Food allergy after liver transplantation in children: a prospective study

Food allergy has been increasingly reported in children who had orthotopic liver transplantation (OLT). We aimed to conduct a prospective study to investigate the prevalence of sensitizations and food allergy in pediatric OLT recipients. We also aimed to identify potential risk factors. The study group consisted of 28 children (14 male, 14 female, mean age 4.96 ± 0.76 yrs) who had OLT. Total eosinophil count (TEC), total IgE, and specific IgEs were studied before and 3, 6, 12 months after OLT. Six patients (21%) developed multiple food allergies. Mean age of six patients at OLT who developed food allergy was younger compared to the non‐food allergy group (10.2 months vs. 68.9 months, p < 0.05). Food allergy has been developed within 1 yr in 5, and in 20 months in one patient after OLT. All six patients had cow’s milk and egg allergy after OLT. Five children developed wheat, one children developed lentil and another one developed peach allergy in addition to cow’s milk and egg allergy. Out of six food‐allergic patients after OLT, four children developed Epstein–Barr virus (EBV) infection prior to food allergy. Before OLT, TECs and total IgE levels were not differed among food allergic and non‐food allergic patients (p > 0.05). Mean of TECs were significantly higher in food allergic group compared to non‐food allergic group at each time point after OLT (p < 0.05). Though statistically insignificant, mean of total IgE levels were also higher in the food allergic group (p > 0.05). These findings suggest that food allergy should be considered after OLT in patients who are younger than 1 yr of age, who developed hypereosinophilia, high total IgE levels or EBV viremia.     

A morphometric study of the inferior orbital fissure using three‐dimensional anatomical landmarks: Application to orbital surgery

The inferior orbital fissure (IOF) is an important structure during orbital surgery, however, neither its anatomical features nor the procedures necessary to expose the IOF have been examined in detail. A morphometric analysis of the IOF was performed on 232 orbits using computer software. The longest and shortest borders of the IOF were 18.2 ± 4.9 and 1.9 ± 1.3 mm, respectively. The outer and the inner angles were 138.9 ± 32.7° and 38.4 ± 24.7°, respectively. The perimeter of the IOF was 50.6 ± 13.5 mm and its area was 61.3 ± 39.1 mm². Eight types of IOF were observed. Type 1 IOF was observed in 42.2% and the Type 2 IOF was identified in 15.9%. A statistically significant relation was found between the longest edge and area and the widest edge and area of the IOF. The findings of our study suggest that the removal of the lateral wall should begin inferiorly, just lateral to the IOF and extended superolaterally. These data may be useful during surgical approaches to the orbit. Clin. Anat. 22:649–654, 2009. © 2009 Wiley‐Liss, Inc.     

Giant lymphadenopathy infiltrated by gaucher cells mimicking lymphoma

Gaucher disease (GD) is a lysosomal storage disease characterized by deficiency of β‐glucocerebrosidase, which results in accumulation of glucocerebroside in reticuloendothelial system, bone marrow infiltration, progressive hepatosplenomegaly, and skeletal complications. Herein we report a 5‐year‐old female with GD receiving enzyme replacement therapy who had giant mesenteric lymphadenopathies. Pediatr Blood Cancer 2009;52:870–871. © 2009 Wiley‐Liss, Inc.     

Prevalence of endothelial nitric oxide synthase E298D polymorphism in Turkish patients with essential hypertension

AimsOur aim was to evaluate the effects of endothelial nitric oxide synthase (eNOS) E298D polymorphism in obesity variables and essential hypertension (eHT) development risk. The genotype frequencies of E298D polymorphism in eHT patients and non-hypertensive (non-HT) controls (proven to have normal coronaries angiographically) were analyzed for their association with demographic and obesity related data of the eHT patients and controls.Materials and methodseNOS gene E298D genotypes were determined with qPCR.ResultsThe eNOS E298D polymorphism frequencies for 298E/E, 298E/D and 298D/D genotypes were respectively as 41.1%, 44.6%, 14.3% in subjects eHT and 52.8%, 38.9%, 8.3% in the non-HT groups. The combined E298D homozygous polymorphic and heterozygous genotypes were found to have a decreasing effect on serum total-cholesterol levels in comparison to wild-type genotypes in eHT patients but not controls.ConclusionsOur results support the idea that, the eNOS E298D polymorphism, which is not associated with hypertension, may increase the risk of hypertension when associated with high serum total-cholesterol levels.     

经瞳孔温热疗法治疗老年黄斑变性所致黄斑中心凹下脉络膜新生血管的长期观察(英文)

目的:评价经瞳孔温热疗法(TTT)治疗年龄相关性黄斑变性(AMD)所致黄斑中心凹下脉络膜新生血管(CNV)的长期疗效。方法:AMD所致黄斑中心凹下脉络膜新生血管14例14眼。平均年龄67.1岁。记录详尽的眼科检查结果,拍摄彩色眼底相,并行黄斑部光学相干断层成像(OCT)检查。在初诊及随后的复诊中行眼底荧光素血管造影和吲哚青绿血管造影。TTT的治疗参数为:时间1min,光斑大小2 ~3mm,激光能量650 ~800mW。随诊时间5 ~64mo,平均28.6mo。结果:在14眼中,典型性CNV有10眼,典型为主性有2眼,1眼为少量典型性,1型隐匿性CNV有1眼。共4例患者出现治疗后出血,均在短期内吸收。有1眼在治疗后立刻出现了黄斑无灌注区。多数患眼在随诊中可见渗出逐渐减少。在平均28.6mo的随诊中,14只患眼,有5眼视力提高,8眼保持稳定,1眼视力下降。结论:经瞳孔温热疗法在AMD患者中能封闭黄斑中心凹下的CNV,促进网膜下积液的迅速吸收,从而稳定患者的视力。它可以作为一种治疗典型和典型为主性黄斑中心凹下脉络膜新生血管的激光治疗手段。     

Two-Year Results of Intravitreal Triamcinolone Acetonide Injection for the Treatment of Macular Edema Due to Central Retinal Vein Occlusion

We investigated intravitreal triamcinolone acetonide injection for the treatment of macular edema due to central retinal vein occlusion in 20 patients. Mean central macular thickness at 3 days, 1, 3, 6, 12, 18, and 24 months postoperatively was different than baseline. Visual acuity did not change. Intravitreal triamcinolone injection significantly improves short-term anatomy, but recurrences and steroid-related complications were noted in the longer term.     

Griscelli syndrome: Report of Three Cases

The clinical features of three children with Griscelli syndrome and autopsy findings of two are presented. The patients were 5 years, 9 months, and 3 months old, respectively. Clinical features included partial albinism, hepatosplenomegaly, and various neurological symptoms. Light and electron microscopic studies of the skin were compatible with Griscelli syndrome. Postmortem examination of the viscera and central nervous system revealed lymphohistiocytic infiltration with erythrophagocytosis. Bilateral diffuse involvement of the central nervous system, cranial nerve, and spinal cord was detected in both cases.     

Medulloblastoma in a patient successfully treated for immature teratoma of the ovary

We report a case of medulloblastoma as a secondary malignancy in a patient treated for immature teratoma of the ovary (ITO). ITO is a rare but curable tumor of the ovary using combination chemotherapy. There is a great deal of interest in the long-term effects of chemotherapy in these patients. Once regarded as fatal not many series of patients with ITO have been reported with the long follow up as in the present case. This case may start a debate on the susceptibility of central nervous system tumors following chemotherapy in patients with ITO.     

Is the Cell Death in Mesial Temporal Sclerosis Apoptotic?

PURPOSE: Mesial temporal sclerosis (MTS) is characterized by neuronal loss in the hippocampus. Studies on experimental models and patients with intractable epilepsy suggest that apoptosis may be involved in neuronal death induced by recurrent seizures. METHODS: We searched evidence for apoptotic cell death in temporal lobes resected from drug-resistant epilepsy patients with MTS by using the terminal deoxynucleotidyl transferase (TdT) and digoxigenin-11-dUTP (TUNEL) method and immunohistochemistry for Bcl-2, Bax, and caspase-cleaved actin fragment, fractin. The temporal lobe specimens were obtained from 15 patients (six women and nine men; mean age, 29 +/- 8 years). RESULTS: Unlike that in normal adult brain, we observed Bcl-2 immunoreactivity in some of the remaining neurons dispersed throughout the hippocampus proper as well as in most of the reactive astroglia. Bax immunopositivity was increased in almost all neurons. Fractin immunostaining, an indicator of caspase activity, was detected in approximately 10% of these neurons. Despite increased Bax expression and activation of caspases, we could not find evidence for DNA fragmentation by TUNEL staining. We also could not detect typical apoptotic changes in nuclear morphology by Hoechst-33258 or hematoxylin counterstaining. CONCLUSIONS: These data suggest that either apoptosis is not involved in cell loss in MTS, or a very slow rate of cell demise may have precluded detecting TUNEL-positive neurons dying through apoptosis. Increased Bax expression and activation of caspases support the latter possibility.