Search

We evaluated the severity grades and the skin severity scores of the skin symptoms who visited the annual examinations of Fukuoka prefecture in 2003 and 2004. The severity of skin symptoms improved significantly in the first 20 years; nowadays, however, further improvement can hardly be observed. More than 36 years have passed since the Yusho incident, and about 60% of the patients currently present no skin symptoms. In contrast, in about 40% of the patients, characteristic skin symptoms of Yusho, such as pigmentation of skin, black comedones and acneform eruptions, could still be observed. Using Peason's correlation coefficient test and Spearman's correlation coefficient test, we analyzed correlation between "PCB pattern" and the blood PCB concentration, the skin severity grade and the skin severity scores. However, we could not find out any obvious correlation.

We evaluated the severity grades and the skin severity scores of the skin symptoms of Yusho patients who visited the annual examinations in 2001 and 2002. The patients who participated in the examinations had been decreased gradually. However, because of enhancement of social interest, the number of the patients who visited the examination increased. The pattern of the severity grades and the severity scores was different from that of the past. A careful follow-up and analysis is required.

We organized an inter-hospital teledermatology conference with images through a digital telephone line (ISDN, 128kbps). Our conference system consists of two videophones. A videophone "Phoenix PICSEND-R" (NTT) in the multi-point connection mode is used for discussion among doctors from five hospitals. In addition, using another videophone "Phoenix mini type-S" (NTT), clinical and dermoscopic findings obtained with a digital video camera and a videomicroscope "VMS-1900" (Scalar, Tokyo) respectively were transmitted to Shinshu University Hospital from four rural sites. We have found that the quality of the images obtained is entirely sufficient to make an accurate diagnosis. To calibrate the color and size of skin lesions, a matching sticker "CASMATCH" (Bearmedic, Tokyo) has proved useful. Forty-one times of conference were held from September 1999 to August 2002. In total, the concordance rate between the telediagnosis and the finally confirmed diagnosis was 69% (77 of 112 cases). In cases limited to pigmented skin lesions, the rate was higher (84%) and it was concluded that such conditions are suited for the telediagnosis. The ease with which the data can be manipulated enables us to discuss difficult cases in detail. This style of teleconference system may have benefits for dermatologists especially at rural hospitals in consultation with senior doctors.

The frequency of skin involvement of sarcoidosis is 10-30% of all cases, but the prevalence of a particular type of cutaneous lesion varies among races as well as individual cases. Cutaneous involvement is divided into specific and nonspecific categories. Specific lesions include nodules, plaques, lupus pernio, subcutaneous nodules, and other rare manifestations as well as scar infiltrates. Despite the clinical importance of scar infiltrates in the diagnosis of sarcoidosis, it is often overlooked because the lesions are usually small and asymptomatic. There is some clinical importance of cutaneous sarcoidosis; the ease in obtaining lesional samples which enables a histological diagnosis of sarcoidosis, and the association of a particular type of cutaneous lesion with other organ involvement.

We analyzed the severity grades of the skin symptoms of Yusho patients who visited the annual examinations in 1999 and 2000. The severity grades of the skin symptoms clearly improved. The patients graded as 0 increased and those graded as II.III-III or III.IV-IV decreased as compared to the data in 1993. The pattern of the skin severity scores did not change much, although the patients who showed 0.1 reached 68% in 2000. The blood PCB concentration of Yusho patients also clearly decreased, especially in the patients who showed "A" pattern. Furthermore, the skin changes of the aged patients should be analyzed in detail in the future.

We analyzed the severity grades of the skin symptoms of Yusho patients who visited the annual examinations in 1997 and 1998. The severity grades of the skin symptoms clearly improved. The patients graded as 0 I-II increased and those graded as II III-III decreased as compared to the data in 1993 and 1994. The skin severity scores did not change much, although the patients who showed 0 or 1 reached more than 60% in both 1997 and 1998. The blood PCB concentration of Yusho patients also clearly decreased, especially in the patients who showed "A" pattern.

We reported the grades of severity of skin symptoms and the blood PCB patterns and concentrations in Yusho patients who were examined in the annual examinations in 1993 and 1994. The skin severity grades and skin severity scores showed the same tendency as recorded in the last 15 years. Approximately 20% of the patients, however, claimed the tendency of recurrence of skin infections and/or infected epidermal cysts, and still approximately 30% of the patients exhibited acneiform eruptions. Ten patients recorded with more than 6 points of skin severity scoring in these examinations were further investigated their initial skin severity grades and blood PCB patterns and concentrations. It was found that most of their blood PCB patterns showed the A pattern, and the level of the blood PCB in one patient was 55.5 ppb in the initial stage. Five patients out of 10 patients still have more than 10 ppb of blood PCB concentration. Thus, it is concluded that small populations of Yusho patients still have active skin symptoms with considerable blood PCB levels even at present.

DNA-flow cytometry was performed on paraffin-embedded tissues from 7 cases of keratoacanthoma (KA) and squamous cell carcinoma (SCC). Proliferation index of tumor cells (% greater than 4SD) was defined as the percentage of cells that exceeded the diploid peak (G0G1) plus 4 standard deviations (SD). Proliferation index (% greater than 4SD) was lower than 20% in six out of 7 cases of KA, but higher than 25% in six out of 7 cases of SCC. One case of SCC showed a DNA aneuploidy. These results indicate that DNA-flow cytometry analysis using paraffin-embedded tissues may be a useful tool in differential diagnosis between keratoacanthoma and squamous cell carcinoma.

After 6 months on hemodialysis, a 58-year-old male patient with diabetes developed photosensitive bullous dermatosis on his hands and face. There was no evidence of liver diseases although the patient had a history of excessive alcohol consumption. He was suspected to have iron overload in the liver. Analysis of porphyrins in plasma, hemofiltrate, urine and feces by high performance liquid chromatography revealed significantly high levels in these samples with a porphyrin profiles which is consistent with porphyria cutanea tarda. The fluorometric assays of plasma also disclosed an elevated plasma porphyrin level. And it seemed that there were correlation between the fluctuation of vesicle formation, serum ferritin level and plasma porphyrin level. Small volume plasma exchange temporarily reduced the plasma porphyrin level and prevented vesicle formation.

Technical advances continue to expand the number of genetic disorders that can be diagnosed in utero. The current methods for prenatal diagnosis are as follows: Amniocentesis, fetoscopy, fetal blood sampling, biopsy of fetal skin, and chorionic villus sampling (CVS). The method for growing fetal cells obtained by amniocentesis in short term culture and karyotyping has opened a new area to chromosomal anomalies. By using cultured amniotic fluid cells in larger numbers, it is also possible to diagnose many metabolic disorders. Fetoscopy has been developed which permits the perinatologist to enter the uterus and obtain tissue sample or to actually view the fetus. However, it is very difficult to visualize the fetus directly through fetoscope. Only specific parts of the fetus can be readily identified, but a total examination of surface anatomy is rarely possible. Now ultrasonography with improved resolution can clearly define many major anatomical abnormalities without apparent risk. And also, fetal blood sampling and skin biopsy have been successfully performed under ultrasound guidance rather than under direct fetoscopic visualization. Recently, the advent of fetal blood sampling has made it possible to diagnose genetic disorders which have hitherto been impossible to recognize in the fetus. The main applications are for the prenatal diagnosis of the fetal infection, coagulopathies, hemoglobinopathies, and muscular dystrophies. Several severe genodermatoses result in early death or are associated with significant morbidity. Some of these disorders can be diagnosed in utero with skin biopsies. Harlequin Ichthyosis is a typical case. A positive prenatal diagnosis of Harlequin Ichthyosis was reported.(ABSTRACT TRUNCATED AT 250 WORDS)

APA is a common cause of constipation, and is the mild case of the imperforated anus. On diagnosing APA, anterior displacement of the anus and normal distribution of the external anal sphincter to the anus are essential. To determine the location of the anus in the perineum simple clinical technique was developed. In 61 normal cases, the result of measurement was almost same in each sex, but in 3 APA cases the location were anteriorly dislocated than normal cases. Distribution of the external anal sphincter was evaluated with electromyographic technique, and location map of the sphincter was made. In 3 APA cases, the anus was totally surrounded by the external anal sphincter, but in 17 ano-cutaneous fistula cases, the opening was anteriorly dislocated to the sphincter distribution map. As a conclusion, newly proposed simple clinical technique to determine anal location and electromyographic examination of the external and sphincter distribution are very useful in objective diagnosis of APA.