A case of generalized pustular psoriasis caused by hydroxychloroquine in a patient with systemic lupus erythematosus.

Hydroxychloroquine (HCQ) has been used to treat systemic lupus erythematosus (SLE) in Japan since 2015. We herein report a case of SLE that developed generalized pustular psoriasis (GPP) following the administration of HCQ. Twenty-one days after the HCQ treatment, a pustular rash with itching appeared on the auricle, scalp, and forearm, and spread rapidly to the face and body trunk with a high fever and arthralgia. Skin biopsy showed pustule formation under the cornified layer, neutrophil infiltration, the destruction of keratinocytes, and spongiform pustules of Kogoj. The patient was diagnosed with GPP. HCQ was immediately discontinued, the dose of prednisolone (PSL) was increased, and granulocyte and monocyte adsorption apheresis was performed. Her symptoms subsequently disappeared. Since arthralgia relapsed after the tapering of PSL, cyclosporine was added. Although single nucleotide polymorphisms (c.28C>T and c.115+6T>C) in the interleukin (IL)-36RN gene, which encodes the IL-36 receptor antagonist, have frequently been reported in GPP, these mutations were not observed in the present case. The potential development of GPP needs to be considered when administering HCQ to patients with SLE.

Protective effects of the calmodulin antagonist bepridil on ischaemia induced in the rat myocardium.

The effects of a block of the slow calcium channel by bepridil and its antagonising effects on calmodulin were determined in the ischaemic rat myocardium. When isolated rat hearts were treated with a cardioplegic solution containing bepridil or verapamil there was a significant diminution in ischaemic damage in the myocardium. Bepridil was more effective than verapamil in protecting against this ischaemic damage. Bepridil effectively inhibited the activation of calmodulin dependent enzymes, such as calcium calmodulin dependent cyclic nucleotide phosphodiesterase and myosin light chain kinase. The inhibitory effect of verapamil on these enzymes was weaker than that of bepridil. Since bepridil protects the myocardium and minimises ischaemia induced damage these events might be related to a calmodulin antagonistic action as well as a calcium channel blocking action.

Differential selectivity of endothelium-derived relaxing factor and nitric oxide in smooth muscle.

The selectivity of endothelium-derived relaxing factor (EDRF) and nitric oxide (NO) on smooth muscle relaxation was examined and compared. EDRF released from was examined and compared. EDRF released from bovine pulmonary arterial endothelium (BPAE) in culture and NO were superfused over vascular, tracheal, gastrointestinal and uterine smooth muscle. EDRF relaxed vascular smooth muscle but not tracheal, gastrointestinal or uterine smooth muscle. NO relaxed vascular and gastrointestinal smooth muscle but not tracheal or uterine smooth muscle. There was a differential selectivity between the relaxant effect of EDRF and NO on smooth muscle.

Preoperative evaluation and surgical treatment for tricuspid regurgitation associated with acquired valvular heart disease. The Kay-Boyd method vs the Carpentier-Edwards ring method.

This study compared the results of annuloplastic repair of tricuspid regurgitation (TR) using Doppler echocardiography. Sixty-three patients who underwent tricuspid annuloplasty were studied. Thirty-four patients received Kay-Boyd annuloplasty and 29 Carpentier-Edwards ring annuloplasty. A new classification of TR based on the direction and area of regurgitation flow on Doppler echocardiogram was applied preoperatively. In the Kay-Boyd group, 10 cases showed massive TR and 24 cases showed localized TR preoperatively. Localized TR was well controlled in all cases, but 8 of 9 cases of massive TR showed grade III residual TR. In the C-E group, 21 cases showed massive TR and 8 cases showed localized TR. All cases were well controlled postoperatively. We conclude that (1) although the Kay-Boyd method is acceptable for localized TR, the C-E method should be employed for massive TR; (2) analyzing the regurgitant pattern of TR by Doppler echocardiogram is useful in selecting an appropriate surgical technique.

Endometrial cytodiagnosis with the Uterobrush and Endocyte.

OBJECTIVE: To compare two endometrial cytologic sampling devices, the Uterobrush and Endocyte, for their clinical applicability. STUDY DESIGN: Specimen collection and comparison in 60 women. RESULTS: Collection of specimens with both devices succeeded in 100% of cases and was practically painless. The cells' appearance with the Endocyte tended to be dense. Nevertheless, the amount of cells collected with both devices was adequate for diagnosis except in a few cases. CONCLUSION: The Uterobrush method is simple and painless and therefore very acceptable to patients and suitable for clinical use.

Direct preparation of radioactive fullerenes as a tracer for applications.

The C60 and C70 fullerenes were irradiated by high-energy gamma-rays and charged particles. The irradiated samples were dissolved in CS2 and/or toluene and filtered to remove insoluble by-products. Finally, radioactive fullerenes and products labeled with 11C or 13N were isolated and detected in the liquid phase by radiochromatography. It was found that (1) not only 11C or 13N radioactive monomer fullerenes but also their dimers (trimers and, possibly, tetramers) were produced by recoil implantation process following nuclear reaction and (2) the radioactive fullerene labeled with 11C yields has led to high yields.

[Selective cerebral perfusion and pharmacological cerebral protection in the patients with aortic arch aneurysm].

We have developed the protocol for selective cerebral perfusion (SCP) and pharmacological cerebral protection, and used it successfully in cases of aortic arch aneurysm. The subjects of the present study were 34 patients (28 males, 6 females) whose aortic arch aneurysm were surgically treated. Preoperative brain CT and brain scintigram showed high incidence of brain ischemia. However only 4 patients experienced a neurological episode. We conclude that our SCP technique and pharmacological cerebral protection are useful component to surgery of the aortic arch.

[Human papillomavirus DNA in vulvar lesions].

In order to study the role of human papillomavirus (HPV) in genital cancer, we attempt to determine the presence of HPV in tumors of the genital tract. In the current study, we have examined 35 histologically diagnosed cases of vulvar lesions in attempts to compare the sensitivities of various methods of detecting HPV. All but 7 vulvar lesions contained HPV DNA by Southern blot DNA hybridization. Detectability of HPV by immunocytochemistry and koilocytosis significantly declined as compared to DNA hybridization. The detection of HPV DNA by in situ hybridization is discussed.

[Recent advances in EDRF research].

We have developed a new bioassay system for endothelium-derived relaxing factor (EDRF), using endothelial cells in culture. Bovine pulmonary arterial endothelial cells (BPAE) were grown on microcarrier beads and superfused in a cell column. The effluent was applied to bioassay tissues and biological and the chemical characters of EDRF were examined and compared with those of nitric oxide (NO). EDRF was vascular selective and negatively charged, whereas NO was a general relaxant and not charged. The hypothesis that EDRF is identical to NO is discussed. We also examined the interaction of some EDRF agonists with endothelial cells and biological characteristics of the agonists were discussed.

Statistical analysis of bilingual speaker's speech for cross-language voice conversion.

The goal of cross-language voice conversion is to preserve the speech characteristics of one speaker when that speaker's speech is translated and used to synthesize speech in another language. In this paper, two preliminary studies, i.e., a statistical analysis of spectrum differences in different languages and the first attempt at a cross-language voice conversion, are reported. Speech uttered by a bilingual speaker is analyzed to examine spectrum difference between English and Japanese. Experimental results are (1) the codebook size for mixed speech from English and Japanese should be almost twice the codebook size of either English or Japanese; (2) although many code vectors occurred in both English and Japanese, some have a tendency to predominate in one language or the other; (3) code vectors that predominantly occurred in English are contained in the phonemes /r/, /ae/, /f/, /s/, and code vectors that predominantly occurred in Japanese are contained in /i/, /u/, /N/; and (4) judged from listening tests, listeners cannot reliably indicate the distinction between English speech decoded by a Japanese codebook and English speech decoded by an English codebook. A voice conversion algorithm based on codebook mapping was applied to cross-language voice conversion, and its performance was somewhat less effective than for voice conversion in the same language.

Endothelium-derived relaxing factor is a selective relaxant of vascular smooth muscle.

The present study examines the relaxant selectivity of endothelium-derived relaxing factor (EDRF) released from cultured endothelial cells. Endothelial cells from bovine pulmonary artery (CCL-209) in culture were grown on Cytodex-3 microcarrier beads, packed into a column and superfused to release EDRF. EDRF response was estimated by its ability to relax phenylephrine-contracted rings of rabbit aorta. Bradykinin and A23187 (10(-10) to 10(-6) M) caused dose-dependent release of EDRF from cultured bovine pulmonary artery endothelial cells. The release was dependent on endothelial cell number. A23187 caused a larger and longer-lasting release of EDRF than bradykinin. EDRF relaxation was selective for blood vessels. EDRF relaxed rabbit aortic rings, but it did not relax histamine-contracted guinea pig tracheal, rabbit taenia coli strips or oxytocin-contracted guinea pig uterine rings. These nonvascular smooth muscles were, however, relaxed by isoproterenol (10(-4) M) and sodium nitroprusside (SNP, 10(-5) M). The sensitivity of guinea pig aortic rings and tracheal strips to SNP were compared. The IC50 values for SNP (10(-9) to 10(-5) M) were 0.07 and 0.3 microM for aortic rings and tracheal strips, respectively. Although the tracheal strips were about 4-fold less sensitive than the aorta toward SNP, a complete relaxation was achieved. These results suggest that EDRF relaxes vascular smooth muscles but not respiratory, Gl or reproductive smooth muscles. Thus, EDRF may be a selective relaxant of vascular smooth muscle.

[Ultrastructural observation of human papillomavirus particles in the uterine cervix intraepithelial neoplasia].

Using transmission electron microscopy (TEM), twenty two cases of an intraepithelial lesion in the uterine cervix have been examined for the presence of human papillomavirus (HPV) particles. In 21 of these cases (95%), HPV particles were detected in the nucleus, and in 5 cases, in the cytoplasm. The distribution of the intranuclear HPV particles was classified into 4 types. In only 2 cases did the exhibited particles show a geometrical crystalline array (type I). In most cases, the exhibited particles were either seen to show an aggregate non-crystalline array (type II) or were concentrated around the chromatin (type III). Some cases also were found to show particles that were scattered sporadically in the nucleoplasm (type IV).

Comparative pharmacology of endothelium-derived relaxing factor and nitric oxide.

The present study was designed to characterize endothelium-derived relaxing factor (EDRF) and nitric oxide (NO) by employing both biological and chemical methods. EDRF was released by the calcium ionophore A23187 from cultured bovine pulmonary artery endothelium (BPAE) grown on microcarrier beads and then superfused in a cell column. The maximum relaxations induced by EDRF (83%) or NO (79%) on phenylephrine (PE)-contracted rabbit aorta were similar. In contrast, EDRF was only half as potent as NO in relaxing the KCl-contracted rabbit aorta. EDRF induced a concentration-dependent relaxation of both PE-contracted rabbit aorta and histamine-contracted guinea pig aorta that was accompanied by a marked elevation in cyclic GMP levels. However, EDRF was vascular selective and did not relax or increase cyclic GMP levels of the histamine-contracted taenia coli of either species. NO was not vascular selective and relaxed both aorta and taenia coli and also markedly increased cyclic GMP levels in each. NO also relaxed dog femoral artery and gastrointestinal smooth muscle preparation of the lower esophageal sphincter, whereas EDRF only relaxed the femoral artery. Experiments were also performed describing the actions of a series of different resins: anion exchange resins (NH2/NH, AG-1), cation exchange resin (-COOH), reversed phase resin (C18) and hemoglobin-agarose on EDRF- or NO-induced relaxation. NH2/NH, AG-1 and hemoglobin-agarose resins inhibited EDRF-induced relaxation, but -COOH and C18 did not. The inhibition was dependent on the amount of resin employed. NO-induced relaxation was blocked only by hemoglobin-agarose but by none of the other resins.(ABSTRACT TRUNCATED AT 250 WORDS)