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ABSTRACT: Background: This study was a cerebral aneurysm registry study conducted in a region with few climatic differences. Based on data collected for over 20 years, seasonal variations and characteristics of subarachnoid hemorrhage (SAH) due to ruptured aneurysms were analyzed. Methods: This study included 5,007 patients in the Yamaguchi Prefecture with aneurysmal SAH between 1986 and 2005. Incidence rates by month, sex, age, severity, and aneurysm site were analyzed. Results: In women, seasonal variation was observed, in particular among those aged ≥50 years. Among those aged 50-69 years, the highest incidence was in October, and the nadir was in June (peak-to-trough ratio = 1.72). At age ≥70 years, this was slightly different, with the highest incidence in December and the nadir in July (peak-to-trough ratio = 1.48). However, there was no seasonal variation in men overall; it was limited to elderly men at age ≥70 years, with the highest incidence in January and the nadir in July (peak-to-trough ratio = 2.9). Aneurysm site and severity showed no relationship with seasonal variation. Conclusion: The present study shows seasonal variations in the onset of SAH. Seasonal variations in SAH differed depending on age and sex.
Neuroepidemiology 03/2013; 41(1):7-12. · 2.31 Impact Factor
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ABSTRACT: BACKGROUND: The effects of glucocorticoids on viral myocarditis are contentious. The aim of the present study was to determine whether there is a "window of opportunity" for glucocorticoid treatment in a mouse model of acute viral myocarditis induced by Coxsackie group B3 virus (CVB3). METHODS: A/J (H-2a) mice were randomly assigned to one of four experimental groups: (1) viral infection without dexamethasone (DEX) treatment; (2) treatment with 0.75mg/kg, i.p., DEX each day for 5 days prior to viral infection; (3) 0.75mg/kg, i.p., DEX treatment for 5 days immediately after viral infection; and (4) 0.75mg/kg, i.p., DEX treatment for 5 days starting on day 7 after infection. RESULTS: DEX administration before or immediately after viral infection improved survival and attenuated left ventricular dilatation, systolic dysfunction, fibrosis, and infiltration of immune cells in the post-infectious heart. In contrast, late administration of DEX reduced survival (as determined on day 14), and was associated with sustained increases in cardiac tumor necrosis factor-α and interferon-γ levels. The beneficial effects of early DEX administration on survival were completely abrogated by coadministration of a selective cyclooxygenase (COX)-2 inhibitor (NS-398; 5mg/kg per day, p.o.). Notably, the virus titer in the post-infectious heart was significantly suppressed by DEX, but coadministration of NS-398 at the time of viral infection abolished the suppressive effects of DEX and, in fact, increased virus titers. CONCLUSIONS: Early administration of DEX is beneficial in the treatment of fulminant viral myocarditis, whereas late administration of DEX is harmful. The beneficial effects of DEX on survival were completely abolished by simultaneous administration of a selective COX-2 inhibitor. Hence, we speculate that a direct action of DEX on cardiomyocytes, rather than anti-inflammatory effects of DEX on immune cells, confers resistance to myocardial damage induced by viral infection.
Journal of Cardiology 02/2013; · 1.28 Impact Factor
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ABSTRACT: Hemorrhagic transformation (HT) following acute ischemic stroke is a major problem, especially for the indication of reperfusion therapy including intravenous administration of recombinant tissue plasminogen activator (IV rt-PA). The specific predictive factors of HT have not yet been established. The present study evaluated the findings of computed tomography perfusion (CTP) images as predictors of subsequent HT to identify patients with low HT risk for reperfusion therapy such as IV rt-PA.
We retrospectively reviewed 68 consecutive stroke patients (41 males; mean age 72.9 years) with steno-occlusive lesions in the major trunk, including 10 patients who underwent IV rt-PA. Each HT was detected on a follow-up T2*-weighted magnetic resonance image until 2 weeks after stroke onset and categorized into four groups [hemorrhagic infarction (HI) type 1 and 2, and parenchymal hematoma (PH) type 1 and 2] according to the European Cooperative Acute Stroke Study (ECASS) classification. We assessed clinical features and radiological findings between the HT and non-HT groups or the PH2 and non-PH2 groups. The efficacy of initial time to peak (TTP) mapping of CTP for predicting HT or PH2 was evaluated.
Thirty-four patients (50%) developed subsequent HT: 18 (52.9%) had HI and 16 (47.1%) had PH, including 9 PH2 patients (13.2%). IV rt-PA was not significantly associated with HT or PH2 occurrence. Forty of the 68 patients (59%) revealed defect areas on the initial TTP mapping (TTP map-defect), and 34 of these 40 patients (85%) developed secondary HT and 9 patients (22.5%) developed PH2. Initial 'TTP map-defect' was significantly associated with the occurrence of HT (p < 0.0001) and PH2 (p = 0.0070). Thirty of the 34 patients (88.2%) in the HT group experienced delayed recanalization of the occluded vessels, in contrast to only 8 of the 34 patients (23.6%) in the non-HT group. All patients of the PH2 group showed recanalization (p = 0.0042). In 40 'TTP map-defect'-positive patients, delayed recanalization was associated with the occurrence of HT (p < 0.0001) and PH2 (p = 0.0491). All 28 patients without 'TTP map-defect' did not develop HT, including 8 patients (28.6%) with delayed recanalization.
Initial 'TTP map-defect' of CTP could accurately predict HT risk including PH2 risk and identify low-risk patients even in the delayed period.
Cerebrovascular diseases extra. 01/2013; 3(1):14-25.
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Yeting He,
Masami Fujii,
Takao Inoue,
Sadahiro Nomura,
Yuichi Maruta,
Fumiaki Oka,
Satoshi Shirao,
Yuji Owada,
Hiroyuki Kida, Ichiro Kunitsugu,
Toshitaka Yamakawa,
Tatsuji Tokiwa,
Takeshi Yamakawa,
Michiyasu Suzuki
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ABSTRACT: Although systemic hypothermia provides favorable outcomes in stroke patients, it has only been adopted in a limited number of patients because of fatal complications. To resolve these issues, focal brain cooling (FBC) has recently drawn attention as a less-invasive treatment for brain injuries. Therefore, we investigated whether FBC has a favorable effect on focal cerebral ischemia (FCI). Male-adult-Wistar rats were used. Under general anesthesia, a small burr-hole was made and FCI was induced in the primary sensorimotor area (SI-MI) using photothrombosis. An additional craniotomy was made over the SI-MI and FBC was performed at a temperature of 15°C for 5h. Electrocorticograms (ECoG) were recorded on the border cortex of the ischemic focus. Thereafter, rats were sacrificed and the infarct area was measured. In another experiment, rats were allowed to recover for 5 days after cooling and neurobehavioral function was evaluated. FBC suppressed all ECoG frequency bands during and after cooling (p<0.05), except for the delta frequency band in the precooling versus rewarming periods. The injured areas in the cooling and non-cooling groups were 0.99±0.30 and 1.71±0.54mm(2), respectively (p<0.03). The grip strength at 2 days after surgery was preserved in the cooling group (p<0.05). We report the novel finding that epileptiform discharges were suppressed in the ischemic border, the infarct area was reduced and neurobehaviour was preserved by FBC. These results indicate that FBC is neuroprotective in the ischemic brain and has demonstrated therapeutic potential for cerebral infarction.
Brain research 12/2012; · 2.46 Impact Factor
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ABSTRACT: Emotional and behavioral disorders in children are school-health concerns; however, Japanese screening tools for such disorders are not yet available. We examined the association between psychosocial functioning as measured by the Pediatric Symptom Checklist (PSC) and self-rated health within school settings. A cross-sectional study was conducted for 2513 fifth and eighth graders from all of the primary and secondary schools in Shunan City, Japan. The Japanese PSC had high internal consistency (Cronbach's α = 0.90) and a factor structure similar to that of the English PSC. When the cut-off values were set to ≥ 28 and ≥ 17, 4-9% and 20-39% of our respondents, respectively, reported high PSC scores. A multiple ordinal logistic regression analysis showed that the odds ratio of a positive PSC score (≥ 28) for poorer self-rated health among ratings of "very good," "good," "fair," and "poor" was 3.5 (95% confidence interval = 2.6-4.8). There was a clear association between psychosocial dysfunction identified by a PSC score ≥ 28 and poor self-rated health. We offer directions for further research on appropriate PSC cut-off values with Japanese samples.
Nursing and Health Sciences 10/2012; · 0.68 Impact Factor
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ABSTRACT: BACKGROUND: After cardioembolic stroke (CES), left atrial thrombus (LAT) is detected by transesophageal echocardiography (TEE) in some cases but not in others. We propose that there are 2 types of embolization in CES: fragmental and massive embolization. METHODS: Consecutive patients with nonvalvular atrial fibrillation (AF) of acute CES or transient ischemic attack (TIA) were prospectively enrolled in the study between May 2009 and July 2011. TEE was performed within 7 days of admission. The patients were classified into 2 groups: those with occlusion of the main trunk (internal carotid artery, M1, and basilar artery; group M) and those with occlusion of other distal arteries (group D). Clinical features were compared between patients who did and did not have a thrombus on TEE. RESULTS: Of the 41 patients in the study, 21 were in group M and 20 were in group D. Age, sex, and treatment with tissue plasminogen activator did not differ significantly between the 2 groups. The rate of detection of LAT was significantly higher in group D (14% v 65%; P < .001). CONCLUSIONS: Patients with distal artery occlusion had a significantly higher rate of LAT compared to those with main trunk occlusion. Distal artery occlusion in CES therefore tends to result from fragmental embolization and is associated with a remnant LAT, with which there may be a concern of a risk of early recurrence.
Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association 10/2012;
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ABSTRACT: The consumption of meat products is considered to be a feasible solution to prevent anemia, which is a critical health problem. The present study assessed hematological parameters and the prevalence of anemia in Japanese children and adolescents, and examined the association with the frequency of meat intake. Data from the Shunan Children Health Cohort Study were analyzed. The participants included male and female residents, 3373 children (aged 10-11 years), and 3085 adolescents (aged 13-14 years). The frequency of meat intake was determined with a questionnaire, and blood samples were analyzed. Anemia was defined according to the criteria of the World Health Organization. The prevalence of anemia in children was 3.6% and 2.5% in girls and boys, respectively, and in adolescents, it was 4.5% in girls and 0.8% in boys. The frequency of meat intake did not show a positive association with the hematological indices or the prevalence of anemia. These results suggest that the promotion of meat consumption is not an effective strategy to decrease anemia, and that other approaches are necessary to prevent anemia in this population.
Nursing and Health Sciences 03/2012; 14(2):197-203. · 0.68 Impact Factor
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Masami Fujii,
Takao Inoue,
Sadahiro Nomura,
Yuichi Maruta,
Yeting He,
Hiroyasu Koizumi,
Satoshi Shirao,
Yuji Owada, Ichiro Kunitsugu,
Toshitaka Yamakawa,
Tatsuji Tokiwa,
Satoshi Ishizuka,
Takeshi Yamakawa,
Michiyasu Suzuki
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ABSTRACT: Focal brain cooling is effective for suppression of epileptic seizures, but it is unclear if seizures can be suppressed without a substantial influence on normal neurologic function. To address the issue, a thermoelectrically driven cooling system was developed and applied in free-moving rat models of focal seizure and epilepsy.
Focal seizures limited to the unilateral forelimb were induced by local application of a penicillin G solution or cobalt powder to the unilateral sensorimotor cortex. A proportional integration and differentiation (PID)-controlled, thermoelectrically driven cooling device (weight of 11 g) and bipolar electrodes were chronically implanted on the eloquent area (on the epileptic focus) and the effects of cooling (20, 15, and 10°C) on electrocorticography, seizure frequency, and neurologic changes were investigated.
Cooling was associated with a distinct reduction of the epileptic discharges. In both models, cooling of epileptic foci significantly improved both seizure frequency and neurologic functions from 20°C down to 15°C. Cooling to 10°C also suppressed seizures, but with no further improvement in neurologic function. Subsequent investigation of sensorimotor function revealed significant deterioration in foot-fault tests and the receptive field size at 15°C.
Despite the beneficial effects in ictal rats, sensorimotor functions deteriorated at 15°C, thereby suggesting a lower limit for the therapeutic temperature. These results provide important evidence of a therapeutic effect of temperatures from 20 to 15°C using an implantable, hypothermal device for focal epilepsy.
Epilepsia 03/2012; 53(3):485-93. · 3.96 Impact Factor
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ABSTRACT: To investigate breakfast eating habits on daily energy and fish, vegetable, and fruit intake in Japanese adolescents.
This study was completed as part of the Shunan Child Health Cohort Study. Two types of questionnaires, one on lifestyle habits and the other a brief-type, self-administered questionnaire on diet history, were administered to second-year junior high school students (1,876 boys and 1,759 girls) in Shunan City, Yamaguchi, Japan. The different breakfast habits were compared using the general linear model and the estimated means and P value for trend were calculated, with energy-adjusted food intake as the dependent variable and body mass index, gender, age, residential areas, and living status as covariates.
In both males and females, the proportion of those who ate breakfast irregularly was about 10%. The daily intake of fish, vegetables, and fruit was significantly higher in those who ate breakfast with their guardians than in those who ate breakfast alone (P for trend <0.01). The daily intake of fish, seafood, and vegetables was significantly higher in those who less frequently ate cooked foods for breakfast (P for trend <0.01). Those who ate rice more frequently than bread at breakfast had a higher daily intake of fish, seafood, and vegetables (P for trend <0.01).
Eating breakfast with the family, reducing the intake of cooked foods at breakfast, and eating breakfast with rice as a main staple food are suggested to contribute to an improved quality of diet in adolescents.
Environmental Health and Preventive Medicine 02/2012; 17(5):408-14.
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ABSTRACT: Management of elderly patients with poor-grade subarachnoid hemorrhage (SAH) remains controversial. The objective of this study was to investigate whether there is an age-dependent difference in the outcome of poor-grade SAH after surgical obliteration of the aneurysm.
Data were reviewed retrospectively for 156 patients with poor-grade aneurysmal SAH at multiple centers in Chugoku and Shikoku, Japan. Patients were divided into age groups of 65-74 and ≥75 years old. Factors influencing a favorable outcome at discharge (Glasgow Outcome Scale, good recovery or moderately disabled) were determined using multivariate logistic regression analyses.
A favorable outcome at discharge was achieved in 37 of the 156 patients (23.7%). Advanced age (≥75 years old, P < 0.01), improvement of World Federation of Neurosurgical Societies (WFNS) Grade after admission (P = 0.02), Fisher grade (P < 0.001), and a low density area (LDA) associated with vasospasm on computed tomography (CT) (P < 0.01) were significantly associated with outcome. Multivariate analysis identified advanced age (≥75 years old, P = 0.01), Fisher group 4 (P = 0.002), and a new LDA associated with vasospasm on CT (P = 0.007) as predictors of a poor outcome in elderly patients with poor-grade SAH after surgical obliteration of the aneurysm. WFNS Grade V at admission (P = 0.052) was weakly associated with a poor outcome.
Advanced age (≥75 years old), Fisher group 4, and LDA associated with vasospasm on CT were independent predictors of clinical outcome in elderly patients with poor-grade SAH. A favorable outcome in these patients occurred more frequently after Guglielmi detachable coil embolization than after surgical clipping, but without a significant difference.
Surgical neurology international. 01/2012; 3:143.
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Takehisa Susa,
Shigeki Kobayashi,
Takeo Tanaka,
Wakako Murakami,
Shintaro Akashi, Ichiro Kunitsugu,
Shinichi Okuda,
Masahiro Doi,
Yasuaki Wada,
Tomoko Nao,
Jutaro Yamada,
Takeshi Ueyama,
Takayuki Okamura,
Masafumi Yano,
Masunori Matsuzaki
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ABSTRACT: The authors recently reported that urinary 8-hydroxy-2'-deoxyguanosine (U8-OHdG) derived from cardiac tissue reflects clinical status and cardiac dysfunction severity in patients with chronic heart failure (CHF). The aim of the present study was to investigate whether U8-OHdG levels can accurately predict cardiac events in CHF patients and their response to β-blocker treatment.
Plasma brain natriuretic peptide (BNP) and U8-OHdG levels were measured in 186 consecutive CHF patients before discharge. Patients were then prospectively followed (median follow-up, 649 days) with endpoints of cardiac death or hospitalization due to progressive heart failure. From receiver operating characteristic curve analysis, cut-offs were 12.4ng/mg creatinine (Cr) for U8-OHdG and 207pg/ml for BNP. On multivariate Cox analysis, U8-OHdG and BNP were independent predictors of cardiac events. Patients were classified into 4 groups according to U8-OHdG and BNP cut-offs. The hazard ratio for cardiac events in patients with BNP ≥207pg/ml and U8-OHdG ≥12.4ng/mg Cr was 16.2 compared with approximately 4 for patients with only 1 indicator above its respective cut-off. Furthermore, carvedilol therapy was initiated in 30 CHF patients. In responders (≥10% increase in left ventricular ejection fraction [LVEF] or ≥1 class decrease in New York Heart Association [NYHA] class), U8-OHdG levels decreased significantly along with improved NYHA class, LVEF, and BNP levels after treatment.
U8-OHdG may be a useful biomarker for predicting cardiac events and evaluating β-blocker therapy effectiveness in CHF patients.
Circulation Journal 01/2012; 76(1):117-26. · 3.77 Impact Factor
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ABSTRACT: The effects of fish consumption and n-3 poly-unsaturated fatty acid (PUFA) levels on atopic disorders are inconsistent in previous reports, but few studies have investigated the effects of both fish and n-3 PUFA. The aim of the present study was to investigate whether erythrocyte fatty acids and the consumption of fish are associated with atopic diseases in pre- and early adolescents.
A total of 135 students with eczema, 136 students with asthma, and 137 healthy control students were selected from fifth and eighth grades in Shunan, Japan. Atopic disorders and dietary intake were evaluated with questionnaires, and total serum IgE was measured using an enzyme-linked immunosorbent assay. In addition, erythrocyte membrane levels of PUFA were assessed via gas chromatography.
Total IgE was significantly elevated in the atopic subjects (P < 0.001). The intake of fatty and dried fish or seafood was significantly associated with eczema (odds ratios of the highest quartiles: 0.46, 95% confidence interval (95%CI): 0.22-0.94; 0.34, 95%CI: 0.16-0.71, respectively). Additionally, only erythrocyte eicosapentaenoic acid (EPA) level had a negative association with eczema (P= 0.048). For asthma, the effect of fish consumption was not significant.
Fish consumption was related to a low prevalence of eczema, but not asthma in Japanese pre- and early adolescents. EPA may be involved in this mechanism.
Pediatrics International 12/2011; 54(2):233-7. · 0.63 Impact Factor
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ABSTRACT: Self-reported body mass index (BMI) has been widely used in epidemiological studies, but no study thus far has validated the self-reported BMI of Japanese children and adolescents. The aim of the present study was to assess the accuracy of self-reported BMI and its use for classification into weight categories.
Fifth- and eighth-grade students (n= 358) from all schools in Shunan City, Japan, from 2006 to 2010 were included. BMI was calculated from both self-reported and measured data. Pearson's correlation, Kappa statistics and the number of overweight children, and Bland-Altman plots with 95% limits of agreement were calculated to assess the agreement.
Pearson's correlation between self-reported and measured data ranged between 0.946 and 0.987 for height, 0.978 and 0.992 for weight, and 0.930 and 0.964 for BMI, depending on gender or age. Kappa was excellent: 0.949 for boys, 0.867 for girls, 0.897 for 10-11-year-old children, 0.928 for 13-14-year-old adolescents. The number of overweight children based on self-reported BMI was not significantly different from that based on measured BMI. The 95% limits of agreement were -3.62 and 2.90 cm for height, -2.80 and 2.38 kg for weight, and -1.42 and 1.44 kg/m(2) for BMI.
Self-reported BMI was generally reliable for predicting the number of overweight Japanese children and adolescents. There is slight discrepancy, however, between self-reported BMI and measured BMI, and self-reported BMI should be used with caution, keeping the variance and concordance rate in mind.
Pediatrics International 12/2011; 54(3):397-401. · 0.63 Impact Factor
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ABSTRACT: Self-administered questionnaires about physical activity are useful for collecting data to develop public health policies. There is currently no validated physical activity questionnaire, however, for Japanese children and adolescents. The purpose of the present study was to evaluate the validity and reliability of self-administered, physical activity questionnaires for Japanese students.
Fifth- and eighth-grade students were asked to complete two questionnaires that estimated the intensity and time of moderate-to-vigorous physical activities in which they participated, and the frequency and duration spent performing sports activities. Students also wore triaxial accelerometers to compare their actual activity levels to their estimates, to investigate the validity and reliability of the questionnaires.
The intensity and time spent performing moderate-to-vigorous physical activity that were estimated from the questionnaire were higher than those measured by accelerometry (9-161% of accelerometry). Questionnaire data were highly correlated with accelerometer data for eighth graders (Spearman correlation, 0.642-0.754), but the correlations were lower for fifth graders (≤ 0.331). Furthermore, there was higher repeatability in the data collected from eighth graders (intraclass correlation, 0.625-0.645) than from fifth graders (0.136-0.194).
Questionnaires may be useful in epidemiological studies for ranking physical activity levels of adolescents, such as a confounding factor for other lifestyle surveys, but these surveys are less accurate for younger children.
Pediatrics International 07/2011; 53(6):956-63. · 0.63 Impact Factor
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ABSTRACT: The association between the fat mass- and obesity-associated (FTO) gene and a predisposition to obesity is inconsistent in adult Asian populations. We investigated the association of the FTO gene with weight status in Japanese children and adolescents.
Nested case-control study and 3-yr longitudinal study - In the Shunan Child Cohort Study, fifth and eighth grade students attending all schools of Shunan completed the questionnaires. Overweight, including obesity, was defined as a percentage of overweight of 20% or in accordance with the International Obesity Task Force. We recruited 133 obese subjects and randomly selected controls from the 2006 cohort. We genotyped three FTO single nucleotide polymorphisms (SNPs): rs3751812, rs9939609, and rs1558902.
The three genotyped SNPs were in tight linkage disequilibrium, with the exception of one case. The minor SNP allele of rs3751812 conferred a predisposition to obesity, and its odds ratio was 2.2 [95% confidence interval (CI), 1.5-3.4] in the additive model and 2.7 (95% CI, 1.6-4.4) in the dominant model (p < 0.001). Although blood parameters and some lifestyle behaviors were significantly different between the cases and controls (p < 0.01), these traits were not significantly different among the genotypes. In addition, we did not find an association between the genotypes and body mass index change during the 3 yr.
The FTO gene is associated with the early onset of overweight in the Japanese population as well as in European populations. The results suggest that obesity-related risk factors in fifth and eighth graders appear because of their overweight status.
Pediatric Diabetes 03/2011; 12(5):494-500. · 2.16 Impact Factor
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ABSTRACT: Iron plays a pivotal role in adult steatosis, but its role in child and adolescent steatosis is unclear. We investigated the effect of dietary iron, serum iron, and ferritin on serum transaminases and γ-glutamyltransferase in 10- and 13-year-olds.
The study included 4894 fifth and eighth graders enrolled between 2006 and 2009 in all schools in Shunan City, Japan. Multiple regression analyses were performed with adjustments for grade, sex, z score of the body mass index, serum lipids, plasma glucose, frequency of sports activities, having a single parent, number of siblings, tobacco smoking behavior, passive smoking at home, resident areas, and schools, using linear mixed models. In addition, we analyzed ferritin and insulin resistance in randomly selected subset of participants.
Dietary iron intake was positively associated with serum alanine aminotransferase levels (standardized coefficient β = 2.35, P = 0.019). Serum iron concentrations were associated with transaminase and γ-glutamyltransferase levels (β = 3.22, and 4.05, respectively, P < 0.01). In the subset of 421 subjects with further serum analysis, serum ferritin levels were significantly associated with serum enzyme levels (β = 2.43-3.35; P < 0.05) and showed significant odds ratio for the elevated alanine aminotransferase levels (1.05 for 1 SD with 95% confidence intervals 1.02-1.08). However, iron load did not show a positive association with insulin resistance.
Although an effect size for iron is small in regression analyses, iron is implicated in increased transaminase levels in prepubertal and pubertal children.
Journal of pediatric gastroenterology and nutrition 02/2011; 52(3):333-8. · 2.18 Impact Factor
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ABSTRACT: Transaminase levels increase with body mass index (BMI) and also with an extreme drop in the BMI, as in the case of patients with anorexia nervosa. We examined these levels over the BMI spectrum in Japanese 10- and 13-year-olds.
Fifth- and eighth-grade students (n= 3747) from all schools in Shunan City, Japan, between 2006 and 2008 were included in the study. BMI z-score and serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (GGT) were measured.
The ALT and GGT levels increased with z-BMI values in the boys and 10-year-old girls (P≤ 0.001). In the 13-year-old girls, only the ALT levels increased with the z-BMI values (P= 0.018). Similarly, the proportion of subjects with elevated ALT and GGT levels increased with the z-BMI values (p(trend) < 0.05). The AST levels were negatively associated with BMI in the girls (P < 0.001). Among the boys, these levels were elevated at the highest z-BMI values and slightly elevated at lower values, but not significantly. These associations did not change after adjustments for confounders. Generalized additive model analyses revealed that transaminase had non-linear relationships with z-BMI, except for the AST levels in the girls.
The elevated ALT and GGT levels were associated with high BMI in both sexes. In the same study population, however, AST increased in the girls with low BMI and in the boys with high BMI.
Pediatrics International 10/2010; 52(5):813-9. · 0.63 Impact Factor
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ABSTRACT: Background: Transaminase levels increase with body mass index (BMI) and also with an extreme drop in the BMI, as in the case of patients with anorexia nervosa. We examined these levels over the BMI spectrum in Japanese 10- and 13-year-olds.Methods: Fifth- and eighth-grade students (n= 3747) from all schools in Shunan City, Japan, between 2006 and 2008 were included in the study. BMI z-score and serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (GGT) were measured.Results: The ALT and GGT levels increased with z-BMI values in the boys and 10-year-old girls (P≤ 0.001). In the 13-year-old girls, only the ALT levels increased with the z-BMI values (P= 0.018). Similarly, the proportion of subjects with elevated ALT and GGT levels increased with the z-BMI values (ptrend < 0.05). The AST levels were negatively associated with BMI in the girls (P < 0.001). Among the boys, these levels were elevated at the highest z-BMI values and slightly elevated at lower values, but not significantly. These associations did not change after adjustments for confounders. Generalized additive model analyses revealed that transaminase had non-linear relationships with z-BMI, except for the AST levels in the girls.Conclusion: The elevated ALT and GGT levels were associated with high BMI in both sexes. In the same study population, however, AST increased in the girls with low BMI and in the boys with high BMI.
Pediatrics International 05/2010; 52(5):813 - 819. · 0.63 Impact Factor
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ABSTRACT: The present study assessed whether serum carotenoids and tocopherols are associated with atopic diseases (eczema and asthma) in 10- and 13-yr-olds in a Japanese community. Of 2796 students attending schools in Shunan, Japan, in 2006, 396 students were randomly selected for this study using nested case-control design. Atopic diseases and dietary food intake were assessed using self-administered questionnaires, and serum antioxidants were analyzed using high-performance liquid chromatography. We found no associations between serum carotenoids and atopic diseases. However, odds ratios (OR)s for the third and fourth quartiles of serum alpha-tocopherol with atopic eczema were 0.33 (95% confidence interval: 0.15-0.73) and 0.36 (0.14-0.89), respectively, and the trend was negatively significant (P(trend) = 0.048). We did not find a significant association for asthma. In conclusion, serum alpha-tocopherol was negatively associated with the prevalence of eczema. Serum carotenoids did not show definitive protective effects in Japanese youth.
Pediatric Allergy and Immunology 04/2010; 21(4 Pt 2):e705-10. · 2.46 Impact Factor
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ABSTRACT: The management of patients with poor-grade subarachnoid hemorrhage (SAH) continues to be controversial. The objective of this study was to examine predictors of outcome of poor-grade SAH after surgical obliteration of the aneurysm.
The study was performed as a retrospective review of 283 patients with poor-grade SAH who underwent surgical obliteration of the aneurysm at multiple centers in Chugoku and Shikoku, Japan.
A favorable outcome at discharge was achieved in 97 of the 283 patients (34.3%). Age (p < 0.001), World Federation of Neurosurgical Societies (WFNS) grade V at admission (p = 0.002), improvement in WFNS grade after admission (p = 0.002), Fisher grade (p = 0.039) and a low-density area (LDA) associated with vasospasm on computed tomography (CT; p < 0.001) showed a significant association with outcome. Further analysis of WFNS grades indicated that most patients who only improved to preoperative grade IV from grade V at admission did not have a favorable outcome. Multivariate analysis identified age (especially of > or =65 years; p < 0.001), WFNS grade V (p < 0.001) and LDA associated with vasospasm on CT (p < 0.001) as predictors of a poor outcome, and improvement in WFNS grade (p = 0.001) as a predictor of a favorable outcome after surgical obliteration of the aneurysm.
Advanced age, WFNS grade V, improvement in WFNS grade, and LDA associated with vasospasm on CT were found to be independent predictors of clinical outcome, whereas rebleeding, early aneurysm surgery and treatment modality (surgical clipping or Guglielmi detachable coil embolization) were not independently associated with outcome in patients with poor-grade aneurysm.
Cerebrovascular Diseases 01/2010; 30(2):105-13. · 2.72 Impact Factor
