[Anticholinergic syndrome after postoperative dimenhydrinate administration]. / Anticholinerges Syndrom nach postoperativer Dimenhydrinatgabe.

Appearance of an anticholinergic syndrome after treatment with drugs in therapeutic dosages is seldom reported in the literature. Based on a case report, the development and course of an anticholinergic syndrome after treatment with dimenhydrinate are described. The drug was given due to different symptoms such as vertigo and vomiting after surgery. The anticholinergic syndrome could successfully be treated with physostigmine.

[Glomus tumor of the nose]. / Glomustumoren der Nase.

Between May 1995 and March 1996 we were able to diagnose and remove glomus tumors of the left nasal cavity from three female patients. Ages of the patients were 9, 36 and 74 years. All patients suffered from a frequent epistaxis and all were extremely sensitive to the slightest nasal touch. One patient reported breathing difficulties due to nasal congestion. Examination revealed a tumor that filled the entire nasal cavity. The method of choice in treatment of these tumors is surgical removal. Hemangiopericytoma, non-chromaffin paraganglioma, hidradenoma, cavernous hemangioma and nevus cell nevi have to be excluded by histology and immunohistochemical techniques. From a clinical perspective the bleeding septal polyp (granuloma telangiectaticum sive pyogenicum sive pediculatum) has to be considered because it often comes from Kieselbachi's plexus, has a mushroom-like appearance and bleeds slightly.

Influence of ion pairing on ex vivo penetration of erythromycin into sebaceous follicles.

Microorganisms play an important role in the pathomechanism of acne vulgaris which is treated with antibiotics, particulary erythromycin (ERY). The main problem in the topical use of ERY lies in achieving sufficient penetration of the drug into sebaceous follicles. Doubly enhanced penetration of an ion pair composed of ERY and octadecansulfonate (OS) in contrast to the commonly used ERY base was observed, using a multilayer membrane model (MMM). The aim of the present study was to evaluate the results obtained on the MMM using excised human skin. The amount of ERY penetrating into sebaceous follicles of freshly excised human skin was measured using [N-methyl-14C]erythromycin. The ex vivo penetration of the ion pair ERY/OS into the sebaceous follicles was observed to be doubly enhanced compared with the penetration of the ERY base. The model was shown to be suitable for predicting in vivo penetration of anti-acne formulations into sebaceous glands.

Influence of aromatic hydrocarbons on the metabolism of dichloromethane to carbon monoxide in rats.

The influence of prior or simultaneous oral administration of benzene, toluene, o-, m-, or p-xylene on the carboxyhemoglobin (COHb) level after a single dose of dichloromethane (DCM) was investigated in male rats. Six hours after administration of DCM, 6.2 mmol/kg, the mean maximum COHb level was 9.3 +/- 1.9%. This level was significantly enhanced by prior administration of benzene (16.9 mmol/kg) at 12-24 h, of toluene (18.8 mmol/kg) at 20-28 h, of o- (16.6 mmol/kg) and m-xylene (16.3 mmol/kg) at 20-32 h, and of p-xylene (16.2 mmol/kg) at 24-32 h. The corresponding maximum COHb levels were 20.7 +/- 1.3, 18.6 +/- 1.1, 18.9 +/- 1.1, 22.7 +/- 1.2, and 13.2 +/- 1.0%, respectively. After simultaneous administration of both DCM and the aromatic solvent, the COHb formation was inhibited: values of 1.3 +/- 0.3, 1.7 +/- 0.4, 3.6 +/- 0.2, 1.9 +/- 0.2, and 2.0 +/- 0.2% COHb, respectively, were found. The inhibition was also evident when DCM was administered 12 h after toluene or m-xylene and 12, 16 or 20 h after p-xylene. The inhibition was dose-related as seen after combined gavage of o-, m-, or p-xylene and DCM. The o- and m-, but not the p-methylhippuric acid (MHA) excretion in the urine was significantly reduced after simultaneous administration of equimolar doses of DCM and the corresponding xylenes. In conclusion, it seems that the stimulation or inhibition of the COHb formation after DCM caused by pretreatment with or by simultaneous administration of the aromatic solvents is due to the induction of cytochrome P-450 IIE1 or to competition between DCM and the aromatic solvent on this isozyme of cytochrome P-450.