Search

A 55-year-old man was admitted to our hospital because of progressive dyspnea. Chest radiography showed interstitial shadows in the upper lobe. The pathological diagnosis of lung biopsy specimens obtained from upper and middle lobes by video-assisted thoracoscopy was non-specific interstitial pneumonia, group 2. Administration of glucocorticoids improved the symptoms, the chest radiography findings, and the serum KL-6 level. This patient may belong to the new category of idiopathic interstitial pneumonia, though he exhibited several features of idiopathic pulmonary upper lobe fibrosis originally described by Amitani et al.

Background: The production of peroxynitrite, an extremely potent oxidant, is increased in inflammatory lung disease. It is therefore important to measure antioxidant activity against peroxynitrite in epithelial lining fluid to examine the physiological effects of peroxynitrite in the airways of patients with asthma. This study was designed to determine whether peroxynitrite inhibitory activity in induced sputum is correlated with clinical characteristics and airway inflammatory indices in asthmatic patients. Methods: Inflammatory indices were measured in induced sputum from 25 patients with asthma and 12 normal control subjects. Peroxynitrite inhibitory activity was also measured by monitoring rhodamine formation in sputum samples. Results: Peroxynitrite inhibitory activity in induced sputum was significantly lower in asthmatic patients (52.4 (24.5)%) than in normal control subjects (92.1 (3.9)%, p

We have employed a successful therapy for epidermolysis bullosa with high-dose oral tocopherol acetate. Two siblings with dominant dystrophic epidermolysis bullosa of the Cockayne-Touraine type were reported. Both siblings suffered from tense blisters and erosions healing with scars and transient milia on the extremities. Electron microscopic study of the blisters revealed a cleavage beneath the lamina densa in both siblings. High-dose oral tocopherol acetate therapy was administered to them with satisfactory clinical reduction of the blister formation.

Peroxynitrite plays an important role in the pathogenesis of inflammatory diseases, including those affecting the lung. In inflamed airways, simultaneous cellular production of superoxide anion (.O2-) and nitric oxide (NO) may occur, potentially resulting in continuous formation of peroxynitrite. However, because peroxynitrite has a short half-life, its in vivo physiologic effects in the airways may not be sufficiently evaluated with a single administration. Accordingly, this study was designed to use 3-morpholinosydnonimine (SIN-1), a compound that releases peroxynitrite, to determine whether peroxynitrite could alter airway beta2-adrenoceptor (beta2-AR) function in anesthetized guinea pigs. Though SIN-1(10(-)7 M) alone had no effect on pulmonary resistance, pretreatment with SIN-1 significantly attenuated isoprenaline- and salbutamol-induced bronchoprotection against acetylcholine. Pretreatment with SIN-1 also attenuated forskolin-induced bronchoprotection. S-Nitroso-N-acetylpenicillamine (SNAP), a potent NO donor, did not have the same effect as SIN-1. N-Acetylcysteine and glutathione each significantly reversed the inhibitory effect of SIN-1 on isoprenaline-induced bronchoprotection in a dose-dependent manner. These striking findings suggested that peroxynitrite, but not NO, is an important mediator of alteration of beta2-AR function in airway smooth muscle. Additionally, the action of peroxynitrite seems to be directed either at adenylate cyclase activity or at effects downstream of such activity.

Partially engorged adult female ticks, Haemaphysalis longicornis Neumann, received complete, incomplete, or no copulatory stimuli. Subsequently, they were inflated with physiological saline by injection into the haemocoel. Ticks that copulated received both preinseminational and inseminational stimuli and increased their body volume > 10-fold. Ticks that incompletely copulated received only preinseminational stimuli and expanded slightly, whereas ticks that did not copulate did not expand. These results show that the soft integument of H. longicornis only expanded after complete copulation. Therefore, copulatory stimuli induced cuticular plasticization.

A 37-year-old male presented with a cauliflower-like tumor in the right buccal mucosa, leukoplakia of the tongue and esophagus, and keratotic papules or plaques on the extremities including bilateral palms and soles, associated with borderline diabetes mellitus and a repeated history of infections. A multi-system keratinizing abnormality was suspected, although no distinct disease category has been found showing similar involvements.

Membrane co-factor protein (MCP; CD46) is an integral membrane protein with molecular weight (MW) of the two species of 63 kD and 55 kD, and regulates autologous complement activation, with the activity of factor I cofactor. The quantity of each species is genetically regulated, and two codominantly inherited allelic variants account for the three phenotypic patterns. By immunohistochemical study, MCP was found both in the intercellular spaces of the epidermis and on the endothelial cells in the dermis of normal human skin in vivo. The intensity of the staining pattern was higher in the basal layer than in the granular layer. By Western blot analysis with use of a monoclonal antibody, MCP in the epidermis appeared as several bands ranged from 60-50 kD, with a major band of 56 kD, which was different from those in either polymorphonuclear cells, platelets, and cultured keratinocytes. No other variants were found in the epidermis obtained from skin of 20 normal humans. Complement activation in human skin may be regulated at several steps, including DAF and HRF20, thereby protecting cells from autologous complement attack.

Identical twin sisters developed generalized erythema and bullae on skin and mucous membranes at 18 and 19 years of age. Atrophic scars and milia were formed later. Indirect immunofluorescence (IF) study of the separated skin by incubation in 1.0M NaCl showed antibasement membrane zone (BMZ) antibodies bound to the dermal side. The HLA-DR typing demonstrated DR2/DW11. Pulse therapy resulted in marked clinical improvement. This is the first report of epidermolysis bullosa acquisita (EBA) in identical twins and suggests the possibility that the disease may have a genetic component.

The midgut epithelial cells in nymphs fed on laboratory rabbits were examined during feeding and after detachment. The midgut epithelium at the unfed stage consisted of digestive cells of lower activity, containing such nutritive substances as protein, lipid and glycogen. As feeding proceeded, the cells became active in intracellular digestion. At the middle of the feeding stage, the spent digestive cells derived from the active digestive cells began to be replaced by the new digestive cells of lower activity. After detachment, the pinocytotic activity of the above cells increased greatly, and the digestive activity increased to some extent. As a result, many large endosomes were formed by fusion of numerous pinosomes. Thereafter, endosomes decreased in size as digestion proceeded and there was an increase of haematin granules. On day 7 after detachment, the new digestive cells of lower activity, belonging to the 'nutritional reserve' type, appeared adjacent to the spent digestive cells which had almost exhausted all endosomes, and these new cells had completely replaced the spent cells by day 3 after moulting.

A 38-year-old Japanese man was seen for severe palmoplantar keratoderma, extending to the dorsal aspects with red rims. He had had spontaneous amputations of the toes and surgical amputation of the right lower leg because of squamous cell carcinoma of the right sole. The clinical symptoms suggested those of mal de Meleda, except for the absence of consanguinity and of granular layers in the epidermis. The keratoderma improved with oral etretinate treatment.

To the Editor.— A 65-year-old Japanese woman was first seen in January 1979 because of a slowly enlarging, extensive, well-demarcated erythematous plaque on the right side of her face (Fig 1, panel A), which had started as a red papule 30 years before. No history of preceding trauma was offered. The general condition of this patient was not impaired. Her family history showed no apparent or chronic infections. Histologic examination of the lesion revealed an epithelioid cell granuloma with periodic acid-Schiff-positive fungal elements in the dermis. Based on the culture findings, a diagnosis of infection with Fusarium species was suggested, but could not be confirmed at the time. The patient was treated with oral griseofulvin and flucytosine with no favorable response. Topical 0.1% to 0.5% amphotericin-B injections were then tried weekly or monthly for 1 year, with partial regression of the plaque. The patient failed to appear for further

苔癬型薬疹の原因には従来, 砒素, 金製剤, 抗マラリア剤, 抗結核剤, サイアザイド系降圧利尿剤, スルフォニール·ウレア系糖尿病剤が知られていたが, 最近では欧米に比べ脳代謝改善剤, 末梢血管改善剤によるものがはるかに増加しており全報告数の66.7%を占めていた。教室で経験した苔癬型薬疹のうち, 定型的な扁平苔癬の組織像を呈する症例は37.5%であつた。苔癬型組織反応を呈する疾患は扁平苔癬, LE, graft vs host反応, 苔癬様日光角化症など多数あるが, 扁平苔癬では発症初期にランゲルハンス細胞の増加, Tリンパ球の表皮·真皮内浸潤, ついで基底層ケラチノサイトの破壊と再生が起ることからこれらの疾患の発生に遅延型アレルギーが関与していると考えられる。治療には, 原因薬剤の中止, 抗ヒスタミン剤, 副腎皮質ホルモン剤の外用のほかPUVA療法, エトレチネート, グリセオフルビンなどが有効である。

This experiment was carried out in order to investigate the time sequence of tissue fibrinolytic activity in human skin following UVB or UVA after topically applicated psoralen using Todd's technique of fibrinolytic autography. Tissue fibrinolytic activity increased in the upper dermis for one to six hours after exposure to psoralen and subseqent UVA, when erythema responses were absent. The return to a normal pattern of fibrinolysis occured in the upper dermis 12–18 hours after treatment with psoralen and UVA, and then psoralen-UVA-induced erythema responses began. These responses were maximal 96 hours after treatment with psoralen and UVA, although no fibrinolytic activity was found in the upper dermis. Little change was observed in the lower dermal activity throughout the course of these responses. After UVB irradiation, a transient increase in fibrinolytic activity occured, with a normal pattern of lysis returning in the lower dermis at 12–18 hours. In the lower dermis an increase was observed at one to 6 hours although the activity in the upper dermis had already decreased. UVB erythema responses appeared within this period, were maximal at 6–12 hours, and declined gradually after 12 hours concomitantly with the activity in the upper and lower dermis. The upper dermal activity disappeared at 18 hours, while the lower dermal activity was not found after 72 hours.

The growth and development of known-age, nine Black-eared Kite nestlings from four nests were investigated in the vicinity of the Wakimisaki fishing-port, situated at the southern edge of the Nagasaki peninsula, Nagasaki Prefecture, in 1984. The results obtained are summarized as follows.1) The second down appeared on the body by 9-12 days after hatching, and the body feathers emerged at 18-22 days. The nestlings began standing on both legs at 17-19 days and flapping their wings at 27-31 days. They began to eat prey animals by themselves at 45-47 days.2) Some diurnal raptors rear a young each brood (Bl species) and some others raise two or more young (B2 species). Of the four nests examined, three nests each contained two nestlings, and a nest had three. Therefore, the Black-eared kite belongs to the B2 species. At one nest the younger and elder nestlings increased their body weight at the same growth rate; at two nests the younger sibling(s) gained slower their body weight than did the elder. At the other nest, the younger chick died of starvation. Judging from the uniformity of the environmental condition in relation to food availability among the four nests, it seemed that the foraging ability of the parent kites varied with the individual and influenced the survival and growth of younger sibling(s).3) The growth rate constant of the logistic equation fitted to weight data for each nestling averaged 0.133. This value did not differ significantly from the expected value of 0.169, which was calculated by the equation correlating the growth rate constant with the asymptotic body weight for 27 species of the B2 diurnal raptors.4) The emergence of body feathers and the initiation of standing on both legs tended to occur at an earlier growth stage in large raptors than in small ones. In this connection, it was concluded that the Black-eared Kite, in spite of being a medium-sized raptor, possesses about the same developmental pattern as that of the large raptors rather than that of small or other medium-sized ones.

A slowly growing, subcutaneous mass in the left eyebrow region of a 54-year-old Japanese woman showed numerous small epithelial cell nests surrounded by a dense desmoplastic stroma. The epithelial cell nests showed partially keratinizing cystic structures containing a small amount of glycogen. Immunoperoxidase staining for carcinoembryonic antigen was positive only in the lumina or on the ductal lining surface of tumor cells; staining for S-100 protein was positive within almost all of the tumor nests. Birbeck granules indicating Langerhans cells were found within some of the cells.

妊娠10ヵ月前期に発症した25才初産婦例を経験し, 免疫学的検索を加えて報告した。(1)皮疹の形態は類天疱瘡様であつた。(2)免疫血清学的所見ではIgM抗体産生よりIgG抗体産生へのconversionがみられ, CH50は高値であつた。(3)免疫組織学的所見では皮疹部, 無疹部に免疫グロブリン (IgG, IgM, IgA) 補体成分C1qの沈着はなくβ1C/β1Aグロブリン (C3) の沈着が表皮真皮間基底膜部にみられた。また血清中にはHG因子を認めた。(4)治療はステロイドが有効であつた。

四肢に緊満性水疱をともなう腫脹, 浮腫とそう痒のある多形紅斑様皮疹を生じ, 水疱中の好酸球が目立ち, 真皮, 皮下組織にも好酸球が浸潤し, 末梢血, 骨髄中の好酸球の増多と補体価, 皮疹, 発熱の消長が並行した8才女児例を経験し, disseminated eosinophilic collagen diseaseと考えた。なおIgEは高く, ステロイド投与により, IgEの著明な減少につれて皮疹は改善した。

徳島大学皮膚科教室において経験したスポロトリコーシス25例につき概略と解析を試みた。25例中男子12例, 女子13例と男女差なく, 10才以下の小児7例, 40才以上17例と中高年令, 小児に多発している。外傷が誘因と思われる例は44%, 病型はリンパ管型40%, 限局型60%, 播種型, その他の例はみられず, 初発部位は顔面が52%, 上肢44%, 下肢4%, 躯幹, その他0%であつた。治療はヨードカリの内服, 温熱療法により著効をおさめた。

A Statistical survey of viral disease in Department of Dermatology, Tokushima University, for the last 14 years from 1964 to 1977 was reported. The proportion of viral disease to the outpatients was 4.40% and the ratio between male and female was 1 to 1.45. Viral disease were classified to herpes zoster (25.98%), verruca vulgaris (25.74%), verruca plana juvenilis (17.21%), herpes simplex (11.71%), molluscum contagiosum (9.59%), varicella (3.56%), condyloma accuminatum (1.78%), rubeolla (1.54%) and others (2.84%).

58才農夫の頭部熱傷瘢痕に, 受傷後56年して発症したケラトアカントーマの1例を報告した。われわれが集めえた本症の本邦報告は157例におよぶが, 熱傷瘢痕に生じた報告例は2例目であつた。記載の明らかな先行病変は色素性乾皮症, DLE, sunburn, 老人性色素斑, 熱傷, 紅皮症, 湿疹病変などであつた。

The development of homeothermy was investigated in a hand-reared black-eared kite, Milvus migrans lineatus. The 20-day-old nestling was capable of thermoregulat ing at about 95% of the adult ability at the ambient temperature of 20°C. In effect, the kite which is one of large altricial birds acquires the homeothermy in an earlier growth stage than do small altricial ones, Such precocious development of homeothermy in the kite appears to be caused by the large body mass resulting in decreased surface to volume ratio and in increased heat production, and it allows the parents to increase the foraging time early in the nestling period. In other words, the precocious development of homeothermy plays an important part in the growth and survival of the kite nestling which requires more food and energy than do the nestlings of small altricial birds.