Two neonatal cases of food protein-induced enterocolitis syndrome with pale stool and transient biliary dilatation

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Size-dependent immune-modulating effect of amorphous nanosilica particles.

The immune-modulating effect following intradermal injection of various-sized amorphous silica particles was analyzed in terms of induction of ovalbumin-specific CD8+ T cells in vivo. IFN-gamma ELISPOT assays revealed that only nanosilica particles with a diameter of less than 100 nm significantly enhanced CD8+ T cell responses against ovalbumin. These results indicate that the size of nanomaterials is a critical determinant in terms of their safe use.

Determination of 40 synthetic food colors in drinks and candies by high-performance liquid chromatography using a short column with photodiode array detection.

Forty synthetic food colors were determined in drinks and candies by reversed-phase high-performance liquid chromatography with photodiode array detection. The following food colors were analyzed within 19 min using a short analytical column (50 mm x 4.6 mm i.d., 1.8 microm) at 50 degrees C with gradient elution: Ponceau 6R, Tartrazine, Fast yellow AB, Amaranth, Indigotine, Naphthol yellow S, Chrysoine, Ponceau 4R, Sunset yellow FCF, Red 10B, Orange G, Acid violet 7, Brilliant black PN, Allura red AC, Yellow 2G, Red 2G, Uranine, Fast red E, Green S, Ponceau 2R, Azorubine, Orange I, Quinoline yellow, Martius yellow, Ponceau SX, Ponceau 3R, Fast green FCF, Eosine, Brilliant blue FCF, Orange II, Orange RN, Acid blue 1, Erythrosine, Amido black 10B, Acid red 52, Patent blue V, Acid green 9, Phloxine B, Benzyl violet 4B, and Rose bengal. The recoveries of these compounds added to soft drinks and candies at 5 microg/g ranged from 76.6 to 115.0%, and relative standard deviations (R.S.D.s) were within 6.0%. The limits of detection and the limits of quantitation were 0.03 and 0.1 microg/g, respectively.

Ventricular tachycardia in a neonate with prenatally diagnosed cardiac tumors: a case with tuberous sclerosis.

We report a patient with prenatally diagnosed tuberous sclerosis. Fetal ultrasonography demonstrated multiple cardiac tumors and arrhythmia. After birth, because of frequent supraventricular extrasystoles, the infant was admitted to the neonatal intensive care unit. Findings on 24-hour ambulatory electrocardiogram (ECG) showed frequent supraventricular tachycardia and ventricular tachycardia with four beats as the longest run. At the age of 12 days, he developed cardiopulmonary arrest after crying out. A monitored ECG showed ventricular tachycardia. Twenty minutes after onset, a 12-lead ECG showed ventricular fibrillation, which returned to normal sinus rhythm with repeated DC cardioversion. Oral antiarrhythmic therapy with carteolol hydrochloride was effective. The patient showed no further symptoms after oral medication was initiated and the tumors regressed spontaneously.

Endogenous formation of protein adducts with carcinogenic aldehydes: implications for oxidative stress.

In the present study, we characterize the covalent modification of a protein by crotonaldehyde, a representative carcinogenic aldehyde, and describe the endogenous production of this aldehyde in vivo. The crotonaldehyde preferentially reacted with the lysine and histidine residues of bovine serum albumin and generated a protein-linked carbonyl derivative. Upon incubation with the histidine and lysine derivatives, crotonaldehyde predominantly generated beta-substituted butanal adducts of histidine and lysine and N(epsilon)-(2,5-dimethyl-3-formyl-3,4-dehydropiperidino)lysine (dimethyl-FDP-lysine) as the putative carbonyl derivatives generated in the crotonaldehyde-modified protein. To verify the endogenous formation of crotonaldehyde in vivo, we raised the monoclonal antibody (mAb82D3) against the crotonaldehyde-modified protein and found that it cross-reacted with the protein-bound 2-alkenals, such as crotonaldehyde, 2-pentenal, and 2-hexenal. The anti-2-alkenal antibody recognized multiple crotonaldehyde-lysine adducts, including dimethyl-FDP-lysine and an unknown product, which showed the greatest immunoreactivity with the antibody. On the basis of the chemical and spectroscopic evidence, the major antigenic product was determined to be a novel Schiff base-derived crotonaldehyde-lysine adduct, N(epsilon)-(5-ethyl-2-methylpyridinium)lysine (EMP-lysine). It was found that the lysine residues that had disappeared in the protein treated with crotonaldehyde were partially recovered by EMP-lysine. The presence of immunoreactive materials with mAb82D3 in vivo was demonstrated in the kidney of rats exposed to the renal carcinogen, ferric nitrilotriacetate. In addition, the observations that the metal-catalyzed oxidation of polyunsaturated fatty acids in the presence of proteins resulted in an increase in the antigenicity of the protein indicated that lipid peroxidation represents a potential pathway for the formation of crotonaldehyde/2-alkenals in vivo. These data suggest that the formation of carcinogenic aldehydes during lipid peroxidation may be causally involved in the pathophysiological effects associated with oxidative stress.

Flow pattern of the superior caval vein in children after closure of atrial septal defect: a comparison of catheter therapy with open-heart surgery.

To compare the flow pattern of the superior caval vein (superior vena cava; SVC) after catheter therapy with that after open-heart surgery, we examined the flow velocity curves of the SVC in 10 pediatric patients who underwent catheter closure of atrial septal defect (ASD) and in 20 pediatric patients who underwent open-heart surgery. We used pulsed Doppler examinations to record the velocity curves. On the velocity curve of the SVC in children after open-heart surgery, the velocity in systole was lower than that in diastole, which is contrary to the normal pattern. The velocity in systole increased more than that in diastole during inspiration, which also differs from the normal pattern. In contrast, the velocity curve of the SVC in patients after catheter therapy showed a normal pattern. The change of flow velocity during respiration became smaller after treatment in the surgery group, although it did not change after treatment in the catheter group. These results might indicate less reserve ability in the right atrium in patients who undergo open-heart surgery. ASD closure by catheter is useful not only for its economy and noninvasiveness but also for its potential to contribute conservation of right atrial function.

Prenatal MRI in a fetus with a giant neck hemangioma: a case report.

We report a fetus with a giant neck hemangioma which was examined by MRI in utero. The initial diagnosis was made by ultrasonography. The sonolucent aspect of the mass, together with the presence of pulsating Doppler flow signals, was highly suggestive of a fetal hemangioma. In late pregnancy, fetal MRI revealed the location, size and characteristics of the neck tumor. Following prenatal corticosteroid treatment and premature delivery of the pregnancy due to fetal cardiac failure, the newborn received angiography and coil embolization of the tumor vessels. Despite vigorous treatments, the newborn died 12 h after birth. Evaluation of a fetal neck hemangioma by MRI is recommended late in pregnancy for precise information on the tumor and adjacent organs since the image is valuable for planning optimal perinatal treatment.

Abnormal pattern of flow in the superior caval vein in children after open heart surgery.

To investigate the pattern of flow in the superior caval vein in children after open heart surgery, we examined the flow velocity curves in 37 patients who had undergone surgical correction of either ventricular or atrial septal defects. The control group consisted of 64 age-matched children. We used pulsed Doppler examinations to record the velocity curves. We measured the highest and lowest peak flow velocities during systole and diastole, and calculated ratios for the various measurements. We found that the velocity of the wave in systole is lower than that of the wave in diastole in the postoperative patients, which is contrary to the normal pattern. The velocity in systole increases more than that in diastole during inspiration, which is also different from the normal pattern. The change in pattern of flow velocity curve during respiration was smaller in patients after surgery than in normal subjects, which might indicate that there is less reserve ability in the right atrium in postoperative patients.

High-speed counter-current chromatography of apple procyanidins.

Apple procyanidins were separated by high-speed counter-current chromatography using a type-J multilayer coil planet centrifuge. Several two-phase solvent systems with a wide range of hydrophobicities from a non-polar hexane system to polar n-butanol systems were evaluated their performance in terms of the partition coefficient and the retention of the phase. The best separation of procyanidins B and C was achieved with a two-phase solvent system composed of n-butanol-methyl tert.-butyl ether-acetonitrile-0.1% trifluoroacetic acid (2:4:3:8) using the lower phase as a mobile at a flow-rate of 1.0 ml/min.

Inhalation of nebulized nitroglycerin in dogs with experimental pulmonary hypertension induced by U46619.

BACKGROUND: Pulmonary hypertension (PH) causes mortality in some congenital and acquired heart and lung diseases. However, inhalation of NO gas requires complicated and expensive instruments and elaborate preparations to avoid toxic gas administration. We tested the effectiveness and safety of inhaled nebulized nitroglycerin (Neb-NTG) in dogs with experimental PH. METHODS: Experimental PH was induced by continuous infusion of a thromboxane analog (U46619). The U46619 infusion rate was adjusted to maintain a systolic pulmonary artery pressure (PAP) at 40 mmHg in 10 anesthetized and mechanically ventilated dogs. Then, 20 micrograms/kg of NTG liquid nebulized by compressed air was inhaled. RESULTS: After infusion of U46619, the systolic, diastolic and mean PAP increased by 119%, 228% and 169%, respectively, and the systolic, diastolic and mean systemic arterial pressures (SAP) increased by 19%, 29% and 23%, respectively. The systolic pulmonary to systemic pressure ratio (Pp/Ps) and mean Pp/Ps increased by 83% and 113%, respectively, and the pulmonary vascular resistance (PVR), systemic vascular resistance (SVR) and pulmonary to systemic resistance ratio (Rp/Rs) increased by 341%, 100% and 145%, respectively. After inhalation of Neb-NTG in dogs with experimental PH, systolic, diastolic and mean PAP and PVR decreased by 25 +/- 4, 26 +/- 11, 25 +/- 9 and 31 +/- 21%, respectively. There were no significant changes in systolic, diastolic and mean SAP, SVR, cardiac output and plasma methemoglobin concentrations. The systolic and mean Pp/Ps decreased by 18 +/- 7 and 20 +/- 7%, respectively. The Rp/Rs decreased by 25 +/- 13%. CONCLUSIONS: The results of this study demonstrate that Neb-NTG is an effective and selective pulmonary vasodilator and may offer a new therapeutic option for PH.

Effects of aging on aortic diameters and distensibility in Marfan's syndrome: comparison with healthy subjects.

The relationships between age, aortic diameter, and aortic distensibility were examined in patients with Marfan's syndrome. Aortic diameters were measured at the sinus of Valsalva, the ascending aorta, the aortic arch, and the abdominal aorta in 20 patients (aged 5-63 years) with Marfan's syndrome and 30 age-matched normal control subjects. The aortic distensibility was calculated as follows: aortic distensibility = 2 (change in aortic diameter)/(diastolic aortic diameter) (systolic pressure-diastolic pressure). Aortic diameter increased with age in both groups. The diameters of the sinus of Valsalva and the ascending aorta were greater in the Marfan group than in the control group, and increased even after adolescence in patients with Marfan's syndrome. Aortic distensibility was the highest at the abdominal aorta and the lowest at the sinus of Valsalva in both groups. Aortic distensibility decreased with age in both groups, but aortas were less distensible in the Marfan group than in the control group at all ages. The sinus of Valsalva and the ascending aorta dilate abnormally after adolescence in patients with Marfan's syndrome. However, aortic elastic properties in patients with Marfan's syndrome were abnormal even in childhood.

Changes in ventricular and muscle volumes of neonates.

BACKGROUND: To examine the changes in cardiac ventricular and muscle volumes in neonates, echocardiography was performed in 25 normal neonates at 3-5 and 30-35 days after birth. METHODS: A standard apical four chamber view and a parasternal short axis view were used for the analysis of the left ventricle. For the analysis of the right ventricle, only an apical four-chamber view was used. A formula based on the area length method was used to calculate the left ventricular and muscle volumes and the single plane Simpson's rule was used for the right ventricular and muscle volumes. RESULTS: The left ventricular and muscle volumes per body surface did not change during the month following birth. The ratio of the muscle to ventricular volume of the left ventricle was also unchanged. However, the ratios of the right muscle volume to body surface and to the ventricular volume decreased after one month. CONCLUSIONS: The authors suggest that the decreases in pulmonary hypertension and right ventricular stroke volume play a role in the changes of right muscle volume.

Change in cardiac diastolic function in neonates.

In this study we used Doppler echocardiography to examine changes in ventricular diastolic function in neonates. Echocardiograms were performed in 25 healthy neonates at 1-6 days (2.7+/-1.6 days) and at 25-35 days (29.4+/-3.3 days) after birth. Ventricular inflow velocity curves were recorded using the pulsed-Doppler method. Peak velocities (peak E, A). mean velocities (mean E, A), times (time E, A), and diastolic velocity-time integrals (area E, A) were measured during both early ventricular filling and atrial systole. The acceleration time of the wave during early ventricular filling was also measured. Peak E and A and mean E and A in both ventricles increased at 1 month after birth. Acceleration times in both ventricles were shortened. The ratio of area E to A in both ventricles and of peak E to A in the left ventricle did not change at 1 month after birth. Only the ratio of peak E to A in the right ventricle increased. The ratio of peak E to (area E + area A), which is thought to be a load-independent index, increased in both ventricles. The authors concluded that ventricular relaxation appears to increase in both ventricles, 1 month after birth, and that changes in diastolic function occur even in neonates.

[Examination on aspirin-induced asthma and hypersensitivity to steroids--a questionnaire to 850 asthma on hypersensitivity to non-steroidal anti-inflammatory drugs and hypersensitivity to steroids].

We surveyed 850 patients with bronchial asthma and investigated such clinical features as the frequency of aspirin-induced asthma and hypersensitivity to steroids in the 457 available answers. We divided them into two groups, one was ASN: the asthmatics who had history of hypersensitivity to non-steroidal anti-inflammatory drugs, another was non-ASN: the asthmatics who had no history of hypersensitivity to non-steroidal anti-inflammatory drugs, and compared the two groups. The survey showed that the frequency of ASN was 12.0%. Its frequency rose with the severity of asthma to a level of 29.0% in severe cases. In ASN it was more frequent rates of female, infectious type, severe cases, and ASN had more frequent histories of oral use of steroids, use of ambulance, treatment in emergency rooms, and hospitalization than non-ASN. The serum IgE level was lower in ASN. The patients were 6 in ASN, none in non-ASN who had histories of hypersensitivity to steroids. They were 1.3% in all patients. 5 of 6 had past asthma attack progressived severely by rapid injection of succinate ester steroids and 2 of 6 had past by rapid injection of phosphoric acid ester steroids. In conclusion it was considered that we had to avoid rapid injection of steroids to aspirin-induced asthma and severe cases who were doubtful of aspirin-induced asthma in case of treatment of asthma attack.

Cerebellar ataxia in patients with Leber's hereditary optic neuropathy.

We report the cases of a mother and son with Leber's hereditary optic neuropathy (LHON), where a point mutation of mitochondria DNA from guanine to adenine on nucleotide position 11778 was verified. Both also had cerebellar ataxia and dysarthria and in both cases cerebellar atrophies were detected by computed tomography or magnetic resonance imaging. It was not possible to elucidate the relationship between LHON and the cerebellar atrophy, but it should be kept in mind that various neurological complications may occur in LHON.

[Stress analysis on the acetabular side of bipolar hemiarthroplasty by the two-dimensional finite element method incorporating the boundary friction layer].

We compared the biomechanical characteristics of bipolar and unipolar hemiarthroplasty on the proximal migration of the outer head by determining the von Mises stress distribution and acetabular (outer head) displacement with clinical assessment of hemiarthroplasty in 75 patients. This analysis used the two-dimensional finite element method, which incorporated boundary friction layers on both the inner and outer bearings of the prosthesis. Acetabular reaming increased stress within the pelvic bone and migration of the outer head. A combination of the acetabular reaming and bone transplantation increased the stress within the pelvic bone and grafted bone, and caused outer head migration. These findings were supported by clinical results. Although the bipolar endoprosthesis was biomechanically superior to the unipolar endoprosthesis, migration of the outer head still occurred. The bipolar endoprosthesis appeared to be indicated in cases of a femoral neck fracture or of avascular necrosis in the femoral head, but its use in cases of osteoarthritis in the hip required caution.

Central diabetes insipidus caused by nonspecific chronic inflammation of the hypothalamus: case report.

A case of central diabetes insipidus (DI) caused by non-specific chronic inflammation of the hypothalamus was reported. As the central DI was associated with acute posterior multifocal placoid pigment epitheliopathy with an immunogenic predisposition, and human leukocyte antigen class I antigen A2 and class II antigen DR4 were found, it might be a case of autoimmune reaction.

New topographic mapping of temporal lobe seizures.

A unique topographic map has been developed based on EEG data of ictal events originating from the basal/mesiotemporal lobe regions. This technique involves a new mapping method of temporal lobe seizures as opposed to the interictal activity maps of most commercially available software. The map integrates data from sphenoidal electrodes as well as the standard 10-20 surface electrodes recorded with bipolar montages. A basal view is ideal for visualization of onset of temporal lobe ictal discharges recorded with chronic sphenoidal electrodes. We used the last 150 ictal events from 40 patients with basal/mediotemporal lobe epilepsy to develop this technique. Results indicate that a topographic view incorporating sphenoidal and scalp electrodes may provide a useful adjunct for interpretation of EEG recordings and a basis for comparison between and among patient groups for both ictal and interictal epileptic discharges.

The use of intravenous immunoglobulin in Miller Fisher syndrome.

We report a patient with Miller Fisher syndrome who was treated with an intravenous high-dose of immunoglobulin. This syndrome is considered to be a benign variety of acute inflammatory demyelinating polyneuropathy (Guillain-Barré syndrome). However, there have been several reports of the need for ventilatory support and a few cases have had a fatal outcome. We observed a case of progressive Miller Fisher syndrome in a 3-year-old boy. Following 2 episodes of apnea lasting about 50 s each, he was treated with intravenous immunoglobulin (400 mg/kg/day) for 5 consecutive days. His respiratory state, general muscle strength, truncal ataxia and emotional state improved remarkably after this therapy.