To identify factors that might improve the prognosis of adult T-cell leukemia/lymphoma (ATL), we reviewed data on 47 autopsied cases of ATL with reference to the complications and cause of death. The primary cause of death was respiratory insufficiency due to pulmonary infection. Respiratory insufficiency was also attributed to the diffuse alveolar damage and pulmonary fibrosis resulting from chemotherapy given and oxygen. About 90% of the cases had infections with one or more pathogens. Cytomegalovirus (CMV) was the most frequent pathogen involved in 35/47 (74.5%) while fungal infections were also commonly seen in 25 of the 47 cases (53.2%). Of these, 17 (70%) had pulmonary aspergillosis. Other neoplasias were present in 10 of the 47 cases, while hypercalcemia was evident in 21 patients. These findings suggest that the prevention and treatment of nosocomial infections and of drug-induced pulmonary toxicity may improve the prognosis and quality of life of ATL patients.

The natural course of nail pigmentation was documented in 4 Japanese children. Although initial progression of melanosis concerning size and degree of pigmentation was noted, all cases showed a tendency to fade during the follow-up period. The published cases of nevoid nail melanosis in childhood were reviewed, and we concluded that they were essentially benign. However, should there be any suspicion of malignant changes, punch biopsy is indicated for medico-legal reasons. Management of growing pigmented nail streaks in childhood is one of the most difficult and delicate problems facing dermatologists, as they can be precursors of malignant melanoma. There is a condition of the nail known as longitudinal melanonychia or naevus striae unguis, possibly of nevoid nature. Prevalence rates of nevoid diseases showing pigmentation of the skin vary depending on the ethnic origin. In order to understand the natural course of nail area pigmentation in childhood, we have followed 4 Japanese children with such a condition. We report our observations and review the literature.

Our previous results indicated that noncrystalline regions in a regenerated cellulose film comprised at least three domains engaged in different manners of molecular assembly [Kondo et al. In Cellulose Derivatives; Heinze, T. J., Glasser, W. G., Eds.; ACS Symposium Series 688; American Chemical Society: Washington, DC, 1998; Chapter 12]. In this article, we attempt to characterize each of the three noncrystalline domains in the film. The method used was a FTIR monitoring of deuteration from hydroxyl (OH) groups to OD, leading to the two-dimensional (2D) correlation analysis. The time-scan spectra in the OH-OD exchanging reaction were transformed into two kinds of 2D correlation spectra, the synchronous and the asynchronous spectra. Of the two, some cross-peaks were found in the latter spectrum. This suggests that the asynchronous 2D correlation spectrum could differentiate the contribution of OH groups due to different frequencies of hydrogen bonds in each domain. Here we will show the validity of this 2D correlation method as a powerful tool to predict hydrogen-bonding networks of the noncrystalline domains in cellulose.

Stiff skin syndrome was first documented by Esterly and McKusick. We saw a patient with this disease, as well as another who had a similar condition but a somewhat different histology. These two patients shared heritable stiff skin, restricted joint mobility, and absent mucopolysacchariduria. In stiff skin syndrome, which may have two variants, skin biopsy demonstrates large cells stained metachromatically by toluidine blue. These cells are shaped like dermal melanocytes or rounded cells and their presence may be directly related to the deposition of mucopolysaccharide in the dermis. In some cases they may invade the deeper tissues. Two cases of stiff skin syndrome that were in the Japanese literature are also discussed.