Pyoderma gangrenosum and underlying diseases in Japanese patients: A regional long-term study

Pyoderma gangrenosum (PG) is a chronic inflammatory disease of unknown cause that presents as an inflammatory and ulcerative disorder of the skin. PG is often associated with an underlying systemic disease. However, the frequencies of the underlying diseases are unclear in Japanese patients. In this retrospective, observational study, all patients diagnosed with PG who visited dermatology departments of nine regional hospitals in and around Ibaraki Prefecture were collected from 1982 to 2011 or 2014. The diagnoses of PG were based on the characteristic clinical and histological appearances and ruling out of infection. Sixty-two PG patients, including 29 males and 33 females, were identified. The ages of onset were 16-89 years, and the mean age was 50.2 years. Fifty (80%) of the 62 patients presented with an ulcerative PG, and the lower leg was the most common site (74%). Forty-six (74%) PG patients had underlying diseases. The most frequent was ulcerative colitis (32%), followed by myelodysplastic syndrome (11%), rheumatoid arthritis (6%) and aortitis syndrome (5%). For treatment, 54 cases (87%) received systemic corticosteroids and 10 received additional treatment with cyclosporin. There was no significant correlation between underlying diseases and response to the initial treatment. Multivariate analysis revealed that the number of affected sites negatively correlated with successful initial treatment. Fifteen (24%) of the 62 cases relapsed. In conclusion, ulcerative colitis and hematological disorders were frequently associated with PG while approximately a quarter of the cases were idiopathic.

Nuclear shuttling of mitogen-activated protein (MAP) kinase (extracellular signal-regulated kinase (ERK) 2) was dynamically controlled by MAP/ERK kinase after antigen stimulation in RBL-2H3 cells

The mitogen-activated protein kinase (MAPK) cascade consists of the MAPK (extracellular signal-regulated kinase 2; ERK2) and its activator, MAPK kinase (MAP/ERK kinase; MEK). However, the mechanisms for activation of ERK2 have not been defined yet in cells. Here, we used fluorescent protein-tagged ERK2 and MEK to examine the localization of ERK2 and MEK in living rat basophilic leukemia (RBL-2H3) cells. ERK2 was mainly in the cytoplasm in resting cells but translocated into the nucleus after the ligation of IgE receptors. The import of ERK2 reached the maximum at 6--7 min, and then the imported ERK2 was exported from the nucleus. MEK mainly resided in the cytoplasm, and no significant MEK translocation was detected statically after ligation of IgE receptors. However, analysis of the dynamics of ERK2 and MEK suggested that both of them rapidly shuttle between the cytoplasm and the nucleus and that MEK regulates the nuclear shuttling of ERK2, whereas MEK remains mainly in the cytoplasm. In addition, the data suggested that the sustained calcium increase was required for the optimal translocation of ERK2 into the nucleus in RBL-2H3 cells. These results gave a new insight of the dynamics of ERK2 and MEK in the nuclear shuttling of RBL-2H3 cells after the ligation of IgE receptors.

[Studies on changes in the uterine cervix during pregnancy]

The uterine cervix becomes increasingly soft during pregnancy and at parturition in comparison with the non-pregnant state. The purpose of the study is to evaluate the changes in consistency of the cervix during pregnancy by two methods. One is based upon the acoustical theory that the elasticity of the tissue correlates to the sound velocity (V). V = (E/rho)1/2 where E is an elastic modulus and rho is the density of the tissue. The ultrasonic velocities of 355 pregnant and 12 non-pregnant women were measured and the data are as follows: Sound velocities were 1587.5 +/- 6.0m/sec in controls, 1579.8 +/- 6.1m/sec in the first trimester, and 1572.8 +/- 5.4m/sec in the third trimester. The other study involved the quantification of collagenous fibers of the tissue sections stained by Masson's trichrome stain in the cervical stroma by means of an image processing technique. Area ratios of collagenous fibers in cervical stroma were 68.6 +/- 20.2% in non-pregnant, 46.3 +/- 14.0% in the first trimester, and 29.1 +/- 10.3% in near term. Two conclusions were reached based on these studies. The gradual decline in sound velocity with the progress of gestation reflects the softening of the cervix. Automatic image-analysis of sections stained by trichrome stain showed a decrease in collagenous fibers during gestation. The above results suggest that a decrease in collagenous fibers may be involved in the process of the ripening of the cervix.

Radioimmunoassay of carcinoembryonic antigen and clinical significance of its level in plasma

The level of carcinoembryonic antigen (CEA) in the plasma was measured in 258 patients, consisting of 198 patients with various cancers and 60 with various non-malignant diseases. As the normal control, the plasma CEA level was examined in 330 apparently healthy individuals and the value was 3.1 +/- 1.1 ng/ml on the average. If the level higher than 4.2 ng/ml could be assumed to be above the normal, 109 out of 198 (55%) patients with malignant diseases were considered to show abnormally elevated CEA values. Based on the above criterion, the CEA titer was abnormally elevated only in 11 out of 60 cases (18%) without cancers. Among cancerous patients, the ones with carcinomas of the digestive tract and the lung exhibited a positive titer of CEA higher than 10.1 ng/ml. When the relationship between the plasma CEA level and histological findings in patients with lung cancer was examined, cases with the adenocarcinoma had more elevated titers than those with any other types of lung cancer. It was also found, by the serial estimation of plasma CEA, that the titer dropped after a successful therapy but elevated again with the recurrence of cancer. Repeated estimation of Cea is thought to be valuable as an indicator for clinical phases of cancer patients.