Faculty Profiles - TSUKAHARA Hirokazu

MISC - TSUKAHARA Hirokazu

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A randomized study of two long-course prednisolone regimens for nephrotic syndrome in children

M Hiraoka, H Tsukahara, K Matsubara, M Tsurusawa, N Takeda, S Haruki, S Hayashi, K Ohta, T Momoi, Y Ohshima, N Suganuma, M Mayumi

AMERICAN JOURNAL OF KIDNEY DISEASES 41 ( 6 ) 1155 - 1162 2003.6

Language：English Publisher：W B SAUNDERS CO

Background Long-course prednisolone regimens have been shown to be more effective than short-course regimens In sustaining remission of nephrotic syndrome in children. However, the most beneficial approach among the long-course regimens remains unknown. Methods: Seventy-three children with new-onset nephrotic syndrome were allocated at random to the two long-course regimens and followed up for 2 years. Group A was administered prednisolone at a daily dose of 60 mg/m(2) for 6 weeks, followed by an alternate-day dose of 40 mg/m(2) for 6 weeks (the long daily regimen). Group B was administered the same daily dose for 4 weeks, followed by an alternate-day dose of 60 mg/m(2) for 4 weeks, and doses were tapered by 10 mg/m(2) every 4 weeks (the long alternate-day regimen). Results Group B had a lower incidence of corticosteroid toxicities than group A during the initial treatment. Kaplan-Meier analysis of the sustained remission rate of the two treatment groups showed a marginally significant difference (P = 0.069) and showed a significant difference when patients were stratified for age of disease onset (P = 0.048). In a subgroup of younger children (<4 years at onset), group B had a greater rate of sustained remission (P < 0.01) and fewer children with frequent relapses (P < 0.05) than group A, whereas in older children (&GE;4 years at onset), both groups had similar good sustained remission rates. Conclusion. These findings collectively indicate that the long alternate-day regimen may be more beneficial, with less corticosteroid toxicities, than the long daily regimen, and children with younger age at disease onset may be susceptible to relapse and especially benefit from the long alternate-day regimen for sustaining remission of the disease.

DOI： 10.1016/S0272-6386(03)00346-9

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Nitric oxide modulates bone mineralization in growing rats

H Tsukahara, Y Todoroki, S Sato, N Ohta, M Hiraoka, M Mayumi

BONE 32 ( 5 ) S202 - S202 2003.5

Oxidative stress and altered antioxidant defenses in children with acute exacerbation of atopic dermatitis

H Tsukahara, R Shibata, Y Ohshima, Y Todoroki, S Sato, N Ohta, M Hiraoka, A Yoshida, S Nishima, M Mayumi

LIFE SCIENCES 72 ( 22 ) 2509 - 2516 2003.4

Language：English Publisher：PERGAMON-ELSEVIER SCIENCE LTD

The underlying mechanisms of skin inflammation in atopic dermatitis (AD) are not completely understood. The purpose of the present study was to examine the involvement of oxidative stress and antioxidant defenses in children with acute exacerbation of AD. We studied 13 children who were hospitalized for acute exacerbation of AD with purulent skin infection by Staphylococcal aureus (age, 1.5 to 10.0 years), and 28 age-matched healthy subjects (controls). Urine samples obtained from the patients on admission, on 2nd and 7th-9th hospital days, as well as from the controls were analyzed for 8-hydroxy-2'-deoxyguanosine (8-OHdG) (a marker of oxidative DNA damage), acrolein-lysine adducts (a marker of lipid peroxidation), bilirubin oxidative metabolites (BOM) (a marker of antioxidant activity of bilirubin under oxidative stress) and nitrite/nitrate (NOx-) (a marker of endogenous nitric oxide production). Of these, urinary concentrations of 8-OHdG, acrolein-lysine adducts and BOM, but not NOx-, were significantly higher in AD children on admission than those in control subjects. Response to treatment was associated with significant falls in the concentrations of 8-OHdG and acrolein-lysine adducts. Urinary concentrations of acrolein-lysine adducts, but not 8-OHdG, were still significantly higher in AD patients on the 7th-9th hospital day relative to the control. Urinary BOM remained almost constant and significantly high in AD children during hospitalization. Our findings indicate that oxidative stress and altered antioxidant defenses are involved in the pathophysiology of acute exacerbation of AD, and that suppression of oxidative stress might be a potentially useful strategy for the treatment of AD. (C) 2003 Elsevier Science Inc. All rights reserved.

DOI： 10.1016/S0024-3205(03)00145-0

Early treatment of urinary infection prevents renal damage on cortical scintigraphy

M Hiraoka, G Hashimoto, S Tsuchida, H Tsukahara, Y Ohshima, M Mayumi

PEDIATRIC NEPHROLOGY 18 ( 2 ) 115 - 118 2003.2

Language：English Publisher：SPRINGER-VERLAG

Diagnosis of urinary infection in young children is often delayed, which may result in renal damage. However, it remains to be clarified how soon the treatment should be started to prevent renal changes. The present study prospectively enrolled young children with diagnosis of their first febrile urinary infection who underwent technetium-99m dimercaptosuccinate renal cortical scintigraphy within 120 h of initiation of treatment. Patients with abnormal renoscintigraphy received antibiotics for 2 weeks and scintigraphy was repeated 1 year later. Twenty-two children were enrolled from July 1995 through March 2000. Acute-phase renoscintigraphy identified focal defects in 0 of the 14 children who were treated within 24 h of the disease, 1 of the 3 treated in 24-18 h, and 2 of the 5 treated in 48-72 h. Repeat renoscintigraphy showed disappearance of the focal defects in all 3 children. The present study has shown that early treatment within 24 h of onset of the fever due to urinary infection should deter renal changes. Fever for more than 24 h prior to diagnosis indicates a high risk for renal changes and needs an immediate effective treatment to avoid renal damage.

DOI： 10.1007/s00467-002-1023-y

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小児アトピー性皮膚炎の発症に関する因子および発症予測・予防に関する実験的・文献的解析

眞弓光文, 大嶋勇成, 塚原宏一

平成14年度厚生労働科学研究費補助金: 免疫アレルギー疾患予防・治療等研究事業研究報告書（免疫アレルギー疾患予防・治療研究事業事務局） 10 - 12 2003

1型糖尿病若年患者におけるカルボニル/酸化ストレスの評価

塚原宏一, 畑郁江, 巨田尚子, 佐藤周子, 轟夕起子, 平岡政弘, 眞弓光文, 内山真由美, 川上寿子, 関根恭一, 三浦雅一

日本小児腎臓病学会雑誌 16 ( 2 ) 143 - 150 2003

Language：Japanese Publisher：The Japanese Society for Pediatric Nephrology

糖尿病合併症の成因としてカルボニル／酸化ストレスの関与がおもに成人領域で注目されている。われわれは，１型糖尿病若年患者が受けるカルボニル／酸化ストレスについて検討した。１型糖尿病患者38名（男／女：17/21，年齢12.8±4.5歳，罹病期間：5.7±4.3年［平均±SD］），正常対照60名（男／女：28/32，年齢：11.4±4.5歳）の早朝尿中のpentosidine， pyrraline（カルボニルストレスマーカー)，8-OHdG，acrolein-lysine（酸化ストレスマーカー）濃度を計測した。１型糖尿病患者では尿pentosidine，8-OHdG，acrolein-lysineは正常対照よりも有意に高かった。pentosidine はpyrraline，8-OHdG，acrolein-lysineと，pyrralineはacrolein-lysineと有意に正相関した。pentosidine，8-OHdG，acrolein-lysineは尿中アルブミンと有意に正相関した。微小アルブミン尿陽性患者（≥15mg/g Cr; 11名）では，すべてのマーカーが微小アルブミン尿陰性患者および正常対照よりも有意に高かった。今回の研究により，１型糖尿病若年患者では酸化ストレスとそれに連動したカルボニルストレスが亢進していることが示された。

DOI： 10.3165/jjpn.16.143

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Other Link： http://search.jamas.or.jp/link/ui/2004145192

周生期における血管作動因子・利尿因子の果たす生理学的役割

塚原宏一

小児科臨床 56(2) ( 2 ) 163 - 167 2003

高マグネシウム血症, 低カルシウム血症, 心機能障害, 壊死性腸炎の発症に硫酸マグネシウムの母体投与の関連が考えられた早産児例

鈴木孝二, 塚原宏一, 椎間優子, 早川和代, 古畑律代, 佐藤周子, 西田公一, 谷澤昭彦, 平岡政弘, 宿南憲一, 小辻文和, 眞弓光文

小児科臨床 56 ( 2 ) 210 - 214 2003

Gas-phase disproportionation of nitric oxide at elevated pressures

H Tsukahara, T Ishida, Y Todoroki, M Hiraoka, M Mayumi

FREE RADICAL RESEARCH 37 ( 2 ) 171 - 177 2003

Language：English Publisher：TAYLOR & FRANCIS LTD

T.P. Melia's chemical kinetics study of the disproportionation of nitric oxide (NO), 3NO --> NO2 + N2O , (Melia, T.P. (1965) J. Inorg. Nucl. Chem. , 27 , 95-98), which is the most quoted quantitative investigation presently available, revealed a rather strong dependence of the effective rate constant, Kk', of Melia's third-order rate law,- d[NO]/dt = Kk'[NO](3) , on the initial pressure of NO. In order to estimate extent of accumulation of NO2 and N2O as a function of time by integration of the rate law, we have evaluated the dependence of the effective rate constant as a function of pressure and thus as a function of time on the basis of the non-ideality of NO gas. Although our approach is crude in that the non-idealities of NO2 and N2O and other NOx products and a probable deviation of the gas mixture from the Dalton's law have not been considered, it provides a means for approximately estimating the rate of accumulation of NO2 and N2O based on Melia's data. According to these calculations, the extent of the disproportionation is generally negligible at low initial pressures, e.g. 5 atm or less, while at 200 atm, the mole fractions of NO2 and N2O can become as high as 12-13% only after 10 days. These values are alarmingly high for handling pressured NO- in N-2-mixture in either research or clinical settings. This information must be borne in mind when compressed NO in commercial cylinders is employed in high precision experiments. Disproportionation of NO under pressure also deserves attention in inhalation of low doses of NO in the treatment of diseases characterized by pulmonary hypertension and hypoxemia.

DOI： 10.1080/1071576021000036489

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拡散強調画像にて明瞭な病変を認めたSalmonella脳症の1例

小淵信子, 塚原宏一, 西田公一, 大嶋勇成, 平岡政弘, 眞弓光文, 石森佳幸, 河村泰孝

福井MR研究会誌 6 15 - 16 2003

Reversible diffusion-weighted MR findings of Salmonella enteritidis-associated encephalopathy

N Kobuchi, H Tsukahara, Y Kawamura, Y Ishimori, Y Ohshima, M Hiraoka, Y Hiraizumi, M Ueno, M Mayumi

EUROPEAN NEUROLOGY 49 ( 3 ) 182 - 184 2003

MRIで脳梁膨大部正中に可逆性孤発病変を認めた急性脳炎の一例

麻生浩子, 前田正幸, 大達清美, 塚原宏一, 竹田寛

臨床放射線 48(3) ( 3 ) 425 - 428 2003

母体への硫酸マグネシウム長期投与による骨減少症が疑われた超低出生体重児例

山田直江, 塚原宏一, 古畑律代, 鈴木孝二, 早川和代, 佐藤周子, 平岡政弘, 眞弓光文

日児誌 107 925 - 927 2003

急性脳症を呈した猫ひっかき病の1小児例

小倉一将, 原慶和, 塚原宏一, 塚原正人, 眞弓光文

小児感染免疫 15 211 - 216 2003

高マグネシウム血症, 低カルシウム血症, 心機能障害, 壊死性腸炎の発症に硫酸マグネシウムの母体投与の関連が考えられた早産児例

鈴木孝二, 塚原宏一

Bibliography in Gastroenterology 17(3) ( 2 ) 38 - 214 2003

Intrauterine exposure to ritodrine and magnesium sulphate and infantile renal dysfunction

H.Tsukahara, N.Ohta, R.Kobata, Y.Todoroki, S.Sato, M.Hiraoka, M.Mayumi, K.Shukunami, F.Kotsuji

J Jpn Soc Pediatr Renal Fail 23 95 - 97 2003

The transition from fetus to neonate: Physiological significance of vasoactive and natriuretic mediators

Tsukahara, H

J Dev Nephrol 11(1) 26 - 31 2003

レドックス制御が急性肺傷害におよぼす治療的効果

眞弓光文, 塚原宏一

平成14年度科学研究費補助金基盤研究(B)(2) 研究実績報告書 2003

腎不全に対してレドックス制御がもたらす治療的効果

塚原宏一

平成13年度〜14年度科学研究費補助金基盤研究(C)(2) 研究実績報告書 2003

小児アトピー性皮膚炎における酸化ストレスおよびレドックス制御機構の関与に関する研究

眞弓光文, 塚原宏一, 大嶋勇成

平成14年度厚生労働科学研究費補助金: 免疫アレルギー疾患予防・治療等研究事業研究報告書（免疫アレルギー疾患予防・治療研究事業事務局） 13 - 15 2003

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