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Biomedical subjects

Kensuke Harada

Publications and source records attributed to Kensuke Harada.

At least 37 records · Page 2Linked to original sources
PubMed2005

Assessment of coronary artery abnormalities by multislice spiral computed tomography in adolescents and young adults with Kawasaki disease.

Multislice spiral computed tomography was performed in 16 adolescents and young adults who had Kawasaki's disease to assess coronary artery abnormalities. Adequate images were obtained for 96% of major coronary segments. The sensitivity of multislice spiral computed tomography to detect coronary artery aneurysms was 100%, and that for significant stenoses and occlusions was 87.5%, whereas false-positive results due to severe calcification was present in 5 arteries and those due to cardiac motion artifact were present in 2, resulting in a specificity of 92.5%.

Adolescent↗
PubMed2005

Optimal use of quick-acting insulin analogue in combination with basal insulin and its long-term effect in Japanese children and adolescents with type 1 diabetes.

The aim of the study was to examine the optimal use of quick-acting insulin analogue (Q) switching from regular insulin (R) in combination with basal insulin and its long-term effects in 40 Japanese children and adolescents with type 1 diabetes. Insulin regimens after administration of Q were increased to twice daily injections of basal insulin and modified use of Q or R as bolus insulin depending on the blood glucose profile and lifestyles. The mean dose of total insulin remained unchanged during treatment with using Q, but that of basal insulin increased 12 months after the use of Q (baseline: 25.8 +/- 12.2, after 12 months: 27.1 +/- 12.6 U/day). After switching to Q, the mean HbA1c value decreased in all patients (baseline: 7.6 +/- 1.0, after 12 months: 7.3 +/- 0.8%), which reflected improvement of HbA1c in patients with HbA1c > or = 8% at baseline. These results indicated that insulin regimens after switching from R to Q varied with increases of the number and the dosage of basal insulin. Use of Q seems to be useful to improve hyperglycemia in patients with a poor glucose profile under conventional insulin treatment with using R. The choice of insulin regimens with using Q in consideration of the blood glucose profile as well as lifestyles may lead to better glycemic control.

Adolescent↗
PubMed2005

Plasma palmitoleic acid content and obesity in children.

BACKGROUND: Palmitoleic acid (16:1n-7) is a product of endogenous lipogenesis. In human obesity, 16:1n-7 is reported to correlate with indexes of adiposity and insulin concentrations. OBJECTIVE: We investigated the relation between adiposity, especially in the abdominal region, and plasma monounsaturated fatty acid (MUFA) profiles in obese children. DESIGN: A case-control study was performed. The study subjects were 59 obese children (x +/- SD age: 11.8 +/- 3.8 y) and 53 age- and sex-matched healthy, nonobese children (aged 12.5 +/- 0.5 y). The study's variables included anthropometric measurements, serum lipids, leptin, and fatty acid composition in plasma. RESULTS: MUFA profiles of obese subjects showed a significantly higher content of 16:1n-7, 18:1n-9, and 20:1n-9 and significantly higher stearoyl-CoA desaturase (SCD) activity (ratio of 16:1n-7 to 16:0) than in nonobese controls. In a multiple regression analysis, percentage body fat, waist-to-height ratio, and waist-to-hip ratio (WHR) were significant determinants of 16:1n-7 content. SCD activity had a positive, significant correlation with leptin. However, in a multiple regression analysis that included percentage body fat, WHR, and leptin as independent determinants, WHR was the only determinant of SCD activity. CONCLUSIONS: Plasma 16:1n-7 content has a significant relation with abdominal adiposity in obese children. This change in the MUFA profile may be caused by activation of SCD that is not sufficiently suppressed by leptin. Endogenous lipogenesis may be an important factor in the pathogenesis of obesity in children.

Abdomen↗
PubMed2005

Revision of diagnostic guidelines for Kawasaki disease (the 5th revised edition).

Diagnostic guidelines for Kawasaki Disease was revised to meet the present situation in 2002. This issue intends to explain new guidelines and their backgrounds. Major alterations are interpretation of cases with 4 or fewer febrile days shortened by early intravenous immunoglobulin treatment, and the clinical importance of atypical (incomplete, or suspected) cases.

Humans↗
PubMed2005

Usefulness of the addition of metformin to insulin in pediatric patients with type 1 diabetes mellitus.

BACKGROUND: The aim of this study was to evaluate the effect of metformin in addition to insulin therapy in adolescents and young adults with type 1 diabetes mellitus. METHODS: Nine patients, two males and seven females, aged 18.1 +/- 3.0 years, with type 1 diabetes mellitus were studied. They were relatively overweight with a body mass index (BMI) of 24.2 +/- 1.8 and had high levels of HbA1c at 9.5 +/- 1.2% despite high doses of insulin of 74.0 +/- 31.2 U/day. Metformin at the dose of 500-750 mg daily was administered to the patients in addition to insulin therapy for 1 year. RESULTS: HbA1c, BMI and insulin dose were compared before 1 year without metformin therapy, at baseline, and at 3, 6 and 12 months during the use of metformin in addition to insulin therapy. HbA1c lowered (8.6 +/- 1.4**, 8.4 +/- 1.3**, 8.4 +/- 1.2*%), BMI was reduced (23.9 +/- 1.7*, 23.8 +/- 1.8, 23.5 +/- 1.8*), and insulin requirement decreased (69.8 +/- 29.7*, 68.7 +/- 29.8**, 67.3 +/- 29.1**U/d) significantly after the start of metformin therapy (*P < 0.05, **P < 0.01 vs at baseline). There were no adverse events, not even lactic acidosis, during the study period. CONCLUSION: Metformin is safe and may represent a useful adjunct to the management of type 1 diabetes mellitus in adolescents and young adults who have poor glycemic control despite a large amount of insulin.

Adolescent↗
PubMed2005

Safety and efficacy of palivizumab prophylaxis in children with congenital heart disease.

BACKGROUND: Infants with congenital heart diseases (CHD) are at high risk for Respiratory syncytial virus (RSV) infection, which causes severe respiratory distress. Palivizumab, an anti-RSV monoclonal antibody, was licensed in the USA, Europe and Canada, and a large-scale placebo-controlled double-blind test in these countries confirmed its efficacy and safety. A survey using questionnaires to assess usage, prophylactic efficacy, and safety of palivizumab in Japanese infants and young children with CHD was conducted. METHODS: The survey was conducted between October 2002 and March 2003. The questionnaire asked for patients' characteristics, presence of CHD, underlying diseases, starting date and number of injection, adverse events, correlation between adverse events and treatment with palivizumab, and evaluation of efficacy. RESULTS: In total, 108 infants were reported from 61 institutions. A total of 60 of the 108 infants evaluated without major non-cardiac complications received intramuscular injection of 15 mg/kg per month of palivizumab in a manner not consistent with approved indications for this drug. A total of 43 cases (39.8%) had complexed CHD, while 64 cases (59.3%) had the first injection in October or November. The average number of injections was 3.0 +/- 1.4. Seven children (6.5%) had notable respiratory infections confirmed by positive test for RSV antigen, and five (4.6%) were hospitalized. No children died nor received mechanical ventilation. The number of adverse events was nine in five cases. There was no significant relationship between adverse events and treatment with palivizumab. CONCLUSION: Palivizumab is well-tolerated, fairly effective and safe in preventing severe RSV infection in infants and young children with CHD.

Antibodies, Monoclonal↗
PubMed2005

Assessment of individual changes in body fatness in boys during early pubertal period.

BACKGROUND: In order to know whether the changes in indexes of overweight, body mass index (BMI; kg/m2) and percentage of overweight (POW) (%), really represent the tendency toward obesity, we examined longitudinal individual changes in these indexes, and the change in body composition in boys during early pubertal period. METHODS: The subjects were 50 school boys who lived in Shizuoka, Japan. Standing height and weight were measured, and BMI and POW were obtained. Body fat percentage (BF%), fat mass (FM) and lean body mass (LBM) were estimated by bioelectrical impedance method. The influence of predictive variables (LBM, FM) on the changes in BMI and POW was investigated by multiple regression analysis. We examined the 3-year changes in BMI, POW and predictive variables in each individual, from 9 to 12 years of age. RESULTS: The mean change of BMI was 1.7 +/- 0.3 (mean +/- SEM) kg/m2 and that of POW was 2.2 +/- 1.9%. The influence of predictive variables on the changes in BMI and POW was determined. The variance of the change in POW could be explained by that in FM (r(2) = 0.737, P < 0.0001), while the change in BMI was influenced by both LBM and FM (r2 = 0.891, P < 0.0001). CONCLUSIONS: Based on the definition of obesity, POW is the better index of body fatness to assess its individual change for boys during early pubertal period, because the index independent from the change in LBM is supposed to be the appropriate index for obesity in practical use.

Body Composition↗
PubMed2005

Adult Kawasaki disease unrelated to epstein-barr virus and group A Streptococcus.

A 23-year-old Japanese woman with a fever and generalized skin eruptions was referred to our hospital in July 1999. At admission, her temperature was 38.9 degrees C, and she had fluctuating symptoms including erythema of the extremities, conjunctival hyperemia, strawberry tongue, and generalized skin eruptions, but lymphadenopathy was not verified. An initially elevated urine leukocyte count (more than 100 per high power field) later returned to normal range without antibiotic therapy. Adult Kawasaki disease was diagnosed on the basis of the above symptomology. Echocardiograph showed transient effusion in the pericardium. Using the Harada scoring system for treatment of Kawasaki disease, we gave the patient aspirin and did not administer intravenous immunoglobulin. The clinical course was uneventful, and on the day of discharge (day 22 after onset), the laboratory test results were nearly normal. Laboratory test results were negative for both Epstein-Barr virus and group A Streptococcus.

Adult↗
PubMed2005

Annual incidence and clinical characteristics of type 2 diabetes in children as detected by urine glucose screening in the Tokyo metropolitan area.

OBJECTIVE: This study investigates the annual incidence and clinical characteristics of type 2 diabetes among school-aged children as detected by urine glucose screening from 1974 to 2002 in the Tokyo metropolitan area. RESEARCH DESIGN AND METHODS: In total, 8,812,356 school children were examined for glucosuria. Morning urine was used for the analysis. When the urine was positive for glucose, an oral glucose tolerance test was carried out to confirm diabetes. RESULTS: In all, 232 students were identified to have type 2 diabetes. The overall annual incidence of type 2 diabetes was 2.63/100,000. The annual incidence after 1981 was significantly higher than that before 1980 (1.73 vs. 2.76/100,000, P < 0.0001). The annual incidence was significantly higher for junior high school students compared with primary school students (0.78 vs. 6.43/100,000, P < 0.0001). The overall male-to-female ratio of students with type 2 diabetes was 1.0:1.19 (P = 0.296), but it was 1.0:1.56 (P = 0.278) for primary school students. Overall, 83.4% of children with diabetes were obese (> or = 20% overweight). However, nonobese girls (<20% overweight) with diabetes accounted for 23.0% of the patients, whereas markedly obese boys (> or = 40% overweight) accounted for 61.5% of the patients. The frequency of a family history of type 2 diabetes in second- and first-degree relatives was 56.5%. CONCLUSIONS: We confirmed that the incidence of young people with type 2 diabetes increased after 1981 in the Tokyo metropolitan area. The increase in the frequency of this disorder seemed to be strongly related to an increasing prevalence of obesity. Age and genetic susceptibility may be associated with the occurrence of type 2 diabetes.

Adolescent↗
PubMed2004

Determination of the proton tunneling splitting of the vinyl radical in the ground state by millimeter-wave spectroscopy combined with supersonic jet expansion and ultraviolet photolysis.

The vinyl radical in the ground vibronic state produced in a supersonic jet expansion by 193 nm excimer laser photolysis of vinyl bromide was investigated by millimeter-wave spectroscopy. Due to the proton tunneling, the ground state is split into two components, of which the lower and higher ones are denoted as 0+ and 0-, respectively. Eight pure rotational transitions with Ka = 0 and 1 obeying a-type selection rules were observed for each of the 0+ and 0- states in the frequency region of 60-250 GHz. Tunneling-rotation transitions connecting the lower (0+) and upper (0-) components of the tunneling doublet, obeying b-type selection rules, were also observed in the frequency region of 190-310 GHz, including three R- and six Q-branch transitions. The observed frequencies of the pure rotational and tunneling-rotation transitions were analyzed by using an effective Hamiltonian in which the coupling between the 0+ and 0- states was taken into account. A set of precise molecular constants was obtained. Among others, the proton tunneling splitting in the ground state was determined to be DeltaE0 = 16,272(2) MHz. The potential barrier height was estimated to be 1580 cm(-1) from the proton tunneling splitting, by an analysis using a detailed one-dimensional model. The spin-rotation and hyperfine interaction constants were also determined for the 0+ and 0- states together with the off-diagonal interaction constants connecting the 0+ and 0- states, epsilonab + epsilonba for the spin-rotation interaction and Tab for the hyperfine interaction of the alpha (CH) proton. The hyperfine interaction constants, due to the alpha proton and the beta (CH2) protons, are consistent with those derived from electron spin resonance studies.

Journal Article↗
PubMed2004

Assessment of coronary artery abnormalities in a patient with Kawasaki disease by multislice computed tomography.

The high spatial resolution of multislice computed tomography (MSCT) permits direct visualization of the coronary artery system. In this report, we describe coronary artery abnormalities in a young adult with Kawasaki disease. MSCT detected a giant coronary artery aneurysm, coronary artery stenosis in the first diagonal artery, and a multi-layered structure in the right coronary artery and the left circumflex artery. These findings corresponded well to those obtained by coronary angiography. MSCT has the potential to be the standard diagnostic tool for the follow-up evaluation of coronary artery disease in adolescents and young adults with Kawasaki disease.

Adult↗
PubMed2004

Hemophagocytic syndrome and hepatosplenic gammadelta T-cell lymphoma with isochromosome 7q and 8 trisomy.

The authors describe a 15-year-old boy with hepatosplenic gammadelta T-cell lymphoma associated with hemophagocytic syndrome (HPS) along with isochromosome 7q and trisomy 8. He presented with prolonged fever, mild anemia, thrombocytopenia, and hepatosplenomegaly. Physical examination, radiography, and ultrasound tomography revealed no lymphoadenopathy. He had elevated levels of serum ferritin, interferon-gamma, soluble interleukin-2 receptor, and interleukin-6. Bone marrow aspirate showed hypercellularity with 50% lymphoblasts and erythrophagocytosis of macrophage. A cytogenetic study of bone marrow revealed an abnormal karyotype, 47,XY,I(7q),+8, in 5/30 cells. Clonal rearrangement of the genes for T-cell receptor gamma and delta chains was elucidated by polymerase chain reaction. He achieved a complete remission after intensive chemotherapy and underwent splenectomy 18 months after diagnosis. Although the patient was clinically in remission, minimal residual disease (MRD) was detected in the removed spleen by polymerase chain reaction. This might mean that this type of lymphoma is refractory, as reported previously, and might indicate that marrow ablative therapy is needed to achieve a cure. The present case illustrates the usefulness of MRD analysis, and MRD studies in this group of disorders may be helpful in the decision of whether to continue a more aggressive therapeutic approach.

Base Sequence↗
PubMed2004

Serum lipid profile in obese children in China.

BACKGROUND: The aim of the present study was to examine the serum lipid profile in obese Chinese children, their serum lipid and apolipoprotein A-I (apoA-I) and B (apoB) levels were examined. METHODS: The subjects were 153 patients (109 male and 44 female) aged 4-16 years with obesity, who attended the outpatient clinic of Beijing Children's Hospital. Percentage bodyweight (%BW) ([(bodyweight - standard weight)/standard weight]x 100) were obtained. Skinfold thickness and hip and waist circumference were measured. Percentage body fat (%BF) was estimated by bioelectrical impedance analyzer. Serum total cholesterol (TC), high density lipoprotein cholesterol (HDLC), triglyceride (TG), apoA-I and apoB levels were also measured. RESULTS: TC showed an acceptable level in 86.8% of obese children. The prevalence of high TC levels (3.3%) or high LDLC levels (6.0%) was rather low. The HDLC level was reduced in 31.3% of obese children. Anthropometric variables had no linear relationship to TC, HDLC, TG, LDLC, apoA-I or apoB, but in the older age group (over 10 years old) %BW and %BF showed a weak correlation with HDLC (r = -0.202, r = -0.211, respectively). CONCLUSION: In obese Chinese children, HDLC as well as TC levels should be examined in order to assess coronary risk.

Adolescent↗
PubMed2004

Cationic charge-preferential IgG reabsorption in the renal proximal tubules.

BACKGROUND: The brush border of the renal proximal tubules has a polyanionic charge. Since immunoglobulin G (IgG) molecules have a wide range of charge diversity, reabsorption of urinary IgG molecules are supposed to be influenced by the electrostatic interaction. METHODS: Charge diversity of serum and urinary IgG molecules in patients with various renal diseases (N= 12) and premature neonates (N= 3) were analyzed by isoelectric focusing and Immunoblotting. RESULTS: In patients with glomerular diseases, urinary IgG was solely composed of neutral and anionic IgG, whereas that of the cationic part (isoelectric point >8) was not observed. By contrast, in patients with proximal tubular diseases (Dent's disease and idiopathic Fanconi syndrome), the proportion of the cationic IgG was similar to that of serum IgG. In addition, the cationic part of IgG in the urine was found in the neonates with a gestational age of 28 and 31 weeks, but not found in those of 35 weeks. CONCLUSION: The results suggest that renal proximal tubules reabsorb the urinary IgG in a cationic preferential way, and this mechanism requires renal maturation.

Adolescent↗
PubMed2004

Autologous cord blood transfusion in an infant with a huge sacrococcygeal teratoma.

We describe a case of cord blood harvest for autologous transfusion in a neonate weighing 3,992 g with a giant sacrococcygeal teratoma. The umbilical vein was pierced with an 18-gauge needle, and placental blood was withdrawn into two 50-ml syringes filled with 4 ml of citrate-phosphate-dextrose solution. Resection of the sacrococcygeal teratoma was performed on day one. During the operation the infant lost 46 ml of whole blood, more than 15% of the estimated total blood volume, and thus underwent autologous transfusion with 27.8 ml of packed red cells obtained from autologous cord blood. Consequently, she could avoid homologous blood transfusion during the hospital stay. This case highlights the safety of this procedure, with no evidence of consumption coagulopathy, hemolysis or bacterial infection.

Blood Loss, Surgical↗
PubMed2003

Detection of myocardial contractile reserve by low-dose dobutamine quantitative gated single-photon emission computed tomography in patients with Kawasaki disease and severe coronary artery lesions.

We studied 24 patients with severe coronary artery lesions to assess myocardial perfusion and left ventricular contractile reserve simultaneously using low-dose dobutamine quantitative electrocardiographically gated single-photon emission computed tomography in patients with Kawasaki disease. Low-dose dobutamine infusion was started after an injection of technetium-99m tetrofosmin at rest. Myocardial contractile reserve was evaluated using the post-stress and low-dose dobutamine images, and myocardial perfusion was evaluated using the stress and rest images. Quantitative electrocardiographically gated single-photon emission computed tomography during low-dose dobutamine infusion is a useful and safe method for the combined evaluation of myocardial contractile reserve and myocardial perfusion.

Adolescent↗