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Biomedical subjects

H Sueki

Publications and source records attributed to H Sueki.

At least 37 records · Page 2Linked to original sources

[Two cases of metastasizing benign leiomyomatosis from myoma uteri].

Case 1. A 50-year-old woman was referred to our hospital because of multiple bilateral small round lesion on chest radiography. She had undergone total hysterectomy for myoma uteri at the age of 33. She underwent thoracoscopic tumor excision at left lung. The lesion was proved benign. Right side lesions were laterly excised using thoracotomy. Case 2. A 49-year-old woman was referred to us because of two ovoid lesion at left lung area of chest radiography. She also had undergone total hysterectomy for myoma uteri at the age of 37. She underwent tumor extirpation using thoracotomy. All samples of two patients revealed, pathologically, lesions were consisted of benign spindle-like calls similar to those of myoma uteri. Therefore, we consider these lesions were pulmonary metastasis of myoma uteri. Myoma uteri has certain potential of metastasizing to the lung, in spite of benign disease.

Female↗

[The role of surgery for chronic empyema of the advanced ages].

Chronic empyema, a sequelae of pulmonary tuberculosis, is now a only tuberculosis-related disease which was remained to be treated surgically. The candidates who have basically poor respiratory function are now attained advanced age. Over a 15 years period (1980-95), 22 patients 70 years of age or older underwent surgical intervention for chronic empyema at our hospital. There were 17 men and 5 women, ranging from 70 to 80 years of age (median age 75.0). They were 15.3% of all 145 surgically treated patients during same period. The empyema continued latent from 25 to 58 years (average 39.8 years). On admission they complained of productive cough (9), fever (9), hemosputam (5) and mass on the chest wall. Their Hugh-Johnes classification for dyspnea was I.: 4, II.: 6, III.: 11, IV.: 1 respectively. Their %VC ranged from 31.5 to 79.0 (average 54.8). In fifteen patients, tubercle bacilli (5), aspergillus (3) and other bacteria (9) were discovered in the empyema space. Surgical procedures consisted of 1 pneumonectomy (4.5%), 12 decortication or curettage of empyema wall (54.5%), 4 extraperiosteal air plombage (18%) and 5 other procedures (muscle or omental plombage, thoracoplasty, fenestration and others) (22.7%). There were no operative death and no lethal postoperative complication. In contrast, lethal postoperative complications such as GVIID, MOF and gastrointestinal bleeding occurred in the younger group. There were 2 cases of late respiratory failure in 70 years or older and 6 cases in younger group. Seventy-four years man who, preoperative %VC 33.0, underwent pneumonectomy died of asphyxia 6 month postoperatively. Another 74 years man who, preoperative %VC 76.1, developed respiratory failure after relapse of pulmonary tuberculosis. Four patients of younger group who developed late respiratory failure had all received thoracoplasty as a second operation. Other 2 patients, preoperative %VC 33.0 and 27.4 respectively, had undergone pneumonectomy. The risk of lethal postoperative complication or late respiratory failure were dependent mainly on preoperative respiratory function or surgical procedure selected rather than the age of patients.

Age Factors↗

Dominantly inherited epidermal acantholysis in dogs, simulating human benign familial chronic pemphigus (Hailey-Hailey disease).

We report on dominantly inherited epidermal acantholysis in three dogs, a sire and two female offspring. The skin lesions were characterized by hairless, hypertrophic plaques. Histopathologically, these lesions showed epidermal hyperplasia with individual enlargement of keratinocytes, extensive acantholysis and minimal dyskeratosis. Ultrastructural analysis revealed that attachment plaques of desmosomes were still intact while some tonofilaments were detached from them in early lesions; there were well-developed microvilli at dissociated cell surfaces. The data imply that these animals have undergone a process similar to human benign familial chronic pemphigus (BFCP). Immunohistochemical examination revealed that staining for E-cadherin and actin variably remained in dissociated keratinocytes. Focal intracellular staining for desmosomal glycoproteins and desmosomal proteins were observed within the dissociated keratinocytes. This dominantly inherited acantholytic disease in dogs could be a useful animal model for investigating the pathogenesis of BFCP in humans.

Acantholysis↗

Effects of alpha-hydroxy acids on photoaged skin: a pilot clinical, histologic, and ultrastructural study.

BACKGROUND: alpha-Hydroxy acids (AHAs) have been reported to improve aging skin. The mechanisms of action of AHAs on epidermal and dermal compartments need clarification. OBJECTIVE: Our purpose was to determine the effects of AHAs on photoaged human skin by clinical and microanalytic means. METHODS: Patients applied a lotion containing 25% glycolic, lactic, or citric acid to one forearm and a placebo lotion to the opposite forearm for an average of 6 months. Thickness of forearm skin was measured throughout the study. Biopsy specimens from both forearms were processed for analysis at the end of the study. RESULTS: Treatment with AHAs caused an approximate 25% increase in skin thickness. The epidermis was thicker and papillary dermal changes included increased thickness, increased acid mucopolysaccharides, improved quality of elastic fibers, and increased density of collagen. No inflammation was evident. CONCLUSION: Treatment with AHAs produced significant reversal of epidermal and dermal markers of photoaging.

Aged↗

Increased factor XIIIa transglutaminase expression in dermal dendrocytes after treatment with alpha-hydroxy acids: potential physiologic significance.

BACKGROUND: Topical alpha-hydroxy acids (AHAs) have been shown to improve photoaging in human skin. OBJECTIVE: We studied factor XIIIa transglutaminase expression in dermal dendrocytes (DDs) and mast cell degranulation after treatment of the skin with AHAs. METHODS: Skin biopsy specimens obtained from patients after 4 to 8 months of treatment with lotions containing 25% AHAs were evaluated for factor XIIIa transglutaminase expression with immunoperoxidase and electron microscopy. Immunoperoxidase-stained sections were studied by means of semiquantitative methods and image analysis. Mast cell degranulation was studied by image analysis. RESULTS: Increased factor XIIIa transglutaminase expression was seen after treatment with AHAs. All treated sites had increased scores compared with control sites by semiquantitative methods. Seventy-five percent of treated sites showed an increased mean area over control sites of factor XIIIa transglutaminase positivity with image analysis. These results correlated with an increased level of mast cell degranulation in treated sites and with activation of DDs as seen by electron microscopy. CONCLUSION: Treatment of the skin with AHAs leads to mast cell degranulation and increased expression of factor XIIIa transglutaminase by activated DDs. Mast cell degranulation may lead to activation of DDs and increased factor XIIIa transglutaminase expression, via the action of tumor necrosis factor-alpha. We speculate that clinical and histologic improvement in photoaged skin after treatment with AHAs may be somehow related to this process.

Administration, Cutaneous↗

Enhancing effect of ultraviolet A on ornithine decarboxylase induction and dermatitis evoked by 12-o-tetradecanoylphorbol-13-acetate and its inhibition by curcumin in mouse skin.

BACKGROUND: Previous studies have demonstrated appreciable tumor induction in mouse skin by daily irradiation with high-power long-wavelength ultraviolet A (UVA). OBJECT: The aim of the present study was to examine the enhancing effects of UVA on changes in mouse skin mediated by the tumor promoter 12-o-tetradecanoylphorbol-13-acetate (TPA) by measurement of ornithine decarboxylase (ODC) activity and morphometric analysis. In addition, we examined the inhibitory effects of curcumin, a component of turmeric, on these changes. METHOD: ODC activity in the epidermis of CD-1 mice was determined by the method of Russell and Snyder. Epidermal and dermal thickness, and the number of dermal infiltrating inflammatory cells were quantified using a computer-assisted image analyzer. RESULTS: A combination of topical TPA application and UVA irradiation produced a greater increment of ODC activity at 4 h than TPA alone (p < 0.05). Histopathologically, TPA plus UVA tended to increase the dermal infiltrating inflammatory cells in contrast to TPA alone. Pretreatment of mice with curcumin significantly abrogated the TPA-induced changes in ODC activity and the dermal infiltrating inflammatory cells as well as the TPA plus UVA-mediated enhancement of these changes. CONCLUSION: Our data indicate that UVA irradiation (18.72 J/cm2) significantly enhances ODC induction at an early stage (4-6 h) after topical application of TPA, and aggravates the dermatitis elicited by TPA. Pretreatment with curcumin significantly inhibits these enhancing effects.

Animals↗

Adult-onset xanthogranuloma appearing symmetrically on the ear lobes.

Clinical backgrounds of patients with adult-onset xanthogranuloma are somewhat different from those of patients with juvenile xanthogranuloma, but the histologic findings of both forms of the disease are identical. The lesions of the adult form are usually asymmetric. We describe a patient with adult-onset xanthogranuloma that appeared symmetrically on the ear lobes. This case suggests a possible role for mechanical stimuli (e.g., earrings) in the pathogenesis of adult-onset xanthogranuloma.

Diagnosis, Differential↗

Computer-assisted three-dimensional reconstruction of human dermal dendrocytes.

We attempted to characterize the three-dimensional structure of dermal dendrocytes and to clarify the spatial relationships between dermal dendrocytes and mast cells, macrophages, and nerves. Normal human adult skin (breast, n = 2) was routinely processed for electron microscopy. Every other section (about 50 per data set) was collected at 80-nm intervals traversing about 8 microns of tissue. Grids showing the same cells were photographed by electron microscopy at a magnification of 4000x. Based on the 10-20 photographs per data set, cell outlines were digitized into the reconstruction program at appropriate layers and aligned. Thin, elongated cytoplasmic "dendrites" of dermal dendrocytes in two-dimensional micrographs proved to be thin, membrane-bound flaps in three-dimensional reconstruction. For dermal dendrocytes concentrated about superficial vessels (perivascular dendrocytes), the flaps enshrouded the vessel wall, and for dermal dendrocytes directly beneath the epidermis (subepidermal dendrocytes), these flaps were aligned parallel to the dermal-epidermal junction. The three-dimensional feature of dermal dendrocytes (perivascular and subepidermal) is quite similar to that of perivascular adventitial veil cells, suggesting ultrastructurally identified perivascular dendrocytes and veil cells must be identical cells. In conventional ultrathin sections, 20-40% of perivascular dendrocytes and occasional subepidermal dendrocytes were closely associated with mast cells. When viewed by computer-assisted three-dimensional reconstruction, membrane flaps of dermal dendrocytes consistently shrouded mast cell membranes for 50-90% of their perimeter; mast cells resembled a ball in a baseball glove (dermal dendrocytes). Occasional dermal dendrocytes surrounded non-myelinated nerves in the superficial dermis. Membrane flaps also enabled dermal dendrocytes to present extensive areas to the plasma membranes of adjacent monocyte/macrophages. These findings indicate that dermal dendrocytes are non-dendritic cells that are spatially related to mast cells, monocyte/macrophages, microvessels, and nerves by their membranous flaps. This suggests the need for further study of functional interactions between these cells.

Adult↗

Role of mast cells in early epithelial target cell injury in experimental acute graft-versus-host disease.

The skin is a major target organ for graft-versus-host disease (GVHD), the principal complication of allogeneic bone marrow transplantation. The purpose of the present study was to test whether mast cell degranulation might be related to early target cell injury in the development of acute GVHD. We employed two irradiated murine strain combinations, one in which disease was mediated by CD4+ effector T cells (B10.D2-->DBA/2), and the other by CD8+ effector T cells (B10.BR-->CBA). As compared to controls, both models exhibited mast cell degranulation of differing extents and patterns, as well as dyskeratosis in the epidermis before the influx of effector lymphocytes. These results suggested that factors produced and released by degranulated dermal mast cells might contribute to early target cell injury. Accordingly, the possible role of tumor necrosis factor (TNF)-alpha, a cytokine recently discovered in mast cell granules, was investigated by the injection of anti-TNF-alpha antibody during the course of disease mediated by either CD4+ or CD8+ T cells. Although overall survival of recipients undergoing CD4+ T-cell-mediated GVHD was only slightly improved and the extent of mast cell degranulation was not affected by anti-TNF-alpha antibody treatment, the skin exhibited a significant diminution in the number of dyskeratotic cells/linear mm at 3-4 weeks post-transplantation. In contrast, anti-TNF-alpha antibody failed to enhance survival or reduce the number of dyskeratotic cells in the skin during CD8+ T-cell-mediated disease. Finally, to determine whether CD8+ T-cell-mediated GVHD was at all dependent upon mast cell involvement, the C3H.SW-->B6WWv strain combination was utilized, in which recipients were genetically deficient in mast cells. Onset of GVHD was significantly delayed in B6WWv mice and was clearly correlated to the appearance and increase of de novo mast cells at later time points.

Animals↗

Novel interactions between dermal dendrocytes and mast cells in human skin. Implications for hemostasis and matrix repair.

BACKGROUND: Dermal dendrocytes are a newly-recognized cell type in human skin. They express coagulation Factor XIIIa (FXIIIa), also known as fibrin stabilizing factor, and their number is increased in certain inflammatory dermatoses. Current dogma suggests that these recently described cells may represent a subset of antigen-presenting macrophages. The present study therefore was undertaken to examine further the phenotype and potential function of these novel cells. EXPERIMENTAL DESIGN: Conventional ultrastructure, single and dual label immunofluorescence and immunocytochemistry, confocal laser scanning microscopy, and immunoelectron microscopy were used to define structure and potential heterogeneity among dermal dendrocytes. Human neonatal foreskin organ culture exposed to mast cell secretagogues, inhibitors, and relevant recombinant cytokines (tumor necrosis factors alpha) was employed to gain insight into functional characteristics of FXIIIa expression. RESULTS: We found that dermal dendrocytes are phenotypically unique dermal cells, separate from conventional macrophages, with antigenic heterogeneity of FXIIIa and CD34 expression related to their microanatomical location in the dermis. Moreover, they express specialized membrane-matrix plaques that may stabilize their placement in various dermal strata. Finally, superficial subpopulations of dermal dendrocytes are closely-associated with mast cells and show enhanced FXIIIa expression in response to mast cell degranulation, an event that appears to result from liberation of mast cell tumor necrosis factor in the dendrocyte microenvironment. CONCLUSIONS: These new insights establish dermal dendrocytes as distinctive fixed skin cells with potential functional capacity for mast cell-dependent facilitation of fibrin cross-linking and matrix remodeling. These previously unrecognized phenotypic and functional characteristics of dermal dendrocytes therefore may be relevant to cellular interactions responsible for cutaneous wound healing and hemostasis.

Cell Communication↗

Immunohistochemical and ultrastructural characterization of tonofilament and hemidesmosome abnormalities in a case of epidermolysis bullosa herpetiformis (Dowling-Meara).

BACKGROUND: A neonate with epidermolysis bullosa herpetiformis (EBH) (Dowling-Meara) had an undescribed ultrastructural and immunohistochemical abnormality. OBJECTIVE: The objective was to clarify the ultrastructural and immunohistochemical abnormalities in EBH to gain further insight into the pathogenesis of this disorder. METHODS: Tissue from the patient was studied with routine histochemistry, electron microscopy, and immunohistochemistry. RESULTS: Excessive clumping of tonofilaments on electron microscopic examination, anomalous hemidesmosomes, and immunohistochemical evidence of aberrant keratin expression by basal epidermal cells was found. CONCLUSION: This case of EBH provides further evidence for primary abnormalities involving cytoskeletal-membrane attachment plaque formation in this rare disorder.

Desmosomes↗

Eccrine syringofibroadenoma (Mascaro): an ultrastructural study.

To confirm the eccrine acrosyringeal differentiation of eccrine syringofibroadenoma (ESFA) and to elucidate the histogenesis of its angiofibrotic stroma, a case of ESFA from a 45-year-old man was examined by light and electron microscopy. Histologically, the parenchyma featured anastomosing, slender epithelial cords containing small cuboidal cells and occasional duct-like structures. The stroma had increased numbers of mast cells, increased capillaries with swollen endothelial cells, and prominent fibrosis. Ultrastructurally, the following findings were characteristic of ESFA: a) abundant glycogen particles in epithelial cells, b) numerous intracytoplasmic and extracellular spaces lined with microvilli, c) intraepithelial duct formation, consisting of microvilli, vesicles, rod-shaped dense bodies, multivesicular dense bodies, and peripheral network of tonofilaments, and d) large numbers of mast cells, closely associated with fibroblasts, surrounding increased numbers of capillaries containing swollen endothelial cells. These ultrastructural features support the acrosyringeal differentiation of ESFA. We hypothesize that mast cell hyperplasia and degranulation may play an important role in the formation of the angiofibrotic stroma.

Adenofibroma↗

Pigmented malignant pilomatrixoma: report of a case and review of the literature.

An unusual variant of malignant pilomatrixoma displaying melanization of epithelial elements is described. Melanization is a rare event even in the benign form of this adnexal neoplasm. Previously reported cases of malignant pilomatrixoma are reviewed; none containing pigment have been previously reported to our knowledge. Possible etiologies for lack of pigment in most benign and malignant pilomatrixoma are discussed.

Aged↗

Simultaneous development of insulin dependent diabetes mellitus and alopecia areata universalis.

Alopecia areata universalis developed gradually over nine months in a 25-year-old woman. When her scalp hairs were totally lost and other body hair began to fall out, the symptoms of insulin dependent diabetes mellitus, an organ-specific autoimmune disease, developed rapidly and progressed to diabetic coma. Alopecia did not regress after the metabolic state improved following insulin therapy. Biopsy of the scalp skin revealed significant reduction of the total number of hair bulbs and prominent lymphocyte infiltration into the remaining hair follicles. Insulin dependent diabetes mellitus and alopecia areata universalis are both thought to be related to the autoimmune mechanism and sometimes coexist. However, simultaneous development of these two disorders is extremely rare.

Adult↗

Effect of non-enzymatic glycosylation and heating on browning of human stratum corneum and nail.

The purpose of the present study was to examine the effect of non-enzymatic glycosylation and subsequent heating on the browning of the plantar stratum corneum and the finger-nail, and to elucidate the pathogenesis of the yellow skin and the yellow nail seen in diabetic subjects. We incubated stratum corneum and nail from non-diabetics in 0 (control), 10 (only nail), 20 (only nail), 100 and 250 mM glucose buffer at 37 degrees C for 5 days. These glycosylated samples were dialysed against distilled water for 96 h. Distilled water was changed every 24 h. Then samples were dried for 24 h. The extent of non-enzymatic glycosylation was measured by furosine content. Each 5 mg of sample was hydrolysed by 6 N HCl and processed for measurement of furosine by high-performance liquid chromatography. The rest of each sample was stored at 37, 42 (only nail), 47 and 52 degrees C for 14 days. Browning of the stratum corneum was assessed macroscopically, and that of the nail by spectrophotometry. Based on their spectrophotometric reflectances. Munsell's scores (H = hue score, V = lightness score, C = saturation score) and (H + C)/V were calculated for objective evaluation of browning. Incubation of the stratum corneum and nail with glucose buffer increased their non-enzymatic glycosylation (furosine) dose dependently. Macroscopically, the browning of the stratum corneum was enhanced in proportion to the glucose concentration and storage temperature. However, samples incubated in 10 and 20 mM glucose and stored at 42 degrees C did not show visible browning. Munsell's score of the nail samples treated by glycosylation and heating showed increased hue and saturation but reduced lightness. (H + C)/V values of these nail samples were significantly higher than those of the control. We could not detect any fluorescence with Wood light in the browned samples. The present in vitro study demonstrated that the browning of the stratum corneum and the nail depended on the extent of both non-enzymatic glycosylation and storage temperature. We suggested a hypothesis that the non-enzymatic glycosylation and the storage temperature of the stratum corneum and the nail might be a contributory factor in the development of yellow skin and yellow nail in diabetic patients.

Adult↗

MS-1 sinusoidal endothelial antigen is expressed by factor XIIIa+, HLA-DR+ dermal perivascular dendritic cells.

We have recently described a monoclonal antibody, termed MS-1, which reacts with sinusoidal endothelium as well as interstitial cells in a variety of nonlymphoid organs. In this report, we characterize the phenotypes of MS-1-positive cells in normal human skin. Double immunohistochemical and immunofluorescence labeling techniques demonstrate that MS-1 antibody identifies two cell types in human dermis: the first represented by weakly reactive lymphatic endothelial cells; and the second comprised of strongly reactive, highly dendritic perivascular cells which constitutively express both HLA-DR and factor XIIIa. These MS-1-positive dendritic interstitial cells are ultrastructurally distinctive, separate from mast cells, phagocytic macrophages, pericytes, blood vascular endothelial cells, and fibroblasts. MS-1-positive cells express this protein in discrete cytoplasmic compartments, and possibly as small plasma membrane-associated regions. The phenotype, dendritic morphology, and perivascular localization of MS-1-positive cells suggest that MS-1 antibody recognizes an epitope expressed by cells previously referred to as dermal perivascular dendritic cells or dermal dendrocytes. We have proposed that MS-1 protein may serve as an anchoring molecule for endothelial cells in sinusoidal spaces in the absence of well-formed basement membranes. MS-1 may similarly function to maintain the spatial relationship of dermal perivascular dendritic cells with the microvasculature.

Antigen-Presenting Cells↗