Late anaphylactic reaction to cuttlefish

A 10-year-old girl exhibited a late-onset systemic anaphylactic reaction, three and one-half hours after ingestion of cuttlefish. The late reaction was not preceded by an early-phase reaction but occurred seven days after an immediate anaphylactic reaction to this allergen. The patient had a high level of specific IgE antibody against cuttlefish.     

Association between chromogranin b gene polymorphisms and schizophrenia in the Japanese population.

BACKGROUND: We found in previous work a significant association between schizophrenia and D20S95 on chromosome 20p12.3. In this study, we analyzed 10 microsatellite markers and found an association of schizophrenia with D20S882 and D20S905 that flank D20S95. The chromogranin B gene (CHGB) is 30 kb from D20S905. The chromogranin B (secretogranin I) belongs to a series of acidic secretory proteins that are widely expressed in endocrine and neuronal cells, and its cerebrospinal fluid levels have been reported to decrease in patients with chronic schizophrenia. METHODS: We screened for polymorphisms in CHGB with polymerase chain reaction direct sequencing methods in 24 Japanese schizophrenic patients and identified a total of 22 polymorphisms. Allelic and genotypic distributions of detected polymorphisms were compared between unrelated Japanese schizophrenic patients (n = 192) and healthy control subjects (n = 192). RESULTS: Statistically significant differences in the allelic distributions were found between schizophrenic patients and control subjects for 1058C/G (A353G) (corrected p = 7.7 x 10(-5)) and 1104A/G (E368E) (corrected p = 8.1 x 10(-6)). The 1058C/G and 1104A/G alleles were in almost complete linkage disequilibrium and were in linkage disequilibrium with D20S95. CONCLUSIONS: Results suggest that the CHGB variations are involved in the susceptibility to schizophrenia in our study population.     

Vasopressin increases type IV collagen production through the induction of transforming growth factor-beta secretion in rat mesangial cells.

Production of extracellular matrix proteins, such as type IV collagen, by mesangial cells contributes to progressive glomerulosclerosis. Transforming growth factor-beta (TGF-beta) modulates mesangial cell growth and stimulates extracellular matrix synthesis by mesangial cells. In this study, the ability of vasopressin (AVP), which causes mesangial cell proliferation and hypertrophy, to stimulate type IV collagen production and correlation with TGF-beta secretion by cultured rat mesangial cells was examined. AVP induced a time- and concentration-dependent increase in TGF-beta secretion and mitogenic effect in rat mesangial cells. This AVP-induced increase in TGF-beta secretion was potently inhibited by AVP V(1A) receptor-selective antagonist. AVP also induced a concentration-dependent increase in the production of type IV collagen and this effect was inhibited by V(1A) receptor-selective antagonist. Furthermore, TGF-beta also induced an increase in the production of type IV collagen; the AVP-enhanced production of type IV collagen was inhibited by an anti-TGF-beta antibody. These results demonstrate that AVP stimulates synthesis of type IV collagen by cultured rat mesangial cells through the induction of TGF-beta synthesis mediated by V(1A) receptors. Therefore, AVP-induced TGF-beta secretion by proliferating mesangial cells might act as an autocrine factor to regulate synthesis of extracellular matrix; this mechanism may contribute to glomerulosclerosis in renal diseases including diabetic nephropathy.     

Cerebral edema on MRI in severe preeclamptic women developing eclampsia

OBJECTIVE: The aim of this study is to identify suitable applications for cerebral MR (magnetic resonance) scanning in cases of severe preeclampsia and eclampsia through comparison of clinical course and easily accessible parameters. METHODS: From January 2001 to December 2003, cerebral MR scans were performed on 43 women with severe preeclampsia; of those 41 were enrolled in data analyses. Twenty clinical parameters, including age, body mass index, blood pressure, liver and renal function, and coagulation status, were compared for each patient. Data were analyzed using the SPSS program on a VAX main frame. RESULTS: Among 41 severe preeclamptic women, abnormal MR images were observed in 11 cases including six with systemic seizures. Predictive accuracy of eclampsia with abnormal cerebral MR imaging was 84.9% (P=0.00001), while only 14.3% of severe preeclampsia cases had been diagnosed radiologically. Statistical analysis suggests diastolic BP and serum AST as predictive parameters for abnormal MR images with 82.9% predictive accuracy (P=0.0007). CONCLUSIONS: Cerebral edema can be observed in preeclamptic patients developing eclampsia. Rapid delivery is indicated when diastolic BP and AST are elevated. MR scanning is useful when delivery is delayed due to fetal immaturityin cases of severe preeclampsia.     

Effects of hypnagogic imagery on the event-related potential to external tone stimuli

STUDY OBJECTIVES: The purpose of this study was to examine the influence of hypnagogic imagery on the information processes of external tone stimuli during the sleep onset period with the use of event-related potentials. DESIGN: Event-related potentials to tone stimuli were compared between conditions with and without the experience of hypnagogic imagery. To control the arousal level when the tone was presented, a certain criterion named the electroencephalogram stage was used. Stimuli were presented at electroencephalogram stage 4, which was characterized by the appearance of a vertex sharp wave. SETTING: Data were collected in the sleep laboratory at Hiroshima University. PARTICIPANTS: Eleven healthy university and graduate school students participated in the study. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Experiments were performed at night. Reaction times to tone stimuli were measured, and only trials with shorter reaction times than 5000 milliseconds were analyzed. Electroencephalograms were recorded from Fz, Cz, Pz, Oz, T5 and T6. There were no differences in reaction times and electroencephalogram spectra between the conditions of with and without hypnagogic imagery. These results indicated that the arousal levels were not different between the 2 conditions. On the other hand, the N550 amplitude of the event-related potentials in the imagery condition was lower than in the no-imagery condition. CONCLUSIONS: The decrease in the N550 amplitude in the imagery condition showed that experiences of hypnagogic imagery exert some influence on the information processes of external tone stimuli. It is possible that the processing of hypnagogic imagery interferes with the processing of external stimuli, lowering the sensitivity to external stimuli.     

Recuperative power of a short daytime nap with or without stage 2 sleep

STUDY OBJECTIVES: The recuperative effect of a nap of less than 30 minutes has been confirmed. Such naps consist mainly of stages 1 and 2 sleep. The present study examined whether sleep stage 1 or 2 contributed to the recuperative effect of a short nap. DESIGN: Repeated-measurement within-subject design. After sleep was restricted to 1.5 hours less than their usual nocturnal sleep, participants took a rest (No-nap condition) or a nap at 2:00 PM. In the nap condition, they were awakened after 5 minutes of stage 1 sleep (S1-nap condition) or 3 minutes after stage 2 sleep appeared (S2-nap condition). SETTING: University sleep laboratory. PARTICIPANTS: Ten healthy university students (aged 19 to 24 years). MEASUREMENTS: Subjective mood, performance on visual detection and symbol-digit substitution tasks, and the number of slow eye movements during a performance task were measured before and after the nap or rest. RESULTS: In the No-nap condition, subjective mood and performance deteriorated, and Slow eye movements increased during mid-afternoon, suggesting that the post-lunch dip occurred. In contrast, subjective alertness and performance improved and slow eye movements rarely occurred in the S2-nap condition. Although subjective sleepiness and fatigue improved, performance deteriorated and slow eye movements increased in the S1-nap condition. CONCLUSION: A daytime short nap containing 3 minutes of stage 2 sleep has recuperative effects, whereas these effects are limited following only stage 1 sleep.     

Postoperative portal and splenic vein thrombosis in children: Identification of risk factors

Postoperative portal and splenic vein thrombosis (PSVT) is a rare but potentially fatal complication after abdominal surgery. We present 2 infants with PSVT after splenectomy and total colectomy, respectively, and also provide a review of the literature. We conclude that clinicians should consider that PSVT might occur after splenectomy for a huge splenomegaly or after a total colectomy for ulcerative colitis.This study was not supported by any grant and the data have not been communicated to any society or at any meeting.     

Predictors and consequences of altered mineral metabolism: the Dialysis Outcomes and Practice Patterns Study

BACKGROUND: Altered mineral metabolism contributes to bone disease, cardiovascular disease, and other clinical problems in patients with end-stage renal disease. METHODS: This study describes the recent status, significant predictors, and potential consequences of abnormal mineral metabolism in representative groups of hemodialysis facilities (N= 307) and patients (N= 17,236) participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) in the United States, Europe, and Japan from 1996 to 2001. RESULTS: Many patients fell out of the recommended guideline range for serum concentrations of phosphorus (8% of patients below lower target range, 52% of patients above upper target range), albumin-corrected calcium (9% below, 50% above), calcium-phosphorus product (44% above), and intact PTH (51% below, 27% above). All-cause mortality was significantly and independently associated with serum concentrations of phosphorus (RR 1.04 per 1 mg/dL, P= 0.0003), calcium (RR 1.10 per 1 mg/dL, P < 0.0001), calcium-phosphorus product (RR 1.02 per 5 mg(2)/dL(2), P= 0.0001), PTH (1.01 per 100 pg/dL, P= 0.04), and dialysate calcium (RR 1.13 per 1 mEq/L, P= 0.01). Cardiovascular mortality was significantly associated with the serum concentrations of phosphorus (RR 1.09, P < 0.0001), calcium (RR 1.14, P < 0.0001), calcium-phosphorus product (RR 1.05, P < 0.0001), and PTH (RR 1.02, P= 0.03). The adjusted rate of parathyroidectomy varied 4-fold across the DOPPS countries, and was significantly associated with baseline concentrations of phosphorus (RR 1.17, P < 0.0001), calcium (RR 1.58, P < 0.0001), calcium-phosphorus product (RR 1.11, P < 0.0001), PTH (RR 1.07, P < 0.0001), and dialysate calcium concentration (RR 0.57, P= 0.03). Overall, 52% of patients received some form of vitamin D therapy, with parenteral forms almost exclusively restricted to the United States. Vitamin D was potentially underused in up to 34% of patients with high PTH, and overused in up to 46% of patients with low PTH. Phosphorus binders (mostly calcium salts during the study period) were used by 81% of patients, with potential overuse in up to 77% patients with low serum phosphorus concentration, and potential underuse in up to 18% of patients with a high serum phosphorus concentration. CONCLUSION: This study expands our understanding of the relationship between altered mineral metabolism and outcomes and identifies several potential opportunities for improved practice in this area.