Akira Tomita

Scanning electron microscopic evaluation of the skin surface after ultrasound exposure

Transdermal drug‐delivery systems have become widely accepted clinically for the administration of several systemic drugs. Recently, research on ultrasound irradiation to facilitate the penetration of drugs through the skin have been reported. The present study investigated the morphological changes induced in skin after ultrasound irradiation to hairless mouse skin and human skin.

Expansion of intermediate T cell receptor cells expressing interleukin-2 receptor alpha- beta+, CD8alpha+ beta+, and lymphocyte function-associated antigen-1+ in the liver in association with intrahepatic islet xenograft rejection from rat to mouse: prevention of rejection with anti-interleukin-2 receptor beta monoclonal antibody treatment.

BACKGROUND The precise mechanisms involved in islet xenograft rejection remain unknown. The purpose of the present study was to determine cellular mechanisms responsible for islet xenograft rejection in the liver to facilitate finding a procedure for prevention of immune rejection. METHODS Hepatic mononuclear cells (MNC) as well as splenocytes, peripheral blood MNC, and thymocytes from streptozotocin-induced diabetic mice (BALB/c) rejecting the intrahepatic rat (Lewis) islet xenografts were isolated and examined by two-color FACS analysis. RESULTS The characteristic finding of the hepatic MNC from the mice rejecting islet xenografts compared with mice receiving isografts was a significant increase in the yield as well as in the percentage of the cells expressing CD3+ interleukin-2 receptor (IL-2R) alpha- beta+, CD3+ CD8alpha+ beta+, and T cell receptor (TCR) alphabeta+ lymphocyte function-associated antigen-1+. The expression of CD3 and TCR alphabeta of these T cells was found to be of intermediate intensity (TCR(int) cells). The expansion of these TCR(int) cells occurred predominantly in the liver. There was no significant difference in the cells expressing CD3+ IL-2R alpha+, CD3+ CD4+, CD3+ TCRgammadelta+, CD3- IL-2Rbeta+ (natural killer cells), and B220+ (B cells). In vivo administration of anti-IL-2Rbeta monoclonal antibody directed to the expanded cells produced a prevention of rejection. CONCLUSIONS These findings suggest that islet xenograft rejection in the liver from rat to mouse is an event for which the TCR(int) cells are responsible.

Portal vein thrombosis successfully treated with a colectomy in active ulcerative colitis

Portal vein thrombosis is a rare complication in ulcerative colitis. We present a patient with portal vein thrombosis in ulcerative colitis who was successfully treated with colectomy. A 38-year-old Japanese female was admitted to our hospital because of an exacerbation of colitis. Abdominal ultrasonography performed because of liver dysfunction showed the thrombus in an umbilical portion of the portal vein. The patient underwent a subtotal colectomy and ileostomy because her colitis did not respond to intensive intravenous therapy. Although portal vein thrombus was treated with an intravenous infusion of urokinase before the operation, no change in the thrombus size was found. Approximately three months after the colectomy, the thrombus of the portal vein disappeared without anticoagulant therapy. Although a resection of an inflamed colon may be theoretically effective in the thrombosis in the inflammatory bowel disease, its benefit has not been confirmed. Our case suggests that the resection of the diseased bowel may have a favorable effect on the course of portal vein thrombosis in acute attacks of ulcerative colitis.

A Report of Gastrointestinal Hemorrhage due to Localized Hyperplastic Gastritis Associated with Giant Gastric Folds

消化管出血で発症し, 非上皮性腫瘍との鑑別が困難であった巨大皺壁を伴う限局性肥厚性胃炎の1切除例を経験したので報告する. 症例は44歳の女性で, 全身倦怠感と黒色便が出現, 近医を受診し高度の貧血を指摘された. 精査・治療目的で当院に入院し, 胃内視鏡で, 体上部後壁に出血性潰瘍を認め止血術を行った. 翌日, 同病変は腫大した粘膜皺壁を伴う半球状の粘膜下腫瘍様の形態を呈していた. 潰瘍を合併したgastrointestinal stromal tumor (以下, GIST) を疑い生検組織診断・CT・MRI・超音波内視鏡 (endoscopic ultrasonography: 以下, EUS) を行ったが, いずれもGISTを示唆する所見はなかった. 後日行った胃内視鏡再検査では, 体上部小彎を中心とする一部で立ち上がりが急峻な結節腫瘤状または耳垂様の病変に変化しており, 悪性リンパ腫との鑑別が困難であった. 胃全摘術を施行, 病理組織学的には異所性胃腺管病変を伴った限局性肥厚性胃炎であった.