PROTEIN ALLERGENS: THE IMPORTANCE OF SKIN AS A ROUTE OF EXPOSURE

Protein contact with skin is associated with a number of clinical conditions, including protein contact dermatitis and immunologic contact urticaria. This article reviews the clinical, in vivo, and in vitro evidence that proteinaceous materials penetrate skin. It is concluded that while penetration of intact proteins through normal skin is extremely low and normally without consequence, any damage to the skin barrier may allow penetration. As a result, risk assessment for contact of protein with skin must take into account potential barrier impairment and thus the possibility of both the induction and the elicitation of allergic skin reactions.     

GATIFLOXACIN-INDUCED HYPOGLYCEMIA: A CASE REPORT AND REVIEW OF THE LITERATURE

ABSTRACT

Objective: To describe a case of hypoglycemia related to gatifloxacin use in a patient with non-insulin dependent diabetes mellitus. Clinical Features: An 84 year old male who was treated with glyburide for non-insulin dependent diabetes mellitus experienced severe hypoglycemia following gatifloxacin therapy. The patient's blood sugar dropped from 247 mg/dL upon admission to 35 mg/dL the morning after gatifloxacin administration. The hypoglycemia was not reversed despite several intravenous dextrose administrations. After discontinuation of the gatifloxacin, hypoglycemia was reversed and the blood sugar was increased to 543 mg/dL. Proper control of blood sugar was later maintained with a sliding scale insulin during the hospital admission, and then the patient was switched back to glyburide before hospital discharge. Conclusion: Gatifloxacin has the potential to produce clinically significant hypoglycemia that may not be anticipated by some clinicians. The mechanism for this adverse drug event may be linked to an increase in insulin secretion induced by gatifloxacin. This reaction appears to be more common in diabetic patients.     

SUBSTANCE USE IN THE CONSTRUCTION INDUSTRY: A COMPARISON OF ASSESSMENT METHODS

Most users of illicit drugs are employed adults, with substance use rates especially high in the construction industry. In an effort to shed light on the nature and extent of drug use among construction industry workers, and to compare drug use assessment methods, substance use among construction workers, 60% of whom were apprentices, across six sites was assessed by questionnaire, urinalysis, and hair analysis. Nearly 17% of the participants reported current drug use, although drug use differed dramatically by site. Drug use rates also differed by respondent characteristics, participation rates, and assessment method. The strengths and weaknesses of each assessment method are discussed, along with the rationale for combining methods.     

海洛因依赖者暴露情况调查

目的:了解海洛因依赖者暴露情况,引起有关部门注意。方法:对100名海洛因依赖者在采集病史时用自行设计的《海洛因依赖者暴露情况调查表》进行调查。结果:海洛因依赖者从吸食开始到被家庭主要成员怀疑吸毒的间隔时间12±s6月;从吸食到被家庭主要成员发现的间隔时间18±s6月;其中长期同家人居住生活者较易被家庭怀疑和发现,在吸毒1a以内被怀疑和发现者分别占81%和59%。从吸食到被强制戒毒间隔的时间36±s12月;从吸食到被劳教戒毒的时间54±s18月。其中长期与家庭分住生活者较早被强制(25-36月,占54%)、劳教戒毒(37-60月,占62%)。结论:海洛因依赖者从吸毒到被家庭成员怀疑、发现间隔时间较长;被强制、劳教戒毒似晚。但与家人同住生活者相对较易被家庭成员怀疑、发现,但被强制、劳教戒毒较晚。应引起家庭、社会关注。     

广东,海南锥属植物的整理

本文是对广东、海南两省锥属植物种类的整理,记载了该属植物24种4变种;其中有1个新种(假罗浮锥Castanopsis semifabri X.M.Chen et B.P.Yu),2个新变种(小果海南锥C.hainanensis Merr.var.litoralis X.M.Chen et B.P.Yu、海南华锥C.chinenis Hancevar.hainanica X.M.Chen et B.P.Yu),1个新名称(黧蒴组Castanopsis sect.Fissae X.M.Chenet B.P.Yu)和1个海南分布新记录(丝栗锥C.fargesii Franch.),新归并了1个组、3个种和1个变种。初步总结了该属器官形态的演化特点,并对一些有争议的问题进行了讨论。     

SHORT COMMUNICATION: CATECHOLAMINE CONCENTRATIONS DURING EXPOSURE OF RESTING MAN TO THE HEAT OF A STANDARD SWEAT TEST

1. Normal subjects were heated for 45 min with a heat cradle under the conditions used to investigate sweating clinically. 2. Skin temperatures on the chest and in the external auditory meatus rose but concentrations of noradrenaline and adrenaline decreased during heating. 3. There was no change in adrenoceptor affinity or number as a result of the heat exposure. 4. There was little change in blood pressure and heart rate and no dysrhythmias were observed with an electrocardiogram. 5. It is concluded that heating with a heat cradle is generally not stressful and that there is a reduction in sympathetic nervous activity involving noradrenergic or adrenergic transmission during the procedure.     

THE SYMPATHETIC INNERVATION OF THE MAMMALIAN OVARY. A REVIEW OF PHARMACOLOGICAL AND HISTOLOGICAL STUDIES

The aim of this article is to review the literature concerning the nature and function of the sympathetic innervation of the mammalian ovary. We focus our attention upon evidence relating to suggestions that ovarian smooth muscle participates in ovulatory events, and that such participation may be modulated by the local neural supply. Guttmacher & Guttmacher (1921) mentioned that this possibility was first suggested nearly 70 years before they observed smooth muscle-like cells in the follicular walls of sow ovaries and found that isolated follicular walls were contracted by physostigmine and relaxed by adrenaline. However, Claessen (1947), using polarisation microscopy, was unable to confirm the presence of smooth muscle in the apices of follicles from a number of species, and interest in the Guttmachers' findings temporarily lapsed. In 1967, Jacobowitz & Wallach reported the findings of a histological study of ovaries from cats, monkeys and humans in which they observed catecholamine fluorescence associated with smooth muscle-like cells in the stroma. In 1969, Rocereto, Jacobowitz & Wallach demonstrated that the cat isolated ovary exhibited spontaneous mechanical activity and was reactive to catecholamines. These investigations together with those of Owman & Sjöberg (1966) and Sjoberg (1967) initiated a resurgence of interest in the possibility that the adrenergic innervation of the ovary may play a functional role in ovarian processes; in particular that it might affect the contractility of smooth muscle and so participate in ovulation. With the development of techniques such as electron microscopy and fluorescence histochemistry, together with greater sophistication of pharmacodynamic analysis, an increasing number of publications concerned with the role of smooth muscle and adrenergic innervation in the ovary has appeared in the recent literature. Reference to some of this work is found in the reviews of Marshall (1972, 1973) and Bell (1972). A comprehensive review devoted specifically to the roles of catecholamines and nerves in ovulation was published by Bahr, Kao & Nalbandov in 1974. Their review described the sympathetic innervation of avian as well as of mammalian ovaries and the possible function of such innervation. They considered evidence relating to several possible roles, including modification of contraction of ovarian smooth muscle, participation in ovulation, and/or control of the ovarian vasculature, and concluded that nerves play some role in ovulation, but that it is not clear how this effect is mediated.     

A MODIFIED LARGE SAMPLE APPROACH IN THE ASSESSMENT OF POPULATION BIOEQUIVALENCE

The U.S. Food and Drug Administration (FDA) requires pharmaceutical companies to show bioequivalence between different formulations or generic companies to show bioequivalence between generic drugs and brand drugs before a9680186roval. In a recent FDA guidance on bioequivalence, new criteria were proposed for assessment of population and individual bioequivalence. In this article, computer simulation is used to compare a modified large sample (MLS) upper bound for the population bioequivalence ratio with the bootstrap upper bound recommended by the FDA. The comparison criteria are the ability to maintain the stated confidence level and the estimated power of tests based on these bounds.     

氯胺酮滥用危害的研究进展

氯胺酮是苯环己哌啶(Phencyclidine,PCP)的衍生物,是非竞争性N-甲基-D-天门冬氨酸(N-methyl-D-aspartate,NMDA)受体拮抗剂,是一种静脉全麻药,也是一种目前在青少年人群中广泛流行的毒品。氯胺酮具有中枢兴奋、中枢抑制、镇痛、抗焦虑、麻醉、致幻等作用,长期使用后可以导致神经系统、泌尿系统、消化系统、心血管系统的损害。     

EFFECT OF JP-8 JET FUEL EXPOSURE ON THE ULTRASTRUCTURE OF SKIN

Fuel system maintenance usually requires direct, prolonged exposure to fuel. Thus, both military and commercial aircraft workers are at risk of dermal exposure and toxicity from JP-8 jet fuel. At present, there are no standards for U.S. Air Force personnel regarding dermal exposure to jet fuel. Hence, there are needs for data and approaches to understand the human hazard from dermal exposure to JP-8. In this study, we investigated the alteration in porcine skin at ultrastructural level, after a 24-h exposure to JP-8, with the help of transmission electron microscopy (TEM). Many ultrastructural modifications were noticed in the photomicrographs. Large-scale expansion in intercellular lipid domains of stratum corneum and disruption in its structural integrity; alteration in configuration of basal cells; rupture of hemidesmosomes and desmosomes; and diminished dendritic processes in Langerhans cells were observed. It is concluded that JP-8 exposure can cause alteration in skin anatomy, which may lead to dermal toxicity. Further studies are required to determine comparative damages incurred by individual components of JP-8.     

CHROMIUM IN THE ENVIRONMENT: AN EVALUATION OF EXPOSURE OF THE UK GENERAL POPULATION AND POSSIBLE ADVERSE HEALTH EFFECTS

Chromium in the hexavalent form, Cr(VI), has long been recognized as a carcinogen and there is concern as to the effects of continuous low-level exposure to chromium both occupationally and environmentally. This review summarizes the available exposure data and known health effects and evaluates the potential risk to human health in the United Kingdom. Chromium emissions to the environment in the United Kingdom are predominantly derived from fuel combustion, waste incineration, and industrial processes. The less toxic trivalent form of chromium [Cr(III)] is dominant in most environmental compartments, and any Cr(VI), the more toxic form, that is emitted to the environment can be reduced to Cr(III). Food is a major source of exposure to chromium, and estimated daily oral intakes for infants (1 yr), children (11 yr), and adults are 33-45, 123-171, and 246-343 µg/person/d, respectively. Soil ingestion, particularly common in young children, can contribute to oral intake. Inhalation is a minor route of exposure for the general population. Average daily inhalation intakes in infants can range from 0.004 µg/d for rural infants to 0.14 µg/d for urban infants who are passively exposed to tobacco smoke, whereas adults who live in industrialized areas and smoke may take up between 2 and 12 µg/d. The most serious health effect associated with Cr(VI) is lung cancer, which has been associated with some occupational exposure scenarios, whereas Cr(III) is an essential nutrient with a broad safety range and low toxicity. The human body has effective detoxification mechanisms that can reduce ingested or inhaled Cr(VI) to Cr(III). In conclusion, there is no clear evidence to relate exposure to environmental levels of chromium with adverse health effects in either the general UK population or subgroups exposed to chromium around industrialized or contaminated sites. It can be expected that an improved understanding of the relevance of possible long-term accumulation of Cr(III) in the body may facilitate a more complete assessment, in the future, of the health risks in the general population associated with environmental exposure to chromium.