Decreased Serum Epinephrine in Children With Positive Skin Prick Test

Objectives

To evaluate the association between catecholamine levels and skin prick test results among children.

Methods

Two hundred eight first grade children from one elementary school were invited to participate in this study. Skin prick test (SPT) for six allergens (2 house dust mites, cat, dog, mugwort, and pollen mixture) was performed, and patient demographic information was recorded. The parents were surveyed using questionnaires about rhinitis-related symptoms. Finally, venous blood sampling was done to measure catecholamine levels (epinephrine, norepinephrine, and dopamine) by high-performance liquid chromatography.

Results

Out of 208 children, 174 (106 boys and 68 girls) enrolled in this study. Ninety-six of the children (55%) had negative SPT (nonsensitization group), while 78 (45%) had a positive SPT to at least one of six allergens (sensitization group). The diagnosis of chronic rhinitis was more prevalent in the sensitization group (35.9%) than nonsensitization group (26.0%), however the finding was not significant (P=0.186). Epinephrine levels were decreased between the sensitization group compared to the nonsensitization group (P=0.004). There was no difference in norepinephrine and dopamine levels (P>0.05).

Conclusion

Epinephrine levels are lower in children with positive SPT compared to controls, however, the level of the catecholamine was not associated with the presence or absence of rhinitis symptoms.     

Effects of microbleeds on hemorrhage development in leukoaraiosis patients.

The possible influences of cerebral microbleeds (CMBs) on the development of intracerebral hemorrhage (ICH) in patients with leukoaraiosis (LA) have rarely been examined. We aimed to determine whether CMBs might be a risk factor for ICH in hypertensive patients with leukoaraiosis. We studied 70 hypertensive patients with acute ICH and LA (the ICH group) by brain MRI, including T2*-weighted gradient-echo sequences. The control group was composed of 73 hypertensive LA patients without ICH. CMBs and old lacunae were counted in the group of patients with ICH and in the control subjects and compared. The ICH group contained more patients with CMBs (68 patients; control group, 41; p < 0.01), and showed a higher mean number of lesions (19.9 +/- 31.1; control group, 7.4 +/- 19.6; p < 0.01). The negative predictive value for ICH was highest among the ICH patients without CMB (94.1%), and the positive predictive value was highest among the ICH patients with 6 or more CMBs (75.4%). Old lacunae were observed more frequently in the ICH group (65 patients; control group, 58; p = 0.02), but their predictive value for ICH was not high (positive, 52.3%; negative, 75.0%). Our results indicated that CMBs may be used to predict the risk of ICH in hypertensive patients with advanced LA.     

Benefits of PEGylation in the early post-transplant period of intraportal islet transplantation as assessed by magnetic resonance imaging of labeled islets

While a few studies have demonstrated the benefit of PEGylation in islet transplantation, most have employed renal subcapsular models and none have performed direct comparisons of islet mass in intraportal islet transplantation using islet magnetic resonance imaging (MRI). In this study, our aim was to demonstrate the benefit of PEGylation in the early post-transplant period of intraportal islet transplantation with a novel algorithm for islet MRI. Islets were PEGylated after ferucarbotran labeling in a rat syngeneic intraportal islet transplantation model followed by comparisons of post-transplant glycemic levels in recipient rats infused with PEGylated (n = 12) and non-PEGylated (n = 13) islets. The total area of hypointense spots and the number of hypointense spots larger than 1.758 mm² of PEGylated and non-PEGylated islets were quantitatively compared. The total area of hypointense spots (P < 0.05) and the number of hypointense spots larger than 1.758 mm² (P < 0.05) were higher in the PEGylated islet group 7 and 14 days post translation (DPT). These results translated into better post-transplant outcomes in the PEGylated islet group 28 DPT. In validation experiments, MRI parameters obtained 1, 7, and 14 DPT predicted normoglycemia 4 wk post-transplantation. We directly demonstrated the benefit of islet PEGylation in protection against nonspecific islet destruction in the early post-transplant period of intraportal islet transplantation using a novel algorithm for islet MRI. This novel algorithm could serve as a useful tool to demonstrate such benefit in future clinical trials of islet transplantation using PEGylated islets.     

Ischemic stroke associated with immune thrombocytopenia: lesion patterns and characteristics

Although the patients with immune thrombocytopenia (ITP) have a very low platelet count, which usually causes hemorrhagic complications, they occasionally experience ischemic stroke. However, the mechanism underlying ITP-related ischemic stroke (ITP-IS) has not been fully clarified. We aim to elucidate the ITP-IS mechanism by analyzing the ischemic lesion patterns and clinical characteristics. We assessed consecutive first-ever acute ischemic stroke (AIS) patients with ITP admitted to Seoul National University Hospital between October 2002 and October 2011. The stroke lesion pattern and clinical characteristics of ITP-IS patients were analyzed. Of the 2,185 patients with first-ever AIS, seven patients (4 women) with ITP-IS were identified. Of these seven patients, 3 (43 %) who were classified as undetermined stroke etiology indicated an embolic stroke pattern, and had no remarkable atherosclerotic risk factors, no steno-occlusive lesions in their relevant artery, and no cardioembolic etiologies or conditions causing secondary ITP. Moreover, compared with the patients without ITP, the patients with ITP were younger and had lower platelet counts. Thus, we noted that ITP is a rare cause of ischemic stroke, which primarily occurs due to the development of a thromboembolism in the brain. We believe that this paradoxical mechanism of ITP-associated thrombus formation requires further investigation.     

Osteonecrosis of the Femoral Head: an Updated Review of ARCO on Pathogenesis,Staging and Treatment

Non-traumatic osteonecrosis of the femoral head (ONFH) usually affects adults younger than 50 years and frequently leads to femoral head collapse and subsequent arthritis of the hip. It is becoming more prevalent along with increasing use of corticosteroids for the adjuvant therapy of leukemia and other myelogenous diseases as well as management of organ transplantation. This review updated knowledge on the pathogenesis, classification criteria, staging system, and treatment of ONFH.     

Antiallergic activity of hesperidin is activated by intestinal microflora

When hesperidin isolated from pericarpium of Citrus unshiu (family Rutaceae) was incubated with human intestinal microflora, its main metabolite was hesperetin, which was a main metabolite in urine of orally hesperidin-administered rats. The antiallergic activity of hesperidin and its metabolite hesperetin were investigated. Hesperidin did not inhibit the histamine release from RBL-2H3 cells induced by IgE. However, its metabolite hesperetin potently inhibited the histamine release from RBL-2H3 cells induced by IgE and the PCA reaction. The inhibitory activity of hesperetin was found to be comparable with azelastine, a commercially available antiallergic drug, and to potently inhibit prostaglandin E2 production in lipopolysaccharide-stimulated RAW 264.7 cells. Hesperetin weakly inhibits cyclooxygenase 2 enzyme activities. These results suggest that hesperidin may be a prodrug, which is metabolized to hesperetin by intestinal bacteria.