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Notes: Summary Dystrophic cutaneous calcification may arise at sites of local trauma or in association with various disorders. Calcified nodules of the heel have been reported in high-risk neonates following repeated heel sticks to draw blood. We present a healthy 2-year-old boy with a calcified nodule on the heel secondary to a single heel stick in the neonatal period. The patient was born full-term at 38 weeks' gestation, with a birth weight appropriate for gestational age. A firm nodule was noticed at the age of 8 months; this became tender. Histology revealed epidermal and subepidermal deposition of calcium. Serum calcium and phosphate levels were normal. Although calcified heel nodules occur mostly in high-risk neonates, this case suggests that this condition also can occur in healthy children after only a single heel stick. Dermatologists should include this entity in the differential diagnosis of warty papules on the heels of children.

Notes: Epitaxial [Co/Cu]10 grown on Si (001) has been irradiated by 1 MeV C+ with a dose of 1×1016/cm2. The intrinsic characteristics of epitaxy, such as crystal structure and fourfold magnetic anisotropy, are conserved after ion irradiation. However, the extrinsic magnetic properties are changed such that the coercivity decreases and the squareness of the hysteresis loop is noticeably improved. The intensity of the Cu (200) peak in the x-ray diffraction pattern increases about three times and its half-width decreases after irradiation. It is concluded that the changes of magnetic properties induced by ion irradiation result from the grain growth and the improved crystalline quality. © 2001 American Institute of Physics.

Notes: Three mechanisms for the formation of Cu diffusion channels in the Ta layer of a Cu/Ta/SiO2/Si structure are proposed. First, it is suggested that stacking faults formed during the recovery process induce localized regions of high internal energy in the Ta layer, from which Cu channels originate. Second, chemical reaction occurs at 800 °C and forms Ta4CuO11 across the Cu/Ta interface in Cu and Ta layers, which opens up channels for Cu diffusion. Third, triple junctions at the grain boundary of the Cu and Cu/Ta interface provide sites for the initiation of channel formation at 800 °C. At 950 °C, these channels in the diffusion barrier are absent, but Ta was oxidized into disordered Ta2O5 that may contain pathways for Cu diffusion. © 2002 American Institute of Physics.

Notes: Background Our previous study reported that more than 50% of toluene diisocyanate (TDI)-induced asthma patients had persistent asthmatic symptoms even after complete avoidance. Although specific IgE (sIgE) has been detected in a portion of patients with TDI-asthma, a recent investigation suggests that the presence of serum specific IgG (sIgG), not sIgE, is more closely associated with positive bronchoprovocation test (BPT) results.Objective To evaluate the possible role of sIgE and sIgG in predicting long-term prognosis of TDI-asthma.Materials and methods Forty-one TDI-asthma patients whose diagnosis was confirmed by TDI-BPT, and 20 unexposed healthy controls were enrolled. Both sIgE and sIgG to TDI-human serum albumin (HSA) conjugate were detected by ELISA. All patients with persistent asthmatic symptoms took anti-asthmatic medications during the follow-up period (mean: 67.5 months) and were instructed to avoid exposure to TDI. Airway hyper-responsiveness to methacholine (AHM) was monitored every year during the study period. The patients were classified into three groups according to changing patterns of AHM and asthmatic symptoms as follows: group I, no improvement with persistent asthmatic symptoms (n = 12); group II, partial improvement with persistent asthmatic symptoms (n = 13); group III, in remission (n = 16).Results Favourable prognosis was associated with a mild degree of AHM at initial diagnosis (P 〈 0.05). Although there were no significant differences in the prevalence of sIgE antibody to TDI-HSA conjugate among the three groups (P 〉 0.05), prevalence of sIgG in group I tended to be higher than in group II (0.05 〈 P 〈 0.1). However, the levels of sIgG were significantly higher in group I than in group II (P = 0.05), whereas levels of sIgE were significantly higher in group II than in group I (P = 0.014). No significant differences were noted in exposure duration, sex, age, atopic status, and total IgE level among the three groups (P 〉 0.05).Conclusion This study confirmed that a favourable outcome is related to a mild degree of AHM and to low levels of sIgG to predict persistent asthmatic symptoms, it also suggested that the presence of high serum-specific IgE at initial diagnosis may represent a better prognosis.

Notes: Background Recent investigations have demonstrated that spider mites are important allergens in the development of asthma in fruit-cultivating farmers.Objective The aim of this study was to evaluate the sensitization rate to the citrus red mite (Panonychus citri) in children living in rural areas, and to determine the allergenic cross-reactivity with other mites.Methods A total of 7254 children (ages 7–15 years) living in rural areas were enrolled, and each subject was evaluated by a questionnaire and a skin prick test. Allergenic cross-reactivity was evaluated by ELISA inhibition tests.Results The most common sensitizing allergens were house dust mites, followed by citrus red mite and cockroach. High serum-specific IgE bindings to the citrus red mite were detected in 21 of 100 randomly selected subjects. The prevalence of asthma was higher among those with positive skin responses to the citrus red mite than with negative skin responses to this mite. ELISA inhibition tests showed that IgE bindings to this mite were minimally inhibited with additions of domestic mites.Conclusion Spider mites such as the citrus red mite may be important outdoor allergens among children living in rural areas, and spider mite-derived allergens have unique allergenic determinants compared with domestic mites.

Notes: Background A disintegrin and metalloprotease 33 (ADAM33) is expressed in the lung by fibroblasts and bronchial smooth muscle cells. Given its structure and cellular provenance, ADAM33 may be associated with airway remodelling and bronchial hyper-responsiveness. Single nucleotide polymorphisms (SNPs) and haplotypes of the ADAM33 gene have previously been associated with asthma susceptibility in the Caucasian population.Objective and Methods To assess whether genetic variants of ADAM33 are related to asthma in a Korean population, we conducted an association study of the ADAM33 gene with asthma susceptibility, bronchial hyper-reactivity and serum IgE in Korean asthmatics (n=326) and normal controls (n=151). Five of the 14 polymorphisms originally reported to be associated with asthma development (S1 G〉A, T1 T〉C, V-1 C〉A, V1 T〉A, V4 C〉G) were genotyped using single base extension and electrophoresis. Haplotypes and their frequencies were inferred using the algorithm implemented by the software Arlequin. Allele frequencies of each SNP and haplotypes were compared between the patients and the normal controls using logistic regression analysis.Results There was no significant difference in the distribution of SNPs and the six haplotypes between asthmatics and normal controls. All single SNPs and six haplotypes in ADAM33 were also analysed for the association with level of PC20 using general linear models. The distribution of the T1 T〉C SNP and one haplotype (ht4: GCGG) showed significant association with log-transformed PC20 methacholine level in the asthma patients (P=0.03 and 0.0007, respectively, using a co-dominant model).Conclusion Polymorphism of ADAM33 may contribute to development of BHR in asthma.

Notes: Background Nasal polyps infiltrated with eosinophils are commonly found in chronic asthmatic patients, more frequently in those with aspirin-intolerant asthma (AIA) than aspirin-tolerant asthma (ATA). Some studies have suggested a contribution of superantigens derived from Staphylococcus sp to nasal polyposis and eosinophilia, but their relative importance in AIA and ATA subjects is unknown.Objective We investigated whether local production of specific IgE to staphylococcal enterotoxins A and B (SEA and SEB) and relationships with markers of eosinophilic inflammation differ in the nasal polyps of AIA and ATA subjects.Methods Fifteen AIA subjects with positive responses to lysine–aspirin bronchoprovocation and 15 ATA subjects underwent polypectomy. Immunoassays were used to quantify eosinophil cationic protein (ECP), IL-5, mast cell tryptase, soluble IL-2 recepters (sIL-2R), total IgE, and specific IgE for SEA and SEB.Results ECP levels in nasal polyp homogenates were higher in AIA subjects than in ATA subjects (P〈0.02), with no significant differences in tryptase, IL-5 or sIL-2R. Total IgE, and specific IgE to both SEA and SEB, were detectable in some nasal polyps from both subject groups, but median levels were markedly higher in AIA subjects than in ATA subjects (P=0.04, 0.01, 0.05, respectively). Levels of specific IgE to SEA and SEB correlated significantly with levels of ECP and IL-5, but not those of tryptase or sIL-2R.Conclusion These findings suggest that staphylococcal superantigens may drive local eosinophilic inflammation in nasal polyp tissue, and that this is exacerbated in subjects with AIA.

Notes: Background and objective Persistent asthma symptoms are associated with airway inflammation and remodeling, which may be mediated through metalloproteinase (MMP) and tissue inhibitor of metalloproteinase (TIMP). The aim of this study was to evaluate MMPs and TIMP involvement in toluene diisocyanate (TDI)-induced asthma.Materials and method Induced sputum was collected in eight newly diagnosed TDI-induced asthma subjects (group I) before and 7 h after the TDI and placebo challenges and in 12 subjects with TDI-induced occupational asthma diagnosed 5 years previously with persistent asthma symptoms (group II). Sera was collected in group I at diagnosis, and in group II, they were collected at the time of the study. 12 nonasthmatic healthy subjects were enrolled as controls. MMP-9, MMP-2 and TIMP-1 levels in both sputum and serum were measured by enzyme-linked immunosorbent assay (ELISA). Gelatinase activity in the sputum was confirmed by zymographic analysis.Results The serum TIMP-1 level was significantly higher in asthma patients than in healthy controls (P = 0.01), while MMP-9 level was significantly lower in asthmatic patients (P = 0.03). There was no significant difference in MMP-2 level (P = 0.27). MMP-9 level in the sputum was significantly increased after the TDI challenges (P = 0.01). TIMP-1 level in sputum tended to increase after TDI challenges, but no statistical significance was noted (P = 0.09). MMP-9 and MMP-9/TIMP-1 levels in the sputum were significantly higher in group II than in group I (P = 0.04, P = 0.02) with no significant difference in TIMP-1 level. Minimal amount of MMP-2 was found in sputum. Zymography demonstrated that MMP-9 level increased and active form of MMP-9 was generated after the TDI bronchoprovocation test.Conclusion TDI exposure leads to overproduction of MMP-9, which may induce airway inflammation and remodeling, and then contribute to persistent asthmatic symptoms in TDI-induced asthma.

Notes: Background: We report a case of hypersensitivity pneumonitis (HP) in a 17-year-old male student caused by Fusarium napiforme found in his home environment. Methods: The patient was diagnosed according to history, chest radiograph, spirometry, high-resolution chest CT, and transbronchial lung biopsy. To identify the causative agent, cultured aeromolds were collected by the open-plate method. From the main fungi cultured, fungal antigens were prepared, and immunoblot analysis with the patient's serum and each fungal antigen was performed. Results: Five fungal species were isolated from the patient's home. Immunoblotting analysis with the patient's serum demonstrated more than 10 IgG-binding fractions to F. napiforme extract only, while little binding was noted with the other fungal antigens. Conclusions: We should be aware that HP may be caused by F. napiforme in the home environment.