Down-regulation of protein kinase C isoforms in irritant contact dermatitis

Protein kinase C (PKC) isoforms are important in cell signal transduction associated with regulation of cell proliferation and differentiation. In this study, alterations of PKC isoform levels in irritant patch test reactions were detected by Western immunoblots. 4 chemically and structurally different irritants, 4% and 8% hydrochloric acid (HCl); 1% and 2% sodium hydroxide (NaOH); 20% and 40% nonanoic acid (NON) in 1-propanol; and 5% and 10% sodium dodecyl sulfate (SDS) were applied on the backs of mice in Finn Chambers and fixed with surgical dressings. The patches were kept on the skin for 24 h and removed. 24 h after removal, mild erythema with thickening of skin without vesicles was observed in all irritated skin, except that 4% HCl and 1% NaOH treated skin showed unremarkable skin reaction. No visible skin reaction was detected in vehicle-treated skin. PKC isoform alpha, beta, gamma, and delta levels in irritated skin revealed a 10% to 65% decrease compared to vehicle treated skin. These results indicate that in HCl, NaOH, NON and SDS-induced irritation, activation of the PKC related cell signal transduction cascade may be involved, and that PKC mediated events may be a common phenomenon in irritant contact dermatitis.     

Allergy to cocamidopropyl betaine may be due to amidoamine: a patch test and product use test study

Cocamidopropyl betaine (CAPB) is an amphoteric surfactant commonly used in personal care products and surface cleaners. Patch testing with commercially-available CAPB has yielded occasional reactions indicative of allergic contact dermatitis. To determine if subjects with previous positive patch tests would react in provocative use tests of products containing CAPB, and to study various contaminants in commercial CAPB supplies for allergenicity in these subjects, 10 subjects previously positive to CAPB on patch testing used a hair shampoo, hand soap, and body wash containing CAPB for 1-6 weeks or until a reaction developed. Later, they were patch tested to 2 different purity grades of CAPB and 3 possible manufacturing contaminants (dimethylaminopropylamine, amidoamine, and sodium monochloroacetate). 7 of the 10 subjects developed dermatitis from 1 or more CAPB-containing products at some point during the study. 9 of the 10 use-test subjects were then patch tested, and 6 of these subjects showed a reaction to amidoamine (0.1% aq.). None reacted to dimethylaminopropylamine (0.1% pet.). 1 subject reacted to CAPB but not to amidoamine. In the follow-up patch testing with CAPB that was free of amidoamine, there were no positive reactions. Most subjects who were patch-test-positive showed a reaction when using CAPB-containing skin and hair care products. The chemical amidoamine, which is used in the synthesis of CAPB and which is a known contaminant of CAPB preparations, is likely to be the actual sensitizer in most cases rather than CAPB itself. The results do not rule out the possibility that CAPB itself may be an allergen in rare cases.     

CABG after patch angioplasty of the left main coronary: artery report of a case

A 57-year-old man was admitted to our hospital because of restenosis of the left main coronary trunk (LMT) after patch angioplasty for the LMT lesion. PTCA was repeated four times during three years after patch angioplasty, but recent coronary angiogram still demonstrated 75% restenosis of the LMT lesion. Double-CABG was performed to LAD and LCX using the left internal thoracic artery and saphenous vein graft. Postoperative coronary angiogram revealed an excellent result. A careful consideration must be given to the indication of the patch angioplasty of the LMT lesion.     

Repair of mitral valve and subaortic mycotic aneurysm in a child with endocarditis

Endocarditis requiring surgical intervention in children is uncommon. Individualized operative therapy must be fashioned to the particular pathology of each case. In this case we describe mitral anterior leaflet homograft patch augmentation valvuloplasty, subaortic homograft patch closure of a large mycotic aneurysm, and homograft aortic root replacement in a 3-year-old patient with endocarditis after remote repair of complete atrioventricular canal.     

Prescribing practice of psychotropic drugs in a psychiatric university clinic

From 1989-1991, 214 patients (45 PD/AR, 54 PLE, 115 controls) were patch tested to a sunscreen series containing 9 constituents. 16/214 (7.5%) patients reacted to one or more sunscreens, with allergy being significantly more common in PD/AR patients (10/45 versus 2/54 PLE and 4/115 contact dermatitis clinic controls). The benzophenone group of sunscreens (mexenone, oxybenzone) were the most frequent sensitizers, accounting for 8 of the 27 positive patch tests observed. Clinicians should consider contact allergy to sunscreens in PD/AR patients as an explanation for exposed-site dermatitis episodes.     

A patch technique for reconstruction of stenotic pulmonary bifurcation in a Rastelli-type operation after palliations for cyanotic congenital heart disease. A report of two cases

A Rastelli-type operation was successfully performed on two patients with cyanotic congenital heart disease with pulmonary artesia (PA) and severe stenosis or obstruction of the pulmonary bifurcation, following the improvement of a pulmonary artery index (PA index) after palliative systemic pulmonary shunts. It is a point that stenotic or obstructive pulmonary bifurcation was reconstructed by a patch technique. An extracardiac conduit was used a combination of a bicuspid valved pericardial roll and a prosthetic vessel graft. In a 5-year-old male with an extreme type of tetralogy of Fallot associated with PA and patent ductus arteriosus (PDA), the enlargement of stenotic pulmonary bifurcation was attempted using a brimshaped equine pericardial patch in order to get sufficient suture margin and be safely anastomosed with a conduit. In a 6-year-old female with complete transposition of the great arteries, PA, PDA and right aortic arch (RAA), an obstructive pulmonary bifurcation behind the RAA was enlarged using a brimshaped equine pericardial patch. The attachment of the conduit was shifted to the left pulmonary artery to avoid compression of an extracardiac conduit and pulmonary artery behind RAA. Reconstruction of the pulmonary bifurcation using an equine pericardial patch is useful to anastomose an extracardiac conduit and the stenotic or obstructive pulmonary bifurcation.     

Effect of lamb age, breed and sex on plasma LH after administration of GnRH

Male lambs of the Finn, Fingalway and High Fertility breeds aged 4 or 8 weeks of age were injected i.m. with 5, 10, 50, or 100 micrograms GnRH. Plasma LH after GnRH injection increased with age and GnRH dose but there was no effect of breed. There was no interaction among the three factors studied. In a second experiment the response of male and female lambs, aged 8 weeks, to 100 micrograms GnRH was investigated for 5 genetic groups (Finn, Galway Control, Galway Elite, Fingalway and High Fertility). Breed differences in plasma LH of male lambs were not found, which agreed with the result of the first experiment. Breed differences were observed for females, with the lowest values being observed for Finn and High Fertility lambs which represent the two most prolific breeds. This finding suggested breed differences in the development of the hypothalamic-pituitary-ovarian circuit. The difference between Galway Control and Galway Elite lambs was not significant (P greater than 0.10).     

Crack Propagation Behaviour in Thin Aluminium Alloy Sheet Repaired with Adhesively Bonded CFRP Patch

For reducing the crack tip stress intensity factor, adhesively bonded composite patches are employed for crack repair in thin structure. Experimental work was carried out to study environmental assisted cracking behaviour of crack repaired with single-sided bonded patch in aluminium alloy of 7xxx series in peak-aged condition. The observations were also made on crack in this alloy without any patch repair. The specimen developed for conducting the experiments simulated plane stress condition of thin structure. The patched and un-patched tensile test specimens were loaded simultaneously at constant load in the presence of 3.5% weight NaCl solution. The experimental set-up simulated the saline or corrosive environment. Aggressive effect of corrosion attack on crack due to anodic dissolution along with hydrogen embrittlement leading to faster crack growth in patched specimen was revealed compared to un-patched specimen. The present study is the improvement over similar researches carried out earlier in terms of design of test specimen under plane stress condition so as to obtain all the three regions of crack growth.     

Physical properties of CH61, a newly developed root canal sealer

Tea tree oil is currently enjoying popularity as a 'cure-all' for a variety of skin conditions, from infections to psoriasis, and many household and personal products containing Melaleuca oil are available. However, despite its chemical complexities and enthusiastic use, there have been only a few reports of allergic reactions to tea tree oil. At the Skin and Cancer Foundation (Sydney, NSW, Australia), three of 28 normal volunteers tested strongly positive to patch testing with tea tree oil. Following further patch testing with tea tree oil constituents, all three patients reacted strongly to two preparations containing sesquiterpenoid fractions of the oil. Because patients often neglect to mention that they have used 'natural' remedies, it is important that physicians are aware of the potential adverse effects of these products. Furthermore, identification of the allergenic ingredients in tea tree oil may assist the growing industry to produce safer products.     

Screening for corticosteroid contact hypersensitivity

To evaluate which corticosteroids are most useful for the detection of corticosteroid contact allergy in our population, 2123 patients were patch tested with a series of 6 corticosteroids, in parallel with a standard series, and other relevant investigations. 127 patients (5.98%) were allergic to one or more corticosteroids; 96 to tixocortol pivalate, 51 to hydrocortisone butyrate, 47 to budesonide, 11 to betamethasone valerate, 11 to clobetasone butyrate and 8 to clobetasol propionate. 511 patients with negative patch tests to the limited corticosteroid series were in addition tested to a further 12 corticosteroids; only 1 of these patients reacted to a corticosteroid. A combination of tixocortol pivalate and budesonide thus detected 91.3% of corticosteroid-allergic subjects. We believe that both these allergens should be included in the standard series and that there may be a case for extending this further.     

Epidemiologic and genetic approaches in the study of gene-environment interaction: an overview of available methods

The purpose of this study was to assess what impacts on organized mosquito control the implementation of an Endangered Species Protection Program for the Houston toad might have in Chambers and Harris counties, Texas. The study was also intended to demonstrate the value of using geographic information system (GIS) techniques and methodologies in making such assessments to those in mosquito control who are unfamiliar with GIS and its applications. Using the GIS, Geographical Analysis Support System (GRASS), databases were developed on the habitats and patterns of mosquito control insecticide usage occurring in Chambers and Harris counties. These databases were then employed by means of various utilities associated with GRASS and computer-supported, rule-based reasoning processes to create maps depicting the amount and locations of toad habitat and the areas treated annually with insecticides by districts in Chambers and Harris counties. This map information was then used via other GRASS utilities to identify and depict zones of overlap or coincidence between toad habitat and areas treated with insecticides for mosquito control in the 2 counties. As compared to existing maps for toad habitat, our resulting GIS-generated maps gave more precise, easy-to-use information that could be used to make decisions as to how to protect the toad in the zones of coincidence in each county without causing undue disruption to mosquito control activities in these zones.     

How the NHMRC got its fingers burnt

On 20 December 1996, Justice J Finn of the Federal Court of Australia handed down his judgment in the case of the Tobacco Institute of Australia (TIA) Ltd and others v the National Health and Medical Research Council (NHMRC) and others. Justice Finn concluded that, in developing its recommendations for control of environmental tobacco smoke, the NHMRC's Working Party on Passive Smoking erred significantly in regard to the consultative procedures that it employed. As the following discussion shows, the legal decision has profound implications for the NHMRC and the provision of expert advice to Australian governments on matters of health and health policy. The discussion has been prepared by three members of the NHMRC Working Party, but reflects their personal views and not necessarily those of the Working Party as a whole or those of the NHMRC.     

Delayed-type hypersensitivity to a nonionic, radiopaque contrast medium

BACKGROUND: True allergic reactions to iodinated radiocontrast media are rare, and only a few well-documented cases of delayed-type hypersensitivity reactions caused by contrast media have been described. METHODS: We report a 61-year-old patient in whom percutaneous transluminal coronary angioplasty (PTCA) was performed with iopamidol, a nonionic contrast medium. Seven days later, the patient developed generalized maculopapular exanthema. Repeated patch tests with several iodinated agents were performed. RESULTS: A first patch test with iopamidol was positive. Repetition of the patch tests showed positive results to iopamidol as well as to iohexol and ioversol, two other nonionic contrast media, but not to other iodinated substances. Three months later, PTCA was repeated, and iopamidol was used again. Despite premedication, pruritic macular exanthema developed 1 day later. Whether iopamidol or trometamol -- an additive substance in the contrast medium -- was causative could not be determined, since a third set of patch tests was negative. CONCLUSIONS: Delayed-type hypersensitivity reactions to iodinated contrast media are rare. We recommend that patients with delayed exanthematous reactions undergo patch or intradermal tests with different contrast media and their additives, and that readings be performed immediately and later at days 2 and 3.     

Insertion of prosthetic tricuspid valve two years after the tricuspid valvulectomy

A case of a 14-year-old boy who underwent a prosthetic tricuspid valve insertion two years after the tricuspid valvulectomy due to intractable right-sided active endocarditis is presented. At the initial operation, the tricuspid valve was thoroughly resected because of marked destruction and attachment of vegetations, and a concomitant ventricular septal defect was directly closed. When a prosthetic valve was placed in the tricuspid portion, a semicircular Dacron patch was attached to the right side of the interventricular septum in a fashion of up-chord and down-arc to cover the bundle of His. The straight edge of the patch was located near the AV node and was not sutured to the tricuspid valve annulus. A 31 mm of CarboMedics prosthetic valve was sutured to the tricuspid valve annulus and to the free edge of the patch at the position near the AV node to prevent AV block. Postoperative course was uneventful and ECG showed regular sinus rhythm.     

Reoperation for mitral regurgitation 13 years after aortic valve replacement and manouguian's anulus enlargement: report of a case

The patient was 22-year-old female. She had undergone aortic valve replacement and Manouguian's anulus enlargement with low porosity woven Dacron patch for congenital aortic stenosis 13 years ago, and developed mitral regurgitation 9 years after that operation. Two regurgitant flow were observed. One was originated from the orifice due to mitral prolapse. The other was from a tear in the anterior leaflet. It was around the tip of the prosthetic patch, approximately 7 mm in size, and was repaired easily. But the mitral valve itself was found to be malformed and prolapsed, requiring mitral valve replacement. Her postoperative course was uneventful.     

Laparoscopic approach in the surgical treatment of non-advanced achalasia]

A 23-year-old woman presented with a 10 year history of excessive sweating (hyperhidrosis), mostly in the axillae, and to a lesser extent the groin and hands. Initial treatment with a sedative antihistamine and topical Driclor (aluminium chloride hexahydrate in 2% alcohol) for 14 weeks resulted in no improvement. Axillary liposuction, a short and simple procedure, then produced a very satisfactory result.     

A case of eosinophilic pustular folliculitis (Ofuji's disease) induced by patch and challenge tests with indeloxazine hydrochloride

A 73-year-old male developed disseminated erythema over his entire body after exposure to indeloxazine hydrochloride, a cerebral activator. Patch testing with indeloxazine hydrochloride showed a positive reaction, and plaques, vesicles and pustules developed on the face after the patch test. These had the pathologic feature of eosinophilic pustular folliculitis (EPF, Ofuji's disease). A challenge test also provoked eruptions on the face, trunk, arms and legs, which were compatible with EPF. Moreover, both the patch and challenge tests with indeloxazine hydrochloride induced eosinophilia. This is the first report of drug allergy-induced EPF, where drug sensitivity induced an abnormal eosinophilic response mimicking EPF.     

The metabolic and cardiovascular consequences of HRT

In a 39-year-old man an isolated, unruptured extracardiac aneurysm of the left sinus of Valsalva led to almost complete rarefication of one aortic valve leaflet, causing insufficiency of the valve. At operation the aneurysm entrance was closed with a patch and prosthetic replacement of the bicuspid aortic valve was performed. The result was satisfactory.     

Bronchial reactions to exposure to welding fumes

OBJECTIVES: To study the airway response and its mechanism to welding fumes in six welders with respiratory symptoms. METHODS: Methacholine and welding challenge tests were carried out. The concentration of welding fumes during the exposure test was measured. On two subjects who developed bronchoconstricition to welding challenge, additional tests were carried out including prick, patch, and inhalation challenges with metal salt solutions. RESULTS: Three subjects developed immediate bronchial reaction to exposure to welding fume; one to mild steel and stainless steel welding, another to mild steel and galvanised welding, and one only to galvanised welding. They all had a moderate to pronounced degree of non-specific bronchial hyperresponsiveness. The concentration of fumes during welding tests, particularly to galvanised welding, was high. An inhalation challenge test with zinc chloride salt solution in two subjects who reacted to galvanised welding was negative. Prick and patch tests with zinc chloride were also negative. CONCLUSION: The airway response to welding in these subjects is non-specific and is due to irritation rather than to sensitisation.     

Spontaneous rupture of the common carotid artery with pseudoaneurysm formation

A 27-year-old man presented to the ED with an expanding neck mass after a Valsalva maneuver during sexual intercourse. This patient was found to have sustained a spontaneous rupture of the common carotid artery with pseudoaneurysm formation. The defect was repaired surgically with a saphenous vein patch, and the patient recovered. We discuss the rare occurrence of spontaneous carotid artery rupture and subsequent pseudoaneurysm.