Sensitivity of Staphylococcus aureus and Streptococcus pyogenes isolated from skin infections in 1992 to antimicrobial agents

We studied the efficacy of antimicrobial agents against Staphylococcus aureus (S. aureus) and Streptococcus pyogenes (S. pyogenes) isolated from skin infections in 1992. For S. aureus, we measured the minimum inhibitory concentrations (MICs) of the following 10 drugs: methicillin (DMPPC), cefaclor (CCL), gentamicin (GM), erythromycin (EM), clindamycin (CLDM), minocycline (MINO), vancomycin (VAN), fusidic acid (FA), ofloxacin (OFLX) and nadifloxacin (NDFX); for S. pyogenes, we determined the MICs of the following 9 drugs: ampicillin (ABPC), amoxicillin (AMPC), cefpodoxime proxetil (CPDX-PR), erythromycin (EM), clindamycin (CLDM), minocycline (MINO), norfloxacin (NFLX), of loxacin (OFLX) and nadifloxacin (NDFX). These drugs are frequently used to treat skin infections, either systemically or topically. NDFX is a new synthetic fluoroquinolone, recently developed for use as a topical acne medication in Japan. It is used NDFX for acne, but not for skin infections. There were no strains of S. aureus resistant to NDFX, VAN or FA. The resistance (> or = 12.5 micrograms/ml) of S. aureus was highest to GM and lowest to OFLX. Four strains of methicillin-resistant (> or = 12.5 micrograms/ml) S. aureus (MRSA) were found. In contrast, no resistant strains of S. pyogenes were found except to MINO. Only two strains of S. pyogenes were susceptible to MINO. The sensitivity of S. pyogenes to ABPC, AMPC, CPDX-PR, EM and CLDM was very good. All the strains were susceptible at a MIC below > or = 0.05 microgram/ml. However, the S. pyogenes strains were not very sensitive to the new quinolones, especially NFLX. We concluded that penicillins, cephalosporins and macrolides are still effective against streptococcal infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Phototoxicity and photoallergenicity of quinolones in guinea pigs

Clinical reports indicate that the fluoroquinolone group of antibiotics can induce cutaneous photosensitivity reactions. In the present study, phototoxicity and photoallergenicity of quinolones including nalidixic acid (NA) norfloxacin (NFLX), ofloxacin (OFLX), enoxacin (ENX), ciprofloxacin (CPFX), lomefloxacin (LFLX), and tosufloxacin (TFLX) were experimentally examined in an in vivo system using the guinea pig. Phototoxicity of all quinolones tested was demonstrated after a single, oral administration of the drugs and subsequent exposure to long-wave ultraviolet (UVA) at a dose of 30 J/cm2. The phototoxic potencies were: ENX, LFLX > OFLX > NA, TFLX > NFLX, CPFX. Photoallergic reaction was also induced to LFLX and NA by pretreatment with cyclophosphamide, an immunoadjuvant. No cross-reactions in photoallergy were observed among quinolones. The photo-ingestion test was positive in photoallergically sensitized animals, while the photopatch test was negative. This is the first report which demonstrated experimentally the photoallergenicity of quinolones. Clinical features of the photosensitivity due to quinolones can be explained by the results of the present experiments.

A mutation in the Ter gene causing increased susceptibility to testicular teratomas maps to mouse chromosome 18

Little is known about inherited susceptibility to spontaneous germ cells tumours in humans or other species. The Ter mutation in laboratory mice is novel in that it acts codominantly to reduce germ cell numbers on many inbred strain backgrounds and to enhance dramatically inherited predisposition to spontaneous testicular teratocarcinomas in strain 129 inbred mice. We have adopted a PCR-based, DNA pooling method for mice with 'extreme' phenotypes (small testes versus normal-sized testes) to identify a candidate linkage to the Ter locus. Two independent mapping approaches confirmed this evidence for Ter linkage near D18Mit62 on mouse chromosome 18, and suggest a possible human homologue on chromosome 5q.

Mass Production of Ginseng (Panax ginseng) Embryoids on Media Containing High Concentrations of Sugar1

A lot of ginseng embryoids were produced by culturing on high concentrations of sugar media from the embryogenic tissues obtained by moderately high temperature treatment. When the sucrose concentration was 100 g/l, the number of embryoids produced were over 100 pieces per g of inoculum weight. It was about ten times of that produced by culturing on 30 g/l of sucrose. Glucose showed an effect similar to sucrose on the basis of weight percentage. However, mannitol did not show this effect. The embryoids obtained by these processes redifferentiated to normal plantlets on culturing on the medium containing 30 g/l of sucrose. The saponin components of the tissue containing embryoids showed a similar pattern to those of natural GINSENG by HPLC.

The antibiotic susceptibility of Propionibacterium acnes and Staphylococcus epidermidis isolated from acne

We studied the susceptibility of antimicrobial agents to Propionibacterium acnes (P. acnes) and Staphylococcus epidermidis (S. epidermidis) isolated from acne patients. We measured the minimum inhibitory concentrations (MICs) of the following five drugs: roxithromycin (RXM), erythromycin (EM), clindamycin (CLDM), minocycline (MINO) and ofloxacin (OFLX), which are frequently used to treat acne and skin infections. We found many resistant strains of S. epidermidis and some resistant strains of P. acnes. There was a correlation between the resistance of S. epidermidis and the former therapy for acne, but no distinct correlation between the resistance of P. acnes and the former therapy for acne.

Acylated saponins, masonosides A-C, from the corms of Crocosmia masoniorum

Three novel triterpenoid saponins, named masonosides A-C, were isolated from the corms of Crocosmia masoniorum. On the basis of spectral and chemical evidence, the structures of masonosides A-C were elucidated as 3-O-[alpha-L-arabinopyranosyl-(1-->6)-beta-D-glucopyranosyl]-28-O- (2-O- [beta-D-apiofuranosyl-(1-->4)-beta-D-xylopyranosyl-(1-->4)- alpha-L-rhamnopyranosyl]-3-O-(beta-D-glucopyranosyl)-4-O-(2-hydroxy-9-ox o-16- alpha-L-rhamnopyranosyloxyhexadecanoyl)- beta-D-fucopyranosyl)-polygalacic acid, 3-O-[alpha-L-arabinopyranosyl-(1-->6)- beta-D-glucopyranosyl]-28-O-(2-O-[beta-D-apiofuranosyl-(1-->4)-bet a-D- xylopranosyl-(1-->4)-alpha-L-rhamnopyranosyl]- 3-O-(beta-D-glucopyranosyl)-4-O-(2,16-dihydroxy- 9-oxohexadecanoyl)-beta-D-fucopyranosyl)-polygalacic acid and 3-O-[alpha-L-arabinopyranosyl-(1-->6)-beta-D-glucopyranosyl]- 28-O-(2-O-[beta-D-xylopyranosyl-(1-->4)-alpha-L-rhamnopyranosyl]-3-O- (beta-D-glucopyranosyl)-4-O-(2,16-dihydroxy- 9-oxohexadecanoyl)-beta-D-fucopyranosyl)-polygalacic acid, respectively.

Effects of N omega-nitro-L-arginine and capsaicin on neurogenic vasomotor responses in isolated mesenteric arteries of the monkey

Monkey isolated mesenteric arterial rings denuded of endothelium constricted upon transmural nerve stimulation (TNS) in the absence of active muscle tone. The constriction was potentiated by N omega-nitro-L-arginine (3 x 10(-5) M), but not by the D-enantiomer (3 x 10(-5) M). The potentiation was reversed by L-arginine (3 x 10(-4) M). The neurogenic vasoconstriction of mesenteric arteries was also augmented by capsaicin, but to a lesser extent than that induced by N omega-nitro-L-arginine. Indomethacin (10(-5) M) did not affect TNS-induced vasoconstriction. These findings suggest that nerve-derived nitric oxide or a related substance may play a greater role than do capsaicin-sensitive vasodilator transmitters in neurogenic regulation of mesenteric arterial tone in the monkey. The transmitter mechanisms for vasodilation in mesenteric circulation vary among species.

Cockayne syndrome in two adult siblings

Although survival beyond the second decade is unusual in patients who have Cockayne syndrome, we describe two brothers with the syndrome who are 42 and 55 years of age. Their cultured skin fibroblasts showed extreme UV sensitivity but had almost normal UV-induced unscheduled DNA synthesis. The patients were classified as genetic complementation group B after study of the recovery of RNA synthesis after UV irradiation of fused cells. Clinical phototesting revealed a reduced threshold for UVB erythema.

Endoscopic resection of large colorectal polyps using a clipping method

PURPOSE

In conventional endoscopic snare polypectomy, bleeding and perforation are the principal concerns. To prevent these complications, we employ an endoscopic clipping technique using the HX-3L clipping apparatus.

METHODS

With this method, clips are used to clamp the base of a polyp. A snare is hung peripheral to the clips. The polyp is then resected by coagulating and cutting with an electric current.

RESULTS

Neither bleeding nor perforation during or after polypectomy has occurred, nor have complications related to the use of clips developed. Gigantic polyps were not resected piecemeal, but rather were resected en bloc facilitating a clear determination of cancer on the surface of the resected site. Endoscopic clipping permitted site marking for colonoscopic surveillance.

CONCLUSION

We conclude that the clipping method has many advantages and is a useful technique in colonoscopic polypectomy.

Identification of two point mutations in the gene coding luteinizing hormone (LH) beta-subunit, associated with immunologically anomalous LH variants

To analyze the structure of LH in three patients with immunologically anomalous LH, the whole coding region of the LH beta-subunit gene was examined. These patients were infertile, and their serum LH levels could not be measured with an immunoassay kit. Immunoblotting of the LH beta-subunit showed no marked changes in the molecular size of LH beta. Genomic DNA was extracted from peripheral lymphocytes of the patients and normal controls, and LH beta genes were amplified by the polymerase chain reaction technique, using primer pairs that are capable of specifically amplifying only the LH beta gene without interference by the CG beta genes. No deletions were observed in the coding regions of the LH beta gene of the patients. Nucleotide sequencing revealed two nucleotide substitutions in the LH beta gene of the patients, which cause amino acid replacements from Trp8 (TGG) to Arg8 (CGG) and Ile15 (ATC) to Thr15 (ACC). Restriction fragment length polymorphism analysis in three families indicated that the affected probands were homozygous, and their family members were heterozygous, except for their husbands. The heterozygotes showed reduced detectability with the LH immunoassay kit. These results suggest that these amino acid replacements are responsible for this immunologically anomalous variant.

Biotransformation of 18 beta-glycyrrhetinic acid by ginseng hairy root culture

On administration of 18 beta-glycyrrhetinic acid to hairy root cultures of Panax ginseng, three new biotransformation products, 30-O-[beta-D-glucopyranosyl-(1-->2)-beta-D- glucopyranosyl]18 beta-glycyrrhetinic acid, 30-O-(6- O-malonyl-beta-D-glucopyranosyl)18 beta-glycyrrhetinic acid and 3-O-[6-O- malonyl-beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranosyl]18 beta-glycyrrhetinic acid, were isolated together with three known compounds. Ginseng hairy roots showed the biotransformation abilities of glycosylation and malonylation to 18 beta-glycyrrhetinic acid.

An evaluation, using computerized image analysis, of antimicrobial efficacy of an automatic hand washing machine with ultrasonic wave spraying

We studied the antimicrobial efficacy of hand washing with a quick-dry hand washing machine [TE-KIREIKI] employing ultrasonic wave spraying and its incidental alcohol-based product [AROKULIN-E]. The subjects of this study were 10 males who had been instructed not to use any antimicrobial agent for the previous 2 weeks or any hand soap for the previous 5 hours. They pressed their palms on agar before and after washing their hands. After 48-hour incubation at 37 degrees C, the bacterial colonies grown on the agar were counted using the [ASPECT] image processing system. The colony count was expressed as the post-stamp versus pre-stamp percent (%) reduction. Two patterns of hand washing were examined in this study: [A] a 3-second hand wash using an alcohol-based product [AROKULIN-E] and [B] a 30-second hand wash using a nonmedicated detergent soap with running water in addition to hand washing by [A]. The percent (%) reduction after hand washing patterns [A] and [B] were 49.1% and 51.3%. These reduction rates indicated that these patterns did not eradicate bacteria from the hand surface. Therefore, we concluded that this quick-dry hand washing machine employing an ultrasonic wave spraying method combined with an alcohol-based product needs improvement.

Expression of dipeptidyl aminopeptidase IV activity in human lung carcinoma

Dipeptidyl aminopeptidase IV (DAP IV) staining was examined in various histological types of lung carcinomas to evaluate this enzyme activity. A total of 45 lung carcinomas were examined for their enzyme activity. Almost all (93.1%) cases of adenocarcinoma were positive for DAP IV activity, whereas all cases of squamous cell carcinoma, small cell carcinoma, large cell carcinoma and carcinoid were negative. DAP IV activity of microsomes in lung carcinomas was significantly higher in papillary adenocarcinomas than in squamous cell carcinomas. These data suggest that DAP IV may be a good marker to distinguish adenocarcinoma from other histological types of lung carcinoma.

Solid basal cell epithelioma (BCE) possibly originates from the outer root sheath of the hair follicle

The presence and distribution of several cytokeratins (CKs) in 20 solid basal cell epitheliomas (BCEs) were investigated and compared with the pattern of CKs in normal epidermis, perilesional skin and in the outer root sheath (ORS) of the human hair follicle. Tissue samples were stained with monoclonal antibodies (MoAbs) against human CKs, using the APAAP technique. Additionally, CK profiles were assessed by gel electrophoresis and immunoblot technique. Cells of BCE and ORS were positively stained with the MoAb KL1, whereas the basal layer of normal epidermis remained negative. Six out of 20 BCEs were partially stained with the MoAb RPN1165, which also stained the lower ORS, but not the epidermal basal layer. Using SDS-PAGE and immunoblot, the CK profiles of BCE and ORS were almost identical, showing the presence of CKs 5, 6, 14, 16 and 17; the CK pattern of normal epidermis, however, showed the presence of CKs 1, 5, 10 and 14. Perilesional skin (< 5 mm) showed keratin changes similar to the BCE pattern; the basal layer was stained with the MoAb KL1 and the suprabasal layer was negative to MoAb CK1, in contrast to normal epidermis. Keratin analysis revealed a CK pattern of perilesional skin different from that of normal epidermis (CKs 1, 5, 6, 10, 14, 16 and 17). Our immunohistochemical and biochemical investigations underline the possible role of the lower ORS as a cellular pool for the generation of BCE.

Protothecosis in a patient with systemic lupus erythematosus

A rare case of protothecosis in a 40-year-old Japanese woman with systemic lupus erythematosus, under long-term prednisolone treatment is presented. The patient developed extensive ulcerative skin lesions after injury. The characteristic histopathological findings and biochemical sugar assimilation tests indicated infection by Prototheca wicherhamii. The lesions improved following treatment with amphotericin B. The immunodeficient state of this patient seemed to contribute to the infection with Prototheca.

The effect of oxatomide on neutrophil oxygen radical generation

The effect of oxatomide on reactive oxygen species (ROS) generated both by neutrophils and in a cell-free, xanthine-xanthine oxidase system was examined. The species investigated were superoxide radical anion (O2-), hydrogen peroxide (H2O2) and hydroxyl radical (OH.). Oxatomide significantly decreased neutrophil-generated O2-, H2O2 and OH. in a dose-dependent manner. H2O2 and OH. generated in a cell-free system were also reduced in the presence of oxatomide. The present study indicates that oxatomide decreases ROS generation presumably by inhibiting the neutrophil oxygen metabolism, and has the ability to scavenge H2O2 and OH.

IgE and its related phenomena in bullous pemphigoid

This study was designed to analyse IgE and its related phenomena in bullous pemphigoid (BP). We analysed 17 BP sera by indirect immunofluorescence (IIF) and immunoblotting (IB) using a monoclonal antibody to IgE. In addition, inflammatory cells in lesional skin from 11 patients with BP were analysed by the alkaline phosphatase-anti-alkaline phosphatase (APAAP) technique using monoclonal antibodies to IgE and Fc epsilon RII/CD23. IgE class anti-basement membrane zone (BMZ) autoantibody was detected in nine of 17 sera (52.9%) by IIF. IgG class anti-BMZ antibody could block the BMZ-binding reactivity of IgE class antibody. Titres of IgE class autoantibody in the sera ranged from 1:40 to 1:320, and statistically correlated with serum IgE levels. Two of 11 sera contained an IgE class autoantibody which recognized a 230-kDa BP antigen by IB. By radio-allergosorbent test (RAST), IgE-specific antibodies to an extended series of common inhalant and food allergens were detectable in six sera with high concentrations of total IgE (over 3,300 IU/ml). IgE-bearing and Fc epsilon RII-expressing cells were demonstrated in the upper dermis and along the BMZ in seven of 11 biopsy specimens by the APAAP technique. The distribution and number of IgE-bearing cells in the lesions were similar to those of the Fc epsilon RII-expressing cells. These results suggest that both IgE-mediated immune responses and autoimmunity characterize BP as distinctive features.

The incidence of isolation of methicillin-resistant Staphylococcus aureus (MRSA) strains from skin infections during the past three years (1989-1991)

We did a statistical study of 294 strains of Staphylococcus aureus (S. aureus) isolated from skin infections during the period from January of 1989 to December of 1991 in the Department of Dermatology, Kansai Medical University Hospital. We especially examined methicillin-resistant S. aureus (MRSA) from the point of view of incidence, variety of skin infections with MRSA, coagulase type, phase type, and resistance against antimicrobial agents. The frequency of isolation of MRSA has been increasing. In 1991, the proportion of MRSA isolates among all S. aureus strains isolated from skin infections was 41.5%. MRSA was isolated most often from infectious decubitus. Coagulase type II and phage group NT (not typable) MRSA were most frequently isolated. The resistance of MRSA to OFLX and IMP/CS had remarkably increased. Notably, the resistance to MINO was low before 1991.

N omega-nitro-L-arginine, an inhibitor of nitric oxide synthesis, decreases noradrenaline outflow in rat isolated perfused mesenteric vasculature

In the isolated perfused rat mesenteric vasculature with intestine attached N omega-nitro-L-arginine (L-NNA) (30 mumol/l), an inhibitor of nitric oxide (NO) synthesis from L-arginine, did not alter spontaneous noradrenaline outflow. Transmural field stimulation (2-10 Hz) caused a frequency-dependent increase in noradrenaline outflow. The evoked overflow was reduced by L-NNA. L-Arginine (0.3 mmol/l) attenuated the inhibition of noradrenaline overflow by L-NNA. These results suggest that NO increases the release of noradrenaline in rat mesenteric vasculature.

[Histopathology of thrombotic thrombocytopenic purpura]

The most striking lesions of thrombotic thrombocytopenic purpura (TTP) are the subendothelial hyaline deposits and multiple occlusive thrombi. They are found in the small arteries, arterioles, and capillaries of many organs, especially the heart, brain, kidneys, and adrenal glands. Immunohistochemical examination demonstrates that the thrombi in TTP are strongly positive for von Willebrand factor (vWF) antigen, but only weakly for fibrinogen/fibrin. Electronmicroscopically, the thrombi in TTP were composed of tightly packed platelets, showing varying degrees of cytoplasmic alteration and degranulation with a small amount of interspersed fibrin and amorphous materials. Many etiological factors causing intravascular platelet aggregation have been postulated, including unusually large vWF multimers, platelet agglutinating proteins and immune abnormalities. All the lesions in TTP are strongly positive for vWF antigen. This result suggests that vWF multimers may play an important role in the pathogenesis of TTP.