In-vitro Permeability to Salicylic Acid of Human,Rodent, and Shed Snake Skin

Abstract— In-vitro permeability to salicylic acid of human, rodent, and shed snake skin has been examined for the purpose of selecting model membranes for human skin corresponding to different anatomic sites, since a marked regional variation is suggested among the different sites. The greatest permeability to salicylic acid was observed in the scrotum, that of the sole was negligible. The cheek, neck, and inguinal skin seemed more permeable than the breast, back, thigh, lower leg, or foot skin. Shed snake and skin of hairless rat were found to show similar permeability to human breast and thigh skin. Wistar rat and nude mouse skin showed similar permeability to human cheek, neck, and inguinal skin.     

Common clonal origin of lymphocytes and plasma cells in splenic lymphoma with villous lymphocytes

In two-thirds of patients with splenic lymphoma with villous lymphocytes (SLVL) a small amount of M-protein can be detected in association with the presence of plasma cells in the peripheral blood (PB) and/or bone marrow (BM). However, it is not known whether lymphoma cells and plasma cells originate from the same clone. In this report we describe a case of SLVL which was characterized by the presence of marked monoclonal gammopathy (IgG-κ 90 g/l) and increased plasma cells in the BM. In an attempt to elucidate the origin of lymphoma cells and plasma cells, we performed morphological, cytogenetic and molecular studies on PB mononuclear cells (PBMNC) without plasma cells and BMMNC containing 10% plasma cells from this patient.
Immunofluorescence showed that lymphoma cells and plasma cells were positive for cytoplasmic γ heavy and κ light chains. Well-developed endoplasmic reticulum was observed in the cytoplasmic organelles of PBMNC using an electron microscope. The mean IgG concentration in the 3 d supernatant cultures of PBMNC was 374±24μg/l. More than 50% PBMNC differentiated into plasmacytoid cells in 6 d of liquid culture with IL-3 and IL-6. Analysis by two-colour FISH revealed that karyotypic abnormalities of monosomy X and trisomy 17 existed simultaneously in both lymphoma cells and plasma cells. JH gene rearranged bands from PBMNC and BMMNC by Southern blot hybridization were identical, whereas DNAs from PBMNC failed to hybridize with the Cμ probe.
These observations strongly suggest that lymphoma cells and plasma cells originate from the same clone, and that plasma cells, as well as lymphoma cells, which have undergone class switch recombination, could produce IgG type M-protein in this case.     

Systemic sclerosis in children: A national retrospective survey in Japan

A retrospective questionnaire survey of pediatric departments, for childhood collagen disease from 1985 to 1994 was used to clarify the clinical features of scleroderma in Japan. In the primary survey, 0.9% of the children with a rheumatic condition had scleroderma. Answers to this questionnaire were received on 18 (localized 9; systemic 9) patients from 15 institutions. In order to examine systemic sclerosis (SSc), seven cases of SSc in Japanese articles during the same period as the questionnaire were added to these answers and compared to the Japanese epidemic study investigated by Fukuyama in 1974. There were 16 children, seven boys and nine girls, with SSc during the 10-year period in Japan. The mean age of onset of symptoms was 8.0 ± 2.8 years and the age at diagnosis was 10.1 ± 3.0 years. Eighty percent of children had Raynaud's phenomenon at the onset of SSc, and skin and musculoskeletal involvement was highly recognized during the course of the disease. Atrophy of the frenulum linguae and lung fibrosis were commonly seen in SSc. In serological studies, 80% of children have antinuclear antibodies and approximately 50% of patients have anti-Scl-70 (topoisomelase I) antibodies at the onset and during the course of childhood SSc. The prognosis is poor, as remission occurred in only one child. The clinical symptoms and examination of serological autoimmune antibodies were supportive of an early diagnosis of SSc. When compared to the previous national survey of children with SSc, the present results showed that the male-to-female ratio was reduced, the age at onset was low, the positive incidence of serological autoimmune antibodies elevated, and the usage of vasodilators and nonsteroid anti-inflammatory drugs (NSAID) increased, with corticosteroids decreased. But, the positive percentage of clinical symptoms were not changed in both studies. For a complete retrospective nationwide epidemic survey carried out on children with scleroderma, especially SSc, it is important to include dermatology departments.     

Histopathology of the liver in non-cirrhotic portal hypertension of unknown aetiology

Non-cirrhotic, long-standing portal hypertension of unknown aetiology is being re-evaluated histopathologically and clinically. In this study, we examined 107 livers with this condition (92 wedge biopsy and 15 autopsy specimens) from five institutions in Japan. These cases were histologically categorized into four groups: idiopathic portal hypertension (66 cases), nodular regenerative hyperplasia (14 cases), partial nodular transformation (two cases), and incomplete septal cirrhosis (25 cases). These four groups shared several histological features: dense portal fibrosis with portal venous obliteration and intralobular slender fibrosis. In addition, the histopathological features characteristic of one group were also found to a mild degree in other groups. The histopathological lesions preceding portal venous obliteration remain speculative. However, the portal venous obliteration may be responsible for the occurrence of sustained portal hypertension and several of the pathological changes in these livers. It seems likely that idiopathic portal hypertension, nodular regenerative hyperplasia, partial nodular transformation and incomplete septal cirrhosis comprise a family of non-cirrhotic, long-standing portal hypertension in Japan, and the histological differences between them may reflect chronological progression of a single disease.     

Effect of Recording Site on Postpacing Interval Measurement During Catheter Mapping and Entrainment of Postinfarction Ventricular Tachycardia

Postpacing Interval and VTCL. Introduction : During entrainment of reentrant ventricular tachycardia (VT), the difference between the postpacing interval (PPI) and the VT cycle length (VTCL) measured at the pacing site is an indication of the conduction time from the pacing site to the reentry circuit. The difference is usually ≤ 30 msec at successful ablation sites. However, electrical noise during pacing sometimes obscures the electrograms recorded directly from the pacing site. The objective of this study is to determine if the PPI-VTCL difference measured at the mapping catheter electrodes proximal to the stimulating electrode accurately predicts the PPI-VTCL difference at the stimulating electrode.
Methods and Results : Endocardial catheter mapping was performed in 26 patients with in-farct-related VT. At 191 sites during 56 VTs, unipolar pacing from the distal electrode entrained VT and electrograms recorded from the mapping catheter were discernable following pacing in both the bipolar recordings from the distal electrode pair (BI 1–2) and the electrode pair 6 mm proximal to the distal electrode (BI 3–4). The PPI-VTCL difference at BI 1–2 correlated well with that measured at BI 3–4 (r = 0.88, P = 0.001). A PPI-VTCL difference at BI 3–4 ≤ 30 msec predicted a PPI-VTCL difference at BI 1–2 ≤ 30 msec with a sensitivity of 95%, specificity of 87%, and predictive accuracy of 91 %.
Conclusions : Measurement of the PPI from electrodes proximal to the stimulating electrode is a reasonable alternative when the PPI cannot be assessed from the pacing electrode.     

A multicenter,randomized, controlled trial of intravenous gamma globulin therapy in children with acute Kawasaki disease

We studied the effect of intravenous, polyethyleneglycol-treated, human immunoglobulin, administered at 200 mg/kg per day (group A: n = 147; male 86, female 61; age < 1 year, 50) or 400 mg/kg per day (group B: n = 152; male 87, female 65; age < l year, 52) for five consecutive days and compared it with freeze-dried, sulfonated human immunoglobulin [group C: n = 152; male 87, female 65; age < 1 year, 51), administered at 200 mg/kg per day for five consecutive days, on the prevention of coronary artery abnormalities in Kawasaki disease. Echocardiograms were interpreted blindly and independently. Proportions of 87.1%, 95.4%, and 82.3% in groups A, B, and C, respectively, had no coronary artery abnormalities. The confidence limits of difference between the proportions of groups A and C, groups B and C, and groups B and A were −4.4% and 10.4%, 7.8% and 15.9%, and 4.0% and 10.8%, respectively. Duration of fever and serum immunoglobulin G (IgG) levels were correlated with the prevalence of coronary artery abnormalities. We concluded that intravenous, polyethyleneglycol-treated, human immunoglobulin and freeze-dried, sulfonated human immunoglobulin had clinically equivalent effects on coronary artery abnormalities, and that five daily doses of 400 mg/kg of intravenous, polyethyleneglycol-treated, human immunoglobulin is more effective than that of 200 mg/kg gamma globulin.     

B7-2 positive cells around interlobular bile ducts in primary biliary cirrhosis and chronic hepatitis C

Bile duct damage in patients with chronic hepatitis C (hepatitis-associated bile duct lesion) as well as that in patients with primary biliary cirrhosis (PBC; chronic non-suppurative destructive cholangitis), may be causally related to immunological assaults. Efficient antigen presentation is known to require the provision of a costimulatory signal which is dependent on the CD28 on T cell surfaces, and that at least two molecules, B7-1 and B7-2, work as costimulatory ligands for CD28. In this study, we examined immunohistochemically, the expression of B7-2 in portal tracts of liver biopsy specimens obtained from 75 patients with chronic hepatitis C who had hepatitis-associated bile duct lesions, and from 63 PBC patients with chronic non-suppurative destructive cholangitis. B7-2 positive cells were recognizable as large mononuclear cells scattered in portal tracts. Some of these cells showed a dendritic cell-like appearance. B7-2 positive cells were observed more frequently (41%) in PBC liver specimens than in chronic hepatitis C specimens (17%, P< 0.05). In PBC livers, such cells were preferentially observed around the damaged bile duct with a few located in the biliary epithelial layer. There was no such finding in chronic hepatitis C livers. The frequency and density of B7-2 positive cells in the liver specimens tended to decrease according to the stage of PBC (45% in stages 1 and 2, and 33% in stages 3 and 4; P=0.10), whereas with chronic hepatitis C, no such tendency was observed. These findings suggest that B7-2 positive cells may play a role in the bile duct lesions that appear in the early histological stages of PBC and that the immunological mechanisms of bile duct damage, particularly of antigen presentation and B7-2 expression, differ between PBC and chronic hepatitis C.     

Endoscopic Variceal Injection Sclerotherapy for Liver Cirrhosis with Hepatocellular Carcinoma—A Prognostic Evaluation—

The prognostic evaluation of endoscopic injection sclerotherapy (EIS) for patients with severe esophageal varices in unresectable hepatocellular carcinoma complicated with advanced liver cirrhosis (HCC c? LC) was studied. (1) Cumulative survival rate and cause of death were compared in cases of variceal bleeding managed by EIS (18 cases) to cases with variceal bleeding without EIS (12 cases). (2) Cumulative percentage of patients free of bleeding, cumulative survival rate and cause of death were compared in cases managed by prophylactic EIS (14 cases) to cases without prophylactic EIS (30 cases). In the two bleeding groups with and without EIS, and in the non-bleeding groups with and without prophylactic EIS, patients of each group were comparable in respect to sex ratio, age, and Child's classification. In the bleeding groups, cumulative survival rate at 30 days after EIS was significantly higher in cases with EIS than cases without EIS (P < 0.01). The rate of death after initial bleeding was 16. 7% in cases with EIS and 66.7% in cases without EIS: statistical significance was demonstrated in these two groups (P < 0.01). In the non-bleeding groups, cumulative percentage of patients free of bleeding and cumulative survival rate were significantly higher in cases with EIS than those without EIS (P < 0.01 and P < 0.05, respectively). Furthermore, no bleeding fatalities from varices were seen in cases with prophylactic EIS. We suggest that EIS improves survival rate and prophylactic EIS prevents variceal bleeding leading to death in cases of unresectable HCC c? LC.     

A Clinical and Pathological Study of Myeloneuropathy following Abdominal Disorders

A man aged 58, who had suddenly an attack of severe watery diarrhoea, abdominal pain and nausea with febricula, which continued for 5 days. For these symptoms he was administrated with chloramphenicol for 7 days (total does 7000 mg). Following this he began to have paresthesia, hypes-thesia, and disturbance of motility in the lower limbs. Then he had flaccid paralysis, hypotonus of muscles, decrease of tendon reflexes, positive sign of Babinski in the lower limbs. Although he had period of convalescence for a while, the disease gradually grew worse to die. The period of the disease was 510 days. Histopathologi-cally, noticeable changes were observed on the peripheral nerve and spinal cord; the degeneration of sciatic nerve and Goll's tract from upper part of cervical spinal cord to lower part of lumber spinal cord. In addition to these changes, degeneration or deletion of the nerve cell in Ammon's horn, central chromatolysis of Betz cells and accumulation of fat granules in the anterior horn cells were observed. These histopatho-logical changes were very similar to those of nicotinic acid deficiency (Pellagra). On the other hand, he had been treated with many kind of drugs. In this point of view, the etiology of SMON was supposed various factors, such as nicotinic acid deficiency, vitamin deficiency, metabolic disturbance and poisoning. However, disposition of the body site must be attached great importance to this disease. In addition to this case, other two cases also had not taken chinoform. Considering these facts, it is the authors opinion that the etiology of SMON can not exclusively be attributed to chinoform intoxication.