Yasuyuki Tokura

The urokinase type of plasminogen activator in cancer of digestive tracts

The amounts of urokinase (UK) antigen and tissue plasminogen activator (t-PA) antigen were determined in plasma, urine and tissues of patients with cancer of digestive tracts. Urinary levels of UK, but not those of t-PA increased in patients with cancer, and generally decreased after the removal of cancer by operation. Urinary UK levels kept increasing in patients with recurrence of cancer or with metastasis into liver or peritoneum. Plasma levels of t-PA, but not those of UK decreased in patients with cancer. When the amounts of UK were compared in cancer tissues and their adjacent normal mucosal layer, cancer tissues always had higher levels of UK, but t-PA levels were same between tumor tissues and normal mucosa. The results suggest that the type of plasminogen activator was UK-type in cancer of digestive tracts.

S–100 protein-positive cells in hidrocystomas

The histogenesis of hidrocystomas was examined by the use of immunostaining for S–100 protein. In normal sweat glands, S–100 protein was found exclusively in the secretory cells of eccrine glands, whereas this protein was not present in the other parts of eccrine glands or at any levels of the structure of apocrine glands. On the bases of this immunostaining pattern in normal sweat glands, we attempted to correlate the origin of 8 cases of hidrocystoma to the presence of S–100 protein‐positive cells. S–100 protein was detected in the cells of one solitary eccrine hidrocystoma, but not in those of 2 cases of “classic”, multiple‐lesion type of eccrine hidrocystoma. This indicated that the former arose from the secretory portion of the eccrine gland and the latter from the eccrine ductal cells. Two of the 5 cases of apocrine hidrocystoma showed positive staining in a part of the lining cells of the cyst wall, while the other 3 cases were negative to this protein. This finding suggests that some of the tumors diagnosed morphologically as apocrine hidrocystoma differentiate in the direction of eccrine secretory cells. In addition to S–100 protein, we also surveyed for the presence of carcinoembryonic antigen (CEA), and all cases examined were consistently positive to this substance. The detection of S–100 protein was considered to be more helpful in classifying hidrocystomas than that of CEA.

Sparfloxacin phototoxicity: Potential photoaugmentation by ultraviolet A and B sources

Sparfloxacin, a quinolone antibacterial agent, frequently elicits photosensitive skin reactions. Our clinical studies of patients treated with sparfloxacin have demonstrated that this photosensitivity is primarily phototoxic and that a marked erythematous response is induced by sequential irradiation with ultraviolet A (UVA) and B (UVB) but not UVA or UVB alone, suggesting potential synergism between UVA and UVB. We evaluated the phototoxicity of this agent using in vitro DNA breaking activity and in vivo murine cutaneous response. Sparfloxacin induced DNA strand breaks in vitro and converted the supercoiled closed circular form of plasmid DNA to the open circular form by its photodynamic action. In mice, the topical application of sparfloxacin and subsequent irradiation with UVB, but not UVA, induced ear swelling responses. However, the UVB-induced ear swelling response was augmented by irradiation with UVA before or after UVB exposure. Such interaction between UVA and UVB in the production of ear swelling was further confirmed by systemic administration of sparfloxacin. Our study suggests that sparfloxacin is a unique phototoxic agent in that photosensitivity dermatitis is evoked by photoaugmentation between UVA and UVB.

Histological diagnostic criteria for accessory tragi

The histological features of accessory tragi from 13 patients were analyzed. All the lesions showed numerous tiny mature hair follicles in various phases, while the presence of cartilage was not essential. Of importance was the prominent connective tissue framework in the subcutaneous fat that seemed to be one of the diagnostic criteria for accessory tragi.

Measurement of Urinary Trypsin Inhibitor in Urine, Plasma and Cancer Tissues of Patients with Stomach Cancer

Antiserum was obtained from rabbits immunized with a highly purified preparation of urinary trypsin inhibitor (UTI) conjugated with rabbit serum albumin. Anti-UTI antibody did not cross-react with antibody against inter-alpha-trypsin inhibitor (I alpha I) as determined by immunodiffusion against human plasma. A highly sensitive enzyme immunoassay was developed for the determination of UTI-related antigens (UTIR) in plasma, urine and cancer tissues. The level of UTIR correlated with UTI activity in urine. UTIR levels in urine and plasma did not change with age, but UTIR levels were higher in the stomach cancer tissue than in the surrounding stomach mucosa. UTIR levels did not correlate with I alpha I levels in the plasma of patients with stomach cancer, thus the increase was not considered due to the contamination of circulating I alpha I in the cancer tissues.

Induction of contact photosensitivity to TCSA using photohapten-modified syngeneic spleen cells.

SummaryWe investigated the induction and transfer of contact photosensitivity (CPS) to the photohapten 3,3′,4′,5-tetrachlorosalicylanilide (TCSA) using photo-TCSA-coupled syngeneic cells in mice. Photo TCSA-modified spleen cells (photo TCSA-SC) with efficient immunogenicity were prepared with ultraviolet A (UVA) irradiation of spleen cells suspended in TCSA solution. Subcutaneous inoculation of photoTCSA-SC into syngeneic mice induced a highly specific CPS response detected by ear swelling upon epicutaneous challenge with TCSA painting plus UVA irradiation. The sensitivity was determined to be a cell-mediated, delayedtype hypersensitivity reaction from the time course of the reactivity, the characteristic histology, and the successful transfer of the sensitivity into syngeneic naive recipients by immune lymph node T cells with the phenotype of L3T4+, Lyt-2-. In contrast to the conventional TCSA painting plus UVA irradiation method, this immunization procedure did not evoke an ordinary contact sensitivity reaction to TCSA. The present procedure represented a new way to induce CPS.

Endoscopic Clipping of Esophageal Varices

Abstract: A new method of endoscopic therapy for esophageal varices using a clipping apparatus was devised and applied prophylactically in nine patients with esophageal varices which were not bleeding. Eighty two ligations were placed in 21 separate treatment sessions in this study. All the esophageal varices were eradicated or reduced in size and length within 2 months following treatment. No major complications such as massive bleeding, the development of deep esophageal ulcers, esophageal perforation, esophageal stenosis and pleural effusion developed. The follow‐up period ranged from 6 months to 18 months. Three patients (33%) were re‐treated by the same method because of the regrowth of esophageal varices during this period, but no bleeding occured in these patients. It seems that this newly developed method is a safe, simple and effective technique for the treatment of esophageal varices.

In vitro activation of immune lymph node cell proliferation by photohapten-modified cells in murine contact photosensitivity

SummaryPainting of 3,3′,4′,5-tetrachlorosalicylanilide (TCSA) plus ultraviolet A (UVA) irradiation to the same site induces contact photosensitivity (CPS), but at the same time results in death of the photohapten-modified cells. Using an in vitro immune lymph node cell (LNC) proliferation system, we investigated the mechanism of induction and elicitation of CPS by TCSA painting plus UVA irradiation. The proliferation of LNC from TCSA-photosensitized mice was not augmented by the addition of TCSA-photocoupled syngeneic spleen cells (SC) or epidermal cells (EC), whereas the picryl chloride immune LNC proliferation was activated by trinitrophenyl-coupled (TNP-coupled) SC or EC. While the viability of SC and EC was unchanged even after TNP haptenization, cells showed very low levels of viability after TCSA photohaptenization. This suggests that the inability of photoTCSA-modified cells to activate LNC proliferation is because of their low viability. Nylon wool column purified lymph node T cells from TCSA-photosensitized mice were activated by photohapten-conjugated SC or photohaptenized EC fragments only in the presence of peritoneal macrophages (MΦ). The function of live MΦ was not replaced by interleukin-1 (IL-1), suggesting that MΦ were required for processing and/or presentation of photohapten rather than simply providing IL-1. Our in vitro study implies that photoTCSA-modified cells generated in vivo require intact antigen-presenting cells to effectively induce and elicit the CPS reaction.

Bullous Pemphigoid, Figurate Erythema and Generalized Pigmentation with Skin Thickening in a Patient with Adenocarcinoma of the Stomach

A 52-year-old woman with bullous pemphigoid developed a bizarre figurate erythematous eruption and generalized pigmentation and velvety skin thickening. Later on, these cutaneous signs were found to be associated with an underlying adenocarcinoma of the stomach. Double-diffusion precipitation and indirect immunofluorescence, however, failed to demonstrate circulating antibodies against the tumor tissue in our patient.

Follicular cyst derived from hair matrix and outer root sheath.

A new follicular cyst was reported. The lower part of the cyst wall was composed of both basophilic and shadow cells as seen in pilomatricoma, whereas the upper part of the wall consisted of clear cells. Our case apparently derives from hair matrix and outer root sheath.