An immunodominant haptenic epitope of carbamazepine detected in serum from patients given long-term treatment with carbamazepine without allergic reaction

An anticarbamazepine antibody was detected in the serum of a patient with severe carbamazepine-induced serum sickness. We found that the patient's T cells and IgG antibody recognized an epitope which appeared in subjects showing an allergic reaction, as well as that in subjects who showed no allergic reaction, after long-term carbamazepine therapy. These results show that an anti-carbamazepine immune response does not occur in the majority of subjects who undergo long-term carbamazepine therapy without developing allergic symptoms, although the immunodominant haptenic epitope of carbamazepine is present in their sera.     

珍珠散协同爱宝疗治疗重度宫颈糜烂的临床疗效与药物经济学研究

目的观察中药珍珠散协同爱宝疗浓缩液治疗重度官颈糜烂临床疗效和药物经济学效益。方法将有生育要求的Ⅲ度官颈糜烂患者111例随机分为治疗组和对照组，治疗组用中药珍珠散联合爱宝疗浓缩液治疗，对照组则单用爱宝疗浓缩液治疗，均每3d治疗一次。45d后，比较两组疗效、疗程及治疗费用。结果治疗组治愈率明显高于对照组（67．9％vs36．4％），差异有统计学意义（P〈0．05）。治疗组费用明显低于对照组[（371．6±138．4）vs（483．6±36．6）]元（P〈0．01）。治疗组治疗时间比对照组显著缩短[（32．4±12．1）vs（44．0±3．3）]d（P〈0．01）。治疗组中提前结束治疗患者多于对照组（35／56vs6／55，P〈0．05）。治疗组与对照组均未见副作用发生。结论珍珠散协同爱宝疗浓缩液治疗重度官颈糜烂疗效好，药物经济学效益高，值得临床推广。     

148例新生儿眼结膜炎与产妇阴道病原感染相关性的分析

目的了解自然分娩产妇产道细菌性感染（不包括衣原体）对于新生儿眼结膜炎的发病影响，加强围产期保健，防止婴幼儿视力损害。方法对148例新生儿眼结膜炎患者作结膜囊渗出物细菌培养和药敏试验，根据培养结果将患儿分为A组：培养阴性（无菌生长）组，B组：培养阳性组（有菌生长），同时相应将A组、B组患儿母亲分为产妇A组和产妇B组，作阴道分泌物涂片革兰染色检查相对照。结果产妇A组检出病原菌者5例（17．2％），清洁度正常，未检出病原菌及滴虫者24例（82．8％）。患儿B组检出淋病奈瑟氏菌13株（10．9％），其它各属菌株106株（89．1％）。产妇B组涂片见有白细胞内外革兰阴性双球菌者11例（9．2％）；其它病原菌及念珠菌、滴虫感染者76例（63．9％），清洁度正常，未检出病原菌及滴虫者32例（26．9％）。产妇A组产道感染阳性率17．2％，B组阳性率73．1％，两者比较差异有极显著性（P〈0.001）。结论新生儿眼结膜炎与产妇产道感染有密切相关性，应加强对妊娠中晚期孕妇的生殖道感染防治，减少新生儿经产道感染的几率。     

Sensitivity of early mouse embryos to the antifolic drug pyrimethamine

The effect of the antifolic drug pyrimethamine (2,4-diamino-5-p-chlorophenyl-6-ethylpyrimidine) on cleavage of CBA mouse embryos was studied. Pyrimethamine does not affect the development of early mouse embryos in utero but considerably inhibits cleavage of embryos explanted into medium containing the drug. The sensitivity of mouse and rat embryos to pyrimethamine is compared and it is concluded that there are no interspecific differences in their response to the teratogen at the level of the embryonic cells themselves.Department of Embryology, Institute of Experimental Medicine, Academy of Medical Sciences of the USSR, Leningrad. (Presented by Academician of the Academy of Medical Sciences of the USSR A. N. Klimov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 82, No. 10, pp. 1247–1250, October, 1976.     

Synergistic effect of a combination of nicarbazin and monensin against coccidiosis in the chicken caused by Eimeria spp.

ABSTRACT

A clinical study was made into the abilities of nicarbazin and monensin and a nicarbazin?+?monensin combination to control Eimeria acervulina, E. maxima, and E. tenella in chickens. When included in the feed, at concentrations of 40?ppm nicarbazin or 40?ppm monensin, these products showed partial efficacy evaluated by daily weight gain (DWG) but no activity judged by daily feed intake (DFI) or feed conversion ratio (FCR). By contrast, the combination of 40?ppm nicarbazin?+?40?ppm monensin provided complete control of infection judged by greater DWG and DFI, and lower FCR. Monensin at a concentration of 40?ppm was ineffective in preventing lesions caused by all three species. Nicarbazin at a concentration of 40?ppm was unable to suppress lesions of E. acervulina and E. maxima but was able to suppress lesions caused by E. tenella. Nicarbazin 40?ppm?+?monensin 40?ppm suppressed lesions of all three species.

RESEARCH HIGHLIGHTS

• Nicarbazin or monensin at 40 ppm gave only partial control of Eimeria spp.

• A combination of 40 ppm nicarbazin + 40 ppm monensin controlled DWG, DFI and FCR.

• Nicarbazin or monensin at 40 ppm did not suppress all Eimeria spp. lesions.

• Nicarbazin 40 ppm + monensin 40 ppm suppressed lesions of all three species.

     

Monitoring of basophil activation using CD63 and CCR3 in allergy to muscle relaxant drugs

Allergic or pseudoallergic reactions that occur during anesthesia have been increasing for the last few years. To date, the diagnosis of allergy to muscle relaxants remains difficult. In this respect, we developed a flow cytometric method for the study of drug-induced basophil degranulation using CD63 and CCR3. Fifty patients who developed clinical features evocative of allergic reactions immediately after induction of anesthesia were included and classified into two groups. Group 1 (n = 39) comprised true allergic patients, who developed typical signs of shock associated to positive skin testing. Group 2 (n = 11) consisted of patients whose clinical history was not typical and skin testing was negative or nonconclusive. Seventeen control subjects were also studied in this report. We compared data from flow cytometry to skin tests, specific IgE, and histamine release results. Flow cytometry showed a sensitivity of 54%, while that of specific IgE was similar, at 62%. Interestingly, when considering the sensitivity of IgE + CD63 for diagnosis, we reached a sensitivity value of 80%. Of 15 negative results for specific IgE, we found 7 positive CD63 tests, while histamine release gave positive results in only 2 cases. Furthermore, the CD63 protocol showed good specificity (100%). We conclude that our flow cytometry protocol is a promising tool in allergy diagnosis since it is specific and complementary to specific IgE detection.     

An Autopsy Case of Metastatic Foci of Hepatocellular Carcinoma in Adenomatous Hyperplasias of the Liver

Adenomatous hyperplasia of the liver is known as a preneoplastic or early developmental stage of hepatocellular carcinoma, in which overt malignant foci occasionally develop. We have recently experienced an autopsy case (a 70-year-old male) of liver cirrhosis with hepatocellular carcinoma and two nodules of adenomatous hyperplasia. The latter two nodules contained several microscopic foci of moderately differentiated hepatocellular carcinoma. There were a number of tumor microemboli in portal vein branches within areas of adenomatous hyperplasia in addition to areas surrounding cirrhotic liver, some of which grew into the parenchyma of adenomatous hyperplasia and cirrhotic regenerative nodules. These findings and the fact that adenomatous hyperplasia contained portal tracts including portal venous branches, suggest that malignant foci in adenomatous hyperplasia of the liver in this case might represent metastases from hepatocellular carcinoma in other parts of the liver via the intrahepatic portal venous system. Acta Pathol Jpn 41: 911 915, 1991.     

An observational study of variation in GPs' out-of-hours emergency referrals.

Out-of-hours organisations are responsible for the care of patients 70% of the time, and their GPs act as gatekeepers to secondary care services. This observational study identifies the variations in GPs' out-of-hours referral rates to secondary care and factors that could explain these variations. One hundred and forty-nine GPs who worked in one UK general practice out-of-hours cooperative which served 19 practices with 167 000 registered patients. Data on patients who accessed the out-of-hours service over 3 years (2001-2004) were examined. Factors thought to be predictors of variation in referral rates were investigated using logistic regression analysis. There was a fivefold difference in referral rates between the lowest and highest referring quartiles of GPs (OR [odds ratio] = 4.56, CI [confidence interval] = 3.86 to 5.38). The sex (female) of the clinician, the time of the consultation (11 pm to 7 am), and the place of the consultation (home visit) accounted for some, but not all, of the increased referral rates. A doctor working out-of-hours disproportionately influences the fate of the patient, the number of hospital admissions, and extra costs to the health service. There is a need for follow-up studies to investigate the factors associated with referral behaviour, and how the variation relates to patient factors and the resources available. These findings could be used when planning the staffing of out-of-hours services to optimise appropriate care and minimise patients' exposure to unnecessary intrusive and expensive hospital care.