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Kensuke Harada

Publications and source records attributed to Kensuke Harada.

51 records · Page 3Linked to original sources
PubMed2003

Agenesis of the internal carotid artery and congenital pituitary hypoplasia: proposal of a cause of congenital hypopituitarism.

UNLABELLED: We describe a patient with microphallus without pigmentation and multiple pituitary hormone deficiencies. The left internal carotid artery and carotid canal were absent and the pituitary gland and sella turcica showed hypoplasia on MRI and magnetic resonance angiography. The internal carotid artery develops in the 4th embryonic week, while the pituitary primordium develops in the 3rd to 4th week. This suggests a possible relationship between internal carotid artery and congenital hypopituitarism. However, there is bilateral blood supply to the hypophysis via the superior and inferior hypophysial arteries, so it is unknown why pituitary hypoplasia may arise from blocking the unilateral blood supply. CONCLUSION: Disruption of internal carotid artery perfusion may lead to pituitary hypoplasia with congenital hypopituitarism as a new disease entity in humans.

Abnormalities, Multiple↗
PubMed2003

Body fat ratios in urban Chinese children.

OBJECTIVE: As obesity has been increasing in China, the present study examined the body composition of children to assess their fatness. STUDY DESIGN: A total of 532 healthy schoolchildren who lived in central Beijing were examined. Skinfold thicknesses, hip and waist circumferences, and body fat percentage were measured, as well as height and weight. RESULTS: The prevalence of overweight (Body Mass Index (BMI) >or= 95% for age and sex of Chinese children) was 27.7% in boys and 14.2% in girls (chi-squared; P = 0.0001). The percentages of body fat (BF%), waist/hip ratios and skinfold thicknesses ratios (subscapular/triceps) in overweight children were significantly higher than those in non-overweight children (Mann-Whitney U-test). The BF% of non-overweight boys was significantly higher than that of non-overweight girls. CONCLUSION: Urban Chinese overweight children have high BF% with adverse fat distribution. They may have high risk of atherogeniety. Boys in the non-overweight category may have higher fat accumulation than predicted by BMI. The establishment of an intervention program for childhood obesity is strongly recommended.

Body Composition↗
PubMed2003

Detection of coronary artery aneurysms, stenoses and occlusions by multislice spiral computed tomography in adolescents with kawasaki disease.

In patients with Kawasaki disease (KD), serial evaluation of coronary artery aneurysms (CAAs) and luminal narrowing is essential for risk stratification and therapeutic management. Therefore, non-invasive assessment of the status of the coronary artery is of utmost importance in patient management. Multislice spiral computed tomography (MSCT) permits non-invasive visualization of the entire coronary artery system and was used in the evaluation of 4 patients with KD. CAAs and high-grade coronary artery stenoses were detected by MSCT and corroborated the findings of coronary angiograms performed within the previous 2 years. MSCT has the potential to be the standard diagnostic tool in adolescents with KD.

Adolescent↗
PubMed2003

Screening for familial combined hyperlipidemia in children using lipid phenotypes.

The purpose of this study was to screen for FCHL in children using serum lipid phenotypes. The subjects were 1190 (599 male, 591 female) children who participated in a screening and care program for life style-related diseases in school children. Total cholesterol, high-density lipoprotein cholesterol and triglyceride were determined, and information on the family history of parents was obtained by questionnaire. Candidates for FCHL were screened by the following criteria; type IIb hyperlipidemia, type IIa hyperlipidemia with positive family history of CHD, hyperlipidemia or both. We informed them of the results by mail. A second series of examinations to diagnose FCHL was performed on volunteer participants, including their parents. The candidates consisted of 9 children with type IIb and 27 with type IIa hyperlipidemia, 11 of whom participated, in the second series of examinations, in which 5 children were diagnosed with FCHL. The prevalence was 0.4%, suggesting that at least half of all individuals with FCHL already demonstrate hyperlipidemia in childhood.

Child↗
PubMed2002

Mortality among persons with a history of Kawasaki disease in Japan: the fifth look.

OBJECTIVE: To determine whether patients with Kawasaki disease have a higher death rate than an age-matched healthy population after disease occurrence. STUDY DESIGN: From July 1, 1982, to December 31, 1992, 52 collaborating hospitals collected data on all patients with a new definite diagnosis of Kawasaki disease. Patients were followed up until December 31, 1999, or death. The expected number of deaths was calculated from Japanese vital statistics data and compared with the observed number. RESULTS: Of 6576 patients enrolled, 27 (19 male, 8 female) died. The standardized mortality ratio (the observed number of deaths divided by the expected number of deaths based on the vital statistics in Japan) was 1.25 (95% confidence interval, 0.84-1.85). Despite the high standardized mortality ratios during the acute disease phase, the mortality rate was not high after the acute phase for the entire group of patients. Although the standardized mortality ratio after the acute phase was 0.76 for those without cardiac sequelae, 6 male patients (no female patients) with cardiac sequelae died during this period, and the standardized mortality ratio for the male group with cardiac sequelae was 2.35 (95% confidence interval, 0.96-5.19). CONCLUSIONS: Although it was not statistically significant, the mortality rate among male patients with cardiac sequelae due to Kawasaki disease seemed higher than that in the general population. On the other hand, mortality rates for female patients with sequelae and both male and female patients without sequelae were not elevated.

Age Distribution↗
PubMed2002

Brain evoked potentials of 3-D auditory stimuli.

BACKGROUND: For evaluation of spatial cognitive function, we studied the brain evoked potentials (EP) of 3-D auditory stimuli in regard to the change of latencies in normal subjects aged 1-21 years and compared them with patients who have mental retardation (MR). METHODS: A total of 144 normal subjects and 67 patients with MR were tested. The EP were elicited by 1000 Hz fixed and enlarged tones with Doppler effect randomly presented. No specific task was imposed in relation to the auditory stimuli. Electroencephalograms were recorded at the Fpz, Fz, Cz, Pz and Oz scalp locations (10-20 system), referenced to linked earlobes. The 64 responses of EP were averaged. The EP were measured from the difference in waveform by subtracting the EP of the fixed tone stimuli from that of the enlarged tone stimuli. RESULTS: The waveforms of EP consisted of the components P0, N1, P1, N2 and P2. These components (P0, N1, P1, N2 and P2) in the EP gradually shortened with increasing age in children. About 30% of patients with MR showed more prolonged latencies than normal subjects. CONCLUSION: These results suggest that these components indicated auditory kinetic evoked potentials. This developmental change could be related to maturational phenomena regarding spatial cognitive function. The EP of 3-D auditory stimuli may be used in children to evaluate the development of spatial cognitive function.

Adolescent↗
PubMed2002

Follow-up study of auditory brainstem responses in infants with high unbound bilirubin levels treated with albumin infusion therapy.

BACKGROUND: Several authors reported that there was a close relationship between unbound bilirubin concentrations and abnormal results of auditory brainstem responses. Full-term infants with high-unbound bilirubin concentrations who were treated with human albumin were followed to evaluate their hearing abilities by using auditory brainstem responses. METHODS: Fifty-eight infants (gestational age, 39.4 +/- 1.4 weeks; birthweight, 3,245 +/- 435 g) with high unbound bilirubin concentrations (> or = 0.9 micro g/dL) were treated with intensive phototherapy. Twenty infants (control group) received only phototherapy, while 38 others (albumin-treated group) were also given i.v. human albumin administration (1 g/kg bodyweight) during the first 2 h of phototherapy. The follow-up study of auditory brainstem responses was carried out at 6 and 12 months of age. Development quotient tests were carried out at 18 months of age. RESULTS: Abnormalities of auditory brainstem response were detected in three infants in the albumin-treated group and six infants in the control group at 6 months. Two infants in the albumin-treated group and four infants in the control group had improved at 12 months. The results of the follow-up study at 18 months of age in the both groups were normal with development quotient >85. No patients with hearing disability and cerebral palsy were clinically detected at the age of 2 years. CONCLUSION: The results suggest that albumin priming might be effective for decreasing the rate of auditory brainstem response abnormalities at 6 months.

Bilirubin↗
PubMed2002

New criteria of normal serum lipid levels in Japanese children: the nationwide study.

AIM: To make new criteria of serum lipid levels in current Japanese children using the large nationwide data provided from Japan Association of Health Service for the analysis. METHODS: The subjects were schoolchildren who received screening and care programs for lifestyle related diseases since 1993-1999. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDLC) and triglyceride (TG) levels were measured, and low-density lipoprotein cholesterol (LDLC) levels were calculated. Serum lipid levels were analyzed by age and sex. For each serum lipid, we extracted age- and sex-specific group which the mean value was not statistically different from that in 1999 by Student's t-test analysis. RESULTS: The level below the 75th percentile was defined to be acceptable, from the 75th to 95th to be borderline and over the 95th to be high in TC/LDLC. The level below the fifth percentile in HDLC was defined to be low and the level over the 95th percentile in TG to be high. Therefore, TC level was categorized as follows: acceptable < 190 mg/dL; borderline 190-219 mg/dL; and high > 220 mg/dL. The LDLC level was also categorized into: acceptable < 110 mg/dL; borderline 110-139 mg/dL; and high > 140 mg/dL. The cut-off value in TG was determined to be 140 mg/dL and in HDLC was 40 mg/dL. CONCLUSIONS: This new criteria should prove valuable in health strategies for rational prevention and intervention in children. It should be emphasized to provide some intervention for Japanese children immediately.

Adolescent↗
PubMed2002

Intravenous ulinastatin therapy for Stevens-Johnson syndrome and toxic epidermal necrolysis in pediatric patients. Three case reports.

BACKGROUND: More effective therapy is needed for the treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The clinical efficacy of intravenous ulinastatin therapy was investigated in 3 Japanese pediatric patients with SJS or TEN. METHODS: Ulinastatin was given to 1 pediatric SJS patient and 2 pediatric TEN patients within 7 days (patient 1; SJS), 6 days (patient 2; TEN), or 4 days (patient 3; TEN) after the onset of the skin rash. Ulinastatin was administered intravenously at a dose of 7,500 U/kg/day (maximum dose: 300,000 U/day). No corticosteroids were given. After the skin lesions resolved, the ulinastatin dose was reduced to between 2,500 and 5,000 U/kg/day as maintenance therapy and then the drug was withdrawn. RESULTS: Erythema, fatigue, and fever improved within 12-36 h of starting the ulinastatin infusion, and the skin lesions resolved completely after 4-7 days of ulinastatin therapy. None of the patients had cutaneous or ocular sequelae. No patient developed secondary infection or relapse and ulinastatin therapy caused no side effects. CONCLUSION: Ulinastatin dramatically reduced the febrile period with no adverse effects and was very safe in this study. Ulinastatin appears to be a useful and effective therapy for controlling SJS and TEN without sequelae.

Animals↗
PubMed2002

Waist-to-height ratio is the best predictor of cardiovascular disease risk factors in Japanese schoolchildren.

In adults, visceral fat accumulation is an important indicator for cardiovascular disease risk. This relationship is not fully understood in children. To determine the best predictor of cardiovascular disease risk factors among anthropometric indices such as body mass index (BMI), percent body fat (%Fat), waist-to-hip ratio (WHR), waist circumference, and waist-to-height ratio (W/Ht ratio) in Japanese schoolchildren. This study included 880 children (447 boys and 433 girls), 9-13y of age. Dependent variables were total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), atherogenic index (AI), life style related disease prevention score, and systolic (SBP) and diastolic (DBP) blood pressure. The strongest correlation was found between W/Ht ratio and the score by Pearson's correlation analysis. Multiple regression analysis showed that significant independent correlates for the score included W/Ht ratio and %Fat. Among the anthropometric indices, W/Ht ratio was the most significant predictor for TC, TG, LDLC, AI, and the score. W/Ht ratio is the best predictor of cardiovascular risk factors in Japanese schoolchildren. We propose using W/Ht ratio for detecting cardiovascular disease risk in children.

Adolescent↗
PubMed2002

Familial combined hyperlipidemia (FCHL) in children: the significance of early development of hyperapoB lipoproteinemia, obesity and aging.

It is not easy to make diagnose FCHL in children, since a clear expression of lipoprotein abnormality is unlikely and standard criteria have not yet been established. We investigated eight cases of childhood FCHL and their families with respect to familial history, anthropometric parameters and serum lipoprotein levels, to explore the characteristics of childhood FCHL. To diagnose childhood FCHL it is necessary to clarify both the family history and lipid profiles of the parents. In this study, two prominent features were suggested; that serum TG level is affected by both obesity and age, and also in particular, that a significantly elevated level of serum apoB is a predominant feature of FCHL in childhood. It was found that hyperapoB may be revealed antecedently without other lipid abnormalities at an early age. Regardless of other lipoprotein abnormality, it was suggested that hyperapoB might be added to the early diagnostic criteria for FCHL.

Adult↗
PubMed2002

[A case of rhabdomyolysis associated with Salmonella encephalopathy].

We report a case of severe rhabdomyolysis associated with Salmonella encephalopathy. A 3-year-old girl was admitted to our hospital because of status convulsives and unconsciousness. She was diagnosed as having Salmonella encephalopathy with rhabdmyolysis, and was treated by mild hypothermia and mechanical ventilation. Five days later she developed anuria with increased serum levels of myoglobin, CK and creatinine. And the diagnosis of acute renal failure was made. Peritoneal dialysis was begun from 6 days after admission. Hyperinfusion, the usual therapy of rhabdomyolysis, was not performed. She survived showing gradual improvement of renal function and consciousness. In a case of rhabdomyolysis complicating a neurologic disorder, a well-known poor prognostic factor, priority should be given to brain protection rather than to symptomatic treatment of rhabdomyolysis.

Acute Kidney Injury↗
PubMedDate not supplied

No clinical correlation between bilirubin levels and severity of retinopathy of prematurity.

PURPOSE: To evaluate the hypothesis that bilirubin has a protective effect against the development of severe retinopathy of prematurity (ROP). METHODS: An assessment of 76 infants born at 24 and 25 weeks' gestation and admitted to the level III neonatal intensive care unit at Saitama Children's Medical Center was made. Indirect ophthalmoscopy fundus examinations were performed on all infants to identify the degree and progression to threshold ROP. We analyzed the daily bilirubin levels and grouped the patients according to the severity of ROP based on the infant's worst ROP examination. The first group was comprised of infants with less than stage 3 ROP and infants with stage 3 ROP. The second group was infants with less than prethreshold ROP or prethreshold ROP, and infants with threshold ROP. Next, we divided the infants into 3 groups: less than prethreshold ROP, prethreshold ROP, and threshold ROP. The daily changes in serum bilirubin concentrations during the first 14 days of life were determined for each infant. Three groups (less than prethreshold ROP, prethreshold ROP, and threshold ROP) were comparable as to their basic data, clinical characteristics, and treatments. RESULTS: ROP was found in 76 infants. There were no statistical differences in the clinical characteristics and treatments, excluding the duration of phototherapy, among the 3 groups. During the first 14 days of age, there were no significant differences in the daily mean bilirubin concentrations according to the groups separated by severity of ROP. CONCLUSION: These results indicate that there is no distinct protective effect of bilirubin on the development of severe ROP.

Bilirubin↗