yagami akiko

Abstract: A 51-year-old man went mandarin orange picking near Lake Hamanako in Shizuoka Prefecture 15 days before the initial consultation to our hospital, followed by fishing at a pond in Nagoya City, Aichi Prefecture. He developed high grade fever and headache 5 days after fishing. When he visited our hospital, he had fever of 38°C, headache, faint erythema on the trunk and extremities, a crust bite mark on the left lower leg, and enlarged lymph nodes in both inguinal regions. We suspected tsutsugamushi disease; therefore, a blood sample was subjected to PCR. Kawasaki genotype was identified. Close to full recovery was achieved after a two-week treatment with minocycline hydrochloride initiated at the initial consultation. When we see a patient with fever and eruptions, it is necessary to keep in mind the possibility of tsutsugamushi disease. It is important to make a rapid diagnose with PCR and start medical treatment in this disease.Skin Research, 11: 220-223, 2012

A 72-year-old male presented with a 6-month history of a lower lip nodule with erosion. We suspected lichen planus or solar dermatitis. The histopathology of 2 biopsies showed benign epithelial hyperplasia. The nodules grew in size from 15 mm to 45 mm in diameter. From the clinical and pathological findings, we diagnosed the lesion as a squamous cell carcinoma. The tumor was surgically excised and the defect was closed by an Abbe flap. Histopathological examination of the specimen showed squamous cell carcinoma. Early stage squamous cell carcinoma of the lip often shows mild features clinically and pathologically. It may be difficult to diagnose early stage squamous cell carcinomas of the lip by a partial biopsy.[Skin Cancer (Japan) 2012 ; 27 : 226-230]

Although there are many reported cases of immediate allergy after ingestion of foods containing cochineal, there are few reports of allergic contact dermatitis from carmine. We present a rare case of allergic contact dermatitis due to carmine. A 52-year-old female presented with an itchy erythema on her cheeks at the site where blush had been applied. Patch-tested with her cosmetics, she showed a positive reaction to the blush (30% in petrolatum) and to 0.2% (but not 0.1%) carmine in petrolatum. In this case, the optimum patch-test concentration of carmine was 0.2% in petrolatum.

Background: In recent years, it has been reported that stem cells exist in the mesenchymal tissues of the bone marrow and adipose. These stem cells are thought to express specific cell surface markers such as CD44, CD54, CD105, CD90, and CD271 and have been confirmed to be pluripotent. Furthermore, although it has been reported that stem cells are also present in the dermis, their cell surface markers and characteristics are not fully understood. Objective: To confirm the presence of stem cells in the dermis and their ability, employing the mesenchymal stem cell markers which have previously been reported as an indication. Methods: We analyzed the percentages of CD44 (+), CD54 (+), CD90 (+), CD105 (+), and CD271 (+) cells in the dermis of neonatal mice (HR-1 mouse) by performing immunostaining and FACS. Secondly, we isolated each type of marker-positive and -negative cells from dermal tissues and evaluated their proliferation potential and their ability to differentiate into adipocytes, osteoblasts, and chondrocytes. Results: According to the immunostaining and FACS results, we confirmed that stem cells that express CD44, CD54, CD90, CD105, and CD271 are present in the dermal tissues of neonatal mice. In addition, when we measured the proliferation and differentiation potentials of each type of marker-positive cells, it was revealed that cells expressing CD54 or CD271 have a high proliferation potential and are able to differentiate into adipocytes, osteoblasts, and chondrocytes. Conclusions: These results indicated that dermal tissues contain stem cells that express CD44, CD54, CD90, CD105, and CD271 which are stem cell markers. More precisely, it was suggested that both CD54 (+) and CD271 (+) stem cells have high proliferation and differentiation potentials. (C) 2011 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

A 13-year-old girl who had had pollinosis since the age of eight began to experience itching of the ears and vomiting after eating fresh fruits such as peach, apple and watermelon. This occurred at 10 years of age. The girl displayed positive reactions to six kinds of pollens, eleven kinds of fruits, numerous vegetables and to recombinant: rBet v2 present in specific IgE antibodies. She also reacted positively to several pollens, fruits and rBet v2 in the skin prick test. In the component-resolved diagnosis (CRD) using microarray technology, she also tested positive for profilin, a pan-allergen among plants. It is reported that profilin cross-reacts between pollen, fruits, vegetables and latex. From these results, we concluded that the allergic reactions to multiple kinds of foodstuff and pollens observed in this subject were due to cross-reactivity induced by profilin. Our results demonstrate that CRD by microarray is a reliable test in the diagnosis of PFAS. © 2011 Japanese Society of Allergology.

IL-33 is a member of the IL-1 family and mediates its biological effects via the ST2 receptor, which is selectively expressed on Th2 cells and mast cells. Although polymorphic variation in ST2 is strongly associated with asthma, it is currently unclear whether IL-33 acts directly on lung tissue cells at sites of airway remodeling. Therefore, we aimed to identify the IL-33-responsive cells among primary human lung tissue cells. ST2 mRNA was expressed in both endothelial and epithelial cells but not in fibroblasts or smooth muscle cells. Correspondingly, IL-33 promoted IL-8 production by both endothelial and epithelial cells but not by fibroblasts or smooth muscle cells. Transfection of ST2 small interference RNA into both endothelial and epithelial cells significantly reduced the IL-33-dependent upregulation of IL-8, suggesting that IL-33-mediated responses in these cells occur via the ST2 receptor. Importantly, Th2 cytokines, such as IL-4, further enhanced ST2 expression and function in both endothelial and epithelial cells. The IL-33-mediated production of IL-8 by epithelial cells was almost completely suppressed by corticosteroid treatment. In contrast, the effect of corticosteroid treatment on the IL-33-mediated responses of endothelial cells was only partial. IL-33 induced activation of both ERK and p38 MAPK in endothelial cells but only ERK in epithelial cells. p38 MAPK was required for the IL-33-mediated responses of endothelial cells, whereas ERK was required for IL-33-mediated IL-8 production by epithelial cells. Taken together, these findings suggest that IL-33-mediated inflammatory responses of lung tissue cells may be involved in the chronic allergic inflammation of the asthmatic airway. The Journal of Immunology, 2010, 185: 5743-5750.

We report two cases of anaphylaxis due to ingestion of mite-contaminated Okonomi-yaki (Japanese pancake) mix. Case 1: A 50-year-old female developed anaphylaxis after eating Okonomi-yaki prepared from Okonomi-yaki mix that had been stored at room temperature after opening. She demonstrated serum specific IgE against Dermatophagoides farinae (Der. f.), but did not demonstrate any wheat- or gluten-specific IgE antibodies. Prick tests showed positive reactions to Der. f. antigen (Torii) but not to previously unopened Okonomi-yaki mix or wheat flour that had been stored in a freezer. Case 2: A 28-year-old female developed anaphylaxis after eating Monja-yaki prepared from Okonomi-yaki mix that had been stored at room temperature after opening. She demonstrated serum specific IgE antibodies against Der. f. but no wheat- or gluten-specific IgE antibodies. Prick tests showed positive reactions to the responsible Okonomi-yaki mix and Der. f. antigen (Torii), but not to wheat flour that had been stored in a freezer. The responsible Okonomi-yaki mix contained 50 heads/g of Der. f., and a high level (64.1 μg/g) of Der f1 antigen was detected by specific ELISA. Immunoblotting revealed a specific 25 kDa band in patient sera against the responsible Okonomi-yaki mix, which was absorbed by Der. f. crude antigen.

Three elderly male patients aged 55, 76 and 91 years presented with widespread eruptions of erythematous, flat-topped confluent red to reddish-brown papules that spared the skin folds. They had each undergone various unsuccessful treatments (oral antihistamines, topical and oral corticosteroids). We diagnosed these patients as having Ofuji's papuloerythroderma. These eruptions were not associated with malignant tumors. Their eruptions and subjective symptoms started to reduce after approximately 4-7 narrow-band UVB treatments, and the eruptions virtually disappeared after approximately 10 treatments. They had slight exacerbation but the eruptions subsided. We conclude that narrow-band UVB is more useful for papuloerythroderma than other treatments because of its convenience and limited side effects.

Background: Amphiregulin (AR) is expressed in Th2 cells, rather than Th1 cells, and plays an important role in Th2 cell/cytokine-mediated host defense against nematodes. We also found earlier that AR mRNA expression was strongly upregulated in inflamed tissue during Th2 cell/cytokine-mediated fluorescein isothiocyanate (FITC)-induced contact hypersensitivity (CHS), suggesting a contribution of AR to the induction of those responses. Methods: To elucidate the role of AR in the induction of FITC- or dinitrofluorobenzene (DNFB)-induced CHS, AR-deficient mice were sensitized and/or challenged with FITC or DNFB epicutaneously. The levels of FITCmediated skin dendritic cell (DC) migration and FITC-specific lymph node cell proliferation and cytokine production were assessed by flow cytometry, [3H]-thymidine incorporation and ELISA, respectively, after FITC sensitization. The degree of ear swelling, the activities of myeloperoxidase (MPO) and eosinophil peroxidase (EPO) in inflammatory sites and the levels of FITC-specific immunoglobulin (Ig) in sera were determined by histological analysis, colorimetric assay and ELISA, respectively, after FITC challenge. Results: DC migration and FITC-specific lymph node cell proliferation and cytokine production were normal in the AR-deficient mice. Ear swelling, tissue MPO and EPO activities and FITC-specific serum Ig levels were also similar in AR-deficient and -sufficient mice. Conclusions: Amphiregulin is not essential for the induction of FITC- or DNFB-induced CHS responses in mice. © 2010 Japanese Society of Allergology.

We report two Japanese patients with Stevens-Johnson syndrome (SJS) who were investigated for HLA gene markers associated with SJS and toxic epidermal necrolysis. Patient 1 was a 53-year-old woman. She developed eruptions in oral provocation tests and was diagnosed with SJS due to allopurinol, clarithromycin, and loxoprofen sodium. Gene analysis revealed HLA-B^∗5801. Patient 2 was a 54-year-old man. He was positive on a carbamazepine patch test and drug-induced lymphocyte stimulation test, and was diagnosed with SJS due to carbamazepine. HLA-B^∗1502 was not detected on gene analysis.

花粉飛散時期に、もやしによるアナフィラキシーを来した11歳男児症例について検討した。5月に外食での摂取後にアナフィラキシーを認めた。皮膚検査や血清学的検査ではシラカンバ>100、ハンノキ>100、生のもやしが強陽性で、感染特異的タンパク質(PR)-10関連抗原による交差反応性を示すpollen-food allergy sydromeと考えられた。この症例は、もやし摂取によりアナフィラキシーを来した時期とシラカンバ飛散時期が一致していること、花粉の飛散時期を過ぎると症状が消失していたなどの特徴が認められた。

We report a 22-year-old woman with urticaria, dyspnea and bronchial asthma-like attacks after eating curried rice. We found the symptoms to be due to an immediate-type allergy caused by spice antigens contained in curry spices by detailed questioning, skin test and measurement of specific immunoglobulin (Ig)E antibodies. This case was complicated with pollen-food allergy syndrome (PFAS) from melon and latex allergy (LA) to natural rubber latex (NRL) antigen and she had also had atopic dermatitis, allergic rhinitis and pollinosis. Serum specific IgE antibodies to birch profilin (Bet v 2), latex profilin (Hev b 8), and timothy profilin (Phl p 12) were detected. She also showed positive reactions to several Apiaceae families, fruits and latex antigens in skin prick test. Based on these findings, we considered her symptoms to be involved with spice allergy, PFAS and latex-fruit syndrome.

Oral allergy syndrome to soy milk is classified as a phenotype of pollen-food allergy syndrome (PFAS). As causative antigens, Gly m 4 (Bet v 1 homolog, 17 kD) and oleosin (23 kD), have been reported. In this study, we report two cases of PFAS to soy milk. Both cases showed positive reactions to soy milk in skin prick tests (SPT) and to Gly m 4 in specific serum immunoglobulin (Ig)E antibody. When we measured specific serum IgE antibody of soy-related proteins using a new laboratory testing method, microarray analysis, both cases showed a positive reaction for Bet v 1. One case was weakly positive for a soybean protein, beta-conglycinin. Other results for reactivity to soy, peanut, cross-reactive carbohydrate determinants and profilin were negative. Based on these results, we diagnosed the two cases as PFAS to Gly m 4. We also performed protein microarray analysis and found it useful as a screening test for immediate allergy, such as PFAS.

Background: Natural rubber latex (NRL) allergy is a common occupational disease in health care workers (HCW). However, few reports have compared the major allergen of HCWs to those in gloves that are routinely used in the hospital. The aim of this study was to evaluate the major NRL allergens in gloves used by HCWs. Methods: We studied 20 HCWs who were suspected to have latex allergy (LA). We performed a skin prick test (SPT) using NRL allergens. Serological testing was performed using the ImmunoCAP™. The total amount of protein and the antigenic protein concentrations extracted from NRL gloves were measured. Four different types of FITkit™ were used to measure the concentrations of Hev b 1, 3, 5, and 6.02 in the gloves. Results: A SPT using NRL extract identified 14 cases with positive reactions. The sensitivity and specificity of the SPT scores to the NRL glove extract were 100%. The sensitivity of latex specific IgE was 100% but the specificity was 14.2%. The sensitivity and specificity of rHev b 6.02 specific IgE were 100% in the LA group. The total amounts of protein from the medical gloves for surgery and examination were 265 μg/g and 95 μg/g, respectively. The antigenic protein concentrations in the gloves were 24.9 μg/g and 1.0 μg/g, respectively. The total amounts of the specific four allergens in the NRL gloves were 2.18 μg/g and 0.45 μg/g, respectively. Conclusions: We concluded that the main allergen of HCWs who have been sensitized occupationally by NRL gloves was Hev b 6.02. ©2009 Japanese Society of Allergology.