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Ito K.,Aichi Childrens Health and Medical Center
Chemical Immunology and Allergy | Year: 2015

Among grains and legumes, wheat and soybean are the most frequent and well-characterized allergenic foods. Wheat proteins are divided into water/salt-soluble and water/salt-insoluble (gluten) fractions. The most dominant allergen in the former is α-amylase/trypsin inhibitor, which acts as an inhaled allergen causing baker's asthma. Gluten allergens, including ω-5 gliadin and high- and low-molecular-weight glutenins, contribute to wheat-dependent exercise-induced anaphylaxis in adults and immediate-type wheat allergies, including anaphylaxis, in children. Recently, wheat allergies exclusively caused by hydrolyzed wheat proteins or deamidated glutens have been reported, and the presence of unique IgE-binding epitopes has been suggested. Soybean allergens contributing to immediate-type allergic reactions in children are present in seed storage proteins, namely Gly m 5, Gly m 6 and Gly m 8. However, pollen-related soybean allergy in adults is caused by the Bet v 1 homolog of soybeans, Gly m 4. Taken together, the varying clinical manifestations of wheat and soybean allergies are predominantly caused by their different allergen components. © 2015 S. Karger AG, Basel. Source


Ebisawa M.,Clinical Research Center for Allergy and Rheumatology | Shibata R.,Fukuoka National Hospital | Sato S.,Clinical Research Center for Allergy and Rheumatology | Borres M.P.,Phadia AB | And 2 more authors.
International Archives of Allergy and Immunology | Year: 2012

Background: There are contradictory results regarding the clinical usefulness of the determination of IgE antibodies to ω-5 gliadin in children with a suspicion of wheat allergy (WA). Methods: The study comprised 311 children and young adults with suspected wheat intolerance treated at three separate pediatric clinics and, with the exception of 25, were found to be positive in specific IgE antibody determinations to wheat. Their ages ranged from 6 months to 20.4 years (median age, 2.3 years). Possible relationships between IgE antibodies to ω-5 gliadin and a physician's diagnosis of WA and challenge symptoms were studied. Results: The mean concentration of IgE antibodies to ω-5 gliadin was 1.2 kU A/l in WA patients and <0.35 kU A/l in patients without WA (p < 0.0001). Seventy-two percent of the WA patients had positive ω-5 gliadin levels and 75% of the patients without WA had negative levels. Logistic regression showed a significant relationship between the probability of WA and the concentration of IgE antibodies to ω-5-gliadin with a 2.6-fold (95% CI: 2.0-3.3) increased risk. Age was an important factor to consider as the risk of WA increased 5.4-fold (95% CI: 1.4-21) for children ≤1 year of age and 2.5-fold (95% CI: 2.0-3.2) for children >1 year of age with increasing levels of IgE. Conclusion: Detection of IgE to ω-5 gliadin seems to be associated with responsiveness to the challenge test and is particularly useful in infants with a suspicion of WA. Copyright © 2011 S. Karger AG, Basel. Source


Hino A.,Aichi Childrens Health and Medical Center
Arerugī = [Allergy] | Year: 2013

An original symptom score sheet named "Anaphylaxis Scoring Aichi (ASCA)" was created to quantitatively determine the severity of allergic symptoms provoked in an oral food challenge. ASCA lists and sorts subjective and objective symptoms into five organs (respiratory, skin-mucosal, gastrointestinal, psycho-neurological and cardiovascular). The organ scores were given (0 to 60 points) in accordance with the severity of each symptom. The total score was defined as the sum of the highest 5 organ scores (maximum 240 points) observed throughout the course of an OFC. This study evaluated the ASCA score in 253 cases of a positive food challenge (age 1-16 years, mean 5.3±3.2 years) conducted from April to August 2011 in our institute. The results were compared to the modified anaphylaxis grading presented in the Japanese Pediatric Guideline for Oral Food Challenge Test in Food Allergy 2009. At the same time, we evaluated the indications of symptomatic treatment using ASCA score. The total score closely correlated with the anaphylaxis grading, but there was a wide range of overlap between grade 2 and grade 3. All cases with a total score≥60 points were equivalent to grade 4 or 5, and that were consisted of three or more organ symptoms. These severe cases contained respiratory or skin/mucosal symptoms, and despite the early induction of initial therapy, the symptoms became worse. ASCA is therefore considered to be a useful tool for use in an oral food challenge test. Source


Sasaki T.-K.,Aichi Childrens Health and Medical Center | Yoshida A.,Sagamihara Public Health Center | Kotake K.,Sagamihara Public Health Center
Southeast Asian Journal of Tropical Medicine and Public Health | Year: 2013

We conducted this study to determine the use of Japanese municipal information sources about the 2009 H1N1 influenza pandemic among 109 pregnant Japanese women during October and November 2009 and to determine their attitudes regarding the pandemic. During November 2009, the number of municipality information users increased significantly, however, the percentage of public magazine users remained under 40% and the percentage of municipality website users remained significantly lower than other website users. The accession of municipality information did not alleviate the anxiety of subjects caused by inaccurate information, such as mortality due to the virus infection and the safety of oseltamivir use. Those who obtained information about the pandemic from the municipality were more willing to receive the influenza vaccine than non-users. The results show the municipality information system needs to be improved to ameliorate anxiety and more effectively convey health information for future pandemics. Other Japanese public health service information systems shoud be assessed as well to determine their efficacy in delivering information regarding the 2009 H1N1 influenza pandemic. Source


Takasu H.,Aichi Childrens Health and Medical Center | Watanabe Y.,Aichi Childrens Health and Medical Center
Journal of Pediatric Surgery | Year: 2010

Purpose: In cases of large umbilical hernias, standard surgical techniques have proven inadequate for diminishing the diameter of the umbilicus. We have modified the 3- and 4-triangular-skin-flap techniques to diminish the diameter of the umbilicus and achieve a cosmetically acceptable umbilicus. Materials and Methods: Umbilicoplasty was performed in 149 children (median age, 2.5 years; range, 3 months-10 years) between 2003 and 2008. We created 4 skin flaps 1.5 cm in length on the umbilicus and excised the cranial diamond-shaped skin flap. After closure of the fascial defect, the diameter of the umbilicus was diminished by suturing the opened cranial part of the diamond-shaped skin flap vertically. The tips of the 3 remaining flaps were then anchored to the closed fascia. Results: Postoperatively, granulation tissue occurred in 18 cases (12%), transient erythema of a flap in 15 cases (10%), and bulging of a skin flap in 15 cases (10%). These complications were reduced by suturing adjoining skin flaps. No recurrent hernias were encountered. The postoperative umbilical appearance was satisfactory in all cases. Conclusion: This surgical technique is effective for diminishing the diameter of the umbilicus and creating a cosmetically acceptable shaped umbilicus, even for large umbilical hernias. © 2010 Elsevier Inc. All rights reserved. Source

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