Asunto(s)
Erupciones por Medicamentos/etiología , Glucocorticoides/efectos adversos , Metilprednisolona/efectos adversos , Psoriasis/inducido químicamente , Acetaminofén/uso terapéutico , Amoxicilina/uso terapéutico , Analgésicos no Narcóticos/uso terapéutico , Antibacterianos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Erupciones por Medicamentos/genética , Erupciones por Medicamentos/inmunología , Quimioterapia Combinada , Femenino , Humanos , Interleucinas/genética , Mutación , Fenilpropionatos/uso terapéutico , Psoriasis/genética , Psoriasis/inmunología , Adulto JovenAsunto(s)
Cuero Cabelludo/patología , Neoplasias de las Glándulas Sudoríparas/congénito , Neoplasias de las Glándulas Sudoríparas/patología , Adenomas Tubulares de las Glándulas Sudoríparas/congénito , Adenomas Tubulares de las Glándulas Sudoríparas/patología , Humanos , Recién Nacido , Masculino , Cuero Cabelludo/cirugíaAsunto(s)
Dermatitis Atópica/genética , Ictiosis Ampollosa de Siemens/genética , Proteínas de Filamentos Intermediarios/genética , Queratina-2/genética , Adolescente , Adulto , Dermatitis Atópica/complicaciones , Proteínas Filagrina , Humanos , Ictiosis Ampollosa de Siemens/complicaciones , Inmunoglobulina E/sangre , Lactante , Recién Nacido , MasculinoAsunto(s)
Tuberculosis Cutánea/diagnóstico , Tuberculosis Miliar/diagnóstico por imagen , Tuberculosis Pulmonar/diagnóstico por imagen , Anciano de 80 o más Años , Femenino , Articulación de la Cadera/diagnóstico por imagen , Humanos , Nariz , Tomografía Computarizada por Rayos X , Tuberculosis Cutánea/microbiología , Tuberculosis Miliar/microbiología , Tuberculosis Osteoarticular/diagnóstico por imagen , Tuberculosis Pulmonar/microbiologíaAsunto(s)
Carcinoma Mucoepidermoide/genética , Proteínas de Unión al ADN/genética , Neoplasias Faciales/genética , Proteínas Nucleares/genética , Neoplasias de la Parótida/genética , Factores de Transcripción/genética , Anciano , Carcinoma Mucoepidermoide/metabolismo , Neoplasias Faciales/metabolismo , Femenino , Fusión Génica , Factor Estimulante de Colonias de Granulocitos/metabolismo , Humanos , Neoplasias de la Parótida/metabolismo , Pronóstico , TransactivadoresAsunto(s)
Factor Estimulante de Colonias de Granulocitos/metabolismo , Melanoma/metabolismo , Neoplasias Cutáneas/metabolismo , Anciano , Anemia/etiología , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioterapia Adyuvante/efectos adversos , Resultado Fatal , Factor Estimulante de Colonias de Granulocitos/sangre , Humanos , Recuento de Leucocitos , Masculino , Melanoma/patología , Melanoma/terapia , Metástasis de la Neoplasia , Estadificación de Neoplasias , Hombro , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/terapia , Tomografía Computarizada por Rayos X , Privación de Tratamiento , Melanoma Cutáneo MalignoAsunto(s)
Linfoma de Células B Grandes Difuso/complicaciones , Síndromes Paraneoplásicos/complicaciones , Pénfigo/complicaciones , Anciano , Autoanticuerpos/metabolismo , Vesícula/complicaciones , Vesícula/patología , Femenino , Humanos , Linfoma de Células B Grandes Difuso/patología , Síndromes Paraneoplásicos/inmunología , Síndromes Paraneoplásicos/patología , Pénfigo/inmunología , Pénfigo/patologíaRESUMEN
Aim: There has been no indicator that allows an early quantitative evaluation of the severity of a mamushi snake (Gloydius blomhoffii) bite. Because the number of severe mamushi bite cases is much fewer than non-severe cases, a formal case-control study is difficult. Therefore, we tried to generate a preliminary quantitative, real-time index for its severity by referring to published reports of severe mamushi bite cases. Methods: We enrolled patients who presented with a mamushi bite and visited our outpatient clinic. Severe cases were collected from published works. Creatinine kinase levels and white blood cell counts of non-severe and severe cases were compared and analyzed. Results: There was a lag time of 10 h before the creatinine kinase level began to rise. The speed of the increase was higher in severe cases than in non-severe cases, and severe cases were recognized as those showing speeds of above 250 IU/L/h. White blood cell counts increased earlier than creatinine kinase levels without any lag time. Severe cases were recognized as those with the counts of over 1,000 × (h) + 6,000 [/µL] before 5 h and 300 × (h) + 10,000 [/µL] after 5 h. Conclusion: We herein present the creatinine kinase level and white blood cell count trends and demonstrate preliminary cut-off equations. The trends for both parameters serve as quantitative indicators of the severity of a mamushi bite until a large scale case-control study is achieved.
Asunto(s)
Adenocarcinoma/cirugía , Liquen Plano/patología , Síndromes Paraneoplásicos/diagnóstico , Penfigoide Ampolloso/patología , Neoplasias del Recto/cirugía , Adenocarcinoma/complicaciones , Adenocarcinoma/patología , Anciano de 80 o más Años , Biopsia con Aguja , Colectomía/métodos , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Liquen Plano/complicaciones , Liquen Plano/tratamiento farmacológico , Síndromes Paraneoplásicos/terapia , Penfigoide Ampolloso/complicaciones , Penfigoide Ampolloso/tratamiento farmacológico , Neoplasias del Recto/complicaciones , Neoplasias del Recto/patología , Medición de Riesgo , Resultado del TratamientoRESUMEN
We performed skin cancer screenings for 2 or 3 days annually from 2006 through 2013 in Oita Prefecture, Japan. Screening of approximately 3000 people in total allowed us to identify and treat several skin cancers, including five cases of malignant melanoma, four of squamous cell carcinoma, 16 of basal cell carcinoma, 11 of Bowen's disease, 17 of actinic keratosis, one of extramammary Paget's disease and one of metastatic breast carcinoma. The sensitivity and specificity for the category defined by an identified lesion associated with risk of cancer and requiring further examination (category C) were 92.7% and 95%, respectively. We cannot estimate the outcome of our skin cancer screenings in terms of cancer mortality because of the small number of subjects examined and the brief follow-up period. However, we did estimate the effectiveness of these screenings in terms of stages or sizes of cancerous lesions. The relative numbers of subjects with malignant melanoma at various clinical stages, identified during skin cancer screenings and during a routine visit to our hospital, were significantly different. We also compared, statistically, the sizes of lesions in Bowen's disease that were found during cancer screenings and during a direct visit to our hospital. The former lesions were smaller than the latter. Our data suggest the benefits of our skin cancer screenings and the importance of campaigns and education to encourage people to visit dermatologists for the detection of skin cancers at an early stage.
Asunto(s)
Neoplasias Cutáneas/epidemiología , Enfermedad de Bowen/epidemiología , Neoplasias de la Mama , Carcinoma Basocelular/epidemiología , Carcinoma de Células Escamosas/epidemiología , Femenino , Humanos , Japón/epidemiología , Queratosis Actínica/epidemiología , Masculino , Tamizaje Masivo , Melanoma/epidemiología , Enfermedad de Paget Extramamaria/epidemiología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/secundarioRESUMEN
BACKGROUND: Human leukocyte antigen (HLA) genotypes in lamotrigine -induced (LTG-induced) cutaneous adverse drug reactions (cADRs) have been described in several reports but controversy remains even for a given ethnic group. We attempted to clarify a possible association between LTG-induced cADRs and HLA alleles in Japanese patients. METHOD: Sixteen subjects, including eight patients with LTG-induced cADRs and eight LTG-tolerant controls were included in this study. All eight patients with LTG-induced cADRs gave positive results in a drug-induced lymphocyte stimulation test (DLST) with LTG. We performed HLA-typing for HLA-A, -B, -C, -DRB1, -DQA1, -DQB1, -DPA1 and -DPB1, using PCR with sequence-specific oligonucleotide probes and multiple analyte profiling (xMAP) technology (Luminex System; Luminex Corporation, Austin, TX). We examined differences between allele frequencies in our two groups of subjects and the allele frequencies in the general Japanese population. RESULTS: The frequencies of HLA-DRB1*0405, and HLA-DQB1*0401 alleles were higher in our LTG-cADRs patients than the reference frequencies in the general Japanese population. We also detected HLA-DQA1*0303 frequently in our LTG-cADRs patients, but data for this allele in the Japanese population was not available. Our observation was presumably due to the linkage disequilibrium among the three alleles. The haplotype frequency of HLA-DRB1*0405, DQB1*0401 and DQA1*0303 in our LTG-cADRs subjects was also different from the corresponding haplotype frequency in the database for the Japanese population and the difference was statistically significant. One patient with the HLA-DRB1*0405, -DQB1*0401 and DQA1*0303 haplotype was safely re-treated with LTG after results of a DLST with LTG ceased to be positive about 4 months after discontinuation of LTG. LIMITATIONS: Our analysis included only 16 patients. Associations between LTG-induced cADRs and specific HLA loci will have to be confirmed in larger studies. CONCLUSIONS: LTG-induced cADRs are associated with HLA-DRB1*0405, -DQB1*0401 and -DQA1*0303.
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Alelos , Cadenas alfa de HLA-DQ/genética , Cadenas beta de HLA-DQ/genética , Cadenas HLA-DRB1/genética , Triazinas/efectos adversos , Adulto , Anciano , Pueblo Asiatico/genética , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Haplotipos , Prueba de Histocompatibilidad , Humanos , Japón , Lamotrigina , Desequilibrio de Ligamiento , Masculino , Persona de Mediana Edad , Proyectos PilotoAsunto(s)
Fármacos Dermatológicos/uso terapéutico , Infliximab/uso terapéutico , Complicaciones Posoperatorias/etiología , Psoriasis/etiología , Colectomía , Colitis Ulcerosa/cirugía , Femenino , Humanos , Complicaciones Posoperatorias/tratamiento farmacológico , Psoriasis/tratamiento farmacológico , Adulto JovenAsunto(s)
Tejido Elástico/química , Fibroma/química , Proteínas de Unión a TGF-beta Latente/análisis , Neoplasias Cutáneas/química , Anciano , Proteínas de Unión al Calcio/análisis , Proteínas de la Matriz Extracelular/análisis , Femenino , Humanos , Inmunoglobulinas/análisis , Inmunohistoquímica , Masculino , Persona de Mediana EdadRESUMEN
Elimination of epiplakin (EPPK) by gene targeting in mice results in acceleration of keratinocyte migration during wound healing, suggesting that epithelial cellular EPPK may be important for the regulation of cellular motility. To study the function of EPPK, we developed EPPK knock-down (KD) and EPPK-overexpressing HeLa cells and analyzed cellular phenotypes and motility by fluorescence/differential interference contrast time-lapse microscopy and immunolocalization of actin and vimentin. Cellular motility of EPPK-KD cells was significantly elevated, but that of EPPK-overexpressing cells was obviously depressed. Many spike-like projections were observed on EPPK-KD cells, with fewer such structures on overexpressing cells. By contrast, in EPPK-KD cells, expression of E-cadherin was unchanged but vimentin fibers were thinner and sparser than in controls, and they were more concentrated at the peri-nucleus, as observed in migrating keratinocytes at wound edges in EPPK(-/-) mice. In Matrigel 3-D cultures, EPPK co-localized on the outer surface of cell clusters with zonula occludens-1 (ZO-1), a marker of tight junctions. Our results suggest that EPPK is associated with the machinery for cellular motility and contributes to tissue architecture via the rearrangement of intermediate filaments.
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Autoantígenos/fisiología , Movimiento Celular/fisiología , Queratinocitos/metabolismo , Actinas/metabolismo , Western Blotting , Cadherinas/metabolismo , Técnicas de Silenciamiento del Gen , Silenciador del Gen/fisiología , Células HeLa/citología , Células HeLa/metabolismo , Humanos , Queratinocitos/inmunología , Microscopía Fluorescente , Microscopía de Contraste de Fase , Modelos Animales , Fenotipo , ARN Interferente Pequeño/genética , Transfección , Vimentina/metabolismo , Cicatrización de Heridas/fisiologíaRESUMEN
A 73-year-old Japanese woman presented with cutaneous horn on the right cheek. The resected tumor was 9 mm in diameter, with 14 mm protrusion, and showed exophytic growth with marked papillomatosis. Histopathology showed proliferation of atypical melanocytes with melanin pigments in the epidermis and dermis under the cutaneous horn. These cells were confined to the base of the cutaneous horn, and did not spread to the surrounding epidermis. The final diagnosis was cutaneous horn malignant melanoma. This pathological entity is considered a specific form of verrucous melanoma, and might be added to the list of cutaneous horn-forming lesions.
RESUMEN
BACKGROUND: Previous studies have reported a high prevalence of autoimmune thyroid disease (AITD) in adult patients with pulmonary arterial hypertension (PAH). The aim of this retrospective study was to determine the prevalence of AITD in children and adolescents with idiopathic PAH (IPAH). METHODS AND RESULTS: The study group included 16 patients who had been diagnosed as having idiopathic PAH when they were younger than 15 years old; all were younger than 20 years of age. Thyroid function and antithyroid antibody levels were examined regularly at 6-12-month intervals and when there were clinical signs of thyroid dysfunction. In total, 7 patients (44%) had AITD; 2 patients developed Graves' disease, 2 developed silent thyroiditis, and 3 had antithyroid antibodies with euthyroidism. The duration after PAH onset and the prostacyclin (PGI(2)) treatment period were significantly longer in patients with AITD (7.6+/-2.1 and 7.4+/-2.3 years, respectively) than in patients without AITD (5.0+/-1.1 and 4.8+/-1.2 years, respectively; P<0.01 and P<0.05). CONCLUSIONS: The prevalence of AITD is high in children and adolescents with IPAH, so evaluation of thyroid function is important to prevent deterioration of right heart failure.
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Enfermedades Autoinmunes/epidemiología , Hipertensión Pulmonar/epidemiología , Hipertiroidismo/epidemiología , Adolescente , Antihipertensivos/uso terapéutico , Autoanticuerpos/sangre , Enfermedades Autoinmunes/diagnóstico , Enfermedades Autoinmunes/inmunología , Niño , Preescolar , Epoprostenol/uso terapéutico , Femenino , Humanos , Hipertensión Pulmonar/tratamiento farmacológico , Hipertiroidismo/diagnóstico , Hipertiroidismo/inmunología , Japón/epidemiología , Masculino , Prevalencia , Estudios Retrospectivos , Pruebas de Función de la Tiroides , Factores de TiempoRESUMEN
BACKGROUND: There is little data on the long-term effects of continuous intravenous epoprostenol for children with idiopathic pulmonary arterial hypertension (IPAH) in Japan. METHODS AND RESULTS: Thirty-one IPAH patients younger than 18 years old who had begun epoprostenol therapy at Toho University Omori Medical Center between January 1999 and June 2004 were reviewed. During a mean follow up of 3.4 years, the rate of those who survived or did not undergo a lung transplantation among the 27 patients who received home infusion therapy of epoprostenol was 100% at 1 year, 96.3% at 2 years, and 79.4% at 3 years. In 82% of survivors, the World Health Organization functional class was changed from III or IV to II according to improvements in the plasma brain natriuretic peptide level and the distance walked in 6 min during the follow-up period. In most cases, mean pulmonary artery pressure and the ratio of pulmonary to systemic vascular resistance remained high, although the cardiac index had improved to within a normal range 1 year after the initiation of epoprostenol. Therefore, sildenafil was administered as an additional therapy to 16 patients who presented with sustained severe PAH. CONCLUSIONS: Continuous IV epoprostenol certainly improves survival and exercise tolerance in childhood IPAH, although the improvement of pulmonary vascular resistance regardless of long-term epoprostenol therapy is insufficient. Therefore, the addition of a new drug, such as sildenafil, is recommended to be administered in adjunction with epoprostenol.
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Antihipertensivos/uso terapéutico , Epoprostenol/uso terapéutico , Hipertensión Pulmonar/tratamiento farmacológico , Adolescente , Antihipertensivos/administración & dosificación , Presión Sanguínea/fisiología , Niño , Preescolar , Relación Dosis-Respuesta a Droga , Epoprostenol/administración & dosificación , Humanos , Hipertensión Pulmonar/sangre , Hipertensión Pulmonar/fisiopatología , Lactante , Recién Nacido , Infusiones Intravenosas , Japón , Péptido Natriurético Encefálico/sangre , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The manganese(III) complex K[MnL(py)(2)].py (H(4)L = 1,2-bis(2-hydroxybenzamido)benzene, py = pyridine) reacted as a ligand complex at the two phenoxo oxygen atoms with metal(II) ion and 2,2'-bipyridine to give a series of heterometal complexes [Mn(MeOH)L(OH)M(bpy)](2) (M(II) = Zn (1); Cu (2); Ni (3); Mn (4)). X-ray structures were determined 1, C(68)H(74)N(8)O(18)Mn(2)Zn(2): a = 12.367(3) Å, b = 12.844(2) Å, c = 12.262(2) Å, alpha = 106.58(1) degrees, beta = 117.89(1) degrees, gamma = 78.57(2) degrees, triclinic, P&onemacr;, and Z = 1. 2, C(68)H(74)N(8)O(18)Mn(2)Cu(2): a = 13.447(1) Å, b = 12.670(2) Å, c = 21.732(1) Å, beta = 107.076(5) degrees, monoclinic, P2(1)/n, and Z =2. 3, C(68)H(74)N(8)O(18)Mn(2)Ni(2): a = 12.358(3) Å, b = 12.847(3) Å, c = 12.315(3) Å, alpha = 106.63(2) degrees, beta = 118.71(1) degrees, gamma = 78.32(2) degrees, triclinic, P&onemacr;, and Z = 1. 4, C(66)H(66)N(8)O(16)Mn(4): a = 12.511(2) Å, b = 21.129(3) Å, c = 12.811(1) Å, beta = 110.12(1) degrees, monoclinic, P2(1)/n, and Z = 2. The X-ray analyses confirmed that each of the crystals consists of an incomplete double-cubane molecule with a [Mn(2)M(2)O(6)] core, in which two M(II) ions are bridged by two hydroxo groups to form a planar dinuclear moiety bridged by di-&mgr;-hydroxo groups [(bpy)M(OH)(2)M(bpy)](2+) and the dinuclear moiety is sandwiched between two Mn(III) complexes [Mn(MeOH)L](-). The Mn(III) ion and the dinuclear M(II) moiety are triply bridged by the one hydroxo oxygen of the dinuclear moiety and two phenoxo oxygen atoms of the Mn(III) ligand complex. The two phenoxo oxygen atoms of the Mn(III) ligand complex coordinate as an axial ligand to two independent metal(II) ions of the dinuclear moiety. The magnetic susceptibilities of 1-4 were measured in the temperature range of 2-300 K. All the Mn(III) ions in these complexes are in a high-spin state of S(Mn) = 2 with a d(4) electronic configuration, and the metal(II) ions are in the spin states of S(Zn) = 0, S(Cu) = 1/2, S(Ni) = 1, and S(Mn(II)) = 1/2 (low-spin). The magnetic susceptibility data are well reproduced by the following spin Hamiltonian based on the rhombus spin coupling model with spin (S(1), S(2), S(3), S(4)) = (2, S(M), 2, S(M)), including a zero-field splitting term for the Mn(III) centers: H = g(Mn)beta(S(1) + S(3)).H + g(M)beta(S(2) + S(4)).H - 2J(S(1).S(2) + S(2).S(3) + S(3).S(4) + S(4).S(1)) - 2J'(S(2).S(4)) + D(Mn)[S(1z)(2) + S(3z)(2)], in which g(Mn) and g(M) are the g factors of the Mn(III) and M(II) ions, J and J' are the Mn(III)-M(II) and M(II)-M(II) Heisenberg coupling constants, and D is the zero-field splitting parameter of Mn(III). The calculated best-fit parameters are as follows: g(Mn) = 1.91, g(Cu) = 2.39, J = -4.5 cm(-)(1), J' = -8.1 cm(-)(1), and D(Mn) = -4.9 cm(-)(1) for 2; g(Mn) = 1.97, g(Ni) = 2.23, J = -1.5 cm(-)(1), J' = -2.6 cm(-)(1), and D(Mn) = -5.5 cm(-)(1) for 3; and g(Mn) =1.95, g(Mn(II)) = 2.29, J = -3.5 cm(-)(1), J' = -14.1 cm(-)(1), and D(Mn) = -12.0 cm(-)(1) for 4. The spin frustration due to the incomplete double-cubane structure is discussed.