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STIL overexpression is associated with chromosomal numerical abnormalities in non-small-cell lung carcinoma through centrosome amplification
Get PDF浜松医科大学Hamamatsu University School of Medicine博士（医学）doctoral医学系研究科thesi
Identifying pathogenic variants in rare pediatric neurological diseases using exome sequencing
Get PDF浜松医科大学Hamamatsu University School of Medicine博士（医学）doctoral医学系研究科thesi
Changes in the plasma protein-binding rate of remifentanil during cardiopulmonary bypass
Get PDF浜松医科大学Hamamatsu University School of Medicine博士（医学）doctoral医学系研究科thesi
Obesity impairs ciliary function and mucociliary clearance in the murine airway epithelium
Get PDF浜松医科大学Hamamatsu University School of Medicine博士（医学）doctoral医学系研究科thesi
Characterization of BRAFThr599dup mutation as a targetable driver mutation identified in lung adenocarcinoma by comprehensive genomic profiling
Get PDF浜松医科大学Hamamatsu University School of Medicine博士（医学）doctoral医学系研究科thesi
The structural abnormalities are deeply involved in the cause of RPGRIP1-related retinal dystrophy in Japanese patients
Get PDF浜松医科大学Hamamatsu University School of Medicine博士（医学）doctoral医学系研究科thesi
Corneal trauma of neonate caused by forceps delivery
Get PDF新生児が生直後から角膜混濁を生じていることは稀である．緑内障等の先天異常の他に鉗子による分娩時角膜損傷も鑑別に挙がる．しかし，生後早期に角膜損傷と診断し急性期の経過を記載した報告はない．
症例は日齢3の新生児，在胎41週6日に体重3,340gで鉗子分娩により出生した．日齢2に看護師が左角膜の混濁に気づき，日齢3に小児科医が診察した．眼科医の診察を受けるため当院に転院した．左角膜は高度に混濁していて，Descemet膜は角膜の縦方向に損傷していた．額眉上方に鉗子痕を認めたが，眼瞼には損傷がなかった．眼圧正常であることも合わせて，鉗子による分娩時角膜損傷と診断された．日齢6にはかすかな白い縦線を残して混濁は急速に消退した．
分娩時角膜損傷による混濁は自然軽快することが多いが，角膜の変形が残り将来弱視に繋がると言われている．正確な診断と視機能経過観察を受けるため，角膜混濁が軽快していても速やかに眼科医へ紹介すべきである．Corneal opacities early after birth are rare. In addition to congenital anomalies such as glaucoma, corneal damage caused by the application of forceps during delivery is also considered in the differential diagnosis of corneal opacity. However, there have been few detailed reports of the course of acute symptoms of corneal damage diagnosed immediately after birth.
This case involved a 3-day-old newborn weighing 3,340g at 41 weeks and 6 days of gestation, who was delivered by forceps. On day 2, a nurse noticed opacity in the left cornea, and on day 3, a pediatrician examined the baby. The baby was transferred to our hospital’s maternal-fetal neonatal care center to be examined by an ophthalmologist. The left cornea was severely opacified, and Descemet’s membrane was damaged vertically across the cornea. Forceps marks were noted above the forehead, but there was no damage to the eyelids. Given that intraocular pressure was normal, a diagnosis of corneal damage caused by application of forceps during delivery was made. On day 6, the corneal opacity had rapidly disappeared, leaving only a faint vertical white line.
Although corneal opacities caused by injury during childbirth often improve naturally, it is said that corneal deformation remains and can lead to amblyopia in the future. Even if the corneal opacity improves, the patient should be promptly referred to an ophthalmologist for follow-up observation of visual function in cases of corneal damage.journal articl
A pediatric case of immediate hypersensitivity to tosufloxacin involving no cross-reactivity to other topical quinolones
Get PDFキノロン系抗菌薬アレルギーの交差反応性は少しずつ知見が蓄積されているが，トスフロキサシントシル酸塩水和物（以下トスフロキサシン）への即時型アレルギー反応は報告が少なく，検査法や交差反応性が明確となっていない．
症例は6歳女児で，トスフロキサシンを内服10分後に顔面の膨疹，20分後に全身の膨疹が出現し，夜間救急室を受診した．喘鳴も出現し，SpO2が84%（室内気）のため，アナフィラキシーの診断でアドレナリンが筋注された．当院でのSkin prick test（トスフロキサシン100μg/mL）は平均膨疹径2mmと陰性で好塩基球活性化試験も陰性であった．薬物誘発試験では，内服10分後に顔全体の掻痒，口唇の血管性浮腫と眼瞼周囲の膨疹が出現したため，陽性と判定された．
他のキノロン系抗菌薬は，ナジフロキサシン軟膏，オフロキサシン眼軟膏の塗布試験，レボフロキサシン点眼液，モキシフロキサシン点眼液の塗布試験・点眼負荷試験は陰性で交差反応性が無いことが確認された．Although evidence for cross-reactivity in quinolone allergy is gradually accumulating, immediate hypersensitivity to tosufloxacin tosilate hydrate (tosufloxacin) have not been reported, and testing methods and cross-reactivity have not been clarified.
A 6-year-old girl received tosufloxacin. She developed facial wheals 10 minutes after ingesting the drug, and generalized urticaria after 20 minutes, and she was taken to the emergency department. She was diagnosed with anaphylaxis based on stridor and 84% SpO2 and was treated with adrenaline intramuscularly. A skin prick test with 100 μg/mL of tosufloxacin was negative with an average wheal diameter of 2 mm. She performed a drug provocation test for tosfloxacin. She developed swelling and strong itching of her lips, mouth and eyelids 10 minutes after the initial dose. This case was diagnosed as immediate hypersensitivity to tosufloxacin using oral drug provocation test.
We administered nadifloxacin and ofloxacin as ointment, levofloxacin and moxifloxacin as eye drops, which were also negative, indicating no cross-reactivity.journal articl