Drug-Induced Cutaneous Toxicity

The skin is the largest organ in the body and is continually exposed to external stimuli, such as chemical and environmental substances. Cutaneous toxicity can be broadly classified according to the mechanism of onset, namely: contact dermatitis, i.e., damage resulting from contact with a substance (irritant dermatitis, allergic contact dermatitis, chemical burns); photosensitivity, i.e., caused by combined effects of a substance and ultraviolet light (phototoxic dermatitis, photoallergic contact dermatitis); contact urticaria; chemical-induced acne; pigmentary disturbance; drug rash; hair disturbance; nail disturbance; or tumor-induced. This review outlines the function and structure of the skin, outlining characteristics of these types of cutaneous toxicity. In recent years, advances have been made in the development of pharmaceutical products targeting specific molecules or genes and nanotechnology-based pharmaceutical products, raising concerns about the onset of toxicity by novel mechanisms involving new pharmaceutical products. Therefore, it is important to understand the basic toxicity-related changes described herein

Characteristics of Clinical and Imaging Findings of Epidermoid Cysts under the Skin of the Mental Region

Epidermoid cyst often arises in the fl oor of oral cavity; however, it is relatively rare to arise subcutaneously in the mental region. We reported characteristics of clinical and imaging fi ndings of epidermoid cysts under the skin of the mental region. The patient was a 53-year-old male. He complained of a subcutaneous mass without pain in the left mental region. A palpable soft and movable thumb-sized mass without pain was observed at the fi rst examination. Ultrasound examination revealed a well-demarcated mass with heterogenous hyper-echoic internal echo and posterior echo enhancement. On power Doppler sonography, a small amount of blood supply was found around the periphery of the mass. Plain CT scan revealeda globular soft-tissue mass with peripheral high and central low CT values area. The mass was removed under local anesthesia using intraoral approach. A histopathologic diagnosis was epidermoid cyst. Recurrence is not observed 2 years after surgery. There were only 3 reports of epidermoid cysts in the mental region, including our case in Japan, clinically characteristics of age ranging 20 to 66 years of age and the mean age of 46 years, with 2 males and 1 female. The size wasfrom 20 mm to 12 mm in diameter and from the tip of a thumb up to the tip of a small fi nger. Ultrasound images of the inside of epidermoid cysts that we experienced this time showed enhancement of relatively uniform hyperechoic image and posterior echo, which was characteristically slightly diff erent from fi ndings of epidermoid cysts generally reported

Intrafamilial clustering of genotypes of hepatitis C virus RNA.

Hepatitis C virus (HCV)-RNA in the blood was measured by polymerase chain reaction (PCR) in 37 subjects from eight families in which 2 or more persons tested seropositive for antibodies against C100-3 or CP9. HCV-RNA was positive in 17 of 37 subjects. Two or more HCV-RNA-positive subjects were observed in six of the families. Intrafamilial HCV infection was studied by determining the HCV-RNA type (I, II, III or IV) by PCR using type-specific primers. In two families, all of the subjects showed type III infection, and in three other families, all of the subjects showed type II infection, with different types of HCV infections being observed in only one family. The HCV type was uniform in all but one. These findings suggest a possibility of intrafamilial infection between husbands and wives and between members of the same household.</p

Endobronchial Ultrasound-guided Transbronchial Needle Aspiration for the Diagnosis of Intrathoracic Lesions : Experience of a Single Academic Medical Center

Article信州医学雑誌 60(5): 249-255(2012)journal articl

β-リン酸三カルシウムによる担体を併用した歯の移植は骨と歯周組織再生を促進する

緒言歯の先天性欠如の治療法として，他の治療法に対して，より高い機能性，審美性の向上，治療時間の短縮の利点により歯の移植の有用性が報告されている．しかしながら，移植床が歯の歯根幅に対し矮小な場合，適応外となる症例があった．そこで，本研究では歯の移植に合わせて不足する歯槽骨を再生させる事で，歯の移植治療の適応拡大を目指すことを目的として，移植された歯根周囲の骨再生に対するβ-TCPブロックおよび/または単核球（BM- MNCs）の影響を調査した，実験材料および方法移植歯と細胞のドナーとして，3週齢雄性C57BL/6Jマウスを用いた．上顎第一臼歯，上顎第二臼歯の抜歯を行い, 同系マウス大腿骨・脛骨の骨髄から， 密度勾配遠心法にてBM- MNCsの分離を行った．抽出したBM- MNCsは flow cytometryで分析した． 実験はMNC群，β-TCP群，Control群の3群とし，MNC群ではβ-TCP担体+MNC+歯, β-TCP群ではβ-TCP担体+歯，Control群では歯のみを6週齢雄性同系マウスの大腿筋内に移植した．移植4週間後に移植物を摘出し, 動物用マイクロCTにて評価を行った．標本は，HE染色，マッソントリクローム染色，およびOsteopontin(OPN)，Osteocalcin(OCN)，Periostin，type I Collagenに対する免疫組織染色をおこなった．再生組織の形態計測分析にはTRI/3D-BON（ラトック社）を用いた．結果抽出したBM- MNCsは，CD29 +/CD90+/CD45-細胞が0.5%であった．3群とも歯根周囲に骨再生を伴う歯周組織の再生が認められた．MNC群とβ-TCP群では，Control群と比較して，新生骨の骨組織体積（TV）， 骨体積（BV），骨表面積(BS)，ダイレクト計測骨梁幅（Tb. Th）とフラクタル次元が有意に大きかった（P<0.05）．また，MNC群とβ-TCP群では歯根の外側にも新生骨が認められたが，Control群では新生骨は外側での骨形成はわずかであった．新生骨は歯根周囲に限局していた．組織学的解析では，すべての群で未成熟な新生骨を示した．OPN陽性細胞，OCN陽性細胞は全ての実験群で新生骨の周囲に観察された．また，MNC群とβ-TCP群の根尖部は肥大したセメント質様組織が時折認められ，Control群では歯根外部吸収が認められた．歯根と新生骨間にはコラーゲンを含む歯根膜様の組織が形成され，一部はPeriostinおよびtype I Collagen陽性であった．この膠原線維は歯根表面に対して，MNC群，β-TCP群では垂直または斜走する線維だったが，Control群ではより平行な線維が観察された．また，全群で歯髄腔内に骨様構造の形成を認めた．考察β-TCPを用いた群ではControl群と比較して骨形成が促進されたが，このメカニズムとしてβ-TCPの骨伝導効果，多孔質構造による血管新生の促進，および骨再生のためのスペース確保が考えられた．新生骨量には，MNC群とβ-TCP群で差が見られなかった．分離されたBM-MNCsの中で間葉系幹細胞を含むCD29+/CD90+/CD45-分画はわずか0.5%であり，新生骨の形成の促進には細胞数が十分でなかった可能性がある．但し，Tb.Th，やフラクタル次元ではMNC群がβ-TCP群と比較し有意に大きかったことから，BM-MNCsは骨成熟を促進したと考えられた．移植した歯根と，新生骨間には歯根膜様組織の再生が見られたが，コラーゲン線維の走行やPeriostin， type I Collagenの発現から，再生歯根膜は正常な歯根膜と比較して未熟であった．歯周組織の成熟には機械的刺激が必要とされており，移植後の歯に対して負荷が無いことが原因と考えられた．2020博士（歯学）松本歯科大

Early uptake and continuous accumulation of thallium-201 chloride in a benign mixed tumor of soft tissue: Case Report

A case of benign mixed tumor of the soft tissue in a 64-year-old Japanese male is presented. He noticed a painless, elastic hard mass sized 3 cm in the right knee, which gradually grew larger and harder in the last 5 years. Magnetic resonance imaging demonstrated a mass lesion embedded in the subcutaneous tissue with low and high signal intensity at T1- and T2-weighted images, respectively. Tl-201 scintigraphy showed an early uptake of Tl-201 within the lesion at 10 minutes after injection, which was slightly decreased but still continued at 2 hours later. The patient underwent a resection of tumor, and the pathological diagnosis was a benign mixed tumor of soft tissue without high vascularity, characterized by histological features similar to pleomorphic adenomas in the salivary glands. Immunohistochemical study proved expression of Na(+)/K(+)-ATPase of tumor cells. Overexpression of Na(+)/K(+)-ATPase of the tumor might be responsible for the early uptake of Tl-201, and poor vascular structure in this tumor might lead to continuous accumulation. The Tl-201 scintigraphic features of mixed tumor of soft tissue are assessed to resemble those of malignant soft tissue tumors

Cutaneous T-cell-attracting chemokine as a novel biomarker for predicting prognosis of idiopathic pulmonary fibrosis: a prospective observational study

[Background] Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrotic lung disease that leads to respiratory failure and death. Although there is a greater understanding of the etiology of this disease, accurately predicting the disease course in individual patients is still not possible. This study aimed to evaluate serum cytokines/chemokines as potential biomarkers that can predict outcomes in IPF patients. [Methods] A multi-institutional prospective two-stage discovery and validation design using two independent cohorts was adopted. For the discovery analysis, serum samples from 100 IPF patients and 32 healthy controls were examined using an unbiased, multiplex immunoassay of 48 cytokines/chemokines. The serum cytokine/chemokine values were compared between IPF patients and controls; the association between multiplex measurements and survival time was evaluated in IPF patients. In the validation analysis, the cytokines/chemokines identified in the discovery analysis were examined in serum samples from another 81 IPF patients to verify the ability of these cytokines/chemokines to predict survival. Immunohistochemical assessment of IPF-derived lung samples was also performed to determine where this novel biomarker is expressed. [Results] In the discovery cohort, 18 cytokines/chemokines were significantly elevated in sera from IPF patients compared with those from controls. Interleukin-1 receptor alpha (IL-1Rα), interleukin-8 (IL-8), macrophage inflammatory protein 1 alpha (MIP-1α), and cutaneous T-cell-attracting chemokine (CTACK) were associated with survival: IL-1Rα, hazard ratio (HR) = 1.04 per 10 units, 95% confidence interval (95% CI) 1.01–1.07; IL-8, HR = 1.04, 95% CI 1.01–1.08; MIP-1α, HR = 1.19, 95% CI 1.00–1.36; and CTACK, HR = 1.12 per 100 units, 95% CI 1.02–1.21. A replication analysis was performed only for CTACK because others were previously reported to be potential biomarkers of interstitial lung diseases. In the validation cohort, CTACK was associated with survival: HR = 1.14 per 100 units, 95% CI 1.01–1.28. Immunohistochemistry revealed the expression of CTACK and CC chemokine receptor 10 (a ligand of CTACK) in airway and type II alveolar epithelial cells of IPF patients but not in those of controls. [Conclusions] CTACK is a novel prognostic biomarker of IPF

A case of intramuscular lipoma of the left buccal region

We report a case of intramuscular lipoma of the left buccal region, along with a review of the relevant literature. Magnetic resonance imaging showed a spindle–shaped mass extending from the canine region to the anterior portion of the masseter muscle in the buccal–alveolar portion of the left mandible. The inner part was visualized as homogeneous high–signal intensity on both T1– and T2–weighted images, and a partial linear region with the same signal intensity as muscle was also observed. The removed tumor measured 35×40×15mm in size, and histopathological findings showed an intramuscular lipoma composed of adipose, muscle and connective tissues. Intramuscular lipomas account for 1.7%–2% of all lipomas, and they very rarely occur in the oral and maxillofacial region. Twenty–three cases with intramuscular lipomas in the oral and maxillofacial region, including our case, have been reported in Japan. The postoperative healing process is generally good. We followed–up our patient after explaining to him the importance of careful, long–term follow–up. It has been only 2 months, to date, since surgery but the outcome appears to be good

A case that has been diagnosed with glandular odontogenic cyst by histopathological examination

Glandular odontogenic cyst (GOC) is a rare odontogenic cyst, classified as a developmental odontogenic cyst by the WHO histological typing of odontogenic tumours in 1992. GOC generally occurs in the mandible and arises in each age. The clinical differential diagnosis of odontogenic tumor and cyst is important however, it is difficult to discriminate between them in clinical and radiographical findings. Thus, pathological searches become an essential step for the definite diagnosis. We report a case of GOC, that primary diagnosis was dentigerous cyst by biopsy, but the definite diagnosis was GOC after total extirpation of cyst. Because of a high recurrence rate of GOC, the patients should be followed for a long term