PELGEROID-LIKE ANOMALOUS CELLS IN THE DIAGNOSIS OF NEUTROPHILIC DERMATOSIS ASSOCIATED WITH MYELODYSPLASTIC SYNDROME

Neutrophilic dermatoses (ND), with or without accompanying myelodysplastic syndrome (MDS), were examined in terms of nuclear abnormality like pelgeroid anomaly of infiltrating cells into skin lesions. Six ND accompanying MDS showed 1.0 to 13.5% of such anomalous cells among infiltrating cells. In contrast, ND without accompanying myeloproliferative disorders rarely had such anomalous cells. Our findings suggest that pelgeroid-like anomalous cells infiltrating into ND are probably a good marker of underlying MDS.     

Effects of participatory workplace improvement program on stress-related biomarkers and self-reported stress among university hospital nurses: a preliminary study

Although participatory workplace improvement programs are known to provide favorable effects on high stress occupations like nursing, no studies have confirmed its effect using biomarkers. The aim of this study was to determine whether a participatory workplace improvement program would decrease stress-related symptoms as evaluated by biomarkers and self-reported stress among hospital nurses. Three actions to alleviate job stress, which were determined through focus group interviews and voting, were undertaken for two months. A total of 31 female Japanese nurses underwent measurement of inflammatory markers, autonomic nervous activity (ANA), and perceived job stress (PJS) at three-time points; before the program (T1), within a week after the completion of the program (T2), and three months after the program (T3). A series of inflammatory markers (Interferon-γ, Interleukin (IL)-6, and IL-12/23p40) decreased significantly at T2, and IL-12/23p40 and IL-15 significantly decreased at T3 compared to T1, while ANA and PJS remained unchanged. Our participatory program exerted beneficial effects in reducing inflammatory responses, but not for ANA and PJS. Further investigations with a better study design, i.e., a randomized controlled trial, and a larger sample size are warranted to determine what exerted beneficial effects on inflammatory markers and why other outcomes remained unchanged.     

Chronically Recurrent and Disseminated Tinea Faciei/Corporis—Autoinoculation from Asymptomatic Tinea Capitis Carriage

Abstract: We report clinical findings in a 12‐year‐old girl with long‐term recurrent and disseminated multiple eruptions of tinea faciei and tinea corporis, which persisted for 10 years. Mycological examination revealed the dermatophyte Trichophyton tonsurans in both scale samples from the body lesions and in brushing samples from her asymptomatic scalp, suggesting that she was an asymptomatic dermatophyte carrier on the scalp, and autoinoculation of the dermatophyte was responsible for the recurrent and disseminated tinea faciei/corporis.     

Expression of β‐Adrenoceptor Subtypes in Urothelium,Interstitial Cells and Detrusor of the Human Urinary Bladder

Objective: We examined whether interstitial cells (ICs) of the human urinary bladder expressed β‐adrenoceptor (AR) subtypes, and semiquantitatively compared the staining intensity among urothelium, ICs and detrusor muscles. Methods: Paraffin sections of the human urinary bladder were obtained from histologically normal areas of formalin‐fixed specimens removed for bladder carcinoma. Double‐labeling immunohistochemical methods using antibodies against each β‐AR subtype and vimentin were performed to identify ICs of the human urinary bladder. The staining intensity of β‐ARs was semiquantitatively compared among urothelium, ICs and detrusor muscles. Further, gender‐related difference or age‐related correlation in the staining intensity of β‐ARs was compared in the same cell types. Results: The expression of β₁‐, β₂‐, and β₃‐AR was observed in vimentin‐positive ICs localized in suburothelium, between detrusor muscle bundles, and within these bundles of the human urinary bladder. The rank order of the staining intensity was urothelium > ICs = detrusor muscles in β₁‐AR, urothelium > ICs > detrusor muscles in β₂‐AR, whereas its order was ICs = detrusor muscles > urothelium in β₃‐AR. Except for urothelial β₁‐AR, there was no gender‐related difference in the signal intensity of β‐ARs in the urothelium, ICs or detrusor muscles. Age negatively correlated with the signal intensity of all β‐AR subtypes. Conclusion: β‐ARs were expressed in vimentin‐positive ICs of the human urinary bladder. As for β₂‐ and β₃‐AR, there was no gender‐related difference or age‐related correlation in urothelium, ICs and detrusor muscles. In the human urinary bladder, β‐ARs expressed in ICs may play a role in bladder physiology.     

Changes of cytokeratin and involucrin expression in squamous cell carcinomas of the skin during progression to malignancy

The detection of cytokeratins in neoplastic tissues by immunohistochemical methods has numerous diagnostic and investigative applications, because cytokeratins are usually conserved in tumour cells during malignant transformation. Recently, however, it has been reported that progression to malignancy is associated with commencement of expression of low-molecular-weight cytokeratins. In the present study, 42 specimens from 35 cases of squamous cell carcinoma (SCC) of the skin were analysed by immunohistochemical techniques, using polyclonal anti-involucrin antibody and a panel of monoclonal antikeratin antibodies, in order to investigate the nature and differentiation of SCCs. The expression of cytokeratins and involucrin in well-differentiated SCCs was similar to that in normal epidermis. In contrast with well-differentiated SCCs, the expression of differentiation-specific cytokeratins and involucrin was diminished in the immature tumour cells in proportion to the malignancy of the SCCs. Some antibodies, however, stained all tumour cells, irrespective of the degree of malignancy. Furthermore, expression of simple epithelial and non-cornifying stratified squamous epithelial cytokeratins was observed in atypical tumour cells of poorly differentiated SCCs. It is of interest that similar expression was noted in many tumour cells in the lymph node metastases and in some tumour cells in the primary cutaneous lesions. Cytokeratin expression similar to that in normal epidermal keratinocytes was conserved in well-differentiated SCCs, but the expression of cytokeratins changed during progression to malignant transformation. The expression of simple epithelial or non-cornifying stratified squamous epithelial cytokeratins in cutaneous SCCs may be a marker for their capability of invasion and metastatic potential.     

Autoantibodies to bullous pemphigoid and epidermolysis bullosa acquisita antigens in an infant

We describe a 1-year-old boy with multiple tense blisters on the skin, who showed circulating autoantibodies directed to both bullous pemphigoid and epidermolysis bullosa acquisita antigens. The patient's serum IgG antibodies bound to the 290-kDa epidermolysis bullosa acquisita antigen with immunoblot analysis of human dermal extracts. Immunoblot analysis also demonstrated that the patient's serum autoantibodies were reactive with recombinant NC16a domain of the 180-kDa bullous pemphigoid antigen. This study confirmed the presence of circulating autoantibodies directed to both bullous pemphigoid antigen and epidermolysis bullosa acquisita antigen.     

A study of verbal and spatial information processing using event-related potentials and positron emission tomography

Abstract  The activated cerebral regions and the timing of information processing in the hemispheres was investigated using event-related potentials (ERP) and regional cerebral blood flow (rCBF) as the neurophysiological indicators. Seven men and one woman (age 19–27 years) were asked to categorize two-syllable Japanese nouns (verbal condition) and to judge the difference between pairs of rectangles (spatial condition), both tests presented on a monochrome display. In the electroencephalogram (EEG) session, EEG were recorded from 16 electrode sites, with linked earlobe electrodes as reference. In the positron emission tomography (PET) session, rCBF were measured by the ¹⁵O-labeled H₂O bolus injection method. Regions of interest were the frontal, temporal, parietal, occipital and central lobes, and the entire cerebral hemispheres. When the subtracted voltages of the ERP in homologous scalp sites were compared for the verbal and spatial conditions, the significant differences were at F7-F8 and T5-T6 (the 10–20 system). The latencies of the differences at T5–T6 were around 200, 250 and 320 ms. A significant difference in rCBF between the verbal and spatial conditions was found only in the temporal region. It was concluded that early processing of information, that is, registration and simple recognition, may be performed mainly in the left temporal lobe for verbal information and in the right for spatial information.     

The Value of a Transparent Hood for Biopsy of Minute Lesions of the Esophagus

Minute lesions of the esophagus were biopsied using a transparent hood designed by the authors to fit on the tip of a forward viewing endoscope. The quality of the bite biopsies performed using the hood and their accuracy, as well as technical difficulty, were investigated. Minute lesions of less than 5 mm in diameter located at 1, 2 or 3 o'clock were chosen for investigation since these are usually difficult areas from which to obtain a biopsy. Twenty subjects were biopsied using the hood and 20 were biopsied without it, in the conventional way, over the 15 month period from November 1993 to January 1995. A comparison of first biopsy success rates, with and without the hood, was made. The rate of success was very high (19/20; 95%) when the hood was used, but low (11/20; 55%) when the hood was not used (p<0.01). A comparison of the time taken for the first biopsy showed that when the hood was used, the time taken was shorter, averaging 21.9 seconds, in contrast to the rather slow average of 118.2 seconds taken when the hood was not used (p<0.01). The transparent hood is used by positioning it gently on the oral side of a tangential lesion, and then angulating the tip of the endoscope with this point as a fulcrum to position the tip so as to be virtually perpendicular to the esophageal wall, facilitating attainment of a frontal view of the lesion. The lesion thus brought forward can then be fixed, enabling the operator to obtain a biopsy with great ease and accuracy.