Clinical and histopathologic analysis of the relationship between lichen planus and chronic hepatitis C

A prospective clinical investigation of 45 patients with lichen planus (LP) demonstrated a significant association between LP and chronic hepatitis C. Anti-hepatitis C virus (HCV) antibodies were found in 17 (37.8%) of the 45 LP patients. This was significantly higher than in the controls. This higher prevalence of anti-HCV antibodies was found equally in both male and female patients in the three types of LP; cutaneous only type, mucous only type, and both cutaneous and mucous type. Most of the patients with positive anti-HCV antibodies had abnormal values of transaminase enzymes and/or a past history of chronic hepatitis. Histological and immunohistological investigations of three cases with LP and chronic hepatitis C demonstrated some morphologic similarities between these two diseases. Histopathologic findings of both LP and chronic hepatitis C were based on a T lymphocytic infiltrate with keratinocyte or hepatocyte damage. The degrees of infiltrating cells positive to UCHL-1, MX-panB, Leu-7, and human leukocyte antigen (HLA)-DR antibodies in the chronic hepatitis C lesions seemed to be similar to those in the LP lesions. These results may support a possible relationship between LP and chronic hepatitis C and the hypothesis that LP may be associated with chronic liver diseases as a result of a cytotoxic attack on the hepatocytes.

Site-specific protein synthesis in liver regeneration determined by PET

Site-specific regeneration of the liver after 70% partial hepatectomy was investigated noninvasively in terms of protein synthesis using PET with L-[methyl-11C]methionine in a living animal. Protein synthesis in rat liver at 24 hr after partial hepatectomy did not occur uniformly in the whole liver but intensely in the middle part of the regenerating organ in comparison with the other parts. The activity was significantly low at the posterior aspect of the liver. On the other hand, site-specific protein synthesis was not observed in normal liver. These results were confirmed by bioimaging analyzer system (BAS) analysis, an invasive method that indicates radioactivities of precise intrahepatic sites. DNA synthesis in regenerating liver was also monitored with [2-14C]thymidine and analyzed by BAS 24 hr after 70% hepatectomy. Site-specific DNA synthesis in regenerating liver corresponding to the protein synthesis was also observed by BAS analysis. These results indicate that liver regeneration occurs intensely in the middle part of the liver and that PET enables noninvasive in vivo biochemical analysis.

The expression of tyrosinase, tyrosinase-related proteins 1 and 2 (TRP1 and TRP2), the silver protein, and a melanogenic inhibitor in human melanoma cells of differing melanogenic activities

The expression of various melanogenic proteins, including tyrosinase, the tyrosinase-related proteins 1 (TRP1) and 2 (TRP2/DOPAchrome tautomerase), and the silver protein in human melanocytes was studied in six different human melanoma cell lines and compared to a mouse derived melanoma cell line. Analysis of the expression of tyrosinase, TRP1, TRP2, and the silver protein using flow cytometry revealed that in general there was a positive correlation between melanin formation and the expression of those melanogenic enzymes. Although several of the melanoma cell lines possessed significant activities of TRP2, the levels of DOPAchrome tautomerase in extracts of human cells were relatively low compared to those in murine melanocytes. Melanins derived from melanotic murine JB/MS cells, from melanotic human Ihara cells and HM-IY cells, from sepia melanin, and from C57BL/6 mouse hair were chemically analyzed. JB/MS cells, as well as Ihara cells and HM-TY cells, possessed significant amounts of 5,6-dihydroxyindole-2-carboxylic acid (DHICA) derived melanins, this being dependent on the activity of TRP2. Kinetic HPLC assays showed that 5,6-dihydroxyindole (DHI) produced during melanogenesis was metabolized quickly to melanin in pigmented KHm-1/4 cells, whereas DHI was stable in amelanotic human SK-MEL-24 cells. A melanogenic inhibitor that has been purified from SK-MEL-24 cells that suppressed oxidation of DHI in the presence or absence of tyrosinase, but had no effect on DHICA oxidation. The sum of these results suggests that the expression of melanogenic enzymes as well as the activity of a melanogenic inhibitor are critical to the production of melanin synthesis in humans.

Clinical and pharmacokinetic investigations of oral terbinafine in patients with tinea unguium

A clinical trial of once-daily administration of a 125-mg tablet of terbinafine, an oral antimycotic agent, was performed on patients with tinea unguium to evaluate its efficacy, safety, possible side-effects and its incorporation into nails and hair. Thirty-four patients were recruited into the study. For the statistical analysis, one of these patients was used only for the safety rating. Accordingly, 33 patients were used for the efficacy rating, and all 34 patients were employed for the safety rating. The efficacy rating in the overall efficacy evaluation was 90.9% (30/33). No adverse effects, including abnormal changes in laboratory test values, were observed. A pharmacokinetic study revealed that terbinafine was detected in the nail tissue at and after week 2. It reached 0.78 ng mg-1 at the end of week 12 and remained at almost the same level thereafter. Terbinafine was also detected in hair at and after week 23. The average value was 3.14 ng mg-1. The plasma concentration of the drug reached a steady state (280.3 ng ml-1) at approximately week 10, and no tendency to further accumulation was noted. These results confirm the favourable incorporation of terbinafine into nail and hair. On the basis of these results, it was concluded that the drug demonstrates excellent efficacy and satisfactory safety in patients with tinea unguium. The pharmacokinetic investigation also demonstrated its excellent treatment efficacy.

[Treatment of tuberculous tracheobronchial stenoses with expandable metallic stent (EMS)s placed during percutaneous cardiopulmonary support (PCPS)]

A 63-year-old woman was taken to a hospital by ambulance because of dyspnea. She was admitted in nearly complete cardiopulmonary arrest. CPR was started immediately, and the patient was mechanically ventilated via a tracheostomy tube. Abnormally high airway pressures 40-50 cmH2O were required during positive pressure ventilation. Saber-sheath like stenoses of the lower trachea 3 cm long and left main stem bronchus 2 cm long were found by bronchoscopy. It was difficult to pass a 3-mm-diameter bronchoscope through these stenoses. The right main stem bronchus was completely obstructed. A chest radiograph showed a completely collapsed right lung and a scarred upper lobe of the left lung, probably caused by previous tuberculosis. Weaning from the ventilator was attempted over three months. However, the patient could not breathe by herself because of airway obstruction. She was referred to our hospital for the placement of stents into the stenotic parts of the airways. A longitudinally connected Gianturcotype EMS, 15 mm in diameter and 50 mm long was placed in each area of stenosis under general anesthesia. During the placement of EMSs, PCPS was used for 113 minutes instead of mechanical ventilation of the lungs. Hemodynamics were stable during PCPS. A bypass flow of 2.0-2.8 l/min/m2 was used. Oxygen saturation of arterial blood taken from an earlobe was maintained at 100%. Blood taken from the left radial artery had a PaO2 of 269.4 mmHg and a PaCO2 of 40.2 mmHg. There were no complications after the procedure. One month later, the stenoses had become slightly dilated.(ABSTRACT TRUNCATED AT 250 WORDS)

Pustular psoriasis and aseptic purulent arthritis: possible role of leukotrienes B4 and C4 in a flare of synovitis

BACKGROUND

Arthritis is a frequent complication of pustular psoriasis. However, the mechanism of onset of this arthritis still remains unclear.

OBJECTIVES

The present study was conducted to determine whether leukotriene (LT) B4 or LTC4 is one of the proinflammatory mediators that possibly enhance exacerbation of the arthritis lesions.

METHODS

We investigated the condition of the arthritis and autopsy findings of two cases of generalized pustular psoriasis with the severe complication of aseptic purulent arthritis. We also measured the synovial fluid levels of LTB4 and LTC4 by radioimmunoassay.

RESULTS

The collected synovial fluid was purulent, but nonbacterial, and the synovium of the knee joint showed histopathologic evidence of polymorphonuclear leukocyte (PMN) invasion, edema and dilatation of small vessels showing similarity to a histologic reaction in the skin lesions. The immunoreactive (i-) LTB4 and i-LTC4 in the samples significantly exceeded the amount measured in osteoarthritis patients used as the controls.

CONCLUSION

Thus, i-LTB4 and i-LTC4 appear to be generated in the arthritis lesions of pustular psoriasis, the former attracting PMNs to the joints and the latter causing exudation of synovial fluid.

Brain activation study by use of positron emission tomography in unanesthetized monkeys

A system for the measurement of brain activity in conscious monkeys by positron emission tomography (PET) was established in the present study. The signal/noise ratio was maximal around 40 s for data acquisition in the PET scan with 15O-labeled water. When the monkey was stimulated by vibration and subtraction images of the data sets from regional cerebral blood flow (rCBF) changes in paired stimulation and control were superimposed on magnetic resonance images obtained from the same specimens, a somatotopic map corresponding to the sites stimulated was clearly demonstrated. Visual stimulation with a photic stimulator activated the corresponding regions of the primary visual cortex. Comparison of the activated sites and extents under the conscious state with those under anesthesia assured that the study is controllable; there was little unpredictable activation due to unlimited subject movement or to psychological effects.

Changes in clinical features, histologic findings, and antigen profiles with development of pemphigus foliaceus from pemphigus vulgaris

BACKGROUND AND DESIGN

Several articles have described patients with pemphigus who showed a transition from pemphigus vulgaris (PV) to pemphigus foliaceus (PF) or vice versa. However, there have been no adequate reports in the literature on the association between transition in disease type and change in autoantibody reactivity against the pemphigus antigens. We investigated the antigen profiles of the serum samples obtained from two patients with pemphigus who were demonstrated to shift from PV to PF with evidence from clinical, histologic, and immunohistologic findings. Western blot technique was performed using normal human epidermal extracts as an antigen source.

RESULTS

The serum samples of both cases at the PV stage reacted with the 130-kd antigen and the serum samples at the PF stage reacted with the 150-kd antigen. Accordingly, the dermatologic, histologic, and immunohistologic findings before and after the transition from PV to PF were clearly related to changes in the serum reactivity with the pemphigus antigens.

CONCLUSIONS

This was the first investigation completely demonstrating changes in antigen profiles at the molecular level consistent with transition from the PV to the PF form of the disease. Moreover, the findings of this study confirmed the existence of a close correlation between the 130- and the 150-kd antigens, with the onset of each form of the disease.

Genistein but not staurosporine can inhibit the mitogenic signal evoked by lithium in rat thyroid cells (FRTL-5)

Long-term administration of lithium is one of the well-known causes of goiter. It can stimulate DNA synthesis in rat thyroid cells (FRTL-5) treated with thyroid-stimulating hormone (TSH). To investigate the mitogenic signal transduction system activated by lithium, lithium-induced DNA synthesis and Ca2+ influx were studied using two protein kinase inhibitors, genistein as a specific tyrosine kinase inhibitor and staurosporine as a potent inhibitor of protein kinase C. Genistein but not staurosporine blocked the DNA synthesis induced by lithium in TSH-primed cells but neither compound had any effect on the Ca2+ entry stimulated by lithium. Genistein clearly attenuated the phosphotyrosine content of the 175 kDa substrate in the presence of lithium but staurosporine failed to do so. Moreover, lithium could also stimulate DNA synthesis in protein kinase C down-regulated cells. These data demonstrate that lithium may require the activation of a particular genistein-sensitive kinase, possibly a tyrosine kinase, to induce cell proliferation. It is suggested that the phorbol ester-sensitive protein kinase C family might not participate in the mitogenic signal transduction pathway activated by lithium.

Effects of agars on determination of potency of polymyxin B sulfate by the agar plate diffusion method

The effects of agars on the determination of the potency of polymyxin B sulfate by the agar plate diffusion method were investigated. The results showed that there were significant differences in the potency of polymyxin B sulfate between agars produced by different manufacturers. In order to investigate this phenomenon, two major components of polymyxin B sulfate, namely, the polymyxin B1 and B2 fractions, were isolated and purified by preparative high-pressure liquid chromatography, and the effects of agars on the potencies of these two components were individually examined. The results showed that there were significant differences in the relative potency of the B1 component versus that of the B2 component between the agar preparations produced by different manufacturers. On the basis of the relative potency of each of the components and the composition of the components, we developed a theoretical equation with which we could calculate the activity of polymyxin B sulfate on a certain agar. The values computed from the equation were consistent with those obtained from actual measurements. It was concluded that the effects of agars on the determination of polymyxin B sulfate activity will become evident only when the composition of the reference standard significantly differs from that of the samples. When the standard and samples have the same compositions, the sources of the agar preparation exert no effect on the determination of the potency by the agar plate diffusion method.

Epidermolysis bullosa simplex with transient erythema circinatum

A 4-week-old male infant who developed blisters on the face, hands and buttocks immediately after birth was diagnosed as suffering from generalized epidermolysis bullosa (EB) simplex (Köbner). At 6 months of age, centrifugally expanding erythema circinatum suddenly appeared on the trunk and limbs. Blood tests showed transient elevation of liver enzymes. An intercurrent illness such as a bacterial or viral infection, or an adverse reaction to a drug was suspected, but no supportive evidence was obtained. The circinate or arciform pattern of the eruption, and the ultrastructural findings of basal cell cytolysis and some tonofilament aggregation suggested a possible diagnosis of epidermolysis bullosa herpetiformis (Dowling-Meara) [DM-EB]. However, the predominant feature of this child's dermatosis was erythema circinatum, with a small number of blisters limited to the areas affected by erythema. The erythema resolved spontaneously after 8 months. Round or whisk-like clumping of tonofilaments, a typical finding in DM-EB, was not demonstrated on electron microscopy. These observations were not consistent with classical DM-EB, and we consider that this case is an unusual form of EB simplex showing transient erythema circinatum.

Isolation and structure elucidation of the major photodegradation products of pirmenol hydrochloride

Column chromatography, thin-layer chromatography, high-performance liquid chromatography, nuclear magnetic resonance spectrometry, and high-resolution mass spectrometry were employed to separate and identify the photodegradation products of pirmenol hydrochloride [(+/-)-cis-alpha-[3-(2,6-dimethyl-1-piperidinyl)propyl]-alpha-phenyl-2- pyridinemethanol monohydrochloride monohydrate], a new antiarrhythmic drug. A methanol solution of pirmenol was irradiated using a low-pressure mercury lamp. The solution afforded four major degradation products, three of which were identified as 3-(cis-2,6-dimethylpiperidinyl)propyl 2-(2-pyridyl)phenyl ketone, 2-(2-pyridyl)benzoic acid, and methyl 2-(2-pyridyl)-benzoate. The degradation followed apparent-first-order reaction kinetics. In addition, the possible photodegradation pathways are discussed with reference to reaction mechanisms.

Staurosporine can inhibit the G1-S transition induced by a calcium channel agonist by blocking the pathway independent of phorbol ester-sensitive protein kinase C in rat thyroid cells (FRTL-5)

IGF-I, when added to TSH-primed FRTL-5 cells, can induce a long lasting Ca2+ influx followed by the DNA synthesis. BAY K8644, a Ca2+ channel agonist, can also induce the DNA synthesis in TSH-treated cells. Staurosporine, which is known to be a potent inhibitor of protein kinase C(PKC) strongly inhibited the DNA synthesis caused by these two reagents. However, in PKC-down regulated cells, IGF-I and BAY K8644 could also evoke the DNA synthesis and the inhibitory effect of staurosporine persisted. These inhibitory effects did not relay on inhibition of the Ca2+ influx induced by BAY K8644. Thus these results demonstrate that staurosporine acts at a point distal to Ca2+ influx to inhibit G1-S transition and this staurosporine-sensitive pathway possibly mediates the mitogenic signal in PKC-independent manner.

Can renal handling of phosphate predict response to growth hormone therapy in normal variant short children by short-term treatment?

We investigated if renal handling of phosphate could predict height velocity in 28 normal variant short children (16 boys and 12 girls). Before and after human growth hormone was given for four consecutive days, the ratio of maximum tubular reabsorption rate for phosphorus to glomerular filtration rate (TmP/GFR) was calculated. Based on increments in TmP/GFR (delta TmP/GFR) with growth hormone administration, the patients were divided into two groups; children in whom the levels of delta TmP/GFR were 0.8 mg/dl GF or more (group A, n = 7) and those with levels less than 0.8 mg/dl GF (group B, n = 21). All children in group A and some in group B (n = 9) were injected with 0.5 IU/kg/week of recombinant human growth hormone for over one year. Height velocity during therapy was significantly greater in treated children in group A than in group B and was similar among treated (n = 9) and untreated (n = 12) children in group B. The present study suggests that change in renal handling of phosphate during short-term growth hormone administration can serve to select normal variant short children who will respond well to growth hormone therapy.

Comparative study of staphylococcal flora on the skin surface of atopic dermatitis patients and healthy subjects

Bacterial samples were obtained from the facial and forearm skin of atopic dermatitis (AD) patients and healthy subjects in humid summer weather. Staphylococcus (Staph) species bacteria were selectively sampled by a plate-contact technique using mannitol salt medium-coated film. Staph species were isolated from the film after the number of colonies was counted, and the species were determined by the API-Staph system and coagulase test. Large numbers of S. aureus were isolated in the samples from the facial skin of patients with severe dermatitis, as previously reported. The number of S. aureus colonies in the samples from the forearm skin of the patients was significantly greater than from the healthy subjects; the mean and standard deviation of colony forming units per 10 cm2, expressed as log10 value, were 1.64 +/- 0.96 for patients and 0.02 +/- 0.07 for healthy subjects (p < 0.01). One hundred and seventeen strains were isolated, and their sensitivities to ten antibiotics were tested. Ten of the strains were resistant to some antibiotics; all of these were isolated from patients. Penicillin type antibiotics had weak effects, but cephem type had strong effects. The number of S. aureus colonies isolated in this study was compared with the number isolated during the winter, in our previous study, in order to identify seasonal variations. The only significant seasonal difference was on the forearm skin of the AD patients, which had significantly more S. aureus colonies (p < 0.01) in this study. There were no significant seasonal differences in S. aureus numbers on the facial skin of patients or healthy subjects.

[A study on nephrotoxicity of arbekacin and vancomycin in rats]

Nephrotoxicities of arbekacin (ABK) and/or vancomycin (VCM) were examined by administrating rats intravenously with single doses or 10 times repeated daily doses. ABK was found less toxic to kidney than VCM, and the toxicity was strengthened by combined treatment with VCM and ABK. Fosfomycin decreased the nephrotoxicity when added to the single or combined treatment with ABK and VCM.

Abundant existence of 40kD-cdc2-related protein in rat thyroid cells

The cdc2 kinase family is known to be one of the important factors for cell proliferation in both yeast and mammalian cells. By using polyclonal antibodies against PSTAIRE region of cdc2HS, we studied the amount of cdc2-related kinases in the rat thyroid cell line, FRTL-5, during the cell cycle. The immunoreactive protein with molecular weight 34kD was hardly detectable, instead, 40kD protein exists constantly in amount through G0 phase to S phase. Further, it did not decrease when the cells were cultured in serum- and hormone-free medium. Moreover, we observed an increase of this protein in the nuclear fraction as the cells enter S phase. On the contrary, we could not detect any immunoreactive 40kD protein in primary cultures of rat thyroid cells. These results may indicate abundant existence of this protein might concern cell cycle regulation of FRTL-5 or its immortal feature.

Phorbol ester inhibits DNA synthesis induced by interleukin-6 in TSH-pretreated FRTL-5 cells

Combination of TSH and Interleukin-6 (IL-6) can stimulate DNA synthesis in FRTL-5 cells. Phorbol 12-myristate 13-acetate (PMA) stimulates G0 to G1 transition but inhibits G1 to S transition in these cells. We studied the effect of IL-6 on DNA synthesis in TSH-pretreated FRTL-5 cells in the presence or absence of PMA. IL-6 induced DNA synthesis when it was added to TSH-pretreated cells. Further, PMA inhibited the DNA synthesis induced by IL-6. These data might suggest that in FRTL-5 cells IL-6 can show its mitogenic effect in G1 phase of their cell cycle progression.

In situ expression of interleukin-6 in psoriatic epidermis during treatment

Interleukin-6 (IL-6) is a multipotential cytokine which may act as a growth factor for keratinocytes. The epidermal hyperplasia of psoriasis may be explained in part by an overproduction of this cytokine. We have previously shown by in situ hybridization that IL-6 mRNA is most strongly expressed in the peripheral lesion of an advancing psoriatic plaque. In the present study, we investigated whether there were differences between the expression of IL-6 in untreated psoriatic epidermis and the lesion during the course of clinical improvement. In the untreated psoriatic lesion, the weak expression of IL-6 mRNA was localized in the lower epidermis. However, IL-6 mRNA was not detected in the clearly improved lesion. In the improving lesion, with clinically less scaling, less induration, and histologically thinner epidermis, IL-6 mRNA-expressing keratinocytes were detectable in a greater proportion of the total epidermal components than in the untreated, fully developed lesion. These results showed that IL-6 mRNA was strongly expressed in lesions with moderate epidermal hyperproliferation, indicating that this cytokine may play a role in the transitional phase during the course of improvement as well as in the lesion's formation.

The silencer of mouse Pgk-2 consists of two discrete DNA elements that individually have no effect

Pgk-2 encodes a testis-specific phosphoglycerate kinase isozyme (PGK), and the expression of mouse Pgk-2 is activated during the spermatogenic pathway at the pachytene spermatocyte stage. We previously reported the identification of a silencer-like cis-acting element in a region between nucleotides (nt) -1404 and -685 of mouse Pgk-2, which could be responsible for the repression of Pgk-2 expression in somatic tissues and pre-meiotic testicular germ cells. In the present study, the silencer was precisely located within an 87-bp region between nt -882 and -796. This region contained two distinct sequences that individually bound factors present in nuclear extracts of mouse cultured cells and rat tissues. The two sequences, when aligned in tandem upstream from the Pgk-2 promoter, inhibited cat expression driven by the promoter in mouse erythroleukemia cells, whereas either sequence alone did not show any effect. The results indicate that the Pgk-2 silencer consists of two distinct DNA elements which do not individually influence promoter activity. Binding of distinct nuclear factors to each DNA element appeared to be required for the silencer action.