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Background: We reported that post-emetic serum thymus and activation-regulated chemokine (TARC) levels may be a potential biomarker to diagnose solid food protein-induced enterocolitis syndrome (FPIES). However, there are no reports on the relationship between FPIES severity and serum TARC levels., Methods: The subjects were 13 cases of FPIES (hen's egg=10, Wheat=1, rice=1, short-neck clam=1) for a total of 22 events (7 emergency outpatient visits, 9 positive and 6 negative results of oral food challenge test). Serum TARC levels at 6 and 24 h after antigen ingestion were compared between the symptomatic and asymptomatic events and the mild-moderate and severe events. We also evaluated the correlation between vomiting duration and serum TARC levels., Results: The median serum TARC (pg/ml) in the asymptomatic, mild-moderate, and severe events were 546, 1093, and 3127 at 6 h after ingestion, and 910, 2053, and 6496 at 24 h after ingestion, respectively. The serum TARC level was significantly higher in the symptomatic events than the asymptomatic events, and it was significantly higher in the severe events than the mild-moderate events (p < 0.01). There was a moderate correlation between serum TARC levels and vomiting duration., Conclusion: Post-emetic serum TARC correlates with the severity of FPIES. It is expected that this information will lead to an objective evaluation of the severity of FPIES.

Nuss procedure for pediatric patients with pectus excavatum has been practiced worldwide, including in Japan, due to the simple procedure and has a high therapeutic effect. Because it is usually performed under thoracoscopy to secure the safety, it is performed not only by pediatric or plastic surgeons but also by general thoracic surgeons. On the other hand, a risk of infection must always be considered in this method in which a foreign metal bar is used. In particular, when the skin barrier mechanism is declining due to skin diseases such as atopic dermatitis, the risk of infection of the implant may increase. The present case was an 8-year-old male with a history of atopic dermatitis. He underwent thoracoscopic Nuss procedure. Although there was no problem during his hospitalization, the bar was exposed from the skin on the 58th postoperative day with the infection triggered, and the unexpected early bar removal was performed on the 66th postoperative day. We report this case with some literature review.

Meningitis has not been described to the same extent as other neurological complications of infective endocarditis(IE). The appropriate selection and dosing of antibiotics for patients with IE and meningitis do not exist. Herein, we described an instructive surgical case of mitral valve endocarditis and meningitis caused in a patient with atopic dermatitis, that was successfully treated using a multi-disciplinary approach.

We report the case of a boy with a history of atopic dermatitis starting in infancy. At the age of four, his family moved into a newly built house at the foot of a mountain. One year later, he was diagnosed with Japanese Cedar pollinosis. During the same year, in March, he began to experience oral symptoms, hoarseness, and coughing, after eating multiple types of fruits and vegetables, like soybeans, apples, etc. His tests for Bet v1 and the pathogenesis-related protein-10 (PR-10) of the corresponding foods were positive; accordingly, he was diagnosed with Pollen Food Allergy Syndrome (PFAS). In order to investigate the relationship between pollen and food allergies, we counted the pollen grains dispersed at the patient's house during a period of one year and measured his specific IgE titers for pollen and food allergens every three months. We found a large amount of Japanese cedar, cypress, oak, and various other species of pollen dispersed at the patient's house. All counts were higher than the average pollen counts in the city of Fukuoka. After the seasonal dispersal of oak pollen, the patient's specific IgE antibody titers against Alder, Oak, Bet v1, Gly m4, and PR-10 protein group of fruits increased, although alder pollen was not detected. We thus inferred that the patient had developed PFAS by exposure to a large amount of Fagales species pollen, including oak.

Background: There is no standard for assessing pediatric chronic urticaria in Japan. UAS7, weekly total values of the Urticaria Activity Score (UAS), has correlation with Dermatology Life Quality Index (DLQI) which assesses Quality of Life (QOL). The current European Academy of Allergy and Clinical Immunology (EAACI) guidelines recommend assessing disease activity in chronic urticaria by using UAS. We translated UAS into Japanese version, and evaluated usefulness of UAS by comparing with QOL score., Methods: Subjects were 42 patients who had received treatments in our clinic from February to September in 2014. They wrote UAS at home. They wrote Children's Dermatology Life Quality Index (CDLQI) when they visited hospital. We assessed correlation UAS7 with CDLQI., Results: Male/Female ratio was 1:1. Median age was 7.5 years old. Duration of chronic urticaria was 5.5 months. Anti-histamine was used in 75%. UAS7 values reflected chronic urticaria patients' quality of life impairment. Change in UAS7 values reflected change in chronic urticaria patients' quality of life impairment., Conclusion: UAS may be a useful tool for assessing QOL in pediatric patients with chronic urticaria.

Addition of medical ingredients to cosmetics is prohibited. However, last year some cases of illegal cosmetics containing steroids were successfully identified. We have already reported an analytical method to detect steroids in cosmetics [Bull. Natl. Inst. Health Sci, 126, 51-56 (2008)]. In this study, we initially examined whether this method could be applied for the detection of some new steroids as target chemicals. We then used this developed method to detect steroids in cosmetics obtained from manufacturers by spot checks. These manufacturers have been advertising the effectiveness of a steroid-free cream against atopic dermatitis. The results revealed that clobetasol propionate (CP) was present in this facial moisturizing cream, which was available in the market. The steroid was extracted with methanol. After ultrasonication and centrifugation, the resulting supernatant was injected into the high-performance liquid chromatography system equipped with an ODS column. The separation was achieved using a mixture of acetonitrile and water as the mobile phase. The retention times of the observed peaks were in accordance with those of some preservatives and CP. The presence of CP was also confirmed by thin-layer chromatography. The concentration of CP in the cream was approximately 0.039%. CP is a steroid that has the strongest effect as compared to those of other steroids. The cream was therefore recalled for safety reasons.

The relationships of the development of intractability in bronchial asthma with 11 factors, namely 1) sex, 2) age of onset, 3) duration of the disease, 4) severity of the disease, 5) disease type, 6) family history within the third degree of consanguinity, 7) history of smoking, 8) history of atopic dermatitis, 9) history of allergic rhinitis, 10) history of chronic sinusitis and 11) history of nasal polyp were studied by multiple factor analysis in 95 patients. The severity of the disease was shown to be the most important factor in whether the disease becomes intractable or not, followed by the age of onset. The history of atopic dermatitis had the least influence, and the influences of the other factors were not markedly different from one another. Evaluation of each factor according to the category score suggested that severe or moderate non-atopic bronchial asthma in males with a positive family history and positive histories of smoking, chronic sinusitis, nasal polyp and atopic dermatitis within a short period after the onset in the second decade or fifth decade or later tend to become intractable.