Plasma thrombomodulin levels in children with atopic dermatitis.

UNLABELLED: Plasma thrombomodulin (TM) levels were measured in 68 patients with atopic dermatitis (AD) and 35 controls. Plasma TM levels in patients with AD were significantly higher than those of controls (p < 0.01). A significant correlation was observed between plasma TM levels and skin scores of AD or peripheral eosinophil counts (p < 0.01). There was also a positive correlation between plasma TM and vascular cell adhesion molecule-1 levels (p < 0.05). CONCLUSION: These results suggest that plasma TM levels may reflect a severity of AD and/or endothelial cell activation induced by an allergic inflammation.

Reduction of Staphylococcus aureus in atopic skin lesions with acid electrolytic water--a new therapeutic strategy for atopic dermatitis.

The subjects studied were 22 pediatric patients newly diagnosed with atopic dermatitis (AD); 11 were treated with acid electrolytic water (AEW), which has a strong bactericidal activity (AEW group), and the other 11 with tap water (placebo group). AEW or tap water, 1 ml/cm2 (body surface area), was sprayed on their skin lesions with a spray gun each twice a day for a week. There were no significant differences between the two groups in regard to sex, age, serum IgE, peripheral eosinophil counts, grading scores of AD, and duration of AD. The study was designed as a randomized, placebo-controlled, double-blind clinical trial. Colony counts of Staphylococcus aureus on skin lesions in the AEW group, both 3 min after spraying (P < 0.05) and after 1 week of skin treatment (P < 0.01), were significantly decreased as compared with colony counts before treatment, while there was no significant difference in the placebo group before and after treatment. Grading scores of AD also decreased in the AEW group (P < 0.01), but not in the placebo group. Both the subjects' guardians' evaluation and a referee physician's evaluation of treatment effect were significantly higher in the AEW group than in the placebo group (P < 0.01). AEW may be potentially effective in preventing a staphylococcal chronic inflammation in AD because of its strong bactericidal activity.

Circulating endothelin-1 levels in patients with bronchial asthma.

We attempted to clarify the relationship between circulating endothelin-1 levels and bronchial hyperreactivity in asthmatic patients. Sixty-two asthmatic patients were studied for plasma endothelin-1 levels during acute asthma. The relationship between plasma endothelin-1 levels and pulmonary function (FEV1/FVC) was examined in 17 patients. Twelve patients were studied for changes in plasma endothelin-1 levels during methacholine inhalation tests. Plasma endothelin-1 levels during acute asthma correlated with the severity of acute asthma defined with the Clinical Asthma Evaluation Score, and those during the methacholine challenge test correlated with the grade of bronchoconstriction (P < .01). A significant negative correlation was observed between plasma endothelin-1 levels and FEV1/FVC ratio (P < .01). These results suggest that circulating endothelin-1 levels may reflect the severity of acute asthma.

Molecular analysis of abnormal pyruvate dehydrogenase in a patient with thiamine-responsive congenital lactic acidemia.

A patient who responded to thiamine therapy with reduction of lactate in the blood and cerebrospinal fluid and clinical improvement was studied. Cultured lymphoblastoid cells of this patient were found to show reduced activities of pyruvate dehydrogenase complex (PDHC) and pyruvate dehydrogenase, decreased affinity of PDHC for thiamine pyrophosphate, and defective activation of PDHC by pyruvate dehydrogenase phosphatase. PDHC deficiency in fibroblasts and biopsied muscle of this patient was also due to the decreased affinity of PDHC for thiamine pyrophosphate. A mutation in the E1 alpha subunit containing the thiamine binding site and serine phosphorylation site regulating the activation/inactivation of PDHC was characterized by the polymerase chain reaction and DNA sequencing. A single A-->G transition was identified at position 131, resulting in the substitution of Arg-44 for His-44. This mutation must be a de novo mutation because it was not found in either parent's genomic DNA. In this study, we have obtained the first evidence at the molecular level for a mutation of thiamine-responsive PDHC deficiency.

[Anti-inflammatory effect of a traditional Chinese medicine, ren-shen-yang-rong-tang (Japanese name: ninjin-youei-to), on alveolar macrophages stimulated by RANTES or TNF-alpha].

This study was performed to clarify the effect of RANTES or TNF-alpha on rabbit alveolar macrophages and the anti-inflammatory effect of NINJIN-YOUEI-TO on alveolar macrophages stimulated by RANTES or TNF-alpha. Phagocytosis of alveolar macrophages was dose-dependently stimulated by RANTES or TNF-alpha. However, phagocytosis of alveolar macrophages was completely suppressed to the basal level when alveolar macrophages were preincubated with NINJIN-YOUEI-TO at 37 degrees C for 20 min. These results suggest that NINJIN-YOUEI-TO has an anti-inflammatory effect on alveolar macrophages through a process still to be determined.

The excitability of blink reflexes in patients with neurologic and psychiatric disorders.

The blink reflex and its recovery curve were studied in 12 patients with neurologic and psychiatric disorders, i.e., juvenile Parkinson's disease (case 1), Gilles de la Tourette's syndrome (case 2), anorexia nervosa (case 3), mild developmental delay (cases 4 and 5), a meningomyelocele with winking spasms (case 6), Parkinson's disease (cases 7-10) and OPCA (cases 11 and 12). The cases were divided into 4 groups on the basis of the results, (1) hyperexcitability of facial motoneurons only (case 6), (2) hyperexcitability of facial motoneurons and brainstem interneurons (case 1 and 2), (3) hyperexcitability of brainstem interneurons only (cases 4, 5 and 7-12) and (4) hypoexcitability of both sides (case 3). Therefore, as to the excitability an abnormal pattern of blink reflexes could be a neurophysiologic marker of some neurologic and psychiatric disorders.

Electrophysiologic studies in an infant with Möbius syndrome.

The electrophysiologic findings in an infant with congenital facial diplegia (Möbius syndrome) are presented. As to serial electrically elicited blink reflexes, the R1 amplitude was significantly reduced and the R2 latency was significantly prolonged. The M response of the orbicularis oculi muscle showed slightly reduced amplitude. Auditory brainstem responses exhibited a prolonged time between waves I and V and reduced amplitude of wave V on the right side. Somatosensory evoked potentials and visual evoked potentials were normal. These findings suggest some degree of impairment of the peripheral facial nerve, and brainstem dysfunction including the pons and lateral medulla.

[A case of severe milk allergy. Relationship with type I and Type III allergic reactions].

A case of cow's milk allergy related to type I and type III allergic reactions is reported. The patient is a one-month-old girl. She had watery diarrhea and abdominal distention soon after commencement of milk feeding two weeks after birth. She was cyanotic and floppy on admission. Intravenous complete hyperalimentation was tried to combat her diarrhea with good clinical effect. Then feeding with 605Z milk (enzyme digested cow's milk antigen, Meiji Milk Products Co., Ltd.) was started, and the diarrhea improved. Laboratory findings showed positive milk PK test, elevated IgE score, and positive milk specific RAST score, decreased serum complement, elevated levels of each immunoglobulin class of milk specific antibodies, especially milk specific IgG1 antibody and increased complement absorption test. She was diagnosed as having milk allergy related to both type I and type III allergies from the above-mentioned results. Specific antibodies were diminished after feeding with 605Z. Although her mother had not taken cow's milk over the past 10 years, she took a lot of milk during her pregnancy. But her serum milk specific antibodies were not elevated. It was suggested that the baby's antibodies were not derived from her mother but that the baby produced them by herself.

[A transcranial Doppler method in the early diagnosis of cerebrovascular vasospasm; comparison with angiographical findings].

Cerebral angiography (CAG) and transcranial Doppler (TCD) were performed at the same time in 18 patients with ruptured aneurysms within 1-3 days after onset, and the results were compared. Delayed ischemic neurological deficits (DIND) accompanying vascular spasm were detected in 8 patients, but three of the 8 patients recovered from the DIND within about 2 weeks. The CAG findings were classified into the following 3 types: (1) diffuse type showing generalized spasm of intracranial arteries (8 patients), (2) proximal type with spasm in the distal part of the internal carotid arteries and/or proximal middle cerebral arteries (5 patients) and (3) peripheral type showing spasm in the peripheral part of the middle cerebral arteries (5 patients). The TCD findings could be classified into (a) high pattern type, in which the blood flow velocity had increased (13 cases), (b) paradoxical pattern type, in which the blood flow velocity was faster in the more peripheral regions (2 cases), and (c) normal pattern type (3 cases). All 13 patients classified as diffuse type (8 patients) or proximal type (5 patients) in terms of the CAG findings showed a high pattern in TCD, indicating that TCD is also capable of diagnosing vasospasm. On the other hand, two of the 5 patients with peripheral type also showed the paradoxical pattern while the remaining 3 showed the normal pattern in TCD. DIND was detected in 6 of the 15 patients with a high or paradoxical pattern in TCD.(ABSTRACT TRUNCATED AT 250 WORDS)

A technique for rapid non-suture vascular anastomosis.

In an attempt to overcome some of the difficulties inherent in vascular anastomosis using standard suture methods, we have developed a technique that allows for rapid non-suture anastomosis of blood vessels. The technique has been used in over 400 anastomoses, including interposition vein grafts in rat, rabbit and dog vessels ranging in size from 0.7 mm to 3 mm in diameter. Animals have been followed for over 1 year postoperatively with serial angiography and histological evaluation including scanning electron microscopy. Stress studies have compared the biomechanical properties of both non-suture and suture anastomosis. The overall patency rate in non-suture end-to-end anastomoses using an interposition vein graft was 85% at 1 year follow up. Histological evaluation revealed a healing pattern that was temporally similar to that of the suture technique. Stress tests revealed no significant difference between suture and non-suture technique. These studies reveal that the non-suture technique compares favourably with the suture technique, and demonstrate the feasibility of applying this technique to man.