Characteristic dermoscopic features of primary cutaneous amyloidosis: a study of 35 cases

BACKGROUND

Primary cutaneous amyloidosis (PCA) is a relatively common skin disorder among Asians and South Americans. It is usually diagnosed clinically. However, for cases with atypical presentations, the diagnosis can be a challenge and skin biopsy may be necessary. Dermoscopy has been proved to be a valuable, noninvasive tool in the diagnosis of cutaneous pigmented diseases. Most lesions of PCA show hyperpigmentation and the major histopathological abnormalities of PCA occur in the epidermis and dermal papillae. Dermoscopy might be a powerful tool to provide valuable information for the diagnosis of PCA.

OBJECTIVES

We aimed to find characteristic dermoscopic features of PCA.

MATERIALS AND METHODS

Cases with typical clinical presentations of PCA, either macular or lichen subtypes, were included in this study. All were evaluated using a hand-held, polarized and nonpolarized dermoscope.

RESULTS

A total of 35 patients with clinically diagnosed PCA were enrolled. Eighteen patients had lesions consistent with macular amyloidosis and 17 with lichen amyloidosus. We found two major dermoscopic patterns characteristic of PCA. The most common dermoscopic finding of PCA was a central hub, which could be either white or brown, surrounded by various configurations of pigmentation. For cases of lichen amyloidosus with prominent hyperkeratosis, the central hub was replaced by a scar-like morphology.

CONCLUSIONS

This is the first study to report the characteristic dermoscopic features of PCA. We demonstrate that the use of a dermoscope may assist in achieving an accurate diagnosis of PCA.

Methicillin-resistant Staphylococcus aureus bacteraemia in neonatal intensive care units: an analysis of 90 episodes

AIM

To delineate the clinical features of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in infants hospitalized at the neonatal intensive care unit.

METHODS

Episodes of MRSA bacteraemia in Chang Gung Children's Hospital neonatal intensive care unit from 1997 to 1999 were reviewed for incidence, predisposing factors, clinical presentations, treatment and outcome.

RESULTS

Ninety episodes of MRSA bacteraemia were identified. The overall rate of MRSA bacteraemia was 1.05 per 1000 patient days during the 3-y period. Most of the patients were premature infants (76%), with prior operation or invasive procedures (39%), had an indwelling intravascular catheter (79%) and exposure to antibiotic therapy (96%). A localized cutaneous infection was found in 53.3% of the episodes. The most common clinical diagnoses were catheter-related infections (54.4%), skin and soft tissue infections (21.1%), bacteraemia without a focus (20%) and pneumonia (16.7%). Metastatic infection occurred in 18% of these infants. Among the patients treated with vancomycin for < or = 14 d, 88.7% did not develop any complications, and 11.3% developed a recurrence.

CONCLUSIONS

MRSA is an established pathogen in our NICU. MRSA bacteraemia in the neonates predominantly presented as catheter-related infections, and metastatic infections were not infrequently seen. In uncomplicated MRSA bacteraemia, treatment with vancomycin for < or = 14 d seems to be adequate.

The small GTPase Rac suppresses apoptosis caused by serum deprivation in fibroblasts

BACKGROUND

The small GTPase Rac1 is a key signaling protein that mediates a number of important physiologic functions including the organization of the actin cytoskeleton, lipid metabolism, and gene transcription. Rac1 has also been implicated in oncogenic transformation. Expression of constitutively active Rac1 in Rat1 fibroblasts elicits serum- and anchorage-independent growth and causes tumorigenicity in nude mice. The signaling pathways that mediate the role of Rac in cell transformation remain to be identified. Here, we study the role of Rac in cell survival in the absence of serum.

MATERIALS AND METHODS

The cell lines used in this study are Ratl fibroblasts that express constitutively active or dominant negative mutants of Rac1. We used long-term video time-lapse microscopy to analyze the effects of these Rac1 mutants on mitogenicity and apoptosis.

RESULTS

We show that the increase in viability, which is stimulated by Rac1 in the absence of serum, is predominantly caused by an inhibition of apoptosis, with a minor increase in cell division. We also show that Rac1-stimulated cell viability in serum-starved cells is inhibited by chemical inhibition of phosphatidylinositol 3-kinase.

CONCLUSIONS

Our observations indicate a role for Rac1 in survival signaling, possibly via activation of phosphatidylinositol 3-kinase. We propose that Rac1-stimulated cell survival may contribute to the role of Rac1 in serum-independent growth and cell transformation.

Distribution and seasonal occurrence of Forcipomyia taiwana (Diptera: Ceratopogonidae) in the Nantou area in Taiwan

We studied the distribution of Forcipomyia taiwana (Shiraki) in Taiwan, and found this species almost island-wide. Midge seasonality was studied for 4 yr at 3 sites in Nantou, central Taiwan, to identify the extent and causes of midge population outbreaks. The midge population in 1995 was significantly lower than in 3 other years because several typhoons inundated breeding sites. Maximum populations of F. taiwana occurred in June, July, and August. There was a highly significant correlation between the monthly abundance of F. taiwana and temperature and rainfall. A step-up multiple regression indicated that temperature was the most important factor leading to the outbreaks of F. taiwana. Temperature increases from 15 degrees C to near 30 degrees C will increase the midge abundance.

Radiation-induced mutations at the autosomal thymidine kinase locus are not elevated in p53-null cells

To explore further the possibility that some forms of mutated p53 may increase mutagenesis in a positive manner, a double p53 knockout cell line was created, using a promoterless gene targeting approach. The identity of these p53-null cells was confirmed by Southern blot and Western blot analyses. Radiation-induced toxicity and mutagenicity was then compared among p53-null cells, TK6 cells with wild-type p53, and WTK1 cells with a p53 point mutation in codon 237. At the autosomal, heterozygous thymidine kinase locus, p53-null cells had equivalent background mutation frequencies and were approximately equally mutable as TK6, whereas WTK1 was much more sensitive to spontaneously arising and X-ray-induced mutation. Thus, these results indicate that the lack of wild-type p53 did not lead to increased mutagenesis.

A specific shifting deficit in Parkinson's disease: a reversal shift of consistent stimulus-response mappings

Two experiments were designed to investigate effects of cueing upon aptitude for shifting by patients with Parkinson's disease. Subjects executed in alternation two different components of a task set over successive items in a list. We compared the costs of shifting when the stimulus ensemble remained constant from trial to trial ("uniform" lists), with the case in which a change of stimulus ensemble cued each shift of task ("mixed" lists). Shift costs with mixed lists were significantly smaller than those with uniform lists (Exp. 1, ns = 12). This suggests that patients with Parkinson's disease can benefit from cues about the stimulus ensemble in performing tasks. Patients' shifting performance was different from that of controls only in a reversal-shift condition of the previously consistent stimulus-response mappings (Exp. 2, ns = 12). This result suggests that patients with Parkinson's disease suffer from a specific but not a general deficit in ability to shift.

Effects of cell cycle position on ionizing radiation mutagenesis. I. Quantitative assays of two genetic loci in a human lymphoblastoid cell line

Relatively little work has been done on the influence of the position of the cell in the cell cycle on ionizing radiation-induced mutagenesis. We synchronized WTK1 human lymphoblastoid cells with 200 microM lovastatin for 48 h; under these conditions more than 80% of the cells were arrested in G1 phase. Upon release, there was a 12-15-h lag followed by movement of a large fraction into S phase. We irradiated cells with either 1.5 Gy X rays at 1, 15, 18, 21 or 24 h or 1.5 Gy gamma rays at 1, 5, 10, 15 or 24 h after release from lovastatin. We showed that WTK1 cells were most sensitive to ionizing radiation-induced toxicity in G1 and into S phase, and more resistant in mid to late S and G2/M phase. Somewhat surprisingly, we found that the two different gene loci had different sensitivities to radiation-induced mutation through the cell cycle. Cells in late G1 through mid-S phase were most sensitive to radiation-induced mutations at the autosomal thymidine kinase (TK) locus, whereas G1 phase was the most sensitive phase at the X-linked hypoxanthine guanine phosphoribosyl transferase (HPRT) locus.

Colonization and bionomics of Forcipomyia taiwana (Diptera:Ceratopogonidae) in the laboratory

An improvement in colonizing the biting midge Forcipomyia taiwana (Shiraki) was achieved by a new technique that facilitated the rearing of the midges and induced them to mate in the laboratory. At temperature of 15, 20, 25, and 30 degrees C, the development duration of the egg, 4 larval instars, and pupa decreased as temperature increased. Among 7 different diets, the blue green algae, Anabaena sp.Ch3, was the best food for rearing the midges. When the larvae were fed on the blue green algae at 25 degrees C, they needed 12 d to pupate, the pupation rate was 71.4%, the emergence rate was 80.2%, and the average longevity of the male and the female 38.3 and 22.6 d, respectively. When 120 paris were kept in a plastic cage (60 by 60 by 60 cm), swarming and copulation occurred during 0700-0900 and 1700-1800 hours. Swarm occurred throughout the cage and consisted of 10 males. The copulation was performed on the wall and the bottom of the cage, and the average duration was 290 s.

Selection and characterization of alpha-amylase-overproducing recombinant Escherichia coli containing the bacterial hemoglobin gene

We previously reported that the presence of the bacterial (Vitreoscilla) hemoglobin gene enhances alpha-amylase production in recombinant Escherichia coli strain MK79. Using the growth of MK79 on starch as a selective method we have produced a mutant strain (BSC9) that produces up to four times as much alpha-amylase as MK79. Both MK79 and BSC9 produce the most alpha-amylase (per cell and per milliliter) in the stationary phase; almost all of the enzyme is intracellular in both strains. Modification of the standard alpha-amylase assay increases the amount of amylase detected about sixfold. BSC9 has about five to nine times as many copies per cell as MK79 of the recombinant plasmid, which carries both the amylase and hemoglobin genes, but both strains produce about the same amount of hemoglobin. While MK79 respiration decreases upon going from log to stationary phase, BSC9 respiration increases during the same period. The two latter results may be of particular importance in determining the way in which hemoglobin enhances the production of cloned protein products in recombinant bacteria.