Biomedical subjects
Publications and source records attributed to M Hiruma.
A 26-year-old man had a primary infection or reinfection of genital herpes due to herpes simplex virus (HSV) type 2 complicated with herpetic urethritis. By analysis of the restriction endonuclease digestion pattern of the viral DNA, two isolates, one from the penile lesion and one from the urethra, were identified as the same strain.
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We report a case of lymphocutaneous nocardiosis due to Nocardia brasiliensis, marked by multiple subcutaneous nodules and abscesses on the extensor aspect of the left forearm in a 53-year-old woman with systemic lupus erythematosus. Nine months before she was first examined, she had fallen on a concrete surface. A nodule had appeared 2 months later at the same site and had expanded and been followed by others, which finally covered most of the extensor aspect of the forearm. We speculated that the bacteria may have been conveyed retrogradely via the lymph vessels in a distal direction, perhaps as a result of the trauma and the subsequent development of an intradermal lesion.
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A case of chromomycosis in which hyperthermia proved effective is reported. The patient was a 56-year-old male bean curd maker who, without any previous history of minor trauma, developed on the extensor side of the left upper arm an eczematous lesion that underwent gradual radial expansion. The lesion showed a well-defined, 7 x 10 cm infiltrated erythematous plaque with the central area healed and, at the upper and lower borders, adherent scales and crusts on the surface. Histological examination revealed granulomatous changes in the dermis, as well as sclerotic cells within giant cells and microabscesses. On culturing, Fonsecaea pedrosoi was isolated. The patient was treated with disposable chemical pocket warmers, which were secured over the lesion with a rather tight elastic bandage, so that they kept the affected area warm for 24 hours a day. After a month of such hyperthermic treatment, the erythema and infiltration had decreased considerably, and microscopic examination and culture of the crusts both yielded negative results. Examination of biopsy specimens of the lesion after the third month showed that it had cicatrized. The treatment was stopped after 4 months, and no relapse occurred. We also summarize the published results of local hyperthermic treatment of chromomycosis in Japan.
The relationship of sun protection factor (SPF) to minimal erythema dose (MED), Japanese skin type, and skin color was investigated on the unexposed backs of 48 healthy subjects. SPF of a UVB-sunscreen was determined using sun lamps as a light source. A significant correlation was found between SPF and MED; subjects with lower MED showed higher SPF. The average SPF decreased with increasing skin type. There was no significant correlation between SPF and skin color (L*a*b* color system).
The relationship among minimal erythema dose (MED), minimal delayed tanning dose (MDTD), and skin color was examined in 16 healthy volunteers using three different spectra. The subjects were exposed to UVB, UVA+B, and UV+Visible light (UV+Visible) with a xenon arc solar simulator as a light source. The MEDs for UVB and UVA+B were less than the MDTDs, whereas the MED for UV+Visible was higher than the MDTD. There was no significant correlation between the MED and the MDTD for UVB or UVA+B. The MED for UV+Visible was significantly correlated to the MDTD (p < 0.01). Skin color significantly correlated with MEDs for UVB and UVA+B (p < 0.01), but not for UV+Visible. There was no significant correlation between skin color and the MDTD for any spectra. From these results, it is suggested that the relationship between erythemal and melanogenic responses is dependent on spectral bands of the light source and that skin color is a predictor of UV-induced erythema.
Early hepatic lesions in rats fed ethionine plus a choline deficient (ECD) diet were examined histopathologically. The purpose of this experiment was to examine preventive and suppressive effects of drugs on fatty or cirrhotic liver induced by ECD, but contrary to our expectations, all groups except the normal diet group showed neoplastic lesions in the liver. Macroscopically, milky-white nodules were seen in most all the rats except for a few dead ones. Microscopically, the characteristic lesions consisted of neoplastic nodules, glandular structures and oval cell hyperplasia. The glandular structures were already present in a rat that died on day 34 of administration and showed neoplastic developmental structures morphologically similar to cholangiofibroma. The neoplastic nodules appeared later than the glandules and were observed in rats that died after day 42. To the best of our knowledge, this is the first report of hepatic lesions consisting of mainly glandular structures induced by an ECD diet.
We report a case of localized cutaneous nocardiosis due to Nocardia asteroides, appearing on the anterior surface of the right forearm of a 29-year-old woman. Examination of the skin revealed a firm subcutaneous nodule measuring 32 x 20 mm and accompanied with a small ulcer. The histology of the lesion showed granulomatous changes interspersed with large numbers of polymorphonuclear leukocytes. On Gram staining, a few bacillary bodies were found scattered through the lesion, but no grains were detected. The classification of the clinical types of cutaneous nocardiosis is discussed, and the Japanese literature on localized cutaneous nocardiosis is examined.
Sun protection factors (SPFs) were evaluated with three light sources (sunlight, a xenon arc solar simulator, and fluorescent lamps) in indoor and outdoor studies. Two types of light, UV-A+B and UV+Visible, were obtained from the solar simulator. The untanned backs of twenty-four healthy male volunteers were used as test sites. A broad spectrum sunscreen containing SPF 6, according to the manufacturer, was used. The sunscreen tested was applied at 2 mg/cm2. The actual SPF values were 4.8 with sunlight, 6.0 with UV-A+B, 4.9 with UV+Visible, and 11.8 with fluorescent lamps. There were no significant differences between the SPF values with sunlight and those with the solar simulator; the SPF value for fluorescent lamps was significantly higher. The SPF with UV-A+B of the solar simulator was similar to that with sunlight; the use of this light served to reduce pain on tested subjects. Therefore, UV-A+B from the solar simulator seems to be the most appropriate artificial light source for evaluating sunscreens.
A 24-year-old married woman had an angiokeratoma of the vulva measuring 3 x 3 x 4 mm localized at the clitoris. The nodule was noticed when she was pregnant with her first child. This tumor grew with occasional tenderness and bleeding during pregnancy, but its size did not change after delivery. The growth of this tumor might be attributable to an increase in venous pressure or serum progesterone levels; therefore this disorder might be classified as a subtype of angiokeratoma of the vulva. This is the first case of angiokeratoma localized at the clitoris.
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Effects of dehydration on vasopressin-secreting cells (VP cells) of the supraoptic nucleus (SON) and the paraventricular nucleus (PVN) in the Mongolian gerbils were studied immunocytochemically and morphometrically. The plasma osmolality was measured at the time of sacrifice of individual animals and the body weight was measured every day during dehydration. The plasma osmolality increased significantly on day 3 of dehydration, followed by a gradual increase to reach nearly its equibilium state on day 10. The body weight decreased rapidly until day 10, followed by a gradual decrease thereafter. The area of VP cells increased significantly in both the SON and PVN on day 1 of dehydration, the level being nearly the same until days 3 to 5 and going up on day 7 to reach the plateau after day 15. These findings seem to reflect a compensation mechanism between the volume of body fluid and the plasma osmolality and to reflect responses of VP cells to the osmotic stimuli. Electron microscopic observation revealed that, at the beginning and late stages of dehydration, the increase in the area of VP cells was in parallel with the expansion of the Golgi area and with the distension of cisternae of the rough endoplasmic reticulum.
A 68-year-old Japanese male (Case 1) and a 59-year-old Japanese male immigrant to Brazil (Case 2) who suffered from subcutaneous eosinophilic lymphoid granuloma (Kimura's disease) of several years duration, developed nephrotic syndrome. Renal biopsy demonstrated membranous nephropathy in Case 1 and minimal-change lesion in Case 2. Both patients were treated with prednisolone for several months. There was complete remission of nephrotic syndrome in eight years in Case 1 and in three months in Case 2. Proteinuria did not reappear after remission of nephrotic syndrome in either case. In contrast subcutaneous tumors subsided in both cases during steroid treatment but again became active immediately following discontinuation of the drug. These clinical observations suggest that, though some common factor(s) might mediate the development of both skin and renal lesions, the mechanism of action on these two target organs may differ, perhaps serving only as a "trigger" for the initiating mechanism of renal disease.
A 34-year-old Japanese female with solar urticaria is described, who had an episode of urticarial response when she was exposed to indoor fluorescent light first and sunlight later. The action spectrum was found to range from 480 to 520 nm with an inhibition spectrum above 650 nm in the visible light by both postirradiation and preirradiation. Injection of in vitro-irradiated serum did not produce an urticarial wheal on the patient. In the Japanese literature, 17 cases of solar urticaria with inhibition spectra have been reported. The wavelength of the inhibition spectrum was longer than that of the action spectrum in each case.
A case of dermatophytosis showing a kerion celsi reaction in the eyebrow of a forty-seven-year-old woman is reported. The causative organism was Trichophyton rubrum. Direct mycologic examination revealed endothrix parasitism within the shafts of the infected hairs, and the trichophytin test gave positive results. Histologic examination of the lesion revealed marked inflammatory infiltration in the dermis, and numerous arthroconidia within the hair shafts. The symptoms disappeared almost entirely after oral treatment with itraconazole for three weeks. In view of the rarity of tinea of the eyebrow, some comments are appended.
A case of polymorphous light eruption with plaque-type lesions is reported. A 55-year-old male had pruritic erythemas and plaques on the head, the face, the nape, the back of the hands, and the left loin within days following sun exposure. The patient's minimal erythema dose (MED) (60 mJ/cm2) of sunlamp irradiation for ultraviolet (UV) B was normal. Three once-daily exposures to 2 MED of UVB (Epstein's repeat phototest technique) produced pruritic papules with a similar microscopic appearance to that of the patient's skin lesion, indicating that the action spectrum causing the lesion seemed to be within the UVB waveband.
We report the appearance of lymphocutaneous sporotrichosis on the left arm of a 28-year-old farmer's wife, followed two months later by the same type of lesion on the right upper eyelid of this patient's three-year-old child. According to the mother, the child was accustomed to sleeping with the right side of her face applied to the lesion on the mother's arm, and so it was presumed that the infection had been transmitted by direct contact from mother to child. Cases of person-to-person contagion of this disorder are thought to be extremely rare, but where there has been close contact on a daily basis, such contagion is likely to occur.