Anti-platelet effects of chalcones from Angelica keiskei Koidzumi (Ashitaba) in vivo.

Angelica keiskei Koidzumi (Ashitaba) is a traditional folk medicine that is also regarded in Japan as a health food with potential antithrombotic properties. The ability of the major chalcones, xanthoangelol (XA) and 4-hydroxyderricin (4-HD) extracted from Ashitaba roots to inhibit platelet aggregation activity in vitro was recently determined. However, the anti-platelet activities of Ashitaba chalcones in vivo have remained unclear. The present study examines the anti-platelet effects of Ashitaba exudate and its constituent chalcones using mouse tail-bleeding models that reflect platelet aggregation in vivo. Ashitaba exudate and the major chalcone subtype XA, suppressed the lipopolysaccharide (LPS)-induced shortening of mouse tail bleeding. However, trace amounts of other Ashitaba chalcone subtypes including xanthoangelols B (XB), D (XD), E (XE) and F (XF) did not affect tail bleeding. These results suggest that the major chalcone subtype in Ashitaba, XA, has anti-platelet-activities in vivo.

Epidermodysplasia verruciformis accompanied by familial large granular lymphocytosis and a decrease in T lymphocytes.

A 40-year-old man with epidermodysplasia verruciformis showed a decrease in peripheral blood T cells and abnormal expansion of large granular lymphocytes, accompanied by increased natural killer cell activity. Surface marker analysis of his large granular lymphocytes demonstrated that the subset, CD 57+ and CD 16+, had increased. His father, who had no skin lesions of epidermodysplasia verruciformis, displayed similar blood changes and his brother showed a decrease in T cells and a slight increase in CD 16+ natural killer cells, whereas his mother revealed only a slight decrease in T cells. Our present study indicates that epidermodysplasia verruciformis might be associated with hereditary abnormal expansion of large granular lymphocytes and a decrease in T cells.

Contact sensitivity to Pityrosporum ovale in patients with atopic dermatitis.

Contact sensitivity and immediate hypersensitivity to extracts from Pityrosporum ovale were studied in patients with atopic dermatitis (AD). In a chamber-scarification patch test, 75 (64%) of 118 patients with AD responded positively, compared with 1 (3%) of 35 healthy volunteers. However, no significant statistical correlations were found between contact sensitivity to P ovale in patients with AD and any of the following factors: age, sex, distribution of skin lesions, presence of pruriginous papules, history of infantile seborrheic dermatitis, or concomitance of other atopic diseases. Lymphocyte transformation test with P ovale antigen confirmed that those with positive patch test reactions showed significantly high stimulation indexes. The antigenic substances divided by gel filtration high-performance liquid chromatography were found in a fraction of components with molecular weights above 60 kd. In addition, 25 (71%) of 35 patients with AD showed a positive immediate response to P ovale extract in a prick test, whereas none of 11 healthy volunteers showed any response. Although the incidence of the positive immediate responses was similar to that in contact sensitivity, there was no clear correlation between the delayed and immediate hypersensitivity reactions. Based on these results, we think that P ovale plays a role as an allergen derived from the host environment in the exacerbation of the skin lesions of AD.

A rapidly growing pigmented nail streak resulting in diffuse melanosis of the nail. A possible sign of subungual melanoma in situ.

Subungual melanomas are one of the most common types of malignant melanoma among the Japanese population. Although most pigmented nail streaks are benign and remain unchanged in their color and shape for a long time, rarely are they precursor lesions of subungual melanomas i.e., a rapid growing pigmented nail streak resulting in diffuse melanosis of the nail is thought to be an early stage of subungual melanoma in situ. We found four patients with these changes: three of these patients were children. The lesions occurred on the right index finger, right thumb, left middle finger, and right great toe, respectively. A slightly haphazard combination of colors ranging from dark brown to black, the important characteristic of subungual melanoma in situ, was observed in two cases. In the remaining two cases, although the haphazard combination of colors was not distinctive, many fine, dark longitudinal lines were seen within diffuse, light-brownish pigmentation. Serial histologic examination of the excised tissue specimens showed great proliferation of vacuolated melanocytes with variable nuclear atypicality along the entire basal layer in all cases. These histologic changes were compatible with those of atypical melanocytic hyperplasia or intraepidermal melanoma (in situ melanoma), which is an early lesion of subungual melanoma. An adult case is thought to be a definite example of a subungual melanoma in situ. We also made the diagnosis of melanoma in situ in the remaining three cases of children with rapidly growing pigmented nail streaks because their histopathologic features were distinguishable from those of the adult case. However, there remains some hesitation about this because invasive subungual melanoma is rare in children.

[A fatal case of pemphigus vulgaris with interstitial pneumonia occurring during gold therapy].

We report a case of a 52-year-old female with therapy-resistant pemphigus vulgaris. She was treated with prednisone, azathioprine and gold sodium thiomalate. After administration of a total dose of 110 mg gold sodium thiomalate, she suddenly developed pityriasis rose-like drug eruptions and interstitial pneumonia and died despite intensive care including pulse therapy. In Japan, there have been 8 reported cases of pemphigus or bullous pemphigoid that developed interstitial pneumonia during gold therapy. In these 7 cases, interstitial pneumonia occurred after administration of 110 to 430 mg gold sodium thiomalate, and 4 cases died. This rate of death is higher than those with other diseases: i.e., 9 dead cases among 99 cases of interstitial pneumonia developing in patients with rheumatoid arthritis or asthma under treatment with gold sodium thiomalate. We think that it is necessary to reevaluate the combined treatment of sodium thiomalate and other immunosuppressive drugs such as azathioprine in pemphigus, because we also found 2 other fatal cases among the 4 reported ones with interstitial pneumonia.

Intratumoral doxycycline for skin metastases of human malignancies.

As soon as its inducibility of lethality via prompt deprivation of heavy metals and HDL-cholesterol was born out, an intratumoral administration of doxycycline, an anti-prokaryotic agent, was undertaken in 7 patients presenting with skin metastases from a variety of malignancies. Complete remission of these lesions was attained in 6. The histological observation of elongated areas of acellularity along with central vessels appeared to suggest doxycycline-mediated cellular disintegration, resulting in empty tumor cords. Specific tumor selectivity of the treatment can be sustained by the intra- and/or peri-tumoral confinement of the agent. The technique may constitute a novel mode of cancer cell elimination.