Anaphylaxis and onsite treatment in schools, kindergartens, and nurseries

BACKGROUND

There have been no reports on both anaphylaxis incidence rate in schools, kindergarten, and nurseries, or how teachers have treated these children. This study was a fact-finding survey aimed at determining if appropriate responses to anaphylaxis onset were implemented in Oita Prefecture, Japan.

METHODS

The Oita Prefectural Allergy Control Committee administered a questionnaire using Google forms to all public and private schools, public and private kindergartens, certified child-care facilities, and day-care centers in the prefecture.

RESULTS

Responses to the questionnaire were obtained from 597 institutions, of which 125 890 children were affiliated with the responding institutions. Forty-eight children developed symptoms for which an adrenaline auto-injector was recommended in an Oita guideline. Among these children, three used the adrenaline auto-injector, three were prescribed the adrenaline auto-injector but were unable to use it, 27 were unable to use it as they were not prescribed an adrenaline auto-injector, and the final 15 responded that they handled their symptoms via another method because none of the above options apply.

CONCLUSIONS

Most children who developed symptoms which an adrenaline auto-injector was recommended had no prescription for an adrenaline auto-injector. There is thus a need for appropriate response training to anaphylaxis whether or not an adrenaline auto-injector was prescribed.

Search for nu(e) from the sun at Super-Kamiokande-I

We present the results of a search for low energy nu(e) from the Sun using 1496 days of data from Super-Kamiokande-I. We observe no significant excess of events and set an upper limit for the conversion probability to nu(e) of the 8B solar neutrino. This conversion limit is 0.8% (90% C.L.) of the standard solar model's neutrino flux for total energy=8-20 MeV. We also set a flux limit for monochromatic nu(e) for E(nu(e))=10-17 MeV.

Immune response to Japanese rabies vaccine in domestic dogs

To evaluate the immune response induced by Japanese rabies vaccine for veterinary use as international units (IU), we measured levels of rabies antibody in serum samples from dogs by the rapid fluorescent focus inhibition test (RFFIT). In dogs immunized with a reference vaccine (potency level of 3.1 IU/ml), prepared by the same method as that used to produce commercial vaccine, and its dilutions (1 : 2 or 1 : 4), neutralizing-antibody levels increased to 1.0-2.0 IU/ml over a period of 1 month and then decreased to 0.2-1.5 IU/ml over a period of 1 year after the first vaccination and showed a remarkable increase to 12-47 IU/ml after the second vaccination. Sixty-five (74.7%) of the 87 serum samples from domestic dogs that were tested were seropositive (> or =0.1 IU/ml). However, the seropositive rate in dogs less than 1-year old at the time of vaccination was low (57.1%), and the antibody levels in these dogs were not sufficiently high for the rabies antibody titre in serum to be maintained for 1-year. Levels of rabies antibody in all serum samples were also measured by the virus neutralizing test (VNT), and a strong correlation (r > 0.95) was found between the results of the RFFIT and those of the VNT.

Search for supernova relic neutrinos at Super-Kamiokande

A search for the relic neutrinos from all past core-collapse supernovae was conducted using 1496 days of data from the Super-Kamiokande detector. This analysis looked for electron-type antineutrinos that had produced a positron with an energy greater than 18 MeV. In the absence of a signal, 90% C.L. upper limits on the total flux were set for several theoretical models; these limits ranged from 20 to 130 macro nu(e) cm(-2) s(-1). Additionally, an upper bound of 1.2 macro nu(e) cm(-2) s(-1) was set for the supernova relic neutrino flux in the energy region E(nu)>19.3 MeV.

Microscopic response of radiation on imaging plates

The microscopic response of alpha particles on an imaging plate was studied experimentally. It is proved that a single alpha event can be discriminated from background signals and be recorded on the imaging plate. The spatial resolution of the dose distribution was found to be 43 +/- 2 microns when alpha particles were injected perpendicularly. The observed output signals are well described by the deposited energy.

Constraints on neutrino oscillations using 1258 days of Super-Kamiokande solar neutrino data

We report the result of a search for neutrino oscillations using precise measurements of the recoil electron energy spectrum and zenith angle variations of the solar neutrino flux from 1258 days of neutrino-electron scattering data in Super-Kamiokande. The absence of significant zenith angle variation and spectrum distortion places strong constraints on neutrino mixing and mass difference in a flux-independent way. Using the Super-Kamiokande flux measurement in addition, two allowed regions at large mixing are found.

Solar 8B and hep neutrino measurements from 1258 days of Super-Kamiokande data

Solar neutrino measurements from 1258 days of data from the Super-Kamiokande detector are presented. The measurements are based on recoil electrons in the energy range 5.0-20.0 MeV. The measured solar neutrino flux is 2.32+/-0.03(stat)+0.08-0.07(syst)x10(6) cm(-2) x s(-1), which is 45.1+/-0.5(stat)+1.6-1.4(syst)% of that predicted by the BP2000 SSM. The day vs night flux asymmetry (Phi(n)-Phi(d))/Phi(average) is 0.033+/-0.022(stat)+0.013-0.012(syst). The recoil electron energy spectrum is consistent with no spectral distortion. For the hep neutrino flux, we set a 90% C.L. upper limit of 40x10(3) cm(-2) x s(-1), which is 4.3 times the BP2000 SSM prediction.

Imported parakeets harbor H9N2 influenza A viruses that are genetically closely related to those transmitted to humans in Hong Kong

In 1997 and 1998, H9N2 influenza A viruses were isolated from the respiratory organs of Indian ring-necked parakeets (Psittacula Krameri manillensis) that had been imported from Pakistan to Japan. The two isolates were closely related to each other (>99% as determined by nucleotide analysis of eight RNA segments), indicating that H9N2 viruses of the same lineage were maintained in these birds for at least 1 year. The hemagglutinins and neuraminidases of both isolates showed >97% nucleotide identity with those of H9N2 viruses isolated from humans in Hong Kong in 1999, while the six genes encoding internal proteins were >99% identical to the corresponding genes of H5N1 viruses recovered during the 1997 outbreak in Hong Kong. These results suggest that the H9N2 parakeet viruses originating in Pakistan share an immediate ancestor with the H9N2 human viruses. Thus, influenza A viruses with the potential to be transmitted directly to humans may be circulating in captive birds worldwide.

A high-Mr glycoprotein fraction from cow's milk potent in inhibiting replication of human rotavirus in vitro

Rotavirus is the major cause of infectious diarrhea in infants and young children all over the world. We have found that a high-M(r) glycoprotein fraction from cow's milk is potent in inhibiting replication of human rotaviruses in vitro. Since the activity seems to be unique and specific, this fraction may be useful as a novel agent for treatment or prevention of rotavirus diarrhea.

[Pharmacokinetic and clinical studies with cefluprenam in the pediatric field. Pediatric Study Group of Gefluprenam]

Evaluation of efficacy and safety of cefluprenam (code number: E1077, abbreviation: CFLP), a newly developed injectable cephem antibiotics was conducted on adult patients with various infections, and followed by the study group organized from 39 institutions in pediatric field, as the drug showed no toxicity problems in suckling animals. Informed consents from legal representatives were obtained prior to the study. 1. Clinical efficacy. Two-hundred eighty one cases were included for analysis of clinical efficacy after 40 cases of exclusion or drop-out were subtracted from a total of 321 cases. However, the cumulative number of cases evaluable for analysis was considered to be 289, because 8 cases that had 2 different diseases at the same time were counted in each category of disease. In the cases in which causative organisms were identified (group A), 148 of 154 cases were rated as good or excellent, with an efficacy rate of 96.1%. As for clinical efficacies by disease, efficacy rates were 6/6 for purulent meningitis, 4/5 for sepsis, 95.7% (62/65) for pneumonia, 100.0% (29/29) for urinary tract infections, and 94.1% (16/17) for skin and soft tissue infections. The rate of excellent responses among excellent and good responses was 73.6% (109/148), showing a higher value than any of recent injectable beta-lactams. On 32 cases with S. pneumoniae infection, the efficacy rate of CFLP was 100.0%. In the cases where causative organisms were not identified (group B), 128 of 135 cases were rated as good or excellent, with an efficacy rate of 94.8%. In the all cases including both the group A and the group B, the efficacy rate was 95.2% (276/289) and the rate of excellent responses among excellent and good response was 70.7% (195/276). Against severe infections, CFLP exhibited excellent clinical efficacy, showing an efficacy rate of 8/8 for meningitis, 3/5 for sepsis and 100.0% (22/22) for severe pneumonia. As for bacteriological responses, eradication rates were 95.2% (177/186) in total. Against Gram-positive cocci, the eradication rate was 92.7% (76/82), with eradication rates of 94.3% (33/35) for Staphylococcus aureus, and 93.3% (28/30) for Streptococcus pneumoniae. Against Gram-negative rods, the eradication rate was 97.1% (101/104), and eradication rates were 100.0% (22/22) for Escherichia coli, 97.5% (39/40) for Haemophilus influenzae and 100.0% (19/19) for Molaxella catarrhalis. In cases in which more than 3 days of treatment with previous chemotherapy resulted in no response, the efficacy rate of CFLP was 94.2% (98/104), rated excellent in 68 cases and good in 30 cases. In these cases, the eradication rate was 98.1% (52/53). 2. Pharmacokinetics. CFLP was intravenously administerrd to 12 subjects at doses of 20 to 40 mg (potency)/kg. In 9 subjects aged more than 12 months, maximum serum levels (Cmax), T 1/2 beta and AUC of CFLP were 155.3 +/- 9.8 micrograms/ml, 1.43 +/- 0.18 hours and 111.7 +/- 15.0 micrograms.hr/ml, respectively, when a dose of 20 mg (potency)/kg was used. In 2 subjects aged not more than 12 months, the mean Cmax, T 1/2 beta and AUC were 153 micrograms/ml, 1.6 hour and 81 micrograms.hr/ml, respectively, at a dose of 20 mg(potency)/kg. The mean Cmax, T 1/2 beta and AUC were 332 micrograms/ml, 0.93 hours and 157.3 micrograms.hr/ml, respectively, in 1 subject at a dose of 40 mg (potency)/kg. In 10 subjects dosed 20 mg (potency)/kg, urinary levels were 2413 +/- 512, 1471 +/- 524, and 470 +/- 115 micrograms/ml in 0-2, 2-4, and 4-6 hours after dosing, respectively, showing a cumulative urinary excretion rate of 61.4 +/- 6.3%. In 1 subject dosed 40 mg (potency)/kg, urinary levels were 5700 and 4770 micrograms/ml in 0-2 p3d 2-4 hours after dosing, respectively, showing a cumulative urinary excretion rate of 42.1%. Cerebrospinal fluid concentrations of CFLP, on 10 subjects with purulent meningitis dosed 40-103 mg (potency)/kg were 3.2-32.9 micrograms/ml at 0.5-2 hours after administration within 4 days after the onset of

Improved skin blood flow and cutaneous temperature in the foot of a patient with arteriosclerosis obliterans by vasopressin V1 antagonist (OPC21268). A case report

A seventy-four-year-old woman with arteriosclerosis obliterans, diabetes mellitus, and hypertension was admitted for the treatment of intermittent claudication and coldness and pain in the right lower extremity. After the administration of a vasopressin V1 antagonist, OPC21268, the symptoms were markedly improved. Furthermore, blood flow in the dorsalis pedis artery and the cutaneous temperature in the right foot increased in response to acute and chronic administration of OPC21268. OPC21268 may be a new useful therapeutic tool for the treatment of arteriosclerosis obliterans.

Electrophysiological responses of Xenopus oocytes to amino acids: criteria for expression of injected mRNA coding chemoreceptors

Responses of endogenous transporters/receptors of Xenopus oocytes to L-alanine, L-arginine, L-leucine and L-serine were investigated under voltage clamp conditions. (a) Concentration-response relations for the amino acids followed Langmuir's adsorption isotherm. (b) The neutral amino acids required Na+ to elicit the responses, whereas L-arginine did not. (c) The responses to L-alanine decreased with decreasing pH and became undetectable at pH 5.5. The present experiments supply criteria to judge if the oocytes translate exogenous mRNA coding taste or olfactory receptor proteins for the amino acids, the best characterized stimuli, especially in fishes.

[Studies of emergency cardiopulmonary bypass (ECPB) for cardiopulmonary-cerebral resuscitation--(3). Neurological outcome and pathological changes of the brain]

Neurological outcome and pathological changes of the brain were studied in 5 female mongrel dogs, which were subjected to normothermic ventricular fibrillation (Vf) cardiac arrest of 15 min and resuscitated by using cardiopulmonary bypass through the femoral artery and veins (F-F bypass). Spontaneous circulation was restored by one or two defibrillating countershocks in all 5 dogs 5.2 +/- 1.1 (mean +/- SD) min after initiation of the F-F bypass. The F-F partial bypass was continued for 164 +/- 30 min under mild hypothermia. After weaning from the bypass, intensive care including controlled ventilation was carried out for the subsequent 6 to 36 h. Intermittent slow waves appeared on the electroencephalogram 62.8 +/- 11.6 min after initiation of the F-F bypass resuscitation and continuous waves at 145.6 +/- 27.5 min. Soon after extubation, the animals barked, moved the forelegs and could drink water. Neurological deficit scores (normal: 0, brain death: 500) improved to become below 100 except in 1 dog. However, macroscopic examination of the brain in 2 dogs with prominent recovery disclosed atrophy of the central gyrus and microscopic examination revealed typical ischemic injuries of the vulnerable neurons at the cerebellum, hippocampus and cerebral cortex in the frontal lobe.

Thyroid ultrasonography related to clinical and laboratory findings in patients with silent thyroiditis

We summarized the clinical course of 10 patients with silent thyroiditis and evaluated the clinical usefulness of ultrasonography, in combination with clinical and laboratory findings, for the differentiation from Graves' disease. Serum T3 and T4 were increased in all cases, and the ratio of T3/T4 (ng/micrograms) was 17.8 +/- 3.6 (SD). But in 3 of 10 patients the ratio was greater that 20. TSH receptor antibody (TRAb) and thyroid stimulating antibody (TSAb) were negative in all cases. The estimated thyroid volume by ultrasonography was 18.4 +/- 5.5 ml, which was slightly increased but significantly lower than those in Graves' disease (p less than 0.05). The internal texture of the thyroid showed a decreased echogenicity with a mean echo level of 70.4 +/- 15.4. There was a weak positive correlation between the echo level at the onset of thyrotoxicosis and the lowest T3 level during the clinical course (p less than 0.05). It is suggested that ultrasonography gives a useful information to the diagnosis and outcome of patients with silent thyroiditis.

Eosinophilic neuronal inclusion bodies in the temporal lobe

Intracytoplasmic neuronal inclusion bodies were found in the temporal lobe of an elderly woman. The oval or rod-shaped inclusion bodies were eosinophilic, showed bright red staining with azan, and were about half the size of the nucleus of a large neuron. They were non-argyrophilic and non-congophilic. Ultrastructurally, the inclusion bodies consisted of aggregates of filamentous materials showing partial periodicity. Among inclusion bodies reported up to now, the present ones resembled some described previously as "thalamic inclusions", but were different with regard to their partial filament periodicity, and unusual in that they were located in the deep layer of the temporal lobe and not in the thalamic nuclei.

Synaptic currents at interpositorubral and corticorubral excitatory synapses measured by a new iterative single-electrode voltage-clamp method

A new iterative single-electrode voltage clamp method was applied to the measurement of synaptic currents in the red nucleus (RN) neuron of the cat. Voltage clamp was attained within 10 repetitions with great stability and the new algorithm was demonstrated to be superior to the original algorithm of iterative voltage clamp. With a conventional microelectrode, it was possible to measure the synaptic current with the time resolution of 50 microseconds. The synaptic currents evoked by stimulation of the contralateral interpositus nucleus (IP) had time-to-peak ranging from 200 to 540 microseconds and fitted well to alpha functions. Corticorubral (CR) synaptic current was also measured by making use of synaptic plasticity. The stimulation of the ipsilateral cerebral peduncle in cats with chronic lesion of the contralateral IP evoked fast rising EPSPs, as reported previously. The CR-EPSPs with times-to-peak less than 1 ms were subjected to voltage clamp. The CR synaptic currents had times-to-peak ranging from 350 to 880 microseconds. Since most of the interpositorubral (IR) synapses and a part of the CR synapses in IP-lesioned cats are situated on the somatic membrane of RN neurons and some of the CR synaptic currents were as rapid as the IR synaptic currents, the observed synaptic currents evoked by stimulation of the IP and those of the fast-rising CR-EPSPs were taken to originate from the synaptic membrane under space-clamp, i.e. soma. The present study provided additional evidence for the sprouting of the CR fibers as well as the time course of the synaptic current at the dendritic synapses remote from the soma, for the first time.

The inhibitory effect of lipid peroxide on the activity of the membrane-bound and the solubilized lipoprotein lipase

The effects of lipid peroxide (15-hydroperoxy arachidonic acid) on the activity of lipoprotein lipase was investigated. The activities were examined in 2 enzyme species: the lipoprotein lipase bound to the coronary vessels of the rat heart and that solubilized in the human post-heparin plasma. As a substrate, 3H-labelled human chylomicron was used. Lipid peroxide decreased the maximal velocity of the reaction between the chylomicron and lipoprotein lipase on the vascular surface. In the post-heparin plasma, the lipid peroxide decreased the maximal hydrolysis rate, but did not change the half life time in the unsaturated reaction. It is suggested that lipid peroxide directly damages a part of the membrane-bound lipoprotein lipase, and that the degeneration of cell membranes and the vasoconstriction caused by lipid peroxide will additionally disturb the hydrolysis of the plasma triglyceride on the vascular surface.