Distinct functions between ferrous and ferric iron in lung cancer cell growth

Accumulating evidence suggests an association between iron metabolism and lung cancer progression. In biological systems, iron is present in either reduced (Fe2+ ; ferrous) or oxidized (Fe3+ ; ferric) states. However, ferrous and ferric iron exhibit distinct chemical and biological properties, the role of ferrous and ferric iron in lung cancer cell growth has not been clearly distinguished. In this study, we manipulated the balance between cellular ferrous and ferric iron status by inducing gene mutations involving the FBXL5-IRP2 axis, a ubiquitin-dependent regulatory system for cellular iron homeostasis, and determined its effects on lung cancer cell growth. FBXL5 depletion (ferrous iron accumulation) was found to suppress lung cancer cell growth, whereas IRP2 depletion (ferric iron accumulation) did not suppress such growth, suggesting that ferrous iron but not ferric iron plays a suppressive role in cell growth. Mechanistically, the depletion of FBXL5 impaired the degradation of the cyclin-dependent kinase inhibitor, p27, resulting in a delay in the cell cycle at the G1/S phase. FBXL5 depletion in lung cancer cells also improved the survival of tumor-bearing mice. Overall, this study highlights the important function of ferrous iron in cell cycle progression and lung cancer cell growth.

Iron accelerates Fusobacterium nucleatum-induced CCL8 expression in macrophages and is associated with colorectal cancer progression

Accumulating evidence suggests that high levels of Fusobacterium nucleatum in colorectal tumor tissues can be associated with poor prognosis in patients with colorectal cancer (CRC); however, data regarding distinct prognostic subgroups in F. nucleatum-positive CRC remain limited. Herein, we demonstrate that high-iron status was associated with a worse prognosis in patients with CRC with F. nucleatum. Patients with CRC presenting elevated serum transferrin saturation exhibited preferential iron deposition in macrophages in the tumor microenvironment. In addition, F. nucleatum induced CCL8 expression in macrophages via the TLR4/NF-κB signaling pathway, which was inhibited by iron deficiency. Mechanistically, iron attenuated the inhibitory phosphorylation of NF-κB p65 by activating serine/threonine phosphatases, augmenting tumor-promoting chemokine production in macrophages. Our observations indicate a key role for iron in modulating the NF-κB signaling pathway and suggest its prognostic potential as a determining factor for interpatient heterogeneity in F. nucleatum-positive CRC.

Glyco-Nanoadjuvants: Sugar Structures on Carriers of a Small Molecule TLR7 Ligand Affect Their Immunostimulatory Activities

Toll-like receptors (TLRs) are pattern recognition receptors that activate innate immunity, and their ligands are promising adjuvants for vaccines and immunotherapies. Small molecule TLR7 ligands are ideal vaccine adjuvants as they induce not only proinflammatory cytokines but also type I interferons. However, their application has only been approved for local administration due to severe systemic immune-related adverse events. In a previous study, we prepared the gold nanoparticles coimmobilized with synthetic small molecule TLR7 ligand, 1V209, and α-mannose (1V209-αMan-GNPs). 1V209-αMan-GNPs were selectively delivered via a cell surface sugar-binding protein, mannose receptor, which enabled selective delivery of TLR7 ligands to immune cells. Besides the mannose receptor, immune cells express various sugar-binding proteins such as macrophage galactose binding lectins and sialic acid-binding immunoglobulin-type lectins and recognize distinct sugar structures. Hence, in the present study, we investigated whether sugar structures on GNPs affect the efficiency and selectivity of intracellular delivery and subsequent immunostimulatory potencies. Five neutral sugars and two sialosides were selected and each sugar was coimmobilized with 1V209 onto GNPs (1V209-SGNPs) and their innate immunostimulatory potencies were compared to that of 1V209-αMan-GNPs. The in vitro study using mouse bone marrow derived dendritic cells (BMDCs) demonstrated that α-glucose, α-N-acetylglucosamine, or α-fucose immobilized 1V209-SGNPs increased interleukin-6 and type I interferon release similar to that of 1V209-αMan-GNPs, whereas galacto-type sugar immobilized 1V209-SGNPs predominantly enhanced type I interferon release. In contrast, sialoside immobilized 1V209-SGNPs did not enhance the potency of 1V209. In the in vivo immunization study using ovalbumin as a model antigen, neutral sugar immobilized 1V209-SGNPs induced comparable T helper-1 immune response to that of 1V209-αMan-GNPs and by 10-fold higher than that of sialoside immobilized 1V209-SGNPs. These results indicate that the sugar structures on 1V209-SGNPs affect their immunostimulatory activities, and functionalization of the carrier particles is important to shape immune responses.

Novel combination therapy with imiquimod and sorafenib for renal cell carcinoma

OBJECTIVES

To investigate whether the combination of the imidazoquinoline immune response modifier, imiquimod, and the multitargeted tyrosine-kinase inhibitor, sorafenib, inhibits the growth of renal cell carcinoma in mice.

METHODS

Female BALB/c mice were implanted subcutaneously with 2 × 10(5) RENCA mouse kidney cancer cells, and were treated with transcutaneously applied cream containing imiquimod and oral administrations of sorafenib beginning 5 days after implantation of the cells. Tumor incidence and burden were determined at 28 days after initiation of therapy. T cell infiltration in the tumor was determined by immunofluorescence staining with anti-CD3-ε and CD8-α antibodies.

RESULTS

Therapy with imiquimod, sorafenib or their combination was well tolerated. Combination therapy with imiquimod and sorafenib significantly inhibited tumor growth when compared with administration of control vehicle, imiquimod or sorafenib alone (P < 0.05). The CD3- and CD8-positive T cells infiltrated into tumors to a greater degree in response to the combination therapy when compared with tumors treated with control vehicle or sorafenib alone.

CONCLUSIONS

Combination therapy with a tyrosine-kinase inhibitor and an imidazoquinoline could be a promising therapeutic strategy for patients with renal cell carcinoma.

Diagnostic criteria for schwannomatosis

The neurofibromatoses are a diverse group of genetic conditions that share a predisposition to the development of tumors of the nerve sheath. Schwannomatosis is a recently recognized third major form of neurofibromatosis (NF) that causes multiple schwannomas without vestibular tumors diagnostic of NF2. Patients with schwannomatosis represent 2.4 to 5% of all patients requiring schwannoma resection and approximately one third of patients with schwannomatosis have anatomically localized disease with tumors limited to a single limb or segment of spine. Epidemiologic studies suggest that schwannomatosis is as common as NF2, but that familial occurrence is inexplicably rare. Patients with schwannomatosis overwhelmingly present with pain, and pain remains the primary clinical problem and indication for surgery. Diagnostic criteria for schwannomatosis are needed for both clinicians and researchers, but final diagnostic certainly will await the identification of the schwannomatosis locus itself.

Changes in phosphorylation of the NMDA receptor in the rat hippocampus induced by status epilepticus

Systemic administration of pilocarpine preceded by lithium induces status epilepticus (SE) that results in neurodegeneration and may lead to the development of spontaneous recurrent seizures. We investigated the effect of Li/pilocarpine-induced SE on phosphorylation of the NMDA receptor in rat hippocampus. Phosphorylation of NR1 by PKC on Ser890 was decreased to 45% of control values immediately following 1 h of SE. During the first 3 h following the termination of SE, phosphorylation of Ser890 increased 4-fold before declining to control values by 24 h. Phosphorylation of NR1 by PKA was also depressed relative to controls immediately following SE and transiently increased above control values upon the termination of SE. SE was accompanied by a general increase in tyrosine phosphorylation of hippocampal proteins that lasted for several hours following the termination of seizures. Tyrosine phosphorylation of the NR2A and NR2B subunits of the NMDAR increased 3-4-fold over control values during SE, continued to increase during the first hour following SE and then declined to control levels by 24 h. SE resulted in the activation of Src and Pyk2 associated with the postsynaptic apparatus, suggesting a role for these enzymes in the SE-induced increase in tyrosine phosphorylation. Changes in phosphorylation of the NMDA receptor may play a role in the pathophysiological consequences of SE.

A case of galactosialidosis

Galactosialidosis is a lysosomal storage disease associated with a combined deficiency of beta-galactosidase and neuraminidase, caused by a defect of another lysosomal protein, the protective protein. Three subtypes are recognized: the early infantile form, the late infantile form and the juvenile/adult form. We saw a patient with galactosialidosis of the juvenile/adult form, a 51-year-old Japanese man with angiokeratomas on both elbows and knees, myoclonus, ataxia, mental retardation and macular cherry-red spots. An electron-microscopic study of a skin biopsy showed membrane-limited vacuoles in the cytoplasm of the endothelial cells, pericytes and fibroblasts. Assays of enzymatic activity in cultured fibroblasts showed a marked decrease in both beta-galactosidase and neuraminidase (sialidase). The substance contained in the cytoplasmic vacuoles appears to be glycoproteins with sialic acid, which is a terminal glycosyl residue, because the cytoplasm of the endothelial cells of the vessels and pericytes are stained by the Limax flavus agglutinin, a lectin that binds specifically with sialic acid. This technology may be useful for easy investigation of the distribution of the accumulation of such substances in the central nervous system.

A case of febrile ulceronecrotic Mucha-Habermann disease requiring debridement of necrotic skin and epidermal autograft

We report a case of febrile ulceronecrotic Mucha-Habermann disease (FUMHD) in a 21-year-old man. This disease is a severe form of pityriasis lichenoides et varioliformis acuta (PLEVA) and is characterized by the sudden onset of diffuse ulcerations associated with high fever and systemic symptoms. It is sometimes lethal especially in elderly patients. In the present case, intense generalized maculopapular erythematous plaques with central necrosis developed progressively in association with a high fever. Initial treatment with systemic betamethasone had been unsuccessful and the skin lesions, which covered about 50% of the body surface, became severely ulcerated. Although the development of new lesions had ceased spontaneously, widespread ulceration of the skin remained. Debridement of the necrotic skin and skin grafting using cultured epidermal autografts and meshed allografts of cadaver skin led to prompt reepithelization.

Measurement of absolute cross sections for excitation of the 3s(2)3p(5) 2P(o)(3/2)- 3s(2)3p(5) 2P(o)(1/2) fine-structure transition in Fe9+

Experimental cross sections are reported for the 3s(2)3p(5) 2P(o)(3/2)- 3s(2)3p(5) 2P(o)(1/2) transition in Fe9+ located at 1.945 eV. The center-of-mass interaction energies are in the range of 1.72 eV (below threshold) through threshold, to 5.6 eV (2.9 x threshold). Data are compared with results of a 49-state Breit-Pauli R-matrix theory. The experiment detects structures at 3.5 and 4.6 eV corresponding to enhancement of the direct excitation via many narrow, closely spaced resonances about these energies calculated by the theory. Iron is present in practically every astrophysical object, as well as being an impurity in fusion plasmas. Present data are the first electron-energy-loss measurements on a highly charged iron ion.

Prolonged herpes zoster in a patient infected with the human immunodeficiency virus

In 1983, varicella zoster virus (VZV) disease was first recognized in the context of infection with the human immunodeficiency virus (HIV). Since that time, there have been many reports discussing the occurrence and clinical manifestations of hepes zoster in HIV-infected patients. We describe the development of prolonged herpes zoster in a patient with acquired immunodeficiency syndrome (AIDS) over the course of 104 days. Viral isolates at the three different clinical stages of the skin lesions were sensitive in vitro to acyclovir, and supposed to be a same strain by polymerase chain reaction (PCR) analysis. We also discuss an effective treatment for prolonged cases of zoster.

Effect of long-term, low-dose acyclovir suppressive therapy on susceptibility to acyclovir and frequency of acyclovir resistance of herpes simplex virus type 2

We have examined the susceptibility to acyclovir and frequency of acyclovir-resistant viruses in herpes simplex virus type (HSV) 2 clones isolated directly from genital lesions of 11 patients who had taken suppressive therapy (200 mg/day) for 1-9 years and 15 patients naive to acyclovir. Suppressive therapy significantly reduced the incidence of recurrence and the severity of the skin lesions. HSV samples from genital lesions were directly inoculated into Vero cells, and viral clones were isolated in the absence and presence of 10 microg/ml acyclovir. Five-hundred-and-ninety-two clones, isolated in the absence of acyclovir, were subjected to the acyclovir susceptibility test, and 155 clones isolated in the presence of acyclovir were analysed for the mechanisms of resistance to acyclovir. There were no significant differences in the susceptibility to acyclovir, the frequency of acyclovir-resistant virus and the ratio of thymidine kinase-deficient viruses in acyclovir-resistant viruses between the two groups. The frequency of acyclovir-resistant clones was about three per 10000 plaque forming units (PFU), and genital lesions contained up to 3x10(6) PFU of replicating virus in the specimens from the patients with genital herpes with or without acyclovir-suppressive therapy. Thus, the low dose of acyclovir suppressive therapy did not affect the susceptibility to acyclovir or increase the frequency of acyclovir-resistant viruses in the genital lesions.

Use of a wrist activity monitor for the measurement of nocturnal scratching in patients with atopic dermatitis

BACKGROUND

The amount of nocturnal scratching can be an indirect correlate of itch in pruritic dermatoses. We have previously used an infrared video camera to measure nocturnal scratching in atopic dermatitis (AD). Although this is a reliable method of measuring nocturnal scratching, it is not suitable for routine monitoring in clinical use.

OBJECTIVES

To find a simplified way of monitoring itch.

METHODS

We tried using a wrist activity monitor (ActiTrac) for the measurement of nocturnal scratching in patients with AD. ActiTrac is a wristwatch-shaped device that contains a piezoceramic sensor to measure and record limb movement over a pre-set time interval. The acceleration signal produced by motion of the hands is stored and downloaded into a personal computer. The average value of acceleration (AVA, 10(-3) g min(-1)) was calculated and compared with total scratching time as a percentage of total recording time (TST%) measured with the use of an infrared video camera in 63 recordings of 21 patients with AD. For 261 recordings in 29 patients with AD, the AVA was measured and correlated with disease severity, and compared with the AVA of five non-itchy controls.

RESULTS

There was a significant correlation between the AVA and TST% (r = 0.91, P < 0.001), and a regression equation of y = 0.44x - 2.5 was obtained. The AVA correlated well with the severity of AD and definitely differed from the results observed in normal controls. The AVA (mean +/- SD) was 44.4 +/- 19.1 for 115 recordings in patients with severe AD, 23.2 +/- 10.9 for 89 recordings in patients with moderate AD, 8.9 +/- 6.0 for 57 recordings in patients with mild AD and 4.1 +/- 1.9 for 25 recordings in five normal controls. The units used here are arbitrary units min-1 with a range of 0--250, which corresponds to 0-75 x 10(-6) g min(-1).

CONCLUSIONS

A wrist activity monitor is able to measure nocturnal scratching. However, further methods of analysis should be sought to select scratching activity exclusively.

High resolution deletion analysis of constitutional DNA from neurofibromatosis type 2 (NF2) patients using microarray-CGH

Neurofibromatosis type 2 (NF2) is an autosomal dominant disorder whose hallmark is bilateral vestibular schwannoma. It displays a pronounced clinical heterogeneity with mild to severe forms. The NF2 tumor suppressor (merlin/schwannomin) has been cloned and extensively analyzed for mutations in patients with different clinical variants of the disease. Correlation between the type of the NF2 gene mutation and the patient phenotype has been suggested to exist. However, several independent studies have shown that a fraction of NF2 patients with various phenotypes have constitutional deletions that partly or entirely remove one copy of the NF2 gene. The purpose of this study was to examine a 7 Mb interval in the vicinity of the NF2 gene in a large series of NF2 patients in order to determine the frequency and extent of deletions. A total of 116 NF2 patients were analyzed using high-resolution array-comparative genomic hybridization (CGH) on an array covering at least 90% of this region of 22q around the NF2 locus. Deletions, which remove one copy of the entire gene or are predicted to truncate the schwannomin protein, were detected in 8 severe, 10 moderate and 6 mild patients. This result does not support the correlation between the type of mutation affecting the NF2 gene and the disease phenotype. This work also demonstrates the general usefulness of the array-CGH methodology for rapid and comprehensive detection of small (down to 40 kb) heterozygous and/or homozygous deletions occurring in constitutional or tumor-derived DNA.

Cutaneous lymphomas in Tokyo: analysis of 62 cases in a dermatology clinic

BACKGROUND

The epidemiology of cutaneous lymphomas revealed that the incidence of lymphomas differed depending on various factors including area, race, and sex, among others.

OBJECTIVE

This study was undertaken to analyse the incidence of cutaneous lymphomas in Tokyo.

METHODS

The clinical records and histologic material from 50 patients with lymphomas of the skin and 12 patients with lymphomatoid papulosis seen during the last 10 years at the Department of Dermatology, The Jikei University School of Medicine, Tokyo, have been reviewed.

RESULTS

T-cell lymphomas including mycosis fungoides (MF)-Sézary's syndrome (SS) complex and adult T-cell leukemia/lymphoma (ATL) were more frequent than B-cell lymphomas. The incidence of ATL is associated with the number of human T-cell lymphotropic virus type 1 (HTLV-1) carriers in the general population. Cutaneous B-cell lymphoma (CBCL) is not as rare as previously thought in Japan.

CONCLUSIONS

Although the frequency of these cases depends on many unrelated factors, these values can provide a rough indication of the incidence of cutaneous lymphomas in Tokyo. The incidence of cutaneous lymphomas may be influenced by changes in environmental factors including viral infections.

Cardiovascular malformations and other cardiovascular abnormalities in neurofibromatosis 1

Although it is well recognized that a peripheral vasculopathy may occur in patients with neurofibromatosis 1 (NF1), it is unclear whether cardiovascular abnormalities are more common. We reviewed the frequency of cardiovascular abnormalities, in particular, cardiovascular malformations (CVMs), among 2322 patients with definite NF1 in the National Neurofibromatosis Foundation International Database from 1991-98. Cardiovascular malformations were reported in 54/2322 (2.3%) of the NF1 patients, only 4 of whom had Watson syndrome or NF1-Noonan syndrome. There was a predominance of Class II "flow" defects [Clark, 1995: Moss and Adams' Heart Disease in Infants, Children, and Adolescents Including the Fetus and Young Adult. p 60-70] (43/54, 80%) among the NF1 patients with CVMs. Pulmonic stenosis, that was present in 25 NF1 patients, and aortic coarctation, that occurred in 5, constitute much larger proportions of all CVMs than expected. Of interest was the paucity of Class I conotruncal defects (2 patients with tetralogy of Fallot), and the absence of atrioventricular canal, anomalous pulmonary venous return, complex single ventricle and laterality defects. Besides the 54 patients with CVMs, there were 27 patients with other cardiac abnormalities (16 with murmur, 5 with mitral valve prolapse, 1 with intracardiac tumor, and 5 with electrocardiogram abnormalities). No patient in this study had hypertrophic cardiomyopathy. There were 16 patients who had a peripheral vascular abnormality without an intracardiac CVM, plus an additional 4 patients among those with a CVM who also had a peripheral vascular abnormality.

Distinctive distribution of human papillomavirus type 16 and type 20 DNA in the tonsillar and the skin carcinomas of a patient with epidermodysplasia verruciformis

BACKGROUND

Epidermodysplasia verruciformis (EV) is a rare skin disease characterized by disseminated pityriasis versicolor-like or flat wart-like lesions and by the development of skin carcinomas. It is well established that specific cutaneous human papillomaviruses (EV-HPVs) are associated with both benign and malignant skin lesions in EV patients. However, little is known of the relationship between HPV and the mucosal lesions of EV patients.

OBJECTIVES

To detect and identify HPV types associated with skin and mucosal lesions of an EV patient.

PATIENT/METHODS

We investigated the skin carcinoma and the coexisting tonsillar carcinoma of a 41-year-old man with EV. Histopathologically, both lesions were squamous cell carcinomas. We analysed these two lesions by immunohistochemistry, in situ hybridization, and by molecular virology.

RESULTS

Neither skin nor tonsillar lesions exhibited positivity for HPV capsid antigen by immunohistochemistry. By Southern blot hybridization, however, the skin carcinoma harboured 'EV-specific' HPV20 DNA, while the tonsillar carcinoma harboured 'genital' HPV16 DNA. In addition, in situ hybridization localized the respective viral DNA in the corresponding lesion.

CONCLUSIONS

The results indicate that EV-HPV could be responsible for the development of the skin carcinoma, but not the mucosal carcinoma in this patient.

A case of pemphigus vulgaris successfully treated with single filtration plasmapheresis: a correlation of clinical disease activity with serum antibody levels

We report a patient with pemphigus vulgaris (PV) successfully treated with single filtration plasmapheresis. A 40-year-old man with PV was started on therapy with prednisolone (PSL). Although the dosage of PSL was doubled, and both cyclosporin A (CyA) and pulse therapy were added, the disease was not controlled. After single filtration plasmapheresis began, most of the eroded lesions on the trunk reepithelialized. A switch to double filtration was followed by recurrence. Finally, additional treatments with single filtration plasmapheresis were required to obtain remission. To evaluate the efficacy of the treatment, circulating antibodies were measured by immunofluorescence (IIF) and enzyme-linked immunosorbent assays (ELISAs) using recombinant desmoglein (Dsg) 3. IIF titer and the ELISA scores correlated with the clinical disease activity. It is suggested that ELISA was more sensitive than IIF.

[Alphaherpesvininae--dermatology]

The subfamily alphaherpesuvirinae contains herpes simplex virus(HSV) and varicella-zoster virus(VZV) in the Dermatology. HSV infectious diseases are herpetic gingivostomatitis, herpes labialis, facial herpes simplex, Kaposi's varicelliform eruption, genital herpes, lumbosacral herpes simplex, and herpetic whitlow. The primary form of VZV infection is varicella, and the reactivation form is herpes zoster. These infectious diseases in the dermatological clinics usually occur in adult. In this paper we mention clinical manifestations and treatment.

Coexistence of psoriasis and linear IgA bullous dermatosis

Linear IgA bullous dermatosis (LABD) is characterized by IgA autoantibodies against components of the basement membrane zone (BMZ). A 97-kDa protein is one of the major autoantigens associated with this disease. We report a 68-year-old man who developed LABD after a 3-year history of psoriasis and in the context of active hepatitis C virus infection. He had been treated with cyclosporin for psoriasis for about 9 months. Histologically, there was a subepidermal blister containing neutrophils and eosinophils with lymphocytes infiltrating predominantly in the dermis. Direct immunofluorescent staining showed linear IgA deposition at the BMZ. The patient's IgA autoantibodies bound exclusively to the epidermal side of 1 mol/L salt-split normal human skin. Immunoblot analysis identified a 97-kDa autoantigen in epidermal extracts. This appears to be the first case of LABD with IgA autoantibodies against a 97-kDa autoantigen, associated with psoriasis and hepatitis C virus infection.

The characteristics of nocturnal scratching in adults with atopic dermatitis

Patients with atopic dermatitis (AD) are known to suffer from nocturnal itch, and the resultant scratching may worsen the skin lesions. We observed nocturnal scratching for 112 nights in 35 adult patients with AD, using an infrared video camera system. To quantify the amount of scratching, we counted scratching bouts lasting more than 5 s and calculated the duration of all the scratching bouts (total scratching time, TST). The percentage of TST in the total recording time (TST%) was used as an index of nocturnal scratching. Mean +/- SD TST% was 14.3 +/- 13.9 for patients with severe AD, 6.2 +/- 3.7 for those with moderate AD and 0.7 +/- 0.4 for those with mild AD. The higher TST% in the severely affected group was attributed mainly to a longer duration rather than a higher frequency of bouts. Patients scratched more in the first third of the night than in the later two-thirds. Both the group of patients whose disease distribution pattern was generalized and those who showed a head-neck-shoulder type distribution scratched their heads, faces and necks for longer than other parts of the body. Repeated measurement performed on individual subjects resulted in a similar TST% when there was little change in skin lesions. TST% reduced by 15 +/- 21% when the patients showed marked improvement. The measurement of nocturnal scratching helps to evaluate the severity of itch in AD. In addition, the infrared video successfully detected the location and nature of nocturnal scratching in AD.

Descriptive analysis of tibial pseudarthrosis in patients with neurofibromatosis 1

Five percent of individuals with neurofibromatosis type 1 (NF1) present with congenital long bone pseudarthrosis (PA). In large series, 50-80% of patients with congenital long bone PA also have NF1. Very little information exists on the natural history and pathogenesis of PA in NF1. This report is a descriptive analysis of a large series of patients with NF1 and tibial bowing or PA. Study A is a case-control study using the National Neurofibromatosis Foundation International Database (NNFFID). Eighty-five patients with PA were compared to a control group from the same database. There was a statistically significant male predominance of NF1 cases with PA (54 males to 31 females), compared to controls (85 males to 87 females) (chi2 = 4.0, P = 0.046, using a two-tailed test with Yates' correction). There was no significant difference in the clinical presentation of NF1 manifestations in NF1 patients with PA than in NF1 patients without PA. Of the affected individuals with PA, there were 24 de novo cases and 21 familial cases (9 through maternal and 12 through paternal inheritance). Questions that could not be answered by Study A were addressed by a partially overlapping case-series report, Study B, in which data on 75 cases ascertained through questionnaires completed by NF center directors were collected. From Study B we determined that half of the patients who had a fracture sustained it before age 2, and approximately 16% of the pseudarthrosis patients had an amputation. Our data indicate a male predominance and no parent-of-origin effect. Male gender may be a susceptibility factor for pseudarthrosis in NF1.

Paget's disease arising near a male areola without an underlying carcinoma

We report a 56-year-old man with Paget's disease occurring near the left areola without any underlying breast carcinoma. Histologically, there was no evidence suggesting continuity with a lactiferous duct, accessory breast, or microscopic gynecomastia. We review previous case reports of Paget's disease occurring in unusual sites and discuss their nomenclature from the histogenetic point of view.

Effects of nucleic acid inhibitors on the development of Angiostrongylus costaricensis in vitro

Nucleic acid biosynthesis of Angiostrongylus costaricensis was examined with various inhibitors; aminopterin (inhibitor of purine and pyrimidine de novo biosynthetic pathways), 8-azaguanine (specific inhibitor of purine salvage pathway) and PALA (specific inhibitor of pyrimidine de novo biosynthetic pathway) were applied in in vitro culture developing from the third stage larvae to young adult in chemically defined medium. It was suggested that A. costaricensis possessed functional purine and pyrimidine de novo biosynthetic pathways and also that they could utilize exogenous sources of purines and pyrimidines by salvage pathways for their development.

Caffeine inhibits paresthesia induced by herpes simplex virus through action on primary sensory neurons in rats

Herpetic infection causes paresthesia, including hypoalgesia, in humans and hypoalgesia in rats. This study was conducted to examine the effect of caffeine, which inhibits replication of herpes simplex virus type-1 (HSV) and affects several neuronal functions, on HSV-induced paresthesia in rats. HSV-induced hypoalgesia was suppressed by repeated treatment of unilateral hindpaw with 10% caffeine gel regardless of when the treatment was started. Repeated treatment with acyclovir, an anti-HSV agent, suppressed HSV-induced hypoalgesia only when started before inoculation; acyclovir did not produce therapeutic effects on the HSV-induced sensory abnormality. Many dorsal root ganglion neurons were positive for HSV antigen following HSV inoculation of the hindpaw. Repeated treatment with caffeine and acyclovir markedly decreased HSV antigen-positive neurons in the dorsal root ganglia when started before, but not 2 or 4 days after, infection. These results suggest that topical caffeine inhibited HSV-induced paresthesia through direct action on sensory neurons, and that not only antiviral activity but also direct alteration of neural functions are involved in the caffeine sensory actions.

Effects of nitrazepam on nocturnal scratching in adults with atopic dermatitis: a double-blind placebo-controlled crossover study

We investigated the effect of nitrazepam on nocturnal scratching in 10 adult out-patients with atopic dermatitis (AD) using a double-blind placebo-controlled crossover method. Patients were given either nitrazepam (Benzalin tablets containing 5 mg nitrazepam) or a placebo on 3 successive nights, with a washout interval of 4 days. We used an infrared video camera to identify bouts of scratching lasting more than 5 s. These were counted and the duration of all the bouts of scratching (total scratching time, TST) was calculated. The percentage of TST to total recording time (TST%) was used as an index of nocturnal scratching. The frequency with which bouts of scratching (bouts/h) occurred was reduced by 10 mg nitrazepam (7.7 +/- 3.6 with nitrazepam vs. 9.6 +/- 3.6 with placebo, P < 0.05). However, the mean duration (s/bout) of the bouts of scratching was longer with 10 mg nitrazepam (32.3 +/- 23.4 with nitrazepam vs. 19.1 +/- 10.0 with placebo, P < 0.05). As a result, there was no significant difference between TST% (6.5 +/- 4.2 with nitrazepam vs. 5.4 +/- 3.8 with placebo, not significant). All the above values are mean +/- SD. The degree of itching and the condition of the AD did not change during the 2 weeks of the study. We conclude that taking 10 mg nitrazepam is not an effective way of reducing the total duration of nocturnal scratching in AD patients, although it decreases the frequency with which bouts of nocturnal scratching occur.

Detection of microfilarial antigen in circulating immune complex from sera of Wuchereria bancrofti-infected individuals

Polyethylene glycol-precipitated circulating immune complexes (CICs) from the sera of patients with Bancroftian filariasis were examined for parasite antigen content by an ELISA. Of the 227 patients, 214 were asymptomatic microfilariae carriers with microfilaremias ranging between six and 14,000/ml blood, and 13 were symptomatic patients with chronic filariasis without microfilaremia. In addition, the sera of 10 of the patients treated with diethyl carbamazine were also examined. These assays were devised using mouse monoclonal antibody raised against microfilariae of Wuchereria bancrofti. Using an acid-phase covalent-bound plate for the ELISA makes it possible to assay the antigen contents simply. Microfilarial antigens were detected from 92 (43.0%) of microfilaria (mf)-positive individuals. Furthermore, the level of antigen in CIC was correlated with mf counts from night blood Nuclepore filtration results. Antigen was not detected in CIC from patients with a variety of nonfilarial helminth infections. These findings indicate that microfilariae play an important role of CIC formation in lymphatic filariasis.

Serum sex hormone levels in adult patients with atopic dermatitis

Serum levels of sex hormones were measured in adult patients with atopic dermatitis (AD) and compared with those in sex- and age-matched healthy controls. In 40 male patients with AD, serum levels of testosterone (T) (447 +/- 96 vs 593 +/- 149 ng/dl, P < 0.001), free testosterone (FT) (14.6 +/- 3.2 vs 20.0 +/- 5.1 pg/ml, P < 0.001) and estradiol (E2) (27.2 +/- 7.2 vs 33.2 +/- 7.9 pg/ml, P < 0.05) were significantly lower and serum levels of luteinizing hormone (LH) (4.57 +/- 1.6 vs 3.11 +/- 1.2 mIU/ml, P < 0.001) were significantly higher than those in healthy controls. There were no significant differences in serum levels of dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), dehydroepiandrosterone (DHEA), or follicle stimulating hormone (FSH) between the two groups. In 25 female patients with atopic dermatitis, T, FT, DHT and DHEA-S levels did not differ from controls. In conclusion, serum T levels were lower in male patients with AD. However, similar changes were not seen in female patients.

Mild insulin resistance during oral glucose tolerance test (OGTT) in women with acne

The purpose of this study was to evaluate serum levels of basal insulin and glucose-stimulated insulin, and to evaluate their correlations with androgen levels in women with acne. Serum levels of total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), sex hormone binding globulin (SHBG), insulin-like growth factor-1 (IFG-1), and immunoreactive insulin (IRI) were measured and compared in thirty women with moderate or severe acne and thirteen healthy controls. Serum FT, DHT and DHEA-S levels in the acne group were significantly higher than those in the control group. In the acne group, there were no significant correlations between insulin or IGF-1 levels and T, FT, DHT and SHBG, despite the positive correlation between insulin and IGF-1. In order to determine the effects of insulin secretion as a dynamic response to an oral glucose tolerance test (OGTT) on serum androgen levels in acne patients, we examined the responses of serum insulin and androgen levels to a 75 g, 2 hour OGTT in the acne group and in the control group. Basal insulin levels were not significantly higher than those in the control group, but the summed insulin levels during the OGTT in the acne group were significantly higher than those in the control group. Serum T and FT levels in the acne group decreased during the OGTT, but these changes were not so significant when compared to normal controls. In conclusion, we tried to demonstrate mild insulin resistance during the OGTT in acne patients. However, postmeal transient hyperinsulinemia does not seem to play an important role in determining hyperandrogenemia in acne patients.

Trichinella spiralis: ultrastructural localization of a target antigen recognized by a monoclonal antibody

The localization of a 160-kDa molecule recognized by a monoclonal antibody of the IgG1-class (TS32D12) to Trichinella spirilis was demonstrated at the subcellular level. Mature muscle larvae recovered from infected mice were fixed with Zamboni solution, and embedded in LR white resin. Ultrathin sections were incubated with TS32D12 and subsequently stained using a secondary antibody-coated colloidal gold probe. TS32D12 reacted to constituents in the alpha-stichosome cells of the parasite; that is, alpha-granules and rough endoplasmic reticulum. Other structures were not recognized by the immunogold probe, but occasionally weak positive staining was seen on beta-granules, the cuticle, hypodermis and myofibrils.

Androgen status in adolescent women with acne vulgaris

Androgens are essential for the development of acne. The object of this study was to elucidate the androgen status of women with adolescent (Tanner's stage IV-V) acne alone and compare them to age-matched normal controls. We measured serum levels of total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), and dehydroepiandrosterone sulfate (DHEA-S) in 15 women with adolescent acne and 13 age-matched healthy controls. No significant differences were found between the mean levels of T, FT or DHT levels in patients and controls. However, the mean levels of DHEA-S in the patient population (1886 +/- 829 ng/ml) were significantly (p < 0.05) higher than normal controls (1287 +/- 620 ng/ml). There was also no correlation between androgen levels and acne severity. Thus it is unlikely that serum androgens play a principal role in women with adolescent acne.

Elevated serum insulin-like growth factor-1 (IGF-1) levels in women with postadolescent acne

The purpose of this study was to measure the serum levels of IGF-1 in women with postadolescent acne compared to normal controls, and evaluate the relationship of these levels to the levels of androgens, in order to investigate the possible role of IGF-1 in the pathogenesis of acne. Eighty-two female patients with acne between 20 and 25 years of age and thirty-one age-matched control women were studied. We measured the serum levels of total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), and insulin-like growth factor-1 (IGF-1). The levels of IGF-1 in patients with acne (1.26 +/- 0.52 U/ml) were significantly (p < 0.001) increased over those of controls (0.96 +/- 0.32 U/ml). Of 82 acne patients, six (7%) had IGF-1 levels which exceeded the normal range, but there were no significant correlations between IGF-1 and T, FT, DHT or DHEA-S levels or between IGF-1 and acne severity. Since the measurement of serum IGF-1 levels is a convenient indicator of GH secretion, the increase of serum IGF-1 levels seen in some acne patients might reflect an increase of GH.

Neurofibromatosis 2 and neurilemmomatosis gene are identical

Neurofibromatosis 2 (NF2) is an autosomal dominant disorder characterized by the occurrence of bilateral acoustic neuromas, as well as meningiomas and schwannomas. The gene locus for NF2 resides on chromosome 22q12 and has been cloned recently. Neurilemmomatosis is characterized by multiple cutaneous and spinal neurilemmomas without other signs of NF1 or NF2. Many cases with this disorder include the diagnosis of neurofibromatosis or other rare diseases unexplained by current nosology. In this study, we analyzed the peripheral leukocytes and tissue from cutaneous neurilemmomas of seven patients with neurilemmomatosis using DNA markers for different regions of chromosome 22. We detected allelic losses in three of seven tumors from seven patients with a probe for the NF2 region of the long arm of chromosome 22 and the germ-line mutations in two of three tumors from the same three patients. Mutations in the NF2 gene were a deletion from at least codon 334 to 579 and G insertion at codon 42. We conclude that the neurilemmomatosis locus lies within the NF2 region and that these diseases might be identical.

A case of peculiar plantar warts. Human papillomavirus type 60 infection

BACKGROUND

Various kinds of viral warts have their own typical clinical appearances and histologic properties. From each of them, a corresponding unique type of human papillomavirus (HPV) has been detected. More than 60 types of HPV have been identified from the warts and other squamous cell epithelial tumors. Human papillomavirus type 60 has been identified in an epidermal cyst on the sole. We present a case of a peculiar plantar wart infected with HPV type 60.

OBSERVATIONS

A 21-year-old male student complained of yellowish hyperkeratotic slightly elevated nodules on the right plantar arch. The surface of the nodules was not papillary, but a normal ridge pattern of the sole could be traced. Histologic findings included moderate acanthosis, papillomatosis, and eosinophilic intracytoplasmic large granules with or without surrounded vacuoles. These were noted in the middle and upper epidermis, including the hypertrophic stratum corneum. Virologic findings included HPV antigen detected by anti-HPV polyclonal antibody. The DNA of HPV type 60 was detected by in situ hybridization.

CONCLUSION

A new type of plantar wart infected with HPV type 60 is reported. It shows unique clinical and histologic findings that can be distinguished from those of ordinary verruca or myrmecia on the sole.

Detection of human papillomavirus type 60 in plantar cysts and verruca plantaris by the in situ hybridization method using digoxigenin labeled probes

BACKGROUND

Since 1987, many cases have been reported in which human papillomavirus (HPV) could be associated with epidermoid cysts of the palms and soles. In 1989, the HPV found in an induced epidermoid cyst was cloned and named HPV 60.

OBJECTIVE

Our purpose was to examine the relationship of HPV 60 to plantar cysts.

METHODS

Ten cases of plantar cysts and two cases of verruca plantaris containing single inclusion bodies were obtained by biopsy and examined by the in situ hybridization (ISH) method with a digoxigenin labeled HPV 60 DNA probe.

RESULTS

Six of ten cases were found to have cytopathic effect (CPE) in the cyst wall and inner contents of the cyst. HPV 60 was detected in these cases by ISH. Two cases of verruca plantaris showing CPE also demonstrated the presence of HPV 60. Of the six HPV type 60 positive cases, four cases also showed CPE in the overlying epidermis.

CONCLUSION

At first, punctate keratotic lesions are induced by HPV 60. HPV 60 induces irregular elongation of the rete ridges into the dermis. Plantar cysts probably form as a result of the traumatic implantation of HPV 60 infected epidermis with irregularly long and narrow rete ridges into the dermis.

Enhancing effect of zinc acetate on the binding of 1-nitropyrene to polydeoxyguanylic-polydeoxycytidylic acid in the hypoxanthine-xanthine oxidase system

The main aim of this research was to investigate whether conformational alteration of polydeoxyguanylic-polydeoxycytidylic acid (poly[dG-dC].poly[dG-dC]) by zinc acetate would have an effect on the binding of 1-nitropyrene(1-NP) to poly[dG-dC].poly[dG-dC]. The binding of 1-NP to poly[dG-dC].poly[dG-dC] in the hypoxanthine-xanthine oxidase system in vitro was increased by zinc acetate. This increase was abolished when EDTA was added to the preincubated mixture of poly[dG-dC].poly[dG-dC] and zinc ions. Neither the production of 1-aminopyrene and its expected intermediates, N-hydroxy-1-aminopyrene and 1-nitrosopyrene, nor the 1-NP remaining in the reaction mixture was altered by the addition of zinc acetate without poly[dG-dC].poly[dG-dC]. From these findings, it seems that the hypoxanthine-xanthine oxidase system is not activated by zinc acetate. On the other hand, under the same reaction conditions but the hypoxanthine-xanthine oxidase system and 1-NP, it has been reported that zinc ions or complexes transform the B-form of poly[dG-dC].poly[dG-dC] to the Z-form. Therefore, these findings indicate that the formation of the Z-form or intermediates from the B-form by zinc ions may promote the binding of 1-NP to poly[dG-dC].poly[dG-dC].

Photoleukomelanodermatitis (Kobori) induced by afloqualone

We reported a case of photoleukomelanodermatitis (Kobori) type drug eruption due to afloqualone (Arofuto). The patient was given afloqualone and imipramine hydrochloride (Chrytemin) for cervical spondylosis from November of 1990. Edematous erythema with slight itching appeared on the sun-exposed areas in December of 1990. As drug eruption was suspected, drugs were ceased, and the cutaneous lesions almost disappeared but pigmentations and depigmentations developed in spots in sun-exposed areas in March of 1991. Photopatch and oral challenge tests were positive.

Molecular genetic analysis of the von Recklinghausen neurofibromatosis (NF1) gene using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) method

Von Recklinghausen neurofibromatosis (NF1) is a common autosomal dominant disorder characterized by abnormalities in multiple tissues derived from the embryonic neural crest. The NF1 gene has been mapped to the pericentromeric region of the long arm of chromosome 17. Chromosome walking and sequencing of the NF1 gene have extended it's open reading frame; to date 49 exons have been identified. To investigate the mutation of the NF1 gene, the polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) method was applied to 4 exons of NF1 genes. We examined the DNAs from 49 samples, including those of 23 Japanese patients with NF1 (4 of these patients developed malignant schwannoma), a patient with segmental neurofibromatosis, and 14 clinically normal controls. A mutational band was detected in an exon of a tumor DNA extracted from a malignant schwannoma of a female NF1 patient. However, the mutation was not found in the germ line DNA of this patient. No mutations were detected in the other samples.