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Nishi-Tokyo-shi, Japan

Martin D.D.,University of Tubingen | Sato K.,Tohoku University | Sato M.,Toho University | Tanaka T.,Tanaka Growth Clinic
Hormone Research in Paediatrics | Year: 2010

BoneXpert, an automated method for analysis of hand radiographs of children, has recently been developed and validated in European children. It determines Tanner-Whitehouse (TW) and Greulich Pyle (GP) bone ages (BA). The purpose of this work is to validate BoneXpert BA in Japanese children and determine the following two properties of the method: (1) The accuracy of the BA, i.e. the standard deviation from an experienced Japanese TW BA rater. (2) The precision of the BA, i.e. BoneXpert's ability to yield the same BA value on a repeated radiograph. The data consist of two studies: 185 radiographs of 22 normal children followed longitudinally from approximately 7 years to full maturity, and 284 radiographs of 22 patients with growth hormone deficiency treated with growth hormone and gonadotropin-releasing hormone analogue followed from an age of 4-11 years to almost full maturity. All radiographs were rated manually according to the TW-Japan system. BoneXpert processed all images, and the accuracy (SD) of TW-Japan BA was 0.72 years (95% CI 0.68-0.76). The precision error (SD) on a single determination of GP BA was 0.17 years (95% CI 0.15-0.19). It is concluded that BoneXpert performs as well in Japanese children as it does in Caucasian children. This study accomplishes a calibration of BoneXpert to the TW-Japan standard, which performs well for the entire BA range from 4 years up to full maturity. © 2010 S. Karger AG.

Kato N.,Japan National Institute of Public Health | Takimoto H.,National Institute of Health and Nutrition | Yokoyama T.,Japan National Institute of Public Health | Yokoya S.,National Center for Child Health and Development | And 2 more authors.
Acta Paediatrica, International Journal of Paediatrics | Year: 2014

Aim To provide updated growth references for Japanese children from birth to 6 years of age, for use in both growth monitoring and child care. Methods We analysed data from two national representative surveys that provided cross-sectional data on 3000 areas in the 2005 national census and longitudinal data from 136 hospitals. Growth references for length/height, weight, head circumference and chest circumference were constructed using the lambda-mu-sigma (LMS) method, with estimates of the L, M and S parameters. These updated values were then compared with growth references published by the World Health Organization. Results The 3rd, 50th and 97th smoothed percentile values of length/height, weight, head circumference and chest circumference for boys and girls from birth to 6 years are presented. The comparisons show some large differences in median measurements between the charts. Conclusion Our growth references are based on a current, nationally representative sample of Japanese children. The results provide deep insight into child growth from a historical, ethnic and environmental point of view. © 2014 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

Ranke M.B.,University Hospital of Tuebingen | Lindberg A.,Pfizer | Mullis P.E.,University of Bern | Geffner M.E.,University of Southern California | And 3 more authors.
Hormone Research in Paediatrics | Year: 2013

Treatment with growth hormone (GH) has become standard practice for replacement in GH-deficient children or pharmacotherapy in a variety of disorders with short stature. However, even today, the reported adult heights achieved often remain below the normal range. In addition, the treatment is expensive and may be associated with long-term risks. Thus, a discussion of the factors relevant for achieving an optimal individual outcome in terms of growth, costs, and risks is required. In the present review, the heterogenous approaches of treatment with GH are discussed, considering the parameters available for an evaluation of the short- and long-term outcomes at different stages of treatment. This discourse introduces the potential of the newly emerging prediction algorithms in comparison to other more conventional approaches for the planning and evaluation of the response to GH. In rare disorders such as those with short stature, treatment decisions cannot easily be deduced from personal experience. An interactive approach utilizing the derived experience from large cohorts for the evaluation of the individual patient and the required decision-making may facilitate the use of GH. Such an approach should also lead to avoiding unnecessary long-term treatment in unresponsive individuals. Copyright © 2013 S. Karger AG, Basel.

Tanaka T.,Tanaka Growth Clinic
Pediatric Endocrinology Reviews | Year: 2012

Growth hormone (GH) treatment was approved for growth hormone deficiency (GHD) in Japan in 1975. Since then, GH treatment has been approved for treating five other diseases with short stature. However, available data on adult height after long-term GH treatment is limited to patients with GHD and Turner syndrome. Although adult height of patients with GHD has improved with early diagnosis and early initiation of treatment, the adult height after long-term GH treatment is still not so satisfactory because the therapeutic dose used in Japan is smaller than that used in US and Europe. With early diagnosis, early high-dose treatment, and low-dose estrogen replacement therapy, both adult height and quality of life (QOL) of the patients with Turner syndrome have been improved.

Tanaka T.,Tanaka Growth Clinic | Yokoya S.,National Center for Child Health and Development | Seino Y.,Osaka Kosei Nenkin Hospital | Togari H.,Nagoya City University | And 3 more authors.
Hormone Research in Paediatrics | Year: 2011

Background/Aims: To investigate the long-term efficacy and safety of two doses (33 and 67 μg/kg/day) of growth hormone (GH) in short Japanese children born small for gestational age (SGA). Methods: 96 children born SGA (age 3 to <8 years) were randomized to GH at 33 or 67 μg/kg/day for 104 weeks, or to an untreated control (UC) group for 52 weeks. After 52 weeks, the UC group was randomized to GH at a dose of 33 or 67 μg/kg/day for a 156-week extension study. Initial treatment groups continued unchanged for the extension phase. Efficacy was evaluated by change in height SDS for chronological age from baseline to 208/260 weeks. Results: After 208 weeks, change in height SDS from baseline (least square (LS) means (SE)) was 1.01 (0.47) and 1.99 (0.67) in the UC 33 and UC 67 μg/kg/day groups, respectively. After 260 weeks, change in height SDS from baseline was 1.22 (0.51) and 2.01 (0.64) in the 33 and 67 μg/kg/day groups, respectively. Insulin-like growth factor-1 levels were significantly higher in the groups receiving 67 μg/kg/day but largely remained within normal limits (-2 to +2 SDS). Conclusion: Long-term continuous GH treatment was well tolerated and effective in improving height SDS. Improvements were dose-dependent and significantly higher at 67 than 33 μg/kg/day. Copyright © 2011 S. Karger AG, Basel.

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