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Biomedical subjects

M Hiruma

Publications and source records attributed to M Hiruma.

At least 19 recordsLinked to original sources
PubMed1999

Case report. Sporotrichosis successfully treated with itraconazole in Japan.

A case of lymphocutaneous sporotrichosis that had developed from the dorsum nasi to the left buccal region of a 65-year-old woman was treated with itraconazole 100 mg day-1. The lesion healed in 10 weeks after starting treatment leaving crusts, mild erythema and pigmentation, and the treatment was completed 16 weeks after the start of treatment. Neither adverse reactions nor abnormal clinical laboratory values were noted. Until the present time, 1 year and 2 months after the completion of treatment, no recurrence has been observed. In Japan, 43 cases of sporotrichosis have been treated with itraconazole, and 38 cases (88%) have been assessed as effective or better. The mean dose of itraconazole and the mean duration of administration are 100 mg day-1 and 11 weeks, respectively, in these reported Japanese cases. The use of itraconazole is expected to be one of the effective therapies for sporotrichosis.

Aged↗
PubMed1999

Effectiveness of treatment of severe tinea pedis with 1% terbinafine cream in members of the Japanese self-defense forces.

A clinical study was conducted to determine the efficacy of terbinafine cream in severe cases of tinea pedis. The subjects were 21 men, members of the Japanese Self-Defense Forces who were judged to have severe symptoms of tinea pedis. The description 'severe' was defined as 'considered to require the concurrent internal administration of antifungals for complete cure', or as meeting criterion 5 or 6 for the severity of tinea pedis. A simple surface application of terbinafine cream was given once daily, the subjects' clinical manifestations, mycological cure rates and safety-related changes were observed, and a final assessment was made in the 12th week. In the final assessment, the improvement rate of the cutaneous symptoms was 95.2%, and the fungal eradication and efficacy rates were 81.0%. As for side-effects, one patient complained of local irritation. These results suggested that terbinafine cream is a beneficial topical antifungal cream for severe tinea pedis.

Administration, Topical↗
PubMed1999

[Pediatric onychomycosis treated with oral antifungal drugs].

Pediatric onychomycosis is a rare disease and it is difficult to decide in such cases whether or not an oral antifungal is indicated. We have observed 6 pediatric cases with onychomycosis who were treated with fluconazole or itraconazole: four male and two female patients, ranging in age from three to 14 years. One patient suffered infection in the fingernails and toenails. The etiologic organism was identified as Trichophyton rubrum. The treatment regimen consisted of systemically administering fluconazole to four of the patients and itraconazole to the other two. Treatment resulted in three of the 4 patients treated with fluconazole, and one of the 2 treated with itraconazole being healed completely. The other two patients treated with fluconazole and itraconazole showed an alleviation of symptoms. Further results of our study were that while younger patients respond quickly and positively to treatment, long-term follow-up is necessary even after treatment ceases due to the easy recurrence of this condition.

Administration, Oral↗
PubMed1999

[Fungi and atopic dermatitis].

Attention has recently been centered on fungi as aggravating factors of atopic dermatitis (AD) due to the frequent detection of IgE antibodies to fungi in patients with severe AD and to positive response of some cases of AD to antifungal therapy. Malassezia sp.: In AD patients with prominent symptoms in the head and neck, areas prone to colonization by Malassezia, the titers of specific anti-Malassezia IgE antibodies are high, which positively correlate with the total IgE value and the severity of AD. The patch test against Malassezia antigens is positive. The rate of isolation of Malassezia from the skin of AD patients is higher than that from the skin of healthy control subjects. Candida sp.: In patients with severe AD, the rate of positive skin prick tests for Candida is high, and a correlation exists between positive skin prick test results and the presence of Candida albicans in nasopharynx. However, the reactivity to Candida antigens in the patch tests is reduced, and a negative correlation is seen. There is no difference between the isolation rate of C. albicans from patients with adult-type AD and normal controls. However, AD patients give a significantly greater number of separate colonies. The range of efficacy rate of antifungal therapy of AD is reported to be 50-65 %. The efficacy rate of our own trial falls within this range. Following treatment, the rate of isolation of fungi decrease significantly, and the titers of specific antifungal IgE antibodies are not statistically significant. The clearance of fungi from the tissue following antifungal therapy probably results in the suppression of direct or indirect inflammatory reaction caused by the fungi. We therefore consider antifungal therapy as one of the second-line therapies to be administered in AD cases resistant to conventional basic therapy.

Adult↗
PubMed1999

Analysis of strain variation of R1 repeated structure in varicella-zoster virus DNA by polymerase chain reaction.

The tandem direct reiteration R1 in the varicella-zoster virus genome consists of two elements: units composed of 18 bp and those having 15 bp, both of whose numbers and types of combination patterns vary among strains. The variations of the R1 structure were examined in order to differentiate between the wild strains and a varicella vaccine (Oka) strain by the polymerase chain reaction using two primer sets. The results showed that the 31 wild strains were classified into nine patterns: the R1 structure consisted of a combination of 5 to 7 18-bp units and 8 to 12 15-bp units. The strain with a combination of 6 18-bp units and 10 15-bp units was found to be predominant in Japan, and the same pattern was found in the vaccine strain, so that differentiation between the vaccine strain and the wild strains in Japan merely by analysis of R1 in VZV genome is difficult.

DNA, Viral↗
PubMed1998

A pediatric case of atypical Mycobacterium avium infection of the skin.

We report a case of cutaneous atypical mycobacteriosis in a 12-year-old healthy girl due to Mycobacterium avium. The cutaneous symptoms were three well-defined subcutaneous nodules on both buttocks and on the posterior surface of the left thigh. One had a fistulous opening on the skin surface. Histopathological examination revealed epithelioid cell granulomas surrounded by dense lymphocytic infiltration and acid-fast bacteria were seen with modified periodic acid-carbol fuchsin staining. Using Ogawa's medium at 37 degrees C, acid-fast bacteria were isolated from the biopsied specimen and identified by the DNA-DNA hybridization method as Mycobacterium avium. In drug susceptibility test, these were resistant to all antituberculous drugs. Oral administration of minocycline 100 mg/day for two months had little effect on the two remaining lesions, which were therefore excised. Based upon reported cases of Mycobacterium avium complex, we considered that our pediatric patient with multiple intradermal or subcutaneous nodules on the buttocks and the thigh exhibited the characteristic symptoms of M. avium infection.

Administration, Oral↗
PubMed1998

Cathepsin D expression in skin metastasis of breast cancer.

Cathepsin D, an aspartic proteinase, correlates with invasion and metastasis in breast cancer and with poor prognosis. In the present study, we examined the immunohistological expression of cathepsin D in both primary (5 cases) and skin-metastatic breast cancers (13 cases) and compared it to those in gastric (2 cases) and lung (4 cases), and primary eccrine cancers (3 cases). All breast and gastric cancers were adenocarcinomas. The 2 gastric cancers were poorly differentiated, while the 4 lung cancers consisted of 2 poorly differentiated adenocarcinomas, 1 poorly differentiated large cell carcinoma, and 1 moderately to poorly differentiated squamous cell carcinoma. We also surveyed the immunohistological distribution of cathepsin B, carcinoembryonic antigen, gross cystic disease fluid protein-15, c-erbB-2, and estrogen receptor. In almost all breast cancer samples, the cancer cells demonstrated strong expression of cathepsin D in the cytoplasm, but weak staining patterns with other antibodies. Gastric and lung cancer cells did not respond with cathepsin D (except one metastatic lung cancer) or the other immunohistological markers. Since cathepsin D is strongly expressed in primary and metastatic lesions of breast cancer, cathepsin D could be useful as an adjunct to a panel of immunohistochemical stains in determining the primary site of origin of metastatic cancer in the skin.

Adenocarcinoma↗
PubMed1997

Stimulation of human keratinocyte growth by alginate oligosaccharides, a possible co-factor for epidermal growth factor in cell culture.

Oligosaccharides, involved in regulation of plant developmental and defensive processes, were tested to determine their ability to enhance proliferation of human keratinocytes. A mixture of alginate oligosaccharides remarkably stimulated keratinocyte growth and [3H]thymidine uptake in the presence of epidermal growth factor (EGF). The activity was comparable to bovine pituitary extract, a common complement in keratinocyte culture, and additive on BPE-induced stimulation. The most effective oligosaccharide in the mixture was identified and its chemical structure was determined. These findings demonstrate a novel activity of alginate oligosaccharide(s) in keratinocyte growth and suggest a possible co-factor for EGF-dependent stimulation in medium for keratinocytes.

Alginates↗
PubMed1997

Processing of cathepsins L, B and D in psoriatic epidermis.

Proteinase activity is increased in psoriatic epidermis. To elucidate the involvement of enzymes in psoriatic epidermis, the expression of cathepsins, L, B and D was investigated by Western blotting and immunohistological studies. Normal epidermis contained abundant inactive precursors (39 kDa) of cathepsins L and B and an inactive intermediate form (45 kDa) of cathepsin D. Cathepsin L in psoriasis was processed to a variable extent from the precursor to a single-chain form (30 kDa) and a mixture of single- and heavy-chain (25 kDa) forms of the active mature enzyme, corresponding to the immunohistological staining patterns 'diffuse dense', 'small granular', and unevenly distributed 'condensed granular'. Cathepsin B showed a mixture of precursor form (39 kDa) and single-chain (30 kDa) forms and was expressed as a 'diffuse dense' staining pattern in the mid-spinous layer and as a 'condensed' pattern in the upper spinous and granular layers. Cathepsin D was processed to the heavy-chain (31 kDa) form of activated mature enzyme with small granular staining and a mixture of heavy-chain and degraded protein (28 kDa) with larger and more condensed granular staining. The distribution patterns of 'small granular' cathepsin L, and of cathepsins B and D expression in suprabasal keratinocytes were very similar to that of involucrin. After complete clinical resolution of psoriasis by 8-methoxypsoralen plus UVA treatment, the expression of the three cathepsins was normalized. These results suggest that cathepsins L, B and D in forms activated to a variable extent may be involved in the pathology of psoriasis.

Adolescent↗
PubMed1997

Expression of cathepsin D and B in invasion and metastasis of squamous cell carcinoma.

To determine the involvement of proteinases with hydrolytic activity towards extracellular matrix and basement membrane, in invasion and metastasis of tumour cells, the expression of cathepsin D, an aspartic proteinase, and cathepsin B, a cysteine proteinase, was studied. Formalin-fixed paraffin-embedded specimens from 13 patients who had squamous cell carcinomas (SCC) with local recurrence, skin and/or lymph node metastasis were examined. Cathepsin D stained intensely as a granular pattern (mature enzyme) in tumour cells of 69% of primary lesions and all the secondary lesions of the patients with SCC. Cathepsin B stained more intensely in SCC cells of all of the primary and secondary lesions than in normal epidermis; staining patterns were almost diffuse (procathepsin B). Granular and diffuse patterns (mature enzyme of cathepsin D and procathepsin B, respectively) appeared in the outer and inner parts of tumour islands, respectively. The presence of the active mature form of cathepsin D and procathepsin B in metastatic skin lesions of SCC was confirmed by Western blotting analysis. The presence and localization of the active mature form of cathepsin D suggests that activated cathepsin D may be involved in the invasion and metastasis of SCC.

Blotting, Western↗