Severely obese children have a higher risk of becoming obese adults even when they received obesity treatment in childhood. The risk of adulthood obesity was twice as high in moderately obese boys than in girls. On the other hand, many cases of childhood obesity can be corrected with obesity treatment, which in turn can decrease the risk for adult chronic diseases.

The purpose of this study was to investigate the combined effect of dietary treatment and exercise treatment on abdominal fat distribution and the risk factors for chronic disease in obese Japanese children. The subjects were 33 obese children. The areas of subcutaneous and visceral fat were measured using CT images at the level of the umbilicus. Blood samples were taken to measure risk factors for chronic disease such as triglycerides (TG), total cholesterol (T-Cho), high-density lipoprotein cholesterol (HDL-C), insulin, asparate amino-transferase (AST), alanine aminotransferase (ALT) and uric acid (UA). Supervised exercise treatment at 50% Vo 2 max for about 60 min/day was performed 5 or 7 days/week for 3 months. The dietary treatment was varied with daily calorie intake between 1400 and 1900 kcal depending on the degree of obesity. After dietary treatment combined with exercise treatment, the areas of subcutaneous and visceral fat decreased significantly, and such risk factors as TG, T-Cho, insulin, AST, ALT, and UA were noticeably reduced. These data suggest that dietary treatment combined with exercise treatment in obese children normalizes the Intervention Study for Obese Children on Abdominal Fat 63 distribution of abdominal fat and reduces the risk factors for chronic disease.

In Japanese obese youths ranging in age from 6 to 15 years, the diagnostic criteria for the waist circumference was 82 cm, and that for VAT area was 55 cm2.

The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes (JSGIT) was established in July 1994 with the chief aim to improve the quality of therapy for type 1 diabetes in children, an entity far less common in Japan than in Europe. We proposed four initial research topics: (i) to determine the current status of medical care and glycemic control in Japanese children with type 1 diabetes mellitus; (ii) to standardize the measurement of hemoglobin A1c; (iii) to establish a registry of a large cohort of patients in order to enable prospective studies to improve the quality of therapy for children with type 1 diabetes in Japan; and (iv) to enable participants of the JSGIT to hold a workshop twice annually. We registered a total of 736 patients from 45 hospitals throughout Japan. Intervention via insulin treatment was instituted after 2 yr for those patients whose hemoglobin A1c level was more than 8.1%. The proportion of patients receiving multiple insulin injections increased after intervention; however, average hemoglobin A1c in females remained significantly higher than in males. We identified two forms of diabetes in Japanese children: a rapidly progressive form and a more slowly progressive form. There was a significantly higher prevalence of a family history of diabetes in first-degree relatives in the slowly progressive form. These preliminary findings are the result of the first collaborative study of childhood diabetes in Japan.

Neurological complications may occur following intensive chemotherapy and hematopoietic cell transplantation. Postirradiation somnolence syndrome has been observed in children with acute lymphoblastic leukemia who received central nervous system preventive therapy with 1800-2400 cGy cranial irradiation. The authors report a 16-year-old boy with chronic myelogenous leukemia in chronic phase, who developed symptoms compatible with the somnolence syndrome (SS) 6 weeks following HLA-matched unrelated bone marrow transplantation (BMT). The preparative regimen consisted of 1200 cGy total body irradiation (TBI), cytosine arabinoside and cyclophosphamide. The patient developed lethargy and low-grade fever, with intermittent rhythmical delta activity in electroencephalograph. He recovered spontaneously without specific therapy 3 weeks after developing symptoms. This is the first report describing that as low as 1200 cGy TBI can induce SS in a child. After allogeneic BMT, some patients develop neurological symptoms. The authors suggest that somnolence syndrome should be included in differential diagnosis in these patients.