Sulfamethoxazole / Trimethoprim confer no change on the clinical course of Kawasaki disease

Kawasaki disease (KD) is one of the most common vasculitis in childhood, but its etiology is still unknown. We hypothesized that Sulfamethoxazole / Trimethoprim (S/T) would inhibit overproduction of cytokine due to heat shock protein produced by intestinal bacteria in patients with KD and improve the clinical course of KD indirectly. We have conducted a prospective study to assess the usefulness of S/T for KD. For patients with KD (S/T group, N=23), we use S/T in addition to the standard treatment in the guidelines such as intravenous immunoglobulin (IVIG) and moderate dose aspirin. The control group (non S/T group, N=32) is patients with KD treated with the standard treatment in the guidelines. The baseline characteristics did not demonstrate notable differences between the two groups. We compare duration of fever, rate of initial IVIG failure, the day of illness membranous desquamation appeared, and the occurrence of coronary artery lesion (CAL) between two groups. Membranous desquamation appeared rather earlier in S/T group than in non S/T group (11.4±3.0 day of illness vs 12.9±3.5 day of illness, P=0.078), but there was no statistically significant difference. Duration of fever (39±59 hours vs 42±57 hours, P=0.41), rate of initial IVIG failure (26% vs 31%, P=0.30), and number of CAL (8.6% vs 9.3%, P=0.87) were found no significant difference between two groups. These data indicated that the use of S/T in acute phase of KD didn\u27t improve any clinical course of KD

Long-term survival with RAS-associated autoimmune leukoproliferative disorder with somatic KRAS mutation:A case report

　RAS -associated autoimmune leukoproliferative disorder (RALD) is a recently reported rare nonmalignant autoimmune disorder. The characteristic clinical findings of RALD include monocytosis, leukocytosis, lymphoproliferation, and autoimmune phenomena. RALD is defined by somatic mutations in KRAS or NRAS . It is a new disease that was reported by Niemela and Takagi in 2011. The prognosis and incidence are currently unknown and the treatment strategy has not yet been established.　Here we describe the long-term survival of a patient with who displayed a somatic KRAS G12D mutation. His clinical features and labolatory data were overlapped with juvenile myelomonocytic leukemia and chronic myelomonocytic leukemia. Mercaptopurine hydrate, hydroxycarbamide and azacitizine were administered to control white blood cell count and improve clinical symptoms. He had a long survival time without hematopoietic stem cell transplantation

幼稚園教育要領改訂に伴う保育内容領域「健康」に求められる授業内容に関する一考察 : 新しい教職課程におけるモデルカリキュラムとの比較を通して

本稿の目的は，近年の学校教育改革の中核をなす質の高い教員養成を目指すため，筆者らが関連する領域「健康」の授業内容を再考することである．具体的には，これまでの領域「健康」の授業内容と新課程における「モデルカリキュラム」を比較検討する中で，現状と課題を浮き彫りにし，これからの教員養成に資する領域「健康」のカリキュラム開発の一助としていく．分析の結果，現行シラバスは「領域に関する専門的事項」には十分対応できているが，「保育内容の指導法（情報機器及び教材の活用を含む．）」に関する「領域『健康』において幼児が経験し身に付けていく内容の関連性及び小学校の教科等とのつながりを理解している．」と，「領域『健康』の特性に応じた現代的課題や保育実践の動向を知り，保育構想の向上に取り組むことができる．」の2 つの到達目標において，対応できていないことが明らかになった