研究者詳細 - 塚原　宏一

論文 - 塚原　宏一

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Empowering pediatric, adolescent, and young adult patients with cancer utilizing generative AI chatbots to reduce psychological burden and enhance treatment engagement: a pilot study

Joe Hasei, Mana Hanzawa, Akihito Nagano, Naoko Maeda, Shinichirou Yoshida, Makoto Endo, Nobuhiko Yokoyama, Motoharu Ochi, Hisashi Ishida, Hideki Katayama, Tomohiro Fujiwara, Eiji Nakata, Ryuichi Nakahara, Toshiyuki Kunisada, Hirokazu Tsukahara, Toshifumi Ozaki

Frontiers in Digital Health 7 2025年2月

掲載種別：研究論文（学術雑誌）出版者・発行元：Frontiers Media SA

Background

Pediatric and adolescent/young adult (AYA) cancer patients face profound psychological challenges, exacerbated by limited access to continuous mental health support. While conventional therapeutic interventions often follow structured protocols, the potential of generative artificial intelligence (AI) chatbots to provide continuous conversational support remains unexplored. This study evaluates the feasibility and impact of AI chatbots in alleviating psychological distress and enhancing treatment engagement in this vulnerable population.

Methods

Two age-appropriate AI chatbots, leveraging GPT-4, were developed to provide natural, empathetic conversations without structured therapeutic protocols. Five pediatric and AYA cancer patients participated in a two-week intervention, engaging with the chatbots via a messaging platform. Pre- and post-intervention anxiety and stress levels were self-reported, and usage patterns were analyzed to assess the chatbots’ effectiveness.

Results

Four out of five participants reported significant reductions in anxiety and stress levels post-intervention. Participants engaged with the chatbot every 2–3 days, with sessions lasting approximately 10 min. All participants noted improved treatment motivation, with 80% disclosing personal concerns to the chatbot they had not shared with healthcare providers. The 24/7 availability particularly benefited patients experiencing nighttime anxiety.

Conclusions

This pilot study demonstrates the potential of generative AI chatbots to complement traditional mental health services by addressing unmet psychological needs in pediatric and AYA cancer patients. The findings suggest these tools can serve as accessible, continuous support systems. Further large-scale studies are warranted to validate these promising results.

DOI： 10.3389/fdgth.2025.1543543

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Spatiotemporal expression pattern of dyslexia susceptibility 1 candidate 1 (DYX1C1) during rat cerebral cortex development

Kazumasa Zensho, Ikuko Miyazaki, Aika Isse, Ichika Misawa, Kaori Masai, Makio Oka, Hirokazu Tsukahara, Masato Asanuma

Pediatric Research 2025年2月

掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

Abstract

Background

Developmental dyslexia (DD) is a common learning disorder with significant consequences for affected individuals. Although several candidate genes, including dyslexia susceptibility 1 candidate 1 (DYX1C1), have been implicated in dyslexia, their role in brain development remains unclear. We aimed to elucidate the spatiotemporal expression patterns of DYX1C1 during cerebral cortex development in rats.

Methods

We investigated DYX1C1 expression during cerebral cortex development using rat embryos at various gestational stages (E13.5, 15.5, 17.5 and 20.5) by immunohistochemistry (n = 7 embryos/stage), quantitative real-time PCR (n = 6), and in situ hybridization (n = 11–15).

Results

The DYX1C1-positive cells were predominantly located in the outermost layers of the cortical plate, particularly at E15.5. DYX1C1 mRNA expression peaked at E15.5 and subsequently declined. DYX1C1-positive cells did not co-localize with reelin-positive Cajal-Retzius cells, but co-localized with neuronal markers expressed during development, and had shorter primary cilia than DYX1C1-negative cells.

Conclusions

Our findings highlight the dynamic expression of DYX1C1 in the developing cerebral cortex of rats, implicating its involvement in neurodevelopmental processes. Further investigation of the functional interactions of DYX1C1, particularly its relationship with reelin and its role in cerebrocortical and hippocampal development, may provide insights into the pathophysiology of dyslexia and neurodevelopmental disorders.

Impact

Our study elucidates spatiotemporal expression patterns of endogenous DYX1C1 predominantly in the primitive cortical zone (PCZ), outermost layer of the cortical plate (CP) during cerebral cortex development, particularly peaked at E15.5.

We revealed the spatial relationship between DYX1C1-positive and reelin-expressing Cajal-Retzius (CR) cells, and co-localize with neuronal markers expressed during cerebral cortex development, indicating its contribution to neuronal migration and cortical layer formation.

DYX1C1-positive cells mainly in the PCZ possess shorter primary cilia than DYX1C1-negative cells, suggesting the completion of migration.

DOI： 10.1038/s41390-025-03920-6

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その他リンク： https://www.nature.com/articles/s41390-025-03920-6

Impact of Birth Order on Paediatric Allergic Diseases: A National Birth Cohort in Japan. 国際誌

Mitsuro Kobayashi, Masanori Ikeda, Naomi Matsumoto, Mitsuru Tsuge, Masato Yashiro, Takashi Yorifuji, Hirokazu Tsukahara

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology 2025年1月

Maternal smoking during infancy increases the risk of allergic diseases in children: a nationwide longitudinal survey in Japan. 国際誌

Kenji Shigehara, Naomi Matsumoto, Mitsuru Tsuge, Kazuhiro Uda, Yukie Saito, Masato Yashiro, Takashi Yorifuji, Masanori Ikeda, Hirokazu Tsukahara

Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology 21 ( 1 ) 4 - 4 2025年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The incidence of allergic diseases has been increasing in Japan. In particular, a serious decline in the age of onset of allergic rhinitis has been observed. Passive smoking from parental smoking has a significant impact on children's health; however, it is difficult to restrict smoking in the home. While various studies have previously reported on the relationship between passive smoking and the development of allergic diseases in children. However, there have been no reports on passive smoking and allergic diseases on a national scale. METHODS: Using Japanese national longitudinal survey data (n = 38,444) for newborns born between May 10 and 24, 2010, we assessed parental smoking habits when their children were 6 months old and investigated the association with the development of allergic diseases until the age of 5.5 years. The risk ratios and 95% confidence intervals for the development of different allergic diseases were analyzed after adjusting for potential confounders using Poisson regression with a robust error variance. RESULTS: The risk ratio for developing allergic rhinitis/allergic conjunctivitis (AR/AC) in children was significantly higher in the maternal smoking groups ( ≦ 10 cigarettes/day; RR 1.15, 95% CI 1.02-1.30; ≧11 cigarettes/day; RR 1.16, 95% CI 0.93-1.44). Furthermore, associations were found between the maternal smoking group in the presence of paternal smoking and the risk of developing bronchial asthma ( ≦ 10, RR 1.33 95% CI 1.17-1.52; ≧11, RR 1.71 95% CI 1.38-2.1), food allergy ( ≦ 10, RR 1.36 95% CI 1.12-1.63; ≧11, RR 1.25 95% CI 0.84-1.86), atopic dermatitis ( ≦ 10, RR 1.42 95% CI 1.22-1.66; ≧11, RR 1.6 95% CI 1.2-2.13), and AR/AC ( ≦ 10, RR 1.21 95% CI 1.07-1.36; ≧11, RR 1.35 95% CI 1.09-1.67). CONCLUSIONS: Maternal smoking during infancy increases the risk of developing AR/AC in children. Considering paternal smoking, maternal smoking further increased the risk of developing allergic diseases in children, suggesting that reducing parental smoking at home may reduce the risk of developing allergic diseases in children.

DOI： 10.1186/s13223-025-00952-9

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Paediatric anaplastic large-cell lymphoma with cardiac tamponade. 国際誌

Takahiro Shiwaku, Kosuke Tamefusa, Hisashi Ishida, Kaori Fujiwara, Kana Washio, Hirokazu Tsukahara

British journal of haematology 2025年1月

Effect of calcium supplementation on bone deformity and histopathological findings of skin papules in a pediatric patient with vitamin D–dependent rickets type 2A: a case report

Kosei Hasegawa, Tomoko Miyake, Mina Kobashi, Tomonori Tetsunaga, Yuko Ago, Natsuko Futagawa, Hiroyuki Miyahara, Yousuke Higuchi, Shin Morizane, Hirokazu Tsukahara

Clinical Pediatric Endocrinology 2025年

A case of fetal myocardial calcification with hyperechoic area in fetal echocardiography. 国際誌

Takeshi Sato, Yosuke Washio, Hotaka Kawai, Kenji Baba, Eriko Eto, Hisashi Masuyama, Hirokazu Tsukahara

Pediatrics international : official journal of the Japan Pediatric Society 67 ( 1 ) e15868 2025年

Psychogenic fever and neurodevelopmental disorders among Japanese children. 国際誌

Ayumi Okada, Yoshie Shigeyasu, Chikako Fujii, Chie Tanaka, Mana Hanzawa, Akiko Sugihara, Makiko Horiuchi, Hirokazu Tsukahara

BioPsychoSocial medicine 18 ( 1 ) 23 - 23 2024年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Psychosocial stress can induce various physical symptoms, including fever, which is a commonly seen symptom in pediatric practice. In cases of unexplained fever, psychogenic fever should be considered as a potential cause. Children with neurodevelopmental disorders may be more vulnerable to stress and therefore more prone to developing somatic symptoms than their peers. This study aimed to elucidate the characteristics of children with psychogenic fever and comorbidity. METHODS: This study included 21 patients with psychogenic fever who visited the Department of Pediatric Psychosomatic Medicine, Okayama University Hospital. Information on age, sex, disease onset, final estimated diagnosis, comorbidities, treatment course, and outcome was obtained from the patients' medical records. RESULTS: Of the 21 patients included, 7 were boys and 14 were girls, and their median age was 13.0 (range: 8.6-14.6) years. A total of 19 patients had no attendance at school, and all patients showed signs of maladjustment in school. The comorbidities included orthostatic dysregulation (n = 4) and migraine (n = 3). Neurodevelopmental disorders were observed in nine patients, eight of whom were diagnosed after the initial visit. The mean treatment duration was 37.2 months. The outcomes were complete remission (n = 9), improvement (n = 4), discontinuation (n = 1), and referral to another physician (n = 7). CONCLUSION: Various comorbidities were observed in the patients of this study with psychogenic fever, including the coexistence of neurodevelopmental disorders, such as autistic spectrum disorder. Children with neurodevelopmental disorders are prone to psychological stress resulting from difficulties in social adjustment. It is crucial to understand the developmental characteristics and environmental adaptation of patients to facilitate accurate diagnosis and treatment.

DOI： 10.1186/s13030-024-00322-8

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Trabecular bone scores in children with osteogenesis imperfecta respond differently to bisphosphonate treatment depending on disease severity. 国際誌

Natsuko Futagawa, Kosei Hasegawa, Hiroyuki Miyahara, Hiroyuki Tanaka, Hirokazu Tsukahara

Frontiers in pediatrics 12 1500023 - 1500023 2024年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Frontiers Media SA

Introduction

Osteogenesis imperfecta (OI) is a congenital skeletal disorder characterized by bone fragility. Bisphosphonates (BISs) have become the mainstream treatment in children with OI. However, an optimal treatment protocol has not yet been established, while BIS treatment tends to be administered to normalize bone mineral density (BMD). Bone quality is an important component of bone strength. The trabecular bone score (TBS) is a quantitative measure of the microstructure that affects bone quality. This study investigated the TBS during BIS treatment in children with OI.

Materials and methods

Twenty-nine children with OI were enrolled and classified into two groups: mild (type 1) and moderate to severe (types 3 and 4). Dual-energy x-ray absorptiometry images were retrospectively analyzed for TBS calculation. The relationship between the areal BMD (aBMD), its Z-score, height-adjusted BMD (BMD_HAZ) Z-score, TBS, and TBS Z-score with the treatment duration was assessed for each group.

Results

In the mild group, the aBMD, its Z-score, and BMDHAZ Z-score showed a significant positive correlation with treatment duration (r = 0.68, 0.68, 0.72, respectively, p &lt; 0.01). The TBS Z-score tended to increase with treatment duration, albeit without reaching significance. In the moderate to severe group, the TBS Z-score showed a significant positive correlation with treatment duration (r = 0.48, p &lt; 0.01), in contrast to the aBMD Z-score, which did not increase. Finally, the BMDHAZ Z-score only showed a weak positive correlation with treatment duration (r = 0.37, p &lt; 0.01).

Conclusion

Because BIS affect the BMD and TBS differently based on the severity of OI, treatment goals may need to be stratified by disease severity.

DOI： 10.3389/fped.2024.1500023

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Alectinib maintenance therapy following cord blood transplantation for relapsed pediatric anaplastic large cell lymphoma with central nervous system involvement. 査読国際誌

Kosuke Tamefusa, Hisashi Ishida, Daisuke Miyahara, Takahiro Shiwaku, Motoharu Ochi, Kiichiro Kanamitsu, Kaori Fujiwara, Yasuhisa Tatebe, Kana Washio, Tomoyuki Akiyama, Hirokazu Tsukahara

Annals of hematology 103 ( 11 ) 4805 - 4809 2024年11月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

Pediatric ALK-positive anaplastic large cell lymphoma is a rare subtype of non-Hodgkin lymphoma, and approximately 30% of patients relapse following treatment with conventional chemotherapy. Alectinib monotherapy has demonstrated excellent activity in relapsed and refractory ALCL, but its role as a maintenance therapy after hematopoietic cell transplantation is unclear. We experienced a relapse case of pediatric ALK-positive ALCL with central nervous system involvement treated with alectinib maintenance therapy following cord blood transplantation. The patient has maintained complete remission for more than 3 years after transplantation. There were no remarkable adverse effects that led to discontinuation of alectinib.

DOI： 10.1007/s00277-024-06000-7

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突発性発疹関連脳症における免疫応答に関連した宿主遺伝子発現解析

津下充, 濃野優, 宇田和宏, 茂原研司, 塚原宏一

日本小児感染症学会総会・学術集会プログラム・抄録集 56回 211 - 211 2024年11月

Correction: Assessment of the renal function of patients with anorexia nervosa. 国際誌

Hiroyuki Miyahara, Yoshie Shigeyasu, Chikako Fujii, Chie Tanaka, Mana Hanzawa, Akiko Sugihara, Ayumi Okada, Hirokazu Tsukahara

BioPsychoSocial medicine 18 ( 1 ) 22 - 22 2024年10月

Assessment of the renal function of patients with anorexia nervosa. 国際誌

Hiroyuki Miyahara, Yoshie Shigeyasu, Chikako Fujii, Chie Tanaka, Mana Hanzawa, Akiko Sugihara, Ayumi Okada, Hirokazu Tsukahara

BioPsychoSocial medicine 18 ( 1 ) 19 - 19 2024年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: A decreased glomerular filtration rate (GFR), estimated using creatinine (Cr- eGFR), is often found at the initial presentation of anorexia nervosa (AN). Its pathophysiology has been explained mainly by dehydration, and chronic hypokalemia is also thought to be a cause. However, because we have often experienced cases of AN with decreased Cr-eGFR without these conditions, we must consider different etiologies. The focus of this paper is on low free triiodothyronine (FT3) syndrome. We also discuss the utility of eGFR, estimated using cystatin-C (CysC-eGFR), for these patients. METHODS: The data of 39 patients diagnosed with AN between January 2005 and December 2023 was available for study. The characteristics of patients at the lowest and highest body mass index standard deviation score (BMI-SDS) were examined. Data on the parameters Cr-eGFR, CysC-eGFR, dehydration markers, potassium (K), and hormonal data and BMI-SDS were assessed during the treatment course to evaluate the correlations in these parameters. Blood hematocrit, uric acid (UA), blood urine nitrogen (BUN) level, and urine specific gravity were adopted as dehydration markers; FT3, free thyroxine, thyroid stimulating hormone, and insulin-like growth factor were adopted as hormonal data. Cr-eGFR and simultaneously evaluated dehydration markers, K, or hormonal data were extracted and correlations associated with the changes in BMI-SDS were examined. Furthermore, Cr-eGFR and simultaneously assessed CysC-eGFR were compared. RESULTS: When the BMI-SDS was at the lowest value, low-FT3 syndrome was shown. Severe hypokalemia was not found in our study. A linear relation was not found between Cr-eGFR and BMI-SDS. A statistically significant correlation was found between Cr-eGFR and FT3 (p = 0.0025). Among the dehydration markers, statistically significant correlations were found between Cr-eGFR and BUN or UA. The difference between Cr-eGFR and CysC-eGFR was prominent, and CysC-eGFR showed much higher values. CONCLUSIONS: Our data indicates that low-FT3 syndrome and dehydration were related to the renal function of our patients with AN. Furthermore, our data suggest that caution is needed in the interpretation of kidney function evaluation when using CysC-eGFR in cases of AN.

DOI： 10.1186/s13030-024-00316-6

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全前脳胞症を合併した13番染色体長腕部分トリソミーの一例

大野友香子, 吉本順子, 秋山麻里, 鷲尾洋介, 岡村朋香, 渡邉宏和, 森本大作, 佐藤剛史, 塚原宏一, 小林勝弘

日本周産期・新生児医学会雑誌 60 ( 2 ) 287 - 291 2024年9月

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

13番染色体長腕部分トリソミー(以下,13q部分トリソミー)に全前脳胞症(holoprosencephaly:HPE)が合併した1例を経験した.小頭,眼間狭小,鼻中隔欠損,右唇顎口蓋裂など顔面正中部の低形成を認め,頭部単純MRI検査でlobar型のHPEと診断した.生後3ヵ月でWest症候群を発症し,急性呼吸不全のため4歳2ヵ月で死亡した.染色体核型は46,XX,rec(13)dup(13q)inv(13)(p12q14.1)matで,母の腕間逆位に由来していた.13q部分トリソミーの表現型は,13トリソミーに比べ軽症例が多く,生命予後も良好と考えられてきた.本症例は,これまでの報告例には共通しない表現型としてHPEを合併したために重篤な経過を示した.13q部分トリソミーの表現型と重複部位の関連を明らかにするためには,さらなる症例の集積が必要と考えられる.(著者抄録)

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J04116&link_issn=&doc_id=20240913470018&doc_link_id=10.34456%2Fjjspnm.60.2_287&url=https%3A%2F%2Fdoi.org%2F10.34456%2Fjjspnm.60.2_287&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Increased Oxidative Stress and Decreased Citrulline in Blood Associated with Severe Novel Coronavirus Pneumonia in Adult Patients. 査読国際誌

Mitsuru Tsuge, Eiki Ichihara, Kou Hasegawa, Kenichiro Kudo, Yasushi Tanimoto, Kazuhiro Nouso, Naohiro Oda, Sho Mitsumune, Goro Kimura, Haruto Yamada, Ichiro Takata, Toshiharu Mitsuhashi, Akihiko Taniguchi, Kohei Tsukahara, Toshiyuki Aokage, Hideharu Hagiya, Shinichi Toyooka, Hirokazu Tsukahara, Yoshinobu Maeda

International journal of molecular sciences 25 ( 15 ) 2024年7月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

This study investigated the correlation between oxidative stress and blood amino acids associated with nitric oxide metabolism in adult patients with coronavirus disease (COVID-19) pneumonia. Clinical data and serum samples were prospectively collected from 100 adult patients hospitalized for COVID-19 between July 2020 and August 2021. Patients with COVID-19 were categorized into three groups for analysis based on lung infiltrates, oxygen inhalation upon admission, and the initiation of oxygen therapy after admission. Blood data, oxidative stress-related biomarkers, and serum amino acid levels upon admission were compared in these groups. Patients with lung infiltrations requiring oxygen therapy upon admission or starting oxygen post-admission exhibited higher serum levels of hydroperoxides and lower levels of citrulline compared to the control group. No remarkable differences were observed in nitrite/nitrate, asymmetric dimethylarginine, and arginine levels. Serum citrulline levels correlated significantly with serum lactate dehydrogenase and C-reactive protein levels. A significant negative correlation was found between serum levels of citrulline and hydroperoxides. Levels of hydroperoxides decreased, and citrulline levels increased during the recovery period compared to admission. Patients with COVID-19 with extensive pneumonia or poor oxygenation showed increased oxidative stress and reduced citrulline levels in the blood compared to those with fewer pulmonary complications. These findings suggest that combined oxidative stress and abnormal citrulline metabolism may play a role in the pathogenesis of COVID-19 pneumonia.

DOI： 10.3390/ijms25158370

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Pulmonary Flow Management by Combination Therapy of Hemostatic Clipping and Balloon Angioplasty for Right Ventricular-Pulmonary Artery Shunt in Hypoplastic Left Heart Syndrome. 査読国際誌

Yusuke Shigemitsu, Maiko Kondo, Yoshihiko Kurita, Yosuke Fukushima, Yuya Kawamoto, Kenta Hirai, Mayuko Hara, Tomoyuki Kanazawa, Tatsuo Iwasaki, Shingo Kasahara, Koichi Kataoka, Hirokazu Tsukahara, Kenji Baba

Pediatric cardiology 2024年7月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

Controlling pulmonary blood flow in patients who have undergone Norwood palliation, especially early postoperatively, is challenging due to a change in the balance of systemic and pulmonary vascular resistance. We applied a combination therapy of clipping and balloon angioplasty for right ventricle-pulmonary artery (RV-PA) shunt to control pulmonary blood flow, but the influence of the combination therapy on the PA condition is uncertain. Retrospectively analysis was conducted of all infants with hypoplastic left heart syndrome who had undergone Norwood palliation with RV-PA shunt at Okayama University Hospital from January 2008 to September 2022. A total of 50 consecutive patients underwent Norwood palliation with RV-PA shunt in this study period. Of them, 29 patients underwent RV-PA shunt flow clipping, and the remaining 21 had unclipped RV-PA shunt. Twenty-three patients underwent balloon angioplasty for RV-PA shunt with clips. After balloon angioplasty, oxygen saturation significantly increased from 69 (59-76)% to 80 (72-86)% (p < 0.001), and the narrowest portion of the clipped conduit significantly improved from 2.8 (1.8-3.4) to 3.8 (2.9-4.6) mm (p < 0.001). In cardiac catheterizations prior to Bidirectional cavo-pulmonary shunt (BCPS), there were no significant differences in pulmonary-to-systemic flow ratio (Qp/Qs), ventricular end-diastolic pressure, Nakata index, arterial saturation, mean pulmonary artery pressure and pulmonary vascular resistance index. On the other hand, in Cardiac catheterizations prior to Fontan, Nakata index was larger in the clipped group (p = 0.02). There was no statistically significant difference in the 5-year survival between the two groups (clipped group 96%, unclipped group 74%, log-rank test: p = 0.13). At least, our combination therapy of clipping and balloon angioplasty for RV-PA shunt did not negatively impact PA growth. Although there is a trend toward better but not statistically significant difference in outcomes in the clipped group compared to the non-clipped group, this treatment strategy may play an important role in improving outcomes in hypoplastic left heart syndrome.

DOI： 10.1007/s00246-024-03579-6

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後頭部可逆性白質脳症を合併した肢端紅痛症の1例

武川真也, 鈴木健吾, 宇田和宏, 茂原研司, 荒川恭佑, 齋藤有希惠, 宮原宏幸, 長谷川高誠, 小原隆史, 塚原紘平, 八代将登, 津下充, 塚原宏一

日本小児科学会雑誌 128 ( 7 ) 1004 - 1005 2024年7月

専門機関での治療継続に難渋した不登校例査読

椙原彰子, 藤井智香子, 重安良恵, 田中知絵, 半澤愛, 堀内真希子, 岡田あゆみ, 塚原宏一

小児心身症研究 ( 30 ) 27 - 34 2024年6月

担当区分：最終著者記述言語：日本語出版者・発行元：日本小児心身医学会-中国四国地方会

関係機関につながりにくい不登校男児に小児科医,公認心理師(CP)が行った面接の過程を振り返り報告する.初診時小5男児(A)は,不登校を主訴として来院した.Aは数ヶ所の医療機関で自閉スペクトラム症(ASD),境界知能と診断された.小学校1年生から不登校があり,小児科,児童精神科,フリースクールなどと関わりがあったが通院や通所は長続きしなかった.当初Aは妄想的な自己肥大的発言や被害的発言が多く,幻聴や幻覚が懸念された.そのため,感情に焦点を当てて洞察を深める心理面接は侵襲的と考えて,CPは今,出来ている事を聞くことに徹した.コロナ禍等で半年間受診が途絶えた時期もあったが,通院は継続できた.学校との関わりを持つことで,困難であった放課後登校が継続可能となり,現実的な心配事を相談する経験を経て通信制高校へ進学した.専門機関とつながりにくい親子が小児科の非侵襲的な関わりで関係維持が可能となった.学校での関わりが成長を促した.(著者抄録)

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専門機関での治療継続に難渋した不登校例

椙原彰子, 藤井智香子, 重安良恵, 田中知絵, 半澤愛, 堀内真希子, 岡田あゆみ, 塚原宏一

小児心身症研究 ( 30 ) 27 - 34 2024年6月

記述言語：日本語出版者・発行元：日本小児心身医学会-中国四国地方会

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2番染色体短腕中間部欠失の一例

福田花奈, 吉本順子, 鈴木健吾, 二口慧介, 佐藤剛史, 森本大作, 岡村朋香, 渡邉宏和, 鷲尾洋介, 塚原宏一

日本周産期・新生児医学会雑誌 60 ( Suppl.1 ) P354 - P354 2024年6月

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