Near-threshold Lambda(1520) production by the gamma(p)-->K{+}Lambda(1520) reaction at forward K+ angles.

Differential cross sections and photon-beam asymmetries for the gamma(p)-->K{+}Lambda(1520) reaction have been measured with linearly polarized photon beams at energies from the threshold to 2.4 GeV at 0.6or=5/2 or by a new reaction process, for example, an interference effect with the phi photoproduction having a similar bump structure in the cross sections.

Spiny keratoderma: a common under-reported dermatosis.

Spiny keratoderma is a dermatosis consisting of multiple projections located on the palms and soles, with a distinct histology characteristic of a parakeratotic column above a hypogranular epidermis. We report six cases discovered within a year and review the present literature on spiny keratoderma. The average age of the patients was 57 years. Fifty-seven percent of the patients were male and forty-three percent were female. The duration of lesions ranged from 4 months to 40 years. Symptoms were variable, however, lesions were often unnoticed by the patient. The location of the lesions involved the palms and soles or the palms alone. Past medical history was significant for hypertension and hyperlipidemia treated with HMG-CoA reductase inhibitors. Lesions often occurred in patients involved in manual labor. Spiny keratoderma is a relatively common under-reported dermatosis found most often in older patients with history of manual labor and is possibly related to treatment with HMG-CoA reductase inhibitors.

Cross sections and beam asymmetry for K;{+}Sigma;{*-} photoproduction from the deuteron at E_{gamma}=1.5-2.4 GeV.

The Sigma(1385) resonance, or Sigma;{*}, is well known as part of the standard baryon decuplet with spin J=3/2. Measurements of the reaction gammap-->K;{+}Sigma;{*0} are difficult to extract due to overlap with the nearby Lambda(1405) resonance. However, the reaction gamman-->K;{+}Sigma;{*-} has no overlap with the Lambda(1405) due to its charge. Here we report the first measurement of cross sections and beam asymmetries for photoproduction of the Sigma;{*-} from a deuteron target. The cross sections at forward angles range from 0.4 to 1.2 mub, with a broad maximum near E_{gamma} approximately 1.8 GeV. The beam asymmetries are negative, in contrast with positive values for the gamman-->K;{+}Sigma;{-} reaction.

Near-threshold photoproduction of Lambda(1520) from protons and deuterons.

Photoproduction of Lambda(1520) with liquid hydrogen and deuterium targets was examined at photon energies below 2.4 GeV in the SPring-8 LEPS experiment. For the first time, the differential cross sections were measured at low energies and with a deuterium target. A large asymmetry of the production cross sections from protons and neutrons was observed at backward K+/0 angles. This suggests the importance of the contact term, which coexists with t-channel K exchange under gauge invariance. This interpretation was compatible with the differential cross sections, decay asymmetry, and photon beam asymmetry measured in the production from protons at forward K+ angles.

Differential cross section and photon-beam asymmetry for the gamma n --> K+ Sigma- reaction at E gamma = 1.5-2.4 GeV.

Differential cross sections and photon-beam asymmetries have been measured for the gamma n --> K+ Sigma- and gamma p --> K+Sigma0 reactions separately using liquid deuterium and hydrogen targets with incident linearly polarized photon beams of E gamma = 1.5-2.4 GeV at 0.6 < cos ThetacmK< 1. The cross section ratio of sigma K+ Sigma-/sigma K+ Sigma0, expected to be 2 on the basis of the isospin 1/2 exchange, is found to be close to 1. For the K+ Sigma- reaction, large positive asymmetries are observed, indicating the dominance of K* exchange. The large difference between the asymmetries for the K+ Sigma- and K+ Sigma0 reactions cannot be explained by simple theoretical considerations based on Regge model calculations.

Near-threshold diffractive psi-meson photoproduction from the proton.

Photoproduction of a phi meson on protons was studied by means of linearly polarized photons at forward angles in the low-energy region from threshold to Egamma = 2.37 GeV. The differential cross sections at t = -|t|min do not increase smoothly as Egamma increases but show a local maximum at around 2.0 GeV. The angular distributions demonstrate that phi mesons are photoproduced predominantly by helicity-conserving processes, and the local maximum is not likely due to unnatural-parity processes.

Functional involvement of urokinase-type plasminogen activator receptor in pemphigus acantholysis.

Urokinase-type plasminogen activator (uPA) has been well documented in the development of pemphigus acantholysis. The function of its receptor (uPA-R) in pemphigus acantholysis has only recently attracted attention. Increased expression of uPA-R has been demonstrated in pemphigus vulgaris. In this study, we have further explored the functional involvement of uPA-R in pemphigus acantholysis. Our results show that uPA-R expression is significantly increased in acantholytic foci of pemphigus vulgaris and pemphigus foliaceus but not in bullous pemphigoid or normal skin specimens; the expression of uPA-R in cultured human keratinocytes is subjected to regulation by pemphigus vulgaris IgG but not by pemphigoid IgG or normal human IgG; furthermore, anti-uPA-R monoclonal antibody effectively inhibits pemphigus vulgaris IgG induced acantholysis in skin organ cultures. These data suggest that uPA-R may play an important role in the pathogenesis of pemphigus acantholysis.

Infra-auricular fissures in atopic dermatitis.

Retro-auricular or auricular dermatitis in atopic dermatitis (AD) is common and important for the diagnosis of AD in infancy and even in adulthood. Particularly, "infra-auricular fissures", acute eczematous changes like fissures at the adhesive junction of ear lobes, seem to be prominent features for the diagnosis of AD. Of 137 patients with AD, 81.8% showed present or past existence of infra-auricular fissures, but only one of the 30 controls. Of the 46 patients with severe AD, 98% had infra-auricular fissures, compared to 74% in those with moderate and mild AD. Our findings suggest that infra-auricular fissures are important for the diagnosis of AD and should be cited in a list of criteria for the diagnosis of AD.

Spiny keratoderma--a demonstration of hair keratin and hair type keratinization.

Six cases of spiny keratoderma were analyzed with hair specific antikeratin antibodies (AE13, AE14) and by electron microscopy. The keratotic column exhibited a different keratin birefringence and the underlying viable epidermis was less eosinophilic than the surrounding epidermis. AE13, which is specific for hair cortex, was positive in the lower column and variably positive in the viable epidermis, often beyond the columnar lesion. AE14 was negative in the lesion. Electron microscopy demonstrated features of keratinization of normal hair cortex, i.e. by the accretion of keratin filaments without production of keratohyalin or trichohyalin granules. Cementsomes (lamellar granules) and marginal bands were not produced as they are not formed in normal cortical keratinization. It was suggested that spiny keratoderma represents an ectopic hair formation of palms and soles.

A combination of roxithromycin and imipenem as an antimicrobial strategy against biofilms formed by Staphylococcus aureus.

We examined the effects of a combination of roxithromycin and imipenem on a biofilm model of Staphylococcus aureus. Treatment with roxithromycin alone and imipenem alone did not decrease the number of viable bacterial cells compared with the control. However, a combination treatment of roxithromycin and imipenem significantly decreased the number of viable bacterial cells on day 8 after inoculation in the in vivo model (P < 0.01). On days 5 and 8 after inoculation, numerous polymorphonuclear leucocytes and macrophages invaded the bacterial clusters in the roxithromycin- and roxithromycin/imipenem-treated groups, but did not invade the control or imipenem-treated groups. The present study indicated that a combination of roxithromycin and imipenem is a potentially effective treatment for S. aureus biofilm-associated skin infections as it can induce the invasion of polymorphonuclear leucocytes into the biofilm.

Antinuclear antibodies in patients with atopic dermatitis and severe facial lesions.

BACKGROUND: In adult patients with atopic dermatitis (AD), the presence of autoantibodies such as anti-IgE and antinuclear antibodies (ANA) has been demonstrated. The patients may have altered immune regulation. OBJECTIVE: The purpose of this study is to examine the prevalence of ANA in AD patients with severe facial eruptions and to evaluate the differences between ANA-positive and ANA-negative AD patients. METHODS: ANA, blood eosinophil count, total serum IgE levels, specific IgE antibody to Dermatophagoides pteronyssinus, disease duration, photosensitivity and association with respiratory allergic diseases were checked in 89 AD patients. RESULTS: Twenty-three (25.8%) AD patients showed positive ANA at titers ranging from 1:40 to 1:640, and the incidence of positive ANA was 12.1% in controls. Twenty-five (71.4%) of 35 AD patients with positive ANA at titers ranging from 1:20 to 1:640 were females. CONCLUSION: Adult AD patients with severe facial lesions should be examined for serum ANA. Particularly in female and photosensitive AD patients with severe facial lesions, serum autoantibodies have to be carefully investigated to differentiate from autoimmune diseases.

Giant neuroendocrine (Merkel cell) carcinoma of the skin.

An 82-year-old woman had a dark red to purple tumor on the left buttock that had gradually enlarged during the last 5 years. Although routine histologic examination was not sufficient for diagnosis, neuroendocrine carcinoma was diagnosed by immunohistochemical and ultrastructural studies. Immunohistochemical-positive reactions to neurofilament, cytokeratin, neuron-specific enolase, and epithelial membrane antigen were noted. Electron microscopically, membrane-bound, dense core granules that yielded a positive uranaffin reaction and intermediate filaments in the perinuclear area were observed in the cytoplasm of most tumor cells. Desmosome-like structure between them was also found. Approximately 6 months after local excision, metastatic lesions developed in the regional lymph nodes and liver.

Linear IgA disease with IgA antibodies directed against 200- and 280-kDa epidermal antigens.

We report an 80-year-old man with the lamina lucida type of linear IgA disease, with IgA autoantibodies reactive with 200-kDa and 280-kDa epidermal proteins. The patient presented with widespread bullous lesions on his trunk and extremities without mucosal involvement. Histopathology of lesional skin showed a subepidermal blister with papillary microabscesses of neutrophils and a few eosinophils. Direct immunofluorescence microscopy of perilesional skin showed linear deposits of IgA and C3 at the basement membrane zone. The patient's serum contained IgA autoantibodies that bound exclusively to the epidermal side of 1 mol L-1 NaCl split skin as determined by indirect immunofluorescence microscopy. Circulating IgA autoantibodies to 200- and 280-kDa antigens were detected in the patient's serum by immunoblot analysis using extracts from normal human epidermis and human epidermal keratinocytes. These two antibodies, eluted from individual nitrocellulose membranes, reacted with the epidermal side of 1 mol L-1 NaCl split skin on indirect immunofluorescence microscopy, and bound to hemidesmosomes as determined by immunoperoxidase electron microscopy. This observation suggests the presence of hitherto uncharacterized 200- and 280-kDa hemidesmosomal proteins distinct from BPAG1, BPAG2 and beta4 integrin as target antigens in linear IgA disease.

Possible influences of Staphylococcus aureus on atopic dermatitis-- the colonizing features and the effects of staphylococcal enterotoxins.

BACKGROUND: Heavy colonization of atopic dermatitis (AD) with Staphylococcus aureus is well documented. This phenomenon suggests that S. aureus in AD lesions influences the disease processes of AD. OBJECTIVE: We describe the importance of the presence of S. aureus and staphylococcal enterotoxins A and B (SEA, SEB) in AD lesions. METHODS: We investigated the colonizing features of S. aureus in AD lesions using electron microscopy, the distribution of SEB in the eczematous skin of AD using immunofluorescence, the effects of SEA and SEB on normal human epidermal keratinocytes in organ culture, and the presence of specific IgE antibodies to SEA and/or SEB in serum of AD patients by enzyme immunoassay. RESULTS: S. aureus in AD lesions colonized on and in the horny layers of the eczematous skin. SEB produced by S. aureus was distributed mainly on the dermal-infiltrated cells, especially on eosinophils. SEA and SEB stimulated expression of ICAM-1 and HLA-DR in normal human keratinocytes. More than half of the AD patients in the present study had specific IgE antibodies to SEA and/or SEB in their serum. CONCLUSION: S. aureus and SEs have important roles in the exacerbation and prolongation of AD.

Is the face and neck pattern of atopic dermatitis in Japan a special variant?

BACKGROUND: Adult atopic dermatitis (AD) with severe and refractory eruptions on the face, neck, and upper trunk, although quite rare in western countries, has increased in Japan. OBJECTIVE: We have tried to clarify the possible causative factors for this particular type of AD, predominantly seen in Japan. METHODS: Eighty-seven AD patients (37 men and 50 women) who had severe and refractory facial and neck lesions were patch tested with topical medicaments, cosmetics, and skin-management products. RESULTS: Thirty-seven (42. 5%) patients showed positive reactions to more than one of those products: 14 patients to shampoo, rinse, or soap; 11 to topical nonsteroidal anti-inflammatory agents (NSAIDs); 7 to cosmetics; and 6 to corticosteroids. CONCLUSION: We believe that topical NSAIDs, (which are often prescribed for the treatment of AD in Japan and rarely used for the treatment of eczamatous skin disorders in western countries), as well as common detergents, play important roles in the increased prevalence of AD patients with severe and refractory lesions on the face, neck, and upper trunk in Japan.

Anti-epiligrin cicatricial pemphigoid with IgG autoantibodies to the beta and gamma subunits of laminin 5.

Anti-epiligrin cicatricial pemphigoid is an autoimmune subepithelial blistering disorder of mucous membranes and skin. By immunoblot analyses, sera of most patients with antiepiligrin cicatricial pemphigoid have been shown to react specifically with the alpha3 chain of laminin 5. We describe the first patient with anti-epiligrin cicatricial pemphigoid in whom circulating IgG autoantibodies directed against the beta3 and gamma2-chains of laminin 5 were detected. Treatment with oral prednisolone was beneficial in controlling the disease.

Thyroid gland tumour, pemphigus foliaceus and myasthenia gravis in the daughter of a woman with myasthenia gravis.

We describe a rare case of pemphigus foliaceus associated with familial myasthenia gravis (MG). A 35-year-old woman developed MG during oral corticosteroid treatment for pemphigus foliaceus. She had been operated on for a thyroid gland tumour that was confirmed histopathologically to be papillary carcinoma without metastasis. At the time of treatment, her mother had had MG for 30 years and undergone thymectomy 22 years ago. A specific ELISA technique showed that antidesmoglein 1 antibody was present in the daughter. There are many reports of multiple diseases such as pemphigus, thymoma, malignancy, and other autoimmune diseases associated with MG. However, familial MG following pemphigus foliaceus has not been reported previously.