Allergic contact dermatitis in venous leg ulcer patients.

Our aim was to determine the frequency and nature of contact sensitivity in venous leg ulcer patients in Lanarkshire. We performed patch testing with the European standard series, antimicrobials and medicaments on 200 patients referred to our leg ulcer clinics. Positive patch tests were found in 136 (68%) patients. Multiple allergies occurred in 102 (51%). The most frequent allergen groups were fragrances (30.5%), antimicrobials (19.5%), topical excipients (19.5%), rubber accelerators (13.5%) and topical corticosteroids (8%). We also found a high prevalence of positive patch tests to Intrasite gel (9.5%) and Hioxyl cream (8.5%), medicaments which are commonly used to treat leg ulcers in our area. Contact sensitivity is common in venous leg ulcer patients and has important implications for patient management. The allergens involved vary depending on local nursing practice. We suggest that all venous leg ulcer patients be patch tested with a locally relevant patch test series.

Evaluation of the pharmacokinetic profiles of the new testosterone topical gel formulation, Testim, compared to AndroGel.

A two-period, randomized, complete crossover study was performed to evaluate the pharmacokinetic profiles of Testim (AA2500), a new 1% testosterone topical gel formulation, compared to AndroGel, an already available 1% testosterone topical gel. Twenty-nine hypogonadal subjects received a single dose (50 mg testosterone) of each formulation seven days apart. C(max) estimates for total testosterone, dihydrotestosterone and free testosterone were greater (30, 19 and 38%, respectively) following the application of Testim compared to AndroGel. Similarly, AUC(0-24) estimates for total testosterone, dihydrotestosterone, and free testosterone were greater (30, 11 and 47%, respectively) following the application of Testim compared to AndroGel. Confidence intervals for C(max) and AUC(0-24) were not wholly contained within the bioequivalence limits for testosterone, therefore Testim trade mark and AndroGel are not bioequivalent with Testim providing higher serum levels and greater bioavailability than AndroGel.

Stress-induced alteration of polymorphonuclear leukocyte function in rats.

We have used a laboratory model of footshock stress in rats to determine whether stressor-induced alterations can be induced in polymorphonuclear leukocyte (PMN) function. We studied the ability of peripheral blood PMN to ingest and kill gram-positive bacteria. A single, 1-h session of footshock stress did not alter the ability of PMN to ingest or kill bacteria. However, 3 consecutive days of a 1-h session of footshock stress significantly enhanced the phagocytic activity of PMN but suppressed the ability of PMN to kill bacteria. Thus, this experimental model suggests that both the phagocytic and killing functions of PMN can be altered by repeated exposure to a stressor.

The influence of mouse strain and housing on the immune response.

Five strains of mice housed individually (one per cage) or in a group (five per cage) were immunized with sheep erythrocytes (SRBC) to determine if the major histocompatibility complex (MHC) was associated with altered immune reactivity based on housing. Individually housed mice from two strains which shared neither the H2D and H2K loci, produced more antibody forming spleen lymphocytes to SRBC than group-housed mice. Corticosterone levels were not related to the level of the immune response. Thus, genetic factors related to the MHC do not influence alteration of the immune response which occurs with differential housing conditions.

Neck node immunoreactivity in head and neck carcinoma.

T-lymphocyte subpopulations were quantitated in lymph nodes that contained metastatic tumor--or no metastasis--from patients who had squamous cell carcinoma of the upper aerodigestive tract. In addition, the lymphocyte subpopulations in peripheral blood were quantitated. The content of prostaglandin E2 within each node that was evaluated was also determined. Lymph nodes containing metastatic tumor had significantly higher helper/suppressor ratio than lymph nodes that were not involved. Quantification of the T-lymphocyte subpopulations in peripheral blood did not indicate the presence of metastatic disease. Significantly more prostaglandin E2 was present in lymph nodes containing metastatic disease, in comparison to lymph nodes without metastatic disease. Thus, both the lymphocyte subpopulations and prostaglandin levels were found to differentiate lymph nodes with metastasis from those without.

Anti-autologous erythrocyte plaque-forming cells in pregnancy. A parameter of immunoregulatory change.

Peripheral blood leukocytes (PBL) from 16 persons (6 Rh-sensitized pregnant women, 1 pregnant non-Rh-sensitized woman, 3 nonpregnant non-Rh-sensitized women, and 6 non-Rh-sensitized males) were assayed for plaque-forming cells (PFC) against several erythrocyte targets. 6 of 7 pregnant women had PFC, whereas only 1 of 6 males had PFC to autologous red cells. Antiautologous erythrocyte PFC in all of the pregnant Rh-sensitized women as well as the 1 nonpregnant multiparous woman may be the result of alloimmunization of mothers by their fetuses during gestation. Further studies in this area would be valuable in determining not only the immune status of a mother in relation to her fetus, but also would be of value in determining the consequences of that immune status on both mother and fetus. Such information would also provide a further clue to the etiology of autoimmune disease.

Fetal human hemolytic plaque-forming cells. Evidence of reactivity to maternal and other erythrocytes.

Lymphoid tissues from 24 human fetuses were assayed for hemolytic plaque-forming cells (PFC) against a variety of erythrocyte targets. PFC against maternal and other erythrocyte antigens were commonly detected in human fetal liver, lymph nodes, spleen, or thymus as early as 16 weeks gestation and were usually more abundant in liver than in spleen after 16 weeks gestation. These data corroborate studies from other laboratories which indicate that human fetuses develop some forms of immunocompetence very early during gestation.

Psychiatric and social factors in the abortion decision.

A total of 132 consecutive referrals for psychiatric opinion on termination of pregnancy were examined and followed up at nine months. Of these, 48 (36%) were refused and 44 of the 84 terminated were sterilized. Those recommended for abortion tended to be older, married, and to have children. They had used contraception more often and they showed more clinical psychiatric abnormalities. The group had numerous social problems, but these did not distinguish those terminated from those refused, nor were there differences in religious affiliation or duration of pregnancy. Most of those refused obtained an abortion elsewhere and only 25 of the original 132 had a live child. General practitioners were more likely to disagree with a refusal decision than with termination. Psychiatric, physical, and social sequelae were infrequent in both groups. Contraception before and after was inadequate in most patients.