Possible role of L-selectin in T lymphocyte alveolitis in patients with active pulmonary sarcoidosis.

A number of adhesion molecules participate in the recruitment of inflammatory cells to the site of inflammation, and selectins together with their ligands are important in the early transient adhesion phase. In this study, we evaluated the role of L-selectin in T lymphocyte alveolitis in patients with active pulmonary sarcoidosis. We measured serum and bronchoalveolar lavage fluid (BALF) concentrations of soluble (s)L-selectin using an ELISA. Serum and BALF concentrations of sL-selectin were significantly elevated in patients with sarcoidosis compared with control healthy subjects and idiopathic pulmonary fibrosis (IPF) patients (P < 0.05 and P < 0. 01, respectively). The lymphocyte surface marker was also examined in peripheral blood and BALF by flow cytometric analysis. The percentage of CD3+CD62L+ cells (L-selectin-bearing T lymphocytes) was significantly lower in peripheral blood of sarcoidosis than in that of healthy subjects (P < 0.01). In contrast, the percentage of CD3+CD62L- cells (L-selectin-negative T lymphocytes) in BALF of patients with sarcoidosis was significantly higher than in healthy subjects (P < 0.05) and IPF patients (P < 0.01). Furthermore, there was a significant correlation between serum concentrations of sL-selectin and the number of L-selectin-negative T lymphocytes in BALF (r = 0.535, P < 0.01). Our results suggest that L-selectin may be involved in T lymphocyte alveolitis in patients with active pulmonary sarcoidosis.

Disaggregation of corneocytes from surfactant-treated sheets of stratum corneum in hyperkeratosis on psoriasis, ichthyosis vulgaris and atopic dermatitis.

To elucidate the pathogenesis of impaired barrier function and the influence of surfactant on the stratum corneum in hyperkeratosis, we investigated morphological alterations of the corneocytes with soap solution. Groups of five patients each with psoriasis vulgaris (PV), ichthyosis vulgaris (IV), atopic dermatitis (AD), and normal controls were examined. Four samples of the horny layer were obtained from the same site by cyanoacrylate adhesive biopsy. The first sample was used for the superficial layer, and the fourth, for the basal horny layers. Each sample was agitated in 1% stirred soap solution at 60 degrees C. The number and size of isolated corneocytes and the morphologic changes were investigated. The release of corneocytes was greater and the swelling and morphological changes of corneocytes exposed to soap solutions were less in PV and AD than in IV or in healthy subjects. In IV, the release was markedly less than in controls. The release and swelling were greater in the superficial than in the basal horny layers. It was concluded that the cohesiveness of corneocytes was probably less in PV and AD and greater in IV than in normals. It was also suggested that the cohesion of corneocytes from the superficial horny layer was less than that from the deep layer. The permeability of the cornified envelope in PV and AD patients was less than in IV or healthy subjects. It was confirmed that highly potent soaps induce loss of many corneocytes and reduce the barrier function of the stratum corneum.

A new model for assessing the damaging effects of soaps and surfactants on human stratum corneum.

To elucidate the damage to the horny layers of human skin produced by surfactants and soaps, we evaluated the cytological alterations of corneocytes using an in vitro assay. Suction blisters, 8 mm in diameter, were raised on the forearms of young adult Caucasoids. The roofs were cut off and the viable epidermis was removed. The discs of stratum corneum were then agitated for up to 6 h at 60 degrees C in 1% solution of five soap bars of differing irritancy. Additionally, individual examples of anionic, cationic and nonionic surfactants were similarly evaluated. Measurements of corneocytes included: (1) the number released with time (disaggregation), (2) size (swelling) and (3) morphologic degradation. The effects of the cationic and non-ionic surfactants did not differ significantly from those of distilled water. The anionic surfactant caused more release and less swelling and morphological change. The test soaps had vastly different effects on the structural integrity of the stratum corneum. The harsher ones caused greater disaggregation, more swelling and greater morphologic deterioration of corneocytes, whereas the milder ones had less marked effects on these parameters. This model would be a useful screening technique for formulating milder soaps and might also provide insights into the complex modes of action of surfactants on the stratum corneum.

Topical treatment of resistant warts with glutaraldehyde.

UNLABELLED: Therapy with glutaraldehyde (GA) was used to treat twenty-five patients with selectively resistant warts. The patients were categorized as having one or more of the following conditions: 1) the location of the warts was either periungual, palmar or plantar, 2) the age of the patient was five years or younger, 3) the number of warts was two or more. RESULTS: Eighteen (72%) out of twenty-five cases were cured, and the other seven (28%) were not. The individual cure rates of the three conditions above were 80%, 60%, and 68.5% respectively. Pigmentary changes occurred immediately after the initial topical application of glutaraldehyde, and the surface of the verruca hardened. Soon afterwards some debris began to drop off of the verruca tissue little by little, and final healing was completed by less than twelve weeks without disagreeable marks. This therapy was found to be extremely useful, not only because the cure rate was high, but the following advantages were also noted: 1) no pain or pruritus, 2) no evidence of scarring or permanent pigmentary change, 3) good penetration in any location, 4) no need for special instruments or reagents except the solution, and 5) no special technique required (possible home treatment). This therapy is superior to cryotherapy (CT) in that it is useful for warts on any location, regardless of the number of lesions, and it is good for young children, although the cure rates for CT and GA are almost equal.

[A study of epidermal alterations induced by PCDF on experimental carcinogenesis].

An effect of 2,3,4,7,8-pentachlorodibenzofuran (PCDF) as a promoter on a course of experimental skin carcinogenesis in mice by chemicals 20-methylcholanthrene (MC) has been proved by our previous studies. Details of ultrastructural epidermal alterations induced by MC and PCDF were observed and an attempt to differentiate benign tumor from malignant one in which a combined application of MC and PCDF on mice skin resulted was done electron microscopically. Four significant findings as follows were detected. First of all even the epidermal cells without tumor had some atypicality. Secondly both of benign tumor and normal-appeared skin without tumor had giant and round-shaped keratohyalin granules (KHGs) which show a tendency of less keratinization. Thirdly cytoplasmic projections of epidermal cells increased in number and sparse tonofilaments scattered in the cytoplasm of benign tumor. This is also an appearance of mucous metaplasia of keratinocytes as well as the form of KHGs mentioned above. Finally benign tumor had thick horny cells including numerous lipid droplets, and that is a sign of acceleration of epidermal turn over. Since epidermal cells have little chance to be exposed to carcinogens when they quickly keratinize, they rarely form a cancer. When epidermal cells have such tendency as less keratinization or more keratinization, they are supposed to be less sensitive to any stimuli of carcinogens, and consequently they incline to be benign tumor instead of malignant one.

A comparative study of fluorescence in malignant melanoma and nevocellular nevus using a fluorescence microscope and formalin-fixed specimens.

Fluorescence in malignant melanoma cells was investigated. The specimens from 18 cases of malignant melanoma and 26 cases of nevocellular nevus, which were fixed with formalin and embedded in paraffin wax, were studied by the fluorescence microscopic method. On the fluorescence microscope, the malignant melanoma cells emitted intense fluorescence from the cytoplasm. The nevus cells with large amounts of melanin granules showed moderate fluorescence. The tumor cells of melanoma in situ and nevus cells with few melanin granules emitted little fluorescence. Not only malignant melanoma cells but also nevus cells in the formalin fixed specimens had various degrees of fluorescence. Many cases of malignant melanoma emitted intense fluorescence, but this was rarely found in nevocellular nevus. This method is also useful in differentiating melanoma from nevocellular nevus.

[Influences of polychlorinated dibenzofuran on experimental carcinogenesis in mice].

To ascertain whether 2,3,4,7,8-pentachlorodibenzofuran (PCDF) has the possibility of cocarcinogen, three different concentrations of 0.5, 1 and 5 ppm PCDF was evaluated in the course of experimental carcinogenesis in mice. Concerning the difference of total number of tumors occurred among the groups of mice with various treatments, the mice treated with 0.5 ppm PCDF and 20-methylcholanthrene (MC) have produced twice as many tumors as those of the other groups. Then the adequate concentration of PCDF to be a promoter was supposed to be 0.5 ppm. Two kinds of tumors were seen in mice which were treated by MC with or without PCDF, and there was no difference of tumors between the groups by appearance and pathologically. One is a benign papilloma, and the other is a squamous cell carcinoma which tends to keratinize and looks like a keratoacanthoma. The latter had a tendency to arise much more four weeks after the treatments had been done, even though the number of the former increased gradually. There was no evidence that PCDF of these concentrations could permeate through the skin and could be toxic. Furthermore PCDF seemed to neither stay nor act directly on the follicular epithelium, since there was no acne formation on the back skin of mice. One of the possible factors to cause malignant changes of epidermal cells was supposed to be a prolonged inflammation of the skin.