川崎富作先生との出会い　Encounter with Tomisaku Kawasaki Sensei

川崎先生が亡くなられて急に寂しくなりました。先生とは約55年のお付き合いをさせていただき、先生の医学に対する真摯な態度、探求心、患者さんや人に温かく接するやさしさ、など多くのことを学ばせていただきました。 先生との最初の出会いは1973年に久留米大学で講演を依頼した時、福岡空港にお迎えに行ったのが最初です。当時、川崎病の心臓死の剖検例が話題になっており、いかに冠動脈障害を診断するかが大きな問題でした。当時、循環器内科で冠動脈造影がスタートした頃で、冠動脈造影で冠動脈瘤は診断できると思いつき、生後4か月の乳児に大動脈造影を行いました。驚くことに左右冠動脈に多発性の冠動脈瘤が造影され、この時の驚きと興奮はいまだに忘れられません。急いで20例に冠動脈造影をすると7例に冠動脈瘤が見つかり、多くは無症候性の動脈瘤でした。このことを先生にお話しすると、先生も興奮され早くまとめて国際誌に投稿するように勧められました。最初のPediatrics 誌(1974)の先生の論文のすぐ後にJ Pediatrics 誌(1975)に発表しましたが世界各地から別冊請求が400通も来てびっくりしました。

冠動脈瘤の自然消退(regression)を最初に報告した時も多くの人から、信じられない、病理の先生からは考えられない、などと批判を受けましたが、川崎先生だけが発育の旺盛な乳児では起こり得るかもしれない、とのコメントを頂きました。今では誰でも知っている常識的なこととなっています。　“あり得ないと思うことでも在り得る、これが研究の面白い所だ”と先生と話したことを思い出します。この先生との出会いから川崎病をライフワークにしようと決め、その後の私の研究、医師生活の生き方に影響を与える大きなきっかけになりました。

川崎先生はお会いするたびに川崎病の原因は自分の生存中に解明できたらと仰ってました。この原因究明は先生の後を継ぐ者の大きな責務であり、先生の遺言でもあります。

Kawasaki sensei passed away and we suddenly became lonely. I had a relationship with Kawasaki sensei for about 55 years, and learned many things, such as his sincere attitude toward medicine, his inquisitiveness, and the kindness to treat patients and people warmly. The first meeting with him was when I asked him to give a lecture at Kurume University in 1973, and I picked him up at Fukuoka Airport. Around that time, the autopsy cases of cardiac death of Kawasaki disease became a hot topic, and the major clinical issue was how to diagnose coronary artery lesions. At that time, when coronary angiography started in adult cardiology, I thought that a coronary aneurysm could be diagnosed by the coronary angiography, so I performed angiography on a 4-month-old infant. Surprisingly, multiple coronary aneurysms were imaged in the left and right coronary arteries, and the surprise and excitement at this time is still unforgettable for me. Coronary angiography in 20 cases was found urgently, and in 7 cases a coronary aneurysm was found, most of which were asymptomatic aneurysms. When I told Kawasaki sensei about this, he was excited and recommended to submit the article to the international journal. I published it in J Pediatrics (1975) shortly after the first English paper of Kawasaki sensei in Pediatrics (1974), and I was surprised to get 400 reprint requests from all over the world.

When I first reported spontaneous regression of coronary aneurysms, many pediatricians and pathologists criticized me for being incredible and unthinkable, but only Dr. Kawasaki commented that in infants and young children in active growth it may be possible. This is now generally recognized phenomenon that everyone knows. I remember talking with Kawasaki sensei, “This is an interesting place for the health science research, which is possible even if most of people think it impossible.” From the encounter with him, I decided to make Kawasaki disease as my life work, and it was a great opportunity to influence of my clinical research and the way of life as a pediatrician.

Every time I met him, Kawasaki sensei told me that “I could clarify the cause of Kawasaki disease during my life”. To clarify of the cause of this mysterious disease is a great responsibility of the successor and is his will.