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Biomedical subjects

A Yamakage

Publications and source records attributed to A Yamakage.

At least 37 records · Page 2Linked to original sources
PubMed1998

Bandlike melasma mimicking linear morphea ("en coup de sabre" type).

A case of bandlike melasma on the median line of the forehead of a middle-aged woman is described. It was an atypical case for its clinical shape and distribution. At initial examination, it was diagnosed as linear morphea. Epidermal nevus was another differential diagnosis. Based on the presence of minor protuberance and the absence of atrophy, clinically, and the presence of sebaceous glands and the absence of swelling of collagen fibers, documented histologically, we revised our diagnosis to that of an atypical type of melasma.

Adult↗
PubMed1997

Nailfold capillary abnormality and pulmonary hypertension in systemic sclerosis.

BACKGROUND: Patients with systemic sclerosis (SSC) show a capillary abnormality of nailfolds with controversial correlation with organ involvement. Our purpose was to study the correlation between this nailfold capillary abnormality and pulmonary hypertension in patients with SSC. METHODS: We studied the nailfold capillaries, using capillary microscopy, and the pulmonary arterial pressure, using right-heart catheterization, in 44 patients with SSC. Canonical discriminant analysis was used to define the capillary abnormality in patients with SSC, which was then compared with that of 40 normal controls. The correlations between the patterns of nailfold capillaries and the cardiopulmonary findings, including the pulmonary arterial pressure, were examined using Fisher's test. RESULTS: Thirty-two of 44 patients with SSC could be differentiated from normal controls by our definition of the SSC pattern. The SSC pattern correlated significantly with elevated pulmonary vascular resistance, as well as with pulmonary fibrosis, electrocardiographic abnormalities, decreased vital capacity, and decreased diffusing capacity for carbon monoxide. All SSC patients with pulmonary hypertension showed this SSC pattern. In patients with elevated pulmonary arterial pressure, capillary microscopy and diffusion capacity for carbon monoxide (DCCM) showed the highest rate of abnormalities. A limited-type SSC significantly correlated with DCCM and with anticentromere antibody, and the diffuse-type SSC with pulmonary fibrosis and anti-sci-70 antibody. CONCLUSION: Our data suggest that in patients with SSC, nailfold capillary abnormalities correlate with pulmonary arterial hypertension as well as with clinical and laboratory findings indicating pulmonary hypertension.

Adolescent↗
PubMed1997

Cutaneous localization of endothelin-1 in patients with systemic sclerosis: immunoelectron microscopic study.

BACKGROUND: Endothelin-1 (ET-1) has some relation to the pathogenesis of systemic sclerosis (SSc) and Raynaud's phenomenon. This study was performed to determine the localization of ET-1 in patients with SSc. METHODS: The localization of ET-1 on the specimen by skin biopsies from nine patients with SSc, was observed with immunoelectron microscopic techniques. RESULTS: High-density deposits existed on the ribosomes and on the rough endoplasmic reticulum in the endothelial cells of microvessels of the upper dermis. The same findings were also seen in the fibroblasts of the dermis, but not found in the skin of normal controls. The level of deposits in the endothelial cells and dermal fibroblasts seemed to have a positive correlation with the serum levels of ET-1 of patients with SSc. CONCLUSIONS: From these results, it can be seen that ET-1 is produced much more from the endothelial cells and fibroblasts of the dermis in the skin of SSc patients than from the normal controls. It is suspected that ET-1 is one of the pathogenetic factors of SSc.

Biopsy↗
PubMed1996

Electron-microscopic study of sclerodermatous chronic graft-versus-host disease.

BACKGROUND: Sclerodermatous chronic graft-versus-host disease (SC-GVHD) resembles systemic scleroderma (SSD) closely, both clinically and histologically. Our purpose was to try to define the morphologic differences of collagen fibers between SC-GVHD and SSD. MATERIALS AND METHODS: Using electron microscopy, we compared the morphology of collagen fibers in a 15-year old girl with SC-GVHD with those of three patients with SSD. RESULTS: In SC-GVHD, sclerosis is located in the superficial dermis and collagen fibers of irregular diameter are seen in the subepidermal area. In SSD, sclerosis is seen in the lower dermis and subcutaneous fatty tissue, and collagen fibers of irregular diameter are located in the deep dermis. Some of the collagen fibers were degenerative in the superficial dermis in SC-GVHD. We observed low-density, round structures in cross sections of collagen fibers. CONCLUSIONS: The difference in initial location and morphologic appearance of collagen fibers may indicate a different pathogenesis in SC-GVHD compared to SSD.

Adolescent↗
PubMed1995

Image analysis of nailfold capillaries in patients with undifferentiated connective tissue syndromes.

Several studies have reported patients that show nailfold capillary abnormality without fulfilling any of the criteria for rheumatic diseases. Our objective was to define how many patients with undifferentiated connective tissue syndrome (UCTS) have nailfold capillary abnormalities and to determine the correlation between capillary abnormality and clinical findings. We analyzed videograph images of nailfold capillaries in 75 patients with UCTS, comparing them with 22 normal controls (NL) and 55 patients with systemic sclerosis (SS), using standardized canonical discriminant analysis. Sixty patients with UCTS showed the SS type pattern and 15, the NL type pattern. The SS type pattern in patients with UCTS significantly correlated with Raynaud's phenomenon, telangiectasia, and anti-nuclear antibody. The UCTS patients with nailfold capillary abnormalities correlated with symptoms of SS have a possibility of progressing to SS. The follow up study of these patients will show whether progression to SS occurs.

Adolescent↗
PubMed1995

Image analysis of nail fold capillaries in patients with Raynaud's phenomenon.

Videograph images of nail fold capillaries in patients with Raynaud's phenomenon were analyzed, and capillary patterns were defined using standardized canonical discriminant analysis. Of sixty-eight patients with Raynaud's phenomenon, forty-nine (72 percent) showed a systemic sclerosis pattern and nineteen (28 percent) showed a normal pattern. The systemic sclerosis type capillary pattern significantly correlated not only with secondary Raynaud's syndrome but also with sclerodactyly, telangiectasia, and antinuclear antibody. This study confirms the value of nail fold capillary microscopy as a noninvasive technique for the examination of the cutaneous microcirculation in vivo. We should continue to evaluate the patients with Raynaud's phenomenon who showed systemic sclerosis pattern abnormality to determine if these patients would show a progression to systemic sclerosis or not.

Adolescent↗
PubMed1995

Elevated levels of platelet derived growth factor and transforming growth factor-beta 1 in bronchoalveolar lavage fluid from patients with scleroderma.

OBJECTIVE: Systemic sclerosis (scleroderma, SSc) frequently affects the lungs, and interstitial pulmonary fibrosis is one of its major complications. The pathophysiology of SSc lung disease s poorly understood, but recent studies document an inflammatory process resembling that of idiopathic pulmonary fibrosis with increased numbers of activated alveolar macrophages and granulocytes in bronchoalveolar lavage (BAL) fluid). We determined levels of 2 potentially important mediators of fibroproliferative repair in BAL fluid from patients with SSc. METHODS: Using Western blot and ELISA techniques we measured levels of platelet derived growth factor (PDGF) and transforming growth factor-beta (TGF-beta in BAL fluid from patients with SSc and healthy controls. The mitogenic effect of these cytokines on SSc lung myofibroblasts was determined by [3H]thymidine incorporation. RESULTS: SSc BAL fluid contains significantly elevated levels of PDGF-AA and PDGF-BB. Where TGF-beta 1 was significantly elevated in SSc lavage fluid, the amount of TGF-beta 2 was significantly less than that observed in normal lavage fluid. Myofibroblasts cultured from SSc lavage fluid exhibited enhanced [3H]thymidine incorporation upon exposure to the growth factors present in SSc BAL fluid: PDGF and TGF-beta 1. SSc lung myofibroblasts pretreated with TGF-beta 1 exhibited an enhanced mitogenic effect upon stimulation by PDGF, due in part to the induction of the PDGF alpha receptor. CONCLUSION: Our studies support a role for PDGF and TGF-beta 1 in the pathogenesis of SSc lung disease.

Bronchoalveolar Lavage Fluid↗
PubMed1994

Statistical definition of nailfold capillary pattern in patients with psoriasis.

BACKGROUND: The microvasculature plays an important role in the pathogenesis of psoriatic skin lesions. Our purpose was to try to define a psoriatic pattern in the nailfold capillary, to clarify the relationship between nailfold capillary microscopic changes and nail involvement and to note the general clinical features of psoriasis. METHODS: Image analysis of nailfold capillaries was performed in 62 patients with psoriasis. The capillary pattern was defined statistically comparing it with that of 51 healthy volunteers. We attempted to differentiate the psoriatic pattern from normal controls with "canonical discriminant analysis." RESULTS: Forty-nine of 62 patients with psoriasis could be differentiated from normal controls by our definition of psoriatic pattern that was significantly correlated with periungual psoriatic plaque, nail pitting, onycholysis, and the extent of the involved area. CONCLUSIONS: Our data suggest that nailfold capillary changes reflect microvascular changes of psoriasis and that the nailfold capillary pattern is a useful tool in evaluating nail involvement and the severity of psoriasis.

Adolescent↗
PubMed1994

Lipodystrophia centrifugalis abdominalis infantilis occurring in the neck.

We report a Japanese girl with atypical lipodystrophia centrifugalis abdominalis infantilis. The initial lesion developed on the neck as an area of erythema which showed centrifugal spread to the nape, submandibular area and upper breast and central fading to leave a residual depression and purplish brown pigmentation symmetrically. A central depression on the neck, nape, submandibular area and upper breast was surrounded by a distinctive erythematous, slightly elevated and indurated border. Histological examination of the erythematous border revealed inflammatory changes in the subcutaneous fat. Although this patient was affected in an unusual site, we concluded that she had lipodystrophia centrifugalis abdominalis infantilis, because of the overall features of the lesions.

Adipose Tissue↗