bluuebunny/crossref_metadata_2025 huggingface dataset:
C283Y gamma‐sarcoglycan gene mutation in the Bulgarian Roma (Gypsy) population: prevalence study and carrier screening in a high‐risk community
Authors: Georgieva B , Todorova A , Tournev I , Mitev V , Kremensky I
Published: October 2004

Limb‐girdle muscular dystrophy type 2C (LGMD2C) is caused by mutations in the gamma‐sarcoglycan gene where a founder Gypsy mutation C283Y was detected. The Bulgarian Gypsy LGMD2C patients, as the Gypsy patients from other countries, were found to be homozygous for this mutation. Considering the large number of Gypsies in Bulgaria and the high percent of consanguinity and endogamy a raised carrier frequency of the C283Y mutation was expected especially in North‐Eastern Bulgaria where most of the patients originate from. Here, we present the precise geographic distribution of the C283Y mutation in the general Roma population from the whole Bulgarian territory by determining the carrier frequency of the mutation in dry blood newborn samples. Our results show that the geographic distribution of this founder mutation and the disease are not geographically restricted only among Gypsies from North‐Eastern Bulgaria. We stress upon the regions with detected high carrier and/or disease frequency and upon the results from the performed carrier screening on volunteers in one of these regions. The ongoing carrier‐screening programs in isolated Gypsy groups would be of a great benefit for the genetic prophylaxis of the disease. Such regions should be with priority in the Bulgarian healthcare system for performing a carrier‐screening program.
Familial colloid cysts of the third ventricle
Authors: Partington MW , Bookalil AJ
Published: October 2004

A father and daughter with colloid cysts of the third ventricle are described. The nine previously reported examples of familial occurrence are reviewed, and the conclusion is reached that inheritance is likely autosomal dominant. The proportion of all cases which are genetic is not known. A plea is made for routine detailed and thorough family histories on all patients with such cysts and a high index of suspicion for non‐specific symptoms in relatives such as headaches, migraine, depression, anxiety, nausea and vomiting.
Growing bone knowledge
Authors: Superti‐Furga A
Published: October 2004

Molecular dissection of genetic bone diseases continues to deliver exciting insights on developmental control of skeletal patterning and growth. But will diagnostic tests become available to the genetic community on a wide basis?
General paediatricians and the case of resolving peanut allergy
Authors: Rangaraj Satyapal , Ramanathan Veena , Tuthill David P. , Spear Elizabeth , Hourihane Jonathan O'B , Alfaham Mazin
Published: October 2004

Children with peanut allergy are almost always advised to avoid nuts for life. There have been recent reports from academic centres that in some cases the allergy might resolve and thus these dietary restrictions can be lifted. To evaluate resolution of peanut allergy in a selected group of children in a general paediatric setting. Children 4–16 yr old with a clear history of an allergic reaction to peanuts who had not had any reaction in the previous 2 yr were eligible. Specific immunoglobulin E (IgE) or skin prick test (SPT) at the time of diagnosis was sought. A SPT and specific IgE was then done and if this was ≤8 mm and ≤17.5 kU[A]/l respectively, a double‐blind placebo‐controlled food challenge was undertaken. A negative challenge consisted of tolerance to a cumulative dose of 15.8 g peanuts followed by an open challenge. From the 82 case notes reviewed 54 children were eligible to participate. Twenty‐nine agreed to participate and underwent SPT (29) and specific IgE (28). Of these children eight were eligible for food challenge. Four challenges were negative and four positive. Peanut allergy may resolve in approximately 15% of selected children attending an allergy clinic run by general paediatricians in a district general hospital. Food challenge constitutes the appropriate way of removing the burden that comes with a diagnosis of peanut allergy and enables dietary restriction to cease.
The occurrence of mite‐containing wheat flour
Authors: Matsumoto Tomoaki , Satoh Ayumi
Published: October 2004

Anaphylaxis after eating mite‐infested wheat flour has been recently reported. This paper is to describe two cases and examine the occurrence of mite contamination in wheat flour in Japan. Packages of wheat flour from retail outlets and homes were examined microscopically for the presence of mites. Three of 176 packages from retail outlets and seven of 127 from homes were infested with mites, and it seems likely that the mite contamination takes place in most cases at homes after the packages have been opened. No mites were found in packages stored in a refrigerator, therefore, mite‐sensitive patients must be advised to store wheat flour products in a refrigerator.
Dermatophagoides‐induced interleukin‐10 production by peripheral blood lymphocytes from patients with asthma in remission
Authors: Noma Takeshi , Sugawara Yoko , Ogawa Norifumi , Saeki Tosiaki , Yamaguchi Koichi , Kawano Yutaka
Published: October 2004

Interleukin (IL)‐10 is a cytokine that regulates inflammatory responses. We studied the role of IL‐10 in the development of tolerance to Dermatophagoides farinae in asthma patients in remission, since asthma improves in most children during adolescence. The spontaneous production of IL‐10 by cultured peripheral blood mononuclear cells (PBMC) was higher in patients with active asthma than in normal subjects. IL‐10 production decreased when 1 μg/ml D. farinae was added to cultures, but increased again in a dose‐dependent manner when higher concentrations of D. farinae were added. In patients with remission of asthma, IL‐10 production was lower than in patients with active asthma. However, production of IL‐10 showed a reciprocal increase in the presence of 1 μg/ml D. farinae, and decreased again at 10 and 50 μg/ml D. farinae. Such alterations were not observed in normal subjects. Cell lines established from patients asthma in remission showed higher IL‐10 production when compared with that by cell lines from normal subjects or patients with active asthma when the cells were stimulated by D. farinae at 1 or 10 μg/ml. Neutralization of IL‐10 led to revival of the D. farinae‐specific proliferative response of PBMC from patients in remission, which was otherwise decreased. The increase of IL‐10 production stimulated by D. farinae was inhibited by addition of an anti‐IL‐10 antibody. In contrast, antigen‐induced interferon (IFN)‐γ production, which was increased by D. farinae stimulation when patients were in remission, did not increase after treatment with anti‐IL‐10, although spontaneous IFN‐γ production increased to the level seen after D. farinae stimulation. The reduced IL‐4 production by cells from patients in remission after stimulation with D. farinae antigen, which was significantly higher in active patients, was not reversed by neutralization of IL‐10. The D. farinae‐induced IL‐10/IL‐4 production ratio, but not the IL‐10/IL‐5 production ratio, may be a significant indicator for evaluation of whether a patient has been in remission. In conclusion, D. farinae‐specific anergy of T cells is likely to be induced by increased levels of IL‐10 and IFN‐γ that are initially produced by specific T cells after exposure to relevant mite allergen in patients in remission.
BCG vaccine modulates intestinal and systemic response to β‐lactoglobulin
Authors: Rytkönen Jani , Karttunen Tuomo J. , Karttunen Riitta , Valkonen Kaija H. , Björkstén Bengt , Kokkonen Jorma
Published: October 2004

β‐Lactoglobulin (BLG) is a clinically important antigen in cow's milk and one of the major allergens causing cow's milk allergy. Bacillus Calmette‐Guérin (BCG) vaccination has been suggested to modify immune response possibly decreasing the risk of allergy to some antigens in both human and experimental animals. In the present study, we have analyzed whether the early BCG vaccination has any effect on the markers of systemic and gastrointestinal (GI) sensitization to BLG. We immunized two groups of Hooded‐Lister rat puppets with intraperitoneal injections of native BLG at 43 and 62 days with pertussis vaccine as adjuvant, one group receiving additionally BCG. The animals were then fed native and denatured milk products twice weekly from 73 to 131 days of age, when they were killed. Control group was not vaccinated and received normal rat forage. Total immunoglobulin E (IgE) levels and BLG‐specific IgG1 and IgG2a concentrations were determined in serum samples. Spontaneous interleukin (IL)‐4 and interferon (IFN)‐γ production from duodenal specimens were measured, and the inflammatory cells were quantitated in specimens from different sections of the GI tract. Administration of BCG simultaneously with BLG resulted in reduced IgE concentration in serum, while the specific IgG1 and IgG2a antibody responses and the spontaneous secretion of IL‐4 and IFN‐γ were not affected. Furthermore, BCG‐induced eosinophilic infiltration and increase of intraepithelial lymphocytes (IEL) in the GI mucosa, and a trend toward increased number of lamina propria mononuclear inflammatory cells in the colon (BCG compared with BLG, p = 0.09; BCG compared with controls, p = 0.02). Controls showed increment of IgG1 response in comparison with the BLG group (p = 0.04) and increase of mucosal eosinophilic infiltration. The BCG modified the response to BLG both at the systemic level as shown by decrease of total IgE and at GI mucosa where increase of eosinophilic infiltration and increased number of IEL were seen. Increment of IgG1 level and eosinophils in the controls might be related with the lack of modulatory effect of pertussis vaccination. A shift of response toward the lower GI tract after BCG immunization as shown by a trend for increase of mononuclear inflammatory cells in colon lamina propria mimics disease development in some cases of clinical food allergy, and emphasizes the need for evaluation of the changes in the whole GI tract in food allergy models.
Food allergy and atopic dermatitis in infancy: an epidemiologic study
Authors: Hill D. J. , Hosking C. S.
Published: October 2004

Atopic dermatitis is common in infancy. The role of food allergy in atopic dermatitis of infancy is unclear. We examined the relationship between atopic dermatitis and immunoglobulin E (IgE)‐mediated food allergy in infancy. A birth cohort of 620 infants with a family history of eczema, asthma, hayfever or immediate food allergy in a parent or sibling: 487 children had complete data including skin prick tests (SPTs) to evaluate IgE‐mediated food allergy to cow milk, egg and peanut. Participants were grouped as no atopic dermatitis (Gp 0) or in quartiles of increasing severity of atopic dermatitis (Gps 1–4) quantified by days of topical steroid use as reported monthly. Adverse reactions to foods were recorded. The cumulative prevalence of atopic dermatitis was 28.9% to 12 months (10.3% of the cohort of moderate severity). As atopic dermatitis severity increased so did the prevalence of IgE‐mediated food allergy (Gp 0, 40/346 vs. Gp 1, 6/36 vs. Gp 2, 8/35 vs. Gp 3, 12/35 vs. Gp 4, 24/35; χ2 = 76; p < 10−6), and the frequency of reported adverse food allergy reactions (Gp 0, 43/346 vs. Gp 1, 4/36 vs. Gp 2, 8/35, vs. Gp 3, 5/35, vs. Gp 4, 13/35; χ2 = 17; p = 0.002). The relative risk of an infant with atopic dermatitis having IgE‐mediated food allergy is 5.9 for the most severely affected group. Atopic dermatitis is common in infancy. There is a strong association between IgE‐mediated food allergy and atopic dermatitis in this age group.
Cough, wheezing and asthma in children: lesson from the past
Authors: De Benedictis Fernando Maria , Selvaggio David , De Benedictis Diletta
Published: October 2004

Recurrent cough is an important medical and sometimes frustrating problem encountered by pediatricians, especially if it is not associated with wheeze or other evidence of systemic disease. In the past, many children with chronic cough have been diagnosed as asthmatic. However, epidemiological, clinical and laboratory studies conducted over the last ten years elucidated many aspects of the relationship between cough and bronchoconstriction. It is difficult to make a diagnosis of asthma on cough alone, but the setting in which the patient is seen (i.e., in a primary care setting or ain a specialistic clinic) may address doctors to the right diagnosis. A prudent ‘‘wait and see’’ approach may be useful in many occasions.
Antimicrobial susceptibility of skin‐colonizing S. aureus strains in children with atopic dermatitis
Authors: Hoeger Peter H.
Published: October 2004

Children with atopic dermatitis (AD) are prone to recurrent cutaneous and occasional systemic infections caused by Staphylococcus aureus. Antibiotic therapy represents an important component of the overall management of AD, especially during exacerbations of disease. Erythromycin is still widely used as a first‐line antibiotic for this indication. We studied 115 consecutive children (mean age: 2.7 yr, range: 0.2–15) with moderate to severe AD (mean SCORAD: 43.2, range: 16–77) presenting to our outpatient department. Staphylococcus aureus was isolated from 100 of 115 (87%). Antimicrobial susceptibility testing revealed resistance against erythromycin in 18 and against roxithromycin in 19%, respectively. Six percentage of the strains were resistant or only intermediately susceptible to fusidic acid, 13% to amoxicillin and 1% to clindamycin. All strains isolated were susceptible to oxacillin, amoxicillin/clavulanic acid, cefadroxil and cefuroxim. The high rate of primary resistance to macrolides should be born in mind when starting antibiotic therapy in children with AD. Since Gram‐positive cocci represent the only relevant microbial agents in AD, first generation cephalosporins such as cefadroxil, whose antimicrobial spectrum is basically restricted to Gram‐positive bacteria, would appear to be the ideal first‐line antibiotics for the treatment of bacterial superinfections.
Montelukast and airway remodeling in children with chronic persistent asthma: an open study
Authors: Pifferi Massimo , Caramella Davide , Ragazzo Vincenzo , Marco Emanuela De , Pietrobelli Angelo , Boner Attilio L.
Published: October 2004

We report a 4 yr follow up study of seven asthmatic children with chronic persistent asthma, high‐residual volume and low‐density areas at high‐resolution computerized tomography after treatment with salmeterol and fluticasone. Improvement of lung function with disappearance of low‐density areas in six patients after treatment with fluticasone and montelukast was obtained.
Tolerance of heat‐treated kiwi by children with kiwifruit allergy
Authors: Fiocchi Alessandro , Restani Patrizia , Bernardo Luca , Martelli Alberto , Ballabio Cinzia , D'Auria Enza , Riva Enrica
Published: October 2004

Kiwifruit allergy is increasing among children but whether heating affects clinical tolerance to kiwifruit is unknown. To assess tolerance to heated kiwifruit in children allergic to fresh kiwifruit. In this prospective trial, 20 children (median age 9.4 yr) with a history of immediate allergic reactions to fresh kiwifruit underwent double‐blind placebo‐controlled food challenges with steam‐cooked (100 °C for 5′) and industrially homogenised kiwifruit. Skin prick tests with a commercial kiwifruit allergen, raw kiwifruit and double‐blind placebo‐controlled food challenge with 25 g of fresh kiwifruit were used to confirm the history. Specific kiwifruit IgE to native and homogenized fruit were identified by immunoblotting. Fresh kiwifruit induced positive skin prick wheals in all children (confirmed during challenge in 19 patients). Commercial skin prick test elicited a positive response in five children, steam‐cooked kiwifruit in five, and the homogenised kiwifruit preparation in none. UniCAP© determinations were positive for kiwifruit in three patients. All children's sera showed specific IgE at immunoblotting with raw kiwifruit and one with the homogenised preparation (major allergens identified: Act c 1 and Act c 2). There was no clinical reactivity following challenge with homogenised kiwifruit but one child reacted to cooked kiwifruit challenge. Industrial heat treatment and homogenisation can make kiwifruit safe for children who are allergic to this increasingly popular fruit. This has dietary implications for children who are allergic to several fruit and vegetable proteins.
The diagnostic value of skin prick testing in children with food allergy
Authors: Hill David J. , Heine Ralf G. , Hosking Clifford S.
Published: October 2004

The diagnostic accuracy of the skin prick test (SPT) in food allergy is controversial. We have developed diagnostic cut‐off levels for SPT in children with allergy to cow milk, egg and peanut. Based on 555 open food challenges in 467 children (median age 3.0 yr) we defined food‐specific SPT weal diameters that were ‘100% diagnostic’ for allergy to cow milk (≥8 mm), egg (≥7 mm) and peanut (≥8 mm). In children <2 yr of age, the corresponding weal diameters were ≥6 mm, ≥5 mm and ≥4 mm, respectively. These SPT cut‐off levels were prospectively validated in 90 consecutive children ≤2 yr with challenge‐proven food allergy. In young infants under 6 months of age who have not previously been exposed to a particular food item, the SPT were often negative or below the diagnostic cut‐off but reached the diagnostic cut‐off at the time of challenge in the second year of life. We assessed the diagnostic agreement between food‐specific immunoglobulin E (IgE) antibody levels and SPT in a cohort of 820 infants and children under 2 yr of age (median age 13.1 months) with suspected allergy to cow milk, egg or peanut. When applying published 95%‐positive predictive CAP values, the diagnostic accuracy of SPT and IgE antibody levels was similar for cow milk, but SPT was more sensitive in diagnosing allergy to egg (p < 0.0001) and peanut (p < 0.0001). Further studies are required to define age‐specific diagnostic IgE antibody and SPT cut‐off levels use in infants under 2 yr of age with suspected food allergies.
Influence of MMR‐vaccinations and diseases on atopic sensitization and allergic symptoms in Swiss schoolchildren
Authors: Roost H.‐P. , Gassner M. , Grize L. , Wüthrich B. , Sennhauser F. H. , Varonier H. S. , Zimmermann H. , Braun‐Fahrländer Ch. ,   the SCARPOL‐team
Published: October 2004

The prevalence of asthma and allergic disease has increased in many countries. It has been proposed that vaccinations may contribute to the development of allergic disease by reducing clinical infections in infancy or through the direct IgE‐inducing effects of the vaccines. Evidence for a potential role of immunizations in the development of allergic disease is scarce. Therefore the objective was to study the associations between vaccinations against measles, mumps and rubella (MMR), natural infections of these diseases and atopic sensitization to indoor and outdoor allergens and allergic symptoms in schoolchildren. The cross‐sectional study including 1537 8th grade school children aged 13–15 years living in 10 communities across Switzerland was organized in the framework of an environmental health surveillance program within the School Health Services (Swiss Surveillance Program of Childhood Asthma and Allergies with respect to Air Pollution and Climate, SCARPOL). Main outcome measures were asthma and sneezing during pollen season assessed by parental questionnaires and atopic sensitization determined by IgE concentrations to various allergens. It was found that parents' reported history of measles or mumps was associated with a stronger immune response than two or more vaccinations against the respective infection (measles: geometric mean IgG titers (GMT) lU/ml (95% Cl) 2.8 (2.0–3.9) vs. 1.2 (1.0–1.4), mumps: GMT PE/ml (95% Cl) 16.3 (13.9–19.1) vs. 8.5 (6.1–11.7). With respect to atopic sensitization similar associations for exposure by natural MMR‐infections or MMR‐vaccinations were found: measles: OR (95% Cl) 1.02 (0.53–1.96) vs. 1.22 (0.69–2.16), mumps: 0.59 (0.38–0.93) vs. 0.79 (0.49–1.27), rubella: 0.93 (0.61–1.43) vs. 0.95 (0.66–1.37), respectively. Inverse relationships were found between the risk of asthma and a positive disease history or vaccination of measles 0.36 (0.14–0.91) vs. 0.45 (0.21–0.98) or a positive serum titer against measles 0.65 (0.35–1.20). From the present study can be concluded that exposure by MMR‐vaccinations or natural MMR‐infections in childhood does not increase the risk of sensitization to common allergens as well as to allergic respiratory diseases. MMR‐vaccinations or natural MMR‐infections are therefore an unlikely factor contributing to the increase in atopic disease in developed countries.
An evaluation of the diagnostic value of different skin tests with egg in clinically egg‐allergic children having atopic dermatitis
Authors: Hansen Tine K. , Høst Arne , Bindslev‐Jensen Carsten
Published: October 2004

Skin testing is a common diagnostic procedure in food allergy, but the final diagnosis of food allergy is based on the clinical response to food challenge. We studied the value of the skin prick‐prick test (SPT), skin application food test (SAFT) and atopy patch test (APT) with fresh egg extract in diagnosing egg allergy. Ten clinically egg‐allergic children with atopic dermatitis (AD; age 10 months to 8.4 yr, mean 3.4 yr) and 10 egg‐tolerant children with and 10 without AD (age 2.4–11 yr, mean 5.5 yr) participated. In SAFT several false‐negative reactions were seen, whereas all clinically egg‐allergic children were positive in SPT and 40–60% in APT. In APT and in SPT false‐positive reactions to egg were observed. In this study comprising a small number of patients including control subjects, neither SAFT nor APT with fresh whole egg extract were able to increase the diagnostic accuracy in detecting egg‐allergic children with AD compared with SPT.
Effect of BCG vaccination in asthmatic schoolchildren
Authors: Vargas Mario H. , Bernal‐Alcántara Demetrio A. , Vaca Miguel A. , Franco‐Marina Francisco , Lascurain Ricardo
Published: October 2004

Recent studies have explored the effect of Bacilli Calmette‐Guerin (BCG) or Mycobacterium vaccae vaccination in asthmatic patients, yielding conflicting results. We investigated the effect of BCG vaccination in asthmatic schoolchildren, especially focusing on the cytokine pattern released by mononuclear cells. After a 1‐yr run‐in period, 67 asthmatic schoolchildren received intradermal immunization with BCG (33 patients) or placebo (34 patients). Both groups were followed during 1 yr. Serum immunoglobulin E (IgE) levels did not change after BCG (407.1 ± 86.6 vs. 415.1 ± 86.7 IU/ml, mean ± s.e.m.), but increased after placebo (406.7 ± 67.0 vs. 619.7 ± 90.7 IU/ml, p = 0.001) administration. Interleukin (IL)‐4 and interferon (IFN)‐γ measured in the supernatant of stimulated cultured blood mononuclear cells did not change in the BCG group (10.8 ± 2.3 vs. 17.9 ± 5.7 pg/ml, and 348.6 ± 118.0 vs. 354.8 ± 139.0 pg/ml, respectively), while in the control group IL‐4 increased (from 6.7 ± 1.3 to 16.1 ± 6.0 pg/ml, p < 0.05), and IFN‐γ decreased (from 279.9 ± 82.1 to 232.1 ± 109.6 pg/ml, p = 0.01). In comparison with their initial status, most patients maintained the same asthma severity and the same proportion of emergency room visits at the end of the study. The proportion of those in whom asthma improved or worsened was the same in both groups. We concluded that, contrary to the common hypothesis, BCG vaccination in asthmatic children was unable to cause a long‐term reinforcement of Th1 response, although it could avoid the increased Th2 response observed in control patients.
Specific immunoglobulin E antibodies to peanut over time in relation to peanut intake, symptoms and age
Authors: van Odijk J. , Bengtsson U. , Borres M. P. , Hulthén L. , Ahlstedt S.
Published: October 2004

The clinical outcome of peanut allergy and some factors associated with development of peanut allergy remain unsolved. It has not been clarified to what extent peanut intake affects immunoglobulin (IgE) antibody formation in peanut sensitized individuals. The aim of the study was to investigate the development of peanut hypersensitivity in children and adolescents with specific IgE antibodies to peanut, using questionnaires and current serum tests and comparing it to information obtained 5–6 yr earlier, to investigate how peanut intake during this period related to subject age, IgE antibody levels and symptoms and to investigate what information this patient group was given at the time of diagnosis regarding avoidance of peanut related food. All patients with detectable peanut‐specific IgE antibodies investigated during 1994–1996 deriving from two allergy laboratories in the western region of Sweden were traced and reinvestigated (n=132). A total of 111 subjects (63 with peanut allergy and 48 peanut sensitized) participated in the questionnaire. Eighty‐six of them consented to be enrolled in a further interview and renewed testing of specific IgE antibody to peanut 5 yr later. All tests were done using the Pharmacia CAP system®. Increased IgE antibody levels during follow‐up was related to age; subjects 0–6 yr at initial test occasion were more likely to have higher IgE antibody class than the older individuals (p=0.018). Exposure to peanut during the study, i.e. 5–6 yr since diagnosis, did not seem to affect the result. During the follow‐up period, 29 out of 86 (34%) increased their IgE antibody class. At the second test occasion the remaining subjects had similar (28%) or lowered (38%) levels of IgE antibodies. Exposure to peanut during follow‐up was more common in subjects with IgE antibody class 1–3 compared to subjects with high value (>3) at the initial test (p=0.003). Reported symptoms during follow‐up were also more common in subjects with initially high IgE antibody value. Individuals with initially high IgE antibodies to peanut had been given more information about peanut allergy and cross‐reacting allergens than other individuals. The subjects over 6 yr of age showed a decrease in peanut‐specific IgE class over a 5‐yr period. Together with the literature, our result suggest that follow‐up and renewed testing is recommended, since there may be a change in IgE antibody classes and clinical sensitivity over time. Even in Sweden, with a low consumption of peanuts, the youngest individuals with peanut sensitization experienced a similar course of events that has been reported in other countries.
Coughing in pre‐school children in general practice: When are RAST's for inhalation allergy indicated?
Authors: Eysink Petra E. D. , Bottema Ben J. A. M. , Ter Riet Gerben , Aalberse Rob C. , Stapel Steven O. , Bindels Patrick J. E.
Published: October 2004

To identify patterns of clinical history associated with extreme (high or low) probabilities of allergic sensitization in coughing children so as to restrict allergy testing to those with an intermediate probability of sensitization. A total of 752 children, aged 1–4, visiting their GPs for coughing (≥5 days), were tested for IgE‐antibodies to house dust mite, cat and dog [RadioAllergoSorbent Test (RAST)]. Parents completed a questionnaire on family history of atopy, breastfeeding, smoking, pets, and floor covering. Data of 640 children could be analyzed, 83 (13%) were IgE‐positive. In a logistic regression analysis, a scoring formula for the prediction of being IgE‐positive was constructed using variables from the patient's history. Significant contributors for sensitization were: age (3–4 yr), infantile eczema, positive family history of mite‐allergy, sibling(s) with pollen‐allergy, and smoking by parents. If only one of these characteristics is present, the probability of sensitization is <25%. In such cases watchful waiting may be preferred over allergy testing. In other cases, a negative RAST may help to exclude sensitization, whereas a positive RAST helps to establish the diagnosis. Thus, acting on clinical history alone may save approximately 80% of RAST's. Patient history‐derived information contributes to distinguishing children who are at low risk for sensitization to house dust mite, cat, and dog. The scoring formula may help GPs to identify children with a low probability of being sensitized. This may form the basis for watchful waiting. In others, allergy testing may be useful to gain more diagnostic certainty.
Exploring the effects of psychosocial and acculturation factors on drinking behavior among aboriginal adolescents in Taiwan
Authors: YEH MEI‐YU
Published: October 2004

Abstract  The purpose of this study was to examine the effects of psychosocial and acculturation factors on drinking behavior among Taiwanese aboriginal teenagers. Stratified random sampling was used to select six of the 19 aboriginal schools in Taipei, Pingtung, Hualien, and Taitung counties. A total of 495 student subjects were enrolled in the study, including 290 boys and 205 girls, with classification by tribe of 206 Amis, 97 Atayal, 94 Paiwan, 47 Bunun, 19 Rukai, 15 Yami, 10 Puyuma, two Saisiyat, one Tsou, and four unknown. The analysis indicated that the psychosocial and acculturation factors that directly influenced drinking behaviors of aboriginal teenagers were: self‐efficacy, drinking behaviors of parents, peer alcohol use, social assimilation, social attitude, and territorial attitude. In this model, peer alcohol use had the most prominent impact on drinking behavior among aboriginal teenagers. The findings suggest that parents’ behaviors play a significant role in the development of problematic drinking behavior in the aboriginal teenager through observation and imitation, and also that self‐efficacy and the level of acculturation influences drinking behavior in aboriginal teenagers.
The possible factors affecting suicide attempts in the different phases of the menstrual cycle
Authors: ÇAYKÖYlÜ ALI , ÇAPOGLU ILYAS , ÖZTÜRK ISIK
Published: October 2004

Abstract  This study was designed to investigate whether there is a relationship between the menstrual cycle and suicide attempts, and to determine the factors affecting suicide attempts in different phases of the menstrual cycle. The study sample included 52 women who were admitted to the emergency room because of a suicide attempt. The incidence of suicide attempts in menstrual follicular phase (MFP) was significantly higher than in other phases. No significant difference of socio‐demographic and clinical characteristics was observed between MFP and the other phases. Also, hormone levels of patients who attempted suicide were not different from those of healthy control subjects. In spite of the fact that suicide attempts were often made in MFP, there was substantial difficulty in explaining why this frequency was different than other phases. Furthermore, the event may be linked to low estrogen and progesterone levels in this phase. It has, however, been thought that hormonal effects cannot be responsible alone for suicide attempts.
Impairment of recognition memory in schizophrenia: Event‐related potential study using a continuous recognition task
Authors: KIM MYUNG‐SUN , KWON JUN SOO , KANG SEUNG‐SUK , YOUN TAK , KANG KYUNG‐WHUN
Published: October 2004

Abstract  Recognition memory and the dissociation of immediate and delayed repetition in schizophrenic patients were investigated using event‐related potential (ERP) and a continuous word recognition task. In total, 14 schizophrenic patients and 14 age and gender‐matched control subjects, were recruited. Among 240 stimulus words used, 40 words were not repeated, 100 were repeated immediately, and 100 were repeated after five intervening words. Both schizophrenic and control groups responded faster to words repeated immediately than to words repeated after a delay and to new words. However, schizophrenic patients responded less accurately to words repeated immediately and to words repeated after a delay than the controls. In terms of ERP, schizophrenic patients showed significantly reduced N200, late positive component (LPC), and N400 amplitudes, and a more frontally‐distributed N200 topography than the controls. For controls, immediate repetition was associated with a large LPC amplitude and the absence of N400, while delayed repetition was associated with a small LPC amplitude and the presence of N400. However, this dissociation between immediate and delayed repetition was not observed in schizophrenic patients. All of these results suggest that schizophrenic patients have recognition memory impairment, the cause of which may range from early encoding, and memory search to late retrieval.
Autochthonous experience, heightened awareness, and perception distortion in patients with schizophrenia: a symptomatological study
Authors: HONDA TERUYUKI , SUZUKI HIROSHI , IWAI KEIJI , FUJIWARA YUTAKA , KAWAHARA HIROKO , KURODA SHIGETOSHI
Published: October 2004

Abstract  ‘Early symptoms of schizophrenia’ (ESS) proposed by Nakayasu, are present during schizophrenic prodromal periods. Some of these symptoms can continue after the florid manifestation of the disease and the patients often experience them with ego‐alien feelings. Autochthonous experience, heightened awareness, and perception distortion (AHP) were selected from the list of ESS. The aim of this study was to confirm both prevalence and specificity of AHP in patients with schizophrenia as well as the relevance of the presence of AHP to symptomatology of schizophrenia. A structured interview was conducted to identify the presence of AHP in three groups of subjects; a schizophrenia group (Sc) with 37 patients, an affective disorder group (AD) with 27 patients, and a control group (NC) with 39 people. The prevalence of AHP was compared among the groups. Within the Sc, the relevance of AHP to Brief Psychiatric Rating Scale (BPRS) was assessed. AHP were present significantly more frequently in the Sc. The total scores for BPRS in the schizophrenic patients with AHP were significantly higher than in the patients without AHP. There was close correlation between AHP and BPRS items, with the degree of relevance depending on the form or perceptual domain. In conclusion, AHP were characteristic of patients with frank schizophrenia. To judge whether AHP were adequately specific to frank schizophrenia, further research of larger subjects is needed. Understanding the characteristics of AHP in patients with frank schizophrenia is important in the symptomatological evaluation of schizophrenia.
Inter‐episode mood lability in mood disorders: residual symptom or natural course of illness?
Authors: BENAZZI FRANCO
Published: October 2004

Abstract  Residual depressive symptoms are common in mood disorders. Inter‐episode mood lability (IML; i.e. frequent ups and downs of mood) is understudied as a possible residual symptom. The study aim was to find the frequency of IML, and to find if it was more likely to be a residual symptom or if it was instead part of the natural course of mood disorders. Consecutive 89 bipolar‐II (BP‐II) and 89 major depressive disorder (MDD) outpatients who were not on psychoactive drugs, were interviewed by the Structured Clinical Interview for the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders as modified by Benazzi and Akiskal. Kraepelin's basic definition of IML (i.e. frequent up and down fluctuations of mood between episodes) was followed. IML was present in 48.3% of the patients, significantly more common in BP‐II than in MDD (62.9% vs. 33.7%, P= 0.000). The sample of BP‐II and MDD plus IML, versus the sample BP‐II and MDD without IML, had significantly more BP‐II, lower age at onset, longer illness duration, more depressive recurrences, more depressions with atypical features, more depressive mixed states, and more family history of mood disorders. Logistic regression of IML versus recurrences, controlled for duration of illness, found odds ratio = 1.8, z= 1.6, P= 0.103. Forward stepwise multiple logistic regression of IML versus the variables found significant in the univariate analysis, showed that only BP‐II (P = 0.002) and duration of illness (P = 0.015) were significant predictors of IML. IML was common in mood disorder outpatients. Its association with BP‐II (an unstable disorder by definition) and duration of illness (but not with recurrences when controlled for illness duration), suggest that IML may be more likely to be part of the natural course of illness than the result of kindling induced by recurrences. Its association with depressive mixed state (a depression reported to be more difficult to treat) and the possibility that it may induce/facilitate recurrences (to be shown by prospective studies), support the need to better study IML for its possible important impact on treatment.
Attention deficit hyperactivity symptoms and Internet addiction
Authors: YOO HEE JEONG , CHO SOO CHURL , HA JIHYUN , YUNE SOOK KYUNG , KIM SEOG JU , HWANG JAEUK , CHUNG AIN , SUNG YOUNG HOON , LYOO IN KYOON
Published: October 2004

Abstract  The objective of this study was to evaluate the relationship between attention deficit‐hyperactivity/impulsivity symptoms and Internet addiction. In total, 535 elementary school students (264 boys, 271 girls; mean age, 11.0 ± 1.0 years) were recruited. The presence or severity of Internet addiction was assessed by the Young's Internet Addiction test. Parents and teachers of the children completed the DuPaul's attention deficit hyperactivity disorder (ADHD) rating scale (ARS; Korean version, K‐ARS) and Child Behavior Checklists. Children with the highest and lowest quartiles in K‐ARS scores were defined to be in ADHD and non‐ADHD groups, respectively. Five children (0.9%) met criteria for a definite Internet addiction and 75 children (14.0%) met criteria for a probable Internet addiction. K‐ARS scores had significant positive correlations with Young's Internet Addiction test scores. The Internet addiction group had higher total scores of K‐ARS and ADHD‐related subcategories in the Child Behavior Checklists than the non‐addiction group. The ADHD group had higher Internet addiction scores compared with the non‐ADHD group. Therefore, significant associations have been found between the level of ADHD symptoms and the severity of Internet addiction in children. In addition, current findings suggest that the presence of ADHD symptoms, both in inattention and hyperactivity‐impulsivity domains, may be one of the important risk factors for Internet addiction.
Family functioning perceived by patients and their family members in three Diagnostic and Statistical Manual‐IV diagnostic groups
Authors: KOYAMA ASUKA , AKIYAMA TSUYOSHI , MIYAKE YUKO , KURITA HIROSHI
Published: October 2004

Abstract  The aim of this study was to clarify the difference in the perception of family functioning measured on the Family Assessment Device (FAD) by Diagnostic and Statistical Manual‐IV diagnoses (i.e. schizophrenia, major depressive disorder and bipolar disorder) and by raters (patients and family members). The subjects were 70 psychiatric outpatients paired with their family members (i.e. principal caretaker), divided into three groups based on the patient's diagnosis of schizophrenia (24 pairs), major depressive disorder (28 pairs) or bipolar disorder (18 pairs). They rated their perceived family functioning on the FAD. There was no significant difference in perceptions of family functioning between the three groups of family members, while there were differences between the patient groups in some FAD dimensions. Perceptions of family functioning were not significantly correlated between the schizophrenic patients and their family members. The perceptions of family functioning were correlated more strongly between patients and their family members in the bipolar group than between patients and family members in the other two diagnostic groups. As for the FAD Problem Solving dimension, the schizophrenia patients saw it more negatively than did their family members, whereas the depressive patients saw it more positively than did their family members. These results might reflect psychopathological characteristics of each disorder. When clinicians evaluate the family functioning of psychiatric patients, it is important to consider the diagnoses of patients as well as who assesses it.
Quality of life and its correlates in HIV/AIDS male outpatients receiving highly active antiretroviral therapy in Taiwan
Authors: YEN CHENG‐FANG , TSAI JIH‐JIN , LU PO‐LIANG , CHEN YEN‐HSU , CHEN TUN‐CHIEN , CHEN PEI‐PEI , CHEN TYEN‐PO
Published: October 2004

Abstract  Long‐term care of human HIV and AIDS cases has raised quality of life (QoL) issues. The aim of this study was to identify QoL in HIV/AIDS male outpatients receiving highly active antiretroviral therapy (HAART) and its correlates in Taiwan. In total, 41 HIV/AIDS male outpatients receiving HAART yet presenting few symptoms of infection, were recruited for the study. Their QoL levels were measured with the Taiwan version of the Short Form of the World Health Organization Quality of Life questionnaire (WHOQOL‐BREF). The relationships between QoL and demographic characteristics, social support, negative stressors, depression, characteristics of HIV infection, attitude toward HIV infection, and adverse effects of HAART, were examined. The results of the analysis reveal that multiple factors affect QoL for HIV/AIDS male outpatients receiving HAART, including severity of depression, deterioration of work function, inconvenience resulting from medication schedules and medical appointments, lack of social support, negative stressors, and adverse effects of HAART. The results provide screening factors so that clinicians can intervene to improve the QoL for their HIV patients.
Can a less pejorative Chinese translation for schizophrenia reduce stigma? A study of adolescents’ attitudes toward people with schizophrenia
Authors: CHUNG KA FAI , CHAN JOHN HUNG
Published: October 2004

Abstract  The term jing‐shen‐fen‐lie‐zheng (mind‐split‐disease) has been used to denote schizophrenia in Chinese societies. Many Asian countries, where the Chinese writing system is used, adopt a similar translation. This study examined whether a less pejorative name si‐jue‐shi‐diao (dys‐regulation of thought and perception) as a diagnostic label for symptoms of schizophrenia could reduce stigma. Secondary school students (n = 313) were randomly assigned to read a vignette with one of four labels: si‐jue‐shi‐diao, jing‐shen‐fen‐lie‐zheng, jing‐shen‐bin (mental illness), and no label. Students expressed their social distance, stereotypes held, and attributions toward a young adult who met the Diagnostic and Statistical Manual‐IV of Mental Health Disorders criteria for schizophrenia. It was found that psychiatric labeling did not have a statistically significant main effect on attitude measures. However, students with religious beliefs were more accepting toward the target individual associated with diagnostic label than one with no labeling. The results cast doubts that less pejorative labels can reduce the social stigma of schizophrenia. Some potential drawbacks in using politically correct terms to describe schizophrenia are highlighted.
White matter hyperintensities in subjects with bipolar disorder
Authors: AHN KYUNG HEUP , LYOO IN KYOON , LEE HO KYU , SONG IN CHAN , OH JUNG SU , HWANG JAEUK , KWON JUYONG , KIM MINUE J. , KIM MINJEONG , RENSHAW PERRY F.
Published: October 2004

Abstract  There have been divergent reports on the prevalence and severity of white matter hyperintensities (WMH) on brain magnetic resonance (MR) images in subjects with bipolar disorder. In the present study, evaluations were made on the prevalence and severity of WMH in subjects with bipolar disorder using contiguous 3‐mm thick MR slices as well as fluid attenuated inversion recovery (FLAIR) images. A detailed WMH rating system was employed to assess these WMH. A total of 43 bipolar patients, as diagnosed by the Structured Clinical Interview from the Diagnostic and Statistical Manual‐IV (SCID‐IV), and 39 healthy comparison subjects were scanned using a 1.5‐T whole body GE magnetic resonance scanner. WMH were assessed with a modified composite version of the Fazekas’ and Coffey's rating scales to detect less severe WMH. Periventricular and subcortical WMH were coded separately. Subjects with bipolar disorder had greater prevalence of WMH abnormalities than comparison subjects (Bipolar, grade 1 = 11.6%, grade 2 = 9.3%, grade 3 = 7.0%; Comparison, grade 1 = 5.1%, grade 2 = 2.6%, grade 3 = 0%). This difference is mainly due to the differences in deep WMH (Bipolar, grade 1 = 14.0%, grade 2 = 14.0%; Comparison, grade 1 = 7.7%, grade 2 = 0%). The current study confirms the higher prevalence of WMH in subjects with bipolar disorder. Differences of small‐sized WMH abnormalities between groups were successfully detected using a large number of bipolar subjects and thinner sliced MR images with FLAIR.
Where is help sought for depression or suicidal ideation in an elderly population living in a rural area of Japan?
Authors: SAKAMOTO SHINJI , TANAKA ERIKO , NEICHI KEIKO , ONO YUTAKA
Published: October 2004

Abstract  Although suicide is increasingly becoming a social problem in Japan, especially among the elderly, little early intervention or suicide prevention is done. A project was begun which, since 1999, has aimed to detect depression at an early stage as a suicide prevention measure in a model area of Town A, which had a high suicide rate. In order to promote early intervention and prevention in a community, it is important to know where residents seek help if they become depressed or have suicidal ideation. Therefore, in the present study, help‐seeking behavior using case vignettes was investigated. Data from 230 residents (82 men, 148 women) in the model area of Town A, aged 65 or over, were analyzed in the present study. If participants were unable to answer by themselves due to physical condition, public health nurses read out each item and wrote in their answers. The relationship between help‐seeking behavior and demographic variables, psychosocial variables, depressive symptoms and so forth, were examined. The results show that participation in mental health workshops facilitated consultation with specialists (e.g. primary care doctors and nurses). The expected effects of psychoeducation on the general public and specialists were considered.
Long‐term suppression of methamphetamine‐induced c‐Fos expression in rat striatum by the injection of c‐fos antisense oligodeoxynucleotides absorbed in water‐absorbent polymer
Authors: SEMBA JUN’ICHI , WAKUTA MAKI , SUHARA TETSUYA
Published: October 2004

Abstract  The use of water‐absorbent polymer (WAP) as a hydrogel carrier for the slow delivery of antisense oligodeoxynucleotides (ODN) in the brain, was recently developed. In this experiment, 15‐mer phosphorothioate ODN, complementary to c‐fos gene absorbed in WAP, was injected in the rat striatum. The expression of c‐Fos‐immunoreactivity induced by methamphetamine (6 mg/kg, intraperitoneally) around the injection site was suppressed until 5 days after injection. Using this method, it was observed that unilateral injection with c‐fos antisense ODN into the rat striatum caused robust ipsilateral rotations after methamphetamine challenge 4 days post injection. This method is simple, and the biological and behavioral effects of antisense ODN in WAP can be maintained for several days even after a single injection into the brain.