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[Sweet's syndrome. A study of 10 cases and review of the literature].

Ten cases of acute febrile neutrophilic dermatosis or Sweet's disease have been studied clinically and histologically. Seventy percent of the patients were females with mean age of 43.1 +/-9 years. All of them presented the typical skin lesions consisting of papules and painful erythematous--edematous plaques in face, neck and upper chest. Fever was observed in seven patients and painful joints in four cases. One case presented polyarthritis of the big joints and there was one other case of conjuntivitis. The analytical data revealed a constant increase in sedimentation rate observed in 90% of patients. Leukocytosis was observed in 30% of patients and neutrophilia in 40%. Histologically, the lesions showed a neutrophilic infiltration of the skin without signs of vasculitis. Eight patients received treatment with Prednisone per os, one of whom, because of his relapses, was later given Potassium Iodine. Another patient was treated with Indomethacin, and one patient did not received any treatment. The evolution was favorable in all cases with sustained remissions. Sweet's Syndrome has been described associated mainly with acute myeloid leukemia in 10-20% of patients and in isolated instances with other systemic and neoplasic diseases. The concomitant conditions in 50% of our cases were: Ulcerative colitis, nodular sclerotic Hodgkin disease, infiltrative ductal carcinoma of the breast, carcinoma of the uterus neck and Crohn's disease; these last two associations had not been previously described in the literature.

Adult↗

Postmortem forensic toxicology.

After all of the analytic data have been accumulated, the final step in the toxicologic process is to assess the meaning of the results. In suspected drug intoxications, one must determine if the amount of toxicant or toxicants present in the appropriate specimens is consistent with producing lethality. This decision ultimately must be made by the medical examiner or coroner, who must also consider the history, scene investigation, and gross and microscopic autopsy findings in reaching this decision. Once the cause of death has been determined, the manner of death needs to be decided. This can produce another group of questions to be addressed by the toxicologist. Items such as route of administration, acute versus chronic dose, and consistency between drug concentrations and behavioral effects may be critical factors in assessing the manner of death. These questions may arise even if the cause of death is ruled not to be drug related.

Autopsy↗

[Suicidal administration of elemental arsenic].

A case of suicidal arsenic poisoning with predominantly gastrointestinal symptomatology is reported. According to his own statement, a student of chemistry had taken in 30 g of metallic arsenic. During the following period he suffered from frequent vomiting and excessive diarrhoea. Approximately 15 hours after the oral application he sought for medical help and was brought into a hospital. Despite of gastric lavage with carbo animalis, hemodialysis, and BAL as antidote the patient died after a survival time of altogether 48 hours. By means of x-ray fluorescence analysis and atomic absorption spectrometry 350 mg of arsenic could be detected in the gastric fluid of the corpse; x-ray diffractometric analysis actually proved the presence of elemental arsenic. Nevertheless it can't be excluded that the metallic form was contaminated with arsenic oxides. The paper presents the clinical course, the analytical data, and the postmortem findings.

Adult↗

[Total mercury levels in human milk from Italian mothers having not been particularly exposed to methyl-mercury].

Some researches have been carried out about the foetal and neonatal exposure to methylmercury among the epidemiological studies on the effects of the exposure to this compound with foodstuffs. From the whole of these studies it seems that newborns are particularly sensitive to organic mercury compounds. The health effects can also appear in newborn of mother without symptoms. Now we show the early results of a carried out survey on some mothers without stated exposure to methylmercury living in the area or near Padua (Italy). The analytical data are concerning the levels of total mercury, total fats, lactose and total proteins in the breast-milk. The data, on 33 women, are summarized in a table, as: the number of sample, the mother's age, the time-lag from the delivery and the beginning of milk collection (day after delivery), the levels of total mercury, total fats, lactose and total proteins in breast-milk. In the table, also, the smoking habits, the alcohol consumption and the frequency during the last weeks before the delivery of the consumption of fish, if available, are registered. All the samples of breast-milk were positive in the mercury level. The mean total mercury level was 13.94 +/- 12.94 micrograms/L. The range of values was among 1.63 micrograms/L and 52.5 micrograms/L. 11 mothers eat fish on average once a week, only 3 mothers eat fish twice a week. 12 mothers eat fish seldom, between twice a month or once every two months. Present Italian values don't differ significantly from that of Spain and of coastal areas of Alaska. Present Italian values are significantly higher than those of inner areas of Alaska, Poland, Iowa and Tokyo. No statistic significant correlation is between mercury levels and nutritional components of breast-milk. In order to assess the health risk, we utilize the calculated tolerance concentration of mercury in human milk by Jensen, as 4 ppb. Only 11 (33.3%) of the analyzed breast-milk samples have total mercury levels below 4 ppb. Nevertheless, the possible high intake of mercury is over estimated by PTWI.

Adult↗

Factors modifying valproate plasma level/dose ratio: age, sex, dose and plasma level.

Valproate plasma level/dose (L/D) ratios obtained from 155 outpatients under long-term monotherapeutic regimen have been studied. Analytical data were obtained by enzymatic immunoassay (EMIT) from paired samples taken before the morning drug dosage. L/D ratios were increased with age and plasma level and decreased with dose. There were no sex differences in L/D in the different age, dose and concentration groups. L/D ratios were higher than those found by other researchers in our country.

Adolescent↗

Progress in purification of virus-inactivated factor VIII concentrates. Three generations of solvent/detergent treated plasma derivatives.

A production process of a newly developed highly purified and virus-inactivated Factor (F) VIII-concentrate (Octa V.I. and Octavi) is presented. Taking advantage of a selective resin matrix and the solvent/detergent procedure for virus inactivation--known not to denaturate proteins--a product of a specific activity greater than or equal to 100 IU F VIII/mg could be developed in the final container without the use of an immuno-affinity adsorption step. The main steps of the procedure are: Pooled cryoprecipitate is extracted, the extract is cleared from fibrinogen at + 10 degrees C and virus-inactivated at + 28 degrees C after addition of tributyl-phosphate (TNBP) and detergent. Thereafter the extract is brought in contact to a F VIII-selective anion exchange resin using a chromatographic column. TnBP and the detergent are removed by an extensive washing process and the F VIII-activity is concentrated in a fraction, ready for filling, by means of a cascade of wahing- and elution-buffers. The product is free from coagulable protein and gamma-globulins. The F VIIIC: Ag/F VIII:C-ratio is about unity, suggesting the F VIII-molecule remained in its native state. The development of highly purified F VIII concentrate is based on two previous products of lesser purity (spec. activity of about 1 and 10 IU/mg). The evolution is shown by a comparison of detailed analytical data.

Chromatography, Ion Exchange↗

[Pilot study of the evaluation of the nutritional status in a population sample in a health area].

We report the evaluation of a pilot study for the nutritional state carried out at a Health Center in Murcia, using a qualitative foodstuff questionnaire related to the previous 24 hours and the evaluation of anthropometric and analytical data. The evaluated individuals were randomly selected between the persons who had previously consulted. The survey was carried out by an interviewer. An outstanding result was that 90% of the surveyed individuals had ingested, at least one foodstuff from each group. The fat compartment was measured through the tricipital and subscapular fold and Quetelet index, and the protein compartment was measured through the muscular area of the arm. As reference values, the NHANES (USA) and the Alastrue Vidal (Spain) tables were used. It was found that the tricipital fold of the investigated population was underrated in the american tables (p less than 0.01).

Adolescent↗

[Cholecalciferol Reference Standard (Control 871) of National Institute of Hygienic Sciences].

Cholecalciferol Reference Standard (Control 871) for the Japanese Pharmacopoeia was prepared. The following analytical data were obtained: melting point, 86.3 degrees C; infrared spectrum, same as the Japanese Pharmacopoeia Standard "Cholecalciferol Standard (Control 851)"; absorbance, E1%1cm (265 nm) = 474.5; optical rotation, [alpha]20D = + 110.0 degrees; thinlayer chromatography, same as the Japanese Pharmacopoeia Standard; highperformance liquid chromatography, contaminants were not detected; assay, 100.7%. On the basis of those results, this material was authorized as the Japanese Pharmacopoeia Standard (control 871).

Chemical Phenomena↗

Hartmann on adaptation: an incomparable or incomprehensible legacy?

Hartmann's essay sets forth ideas of incomparable value as well as incomprehensible density. While he developed many important concepts which have far-ranging clinical utility even today, his attempt to extend psychoanalysis into a general psychology back-fired because it separated psychoanalytic concepts from analytic data. Because of his lack of clinical material or anecdotal illustration, Hartmann's theoretical scaffolding has been frequently misunderstood and misapplied. This paper re-examines Hartmann's essay in light of current clinical and metapsychological issues, and illustrates some of his more important ideas.

Adaptation, Psychological↗

Spectrophotometric determination of some benzene sulfonamides with 7,7,8,8-tetracyanoquinodimethane.

A new spectrophotometric method for the determination of some unsubstituted benzene sulfonamides is presented. The method is based on the interaction of these derivatives with 7,7,8,8-tetracyanoquinodimethane at pH 9.0-9.5 to produce intense blue products. The quantitation of the products was carried out at 578 nm. Beer's law was obeyed over a wide range of concentrations for all sulfonamide compounds studied. Optimum analytical conditions were determined, and the color produced was stable for at least 90 min at 25 degrees C. Analytical data for determination of sulfonamide compounds in pure form are presented together with application of the proposed method for analysis of some commercially available pharmaceutical preparations. The results are in good agreement with those obtained by official procedures.

Benzene Derivatives↗

Histomorphological and lectin-histochemical confirmation of the antidegenerative effect of diclofenac in experimental osteoarthrosis.

The integrity of cartilage matrix depends on the homeostasis of synthetic and degradative processes. Any disturbance of the rate of synthesis and catabolism may alter the amount of matrix components (e.g. proteoglycans). Based upon a biochemically induced osteoarthrosis (OA) in the knee joints of rats we investigated the histomorphological alterations under therapy with diclofenac sodium by histological-histochemical grading. Lectin-binding techniques using labelled wheat germ agglutinin (WGA), concanavalin A (Con A), Ulex europeus agglutinin I (UEA I), soybean agglutinin (SBA), and peanut agglutinin (PNA) were applied to analyze the cellular as well as the extracellular glycoconjugates in situ. Lectin-binding patterns quantitatively describe the topographical localization of structural components of the cartilage matrix which carry certain sugar residues. The therapy of the experimental OA with diclofenac sodium (2.0 mg/kg s.c.) led to a marked reduction of cartilage degenerations. Our results indicate antidegenerative properties of this compound. These findings are consistent with the fluorescent analytical data which show a stimulating effect on the anabolic activity of chondrocytes in the osteoarthritic joints under the treatment with diclofenac sodium. Fluorescein isothiocyanate labelled lectins are useful histochemical tools to determine alterations in the integrity of cartilage by their specific binding patterns, because zonal differentiation in physiological function and morphological structure of cartilage tissue as well as cellular, pericellular, and interterritorial local events are characterized.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Lead exposure: assessment of the risk for the general Italian population.

According to the regulations contained in the presidential decree DPR 496/82 certain Italian regions have carried out investigations--based on the blood lead level measurement--for the biological surveillance of the general population against the risk of saturnism. A work-group from the Istituto Superiore di Sanità (Italian National Institute of Health) coordinated the activity of the various centers and organized an appropriate quality control program to guarantee the quality of the analytical data collected. A total of 8635 subjects (4864 females and 3771 males) have been examined, 1968 of which (1058 females and 910 males) were under 14 years of age. The median values of the observed blood lead levels were, for the adults, 153 micrograms/l in males and 100 micrograms/l in females; and, for the children, 94 micrograms/l in males and 86 micrograms/l in females. The reference limit decreed by law for the 98th percentile is exceeded by the adult-males group, while both limits, at the 90th and 98th percentiles are exceeded by the population residing in the Portoscuso (CA) municipality. Our investigation confirms the correlation between blood lead levels, alcohol consumption, and cigarette smoking; in both sexes and in all age groups (except for females 15-25 years of age) a positive correlation of blood lead levels with alcohol consumption and cigarette smoking is clearly evident. The association of blood lead levels with alcohol seems to be stronger than that with cigarette smoking. The comparison with the results of previous investigations shows a 25% reduction of blood lead levels in the general Italian population during the 1979-1985 period.

Adolescent↗

[Dammarane-type saponins in leaves of Panax collected in Sichuan].

Three saponins have been isolated from the leaves of Panax japonicus ssp. elegantior var. major (Burkill) Wu et Feng collected in Sichuan, China. They were identified as ginsenoside-Rd (0.5%), ginsenoside-Rg2 (0.025%) and ginsenoside-Rg1 (0.016%), respectively, based on the chemical and spectral analytical data obtained.

Ginsenosides↗

[Oral lesions in toxic epidermal necrolysis].

In the oral mucosa it can be observed lesion produced by general disease. These, in some occasions help to obtained diagnosis, but in other it makes a lot of difficulties. We observed a patient with a toxic epidermal necrosis. His first signs were herpes oral lesions. We made a differential diagnosis with other dermatological process, and examined the possibilities in obtaining a diagnosis and the validity of the analytical data.

Adult↗

[Determination of nicotinic acid in injections by high-performance liquid chromatography].

A high-performance liquid chromatographic method for determination of nicotinic acid (NA) in commercial injections was established. NA was determined by high-performance liquid chromatography on an Inertsil ODS column (4.6 x 150 mm) using a mixture of 0.05M monobasic sodium phosphate solution (pH 3) and methanol (80:20) containing 1.5 mM sodium 1-octanesulfonate as the mobile phase at 35 degrees C and the detection wavelength at 260 nm. The working curve for 0 to 120 micrograms nicotinic acid/ml against 100 micrograms caffeine/ml as internal standard passed through the origin and was linear. On comparing the analytical data obtained by this method and those by the colorimetric method, both data were in good agreement.

Chromatography, High Pressure Liquid↗

[Ergocalciferol Reference Standard (Control 871) of National Institute of Hygienic Sciences].

The Ergocalciferol Reference Standard (Control 871) for the Japanese Pharmacopoeia was prepared. The following analytical data were obtained: melting point, 115.9 degrees C; infrared spectrum, same as the Japanese Pharmacopoeia Standard "Ergocalciferol Standard (Control 851)"; absorbance, E1%1cm (265 nm) = 464.8; optical rotation, [alpha]20D = +104.7 degrees; thin-layer chromatography, same as the Japanese Pharmacopoeia Standard; high-performance liquid chromatography, contaminants were not detected; assay, 101.2%. On the basis of those results, this material was authorized as the Japanese Pharmacopoeia Standard (control 871).

Chemical Phenomena↗

[Diflucortolone-21-valerate Reference Standard (Control 871) of National Institute of Hygienic Sciences].

Diflucortolone-21-valerate was tested for the preparation of "Diflucortolone-21-valerate Reference Standard (Control 871)". Analytical data obtained were as follows: loss on drying, 0.05%; infrared spectrum, 1745, 1727, 1667, 1625, 1611, 1169 cm-1; ultraviolet spectrum, lambda max = 239 nm; absorbance, E1%1cm (239 nm) = 348.8; optical rotation, [alpha]20D: + 100.8 degrees; melting point, 203.2 degrees C; thin-layer chromatography, three contaminants were detected; high-performance liquid chromatography, two contaminants were detected; fluorine, 8.06%. On the basis of those results, this material was authorized as the National Institute of Hygienic Sciences Reference Standard (Control 871).

Chemical Phenomena↗