Nonconvulsive status epilepticus following rotavirus gastroenteritis in two pediatric patients.

BACKGROUND: Nonconvulsive status epilepticus (NCSE) comprises a range of conditions in which prolonged electrographic seizures result in nonconvulsive clinical symptoms. An understanding of NCSE is especially important in emergency care. Among the various causes of NCSE, an infectious etiology has been rarely reported to date. CASE REPORTS: We report two pediatric cases of rotavirus gastroenteritis complicated by NCSE. In both cases, bilateral rhythmic delta activity (2.5-3 Hz) with occipital predominance fluctuated with the patient's consciousness level. The paroxysmal waves disappeared completely and consciousness immediately and remarkably improved after intravenous midazolam infusion. The patients remained alive 10 and 2 years, respectively, after short-term oral anticonvulsant administration, with no epileptic seizures. CONCLUSION: The etiology of NCSE was identical and the clinical presentations were analogous in the two patients. The seizure semiology differed from that in benign convulsion with gastroenteritis. NCSE was considered the prominent cause of neurological symptoms; however, the pathogenic mechanism remains unclear, including the coexistence of acute encephalopathy.

Venous thromboembolism in two adolescents with Down syndrome.

Kurokami T, Takasawa R, Takeda S, Kurobe M, Takasawa K, Nishioka M, Shimohira M. Venous thromboembolism in two adolescents with Down syndrome. Turk J Pediatr 2018; 60: 429-432. Although venous thromboembolic events are relatively rare in children, they are an increasingly recognized clinical entity in pediatric tertiary care hospitals. Although vascular disorders are prevalent with Down syndrome, it remains unclear whether Down syndrome patients are at higher risk for venous thromboembolic events. We report two adolescent cases with Down syndrome who unexpectedly developed venous thromboembolism in a general care unit. Our cases had a few risk factors; laparoscopic radical surgery for Hirschsprung's disease with central venous catheterisation in Case 1, and bacterial hepatic abscess in Case 2. Despite preventive heparinization with catheterisation and minor surgery in Case 1 and non-sepsis in Case 2, bed rest for only a few days triggered sudden onset of deep vein thrombosis in lower limbs with pulmonary thromboembolism in both cases. We speculate that the characteristics of Down syndrome, including physical and behavioural problems, might cause venous thromboembolic events. Thus, we should pay more attention to the relationship specifically between venous thromboembolism and Down syndrome, especially in adolescents, and increase prevention, early detection and treatment efforts.

Mayonnaise contributes to increasing postprandial serum ß-carotene concentration through the emulsifying property of egg yolk in rats and humans.

We performed in vitro, animal, and human studies to clarify the effect of mayonnaise on ß-carotene intake and its mechanism. In an artificial gastric juice model, we examined the transfer of ß-carotene from grated carrot to mayonnaise or vegetable oil. Mayonnaise was more easily dispersed in artificial gastric juice than vegetable oil. The ß-carotene concentration was greater in mayonnaise than vegetable oil. In rats, the postprandial serum ß-carotene concentration in the mayonnaise group (ß-carotene with mayonnaise) was higher than that in the control (ß-carotene only) and vegetable oil (ß-carotene with vegetable oil) groups. Continuous feeding of dietary ß-carotene (14 d), employing mayonnaise or egg yolk, resulted in an increased accumulation of ß-carotene in the liver. In a human study, diets were provided in the form of (1) carrot as a control (CON), (2) carrot juice (JU), (3) carrot with oil (OIL) and (4) carrot with mayonnaise (MS). Following collection of fasting blood samples, nine adult males consumed one of the four diets in random order. Fasting and postprandial changes in serum ß-carotene were assessed at 2, 3, 4, 6 and 8 h following ingestion of each diet. The incremental areas under the curves of serum ß-carotene concentration were higher following MS than following both CON and JU. In conclusion, we suggest that mayonnaise contributes to raising the serum ß-carotene concentration when consumed with carrots rich in ß-carotene, and that its mechanism is related to the emulsifying property of the egg yolk contained in mayonnaise.

Relationship among food-safety knowledge, beliefs, and risk-reduction behavior in university students in Japan.

OBJECTIVE: To identify whether university students who have both food-safety knowledge and beliefs perform risk-reduction behaviors. DESIGN: Cross-sectional research using a questionnaire that included food-safety knowledge, perceptions, risk-reduction behavior, stages for the selection of safer food based on the Transtheoretical Model, and demographic characteristics. SETTING: Four universities in eastern Japan and 2 universities in western Japan. PARTICIPANTS: University students (n = 799). MAIN OUTCOME MEASURES: Food-safety knowledge, beliefs, and risk-reduction behaviors. ANALYSIS: Answers on measures assessing risk perception and food-safety knowledge were combined to form 4 groups of participants. Relationships among demographic characteristics, the 4 groups, risk-reduction behaviors, stage of change, and severity and susceptibility were assessed. RESULTS: The proportion of students who had more knowledge of food safety and a belief that "there are no 100% safe food items" was high in the group that frequently performed risk-reduction behaviors, as it was in the group who had taken a basic class about food or health care and who had, or were working toward, a food or nutrition qualification. CONCLUSIONS AND IMPLICATIONS: University students who thought that there were no 100% safe food items and who had more knowledge about food safety were more likely to confirm food-safety information when selecting food.

Effects of mayonnaise on postprandial serum lutein/zeaxanthin and beta-carotene concentrations in humans.

To clarify the effects of different physical forms of oil on postprandial serum lutein/zeaxanthin and beta-carotene concentrations, we performed a vegetable meal loading test. Eighteen healthy subjects participated in the test, which consisted of broccoli as a control (CON) meal, broccoli with oil (OIL), and broccoli with mayonnaise (MS), consumed in random order. After collection of fasting blood samples, subjects consumed one of the three test meals. Fasting and postprandial changes in serum carotenoids were assessed 2, 4, and 6 h after ingestion of each test meal. Serum lutein/zeaxanthin and beta-carotene concentrations were measured. Although no significant change was noted after the CON meal, the serum lutein/zeaxanthin concentration was higher at 4 h after consumption of the OIL meal, and at 2, 4 and 6 h after consumption of the MS meal, as compared with the fasting state. Serum beta-carotene concentrations did not change after ingestion of either the CON or the OIL meal but were elevated 2, 4, and 6 h after MS ingestion as compared with the fasting state. The incremental areas under the curves (IAUCs) of serum lutein/zeaxanthin and beta-carotene concentrations were higher after the MS meal than after the CON meal. IAUCs after the OIL meal exhibited no statistically significant differences from the CON and MS meals. We suggest that mayonnaise contributes to increase serum lutein/zeaxanthin and beta-carotene concentrations when consumed with vegetables rich in these carotenoids.

[Minimal effective dose on serum cholesterol concentration and the safety evaluation of dressing containing plant sterol in Japanese subjects].

We examined the minimal effective dose on serum cholesterol concentration and the safety of dressing containing plant sterol in humans. EXP.1: Sixty-eight healthy Japanese males (total cholesterol (TC) > or = 170 mg/dL) were randomly divided into four groups, and were given 0, 400, 800 or 1200 mg/day of plant sterol in 15 g dressing for 4 weeks followed by the washout period of 4 weeks. Although there were no significant differences in serum TC and low-density lipoprotein cholesterol (LDL-C) concentrations among all groups after feeding plant sterol for 4 weeks, in 36 subjects with TC > or = 220 mg/dL, serum LDL-C concentration tended to reduce when received 800 or 1200 mg of plant sterol, and the difference between 0 and 1200 mg groups was statistically significant. The difference between 0 and 800 mg groups was near significant (p=0.053). Intake of 400 mg of plant sterol did not change serum LDL-C concentration. EXP.2: Twenty-one healthy Japanese subjects (TC > or = 180 mg/dL, 10 men, 11 women) were given 2400 mg/day of plant sterol in 45 g dressing for 4 weeks. Clinical data were all remained normal. These results indicated that minimal effective dose of the plant sterol on serum cholesterol concentration in healthy male subjects is around 800 mg/day, and intake of 2400 mg/day of plant sterol is regarded to be safe.

[Effects of dressing containing plant sterol on serum cholesterol concentration and the safety evaluation in borderline or mildly hypercholesterolemic Japanese subjects].

In a placebo-controlled double-blind study, we examined the effects of dressing containing plant sterol (PS) on blood lipids and the safety in Japanese borderline or mildly hypercholesterolemic subjects. Fifty-nine subjects [total cholesterol (TC) concentration > or = 200 mg/dL] were randomly divided into two groups and were given daily 15 g of dressing containing 800 mg of PS [PS(+)-group] or without PS [PS(-)-group] for 12 weeks. Every 4 weeks, fasting blood was examined and subjective symptoms were analyzed. Serum TC, low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (ApoB) concentrations did not change in the PS(-)-group, while TC and ApoB significantly decreased in the PS(+)-group at 8 and 12 weeks and LDL-C at 4, 8 and 12 weeks. Moreover, serum TC, LDL-C and ApoB concentrations were significantly lower than those of PS(-)-group at 8 and 12 weeks. Other laboratory tests were all in normal ranges and no adverse events were observed. The results indicated that PS-containing dressing decreased serum TC, LDL-C and ApoB concentrations in borderline or mildly hypercholesterolemic subjects. It is therefore proved that the dressing containing PS is helpful in maintaining blood cholesterol level normal and hence, the health of Japanese.

Combination of TLC blotting and gas chromatography-mass spectrometry for analysis of peroxidized cholesterol.

We have established a sensitive and convenient method for analysis of cholesterol hydroperoxides (Chol-OOHs) as trimethylsilyloxyl derivatives using diphenylpyrenylphosphine (DPPP)-thin-layer chromatography (TLC) blotting and gas chromatography-electron ionization-mass spectrometry/selected-ion monitoring (GC-EI-MS/SIM). Chol-OOH standards were prepared by photosensitized oxidation and azo radical-induced peroxidation of cholesterol. Trimethylsilyloxyl derivatives of cholesterol 5alpha-hydroperoxide (Chol 5alpha-OOH), cholesterol 7alpha-hydroperoxide (Chol 7alpha-OOH), and cholesterol 7beta-hydroperoxide (Chol 7beta-OOH) could be separated from one another in the SIM chromatogram using a fragment ion with elimination of trimethylsilanol from the molecular ion. This method was used to characterize peroxidized cholesterol from azo radical-exposed human low-density lipoprotein and UVA-irradiated human keratinocytes in the presence of hematoporphyrin. Finally, we succeeded in the quantification of each Chol-OOH isomer present in hairless mouse skin with and without UVA irradiation by use of beta-sitosterol hydroperoxide as internal standard. The accumulation of Chol 5alpha-OOH with Chol 7alpha/betaOOH in the skin indicates that singlet molecular oxygen ((1)O(2)) participated in the peroxidation of skin cholesterol, because Chol 5alpha-OOH is known to be a (1)O(2) specific cholesterol peroxidation product. We concluded that the combination of DPPP-TLC blotting and GC-EI-MS/SIM is useful for quantifying peroxidized cholesterol in biological samples and confirming the participation of (1)O(2) in oxidative stress.

Lipidomic analysis for lipid peroxidation-derived aldehydes using gas chromatography-mass spectrometry.

A lipidomic method is described for the measurement of lipid peroxidation-derived aldehydes using gas chromatography/electron ionization/mass spectrometry with selected ion monitoring (GC/EI/MS-SIM). Aldehydes in the samples were converted into their pentafluorobenzyl (PFB)-oximes using PFB-hydroxylamine, and other functional groups such as the hydroxyl groups were further derivatized into the trimethylsilyl ethers. The PFB-oxime derivatives could be comprehensively detected by the SIM of m/z 181, which is a characteristic fragment ion of the PFB-oxime derivatives. At the same time, each aldehyde was classified into five groups (alkanals, 2-alkenals, 2,4-alkadienals, 2-hydroxyalkanals, and 4-hydroxy-2-alkenals) by SIM of the structure-specific fragment ions. Determination of the 4-hydroxy-2-alkenals was also performed by confirmation of their higher reactivity with the sulfhydryl group. On the basis of the mass spectrometric characterization, we have identified at least 33 aldehydes formed upon the FeII-mediated decomposition of the arachidonic acid-, linoleic acid-, and docosahexaenoic acid-hydroperoxides in vitro. We then applied this system to the in vivo samples and successfully observed the increase in aldehydes in the liver of mice intraperitoneally injected with bromobenzene, an experimental animal model for lipid peroxidation. Using this comprehensive analysis, unique differences in the formation between each aldehyde could be observed. This method is useful for simultaneously monitoring the lipid peroxidation-derived aldehydes formed under oxidative stress in vivo.