Analysis of Image Gently Abdominal CT Protocol With the Use of Body Phantom Adapted to the Japanese Size.

OBJECTIVE: The purpose of this study was to analyze in detail the quality of abdominal CT images obtained using three protocols reported by Image Gently in 2014 (hereafter referred to as Image Gently 2014), with the use of a handmade body phantom adapted to typical body sizes of the Japanese population. Moreover, we converted the findings of Image Gently 2014 to match Japanese body sizes and referred to our converted findings as Image Gently Japan. MATERIALS AND METHODS: We scanned each phantom in a mechanical isocenter in accordance with the Image Gently 2014 abdominal imaging protocol. We changed the tube current-exposure time product per rotation from 25 to 250 mAs. The bowtie filter was set with a minimum FOV for the phantom size. We then analyzed the volume CT dose index (CTDIvol)-measured CT number curve. We then used this CT number curve to calculate the CT number recommended by Image Gently Japan for each of the designated patient ages. RESULTS: The CTDIvol-measured CT number curve showed that, as the CTDIvol increased with each age, image noise decreased. When we assumed that the CTDIvol value for adults was 20 mGy, the measured CT number was 12.5 HU. We then multiplied each reduction coefficient by age (neonate and 1, 5, 10, and 15 years). The measured CT numbers for Image Gently Japan performed to attain limited dose reduction were 3.0, 3.9, 4.9, 6.0, and 9.0 HU, respectively, whereas those for Image Gently Japan performed to achieve moderate dose reduction were 3.3, 4.3, 5.3, 6.3, and 9.3 HU, respectively, and those for Image Gently Japan performed to attain aggressive dose reduction were 4.1, 5.1, 5.8, 6.8, and 9.5 HU, respectively. CONCLUSION: We analyzed the abdominal image quality demanded by Image Gently 2014, and we were able to adapt the results to the Japanese population and present them as our own Image Gently Japan recommendations. If the results of the present study become a foundation for scanning parameters for Japanese patients, we believe that they will eventually lead to a reduction in medical radiation exposure for this patient population.

Bone mineral density in children and adolescent girls with anorexia nervosa in Japan.

BACKGROUND: The correlation between reduced bone mineral density (BMD) and the disease anorexia nervosa (AN) has long been established. The aim of the present study was to examine the relationship in more detail, particularly focusing on the increasing incidence of the disease occurring in adolescent patients. METHOD: Twenty-four girls diagnosed with AN were enrolled in the study. All subjects ranged in age from 11.1 to 15.5 years, with an average age of 13.5 years. The BMD of lumbar spines and femoral necks were measured. All the values for BMD at admission were expressed as means +/- SD and patients with and without menarche were separately investigated. RESULTS: The average BMD of lumbar spines at the time of admission was -0.51 SD in total. However, the average BMD of patients without menarche was -1.28 SD, which was significantly lower than the -0.16 SD on average in patients with menarche. As a whole the BMD of femoral necks at admission tended to be lower than that of lumbar spines. Similarly, it was lower in patients without menarche (-1.7 SD on average) than in those with menarche (-0.77 SD on average). CONCLUSIONS: BMD was lower in children and adolescent AN patients without menarche, and such a tendency was more significant at the femoral neck region. In child AN cases without menarche, the BMD, especially at the femoral neck, needs to be measured, and later recovery should be monitored closely over a long period.

Evaluation of psychosomatic stress in children by measuring salivary chromogranin A.

AIM: To investigate the usefulness of salivary chromogranin A (CgA) and cortisol as stress markers, and the effects of distraction on the suppression of stress in children. METHODS: We examined salivary CgA and cortisol responses before and after venipuncture in hospitalized children with and without distraction using a kaleidoscope. RESULTS: Salivary CgA levels immediately after venipuncture were significantly higher than those immediately before it, and at 60 min after venipuncture they were significantly lower than those immediately after it. However, salivary cortisol showed no significant differences at any of the three time points. In contrast, distracted by the kaleidoscope, there were no significant differences in salivary CgA and cortisol levels at all three time points. CONCLUSION: In children, salivary CgA level is a useful marker of stress. As an index of the effect of distraction, the measurement of salivary CgA is useful.

Two motifs essential for nuclear import of the hnRNP A1 nucleocytoplasmic shuttling sequence M9 core.

Heterogeneous nuclear ribonucleoprotein (hnRNP) A1 regulates mRNA genesis. It shuttles between the nucleus and cytoplasm. Its shuttling signal is a 38-residue sequence M9. We studied the nuclear import and export of M9 by mutational analysis. Heterokaryon assay indicated that the 19-residue sequence SNFGPMKGGNFGGRSSGPY (M9 core) is necessary and sufficient for shuttling. Moreover, M9 core mutation revealed that in addition to the hitherto characterized N-terminal motif SNFGPMK, the C-terminal motif PY is crucial for nuclear import as well as for binding to transportin. Key residues of the motifs are conserved in the shuttling signals of hnRNP D and JKTBP.

Two separate regions essential for nuclear import of the hnRNP D nucleocytoplasmic shuttling sequence.

Heterogeneous nuclear ribonucleoprotein (hnRNP) D/AUF1 functions in mRNA genesis in the nucleus and modulates mRNA decay in the cytoplasm. Although it is primarily nuclear, it shuttles between the nucleus and cytoplasm. We studied the nuclear import and export of the last exon-encoding sequence common to all its isoforms by its expression as a green fluorescent protein-fusion protein in HeLa cells and by heterokaryon assay. The C-terminal 19-residue sequence (SGYGKVSRRGGHQNSYKPY) was identified as an hnRNP D nucleocytoplasmic shuttling sequence (DNS). In vitro nuclear transport using permeabilized cells indicated that nuclear import of DNS is mediated by transportin-1 (Trn-1). DNS accumulation in the nucleus was dependent on Trn-1, Ran, and energy in multiple rounds of nuclear transport. Use of DNS with deletions, alanine scanning mutagenesis and point mutations revealed that two separate regions (the N-terminal seven residues and the C-terminal two residues) are crucial for in vivo and in vitro transport as well as for interaction with Trn-1. The N- and C-terminal motifs are conserved in the shuttling sequences of hnRNP A1 and JKTBP.

Factors involved in the regulation of plasma leptin levels in children and adolescents with anorexia nervosa.

OBJECTIVE: The effects of changes in body mass index (BMI) and other factors on plasma leptin levels in children and adolescents with anorexia nervosa (AN) were examined. METHODS: Plasma leptin levels and BMI was measured before and after initiation of refeeding therapy every 2 weeks for 8 weeks in 12 children and adolescents with AN. The plasma levels of insulin, cortisol, insulin-like growth factor-I (IGF-I), and tumor necrosis factor-alpha (TNF-alpha) were also measured in these subjects before and after 8 weeks of the refeeding therapy, and the results were compared with those from 12 age-matched healthy girls. RESULTS: The plasma leptin and IGF-I levels, as well as the BMI, in the AN patients before refeeding therapy were significantly lower than both of these indices in the AN patients 8 weeks after initiation of the therapy and in the controls. The plasma leptin levels and BMI in the AN patients 8 weeks after initiation of the therapy were still significantly lower than those in the controls. Significant correlations between the plasma leptin levels and BMI were detected in the AN patients both before and 8 weeks after initiation of the refeeding therapy, as well as in the controls. The BMI showed a significant increase beginning at 2 weeks after initiation of the therapy compared with that before refeeding, but the plasma leptin levels did not significantly increase until 4 weeks after the initiation of therapy. CONCLUSION: The results suggest that plasma leptin levels reflect changes in body fat content in children and adolescents with AN, although there is a delay in the recovery of plasma leptin levels compared with those of BMI in the early period of refeeding therapy, which is probably regulated by other factors.

Resting energy expenditure and plasma leptin levels in adolescent girls with anorexia nervosa.

OBJECTIVE: Our aim was to examine the relationship between resting energy expenditure (REE) and circulating leptin levels during long-term refeeding in adolescent girls with anorexia nervosa (AN). METHOD: We measured REE, the plasma leptin level, the free T(3) level, body surface area (BSA), and dietary energy intake in AN adolescents before and 8 weeks after refeeding therapy. RESULTS: All parameters in AN subjects before the refeeding therapy were significantly lower than those in AN subjects after the therapy and in the controls. There were no significant differences in REE and BSA between posttherapy AN subjects and controls, but plasma leptin levels in the posttherapy AN subjects were still significantly lower than those in the controls. Significant correlations between REE and BSA were detected in the AN subjects both before and after the refeeding therapy, but REE did not correlate significantly with plasma leptin level in either of the AN groups. DISCUSSION: Our results suggest that the REE in AN subjects after long-term refeeding therapy is not associated with the changes in plasma leptin levels but with BSA.