Lupus erythematosus-like syndrome induced by thiamazole and propylthiouracil

A 17-year-old Japanese woman developed a lupus erythematosus-like syndrome during treatment for Graves' disease with thiamazole and propylthiouracil. Erythema, arthralgia, and low grade fever developed during therapy with thiamazole; purplish-red erythema developed during therapy with propylthiouracil. Antinuclear antibodies, anti-single-stranded DNA antibodies, and anti-double-stranded DNA antibodies were positive throughout the administration of these two drugs. Eruptions and other symptoms improved after their discontinuation. The titers of autoantibodies also decreased two months after withdrawal. The patient had HLA DR4.

Primary adenocarcinoma of the vermiform appendix associated with transitional cell carcinoma of the bladder

A case of primary adenocarcinoma of the vermiform appendix coexisting with transitional cell carcinoma (TCC) of the bladder is presented. The patient was a 74-year-old male who underwent radical cystectomy with continent urinary diversion using the Florida pouch. Two different cancers were found, TCC of the bladder and mucinous adenocarcinoma of the appendix. To our knowledge, this is the only such case reported in the medical literature.

Substance P induces inositol 1,4,5-trisphosphate and intracellular free calcium increase in cultured normal human epidermal keratinocytes

Substance P is a neuropeptide which is present in peripheral C nerve endings and released from them. Free nerve endings of C nerve are present in human epidermis. The effects of substance P on the transmembrane signaling system of pig epidermal sheets were previously reported. In these studies, a small amount of cells other than keratinocytes contaminated the epidermal sheets and the species difference from human was also noticed. Therefore we investigated the effects of substance P on cultured normal human epidermal keratinocytes. Alteration of intracellular free calcium (Ca2+) in single living keratinocytes was studied using an inverted fluorescence microscope and Ca(2+)-sensitive dye, Fura 2-AM. Treatment of normal human epidermal keratinocytes with substance P resulted in an increase in inositol 1,4,5-trisphosphate and in intracellular Ca2+. Substance P inhibited DNA synthesis of the keratinocytes in a dose-dependent manner. These results are consistent with the view that substance P stimulates phosphatidylinositol-4,5-bisphosphate hydrolysis of human keratinocytes, resulting in inositol 1,4,5-trisphosphate-Ca2+ signal.

Differentiation-associated localization of nPKC eta, a Ca(++)-independent protein kinase C, in normal human skin and skin diseases

The expression of nPKC eta, a Ca(++)-independent isoform of protein kinase C in normal human skin, and skin from patients with psoriasis, squamous cell carcinoma, basal cell epithelioma, nevus pigmentosus, and seborrheic keratosis, were examined by immunohistochemical staining using a polyclonal antibody raised against a synthetic peptide at a diverse region of the nPKC eta molecule. In normal epidermis, the strongest staining was observed in the uppermost granular layer with no staining of the spinous or basal layers. The inner layer of the intra-epidermal eccrine duct was also strongly stained. Weak staining was observed in several layers of the outer root sheath of the follicular infundibulum. No staining was detected in the inner root sheath of the hair follicles, hair matrix, sebaceous gland, eccrine gland, intradermal eccrine duct, arrectores pilorum, melanocytes, Langerhans cells, fibroblasts, or blood vessels. In psoriatic skin, stained keratinocytes were distributed in the suprabasal layers with the most being observed in the uppermost layer and the least in layers closed to the basal layer. In squamous cell carcinoma, weak staining was observed in the keratotic cells around horny pearls. In the basal cell epithelioma and nevus pigmentosus, the cells were not stained, whereas in seborrheic keratosis, cells that stained were located in the granular layer. We conclude from the evidence presented above that nPKC eta is expressed in close association with epidermal differentiation in normal skin and skin diseases.

Respiratory activities in relation to external glossal muscles

In this study, the activities of the two external glossal muscles, Genioglossus (Gg) and Styloglossus (Sg), related to respiration were examined through the electromyography (EMG) in dog. During quiet breathing, no phasic respiratory activity were observed in either muscle. With hypercapnic condition induced by closed rebreathing respiratory system, both Sg and Gg showed phasic respiratory activities in respiration period. At first inspiratory EMG activity was observed from Sg (PaCO2 > 50 mmHg), then after a while from Gg (PaCO2 > 55 mmHg). NaCN injection bilaterally to the carotid body enhances the inspiratory ENG activities in both muscles. Sg was more sensitive than Gg to respiratory stimulation such as hypercapnia or NaCN injection.

Identification of a killer cell-specific regulatory element of the mouse perforin gene: an Ets-binding site-homologous motif that interacts with Ets-related proteins

The gene encoding the cytolytic protein perforin is selectively expressed by activated killer lymphocytes. To understand the mechanisms underlying the cell-type-specific expression of this gene, we have characterized the regulatory functions and the DNA-protein interactions of the 5'-flanking region of the mouse perforin gene (Pfp). A region extending from residues +62 through -141, which possesses the essential promoter activity, and regions further upstream, which are able to either enhance or suppress gene expression, were identified. The region between residues -411 and -566 was chosen for further characterization, since it contains an enhancer-like activity. We have identified a 32-mer sequence (residues -491 to -522) which appeared to be capable of enhancing gene expression in a killer cell-specific manner. Within this segment, a 9-mer motif (5'-ACAGGAAGT-3', residues -505 to -497; designated NF-P motif), which is highly homologous to the Ets proto-oncoprotein-binding site, was found to interact with two proteins, NF-P1 and NF-P2. NF-P2 appears to be induced by reagents known to up-regulate the perforin message level and is present exclusively in killer cells. Electrophoretic mobility shift assay and UV cross-linking experiments revealed that NF-P1 and NF-P2 may possess common DNA-binding subunits. However, the larger native molecular mass of NF-P1 suggests that NF-P1 contains an additional non-DNA-binding subunit(s). In view of the homology between the NF-P motif and other Ets proto-oncoprotein-binding sites, it is postulated that NF-P1 and NF-P2 belong to the Ets protein family. Results obtained from the binding competition assay, nevertheless, suggest that NF-P1 and NF-P2 are related to but distinct from Ets proteins, e.g., Ets-1, Ets-2, and NF-AT/Elf-1, known to be expressed in T cells.

[A case report of an advanced esophageal carcinoma treated by neoadjuvant chemotherapy (CDDP + 5-FU) and evaluation of effect on metastatic lymph nodes]

A 69-year-old woman was diagnosed to have type 2 advanced esophageal carcinoma measuring Im 9 cm by X-ray and endoscopic examination. CT scan revealed much swelling of No. 106 and 9 lymph nodes. As the patient had dry cough and these lymph nodes, we tried neoadjuvant chemotherapy for reduction of metastatic lymph nodes. The regimen consisted of CDDP 80 mg/m2 (day 1), 5-FU 800 mg/m2 (day 1-4, continuous). After 2 courses, an operation was performed. Histopathological examination of the section of the primary tumor revealed that only a few cancer cells nests (sq. c.c., mod.) remained in the muscle layer. In 41 dissected lymph nodes, 12 lymph nodes had metastatic cancer cell nests before neoadjuvant chemotherapy and only 4 lymph nodes had a few remaining cancer cells nests. The effect of CDDP + 5-FU therapy is the same for primary tumor and lymph nodes.

Normal developmental profiles of CSF gangliotetraose-series gangliosides from neonatal period to adolescence

The normal developmental profiles of cerebrospinal fluid (CSF) gangliosides were examined from the neonatal period to adolescence, using 1 ml of clinically available CSF, by the thin-layer chromatography/enzyme-immunostaining method. The level of total gangliotetraose-series gangliosides, including GM1, GD1a, GT1a, GD1b, GT1b, and GQ1b, increased 3.8-fold from the neonatal period to age 5 years, followed by a plateau, and then a mild decrease. The developmental profiles of individual gangliosides differed from each other. CSF gangliosides change with age, reflecting the maturational changes of the central nervous system gangliosides in situ. CSF ganglioside analysis and this developmental profile might be useful for examining ganglioside aberrations and basic neurochemical mechanisms underlying neurologic disorders, especially age-dependent diseases.

Axial eye-length measurement by wavelength-shift interferometry

A simplified noncontact measuring technique for axial eye length was developed. According to this method, the wavelength shift of a single-mode laser-diode beam that is irradiated onto the eyeball causes a phase shift in the interference fringes of reflections from the retina and the cornea. Then the optical distance between the cornea and the retina is obtained from the phase-shift measurement. High-speed axial eye-length measurements can be performed by using a laser diode on a pulse-modulation drive and signals from the reference light path as an analog-to-digital-conversion trigger. Compared with the technique that uses partially coherent light, this technique is inferior in terms of measurement accuracy but superior in its wide, measurable range of 16-32 mm. The results of measurements of 21 adults showed that 2 standard deviations of measurement was 2 sigma = +/- 0.11 mm.

Clinical significance of serum adenosine deaminase activity in patients with mycosis fungoides

Adenosine deaminase is one of the key enzymes in purine nucleotide degradation. This enzyme exists in most of the human tissues and the activity is high in lymphatic tissues, especially in T lymphocytes. Elevated adenosine deaminase activity in T cell leukemia has been reported, and its inhibitor, deoxycoformycin, has been developed as an antitumor agent. In some types of leukemia, serum adenosine deaminase activity increases in accordance with the severity of the disease. Although mycosis fungoides rarely involves peripheral blood, tumor cells do invade the skin. In order to evaluate the clinical significance of adenosine deaminase in mycosis fungoides, adenosine deaminase activity was measured in sera of 15 patients with mycosis fungoides at various stages. The mean enzyme activity was 23.2 IU/l, which was high with statistical significance compared with healthy controls (P < 0.001). Nine of twelve patients in the plaque stage (T2N0M0, IB) showed higher adenosine deaminase activity than did the normal population. The mean adenosine deaminase activity in sera in the patients in the plaque stage (T2N0M0, IB) was as high as 19.0 IU/l (range 13.7-21.4) with statistical significance compared with healthy control (P < 0.001). Three tumor stage patients without visceral involvement (T3N0M0, IIB) showed higher levels of adenosine deaminase activity (19.7, 21.5, 24.4 IU/l). An erythrodermic patient (T4N0M0, III) also had a high adenosine deaminase activity 28.4 IU/l. Two tumor stage patients with organ involvement (T3N0M1, IVB) exhibited extremely high adenosine deaminase activity (60.9, 32.2 IU/l). The adenosine deaminase activity in sera showed a tendency to become higher with the extension of the stages.(ABSTRACT TRUNCATED AT 250 WORDS)

Low levels of CSF gangliotetraose-series gangliosides in West syndrome: implication of brain maturation disturbance

One ml of cerebrospinal fluid (CSF) from each patient with West syndrome and patients from disease control groups were analyzed separately by highly sensitive thin-layer chromatography/enzyme-immunostaining method. The levels (mean +/- S.D.) of GM1, GD1a, sum of GD1b, GT1b, and GQ1b, and total gangliotetraose-series gangliosides in West syndrome patients (n = 14) and in an age-matched control group (n = 14) were as follows: 11.6 +/- 7.8 and 30.9 +/- 12.3 ng/ml CSF, 51.5 +/- 23.2 and 91.7 +/- 41.2 ng/ml CSF, 129.6 +/- 57.6 and 195.9 +/- 123.6 ng/ml CSF, and 192.7 +/- 78.6 and 318.4 +/- 131.6 ng/ml CSF, respectively. The differences were statistically significant except for the sum of GD1b, GT1b, and GQ1b (by 2 sample t test). Because they are abundant in the outer surface of neuronal plasma membranes, gangliosides may play an important role in the transformation of a neuroblast into a functionally mature neuron. Low levels of CSF gangliotetraose-series gangliosides, especially GM1 and GD1a, in patients with West syndrome may suggest a maturation disturbance of the brain from an early developmental stage.

Lichenoid skin lesions as a sign of beta 2-microglobulin-induced amyloidosis in a long-term haemodialysis patient

We report a case of beta 2-microglobulin-induced amyloidosis. The patient was a 40-year-old man suffering from non-amyloid nephropathy, who had been treated by haemodialysis for 20 years. Lichenoid skin lesions, consisting of groups of pin-head-sized shiny papules, were present on the arms and trunk. On histological examination, amyloid deposits were present, principally in the dermal papillae, but also around the sweat ducts and hair follicles. The amyloid displayed potassium-permanganate-resistant Congo red affinity, and green birefringence under polarized light. Immunohistochemically, beta 2-microglobulin was demonstrated in the lesions, confirming that they were a manifestation of beta 2-microglobulin-associated amyloidosis. Skin lesions of this type have not been reported previously in beta 2-microglobulin-associated amyloidosis.

Granulomatous angiitis of the central nervous system--case report

A 22-year-old male presented with granulomatous angiitis manifesting as headache. Computed tomography (CT) demonstrated a low-density area and ring-like enhancement in the right frontoparietal region. Steroid therapy caused rapid improvement in the signs and symptoms. Withdrawal of steroid was followed by recurrence of the headache and low-density area. The steroid treatment was resumed until he became asymptomatic 3 months after admission. He was followed up as an outpatient once every 2 weeks. One month after discharge, he complained of mild headache, and CT again demonstrated a mild increase in the low-density area. He was followed up continuously without steroid treatment. Two months after discharge, he suddenly lost consciousness, and CT demonstrated multiple intracerebral hematomas in the bilateral parietal regions. Removal of an intracerebral hematoma in the right parietal region and external decompression were carried out, but he died 3 days later. Histological examination of tissues from the right parietal cortex and leptomeninges demonstrated granulomatous inflammation with several giant cells in the vessels of the cerebral cortex and leptomeninges.

Adenosine deaminase activity in sera of patients with psoriasis, mycosis fungoides and adult T cell leukemia

Adenosine deaminase activities in sera were measured in 18 psoriatic patients, 8 mycosis fungoides patients, and 9 patients with adult T cell leukemia. Adenosine deaminase activity in the sera of the psoriatic patients showed no significant increase. An elevated adenosine deaminase activity was observed in 7 of the 8 patients with mycosis fungoides and 8 of the 9 patients with adult T cell leukemia. After chemotherapy, adenosine deaminase activity in serum of acute adult T cell leukemia was reduced. Adenosine deaminase activity in the sera of 2 patients with smoldering adult T cell leukemia was more elevated, with exacerbation of the disease. It is difficult to grade the extension of the tumors in plaque stage mycosis fungoides and smoldering adult T cell leukemia. To know the progression of the disease is critical in determining its management. These results indicate that adenosine deaminase activity in serum is one of the reliable indicators for the grading of mycosis fungoides and adult T cell leukemia.

Predominant expression of nPKC eta, a Ca(2+)-independent isoform of protein kinase C in epithelial tissues, in association with epithelial differentiation

Of the nine known members of the protein kinase C (PKC) family, we found that novel (n-) PKC eta, a newly isolated Ca(2+)-independent isoform, was expressed at the highest level in the epidermis of mouse skin and epithelia of the digestive and respiratory tracts including the tongue, esophagus, forestomach, glandular stomach, intestine, colon, trachea, and bronchus. Expression of nPKC eta mRNA in these epithelial tissues was 3-10 times that in the brain and was especially high in squamous epithelium. Two other PKC isoforms, conventional (c-) PKC alpha and nPKC delta, were also expressed in these epithelial tissues, but no cPKC gamma was detected. In situ hybridization and immunohistochemical analyses demonstrated the localization of nPKC eta in suprabasal layers of the skin, tongue, esophagus, and forestomach. In the intestine, it was expressed in the epithelial cells of villi, but not of crypts. In the lung, only bronchial epithelium expressed nPKC eta. The localization of nPKC eta in differentiating or differentiated epithelial cells, rather than in proliferating basal cells, suggests the involvement of nPKC eta in epithelial differentiation.

Correction of translational motion artifacts in multi-slice spin-echo imaging using self-calibration

In this paper, we describe a method for detecting and correcting in-plane bulk translational motion in multislice spin-echo imaging using self-calibration and postprocessing. A constant phase encoding offset between slices is used to evenly spread out the low spatial frequency echoes to allow accurate motion detection by self-calibration. Motion detection in both x and y directions is achieved by interchanging the readout and phase encoding directions for the alternate slices. Displacements are determined by cross correlating the modulus of each 1D transformed echo with a reference box car function whose width equals that of the imaged object. In addition, phase errors induced by the velocity in the readout direction are estimated and corrected using the displacement data. The results obtained from knee studies at 0.5 T and 1.5 T show that the artifacts due to translational motions are significantly suppressed upon correction. The method does not require any additional pulses or time, and the data processing can be easily implemented.

Localization of proteins immunologically related to erythrocyte protein 4.1, spectrin and ankyrin in thyroid gland

Analogues of erythrocyte protein 4.1, spectrin and ankyrin were examined in the thyroid gland of pig and rat by immunohistochemical techniques. Analysis with immunofluorescence microscopy revealed that the peripheral cytoplasm and apical-lateral plasma membrane of follicle epithelial cells of thyroid glands were stained with antibodies against erythrocyte protein 4.1, spectrin, or ankyrin. The results indicate that membrane skeletal protein lattice might exist in thyroid follicle epithelial cells.

Adenylate cyclase induces intracellular calcium increase in single human epidermal keratinocytes measured by fluorescence microscopy using Fura 2-AM

Intracellular calcium ([Ca2+]i) is an important second messenger of extracellular signals to induce various cellular responses. Extracellular and intracellular Ca2+ are considered to be important for cellular differentiation and proliferation of epidermal keratinocytes. Several mechanisms which increase [Ca2+]i have been demonstrated in various tissues, but in epidermal keratinocytes these mechanisms are poorly understood. In epidermal keratinocytes the adenylate cyclase-cyclic AMP response is thought to regulate cell proliferation and differentiation. However, the series of reactions which follow the cyclic AMP response remain unknown. Beta-adrenergic agonists increase [Ca2+]i in cultured epidermal keratinocytes, and we have therefore studied whether stimulation of keratinocyte adenylate cyclase could induce [Ca2+]i increase, by using fluorescence microscopy with Fura 2-AM. Adenosine and histamine, which are known to be keratinocyte adenylate cyclase receptor agonists, induced transient [Ca2+]i increase, as did epinephrine. In addition, forskolin, a direct adenylate cyclase activator, and dibutyryl-cyclic AMP also induced an increase in [Ca2+]i. In a calcium-free medium epinephrine, adenosine, histamine and dibutyryl-cyclic AMP induced an increase in [Ca2+]i. These results suggest that cyclic AMP in human epidermal keratinocytes regulates [Ca2+]i, which is released from intracellular stores.

Substance P induces intracellular calcium increase and translocation of protein kinase C in epidermis

Substance P is a neuropeptide present in, and released from, peripheral C nerve endings. The presence of substance P-positive nerve fibres in the epidermis has been reported. We investigated the effect of substance P on the transmembrane signalling system of pig epidermal keratinocytes. Treatment of pig epidermis with substance P resulted in an increase in inositol 1,4,5-trisphosphate (IP3), and in intracellular free calcium. The treatment also resulted in translocation of protein kinase C from a cytosol to a membrane fraction. Substance P, however, did not affect the beta-adrenergic- or histamine (H2)- adenylate cyclase responses of the epidermis. Neither forskolin-induced, nor cholera toxin-induced cyclic AMP accumulation were affected by substance P treatment. These results consistent with the view that substance P stimulates phosphatidylinositol-4,5-bisphosphate (PIP2) hydrolysis of keratinocytes, resulting in IP3-Ca2+ and diacylglycerol-protein kinase C signal activation. Although protein kinase C is known to affect the epidermal adenylate cyclase system, no evidence for such 'cross-talk regulation' was detected in keratinocytes by substance P treatment.

Intramuscular hemangioma in the digastric muscle

Intramuscular hemangioma is a distinctly rare neoplasm originating within normal muscle. In the head and neck region, it occurs most frequently in the masseter muscle. Diagnosis of intramuscular hemangioma is extremely difficult because it is not encountered frequently and is often confused with salivary gland stone, parotid neoplasm or other tumors. In this report, a second case of intramuscular hemangioma of the digastric muscle and the diagnosis of this type of tumor in the early stage and the importance of its treatment are described.

MR imaging of brain surface using steady-state free precession

We present an imaging technique that affords direct and noninvasive visualization of brain surface structure. This technique utilizes the signal before the rf pulse in steady-state free precession. This signal highly reflects the spin-spin relaxation time T2 as was studied in our laboratory (Matsui et al. J. Magn. Reson. 62, 12, 1985). Therefore the cerebrospinal fluid (CSF), having a long T2, is depicted as high intensity. The CSF permeates cerebral sulci and fissures. The imaging time with this technique is less than 1 min.

Perforin gene expression in stimulated human peripheral blood T cells studied by in situ hybridization and northern blotting analysis

In situ hybridization was used here to monitor the mRNA level of the pore-forming protein perforin in mitogen-stimulated primary peripheral blood human T cells. In situ hybridization was performed using sense and antisense ribonucleotide probes specific for this granule mediator. After IL-2 treatment, an increase in perforin mRNA could be detected by 4 h; they peaked at 12 h, and decreased after 24 h. The perforin mRNA was also induced in T cells treated with a combination of phorbol ester PMA plus lectin or OKT3 mAb. This latter induction followed slower kinetics, peaking at 48 h. For all three mitogens used, even at peak induction times less than 10% of T cells were labeled with perforin probe. Similar patterns of mRNA expression were observed for both unprimed T cells and lectin-primed T blasts. The induction response of mRNA due to IL-2 stimulation is probably mediated by the IL-2 receptor p75 chain since its mRNA was upregulated by IL-2 with a kinetics comparable to that associated with an increase of perforin mRNA. The p55 IL-2 receptor chain increased much more slowly than p75.

Triple cancers in the urogenital area of a patient with aplastic anemia

Three epithelial neoplastic lesions, perineal Bowenoid papulosis, uterine cervical carcinoma, and bladder transitional cell carcinoma, which occurred in a mildly immunosuppressed patient who had aplastic anemia were studied for human papillomavirus (HPV) infection. In the Bowenoid papulosis, HPV type 16 DNA was identified by polymerase chain reaction (PCR) and by in situ hybridization (ISH). In contrast, in the uterine cervical carcinoma, HPV 16 was not detected, although possibly another unidentified type of HPV in the lesion was suggested by the ISH findings. In the bladder transitional cell carcinoma, neither papillomavirus genus-specific (PGS) antigen nor HPV DNA was found.

Respiratory activities in relation to palatal muscle contraction

This study investigated the activities of the tensor and levator veli palatini muscles related to respiration. During quiet breathing, no activity was observed in either muscle. With either hypercapnic or hypoxemic condition, the tensor veli palatini muscle exhibited phasic activity during inspiration. The levator veli palatini muscle showed phasic activity during expiration with hypoxemia (PaO2 less than 40 mm Hg). NaCN perfused bilaterally through the carotid sinus induced these respiratory activities. The tensor veli palatini muscle was more sensitive than the levator veli palatini muscle to NaCN.

Effects of novel synthesized retinobenzoic acid (Am-80) on adenylate cyclase and arachidonic acid release in pig epidermis

It has been well established that the psoriatic hyperproliferative epidermis is characterized by a defective beta-adrenergic adenylate cyclase response and an increased arachidonic acid metabolism. Effects of a newly synthesized retinoid, Am-80 (4-[(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl)amino) carbamoyl]benzoic acid), on the beta-adrenergic adenylate cyclase response and on the arachidonic acid metabolism of pig epidermis were investigated. Am-80 augmented the beta-adrenergic adenylate cyclase response of the epidermis. The effect was observed at the concentrations of more than 1 microM. The maximum beta-adrenergic augmentation effect induced by Am-80 was similar to those of all-trans-retinoic acid and of hydrocortisone. Am-80 inhibited the basal arachidonic acid release as well as 12-O-tetradecanoylphorbol-13-acetate (TPA)-stimulated arachidonic acid release from epidermal keratinocytes. The effect was observed at the concentrations of 50-100 microM. The inhibitory effect of Am-80 was similar to those of all-trans-retinoic acid and of hydrocortisone. Our results indicate that Am-80, a newly synthesized retinoid, reveals the beta-adrenergic adenylate cyclase response augmentation effect and the inhibitory effect on the arachidonic acid metabolism of the epidermis. These effects are consistent with a view that Am-80 is another retinoid which has significant pharmacological effects on keratinocytes.

[An epidemiogenetic study of typical retinitis pigmentosa in Japan--a preliminary report of nationwide, multicenter study]

We performed a nationwide, multicenter study of typical retinitis pigmentosa with reference to the inheritance patterns of the disease. A total of 253 probands were registered during two months of 1989, and an analysis of the parental consanguinity of 182 probands with the method of inbreeding coefficient enabled us to estimate the relative prevalence of genetic types; autosomal recessive trait: 47.6%; autosomal dominant trait: 17.3%; sporadic cases: 34.6%. A comparison of the results with previous studies has indicated a decrease in the prevalence of the autosomal recessive trait and an increase in the sporadic cases, as would be expected from the decrease in consanguineous marriages and offsprings in the past few decades in Japan. X-linked retinitis pigmentosa was rarely identified, but precise evaluation of its frequency needs further investigation.

An association of acanthosis nigricans and Crouzon syndrome

An 11-year-old Japanese female having acanthosis nigricans associated with Crouzon syndrome is reported. Crouzon syndrome is a craniostenotic craniofacial malformation associated with premature closure of selective calvarial sutures, exophthalmos, maxillary hypoplasia, and a beak-shaped nose. It is an autosomal dominant inherited disorder. Crouzon syndrome is one of the syndromes which may be associated with acanthosis nigricans. The association of acanthosis nigricans with Crouzon syndrome is assumed to be a rare abnormality, although the true frequency is uncertain. We have reviewed the reported cases of acanthosis nigricans associated with Crouzon syndrome and characteristics were discussed.

[Effects of induced hypotensive anesthesia on the blood coagulation-fibrinolysis system measured by thrombelastography--comparison between prostaglandin E1 and trimethaphan]

The coagulation-fibrinolysis system has been studied in two groups of 16 patients classified ASA 1 undergoing radical mastectomy during controlled hypotensive anesthesia induced by prostaglandin E1 (PGE1) or by trimethaphan (TMP) under enflurane anesthesia. Thrombelastography (TEG) was used to evaluate both coagulation and fibrinolysis systems, while simultaneously measuring platelet aggregation in response to ADP and collagen, prothrombin time (PT), activated partial thromboplastin time (APTT), serum concentrations of fibrinogen, and platelet counts. In the PGE1 group, APTT was significantly shortened (P less than 0.05) while the drug was being infused, but there was no statistically significant difference between the two groups, which was considered due to the effect of enflurane. Also, no statistically significant changes were noted in the other measured parameters. These results suggest that controlled hypotensive anesthesia using either PGE1 or TMP under enflurane anesthesia produces no significant changes in the blood coagulation-fibrinolysis system and that both are useful for the management of bleeding during surgery. Further, TEG was found to reflect other parameters properly. It is therefore useful for monitoring the blood coagulation-fibrinolysis system during anesthesia.

Apolipoprotein B is a major perforin inhibitor protein in human serum

We purified the high-molecular-weight perforin inhibitor protein from normal human serum using DEAE-cellulose, HPLC-gel filtration and hydroxylapatite chromatography. This protein was shown to be identical to the serum apolipoprotein B-100 in terms of amino acid composition and the sequence of the digested peptides. This inhibitor protein not only inhibits the membrane binding activity of perforin but also the pore insertion activity of membrane-bound perforin.

Leukemia cutis in acute myelomonocytic leukemia: infiltration to minor traumas and scars

We describe a patient with acute myelomonocytic leukemia who demonstrated leukemic cell infiltration to scratched wounds and scars from trauma. A 65-year-old Japanese woman developed low grade fever, headache and exanthema. Hematology testing disclosed leukocytosis of 95,600/mm3 with 65% monocytes and 9% blast cells. Infiltrated erythema and nodules were disseminated over most of her body. Moreover, linear scratched wounds and traumatic scars were indurated. Skin biopsy showed dense atypical mononuclear cell infiltration with monocytic characteristics. We discuss the possible reasons for the infiltration of leukemia cells into the wounds and scars from trauma.

Adenylate cyclase induces intracellular Ca2+ increase in single human epidermal keratinocytes of the epidermal sheet as measured by digital imaging microscopy using Fura 2-AM

Intracellular Ca2+ ([Ca2+]i) is thought to act as a second messenger of transmembrane signalling systems. However, no measurement of [Ca2+]i has been made in intact epidermal keratinocytes. We have developed a method for measuring [Ca2+]i in human keratinocytes from pure epidermal sheet by the application of digital imaging fluorescence microscopy with the use of Fura 2-AM. Normal human pure epidermal sheets were obtained by dispase treatment. Epinephrine and salbutamol induced transient [Ca2+]i increases. Propranolol, a beta-antagonist, inhibited this response, while prazosin and yohimbine (alpha 1- and alpha 2-antagonists, respectively) did not affect the response. Histamine and adenosine, also receptor agonists of the epidermal adenylate cyclase system, induced a similar [Ca2+]i increase, as did forskolin, a direct activator of adenylate cyclase. These data coincide with those previously presented for cultured human epidermal keratinocytes, and reveal that adenylate cyclase activation induces an increase of [Ca2+]i in intact epidermal cells. This technique enables the kinetics of [Ca2+]i in various skin disorders to be investigated.

HTLV-I-associated myelopathy in a patient with adult T-cell leukemia

Disseminated erythematous papules and plaques developed in a 60-year-old man 3 years before the appearance of neurologic manifestations. A biopsy specimen of the plaque revealed Pautrier's microabscess and a dense mononuclear cell infiltration with atypical convoluted nuclei in the papillary dermis. These cells were helper/inducer T lymphocytes that expressed the interleukin 2 receptor. The patient's white blood cell count was normal, but 1% atypical lymphocytes and a high titer of anti-human T-lymphotropic virus (HTLV)-I antibody were detected in his serum. A smoldering type of adult T-cell leukemia was diagnosed. While he was being treated with PUVA, a gait disturbance developed. A high titer of anti-HTLV-I antibody, characteristic of HTLV-I-associated myelopathy, was demonstrated in his cerebrospinal fluid.

Presence and localization of proteins immunologically related to erythrocyte protein 4.1 in human skin

Analogues of human erythrocyte protein 4.1 have been examined in the human skin by immunochemical techniques using anti-human erythrocyte protein 4.1 antibodies. Immunoblot analysis revealed that human epidermis contains 4.1-like proteins of 80 kDa and 78 kDa that cross react with anti-protein 4.1 antibodies. Analysis with immunofluorescence microscopy revealed that the plasma membrane of the human epidermal keratinocyte was stained intensively in the basal cells, whereas spinous cells were moderately stained. It is noted that eccrine sweat gland cells and ductal cells were also stained in the peripheral cytoplasma. Taken together, these results demonstrate that 4.1-like proteins are present in human epidermal keratinocytes, eccrine sweat gland cells and ductal cells. The present findings enable us to suggest that a membrane skeletal protein lattice might exist in these cells.

Beta-adrenergic stimulation induces intracellular Ca++ increase in human epidermal keratinocytes

Intracellular Ca++ ([Ca++]i) is one of the most important second messengers of extracellular signals that induce cellular responses. In epidermal keratinocytes, both extracellular and intracellular Ca++ are reported to be important to cell differentiation and proliferation. Several mechanisms that increase [Ca++]i have been elicited in various tissues; however, in epidermal keratinocytes they remain unknown. Thus, we investigated the [Ca++]i modulation in cultured human epidermal keratinocytes and the stimulation that increases the concentration. The [Ca++]i concentration of keratinocytes was increased immediately and transiently by epinephrine. Methoxamine hydrochloride and clonidine (alpha-1- and 2-adrenergic agonists) did not induce an increase in [Ca++]i. The beta-antagonist, propranolol, inhibited the [Ca++]i increase induced by epinephrine and salbutamol (a beta-2-agonist). These results reveal that the beta-adrenergic stimulation induces an immediate and transient [Ca++]i increase in human keratinocytes. Beta-adrenergic stimulation is known to induce adenylate cyclase activation, which results in cyclic AMP accumulation through stimulatory guanosine 5-triphosphate (GTP) binding proteins in the keratinocytes. Also, epinephrine is reported to inhibit cultured epidermal cell proliferation. The effect of epinephrine has been demonstrated by cyclic AMP accumulation; however, beta-adrenergic stimulation revealed a [Ca++]i increase in keratinocytes in our study. One of epinephrine's regulatory effects on epidermal cell proliferation is assumed to occur through the [Ca++]i increase as well.

Expression of perforin and serine esterases by human gamma/delta T cells

gamma/delta T cells have recently been described in association with a number of disorders, including autoimmune diseases. gamma/delta T cells are thought to play a cytotoxic role, but their mechanism of action is not known. Several granule mediators of cytotoxicity, including a pore-forming protein (perforin), and a family of serine esterases, have been isolated from cytotoxic T lymphocytes (CTL), lymphokine-activated killer (LAK) cells, and natural killer (NK) cells. We demonstrate here that gamma/delta T cells also express these mediators. Northern blots show that gamma/delta T cells express perforin, serine esterase 1 (SE 1), and SE 2. Three polyclonal antisera - raised against murine perforin, a peptide composed of amino acids 1-34 of human perforin, and human peforin expressed in bacteria - all reacted with a 70-kD protein in gamma/delta T cells on Western blots. Immunostaining with antiperforin antisera shows that primary gamma/delta T cells also contain perforin. Electron microscopy reveals that the granules of gamma/delta T cells resemble those of CTL, LAK, and NK cells. Gamma/delta T cells also resemble LAK cells in possessing inclusion bodies in their nuclei. These results imply that gamma/delta T cells resemble other cytolytic lymphocytes in their mechanism of action.

A manifesting carrier of Duchenne muscular dystrophy with severe myocardial symptoms

A 42-year-old so-called manifesting carrier of Duchenne muscular dystrophy (DMD), whose first complaints were severe myocardial symptoms, is described. Immunohistochemical study using anti-dystrophin anti-serum and analysis of cloned segments of X chromosome DNA were performed. Her two sons and one of her brothers appear to have had the same disease. She was admitted to the hospital complaining of dyspnoea, back pain and palpitations and was first diagnosed as having myocardial infarction. However, this diagnosis was excluded. The echocardiogram showed diffuse abnormalities of myocardial function. Serum enzymes were increased. Minimal weakness and decreased deep tendon reflexes were detected in her left lower extremity. Muscle biopsy revealed a small number of necrotic fibres. Immunohistochemical study using anti-dystrophin antiserum showed a mosaic pattern of the surface membrane. Analysis of cloned segments of X chromosome DNA from the patient and her son showed the XmnI(Asp) alleles of pERT 87-15 and the TaqI alleles of pERT 87-8 in both patients.

Ultraviolet action spectrum for intracellular free Ca2+ increase in human epidermal keratinocytes

Effects of UV on normal human epidermal keratinocytes were studied by measuring the intracellular free Ca2+ concentration ([Ca2+]i) using fluorescence ratio imaging (fura-2-AM). Upon UV irradiation the [Ca2+]i increased sharply after a certain lag time, and the UV sensitivity was higher at lower temperatures. Statistically the distribution of [Ca2+]i became broader as the mean values became larger, and the number of affected cells increased sharply above a certain fluence (light intensity x time [photons/cm2]) at all wavelengths studied (200-400 nm). The action spectrum showed a single peak at about 230 nm and decreased gradually toward longer-wavelength UV regions.

Translocation of protein kinase C from cytosol to membrane fractions in human epidermal keratinocytes by recombinant human interferon-gamma

The activation of protein kinase C involves its translocation from a cytosol fraction to a membrane fraction. Effects of interferon-gamma (IFN-gamma) on the epidermal protein kinase C were investigated. The treatment of recombinant human IFN-gamma on intact human epidermis resulted in the translocation of protein kinase C from a cytosol to a membrane fraction. The human IFN-gamma had no translocation effect on pig epidermal protein kinase C. Tumor promoter, 12-o-tetradecanoylphorbol-13-acetate (TPA), and a membrane-permeable diacylglycerol analogue, 1-oleoyl-2-acetylglycerol (OAG), both of which are well-known activators of protein kinase C, translocated the epidermal protein kinase C. The IFN-gamma had no direct effect on the epidermal protein kinase C; the addition of the IFN-gamma to partially-purified pig epidermal protein kinase C had no effect on its activity. The effect of the IFN-gamma on human epidermal protein kinase C appears to be through the species specific IFN-gamma receptors. It has been reported that the epidermal beta-adrenergic adenylate cyclase response is decreased following the TPA- (and OAG-) induced activation of protein kinase C. Human recombinant IFN-gamma, however, had no effect on the beta-adrenergic response of the human epidermis. Our results indicate that IFN-gamma affects intact keratinocytes in vitro, resulting in the activation of protein kinase C, which might be related to the physiological effect of IFN-gamma on keratinocyte.

[Generalized granuloma annulare with primary biliary cirrhosis]

Fifty-six year-old woman had a wide spread nodular and papular eruption on the trunk and arms for one week. She had suffered from primary biliary cirrhosis (PBC) for 8 years. The clinical appearance of the eruption was that of generalized granuloma annulare. Skin biopsy revealed a palisading granuloma in the dermis consisting of suppressor/cytotoxic T cells, Langhans type giant cells, plasmacytoid epithelioid cells and phagocytic macrophages with immunohistochemical analysis and electron microscopy. Liver biopsy showed Scheuer's IIIrd stage of PBC without associated granuloma. In PBC granulomata at the portal area of the liver, lung, muscle, skin and so on has been reported. And the histological findings of the granuloma of this case consisted with that of reported cases. Therefore the skin granuloma in this case was assumed to be related to PBC.

[Clinical evaluation of ofloxacin in the treatment of chronic complicated urinary tract infection]

Ofloxacin was administered orally at a daily dosage of 300 mg and 600 mg in three divided doses for 14 days to 24 and 60 patients with chronic complicated urinary infections, respectively, in order to evaluate the therapeutic efficacy. The clinical efficacy was evaluated according to the criterion proposed by the UTI Committee in Japan and its efficacy was evaluated in 84 cases. In the group of 24 patients receiving a daily dosage of 300 mg, the clinical effectiveness after a 5-day treatment was excellent in 13 cases and moderate in 7 cases. The overall clinical efficacy was 83.8%. In the group of 60 patients receiving a daily dosage of 600 mg, the rate of overall clinical efficacy after a 5-day treatment was 83.3%, being excellent in 23 cases and moderate in 27 cases. The eradication rate was 85.3% and 92.5% by 300 mg and 600 mg dosages of ofloxacin, respectively. As adverse reactions, anorexia and nausea occurred in 2 cases. Laboratory anomalies consisted of 1 case of slight and transient elevation of transaminase, and 1 case of elevated serum creatinine.

[Diffusion of ofloxacin (OFLX) into prostatic tissue in patients with benign prostatic hypertrophy]

Diffusion of ofloxacin (OFLX) into prostatic tissue was studied in 31 patients with benign prostatic hypertrophy. Concentrations of OFLX in the serum and prostatic tissue were measured at scheduled intervals after 200 mg OFLX oral administration. The mean OFLX level in prostatic tissue and tissue/serum ratio at 2 hours, 4 hours and 6 hours was 3.33 +/- 0.96 micrograms/g (1.25 +/- 0.28) in 10 patients, 2.21 +/- 0.55 micrograms/g (0.92 +/- 0.32) in 9 patients and 2.10 +/- 0.99 micrograms/g (1.01 +/- 0.23) in 12 patients, respectively. OFLX levels in prostatic tissue covered the minimum inhibitory concentration for several pathogenic bacteria detected from the infected prostatic fluid. Therefore, OFLX was thought to be a very useful drug for the treatment of bacterial prostatitis and postoperative infection of prostatic surgery.

Immunoblot demonstration of protein kinase C in pig epidermis

Protein kinase C, which has an important role in cell surface signal transduction, has at least 7 subspecies. The role of each isozyme remains unknown; however, the distribution of the subspecies has been reported to differ from tissue to tissue. In order to investigate the subspecies of protein kinase C in epidermis, we used monoclonal anti-protein kinase C antibodies against the alpha and beta subspecies and against the gamma subspecies. Protein kinase C activity was detected in both cytosol and membrane bound fractions in the extract of pig epidermis, although with immunohistochemical analysis the enzyme was not detected in the epidermis. The protein kinase C in pig epidermis was extracted and partially purified with DE52 column chromatography and immunoblot analysis was performed. Western blot analysis with each anti-protein kinase C antibody showed protein kinase C of the alpha and/or beta subspecies in pig epidermis. The gamma subspecies of the enzyme was not demonstrated. Since this gamma subspecies has only been demonstrated in the brain, it is regarded not to be present in epidermis. The differing patterns of the expression of the multiple subspecies of protein kinase C may closely related to its specific function in each tissue. The subspecies of the enzyme expressed in the epidermis should be clarified further.