Biomedical subjects
Publications and source records attributed to O Yamamoto.
In work in which women predominate, the highest rate of the occupational contact dermatitis is seen among hairdressers and medical nursing staffs. Twelve such cases are presented and several points regarding the diagnosis and treatments are discussed. The patients were five hairdressers, two dental technicians, two nurses and three woman divers. A patch test was useful in identifying the allergens or irritants in most cases.
Cadmium is toxic and carcinogenic to humans and animals. The testis and lung are the target organs for cadmium carcinogenesis. Heat shock proteins (HSPs) as well as metallothionein (MT) and glutathione (GSH) play an important role in protection against its toxicity. HSP32, also known as heme oxygenase-1, is a 32-kDa protein induced by heme, heavy metals, oxidative stresses, and heat. We investigated expression of the Hsp32 gene of various organs (the liver, lung, heart, stomach, kidney, and testis) in transgenic mice deficient in the MT-I and -II genes (MT-KO) and in control mice (MT-W) after an injection of cadmium chloride (CdCl2). Survival of MT-W mice after a subcutaneously injection of CdCl2 was higher than that of MT-KO mice, while no significant difference was observed in the level of GSH in each organ between MT-W and MT-KO mice. Northern blot analysis showed that the MT-I mRNA was more extensively induced in the liver, kidney, and heart than other organs 6 h after an injection of CdCl2 (30 micromol/kg body wt, sc). There was little increase of the MT-I mRNA in the testis when induced by CdCl2. Expression of the Hsp32 gene in the liver and kidney in response to CdCl2 was more extensively augmented in MT-KO mice than in MT-W mice. In the lung and testis, there was little induction and no augmentation in expression of the Hsp32 gene induced by CdCl2 in both MT-W and MT-KO mice. In the stomach, there was little induction of the Hsp32 mRNA in MT-W mice, but was increased in MT-KO mice. Immunohistochemical staining revealed that the HSP32 protein was strongly expressed in the kidney and liver of MT-W mice 24 h after an injection of CdCl2 (20 micromol/kg body wt, sc), while the expression of HSP32 protein was not increased in the testis. In metabolically active organs such as the liver and kidney, expression of the Hsp32 gene as well as the MT-I gene was extensively induced by cadmium in MT-W mice, and more eminently induced in MT-KO mice. We suggest that organs of low stress response to cadmium such as the testis and lung may be vulnerable target sites for cadmium toxicity and carcinogenesis.
We report 7 cases of radiation-induced skin cancer. The diagnosis was based on the history of radiotherapy for benign skin diseases (5 cases) and of occupational exposures to medical doctors (2 cases). All cases were squamous cell carcinomas which arose from chronic radiodermatitis. The estimated latent period of these tumors ranged from 6 to 64 years, with an average of 29.9 years. After surgical treatments of the lesions, no local recurrences were observed in all cases. Benign skin diseases had sometimes been treated with low-energy radiation before the 1960s. Considering the estimated latent period, the peak time point of developing risk of radiation-induced skin cancer by such treatment has been already passed, however, the danger of it should not be ignored in future. In association with multiplicity of radiation usage, occupational exposure of radiation may develop the risk of occurrence of skin cancer in future. Therefore, we should recognize that radiation-induced skin cancer is not in the past. In the cases of chronic skin diseases showing warty keratotic growth, erosion and ulcer, we should include chronic radio-dermatitis in the differential diagnosis. It is necessary to recall all patients about the history of radiotherapy or radiation exposure. Rapid histopathological examination is mandatory because of the suspicion of radiation-induced skin cancer.
We report here 9 patients suffering from hydrofluoric acid burn who visited our clinic from July, 1979 to February, 2000. These 9 cases occupied 25% of all chemical burn cases experienced in our clinic. All the patients were men ranging in age from 20 to 53 (mean age 35 years; average 36.8 years). At the time of accidental exposures, 6 patients had been engaged in washing or cleaning work, and 2 had been changing the parts of instruments containing hydrofluoric acid. Eight patients received burns on the hands and/or fingers. During the work, 2 patients had used vinyl chloride or rubber gloves, but three patients employed no protection for the hands. After the symptoms began to develop, it was found that the glove of one patient had a pin hole. Coupled with the occasions described in previous reports, the causal factors of hydrofluoric acid burn could be divided as follows: 1) negligence or carelessness of workers, in particular skilled persons, in handling hydrofluoric acid, 2) ignorance of the dangerousness of hydrofluoric acid, 3) the presence of pin hole (s) in protection gloves, and 4) unexpected accident. Hydrofluoric acid is one of the most corrosive inorganic acids, and can produce progressive and serious tissue necrosis with severe pain. To prevent burns due to this chemical, enlightenment and reeducation of the workers regarding the hazard of hydrofluoric acid are necessary.
A 36-year-old man, working in a chemical industry, had a generalized pruritic eruption. A forty-eight hour patch test revealed positivity for 1% hydroxylamine. Prevention of exposure to this chemical resulted in a dramatic improvement of the symptoms. Based on these findings, we diagnosed this case as occupational contact dermatitis due to hydroxylamine. There has been few case reports of contact dermatitis due to hydroxylamine. Histopathological examination revealed a marked spongiosis and a spongiotic bulla formation in the epidermis and follicular infundibulum, suggesting an allergic reaction.
A 79-year-old Japanese man visited our clinic for evaluation of a large tumor on the left wrist and multiple keratotic tumors. He had handled creosote oil, which is a purified product of coal tar production, for 50 years. Physical examinations revealed poikiloderma with multiple hyperkeratotic tumors on the back of his hand and forearm bilaterally, and a cauliflower-like tumor, 80 x 60 x 15 mm in size, on the left wrist. Histopathologically, the large tumor showed a proliferation of atypical squamoid cells with many keratinization foci, indicating well-differentiated squamous cell carcinoma.
Acute toxicity of bis (tributyltin) oxide in the sweat glands in the rat footpad was investigated by electron microscopy and an energy-dispersive X-ray microanalyzer. Male Wistar rats received an intramuscular injection of 0.5 ml/kg bis (tributyltin) oxide. After 6-8 h, swelling of mitochondria appeared in the secretory cells of the sweat glands. After 12 h, the secretory cells began to show intracytoplasmic edema. After 16-20 h, secretory cells in some sweat glands showed marked hydropic degeneration with swollen cytoplasm. Using X-ray microanalysis, tin peaks were preferentially obtained from the swollen mitochondria of the affected secretory cells. Mitochondria dysfunction due to the toxic effects of bis (tributyltin) oxide induced changes in the secretory cells of rat sweat glands. After 24-48 h, the secretory portion of the sweat glands contained three types of cells: degenerating dark cells, regenerating cells carrying injured mitochondria, and light cells which were morphologically very similar to the cells in the transitional portion of the sweat gland. These light cells appeared to differentiate into active secretory cells after settling down in the secretory portion. Based on these observations, we concluded that the cells in the transitional portion could play an important role at least as reserve cells against secretory cell toxicity. In association with the regenerating process of the damaged secretory portions, increased mitotic activities were seen in different areas of all the dermal sweat ducts. The above-mentioned morphological observations for cell damage and subsequent regeneration and renewal ofsecretory cells in sweat gland intoxication have not been reported so far.
Methyl bromide was experimentally exposed to a 12 cm2 area of the back skin of Wistar rats for 30 s, and for 1, 3, and 5 min, and time courses of both changes in plasma bromide concentration and of histopathological changes were examined. To measure bromide ion, a head space gas chromatography was used. The concentration of plasma bromide ion showed a sharp increase immediately after the exposure in all exposed groups, reaching a peak level after 1 h, then decreased rapidly. The ion level gradually decreased after 72 h to 1 week, and returned to a normal level after 4 to 8 weeks. Calculating from a regressive curve, the biological half lives of plasma bromide ion were 5.0 days to 6.5 days. Histopathologically, the impairments to the epidermal cells, fibroblasts and blood vessels were observed in the early phase. These cellular changes could be due to the direct cytotoxicity of the compound. In the next phase, newly infiltrating cells showed degeneration and necrosis. Subsequently, an impairment of the collagen bundles was observed. Our experiments suggested an immediate permeation and rapid metabolization of methyl bromide in the skin and a multistep formation of the skin damage induced by the compound. These processes of methyl bromide-induced skin damage are quite different from chemical skin injuries caused by the representative causative agents such as alkaline and acid.
BACKGROUND: There are no immunohistochemical studies on cytokeratin (CK) expression in large series of cases of apocrine poroma. In addition, detailed immunohistochemical analysis of cuticular cells, a specific type of constituent cells of poromas, has not been reported. METHODS: Using the avidin-biotin method, we compared immunostaining patterns of eleven different anti-CK antibodies in 12 cases of apocrine and 21 cases of eccrine poromas, and normal adult skin. RESULTS: Poroid cells were exclusively positive for CK1/5/10/14, CK5/8 and CK14, which were expressed in the outer cells of normal dermal sweat ducts. Poroid cells were heterogeneously stained with anti-CK7, CK8/18, CK 10/11 and CK19 antibodies, which reacted in the inner cells of dermal ducts and in the secretory cells of sweat glands. The cuticular cells showed constant expression of CK1/5/ 10/14 and CK10/11, and various expression patterns of CK5/8, CK6, CK7, CK14, CK8/18, CK17, and CK19. CONCLUSIONS: Based on the keratin immunohistochemistry, the neoplastic cells in eccrine and apocrine poromas are considered to be closely related to the cells of dermal sweat ducts. Also the cuticular cells are considered to occupy an intermediate spectrum between the inner and outer cells of the dermal ducts. Although it is difficult to differentiate apocrine poroma from eccrine poroma by keratin expression patterns alone, the data obtained here can be helpful in differentiation of apocrine poroma from other hair follicle-related neoplasms.
BACKGROUND: Since the first description by Hashimoto et al., there have been only a few case reports of rippled-pattern tricogenic tumor. In addition, there are no reports on detailed immunohistochemical analyses of this rare neoplasm. We describe here an additional case of rippled-pattern trichogenic tumor with a special reference to its immunohistochemical features. METHODS: A nodule arising on the occipital area of a 62-year-old Japanese woman was histologically and immunohistochemically investigated. RESULTS: Histopathologically, the lesion contained various-sized lobular nests, which consisted of oval to elliptical shaped basaloid cells without any atypia and were embedded in the collagenous stroma. Some elongated basaloid cells were arranged in a palisading fashion forming parallel rows of epithelial ribbons in a rippled-pattern. Cytokeratin (CK) immunohistochemistry showed constant expressions of CK1/5/ 10/14, CK5/8, CK14 and CK7, and focal expressions of CK17 and CK19 in the basaloid cells, suggesting a keratin phenotypical similarity to the cells in small nodular type trichoblastoma. CONCLUSIONS: The present tumor is a variant of trichoblastoma, and considered to be in close association with the outer root sheath and/ or follicular germinative cells.
We studied the effect of alpha-2 adrenoceptor antagonists on colonic function stimulated by water-avoidance stress, 5-hydroxytryptamine (5-HT), bethanechol and castor oil by comparison with the effects of atropine and a 5-hydroxytryptamine 3 (5-HT3) receptor antagonist, ondansetron. Yohimbine, idazoxan and atropine, but not ondansetron, significantly inhibited water-avoidance stress-stimulated faecal excretion. Yohimbine and idazoxan inhibited neither 5-HT- nor bethanechol-stimulated faecal excretion. In contrast, atropine inhibited both 5-HT- and bethanechol-stimulated faecal excretion and ondansetron inhibited 5-HT-stimulated faecal excretion. Yohimbine did not inhibit the incidence of diarrhoea induced by castor oil, but idazoxan significantly inhibited diarrhoea observed during a 1-h period after the administration of castor oil. Both atropine and ondansetron inhibited diarrhoea during a 2-h period after the administration of castor oil. These findings suggest that alpha-2 adrenoceptor antagonists specifically inhibit colonic motor function stimulated by stress in rats.
We report a case of toxic epidermal necrolysis-type drug eruption. A 23-year-old man took an oral over-the-counter preparation for the common cold. A few days later, generalized erythema developed with systemic malaise and pain. A multiple blister formation followed, and Nikolsky's sign was noted on each blister. A lymphocyte stimulation test (LST) with the patient's peripheral lymphocytes strongly suggested that the eruption was attributable to lysozyme chloride which was included in the preparation taken. Following an intravenous drip of betamethasone for two weeks, the eruptions improved favorably.
Among the several forms of Langerhans cell histocytosis (LCH), Letterer-Siwe disease is the most acute disseminated multisystemic variant. The course of Letterer-Siwe disease is usually rapid and fatal. We report here a cases of Letterer-Siwe disease which showed a good response to chemotherapy. We also describe the unusual ultrastructural findings in the histiocyte-like cells in this case.
Hydrogen peroxide is widely used in products such as rocket fuel, bleaching preparations and topical disinfectants. Contact of hydrogen peroxide with the skin can cause severe skin damage. In this report, we describe a case of skin injury induced by hydrogen peroxide. The patient was a 34-year-old man working in a dry cleaning shop. While he was pouring 35% hydrogen peroxide, some of it accidentally splashed over his left shoulder and back, and then an erythema, purpura and vacuolar eruption, similar to bubble wrap, appeared on his left shoulder and down the left side of his back. Histologically, numerous vacuolar structures were observed in the epidermis, dermis and subcutaneous tissue. Coupled with the clinical features, these vacuolar structures were considered as 'oxygen bubbles'. Subcutaneous emphysema was detected by chest X-ray examination. All skin eruptions rapidly healed without scarring by using a steroid ointment. As far as we know, this is the first time such clinical and histological features have been described
Rubrobacter radiotolerans is an extremely radioresistant bacterium. It exhibits higher resistance than the well-known radioresistant bacterium Deinococcus radiodurans, but the molecular mechanisms responsible for the radio-resistance of R. radiotolerans remain unknown. In the present study, we have demonstrated the presence of a novel DNA repair enzyme in R. radiotolerans cells that recognizes radiation-induced DNA damages such as thymine glycol, urea residues, and abasic sites. The enzyme was purified from the crude cell extract by a series of chromatography to an apparent physical homogeneity. The purified enzyme showed a single band with a molecular mass of approximately 40 kDa in SDS-polyacrylamide gel electrophoresis, and was designated as R-endonuclease. R-Endonuclease exhibited repair activity for thymine glycol, urea residues, and abasic sites present in plasmid DNA, but did not act on intact DNA, UV-irradiated DNA and DNA containing reduced abasic sites. The substrate specificity together with the salt and pH optima suggests that R-endonuclease is a functional homolog of endonuclease III of Escherichia coli.
BACKGROUND: There are few studies regarding the time-dependent effectiveness of topical calcium gluconate treatment for the experimental hydrofluoric acid (HF) burn. METHODS: For producing a HF-burn, a drop of 46% or 23% HF solution was put on the back of rats for 3 minutes followed by washing with tap water. Calcium gluconate jelly or ointment was then applied to the burn area at various time intervals. The ointment was applied once a day thereafter. RESULTS: The topical calcium gluconate treatment was much more effective if the application was started within 3 hours. On the other hand, if the application was started after 6 hours or more, there was no difference between the groups and the non-treatment groups. CONCLUSIONS: It is suggested that practitioners should be ready to prepare quickly the calcium gluconate ointment to treat a HF burn, since the calcium gluconate ointment is not commercially available in Japan.
A 70-year-old man, who had sustained ventricular tachycardias following a previous anterior myocardial infarction, suffered from skin eruptions and abnormal blood tests after 10 days following the oral administration of 1500 mg/day of procainamide. These abnormalities disappeared early after the discontinuation of oral procainamide. However, similar skin eruptions exhibited again when the procainamide was resumed. These results suggest that oral procainamide therapy induces skin eruptions and serious abnormal blood tests in the patient. No reports have suggested such a serious early complication by procainamide therapy. Careful follow-up is needed after the administration of oral procainamide therapy.
Classical trichoblastic fibroma or small nodular type trichoblastoma (Ackerman) is a rare tumour. This tumour, trichoepithelioma and basal cell carcinoma (BCC) have some overlapping histopathological features. There are only a few reports on immunohistochemical studies in large series of these three neoplasms. We investigated immunostaining patterns of 10 different anticytokeratin (CK) antibodies and several other markers in these neoplasms, comparing them with the patterns in normal adult and fetal skin. In trichoblastic fibroma (three cases), CK1/5/10/14, CK7, CK8/18, CK10/11, CK14, CK17 and CK19 were expressed in the basaloid nests, and CK6 and involucrin were detected in the inner layers of keratinous cysts. Trichoepithelioma (seven cases) expressed CK1/5/10/14, CK8/18, CK14, CK17 and CK19 in the basaloid nests, and CK6, CK10, CK10/11 and involucrin were positive in the keratinous cysts. However, no CK7 expression was observed. Solid and keratotic types of BCC (29 cases) expressed CK1/5/10/14, CK7, CK8/18, CK14, CK17 and CK19 in the basaloid nests. The keratinous cysts in BCC were stained with anti-CK6, CK10, CK10/11 and involucrin antibodies. Coupled with the expression of CK8/18, CK17 and CK19 in the outer root sheath of the adult hair follicle, these three neoplasms shared a keratin phenotype characteristic of the outer root sheath. Judging from our immunohistochemical results, trichoblastic fibroma and BCC cannot be differentiated by their patterns of CK expression. The expression of CK7, which is noted in fetal hair follicles, trichoblastic fibroma and BCC, suggests the presence of subpopulations that retain fetal phenotypic characteristics in these two neoplasms. Although the current concept regards trichoepithelioma and trichoblastic fibroma as a single tumour group, the lack of CK7 expression in trichoepithelioma supports the notion that the two are different.