Oral Muscle Relaxant May Induce Immediate Allergic Reactions

Eperisone and afloqualone act by relaxing both skeletal and vascular smooth muscles to improve circulation and suppress pain reflex. These drugs are typically prescribed with non-steroidal anti-inflammatory drugs (NSAIDs) as painkillers. However, there have been no reports on serious adverse reactions to oral muscle relaxants; and this is the first report to describe three allergic reactions caused by eperisone and afloqualone. All three patients had histories of allergic reactions after oral intake of multiple painkillers, including oral muscle relaxants and NSAIDs, for chronic muscle pain. An open-label oral challenge test was performed with each drug to confirm which drugs caused the systemic reactions. All patients experienced the same reactions within one hour after oral intake of eperisone or afloqualone. The severity of these reactions ranged from laryngeal edema to hypotension. To confirm that the systemic reaction was caused by eperisone or afloqualone, skin prick testing and intradermal skin tests were performed with eperisone or afloqualone extract in vivo, and basophil activity tests were performed after stimulation with these drugs in vitro. In one patient with laryngeal edema, the intradermal test with afloqualone extract had a positive result, and CD63 expression levels on basophils increased in a dose-dependent manner by stimulation with afloqualone. We report three allergic reactions caused by oral muscle relaxants that might be mediated by non-immunoglobulin E-mediated responses. Since oral muscle relaxants such as eperisone and afloqualone are commonly prescribed for chronic muscle pain and can induce severe allergic reactions, we should prescribe them carefully

Caroli's Syndrome with Autosomal Recessive Polycystic Kidney Disease in a Two Month Old Infant

Caroli's syndrome is a rare congenital disorder that involves intrahepatic bile duct ectasia and congenital hepatic fibrosis, frequently seen with concomitant autosomal recessive polycystic kidney disease (ARPKD). Literature on infants with ARPKD is rare. Here, we present a case of a two month old boy who was diagnosed with Caroli's syndrome and ARPKD

The starburst cluster westerlund 1: The initial mass function and mass segregation

Westerlund 1 is the most important starburst cluster in the Galaxy due to its massive star content. We have performed BVIC and JKS photometry to investigate the initial mass function (IMF). By comparing the observed color with the spectral-type-intrinsic-color relation, we obtain the mean interstellar reddening of 〈E(B-V)〉 = 4.19 ± 0.23 and 〈E(J-KS )〉 = 1.70 ± 0.21. Due to the heavy extinction toward the cluster, the zero-age main sequence fitting method based on optical photometry proved to be inappropriate for the distance determination, while the near-infrared photometry gave a reliable distance to the cluster - 3.8 kpc from the empirical relation. Using the recent theoretical stellar evolution models with rotation, the age of the cluster is estimated to be 5.0 ± 1.0 Myr. We derived the IMF in the massive part and obtained a fairly shallow slope of Γ = -0.8 ± 0.1. The integration of the IMF gave a total mass for the cluster in excess of 5.0 × 104 M⊙. The IMF shows a clear radial variation indicating the presence of mass segregation. We also discuss the possible star formation history of Westerlund 1 from the presence of red supergiants and relatively low luminosity yellow hypergiants