RESUMEN
Rowell's syndrome (RS) is a rare type of coexistence of one of the lupus erythematosus (LE) types (systemic, subacute cutaneous or discoid) and erythema multiforme (EM) (including toxic epidermal necrolysis). We present the case of a 51-year-old patient with a diagnosis of RS, most probably caused by drugs given as psychiatric treatment. After cessation of sodium valproate and initiation of treatment with prednisolone, a spectacular clinical remission was achieved. The likely role of psychiatric drugs, namely sodium valproate and sertraline, as triggering factors, is discussed.
Asunto(s)
Antipsicóticos/efectos adversos , Trastorno Depresivo/tratamiento farmacológico , Eritema Multiforme/inducido químicamente , Lupus Eritematoso Cutáneo/inducido químicamente , Ácido Valproico/efectos adversos , Benzodiazepinas/efectos adversos , Trastorno Depresivo/psicología , Quimioterapia Combinada , Eritema Multiforme/patología , Femenino , Humanos , Lupus Eritematoso Cutáneo/patología , Persona de Mediana Edad , Olanzapina , Pericarditis/inducido químicamente , Sertralina/efectos adversos , Síndrome , Resultado del TratamientoAsunto(s)
Dermatomicosis/microbiología , Granuloma/microbiología , Microsporum , Adulto , Humanos , Inmunocompetencia , MasculinoRESUMEN
Peritoneal macrophages and sperm were cultured with and without uropolinum. The macrophages were isolated from female rat peritoneal cavities and sperm from male rat cauda epididymis. Sperm phagocytosis index was estimated in cultures with increasing concentrations of uropolinum. Authors concluded that uropolinum inhibited sperm phagocytosis by peritoneal macrophages. The results were verified by electron microscopic examinations. The latter additionally revealed that uropolinum enhanced an adhesion between the macrophages.
Asunto(s)
Medios de Contraste/farmacología , Diatrizoato de Meglumina/farmacología , Diatrizoato/farmacología , Macrófagos Peritoneales/efectos de los fármacos , Fagocitosis/efectos de los fármacos , Espermatozoides/inmunología , Animales , Adhesión Celular/efectos de los fármacos , Células Cultivadas , Combinación de Medicamentos , Femenino , Macrófagos Peritoneales/inmunología , Macrófagos Peritoneales/ultraestructura , Masculino , Microscopía Electrónica , Fagocitosis/inmunología , Ratas , Espermatozoides/ultraestructuraRESUMEN
UNLABELLED: The aim of the study was an analysis of correlation between mycological examination results and clinical features of changed toenails in patients that visited mycological laboratory due to suspected onychomycosis. MATERIAL AND METHODS: Samples of changed toenails were collected from 579 patients. From all that cases a precise patient's history was taken paying a special attention on previous antimycotic treatment. In the clinical examination features of toenail changes were estimated. RESULTS: Onychomycosis was confirmed by the mycological examination in 23.3% of patients and exclude in 56.3% of individuals. In 20.4% of all cases the fungi growth was not obtained despite of positive results of direct microscopic examination. Among the cultured fungi species the most frequently observed were strains of Trichophyton rubrum--46.6%. 46% of all patients were previously treated with antifungals but the therapy was not efficacious in 23% of them. CONCLUSIONS: In all the cases of toenail changes it is important to take a precise patient's history, because it has an essential influence on the results of diagnostic examinations. Diagnosing onychomycosis one cannot rely only on the clinical examination because in over 50% of patients with typical for onychomycosis toenail changes the mycological examination do not confirm fungal infection.
Asunto(s)
Dermatosis del Pie , Onicomicosis/diagnóstico , Onicomicosis/microbiología , Antifúngicos/uso terapéutico , Humanos , Onicomicosis/tratamiento farmacológicoRESUMEN
It is apparent from numerous communications that hysterosalpinogography (HSG), besides its diagnostic value, may also claim therapeutic activity. After such examinations, more frequent pregnancies were recorded in previously infertile women without resorting to supplementary treatment. Pregnancies were more numerous when applying oil-based contrast media than water-based contrast ones. Hypothesis has been put forward as to the possibility of modulating activity of these agents exerted upon the peritoneal and oviductal macrophages. Increased amount of these cells as well as excessive phagocytosis of spermatozoa was shown in case of endometriosis, one of the most frequent causes of infertility. It is supposed that excessive phagocytosis of spermatozoa by peritoneal macrophages (PM) may be the cause of infertility. Studies were performed to determine the effect of oil- and water-soluble contrast media, on sperm phagocytosis by PM in vitro. PM were obtained from Wistar female rats. Subsequently, the cells were centrifuged, washed and suspended in culture medium. Next 1 million PM were allowed to attach to the cover glass for one hour under standard conditions of incubation. Dilutions of 0.25%, 0.5%, 1.0% Lipiodol Ultra--Fluid (Byk Gulden Konstanz) and Uropolinum 60% (Polfa) were added to chambers with incubated PM for next one hour. The controls were cultured in the same conditions without contrast medium added. Sperm were isolated from the epididymal cauda of male rats and subsequently suspended in culture medium at a concentration 1 million/ml and added to equivalent volume of cultured macrophages for 1.5 hours. After the exposure time the cultures were washed and stained. The spermiophagic index (SPI) was determined. SPI = number of phagocytosed sperm cells/number of macrophages x 100. Statistical analysis was performed by means of Student t-test. Additional histochemical reactions were made and scanning as well as transmission electron microscopy studies were accomplished. The established results (Fig. 1-9) indicate that lipiodol inhibits phagocytosis of spermatozoa by PM stronger (1% lipodol SPI = 1.99 + 0.94 < 0.0001) than uropolinum (1% uropolinum SPI = 5.07 +/- 1.02 p < 0.0001). In control studies, without contrast medium added, SPI was equal to 14.66 +/- 3.12 (p < 0.00001). Marked inhibition involving phagocytosis of spermatozoa was detected already after the treatment with lipiodol in low concentration (0.25% lipiodol SPI = 3.73 +/- 0.89 p < 0.0001). It failed to be so distinct after treating macrophages with uropolinum in low concentration (0.25% uropolinum SPI = 8.34 +/- 1.50 p < 0.0001). Scanning electron microscopy studies have disclosed that in the cultures of macrophages with spermatozoa, the macrophages spread well over the glass bottom. The macrophages' cytoplasmic membrane was highly folded with numerous protrusions different in size and shape. They covered the digested parts of spermatozoon causing its fragmentation. In cultures of macrophages with spermatozoa and 1% uropolinum, the structure of macrophages was similar to that in the control group. Accumulations and conglomerations of a large number of macrophages with spermatozoa were additionally revealed. In cultures of macrophages with spermatozoa and 1% lipiodol, the macrophages were not spread, but rather spherical. Also the cytoplasmic membrane protrusions were small, short, fine and appeared in smaller number. Occasionally areas of smooth cytoplasmic membrane without any folds were seen. Such macrophages did not phagocytose sperm. Transmission electron microscopy studies of macrophages cultured with sperm have disclosed that the macrophages' cytoplasmic membrane was highly folded with numerous protrusions different in size and shape. The latter encircled and closed parts of sperm (head, midpiece or tail) inside inside endosomes, finally linking the latter with lysosomes. The ultrastructure of macrophages cultured with spermatozoa and 1% uropolinum was s
Asunto(s)
Medios de Contraste/farmacología , Diatrizoato de Meglumina/farmacología , Diatrizoato/farmacología , Aceite Yodado/farmacología , Fagocitosis/efectos de los fármacos , Recuento de Espermatozoides/efectos de los fármacos , Animales , Células Cultivadas , Combinación de Medicamentos , Femenino , Histerosalpingografía/métodos , Macrófagos Peritoneales/efectos de los fármacos , Macrófagos Peritoneales/ultraestructura , Masculino , Ratas , Ratas WistarRESUMEN
Morphology of sperm phagocytosing rat peritoneal macrophages (PM) in control and Lipiodol added cultures was evaluated under light as well as scanning electron and transmission electron microscopes. The spermiophagic index (SPI) was assessed to estimate an inhibitory effect of Lipiodol on sperm phagocytosis to be compared with the outcome of morphological studies. Lipiodol inhibits in vitro sperm phagocytosis as indicated by SPI and evaluation under light, scanning electron and transmission electron microscopes. The highest SPI was seen in control cultures (14.44), declined in cultures with 0.25% and 0.5% Lipiodol (3.3 and 3.02 respectively) to reach the lowest value with 1% Lipiodol (1.60). The macrophages in cultures with Lipiodol were covered by a thin layer of oily contrast medium. The layer produced changes in the macrophages' shape and the cytoplasmic surface configuration. Lipiodol hinders both sperm phagocytosis and movement of PM by altering their shape and impairing pseudopodia and protrusions formation. Morphological studies of sperm phagocytosis by PM can help explain therapeutic effects of oily contrast media used in hysterosalpingography. Number of studies have suggested therapeutic effects of hysterosalpingography (HSG). These studies have demonstrated an increase in pregnancy rates after HSG in previously infertile women (Fullenlove, 1969; Palmer, 1960). Pregnancies were even more numerous after applying oil, than water based contrast media (DeCharney et al., 1980; Schwabe, 1983). Sawatari et al., 1993 have lately shown, that Lipiodol significantly increases pregnancy rates in animals. Hypothesis has been put forward as to the possibility of modulating activity of these agents exerted upon the peritoneal and oviductal macrophages (Boyer et al., 1986; Schwabe et al., 1983).(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Aceite Yodado/farmacología , Macrófagos Peritoneales/ultraestructura , Fagocitosis , Espermatozoides , Animales , Femenino , Masculino , Microscopía Electrónica , Microscopía Electrónica de Rastreo , Ratas , Ratas WistarRESUMEN
Zinc content was determined separately in spermatozoa taken from epididymal caput and cauda in rats. It was revealed that spermatozoa transported from the epididymal caput to the cauda reduce about 54% of zinc. This reduction is significantly inhibited in spermatozoa of rats receiving metoclopramide. That is also accompanied by a fall of testosterone level in blood serum and of delta 5, 3 beta-HSD activity in Leydig cells. It was found out that the reduction of zinc in spermatozoa at the time of their passage through the epididymis is the process that depends on androgens.