Yukiko Shikano

Cutaneous signs (Raynaud's phenomenon, sclerodactylia, and efladema of the hands) and hand-arm vibration exposure

SummaryDermatological tests and examinations of the hand(s) were carried out in vibration-exposed and un exposed males. The subjects were 179 chain-saw workers in private forestry companies and 205 local inhabitants who had never used vibrating tools. The prevalences of Raynauds phenomenon (RP), sclerodactylia, and edema of the hands were estimated in both groups, and associations between these cutaneous signs and vibration exposure were evaluated. The prevalences of RP and edema in the exposed group were 9.5% and 1.7%, respectively, and in the unexposed group, 2.9% and 1.5%, respectively. Sclerodactylia was seen in 31.8% of the chain-saw workers but in only 6.4% of the unexposed individuals. In statistical analyses based on unconditional logistic regression models with adjustment for age, RP was associated with long-term (≥ 20 years) vibration exposure [odds ratio (OR) = 7.06; 95% confidence interval (CI) = 2.51−19.87]. Sclerodactylia was associated with both short- and long-term vibration exposure (OR = 6.54, Cl = 3.30-13.36; OR = 7.05; CI = 3.41-14.60, respectively). There were significant dose-response relationships between RP and duration of exposure and between sclerodactylia and duration of exposure. Results of function tests indicated a longer recovery time and a higher vibration threshold for the workers with RP. The presence of sclerodactylia, however, did not have any significant influence on function test results. It is possible to conclude that not only RP but also sclerodactylia could be induced by vibration exposure. However, most cases of sclerodactylia were not so serious as to involve disturbances of peripheral circulatory and nerve function.

Purification and characterization of lysophospholipase-transacylase of pathogenic fungus Candida albicans

A lysophospholipase-transacylase was purified to homogeneity from the culture broth of Candida albicans by ammonium sulfate precipitation and chromatographs on DEAE-cellulose, Ultrogel AcA-44, first Mono Q, hydroxyapatite, TSKgel-3000 and second Mono Q columns. The purified protein was a single band (Mr 41,000) as inferred by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. It had a specific activity of 78 mumol/min per mg protein for fatty acid release and 320 mumol/min per mg protein for phosphatidylcholine formation. Fatty acid release obeyed Michaelis-Menten kinetics and the apparent Km was 76 microM of 1-palmitoyl-sn-glycero-3-phosphatidylcholine, but Lineweaver-Burk plots of transacylase activity was parabolic. The ratio of hydrolase to transacylase activity of the purified enzyme was varied depending upon the concentration of lysophosphatidylcholine. Transacylation was prominent at high concentration of substrate and the ratio of hydrolase to transacylase was 0.24. Low concentration of palmitoylcarnitine (50 microM) inhibited markedly phosphatidylcholine formation but stimulated fatty acid release. The degree of esterification of 1-acyllysophosphatidylcholine was altered with mixtures of different molecular species of substrate, demonstrating acyl chain selectivity in the transfer process. These results suggest that C. albicans lysophospholipase-transacylase is different from the corresponding mammalian enzymes in enzymatic properties.

PREVALENCE OF RAYNAUD'S PHENOMENON AND SPECIFIC CLINICAL SIGNS RELATED TO PROGRESSIVE SYSTEMIC SCLEROSIS IN THE GENERAL POPULATION OF JAPAN

Background. In order to evaluate the prevalence rates of Raynauds phenomenon (RP) and specific clinical signs related to progressive systemic sclerosis (PSS) in the general population of Japan, inquiries were made concerning RP in the hands and dermatologic examinations were also conducted.

DETECTION OF SCLERODERMA WITH CAPILLAROSCOPIC ABNORMALITIES OF NAILFOLDS

Background. Systemic scleroderma is a problem in Gifu Prefecture, Japan.

Manometric evaluation of esophageal function in progressive systemic sclerosis with special regard to the disease severity.

SummaryA study was conducted to elucidate the relation between the severity of progressive systemic sclerosis (PSS) and the grade of esophageal function disorder, the extent of which was estimated using esophageal manometry. Fifty two patients with PSS were divided into the mild, moderate and severe groups according to the severity score established by the PSS Research Group supported by The Ministry of Health and Welfare of Japan. Primary peristaltic pressure in the esophageal body at 25 to 35cm from the incisors as well as lower esophageal sphincter pressure (LESP), which represents the function of the smooth muscle of the esophagus, were significantly decreased in parallel with the increasing severity of PSS. In contrast, there was no significant difference in upper esophageal sphincter pressure (UESP) or in primary peristaltic pressure at 20cm from the incisors, indicating that the function of striated muscle of the esophagus was not impaired. In addition, even in the mild PSS group without dysphagia (19 cases), primary peristaltic pressure in the esophageal body at 25 to 35cm from incisors was found to be significantly decreased in comparison with the control. Hence, esophageal manometry was useful for early detection of the pathophysiological state of the esophageal function in PSS.

Esophageal Manometric Assessment and Esophageal X-Ray-Photogram taken at 10 Seconds Intervals in Progressive Systemic Sclerosis Patients.

PSS 27例および年齢·性を一致させたcontrol 15例を対象に食道内圧を測定し, PSSの罹病期間, 臨床症状, 抗核抗体の型別との相関を検討した。結果, PSSはcontrolに比較して食道の中∼下部の内圧が有意に低下しており, PSSの食道内圧値は罹病期間, 皮膚硬化範囲, 肺線維症およびPSSの重症度(石川のscore値)と相関していた。以上より, 食道内圧値はPSSの内臓侵襲や重症度を知る指標となり得ると考えた。しかし, 萎縮期と考えられる症例で著明な低下を示したり, 胸やけの無い症例の中にも低下を示した例もあり, 興味深い。また, 粒良らが提案した食道X線毎10秒逐次撮影法をPSS患者に施行したところ, その所見と食道内圧値が有意な相関を示した。従って, 上記撮影法は食道内圧測定法同様, 食道収縮機能判定法として今後試みられるべき検査法と考えられる。