DETECTION OF EARLY LESIONS OF "UNGUAL" MALIGNANT MELANOMA

Background. The nail area is commonly affected by malignant melanoma. The prognosis of malignant melanoma of the nail is poor, becuase at the time of diagnosis most lesions are in the advanced stage. Correct diagnosis of early lesions could improve the prognosis. Methods. For 3 years, all patients with nail pigmentation at the dermatology clinic were screened for five specific criteria for the diagnosis of early lesions of malignant melanoma. Histologic examination was performed on 10 of 29 lesions. Results. Five of the 29 lesions were advanced malignant melanoma, easily diagnosed clinically. Two of the remaining 24 lesions fulfilled most of our clinical criteria of early malignant melanoma of the nail apparatus; that is, they appeared as melanonychia striata during adulthood, were wide in breadth measuring 9 and 11 mm, and showed variegated shades of brown. Periungual pigmented macule (Hutchinson's sign) was observed in one of the two cases. Total resection of the lesions was performed, followed by skin grafting. Conclusions. Histologically, an increased number of atypical melanocytes, mainly arranged as solitary units, were observed only in the epithelia of the nail matrix and of the nail-bed, confirming that these lesions were “ungual” malignant melanoma in situ. Such an early lesion of malignant melanoma of the nail apparatus can be completely cured with conservative excision, and the phalanx of the affected digit can be preserved.     

Induction of Apoptosis after Stent Implantation in Canine Portal Vein

The purpose of this study was to analyze apoptosis in the vessel wall after stent implantation in the canine portal vein and also to investigate the expression of the p21 cyclin-dependent kinase inhibitor, which may regulate cellular proliferation after vascular injury. Uninjured, control veins had few detectable TUNEL-positive cells in the intima and media (0.829 ± 0.413%). At 4 weeks after stent implantation, TUNEL-positive cells significantly increased to 50.5 ± 4.639%. These cells were predominantly located around the stent struts, and appeared to be smooth muscle cells morphologically. At 12 weeks, 44.7 ± 6.178% of the intimal and medial cells were still TUNEL positive, and there was no significant difference between 4 and 12 weeks. P21 was not detected in uninjured, normal veins. At 4 and 12 weeks after stent implantation, positive p21 immunostaining was sparsely expressed in the intima and media adjacent to the stent struts. Thus, stent implantation induced a prolonged apoptotic response and increased expression of p21 in the portal venous system. This prolonged apoptotic response, possibly regulated by p21, may have a significant role in modulating the cellularity of intimal formation.     

Posttraumatic volar tendon subluxation out of the first extensor compartment: a case report

Symptomatic volar subluxation of the abductor pollicis longus and the extensor pollicis brevis tendons developed in a 29-year-old man after a sprain that occurred with the wrist in flexion and ulnar deviation. The extensor retinaculum, which forms the extensor compartment, was partially avulsed from its insertion on the radius. Palmar abduction and extension of the thumb with the wrist flexed produced subluxation of the tendons over the volar side of the radius ridge where the retinaculum forming the first extensor compartment attached. Nonoperative treatment including steroid injection and splinting was ineffective. Surgery was performed to reconstruct a new tendon restraint with part of the extensor retinaculum.     

Counteractive effect of Paeonia lactiflora root constituent mudanpioside E against suppressive effect of Shoseiryuto-extract on passive cutaneous anaphylaxis reaction in mice

Ethnopharmacological relevance

Shoseiryuto-extract (SST) is a herbal formula of Japanese traditional kampo medicine used to treat perennial nasal allergy, rhinitis, and bronchial asthma. SST contains eight crude drugs, and is registered in the 16th Edition of Japanese Pharmacopoeia. Previous studies reported anti-allergic effects of SST, but the contribution of the eight crude drugs in SST on these effects has not been evaluated. In the present study, we evaluated the contribution of the eight crude drugs in SST on anti-allergic effect using passive cutaneous anaphylaxis (PCA) reaction in mice.

Materials and methods

The mixture of crude drugs was decocted in water and lyophilized to prepare SST. To evaluate the active ingredients, compositions of crude drugs were modified and decocted. The PCA reaction was induced by intravenous injection of ovalbumin (OVA) and Evans blue 48 h after intracutaneous injection of anti-OVA serum in mice ears. The crude drug extract was orally administered to overnight-fasted mice 2 h before induction of the PCA reaction. Ears were removed 30 min after induction, and the amount of Evans blue present was measured.

Results

Oral administration of SST suppressed the PCA reaction in a dose-dependent manner. Among the eight crude drugs comprising SST, Asiasarum root, Pinellia tuber, and Glycyrrhiza contributed positively, and Peony root contributed negatively to the anti-allergic effects of SST. We isolated mudanpioside E from the extract of Peony root as the counteracting ingredient to exhibit the anti-allergic effects of Peony root-depleted SST.

Conclusions

When we used SST for the treatment of allergic diseases, removal of Peony root from the traditional formula could augment its effect.     

Detection of apoptosis in keloids and a comparative study on apoptosis between keloids, hypertrophic scars, normal healed flat scars, and dermatofibroma

Recent studies have suggested that the regulation of apoptosis during wound healing is important in scar establishment and the development of pathological scarring. In this study, we demonstrate that keloid fibroblasts can be identified as apoptotic cells because of their highly condensed chromatin and discrete nuclear fragments. To further reveal the phenomenon of apoptosis, we quantified the number of terminal deoxynucleotide transferase-mediated dUTP nick-end labeling (TUNEL)-positive cells in surgically resected tissues of keloids (N = 10), hypertrophic scars (N = 10), normal healed flat scars (N = 10), and dermatofibroma (N = 10). The number of TUNEL-positive cells was relatively low, but was significantly higher for the keloid group compared with the normally healed flat scar group (p = 0.004), suggesting reduced cell survival and increased apoptotic cell death in a subpopulation of keloid fibroblasts. Furthermore, the number of TUNEL-positive cells was significantly higher for the keloid group compared with the dermatofibroma group (p = 0.044), suggesting that a subpopulation of keloid fibroblasts may suppress tumorgenicity at a greater rate than dermatofibroma by undergoing cell death. Hypertrophic scars had significantly higher levels of apoptosis than normally healed flat scars (p = 0.033). Therefore, these results suggest that selected fibroblasts in keloids and hypertrophic scars undergo apoptosis, which may play a role in the process of pathological scarring.     

Interaction between interleukin-1beta -31T/C gene polymorphism and drinking and smoking habits on the risk of hepatocellular carcinoma among Japanese

The risk of hepatocellular carcinoma (HCC) increases with the severity of hepatic inflammation. Interleukin (IL)-1beta and tumor necrosis factor (TNF)-alpha are proinflammatory cytokines with multiple biological effects and may play essential roles in inflammation-linked tumor development. We conducted a case-control study including 209 incident HCC cases and two control groups (275 hospital controls and 381 patients with chronic liver disease [CLD] without HCC) to investigate whether IL-1B and TNF-A gene polymorphisms influence HCC susceptibility with any interaction with alcohol and tobacco. By comparing HCC cases with CLD patients, we found that IL-1B -31T/C polymorphism was associated with HCC risk among never drinkers and current smokers; adjusted odds ratios (and 95% confidence intervals) for C/T and T/T genotypes compared with C/C genotype were 1.70 (0.76-3.77) and 2.46 (1.05-5.76) (P trend=0.03), respectively, among never drinkers, and 1.53 (0.60-3.99) and 2.54 (0.81-7.95) (P trend=0.11), respectively, among current smokers. Similarly, HCC risk associated with heavy alcohol intake and current smoking differed by this polymorphism among CLD patients. IL-1B -31T/C polymorphism may modify HCC risk in relation to alcohol intake or smoking.     

Eye blinks: new indices for the detection of deception

Eyeblink variables were investigated while subjects performed a guilty knowledge test (Experiment 1) and a dual modality attention task (Experiment 2). In both experiments, the temporal distribution of blinks was analyzed using an automatic video based blink analysis system [Matsuo and Fukuda, Jpn. J. Physiol. Psychol. Psychophysiol., 14 (1996), 17]. In experiment 1, the blink rate pattern discriminated between relevant and irrelevant stimuli. In experiment 2, the blink rate peak after the auditory stimulus disappeared during visually attended tasks whereas the blink rate peak after the visual stimulus was significant during auditory attended tasks. It was suggested that eye blinks could be related to the selective attention and that eye blinks could provide an additional index for the detection of deception.