ABSTRACT
BACKGROUND: Cutaneous polyarteritis nodosa (cPN) is a necrotizing arteritis of medium-sized vessels limited to the skin. Because of its rarity and the diversity of its clinical manifestations, there is no consensus treatment. Moreover, there are no established indicators that predict disease severity or its outcome. OBJECTIVES: To investigate clinico-laboratory features that predict patients requiring systemic therapy, including corticosteroids, to control the disease activity. METHODS: Thirty-six cPN patients who had not received systemic corticosteroids at the initial visit were retrospectively analysed by correlating the treatment and its response with clinico-laboratory findings. RESULTS: The major medications administered were antiplatelet agents (63.9%), vasodilators (38.9%), and prednisolone (PSL) (36.1%). In all, 23 cases achieved remission without PSL; 5 were managed with compression therapy alone or even observation; 18 received antiplatelet monotherapy or combined with vasodilator/dapsone; 13 required PSL; 10 achieved remission with PSL monotherapy or PSL and single/multiple medications and 3 with PSL and multiple drugs failed to achieve remission and underwent limb amputation. There were more skin ulcers and an elevated peripheral white blood cell (WBC) count and erythrocyte sedimentation rate (ESR) before corticosteroid induction in patients requiring PSL. Three cases with treatment failure had a markedly elevated ESR (>50). CONCLUSIONS: More than half of cPN can achieve remission without corticosteroids; an elevated WBC and the presence of skin ulcers predict the need for PSL; a high ESR before corticosteroid induction predicts treatment resistance, even with PSL.
Subject(s)
Arthritis, Rheumatoid , Colitis, Ulcerative , Erythema Multiforme , Janus Kinase Inhibitors , Humans , Colitis, Ulcerative/drug therapy , Colitis, Ulcerative/chemically induced , Tumor Necrosis Factor-alpha , Janus Kinase Inhibitors/adverse effects , Arthritis, Rheumatoid/drug therapy , Erythema Multiforme/chemically induced , Erythema Multiforme/diagnosis , Erythema Multiforme/drug therapy , Immunologic Factors/adverse effectsABSTRACT
BACKGROUND: Natto (fermented soybeans)-induced hypersensitivity is characterized by delayed symptom onset that hampers diagnosis. We aimed to clarify the clinical utility of the basophil activation test (BAT) in the diagnosis of natto-induced hypersensitivity. METHODS: Five patients with a history of anaphylaxis and chronic urticaria suspected of natto-induced hypersensitivity and seven with chronic spontaneous urticaria clinically unrelated to natto were enrolled in the patient and control groups, respectively. The BAT was performed with two incubation times, 15 min and 1 h, in combination with various concentrations of natto-mucilage extract. RESULTS: In controls, CD203c levels in basophils remained low in the 15-min incubation but were significantly increased in the 1-h incubation. In the patient group, in the 15-min condition, basophil CD203c was significantly upregulated by natto mucilage but not by soybean vs controls (P = 0.001). Low concentrations of natto mucilage were sufficient to upregulate basophil CD203c in the anaphylaxis cases, but high concentrations were required to induce the same effect in the urticaria cases. Finally, the dose-dependent pattern of the BAT results differed significantly between the anaphylaxis and urticaria cases (P = 0.006). Thus, a strong background reaction was observed in the BAT with 1 h incubation; 15 min of incubation was sufficient to identify patients with natto-induced hypersensitivity and may distinguish the clinical phenotype of natto-induced hypersensitivity, i.e., anaphylaxis or urticaria. CONCLUSIONS: The BAT with a 15-min incubation period is useful in diagnosing natto-induced hypersensitivity.
Subject(s)
Basophil Degranulation Test/methods , Food Hypersensitivity/diagnosis , Case-Control Studies , Female , Humans , Male , Phosphoric Diester Hydrolases/blood , Pyrophosphatases/blood , Soy Foods/adverse effects , Urticaria/complicationsABSTRACT
A thermoresponsive fluorophore based on a photochromic diarylethene possessing donor and acceptor moieties in close proximity to each other has been synthesized. The fluorophore exhibits dual fluorescence, where photoresponsive turn-off switching as well as a thermoresponsive relative intensity change are observed.
Subject(s)
Ethylenes/chemistry , Fluorescent Dyes/chemistry , Fluorescent Dyes/chemical synthesis , Light , Quantum Theory , Spectrometry, Fluorescence , Temperature , Ultraviolet RaysABSTRACT
We encountered a case of a 73-year-old man with acute myeloid leukemia who developed Trichosporon asahii systemic infection while on itraconazole prophylaxis during severe neutropenia. Cryptococcal antigen was useful for diagnosis. Although itraconazole was ineffective in protecting against trichosporonosis, treatment was successful with voriconazole following liposomal amphotericin B.
ABSTRACT
Upon visible light irradiation, a thermally reversible photochromic acid generator merocyanine dye gives a proton to the dimethylamino group of a non-photochromic diarylethene in acetonitrile. The protonation rendered the non-photochromic diarylethene photochromic. Thus, the thermally irreversible photochromic nature of the diarylethene is activated without any physical contact or addition of any compound but only by photoirradiation to the merocyanine dye.
ABSTRACT
An on/off switching for charge-transfer interactions between the side chains of a diarylethene based on photochromic reactions has been proved by the disappearance and appearance of an additional fluorescence band.
