Hirohiko Higashino

Vanadate effect on the Na,K-ATPase and the Na-K pump in in vitro-grown rat vascular smooth muscle cells.

The impact of vanadate on the Na,K-ATPase system in the vascular smooth muscle cell is poorly understood. The present study describes the kinetics of the effect of vanadate on Na,K-ATPase and the Na-K pump in in vitro grown rat VSMCs. Vanadate interaction with the Na,K-ATPase system in vascular smooth muscle cells was examined by observing its influence on ouabain-sensitive adenosine triphosphate hydrolysis in disrupted cells rendered permeable by osmotic shock, and the uptake of rubidium by intact cells. The I50 for vanadate inhibition of ouabain-sensitive hydrolysis of adenosine triphosphate occurred at vanadate concentrations of 10−* to 10″7 M. This inhibition was potassium dependent. The maximal inhibitory effect of vanadate occurred at potassium concentrations of 10–20 mEq/liter. Sodium exerted a moderate antagonistic influence on vanadate inhibition of ouabain-sensitive adenosine triphosphate hydrolysis. Rubidium uptake by vascular smooth muscle cells was not altered within 120 minutes when 10−1 M vanadate was added to the medium containing intact vascular smooth muscle cells. Yet, vanadium concentrations in the vascular smooth muscle cells within this incubation period reached levels 1.48-fold higher than the extracellular vanadate concentrations of 10″5 M. These observations indicate that vanadate is a potent inhibitor of the VSMC Na,K-ATPase in disrupted vascular smooth muscle cells. However, in intact vascular smooth muscle cells vanadium gaining access into the vascular smooth muscle cells interior does not inhibit the Na-K pump, probably because of its binding to intracellular proteins and/or conversion from the vanadate to the vanadyl ion.

Intracellular Magnesium and Adipokines in Umbilical Cord Plasma and Infant Birth Size

Many epidemiologic studies have disclosed that restricted fetal growth has been associated with an increased risk of insulin resistance in adulthood. We studied the relationship of intracellular magnesium ([Mg2+]i) in cord blood platelets to adipocytokine and birth size. The subjects were 20 infants with small for gestational age (SGA) and 45 infants with appropriate for gestational age (AGA). By using a fluorescent probe, we examined [Mg2+]i of platelets in the cord blood. Cord plasma insulin, IGF-I, ghrelin, adiponectin, plasminogen activator inhibitor-1 (PAI-1), and leptin levels were determined with the use of ELISA. Mean [Mg2+]i was lower in the SGA than in the AGA groups (p < 0.001). Adiponectin and IGF-I were also lower in the SGA than in the AGA, whereas PAI-1 was higher in the SGA. [Mg2+]i was significantly correlated with birth weight, birth length, and adiponectin. Birth weight was also correlated with cord plasma IGF-I, adiponectin, and leptin. Quantitative insulin sensitivity check index (QUICKI) was lower in the SGA group than in the AGA group. [Mg2+]i and adiponectin were correlated with QUICKI in all subjects. [Mg2+]i, as well as leptin and IGF-I, reflect the extent of fetal growth. Decreased [Mg2+]i may be involved in the underlying processes to insulin resistance.

LHRH analogue and growth hormone did not improve the final height of a patient with juvenile hypothyroidism accompanied by precocious puberty

Editor,—We report an 11 years 8 months old girl with juvenile hypothyroidism and precocious puberty who failed to respond to thyroxine, growth hormone, and luteinising hormone releasing hormone (LHRH) analogue. The patient was considered to be hypothyroid for about two years before the therapy was started. She had a very low serum thyroxine concentration, a height SD score of −3 SD, and a bone age of 10 years 3 months. Her pubertal development was graded as Tanner stage IV of breasts and Tanner stage II of pubic hair. Her menarche occurred at the age of 10 years 3 months. The enlarged …

Possible splenic tuberculosis presenting as unexplained fever

problem to pediatricians. The patient described in the present report visited us with a 3 week history of remittent fever. Among various diagnostic approaches investigated, high serum adenosine deaminase (ADA) activity initially raised the possibility of tuberculosis and repeated ultrasonography (US) of the abdomen eventually helped us to make a diagnosis of possible splenic tuberculosis. The purpose of the present article is to report on such a patient and to direct attention towards abdominal tuberculosis as a possible cause of unknown fever in children.

A Case of Idiopathic Gynecomastia Treated by Endoscopic Reduction Mammoplasty

an increase in breast volume due to proliferation of the mammary gland tissue. The condition in adolescence is a physiological phenomenon observed in 60% to 70% of pubertal males. It usually requires no medical treatment; however, excessive emotional discomfort may occur, necessitating consideration of treatment. We report a 13-year-old boy with gynecomastia who underwent a surgical resection. A 13year-old male patient presented with bilateral breast enlargement. His family history was noncontributory. He had suffered from aseptic meningitis at 9 years of age without sequelae. Breast enlargement in the boy was noticed a year before, with rapid enlargement taking place in the last 6 months just before his presentation to us. The patient visited our clinic, for he started to feel awkward in attending school, particularly in a swimming class. His height was 158.8 cm (+0.42 SD) and he weighed 44.9 kg. No exophthal-

Regional disparities in obesity/emaciation and income in schoolchildren in Osaka City

We assessed the association between socioeconomic status at residential area‐level in the 24 wards of Osaka City, differentiated by indices of mean income‐related deprivation, and inequalities in childhood obesity and emaciation.

Promotion of the Transition of Adult Patients with Childhood-Onset Chronic Diseases among Pediatricians in Japan

The transition of adult patients with childhood-onset chronic diseases (APCCD) from pediatric to adult health-care systems has recently received worldwide attention. However, Japan is lagging behind European countries and North America as this concept of health-care transition was introduced only 10 years ago. In Japan, before the introduction of this concept, APCCD were referred to as “carryover patients,” who were often considered a burden in pediatric practice. In the late 1990s, groups composed of pediatric nephrologists, developmental and behavioral pediatricians, pediatric nurses, and special education teachers researching the quality of life of adult patients with chronic kidney disease began to discuss the physical and psychosocial problems of APCCD. In 2006, a group of pediatricians first introduced the term “transition” in a Japanese journal. By 2010, a group of adolescent nurses had begun a specialized training program aimed at supporting patients during the transitional period. In 2013, the Ministry of Health, Labour and Welfare in Japan convened a research committee, focusing on issues related to social, educational, and medical support for APCCD, and the Japan Pediatric Society established a committee for the health-care transition of APCCD and summarized their statements. Moreover, in 2013, the Tokyo Metropolitan Children’s Medical Center initiated ambulatory services for APCCD managed by specialized nurses. The concept of health-care transition has rapidly spread over these past 10 years. The purpose of this article is to describe how this concept of health-care transition has advanced in Japan, such that APCCD now experience a positive pediatric to adult health-care transition.