A continuum of neutrophilic disease occurring in a patient with ulcerative colitis.

A case of Sweet's syndrome (acute febrile neutrophilic dermatosis) occurring concurrently with bullous pyoderma gangrenosum is reported to emphasize the close relationship between these two disorders. Atypical pyoderma gangrenosum and Sweet's syndrome have been described as occurring simultaneously in haematological dyscrasias but not, to our knowledge, in ulcerative colitis. It has been proposed that pyoderma gangrenosum, Sweet's syndrome, erythema elevatum diutinum and subcorneal pustular dermatosis may represent manifestations along a continuum of neutrophilic dermatoses.

Griseofulvin and terbinafine in the treatment of tinea capitis in children.

Aim: To compare the effectiveness of griseofulvin and terbinafine in the treatment of tinea capitis in children.

Method: Twenty four consecutive patients with culture proven tinea capitis were treated randomly with griseofulvin (10 mg/kg/day for 8 weeks) or terbinafine (62.5-250 mg/day for 4 weeks).

Pellagra in a woman using alternative remedies.

A young woman presented with pellagra. Dietary intake of niacin was in excess of recommended guidelines. She had a low body mass index and was taking a number of alternative remedies.

Hemodynamic, hormonal, and renal effects of intracerebroventricular adrenomedullin in conscious sheep.

Adrenomedullin, the recently described vasodilator that exhibits potent hypotensive actions when administered systemically, is also found in the central nervous system, suggesting a role for adrenomedullin as a neurohormone. However, only a limited number of studies have examined the central effects of adrenomedullin. Therefore, we have examined the integrative hemodynamic, renal, and hormonal effects of intracerebroventricular (I.

Ovine brain natriuretic peptide in cardiac tissues and plasma: effects of cardiac hypertrophy and heart failure on tissue concentration and molecular forms.

Whereas numerous studies have examined the cardiac tissue content and secretion of atrial natriuretic peptide (ANP), the response of brain natriuretic peptide (BNP) in states of experimental cardiac overload is less well documented. Our recent partial cloning of the ovine BNP gene has enabled us to study changes in cardiac tissue concentration, together with tissue and circulating molecular forms of ANP and BNP, in response to cardiac overload induced by rapid ventricular pacing (n = 7) and aortic coarctation (n = 6). In normal sheep, although highest levels of BNP were found in atrial tissue (15-fold those of the ventricle), the BNP/ANP concentration ratio in the ventricles was 10- to 20-fold higher than the ratio calculated for atrial tissue.

Contact dermatitis from cetostearyl alcohol.

Emulsifiers are an uncommon cause of allergic contact dermatitis. Five cases of allergic contact dermatitis to cetostearyl alcohol are presented. In all five cases, multiple positive reactions to other allergens were present, usually topical corticosteroid creams.

Combined neutral endopeptidase and angiotensin-converting enzyme inhibition in heart failure: role of natriuretic peptides and angiotensin II.

We examined for the first time the specific roles of angiotensin II and the natriuretic peptides during inhibition of angiotensin-converting enzyme (captopril, 25 mg bolus + 6 mg/3 h infusion) and endopeptidase 24.11 (SCH32615, 5 mg/kg bolus + 3 mg/kg/3 h infusion), both separately and in combination, in eight sheep with pacing-induced heart failure. Plasma atrial and brain natriuretic peptide levels were similarly increased by SCH32615 and to a lesser extent during combined inhibition but decreased with captopril.

Clearance receptors and endopeptidase: equal role in natriuretic peptide metabolism in heart failure.

The effects of separate and combined endopeptidase inhibition (by SCH-32615) and natriuretic peptide receptor C blockade [by C-ANP-(4-23)] on the clearance and bioactivity of atrial (ANP) and brain (BNP) natriuretic peptides was investigated in eight sheep with heart failure. SCH-32615 and C-ANP-(4-23) administered separately induced significant and proportionate dose-dependent rises in plasma ANP, BNP, and guanosine 3',5'-cyclic monophosphate (cGMP) levels. Associated with these changes were reductions in arterial pressure, left atrial pressure, and peripheral resistance and increases in cardiac output, urine volume, sodium excretion, and creatinine clearance.

Comparison of the effects of ouabain and brain natriuretic peptide in saline-loaded sheep.

1. It has been claimed that ouabain is an endogenous hormone that may be pivotal in the pathogenesis of some forms of hypertension and may exaggerate natriuresis in situations characterized by volume overload. We compared the haemodynamic, renal and endocrine effects of ouabain (at approximately 187 ng/kg per min for 2 h) with those of brain natriuretic peptide (BNP; at 5 pmol/kg per min for 2 h) in nine saline-loaded sheep in a balanced, randomized, single-blind, placebo-controlled crossover study.

Beneficial hemodynamic and renal effects of adrenomedullin in an ovine model of heart failure.

Background: Adrenomedullin is a recently discovered endogenous peptide with hypotensive and natriuretic actions in normal animals. Circulating and ventricular adrenomedullin are elevated in congestive heart failure, suggesting a possible role in the pathophysiology of this disease. No studies have previously examined the effects of adrenomedullin in heart failure.

Nosocomial Trichophyton tonsurans in a long stay ward.

Aims: To document a nosocomial outbreak of Trichophyton tonsurans infection in a long stay ward.

Method: Retrospective review of mycology cultures taken from patients and staff during 1993-5 and clinical examination of both patients and staff.

Results: Thirty-three mycology samples from 13 patients and staff, cultured T tonsurans during the period 1993-5.

Hemodynamic, hormonal, and renal effects of adrenomedullin in conscious sheep.

Adrenomedullin is a recently discovered peptide that has been shown to reduce arterial pressure and induce natriuresis. However, few studies have examined the biological actions of adrenomedullin in conscious animals in an integrative manner. Accordingly, we have examined the hemodynamic, renal, and endocrine actions of adrenomedullin infused intravenously at 10 and 100 ng.

Toxic epidermal necrolysis treated with cyclosporin and granulocyte colony stimulating factor.

A patient developed toxic epidermal necrolysis while on carbamazepine, 80% of her skin surface being involved. She also developed a pancytopenia with a neutropenia of 0.77 x 10(9)/l (normal range 2-7.

Diagnostic accuracy of teledermatology: results of a preliminary study in New Zealand.

Aim: To determine the accuracy of a video conferencing system (telemedicine) in diagnosis of dermatological disorders.

Methods: New patients referred to a dermatology clinic were initially examined by telemedicine and then by a standard face to face consultation. The diagnoses made by each type of consultation were compared and accuracy of telemedicine determined.

The clinical spectrum of necrotising fasciitis. A review of 15 cases.

Background: Necrotising fasciitis represents a spectrum of disease which ranges from fulminant through acute to subacute varieties. While fulminating necrotising fasciitis is a well recognised entity the subacute variety is not.

Aim: To assess six years' experience of necrotising fasciitis at Waikato Hospital.

Comparative bioactivity of atrial and brain natriuretic peptides in an ovine model of heart failure.

1. Whereas many studies have detailed the effects of exogenous atrial natriuretic peptide (ANP) infusions in heart failure, and a limited number have examined the effects of brain natriuretic peptide (BNP), none have directly compared the bioactivity of similar doses of ANP and BNP under standard conditions of impaired cardiac function. We compared the hormonal, haemodynamic and renal effects of 3 h infusions of ANP, BNP and a vehicle control in eight sheep with pacing-induced heart failure (225 beats/min for 8-12 days).

Neutral endopeptidase inhibition: augmented atrial and brain natriuretic peptide, haemodynamic and natriuretic responses in ovine heart failure.

1. Atrial and brain natriuretic peptide are both circulating hormones subject to degradation by neutral endopeptidase 24.11.

Multiple medicament allergies in two patients with chronic leg ulceration.

Medicament allergies in patients with chronic leg ulcers is well recognized. In the past, topical antibiotics, rubber additives and wool alcohols have been the most common reported allergens. Allergy to topical corticosteroids has been reported.

Nitric oxide inhibition in an ovine model of heart failure.

1. The role of nitric oxide (NO) in congestive heart failure was investigated by studying the acute haemodynamic, hormonal and renal effects of N(G)-monomethyl-L-arginine (L-NMMA(, a nitric oxide inhibitor, given as incremental bolus doses in six sheep before (normal) and after induction of heart failure (HF) by rapid left ventricular pacing (LVoff+). 2.

Comparison of chronic neutral endopeptidase inhibition and furosemide in an ovine model of heart failure.

The hemodynamic, hormonal, and metabolic effects of chronic neutral endopeptidase (NEP) 24.11 inhibition and furosemide were compared in the pacing model of ovine heart failure (HF). Intravenous SCH 39370 induced a dose-related inhibition of NEP activity during 4-days treatment, in association with a transient increase in plasma atrial natriuretic peptide (ANP) and, at the higher dose, an increased mean level of plasma cyclic guanosine monophosphate.

Chronic ouabain infusion does not cause hypertension in sheep.

Ouabain is claimed to be a hormone of adrenal origin, capable of raising arterial pressure in rats. We infused ouabain in conscious sheep under carefully controlled circumstances to determine its effects on blood pressure, urine electrolytes, and vasoactive hormones. Eight healthy ewes were studied while taking a constant intake of dietary sodium and potassium.