RESUMEN
A surgically treated case of infectious endocarditis (IE) complicated with preoperative cerebral infarction and rupture of mycotic intracranial aneurysm was reported. A 66-year-old male was admitted with the diagnosis of active IE due to Streptococcus sanguis, complicated with cerebral infarction 17 days previously. Preoperative echocardiography showed mobile vegetations both on the aortic and the mitral leaflet, sizes of which were 12.6 and 25 mm. The magnetic resonance imaging (MRI) demonstrated a subarachnoid homorrhage due to the rupture of an intracranial aneurysm, and was treated surgically. The bacteriological study of the resected aneurysm showed Streptococcus sanguis. Eleven days after the operation, both the aortic and the mitral valve replacement were performed. There were mobile vegetations on the aortic and the mitral leaflet. There were no new neurological findings after operation. The duration between the cranial surgery and the cardiac surgery was thought to be important to prevent the new neurological complication.
Asunto(s)
Aneurisma Infectado/cirugía , Aneurisma Roto/cirugía , Infarto Cerebral/complicaciones , Endocarditis Bacteriana/cirugía , Aneurisma Intracraneal/cirugía , Infecciones Estreptocócicas , Anciano , Aneurisma Infectado/etiología , Aneurisma Roto/etiología , Válvula Aórtica/cirugía , Infarto Cerebral/diagnóstico , Endocarditis Bacteriana/etiología , Implantación de Prótesis de Válvulas Cardíacas , Humanos , Aneurisma Intracraneal/etiología , Imagen por Resonancia Magnética , Masculino , Válvula Mitral/cirugía , Infecciones Estreptocócicas/etiología , Streptococcus sanguis/aislamiento & purificación , Hemorragia Subaracnoidea/etiología , Hemorragia Subaracnoidea/cirugíaRESUMEN
The purpose of this study was to investigate the effects of the non-specific growth factor inhibitor suramin on smooth muscle cell proliferation in vitro and in vivo. Cultured vascular smooth muscle cells (VSMC) were stimulated by platelet-derived growth factor (PDGF) and cellular DNA synthesis assessed by [3H]-thymidine uptake. Suramin dose-dependently inhibited DNA synthesis in VSMC, and 100 microM of suramin completely suppressed the PDGF-AB-induced cellular DNA synthesis. Rabbit carotid arteries were injured by the balloon catheter, and then suramin locally delivered using a porous balloon catheter over ten minutes. Three weeks after the vascular injury, the extent of intimal thickening was compared between the suramin-treated and control rabbits. The neointimal formation triggered by balloon-mediated vascular injury was suppressed significantly and dose-dependently by locally infused suramin, and the intima to media area ratios of the control and 1 mM suramin-treated animals were 48.8+/-14.9 and 12.2+/-6.0%, respectively (p < 0.01. n = 6 for each group). These results suggest that one time local administration of suramin was sufficient to suppress neointimal formation after balloon-mediated vascular injury, and that pharmacological intervention targeting the growth factor's signaling pathways could be a promising approach to prevent smooth muscle cell proliferation in various proliferative vascular diseases.
Asunto(s)
Músculo Liso Vascular/efectos de los fármacos , Suramina/farmacología , Animales , Músculo Liso Vascular/citología , RatasRESUMEN
BACKGROUND: Previous studies have demonstrated that synthetic cell-permeable analogues of ceramide promote differentiation and inhibit proliferation of keratinocytes, and that the vitamin D3 inducible sphingomyelin cycle generates ceramide in keratinocytes. Although it has been suggested that exogenous ceramide induces apoptosis of keratinocytes, which is similar to their effect on other cell types, such as leukaemia cells, only a few studies have reported ceramide-induced apoptosis of keratinocytes. OBJECTIVE: To determine whether ceramide induces apoptosis of keratinocytes, we used the synthetic ceramide analogue, C2-ceramide (N-acetylsphingosine) and a human squamous cell carcinoma cell line, HSC-I. METHODS: We treated HSC-I cells with C2-ceramide, followed by a viability assay, morphological observations, nick end-labelling (TUNEL), DNA electrophoresis, and electron microscopy. RESULTS: In the viability assay, C2-ceramide was toxic to HSC-I cells in a dose-dependent manner. Manifestations of apoptotic morphology occurred in the ceramide-treated cells, whereas these morphological changes did not occur in cells treated with dihydroceramide (N-acetylsphinganine). TUNEL revealed that many of the ceramide-treated cells showed positive reactivity. DNA electrophoresis demonstrated that C2-ceramide caused internucleosomal fragmentation in a dose- and time-dependent manner. Electron microscopy revealed that the ceramide-treated cells manifested morphological characteristics typical of apoptosis. CONCLUSIONS: The present results demonstrate that C2-ceramide induces apoptosis of transformed human keratinocytes, whereas C2-dihydroceramide does not have such an effect. The fact that ceramide induces apoptosis of keratinocyctes raises the possibility that intracellular ceramide, which is increased with differentiation of the epidermis, might be involved in terminal differentiation, a specialized form of apoptosis of keratinocytes.
Asunto(s)
Apoptosis/efectos de los fármacos , Carcinoma de Células Escamosas/patología , Inhibidores Enzimáticos/uso terapéutico , Neoplasias Cutáneas/patología , Esfingosina/análogos & derivados , Esfingosina/uso terapéutico , Carcinoma de Células Escamosas/tratamiento farmacológico , Tamaño de la Célula , Supervivencia Celular , Ceramidas/farmacología , Relación Dosis-Respuesta a Droga , Humanos , Etiquetado Corte-Fin in Situ , Microscopía Electrónica , Neoplasias Cutáneas/tratamiento farmacológico , Células Tumorales Cultivadas/efectos de los fármacosRESUMEN
We report a case of pretibial myxedema with Graves' disease in an 18-year-old Japanese woman. The physical examination revealed waxy indurated plaques with prominent hair follicle openings and nonpitting edema disseminated on her lower legs. Histology from an edematous lesion revealed that the dermis was markedly thickened with abundant mucin, especially hyaluronic acid, and the collagen fibers in this portion were splitting up into fibrils. We also reviewed 112 cases of pretibial myxedema reported in the Japanese literature.
Asunto(s)
Enfermedad de Graves/complicaciones , Dermatosis de la Pierna/complicaciones , Mixedema/complicaciones , Adolescente , Antitiroideos/uso terapéutico , Biopsia con Aguja , Femenino , Enfermedad de Graves/diagnóstico , Enfermedad de Graves/tratamiento farmacológico , Humanos , Japón , Dermatosis de la Pierna/patología , Metimazol/uso terapéutico , Mixedema/patologíaRESUMEN
An 85-year-old Japanese woman had noticed erythema on her vulvar region 3 years before. The erythema gradually increased in size and followed erosion and ulceration with pigmentation on the edge of the erythema. A skin biopsy from the pigmented area showed large round cells with ample cytoplasm, which formed nests or glandular structures. In the dermis there was mass formation of basophilic cells and peripheral cells in a palisade arrangement. The tumor cells in the epidermis showed positive immunoreactivity for carcinoembryonic antigen; on the other hand, the dermal tumor was negative. We diagnosed that the tumor in the epidermis was vulvar Paget's disease, and the dermal tumor was a solid type of basal cell carcinoma. We speculate that the vulvar Paget's disease preceded and then the basal cell carcinoma developed in the area of Paget's disease. This is the first report in which basal cell carcinoma in the area of Paget's disease was documented.
Asunto(s)
Carcinoma Basocelular/complicaciones , Enfermedad de Paget Extramamaria/complicaciones , Neoplasias Cutáneas/complicaciones , Neoplasias de la Vulva/complicaciones , Anciano , Anciano de 80 o más Años , Animales , Carcinoma Basocelular/patología , Cricetinae , Femenino , Humanos , Enfermedad de Paget Extramamaria/patología , Neoplasias Cutáneas/patología , Vulva , Neoplasias de la Vulva/patologíaRESUMEN
BACKGROUND: Since sebaceous carcinomas with a poor prognosis arising from the cutaneous adnexae of the eyelid are sometimes difficult to differentiate from squamous cell carcinoma or basal cell carcinoma on clinical and histopathological findings, definite differentiation between these tumors by additional methods is necessary. OBJECTIVE AND METHODS: To clarify the usefulness of histochemical and immunohistochemical examinations in diagnosing ocular sebaceous carcinoma, histochemical and immunohistochemical studies were carried out on the 2 patients with unusual ocular sebaceous carcinoma. RESULTS: The findings of ocular sebaceous carcinoma, at least in our 2 cases, were almost identical to those of extraocular sebaceous carcinoma. CONCLUSION: Immunohistochemical detection of human milk fat globules subclass 1, human milk fat globules subclass 2, and breast carcinoma-associated antigen 225 was useful for diagnosing ocular sebaceous carcinomas as well as extraocular ones.
Asunto(s)
Adenocarcinoma Sebáceo/diagnóstico , Neoplasias Faciales/diagnóstico , Adenocarcinoma Sebáceo/metabolismo , Adenocarcinoma Sebáceo/patología , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Neoplasias Faciales/metabolismo , Neoplasias Faciales/patología , Femenino , Humanos , Inmunohistoquímica , MasculinoRESUMEN
Percutaneous transluminal coronary angioplasty (PTCA) is widely accepted as a treatment of ischemic heart diseases, such as Angina Pectoris and Acute Myocardial Infarction. However, coronary restenosis frequently observed in the patients treated with PTCA has been one of the major drawbacks of this procedure. Although the pathogenesis involved in this coronary restenosis is not fully understood, multiple growth factors promoting vascular smooth muscle cell (VSMC) proliferation and migration are likely to play a pivotal role in this process. The purpose of this study is to suppress the platelet-derived growth factor (PDGF)-induced VSMC growth by antisense oligonucleotides against PDGF receptor mRNA. Three different antisense S-oligonucleotides (AS-No. 1-3) were synthesized around the initiation codon of the coding sequence of rat PDGF alpha receptor. Rat cultured VSMCs (A10) were incubated with the AS for 3 days, then exposed to 10ng/ml PDGF-AB for 24 hours. Subsequently, DNA synthesis was assessed by 3H-thymidine incorporation into the cells. Among three AS we tested, AS-No. 3 most effectively suppressed the PDGF-induced DNA synthesis. The DNA synthesis of A10 cells induced by 3% fatal bovine serum (FBS), 10ng/ml PDGF-AB and PDGF-BB were significantly inhibited by 1 microM AS-No. 3 (51%, 44% and 49%, respectively). Serum and PDGF-induced DNA synthesis was inhibited dose dependently by AS-No. 3 (0.25-1 microM range). Northern blot analysis revealed high level expression of PDGF beta receptor mRNA, but failed to detected alpha receptor message in control A10 cells. A quantitative RT-PCR method was used so as to detect subtle change of alpha receptor message, and the method showed that the expression of alpha receptor message was significantly suppressed in the cells treated by 1 microM AS-No. 3. In this study, antisense oligonucleotide targeting rat PDGF alpha receptor effectively suppressed the expression of the receptor, and inhibited PDGF/serum - induced DNA synthesis in rat vascular smooth muscle cells. In addition, these results provide an important impetus to initiating in vivo studies to determine the feasibility of antisense strategies in the prevention of coronary restenosis.