Anisakis allergy versus gastric anisakiasis: A case of repeated Anisakis-associated symptoms.

A 53-year-old patient experienced 2 Anisakis-induced allergic episodes: the first with anaphylaxis, the second presenting with gastric symptoms and progressing to systemic anaphylaxis. The case could suggest a common pathophysiology involving allergic reactions in gastric anisakiasis and Anisakis allergy.

Plasmonic-heating-induced nanofabrication on glass substrates.

Fabricating nano-sized through-holes on a coverslip approximately 100 µm thick is challenging but rewarding when applied to ultrafine filters that separate proteins and DNA of various sizes and isolate viruses from cells. Toward this end, we developed an in situ etching-assisted laser processing technique exploiting gold nanoparticles. Plasmonic heating of a single gold nanoparticle through focused illumination of a continuous-wave laser beam enables structural modifications to be localized to the contact area on the glass surface. This results in the embedding of the particle forming nanocavities caused by chemical etching with aqueous tetrabutylammonium hydroxide. Depending on the shape of the nanoparticle, a highly flexible face geometry design such as a disk and triangle was achieved. The etching was monitored in situ through measurements of spectral red shifts in single-particle scattering, indicating an increasing medium refractive index consistent with embedding. The embedding process is unexpectedly fast, at 0.8 µm with 5 minutes of illumination. Besides nanoholes, we fabricated nanodomes around a single gold nanoparticle supported on a glass substrate through laser-heating-induced encapsulation. Overall, we were able to demonstrate true nano-laser processing free from diffraction-limited optics, with potential benefits of simple low-cost fabrication.

Th17 cells reflect colon submucosal pathologic changes in active eosinophilic granulomatosis with polyangiitis.

BACKGROUND: Chronic eosinophilic pneumonia (CEP) or eosinophilic gastroenteritis (EG), or both, with asthma precede the onset of eosinophilic granulomatosis with polyangiitis (EGPA) in half of all EGPA patients. It is not known what determines whether patients with CEP or with EG following asthma will develop EGPA. METHODS: We studied 17 EGPA patients and 12 patients with CEP but without EGPA. We assayed serum ICAM-1, VCAM-1, and VEGF, and the percentage of peripheral blood CD4(+) T cells producing IL-17 (Th17 cells), at both onset and remission. We also examined the numbers of submucosal eosinophils and the basement membrane-to-crypt and crypt-to-crypt distance to evaluate edema in the colon submucosa at onset and remission in EGPA and at onset in CEP. RESULTS: Nine of 12 (75.0%) CEP patients had symptoms or endoscopic findings. Colonic submucosal eosinophil counts and edema in EGPA at onset were greater than at remission or in CEP at onset. Th17 cells (%) and serum ICAM-1 levels at onset were greater in EGPA than in CEP. In EGPA, peripheral blood Th17 cells (%) were significantly correlated with serum ICAM-1 level, colonic submucosal eosinophil count, and degree of edematous change; inversely correlated with serum VEGF level; but not correlated with VCAM-1 level. CONCLUSIONS: Eosinophilia and colonic submucosal edematous change were greater in EGPA than in CEP. The mechanism of vasculitis in EGPA appears related to increases in serum Th17 cell numbers and ICAM-1 levels and decreases in VEGF levels.

An adult patient with Henoch-Schönlein purpura and non-occlusive mesenteric ischemia.

BACKGROUND: Onset of Henoch-Schönlein purpura (HSP) in middle age is uncommon, and adults with renal or gastrointestinal involvement present with more severe disease than do similar pediatric patients. CASE PRESENTATION: We present the case of a 69-year-old male with HSP who, after treatment with steroids, cyclophosphamide, and continuous intravenous prostaglandin E1 (PGE1), died as a result of severe gastrointestinal involvement with non-occlusive mesenteric ischemia (NOMI). Vascular narrowing associated with the NOMI improved after catheter injection of PGE1 and prednisolone, but the patient died of bleeding from an exposed small vessel. At autopsy there was no active vasculitis in the jejunal submucosa. CONCLUSION: Treatment with PGE1 and prednisolone might improve small-vessel vasculitis associated with NOMI.

Analysis of mucin composition in gastric juices of chronic rheumatic patients with upper gastrointestinal damage.

Assessment of the mucin subclasses in the gastric juices of severe chronic rheumatoid arthritis (RA) patients was compared with non-RA cases which received the eradication treatment of Helicobacter pylori (H. pylori). Gastric juice samples were obtained from 8 RA patients (5 for H. pylori-negative and 3 for H. pylori-positive) and 5 control subjects in which we confirmed the successful eradication of H. pylori. The gastric luminal mucins were extracted and isolated by the ethanol precipitation method. These mucin solutions were digested with chymotrypsin, dialyzed, lyophilized, and redissolved. The obtained specimen was applied to an ion exchange column containing DEAE-Sepharose CL-6B and eluted with a discontinuous salt gradient in three salt steps. The gastric luminal mucins were divided into three fractions based on the distinctive sialic acid content. The proportion of acidic mucin rich in sialic acid from the gastric juice of RA patients without the H. pylori infection was significantly lower than those RA patients with H. pylori or the control subjects. A decrease in the acidic mucin content after eradication of H. pylori was commonly observed in all the control subjects. Our investigation raises the possibility that the gastric mucosae of RA patients have resistance against H. pylori infection. And the analysis of the composition in the gastric luminal mucin may be a very useful tool for the evaluation of gastric homeostasis in RA patients.