Suppression of histamine-induced pruritus by hydroxyzine and various neuroleptics

This study evaluates the ability of hydroxyzine and various neuroleptics to suppress histamine-induced pruritus in ten volunteer subjects with the use of a double-blind crossover protocol. The itch threshold was determined in each volunteer by intradermal injection of gradually increasing concentrations of histamine. Volunteers were then given the study drugs and placebo at the same interval of time, under near identical conditions, and the itch threshold was determined. Thiothixene, hydroxyzine hydrochloride, chlorpromazine, thioridazine, and a lactose placebo were evaluated. Compared to other drugs, hydroxyzine alone was more effective in the suppression of histamine-induced itch. Consequently, hydrozyzine may be more effective in histamine-induced pruritus. The neuroleptic drugs used in this study do not significantly suppress histamine-induced pruritus, but they may be beneficial in nonhistamine-induced pruritus or psychogenic pruritus.

North American blastomycosis: a review

North American blastomycosis, first reported in 1894, and once thought to be a geographically localized disease, has now been reported worldwide. The greatest number of cases occur in the Mississippi, Missouri, and Ohio River basins. The organism enters the body via the lungs with subsequent dissemination to other organs, including the skin, eyes, bones, and genitourinary system. Patients most often present with cutaneous or pulmonary complaints. Demonstration of characteristic fungal morphology in microscopic smears or in histologic specimens is highly suggestive of Blastomyces dermatitidis. However, proof of the diagnosis is obtained only by mycologic culture. Some progress has been made using other laboratory methods to produce a rapid diagnosis. This paper reviews in detail the varied clinical presentations of blastomycosis, the laboratory diagnosis, and current treatment.

Filamentous fungal growth assay: correlation between [U-14C] glucose uptake and dry weight determinations

The filamentous fungus Trichophyton mentagrophytes was grown in [U-14C] glucose supplemented nutrient broth. Growth was monitored in 200 microliter microcultures and 5 ml macrocultures by measuring the incorporation of 14C into trichloroacetic acid-insoluble macromolecules and in macrocultures by dry weight determination. Adjustment of the specific activity of the [U-14C] glucose medium supplement from 1080 muCi/mmole to 108 muCi/mmole decreased the rate of isotope uptake and prolonged availability so that growth beyond 36 h could be monitored radiometrically. The dry mycelial weight of the fungus was directly proportional (r = 0.995) to the amount of isotope incorporated. Isotope uptake in microcultures and macrocultures was kinetically identical. These data clearly indicate that the uptake of 14C by T. mentagrophytes can be used to monitor fungal growth accurately in both macrocultures and microcultures.

Intravenous miconazole therapy of mycotic infections

The efficacy and safety of intravenously administered miconazole nitrate was examined in eight patients with the following infections: cutaneous North American blastomycosis (one), extensive dermatophytosis(one), and chronic mucocutaneous candidiasis (six). Mycologic assessment included direct examination for fungal elements, fungal culture, and histopathology. Laboratory evaluations were performed before and at regular intervals during the study. The total miconazole nitrate dosage, which was administered over a seven- to 32-day period, ranged from 4.0 to 46.8 g. Follow-up examinations extended from two to 15 months. Excellent results were obtained in five patients and fair results in three. No renal, cardiac, hepatic, or hematopoietic toxicity was observed. Other side effects, however, necessitated premature cessation of therapy in four patients. Overall, intravenously administered miconazole is an effective antifungal agent for these cutaneous infections.

Irritant and allergic reactions to topically applied Micatin cream

Miconazole nitrate (Micatin cream) is a potent antifungal agent. Few side effects have been reported with topical application. We report on 10 patients who exhibited an intolerance to topical use of this drug. Most of the reactions were irritant in nature but in two instances, an allergic contact dermatitis was observed. Patch tests were positive to the cream base.

Skin changes and diseases associated with pregnancy

During the gestational period, the skin is among the many organs undergoing changes. Various endocrine changes occurring in pregnancy are thought to give rise to certain skin changes such as pigmentary alterations, abnormalities in hair growth, vascular anomalies, and striae. Also, there are several skin diseases unique to the pregnant woman. Whereas the physiologic skin changes are mainly of cosmetic importance, the various pregnancy-unique skin diseases have associated symptoms, and an increase in both fetal and/or maternal morbidity and mortality is associated with several of these skin diseases.

Familial male pseudohermaphroditism with normal Leydig cell function at puberty

Four male pseudohermaphrodites from two families have been described. Although reared as females, at puberty, the timing, pattern, and degree of masculinization was similar to that of a normal male. No feminization occurred. They had normal testicular testosterone synthesis as judged by plasma testosterone, LH and FSH concentrations, as well as incubations of testicular minces with labeled precursors. Studies on cultured skin fibroblasts indicated adequate peripheral 5 alpha-reductase and normal receptor affinity and capacity for dihydrotestosterone. The histology of the testis was suggestive of a primary testicular defect. A mosaic pattern was seen: some areas contained tubules with active spermiogenesis; other areas, only Sertoli cells. These male pseudohermaphrodites appear to have a defect in fetal testicular maturation in which inadequate fetal testosterone synthesis and defective differentiation of germinal elements occurred.

Atopic dermatitis, impaired cellular immunity, and molluscum contagiosum

A substantial elevation in the level of serum IgE (7,000 to 19,000 ng/ml) was noted in a man with atopic dermatitis and chronic molluscum contagiosum. Cell-mediated immunity (CMI) was depressed in vivo (cutaneous anergy), whereas in vitro tests showed normal numbers of "T" rosette-forming lymphocytes, a normal phytohemagglutinin-P-elicited lymphocyte transformation response, and lymphocyte transformation reactivity to the antigens streptokinase-streptodornase and purified protein derivative. Accumulated evidence suggests that patients with atopic dermatitis may have, associated with an elevated serum IgE level, a functional defect(s) in CMI that is greater in vivo than in vitro. This functional defect may impair host defense and account for the chronic molluscum contagiosum infection present in this patient.

The taxonomy of some new isolates of dissimilatory sulfate-reducing bacteria

The interrelationships between 92 isolates of sporing and non-sporing sulfate-reducing bacteria were determined. Of the 116 biochemical and physiological characteristics examined, only 25 were useful for discrimination of groups. Responses to most of the test were negative. A similarity coefficient and a principal component factor analysis of these data were made. The deoxyribonucleic acids buoyant densities (DNA) from all strains and the electrophoretic properties of adenylylsulfotransferase (ATP-sulfurylase), adenylphosphosulfate (APS)-reductase, and sulfite reductase of selected isolated were determined. On the basis of these various data eight groups were recognized. Isolated of seven of these groups appeared to be similar to one or more named strains. Isolates of group E(DNA buoyant density, 1.708) were different from previously named strains. Sporins strains were not isolated from the Papua New Guinea location. Halophilic and non-halotolerant strains were isolated from highly saline locations in Australia. Results pertinent to the taxonomy and ecology of the sulfate-reducing bacteria are discussed.

Dithionite reduction in the presence of a tetrapyrrole-containing fraction from the desulfoviridin of Desulfovibrio gigas

Low-molecular-weight fractions obtained from the desulfoviridin of D. gigas and from the growth medium of Desulfovibrio sp. 10455 promoted the reduction of sodium dithionite to sulphide in the presence of reduced methylviologen. These fractions contained a tetrapyrrole of the isobacteriochlorin type which was not complexed with iron, nor was it complexed with protein. The observations are discussed in relation to the function of sulphite reductases in the sulphate-reducing bacteria.

Urticaria. An updated review

Urticaria can result from many different stimuli, and numerous factors, both immunologic and nonimmunologic, are involved in its pathogenesis. Most commonly considered of immunologic mechanisms is the type I hypersensitivity state mediated by IgE. Another immunologic mechanism involves the activation of the complement cascade, which produces anaphylatoxins that can release histamine. Immunologic, nonimmunologic, genetic, and modulating factors converge on mast cells and basophils to release mediators capable of producing urticarial lesions. In addition to the clinical and laboratory diagnosis and treatment regimens, we review such mediators as histamine, kinins, serotonin, slow-reacting substance of anaphylaxis, prostaglandins, acetylcholine, fibrin degradation products, and anaphylatoxins that increase vascular permeability and can thereby produce wheals. Special consideration is given to histamine and the factors that regulate is secretory release from mast cells and basophils, including the modulating role of intracellular levels of cyclic adenosine monophosphate.

Dithionite Reduction in the Presence of a Tetrapyrrole-containing Fraction From the Desulfoviridin of Desulfovihrio gigas

Low-molecular-weight fractions obtained from the desulfoviridin of D. gigas and from the growth medium of Desul/ovibrio sp. 10455 promoted the reduction of sodium dithionite to sulphide in the presence of reduced methylviologen. These fractions contained a tetrapyrrole of the isobacteriochI orin type which was not complexed with iron, nor was it complexed with protein. The observations are discussed in relation to the function of sulphite reductases in the sulphate-reducing bacteria.

An automated radiometric microassay of fungal growth: quantitation of growth of T. mentagrophytes

An automated radiometric microassay of the growth of Trichophyton mentagrophytes and other filamentous fungi is described. The assay is based upon the incorporation of 14C(U) glucose into the organism. Fractionation studies indicate that 73% of the label is found in trichloroacetic acid-insoluble macromolecular components of the mycelium. Incorporation of label directly correlated with growth as estimated by visual scoring of turbidity and as recorded in photomicrographs. Incorporation of 14C(U) glucose delineated a lag, exponential and stationary or plateau phase of growth. These phases could be completely inhibited by the antifungal agent tolnaftate. It was concluded that the growth of filamentous fungi can be successfully monitored by the radiometric method described. Moreover, this method is sensitive, accurate, reproducible, rapid and free of the variability inherent in many traditional estimates growth.

Variations in the spectrum of desulfoviridin from Desulfovibrio gigas

Desulfoviridin preparations from D. gigas showed variations in the position of the absorption maximum the beta-peak) in the 580-nm region of the specturm. On treatment with Na2S2O4 a preparation with a beta-peak at 585 nm was affected rapidly, the 585-nm peak shifting to the 596-nm region; this was partially reversed by K3Fe(CN)6. Treatment of the original preparation with K3Fe(CN)6 resulted in a shift of the beta-peak to 582-583 nm. Desulfoviridins with beta-peaks from 580 to 583 nm were not rapidly affected by Na2S2O4. The spectrum of the chromophore of desulfoviridin way also affected by Na2S2O4 with the peak at 587 nm shifting to 597 nm; this effect was completely reversed by oxygen. There was no evidence to show that spectral variations in desulfoviridin preparations were due to the loss or acquisition of metal ions during growth or to the selection of mutants containing spectrally different desulfoviridins. It is suggested that during biosynethesis oal detachment of the chromophore, thus causing a change towards the spectral properites of the detached chromophore.

Immediate and delayed hypersensitivity in chronic dermatophytosis

Delayed hypersensitivity (DH) to seven common antigens was examined in 38 men with chronic dermatophyte infections and in 20 controls. A similar percentage of the infected and the control groups reacted to four antigens. In addition to showing a low frequency of DH to trichophytin, the infected group also showed a significant reduction in their reactions to intradermal mumps skin test antigen and to a Rhus oleoresin patch test. Two members (5%) of the infected group were anergic to all tests. Patients with chronic dermatophytosis appear to have a relatively specific defect in DH to trichophytin, but their cell-mediated responses to other antigens may also be somewhat decreased. The subjects studied did not appear to suffer excessive morbidity from infectious diseases, other than dermatophytosis.

Metal accumulation by bacteria with particular reference to dissimilatory sulphate-reducing bacteria

Dissimilatory sulphate-reducing bacteria, genera Desulfovibrio and Desulfotomaculum, exhibit a superior ability, over assimilatory organisms, to extract three amounts of metals from culture media. This property does not appear to be solely a function of the presence of H2S. In media containing elevated amounts of Fe, electron dense particles, provisionally identified as FeS, are deposited within the cells of dissimilatory bacteria.

Topically applied griseofulvin in prevention and treatment of Trichophyton mentagrophytes

Griseofulvin is not considered effective in treatment of superficial fungal infections. However, when applied topically in organic solvents, the drug appeared in very high concentration in all levels of stratum corneum, and it generally persisted there in measurable amounts for four or more days after a single application. Based on this observation, double-blind experimental prophylactic and therapeutic studies were conducted. Topically applied griseofulvin in alcohol solution was highly effective in preventing experimentally induced Trichophyton mentagraphytes infection, but it had no therapeutic effect once the infection was initiated. Topically administered griseofulvin may prove useful in prevention of recurrences or as an adjunct to therapy in selected cases of superficial fungal infection.

Transferrin, iron, and dermatophytes. I. Serum dematophyte inhibitory component definitively identified as unsaturated transferrin

The factor present in normal human serum which inhibits growth of dematophytic fungi is characterized and identified. Serum inhibitory factor (SIF) is nondialyzable, heat stable at 56 degrees C. for 4 hours, and fungistatic. SIF was found to be an inhibitor of the dermatophyte genera Trichophyton, Microsporium, and Epidermophyton as well as the dimorphic yeast Candida albicans. SIF activity directly correlated with a serum's unbound iron-binding capacity (UIBC) in that lower UIBC'S were less inhibitory. Addition of iron to serum neutralized the inhibitory activity and this neutrilization was shown to be specific for iron since zinc, magnesium, managnese, and copper failed to alter serum inhibitory activity. Furthermore, addition of purified iron-free transferrin to a neutralized serum restored the SIF activity in parallel with the UIBC. Removal of transferrin from serum by affinity chromatography was confirmed by polyacrylamide gel electrophoresis and iron-binding assays. Transferrin-free serum produced by this procedure was shown to lack inhibitory activity. These data indicate that SIF is unsaturated transferrin and strongly suggests that it inhibits dermatophytes by binding iron which many organisms need for growth.

Temperature dependence of water content of stratum corneum

The water content of human stratum corneum has been measured gravimetrically in vitro in relation to relative humidity (RH) and temperature. Water content increased with increasing RH. Stratum corneum water content increased 50% when the temperature was raised from 20 to 35 degrees C at RH below 60%. Temperature dependence decreased with increasing RH until there was essentially no temperature dependence at 90% RH. The conclusion is that temperature changes could significantly affect water content in vivo and pliability of skin at RH below 60%.

Localized intracellular polyphosphate formation by Desulfovibrio gigas

The dissimilatory sulphate-reducing bacterium Desulfovibrio gigas, frequently sub-cultured, often contained spherical granules which stained metachromatically with some basic dyes. The granules were examined in situ by transmission electron microscopy of whole organisms and thin sections. The granules were isolated from broken bacteria as a water-insoluble, non-crystalline, white material containing magnesium, phosphorus and organic carbon, but devoid of sulphur and nitrogen. The molar ratio of phosphorus to magnesium (1 to 17) was close to the proportions in magnesium tripolyphosphate. Infrared absorption spectra for the white material and magnesium tripolyphosphate were similar.

Pericutaneous phlebotomy and intravenous injection in the guinea pig

Rapid and repetitious blood collections or intravenous injection were accomplished in the guinea pig via the lateral metatarsal vein. One person could perform the procedure by using an abdominal hold on the animal. There was no morbidity or mortality.

Effect of enzymic assay conditions on sulfite reduction catalysed by desulfoviridin from Desulfovibrio gigas

The type and the amount of end products resulting from sulfite reduction catalysed by a single partially purified desulfoviridin preparation from Desulfovibrio gigas were shown to depend upon the enzymic assay conditions employed. Both manometric and spectrophotometric assays were used, with reduced methyl viologen serving as the electron donor in each system. Trithionate, thiosulfate, tetrathionate and sulfide were identified as possible end products. In the manometric assays, sulfide production was favoured by high reduced methyl viologen concentrations, low sulfite concentrations and a pH value of 7.0 as opposed to 6.0. In the spectrophotometric assays, results approaching the stoichiometric conversion of sulfite to sulfide were obtained only at high initial reduced methyl viologen concentrations.

Atopic disease and serum immunoglobulin-E

Fifty-seven subjects, forty-three with various combinations of atopic disease and fourteen non-atopic controls, were studied using a battery of immediate skin test allergens and a radio-immunoassay for serum Immunoglobulin-E (IgE). The geometric mean serum IgE level (units/ml) was 50 in strictly nonatopic controls, 170 in atopic respiratory disease (ARD) patients, 320 in atopic dermatitis (AD) patients and 772 in those patients with both AD-ARD. The marked elevation of the serum IgE in the latter group was not associated with respiratory disease activity and not closely correlated with extent of the dermatitis, but may relate to patients with both AD-ARD being 'highly atopic'. Overall, there was no correlation between the serum IgE level and the frequency of positive skin tests. Compared to ARD patients, the serum of AD patients contained more IgE, yet they reacted significantly less frequently to common extrinsic allergens.

Trichophytin extraction: biological comparison of trichophytin extracted from Trichophyton mentagrophytes grown in a complex medium and a defined medium

The extraction of antigens (trichophytin) from Trichophyton mentagrophytes var. asteroides grown in both a complex medium and a defined medium proved to be reproducible and feasible. These extracts were first evaluated by skin testing in both infected and noninfected guinea pigs. Further evaluation and standardization was accomplished in selected humans by comparing these antigens to a trichophytin known to elicit allergic reactions to the dermatophytes. The trichophytins produced by this extraction procedure gave no false positive (or negative) skin test reactions. These antigens did, however, reliably elicit allergic sensitivity of both the immediate and delayed type. The potency of both complex and defined media antigen was shown to be equal to that of the standard trichophytin.

Reduction of Sulphite to Sulphide Catalysed by Desulfoviridin From Desulfovibrio gigas

Desulfoviridin from D. gigas was partially purified by column chromatography and further purified by gel electrophoresis into a major band preparation and a minor band preparation. All partially purified and electrophoretically purified preparations catalysed the methylviologen-linked reduction of sulphite to sulphide, but stoichiometric reduction to sulphide was not demonstrated with the major band preparation. Desulfoviridin did not catalyse the reduction of thiosulphate or trithionate.

Pigeon fancier's lung in children

Pigeon fancier's lung occurred in 3 children whose fathers kept pigeons. The clinical features included progressive breathlessness, cough, cynanosis, sweating, and inspiratory râles. Chest x-rays showed diffuse fine mottling. The serum gave positive precipitin tests to pigeon serum or droppings in each case. 2 cases were treated with steroids, but the importance of breaking the contact with pigeons is stressed.

Guanine plus cytosine contents of the deoxyribonucleic acids of some sulfate-reducing bacteria: a reassessment

Guanine plus cytosine (GC) contents of the deoxyribonucleic acids of Desulfovibrio and Desulfotomaculum have been used as a basis for classification. Some of these data have been incorrectly calculated, resulting in errors of as much as 5% GC. This situation has been corrected by a reanalysis of existing data and by the contribution of new data.

Sulfate-reducing bacterium with unusual morphology and pigment content

A dissimilatory sulfate-reducing bacterium was isolated which differed in morphology and pigment content from previously described species. The organism was mesophilic, obligately anaerobic, gram-negative, nonsporulating, long, and slender with one polar flagellum. Whole cells fluoresced red at neutral pH when excited with light at 365 nm owing to the presence of a pink pigment. Desulfoviridin was present. Reduced minus oxidized spectra of whole cells showed peaks in the position of a c-type cytochrome characteristic of Desulfovibrio species and peaks at about 629 and 603 nm. CO difference spectra showed the presence of a CO-binding pigment with a peak at 593 nm. Lactate and pyruvate supported growth in the presence of sulfate but not in its absence. Sulfate, sulfite, and thiosulfate served as electron acceptors for growth. Hydrogenase was present. The deoxyribonucleic acid had a buoyant density of 1.722 g/cm(3) and a guanosine plus cystosine molar percentage of total bases calculated by two different methods of 61.2 or 63.2.