Allergy to pine nuts in children

BACKGROUND

Allergy to nuts is a common and well-known disease. Despite the fact that pine nut is a widely eaten food, only nine cases have been described in literature.

OBJECTIVE

To describe four paediatric patients suffering from allergy reaction on ingestion of pine nuts and compare them with cases described in literature, taking into account clinical symptoms, epidemiological and diagnostic methods.

METHODS

The immuno-allergic study was carried out with skin tests (prick tests) using a commercial and native extract, and specific IgE serum test. An oral provocation test was performed in one case.

RESULTS

Ages ranged from 12 months to 6 years. All patients had a personal history of atopy. Symptoms on ingesting pine nut were severe systemic reactions in three cases. Two of the children had allergic reactions to other nuts. In all cases, both the skin test and the specific IgE serum test were positive. The oral provocation was positive in the case for which it was performed.

CONCLUSIONS

A typical clinical reaction of immediate hypersensitivity to this nut took place in all four children. The skin tests and in vitro studies confirm an IgE-mediated response. We currently have a commercial prick test for pine nut for the diagnosis, which has proven its sensitivity and specificity. In our region, due to the large consumption, the rate of allergic reactions to pine nuts would probably be greater and earlier on in life than in other areas.

The carboxy-terminus of I kappaB alpha determines susceptibility to degradation by the catalytic core of the proteasome

The Rel/NF-kappaB family of transcription factors controls the expression of a wide variety of genes that are implicated in immune and inflammatory responses and cellular proliferation. Disregulation of NF-kappaB is associated with cellular transformation and the maintenance of a high anti-apoptotic threshold in transformed cells. NF-kappaB activity is in turn regulated by its sequestration in the cytoplasm by the inhibitor I kappaB. I kappaB alpha, the most abundant and well-characterized member of the I kappaB multiprotein family, is rapidly degraded in response to multiple physiologic stimuli. In the present study we show that not only the amino-terminus, but also the carboxy-terminus of I kappaB alpha contain transferable signals that must be simultaneously present in an unrelated protein to render it susceptible to activation-induced, proteasome-mediated degradation. We show here that I kappaB alpha amino-terminal modifications occur independently of the carboxy-terminus. Moreover, we present evidence indicating a critical role for the carboxy-terminal region in facilitating proteolysis by the catalytic core of the proteasome. When incubated with 20S proteasome extracted from rat liver, I kappaB alpha was quickly degraded while a deletion mutant lacking the carboxy-terminus was resistant to proteolysis. Likewise, chimeric proteins of beta-galactosidase with the I kappaB alpha carboxy-terminus were degraded in vitro independently of the presence of the I kappaB alpha amino-terminus, whereas chimeric proteins lacking the I kappaB alpha carboxy-terminus were stable. Our results identify the carboxy-terminus of I kappaB alpha as a domain critical for degradation through interaction with an as yet unidentified component of the proteasome.

Electrophysiology and pharmacology of outward potassium currents in semicircular canal hair cells of toadfish, Opsanus tau

Outward currents from hair cells from the horizontal semicircular canal (HSCC) of the toadfish were investigated using whole cell patch clamp methods. Two classes of hair cells are found. One class (approx. 10% of cells) showed only a non-inactivating current (IKCa) which was blocked by 2 mM TEA. A second class had both inactivating and non-inactivating currents. The former (IA) was blocked by 4-AP (1 mM) and the latter (IKCa) by TEA (2-20 mM) . While the majority of the cells expressed both these outward currents, due to IA inactivation both currents are functionally present in the same cell only between -60 and -40 mV. At more depolarized membrane potentials, IA was inactivated, suggesting that a single hair cell may have two distinct signalling modes, one dominated by IA at more hyperpolarized membrane potentials and the other by IKCa at depolarized values where ICa is beginning to grow, increasing both amplitude and activation rate of IKCa. The switch between modes will be determined by the amplitude and frequency characteristics of the stimulus and possibly also by actions of efferent transmitters. In current clamp mode, 10% of the HSCC hair cells showed high Q and high frequency resonance, from 44 to 360 Hz at 12 degrees C. These cells expressed only one outward calcium dependent, non-inactivating, TEA sensitive current, characteristic of IKCa. A suggested role for high frequency resonance is as positive feedback to produce a high frequency updating of the stereociliary compliance to most faithfully transduce angular acceleration.

[Ebastine : treatment of perennial rhinitis in the child]

Ebastine is H1 receptor antagonist, powerful and selective for histamine. Its efficacy has been evaluated in control of symptoms of persistent rhinitis, appearance of secondary effects and tolerance of the drug, in 30 children who were suffering from persistent rhinitis, of which the diagnosis included:- clinical history, skin tests (prick test) nasal and conjunctival provocation tests, total and specific IgE. All the children had treatment for 30 days. The parameters followed were:- clinical score, skin tests, nasal and conjunctival provocations and evaluation of secondary effects, of the start and 10 days after the end of treatment. The results obtained were a disappearance or reduction of the weals from histamine and specific antigens, disappearance or reduction of the response in nasal and conjunctival provocation with carbachol or specific antigens, clear clinical improvement in 22 patients, in 2 small improvement and no response in 6 patients. We conclude that Ebastine improved the clinical symptoms in persistent rhinitis, the skin test is inhibited and sensitivity of the shock organ is reduced. No secondary effects were seen on the Central Nervous System (SNC) and the tolerance of the drug was very good.

Correlations between the clinical picture and the intentionality in schizophrenic and schizoaffective patients

The results are presented of catamnestic research on 24 patients with the diagnosis of schizophrenia at the first clinical episode confirmed according to the ICD-10 criteria. The clinical picture rated with the Positive and Negative Symptoms Scale (Kay, Fiszbein and Opler, 1987) and with the BPRS, was correlated with the intentionality, which was rated with the InSka (IntentionalitätsSkala; Mundt, 1985). The transformation of the phenomenal significance into a numeric value enables the use of mathematical methods for the search of interactions inside the schizophrenic phenomenon. We found the following significant tendencies: (1) the negative syndrome score correlates with the residual intentionality; (2) the negative syndrome score correlates with the premorbid intentionality; (3) the clinical thought disturbance correlates with the premorbid speech content intentional profile.

A randomized study of mitoxantrone plus cytarabine versus daunomycin plus cytarabine in the treatment of previously untreated adult patients with acute nonlymphocytic leukemia

Between May 1985 and November 1988, 143 adult patients with previously untreated acute nonlymphocytic leukemia were randomized to receive mitoxantrone and cytarabine (MTT+Ara-C) or daunomycin and cytarabine (DNM+Ara-C) in order to compare the efficacy and acute and chronic toxicities. Therapy consisted of 3 days of MTT 12 mg/m2/i.v. or DNM 45 mg/m2/i.v.; both groups received Ara-C 100 mg/m2 daily by continuous infusion (CI) for 7 days. Those who failed to achieve a complete remission after one induction course received a second induction course for 2 and 5 days at the same doses. All the patients who achieved complete remission received two consolidations of 2 days of MTT or DNM and 5 days of Ara-C in CI at the same dose as for induction. Of the 72 patients on MTT+Ara-C, 38 (53%) achieved complete remission, compared with 29 (43%) of 67 treated with DNM+Ara-C. Three and 5 patients had partial remission, 7 and 18 failed to respond, 24 and 15 died in the first 21 days of induction, of those treated with MTT+Ara-C or DNM+Ara-C, respectively (p = 0.34). Median duration of complete remission and survival was 185 and 103 days or 165 and 160 days, respectively (p = 0.85). More early deaths were observed with MTT+Ara-C due to greater myelosuppression, and a higher incidence of failure with DNM+Ara-C. No significant differences between treatment groups were observed in 21 categories of adverse events. The results demonstrate similar incidence of complete response, length of duration of complete remission, overall survival, and toxicity with MTT+Ara-C and DNM+Ara-C.

Ultrastructural analysis of the cavernous and dorsal penile nerves in experimental diabetes

The present study was designed to investigate whether experimental diabetes determines structural changes in peripheral nerves involved in reflexogenic erection, namely the cavernous and the dorsal nerve of the penis. Myelinated axons were examined in the dorsal nerve of the penis from rats with streptozotocin-induced diabetes (3- and 6-month duration). Morphometric analysis disclosed a significant decrease of myelinated fibre size most likely due to a progressive axonal atrophy. In addition, morphological analysis revealed diffuse accumulation of glycogen within axons, lipid droplets in Schwann cells and pronounced sequestration of axoplasm by adaxonal Schwann cell processes. These signs were particularly prominent in 6-month-diabetic rats. Myelinated and unmyelinated axons of the cavernous nerve were analysed in 6-month-diabetic animals. No substantial ultrastructural abnormalities were found in the cavernous nerves. These results suggest that in experimental diabetes regionally specific structural changes occur in neuronal pathways subserving erectile function.

[Value of local cerebral hypoperfusion in the diagnosis of frontal syndromes. Importance in medical expert assessment of head injuries]

The importance of the symptoms linked to a frontal disorder in the intellectual and behavioral sequelas of severe cranial trauma, is now measured carefully because these troubles are one of the most important obstacle to the social and professional come-back. The handicap linked to a disorder of the frontal lobe is not well known in all its neurological, mental and sociological dimensions because the diagnosis is not easy. To help to this diagnosis, the study of cerebral blood flow with SPECT is usefull in medical practice. We present here 4 clinical cases of post-trauma frontal syndrome not easy to measure. With a measure of cerebral blood flow with SPECT, it was observed a decrease of frontal blood flow, that allowed to link the neuropsychological symptom to a frontal lobe disorder. It seems that in these conditions the post-trauma frontal syndrome is not so uncommon.

Depression and partial epilepsy: relevance of laterality of the epileptic focus

In a prospective study of 50 epileptic patients (20 with a left hemisphere epileptic focus, 20 with a right one and 10 with a cryptogenic generalized epilepsy), the authors show that depression as appreciated by the H.A.R.D. score, is more frequent and severe in partial epilepsy in males, and when the epileptic focus is localized on left hemisphere. This association is related to the duration of epilepsy, the number of seizures, but not to age or medication status. Vulnerability of left hemisphere to depression is analysed, and neuro-chemical mechanisms are discussed.

Effect of streptozotocin-induced diabetes on electrically evoked erection in the rat

This study was designed to investigate whether experimental diabetes in rats could functionally affect reflexogenic erection. Erection was elicited by means of electrical stimulation of the dorsal nerves of the penis and recorded as intracorporeal pressure. Rats were examined 1, 3 and 6 months after diabetes induction by streptozotocin. Three and 6 month diabetes caused a significant decrease of latency for erection and a slower phase of detumescence when compared to age-matched controls. In addition, a trend for a lower developed intracorporeal pressure was present in the 6 month diabetes group. Our results indicate that experimental diabetes is associated with alterations of reflexogenic erection.

[REM-sleep behavior disorder and olivo-ponto-cerebellar atrophy: a case report]

The authors report the observation of REM-sleep behavior disorder in a patient also suffering from an olivo-ponto-cerebellar atrophy. They discuss the place of this sleep disorder among the parasomnias, its pathophysiological basis and its features similar to those of the somnambulism. Only a polysomnography study can help to make the diagnosis.

Mustard allergy. Two anaphylactic reactions to ingestion of mustard sauce

Two cases of anaphylactic reactions set off by the ingestion of a small amount of mustard sauce are described. Mediation by specific IgE to mustard was determined by skin prick tests and radioimmunoassay, which suggested a type I hypersensitivity mechanism. Despite the antigenic potency of mustard, a spice that is consumed frequently, very few cases of hypersensitivity from ingestion have been described.

[Effects of callosotomy in the treatment of intractable epilepsies in children on psychiatric disorders]

Two children, 13 and 14 years old, presented an intractable epilepsy of Lennox-Gastaut. In front of dangerous tonic and atonic epileptic crisis, a corpus callosotomy was performed. Corpus callosotomy is becoming a more widely used procedure in the treatment of intractable epilepsy as Lennox-Gastaut syndrome, or frontal epilepsy. However, there have been very few series that have reported results in children. It is not a complete but a partial, callosal section including approximately the anterior two thirds of the callosum. After this surgery the two children improved dramatically because the dangerous tonic and atonic crisis disappeared. Secondly we observed improvement of pre-surgical psychiatric troubles, that is a data not developed in the literature. Before surgery, the two children had a frontal syndrome with hyperkinesia, distractibility, aggressiveness, alexithymia, loss of the program of ideas. During the two months after the section of the anterior two thirds of the corpus callosum, we observed a progressive improvement of the frontal syndrome, with possibility to learn new praxies. The intellectual quotient was not altered and associative functions, depending of the posterior third of the corpus callosum were spared. Anti-epileptic medications were not stopped. We think that the improvement of the frontal syndrome is due to reduction of seizures. Therefore, we insist on the interest of the section of the anterior two thirds of the corpus callosum as treatment of tonic and atonic seizures but also as treatment of psychiatric symptoms depending of a frontal syndrome.

Synthesis and anthelmintic activity of carbamates derived from imidazo[2,1-b][1,3,4]thiadiazole and imidazo[2,1-b]thiazole

The anthelmintic activity of 25 compounds, most of them carbamates, was determined. The in vitro results are interesting and show that an aromatic azapentalene can replace the benzimidazole ring without loss of its biological properties. The in vivo results, however, show that the compounds are devoid of practical interest.

Asthma trough to Parietaria in pediatrics

We selected 183 patients with asthma, rhinitis and/or conjunctivitis. They responded positively to Parietaria Judaica skin prick-tests. In the first test 91 were positive. Of those 11 were monosensitive and 80 polysensitive. In the follow-up tests 92 were positive, of which 5 were monosensitive and 87 polysensitive. There were 54 cases of rhinitis, of which 23 developed asthma. Of 129 asthma cases, 90 developed asthma with rhinitis. The main seasons are Spring and Autumn and activity declines during winter. 18.57% are perennial. IgE was greater in the re-examination of the polysensitive cases. The monosensative cases confirmed the clinical symptoms most characteristic of rhinitis syndrome, 16.893% and asthma with rhinitis, 49.18%.

Chronic erosive arthritis associated with an unusual intestinal bypass

We describe an unusual intestinal bypass arthritis in a 37-year-old man. The intestinal bypass was unusual because the intestinal blind loop was entirely composed of colon. The arthritis was first a typical bypass arthritis but later resembled rheumatoid arthritis. In spite of this resemblance, all rheumatic symptoms disappeared after jejunocaecal reanastomosis.

[A clinico-statistical study of the anatomico-clinical and immunohistochemical correlations in chronic lesions of the oral cavity]

A series of 191 biopsies of the oral cavity (epulides, cysts and granulomas) carried out in 1975-76 (104 cases) and 1985-86 (87 cases) is reported. Data regarding age, sex, site, histopathological diagnosis, dimensions of the lesions and type of operation were processed on an AT mod 280 computer in a file specially created using an Ashton Tate DB 111 Plus. Percentage values relating to epulides proved substantially unchanged. Those regarding cysts showed a particularly evident increase in males, while those relating to granulomas showed a decline in both sexes. From the immunopathological viewpoint, angiomatous epulides, prevalent in the female sex, presented a structural framework different to that of plasma cellular epulides, testified by the presence of vessels lined with endothelia reactive to fucose and with scanty plasmocyte immunoglobulin component.

[Advances in dentistry]

After a long period of research, a lot of elements of high technology have come to dentistry. Intraoral camaras, magnetic resonance imaging devices, digital radiographic equipment, laser, and computer systems that custom, mill and place restorations. The future evolution of all these devices, could be spectacular, considering its numerous possibilities in dental field.

An aid to the selection of chemotherapy regimens for oral cavity carcinomas. Early results of a study of 5-year survival based on antioncogram selection of anti-cancer drugs

The antioncogram is an aid to the selection of cytostatic drugs in the treatment of oral cavity carcinomas. In comparison with drug selection based on clinical experience, the antioncogram-oriented choice of the most promising drug in vitro results in improved survival rates.