Mitsuaki Hosoya

Fukushima Medical University, Hukusima, Fukushima, Japan

Are you Mitsuaki Hosoya?

Claim your profile

Publications (163)323.66 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated the efficacy of rituximab and low-dose cyclosporine combination therapy for focal segmental glomerulosclerosis (FSGS) children with steroid-resistant nephrotic syndrome (SRNS). Five FSGS children with SRNS were treated twice with rituximab and low-dose cyclosporine combination therapy (RTX-CyAT). The clinical features and laboratory data were investigated before and after RTX-CyAT, and the outcomes were assessed. Prednisolone (PSL) was discontinued 3 months after RTX-CyAT in all patients. The number of CD19-positive cells decreased to less than 1 % of all white blood cells in all patients at one month after RTX-CyAT, with the duration of the decrease in CD19-positive cells (<1%) continuing for 259.6 ± 68.2 days. All patients remained in remission for the duration of the decrease in CD19-positive cells (<1%). Two patients also remained in remission throughout the observation period, with three patients experiencing a single relapse at 333 ± 89 (range 231-376) days after RTX-CyAT. In all patients, the mean steroid and CyA doses after RTX-CyAT were lower than those before RTX-CyAT. The results of our study suggest that RTX-CyAT is effective in FSGS patients with SRNS and may ameliorate the side effects of PSL and immunosuppressive drugs. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Pediatrics International 08/2015; DOI:10.1111/ped.12804 · 0.73 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In Japan, the seven-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2010. PCV13 has replaced PCV7 since November 2013. The effectiveness of PCV7 in protecting against invasive pneumococcal disease (IPD) in children aged <5 years was evaluated in a nationwide active population-based surveillance of IPD in 2008-2013 in 10 prefectures in Japan. 1181 cases were identified; 711 pneumococcal strains were analyzed for serotyping and antimicrobial resistance. Compared with the baseline IPD incidence (25.0 per 100,000), a 98% decline in IPD caused by PCV7 serotypes was found after the introduction of PCV7. This was partially offset by an increased incidence of IPD caused by PCV13 minus PCV7 and non-PCV13 serotypes, resulting in a 57% decline in overall IPD incidence. Absolute increases in the incidence rates of IPD caused by PCV13 minus PCV7 and non-PCV13 serotypes were 2.1 and 2.8 per 100,000 during the study period, respectively. The proportion of meropenem-nonsusceptible strains, especially with serotypes 19A and 15A, increased significantly after PCV7 introduction. Our data confirmed a 98% decline in IPD incidence caused by PCV7 serotypes in children aged <5 years and serotype replacement after PCV7 introduction. This shows the importance of continuing surveillance of serotypes responsible for IPD and their antimicrobial resistance in Japan. Copyright © 2015. Published by Elsevier Ltd.
    Vaccine 07/2015; DOI:10.1016/j.vaccine.2015.07.069 · 3.49 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Previous studies have shown that control of cardiovascular risk factors deteriorates among residents after a natural disaster. This study assessed the hypothesis that the prevalence of atrial fibrillation (AF) increased among residents in the evacuation zone of Fukushima prefecture after the Great East Japan Earthquake. This longitudinal study examined subjects aged 40-90years using data collected from 26,163 participants (11,628 men and 14,535 women) sourced from general health checkups conducted in twelve communities, including the evacuation zone specified by the government, between 2008 and 2010. The study obtained 12-lead ECG tracings and conducted follow-up examinations from June 2011 to the end of March 2013. A total of 12,410 participants (5704 men and 6706 women, follow-up proportion: 47%) received follow-up examinations after the earthquake, with an average follow-up of 1.4years. The prevalence of AF increased among participants after the earthquake (before: 1.9% vs. after: 2.4%, P<.001). During the follow-up period, 79 incidences of AF occurred among participants. Excess ethanol intake (≥44g/day) and obesity showed associations with an increased risk of AF after the earthquake, with multivariable-adjusted hazard ratios (95% confidence interval) of 3.07 (1.55-6.08) and 1.87 (1.19-2.94), respectively. The prevalence of AF increased among residents in the evacuation zone of Fukushima prefecture after the Great East Japan Earthquake, with excess alcohol intake and obesity associated with an increased risk of AF. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    International journal of cardiology 07/2015; 198:102-105. DOI:10.1016/j.ijcard.2015.06.151 · 6.18 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The Great East Japan Earthquake and Fukushima Daiichi nuclear disaster in 2011 forced the evacuation of a large number of residents and created changes in the lifestyle of the evacuees. These changes may have affected the evacuees’ glucose metabolism, thereby leading to an increase in the incidence of diabetes. This study included Japanese men and women who were living near the Fukushima Daiichi Nuclear Power Plant in Fukushima prefecture before the disaster. Subjects subsequently underwent annual health checkups with a focus on metabolic syndromes, which were conducted under the Health Care Insurers. Using the Comprehensive Health Check survey, we analyzed changes in the glucose metabolism before and after the disaster. A total of 27,486 subjects underwent follow-up examinations after the disaster, with a mean follow-up period of 1.6 years. After the disaster, the prevalence of diabetes increased significantly, and we observed that the incidence of diabetes was significantly greater among evacuees than among nonevacuees. Furthermore,multivariate logistic regression analysis revealed that evacuation was significantly associated with the incidence of diabetes. In conclusion, this is the first study to demonstrate that evacuation is associated with the incidence of diabetes. This information may be used to guide follow-up recommendations for evacuees.
    Journal of Diabetes Research 05/2015; 2015(627390):1-9. DOI:10.1155/2015/627390 · 3.54 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Because influenza virus isolates after cell culture are required to determine their susceptibility to neuraminidase inhibitors, the differences in normal or low-susceptibility variant population frequencies between clinical samples and isolates have not been considered. To identify variations in low-susceptibility populations in clinical samples after initiation of oseltamivir and zanamivir therapy by quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). We measured the populations of the low-susceptibility influenza A H3N2 variants E119V and R292K by qRT-PCR using 305 nasal aspiration samples collected over time from 13, 16, and 11 patients treated with no neuraminidase inhibitors, oseltamivir, and zanamivir, respectively. The variant population in the isolates was also determined when the population of low-susceptibility variants in the clinical samples increased following treatment. Moreover, the susceptibility of all isolates was measured. The E119V variant was detected in only one patient during oseltamivir therapy, exhibiting decreased susceptibility to oseltamivir. Prior to treatment, R292K variants were detected in all clinical samples; however, they comprised only a small fraction of the total population. The proportion of the R292K variant in clinical samples increased for 6/27 (22.2%) patients treated with oseltamivir or zanamivir, whereas an increase in the proportion of the R292K variant in virus isolates was observed in only one patient. Discrepancies in the proportion of R292K variants between clinical samples and isolates should be suspected in clinical settings. qRT-PCR is useful for quantitative analysis of drug-resistant influenza virus and for immediate notification of the result. Copyright © 2015. Published by Elsevier B.V.
    Journal of Clinical Virology 05/2015; 68. DOI:10.1016/j.jcv.2015.05.018 · 3.47 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chronic active Epstein-Barr virus (EBV) infection (CAEBV), characterized by persistent infectious mononucleosis-like symptoms, can lead to cardiovascular complications including coronary artery aneurysm or myocarditis. Here, we present the case of an 11-year-old boy with pulmonary arterial hypertension (PAH) and junctional ectopic tachycardia associated with CAEBV. The patient did not have any major symptoms attributed to CAEBV, such as fever, lymphadenopathy or splenomegaly when the PAH developed. Mild liver dysfunction was found at the first examination, and it persisted. Two years after the PAH symptoms appeared, CAEBV was evident, based on deteriorated liver function, hepatosplenomegaly, and coronary artery aneurysms. CAEBV should be considered as a cause of secondary PAH, particularly when liver dysfunction coexists. © 2015 Japan Pediatric Society.
    Pediatrics International 03/2015; DOI:10.1111/ped.12578 · 0.73 Impact Factor
  • Source
    Fukushima journal of medical science 02/2015; 60(2):211-2. DOI:10.5387/fms.2014-25
  • [Show abstract] [Hide abstract]
    ABSTRACT: The primary manifestations of systemic lupus erythematosus (SLE) are various. One such manifestation is hemophagocytic syndrome (HPS). We here report a child with SLE presenting with HPS as a primary manifestation. In October 2010, an 11-year-old Japanese boy presented with pancytopenia, elevated liver enzymes, hyperferritinemia and hemophagocytosis due to macrophages in the bone marrow, and was diagnosed with HPS. A year later, he was found to have proteinuria and hematuria. Oral aphtha and Raynaud's phenomenon were observed, and the patient showed low serum complement levels and was positive for anti-nuclear antibodies (ANAs). He was subsequently diagnosed with SLE. Moreover, low serum complement levels and ANA positivity were detected in a serum sample preserved at the onset of HPS. The HPS was considered to be a primary manifestation of SLE on the basis of these findings. Based on this case, the presence of an underlying disease, such as SLE, should be investigated in cases of HPS.
    Fukushima journal of medical science 02/2015; 60(2):181-6. DOI:10.5387/fms.2013-24
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To assist in the long-term health management of residents and evaluate health impacts after the Tokyo Electric Power Company's Fukushima Daiichi Nuclear Power Plant accident in Fukushima Prefecture, the Fukushima prefectural government decided to conduct the Fukushima Health Management Survey. This report describes the results for residents aged 16 years or older who received the health check examinations and evaluates the data obtained from 2011 and 2012. The target group consisted of residents aged 16 years or older who had lived in the evacuation zone. The health check examinations were performed on receipt of an application for a health check examination from any of the residents. The examinations, including measurements of height, weight, abdominal circumference/body mass index (BMI), blood pressure, biochemical laboratory findings, and peripheral blood findings, were performed as required. 1) A total of 56,399 (30.9%) and 47,009 (25.4%) residents aged 16 years or older received health checks in 2011 and 2012, respectively. 2) In both years, a number of male and female residents in the 16-39 year age group were found to suffer obesity, hyperlipidemia, hyperuricemia, or liver dysfunction, and the prevalence of obesity and hyperlipidemia among residents increased with age. Furthermore, the proportion of residents with hypertension, glucose metabolic abnormalities or renal dysfunction was higher in those aged 40 years or older. 3) The frequencies of obesity, hypertension and hyperlipidemia among residents in 2012 were lower than those in 2011. However, the prevalence of liver dysfunction, hyperuricemia, glucose metabolic abnormalities and renal dysfunction among residents was higher in 2012 than in 2011. These results suggested the number of residents who had lived in the evacuation zone with obesity, hyperlipidemia, hyperuricemia, liver dysfunction, hypertension, glucose metabolic abnormalities, or renal dysfunction increased with age in all age groups. Therefore, we think that it is necessary to continue with health check examinations for these residents in order to ameliorate lifestyle-related disease.
    Fukushima journal of medical science 02/2015; 60(2):159-69. DOI:10.5387/fms.2014-31
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recombinant human soluble thrombomodulin (rhTM) is a promising therapeutic natural anticoagulant that is comparable to antithrombin, tissue factor pathway inhibitor and activated protein C. In order to clarify the efficacy of rhTM for the treatment of typical hemolytic uremic syndrome (t-HUS), we examined changes in renal damage in t-HUS mice treated with rhTM or vehicle alone. We used severe and moderate t-HUS mice injected with shiga toxin (Stx) and lipopolysaccharide (LPS). The severe t-HUS mice were divided into two subgroups [an rhTM subgroup (Group A) and a saline subgroup (Group B)] along with the moderate t-HUS mice [an rhTM subgroup (Group C) and a saline subgroup (Group D)]. Groups E and F were healthy mice treated with rhTM or saline, respectively. All mice in Group B died at 80-90 h post-administration of Stx2 and LPS whereas all mice in Group A remained alive. Loss of body weight, serum creatinine level, endothelial injury and mesangiolysis scores at 24 h after administration in the t-HUS mice treated with rhTM were lower than those in t-HUS mice treated with saline. The levels of hemoglobin at 6 h and platelet counts at 24 h after administration in Group A were higher than those in Group B. Serum interleukin (IL)-6, IL-1β and tumor necrotic factor (TNF)-α levels at 24 h after administration in Group A were lower than those in Group B. Serum C5b-9 levels at 24 h after the administration and serum fibrinogen degradation product (FDP) at 72 h after the administration of Stx2 and LPS were lower in Group A than in Group B. These results indicate that rhTM might afford an efficacious treatment for t-HUS model mice via the inhibition of further thrombin formation and amelioration of hypercoagulant status. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
    Nephrology Dialysis Transplantation 02/2015; 30(6). DOI:10.1093/ndt/gfv004 · 3.49 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background We examined the epidemiology, clinical manifestations, and prognosis of pediatric systemic lupus erythematosus (SLE) in Fukushima Prefecture, Japan over a 35-year period.Method We collected the medical records of 37 patients diagnosed with SLE between 1977 and 2013. These children were divided into two groups. Group 1 consisted of 19 patients who were diagnosed between 1977 and 1995, and Group 2 consisted of 18 patients diagnosed between 1996 and 2013. The epidemiology, clinical features, and prognosis were retrospectively compared between the two groups.ResultsThe mean numbers of patients per 100,000 children per year for Group 1 and Group 2 were 0.33 ± 0.25 and 0.35 ± 0.30, respectively. The duration from the onset of symptoms to treatment in Group 2 was shorter than that in Group 1; however, the clinical and laboratory findings at onset did not differ between the two groups. All patients were treated with PSL, and 17 patients in Group 1 and 18 in Group 2 were treated with methylprednisolone pulse therapy. The frequency of administration of cyclophophamide decreased whereas the frequency of administration of cyclosporine, tacrolimus and mizoribine pulse therapy increased in Group 2. The SLEDAI scores at the latest follow-up in Group 2 were lower those in Group1. The survivor rate was 84% in Group 1 and 100% in Group 2.Conclusions Our findings suggest that the frequency and severity of SLE in Group 1 were similar to those in Group 2, and that the prognosis of SLE in Group 2 is better than that in Group 1.
    Pediatrics International 01/2015; DOI:10.1111/ped.12588 · 0.73 Impact Factor
  • Source
  • Journal of Diabetes Research 01/2015; 2015. DOI:10.1155/2015/415253 · 3.54 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We estimated the efficacy of the current single administration of peramivir on the basis of peramivir pharmacokinetics in the upper respiratory tract (URT) and determined the predictive peramivir concentration-time curve to assess its efficacy against viruses with decreased susceptibility to neuraminidase inhibitors. Serum, nasal swab, or aspiration samples were collected from 28 patients treated with 10 mg/kg peramivir. Sequential influenza viral RNA load and susceptibility after peramivir administration were measured using a quantitative real-time reverse transcription-polymerase chain reaction and neuraminidase inhibition assay. The peramivir concentration in serum and URT after a single administration at 10 mg/kg was measured and the predictive blood and URT peramivir concentration-time curve was determined to assess various administration regimens against resistant variants. The serum peramivir concentration decreased to <0.1% of Cmax at 24 h after administration. Rapid elimination of peramivir from URT by 48 h after administration may contribute to an increase in the influenza A viral load after day 3 but not to a decrease in the influenza B viral load, despite the absence of decrease in susceptibility to peramivir. A longer maintenance of high level of peramivir in URT is expected by divided administration rather than once daily administration. When no clinical improvement is observed in patients with normal-susceptibility influenza A and B, peramivir readministration should be considered. In severe cases caused by resistant variants, better inhibitory effectiveness and less frequent adverse events is expected by divided administration rather than the once daily administration with an increased dosage. Copyright © 2014, American Society for Microbiology. All Rights Reserved.
    Antimicrobial Agents and Chemotherapy 12/2014; 59(3). DOI:10.1128/AAC.04263-14 · 4.45 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The Great East Japan Earthquake and the Fukushima Daiichi nuclear disaster forced people to evacuate their hometowns. Many evacuees from the government-designated evacuation zone were forced to change their lifestyle, diet, exercise, and other personal habits. The Comprehensive Health Check (CHC), 1 of 4 detailed surveys of The Fukushima Health Management Survey (FHMS), was implemented to support the prevention of lifestyle-related disease. The aim of this study was to analyze changes in red blood cell count (RBC), hemoglobin (Hb) levels, and hematocrit (Ht) levels by comparing data from the medical health checkup before and after the disaster in individuals who were 40 years old or older. Subjects in this study were Japanese men and women living in the vicinity of the Fukushima Daiichi Nuclear Power Plant in Fukushima prefecture. Annual health checkups with a focus on metabolic syndrome for insured persons/dependents aged 40 or older by Health Care Insurers have been conducted since 2008. All analyses in this study were limited to men and women aged 40–90 years. Changes in RBC, Hb levels, Ht levels, and prevalence of polycythemia before and after the disaster were compared. First, RBC, Hb, and Ht significantly increased in both men and women evacuees. The evacuation was significantly associated with increased Hb levels after adjustment for age, gender, smoking status, excess ethanol intake, BMI, and baseline Hb level (β = 0.16, p < 0.001). Furthermore, the prevalence of polycythemia stratified by smoking status or obesity also increased in the evacuee group. To our knowledge, this is the first report revealing that the evacuation was associated with the risk of polycythemia. This information could be very important for periodic health checkup and lifestyle recommendations for evacuees in the future.
    BMC Public Health 12/2014; 14(1):1318. DOI:10.1186/1471-2458-14-1318 · 2.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Antineutrophil cytoplasmic autoantibody-associated glomerulonephritis (GN) in childhood is rare and has a poor prognosis. We report an 11-year-old girl with renal-limited antineutrophil cytoplasmic autoantibody-associated vasculitis. Proteinuria and hematuria were first detected by a school urinary screening (SUS) program. Histopathological examination revealed pauci-immune necrotizing GN. She did not display purpura or peripheral neuropathy. She was diagnosed with antineutrophil cytoplasmic autoantibody-associated GN based on proteinuria, high serum titers of antineutrophil cytoplasmic autoantibodies (ANCAs), and pauci-immune necrotizing GN. The patient was treated with combination therapy, consisting of methylprednisolone and urokinase pulse, prednisolone, mizoribine (MZB), warfarin, and dilazep hydrochloride. At 2 months after treatment, urinary protein excretion was decreased and the hematuria had disappeared, while the serum titer of ANCAs was also decreased. The dose of prednisolone was tapered, and proteinuria and hematuria later disappeared at 9 months after treatment. In conclusion, we reported an 11-year-old girl with renal-limited antineutrophil cytoplasmic autoantibody-associated vasculitis early identified by a SUS program and treated with multi-drug combination therapy including MZB. On the basis of our results, we believe that a SUS programs may be effective for the early identification and treatment of children with renal-limited antineutrophil cytoplasmic autoantibody-associated vasculitis.
    11/2014; 3(2):232-236. DOI:10.1007/s13730-014-0126-1
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Lymphocytes are susceptible to damage from radiation, and the white blood cell (WBC) count, including counts of neutrophils and lymphocytes, is a useful method of dosimetry. According to the basic survey of the Fukushima Health Management Survey (FHMS), among 13 localities where evacuation was recommended, Iitate and Namie had more individuals with external radiation exposure of more than 5 mSv than the other evacuation areas. We analyzed whether or not WBC, neutrophil, and lymphocyte counts decreased after the disaster. Methods The subjects of this study were 45 278 men and women aged 20 to 99 years (18 953 men and 26 325 women; mean age 56 years) in the evacuation zone who participated in the Comprehensive Health Check (CHC) from June 2011 to the end of March 2012. Results Significant differences were detected in the mean values of WBC, neutrophil, and lymphocyte counts, and for the proportion of individuals under the minimum standard for WBC and neutrophil counts, among the 13 localities. However, the distribution of individuals at each 200-cell/µL increment in lymphocyte count were similar in these areas, and the WBC, neutrophil, and lymphocyte counts did not decrease in Iitate or Namie specifically. Conclusions No marked effects of radiation exposure on the distribution of WBC counts, including neutrophil and lymphocyte counts were detected within one year after the disaster in the evacuation zone.
    Journal of Epidemiology 10/2014; 25(1). DOI:10.2188/jea.JE20140092 · 2.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Myeloid/natural killer cell precursor acute leukemia (MNKL) is an aggressive disease with a high relapse rate even after allogeneic hematopoietic stem cell transplantation (SCT). We report a patient with MNKL who had a donor lymphocyte infusion (DLI) for relapse after T cell-replete human leukocyte antigen (HLA)-haploidentical SCT, but relapsed again 20 months later with loss of mismatched HLA. This case suggests that a strong graft-versus-leukemia effect of haploidentical SCT can be expected in MNKL patients. In the haploidentical setting, DLI should be considered for patients with relapsed leukemia whose leukemic cells have not lost HLA cell surface expression. Pediatr Blood Cancer © 2014 Wiley Periodicals, Inc.
    Pediatric Blood & Cancer 10/2014; 61(10). DOI:10.1002/pbc.24962 · 2.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Idiopathic hyperammonemia (IHA) has been described as a complication of intensive chemotherapy for the treatment of hematologic malignancy but has subsequently been found in patients undergoing bone marrow transplantation and in those with solid tumors treated with 5-fluorouracil. Although IHA is a rare complication, it is sometimes associated with high mortality in hematologic malignancies. Here we report the case of a 15-year-old boy in whom hyperammonemia developed during the initial treatment with prednisolone for newly diagnosed acute lymphoblastic leukemia and who survived after early detection and oral lactulose therapy. To the best of our knowledge, this is the first report of IHA that was not induced by intensive chemotherapy, stem cell transplantation, or asparaginase therapy in a patient with newly diagnosed leukemia, but developed during an initial treatment with a steroid. Early detection of IHA by measuring the plasma ammonia level in patients with neurological symptoms may improve the outcome.
    Journal of Pediatric Hematology/Oncology 09/2014; Publish Ahead of Print. DOI:10.1097/MPH.0000000000000255 · 0.96 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Despite improvements in first-line therapies, the outcomes of relapsed or refractory childhood acute leukaemia that has not achieved complete remission after relapse, has relapsed after stem cell transplantation (SCT), has primary induction failure and has relapsed with a very unfavourable cytogenetic risk profile, are dismal.Objectives and Methods We evaluated the feasibility and efficacy of T-cell-replete haploidentical peripheral blood stem cell transplantation (haplo-SCT) with low-dose anti-human thymocyte immunoglobulin (ATG), tacrolimus, methotrexate and prednisolone (PSL) in 14 paediatric patients with high-risk childhood acute leukaemia.ResultsAll patients achieved complete engraftment. The median time to reaching an absolute neutrophil count of more than 0.5 × 109 L−1 was 14 days. Acute graft-vs-host disease (aGVHD) of grades II–IV and III–IV developed in 10 (71%) and 2 (14%) patients, respectively. Treatment-related mortality and relapse occurred in one (7%) patient and six (43%) patients, respectively. Eleven patients were alive and seven of them were disease-free with a median follow-up of 36 months (range: 30–159 months). The probability of event-free survival after 2 years was 50%.Conclusion These findings indicate that T-cell-replete haplo-SCT, with low-dose ATG and PSL, provides sustained remission with an acceptable risk of GVHD in paediatric patients with advanced haematologic malignancies.
    Transfusion Medicine 09/2014; 24(5). DOI:10.1111/tme.12150 · 1.31 Impact Factor

Publication Stats

2k Citations
323.66 Total Impact Points


  • 1998–2015
    • Fukushima Medical University
      • • Department of Pediatrics
      • • Division of Medicine
      • • Department of Microbiology
      Hukusima, Fukushima, Japan
  • 2003
    • Kumamoto University
      • Department of Child Development
      Kumamoto, Kumamoto Prefecture, Japan
  • 1991–1993
    • University of Leuven
      • Department of Biomedical Kinesiology
      Louvain, Flanders, Belgium