肟康唑的实验及临床研究

本文报告我国首次试制成的抗真菌咪唑类新药——肟康唑的抗真菌作用及临床治疗212例体股癣及足癣患者.实验研究证明对24种常见致病性真菌除皮炎着色真菌及3种均霉外,均有一定的抗真菌作用,对絮状表皮癣菌、高里氏念珠菌分别在1μg/ml及0.51μg/ml时即有抗菌作用.临床试用124例体股癣的治愈率达90.32%,治疗88例足癣的近期治愈率达89.78%.     

HISTOPATHOLOGY OF THE SKIN IN ACQUIRED AND HEKEDITARY PORPHYRIA CUTANEA TARDA

Summary.— Immiunofluorescence studies suggest that complement components play a part in bringing about the clinical cbanges in light-exposed skin of patients with symptomatic and hereditary porpbyria cutanea tarda.
Due to photodynamically induced permeability cbanges formed serum elements occur in and around the blood vessel walls of the light-exposed skin.
No indications were found of a primary auto-immune mecbanism operating in porphyria cutanea tarda.     

THE ASSOCIATION OF LUPUS ERYTHEMATOSUS AND PORPHYRIA

SUMMARY.— Two cases of chronic discoid lupus erythematosus associated with porphyria cutanea tarda are described and the literature on this association is reviewed.
The coexistence of these 2 conditions may be fortuitous or may be determined by some unknown mechanism. Since both conditions may present clinically as photosensitivity, one may conceal the presence of the other if their possible association is not considered.     

酮康唑治疗花斑癣的临床和实验室评价

本文用酮康唑每日一次和隔日一次口服200mg对85例花斑癣进行治疗和观察,并测定KCZ对P.orb/ov的MICs和血药峰浓度以及观察隔日服药者皮屑中病原体的超微结构变化.发现两种用法的疗效同样显著且隔日者副作用更小,血药峰浓度(4.20-6.15μg/ml)远高于MICs(0.09-0.22μ/ml).即使隔日疗法亦可见明显的病原体损伤现象,示隔日疗法经济实用.     

乙酰水杨酸酊外用治疗真菌病的研究

作者等发现乙酞水杨酸在试管中具有较强的抗真菌作用,对常见8种皮肤癣菌的最低抑菌浓度为0.5-0.09mg/ml,对白念珠菌及申克氏抱子丝菌为1mg/ml.我们选用5%或10%乙酰水杨酸酊治疗了259例皮肤真菌病.一般情况下,体、股癣选用5配剂,而对手、足癣则应用10%为宜,总治愈率为92.66%.诸种癣疾中体、股癣收效佳,治愈率分别为91.42%, 96.25%.本可剂不但疗效好且副作用小.     

THE ORAL CONTRACEPTIVE AND VARIEGATE PORPHYRIA

Summary.— The effect of the oral contraceptive on previously asymptomatic variegate porphyria is described. The importance of the presence of X-porphyrins in variegate porphyria is discussed.     

THE USE OF A METAL HALIDE LAMP FOR THE INDUCTION OF PHOTOHEMOLYSIS IN PORPHYRIA

Several light sources, including sunlight, xenon lamps, fluorescent lamps, mercury lamps and carbon arc lamps, have been used to provoke skin changes for phototests in patients with porphyrias, or to induce experimental hemolysis of porphyrins for research. The metal halide lamp has a strong emission range between 400 nm and 450 nm, and a relatively low emission range in the ultraviolet region. For this reason, we explored the possibility that this lamp could be used to induce photohemolysis caused by hematoporphyrin (HP) and the radiation of light. Twenty to forty μg of HP-HCl was added to 25 ml of a normal red blood cell suspension. The flask containing this red blood cell suspension was then irradiated using a metal halide lamp with 3.6 to 10.8 J/cm² of light. All of the irradiated red blood cell suspension was hemolyzed, but the non-irradiated control showed very little hemolysis. Compared to natural sunlight, the energy emitted by the metal halide lamp is small. Therefore, a longer exposure from the metal halide lamp is required to obtain an amount of energy equivalent to sunlight. This type of light source covers a wide area for irradiation. From these results, we can speculate that a metal halide lamp source is of value when used experimentally to produce the chronic skin changes of porphyria.     

THE TREATMENT OF CUTANEOUS PORPHYRIA*

Various treatments for porphyria cutanea tarda have been developed and a number of these appear to be effective. Methods of treatment advocated include alkalinization of the urine, venesection, chelation and chlorquine It is difficult to assess the relative merits of these treatments and, in spite of the various theories advanced, there appears to be no agreed exact biochemical explanation for the efficacy of any of these treatments. Since 1969 our routine management of porphyria cutanea tarda has been with low dosage chloroquine therapy, 7.5 mgm twice weekly, and this has proved safe, effective, and easy‘to manage. Remissions of several years’duration have been obtained. Where there has been no improvement after some Weeks on chloroquine., or sometimes initially in seven cases, we have used d-penicillamine 250 mgm three times daily in short intermittent courses.     

THE SELECTIVE DEPIGMENTING ACTION OF 8-HYDROXYQUINOLINE ON HAIR GROWTH IN THE MOUSE

Summary.— Topical applications of 8-hydroxyquinoiine to mouse skin cause depigmented hair to grow in patterns which change with time and appear to be closely associated with the hair growth cycles. Sufficiently frequent applications result in virtually complete depigmentation in young adult C57BL female mice, while single applications cause isolated bands of depigmented hair. Female mice are more sensitive than males, but some treated newborn mice were unaffected, 8-Hydroxyquinaldine has a similar action. Compounds not showing this effect include 2 recognized depigmenting agents, some compounds related to 8-hydroxyquinoline and some other analytical reagents for copper.     

STRUCTURAL AND FUNCTIONAL ABNORMALITIES OF THE LIVER IN PSORIASIS BEFORE AND DURING METHOTREXATE THERAPY

Summary.— The treatment of psoriasis with methotrexate carries a low but definite risk of producing histological abnormalities in the liver. Forty-two patients treated for 3 to 80 months were found to have more histological abnormalities than 25 untreated patients with equally severe psoriasis. Of the treated patients, 3 had cirrhosis, all of whom were heavy drinkers, and 12 had fibrosis. None of the untreated patients had cirrhosis, but 4 had fibrosis. Only the cirrhotic patients showed clinical evidence of hepatic inpairment.
The incidence of histological abnormality increased with increasing cumulative dosage of methotrexate, but patients on weekly therapy had less abnormality than those on daily oral therapy.
Fourteen of the 25 untreated patients were given the drug subsequently, once weekly for a mean period of 23 months. Very few additional histological abnormalities have developed.
In patients with socially and physically crippling psoriasis where methotrexate would be used, the risk of significant hepatic damage is low enough to be acceptable, providing supervision is thorough.