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Biomedical subjects

Tomoo Okada

Publications and source records attributed to Tomoo Okada.

At least 19 recordsLinked to original sources
PubMed2006

B-flow sonographic demonstration for assessing carotid atherosclerosis in young patients with heterozygous familial hypercholesterolemia.

PURPOSE: To determine whether bloodstream swirls detected with B-mode flow (B-flow) sonography at the region of the carotid bifurcation can predict the early progression of atherosclerosis, we prospectively examined the relationships between the size of bloodstream swirls as identified with B-flow sonography, the local mechanical behavior of the common carotid artery (CCA), and some cardiovascular risk factors in young patients with heterozygous familial hypercholesterolemia (FH). METHODS: Thirty-eight young patients (mean age 25.8 +/- 14.1 years) with FH were evaluated for the following parameters: age, sex, body mass index, degree of dyslipidemia, presence of a plaque, intima-media thickness (IMT), elastic modulus (Ep) and internal diameter of the CCA via duplex scan, wall shear stress, maximal diameter of the bloodstream swirl (Sm) at bifurcation, maximal diameter of the CCA (Cm) at the level of the swirl's center, and diameter ratio (Sm/Cm) via B-flow sonography. RESULTS: Bloodstream swirls of varying size at the site of bifurcation were observed in all patients. Six (15.7%) out of 38 patients exhibited plaques at bifurcation. All plaques were located at the far wall and were in contact with the distal portion of the bloodstream swirl as observed with B-flow sonography. Univariate analysis revealed that Sm/Cm and Sm were positively correlated with age, presence of a plaque, IMT, and Ep and were negatively correlated with shear stress. Multivariate analysis revealed that Sm was significantly correlated with age (P < 0.01) and Ep (P < 0.05). CONCLUSIONS: Our results suggest that a bloodstream swirl visualized at the carotid bifurcation with B-flow sonography may be an indicator of a local mechanism for the age-related progression of atherosclerosis in young patients with FH.

Adolescent↗
PubMed2006

Oral cenesthopathy examined by Rorschach test.

Experience of abnormal pains and unusual sensations in the mouth without a somatic base, for example abnormal mucus secretion, pulling sensation on the jaw or teeth, or a vibrating sensation, is termed 'oral cenesthopathy'. Psychological factors were investigated in terms of cognitive functions and personality tendencies, using Rorschach test in 28 patients with this condition (three men and 25 women). In oral cenesthopathy patients (i) the processing of new information is inefficient; (ii) the necessary resources for social adaptation are lacking, emotional control is inadequate, and uncomfortable emotions are expressed less; and (iii) with regard to interpersonal interaction, less interest is shown in others, trust in others is diminished, and they tend to have a higher Coping Deficit Index.

Adaptation, Psychological↗
PubMed2006

Thr-encoding allele homozygosity at codon 54 of FABP 2 gene may be associated with impaired delta 6 desatruase activity and reduced plasma arachidonic acid in obese children.

BACKGROUND: Alanine-for-threonine substitution at codon 54 (A54T polymorphism) in the fatty acid-binding protein 2 gene (FABP2) has been associated with hypertriglyceridemia and insulin resistance. Impairment in the activity of delta 6 and 5 desaturases is also supposed to be a factor predisposing the development of insulin resistance syndrome. AIM: We investigated the relationship between A54T polymorphism in FABP2 and the impairment of long-chain polyunsaturated fatty acid metabolism in obese children. METHODS: Thirty-two obese children participated. During the study, the children continued their habitual diet, which was documented in a 3-day food record using household measures. Anthropometry was performed, and serum lipid and fatty acid composition in plasma were analyzed. The polymorphism of codon 54 in the FABP 2 gene was analyzed. RESULTS: The allele frequency was 0.66 and 0.34 for Ala54 and Thr54, respectively. There were no significant differences in age, body mass index, fasting serum glucose, insulin or serum lipoproteins among the three polymorphism groups. These were also no significant differences in the intake of energy, the percentage of energy nutrients or in the dietary lipid composition. The content of arachidonic acid (AA) in plasma was lowest in Thr/Thr54 (p < 0.05). The indices of delta-6 desaturase (D6D) activity in Thr/Thr54 were significantly lower than in Thr/Ala54 or Ala/Ala54 (p < 0.05, p < 0.01, respectively). CONCLUSIONS: In obese children, Thr/Thr54 of the FABP 2 gene is associated with impaired activation of D6D and reduced AA content. The results in the LCPUFA profile suggest that Thr/Thr54 may predispose the to development of insulin resistance.

Adolescent↗
PubMed2006

Determination of lipid composition of plasma lipoproteins in children with a rapid agarose gel electrophoresis method.

The agarose gel electrophoresis and differential staining system is an easy and quick method for analyzing the serum lipid composition of each lipoprotein fraction. It has been reported in adults that measured values obtained by this method strongly correlated with those obtained by ultracentrifugation. The aim of this study was to examine the clinical application of this method for children, in comparison with the ultracentrifugation method. The subjects were sixteen hyperlipidemic and twenty-five normolipidemic children, aged from two to eighteen years old. Cholesterol (C) and triglyceride (TG) levels were determined in serum very low density lipoprotein (VLDL), low density lipoprotein (LDL), and high density lipoprotein (HDL) fractions by both methods. Correlation coefficients between the two methods for cholesterol levels were 0.937 (HDL), 0.983 (LDL) and 0.837 (VLDL), and for triglyceride levels were 0.735 (HDL), 0.621 (LDL) and 0.964 (VLDL). We confirmed the clinical application of this method to evaluate the lipoprotein lipid profile in children as well as in adults.

Adolescent↗
PubMed2005

Relationship between serum adiponectin level and lipid composition in each lipoprotein fraction in adolescent children.

The association of lipid composition in each lipoprotein fraction with adiponectin level in relation to body fatness was investigated. The subjects were 283 children (144 boys and 139 girls) aged 11.6 years (S.D. 1.5). Cholesterol (C) and triglyceride (TG) levels in each lipoprotein fraction were measured by a combination of agarose gel electrophoresis and differential staining. Adiponectin level was not significantly different between girls and boys. In simple regression analyses, an association of adiponectin level with lipoprotein lipid profile was shown only in girls, and not in boys at all. In girls, very low-density lipoprotein (VLDL)-C, low-density lipoprotein (LDL)-C, VLDL-TG and LDL-TG were negatively correlated with adiponectin level, and high-density lipoprotein (HDL)-C and HDL-C/TG ratio were positively correlated. Multiple regression analyses including adiponectin level and body mass index (BMI) as predictors for the lipoprotein lipid profile demonstrated that adiponectin level was a significant independent predictor of VLDL-TG, LDL-C, LDL-TG, HDL-C and HDL-C/TG ratio. In conclusion, adiponectin level correlates with lipoprotein lipid profile independent of body fatness in adolescent girls.

Adiponectin↗
PubMed2005

A fatal case of ruptured giant coronary artery aneurysm.

A 5-year-old Japanese boy died because of a ruptured left coronary artery aneurysm (CAA). He was diagnosed as having Kawasaki disease (KD) on the 5th day from onset, with all of the principal signs. On the 7th day of illness, bilateral CAAs were already found via echocardiography, and he was treated with intravenous (IV) gamma globulin and oral ASA. However, the fever persisted and the CAA progressed rapidly. Echocardiography on the 12th illness day showed a giant (18-mm) left anterior descending (LAD) artery aneurysm. Oral propranolol and nifedipine were administered, in conjunction with warfarin/aspirin anti-coagulation therapy. On the 13th day of illness, cardiac arrest developed abruptly, and, despite cardiopulmonary resuscitation (CPR), the patient remained unresponsive and died one hour later. The final pathological diagnosis was a ruptured LAD artery aneurysm and cardiac tamponade. Microscopic investigation of the ruptured vascular wall revealed marked neutrophilic infiltration, with fewer macrophages and lymphocytes. CAA ruptures are a very rare, but fatal, complication of KD. Based on a review of previous reports on CAA ruptures, we consider it useful to distinguish aneurysms which rapidly dilate and continue to expand beyond a diameter of 10 mm with ongoing vasculitis (these CAAs can be termed "super-giant") from the more common giant CAAs limited to a diameter of 8 or 9 mm, because a decision must be made as to whether to start intensive care or to intervene surgically, in order to ensure the survival of patients with such a potentially critical complication.

Aneurysm, Ruptured↗
PubMed2005

Evaluation of risk for atherosclerosis in Alagille syndrome and progressive familial intrahepatic cholestasis: two congenital cholestatic diseases with different lipoprotein metabolisms.

OBJECTIVES: To evaluate the risk for atherosclerosis in Alagille syndrome (AGS) and progressive familial intrahepatic cholestasis (PFIC) on the basis of lipoprotein metabolism and by ultrasonography. STUDY DESIGN: Five patients with AGS and 5 with PFIC, ages 3 to 4 years, were enrolled. Intimal-medial thickness and wall stiffness of the common carotid artery were examined by ultrasonography. Serum levels of lipids and lipoproteins were determined. Further, the chemical composition of LDL and its ability to transform macrophages into foam cells were determined. RESULTS: Intimal-medial thickness and wall stiffness were increased in patients with PFIC but not in patients with AGS. Total cholesterol, LDL cholesterol, HDL cholesterol, and lipoprotein X were remarkably increased in patients with AGS, whereas in patients with PFIC, an increase in triglyceride and a decrease in HDL cholesterol were the prominent findings. However, despite the normal LDL cholesterol level, oxidized LDL level was strikingly high in patients with PFIC. LDLs from patients with PFIC had high TG contents and exhibited high abilities to transform macrophages into foam cells. CONCLUSIONS: These findings suggest that patients with PFIC are at high risk for cardiovascular disorders involving atherosclerosis.

Alagille Syndrome↗
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

Threshold values of visceral fat and waist girth in Japanese obese children.

BACKGROUND: In order to define the diagnostic criteria for visceral adipose tissue (VAT) accumulation and abdominal obesity in Japanese youths, a cross-sectional, multicenter study was conducted. METHODS: Subjects were 194 boys and 96 girls ranging in age from 6 to 15 years. Obese youths were classified according to the occurrence of abnormal values in serum triglyceride, alanine aminotransferase or insulin level. A threshold value of each criterion was calculated, using the analysis of receiver operating characteristic (ROC) curve. The areas of total abdominal adipose tissue (AT), VAT and subcutaneous adipose tissue (SAT) were estimated by single slice computed tomography at the level of umbilicus. RESULTS: VAT area was greater in boys than it was in girls. The critical values for VAT area and waist circumference in all subjects were 54.8 cm2 and 83.5 cm, respectively. The values for the area under the ROC curves were VAT area > total AT area > waist circumference > SAT area > percentage overweight > percentage body fat. The sensitivity and specificity for VAT area were 90.5 and 79.5%, respectively. Those for waist circumference were high enough (> 70%) for clinical use. In the linear regression analysis assigning VAT area as an independent variable and waist circumference as a dependent variable, the expected value for the waist circumference was 82 cm. CONCLUSION: In Japanese obese youths ranging in age from 6 to 15 years, the diagnostic criteria for the waist circumference was 82 cm, and that for VAT area was 55 cm2.

Adolescent↗
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↗
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

Relationship between the presence of small, dense low-density lipoprotein and plasma lipid phenotypes in Japanese children.

To clarify the relationship between the expression of atherogenic small, dense low-density lipoprotein (SDLDL) and underlying lipid metabolic abnormalities, the prevalence of SDLDL in relation to the serum lipid phenotype was analyzed in 229 children. The LDL particle size was measured using gradient gel electrophoresis, and a particle size of less than 25.5 nm was considered to represent SDLDL. The overall prevalence of SDLDL in the sample population was 8.2% (19/229; 11/117 for boys and 8/112 for girls). Hyperlipidemia phenotype IIb (elevated concentrations of both triglyceride [TG] and total cholesterol [TC]) was strongly associated with SDLDL in 83% (5/6) of the subjects. An elevated TG concentration (phenotype IV) was associated with SDLDL in 55% (10/18) of the subjects. The association between hyperlipidemia phenotype IIa (elevated TC but a normal TG concentration) and SDLDL was quite low (2%; 1/56), but SDLDL was detected in 5% (8/155) of the subjects who presented with normolipidemia. Therefore, these findings suggest that the expression of SDLDL is largely related to lipid abnormalities characterized by phenotype IIb or IV, the underlying metabolic abnormality of which is suspected to be insulin resistance; however, an additional mechanism for the formation of SDLDL that functions independently of plasma lipid abnormalities also seems to exist.

Child↗