsis due to traumatic rupture of the meningocele during nasal suction. His meningocele remained undiagnosed until it resulted in the fatal complication. The other patients underwent surgical repair without any complications. Their meningoceles were complicated by midfacial anomalies including cleft palate and hypertelorism, or a sign of nasal obstruction such as snoring. CONCLUSIONS: These clinical features may be a clue to the early diagnosis of congenital basal meningocele, which enables its safe preoperative management and provides an opportunity for surgical repair before the condition results in serious complications.

DOI： 10.1186/s13256-017-1497-7

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：旭川医科大学  

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2017&ichushi_jid=J03513&link_issn=&doc_id=20171127380020&doc_link_id=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F5818&url=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F5818&type=%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%EF%BC%9A%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%E5%AD%A6%E8%A1%93%E6%88%90%E6%9E%9C%E3%83%AA%E3%83%9D%E3%82%B8%E3%83%88%E3%83%AA_AMCoR&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80003_3.gif

記述言語：英語  

DOI： 10.1097/MEG.0000000000000504

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Short-rib polydactyly syndrome type III is an autosomal recessive lethal skeletal ciliopathy, which is phenotypically similar to nonlethal asphyxiating thoracic dystrophy. Mutations in DYNC2H1 have been identified in both of these disorders, indicating that they are variants of a single disorder. However, short-rib polydactyly syndrome type III is the more severe variant. Here, we report novel compound heterozygous mutations in DYNC2H1 (p.E1894fsX10 and p.R3004C) in a patient with typical short-rib polydactyly syndrome type III phenotype. R3004 is located within the microtubule-binding domain of DYNC2H1, and its substitution is predicted to disrupt the interaction with microtubules. Considering the severe phenotype of our patient, our findings suggest that R3004 may be a key residue for the microtubule-binding affinity of dynein.

DOI： 10.1111/cga.12098

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: There is little available data on airway humidity during high-frequency ventilation (HFV). The purpose of this study is to evaluate the temperature drop in an endotracheal tube (ETT) during HFV. METHODS: We examined the airway temperature in a neonatal HFV system using Babylog® 8000 plus. We measured the temperature change of inspired gases in the ETT under various oscillatory frequencies and oscillatory volumes with a fixed base flow. The temperatures in the ETT during HFV were compared with the temperatures during conventional intermittent positive pressure ventilation (IPPV). RESULTS: As the oscillatory frequency was increased and the oscillatory volume (VThf) decreased, the difference in temperature between the Y piece and the inlet of an artificial lung in the ETT (ETT outside of body) increased. However, as the oscillatory frequency increased, there was no difference in the ETT temperature under constant oscillatory volume. In contrast, as the oscillatory volume was decreased, the difference in temperature in the ETT was greater under constant oscillatory frequency. Moreover, the temperature drop in the ETT with HFV was lower than that in the IPPV temperature with a similar respiratory volume. CONCLUSIONS: The temperature change in the ETT was not dependent on the oscillatory frequency when the oscillatory volume was fixed; however, the temperature was dependent on the oscillatory volume when the oscillatory frequency was fixed.

DOI： 10.1002/ppul.22973

PubMed

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

致死的とされてきた重症骨系統疾患5例の経過を報告した。診断名は症例1が屈曲肢異形成症(11歳女児)、症例2が扁平椎異形成症Torrance型(3歳女児)、症例3が分節異常骨異型性症Rolland-Desbuquois型(1歳4ヵ月男児)、症例4が耳口蓋指症候群2型(1歳2ヵ月男児)、症例5が短肋骨多指症候群3型(男児)で、肺低形成が高度であった症例5は生後1時間で死亡したが、他の4例は生存中である。5例中4例は胎児期に骨系統疾患を疑い、最近の3例では胎児CTが施行され、家族との話し合いがもたれた。全例出生時に気管挿管などの蘇生を要し、生存例では気管切開を行った。気管軟化症を合併した症例1と2では人工呼吸管理継続中であるが、上気道狭窄が呼吸障害の主体であった症例3と4は人工呼吸器や酸素から離脱できた。生存4例中3例は在宅医療に移行したが、合併症や療育などの課題も残されている。

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although physical properties of neonatal-infantile stratum corneum (SC) change drastically after birth, precise developmental alterations of specific sites have not been fully elucidated. OBJECTIVE: To determine the longitudinal alterations of neonatal-infantile SC functions and components of upper thighs and diaper-covered buttocks during the first year of life. The data were compared with those of adults. METHODS: Nineteen full-term neonates and their mothers were subjected to the measurements. Skin hydration, water sorption/retention capacity, TEWL were measured. Superficial SC analyses for NMF, ester binding sebum, and free fatty acids were performed by ATR-FTIR spectrometer. Total amount of ceramides (CERs) and CER subclasses were analyzed by NPLC-ESI-MS. RESULTS: SC hydration of neonatal thighs was lower than that of their mothers, which rapidly increased during the 1st month. Skin hydration of neonatal buttocks was similar to that of their mothers. This also rapidly increased during the 1st month. The neonatal TEWL was less than those of their mothers indicating more efficient barrier function at both sites, which significantly increased during the 1st year development. This was mostly correlated decreased in the ω-hydroxy fatty acid-esterified CERs. Superficial ester-binding sebum content of neonates was similar to that of their mothers, which significantly decreased during the measurement; the decrease was more marked on buttocks. Neither NMF nor FFA of the superficial SC showed significant alteration during the 1-year development. CONCLUSION: Our results indicate that physical functions and components of neonatal-infantile SC show considerable alterations between diaper-covered buttocks and upper thighs during the 1st year development.

DOI： 10.1016/j.jdermsci.2013.08.015

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND AND PURPOSE: A thrombosed dural sinus malformation (DSM) is a rare condition, the clinical features of which have not yet been completely characterized. Here, we describe the clinical course of a patient with a thrombosed DSM and discuss the outcomes in live birth cases from a review of the literature. CASE DESCRIPTION: An ultrasonography examination of a 32-year-old woman at 25 weeks' gestation indicated a fetal posterior fossa mass. The size of the intracranial mass remained constant during the second trimester and was observed to decrease from 33 weeks of gestation. A postnatal diagnosis of thrombosis in the dural sinus was established by magnetic resonance imaging and venography. No brain damage or hydrocephalus was noted. Although the circumference of the infant's head was enlarged at birth, her neurological outcome was normal at 1 year of age. CONCLUSIONS: Although normal cranial circumference is reportedly an essential factor for a favorable prognosis, the patient in this report with a cranial circumference at + 2.0 SD (35.6 cm) had a favorable prognosis. Further studies focused on improving clinical diagnostic accuracy in this rare entity will facilitate appropriate counseling.

DOI： 10.1111/jon.12099

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Since the mid-1980s, there have been increasing reports of severe invasive group A streptococcal (GAS) disease in children and adults. There are few reports, however, of neonatal invasive disease, particularly neonatal pleural empyema caused by GAS. Although many mechanisms have been reported for the pathophysiology of invasive GAS infections, similar reports for neonates were unable to be located. Reported herein is the case of a 3-day-old girl with pleural empyema caused by GAS that demonstrated a high invasive capacity for human epithelial cells.

DOI： 10.1111/ped.12061

PubMed

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記述言語：日本語   出版者・発行元：名寄市立総合病院  

症例は日齢10の男児で、血便、胆汁性嘔吐を主訴に、旭川医大NICUへ緊急搬送となった。消化管造影やエコー検査では外科疾患は否定的で、禁乳開始と同時に血便と胆汁性嘔吐は消失した。臨床経過から新生児-乳児消化管アレルギーが疑われ、日齢14より加水分解乳の哺乳を開始し、症状の再燃なく経過良好にて、日齢16に当科転院となった。日齢17より肉眼的血尿が再度出現し、日齢21より更に抗原性の低いアミノ酸乳の哺乳に変更したところ症状は消失し、日齢29に退院となった。ALSTの結果が日齢24に到着し、陽性の判定であったことから、新生児-乳児消化管アレルギーの診断が確定した。

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2013&ichushi_jid=J03201&link_issn=&doc_id=20130822210008&doc_link_id=https%3A%2F%2Fsapmed.repo.nii.ac.jp%2Frecords%2F13684&url=https%3A%2F%2Fsapmed.repo.nii.ac.jp%2Frecords%2F13684&type=%E6%9C%AD%E5%B9%8C%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%EF%BC%9A%E6%9C%AD%E5%B9%8C%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%E5%AD%A6%E8%A1%93%E6%A9%9F%E9%96%A2%E3%83%AA%E3%83%9D%E3%82%B8%E3%83%88%E3%83%AA_ikor&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80183_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: As the presence of fetal hemoglobin (HbF) affects the accuracy of hemoglobin A1c (HbA1c) analysis methods, HbA1c measurement may not be a good indicator for patients with neonatal diabetes mellitus, whereas glycated albumin (GA) may be a good indicator. OBJECTIVE: To investigate whether total glycated hemoglobin (GHb) or HbF-adjusted HbA1c (adj-HbA1c) can act as a glycemic control marker in infants. SUBJECTS AND METHODS: Plasma glucose (PG), GA, HbF, GHb measured using the affinity method, and HbA1c measured using the latex-immunoturbidimetry (LA) or the high-performance liquid chromatography (HPLC) methods were determined in 26 full-term newborn infants aged 4-234 d. Adj-HbA1c was calculated as HbA1c/(total Hb - HbF). RESULTS: GHb, adj-HbA1c measured using the LA and the HPLC methods were 4.8 ± 0.5%, 4.5 ± 0.5%, and 4.7 ± 0.6%, respectively. GA was most positively correlated with PG (r = 0.696, p < 0.0001). GHb was positively correlated with both PG (r = 0.479, p = 0.013) and GA (r = 0.727, p < 0.0001). Adj-HbA1c measured using the LA method was positively correlated with GA (r = 0.465, p = 0.017), but not PG (r = 0.304, p = 0.132). Adj-HbA1c measured using the HPLC method was correlated with neither PG (r = -0.077, p = 0.710) nor GA (r = 0.360, p = 0.071). CONCLUSIONS: GHb measured using the affinity method may be a useful glycemic control marker in infants. Although adj-HbA1c measured using the LA method was correlated with GA, it may not be a practical measure because it was not correlated with PG and determining HbF levels using HPLC method can be troublesome. Adj-HbA1c measured using the HPLC method should not be used as a glycemic marker in infants.

DOI： 10.1111/pedi.12013

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Glycated albumin (GA) reflects glycemic control in patients with neonatal diabetes mellitus (NDM). However, GA in NDM patients is apparently low in relation to glycemia. OBJECTIVE: To establish the reference intervals for GA in healthy infants. SUBJECTS AND METHODS: Fifty-eight healthy, full-term newborn infants were used to define the GA reference values and to investigate its relationship to plasma glucose (PG) and serum albumin. The infants were categorized into three groups according to age: group A, 5 (4-6) median (range) d: n = 18; group B, 33 (30-38) d: n = 19; and group C, 181 (50-352) d: n = 21. We also studied 212 non-diabetic adults [group D, 53 (28-78) yr old] and the 5 NDM patients previously reported for GA comparisons. RESULTS: In the infants, GA was strongly positively correlated with logarithmic transformation of age [log (age)] (p = 0.831, p < 0.0001). The GA in groups A, B, C, and D were 7.3 ± 1.0%, 8.6 ± 1.1%, 10.9 ± 0.8%, and 14.0 ± 1.1%, respectively. The GA was more strongly positively correlated with serum albumin (r = 0.768, p < 0.0001) than with PG (r = 0.596, p < 0.0001). When GA levels were compared with the age-dependent reference values, GA in the transient NDM patient was normalized although GA in the four permanent NDM patients decreased but remained high after insulin therapy. CONCLUSIONS: This study showed that the reference range for GA in infants is lower than that of adults and increases with age, with which we confirmed that GA in the NDM patients reflected the clinical course. Consequently, GA in NDM patients should be compared with the age-based reference values to assess the accurate glycemic status.

DOI： 10.1111/j.1399-5448.2012.00895.x

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Heterozygous COL2A1 mutations create a group of skeletal dysplasias collectively termed type II collagenopathies. Sporadic cases of type II collagenopathies are almost exclusively caused by de novo mutations. Very few cases with intrafamilial recurrence due to germinal mosaicism have been known. We report here on a family in which a severe form of skeletal dysplasia was recurrent in two sibs whose phenotype was most consistent with platyspondylic lethal skeletal dysplasia Torrance type (PLSD-T). A COL2A1 analysis showed that the two sibs had a heterozygous mutation in the encoded triple helical region of COL2A1, c.3545G>A (p.Gly1182Asp) in exon 50. The parents did not consent to a molecular analysis; however, the presence of the same mutation in the two sibs is proof of germinal mosaicism in one of the parents. PLSD-T has been shown to arise from a heterozygous dominant negative COL2A1 mutation in the encoded C-propeptide region. However, our observation suggests that the phenotype is also caused by a COL2A1 mutation in the encoded C-terminal triple helical region.

DOI： 10.1002/ajmg.a.35509

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Disseminated neonatal herpes simplex virus (HSV) infection causes a typical systemic inflammatory response syndrome and has a high mortality rate. However, the validity of anti-inflammatory intervention against this condition remains unknown. OBJECTIVES: We sought to demonstrate the sequential changes in the pathophysiology of disseminated neonatal HSV infections. STUDY DESIGN: The HSV serum copy number as well as high-mobility group box 1 (HMGB1) and cytochrome c concentrations, which predict the severity and mortality rate of sepsis, were sequentially evaluated in a patient with disseminated neonatal HSV infection caused by HSV-2. RESULTS: As the patient presented with evidence of hyper-inflammation and severe illness, we empirically undertook anti-inflammatory intervention that included the administration of prednisolone, high-dose immunoglobulin, and blood exchange therapy in addition to high-dose acyclovir (ACV) therapy. The patient survived without significant neurological sequela. We found that (1) the serum concentrations of both HMGB1 and cytochrome c were extremely high, (2) temporal increases in these biomarkers were observed after admission, and (3) interestingly, the increase in HMGB1 level preceded that of cytochrome c. These results suggested that the pathophysiology of this condition changed sequentially in a dramatic manner, and the timing of our anti-inflammatory intervention was prior to the transition of pathological status from hyper-inflammation to massive apoptosis. CONCLUSIONS: Anti-inflammatory intervention may only be effective if it is undertaken during the early phase of disseminated neonatal HSV infections.

DOI： 10.1016/j.jcv.2011.12.017

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

To investigate the correlation between maternal and fetal angiotensin-converting enzyme gene insertion or deletion polymorphism and birth size, angiotensin-converting enzyme gene insertion or deletion polymorphisms of 470 Japanese pairs of mothers and infants were genotyped. The relationships between maternal and fetal angiotensin-converting enzyme gene insertion or deletion polymorphisms and birth sizes (weight, length, head circumference, and the incidence of small-for-gestational age status) were analyzed. No relationship between fetal angiotensin-converting enzyme genotype and birth size was observed. In contrast, the incidence of small-for-gestational age status in babies whose mothers had 1 or 2 deletion alleles was greater than that in babies whose mothers had 2 insertion alleles (7% vs 3%, P  =  0.045). Maternal deletion allele of angiotensin-converting enzyme is associated with fetal growth restriction in the Japanese normal population.

DOI： 10.2350/11-09-1092-OA.1

PubMed

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記述言語：日本語   出版者・発行元：日本小児腎不全学会  

MRI所見から在胎時または出生直後に発症したと考えられた脳室内出血(IVH)を合併した先天性ネフローゼ症候群(CNS)の女児例(4ヵ月女児)を経験した。本例の病態として、CNSに伴う凝固異常や低アルブミン血症に加え、胎児ジストレスや緊急帝王切開といった要素が関与したことにより血栓形成、深部静脈閉塞をきたし、脳室から還流する静脈圧が高まり、IVHに至ったことが推測された。易血栓傾向を伴うCNS患児に対しては、生後早期から脳血栓症由来のIVH発症に注意することが必要であると考えられた。

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

All patients with terminal deletion of chromosome 15q have been reported to show intrauterine growth retardation, postnatal growth retardation, abnormal facial appearance and developmental delay. Haploinsufficiency of IGF1R was considered to be responsible for these symptoms. However, it is difficult to explain other symptoms seen in some of the patients, such as congenital heart defects by the absence of IGF1R alone. Here, we reported a patient with congenital heart defects and a 5.78 Mb terminal deletion of chromosome 15q detected by array-CGH. Among the patients reported to share congenital heart defects and terminal deletion of chromosome 15q, our patient had the smallest deletion. Evaluating the deletion map, NR2F2 was considered a candidate gene contributing to congenital heart defects in patients with terminal deletion of chromosome 15q.

DOI： 10.1016/j.ejmg.2010.12.004

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Campomelic dysplasia (CD) is a rare and usually fatal congenital skeletal disorder with respiratory failure. The SOX9 gene has been cloned as a candidate gene for CD. Here, we report the cases of 2 Japanese patients with CD who have survived for over 5 years. Molecular investigations revealed novel frameshift mutations in SOX9 in these patients; a single G insertion in 1 allele at nucleotide 261 (261-262insG) and a single C insertion in 1 allele at nucleotide 888 (888-889insC). The predicted protein of 261-262insG may lack more than 80% composition of the normal SOX9 protein, including the SRY high mobility group (HMG) domain and the transactivation (TA) domain; the predicted protein of 888-889insC may not contain the normal TA domain. Although it has been reported that most patients with CD die during the neonatal period, our patients have survived for a long time, despite putative severely impaired SOX9 proteins.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: In approximately 60% of infants with posthemorrhagic hydrocephalus (PHH), ventricular dilation resolves by unknown intrinsic mechanisms, without the need for a shunt operation. A pathological hallmark of PHH is extensive deposition of extracellular matrix (ECM) proteins in the subarachnoid space. Our previous study revealed that matrix metalloproteinase (MMP)-9, which degrades ECM proteins, may play an important role in the resolution of ventricular dilation. MMP-9 is known to be induced by hepatocyte growth factor (HGF) in various cell lines. AIMS: The aim of this study is to confirm our earlier finding that MMP-9 contributes to the resolution of PHH, and to investigate whether HGF also contributes to this process. STUDY DESIGN: Cerebrospinal fluid (CSF) samples were collected from 13 infants who developed ventricular dilation after intraventricular hemorrhage (IVH). Of these infants, 9 exhibited resolution of ventricular dilation without shunt operation; however, 4 infants had to be treated with shunt operation. The CSF levels of MMP-9 and HGF were measured using an enzyme immunoassay. RESULTS: Significantly higher CSF levels of MMP-9 and HGF were detected in patients in whom the ventricular dilation resolved without shunt operation than in those with progressive ventricular dilation (MMP-9: median, 128ng/ml; range, 47-900ng/ml vs median, 50ng/ml; range, 12-110ng/ml; p<0.05; HGF: median, 2.42ng/ml; range, 0.81-7.04ng/ml vs median, 1.42ng/ml; range, 0.67-3.87ng/ml; p<0.05). CONCLUSIONS: Our results indicate that MMP-9 and HGF may participate in the resolution of ventricular dilation following IVH.

DOI： 10.1016/j.earlhumdev.2010.03.007

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

IGF-II associates with feto-placental growth in rodent and human. We determined three tag-single nucleotide polymorphisms (SNPs) to investigate haplotype frequency of IGF2 relative to size at birth in 134 healthy Japanese infants. In addition, a total of 276 healthy infants were investigated to determine whether common genetic variation of IGF2 might contribute to feto-placental growth using haplotype analysis. Further, quantitative methylation analysis of the IGF2/H19 was performed using the MassARRAY Compact system. In the initial study, the frequency of haplotype CTG from the paternal allele in small for date (SFD) infants was significantly higher than that in non-SFD infants (p = 0.03). In a second study, the CTG haplotype infants exhibited significantly lower birth length, weight, and placental weight compared with non-CTG infants. Further, the number of infants less than -1.5 SD (SD) birth weight in CTG haplotype was higher than those in non-CTG infants. There was no significant difference in the methylation status of H19/IGF2 in the two haplotypes. In conclusion, inheriting the IGF2 CTG haplotype from a paternal allele results in reduced feto-placental growth, but it is not associated with the methylation status of IGF2/H19.

DOI： 10.1203/PDR.0b013e3181a9e818

PubMed

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その他リンク： http://amcor.asahikawa-med.ac.jp/modules/xoonips/detail.php?id=19390492

記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Transforming growth factor (TGF)-beta1, a cytokine released into the cerebrospinal fluid (CSF) after intraventricular hemorrhage (IVH), stimulates the expression of the components of the extracellular matrix (ECM), which causes progressive ventricular dilatation by impaired CSF absorption. Matrix metalloproteinase-9 (MMP-9), a proteinase involved in the removal of ECM proteins, has been shown to contribute to the resolution of progressive ventricular dilation after IVH. The aim of this study is to clarify the mechanism by which MMP-9 is expressed following IVH. Cultured human meningeal cells were treated with human recombinant TGF-beta1. RT-PCR demonstrated that TGF-beta1 induced MMP-9 expression in the meningeal cells in a dose-dependent manner. The TGF-beta1-induced MMP-9 expression was attenuated in the presence of either MEK or Smad 3 inhibitor. Our data indicated that MMP-9 is released into the CSF from meningeal cells in response to TGF-beta1, most probably through the activation of ERK and Smad pathways.

DOI： 10.1016/j.bbrc.2009.04.038

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Little data are available on airway humidity during high-frequency ventilation (HFV). Our purpose is to evaluate the airway humidification during HFV. METHODS: We examined the airway humidification and temperature in a neonatal HFV system using Babylog 8000 plus. The absolute humidity (AH), relative humidity (RH), and temperature at different sites and under different HFV conditions were compared with those during conventional intermittent positive pressure ventilation (IPPV). RESULTS: The mean AH and RH at the patient end of the respiratory circuit under 37 degrees C in the humidification chamber (HC) during HFV were less than 35 mg/L and 65%, respectively, while those during IPPV were 42.3 mg/L and 96.8%, respectively. The humidification at the outlet of the HC was similar results. Moreover, during HFV an increase in the bias-flow of ventilator led to a further decrease in the humidity at the patient end of respiratory circuit and the outlet of HC. It was necessary to set the temperature in the HC at >39 degrees C to maintain adequate humidity at the HC and the patient end of respiratory circuit during HFV. An increase in the incubator temperature led to an increase in the temperature at the patient end of the respiratory circuit. The temperature at the patient end of the respiratory circuit was about 39-40 degrees C when the incubator temperature was 35-37 degrees C. CONCLUSIONS: The airway humidification at the patient end of respiratory circuit and the outlet of HC in HFV were poorer than those in IPPV. However, the adequacy of humidification and safety in HFV remain to be demonstrated in clinical practice.

DOI： 10.1002/ppul.20990

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(公社)日本新生児成育医学会  

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2009&ichushi_jid=J02568&link_issn=&doc_id=20090223470006&doc_link_id=%2Fcr5newbo%2F2009%2F002101%2F006%2F0033-0038%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcr5newbo%2F2009%2F002101%2F006%2F0033-0038%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本周産期・新生児医学会  

新生児多血症に対する部分交換輸血療法を再評価するため、従来手技の5%アルブミン液を用いた11例(男6例・女5例:A群)と、最近採用している生理食塩水使用の9例(男6例・女3例:B群)で治療効果を比較した。その結果、治療前の静脈血ヘマトクリット値はA群平均73%、B群73%、治療翌日はそれぞれ57%、58%で、いずれも有意な低下を示し、両群間に有意差はなかった。また追加の部分交換輸血を要した例はなかった。血清総蛋白値は治療前がA群平均5.5g/dl、B群5.3g/dl、治療後はそれぞれ5.3g/dl、5.1g/dl、血清アルブミン値は治療前がA群平均3.3g/dl、B群3.1g/dl、治療後はそれぞれ3.3g/dl、3.0g/dlで、いずれも治療前後で有意な変化はなく、両群間の有意差もなかった。多血症に対する部分交換輸血製剤として、生理食塩水はアルブミンと同等に有効であることが示された。

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2008&ichushi_jid=J04116&link_issn=&doc_id=20080905460007&doc_link_id=%2Fdy1jspnm%2F2008%2F004403%2F007%2F0702-0705%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdy1jspnm%2F2008%2F004403%2F007%2F0702-0705%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(株)東京医学社  

在胎38週5日男児。体重2906g、経腟分娩で出生し、出生時に軽度羊水混濁を認め、Apgarスコアは1分値8点、5分値8点であった。出生直後にチアノーゼを認め、超音波検査で新生児遷延性肺高血圧症(PPHN)と診断された。出生時のX線では肺野に異常所見は認めなかった。人工換気療法を開始し肺高血圧症に対してはNO吸入療法と硫酸マグネシウム、ニトログリセリン、ミルリノン投与を開始した。しかし肺高血圧症の改善がなく、換気条件も次第に悪化し、胸部X線で肺野透過性低下、索状陰影など気管支異形成所見が進行した。日齢15に肺出血を起こし、低酸素血症が進行したためサーファクタントを投与した。呼吸不全に対して膜型人工肺(ECMO)を導入した。導入後も改善しなかったがボセンタン、エポプロステロール投与開始を検討し、日齢17からボセンタン、日齢20よりエポプロステロールを投与、ボセンタン投与のみ継続した日齢24に離脱した。

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The cerebrospinal fluid matrix metalloproteinase (MMP) activities were measured in infants with posthemorrhagic hydrocephalus to elucidate the intrinsic mechanism for the resolution of ventricular dilation. Increased MMP-9 activities were observed in the patients who escaped a shunt operation, suggesting its potential contribution to the resolution of ventricular dilation.

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Currently, there are no nutritional indices to predict cognitive function in extremely low-birth-weight (ELBW) infants. OBJECTIVE: To assess the neonatal blood urea nitrogen (BUN) values in ELBW infants according to their cognitive function at the corrected age of 36 months. METHODS: This was a retrospective study that assessed the neonatal factors affecting the developmental outcome in two groups "developmental quotient (DQ)> or =80" and "DQ<80", the groups were divided based on the DQ at the corrected age of 36 months. Between 1996 and 1999, 178 ELBW infants born at <28 weeks of gestation were admitted to our neonatal intensive care unit (NICU), of these, 32 died. Of the surviving 146 infants, 37 infants without any exclusion criteria (that would affect the cognitive function and BUN) except the nutritional factor, were assessed. Area under the curve (AUC) of corrected BUN (CBUN: BUN x 0.5/serum creatinine) from 28 to 84 days of life was used as an index of protein intake. RESULTS: No significant differences were observed between the two groups with regard to the gestational age, birth weight, Z score of birth weight, and sex. However, compared to 15 infants with DQ<80, 22 infants with DQ> or =80 had significantly shorter duration of artificial ventilation and O(2) supplementation, a higher Apgar score at 5 min, and a higher AUC of CBUN. On multiple regression analysis, DQ> or =80 was observed to be significantly correlated with the AUC of CBUN (Odd's ratio 1.03, 95% confidence interval: 1.002-1.06). CONCLUSION: The CBUN level would provide an estimate of adequate protein intake and the subsequent development of an ELBW infant.

PubMed

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その他リンク： http://amcor.asahikawa-med.ac.jp/modules/xoonips/detail.php?id=16891065

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(有)医学の世界社  

著者版
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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2007&ichushi_jid=J01348&link_issn=&doc_id=20070418110006&doc_link_id=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F781&url=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F781&type=%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%EF%BC%9A%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%E5%AD%A6%E8%A1%93%E6%88%90%E6%9E%9C%E3%83%AA%E3%83%9D%E3%82%B8%E3%83%88%E3%83%AA_AMCoR&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80003_3.gif

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(財)小児愛育協会  

2000年に厚生省より神経管閉鎖障害の発症リスク軽減を目的とした葉酸摂取推奨の情報提供書が出されてから、5年が経過した。その効果を評価するために、情報提供書が出された前後5年(計10年)での北海道における脊髄髄膜瘤患者数の推移を調査した。10年間の患者数の総数は85名で、性別の内訳は男児40名、女児45名であった。年度ごとの患者数の推移をみると前半5年間での患者数は34名、後半5年間での患者数は51名であり、減少傾向は認められなかった。葉酸摂取についての情報提供が十分行われていないことが原因である可能性があり、患者数を減らすためには周知徹底を図る必要がある。(著者抄録)

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2006&ichushi_jid=J01547&link_issn=&doc_id=20070406190009&doc_link_id=%2Fda3risyo%2F2006%2F005405%2F009%2F0133-0135%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fda3risyo%2F2006%2F005405%2F009%2F0133-0135%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本周産期・新生児医学会  

症例は緊急帝王切開術にて在胎週数32週6日と在胎30週5日に出生した女児2例で、いずれも在胎27～28週に先天性十二指腸閉鎖症と胎児診断され、経過観察中に破水し、その後、臍帯潰瘍からの出血のためnon-reassuring fetal stausから新生児仮死となった。1例は失血性ショックと呼吸不全のため生後6時間で死亡し、他の1例は救命できたが重度の低酸素性虚血性脳症による痙性四肢麻痺と精神運動発達遅滞を合併した。

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2006&ichushi_jid=J04116&link_issn=&doc_id=20060920460020&doc_link_id=%2Fdy1jspnm%2F2006%2F004203%2F020%2F0684-0688%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdy1jspnm%2F2006%2F004203%2F020%2F0684-0688%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：近畿新生児研究会  

著者らの施設では,早期からown mother's milk(OMM)供給の取り組みを行ったところ,母親による母乳注入が有効であるという示唆が得られたので報告した.対象は母乳摂取率85%以上の児が36名,85%以下の児が14名であった.1)母親が注入を施行することで,子供に必要な量を意識するようになり,注入時間毎に不足分を搾乳してくるなど意識が向上した.2)生後1ヵ月の母乳摂取率が高いほど,退院時の完全母乳率が高く,生後早期の母乳分泌がその後の分泌に重要であることが示された.3)在胎期間が短いほど母乳摂取率が高かったが,未熟な児ほど1回の摂取量が少ないためと考えられた

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

平成14年度のRSウイルス(RSV)流行シーズンから,我が国でも感染を抑制する抗RSVヒト化モノクロナール抗体体パリビズマブが早産児,気管支肺異形成症等の慢性疾患を有するハイリスク児に対して臨床投与が可能となったので,投与初シーズンにおける本剤の予防効果を検討した.適応基準を満たす早産低出生体重児47名を対象に,適応基準を満たすが臨床投与開始前であったため投与されなかった25例と,投与された22名に分けて比較した結果,平均在胎期間,平均出生体重,NICU入院中の酸素投与の有無,NICU入院中の人工呼吸管理の有無については差を認めなかった.しかし,投与群では呼吸器感染症による入院率は低下し,RSV呼吸器症状による外来受診率も低下した.尚,呼吸器感染症は全て気管支炎,細気管支炎等の下気道感染症であった.以上のことからも,パリビズマブは有効であると示唆された

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記述言語：日本語   出版者・発行元：(地独)大阪府立病院機構大阪母子医療センター  

NDチューブ栄養による呼吸に及ぼす効果を後方視的に検討した.在胎28週未満で,人工換気療法を7日間以上行い,後に新生児慢性肺疾患(CLD)と診断された1996年から1998年に入院しNDチューブ栄養を行った児37例を対象とした.1991年から1995年に入院しNDチューブ栄養を行っていない82例を対照群とした.両群で在胎期間,出生体重に差はなく,入院期間,人工換気日数,在宅酸素療法率,吸入ステロイド療法使用率では有意差を認めなかった.NDチューブ群でデキサメサゾン(Dexa)投与は有意に少なく,HFO使用率は高かった.HFO使用例では,NDチューブ群で酸素投与日数が少ない傾向を認めた.NDチューブの使用によりDexa投与なしでも投与時と同等の管理できた.またHFOとの併用が効果的である可能性が示唆された

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(有)医学の世界社  

1歳7ヵ月女児.生後2～3ヵ月頃までは,啼泣などの胸腔内圧上昇時に著明なチアノーゼを呈し,用手換気を必要とした.気管支鏡検査を施行したところ,啼泣時に気管および気管支の扁平化,狭小化を認めた.気管支造影検査でも同様の所見であった.成長とともに用手換気の回数は減少し,生後7ヵ月で人工呼吸器を離脱したが,その後も啼泣時に回復困難なチアノーゼを認めることがあり,緊急時への対応のため,1歳時に気管切開術を施行した.微量酸素送与のみで呼吸状態は安定したため,1歳5ヵ月時に退院し外来で経過観察中である.SOX9遺伝子の解析を行った結果,新規変異(887 ins C/296 ins C)を同定した.この変異によりSOX9蛋白のTA domainがすべて異常蛋白に変異すると予想され,このためSOX9蛋白の転写活性因子としての機能が失われ,本症を発症したと考えられた.本症例は長期生存例になる可能性がある

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2004&ichushi_jid=J01348&link_issn=&doc_id=20050119360027&doc_link_id=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F585&url=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F585&type=%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%EF%BC%9A%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%E5%AD%A6%E8%A1%93%E6%88%90%E6%9E%9C%E3%83%AA%E3%83%9D%E3%82%B8%E3%83%88%E3%83%AA_AMCoR&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80003_3.gif

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本周産期・新生児医学会  

早産児管理での早期母乳分泌に影響する因子を明らかにするため,2002年4月～2003年8月にNICUに入院した早産児40名のデータを調査・検討し以下の結果を得た.生後1ヵ月間のown mother's milk(OMM)による母乳摂取率が85%以上の群は85%未満の群に比べて有意に母親の年齢が若く,授乳開始時間が早く,母親による母乳注入の頻度が高かった.母親が母乳注入していた群はそうでない群に比べて有意に授乳開始時間が早く,面会回数が多く,母乳摂取率が高かった.多変量解析の結果,生後1ヵ月間の母乳摂取率を高める有意な因子として「母親による母乳注入」と「短い在胎期間」が抽出された

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2004&ichushi_jid=J04116&link_issn=&doc_id=20040831110005&doc_link_id=%2Fdy1jspnm%2F2004%2F004003%2F005%2F0539-0543%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdy1jspnm%2F2004%2F004003%2F005%2F0539-0543%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語  

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記述言語：日本語   出版者・発行元：(公社)日本新生児成育医学会  

1996～1999年に新生児科に入院した在胎期間28週未満の超低出生体重児のうち,修正1歳6ヵ月時に発達検査を行った43例を対象に,Moroらが用いた哺乳蛋白強化量の指標であるcorrected BUN(cBUN)の生後4～8週間の平均値が10以上の14例とと10未満の29例の2群に分けて検討した.両群間に,在胎期間,出生体重,SD,Apgar値,人工換気日数は有意差を認めなかった.cBUNが10以上の群は,生後2ヵ月間の母乳哺乳量の割合が高く,修正1歳6ヵ月の認知適応領域の発達指数が有意に高かった.低出生体重児において,cBUNを10以上に保つ栄養方法は児の発達予後を改善し,これには至的蛋白負荷の改善が貢献していると考えられた

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2002&ichushi_jid=J02568&link_issn=&doc_id=20020701090013&doc_link_id=%2Fcr5newbo%2F2002%2F001402%2F015%2F0193-0199%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcr5newbo%2F2002%2F001402%2F015%2F0193-0199%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   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：旭川厚生病院  

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記述言語：日本語   出版者・発行元：旭川厚生病院  

1989年4月から10年間に入院した急性脳炎患者34名について,年齢分布は生後11ヵ月から10歳で,3歳未満の乳幼児が19名と過半数をしめた.性別は男児15名女児19名.原因はアデノウィルス7型感染が9名,インフルエンザウィルスA型が4名,ヒトヘルペスウィルス-6が3名,流行性耳下腺炎が3名,麻疹・風疹・ロタウィルスが各々2名,アデノウィルス3型,Epstein-Barr virus,単純ヘルペスウィルス2型,ヒトヘルペスウィルス-7,Mycoplasma genitaliumが各々1名ずつであった.4名が原因不明.死亡は麻疹脳炎1名,アデノウィルス7型脳炎1名で,死亡率は5.9%であった.34名中23名は後遺症なく回復した

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記述言語：日本語   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：(公社)日本小児科学会  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：旭川厚生病院  

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=1998&ichushi_jid=J02713&link_issn=&doc_id=19990430210012&doc_link_id=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F2042&url=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F2042&type=%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%EF%BC%9A%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%E5%AD%A6%E8%A1%93%E6%88%90%E6%9E%9C%E3%83%AA%E3%83%9D%E3%82%B8%E3%83%88%E3%83%AA_AMCoR&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80003_3.gif

記述言語：日本語   出版者・発行元：旭川厚生病院  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：金原出版(株)  

1)食道,胃,十二指腸には病変を認めず,大腸に主病変をもった好酸球性胃腸炎の11歳男児例を経験した. 2)本症例にステロイドを使用し著効した

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=1998&ichushi_jid=J00639&link_issn=&doc_id=19980626090010&doc_link_id=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F2043&url=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F2043&type=%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%EF%BC%9A%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%E5%AD%A6%E8%A1%93%E6%88%90%E6%9E%9C%E3%83%AA%E3%83%9D%E3%82%B8%E3%83%88%E3%83%AA_AMCoR&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80003_3.gif

記述言語：日本語   出版者・発行元：(株)総合医学社  

発症時の頭部のCT,MRIにて両側視床に典型的な病変部を認めたが,後遺症なく回復した.病初期の脳波検査では今迄の報告とは異なり余波は見られなかった.治療として,脳炎に対する一般的治療に加え,γ-グロブリン1g/kgの大量療法を行った.この疾患に対しては確立した治療法はなく,3割の症例が死の転帰をとることを考慮すると,発症早期の評価及び集中治療の必要性が示唆され,後遺症なく軽快した症例を集積し,治療法の検討を行う必要がある

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=1998&ichushi_jid=J00643&link_issn=&doc_id=19980609270007&doc_link_id=%2Fag1snrsd%2F1998%2F005106%2F008%2F1091-1095%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fag1snrsd%2F1998%2F005106%2F008%2F1091-1095%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：旭川厚生病院  

対象は8例で,平均在胎週数は26.8週,平均出生体重は935gで,全例が(出生体重1500g未満の)低出生体重児で,同時期入院患者1500g未満の5.6%に相当した.対象のエコー所見では,脳室周囲高エコー域2度以上が日齢1から44に,嚢胞性脳室周囲白質軟化症は日齢11から66にとらえられ,その間は8～25日(平均15.8日)であった.発症成因は出生前因子3例,出生後因子5例と考えられ,生後因子として徐脈発作が関与したと考えられた症例は8例中4例50%と多く,いずれも生後4週間を超えた時期のものであった.当施設においては,慢性肺疾患患者の呼吸循環管理の改善が,今後の嚢胞性脳室周囲白質軟化症発症の予防対策と考えられた

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記述言語：日本語   出版者・発行元：旭川厚生病院  

患児は日齢10に発熱を主訴に入院した.入院時の髄液細胞数は2124/3μlで,髄液細胞数増多は多核球優位で経過した.CRPは陰性が持続し,入院時の血液と髄液培養が陰性であったので,第5病日からヘルペス脳炎を考慮してAcyclovir投与を開始した.入院時の髄液で単純ヘルペスウイルスのDNA(PCR法)が検出され,ウイルス分離で単純ヘルペスウイルスII型が分離同定されて新生児単純ヘルペスII型脳炎と診断が確定した.Acyclovir投与を計23日間行い,髄液の単純ヘルペスウイルスのDNAも陰性化したが,画像診断の病変は広範,多発性へと進行した.自験例は,初期に多核球優位の髄液細胞数増多で経過し,初回頭部CT(第5病日)所見が基底核のlow density areaであり,ヘルペス脳炎としては非典型例と考えられた

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記述言語：日本語   出版者・発行元：旭川厚生病院  

1991年1月から1998年6月迄に旭川厚生病院小児科に5名の肺炎球菌による菌血症の児が入院した.年齢は生後8ヵ月から2歳5ヵ月,男児3例女児2例であった.5名とも39℃を超える発熱を認め,3名は発熱時に熱性痙攣を起こして入院し,肺炎球菌菌血症が判明した.2名は発熱が数日間続くため入院し,中耳炎と肺炎球菌菌血症と診断された.5名とも抗生物質治療により速かに改善し,髄膜炎やショックのような重篤な症状を呈した例や後遺症を認めた例はなかった.5名に共通する検査所見は白血球増多であり,CRP値は発熱後数時間で検査した症例では低く,数日経過した症例では高値を示した

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記述言語：日本語   出版者・発行元：(財)小児愛育協会  

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記述言語：日本語   出版者・発行元：(財)小児愛育協会  

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記述言語：日本語   出版者・発行元：(財)小児愛育協会  

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：旭川厚生病院  

CiNii Research

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=1997&ichushi_jid=J02713&link_issn=&doc_id=19981028280009&doc_link_id=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F3577&url=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F3577&type=%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%EF%BC%9A%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%E5%AD%A6%E8%A1%93%E6%88%90%E6%9E%9C%E3%83%AA%E3%83%9D%E3%82%B8%E3%83%88%E3%83%AA_AMCoR&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80003_3.gif

記述言語：日本語   出版者・発行元：旭川厚生病院  

橈骨動脈ラインによる観血的血圧(直接血圧)とDinamapを使用した非観血的血圧(間接血圧)を同時に測定し比較した.対象は,出生体重715～3180g,在胎週数25週6日～42週4日の11例で生後9,12,18,24,36,48時間の計66点の計測で検討した.対象の基礎疾患は呼吸窮迫症候群7例,新生児遷延性肺高血圧症2例,新生児仮死1例,胎児水腫1例.結果,直接血圧と間接血圧は収縮期,拡張期とも有意な相関があり,いずれも間接血圧が有意に高い値を示した.(p<0.0001)対象を1000g未満5例と以上6例に分け直接血圧と間接血圧の差を比較した結果,収縮期血圧における差が1000g未満で高い傾向にあったマンシェットを使用した間接血圧は,直接血圧より高い値が得られ,また体重が小さいほどその圧差は大きくなる傾向がある

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(財)小児愛育協会  

CiNii Research

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=1997&ichushi_jid=J01547&link_issn=&doc_id=19980610160008&doc_link_id=%2Fda3risyo%2F1997%2F004506%2F008%2F0283-0286%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fda3risyo%2F1997%2F004506%2F008%2F0283-0286%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本周産期・新生児医学会  

低出生体重児における無呼吸発作に対するドキサプラム投与について再検討した.従来から言われているドキサプラム少量投与で副作用なく有効な効果が得られた

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=1997&ichushi_jid=J01125&link_issn=&doc_id=19971111190002&doc_link_id=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F2069&url=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F2069&type=%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%EF%BC%9A%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%E5%AD%A6%E8%A1%93%E6%88%90%E6%9E%9C%E3%83%AA%E3%83%9D%E3%82%B8%E3%83%88%E3%83%AA_AMCoR&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80003_3.gif

記述言語：日本語   出版者・発行元：日本小児臨床薬理学会  

低出生体重児におけるarbekacinは1回2.5～3.0mg/kgで,postconceptional ageと血清creatinineを参考にして18～24時間毎に投与すべきと考えた

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記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

1996年2月から1年間に当院に入院し,アデノウイルス7型による感染症と診断した16名の患者の診療録をretorospectiveに検討した.患者の年齢は生後2ヵ月から5歳11ヵ月で,平均年齢は2.0±1.3歳であった.死亡した1例を除いた15名の38℃以上の発熱期間は5日から14日間で平均9.8±3.0日であった.16名に肺炎,11名に筋炎,11名に白血球減少(5,000/μl未満),9名に胃腸炎,7名に脳炎又は髄膜脳炎,3名に肝障害(ALTが100IU/l以上),2名に抗利尿ホルモン分泌異常症候群,2名に血小板減少(10万/μl未満)がみられた.3名が人工呼吸管理を必要とし,1名は発症後2日目に呼吸不全の為,死亡した

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記述言語：日本語   出版者・発行元：旭川厚生病院  

全76例中死亡6例,後障害6例を認めた.新生児仮死症例は減少傾向にあり,その予後も改善してきているが,院外出生例,及び新生児遷延性肺高血圧症,低酸素性虚血性脳症を合併した例の予後は不良であった

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記述言語：日本語  

CiNii Books

CiNii Research

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記述言語：日本語   出版者・発行元：(NPO)日本小児がん学会  

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記述言語：日本語   出版者・発行元：(財)小児愛育協会  

2歳未満の尿路感染症患者57名について検討した.菌血症を伴ったのは11名で全例6ヵ月未満であり,生後1ヵ月未満の10名中5名が菌血症であった.膀胱尿管逆流等の尿路奇形の合併は57名中13名にみられ,菌血症11名中4名に膀胱尿管逆流を認めた.尿路感染症の原因菌はE.coliが45名で最も多く,次いでE.faecalisが6名であった.菌血症の原因菌はE.coliが8名,E.faecalisが3名であった.菌血症を合併した群と生後6ヵ月未満で合併しなかった群とで臨床症状,検査成績の比較したが有意差を認めなかった

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記述言語：日本語   出版者・発行元：(一社)日本小児栄養消化器肝臓学会  

H2-blockerによる治療で再発した2例を含む4例にamoxicillinとomeprazoleを併用しHelicobacter pylori除菌療法を行い,3例で除菌を確認し,4例とも再発を認めなかった.小児の十二指腸潰瘍において,H.pylori除菌療法は再発防止に有用であると思われた

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：旭川厚生病院  

胎児エコーで腹部異常嚢胞像を示し,出生後当院NICUに入院した7症例の在胎週数は36週2日から39週1日,出生体重は1,430～3,392gで,2例が早産児で,その他の6例は満期産であった.内訳は3例が水腎症,2例が多嚢腎,残り2例が,卵巣嚢腫と十二指腸閉鎖であった.これらのうち,水腎症1例,卵巣嚢腫,十二指腸閉鎖の計3例が新生児期の外科的治療を要し,残りの4症例も早期に診断をつけ,経過観察のプログラムを組むことができた

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=1996&ichushi_jid=J02713&link_issn=&doc_id=19970910300006&doc_link_id=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F3578&url=https%3A%2F%2Fasahikawa-med.repo.nii.ac.jp%2Frecords%2F3578&type=%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%EF%BC%9A%E6%97%AD%E5%B7%9D%E5%8C%BB%E7%A7%91%E5%A4%A7%E5%AD%A6%E5%AD%A6%E8%A1%93%E6%88%90%E6%9E%9C%E3%83%AA%E3%83%9D%E3%82%B8%E3%83%88%E3%83%AA_AMCoR&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80003_3.gif

記述言語：日本語   出版者・発行元：(財)小児愛育協会  

内科的治療に抵抗する胃食道逆流現象を有する症例に噴門部fundoplicationと幽門形成術及び胃瘻造設術を施行したところ,術後2日目から麻痺性イレウスを認めた.胃腸液の消化管外漏出を考え,ガストログラフィンによる造影をした結果穿孔はなかったが,2時間後に腎盂が造影されていた.通常はガストログラフィンの消化管から血中への吸収は2%以下とされている.本症例での吸収過多は腸管麻痺による虚血と浮腫,ガストログラフィンの投与量が多かったこと,上部消化管でのガストログラフィンの停滞等が原因と考えられた

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記述言語：日本語   出版者・発行元：(財)小児愛育協会  

5ヵ月にわたって食道内に異物が停留し,異物反応により食道周囲に腫瘤が形成された.これが徐々に増大して気管を圧迫し狭小化した結果,吸気性呼吸困難を呈した.この状態に全身麻酔を施行したため,筋弛緩が起こり気管の緊張が低下し,気道閉塞へと進展した.腫瘤は病理所見から慢性炎症の結果生じたものと考えられる

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記述言語：日本語   出版者・発行元：(財)小児愛育協会  

幼児期には格別の検討がなされず経過し,学童期になって初めて診断された

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記述言語：日本語   出版者・発行元：旭川厚生病院  

theophylline製剤の点滴静注に反応しない喘息重積発作の為,入院中の1歳と2歳の幼児にhydorocortisone 10mg/kg/日点滴静注投与を行った.喘息発作は改善されたが,hydrocortisone投与3日目と4日目に敗血症を発症した.1歳の例の原因菌はKlebsiella pneumoniae, 2歳の例の原因菌はSerratia marcescensと両者ともグラム陰性桿菌であった.侵入門戸は不明であった.ステロイドは喘息重積発作には必須の薬物であるが,このような病態を引き起こすことがあることを注意するべきである

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記述言語：日本語   出版者・発行元：(一社)日本周産期・新生児医学会  

CiNii Books

CiNii Research

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(財)小児愛育協会  

1)出生後,著しい呼吸困難を呈した巨大嚢腫状胎便性腹膜炎の1例を報告した. 2)生後2時間に緊急嚢腫ドレナージを施行し救命し得た. 3)巨大嚢腫状胎便性腹膜炎は自然予後不良の疾患であり,迅速な対応が必須である

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=1995&ichushi_jid=J01547&link_issn=&doc_id=19951115090006&doc_link_id=%2Fda3risyo%2F1995%2F004304%2F006%2F0197-0200%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fda3risyo%2F1995%2F004304%2F006%2F0197-0200%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

日本小児科学会新生児委員会では超低出生体重児の死亡率調査を1990年から5年ごとに実施してきた。今回、2015年に出生した超低出生体重児の死亡率と合併症罹患率について調査するとともに、都道府県別の死亡率の地域差について検討した。調査方法は、国内の産科と小児科を有する病床数100以上の病院および小児専門医療施設、周産期医療センター計831施設に調査依頼文書を送付し、回答が得られた679施設のうち、ハイリスク新生児の診療を行っていなかった86施設を除外した593施設を解析対象とした。個別のデータが得られた超低出生体重児2782例の新生児死亡率は6.2%、NICU入院中の死亡率は9.8%であった。合併症罹患率は壊死性腸炎が3.5%、脳室内出血(Grade3以上)が7.8%であった。また、ICUから生存退院した2508例のうち、慢性肺疾患を53.1%、治療を要する未熟児網膜症を30.4%に認めた。都道府県別のNICU入院中死亡率の中央値は9.1%であったが、0.0～31.4%と広い範囲に分布しており、死亡リスクが高いのは、山形県、福島県、新潟県、愛知県、三重県、奈良県、鳥取県、広島県などであった。

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その他リンク： https://ndlsearch.ndl.go.jp/books/R000000004-I032342833

記述言語：日本語   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：(公社)日本小児科学会  

専攻医研修プログラムを有する基幹施設179施設を対象に、2019年度研修開始専攻医プログラムに関するアンケート調査をWEBサイト上で実施した。その結果、157施設(87.7%)から回答が得られた。アンケートでは、ほとんどの基幹施設が自施設でNICU研修に取り組んでおり、4～6ヵ月間の研修で40～59症例を経験できる施設が多く、指導としては周産期専門医が行う施設が大多数であることが明らかとなった。

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記述言語：日本語   出版者・発行元：(株)メディカ出版  

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記述言語：日本語   出版者・発行元：(一社)日本母乳の会  

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記述言語：日本語   出版者・発行元：(株)診断と治療社  

風呂や外出時期、乗り物の乗車時期などの明確に基準はないが、大人の都合ではなく赤ちゃん主体で考えたい。予防接種で防ぎ得る病気は多く、生後2ヵ月から積極的に接種する。日焼けをする程の日光浴は避けるべきであるが、近年のくる病の増加から適度な日光浴はすすめられる。SIDSのリスク因子のうつぶせ寝とうつぶせ遊びとの区別が大切である。「抱き癖」より「泣き癖」がつかないように、泣いている赤ちゃんは積極的に抱くほうがよい。(著者抄録)

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記述言語：日本語   出版者・発行元：(株)メディカ出版  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：日本酪農科学会  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：(株)メディカ出版  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：(株)メディカ出版  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：KARGER  

Web of Science

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：金原出版(株)  

超低出生体重児において,新生児期の栄養管理はその発育発達予後に大きく影響を及ぼすといわれている.したがって適切な栄養管理が求められるがその至適栄養量は未だ不明な点が多い.そのため栄養管理は児から得られる情報をもとに適宜栄養評価をしながら行うことが必要である.栄養状態の評価方法として生化学的評価方法は,簡便で臨床において身体計測評価法と共に有用な手段である.著者等は蛋白負荷量に関して,血清尿素窒素(BUN)値を指標に管理することが児の発達予後に影響する可能性を示唆する結果を得たので,他の評価法と併せて紹介した

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：(公社)日本新生児成育医学会  

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