Efecto de la inmunidad celular en el tratamiento de las úlceras del pie diabético con Heberprot-P® / Effect of cellular immunity in the treatment of diabetic foot ulcers with Heberprot-P®

Introducción: Los diabéticos muestran una disminuida función del sistema inmune. Su complicación más temida es la aparición de las úlceras del pie. El Heberprot-P® tiene efectos beneficiosos en la curación de estas úlceras. Objetivo: Evaluar el efecto de la inmunidad celular en el tratamiento de las úlceras del pie diabético con Heberprot-P®. Métodos: Se realizó un estudio observacional, prospectivo, de serie de casos, en 30 pacientes con úlcera de pie diabético, ingresados en el Instituto Nacional de Angiología y Cirugía Vascular. Se administraron 75 µg de Heberprot-P®, tres veces por semana, a través de vías peri- e intralesional, durante ocho semanas. Se evaluaron las variables edad, sexo, glucemia en ayunas, creatinina, urea, ácido úrico, prueba de hipersensibilidad retardada, porcentaje de granulación, tiempo de cierre de la lesión y localización de la úlcera, antes de comenzar el tratamiento, a las 4 y 8 semanas. Resultados: Se precisó un predominio del 60 por ciento en el sexo femenino y del color de piel blanca. Los niveles de glucemia y creatinina se comportaron más elevados en los anérgicos; la urea fue similar tanto en anérgicos como en reactivos; y el ácido úrico resultó mayor en hombres reactivos y en mujeres anérgicas. Hubo mayor proporción de reactivos (63,6 por ciento), que en la cuarta semana presentaron un tejido de granulación igual o mayor al 50 por ciento; y a la octava, igual o mayor al 70 por ciento. Conclusiones: La condición en los pacientes diabéticos de ser reactivo a las pruebas de hipersensibilidad retardada con úlcera de pie diabético de tipo neuropática, tratados con Heberprot-P®, está asociada directamente con una mejor respuesta en la cicatrización de sus lesiones, mediante la formación del tejido de granulación, que favorece el cierre total o parcial de la lesión. Esto no ocurrió con los pacientes anérgicos a dicha prueba(AU)

Introduction: Diabetics show decreased immune system function. Its most feared complication is the appearance of foot ulcers. Heberprot-P® has beneficial effects in healing these ulcers. Objective: To assess the effect of cellular immunity in the treatment of diabetic foot ulcers with Heberprot-P®. Methods: An observational, prospective, case series study was conducted in 30 patients with diabetic foot ulcer admitted to the National Institute of Angiology and Vascular Surgery. 75 µg of Heberprot-P®, three times a week, were administered through peri- and intralesional routes, during eight weeks. The variables age, sex, fasting blood glucose, creatinine, urea, uric acid, delayed hypersensitivity test, percentage of granulation, time of closure of the lesion and location of the ulcer, before starting treatment, at 4 and 8 weeks were evaluated. Results: A predominance of 60 % in females and white skin color were specified. Blood glucose and creatinine levels behaved higher in the anergics; urea was similar in both anergics and reagents; and uric acid was higher in reactive men and anergic women. There was a higher proportion of reagents (63.6 por ciento), which in the fourth week presented a granulation tissue equal to or greater than 50 por ciento; and at the eighth week, it was equal to or greater than 70 por ciento. Conclusions: The condition of being reactive to delayed hypersensitivity tests in diabetic patients with diabetic foot ulcer of neuropathic type, treated with Heberprot-P® is directly associated with a better response in the healing of their lesions, through the formation of granulation tissue, which favors the total or partial closure of the lesion. This did not occur with patients who were anergic to this test(AU)

Longitudinal Extensive Transverse Myelitis as a Neurological Sequelae post-Sea Urchin Stings: A Case Report

@#Puncture injury from sea-urchin stings may lead to a local and systemic inflammatory reaction. We are reporting a case of longitudinal extensive transverse myelitis (LETM), which occurred ten days post-sea-urchin stings, where the patient presented with bilateral lower limb weakness. MRI showed multilevel segment spinal cord T2-weighted hyperintensity. Prompt intravenous methylprednisolone was administered, and the patient had a full recovery. To date, there is no case report of LETM associated with sea-urchin stings. Possible mechanism due to delayed immunological hypersensitivity to sea-urchin venom. This case demonstrates the potential serious neurological sequelae that may be associated with post-sea-urchin sting and the importance of prompt recognition and management in aiding recovery.

Delayed-Onset Anaphylaxis Caused by IgE Response to Influenza Vaccination

Influenza vaccine-associated anaphylaxis is a very rare allergic reaction to vaccines, but the most concerning and life-threatening adverse reaction. Although the safety of influenza vaccines has been well documented, occasional cases of anaphylaxis in vaccinated patients have been reported. In this study, we analyzed the immunoglobulin E (IgE) response to whole influenza vaccines in a pediatric case of delayed-onset anaphylaxis after influenza vaccination. The patient showed elevated specific IgE levels against whole influenza vaccines, especially with split virion from egg-based manufacturing process. Specific IgE levels to influenza vaccines showed decreased over. We evaluated a causal relationship between influenza vaccine and anaphylaxis event by enzyme-linked immunosorbent assay. Delayed-onset anaphylaxis after influenza vaccination can occur in children without predisposing allergic diseases. In addition, the results suggested that formulation and production system of influenza vaccines could affect the probability of severe allergic reaction to vaccines.

A case of rapid desensitization for rituximab-induced delayed hypersensitivity reaction

Rituximab is a monoclonal antibody used for the treatment of B-cell malignancies, including diffuse large B-cell lymphoma. Infusion-related hypersensitivity reactions to rituximab is well known, and delayed hypersensitivity reactions to rituximab are also reported. Desensitization is commonly used to prevent immediate hypersensitivity reactions, but recently there have been cases of successful desensitization therapy for delayed hypersensitivity reactions. A 66-year-old patient who underwent rituximab treatment for diffuse large B-cell lymphoma showed repeated rituximab-induced delayed hypersensitivity reactions with whole body rashes. Intravenous rapid desensitization was performed by using a 1-bottle, 11-step protocol for 6 cycles and thereafter hypersensitivity reaction did not recur. We herein reported a case of delayed hypersensitivity reaction caused by rituximab, which was successfully desensitized using our 11-step protocol.

Vasculite urticariforme e exantema: uma reação de hipersensibilidade tardia mista a dimenidrinato ­ relato de caso / Urticarial vasculitis and rash: a mixed delayed hypersensitivity reaction to dimenhydrinate ­ case report

Dimenidrinato é um anti-histamínico H1 do grupo das etanolaminas, com importantes propriedades anticolinérgicas, antisserotoninérgicas e sedativas. Relatamos um caso de uma mulher que após 14 dias de ter usado dimenidrinato, iniciou quadro de exantema e vasculite urticariforme, além de sintomas constitucionais. Avaliação laboratorial sem alterações. Biopsia de pele evidenciou dermatite de interface do tipo vacuolar e púrpura com leucocitoclasia e derrame pigmentar. Imunofluorescência positiva para IgG, com presença de fluorescência dos núcleos dos queratinócitos da epiderme. Tratada com corticoide oral por 2 meses até remissão completa do quadro, e posterior realização de teste intradérmico, que foi positivo na leitura de 48h. A reação de hipersensibilidade tardia observada foi relacionada a mecanismo misto de Gell e Coombs (III e IV), com positividade no teste cutâneo intradérmico de leitura tardia em 48h (reação tipo IV) e biópsia compatível com vasculite cutânea (reação tipo III); lesões exantemáticas (reação tipo IV) e urticária vasculítica (reação tipo III). O teste cutâneo com dimenidrinato positivo reforça o diagnóstico de reação de hipersensibilidade.

Dimenhydrinate is an H1 antihistamine from the ethanolamine group, with important anticholinergic, antiserotoninergic and sedative properties. We report the case of a woman who, after 14 days of using dimenhydrinate, developed rash and urticarial vasculitis, in addition to constitutional symptoms. Laboratory tests were normal. Skin biopsy revealed interface purpuric dermatitis with leukocytoclasia and pigment effusion. Immunofluorescence was positive for IgG, showing nuclear fluorescence of epidermal keratinocytes. She was treated with oral corticosteroid for 2 months until complete remission of symptoms. Subsequent intradermal test resulted positive on the 48-h reading. The delayed hypersensitivity reaction was related to a mixed Gell and Coombs mechanism (III and IV), with positive results in the intradermal cutaneous test on the 48-h reading (type IV reaction) and a biopsy compatible with cutaneous vasculitis (type III reaction), exanthematous lesions (type IV reaction,) and urticarial vasculitis (type III reaction). The positive skin test for dimenhydrinate reinforces the diagnosis of hypersensitivity reaction.

The Incidence of Delayed-Type Hypersensitivity Reactions to Apples Among Patients Allergic to Birch Pollen

The major apple allergen Mal d 1 cross-reacts with the homologous birch pollen allergen Bet v 1 and causes immunoglobulin E (IgE)-mediated immediate-type allergic reactions. In some patients, delayed-type hypersensitivity to apples may develop within 72 hours without evidence of specific IgE or a positive skin prick test (SPT). The aim of the study was to evaluate the concomitance of delayed-type hypersensitivity reactions and immediate IgE-mediated reactions against high- and low-allergenic apple cultivars in patients with birch pollen allergy. Data were obtained from 45 adults with clinical symptoms of birch pollen allergy. Patients were exposed to apple pulp via atopy patch tests (APTs) and SPTs. Levels of IgE specific to Bet v 1 and Mal d 1 were measured with a radioallergosorbent test. Patients allergic to birch pollen showed the highest rate of positive SPT responses to Golden Delicious apples and the lowest rate to low-allergenic cultivar Grey French Reinette. Among these patients, 9% developed delayed hypersensitivity reactions to either Golden Delicious or Grey French Reinette apples; these reactions manifested clinically as erythema with papules (class ++). Fifty percent of APT-positive patients were concomitantly SPT-negative. Here, we show for the first time the clinical relevance of T cell-driven allergic reactions to apples. APTs may reveal type IV sensitization in patients who are negative for the corresponding type I sensitization tests. Thus, utilization of the APT procedure with fresh apple appears to be a valuable tool for the diagnosis of apple allergy and may improve the accuracy of food allergy diagnoses.

Phenytoin/albendazole induced exanthematous eruptions: a case report.

Exanthematous drug eruptions, often called “drug rashes” or “maculopapular eruptions” by non-dermatologists are the most common form of cutaneous drug eruption. Cutaneous reactions are among the most common adverse effects of drugs, including penicillins, cephalosporins, sulfonamides, and allopurinol (with an incidence of up to 50 cases per 1000 new users), and particularly the aromatic amine anti-seizure medications, including carbamazepine, phenytoin, and lamotrigine (with an incidence of up to 100 cases per 1000 new users). Phenytoin is a hydantoin derivative anticonvulsant drug used primarily in the management of complex partial seizures and generalized tonic-clonic seizures. Albendazole is a benzimidazole medication used for the treatment of a variety of parasitic worm infestations. Carbamazepine and phenytoin are among the most common causes of antiepileptic drug-related cutaneous adverse reactions. Manifestations range from a mild erythematous maculopapular rash to life-threatening Stevens-Johnson syndrome and toxic epidermal necrolysis. Albendazole induced rashes and urticaria have been reported in less than 1% of the patients. Here we present the case of a 12-year-old male patient who came to the dermatology outpatient department with complaints of itching and maculopapular eruptions all over the body. The patient gave a history of taking tablet phenytoin and tablet albendazole for neurocysticercosis since 1-week. There was no fever or any other systemic manifestations. There was no history of any other drug intake. A diagnosis of phenytoin/albendazole induced exanthematous eruptions was made. Both the medications were discontinued, and the patient was advised to take syrup sodium valproate 200 mg BD. For the rashes and itching, the patient was advised to take tablet hydroxyzine HCl 10 mg OD, tablet prednisolone and tablet levocetirizine for 5 days. Improvement was seen and the itching reduced. Rechallenge was not done. In this event, casualty assessment using Naranjo adverse drug reaction probability scale revealed that phenytoin/albendazole were probable causes for the adverse drug reaction.

Preliminary study of liver targeting interferon on the immune toxicity of mice / 中国生化药物杂志

Objective To evaluate the immunotoxicity effect of Liver targeting interferon (IFN -CSP) on mice.Methods Mice were randomly divided into five groups:low, middle and high dose of IFN-CSP, solvent control group(saline) and Positive control group (cyclophosphamide).They were injected subcutaneously for 2 weeks.Delayed hypersensitivity test was used to determine the cell immunefunction and plaque forming cell assay was used to determine the humoral immune function.Results There was no significant difference of the the index of immune organ and the ear swelling degree between IFN-CSP groups and control group.There was also no significant difference on hemolytic plaque test between them.Conclusion IFN-CSP has no significant effect on both cellular immunity function and humoral immune function of mice, this results will provides the basis for further safety evaluation.

Successful rapid desensitization to trimethoprim-sulfamethoxazole-induced delayed hypersensitivity

Trimethoprim-sulfamethoxazole (TMP-SMX) is an antibiotic used for the treatment or prophylaxis of Pneumocystis pneumonia and other infectious conditions. Sulfonamide derivatives have been reported to cause delayed hypersensitivity reactions, resulting in switch to less effective second-line antibiotics. Although desensitization is traditionally known to be effective in patients with immediate hypersensitivity, it is also applied to the treatment of delayed hypersensitivity in recent years. A 66-year-old female who had a history of repeated TMP-SMX-induced delayed hypersensitivity presenting as whole body rashes needed to take prophylactic dose of TMP-SMX (80/400 mg daily) before initiation of chemotherapy for multiple myeloma. Intravenous rapid desensitization was performed by using a 11-step, 4-bottle protocol from 1:1,000 to 1:1 solution for 3 hours to reach the target dose for prophylaxis. After successful rapid desensitization of TMP-SMX, 1-month prophylaxis was completed without any complications until the patient recovered normal immunity. We herein reported a case of delayed hypersensitivity reaction to TMP-SMX in an about-to-be immunocompromised host with planned chemotherapy who successfully completed 1-month prophylaxis with the drug without any complications through rapid desensitization.

Iodinated contrast media-induced fixed drug eruption

Iodinated contrast media (ICM) can cause not only immediate onset hypersensitivity but also delayed onset hypersensitivity. While the most common form of delayed onset hypersensitivity reaction to ICM is exanthematous eruption, fixed drug eruption (FDE) can occur rarely related to ICM. A 70-year-old male with liver cirrhosis and hepatocellular carcinoma repeatedly experienced erythematous patches on his right forearm and hand 6 hours after exposure to iopromide for computed tomography scan. ICM induced FDE was diagnosed clinically. Intradermal test with 6 kinds of ICM (iobitridol, iohexol, iomeprol, iopamidol, iopromide, and iodixanol) was performed and showed the weakest positive reaction to iohexol compared to the others in 48 hours. After changing iopromide to iohexol based on these results, FDE did not recur. We report here a case of iopromide induced FDE which was successfully prevented by changing ICM to iohexol based on intradermal test results.

Immunological Effects of Total Flavones from Leaves of Choerospondias axillaris on Mice / 中草药·英文版

Objective: To investigate the effect of total flavones from the leaves of Choerospondias axillaris (TFLCA) on the immune function of normal mice and to provide the experimental basis for the reasonable application of C. axillaris. Methods: The carbon clearance method, cutaneous delayed hypersensitivity reaction method, serum hemolysin method, and index of immune organs were used to study the effect of TFLCA on the immune function of mice. Results: TFLCA could enhance the phagocytic function of mononuclear macrophage and the cutaneous delayed hypersensitivity reaction of mice, and increase the content of hemolysin antibody and the thymus index in mice. Conclusion: TFLCA could improve the celiac macrophage activity and specific immunity of mice, and TFLCA, consisting with the total flavones of Choerospondiatis Fructus (TFCF), has the effect on the immune function of mice. So both TFLCA and TFCF have the regulatory effects on the immune function of mice. © 2013 Tianjin Press of Chinese Herbal Medicines.

Delayed onset urticaria and angioedema caused by components of itraconazole solution

Itraconazole, new triazole agent with a broader antifungal spectrum than fluconazole, has been prescribed widely in the treatment and prophylaxis for fungal infection. Itaconazole has been reported to have gastrointestinal disturbance (4%) and headache (1%) as its most common side-effects. However, allergic reactions caused by this drug are rare. A 53-year-old woman with myelodysplastic syndrome received prophylactic antibiotic therapy including itraconazole solution before chemotherapy. She complained of hive on the face with angioedema at 6 hours after taking them. The symptoms were more aggravated on the next day and reversed by stopping itraconazole solution and injection of antihistamine and steroids. Skin prick tests with itraconazole solution, itraconazole tablet, and ketoconazole showed all the negative responses. The oral challenge test with itraconazole solution was performed and resulted in urticaria and angioedema 6 hours later. Next, the oral challenge test with intraconazole tablet was performed and showed negative response. The patient was finally diagnosed as adverse reaction by additives contained intraconazole solution. We report, a case of delayed onset urticaria and angioedema caused by components of itraconazole solution.

Clinical features of delayed contrast media hypersensitivity

PURPOSE: Delayed hypersensitivity reaction can occur in a couple of hours to several days after injection of iodine-based contrast media (ICM). ICM-related delayed type hypersensitivity is not common but increasing as rapid growth of ICM use. Nevertheless, objective data on delayed type hypersensitivity are still scarce worldwide including Korea. This study was performed to investigate the clinical features of ICM-induced delayed hypersensitivity in Korean patients. METHODS: We retrospectively reviewed the electronic medical records of patients diagnosed with delayed hypersensitivity to ICM from January 2009 to December 2012 at Seoul National University Hospital and analyzed the data to identify the clinical characteristics of these patients. RESULTS: A total of 44 cases were diagnosed as delayed-type hypersensitivity to ICM. The mean age was 54 years, and 70.5% were female. The mean number of previous ICM exposure was 3.8, and skin reactions were the most common symptoms. In 45% of patients, hypersensitivity reaction developed on the first exposure to ICM. Among the 27 patients exposed to ICM again, hypersensitivity reactions recurred in only 4 patients (14.8%). There was no difference of recurrence rate according to the use of premedication or the change in ICM. CONCLUSION: In this study, we observed a female predominance and a low recurrence rate in delayed hypersensitivity to ICM. Premedication and ICM change was not effective in preventing recurrence of delayed type reactions.

Effect of treatment with cyclophosphamide in low doses upon the onset of delayed type hypersensitivity in mice chronically infected with Trypanosoma cruzi: involvement of heart interstitial dendritic cells

Acute infection with Trypanosoma cruzi results in intense myocarditis, which progresses to a chronic, asymptomatic indeterminate form. The evolution toward this chronic cardiac form occurs in approximately 30% of all cases of T. cruzi infection. Suppression of delayed type hypersensitivity (DTH) has been proposed as a potential explanation of the indeterminate form. We investigated the effect of cyclophosphamide (CYCL) treatment on the regulatory mechanism of DTH and the participation of heart interstitial dendritic cells (IDCs) in this process using BALB/c mice chronically infected with T. cruzi. One group was treated with CYCL (20 mg/kg body weight) for one month. A DTH skin test was performed by intradermal injection of T. cruzi antigen (3 mg/mL) in the hind-footpad and measured the skin thickness after 24 h, 48 h and 72 h. The skin test revealed increased thickness in antigen-injected footpads, which was more evident in the mice treated with CYCL than in those mice that did not receive treatment. The thickened regions were characterised by perivascular infiltrates and areas of necrosis. Intense lesions of the myocardium were present in three/16 cases and included large areas of necrosis. Morphometric evaluation of lymphocytes showed a predominance of TCD8 cells. Heart IDCs were immunolabelled with specific antibodies (CD11b and CD11c) and T. cruzi antigens were detected using a specific anti-T. cruzi antibody. Identification of T. cruzi antigens, sequestered in these cells using specific anti-T. cruzi antibodies was done, showing a significant increase in the number of these cells in treated mice. These results indicate that IDCs participate in the regulatory mechanisms of DTH response to T. cruzi infection.

Bioactivity guided isolation and characterization of the phytoconstituents from the Tridax procumbens

Tridax procumbens L., Asteraceae, has been extensively used in Ayurvedic system of medicine for various ailments. Previous studies on the extracts of T. procumbens revealed remarkable immunomodulatory activity of TPEIF (T. procumbens ethanol insoluble fraction) extract. The dried methanol extract of T. procumbens was dissolved in distilled water, and then fractioned by re-extracting with chloroform, ethyl acetate and n-butanol subsequently. Immunomodulatory activities of these fractions were determined in vivo. The amounts of total phenolic compounds were also determined. Ethyl acetate and n-butanol fractions showed the significant immunomodulary activity. However, the ethyl acetate fraction exhibited the highest total phenolic content. Therefore, ethyl acetate fraction was subjected to further separation by chromatographic methods. Two phytochemicals SA-3 and SA-4 were obtained by repeated purification in sufficient amount to screen them for the immunomodulatory activity by the in vivo models i.e. neutrophil adhesion and delayed type hypersensitivity. In addition, the n-butanol fraction was subjected to silica gel column chromatography (CC); SA-6 was isolated from it. Mice were treated with two doses of SA-3, SA-4 and SA-6 (2 and 4 mg/kg) for fifteen days. Immune responses to T-dependent antigen SRBCs were observed using parameters like DTH and Neutrophil adhesion. Overall, SA-4 and SA-6 showed dose relative immunostimulatory effect on in vivo immune functions in mice. From these results, it can be suggested that these compounds may be used as potential immunostimulators. The structures of isolated phytochemicals were determined by UV, IR, NMR, and MS spectroscopic methods.

Caracterização da resposta a testes cutâneos de hipersensibilidade tardia em pacientes internados na UTI / Characterization of the response to the delayed hypersensitivity: skin tests in ICU patients

Infecções hospitalares estão entre as principais complicações associadas a óbito em Unidade de Terapia Intensiva(UTI). Entretanto, existem poucas ferramentas validadas em UTI para tentar caracterizar o risco de tais complicações. Objetivo: Caracterizar a resposta a testes cutâneos de hipersensibilidade tardia no momento da admissão de pacientes em UTI, relacionando-a ao desenvolvimento de infecção hospitalar. Pacientes e métodos: Foram analisadas as respostas dos testes cutâneos (pápulas formadas) para quatro antígenos: PPD, candidina, tricofitina e estreptoquinase em 78 pacientes, à admissão em UTI. Os pacientes foram divididos em três grupos: A) sem infecção na admissão e durante a internação; B)sem infecção na admissão e que desenvolveram infecção durante a internação; C) infecção diagnosticada na admissão. Foram ainda divididos em: eutróficos, obesos e desnutridos. Resultados: Tanto pacientes que desenvolveram infecção na UTI (24 pacientes) quanto aqueles que já apresentavam infecção à admissão (15 pacientes) apresentaram menor positividade dos testes ao PPD (1,75 e 0,53mm) e à candidina (1,45 e 1,06mm), quando comparados a 34 pacientes que nãodesenvolveram infecção (4,97 para PPD e 4,74mm para candidina)(p<0,05). Observou-se ainda que os 40 desnutridos apresentaram menor positividade à candidina (1,91mm) quando comparados aos 21 eutróficos (3,17mm) (p<0,05). Conclusão: Observamos que pacientes com diagnóstico de infecção à internação em UTI e os que evoluíram para infecção na UTI apresentaram uma menor resposta aos testes cutâneos de hipersensibilidade tardia ao PPD e à candidina. Acreditamos que a aplicação dos testes cutâneos possa ser uma ferramenta útil na avaliação de risco de infecção hospitalar em UTI.

The hospital infections are among the major complications associated with death in the Intensive Care Unit (ICU). However, there are few validated tools in the ICU to try to characterize the risk of such complications. Objective: To characterize the response to skin tests for delayed hypersensitivity at the time of admission of patients inthe ICU and its relation to the development of nosocomial infection. Patients and Methods: We analyzed the responses of skin tests (papules formed) to four antigens: PPD, candidina, trichophytinand streptokinase in 78 patients at the ICU admission. Patients were divided into three groups: A) no infection at admission and during hospitalization; B) without infection on admission and who developed infections during hospitalization; C) infection diagnosed on admission. Patients were further divided into: normal weight, obese and malnourished. Results: The patients that developed infections in the ICU(24 patients) and those that already had infection on admission(15 patients) had lower positivity to PPD (1.75 and 0.53mm) and candidina tests (1.45 and 1.06mm), when they were compared to 34 patients without infection (4.97 for PPD and 4.74mm for candidina) (p<0.05). It was also observed that the 40 malnourished patients had lower positivity for candidina (1.91 mm) when they were compared to 21 normal weight(3,17mm) (p<0.05). Conclusion: We found that patients with a diagnosis of infection at admission in the ICU and who progressed to infection in the ICU had a lower response to skin tests for delayed hypersensitivity to PPD and candidina. We believe that the application of skin tests may be a useful tool in assessing risk of nosocomial infection in ICU.

Chlorhexidine urticaria: A rare occurrence with a common mouthwash.

Chlorhexidine is a widely used antiseptic and disinfectant in medical and nonmedical environments. Compared to its ubiquitous use, allergic contact dermatitis from chlorhexidine has rarely been reported and so its sensitization rate seems to be low. The prevalence of contact urticaria and anaphylaxis due to chlorhexidine remains to be unknown. This case report presents a case of urticaria due to oral use of chlorhexidine. The adverse reaction was confirmed by skin prick test.

A Case of Delayed Hypersensitivity to Enoxaparin in Patient with Deep Vein Thrombosis / 대한피부과학회지

Enoxaparin, a low-molecular-weight heparin, is widely used to prevent and treat thromboembolic diseases due to its improved pharmacodynamic properties and better safety profile than unfractionated heparins. Although the most common complication is bleeding, enoxaprin has also been implicated in skin manifestations such as urticaria, bruising, angioedema and skin necrosis. Rarely, cases have been reported of eczema-like plaques caused by delayed hypersensitivity after administration of enoxaparin injections. However, there is no report to describe delayed hypersensitivity to enoxaparin in Korean literature. We present herein a case of delayed hypersensitivity to enoxaparin, which is very rare case but needs the attention of special departments such as dermatologists as well as internalists and phlebologists.

Effects of Xiaofeng Powder on IL-4,IFN-? and sIL-2R in Delayed Hypersensitivity / 中国中医药信息杂志

Objective To study the effects of Xiaofeng Powder on IL-4,IFN-? and sIL-2R in delayed hypersensitivity and to explore the mechanism of treatment. Methods The mice model of allergic contact dermatitis was formed by DNCB. The effect of Xiaofeng Powder on ear swelling and leukocyte counts of the model mice were observed. The serum levels of interleukin-4 (IL-4),interferon-gamma (IFN-?) and soluble interleukin-2 receptor (sIL-2R) of the mice were detected by enzyme-linked immunosorbent assay (ELISA). Results Xiaofeng Powder could inhibit ear swellings and obviously reduced the total amount of leucocytes. Xiaofeng Powder could heighten IL-4 level and reduce the level of IFN-?,sIL-2R. Conclusion Xiaofeng Powder has the function of inhibiting delayed hypersensitivity. The mechanism of treatment may be related to inhibiting the total amount of leucocytes,regulating cell factor and receptor.

Effects of Polysaccharide from B.Jiangsiensis to the immune deficit mouse's specific immunological function / 中国基层医药

Objective To investigate the enhanced effect of polysaccharide from B.jiangsiensis(PBJ) on the immune hypofunction mouse models and its dose-effect relationship.Methods The immune hypofunction mouse models were made by hypodermic injection with cyclophosphamide(Cy) in mice.PBJ's effect on hemolysin content in mouse body induced by chicken erythrocytes and the delayed-type hypersensitivity(DTH) induced by dinitrochlorobenzene in mice were observed and contrasted in the different mouse groups treated with Cy in vivo by hypodermic injection together with PBJ at doses of 400mg/kg,200mg/kg and 50mg/kg,respectively.Results The test showed that the index of hemolysin,hemolytic plaque formation and delayed hypersensitivity reaction in model group markedly decreased while the indexes of hemolysin test in the control group,high and middle dose groups increased(P