Kikuchi's disease (histiocytic necrotizing lymphadenitis) with cutaneous involvement.
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Adult↗
Biomedical subjects
J Tada
Publications and source records attributed to J Tada.
Congenital rubella syndrome with rubella virus-associated generalized brownish macules, indurated erythemas, papules, and pigmentation.
BACKGROUND: We examined an infant with congenital rubella syndrome (CRS). The purpose of this report is to describe the skin manifestations in this patient and to prove that they were associated with rubella virus. OBSERVATIONS: A 7-month-old boy presented with generalized brownish macules, indurated erythemas, papules, and pigmentation. They first appeared at around 3 months of age. His mother had contracted rubella during the 14th gestational week. At the time of examination, rubella-specific IgM antibody was positive in both serum and cerebrospinal fluid of the baby. A physical exam had revealed deafness, mental and physical retardation, interstitial pneumonitis, and hepatosplenomegaly. A skin biopsy specimen showed a dense infiltration mainly of lymphocytes, with B cells predominant in the deep dermis. Electron microscopically abundant tubuloreticular structures were observed in capillary endothelial cells, lymphocytes, and dermal fibroblasts. Polymerase chain reaction (PCR) analysis suggested that rubella virus RNA was present in the patient's skin specimen, cerebrospinal fluid, and total blood. CONCLUSIONS: The cutaneous manifestations of our patient were extraordinary and informative. These prominent skin lesions should be recognized as cutaneous markers of CRS.
Humans↗
Nodular cutaneous lupus mucinosis associated with atrophie blanche-like lesions in a patient with systemic lupus erythematosus.
BACKGROUND: Multiple, pale, atrophic depressions surrounded by erythema developed on nodular cutaneous mucinosis lesions in a patient with systemic lupus erythematosus. OBSERVATIONS: A 22-year-old man developed multiple nodular erythematous lesions on the upper arms, back, and chest during the course of systemic lupus erythematosus. Histologically, these nodular lesions were diagnosed as lupus mucinosis. Three years later, the patient began to have atrophic depressed lesions on several nodular mucinosis lesions. These lesions did not develop on normal appearing skin. A biopsy specimen from one of these lesions showed occlusion of blood vessels with thickening of their walls and perivascular dense lymphocytic infiltration. No leukocytoclastic vasculitis was found. Hyaline degeneration was present in some parts of the fatty tissue. CONCLUSION: The atrophic depressed lesions were atrophie blanche-like and induced by the vascular occlusion. Since these lesions developed only on the lupus mucinosis lesions, mucin deposition and vascular changes may be closely related.
Adult↗
Atopic dermatitis with severe facial lesions exacerbated by contact dermatitis from topical medicaments.
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Administration, Topical↗
Antinuclear antibodies in patients with atopic dermatitis and severe facial lesions.
BACKGROUND: In adult patients with atopic dermatitis (AD), the presence of autoantibodies such as anti-IgE and antinuclear antibodies (ANA) has been demonstrated. The patients may have altered immune regulation. OBJECTIVE: The purpose of this study is to examine the prevalence of ANA in AD patients with severe facial eruptions and to evaluate the differences between ANA-positive and ANA-negative AD patients. METHODS: ANA, blood eosinophil count, total serum IgE levels, specific IgE antibody to Dermatophagoides pteronyssinus, disease duration, photosensitivity and association with respiratory allergic diseases were checked in 89 AD patients. RESULTS: Twenty-three (25.8%) AD patients showed positive ANA at titers ranging from 1:40 to 1:640, and the incidence of positive ANA was 12.1% in controls. Twenty-five (71.4%) of 35 AD patients with positive ANA at titers ranging from 1:20 to 1:640 were females. CONCLUSION: Adult AD patients with severe facial lesions should be examined for serum ANA. Particularly in female and photosensitive AD patients with severe facial lesions, serum autoantibodies have to be carefully investigated to differentiate from autoimmune diseases.
Adolescent↗
Infra-auricular fissures in atopic dermatitis.
Retro-auricular or auricular dermatitis in atopic dermatitis (AD) is common and important for the diagnosis of AD in infancy and even in adulthood. Particularly, "infra-auricular fissures", acute eczematous changes like fissures at the adhesive junction of ear lobes, seem to be prominent features for the diagnosis of AD. Of 137 patients with AD, 81.8% showed present or past existence of infra-auricular fissures, but only one of the 30 controls. Of the 46 patients with severe AD, 98% had infra-auricular fissures, compared to 74% in those with moderate and mild AD. Our findings suggest that infra-auricular fissures are important for the diagnosis of AD and should be cited in a list of criteria for the diagnosis of AD.
Adolescent↗
Incontinentia pigmenti achromians-like depigmentation in the mother of a baby with typical incontinentia pigmenti.
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Female↗
[Megaloblastic anemia due to folate deficiency associated with hereditary spherocytosis].
A 19 years old male admitted to our hospital with fever, abdominal pain in May 1991. Physical examination revealed anemia, jaundice and marked splenomegaly. Severe pancytopenia with macrocytic hyperchronic anemia was noted along with elevated LDH and reduced serum folate. Blood smear showed nucleated RBCs, but only few microspherocytes. Bone marrow showed erythroid hyperplasia with remarkable megaloblastic changes. Megaloblasts were negative for PAS stain. Chromosome analysis revealed normal karyotype. Erythroleukemia was suspected initially, but his general condition as well as hematological data improved following 10 units of RBC transfusion. Following brief folic acid supplements, numerous microspherocytes became evident, typical osmotic fragility test revealed a pattern for hereditary spherocytosis. These observations led us to the diagnosis of hereditary spherocytosis complicated by megaloblastic anemia due to folate deficiency. As he developed folate deficiency again 10 months later, splenectomy were performed. The anemia improved after splenectomy.
Adult↗
[Cytological features and prognosis of megakaryoblastic leukemia].
Nine patients with acute leukemia showing 10% or more positive blast cells with platelet peroxidase (PPO) or CD41b were diagnosed as megakaryoblastic leukemia. Three patients transformed from myelodysplastic syndromes or myeloproliferative disorders. The PPO positivity ranged from 7 to 55% (median 45%), and that for CD41b was 1.6 to 67.0% (median 16.4%). Because electron microscopic myeloperoxidase or glycophorin A were also positive in some patients, and also because CD41b positivity was often discordantly lower than PPO positivity, a possibility of mixed leukemia demonstrating myeloid or erythroid differentiation was suggested in 6 of these cases. As for the treatment results, all 3 pediatric cases who received combination chemotherapy achieved complete remission (CR). Among 6 adult cases CR was obtained in only one patient to whom low-dose cytosine arabinoside was administered. The remaining adult patients who received combination chemotherapy died relatively early.
Adult↗
Characteristics of neutron beam generated by 500 MeV proton beam.
A neutron irradiation facility was constructed at PARMS, University of Tsukuba to produce an ultrahigh energy neutron beam with a depth dose distribution superior to an x-ray beam generated by a modern linac. This neutron beam was produced from the reaction on a thick uranium target struck by a 500 MeV proton beam from the booster synchrotron of the High Energy Physics Laboratory. The percentage depth dose of this neutron beam was nearly equivalent to that of x-rays around 20 MV and the dose rate was 15 cGy per minute. The relative biological effectiveness (RBE) of this neutron beam has been estimated using the cell inactivation effect and the HMV-I cell line. The survival curve of cells after neutron irradiation has a shoulder with n and Dq of 8 and 2.3 Gy, respectively. The RBE value at the 10(-2) survival level for the present neutron beam as compared with 137Cs gamma rays was 1.24. The results suggest that the biological effects of ultrahigh energy neutrons are not large enough to be useful, although the depth dose distribution of neutrons can be superior to that of high energy linac x-rays.
Cell Survival↗
Characteristics of proton beams after field shaping at PMRC.
The proton irradiation control system was developed for cancer radiotherapy at the Proton Medical Research Center, with the extension of a beam line connected to a synchrotron at the High Energy Physics Laboratory. The initial energy of the 500 MeV proton beam supplied by the accelerator is degraded down to 243 MeV after passing through a graphite rod. In the control system, a proton beam is scattered to form a large field, its Bragg peak width is spread out, and its energy is degraded to the optimum value with a range covering tumour depth. The characteristics of the devices required for these procedures have been investigated from the viewpoint of the relationship between dose rate and field flatness, taking the setting-up geometry of these devices into consideration.
Humans↗
Lewy body-like inclusions in Onuf's nucleus from two cases of sporadic amyotrophic lateral sclerosis.
Lewy body-like inclusions in Onuf's neurons from two sporadic cases with amyotrophic lateral sclerosis (ALS) were reported. These inclusions in Onuf's neurons as well as those found in the anterior horn cells were immunostained with an anti-ubiquitin antibody. Neuropathological examination of these two cases revealed neuronal loss and associated gliosis in the anterior horn of the spinal cord and hypoglossal nuclei, and degeneration of the corticospinal tract. In addition to Lewy body-like inclusions, ubiquitinated skein-like inclusions, Bunina bodies, or both were observed in the cytoplasm of the remaining neurons in the anterior horn of the spinal cord, and, to a lesser degree, in Onuf's nucleus. Spheroids and cord-like thickening of cell processes were also found in the anterior horn of the spinal cord. Histometrical study of Onuf's nucleus revealed atrophy and loss of Onuf's neurons from Case 1 with a long clinical course. Similar cases of motor neuron disease with or without tract degeneration have been reported, but the presence of Lewy body-like inclusions in Onuf's nucleus is reported here for the first time. It is suggested that Onuf's nucleus is more or less involved in the degenerative process characteristic of ALS.
Aged↗
Peculiar facial erythematosquamous lesions in two siblings with cyclical summer improvement and winter relapse: a variant of keratosis lichenoides chronica?
A 7-year-old girl had erythematous hyperkeratotic papules and plaques that improved in summer and recurred in winter since the age of 4 months. She had had irregular, ridge-like erythematosquamous lesions on the arms with the same seasonal variation. The lesions on the arms improved with age. Light and electron microscopic examination showed marked degeneration of keratinocytes and prominent apoptosis. Her older brother had a similar but milder dermatosis. We believe these cases may represent a variant of keratosis lichenoides chronica.
Apoptosis↗
Clinical results of fractionated proton therapy.
PURPOSE: Preliminary results of a multi-site Phase I-II clinical trial investigating the efficacy of high-energy proton beams in a wide variety of human malignancies are reported. METHODS AND MATERIALS: Since 1983 proton radiotherapy using 250 MeV proton beams produced by a booster synchrotron of the National Laboratory for High Energy Physics has been carried out at Proton Medical Research Center, University of Tsukuba. As of September 1990, a total of 147 patients received a partial or full treatment with proton beams with curative intent; 92 patients (63%) were treated with proton beams alone and 55 patients (37%) with combined photon and proton beams. There were 91 males and the mean age was 61.8 years old. The follow-up observation period ranged from 10 to 97 months. With regard to a total tumor dose, nearly 80% of patients received 70 Gy or more and 53% received 80 Gy or more. While dose-fractionations used depended upon tumor sites, the large majority of patients received substantially high radiation doses in terms of larger total doses (> 70 Gy) and larger fraction sizes (> 2.5 Gy) than those traditionally used. This fractionation regimen has been used because of limited availability of the accelerator or a shortage of machine time (27-30 weeks/year, 3-3.5 hr/day), and also by the expectation that the superior dose distribution possible with protons will permit administration of high radiation doses without increasing morbidities. In connection with this, we have determined the target volume by setting margins around the tumor boundary as practically small as possible, ranging from 5 to 10 mm. RESULTS AND CONCLUSIONS: The current trial has been based on a site and dose searching program, hence a wide variety of tumor sites including the aerodigestive organs has been treated. So far, our judgment is that proton therapy has proven of potential advantage in treatment of the lung, esophageal, liver, uterine cervix, prostate, and head and neck malignancies; and of possible value in treatment of high-grade gliomas, and gastric, urinary bladder, and pediatric tumors.
Adolescent↗
Association of generalized granuloma annulare with autoantibodies.
Granuloma annulare is a degenerative disease of the skin histopathologically characterized by focal degeneration of collagen with a surrounding infiltrate of lymphoid cells, histiocytic cells, and multinucleated giant cells. Immunological abnormalities such as delayed-type hypersensitivity and vasculitic origin are suspected in the pathogenesis. We describe three patients with generalized granuloma annulare, in whom autoantibodies, including antinuclear antibody, antithyroid stimulating hormone receptor antibody, and immune complex, were detected.
Adult↗
[RAEB transformed into AML (M0) showing Ph1 chromosome and rearrangement of major cluster region].
A 78 year old female was found to have pancytopenia in February 1991. Bone marrow was normocellular with 11.7% blasts and showed dysmegakaryopoietic changes. A diagnosis of MDS (RAEB) was made and she was treated with transfusions and ubenimex. Leukemic transformation was noted in July. On Admission in October 1991, her laboratory examinations revealed the following: WBC 38,900/microliters with 93% blast, Hb 8.0 g/dl, Plt 2.1 x 10(4)/microliters, a hypercellular bone marrow with 74% blasts which were negative for myeloperoxidase (MPO) by light microscopy, but were positive by electron microscopy. Surface marker for CD13 was positive. These findings corresponded to M0 of the FAB subtype. Chromosome analysis revealed Ph1 chromosome with 46XX, t (9;22) (q34;q11) in 3 of 3 cells examined, Southern analysis showed the rearrangement of the break point cluster region (bcr). Reverse transcriptase polymerase chain reaction technique demonstrated the presence of major bcr/abl mRNA. She was treated with transfusions and methyl-prednisolone. Her blast counts declined and Ph1 chromosome was only positive in 1 of 12 metaphases examined. She died of pneumonia in December 1991. Eleven cases with MDS showing Ph1 chromosome have previously been reported. The observations indicate that Ph1 chromosome positive acute leukemias were heterogenous in nature.
Aged↗
Primary systemic pustular vasculitis with severe intestinal involvement.
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Adult↗
Detection of the thermostable direct hemolysin gene (tdh) and the thermostable direct hemolysin-related hemolysin gene (trh) of Vibrio parahaemolyticus by polymerase chain reaction.
Polymerase chain reaction (PCR) protocols were established for specific detection of the tdh and trh genes, the virulence marker genes of Vibrio parahaemolyticus encoding two related hemolysins. The tdh and trh genes are known to have sequence divergence of up to 3.3% and 16%, respectively. Attempts were made to find suitable primer pairs and annealing temperatures to detect each gene without fail. DNAs extracted from 36 representative strains of V. parahaemolyticus were used in the initial screening with various combinations of primer pairs and annealing temperatures. The combinations of primer pairs and annealing temperatures selected were then tested with DNAs extracted from 227 more strains of V. parahaemolyticus and from 133 bacterial strains belonging to 40 species other than V. parahaemolyticus. PCR protocols (primer pairs and annealing temperatures) were established that gave identical results to those obtained with the tdh- and trh-specific polynucleotide probes. These protocols established for the tdh and trh genes could detect 400 fg (100 cells) of cellular DNA carrying the respective gene. Spike experiments demonstrated that the sensitivities of the established PCRs were reduced by a factor of 10(4)-10(5) by an inhibitor(s) present in a normal faecal sample, indicating the need for either DNA extraction or enrichment of the faecal sample in alkaline peptone water for 4 h before the PCR of faecal samples.
Base Sequence↗