Familial cases of psoriasis vulgaris and pustulosis palmaris et plantaris

Two familial cases of psoriasis vulgaris and pustulosis palmaris et plantaris and their HLA types were examined. Our cases suggest a close genetic relationship between these two diseases.

[Application of synthetic retinoids and active vitamin D analogues to the skin disorders]

One of the synthetic retinoids Etretinate has been used in dermatology for the various inflammatory keratosis, congenital hyperkeratotic disorders and etc., and plays an important role in the treatment of these otherwise intractable skin diseases. But, it still has various side effects, the most serious among which being teratogenicity, and contraception for at least two years after cessation of the drug is recommended because of its very long half life. Acitretin, a nonesterified analogue with a much shorter half life and Isotretinoin are also used in the USA and Europe. The latter is reported to be very effective to severe cystic acne. Apparently, better compounds with less toxicity and a shorter half life are needed. A topical application of retinoid is under clinical evaluation. A topical application of active vitamin D3 and its analogues are shown to be effective for psoriasis, one of the most common intractable skin diseases. Calcitriol is already used in several European countries, and 1,24-dihydroxyvitamin D3 successfully completed aclinical studies in Japan. Topical vitamin D preparations will be important and useful in dermatology in the near future. Although an action of active vitamin D on the skin is not fully understood, we speculate that it plays an important role in the regulation of epidermal growth and differentiation.

[A method for measurement of circulating blood volume with fluorescein isothiocyanate labeled red blood cells]

We developed a new method to measure the total circulating blood volume using fluorescein isothiocyanate (FITC) labeled autologous red blood cell as an indicator. Red blood cells were labeled by incubation with 0.1 mg.ml-1 FITC in PBS (pH 7.2) for 30 min at 37 degrees C. Eighteen dogs were given an intravenous injection of FITC labeled red blood cells, which were approximately 0.1% of the total circulating red blood cells estimated from the body weight. The ratio of labeled cells to the normal circulating red blood cells was determined by a flow cytometry. The total blood volume was calculated from its dilution rate. The average circulating blood volume determined by this method was 76.8 +/- 9.2 ml.kg-1 (mean +/- SD). This result coincides well with the values reported previously. This method using non radioactive tracers enables a reproducible measurement of circulating blood volume and its change with time.

[A case of solitary splenic abscess caused by Salmonella enteritidis and cured completely by antibiotic therapy alone]

Solitary splenic abscess is a rare disease and usually treated with splenectomy. A 78-year-old female with diabetes mellitus and liver cirrhosis was admitted to our hospital in a state of fever and left hypochondralgia. The abdominal ultrasonogram and CT scan showed the splenomegaly and one abnormal mass in the spleen. Drainage under sonographic guidance was attempted to the splenic mass but only a little amount of aspiration fluid was obtained, from which Salmonella Enteritidis was detected. No other abscess in the other organs was detected, resulting in the diagnosis as solitary splenic abscess caused by S. Enteritidis. Antibiotic therapy was carried out and the abscess disappeared judging from the ultrasonogram, CT scan, and laboratory data. The present case suggests that the fully application of ultrasonogram, CT scan, and drainage for the diagnosis leads to the healing of solitary splenic abscess without operation. This is the first case of S. Enteritidis infection in the spleen reported in Japan.

Pyridoxine toxicity to cultured fibroblasts caused by near-ultraviolet light

Pyridoxine, like riboflavin, has absorption in the range of near ultraviolet (UVA; 320-400 nm) radiation and is known to decompose after long irradiation with germicidal lamps. Thus, the possibility of UVA-induced pyridoxine photosensitization was studied in cultured normal human, hydroa vacciniforme, and xeroderma pigmentosum fibroblasts. Cytotoxicity caused by the sensitization was measured by post-UVA colony formation. Pyridoxine showed strong cytotoxic effect after UVA radiation and the effect remained for at least 60 min after UVA radiation. Although the cytotoxicity decreased a little when pyridoxine was irradiated under anaerobic conditions, the amount of hydrogen peroxide produced by UVA radiation was hardly cytotoxic and the rate of photodecomposition of pyridoxine was slower under anaerobic conditions than aerobic ones. Thus, the toxicity seemed to depend mostly on the photoproducts of pyridoxine. The UVA-induced pyridoxine cytotoxicity was not due to DNA damage that is to be excision-repaired because group A and C xeroderma pigmentosum fibroblasts were killed as in the case of normal human fibroblasts.

[Successful embolization of bronchial artery in racemose hemangioma]

A 74-year-old male was admitted to our hospital because of hemoptysis. Bronchoscopic examination showed a polypoid lesion in the right middle lobe bronchus. Biopsy of the polypoid lesion caused a massive bleeding. A massive hemoptysis of about 1,200 ml occurred again on the 13th day after biopsy, angiographic embolization of the right bronchial artery was performed successfully. Dilatation, convolution and hypervascularization of the right bronchial artery were observed, and anastomosis with pulmonary artery was seen. The diagnosis of primary racemose hemangioma of the bronchial artery was made. There was no recurrence of hemoptysis 3 years after the embolization procedure. Bronchial artery embolization is an effective method of treatment of hemoptysis due to racemose hemangioma.

[Participation of non-major histocompatibility complex gene in experimental autoimmune uveitis]

It is known that the susceptibility of experimental autoimmune uveitis (EAU) is controlled by both major histocompatibility antigen complex (MHC) and non-MHC genes. In this report, we studied the role of non-MHC gene in the induction of EAU. LEW, WKAH, (LEW x WKAH) F1 and (LEW x WKAH) F2 rats were examined for their incidence and severity to develop EAU by immunization with bovine S-antigen (S-Ag). We found that all LEW rats developed severe EAU within 2 weeks after immunization, but no WKAH rat did. Most F1 rats developed mild inflammation in 3-4 weeks after immunization. A quarter of F2 rats developed EAU within 2 weeks, half of them developed it in 3-6 weeks after immunization, and the others did not. These findings suggest that only one non-MHC gene controls the susceptibility to S-Ag induced EAU in rats.

Nucleotide sequence of the Clostridium stercorarium xylA gene encoding a bifunctional protein with beta-D-xylosidase and alpha-L-arabinofuranosidase activities, and properties of the translated product

The nucleotides of the beta-xylosidase (xylA) gene from Clostridium stercorarium were sequenced. A single open reading frame of 473 codons specifying the subunit (MW 53,340) of xylosidase was identified. The N-terminal amino acid sequence and molecular weight estimated by SDS-polyacrylamide gel electrophoresis of the purified enzyme were quite in agreement with those deduced from the nucleotide sequence. Analysis of the enzyme by gel filtration on an HPLC column gave a molecular weight of 220,000, suggesting that the native enzyme is a tetramer composed of 4 identical subunits. The pH optimum was 7.0 and quite stable over the pH range of 5 to 10 at 4 degrees C. The optimum temperature was 65 degrees C. Vm was estimated to be 5.9 nmol/min/micrograms for p-nitrophenyl-beta-D-xylopyranoside and 16.7 nmol/min/micrograms for p-nitrophenyl-alpha-L-arabinofuranoside, while Km was estimated to be 2.5 mM for p-nitrophenyl-beta-D-xylopyranoside and 17.6 mM for p-nitrophenyl-alpha-L-arabinofuranoside.

Early cancer of the gastric remnant with special reference to the importance of follow-up of gastrectomized patients

Seven patients with early cancer of the gastric remnant (group 1) and nine with gastric remnant cancer that developed after surgery for early gastric cancer (group 2) were studied clinicopathologically. In group 1, the great majority of cases were classified as type I by gross type. Most lesions existed in the posterior wall of the remnant stomach. All lesions were differentiated carcinomas. In group 2, six of the nine early gastric tumors resected at the initial surgery were present in site A and three in site M. Gross tumours were of various types. Six patients underwent Billroth II resection and two underwent Billroth I resection. At second surgery (for gastric remnant cancer) four lesions were found to be located in the gastric stump or anastomosed region and five in the posterior wall of the stomach remnant. Histologically, the lesions included four undifferentiated carcinomas and five differentiated carcinomas. Of the nine lesions involving the gastric remnant, only two were early stage: the remaining seven were in an advanced stage. Prognosis was extremely poor in the group, many patients dying of carcinomatous peritonitis. In summary, most group 1 patients had a type I lesion in the remnant stomach. In group 2, more than half of the lesions were present in the gastric stump or anastomosed site and most were in an advanced stage. These observations suggest that it is very important to follow up patients operated on for early gastric cancer in order to detect malignant lesions, if any, in the remnant stomach before disease progresses to a stage at which radical resection is no longer possible. Follow-up will no doubt improve long-term results following surgery for early gastric cancer. We consider endoscopic examination and biopsy, especially of the gastric stump and anastomosed site, of great importance for gastrectomized patients.

Growth inhibitory effect of eicosapentaenoic acid on cultured human epidermal keratinocytes

The effect of eicosapentaenoic acid (EPA, 20:5n-3) on the proliferation of cultured human epidermal keratinocytes was investigated. The keratinocytes were treated with 3 micrograms/ml of EPA for 48 h and then their fatty acid composition was analyzed by gas liquid chromatography. A significant amount of EPA was incorporated by the cells. The treatment with EPA at concentrations of 0.3-6.0 micrograms/ml resulted in a dose-dependent inhibition of the growth of the cells. These results indicate that EPA can be incorporated by cultured keratinocytes and change their fatty acid composition, which might endogenously affect their growth.

Ultrastructural study of extramammary Paget's disease--histologically showing transition from bowenoid pattern to Paget's disease pattern

Histological, immunohistochemical, and ultrastructural studies were performed on two cases of histologically unusual extramammary Paget's disease. Histologically, the central area of the lesions showed a bowenoid pattern, and the peripheral area showed typical extramammary Paget's disease. The transition zone showed an intermediate pattern. All these areas were positive for CEA and EMA, and negative for S-100 protein. Ultrastructurally, in the intermediate pattern, the tumour cells had abundant cytoplasmic glycogen, and the widened intercellular spaces contained numerous glycogen particles, which were probably secreted by the tumour cells. It is well known that eccrine glands, but not apocrine glands, secrete glycogen particles. Therefore, the present findings suggest that some cases of extramammary Paget's disease are a proliferation of germinative cells with eccrine gland differentiation.

Change of the higher order structure of DNA induced by the complexation with intercalating synthetic polymer, as is visualized by fluorescence microscopy

The electrophoretic movement and Brownian motion of T4DNA, lambda DNA and their complexes with polyacrylamide (PAAm) via intercalative unit from 5-[(4-acryloylamino)phenyl]-3-amino-7-(dimethylamino)-2-methylp henazinium chloride were observed using fluorescence microscopy. It was found that T4DNA/PAAm complex migrates slower than T4DNA alone in gel electrophoresis, although they exhibit similar conformational change during the migration. Quantitative analyses of the translational diffusion of the lambda DNA and its complex in solution demonstrate that the DNA molecules extend due to intercalative binding of PAAm, suggesting the pseudo-grafting structure of the complex.

Isolation and characterization of mouse CD7 cDNA

The human CD7 antigen is a glycoprotein, M(r) 40,000, expressed on the surface of peripheral blood T-lymphocytes and thymocytes, and is the earliest surface antigen to appear on T-cell lineage cells. In this study, putative mouse CD7 cDNA was identified based on its similarities with human CD7. Five independent clones originating from the same mRNA species were isolated (designated as mCD7) by screening a mouse thymocyte cDNA library with human CD7 cDNA, J61, under moderate stringency. The longest insert of a 995 base pair had an open reading frame of 210 amino acids. Northern blot analysis using the mouse CD7 cDNA probe demonstrated a single 1.2 kilobase mRNA in the thymus, spleen, bone marrow, and small intestine. The protein deduced from mCD7 cDNA consisted of the leader, extracellular, transmembrane, and cytoplasmic domains of 24, 126, 21, and 39 amino acids, respectively, based on the hydrophobicity plot and the structure of human CD7. The extracellular domain contained three potential N-glycosilation sites, while the cytoplasmic domain contained one potential protein kinase C phosphorylation site. The amino acid sequence had 45.5% similarity with human CD7, while the similarities for the individual domains ranged from 49.2% to 63.2%. The six highly conserved regions, which may possibly be involved with still unknown CD7-mediated functions, were located in the extracellular and cytoplasmic domains.

Warthin tumor of the parotid gland: MR-pathologic correlation

PURPOSE

To describe the MR appearance of Warthin tumor and correlate the images with pathologic sections.

METHODS

MR studies of seven patients with Warthin tumors in the parotid gland were retrospectively reviewed; MR results were compared with pathologic specimens in five instances.

FINDINGS

One patient had a bilateral tumor; another had three tumors in the right parotid gland and one in the left. Ten tumors showed well-defined borders; the other, which was accompanied by infection, had an indefinite border only at the upper pole. All had thin capsules not shown on MR. Four showed small lobulations at the margins. Fibrosis appeared as septa-like structures of low signal intensity in three cases. There were areas of hemorrhage with accumulation of hemosiderin in two cases. All tumors had low or intermediate T1-weighted signal intensity, four with high intensity areas of cysts containing cholesterol crystals. On T2W images, two tumors had homogeneously intermediate intensity; the other nine had mixed intensity. Areas of intermediate intensity were correlated with abundant epithelial tissues; focal high-intensity areas were correlated with cysts and/or areas of predominant lymphoid proliferation.

CONCLUSIONS

MR findings such as bilaterality and/or multiplicity, well-defined margins, and predominantly intermediate signal intensity on T1W and T2W images with focal areas of high signal intensities on T1W images suggest Warthin tumor, but are not pathognomonic.

NS-398, a novel non-steroidal anti-inflammatory drug with potent analgesic and antipyretic effects, which causes minimal stomach lesions

1. NS-398 (N-[2-cyclohexyloxy-4-nitrophenyl] methanesulfonamide) is a new non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic effects. 2. The anti-inflammatory potency of NS-398 in rat carrageenin-induced edema was as potent as that of indomethacin and 8 times more potent than diclofenac. In rat adjuvant arthritis, NS-398 showed a therapeutic effect comparable to that seen with loxoprofen but less than that seen with indomethacin and diclofenac. 3. The analgesic potency of NS-398 in rat adjuvant arthritic pain was much the same as that of indomethacin, and was about 3-5 times higher than that of diclofenac and loxoprofen. In the Randall-Selitto method in rats, NS-398 was 2-7 times as potent as loxoprofen, diclofenac and indomethacin. In acetic acid-induced writhing in mice, NS-398 was equipotent to indomethacin and diclofenac. 4. In LPS-induced fever in rats, NS-398 was 1.5-4.5 times as potent as loxoprofen and indomethacin, but less potent than diclofenac. 5. NS-398 produced little gastric ulceration in doses of up to 1000 mg/kg, while reference drugs produced distinct stomach lesions in doses of 10-30 mg/kg. 6. NS-398 inhibited prostaglandin (PG) endoperoxide synthase from sheep seminal vesicle microsomes less potent than that of ibuprofen.

Famotidine for gastric radiography

The effectiveness of famotidine (20 mg) in suppressing nocturnal gastric secretion during preparation for gastric radiography was studied in 243 patients. The gastric juice volume was calculated from a single upright radiograph of the stomach. The overall percentage suppression of nocturnal gastric secretion by famotidine was 60%, while it was 47% in patients with upper gastrointestinal symptoms. Radiological examinations were of diagnostic quality in 82% of the controls and 91% of the famotidine group; excellent film were obtained in 45% and 3%, respectively. Our findings suggest that famotidine could be a useful pretreatment for barium meal examinations.

Malignant fibrous histiocytoma coexistent with mucinous cystadenoma of the pancreas

A patient with malignant fibrous histiocytoma (MFH) coexistent with mucinous cystadenoma of the pancreas is reported. Primary MFH of the pancreas is rare, with only six patients reported in the world medical literature. A patient with MFH coexistent with a pancreatic mucinous epithelial tumor has not been reported previously, although two patients with pseudosarcomatous tumor associated with mucinous cystadenocarcinoma of the pancreas have been reported. Mural nodules of similar histologic appearance have been reported in ovarian mucinous tumors. The authors believe this to be the first report of the occurrence of MFH in mucinous cystadenoma of the pancreas.

A two-colour flowcytometric study of cell kinetics and differentiation of human keratinocytes in culture

Double histochemical staining followed by flow cytometric analysis was performed to determine whether involucrin synthesis is associated with a particular phase of the cell cycle. In low-calcium medium (0.1 mM) monolayer cultures the expression of involucrin was confined to about 8% of the total cell populations. When the concentration of calcium was increased to 1.8 mM, the percentage increased and the distribution pattern of the cell cycle changed. The addition of retinoic acid at concentrations in the range 10(-8) M to 10(-6) M to a high-calcium medium induced a further increase. The greatest increase in involucrin expression (up to five-fold) occurred in both the G1/G0 and G2 + M phases, while S phase cells showed a two-fold increase. The results indicate that involucrin synthesis is induced by retinoic acid, which occurs at any stage of the cell cycle, even in the S phase.

A case of hypersensitivity syndrome resembling Langerhans cell histiocytosis during phenobarbital prophylaxis for convulsion

The case of a two-year-old girl with generalized histiocytosis, probably induced by phenobarbital, is reported. Symptoms, including intermittent fever, systemic lymphadenopathy, maculopapular skin eruption and hepatosplenomegaly, suggested Langerhans cell histiocytosis. Laboratory examinations revealed leukocytosis with lymphocytosis and eosinophilia and a high LDH serum level, while GOT and GPT were within normal ranges. Cytological studies of lymph node and pleural effusion specimens revealed proliferation and infiltration of Langerhans cell histiocytes with eosinophilia. No histiocyte proliferation was observed in the bone marrow or skin. The clinical manifestations shown by the patient were, however, transient, and improved spontaneously after the discontinuation of phenobarbital. The case was considered to be one of phenobarbital hypersensitivity syndrome based on clinical course and laboratory findings. The mechanism and differential diagnosis of the syndrome are discussed.

Somatosensory evoked potential correlates of psychophysical magnitude estimations for air-puff stimulation of the foot in man

Short air-puff stimuli were applied to the sole of the right foot to obtain both psychophysical and neurophysiological responses. The detection threshold (So) was first determined, and six levels of stimulus intensity above threshold were adopted for magnitude estimation. Somatosensory evoked potentials (SEPs) were also recorded over the foot projection area (2 cm posterior to Cz) for the six stimulus intensities. Six components (N40, P45, N55, P70, N80 and P90) were recorded within 100 ms following stimulation. A power function with an exponent of 0.94 provided an adequate description of the magnitude estimation values as a function of stimulus intensity, as was verified by the high correlation coefficient (r = 0.87; P < 0.001). Similarly, stimulus-amplitude functions of P45-N55, N55-P70 and P70-N80 SEP components were well represented by power functions with exponents of 0.62, 0.63 and 0.78, respectively. The SEP latencies as a function of stimulus intensity had negative power functions. The latency functions of the P45 and N55 components had the largest negative power exponents (-0.17 and -0.15) and showed the highest negative correlations (r = -0.70 and -0.71, respectively) with the stimulus intensity. These results suggest that both the amplitude and the latency information encoded in the SEPs may contribute to the magnitude estimation of the stimulus.

Pseudomyxoma peritonei with progressive calcifications: CT findings

Development of abdominal calcifications due to pseudomyxoma peritonei is rare. The authors present three cases whereby computed tomographic (CT) studies during or after chemotherapy for pseudomyxoma peritonei demonstrated development and progression of punctate calcifications in the abdomen. The clinical and CT findings of these cases are presented together with a brief review of the pertinent literature.

Opposite effect between intercalator and minor groove binding drug on the higher order structure of DNA as is visualized by fluorescence microscopy

Fluorescence microscopy is applied to obtain the information on the change of the higher-order structure of giant DNA molecules in an aqueous solution. Using T4 DNA, it becomes clear that ethidium bromide, an intercalator, tends to extend the DNA, whereas minor groove binding drugs such as 4',6-diamidino-2-phenylindole and Hoechst 33258 tend to contract the DNA. These changes of higher-order structure have been quantitatively evaluated as the changes in persistent length together with the change of contour length. It is also confirmed that the persistent length obtained by use of fluorescence microscopy is reliable enough comparing with those reported for the shorter DNA by use of light scattering.