The human glutathione S-transferases: comparison of isoenzyme expression in normal and astrocytoma brain.

We describe expression of alpha, mu and pi class glutathione S-transferases (GST) in brain tissue from 21 controls and uninfiltrated and tumour tissue from 17 glioma patients. GST were sequentially resolved by chromatofocusing into the GST2, GST1, GST5, GST2 (5.5), GST3, GST6 sets and the contribution of each to total activity determined.

A prospective study into the value of patch and intradermal tests in identifying topical corticosteroid allergy.

We have prospectively performed patch and intradermal tests on 105 consecutive patients, attending for patch testing, to determine the optimum method of screening for corticosteroid hypersensitivity. Patch tests with Pivalone and a corticosteroid series (all 1% in ethanol) detected all the patients with steroid sensitivity. However, intradermal tests were essential to exclude false positive reactions and detect all relevant steroid allergies in any individual patient.

Hypoxaemia in infants with respiratory tract infections.

Nineteen infants who were graduates from special care baby units underwent two overnight tape recordings of oxygen saturation (SaO2) and breathing movements; one during an upper (n = 12) or lower (n = 7) respiratory tract infection and the other when free of infection. Baseline SaO2 was lower during infection (median 99.6 vs 100%, p less than 0.

Normolipaemic plane xanthomas: an association with increased vascular permeability and serum lipoprotein(a) concentration.

We present a normolipaemic young man with extensive facial plane xanthomas and xanthelasmas with a high level of lipoprotein(a) and possibly increased vascular permeability. These associations are of potential importance in understanding the pathogenesis of xanthoma formation and in the identification of patients at risk from coronary atherosclerosis.

Medical audit: the differing perspectives of managers and clinicians.

The objectives of this study were to gauge the attitudes and perceptions of managers and clinicians to medical audit, and to identify differences which might be barriers to the effective implementation of audit. A questionnaire survey of consultants and health service managers in one health district was conducted prior to the introduction of medical audit. Replies were received from 113/144 (78%) clinicians and 53/70 (76%) managers.

Erythema elevatum diutinum: a clinicopathological study.

Erythema elevatum diutinum is a syndrome of vasculitis in which lesions, typically over the extensor surfaces, showed a mixed inflammatory infiltrate on biopsy. We describe a series of 13 patients. The most common association in our series was with hypergammaglobulinemia; both mono and polyclonal.

Orthodontic relapse.

I believe that British orthodontics is in a mess. Superficially, things may appear remarkably healthy. A regional consultant network is established.

Hand dermatitis in the pottery industry.

Irritant hand dermatitis has long been recognized in the pottery industry. In our series, among workers handling glaze, sensitization to chromate was common and allergy to other metals and to biocides also occurred. Allergy to oil additives was found in mould makers.

Glomerular injury induced by hydrogen peroxide: modifying influence of ACE inhibitors.

The sensitivity of isolated glomeruli from normotensive (Wistar-Kyoto, WKY) and spontaneously hypertensive (SHR) strains to oxidant stress was studied by determining the incidence of pyknosis, karyohexis and karyolysis after incubation with different concentrations of hydrogen peroxide (H2O2) (4.7 x 10(-9) - 10(-3) M). Even though the proportion of glomeruli containing nuclei that demonstrated these features increased progressively with increasing concentrations of H2O2, the number of severely damaged glomeruli was relatively small even at concentrations of 4.

The detection of psychiatric cases by Greek physicians: report on a study carried out in a Greek primary care setting.

The detection of psychiatric disorder by primary care physicians in Greece was investigated using four non-psychiatric physicians. The General Health Questionnaire indicated a high probable prevalence of psychiatric disorder (77.8%), but the physicians rated only 9.

Hydrocortisone sensitivity. An investigation into the nature of the allergen.

11 patients, positive to tixocortol pivalate on patch testing, were tested intradermally with a variety of hydrocortisone analogues. Substitution at the C21 position had no effect on the occurrence of positive reactions to hydrocortisone, whereas alteration of any of the carbon rings significantly reduced the number of positive reactions. We suggest that the C17 side chain is involved in protein binding and subsequent presentation of antigenic sites on the carbon rings.

Red tattoo reactions: X-ray microanalysis and patch-test studies.

Eighteen patients who developed cutaneous reactions to red tattoos were studied to identify the chemicals responsible for the reactions to modern red tattoo pigments. Biopsies from the tattoos were examined histologically and the chemical composition of the red pigments was analysed by X-ray microanalysis. A variety of metallic elements including aluminium, iron, calcium, titanium, silicon, mercury and cadmium were detected.

Raised epidermal phospholipase A2 activity in rheumatoid arthritis.

Epidermal phospholipase A2 (PLA2) in RA patients was significantly higher than in normals (p less than 0.0001) but lower than in psoriatic patients (p less than 0.05).

Hydrocortisone: an important cutaneous allergen.

We have found a high incidence (4.8%) of allergy to hydrocortisone in patients with suspected allergic contact dermatitis. In view of this finding we would suggest that, in any condition that does not improve or that deteriorates after administration of hydrocortisone, allergy to this compound should be considered.

Helping a child to understand her own testicular feminisation.

Children do not think as adults do. They would therefore be less worried than adults are about a diagnosis with serious or ominous implications, yet they are commonly left uninformed until someone judges that they are old enough to understand. For most, this means delivery of painful information during the very vulnerable teenage years.

Porokeratosis of Mibelli and immunosuppression.

Immunosuppression is recognized to predispose to the development of disseminated superficial actinic porokeratosis and to cause the spread of pre-existing lesions. Porokeratosis of Mibelli has been less frequently described following immunosuppression and we report a further case.

Keratoacanthoma arising within organoid naevi.

Two cases of keratoacanthoma arising within organoid naevi are presented. The possible aetiology of keratoacanthoma in relation to organoid naevi is discussed.

The human glutathione S-transferases: a case-control study of the incidence of the GST1 0 phenotype in patients with adenocarcinoma.

The suggestion that individuals with the GST1 0 phenotype have a greater susceptibility to carcinogens than those with other GST1 phenotypes has been examined by using a starch gel zymogram approach to compare the frequency of this phenotype in control subjects and a group of patients with adenocarcinoma of stomach and colon. A significantly greater proportion of the patients with adenocarcinoma demonstrated the null phenotype, odds ratio analysis indicating that individuals with this polymorphic variant have an approximately 3-fold greater risk of developing these cancers.

A comparison between oral ciprofloxacin and intra-peritoneal vancomycin and gentamicin in the treatment of CAPD peritonitis.

Fifty-one patients were included in a prospective, randomized comparison of oral ciprofloxacin and intraperitoneal vancomycin/gentamicin in the treatment of CAPD peritonitis. Staphylococcal species accounted for 40% of the isolates with an equal incidence of Staphylococcus aureus and coagulase negative staphylococci. Although, overall, there was no significant difference between the regimens in outcome, ciprofloxacin was significantly less effective when peritonitis was due to coagulase negative staphylococci.

Necrolytic migratory erythema: association with neuroendocrine tumour with predominant insulin secretion.

We report a case of necrolytic migratory erythema in association with a neuroendocrine tumour producing predominantly insulin. As far as we know this has not been observed before.

Stomal adenocarcinoma in Crohn's disease.

Malignant change occurring at the site of a stoma in two patients with proved Crohn's disease is described. Patients with ulcerative colitis have an increased risk of colonic malignancy and Crohn's disease is also associated with both small and large bowel carcinoma. Most previous reports of stomal carcinoma have been associated with ulcerative colitis although Crohn's disease seems to carry a greater risk of associated small bowel carcinomas.