[Complications after ambulatory gastroscopy].
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Biomedical subjects
Publications and source records attributed to K E Andersen.
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Tris(2,3-dibromoprophyl) phosphate (TDB P) is marketed under many different trade names as a flame retardant, used in clothing and home furnishings. DTB P is chemically related to tricresylphosphate (TCP) and triphenylphosphate (TPP) used as plasticizers in plastics and lacquers. The International Contact Dermatitis Research Group (ICDRG) in 1976 examined the incidence of sensitization to TDB P and found two positives among 1103 patients. One of these two cases is reported here in detail. It concerns a woman, aged 56, with spectacle frame dermatitis. The spectacle frame did not contain TDB P and sensitization with another phosphate ester is assumed.
Two patients with contact allergy to Ultralan preparations are reported. Each Ultralan preparation contains two of three related fluocortolone derivatives. The first patient reacted to all three derivatives. The second patient reacted to flucortolone and when retested 4 months later also to fluocortolone pivalate but ot to flucortolone caproate. The negative reaction to fluocortolone pivalate at the first examination was probably false negative due to a low test concentration. In order to avoid false negative patch test reactions the fluorinated steroids should possibly be applied in concentrations higher than 1%. No cross sensitivity to the other steroids for topical use was found.
Gammacamera scintigraphy studies in three patients with urinary extravasation following renal transplantation are presented. Images were obtained using 131I-orthoiodohippurate. Urinary leakage were detected in each case. The diagnosis were in all three cases confirmed at surgery.
A 78-year-old woman is described, having systemic sarcoidosis for 15 years, involving the lungs, lymph nodes and the skin. Over the last 6 years she developed a progressive cicatricial alopecia with histologic changes of the granulomatous type of necrobiosis lipoidica surrounded by sarcoid granulomas.
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Intramuscular injections of digoxin, bumetanide, pentazocine or isotonic sodium chloride have been given to 39 patients. We followed the serum concentrations of creatine kinase (CK), aspartate aminotransferase (ASAT), lactate dehydrogenase (LDH) and LDH isoenzymes for 4 days. Ten patients receiving 500 mug digoxin showed a significant rise in CK, which lasted for 48 hours, and 6 of them had CK values exceeding the upper normal limit. Pentazocine in a dose of 30 mg given to 9 patients caused a significant rise in CK and LDH isoenzyme 1, but in no case did the level exceed the upper normal limit. No rise in ASAT or total LDH was found after digoxin and pentazocine injections. No changes in enzymes were discovered after bumetanide or isotonic sodium chloride. In the diagnostic evaluation of acute myocardial infarction, a moderate rise in CK must be assessed with caution when the patients have received i.m. injections of drugs with osmolarity and pH outside the physiological limits.
The air around intact feverfew (Tanacetum parthenium) plants was examined for the presence of airborne parthenolide and other potential allergens using a high-volume air sampler and a dynamic headspace technique. No particle-bound parthenolide was detected in the former. Among volatiles emitted from the aerial parts of feverfew plants and collected by the dynamic headspace technique a total of 41 compounds, mainly monoterpenes, were identified and quantified by GC and GC-MS. Alpha-Pinene, camphene, limonene, gamma-terpinene, (E)-beta-ocimene, linalool, p-cymene, (E)-chrysanthenol, camphor and (E)-chrysanthenyl acetate were the predominant monoterpenes accounting for nearly 88% of the total volatiles emitted. The average total yield of volatiles emitted over 24 h was 18,160 ng/g fresh weight of leaves and flowers, corresponding to the emission of approximately 8 mg volatiles per day from one full-grown feverfew plant. No parthenolide or other sesquiterpene lactones were detected. The present investigation does not support the theory of airborne sesquiterpene lactone-containing plant parts or of direct release of sesquiterpene lactones from living plants as the only explanations for airborne Compositae dermatitis. Potential allergens were found among the emitted monoterpenes and their importance in airborne Compositae dermatitis is discussed.
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International test guidelines, such as the Organisation for Economic Cooperation and Development (OECD) guideline #406, recommend 2 guinea pig methods for testing of the contact allergenic potential of chemicals: the Guinea Pig Maximization Test (GPMT) and the Buehler test. Previous comparisons between the methods suggested that the Buehler test was less sensitive than the GPMT although modified Buehler test protocols were used. Parallel GPMT and Buehler tests were conducted according to OECD guideline #406 using a multiple-dose design and test results were analysed using a standard logistic dose-response model. To compare the sensitivity of the 2 test procedures the test conditions were kept identical and the following chemicals with a range of sensitization potentials were tested: chloraniline, chlorhexidine, eugenol, formaldehyde, mercaptobenzothiazole and neomycin sulphate. Formaldehyde and neomycin sulphate were strong sensitizers in both tests. Mercaptobenzothiazole, eugenol and chloraniline were all strong sensitizers in the GPMT, eugenol and mercaptobenzothiazole were negative in the Buehler test and equivocal results were obtained with chloraniline. Chlorhexidine was negative in the GPMT and equivocal responses were obtained with the Buehler test. Higher induction concentrations were needed to show allergenicity in the Buehler test and for some allergens the Buehler test protocol was not sensitive enough to demonstrate allergenic potential.
Hyperkeratotic dermatitis of the palms--also called eczema keratoticum--is a chronic, sometimes disabling condition in middle-aged persons. We carried out a single-blind, placebo-controlled study using acitretin in 29 patients. Fourteen patients received active therapy (30mg acitretin daily) and 15 placebo. All had hyperkeratotic changes of the palms with painful fissures and most had involvement of the volar aspects of their fingers. Approximately half of the patients had similar plantar changes. A semi-quantitative score of six parameters was used: hyperkeratosis, fissuring, scaling, itch, redness and vesicle count. After 4 weeks of treatment, a 51% reduction of all symptoms was observed among patients receiving acitretin (p < 0.01) compared with a 9% reduction in the placebo group (p>0.05). No further improvement was seen over another 4 weeks of treatment. There were no changes in blood biochemistry, including serum lipids. No patients discontinued therapy because of side effects. We conclude that 30 mg of acitretin is efficacious and safe to use in patients with hyperkeratotic dermatitis of the palms.
Microcult G.C. is a kit for cultivation and identification of Neisseria gonorrhoeae. ue of this kit was compared with the cultivation and identification methods of the Neisseria Department, Statens Seruminstitut, Copenhagen (WHO collaborating center for reference and research in gonococci). The investigation included 203 men and 80 women who appeared for examination at our veneral disease clinics. For examination of urethral specimens from men the predictive value of positive tests was found to be 93% and the predictive value of negative tests was 94%. For specimens from the urethra and cervix of women, the predictive value of positive tests was 95% and the predictive value of negative tests was 90%. The reliability of these results makes Microocult G.C. a valuable supplement to microscopy in venereal disease clinics with a relative high prevalence of gonorrhoea. The predictive value of positive tests from the anal canal was 21% and from the tonsils 3%; in these locations the test is not suitable for diagnostic purposes.
Detergents are involved in the causation of contact dermatitis and in promoting percutaneous absorption of toxic chemicals, but limited information is available to allow an assessment of their relative effects on the skin barrier function. The effect of detergents on skin permeability to water and nickel was examined in an in-vitro model using human skin. Twenty-four of the most widely used detergents were studied. After a two-hour exposure to an aqueous detergent solution, penetration of labeled model compounds was followed for 66 hours. Interindividual variation was substantial, but 12 of the detergents caused statistically significant increases in the penetration of water, nickel, or both. Nonionic detergents were as likely as anionic detergents to have this effect. This study demonstrates that useful information may be obtained by a simple in-vitro method, and that such data may provide a basis for substitution efforts.
The value of the dimethylglyoxime stick test for the detection of nickel was determined for 54 randomly purchased metal objects designed for prolonged skin contact, and for 15 metal alloys of known composition. Surface nickel content was determined by EDAX analysis (energy dispersive X-ray) and nickel release in synthetic sweat was measured by Zeemann atomic absorption spectrometry. The study confirmed that the dimethylglyoxime stick test will identify most nickel containing alloys. There are, however, important exceptions. In such cases provocative user tests or patch tests with the suspected alloy are indicated.