[A case of Churg-Strauss syndrome associated with severe leg pain and necrotizing skin lesions]

A 68-year-old woman with bronchial asthma and a history of drug hypersensitivity came to our hospital because of severe pain, swelling, and ecchymoses in the lower extremity. The eosinophil count was 53.5%, therefore Churg-Strauss syndrome was diagnosed and she was given prednisolone (PSL) (30 mg/day). A skin specimen taken the next day showed tissue eosinophilia, acute and subacute necrotizing vasculitis. Immunofluorescence staining showed IgG in the blood vessels. After one month of PSL, biopsy specimens of muscle fiber revealed atrophy of type IIb fibers, and myxomatous degeneration of neuron-fibers. Eosinophilia decreased rapidly after administration of PSL, but the necrotizing lesions of the skin, muscle, and nerve were so severe that she needed orthopedic shoes.

[A case of suspected occupational asthma in an orthopedist, due to cast materials containing MDI]

A 38-year-old male presented complaining of an asthma attack. He had a past history of allergic rhinitis and conjunctivitis, family history of bronchial asthma and atopic dermatitis. He was an orthopedist who had been using cast materials containing methylene diphenyl isocyanate (MDI) for one year, and had developed an early asthmatic response while handling the casts. An acetylcholine inhalation test was done and his value was 20000 micrograms/ml. The scratch test for the cast materials was negative though the inhalation challenge test was positive. We suspected that the patient was suffering from bronchial asthma induced by MDI contained in the cast materials. Studies using isocyanates conjugated with human serum albumin were performed. The results were as follows: IgE-RAST negative, ELISA demonstrated the existence of specific IgG for both toluene diisocyanate (TDI) and MDI, as well as IgG4 for both TDI and MDI. The cast contained MDI but not TDI. We therefore considered TDI to be cross-reactant. It was likely that chronic exposure enhancing specific IgG4 and specific IgG might have caused the high IgG4 value. This is the first case of occupational asthma in an orthopedist due to isocyanates.

[Effectiveness of thrice-weekly injection of romurutide for prophylaxis of leukocytopenia during radiation therapy]

The effectiveness of thrice-weekly injection of Romurutide for leukocytopenia due to radiation therapy was analyzed. Twenty-two patients were randomly divided into two groups. Ten of group A cases were injected 3 times per week 10 times (3 weeks) and 12 of group B cases were injected 5 times per week 10 times (2 weeks). White blood cell counts and neutrophil numbers in group A were almost the same as in group B at day-3 and day-8, and those in group A were more than in group B at day-15 and day-22, although there were no statistical significances. Lymphocyte percentages, monocyte percentages and platelet cell counts between groups showed no differences. Injections were stopped in 3 cases due to fever (2 in group A, 1 in group B). The effects were recognized in nineteen cases (excluding above 3 cases). The effect of this thrice-weekly injection method during the injection period was the same or more than with 5 injections/week, and the period of the former was 50% longer. The 3 weekly injection method is more effective for prophylaxis of leukocytopenia.

[A case variant asthma with acetylcholine inhalation challenge test]

A 55-year-old male presented with a chief complaint of exertional dyspnea. He had a daughter suffering with bronchial asthma. He had no pertinent past history. He visited the outpatient clinic of a nearby hospital for evaluation of exertional dyspnea, but routine examination results were normal. He was therefore followed up for only about two weeks without treatment. He was sent to our hospital for further analysis. Physical examination revealed clear lung fields but his respiratory rate was 34 per a minute, PaO2 72.9 mmHg and PaCO2 39.7 mmHg. Respiratory function tests, chest XP, chest CT and ECG findings were unremarkable. Pulmonary infarction was ruled out with a pulmonary perfusion scintigram. However, he was hyperreactive to the acetylcholine inhalation challenge test, the respiratory threshold being 625 micrograms/ml. A variant form of bronchial asthma was thus suspected and a bronchodilator was administered. The medication was very effective. After several weeks, his symptoms had clearly disappeared. Therefore, in a case complaining of exertional dyspnea only, bronchial asthma should be ruled out as a possible cause and the acetylcholine inhalation challenge test might be helpful in making the correct diagnosis. Bronchodilator administration should also be considered.

Simultaneous multielemental analysis of daily food samples by inductively coupled plasma mass spectrometry

Several toxic elements in total composite food samples of hospital diets were determined simultaneously by inductively coupled plasma mass spectrometry (ICP-MS). Trace element concentrations of Be, Cr, As, Cd, Sn, Sb, Ce, Hg and Pb changed widely ranging from a few ng.g-1 to less than 3 micrograms.g-1 in all 24 samples collected through a year. Be, Sn, and Hg were not detected in rice sample alone, and other trace elements, with the exception of Cr and As, were less than approximately 50% levels, as compared with mixed diet samples. The daily intakes of these toxic elements were in the ranges of a few to several hundreds of micrograms.

Effects of ammonium ion and ammonia on function and morphology of in vitro frog gastric mucosa

The effects of ammonium ion (NH+4) and ammonia (NH3) on function and morphology of gastric epithelial cells were studied in intact sheets of in vitro frog (Rana catesbeiana) gastric mucosa. Luminal 115 mM NH4Cl at luminal pH 8.0 (calculated [NH3] 2.7 mM), but not at 5.0 (calculated [NH3] 3 microM) induced 1) an increase in intracellular pH (pHi) in oxynticopeptic cells (OPC) and decreases in transmucosal potential difference (PD) and electrical resistance (R) in resting tissues, 2) a decrease in histamine-stimulated H+ secretion and an increase in H+ backdiffusion after removal of luminal NH4Cl, and 3) augmented acidification of OPC during luminal acidification. Serosal 30 mM NH4Cl at serosal pH 7.2 (calculated [NH3] 0.47 mM) induced 1) an increase in pHi in OPC and inhibition of the alkalinization of OPC after removal of ambient Cl-, 2) a decrease in PD associated with the increase in R and decrease in short-circuit current, effects attenuated by serosal 15 mM K+, accentuated by 0.2 mM Ba2+, and abolished by removal of ambient Cl-, 3) a sudden drop of PD in resting, but not in stimulated tissues, effects prevented by high serosal pH (7.8), serosal HCO3-, or removal of luminal Cl-, 4) a decrease in histamine-stimulated H+ secretion and an increase in H+ backdiffusion after removal of NH4Cl, and 5) augmented acidification of OPC during luminal acidification. These results suggest that 1) luminal NH3, but not NH+4, increases backdiffusion of H+ from the lumen to the mucosa, 2) serosal NH3 and/or NH+4 induces depolarization of OPC and decreases electrogenic Cl- transport, thereby attenuating the activity of the basolateral Cl(-)-HCO3- exchanger in OPC, and 3) both of these effects contribute to the augmented acidification of OPC during exposure to high luminal [H+].

[Digestion method for detection of ferruginous bodies in human tissues from autopsy cases]

We compared three sodium hypochlorite digestion methods and two potassium hydroxide digestion methods for detection of ferruginous bodies in human tissues. The following results were obtained. 1. Methods using sodium hypochlorite were effective for digestion of lung tissue samples, but only in part for greater omentum tissue samples. The potassium hydroxide digestion method worked well for preparation of lung and greater omentum tissue samples. 2. Results obtained by the different digestion methods were compared by Kruskal-Wallis test and Mann-Whitney U-test. No significant difference was detected in concentrations of ferruginous bodies and naked fibers in samples of lung, and tumor and normal tissues of the greater omentum among the digestion methods. 3. A more simplified procedure for sample processing with potassium hydroxide digestion was recommended for detection of ferruginous bodies in human tissues.

[Concentration and form of asbestos fibers in tap drinking water contaminated from a water supply pipe with asbestos-cement]

The identification and concentration of asbestos fibers in tap drinking water supplied in a central area of Akita Prefecture, Japan, were determined by phase-contrast microscopy and a scanning electron microscope equipped with an energy-dispersive X-ray microanalyzer. The following results were obtained. 1. Asbestos fibers were found in the tap water from two areas in which an asbestos-cement pipe was used for public water supply. The concentrations of asbestos fibers in the tap water were 2.7 x 10(4) to 27.0 x 10(4) fibers per liter of water in area A and 10.0 x 10(4) to 21.0 x 10(4) in area B. On the other hand, no asbestos fiber contamination was observed in tap water of area C, which shared a common water source with area A. A vinyl chloride pipe was used over the entire length of the water supply in route C. 2. Crocidolite was the predominant type of asbestos fiber detected in the tap water. Chrysotile and a mixture of chrysotile and amosite were also observed. 3. Almost all asbestos fibers detected in the tap water possessed the form of thick or sheaved fibers with lengths ranging from ca. 5 to 10 microns. Their shapes were very different from those of asbestos fibers found in the atmosphere. The typical form of the latter is short (ca. 1 micron in length) and needle-like. 4. It was suggested that the contamination of asbestos fibers in the tap water was caused by erosion and peeling off of the inner wall of the asbestos-cement pipe used as a conduit. In order to evaluate the safety of drinking water in Japan, an extensive survey on asbestos-fiber contamination in tap water is necessary.

Primary dermal and eye irritability tests of hydrophobically modified hydroxypropyl methylcellulose in rabbits

Primary dermal and eye irritation tests of hydrophobically modified hydroxypropyl methylcellulose (HM-HPMC, hydroxypropyl methylcellulose modified with stearylglycidylether), a new cellulose derivative used as a thickener for topical pharmaceuticals and cosmetics, were conducted in rabbits. A dispersion of HM-HPMC (3%) was applied to intact and abraded skins and reactions were observed. A very slight erythema was observed in both skins and this polymer was categorized as a "mild irritant". In the eye irritation test, with a dispersion of the same concentration, it was categorized as "marginal" in unrinsed eyes and "negative" in rinsed eyes.

Studies on single-dose toxicity of hydrophobically modified hydroxypropyl methylcellulose in rats

Single-dose toxicological studies of hydrophobically modified hydroxypropyl methylcellulose (HM-HPMC, hydroxypropyl methylcellulose modified with stearylglycidylether) were conducted. A dispersion of HM-HPMC was administered to rats orally or by dermal application at doses up to 900 mg/kg. After the oral administration, the mean body weight of the 900 mg/kg group on the first day after administration was slightly but significantly lower (P less than 0.05) than that of the control group, and one rat had loose stools at 30 min. after the administration. No other abnormalities were noted. In the case of dermal application, no abnormalities were observed. No rats died, and no abnormalities in their organs were found by either route. In conclusion, there was no observed toxicity of HM-HMPC after oral or dermal administration at single dose up to 900 mg/kg under the conditions of these studies.

Rapid changes in concentrations of essential elements in organs of rats exposed to methylmercury chloride and mercuric chloride as shown by simultaneous multielemental analysis

An in vivo study of rats given a dominant lethal dose of methylmercury chloride (MMC) or mercuric chloride (HgCl2) was conducted to elucidate the rapid biotransformation of essential elements. The elements were measured by inductively coupled plasma atomic emission spectrometry. For the rat brain Zn concentrations were higher in the MMC group than in the HgCl2 and control groups. The highest Cu concentration was found in HgCl2 dosed rat liver. For the rat kidney the highest Zn concentration was seen in the MMC group. From principal component analysis on the time dependent behaviour of each element in rat organs, characteristics specific to Cu in the liver and kidney and Mn in the brain were found after exposure to HgCl2 and Ca and Zn in the brain after exposure to MMC.

The tissue distribution of 2,3,7,8-chlorine substituted dibenzo-p-dioxins in humans who died of cancer

The tissue distribution of 2,3,7,8-chlorine substituted dibenzo-p-dioxins was conducted in 11 patients who died of cancer. The concentration of octachlorodibenzo-p-dioxin (octa-CDD) was the highest in each organ and tissue and hepta-CDD was also found at relatively high levels, second only to OCDD. The levels of 1,2,3, 7,8-penta-CDD and 1,2,3,6,7,8-hexa-CDD in the spleen were the highest, respectively. 2,3,7,8-Tetra-CDD was also detected and its concentration was the highest in the gonad (0.8-3.2 pg/g-range). From the 2,3,7,8-TCDD toxic equivalent calculations, the highest equivalent value was obtained from a 54-year-old female who died of cancerous goiter. This individual had the highest concentrations of 2,3,7,8-substituted penta- and hexa-CDDs among the 11 patients.

[Effect of mercuric chloride on phospholipid peroxidation in rat]

Individual molecular species of mercuric chloride induced phospholipid peroxide formed in rat brain, liver and kidney were determined using the multi-channel UV-high-performance liquid chromatography (HPLC) combined with potentiometric determination. Mercuric chloride (0.5 mg/kg/day) was administered subcutaneously to rats for 3 days. In accordance with a specified time schedule following administration (0.5, 1, 3 and 5 days), rats were decapitated and the phospholipids of brains, livers and kidneys were extracted and purified. The samples were then injected into the HPLC and the ratio (235 nm/203 nm) of peak area of each phospholipid was calculated. The peroxide value of each sample was determined using the calibration curve of the auto-oxidized standard phospholipids which were analyzed by both potentiometric determination and UV HPLC. Kidney phospholipid peroxides were easier induced than those in other organs reached their maximum peak (20.5 meq./kg) at 1 day after initial administration. Phospholipid peroxides in kidney and brain showed similar movement, while those in liver showed their maximum peak 3 days later. Of the phospholipids, phosphatidylserine and phosphatidylethanolamine seemed to be more susceptible to lipid peroxidation induced by mercuric chloride, the common feature of these two phospholipids being that both of them have primary amine group(s) on their polary heads and both are located on the cytosolic side of cell membrane. These results may be explained by mechanisms that relate to the interaction between mercurials and cell membranes or that between mercurials and primary amine groups of phospholipids. Further study is necessary to clarify the specific mechanisms involved in the induction of lipid peroxidation by mercurials and the interaction of mercurials with phospholipids.

Postnatal transformation and location of mitoses in the epithelium lining the mouse vomeronasal organ

The structure and the postnatal transformation of the epithelium lining the vomeronasal organ of the mouse was observed. The medial wall of the middle segment of the organ was lined with the sensory epithelium similar to the olfactory epithelium, and was not undergone any transformation in the postnatal life. The lateral wall of the middle segment and the entire lumen of the rostral segment were covered with the stratified cuboidal epithelium in the newborn mouse. The stratified cuboidal epithelium transformed into the ciliated columnar epithelium with advancing ages, excepting in the vomeronasal duct where the epithelium changed into the stratified squamous one. In the mouse aged between 4 and 10 days, mitotic figures were observed not only in the boundary between the sensory epithelium and the ciliated columnar one in the middle segment, but also in the rostral segment of which the entire lumen was covered with the ciliated columnar epithelium.

The intermediate epithelium lining the nasopharynx of the Suncus murinus

In the adult Suncus murinus, the rostral part of the nasopharynx is lined with the ciliated columnar epithelium continuing from the nasal cavity, while the laryngopharynx with the stratified squamous epithelium; i.e., the epithelium lining the caudal part of the nasopharynx forms the transitional zone between the ciliated columnar epithelium and the stratified squamous one. The epithelium shows gradations ranging from ciliated stratified low-columnar through stratified cuboidal to stratified squamous type. It is suggested that the epithelium is identical with the "intermediate epithelium (Nakano, 1986)".

Identification of lactotropes (PRL cells), somatotropes (GH cells), corticotropes (ACTH cells) and thyrotropes (TSH cells) in the pituitary gland of the musk shrew, Suncus murinus L. (Insectivora), by immunohistochemistry

By means of immunohistochemistry, lactotropes, somatotropes, corticotropes and thyrotropes in the pituitary of the male musk shrew, Suncus murinus L., were identified at the electron-microscopic level. Lactotropes were classified into three types: type I containing large (200-450 nm in diameter) round secretory granules, type II with medium-sized (150-250 nm in diameter) ones and type III with small (50-150 nm in diameter) ones. Somatotropes were also classified into type I somatotropes that contain large (450 nm in diameter) spherical secretory granules and type II somatotropes containing comparatively small (300 nm in diameter) round granules. Both type I and II somatotropes were small and sometimes contained rod-shaped granules. Corticotropes were round or oval cells with round secretory granules in various densities and sizes (150-500 nm in diameter) scattered all over the cytoplasm. Thyrotropes were angular or polyhedral cells containing electron-transparent round secretory granules (200-300 nm in diameter) and large irregularly shaped granules with a maximum diameter of about 1,500 nm. Each type of the cells may be distinguished by its respective ultrastructural characteristics alone without the aid of immunohistochemistry.

The epithelium lining the orifice of the laryngeal gland of the Suncus murinus, with special reference to the "intermediate epithelium (Nakano)"

In the lateral wall of the laryngeal ventricle of the Suncus murinus, only a few excretory ducts of the laryngeal gland opened that drained the extensive lobular system. The ducts opened into the "intermediate epithelium (NAKANO, T.: Acta Anat. 127: 22-47, 1986)," which lined the transitional zone between the ciliated columnar epithelium and the stratified squamous one, and that showed gradations ranging from the ciliated stratified low-columnar through stratified cuboidal to stratified squamous type. The orifice of the laryngeal gland was relatively wide for the size of the animal and, therefore, the epithelium within the orifice was clearly observed by use of SEM. As the number of the ciliated cells decreased in the intermediate epithelium surrounding the orifice, the ciliated cells within the orifice reduced in number. Considering from these findings, it is suggested that the epithelium within the orifice has morphologically close resemblance to, and is influenced by, the epithelium surrounding the orifice.

The intermediate epithelium lining the larynx of the Suncus murinus

In the larynx of the Suncus murinus the stratified squamous epithelium lines the tip of the caudal surface of the epiglottis and the region close to the vocal process of the arytenoid cartilage, while the ciliated columnar epithelium is located in the laryngeal sac and the dorsal part of the vocal fold. Further, in the transitional zone between the stratified squamous epithelium and the ciliated columnar one there exists the epithelium which shows gradations ranging from stratified squamous through stratified cuboidal to ciliated stratified low-columnar type. It is suggested that the epithelium lining the transitional zone is identical with the "intermediate epithelium" in the mouse nasopharynx and larynx.

Isolation and identification of embryo-derived platelet-activating factor in mice

We isolated a platelet-activating factor (PAF) derived from mouse embryos and identified it by bioassay utilizing washed rabbit platelets. We also tried further characterization of the factor by high-performance liquid chromatography (HPLC) and electron-impact mass spectrometry (EI-MS). 1. In the thin-layer chromatography (TLC) of the medium after a two day culture of 30 embryos at the two-cell stage, no obvious spot appeared at the site of 1-O-acetyl-2-O-alkyl-SN-glyceryl-3-phosphocholine (AGEPC). But a small, pale spot appeared at the site of lyso-AGEPC. 2. A remarkable aggregation activity was present at the site of the Rf and appearance time that was almost the same as for AGEPC in both TLC and HPLC. However, detection of the substance by UV absorption (203nm) in HPLC was unsuccessful. 3. The PAF activity shown in the culture medium was suspected to be 10(-10 - 10(-11) M/embryo and it was not inhibited by pretreatment with indomethacin and ADP scavenger. 4. Embryo-derived PAF had an HPLC appearance time 1-2 min. longer than that of synthetic AGEPC (C16). EI mass spectrum of embryo-derived PAF was partly inconsistent with that of synthetic AGEPC (C16). These results confirm the evidence of PAF release from mouse embryos and show the possibility that a far greater amount of its lyso-derivative is present in the culture medium. Embryo-derived PAF is presumed to be AGEPC or a substance resembling AGEPC in its chemical structure and some structural difference may exist between embryo-derived PAF and synthetic AGEPC (C16).

Dioxins in cigarette smoke

Dioxins in cigarettes, smoke, and ash were determined using gas chromatography/mass spectrometry. The total concentration of polychlorinated dibenzo-p-dioxins (PCDDs) in cigarette smoke was approximately 5.0 micrograms/m3 at the maximum level, whereas various congeners from tetra-octa-chlorodibenzo-p-dioxin (-CDD) were detected. Particullary, the total concentration of hepta-CDD congeners was the highest among these congeners. Mass fragmentograms of various PCDD congeners were similar to those in flue gas samples collected from a municipal waste incinerator. The PCDD congeners that were not present in the cigarettes were found in the smoke samples. The 2,3,7,8-TCDD toxic equivalent value--an index for effects on humans--for total PCDDs in smoke was 1.81 ng/m3 using the toxic factor of the United States Environment Protection Agency. Daily intake of PCDDs by smoking 20 cigarettes was estimated to be approximately 4.3 pg.kg body weight/day. This value was close to that of the ADIs: 1-5 pg.kg body weight/day reported in several countries. A heretofore unrecognized health risk was represented by the presence of PCDDs in cigarette smoke.