Lichen planus and hepatitis C virus: prevalence and clinical presentation of patients with lichen planus and hepatitis C virus infection

Summary Although cases of lichen planus (LP) associated with hepatitis C virus (HCV) infection have been described, the association between the two diseases has not been established because the geographic origin of patients could be an important factor in HCV prevalence in patients with LP. The serum samples of 78 consecutive patients with cutaneous and/or mucous LP and 82 control patients were analysed for the presence of antibodies to HCV by enzyme-immunoassay and for the presence of antigens of HCV by two-stage polymerase chain reaction (PCR). The clinical features of patients with LP associated with HCV infection were compared with patients with LP without HCV infection. Sixteen of the 78 (20%) patients had anti-HCV antibodies. In 13 of these 16 cases (81%), HCV-RNA was detected by PCR in serum samples. In the 82 control patients, anti-HCV antibodies was observed in two (2·4%) patients. We have found a statistically significant association (P < 0·05) between erosive LP and HCV infection. We conclude that the high prevalence of HCV-RNA in patients with LP provides some evidence for the role of HCV in the pathogenesis of LP. Our results suggest an association between erosive LP and HCV infection.     

Solution synthesis of antigenic and inhibiting peptides of the human renin prosegment-2

The [Tyr⁴⁰]preprorenin (40–50) peptide methyl ester, an undecapeptide related to the human renin prosegment, has been synthesized using a stepwise strategy with hydrogenolisable protections on the side chains. The final deprotection was very difficult as observed by ¹ H NMR and reversed phase HPLC. 2D ¹ H NMR spectroscopy of the purified peptide allowed the assignment of all protons.     

Perforation of the Right Ventricle After Endomyocardial Biopsy Detected by Color Flow Doppler Echocardiography

Right ventricular perforation after endomyocardial biopsy of a heart transplant patient was established by color flow Doppler echocardiography. Systolic filling and diastolic drainage of the pericardium were seen. Healing of the perforation occurred spontaneously with no Doppler signs of perforation 8 days later.     

Transesophageal Doppler Analysis of Coronary Sinus Flow A New Method to Assess the Severity of Tricuspid Regurgitation

Background: Severe mitral regurgitation induces reversal of flow in the pulmonary veins. We hypothesized that severe tricuspid regurgitation may disrupt normal coronary sinus flow. The purpose of this study was to analyze the Doppler flow pattern of the coronary sinus and to determine its value in the assessment of the severity of tricuspid regurgitation. Methods: The coronary sinus flow was analyzed in 70 consecutive patients with some degree of tricuspid regurgitation (27 mild, 14 moderate, and 29 severe) and in 35 patients without tricuspid regurgitation. The coronary sinus flow was obtained by pulsed-Doppler transesophageal echocardiography in a transverse plane, which showed its drainage into the right atrium. Results: The number of patients with adequate studies of the coronary sinus tended to increase with the severity of the tricuspid regurgitation. In patients without or with only mild tricuspid regurgitation the coronary sinus Doppler flow pattern was formed by two negative waves, a late systolic wave and another diastolic one with higher velocity and longer duration. The systolic wave became reversed in 21 (96%) of the patients with severe tricuspid regurgitation. The sensitivity, specificity, and diagnostic accuracy of the presence of a reversed systolic wave in the coronary sinus for the diagnosis of severe tricuspid regurgitation was 95%, 82%, and 80%, respectively. Conclusions: Significant tricuspid regurgitation modifies the coronary sinus flow pattern as assessed by transesophageal echocardiography. The presence of a reversed systolic flow in the coronary sinus appears to be a reliable new sign with good sensitivity, specificity, and diagnostic accuracy for the diagnosis of severe tricuspid regurgitation .     

Biochemical and Cytologic Alterations in the Respiratory Tract of Rats Exposed for 4 Hours to Hydrogen Sulfide

Fischer-344 rats were killed by exsanguination 1, 20, and 44hr after a single 4-hr exposure to an atmosphere of 0, 10, 200,and 400 ppm of hydrogen sulfide (H₂S) Alterations in the activitiesof lactate dehydrogenase and alkaline phosphatase, and cytomorphologyof epithelial cells in fluids obtained by nasal and bronchoalveolarlavage were used as indicators of cell injury. Changes in thenumber of leukocytes were used as indicators of inflammatoryresponse, and changes in the concentration of protein were usedas indicators of altered vascular permeability. Inhalation ofH₂S resulted in 139, 483, and 817% increased cellularity inthe nasal cavity of rats exposed to 10, 200, and 400 ppm, respectively.This was due to marked exfoliation of degenerated epithelialcells and exudation of neutrophils. The high dose of H₂S resultedin a moderate increase in lactate dehydrogenase and proteinin nasal passages; values returned to baseline levels 20 hrlater. Bronchoalveolar cell counts were decreased in rats exposedto 400 ppm and unchanged in those exposed to 10 and 200 ppm.Enzymatic activities in lung lavage fluid were moderately elevated(up to 90%), yet protein concentrations were increased by morethan 3000% and remained significantly elevated up to 44 hr afterexposure to 400 ppm. It was concluded that inhalation of H₂Shas a severe cytotoxic effect on the nasal epithelium and asevere edematogenic effect on lung parenchyma. These resultsare in agreement with autopsy findings of individuals killedby accidental exposure to H₂S-containing sour gas.     

A case of optic atrophy possibly induced by quinoline in acrodermatitis enteropathica

A 2-year-old girl with acrodermatitis enteropathica, developed optic atrophy during quinoline treatment (600 mg/day, later gradually increased to 1700 mg/day; a total dose of 280 g was given). The optic atrophy developed rapidly 9 months after the start of the quinoline treatment. The right eye was blinded and developed a convergent strabismus. Eight months after the quinoline had been stopped, the left eye began a slow and partial recovery of vision with an improvement in the appearance of the optic disc.