Hair fibrous protein compositions in some hereditary hair abnormalities determined by two-dimensional polyacrylamide gel electrophoresis

S-carboxymethylated (SCM) fibrous proteins (FPs) from the scalp hairs of the three different hereditary hair abnormalities (trichorrhexis invaginata in Netherton's syndrome, pili trianguli et canaliculi in uncombable hair syndrome, and fine hair in anhidrotic ectodermal dysplasia) were analyzed by two-dimensional polyacrylamide gel electrophoresis. Comparison of the SCM FP compositions of the three hair abnormalities with that of the normal revealed that the SCM FP compositions of these three abnormal hairs were all electrophoretically different from each other and that of the normal.

Objective evaluation for bite plate therapy in patients with myofascial pain dysfunction syndrome

An electromyographic study of the masseter and anterior temporal muscles together with questioning patients regarding subjective symptoms was performed on 15 patients with myofascial pain dysfunction (MPD) syndrome prior to and during bite plate therapy. The electromyographic study was evaluated by the slopes of the voltage tension (V/T) curves (calculated as the value of the relative inclination between the integrated electromyram and the biting force). The improvement of subjective symptoms was recognized earlier than the relief of objective symptoms by bite plate therapy. The results confirm that judgement of level of improvement following treatment of MPD syndrome is more appropriate through objective evaluation. Follow-up recording of the voltage tension can be considered to be an objective indicator for patients with MPD syndrome.

Viscoelastic properties of tissue conditioners--influence of ethyl alcohol content and type of plasticizer

The effect of both the ethyl alcohol content of liquids and the type of plasticizer on the viscoelastic properties after gelation of tissue conditioners was studied by means of a stress relaxation test. The results are summarized as follows. The liquids containing the larger percentages of ethyl alcohol produced the larger flow after gelation. Furthermore, the ethyl alcohol content had a significant influence on changes in viscoelastic properties with the passage of time. Flow properties were found to reduce rapidly with time of storage with an increase in the ethyl alcohol content. The use of benzyl benzoate produced the larger flow after gelation than dibutyl phthalate, which in turn produced the larger flow than butyl phthalyl butyl glycolate. The type of plasticizer, however, was found to have no influence on changes in viscoelastic properties with the passage of time.

Protein-synthesis inhibitor blocks (R,S)-alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA)-or substance P-induced phase shift of the circadian rhythm of neuronal activity in the rat suprachiasmatic nucleus in vitro

The mammalian suprachiasmatic nucleus (SCN) has been identified as a circadian pacemaker. N-methyl-D-aspartate (NMDA), non-NMDA and substance P receptors have been suggested to be involved in handling of photic information in the SCN. In the Aplysia eyes, in which the circadian clocks are involved, serotonin- or cAMP-induced phase changes of the circadian rhythm were reported to be blocked by protein-synthesis inhibitors. Therefore, we investigated whether protein-synthesis inhibitor can block the non- NMDA receptor agonist (R,S)-alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid hydrobromide (AMPA)- or substance P (SP)-induced phase changes of SCN activity rhythm. Although application of 10 microM cycloheximide alone during the early part of the subjective night did not cause phase change, it blocked both 10 microM AMPA- and 1 microM SP-induced phase delay. The present result suggests that protein synthesis may be required in the manifestation of AMPA- and SP-induced phase change of circadian clock.

Primary anaplastic large-cell lymphoma of the skin. A case report suggesting that regressing atypical histiocytosis and lymphomatoid papulosis are subsets

A patient with primary anaplastic large-cell lymphoma of the skin with characteristic clinical findings is described. The diagnosis was made on the basis of histologic and immunohistochemical findings. The phenotype of the tumor cells was not determined, but rearrangement of the T-cell receptor beta gene indicated that the tumor was of T-cell lineage. Despite high-grade malignancy of the tumor cells, the patient unexpectedly had a benign clinical course. The findings in this case suggest that regressing atypical histiocytosis and lymphomatoid papulosis type A are subsets of anaplastic large-cell lymphoma.

GABAA receptor agonist muscimol can reset the phase of neural activity rhythm in the rat suprachiasmatic nucleus in vitro

We investigated the phase-resetting effect of muscimol, gamma-amino butyric acid (GABA)A receptor agonist, on the circadian neural activity rhythm of the rat suprachiasmatic nucleus (SCN), which contains a circadian pacemaker. Acute application of muscimol inhibited the neural activity of the SCN in a dose-dependent manner. Under the tissue culture condition, the treatment with 10 microM muscimol during the early- to mid-subjective day on the first day (day 1) in vitro produced the largest phase advance in neural activity rhythm of the SCN on day 2. By contrast, the administration of muscimol during the subjective night produced no change. These phase changes were similar to those reported for dark pulses in constant light. These findings indicate that muscimol can directly affect SCN neurons and reset the circadian pacemaker in the SCN. The GABA neural function through the activation of GABAA receptors may play a role in modulating the phase of the SCN clock, especially during the subjective day.

Vanadium induced hemolysis of vitamin E deficient erythrocytes in Hepes buffer

Several vanadium compounds were tested for their ability to induce in vitro hemolysis of vitamin E-deficient hamster erythrocytes. Free vanadyl caused hemolysis in Hepes buffer but not in Tris or phosphate buffer, while hemolysis was inhibited by catalase, chelators such as deferoxamine mesylate and EDTA, and hydroxyl radical scavengers such as ethanol and D-mannitol. Although metavanadate itself could not induce hemolysis, metavanadate with NAD(P)H caused hemolysis in Hepes buffer only, and superoxide dismutase prevented it. Hydrogen peroxide, hydroxyl radical and Hepes radical were involved in vanadyl-induced hemolysis, superoxide anion was further involved in metavanadate plus NAD(P)H-induced hemolysis. Vitamin E prevented hemolysis under both conditions.

Polyhydramnios: ultrasonic detection of fetal and maternal conditions

Estimation of amniotic fluid volume is an important part of routine obstetric sonography. A relationship between polyhydramnios and poor perinatal outcome has been reported. This study correlates the severity of polyhydramnios with perinatal morbidity and mortality. Among 67 cases of polyhydramnios detected in singleton pregnancies, 8 were associated with maternal conditions including noninsulin-dependent diabetes (5 cases), insulin-dependent diabetes (1 case) and gestational diabetes (2 cases). Forty-four were associated with fetal conditions, including fetal anomalies (31 cases), fetal chromosomal disorders (10 cases) and fetal functional disorders (3 cases). Fifteen of the 67 cases had no apparent underlying fetal or maternal cause. Perinatal death occurred in 19 cases (28%) and was associated with fetal anomalies (12 cases), chromosome disorders (6 cases) and a functional fetal abnormality (1 case). Severe polyhydramnios with amniotic pocket dimensions > or = 120 mm (91%) or with a need for amniocentesis (91%) were associated with fetal abnormalities in most cases. The rate of perinatal death was not increased, indicating that severe polyhydramnios does not always result in lethal abnormalities.

Sequential magnetic resonance features of encephalopathy induced by systemic mastocytosis

A 37-year-old man developed encephalopathy with prominent eosinophilia. Magnetic resonance imaging (MRI) revealed multiple T2-weighted high signal intensity lesions with dimeglumine gadopentetate (Gd-DTPA) enhancement on T1-weighted images, which were distributed in the cerebral cortex, thalamus, deep white matter and cerebellum. He was diagnosed as having systemic mastocytosis on the basis of proliferating mast cells in the bone marrow and peripheral eosinophilia. Following steroid administration, there was a rapid improvement of his symptoms and laboratory data. To our knowledge, this was the first reported case of systemic mastocytosis provoking encephalopathy with serial MRI findings.

Rhinophyma in Japan

BACKGROUND

Rhinophyma is an end stage of acne rosacea. It results in a large nose due to a proliferation of sebaceous glands and fibrous tissue. Many cases of rhinophyma have been reported in the Western world; however, in Japan, rhinophyma has been an uncommon disease.

METHODS

We present two patients associated with rhinophyma who were treated by cross-shaped full-thickness excision followed by direct closure and compare the rhinophyma in Japan with that in the West.

RESULTS

To date, only 20 rhinophyma cases including our 2 cases have been reported in Japan. Epidemiologic factors of rhinophyma between the West and Japan do not differ except for location, malignancy and surgical treatment.

CONCLUSIONS

In Japan, almost all cases are located on the lower half of the nose, treated by full-thickness excision followed by application of either skin grafts or direct closure. None have been malignant.

Synaptotagmin can cause an immune-mediated model of Lambert-Eaton myasthenic syndrome in rats

The possible antigenicity of synaptotagmin, a synaptic vesicle protein acting as a cooperative calcium (Ca2+) receptor in exocytosis, was tested to determine whether it is involved in the induction of Lambert-Eaton myasthenic syndrome in which antibodies against voltage-dependent Ca2+ channels or related molecules play a pathogenic role. Repeated injections to Lewis rats with peptides of synaptotagmin residues 20 through 53 or 1 through 30 that are presumably exposed at the nerve terminal surface during exocytosis induced corresponding antipeptide antibodies; on immunoblots, antibodies recognized synaptotagmin that was expressed in the clonal cells. Electrophysiologically, the peptide (residues 20-53)-immunized rats showed (1) reduced acetylcholine quantal content of end-plate potential, (2) an increase in quantal content at high extracellular Ca2+ concentration, and (3) early facilitation followed by less marked depression of end-plate potential amplitude at a tetanic rate of repetitive nerve stimulation. Findings are similar to those in human Lambert-Eaton myasthenic syndrome and passively transferred Lambert-Eaton myasthenic syndrome in mice, and thus suggest that antibody to a synaptotagmin-voltage-dependent Ca2+ channel complex may be involved in the pathogenesis of Lambert-Eaton myasthenic syndrome. The peptide (residues 1-30)-immunized rats showed no electrophysiological abnormality.

Cytopathological changes induced by cadmium-exposure in canine proximal tubular cells: a cytochemical and ultrastructural study

A highly sensitive cytochemical method for demonstrating intracellular Cd using 8-hydroxyquinoline was developed and applied in the cytopathological study of primary-cultured renal tubular cells from beagle kidneys. The Cd-8-hydroxyquinoline emitted a yellowish-green fluorescence which first appeared in the cytoplasm within 30 min and in the nucleus about 60-90 min after exposure to 100 mM CdCl2. It was noteworthy that intranuclear Cd was stained in the nucleolar regions. The sensitivity of the cytochemical method for Cd was estimated to be about 1.0 pg Cd/cell. Ultrastructural features of the dead cells were consistent with those of apoptosis. We conclude that Cd absorbed by proximal tubular cells rapidly reaches to the nuclei and affects nuclear as well as cytoplasmic metabolism.

Bacterial infection in cirrhosis, with and without hepatocellular carcinoma

OBJECTIVE

The extent and type of bacterial infection occurring with liver cirrhosis has remained unknown. Further, while hepatocellular carcinoma (HCC) is known to occur mainly in patients with liver cirrhosis, no report has yet investigated the incidence of bacterial infection in HCC. The purpose of the present study was to establish the prevalence of bacterial infection in patients with HCC.

METHODS

We have retrospectively investigated all 1140 patients with hepatic cirrhosis and/or HCC for any incidence of bacterial infection.

RESULTS

The incidence of bacterial infection was found to be 15.4%, in 740 patients with HCC. This was approximately equal to the incidence of bacterial infection in 400 patients with cirrhosis without HCC, which was found to be 15.3%. When the severity of cirrhosis was graded according to Child-Pugh classification, the incidences of bacterial infection in Child-Pugh class A, class B, and class C were 3.3%, 11.1%, and 31.2%, respectively, in cirrhosis, and 2.3%, 9.1% and 25.6% in HCC. The incidence of bacterial infection increased with the severity of cirrhosis and severe bacterial infections occurred in Child-Pugh class B and C patients.

CONCLUSION

The data suggest that the susceptibility of HCC patients to bacterial infection is mainly related to the underlying cirrhosis and not to the HCC.

The fungicidal effect of human lactoferrin on Candida albicans and Candida krusei

Five oral isolates each of Candida albicans and Candida krusei were studied for their sensitivity to the fungicidal effect of human lactoferrin. Significant inter- and intraspecies variations were observed and with most isolates the sensitivity of C. krusei to lactoferrin was greater than that of C. albicans. Fungicidal activity of lactoferrin was dose-dependent and observable only with the iron-free form of the molecule (apo-lactoferrin). Iron-saturated lactoferrin was ineffective against all isolates. Supernatant protein assays and scanning electron microscopy indicated cell surface alterations--leakage of proteins and formation of surface blebs--only in those Candida isolates that were sensitive to apo-lactoferrin. As lactoferrin is a common, non-immune, mucosal defence protein, its varying mode of action against C. albicans and C. krusei may be related to their different oral carriage rates.

Nucleolar organizer regions are independently associated with a shortened survival in patients with non-small cell lung cancer

We examined nucleolar organizer regions (Ag-NOR) in 102 patients with non-small cell lung cancer (NSCLC). Ag-NOR counts were generally higher in tumours from more advanced stages, or in poorly differentiated adenocarcinomas. Six potential-prognostic indicators included sex, age, year of operation, histology, stage and Ag-NOR count. Stage and Ag-NOR counts had a significant prognostic value in the univariate analysis for 79 patients who died of their lung cancer. In the multivariate analysis, high Ag-NOR counts as well as disease stage were independently associated with a poor prognosis. Furthermore we divided patients into three groups according to their Ag-NOR counts and found that in patients with stage I and II disease higher Ag-NOR counts were associated with shortened survival. This trend did not continue in patients with stage III and IV disease.

[A case of necrotizing scleritis associated with Epstein-Barr virus infection]

Recently Epstein-Barr virus (EBV) is often reported in association with ocular disease. But EBV has not been reported to cause necrotizing scleritis. A 71-year-old woman developed ciliary injection and peripheral corneal ulcer in both eyes. The lesions did not respond to topical steroid and systemic indomethacin. The sclera became transparent and perforated. EBV serologic antibody titers were strongly positive. Anti-viral capsid antigen (VCA)-IgG was 1: 1,280 and anti-early antigen (EA)-IgG was 1: 640. These serologic results suggested active EBV infection. Using immunofluorescence techniques, the squamous epithelial cells of the conjunctiva were stained with monoclonal antibody against EBV-VCA and strongly stained with antibody against IgG. The results of serologic test and the immunofluorescence techniques appeared to suggest that the necrotizing scleritis was caused by EBV.

[Neuropathological study of autosomal dominant ataxia linked to loci on chromosome 6p (SCA 1)]

We reported an autopsy case of hereditary OPCA genetically proved to be SCA 1. Clinically, he showed cerebellar ataxia from beginning to the end stage, and was characterized by slow eye movement with external ophthalmoplegia, pyramidal tract signs, generalized amyotrophy including facial muscle, mild bulbar paresis, mild dementia, and urinary disturbance. Neuropathologically, the degeneration and loss of neurons with gliosis were seen in the Purkinje layer, dentate nucleus of the cerebellum, inferior Olive nucleus, motor nucleus of cranial nerve, anterior horn of the spinal cord, and column of the Clarke. And the myelinpallor was revealed in the connecting nerve fiber of these lesions, posterior column and spinocerebellar tract of the spinal cord.

Detection of human T-cell lymphotropic virus type-1 proviral DNA in the saliva of an adult T-cell leukaemia/lymphoma patient using the polymerase chain reaction

We report a case of adult T-cell leukaemia/lymphoma (ATLL), in whom the polymerase chain reaction (PCR) on genomic DNA from saliva demonstrated the monoclonal integration of human T-cell lymphotropic virus type-1 (HTLV-1) proviral DNA in lymphocytes in the saliva. These results provided evidence of the possibility of saliva-borne transmission of HTLV-1.

[A case of alcoholism presenting pellagra and hypokalemic myopathy]

A 32-year-old man with chronic alcoholism over 10 years developed skin eruptions, dark-red tongue and severe watery diarrhea, followed by weakness of bilateral lower extremities. Physical examination revealed hyperpigmented skin eruptions with scales on the dorsa of his hands and extensor aspects of his forearms. Neurological examination showed proximal muscle weakness of both lower extremities, hyperactive knee and ankle jerks, positive Chaddock reflexes and stocking type sensory disturbances. Laboratory data revealed elevation of myolytic enzyme, hypokalemia and decrease of niacin level in the blood. Diagnosis of hypokalemic myopathy and pellagra was made. With the correction of serum potassium level, muscle weakness improved rapidly and with the supplement of niacin, other physical signs and symptoms improved. In this case hypokalemic myopathy could be attributed to the alcoholic malnutritional state such as pellagrous diarrhea, malnutrition, malabsorption and others.

Effect of somatostatin on circadian rhythms of firing and 2-deoxyglucose uptake in rat suprachiasmatic slices

In mammals, the suprachiasmatic nucleus (SCN) of the hypothalamus appears to act as a circadian clock. The SCN vasoactive intestinal polypeptide-like immunoreactive neurons, which may act to mediate photic information in the SCN, receive input from neurons immunoreactive for somatostatin (SST). Therefore we investigated the role of SST as a transmitter for entrainment by analyzing the phase-resetting effect of SST on the circadian rhythm of SCN firing activity. Perfusion of SST increased 2-deoxyglucose uptake at circadian time (CT) 18, but not at CT6. A 1-h or 15-min treatment with SST produced phase delays when it was administered at CT13-14 and phase advances at CT22-23. Thus SST-induced phase changes are similar to those for light pulses to animals under constant darkness. The present findings suggest that SST is a transmitter for mediating information of entrainment to circadian clocks within the SCN.

Acyclovir-resistant herpes zoster encephalitis successfully treated with vidarabine: a case report

A 78-year-old man developed herpes zoster virus (HZV) encephalitis. Initially, treatment with aciclovir (750 mg per day) improved CSF cell count and protein level. During the treatment, however, encephalitis in the patient deteriorated in spite of the treatment with aciclovir, suggesting that HZV in the patient had become resistant to aciclovir. Subsequent treatment with vidarabine (600 mg per day, for 15 days) resulted in dramatic improvement in CSF pleocytosis. About two months after the discontinuation of vidarabine, the CSF cell count was normal. The patient became alert gradually, but his amnestic syndrome remained unchanged. Vidarabine may be recommended in the treatment of HZV encephalitis when aciclovir is not effective.

T-cell receptor gene rearrangement in cells infiltrating skin eruptions specific to adult T-cell leukemia

We examined T-cell receptor gene rearrangement in skin lesions and peripheral blood from 6 patients with adult T-cell leukemia (ATL) using the Southern blot method and a c beta 1 probe. A rearrangement signal common to skin lesions of all 6 patients was observed. One patient (Case 4) exhibited another rearrangement signal in the skin lesion and an identical signal was detected in the peripheral blood. This is the first report describing a specific pattern of T-cell receptor gene rearrangement in ATL. The signal obtained is assumed to represent receptors of T cells involved in surveillance of HTLV-I infected T cells.

Angiosarcoma of the chest wall with a gastric metastasis

A rare case of chest-wall angiosarcoma with high tendency of local recurrence and with a solitary gastric metastasis is reported. The patient was an 84-year-old man who had a left lateral thoracic mass with a colic pain. The histological diagnosis of a biopsied specimen suggested an angiosarcoma. The first resection was performed, the resected specimen consisted of the 8th, 9th and 10th ribs including the tumor. However the tumor recurred around the primary site and the second resection was undertaken eight months after the first resection. Only three months after the second resection a second chest-wall recurrence together with a solitary gastric metastasis was found. Progressive emaciation, anemia and thrombocytopenia became evident, and the patient died the 40th day after the gastrectomy. Primarily a wide resection of the chest wall beyond the pathologically negative region around the tumor is thought to be necessary.

Acquired dermal melanocytosis of the hand: a new clinical type of dermal melanocytosis

We report a 22-year-old man with acquired dermal melanocytosis on the hand which developed without any history of previous inflammation. He had no history of contact with or oral administration of any drugs or metals which might have caused pigmentation. Histopathologically, spindle-shaped dermal melanocytes were observed running parallel to the collagen bundles and scattered in all portions of the dermis. The dopa reaction of these cells was positive. Ultrastructurally, dermal melanocytes containing numerous melanosomes (stages II to IV) which were surrounded by the extracellular sheath were observed. Differential diagnosis of other dermal melanocytosis was discussed.