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Imataka G, Fujisawa M, Kuribayashi R, Ichikawa G, Watabe Y, Suzumura H, Arisaka O, Yoshihara S. Low-birth-weight infant with Antley-Bixler syndrome-like phenotype caused by POR mutation: a rare case report. Eur Rev Med Pharmacol Sci 2020; 24:11998-12000. [PMID: 33336784 DOI: 10.26355/eurrev_202012_23987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.
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2
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Imataka G, Ishii J, Ando Y, Yoshihara S, Takagi Y, Nitta A, Arisaka O, Yoshihara S. Long-term survival of a patient with acute neonatal-onset metabolic encephalopathy with carbamoyl phosphate synthetase 1 deficiency. Eur Rev Med Pharmacol Sci 2020; 24:10051-10053. [PMID: 33090410 DOI: 10.26355/eurrev_202010_23220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Long-term survival of patients with neonatal-onset carbamoyl-phosphate synthetase 1 deficiency (CPS1D), an autosomal recessive disorder characterized by repeated, life-threatening hyperammonemia, is rare. We describe the diagnosis and clinical management of a teenager with neonatal-onset CPS1D who did not undergo therapeutic liver transplantation. CASE REPORT Following emergent neonatal therapy, the patient was diagnosed with CPS1D based on clinical, radiological, biochemical and genetic analyses. Her clinical course, neurobehavioral development and therapeutic interventions are presented and discussed. RESULTS Born from nonconsanguineous parents, the proband underwent phototherapy for neonatal jaundice, associated with acute encephalopathy, apnea and cerebral edema. Based on blood and urinary biochemical abnormalities, neonatal-onset CPS1D was diagnosed. Her hyperammonemia was corrected by hemodialysis, followed by sodium benzoate, L-arginine, levocarnitine and protein-free diet therapy. Because of a relapse and persistent neurobehavioral regression by age 1, a planned liver transplantation was cancelled. At age 10, sodium phenylbutyrate was substituted as ammonia scavenger. Genetic testing revealed compound heterozygote c.2359C>T (R787X) and c.236+6T>C variants of CPS1, confirming her diagnosis. Despite severe neurological sequelae, the patient is 16 and in stable condition. CONCLUSIONS Our case suggests that early hemodialysis and pharmacologic interventions for acute neonatal hyperammonemia can improve the prognosis of patients with neonatal-onset CPS1D.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan.
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Harada-Shiba M, Ohta T, Ohtake A, Okada T, Arisaka O, Kastelein J, Luirink I. Efficacy and safety of pitavastatin in paediatric FH compared with other statins from Cochrane Database. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yoshihara S, Fukuda H, Tamura M, Arisaka O, Ikeda M, Fukuda N, Tsuji T, Hasegawa S, Kanno N, Teraoka M, Wakiguchi H, Aoki Y, Igarashi H, Terada A, Hasegawa M, Manki A. Efficacy and Safety of Salmeterol/fluticasone Combination Therapy in Infants and Preschool Children with Asthma Insufficiently Controlled by Inhaled Corticosteroids. Drug Res (Stuttg) 2016; 66:371-6. [PMID: 27273710 DOI: 10.1055/s-0042-108852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Clinical evidences of inhaled salmeterol/fluticasone propionate combination (SFC) therapy are insufficient in early childhood asthma. OBJECTIVES To examine the effects of SFC50, a combination product of salmeterol xinafoate (50 μg/day) and fluticasone propionate (100 μg/day), in infants and preschool children with asthma. METHODS The study was conducted at 31 sites in Japan. 35 patients (6 months to 5 years old) with asthma insufficiently controlled by inhaled corticosteroids (100 μg/day) were initiated to treat with SFC50 twice a day for 12 weeks with pressurized metered dose inhalers. The efficacy of SFC50 was assessed using nighttime sleep disorder score as the primary endpoint and the other efficacy measurements. The safety measurement included the incidences of adverse event (AE). RESULTS Mean patient age was 3.1 years, and 94.2% had mild-to-moderate persistent asthma (atopic type: 65.7%). Nighttime sleep disorder scores, assessed by a nighttime sleep diary, significantly decreased after treatment with SFC50 throughout the study period (p<0.01). SFC50 also significantly improved other efficacy outcomes including asthma symptom score, frequency of short-acting beta-agonist treatment, frequency of unscheduled visits to clinic, frequency of exacerbation due to virus infection, asthma control score and patient QOL score (p<0.01). AEs of cold, upper respiratory inflammation and asthmatic attack occurred in each of the 3 patients (8.6%); however, these were not regarded as treatment-related AEs. CONCLUSIONS SFC50 improved nighttime sleep disorder score and other efficacy outcome measures with no safety concerns. The results suggest that SFC50 treatment is useful to control the mild-to-moderate asthma in infant and preschool-aged children.
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Affiliation(s)
- S Yoshihara
- Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan
| | - H Fukuda
- Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan
| | - M Tamura
- Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan
| | - O Arisaka
- Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan
| | - M Ikeda
- Department of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - N Fukuda
- Grimm Pediatrics and Allergy Clinic, Tochigi, Japan
| | - T Tsuji
- Department of Pediatrics, JA Hiroshima General Hospital, Hiroshima, Japan
| | - S Hasegawa
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - N Kanno
- Department of Pediatrics, Nishikata Hospital, Tochigi, Japan
| | - M Teraoka
- Department of Pediatrics, Kurashiki Municipal Hospital, Okayama, Japan
| | - H Wakiguchi
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Y Aoki
- Department of Pediatrics, Nagato General Hospital, Yamaguchi, Japan
| | - H Igarashi
- Department of Pediatrics, Nogi Hospital, Tochigi, Japan
| | - A Terada
- Terada Kid's Allergy & Asthma Clinic, Aichi, Japan
| | - M Hasegawa
- Department of Pediatrics, Yamaguchi Grand Medical Center, Yamaguchi, Japan
| | - A Manki
- Department of Pediatrics, Okayama City Hospital, Okayama, Japan
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Imataka G, Hagisawa S, Nitta A, Hirabayashi H, Suzumura H, Arisaka O. Long-term survival of full trisomy 13 in a 14 year old male: a case report. Eur Rev Med Pharmacol Sci 2016; 20:919-922. [PMID: 27010151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Long term survival for the cases of trisomy 13 into over a first decade is very rare. We reported here the case of a 14-year-old male karyotype with full type of trisomy 13. In this clinical phenomenon, the case had typical facial, finger and limb anomalies for trisomy 13. Arterial septal defect and patent ductus arteriosus were recognized using ultrasonography after birth. Major cerebral malformation such as holoprosencephaly or cerebellar hypoplasia were also not revealed. After 5 months of his age, artificial ventilation therapy for dyspnea associated with laryngomalacia was required. A tracheotomy was performed at 6 months of his age. After 12 years old, intractable partial epilepsy was recognized. For his partial seizures, a treatment with a combination of two anti-epileptic drugs, valproic acid and levetiracetam, were advised. Now he is alive for 14-years-old and he is the 4th longest surviving patient with full karyotype of trisomy 13.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Dokkyo, Japan.
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Imataka G, Nakajima I, Goto K, Konno W, Hirabayashi H, Arisaka O. Drop episodes improved after tracheotomy: a case of Coffin-Lowry syndrome associated with obstructive sleep apnea syndrome. Eur Rev Med Pharmacol Sci 2016; 20:498-501. [PMID: 26914125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Some cases of Coffin-Lowry syndrome recognized episodic drops and it tended to be intractable for medical treatment. We reported here a patient with the Coffin-Lowry syndrome associated with obstructive sleep apnea syndrome (OSAS). The patient had epileptic seizures and drop attacks only during night-time and it was not recognized during the daytime. His sleep-induced electroencephalogram was normal. At 12-years old of his age, his OSAS was worse, so we performed a tracheotomy. Notably after the operation, his epileptic episodes were disappeared.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan.
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Imataka G, Ohwada Y, Shimura N, Yoshihara S, Arisaka O. Del(18)(q12.2q21.1) syndrome: a case report and clinical review of the literature. Eur Rev Med Pharmacol Sci 2015; 19:3241-3245. [PMID: 26400529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The terminal deletion of the long arm of chromosome 18 is relatively common among cytogenetic abnormalities, which occur incidentally in approximately 1 in 40,000 live births. Proximal interstitial deletions of the long arm of chromosome 18 are less frequent. The critical region on chromosome 18 of this syndrome is del(18)(q12.2q21.1) and has recently been recognized as a new clinical entity. We describe a 8-year-old boy with developmental delay, obesity, and epilepsy, with characteristic facial anomalies in whom G-banding chromosome analysis revealed a unique karyotype of 46, XY, del(18)(q12.2q21.1). The patient was diagnosed with interstitial deletion chromosome 18q-syndrome. He received weight control therapy from a medical dietitian. For his epilepsy, he was administered oral carbamazepine at 4 mg/kg/day. At age six, he entered a special needs elementary school. After entering school, he often showed hyperkinesis, and was diagnosed with attention deficit hyperactivity disorder with mild mental retardation. Because patients with only del(18)(q12.2q21.1) have no serious associated malformations, physicians should be aware that even adult patients may have 18q-syndrome. Therefore, if epilepsy occurs in patients with minor facial anomalies, psychomotor retardation, obesity, and the possibility of 18q-syndrome with del(18)(q12.2q21.1) should be kept in mind, and chromosome testing should be performed.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan.
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Imataka G, Tsuboi Y, Kano Y, Ogino K, Tsuchioka T, Ohnishi T, Kaji Y, Wake K, Ichikawa G, Suzumura H, Arisaka O. Treatment with mild brain hypothermia for cardiopulmonary resuscitation after myoclonic seizures in infant with robertsonian type of trisomy 13. Eur Rev Med Pharmacol Sci 2015; 19:2852-2855. [PMID: 26241539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Congenital chromosomal abnormality with trisomy 13 is known to be associated with poor life prognosis and lethal. Therefore, physician advice the patients be kept in intensive treatment with resuscitation and state of the art intensive care when sudden change in the general condition with this trisomy is observed. We report herein, the treatment with mild brain hypothermia therapy for cardiopulmonary resuscitation after myoclonic seizures in infant with Robertsonian type of trisomy 13 in intensive care unit. Our study indicated that brain hypothermia therapy and steroid pulse therapy on an infant who was believed to have post-resuscitation hypoxic encephalopathy was highly effective as the patient's general condition recovered to the original state after four months.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan.
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Imataka G, Wake K, Suzuki M, Yamanouchi H, Arisaka O. Acute encephalopathy associated with hemolytic uremic syndrome caused by Escherichia coli O157: H7 and rotavirus infection. Eur Rev Med Pharmacol Sci 2015; 19:1842-1844. [PMID: 26044229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We reported a case of a 22-months child with hemolytic uremic syndrome associated with encephalopathy. As the cause of this case, the involvements of verotoxin 1 and 2 caused by O157: the H7 strain of the enterohemorrhagic Escherichia coli and rotavirus were presumed. We administered brain hypothermic therapy and steroid pulse therapy in the intensive care unit, but we were not able to save his life and the child died on the 6th day from the onset.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan.
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Imataka G, Wake K, Yamanouchi H, Ono K, Arisaka O. Brain hypothermia therapy for status epilepticus in childhood. Eur Rev Med Pharmacol Sci 2014; 18:1883-1888. [PMID: 25010618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE At the Dokkyo Medical University Hospital, we introduced a brain hypothermia therapy protocol for treating childhood status epilepticus and acute encephalitis/encephalopathy in 2004. PATIENTS AND METHODS This protocol focuses on infants with a minimum age of six months or 7.5 kg in weight. Applicable diseases include acute encephalitis/encephalopathy occurring from status epilepticus or seizures lasting for 30 minutes or longer, in cases such as near drowning, hypoxic-ischemic encephalopathy, post-resuscitation encephalopathy, cardio-respiratory arrest, severe head injury, or other diagnoses in which the pediatric neurologist recognizes the possibility of neurological complications. Brain hypothermia therapy is managed within the intensive care unit (ICU). RESULTS The target body temperature is a bladder or rectum temperature of 34.0 to 35.0 degrees. This body temperature is reduced to the target temperature within six hours of the seizures. Hypothermia is maintained for 48 hours and concomitant steroid pulse therapy may be used at appropriate times. Sodium thiopental is used to sedate and rewarming is carried out at 0.5 degrees per 12 hours. Osmotic diuretics, muscle relaxants and circulatory antagonists may be concomitantly used at appropriate times. CONCLUSIONS This paper reviews the brain hypothermia therapy protocol.
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Affiliation(s)
- G Imataka
- Department of Pediatrics; Dokkyo Medical University School of Medicine, Tochigi, Japan.
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Imataka G, Arisaka O. Serial EEG study in a girl with Landau-Kleffner syndrome associated with continuous spikes and waves during slow sleep. Eur Rev Med Pharmacol Sci 2014; 18:2145-2147. [PMID: 25070819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Landau-Kleffner syndrome (LKS) is rare epileptic encephalopathy in childhood, characterized by both acquired epileptic aphasia and abnormal epileptiform discharges in electroencephalogram (EEG). We herein report a serial EEG study in LKS. A 22-month old girl was referred to our hospital because of frequently partial seizures in her left upper limb. On EEG performed and multiforcal spikes were recognized. Oral treatment of carbamazepine was started but her seizures were not controlled. Her language ability did not progress after 2 years of her age. At age 4 years, carbamazepine was switched to valproic acid, leading to reduction in the frequency of seizure episodes. She was able to speak two-word sentences at 4 years of age, but her word output gradually decreased. At 5 years of age, addition of zonisamide further reduced the frequency of seizure episodes, but failed to achieve complete control of seizures. She increasingly asked for questions to be repeated. Auditory brainstem response testing performed at the department of otolaryngology revealed normal hearing ability. She was diagnosed as having intellectual deficits with an intelligence quotient (IQ) of 61 at 7 years of age. The EEG at 8 years of age showed continuous spikes and waves during slow sleep (CSWS), leading to a diagnosis of LKS. After age 11 years, the CSWS on EEG improved without requiring a change in antiepileptic drugs (AEDs). Treatment with the oral AEDs was discontinued at 13 years of her age. Her IQ at 13 years of age was in the low 70s.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan.
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Imataka G, Arisaka O. An infant with steroid-refractory cytomegalovirus-associated ADEM who responded to immunoglobulin therapy. Eur Rev Med Pharmacol Sci 2014; 18:2148-2151. [PMID: 25070820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Acute disseminated encephalomyelitis (ADEM) develops via an immunological mechanism. We encountered a 10-month-old infant with a rare pathogenesis of cytomegalovirus (CMV)-related ADEM. The patients complaints were; protracted fever; consciousness disorder; and affected cervical stability. Cerebral magnetic resonance imaging (MRI) 9 days after onset, revealed a disseminated lesion, suggesting ADEM. Pulse therapy with methylprednisolone at 30 mg/kg was performed for 3 days. However, its clinical efficacy was not marked. Therapy with immunoglobulin (IVIg) at 400 mg/kg/day was started 15 days after onset, and continued for 5 days. This markedly improved the consciousness level and muscle strength, and the infant was discharged without neurological sequelae. ADEM showed a monophasic course, and the infant's subsequent growth has been favorable. Altough the number of case reports is small, massive-IVIg therapy should be considered in patients with steroid-refractory ADEM, as demonstrated in this case study.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan.
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Imataka G, Okuya M, Hirao J, Arisaka O. Terminal deletion 6q syndrome with 11q partial trisomy mosaicism due to maternal balanced translocation. Genet Couns 2014; 25:63-67. [PMID: 24783657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Imataka G, Tsuboi T, Kuribayashi R, Miyamoto K, Ichikawa G, Suzumura H, Arisaka O. Partial trisomy 3p and monosomy 5p diagnosed by spectral karyotyping (SKY). Genet Couns 2013; 24:445-448. [PMID: 24551991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Imataka G, Suzumura H, Arisaka O. Diagnosis of sex chromosomal abnormalities in neonatal intensive care units. Genet Couns 2013; 24:399-403. [PMID: 24551983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Neonates are hospitalized in the neonatal intensive care unit for complications arising during delivery or for the treatment of congenital anomalies. Some anomalies may warrant chromosomal analysis. We investigated all cases of neonates hospitalized in the NICU at Dokkyo Medical University Hospital between January 1990 and May 2011. Over the study period of 21 years and 5 months, 169 of 6,159 neonates (2.74%) were diagnosed with chromosomal abnormalities. Autosomal chromosomal aberrations were observed in 165 neonates (2.68%), and sex chromosome abnormalities in only 4 neonates (0.07%). Compared with previous studies, we found a much lower prevalence of sex chromosome abnormalities, despite a similar overall prevalence of chromosomal abnormalities. This seems to be due to the fact that sex chromosome abnormalities are likely to be clinically invisible in the NICU.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan.
| | - H Suzumura
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - O Arisaka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan
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Imataka G, Arisaka O. Monosomy 5p and partial trisomy 8q due to maternal balanced translocation. Genet Couns 2013; 24:435-437. [PMID: 24551988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Imataka G, Ishii J, Tsukada K, Suzumura H, Arisaka O. Ring chromosome 8 with mosaic trisomy 8 syndrome in an infant. Genet Couns 2013; 24:441-444. [PMID: 24551990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Imataka G, Noguchi M, Tsukada K, Takahashi T, Yamanouchi H, Arisaka O. Partial epilepsy and developmental delay in infant with ring chromosome 14. Genet Couns 2013; 24:81-83. [PMID: 23610869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Ring chromosome 14 (r14) is clinically characterized by early-onset epilepsy, mental retardation, delayed speech, microcephaly, extremely mild facial dysmorphisms and ophthalmologic abnormalities. We report a case presenting with partial seizures and delayed development in infancy in which r14 was diagnosed based on chromosomal analysis. The patient was a girl with a normal family and delivery history. Afebrile generalized convulsions developed at age 9 months, and phenobarbital was started, but was changed to zonisamide due to impaired liver function. Chromosome analysis led to a diagnosis of 46, XX, r(14) (p11.2q32.3). At age 5 years, while under treatment with zonisamide and clobazam, epilepsy was characterized by multiple daily episodes of complex partial seizures. Although there are no consistent brain MRI or electroencephalogram findings, experienced pediatric neurologists can make a diagnosis based on facial dysmorphisms. When refractory epilepsy is encountered in infancy with developmental delay of unknown cause, chromosome analysis should be performed.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan.
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Abstract
AIM Leptin is one of the factors affecting serum lipid profile. We investigated the association between serum lipids and leptin/leptin receptor (LEPR) gene polymorphisms in obese Japanese children. METHODS One hundred and thirty-six obese children (99 males and 37 females, relative weight over than 20%) from 5 to 17 years of age were recruited from 10 institutes. Four known polymorphisms in leptin gene [(+19)A G, (-2548)G A, (-188)C A, (-633)C T] and four known polymorphisms in LEPR gene [Lys109Arg, Gln223Arg, Pro(G)1019Pro(A), Ser(T)343Ser(C)] were determined using polymerase chain reaction-restriction fragment length polymorphism-based analyses. RESULTS No associations were found between leptin gene polymorphisms and serum lipid profile. On the other hand, Lys109Arg and Ser343Ser polymorphism in LEPR gene, but not Gln223Arg or Pro1019Pro, had significant relationships with serum lipid profile; lower total and low-density lipoprotein cholesterol levels in Arg109Arg homozygotes, and lower TG levels in Ser343Ser(C/C) homozygotes. In addition, LEPR gene also associated with relative weight; Arg109Arg homozygotes had higher relative weight and Ser343Ser(C/C) homozygotes had lower one. CONCLUSION These results suggest that LEPR gene polymorphisms may partly contribute to serum lipid profile in obese children.
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Affiliation(s)
- T Okada
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan.
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Okuya M, Kurosawa H, Kubota T, Endoh K, Ogiwara A, Nonoyama S, Hagisawa S, Sato Y, Matsushita T, Fukushima K, Sugita K, Sato T, Arisaka O. Hematopoietic stem cell transplantation for X-linked thrombocytopenia from a mild symptomatic carrier. Bone Marrow Transplant 2009; 45:607-9. [PMID: 19684625 DOI: 10.1038/bmt.2009.200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Yoshihara S, Morimoto H, Ohori M, Yamada Y, Abe T, Arisaka O. A Neuroactive Steroid Inhibits Guinea-pig Airway Sensory Nerves via Maxi-K+ Channels Activation. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.12.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Imataka G, Nitta A, Suzumura H, Watanabe H, Yamanouchi H, Arisaka O. Survival of trisomy 18 cases in Japan. Genet Couns 2007; 18:303-308. [PMID: 18019371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The prognosis of trisomy 18 is lethal, but recently some long-term survival cases have been recognized. We report here the mortality rate of trisomy 18 based on our hospital data and sporadically published reports in Japan. We collected the 7 previously published reports of mortality and 31 cases from our hospital data with trisomy 18. Our data pool comprised a total of 179 cases of trisomy 18 from 8 institutions. The mortality rates within 24 hours, 7, 28, 60, 180, and 365 days from birth were 14.84% (19/128), 31.01% (40/129), 56.25% (72/128), 64.08% (66/103), 82.17% (106/129), and 90.90% (140/154), respectively. Fourteen of the 154 patients (9.09%) survived for more than 1 year. The Kaplan-Meier survival curves from 78 patients of 5 institutes suggest that trisomy 18 children who have survived over 7 months after birth may have a high probability of long-term survival. We should recognize not only that about 50% of infants with trisomy 18 die within 1 month after birth, but also that about 10% of patients survive over 1 year in Japan. These findings comprise Asia's first clinical statistics concerning trisomy 18, in which the data were collected from multiple institutions. This evidence is valuable in order to perform genetic counseling concerning the natural history of trisomy 18 not only in Japan but also in other countries.
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Affiliation(s)
- G Imataka
- Department of Pediatrics, Dokkyo University School of Medicine, Japan.
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Yoshihara S, Kanno N, Yamada Y, Ono M, Fukuda N, Numata M, Abe T, Arisaka O. Effects of early intervention with inhaled sodium cromoglycate in childhood asthma. Lung 2006; 184:63-72. [PMID: 16622775 DOI: 10.1007/s00408-005-2564-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2005] [Indexed: 10/24/2022]
Abstract
International and Japanese guidelines classify childhood asthma as mild, moderate, or severe, and recommend treatment with "as needed" bronchodilators, inhaled sodium cromoglycate, and inhaled corticosteroids, respectively. Alternatively, some investigators proposed inhaled corticosteroids as first-line therapy to prevent airway inflammatory obstruction. This article describes a clinical study assessing the effect of early intervention with inhaled sodium cromoglycate in childhood asthma. This was a retrospective study of 189 asthmatic children treated with inhaled sodium cromoglycate for five years and whose age of onset of asthma was six year of age or younger. An end-of-study questionnaire completed the examination. Children administered oral or inhaled corticosteroids simultaneously with sodium cromoglycate, were excluded. Asthma scores as defined by the Japanese Pediatric Allergic Committee, were reduced continuously during the five years after the start of sodium cromoglycate treatment. The frequency of emergency department visits and hospitalizations also decreased. Significant between-period intervention differences showed improvement of clinical outcomes for children with severe asthma during the five years of sodium cromoglycate inhalation. The early intervention regime of starting sodium cromoglycate inhalation within two years of the onset of asthma shows a large improvement in the long-term prognosis of childhood asthma, especially for children with severe asthma. It is possible that starting inhaled sodium cromoglycate earlier than the present recommendation of corticosteroids could further improve clinical outcomes, but a prospective study should be performed to verify our results.
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Affiliation(s)
- S Yoshihara
- Department of Pediatrics, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, Japan.
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Yoshihara S, Yamada Y, Abe T, Lindén A, Arisaka O. Association of epithelial damage and signs of neutrophil mobilization in the airways during acute exacerbations of paediatric asthma. Clin Exp Immunol 2006; 144:212-6. [PMID: 16634793 PMCID: PMC1809654 DOI: 10.1111/j.1365-2249.2006.03058.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We examined whether epithelial damage is associated with mobilization of neutrophils or eosinophils in the airway lumen during acute exacerbations of paediatric asthma. Aspirated sputum samples were harvested from 65 paediatric patients (mean age 3.4 +/- 0.4 years) during acute exacerbations of asthma. Patients with signs of infection were excluded. The presence of conglomerates of epithelial cells (i.e. "Creola bodies") in the aspirated sputum was utilized as a marker of epithelial damage. Among the paediatric asthma patients, 60% displayed Creola bodies (CrB+: n = 39) in their sputum samples whereas the remaining patients did not (CrB-: n = 26). CrB+ patients displayed more than a 20-fold increase in the concentration of the neutrophil-mobilizing cytokine interleukin (IL)-8 (pg/ml) and of the neutrophil product neutrophil elastase (NE, g/l), respectively, compared with CrB- patients (IL-8: 7468.2 +/- 1953.6 versus 347.9 +/- 72.6, P < 0.01; NE: 2072.4 +/- 419.0 versus 438.5 +/- 125.7, P < 0.01). Even though not statistically significant, a corresponding trend was observed for the relative number of sputum neutrophils. In contrast, the concentration of the eosinophil-mobilizing cytokine IL-5 and the esoinophil product ECP tended to be lower in CrB+ than in CrB- patients (P > 0.05). In conclusion, as indicated by the analysis of aspirated sputum, epithelial damage is associated with a locally enhanced chemotactic signal for and activity of neutrophils, but not eosinophils, during acute exacerbations of paediatric asthma. It remains to be determined whether these indirect signs of neutrophil mobilization in the airway lumen mirror an increased number of neutrophils in the surrounding airway tissue.
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Affiliation(s)
- S Yoshihara
- Department of Paediatrics, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan.
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Kano K, Yamada Y, Nishikura K, Kojima E, Arisaka O. Low bone mineral density in nephrotic children with steroid dependence and/or frequent relapsers. Clin Nephrol 2005; 64:323-4. [PMID: 16240907 DOI: 10.5414/cnp64323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Kojima M, Kanno H, Yamazaki Y, Koyama S, Kanazawa S, Arisaka O. Association of low-density lipoprotein particle size distribution and cardiovascular risk factors in children. Acta Paediatr 2005; 94:281-6. [PMID: 16028645 DOI: 10.1111/j.1651-2227.2005.tb03070.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The objective of this study was to investigate whether the presence of small, dense lipoproteins, which are thought to be related to the metabolic syndrome caused by insulin resistance, can be predicted by routine serum lipid profiling. METHODS The relationship between low-density lipoprotein (LDL) particle size and serum lipid levels was analysed in 284 school children (148 boys and 136 girls), aged 7 to 13 y old. LDL particle size was determined by gradient gel electrophoresis. RESULTS The LDL particle diameter was significantly correlated with the serum levels of high-density lipoprotein cholesterol (HDL-C) (r = - 0.437, p < 0.001) and triglycerides (TG) (r = -0.432, p < 0.001), and with the atherogenic index (AI) [total cholesterol/ HDL-C] (r = -0.450, p < 0.001), while only weak correlations were observed with the serum levels of total cholesterol, apolipoprotein Al and apolipoprotein B. No significant relationship was observed between LDL particle diameter and the serum LDL-C level. CONCLUSION The presence of small, dense LDL as a metabolic marker of lifestyle-related diseases in children seems to be reflected by a serum lipid profile characterized by an elevation in TG, a reduction in HDL-C, and a raised AI.
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Affiliation(s)
- M Kojima
- Department of Paediatrics, Dokkyo University School of Medicine, Mibu, Tochigi, Japan
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27
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Kano K, Nishikura K, Yamada Y, Arisaka O. No effect of fluvastatin on the bone mineral density of children with minimal change glomerulonephritis and some focal mesangial cell proliferation, other than an ameliorating effect on their proteinuria. Clin Nephrol 2005; 63:74-9. [PMID: 15730048 DOI: 10.5414/cnp63074] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
AIM There are conflicting data regarding the clinical benefit of the effect of HMG-CoA reductase inhibitors (statins) in osteoporosis. We have reported that fluvastatin (a statin) is effective in improving proteinuria and renal function in childhood IgA nephropathy with mild histological findings and moderate proteinuria. The aim of the present study was to clarify the effect of fluvastatin on the bone mineral density, bone metabolic markers, proteinuria, and renal function of children with minimal change glomerulonephritis with some focal mesangial cell proliferation whose glomeruli did not stain positive for IgA and on moderate proteinuria. PATIENTS AND METHODS We conducted a prospective controlled study of 36 children who had recently been diagnosed with normocholesterolemic minimal change glomerulonephritis with some focal mesangial cell proliferation and moderate proteinuria, and in whom strenuous exercise was restricted. The 36 patients were randomly assigned to receive 20 mg of fluvastatin (group 1) or 5 mg/kg of dipyridamole (group 2) for two years. RESULTS By the end of the trial, there was no difference in BMD between the groups, and there were no changes in the four bone metabolic parameters. However, the urinary protein, hematuria and BUN levels had significantly decreased in group 1 compared to baseline, and the serum total protein and albumin levels and creatinine clearance had significantly increased in group 1 compared to baseline and group 2. CONCLUSIONS The results of this study suggest that fluvastatin therapy has an antiproteinuric effect and improves renal function in moderately proteinuric patients with mild histological glomerulonephritis, but does not increase BMD.
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Affiliation(s)
- K Kano
- Department of Pediatrics, Dokkyo University School of Medicine, Tochigi, Japan.
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Abstract
We present a neonatal case with intractable atrial flutter that did not respond to digitalization and electrical cardioversion. Intravenous flecainide administration completely resolved the atrial flutter. Proarrhythmic effects were not induced by flecainide administration. Although the efficacy of flecainide for atrial flutter during the infantile or childhood period is low, intravenous flecainide is worth consideration as a treatment for atrial flutter, even in intractable cases as described here, during the neonatal period.
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Affiliation(s)
- H Suzumura
- Department of Pediatrics, Dokkyo University School of Medicine, 880, Kitakobayashi, Mibu, Shimotsuga-gun, Tochigi 321-0293, Japan
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Arisaka O, Kojima M, Numata M. Issues in interpreting lipoprotein (a) value as a risk indicator for early cardiovascular disease. Acta Paediatr 2003; 92:1226-7. [PMID: 14632346 DOI: 10.1080/08035250310005675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kano K, Nishikura K, Yamada Y, Arisaka O. Effect of fluvastatin and dipyridamole on proteinuria and renal function in childhood IgA nephropathy with mild histological findings and moderate proteinuria. Clin Nephrol 2003; 60:85-9. [PMID: 12940609 DOI: 10.5414/cnp60085] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
AIM In recent reports, some kinds of HMG-CoA reductase inhibitors were able to decrease proteinuria and to improve renal function. Here we aimed to clarify the effect of fluvastatin (an HMG-CoA reductase inhibitor) on proteinuria and renal function in children with mild IgA nephropathy. PATIENTS AND METHODS We conducted a prospective controlled study of 30 children who had been recently diagnosed with normocholesterolemic IgA nephropathy following the detection of a minor lesion or of focal mesangial proliferation and moderate proteinuria. The 30 patients were randomly assigned to receive both of 20 mg of fluvastatin and 5 mg/kg of dipyridamole (group 1), or 5 mg/kg of dipyridamole only (group 2) for 1 year. RESULTS By the end of the trial, urinary protein, hematuria, BUN and serum creatinine levels had significantly decreased in the patients of group 1 as compared to baseline. Serum total cholesterol, triglyceride and LDL cholesterol levels had significantly decreased, while serum total protein and albumin, and creatinine clearance had significantly increased in group 1 as compared to baseline and group 2. The urinary protein level had significantly decreased in the group 2 patients as compared to baseline, but only slightly. CONCLUSIONS The results of this study suggest that fluvastatin and dipyridamole treatment yields an antiproteinuric effect and leads to the amelioration of renal function in moderately proteinuric patients with mild histological IgA nephropathy.
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Affiliation(s)
- K Kano
- Department of Pediatrics, Dokkyo University School of Medicine, Tochigi, Japan.
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31
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Arisaka O, Kanno H, Negishi M, Kojima M, Nishikura K, Numata M, Kanazawa S, Nitta A, Kuribayashi T, Kano K. Bone growth oscillation: longitudinal metabolic process of bone growth in congenital adrenal hyperplasia and nonendocrine short stature. Metabolism 2002; 51:1377-80. [PMID: 12404182 DOI: 10.1053/meta.2002.35590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
To clarify the longitudinal metabolic process of bone growth in children, we observed the relationship between the level of serum osteocalcin (OC), a marker of bone metabolism, and growth velocity in 10 prepubertal patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency and 9 prepubertal patients with nonendocrine short stature (NESS), but no major hormonal abnormalities influencing bone metabolism. Observations were made every 6 months over a 7-year period. In patients with CAH who exhibited a wide variation in growth velocity during the course of the investigation, the levels of OC fluctuated over a wide range, suggesting metabolically variable bone growth. In contrast, in patients with NESS who exhibited a relatively stable growth velocity, the OC level remained within a narrow range, suggesting metabolically stable bone growth. The meaning of such divergent metabolic processes of bone growth observed in CAH and NESS and its relationship to actual bone structure or bone intensity should be further investigated.
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Affiliation(s)
- O Arisaka
- Department of Pediatrics, Dokkyo University School of Medicine, Mibu, Tochigi, Japan
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32
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Kuribayashi T, Arisaka O. [Hypopituitarism]. Ryoikibetsu Shokogun Shirizu 2002:281-5. [PMID: 11596391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- T Kuribayashi
- Department of Pediatrics, Dokkyo University School of Medicine
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33
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Kuribayashi T, Arisaka O. [Acromegaly]. Ryoikibetsu Shokogun Shirizu 2002:277-80. [PMID: 11596389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- T Kuribayashi
- Department of Pediatrics, Dokkyo University School of Medicine
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34
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Hishinuma A, Ohyama Y, Kuribayashi T, Nagakubo N, Namatame T, Shibayama K, Arisaka O, Matsuura N, Ieiri T. Polymorphism of the polyalanine tract of thyroid transcription factor-2 gene in patients with thyroid dysgenesis. Eur J Endocrinol 2001; 145:385-9. [PMID: 11580993 DOI: 10.1530/eje.0.1450385] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE One of the thyroid-specific transcription factors, thyroid transcription factor-2 (TTF-2), performs a crucial role in the development of the thyroid gland. We performed genetic analysis of the TITF2 gene (encoding TTF-2) in patients with thyroid dysgenesis. METHODS By direct sequencing of the PCR products of TITF2, we screened the genomic DNA from 46 patients with thyroid dysgenesis (five had agenesis, six had hypoplasia, 15 had ectopy, and 20 were undetermined). We also studied the transcriptional activities of TITF2 by co-expressing the luciferase gene directed by the human thyroglobulin gene promoter. RESULTS Human TITF2 consists of a forkhead domain, a polyalanine tract, and unique C-terminal residues. In one of the patients with an ectopic sublingual thyroid, we found a polyalanine tract of 11 alanine residues on one chromosome instead of the 14 alanine residues found in normal controls. In one patient with hypoplasia, the polyalanine tract consisted of 12 heterozygous alanine residues. The reduced polyalanine tracts were not detected in 101 normal individuals. However, the expression study showed that the transcriptional activities of TITF2 with reduced polyalanine-tract lengths were equal to that of TITF2 with an unreduced polyalanine tract. CONCLUSION These results suggest that the polymorphism of the polyalanine tract of TITF2 is not a frequent cause of developmental defects of the human thyroid gland.
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Affiliation(s)
- A Hishinuma
- Department of Clinical Laboratory Medicine, Dokkyo University School of Medicine, Mibu, Tochigi 321-0293, Japan.
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35
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Arisaka O, Numata M, Hoshi M, Kanazawa S. Another issue in traditional medical therapy for congenital adrenal hyperplasia. J Pediatr 2001; 139:610. [PMID: 11598617 DOI: 10.1067/mpd.2001.118424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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36
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Abstract
Sex differences are recognized in children's free drawings with respect to motifs, colors, figure compositions, and expression. Boys tend to draw mobile objects and mechanical objects with dark or cold colors and often use bird's-eye-view composition when they draw pictures, whereas girls like to draw human motifs (especially girls and women), flowers, and butterflies with light and warm colors and tend to arrange motifs in a row on the ground. Analyses were made on the drawings of girls with congenital adrenal hyperplasia (CAH) and unaffected boys and girls, using masculine and feminine indexes. Sex difference in masculine and feminine indexes was clear in the drawings by unaffected boys and girls. Their drawings do not or mostly do not contain characteristics typical of the opposite sex. Compared with those of unaffected girls, the pictures of CAH girls more strongly showed masculine characteristics. The feminine index for the pictures of CAH girls was significantly lower than that for unaffected girls, while the masculine index for CAH girls was significantly higher than that for unaffected girls. Furthermore, the masculine index for CAH girls was not significantly different from that of unaffected boys. These results suggest that androgen exposure during fetal life may contribute to shaping masculine characteristics in children's free drawings.
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Affiliation(s)
- M Iijima
- Department of Pediatrics, Juntendo University School of Medicine, Hongo, Tokyo 113-8421, Japan
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37
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38
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Kano K, Yamada Y, Arisaka O. Urinary 17-hydroxycorticosteroids and 17-ketosteroid sulfates in normal children and in children with atopic dermatitis or renal disease. Rinsho Byori 2001; 49:807-12. [PMID: 11573292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
We measured both urinary 17-hydroxycorticosteroids(17-OHCS) and 17-ketosteroid sulfates(17-KS-S) in normal children and in children with some diseases to evaluate adaptation to stress in children. 17-OHCS and 17-KS-S values were measured in morning urine from 60 normal children(3-18 years old) and 24 children with atopic dermatitis or renal disease. In normal children, the 17-OHCS/creatinine showed no difference by age, but both 17-KS-S/creatinine and 17-KS-S/17-OHCS showed significant positive correlation with age. No sex differences were significant. In children with atopic dermatitis or with renal disease treated with cyclosporine A, 17-OHCS/creatinine was significantly higher and the 17-KS-S/17-OHCS ratio was significantly lower than in age-matched controls. These values returned to normal as the conditions improved or as treatment ended. In patients who underwent renal biopsy, both 17-OHCS/creatinine and 17-KS-S/creatinine values were significantly higher after biopsy than before because of the stress caused by pain and complete bed rest. Measurement of urinary 17-OHCS and 17-KS-S in children can be useful for evaluation of adaptation to stress as well as in adults.
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Affiliation(s)
- K Kano
- Department of Pediatrics, Dokkyo University School of Medicine, Shimotsuga-gun, Tochigi-pref. 321-0293
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39
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40
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Arisaka O, Kanazawa S, Numata M, Kuribayashi T. [Neonatal hyperthyroidism]. Ryoikibetsu Shokogun Shirizu 2001:511-3. [PMID: 11269149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- O Arisaka
- Department of Pediatrics, Dokkyo University School of Medicine
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41
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Arisaka O, Kanazawa S, Hoshi M, Kuribayashi T. [Neonatal hypothyroidism]. Ryoikibetsu Shokogun Shirizu 2001:514-7. [PMID: 11269150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- O Arisaka
- Department of Pediatrics, Dokkyo University School of Medicine
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42
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Oyama M, Nitta A, Suzumura H, Arisaka O. [Neonatal hypoglycemia]. Ryoikibetsu Shokogun Shirizu 2001:522-4. [PMID: 11269153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- M Oyama
- Department of Pediatrics, Dokkyo University School of Medicine
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Kano K, Nishikura K, Hoshi M, Yamada Y, Arisaka O. Effectiveness of a second course of cyclophosphamide therapy in children with frequently relapsing nephrotic syndrome after cyclosporin A therapy. Clin Nephrol 2001; 55:424-5. [PMID: 11393392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
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44
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Arisaka O, Hoshi M, Kanazawa S, Nakajima D, Numata M, Nishikura K, Oyama M, Nitta A, Kuribayashi T, Kano K, Nakayama Y, Yamashiro Y. Systemic effects of transdermal testosterone for the treatment of microphallus in children. Pediatr Int 2001; 43:134-6. [PMID: 11285063 DOI: 10.1046/j.1442-200x.2001.01353.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To elucidate the metabolic effects of topical testosterone for the treatment of microphallus in children. METHODS We administered 5% testosterone ointment to 50 prepubertal boys for the treatment of microphallus, allowing us to observe its metabolic effect on plasma concentrations of testosterone as a marker of transdermally absorbed testosterone, insulin-like growth factor (IGF)-I as a marker of growth hormone secretion status, and osteocalcin as a marker of bone metabolic turnover. RESULTS Transdermal application of testosterone for 30 days at a dose that affects penile growth increased mean (+/-SD) plasma testosterone concentrations from 7.5+/-5.1 to 31.0+/-8.2 ng/dL (pre- vs. post-treatment, respectively; P<0.01). This was associated with a slight but statistically significant elevation of IGF-I concentrations (117.2+/-76.9 vs. 154.4+/-81.5 ng/mL; P<0.05). No significant change in osteocalcin levels was found. CONCLUSIONS When using testosterone ointment as a treatment for microphallus, it should be borne in mind that this application has systemic effects.
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Affiliation(s)
- O Arisaka
- Department of Pediatrics, Dokkyo University School of Medicine, Mibu, Japan
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Abstract
BACKGROUND The usefulness of diastolic pulmonary flow velocity determined by echocardiography in the assessment of symptomatic patent ductus arteriosus (sPDA) in preterm infants has not been confirmed. METHODS Echocardiography was performed daily in infants ranging from 23 to 31 gestational weeks of age, and diastolic flow velocity of the left pulmonary artery (DFLPA) was measured. The DFLPA data before indomethacin administration for sPDA were compared with data obtained after indomethacin administration. The normal range of DFLPA was also determined from serial measurements performed in infants who did not develop sPDA during the first 7 days of life. Then, this range was compared with data from infants who did develop sPDA during this time. RESULTS In infants who underwent indomethacin treatment, DFLPA increased with the development of sPDA and decreased when the symptoms of sPDA disappeared. On the basis of results from serial DFLPA measurement, the sensitivity and specificity of DFLPA for assessing sPDA was found to be 0.82 and 0.83, respectively. CONCLUSIONS Measurement of DFLPA by echocardiography is a useful method for assessing sPDA in preterm infants.
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MESH Headings
- Blood Flow Velocity/physiology
- Diastole
- Ductus Arteriosus, Patent/diagnosis
- Ductus Arteriosus, Patent/physiopathology
- Echocardiography, Doppler, Pulsed
- Female
- Gestational Age
- Humans
- Indomethacin
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/physiopathology
- Male
- Predictive Value of Tests
- Prospective Studies
- Pulmonary Artery/diagnostic imaging
- Pulmonary Artery/physiology
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Affiliation(s)
- H Suzumura
- Department of Neonatology, Perinatal Medical Center, Dokkyo University School of Medicine, Tochigi, Japan.
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46
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Arisaka O, Hoshi M, Kanazawa S, Numata M, Nakajima D, Kanno S, Negishi M, Nishikura K, Nitta A, Imataka M, Kuribayashi T, Kano K. Preliminary report: effect of adrenal androgen and estrogen on bone maturation and bone mineral density. Metabolism 2001; 50:377-9. [PMID: 11288028 DOI: 10.1053/meta.2001.21678] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
To clarify the independent physiological roles of adrenal androgen and estrogen on bone growth, we compared the lumbar spine bone mineral density (BMD) in prepubertal girls with virilizing congenital adrenal hyperplasia (CAH) (n = 17) and girls with central precocious puberty (CPP) (n = 18). When BMD was analyzed according to chronologic age, no significant differences were found between CPP and CAH patients. However, when adjusted to bone age, BMD was statistically higher in CAH than in CPP subjects. This finding suggests that adrenal androgen, as well as estrogen, plays an important role in increasing BMD. Adrenal androgen may act on bone not only as androgen, but as estrogen after having been metabolized into an aromatized bone-active compound in peripheral tissues, such as bone and fat. Therefore, adrenal androgen may have a more important role in increasing BMD than previously realized.
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Affiliation(s)
- O Arisaka
- Department of Pediatrics, Dokkyo University School of Medicine, Tochigi, Japan
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47
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Arisaka O, Negishi M, Numata M, Hoshi M, Kanazawa S, Oyama M, Nitta A, Suzumuara H, Kuribayashi T, Nakayama Y. Precocious puberty resulting from congenital hypothalamic hamartoma: persistent darkened areolae after birth as the hallmark of estrogen excess. Clin Pediatr (Phila) 2001; 40:163-7. [PMID: 11307963 DOI: 10.1177/000992280104000307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- O Arisaka
- Department of Pediatrics, Dokkyo University School of Medicine, Mibu, Tochigi, Japan
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Kano K, Nishikura K, Hoshi M, Yamada Y, Arisaka O. Linear growth of low-dose cyclosporin A therapy in children with steroid-dependent nephrotic syndrome. Nephron Clin Pract 2001; 87:293-4. [PMID: 11287771 DOI: 10.1159/000045933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Kano K, Kyo K, Nishikura K, Hoshi M, Ito S, Yamada Y, Ando T, Arisaka O. Skeletal effects of low-dose cyclosporin A therapy in children with nephrotic syndrome. Clin Exp Nephrol 2000. [DOI: 10.1007/s101570070007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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