Outbreak of staphylococcal scalded skin syndrome evaluated by DNA fingerprinting.
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Biomedical subjects
Publications and source records attributed to N Ohtake.
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A 71-year-old Japanese woman had two dome-shaped tumors on her right buttock with several surrounding papules. Histological examination revealed that large anaplastic cells and atypical lymphoid cells densely infiltrated the entire dermis. On immunohistochemical examination, Ki-1, HLA-DR, CD25 (IL-2 receptor alpha), CD122 (IL-2 receptor beta), CD4, CD11c and CD68 were all positive in the tumor cells, whereas CD1a, CD3, CD5, CD8 and CD19 were negative. Neither rearrangement of the T-cell receptor beta, T-cell receptor gamma nor the immunoglobulin heavy-chain was seen. Ultrastructurally, most of the tumor cells contained thick bundles of intermediate filaments in the perinuclear cytoplasm. Thus, this patient was diagnosed as having Ki-1-positive lymphoma of non-T, non-B origin. No recurrence or metastasis of the tumor has been observed in the last 2 years, although surgical resection was required 3 times before control was achieved.
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A 6-year-old boy who had been diagnosed as having Wilms tumor at the prior hospital was admitted to our hospital for investigation of a right flank mass and macrohematuria in October 1990. Magnetic resonance imaging showed Wilms tumor of the right kidney extending into the inferior vena cava. Right radical nephrectomy, lymphadenectomy and thrombectomy were done on October 30th, 1990. Pathological findings indicated clear cell sarcoma of the kidney. One week after the operation, radiotherapy and chemotherapy with actinomycin D (ACTD), vincristine sulfate (VCR), doxorubicin hydrochloride (DXR) and cyclophosphamide (CPM)) were started according to the protocol by National Wilms Tumor Study (NWTS) III. However, he died of bone metastases and pneumomycosis on October 13th, 1992. Clear cell sarcoma of the kidney (CCSK) is a rare tumor accounting for about 4-5% of Wilms tumors. This is the first report on CCSK with tumor thrombus in Japan.
A case-control study was conducted on 303 male bladder cancer patients and controls. General population controls were chosen from 15 areas in Gunma Prefecture and were matched by age (+/- l y.o.) to the subjects. Age-adjusted and smoking-adjusted odds ratio (O.R.) and a 95% confidence interval (C.I.) were calculated for each item. Risk factors for bladder cancer in men were investigated. The O.R. tended to be significantly higher for those who had history of smoking, who smoked more per day, who had smoked longer, whose Brinkman index was higher, who began smoking younger and who inhaled deeper than it was for non-smokers. O.R.s of having a past history or complication of cystitis (age-adjusted) and benign prostatic hypertrophy (age- and smoking-adjusted) were significantly higher, but the difference was supposed to be caused by bias. There was a significantly lower age- and smoking-adjusted O.R. for bladder cancer in men who engaged in sales, whose blood type was O, who drank milk frequently, who ate grains frequently, who age vegetables frequently and who had a past history or complication of hypertension. The number of cases and controls with first degree family members who developed cancer respectively supposed to be highly related to smoking, were as follows; 16 and 8 for lung cancer, 3 and 0 for larynx cancer and 6 and 3 for bladder cancer. The following characteristics failed to show any significant difference between subjects with bladder cancer and the control group; height and weight now and 20 years ago, jobs which deal with dye, academic career, marriage, number of children, alcohol drinking and the use of hair dye or analgesics.
We examined the serum soluble IL-2 receptor and eosinophil cationic protein levels in patients with atopic dermatitis (n = 21), patients with urticaria (n = 12), and normal healthy individuals (n = 14). We found that both soluble IL-2 receptor levels and eosinophil cationic protein levels were significantly higher in atopic dermatitis than in urticaria or normal controls. Although both soluble IL-2 receptor levels and eosinophil cationic protein levels were significantly correlated with clinical severity scores in atopic dermatitis, the correlation between eosinophil cationic protein levels and clinical severity scores was higher than that between soluble IL-2 receptor levels and clinical severity scores. However, soluble IL-2 receptor levels, eosinophil cationic protein levels and clinical severity scores were not significantly correlated with IgE levels. The chronological changes of soluble IL-2 receptor and eosinophil cationic protein levels differ from patient to patient. However, levels of soluble IL-2 receptor and eosinophil cationic protein seem to parallel to each other in 65% of patients with AD. Measurement of serum eosinophil cationic protein or soluble IL-2 receptor levels may be a useful tool to monitor the short-term or long-term disease activity of atopic dermatitis in conjunction with clinical severity scores.
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A 48-year-old Japanese man had miliary calcified papules on the distal fingers after long-term hemodialysis. The crystals in the dermis consisted of calcium oxalate, as revealed by light microscopy and scanning electron microscopy with energy-dispersive x-ray microanalysis. The calcium oxalate was in the form of a dihydrate crystal. Therefore a diagnosis of secondary cutaneous oxalosis was made. In cutaneous oxalosis that occurs as a result of hemodialysis, miliary deposits occur in the fingers, but not the toes, and are present more frequently on the palmar aspects of the fingers. This localization may result from local differences in the metabolism or concentration of calcium or oxalate, or changes in the blood circulation.
We report a Japanese case of Darier's disease with brown and white papules or maculae distributed on the neck, trunk and dorsa of hands. Both brown papules and leukoderma showed typical histological features of Darier's disease. Moreover, there were much fewer melanocytes and melanosomes in the epidermis of both lesions. The corneal layer of the brown papules was far thicker than that of the leukoderma. Therefore, the thick corneal layer of the brown papules may prolong the retention of a few melanosomes or a little melanin to induce hyperpigmentation, while the thin corneal layer of leukoderma may not do so, thereby producing hypopigmentation. The difference in clinical and histological courses after involvement of melanocytes was proposed to be the cause of the discrepancy between the previous reports. We conclude that leukoderma was the primary lesion, the postinflammatory depigmented spots, or the atypical or subclinical eruption of Darier's disease.
To improve the taste profile of glycyrrhizin (1, the saponin of licorice root, relative sweetness to sucrose: x170), a variety of 3-O-glycosides of glycyrrhetic acid were prepared and their sweetness evaluated. It was found that a significant enhancement of sweetness was observed for the 3-O-beta-D-xyloside and the 3-O-beta-D-glucuronide (MGGR). Especially, MGGR had a high sweetness relative to sucrose; x941, and would appear to be a new potent sweetener.
In 14 patients from which methicillin-resistant Staphylococcus aureus (MRSA) was isolated at the Department of Urology, Tone Chuo Hospital June, 1992 and October, 1993, the site of infection, background of patients, and drug resistance were analyzed. The 14 patients consisted of 11 males and 3 females between 45 and 85 years old with a mean of 71.6 years. The site from which MRSA was isolated was urine in 11, wound in 2, nasal cavity in 1, pharynx in 1, and renal fistula in 1 (detected at 2 or more sites in 2). The underlying condition was prostate hyperplasia in 2, prostate cancer in 4 (after radical prostatectomy in 1, complicated by bladder stone in 1), bladder tumor in 3, (during bladder instillation of BCG in 1), perirenal abscess in 2, renal pelvic tumor in 1, neurogenic bladder in 1, and after Boari's operation in 1. Urethral catheterization had been performed in 3. A fewer of 38 degrees C or above was noted in 3. Mixed infection was observed in 10, and was caused by Escherichia coli in 2, Proteus mirabiris in 1, Candida in 1, Klebsiella in 2, Pseudomonas aeruginosa in 2, and Serratia in 2. Four patients has previously been administered antibiotics, which were third generation cephems in 3 and penicillin in 1. The drug sensitivity was 100% for vancomycin (VCM), 30% for imipenam (IMP), 31% for minomycin (MINO), 31% for amikacin (AMK), and 7% for fosfomycin (FOM). As for chemotherapy, VCM+FOM+sulbactam/cefoperazone were administered to 6, and ceftazidime+ MINO were administered to 1.(ABSTRACT TRUNCATED AT 250 WORDS)
A 42-year-old female with a history of systemic lupus erythematosus (SLE) visited the Department of Internal Medicine at our hospital complaining of anorexia. Hydronephrosis was diagnosed, and she was referred to our department for further evaluation. Intravenous pyelography (IVP) revealed bilateral hydronephrosis and hydroureters. Computerized tomography (CT) showed retention of ascitic fluid and thickening of the intestinal and bladder walls with contrast effects in the serosa and mucosa. Lasix-loaded renography showed that both kidneys were normal. Examination of a biopsy specimen revealed interstitial edema, fibrosis, and infiltration of inflammatory cells. Cystometry showed normal intravesical pressure. A diagnosis of lupus cystitis was made and administration of 40mg of prednisolone was started. The anemia was ameliorated, and thickening of the bladder and intestinal walls was no longer seen on CT. Hydronephrosis of the left kidney was less prominent. However, aggravation of the right ureteral stenosis was noted, and a stent was inserted in the stenosed ureter. Stenosis was successfully relieved by the stent, and internal drainage was established. The patient is still receiving steroids and is being followed at our department. Twenty-two reported cases of lupus cystitis in Japan are reviewed.
A 78-year-old man visited our hospital complaining of pollakisuria, dysuria, and edema of lower extremities. Physical examination revealed a hard, fixed and fist size mass in the abdomen Lymph nodes of left supraclavicular fossa were hardly palpable. His prostate was larger than a hen's egg, stony hard and fixed in the pelvis on digital rectal examination (DRE). The prostate specific antigen (PSA) level was elevated to 584 ng/ml. Computerized tomography (CT) revealed enlarged retroperitoneal lymph nodes. Bone scan showed multiple abnormal uptake. Prostate biopsy showed poorly differentiated adenocarcinoma. Treatment with the LH-RH analogue was very effective. The retroperitoneal lymph nodes were no longer enlarged on CT. The prostate had become soft and was reduced to walnut size on DRE. The PSA level had decreased to within the normal range. The multiple abnormal uptake on the bone scan decreased. This is the 21st case of prostate cancer with large lymph node metastasis in Japan.
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