Antibiotics

Acta Orthop Belg, 1991, 57 Suppl 1, 16 - 21
Treatment of infected arthrodesis of the ankle; Harle A; In arthrodesis of the ankle joint the use of external fixation can cause severe problems owing to pintrack infections . As long as infection is active, bony consolidation of the arthrodesis is delayed . In the potentially infected area a normal internal osteosynthesis is risky . Our treatment rationale comprises a two-stage procedure with treatment of infection first by implant removal, thorough debridement and implantation of Septopal beads and then secondary internal stabilization with an antibiotic-releasing bone plate . Of the 42 cases amputation had to be performed in 3; of the remaining 39, infection was cured long-term in 36 . In all 39 a stable bony fusion was achieved.

J Ocul Pharmacol, 1991 Summer, 7(2), 157 - 62
Quantitation of scleral tobramycin levels; Snyder RW et al.; We have devised a new method to solubilize sclera in order to permit quantitative determination of tobramycin by commercially available and widely utilized means . The sclera, containing tobramycin, was digested with Alcalase (Subtilisn A, NOVO Enzymes) and the tobramycin level was quantitated by TDX autoflourophotometry . This technique is accurate and sensitive . The tissue digestion and antibiotic assay are relatively simple to perform and should be applicable to a variety of antibiotics and possibly other therapeutic agents.

Chemotherapy, 1991, 37 Suppl 3, 7 - 10
Once-daily ceftriaxone outpatient therapy in adults with infections; Tice AD; Since 1981 our physicians' office has developed an outpatient parenteral antibiotic therapy programme which has shown advantages in patient care and provided significant cost savings . While we were able to provide any parenteral antibiotic available, the mainstay of our programme was ceftriaxone because of its broad range of activity, safety, and once-daily administration . Two hundred and ninety cases of outpatient ceftriaxone usage were recorded between January 1989 and March 1990 . Ceftriaxone was found to be most useful for bone, soft tissue, and gynaecological infections . Not only was it highly clinically successful, but it was safe to use in the twice-weekly monitoring parameters we routinely perform in our office . The use of ceftriaxone alone during the 15-month period accounted for savings of over US $1.2 million compared to the cost of hospitalization during this period.

Urol Res, 1991, 19(2), 141 - 4
Experimental bacterial prostatitis in rats; Goto T et al.; Experimental acute bacterial prostatitis in rats was induced by four different routes of bacterial inoculation . The most simple and reproducible method of producing bacterial prostatitis was to instil the bacterial suspension into the prostatic urethra after the administration of an appropriate antibiotic to prevent associated pyelonephritis.

An Otorrinolaringol Ibero Am, 1991, 18(3), 231 - 8
{Ambulatory aerosol therapy in the treatment of chronic pathology of the O.R.L . region}; Millan Guevara J et al.; This study considers the efficacity of the ambulatory aerosol therapy in chronic cases of the ENT area . A nebulizer, air-jet type, of 4 microns MMAD, was the device employed, and an ample spectre antibiotic (cefotaxime) a mucolytic (N-acetyl-cysteine) plus a corticoid (methyl-prednisolone) the associated drugs . The antibiotic was discarded when otitis were the problem . The results have been favourable in 75 percent of the cases whilst negative in the resting 24 percent of the treated subjects.

Khirurgiia (Sofiia), 1991, 44(3), 34 - 8
{Granulomatous orchitis}; Khinev A et al.; Granulomatous orchitis is a rare inflammatory disease of poorly understood etiology . Its differentiation from testicular tumor is difficult and is resistant to antibiotic therapy . Five cases of this disease are reported . In 3 of them orchiectomy was performed and in 2 the testis was preserved after biopsy specimen examination . Relapses or injury to the contralateral testis were not recorded during the follow-up period . A review of the literature is made and the etiopathogenesis, clinical and therapeutic aspects of this disease are discussed.

Chem Biol Interact, 1991, 79(2), 137 - 49
The origin of the DNA induced circular dichroism of CC-1065 and analogs; Krueger WC et al.; The calf thymus DNA (CT-DNA) and poly(dI-dC).poly(dI-dC) binding properties of the natural antitumor antibiotic CC-1065 and selected analogs of CC-1065 were studied by circular dichroism (CD) and absorbance methods . The results indicate that the intense long wavelength DNA-induced CD band of these molecules originates from a chiral electronic transition which is delocalized over the whole molecule . Both the covalently bound species (N-3 adenine adduct) and the reversibly bound species exhibit the characteristic spectral behavior of an inherently dissymmetric chromophore when these agents bind within the minor groove of B-form DNA . This mechanism of optical activity accounts for why CC-1065 shows a weak CD in buffer but a very intense induced CD at long wavelength when bound to DNA, why the intensity of the induced CD of CC-1065 analogs depends upon how many fused ring systems the analog contains, and why covalently bound analogs having the mirror image configuration of the natural configuration also exhibit an intense positive induced CD band at long wavelength.

Rev Pneumol Clin, 1991, 47(1), 21 - 7
{Randomized therapeutic trials of community-acquired lung diseases . Analysis of studies published between 1978 and 1988}; Vercken JB; The authors have evaluated the methodology of 21 randomized therapeutic trials concerning community acquired pneumonia . Only 33% of these trials were entirely devoted to community acquired pneumonia; the remainders included various respiratory infections . Only 8 trials were of the double-blind type . The presence of radiological opacity was mentioned as a criterion of inclusion in only 10 trials, and in 9 trials the diagnosis of pneumonia was not defined . The criterion of judgement, which separates success from failure, remained undefined in 6 trials . The number of patients analyzed was much lower than that of patients admitted because of exclusions for negative cultures or for isolation of a bacteria resistant to one of the antibiotics tested . Finally, in only 2 of the 21 trials it was concluded that an antibiotic was superior to the other(s) . Clearly then, the quality of these randomized therapeutic trials needs to be improved by a better definition of their purpose and of the criteria of patients' admission, and by analysis of an intention to treat which is the nearest thing to the future use of the drug under study.

Bone Marrow Transplant, 1991, 7 Suppl 2, 85 - 6
Human recombinant GM-CSF in allogeneic bone marrow transplantation for leukaemia: double-blind placebo controlled trial; Powles R et al.; A double-blind randomised trial compared 20 patients with leukaemia receiving human recombinant granulocyte macrophage colony stimulating factor (GM CSF), with 20 patients receiving placebo for 14 days after allogeneic matched sibling bone marrow transplantation . The median neutrophil count at 14 days was significantly higher in the GM CSF group (1.90 vs . 0.46 x 10(9)/l) . The duration of hospital stay, the number of antibiotic days, and the number of fever days was the same for both patient groups . The lymphocyte count was significantly higher in the GM-CSF group than in the placebo group between days 10 and 15 after transplantation . The GM-CSF group had lower haemoglobin concentrations and platelets counts, and higher plasma urea creatinine and bilirubin, than the placebo group . There was no evidence that GM CSF was associated with a greater incidence of leukaemic relapse.

Klin Khir, 1991, (5), 15 - 7
{Prevention of suppurative-infectious complications after radical surgery in rectal cancer}; Evdokimova EV; In 32 patients with rectal cancer, the endolymphatic antibiotic therapy was performed 2-5 days before and for 7-10 days after radical operation . Attenuation of an inflammation around a tumor, decrease in bacterial contamination of the perineal wound, reduction in incidence of postoperative purulent-inflammatory complications were noted.

Gen Pharmacol, 1991, 22(3), 465 - 74
Effects of NA0344, a new smooth muscle relaxant, on the actin-myosin-ATP interaction and myosin light chain phosphorylation in vitro; Kohama K et al.; 1 . Effects of antibiotic NA0344, a smooth muscle relaxant, on phosphorylation of myosin light chain (MLC, 20 kDa) were compared with those on actin-myosin-ATP interaction using native actomyosin preparation containing MLC kinase activity . 2 . MLC kinase was shown to be the site of action of NA0344 . 3 . NA0344 inhibited the interaction and phosphorylation with IC50 = 7.5 x 10(-6) and 1.6 x 10(-5) M, respectively . 4 . The discrepancy between the inhibitory effects is explained that myosin is in an active form when myosin is fully phosphorylated . 5 . However, the inhibitory effects of NA0359 and NA0362, analogs of NA0344, on the phosphorylation were similar to or more effective than those on the interaction, which cannot be explained by the active form hypothesis . 6 . Plausible explanations for the discrepancies are discussed.

Zentralbl Chir, 1991, 116(8), 505 - 13
{Management of femoral neck fracture with an intermediate (dual head) prosthesis in geriatric surgery}; Kaschner AG et al.; Between 1980 and 1989 in 195 elderly patients with fractures of the femoral neck a duo-cup endoprosthesis was inserted . The average age was 78 years, most of them were high risk patients with sometimes more than 2 preexisting diseases . The hospital mortality after hip replacement was 9.7%, specific complications like protrusio acetabuli and shaft fractures were not observed . In 2 cases immediate postoperative luxation required reintervention . The incidence of infection was significantly reduced to 2.4% after antibiotic therapy . When discharged from hospital, 86% had a good functional result . We regard hemiarthroplasty with duo-cup endoprosthesis as an acceptable alternative to total hip replacement in elderly patients with fractures of the femoral neck.

Scand J Infect Dis, 1991, 23(2), 233 - 8
Evaluation of cloxacillin concentrations in plasma and muscle tissue during cardiopulmonary bypass; Kullberg BJ et al.; Concentrations of cloxacillin in plasma and deep thoracic muscle tissue were measured in 10 patients who underwent elective coronary bypass surgery or valve replacement . One g of cloxacillin was administered after the induction of anaesthesia and 1 g cloxacillin was added to the oxygenator pump priming fluid before the start of the procedure . Blood and tissue samples were obtained before, during and after cardiopulmonary bypass . The relation between unbound plasma concentrations and total tissue contents of the drug was calculated . It was shown that measurement of the free plasma concentration may provide fairly reliable information on the free concentrations of cloxacillin in the tissues, and that determination of tissue contents may therefore not be necessary . Due to the administration of the second dose of cloxacillin at the start of cardiopulmonary bypass free tissue contents were just adequate in most patients . However, to obtain adequate tissue concentrations after bypass it is recommended that a third dose of the antibiotic be administered before the end of the operation.

Mem Inst Oswaldo Cruz, 1991, 86 Suppl 2, 51 - 4
Recent advances in pharmacologic study of natural anticancer agents in China; Xu B; In this paper a number of anticancer agents of natural origin will be presented . Hydroxycamptothecin (HCPT) was found to produce a strong inhibitory action on a variety of animal tumors . It is also effective for treatment of patients with gastric carcinoma, liver carcinoma, tumor of head and neck or leukemia . Pharmacologic studies showed that it could depress S phase of tumor cells significantly and cause formation of cellular chromatid breaks . By means of alkaline elution and nick translation methods it has been proved that HCPT induced DNA single strand breaks remarkably . Homoharringtonine (HHRT) was shown to be effective against acute leukemia . Recent experiments in tumor-bearing mice indicated that (HHRT) could diminish tumor metastasis . Using molecular hybridization technique it was demonstrated that (HHRT) decreased the content of c-myc RNA in the cytoplasm but not in the nuclei . Lycobetaine (LBT) possessed strong inhibitory effects on a number of ascites tumors . In clinical trials it was effective against ovarian and gastric carcinomas . It is able to intercalate into DNA . Oxalysine (OXL) is a new antibiotic and shown to be effective against tumor metastatis . When used in combination with 5-FU, its anticancer action could be enhanced . Other natural compounds such as indirubin, beta-elemene, irisquinone, oridonine, norcantharidin and PSP have been also found to possess antitumor action.

Mem Inst Oswaldo Cruz, 1991, 86 Suppl 2, 17 - 9
Current status of biotechnology in China; Yang SL; There has been increasing interest over past decade in exploring the possibility of using new biotechnology to produce new products and to improve the old productive process . The researches and applications of genetic engineering, cell fusion, mutagenesis, cell and enzyme immobilization in enzyme, antibiotic, vitamins, steroid, amino acid, organic acid, solvent, food and brewage industries is reviewed.

Drugs Exp Clin Res, 1991, 17(10-11), 525 - 9
Safety of multiple doses of ofloxacin in healthy volunteers; Stein GE et al.; A safety profile of ofloxacin, a new fluoroquinolone antibiotic, was assessed in twelve healthy male volunteers . Ofloxacin was dosed at 400 mg twice daily over a 10-day course of treatment . This evaluation included chemistry and haematologic profiles, neurologic evaluations, ophthalmologic examinations, audiometric testing, and electrocardiogram before, during and the end of the study . In addition, plasma samples were analysed for ofloxacin prior to each morning dose and a complete plasma concentration profile was performed on day 6 . Gastrointestinal complaints such as nausea, diarrhoea and upset were the most frequent side effects reported . The only other adverse event that occurred in more than one volunteer was headache . None of the subjects in this study developed a serious side effect and no physical or psychological changes were observed . Laboratory values remained in their normal ranges with the exception of one volunteer who developed a 3-fold rise in one liver function test at the end of the study . The subject was asymptomatic and this aberration resolved without sequelae . In summary, a 10-day course of ofloxacin was found to be safe and have a low potential for toxicity . The side effects observed in this study were mild and similar to those observed with other fluoroquinolones.

Eur J Drug Metab Pharmacokinet, 1991, Spec No 3, 250 - 5
Model choice for teicoplanin kinetics in man; Danese A et al.; Teicoplanin is a new long half life antibiotic, characterized by a polyexponential profile . A pharmacokinetic study was made in healthy volunteers receiving 15, 20 and 25 mg/Kg iv doses of Teicoplanin . Plasma concentration-time data were fitted by a polyexponential equation, consisting of two, three, four and five terms . The software was PCNONLIN, using the Gauss-Newton method with Harley's and Levenberg's modification and 1/Y2 as a weighting factor, where Y is the predicted concentration . The increase of the number of exponential terms from two to five resulted in a continuous minimization of the sum of the weighted squared residuals . To test whether or not this sum had been sufficiently reduced to justify the fitting with additional exponential terms, Akaike, Gallant and F-ratio test criteria were used . The four exponential equation best fit most of the data sets . However, the estimates of the main parameters (AUC, V, Vss, CL, Css min, Css max, number of doses to reach 95%ss) calculated according to tri and four-exponential models did not significantly differ . In the dose range studied teicoplanin pharmacokinetics are linear . In conclusion, an additional exponential term in the equation can significantly improve the best fit of teicoplanin plasma curves according to the above criteria, but it may not lead to a significant variation of the main pharmacokinetic parameters and derived values . This indicated that for clinical purposes a tri exponential model suffices for describing the kinetics of Teicoplanin in man.

J Gynecol Obstet Biol Reprod (Paris), 1991, 20(8), 1063 - 7
{The role of anti-inflammatory agents in the treatment of acute salpingitis . A randomized study of 40 patients with celioscopic control}; Bassil S et al.; In a randomised second look laparoscopic study, concomitant antibiotic--anti-inflammatory therapy for the treatment of pelvic inflammatory disease (P.I.D.) was studied . Six weeks after medical treatment results were evaluated during second look laparoscopy based on three parameters: residual inflammation, pelvic adhesions and tubal patency . The combination treatment resulted in decreased pelvic adhesion and tubal occlusion in severe forms of P.I.D . Anti-inflammatory agents combined with anti-biotics are not more beneficial than anti-biotics alone in mild and moderate forms of P.I.D . so combination therapy must be reserved for severe forms of P.I.D.

Free Radic Biol Med, 1991, 11(6), 573 - 80
Reduction of daunorubicin in the presence of sulfur-containing peptides; Houee-Levin C et al.; Daunorubicin, an anthracycline antitumor antibiotic, was reduced in the presence of reduced (GSH) or oxidized (GSSG) glutathione to evaluate the possibilities of detoxification or of potentiation of the drug by these compounds . The reductants were .COO- free radicals produced by gamma radiolysis . In both cases, the final product is 7-deoxydaunomycinone, i.e., the same as without glutathione . The reduction yield is also the same as without GSH or GSSG (0.23 mumol.J-1) . No glutathione depletion was observed . Limits for the rate constants of some possible nonenzymatic detoxification reactions are given . To evaluate the possible interactions of daunorubicin with sulfur-containing proteins, the reduction of this drug by .COO- free radicals was also studied in the presence of a polypeptide containing two disulfide bridges, aponeocarzinostatine . The final product is also 7-deoxydaunomycinone . The yields of reduction of the drug and of a protein disulfide bridge are, respectively, 0.23 mumol.J-1 and less than or equal to 6 nmol.J-1 . These values indicate that disulfide radical anions of the protein can reduce the drug, giving back the disulfide bridge, but that the drug transients neither oxidize nor reduce the protein.

Eur J Cancer, 1991, 27(10), 1263 - 8
Doxorubicin interactions at the membrane: evidence for a biphasic modulation of inositol lipid metabolism; Thompson MG et al.; Doxorubicin, when incubated for 30 minutes with {32P}-labelled human erythrocyte membrane vesicles, produced an elevation of {32P}inositol-1,4,5-trisphosphate levels . The maximum rise was obtained with 10(-8) mol/l doxorubicin {132 (S.E . 13%) of control, n = 6, P = 0.001} . However, when the inositol lipids were examined, there was no evidence that doxorubicin stimulated the breakdown of {32P}phosphatidylinositol-4,5-bisphosphate under resting conditions, suggesting that the elevated levels of {32P}inositol 1,4,5-trisphosphate were not the result of the stimulation of phospholipase C . Instead, it was found that the dephosphorylation of inositol 1,4,5-trisphosphate by a 5'-phosphomonoesterase was partially inhibited by 10(-8) mol/l doxorubicin so that the rise in {32P}inositol 1,4,5-trisphosphate resulted from the inhibition of the breakdown of constitutively released {32P} inositol 1,4,5-trisphosphate . Similar data was also obtained with another aminoglycoside antibiotic, neomycin . The release of {32P} inositol 1,4-bisphosphate and {32P} inositol 1,4,5-trisphosphate and the breakdown of the inositol lipids in response to calcium (2.5 x 10(-4) and 10(-3) mol/l) stimulation was enhanced by doxorubicin (10(-6) to 10(-12) mol/l) . These effects on resting and stimulated inositol lipid metabolism are discussed with reference to the paradoxical effects of doxorubicin to both stimulate and inhibit proliferation, according to concentration.

Gynecol Obstet Invest, 1991, 31(4), 231 - 4
Pelvic abscesses: pelviscopy or laparotomy; Mecke H et al.; Between 1983 and 1988, we treated 66 patients with pelvic abscesses . Twenty-five patients required laparotomy and 41 underwent pelviscopy for treatment . The choice of the operative procedure, laparotomy or pelviscopy, depended on the age of the patient, the clinical presentation and the operative findings . The two collectives demonstrated no differences in the duration of hospitalization and in-patient treatment with antibiotics . A conservative, organ-preserving procedure could be performed in 80% of patients operated pelviscopically . In follow-up examinations 1-2 years after operation, 27% of the patients treated per pelviscopy complained of chronic abdominal pain as compared to 37% of those treated per laparotomy . In young patients, pelviscopic treatment of pelvic abscesses is a valuable alternative to laparotomyPIP: Physicians at Christian Albrecht University Hospital in Keil, West Germany treated 66 women with pelvic abscesses between 1983-1986 . Pelviscopically treated patients were younger than laparotomy treated patients and IUD usage occurred 17% vs . 20% respectively . They 1st treated many patients with ampicillin and metronidazole or ampicillin and clavulanic acid . They were able to perform pelviscopy on 25 of the 33 patients with inflamed Fallopian tubes . 9 of these women experienced either a uni- or bilateral salpingectomy or salpingo-oophorectomy . They were able to do an organ preserving procedure designed to preserve fertility in 80% of the women, especially pelviscopically treated patients (81% vs . 16% laparotomy patients) . They performed a laparotomy on the 6 patients with bilateral total abdominal tuboovarian abscesses . Of the 25 women who underwent a laparotomy, 20 required only a uni- or bilateral salpingectomy or salpingo-oophorectomy and 5 required a total hysterectomy and bilateral salpingectomy . No differences existed between pelviscopically and laparotomy patients in number of days in the hospital and duration of inpatient antibiotic therapy . Even though more laparotomy treated patients (37%) experienced chronic abdominal pain following treatment than pelviscopically treated patients (27%), the laparotomy patients initially experienced more severe and extensive infections than did pelviscopically treated patients . Of the 45 patients who were able to be examined 1-2 years after surgery, only 3 experienced recurrent pelvic inflammatory disease (8% of pelviscopically treated patients and 5% of laparotomy patients) which the physicians found encouraging since pregnancies may occur . In conclusion, to preserve fertility, they advocated pelviscopy along with organ preservation for patients in their reproductive years .

Biol Met, 1991, 4(1), 23 - 32
Iron(III) hydroxamate transport across the cytoplasmic membrane of Escherichia coli; Koster W; Transport of iron(III) hydroxamates across the inner membrane into the cytoplasm of Escherichia coli is mediated by the FhuC, FhuD and FhuB proteins and displays characteristics typical of a periplasmic-binding-protein-dependent transport mechanism . In contrast to the highly specific receptor proteins in the outer membrane, at least six different siderophores of the hydroxamate type and the antibiotic albomycin are accepted as substrates . A fhuB mutant (deficient in transport of substrates across the inner membrane) which overproduced the periplasmic FhuD 30-kDa protein, bound {55Fe} iron(III) ferrichrome . Resistance of FhuD to proteinase K in the presence of ferrichrome, aerobactin, and coprogen indicated binding of these substrates to FhuD . FhuD displays significant similarity to the periplasmic FecB, FepB, and BtuE proteins . The extremely hydrophobic FhuB 70-kDa protein is located in the cytoplasmic membrane and consists of two apparently duplicated halves . The N- and C-terminal halves {FhuB(N) and FhuB(C)} were expressed separately in fhuB mutants . Only combinations of FhuB(N) and FhuB(C) polypeptides restored sensitivity to albomycin and growth on iron hydroxamate as a sole iron source, indicating that both halves of FhuB were essential for substrate translocation and that they combined to form an active permease . In addition, a FhuB derivative with a large internal duplication of 271 amino acids was found to be transport-active, indicating that the extra portion did not disturb proper insertion of the active FhuB segments into the cytoplasmic membrane . A region of considerable similarity, present twice in FhuB, was identified near the C-terminus of 20 analyzed hydrophobic proteins of periplasmic-binding-protein-dependent systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Chem Pharm Bull (Tokyo), 1991 Jan, 39(1), 170 - 6
Neocarzinostatin: selective tryptophan oxidation and neocarzinostatin-chromophore binding to apo-neocarzinostatin; Edo K et al.; Neocarzinostatin (NCS), an antitumor protein antibiotic, is composed of apo-neocarzinostatin (apo-NCS) and neocarzinostatin-chromophore (NCS-chr), the principle of the biological activities of NCS . Apo-NCS having two tryptophan (Trp) residues at positions (39 and 83) was chemically modified by N-bromosuccinimide in a study on the correlation of the binding site(s) of NCS-chr . Selective oxidation of Trp residues was observed when NCS was titrated with N-bromosuccinimide . In contrast, non-selective oxidation of the two Trps on apo-NCS was observed and both Trp (39 and 83) of apo-NCS were titrated with N-bromosuccinimide . After selective oxidation, the remaining Trp residue of NCS was assigned as Trp (83) . These results clearly indicate that the Trp (83) residue of apo-NCS changed from the "reactive type" to the "non-reactive type" after the binding of NCS-chr with apo-NCS . The fluorescence emission intensity of apo-NCS generated from the Trp (39) residue was quenched by NCS-chr . These data suggest that NCS-chr directly interacts with the Trp (39) residue and that a beta-sheeted loop containing the Trp (83) residue of apo-NCS changes the high-order structure upon binding with NCS-chr.

Med Oncol Tumor Pharmacother, 1991, 8(4), 261 - 3
Late complications of allogeneic bone marrow transplantation; Bacigalupo A et al.; This report underlines the occurrence of multiple early and late complications after allogeneic BMT . Most of these are caused by the conditioning regimen, and especially by the use of total body irradiation . This should discourage the use of radiation for patients with non-malignant disorders such as aplastic anemia . We have shown that interstitial pneumonia is greatly reduced after fractionated TBI, and this should also be considered when designing transplant protocols . Prolonged immunodeficiency post-BMT is responsible for a high rate of infections: this suggests that long-term prophylactic antibiotic therapy should be considered . Great attention should be given to the quality of life of long-term survivors: to this respect a specific program for monitoring and treating gonadal complication can be extremely useful.

J Clin Dent, 1991, 2(4), 103 - 6
An assessment of Plax pre-brushing dental rinse used according to directions with supervised toothbrushing; Emling RC et al.; This study assessed the use of a pre-brushing rinse followed with toothbrushing with toothpaste in compliance with label directions . The treatment pre-brushing rinse was compared to a placebo pre-brushing rinse in a cross-over design . The study was started with 20 subjects . One subject developed a throat infection after the first session and was administered an antibiotic prescription and the data was not included in the analyses . No side effects or reactions to the solutions were observed or reported during or following the study . At baseline, the two groups were found to have similar plaque area scores on buccal, lingual, and total tooth surfaces . After rinsing with the pre-brushing solution (Plax) and brushing with an American Dental Association-approved toothbrush and a commercially-available fluoride toothpaste, there was significantly less plaque area when compared to the same regimen with the placebo pre-brushing rinse . For both buccal and lingual plaque area scores the differences were statistically significant at the p less than .05 level favoring Plax . On all surfaces the subjects removed significant amounts of plaque area following rinsing and brushing with toothpaste compared to their baseline scores.

Beitr Trop Landwirtsch Veterinarmed, 1991, 29(3), 363 - 7
Influence of AVOTAN (avoparcin) containing salt licks on the daily weight gain of bulls; Flachowsky G et al.; 3 group feeding experiments were carried out with the glycopeptide antibiotic avoparcin . Avoparcin was added to salt licks (2.5 g per kg lick stone) and offered to 30 (experiment I), 80 (experiment II), or 20 (experiment III) growing cattle ad libitum over 210, 122, or 281 days . Control animals consumed unsupplemented lick stones . The avoparcin intake amounted to 60 (experiment I), 145 (experiment II), and 100 mg (experiment III) per cattle per day . The daily weight gain increased from 750 to 808 (experiment I), 553 to 649 (experiment II), and from 812 to 822 g per animal per day (experiment III) when avoparcin was added . Avoparcin is a safe feed additive and should be supplemented to various lick stones to improve ruminant performances under tropical rangeland conditions . 15 to 30 mg avoparcin per kg dry matter intake are recommended.

Otolaryngol Pol, 1991, 45(6), 405 - 10
{Otogenic brain abscesses in children}; Szmeja Z et al.; In the years 1953-1989 in the Department of Otolaryngology, Medical Academy in Poznan 75 patients were treated for otogenic brain abscesses, among them 19 were children . In the last ten years the number of cases of this complication was not increased significantly in children and adults . In 3 cases abscess was diagnosed in acute otitis media, in the remaining cases it was a complication of chronic otitis media with cholesteatoma . Brain abscesses were situated more frequently in the temporal lobe . In children they developed more frequently on the right side . The survival in temporal lobe abscesses in children was 90%, and in cerebellar abscesses 75% . In adults the survival rate was about 80% for both localizations . In the treatment of these otogenic complications wide radical operation on the middle ear or ++antro-mastoidectomy with exposure of the dura and simultaneous approach to the abscess from the postoperative ear cavity, with puncture of the abscess and replacement of its contents with normal saline with antibiotic is the routine method in the Department.

Infection, 1991, 19 Suppl 7, S372 - 7
Ofloxacin in lower respiratory tract infections; Petermann W; In order to determine the efficacy and safety of the new quinolone ofloxacin in the treatment of chronic lower respiratory disease, 674 patients (353 with chronic bronchitis, 212 with community-acquired pneumonia and 109 with hospital-acquired pneumonia) were treated with ofloxacin 200 mg twice a day . In total, 627 patients (93%) showed a satisfactory clinical response, and 47 patients (7%) had no change or deterioration . Neither severe side effects nor interactions between ofloxacin and coadministered theophylline were seen . This is important in patients suffering from chronic obstructive airways disease . The antibiotic spectrum of ofloxacin covers nearly all bacterial pathogens causing infectious respiratory disease; furthermore, ofloxacin reaches high concentrations in pulmonary secretions and tissue . Ofloxacin is a proven antibiotic substance useful in the treatment of lower respiratory tract infections.

Trans R Soc Trop Med Hyg, 1991, 85 Suppl 1, 17 - 8
Cytokines in the pathogenesis of bacterial meningitis; Mertsola J; Adjunctive dexamethasone therapy to antibiotic therapy for bacterial meningitis has been shown in several studies to be beneficial . The roles of interleukin 1 beta and tumour necrosis factor alpha (TNF-alpha) in bacterial meningitis and in an experimental rabbit model are reviewed; both cytokines play a pivotal role in induction of meningitis . Using dexamethasone with the initial dose of antibiotics caused a decrease in TNF-alpha and modulated the inflammatory response . Early use of adjunctive dexamethasone is important in therapy of bacterial meningitis.

Pediatrician, 1991, 18(4), 312 - 6
Role of sinusitis in asthma; Zimmerman B et al.; Chronic sinusitis has been suggested to play a causal role in creating recalcitrant asthma . However, this hypothesis has never been confirmed in a blind placebo-controlled study . Several studies have documented an association between abnormal sinus X-rays and asthma in 30-70% of patients, depending on criteria chosen for evaluation of the radiologic changes . Asthma is associated with inflammation in the lower airways, and the same inflammation might involve the sinuses in a parallel fashion . It is now felt that early therapy of this inflammation can modify the course of asthma resulting in its amelioration . Conversely, delay in institution of this therapy might result in the inflammation entrenching airway reactivity . It must be clearly proven in a controlled fashion that antibiotic or other therapy of sinusitis will improve the course of asthma since such therapy could delay the aggressive management of inflammation.

Infection, 1991, 19 Suppl 6, S330 - 6
Efficacy and safety of cefotaxime in the management of pediatric infections; Jacobs RF; The utilization of cephalosporins in serious bacterial infections in children has become more widely accepted by pediatric infectious disease specialists over the past five years . The use of cephalosporins has become increasingly popular in empiric antibiotic regimens . The recognition that age-specific bacterial pathogens in neonates, older infants and children can be effectively treated with cephalosporins alone, or in combination with ampicillin, has led to this increasing popularity . This review will discuss the use of cephalosporins in empiric antibiotic regimens and relate the efficacy and safety of specific cephalosporins in the treatment of serious bacterial infections in children.

Ann Dent, 1991 Winter, 50(2), 3 - 7, 48
Infections of the lateral pharyngeal space: anatomy, diagnosis and management; Lee CY et al.; The incidence of lateral pharyngeal space infections and its dreaded complications have decreased tremendously due to antibiotic therapy . However, this fascial space infection of the deep neck is still occasionally seen . In this article, we emphasize the anatomy, diagnosis and aggressive management of this type of neck infection because of its morbid complications and mortality if not treated promptly.

Acta Chir Hung, 1991, 32(1), 13 - 5
A case of Fournier's gangrene; Czalbert H et al.; Authors report their case of Fournier's gangrene on the basis of their own observations and relying on data of the literature . Complete healing can be expected of immediate radical surgery and of aggressive intensive and antibiotic treatments.

Pharmacology, 1991, 43(5), 242 - 6
Influence of the mode of intravenous administration on the penetration of ceftazidime into tissues and pleural exudate of rats; Miglioli PA et al.; The influence of the mode of intravenous (i.v.) administration (bolus injection or continuous infusion) on the tissue penetration of ceftazidime was studied in the rat . The antibiotic concentration was monitored in serum, pleural exudate, vitreous humor, kidney, liver, lung, testicles and epididymal fat tissue . Administration as a bolus resulted in a significantly higher AUC in pleural exudate and in higher peak levels in serum, liver and lung than continuous infusion, which produced a higher peak concentration in kidney than a bolus . No differences in AUC and peak concentrations between the two methods of administration were observed in the other tissues or fluids . With either method of administration the highest antibiotic accumulation was observed in kidney.

Scand J Thorac Cardiovasc Surg, 1991, 25(3), 167 - 74
Surgical treatment of infective aortic valve endocarditis; Varstela E et al.; Fifty-eight adult patients treated with aortic valve replacement for infective endocarditis were retrospectively reviewed . The operation was performed during antibiotic therapy (group I, n = 25) or after completion of such therapy, on average 17 months after diagnosis (group II, n = 33) . Preoperatively 68% of group I and 24% of group II were in NYHA class IV . Bacterial aetiology was verified in 78% of all cases . Preoperative embolic complications occurred in six group I and three group II cases, causing hemiplegia in eight . At operation the aortic valve was bicuspid in 29 of the 58 patients . Vegetations and cusp perforation were present in most cases . Bacteria were demonstrated in 11 of the excised specimens . A mechanical valve prosthesis was inserted in all cases . Three patients died, one perioperatively and two during their time in hospital (2 from group I) . Low-output syndrome was the commonest postoperative complication . During follow-up averaging 66 months, 12 patients died (6 of cardiac causes) . Late complications were periprosthetic leakage (2 cases), significant embolism (5), and prosthetic valve endocarditis (4), causing periprosthetic leakage in one case.

Probl Tuberk, 1991, (6), 29 - 32
{Immunomodulation in patients with cavernous kidney tuberculosis using piperazine adipinate and amniocene}; Kozin IuI et al.; Findings of a complex immunologic examination of 138 patients with active cavernous tuberculosis of the kidneys concurrent with secondary immunodeficiency are presented . Biostimulators and immunomodulating drugs were administered as conservative treatment in this case . Changes in cellular and humoral immunity indices as well as those of the mononuclear-phagocyte system before and after treatment were traced in the groups of patients receiving biogenic stimulators (such, as aloe extract, vitreous body, plasmol, Fibs) and immunoregulating drugs (like piperazine adipinate and injected amniocene) . It was found that the biogenic stimulators fail to have a pronounced effect on the immunologic indices . The inclusion of piperazine adipinate and injected amniocene into a complex of antibiotic and chemotherapy brings about a significant improvement of the cellular immunity indices and the mononuclear-phagocyte system function which are inhibited to a greater extent in patients with active destructive nephrophthisis . A recommended use of piperazine adipinate and amniocene as adjuncts to a complex treatment has been proved in patients of this category by means of clinicoimmunologic correlations.

Klin Khir, 1991, (9), 36 - 40
{Comprehensive therapy of acute cholecystitis in elderly and very old patients}; Zhumadilov ZhSh et al.; A high effectiveness of the use of target transport of antibiotics in the autological erythrocytic shadows in the complex of surgical treatment of acute cholecystitis in 65 elderly and senile patients when compared with that in use of the existing methods of conservative treatment was revealed . The method developed permits to create in the bile a high and prolonged antibiotic concentration, and as well to reduce 4.5-fold the time for cupping off acute cholecystitis, to increase the quality of examination, preoperative preparation and elective operative treatment of the patients.

Ind Health, 1991, 29(3), 93 - 102
Isolation of mouse cells with heavy metal-dependent resistance to G418; Koizumi S; Metallothioneins (MTs) are heavy metal-binding proteins which play key roles in protection against heavy metal toxicity, and therefore it is toxicologically important to understand the regulatory mechanism of MT production . In the present work, I isolated mouse cell clones which express the bacterial neo gene (G418-resistance gene) under the control of an MT gene regulatory sequence; such cells will serve as parents for the isolation of mutants defective in MT gene regulation . C-127 and L-929 cells were transformed with a plasmid construct containing the regulatory region of the human MTIIA gene linked to the neo structural gene, and stable G418-resistant transformants were selected . When Zn was given during the selection, the number of the resulting colonies increased significantly, suggesting a Zn-induced expression of the introduced neo gene . The C-127 transformants selected in the presence of Zn have several copies of the neo sequence in the chromosome, and express a neo message in a Zn-inducible manner . When Zn was removed from the medium, G418 damaged the cells . These cell clones are expected to be useful for isolating mutants that will help further understanding of the control mechanism of MT gene expression.

Nucleic Acids Symp Ser, 1991, (25), 147 - 8
The molecular recognition mechanism of DNA by bleomycin; Hiroaki H et al.; The interaction between the antibiotic bleomycin (BLM) and an oligonucleotide d(CCACCTAGGTGG) was studied by 1H NMR . The DNA oligomer was titrated with BLM-VO(III), which is an 'inactive analogue' of BLM-Fe(II) . A marked upfield shift was observed for the T10N3H signal, but no other imino proton signals either shifted or broadened . When BLM-VO(III) was titrated with d(CCACCTAGGTGG), a large upfield shift (0.27 ppm) was observed for the delta NH signal of butylguanidinium residue (G) . Analysis of NOESY spectra of a 1:1 complex of DNA:BLM-VO(III) strongly suggests that the connectivities of the sequential NOEs of the DNA duplex are the same as those of free DNA . These results indicate that BLM does not intercalate between the base-pairs but binds to DNA in a different manner . A model of 'minor-groove binding' is more likely to explain our NMR data.

Prep Biochem, 1991, 21(4), 257 - 68
Bleomycin A2 and B2 purification by flash chromatography for chemical and biochemical studies; Freyder CP et al.; The clinically used formulation of the anticancer antibiotic, Blenoxane, is a mixture of bleomycin congeners . A new approach to separating the major A2 and B2 congeners has been developed utilizing the flash chromatography technique . A 5-6-inch column of fine mesh silica gel with a solvent system of 1% ammonium formate:methanol (2:3) was used . Low air pressure was applied to the column to increase the flow rate such that separation was complete in approximately 20 min . Reverse phase size exclusion gravity chromatography with Sephadex G-15 column bedding was an effective, rapid procedure for removal of the 1% ammonium formate, the lowest percentage practical for separating the bleomycins . This separation approach does not damage the antibiotics, as demonstrated by NMR spectroscopy, thin layer chromatography, and DNA cleaving activity . Although not as useful for detection of trace amounts of the drug in biological systems as some of the known HPLC methods, this method is excellent for separating large quantities of the drug (8-32 mg) in order to obtain congeners pure enough for synthetic, biochemical, and biophysical studies.

Biomed Sci, 1991, 2(2), 147 - 50
Covalent binding of bleomycin to concanavalin A and immunoglobulin G enhances the ability of the bleomycin-Fe(II) complex to destroy the erythrocyte membrane; Voznesenskii AI et al.; The antibiotic bleomycin was examined as a possible component of hybrid molecules composed of an address fragment and a generator of reactive oxygen species . The bleomycin-Fe(II) complex was found to destroy the erythrocyte membrane by generating reactive oxygen . The ability of antioxidants to slow down haemolysis points to a free-radical mechanism for this process . The protective effects of catalase and superoxide dismutase indicate that hydrogen peroxide and the superoxide radical formed on autoxidation of the complex are essential for membrane damage . Haemolytic activity is also exhibited by bleomycin-Fe(III) reduced in the NADPH-cytochrome P450 reductase reaction . The covalent binding of bleomycin to such address molecules as concanavalin A and antierythrocyte immunoglobulin G enhances the ability of the bleomycin-Fe(II) complex to destroy the plasma membrane of erythrocytes.

Environ Mol Mutagen, 1991, 18(2), 102 - 6
Analysis of bleomycin-induced mutagenic functions related to the PSO4 (= xs9) gene of Saccharomyces cerevisiae; Severgnini A et al.; In the present work we analyse some properties of the pso4-1 (= xs9) mutant of the yeast Saccharomyces cerevisiae, which is blocked in both reverse mutation and recombination . We have applied the "apparent survival test" as a method to characterize putative inducible error-prone repair activities related to the PSO4 gene . As the mutagenic agent we have used bleomycin, which is an antitumour radiomimetic antibiotic . Survival, reverse mutation yield, and reverse mutation frequency were determined as a function of bleomycin concentrations (1-60 micrograms/ml) in the logarithmic phase of growth . It is shown that the PSO4 gene product is poorly involved in bleomycin sensitivity and that reverse mutation induced by this mutagen is dramatically reduced in the pso4-1 lys2 mutant strain, as compared with the isogenic SC7K (lys2) strain . M(x) functions exhibit linear-quadratic courses for both the SC7K (lys2) and the pso4-1 lys2 strains . The apparent survival functions display "humps" in both strains, corresponding to the resistant components of the survival functions . These facts suggest that the mutagenicity of bleomycin depends on at least one inducible error-prone repair pathway and that the PSO4 gene product could act as a mutation triggering factor.

Int J Biochem, 1991, 23(7-8), 703 - 11
DNA damage by peplomycin and its repair in an in vitro system; Zhang B et al.; 1 . DNA damage by peplomycin, an antitumor antibiotic, and its repair by cellular enzymes were studied using pUC18 plasmid DNA . The DNA damage and repair were measured by monitoring the conformational changes of pUC18 DNA . 2 . Peplomycin-induced DNA damage was enhanced by addition of ferrous ion and inhibited by deferoxamine, a specific iron chelator, suggesting iron-requirement for the DNA damage . 3 . DNA damage by peplomycin was inhibited by superoxide dismutase in both native and heat-inactivated forms, possibly due to non-enzymatic interaction . 4 . Peplomycin-induced, single-strand breaks in pUC18 DNA was repaired by incubating with a priming factor (an exonuclease purified from mouse ascites sarcoma cells), DNA polymerase beta, four deoxynucleoside triphosphates, T4 DNA ligase and ATP . The average repair patch size was estimated to be approximately four nucleotide length.

Anticancer Res, 1991 Jan-Feb, 11(1), 129 - 37
Different malignant phenotypes induced in a stable, subdiploid, benign epithelial clone by DNA transfection; Gibbins JR et al.; Progression to malignancy in carcinomas has been studied in a stable, benign, subdiploid, cloned epithelial cell line (A5P/B10) sensitive to Geneticin at 100 micrograms/ml . A total of 28 cell lines were selected for Geneticin - resistance and inoculated into the footpads of syngeneic animals following co-transfection with pSV2neo and genomic DNA, or transfection with plasmid constructs containing neo and the activated Ha-ras oncogene . The behavior of 12 cell lines cotransfected with normal genomic DNA and inoculated into 146 footpads was the same as the A5P/B10 cells . Low grade primary tumors were produced in 122 footpads by 13 cell lines transfected with Ha-ras, and a proportion (61/122) produced well-differentiated lymph node metastases . One of 3 cell lines cotransfected with genomic DNA from a malignant cell line (BC1) produced 8 anaplastic primary tumors with anaplastic metastases . Cell lines from lymph nodes involved by these anaplastic tumors were sensitive to Geneticin, and genomic DNA from 2 clones of these cells failed to produce a malignant phenotype when co-transfected into the A5P/B10 cells . These results indicated that the progression to a malignant phenotype induced in benign cells from a spontaneous epithelial tumor by co-transfection with genomic DNA from malignant cells was different from that induced by the ras oncogene.

Med Pediatr Oncol, 1991, 19(2), 100 - 5
Early infectious complications after peripheral blood stem cell autografts in children; Watanabe T et al.; Seventeen children underwent marrow-ablative high-dose chemotherapy with peripheral blood stem cell autografts and were studied retrospectively to determine the type, frequency, and outcomes associated with infectious complications 3 months postgraft . The patients were kept in isolated rooms with a laminar air flow facility, but no decontamination procedures, such as gut sterilization with nonabsorbable antibiotics, nonmicrobial diet, and skin cleansing, were used . They were under their mothers' daily care to maintain good psychological conditions . After the completion of marrow-ablative chemotherapy and the infusion of stem cells, the absolute granulocyte count exceeded 0.5 x 10(9)/liter with a mean of 17.9 days (range 6-65 days) . Fifteen patients developed a total of 16 febrile episodes during the first 4 week period, and the confirmed diagnoses were mucositis (12), enterocolitis (nine), septicemia (four), central venous catheter-associated infection (three), pneumonia (one), perianal abscess (one), and possible invasive fungal infection (one) . All episodes were successfully treated with parenteral antibiotic therapy, and no patient died of infectious complications . The observations suggest that high-dose chemotherapy can be performed safely with simple and efficient patient management protocol followed by peripheral blood stem cell autografts.

Drugs, 1991 Jan, 41(1), 60 - 8
Guidelines for drug treatment of male infertility; Haidl G et al.; The prerequisite for rational therapy of male fertility disorders is an exact diagnosis . While the possibilities of influencing disturbances of spermiogenesis are limited, male adnexal diseases can be successfully treated in many cases . Drugs for the treatment of fertility disorders must be applied with this in mind, and empiric therapy is often performed in addition to causal treatment which, however, may be quite rationally determined . The therapeutic spectrum in andrology includes antibiotic and antiphlogistic agents, mast cell blockers, zinc, vitamins, and immunosuppressive drugs (corticosteroids) . These agents are used for the treatment of inflammatory diseases of the testes and the accessory glands or for suppression of antispermatozoal antibodies . Hormonal disturbances are infrequently encountered by the andrologist, but they can be treated, with proven efficacy, with gonadotrophins, gonadotrophin-releasing hormone (GnRH) or androgens . In certain cases that are not hormonally related, the use of antiestrogens (clomifene, tamoxifen) as stimulating agents may be successful . Furthermore, tissue hormone releasing proteases (kallikrein) can be used both therapeutically (especially in motility disturbances that are not due to structural flagellar defects) and diagnostically (in order to distinguish between inflammatory and noninflammatory testicular damage) . Anticholinergics and alpha-sympathomimetics are applied to ameliorate ejaculation or emission failure . In addition to a review of these treatment forms, the development of new concepts, e.g . angiotensin converting enzyme (ACE) inhibitors, is discussed.

J Am Vet Med Assoc, 1991 Jan 1, 198(1), 107 - 8
Bleomycin chemotherapy for metastatic squamous cell carcinoma in a ferret; Hamilton TA et al.; Bleomycin, an antitumor antibiotic, was effective in temporarily reducing the size of a metastatic squamous cell carcinoma in a ferret . The tumor had recurred after previous excision and had metastasized to the right submandibular lymph node . The ferret was treated without effect at a dosage of 10 U/m2, sc, once a week . The dosage was increased to 20 U/m2 once a week, and reduction of tumor size was observed.

Environ Mol Mutagen, 1991, 17(1), 63 - 8
DNA damage and repair induced by bleomycin in mammalian and insect cells; Bianchi NO et al.; We assessed the response of mosquito (ATC-15) and mammalian (CHO) cells to bleomycin (BLM) . Comparison of the data obtained in both cell lines indicates that DNA in the chromatin of mosquito cells is 10 to 20 times more resistant to BLM, and that the DNA damage induced by this antibiotic is better repaired in mosquito than in mammalian cells . Permeability of the cell membrane for BLM was found to be the same for both cell lines . Moreover, the time-kinetics of BLM damage to nuclear DNA was similar for ATC-15 and CHO cells . The low sensitivity of mosquito cells to BLM is reflected in better growth efficiency . These cells exhibit a satisfactory growth at BLM doses that produce a permanent arrest of growth in CHO cells . It is proposed that variations in the chromatin structure and in the intracellular free amino acid pool may play an important role in the differential response of insect and mammalian cells to BLM.

Comp Biochem Physiol C, 1991, 100(3), 413 - 5
The interaction of cefotaxime with the serum albumin of several mammalian species; Fernandez GM et al.; 1 . The interaction of cefotaxime with the serum albumin of several mammalian species; horses, swine, sheep, dogs and rabbits, was studied comparatively . The technique of ultrafiltration and spectrophotometric determination of the free antibiotic in the filtrate was used . 2 . Binding percentages, which vary according to the species studied, were found to be higher in swine and rabbit albumins (between 92 and 81%) and lower for sheep, dog and horse albumins (between 67 and 52%) . 3 . The number of binding sites is usually close to 2; in the case of the horse it is 2.43 . The apparent binding constants are: swine, 1.61 x 10(4) M-1; rabbit, 1.19 x 10(4) M-1; sheep, 2.33 x 10(3) M-1; dog, 2.00 x 10(3) M-1; horse, 1.42 x 10(3) M-1 . The Scatchard model was used for data analysis . 4 . Possible consequences of this interaction regarding clinical use of cefotaxime on different species are discussed.

Comp Biochem Physiol A, 1991, 100(4), 945 - 7
Effects of stressors on blood glucose and hepatic glycogen concentrations in turkey poults; Donaldson WE et al.; 1 . The putatively stressful procedures of sexing, toe trimming, snood removal, beak trimming and injection of antibiotic solution, as performed in a commercial hatchery, elevated blood glucose levels and depressed hepatic glycogen levels in newly-hatched turkey poults . 2 . The first procedure performed, cloacal sexing, was sufficient to elevate blood glucose, but all procedures were required before depression of hepatic glycogen occurred . 3 . Blood glucose levels declined in both untreated (INITIAL) and fully-treated (FINAL) poults over a 24 hr holding period . 4 . Hepatic glycogen declined with 24 hr holding of INITIAL poults but increased with holding of FINAL poults.

Masui, 1991 Jan, 40(1), 109 - 12
{Possible bronchospasm after administration of vecuronium}; Uratsuji Y et al.; A 62 year-old female developed bronchospasm after intravenous vecuronium administration . Vecuronium is reported to have major advantages over pancuronium due to the lack of significant histamine-releasing activity and cardiovascular side effects . However, macular rash, systemic collapse and bronchospasm have been reported before . The patient received cholecystectomy under general anesthesia . She had a history of urticaria when she had had a intravenous pyelography and showed positive skin test to antibiotic, ceftizoxime . During induction with thiopental plus vecuronium and on addition of vecuronium, bronchospasm was induced within five minutes in each time . Both episodes of bronchospasms were relieved with intravenous aminophylline and methylprednisolone . During the operation arterial blood gas samples were taken twice and showed no abnormal findings . Further blood samples were taken for complement C3, C4, plasma IgE and white blood cell counts . Skin test to vecuronium was also performed . In spite of these data, the mechanism of bronchospasm remained obscure . Careful attention should be paid to the use of vecuronium, especially for the patient who showed allergic response to some drugs.

Acta Trop, 1991 Jan, 48(3), 173 - 84
In vitro development of Brugia pahangi and Brugia malayi in cultured mosquito thoraces; Nayar JK et al.; In vitro cultivation of Brugia pahangi and subperiodic Brugia malayi one-day old larvae to infective stage larvae (L3) within thoraces excised from Aedes aegypti (Black Eye, Liverpool) and Anopheles quadrimaculatus was attempted . The mosquito thoraces were excised under aseptic conditions, 24 h after a blood meal on either B . pahangi- or B . malayi-infected jirds . The excised thoraces were washed aseptically and inoculated into a diphasic media . A nutrient agar base was overlaid with either Grace's insect cell culture medium or Schneider's Drosophila medium or a mixture (1:1) of these two media . Each overlay medium contained a 1 x concentration of antibiotic/antimycotic mixture plus 20% fetal bovine serum . The excised thoraces provided the intracellular milieu for development of Brugia larvae . In Grace's or Schneider's insect tissue culture medium alone, the filaria larvae of both species developed only to the second larval stage after 12 days; whereas, in a mixture (1:1) of Grace's and Schneider's media, some one-day old larvae of both Brugia species developed to the infective larval (L3) stage after 12 days . However, large numbers of both species of larvae developed to the infective larval stage when, prior to providing an infective blood meal, the mosquitoes of both species were fed 1 x concentration of antibiotic/antimycotic mixture in a 10% sucrose solution containing 0.1% p-aminobenzoic acid for 6 days . These results showed for the first time that if one-day old Brugia larvae are confined intracellularly in excised thoraces, they can then develop in insect tissue culture media without adding a feeder layer of mosquito cells or conditioning the media with mosquito cell lines.

Boll Ist Sieroter Milan, 1991-92, 70(1-2), 527 - 9
Fluconazole resistance of Candida krusei; Manso E et al.; We present a case of young male treated for a recurrence of Acute Non Lymphoid Leukemia who presented a colonization by C . krusei during prophylaxis with Fluconazole . The fever episode, which he developed while neutropenic, was resolved with the addition of Amphotericin B after the failure of empiric antibiotic therapy . No isolation was performed in blood cultures . A second cycle of antiblastic chemotherapy was needed because of the resistance shown to the first . Despite the prophylaxis with Fluconazole a stream of C . krusei grew in all the blood cultures collected while febrile . Amphotericin B administered did not control the fungemia . We discuss the resistance of C . krusei to Fluconazole.

Acta Clin Belg, 1991, 46(5), 327 - 32
Intrahepatic cholestasis induced by amoxicillin/clavulanic acid (Augmentin): a report on two cases; Alexander P et al.; Two patients who developed a severe but reversible cholestatic jaundice during and after treatment with an amoxicillin/clavulanic acid preparation (Augmentin) are described . The diagnosis of drug-induced intrahepatic cholestasis was based on the clinical course, biochemical pattern and on histological findings . Since amoxicillin alone does not induce liver injury, the combination of amoxicillin and clavulanic acid or clavulanic acid alone could be responsible for this adverse reaction, probably through a metabolic idiosyncrasy or a hypersensitivity mechanism . Although more than 100 cases of hepatotoxic reactions have been reported to the pharmaceutical company (Beecham Laboratories) and several reports have been published, the incidence of hepatotoxicity of this antibiotic is relatively rare, since this antibiotic has been widely used . However, recognition of this benign and reversible cholestatic syndrome is important to avoid unnecessary, expensive and invasive diagnostic procedures.

J Cancer Res Clin Oncol, 1991, 117(6), 503 - 4
Rifampicin as cytotoxic agent for cholangiocarcinoma: preliminary report of seven cases; Sali A et al.; Seven consecutive patients with unresectable cholangiocarcinoma of the major bile ducts, referred to one surgical department with a hepatobiliary interest, were treated by biliary decompression and with the antibiotic rifampicin in an uncontrolled preliminary study . Three patients were also given tamoxifen . Five of the seven are dead, the mean survival being 26 months (expected mean survival 8 months), and two are alive and well in May 1991, 48 and 30 months respectively from the time of presentation . A controlled study of rifampicin with and without tamoxifen is indicated in unresectable cholangiocarcinoma.

J Basic Microbiol, 1991, 31(2), 141 - 7
Highly transformable mutants of Streptomyces aureofaciens containing restriction-modification systems; Muchova J et al.; Streptomyces aureofaciens 13 is a mutant defective in chlortetracycline production . It was chosen as a potentially useful host for gene cloning in investigations of the organization of the biosynthetic genes for the tetracycline antibiotic pathway . From the Streptomyces aureofaciens 13 strain, three suitable clones were used for our work . The conditions for optimal formation and efficient transformation of protoplasts with plasmid DNAs have been determined . Transformation frequencies of about 10(4) to 10(5) per microgram of plasmid DNA were obtained when plasmids were isolated from Streptomyces strains . From the patterns of restriction enzyme digestion of plasmid DNA isolated from Streptomyces aureofaciens transformants, it was observed that the clones express modification systems which render plasmid DNAs resistant to cleavage by HindIII and EcoRI . Additionally, one of the clones produces the restriction endonuclease Sau13I (isoschizomer of SauI) . The presence of the restriction-modification system of Sau13I does not reduce the efficiency of plasmid transformation.

Tsitologiia, 1991, 33(1), 24 - 32
{An ionometric study of Na+ and K+ fluxes across the nystatin-modified human erythrocyte membrane}; Borisov IuA et al.; The application of ion-selective electrodes is discussed for the kinetic determination of K+ and Na+ concentrations in the system, containing human red blood cells modified by nystatin . A series of mixed solutions was worked out, according to which the Na(+)-glass and the K(+)-thick membrane valinomycin electrodes were calibrated . The human erythrocytes were washed for 3 times with the basic solution (in mol per liter: 0.141 NaCl, 0.004 KCl, 0.002 CaCl2, 0.003 MgCl2, 0.01 glucose), and then were resuspended in it . The suspension was kept in a shaking bath at 37 degrees C . The modification of the cell membranes was performed by the introduction of different amounts of the antibiotic nystatin into the probe . Under these conditions the concentration of Na+ decreased, while K+ concentration increased . The values of concentration were registered ionometrically . In an hour and a half the stationary lines were obtained . Being based on the values of the stationary cation concentrations and the final concentrations, registered after the complete lysis of erythrocytes promoted by saponin, the ratio of cation fluxes across the modified membrane to the flux across the nonmodified membrane was calculated in accordance with the Hodgkin-Katz equation.

Hum Gene Ther, 1991 Spring, 2(1), 33 - 9
L-histidinol provides effective selection of retrovirus-vector-transduced keratinocytes without impairing their proliferative potential; Stockschlaeder MA et al.; Retroviral vectors carrying the neomycin phosphotransferase (neo) gene have been shown to confer G418 resistance to canine keratinocytes at relatively high frequency . To investigate the usefulness of keratinocytes as potential target cells for gene therapy, we used a retroviral vector (LASN) that contains both human adenosine deaminase (hADA) and neo genes . We show here that LASN-transduced canine keratinocytes expressed high levels of hADA, a human protein of therapeutic relevance . Selection of LASN-transduced keratinocytes in medium containing G418 resulted in a population of cells that expressed even higher levels of hADA, about 80-fold higher than the endogenous canine ADA level . However, the G418-selected cells had a reduced proliferative potential and altered morphology indicative of terminal differentiation . To test whether L-histidinol is more beneficial for selection of keratinocytes than G418, we constructed two retroviral vectors that contain both the neo and the histidinol dehydrogenase (hisD) genes . Cocultivation of primary keratinocytes with lethally irradiated PA317 retrovirus packaging cells that produce these vectors gave rise to 12-53% drug-resistant colonies in either G418 or L-histidinol . In contrast to G418, selection of transduced keratinocytes in L-histidinol had no apparent effect on the proliferative potential or morphology of drug-resistant cells containing the vectors . Given the utility of this selection system, two hisD-based generic constructs containing cloning sites for cDNA expression from either the retroviral promoter or from an internal human cytomegalovirus immediate early promoter were constructed . Our results suggest that hisD will be a useful selectable marker for use in studies of keratinocyte differentiation and for transfer of genes into keratinocytes for the purposes of gene therapy.

JAMA, 1990 Dec 26, 264(24), 3161 - 5
Derivation and validation of a clinical diagnostic model for chlamydial cervical infection in university women; Johnson BA et al.; We developed and prospectively tested a logistic regression model for chlamydial cervical infection . Study subjects included 2271 women receiving gynecologic care in our student health clinic . Clinical data were collected in a standardized fashion . We identified cell culture--isolated Chlamydia trachomatis from 133 (9%) of 1458 subjects in the derivation set and 73 (10%) of 729 subjects in the validation set . Model variables included a new sexual partner within 2 months or more than one sexual partner within 6 months; cervical ectopy; cervical friability; at least 20 polymorphonuclear leukocytes per high-power field in cervical secretions; white blood cells in vaginal secretions; and use of an antibiotic active against C trachomatis within a month . This model can distinguish women with low, medium, and high risks of chlamydial infection (on derivation set: receiver operating characteristic curve area, 0.710; SE, 0.026; on validation set: area, 0.698; SE, 0.035) using simple clinical information obtained in the office.

Schweiz Med Wochenschr, 1990 Dec 15, 120(50), 1945 - 9
{The evaluation of prescribing practice in a general internal medicine outpatient clinic with special reference to gastrointestinal medicines}; Conen D et al.; Prescribing patterns of 13 residents in a medical outpatient clinic were evaluated between March and June 1986 . Prescribed drugs influencing the gastrointestinal tract were also analyzed in order to define quality of the therapeutic process . Advertising for these special drugs in 3 Swiss medical journals was analyzed and compared with the prescribing behavior of participating physicians . 6300 patients with 3346 prescriptions (0.5 prescription/patient) were enrolled in the study . 16.5% of all prescriptions involved cardiovascular, 13.5% gastrointestinal, 9.5% non steroidal antirheumatic, 9.1% analgesic, 7.7% psychotropic and 7.4% antibiotic drugs . The share of 14 other classes of drugs was less than 4% . 471 prescriptions of gastrointestinal acting drugs were distributed over 288 patients (0.6 prescription/patient) . 160 patients had irritable bowel syndrome, 40 ulcer disease, 23 inflammatory/infectious bowel disease, 18 gastroesophageal reflux, 18 anal diseases, 11 other gastrointestinal disorders and 15 were treated without diagnosis . Distribution of drugs was as follows: 27.5% bulk laxatives, 26% antacids, 15.7% H2-receptor antagonists, 13.5% anticholinergic agents, 4.9% laxatives, 3.4% loperamide, 9% other drugs . There was an increase in prescriptions per visit from 0.8 in 1980 to 1.5 in 1986 . No important influence of drug advertising in 3 different medical journals published between January and June 1986 could be found . Considering the documented diagnoses, the therapeutic decisions were correct in 95.5% of cases treated . In conclusion, drug prescribing habits are permissive, the therapeutic approach is acceptable and the influence of drug advertising is negligible.

Biochim Biophys Acta, 1990 Dec 14, 1030(2), 289 - 95
The effect of surfactants on the aggregation state of amphotericin B; Tancrede P et al.; We have studied the effect of two surfactants, one non-ionic, lauryl sucrose (LS) and the other ionic, sodium deoxycholate (DOC), on the aggregation state of amphotericin B (AmB) and its selectivity towards ergosterol and cholesterol . It is shown that the addition of these surfactants has very similar effects on the AmB micelles . Below the critical micellar concentration of the surfactants, mixed micelles with AmB are first formed as a result of the penetration of the surfactant molecules into the AmB micelles . At higher concentrations of the surfactant molecules, the micellar structure is completely destroyed and AmB is found as monomers in solution . When the concentration of the surfactant is further increased, micelles of the surfactant molecules are built up, AmB remaining in monomeric form . However, the critical micellar concentration of LS is modified by the presence of AmB in solution, while that of DOC is not affected, thereby indicating that the interactions of AmB with LS are stronger than those of DOC with AmB . We also show that both surfactants enhance the selectivity of the AmB binding to sterols at exactly the concentrations of the surfactants which induce the monomerization of the antibiotic . It is observed that the maximal selectivity is found at a concentration of the surfactants corresponding to their particular CMC in presence of the antibiotic.

Science, 1990 Dec 14, 250(4987), 1583 - 7
Homologous recombination and stable transfection in the parasitic protozoan Trypanosoma brucei; Lee MG et al.; Development of methods for the manipulation of the genomes of parasitic protozoa will lead to enhanced understanding of parasite biology and host-parasite relationships . Efficient gene transfer and targeted integration by homologous recombination were achieved in the parasitic protozoan Trypanosoma brucei, the causative agent of sleeping sickness . An expression vector with the neomycin phosphotransferase gene (neo), under the control of a procyclic acidic repetitive protein (PARP) gene promoter, was targeted into an intergenic region in beta alpha-tubulin-gene tandem array . Sixteen copies of neo were found in a tandem array in one of the transfectants where the PARP promoter controlled alpha-amanitin-resistant transcription of neo, whereas transcription of tubulin genes remained alpha-amanitin-sensitive.

Clin Mater, 1991, 7(3), 227 - 31
Methods for improving drug release from poly(methyl)methacrylate bone cement; Downes S; Poly(methylmethacrylate) (PMMA) is a widely used material with both dental and orthopaedic applications . The acrylic cement is produced by the combination of polymethylacrylate beads with methylmethacrylate monomer . After polymerisation, a heterogeneous and porous matrix is formed which can be used to deliver therapeutic agents . In this work, the release of antibiotic, growth hormone and serum albumin is demonstrated . The mechanism is similar for all agents; a rapid release followed by a slow continuous release . The quantity of drug released depends upon the formulation of both the PMMA and the drug . The polymer-to-monomer ratio can greatly affect the ratio of drug release; increased polymer-to-monomer ratio leads to increased release of antibiotic . Optimum release is achieved if a crystalline formulation of the drug is used rather than a fine powder . Experimental methods to improve the drug release performance of bone cements are presented.

Clin Mater, 1991, 8(3-4), 243 - 9
The effects of biological wound dressings on the healing process; May SR; Three major biological dressings are available for the temporary closure of wounds: partial-thickness cadaveric human allograft skin, several forms of partial-thickness antibiotic-treated porcine xenograft skin, and human amnion . Generally, biological dressings reduce pain, close the wound to contamination and fluid loss, and prepare the wound bed for permanent closure, usually with autografts . The three types of biological dressings differ in their performance, with allograft skin being clearly superior in its wound maintenance and preparation characteristics, while porcine xenograft presents serious difficulties in incorporation into the wound bed and antigenic challenge to the recipient, and amnion is excessively fragile and tends to allow wound desiccation . The most serious potential liability of biological wound dressings is transmission of infection; however, the actual incidence of such transmission is extremely low . The advantages of physiological coverage provided by biological wound dressings greatly outweighs the chance for harm in the case of human allograft.

Home Health Care Serv Q, 1991, 12(3), 59 - 108
Home intravenous therapy: Part I--Issues; McAbee RR et al.; Concerns related to providing home intravenous therapy were among the top ten clinical problems identified by Northwest Medicare-certified home care agencies in a 1986 survey . This paper addresses issues related to home intravenous therapy and provides lists of resources for the development of home intravenous therapy programs . Part I of the paper covers concerns related to intravenous therapy as expressed by home care agencies in the Northwest and synthesized the literature about home intravenous therapies . Survey results are presented, followed by a discussion of client and caregiver concerns . These include: discharge planning, client admission criteria and client and caregiver education . Standards, staffing, and staff education issues are discussed followed by sections on economics, marketing regulations and legal and ethical concerns . Finally, there is a discussion of issues related to specific types of intravenous therapies: parenteral nutrition, antibiotic therapy; chemotherapy; blood and blood component therapy and other less frequently used types of intravenous therapies . Each therapy is discussed with regard to complications, client and caregiver instruction and financial considerations . Part II of the paper is a resource guide which lists resources that agencies may use to develop a home intravenous therapy program . In the first section, national organizations and journals and books concerned with intravenous therapy are listed as well as journal articles, guidelines and guidebooks and client and provider educational materials . National and regional product and service representatives of intravenous therapy related companies are also listed . In the second section, addresses for the State Boards of Nursing are given for Alaska, Idaho, Montana, Oregon and Washington . Each state section includes a list of those agencies who indicated in the 1988 survey that they would be willing to share materials . In addition, product and service vendors of intravenous therapy supplies and equipment are listed for the State of Washington.

Nature, 1990 Dec 6, 348(6301), 555 - 7
Synthetic analogues of fumagillin that inhibit angiogenesis and suppress tumour growth; Ingber D et al.; Neovascularization is critical for the growth of tumours and is a dominant feature in a variety of angiogenic diseases such as diabetic retinopathy, haemangiomas, arthritis and psoriasis . Recognition of the potential therapeutic benefit of controlling unabated capillary growth has led to a search for safe and effective angiogenesis inhibitors . We report here the synthesis of a family of novel inhibitors that are analogues of fumagillin, a naturally secreted antibiotic of Aspergillus fumigatus fresenius . We first isolated this fungus from a contaminated culture of capillary endothelial cells . Purified fumagillin inhibited endothelial cell proliferation in vitro and tumour-induced angiogenesis in vivo; it also inhibited tumour growth in mice, but prolonged administration was limited because it caused severe weight loss . Synthesis of fumagillin analogues yielded potent angiogenesis inhibitors ('angioinhibins') which suppress the growth of a wide variety of tumours with relatively few side-effects.

J Immunol Methods, 1990 Dec 5, 134(2), 227 - 35
The use of N-(aminobenzoyloxy) succinimide as a two-level heterobifunctional agent for the preparation of hapten-protein conjugates . Daunomycin as a model hapten with an amino group; Fujiwara K et al.; Three geometric ortho-, meta-, and para-isomers of N-(aminobenzoyloxy)succinimide (ABS) were synthesized, and their usefulness as a two-level heterobifunctional cross-linking agent in the preparation of hapten-protein conjugates was evaluated . The conjugation was based on the principle that ABS reacts immediately with an amino group of a hapten, and an aminobenzoyl group incorporated into the hapten is then activated by diazotization to a functional diazobenzoyl group acting on tyrosine or histidine residues of the protein . Using the anti-tumor antibiotic daunomycin (DM) as a model hapten, the three isomers of ABS were compared for their ability to conjugate DM with bovine serum albumin (BSA); DM incorporation onto a BSA molecular was found to occur to the highest degree with m-ABS, followed by p-ABS . while o-ABS completely failed to conjugate under the same coupling conditions . Using m-ABS it was possible to introduce more than 10 molecules of DM per BSA molecule . One of the DM-BSA samples was used as the immunogen for the production of anti-DM serum in a rabbit . The antibody specificity was shown to be direct to DM but not to other anti-cancer drugs (bleomycin, mitomycin C, actinomycin D and 5-fluorouracil) by the double antibody enzyme immunoassay (DEIA) using DM-beta-galactosidase conjugate as a label . An enzyme-linked immunosorbent assay (ELISA) for anti-DM IgG was developed using a DM-human serum albumin (DM-HSA) conjugate similarly prepared with m-ABS and horseradish peroxidase-conjugated goat anti-rabbit IgG as the solid-phase antigen and the labelled second antibody, respectively . This ELISA permitted us to measure accurately as little as 50 ng of anti-DM IgG per ml using a standard anti-DM IgG which had been purified from the anti-DM serum using an affinity column of Sepharose 4B with DM-HSA as the ligand . Using this ELISA as well as a sandwich enzyme immunoassay (SEIA) for total IgG, serum levels of anti-DM IgG and total IgG levels were easily monitored in a rabbit following immunization with DM-BSA . These results indicate that the use of DBS provides a novel method for preparing hapten-protein conjugates which will be useful in biochemistry and immunochemistry.

J Biol Chem, 1990 Dec 5, 265(34), 21000 - 4
Purification and characterization of elongation factor G from bovine liver mitochondria; Chung HK et al.; The mitochondrial protein synthesis translocase elongation factor Gmt (EF-Gmt) from bovine liver has been purified to greater than 90% homogeneity by a combination of conventional gravity and high performance liquid chromatography . The purification scheme results in an approximate overall 14,000-fold purification with 2% total recovery of EF-Gmt activity . Gel filtration chromatography and sodium dodecyl sulfate-polyacrylamide gel electrophoresis indicate that the mitochondrial factor is a single polypeptide with a molecular weight of 80,000 . EF-Gmt displays similar levels of activity on its homologous mitochondrial ribosomes and on Escherichia coli ribosomes . The mitochondrial translocase is sensitive to temperatures above 37 degrees C, but the factor is partially protected from heat inactivation in the presence of GTP or GDP . The activity of EF-Gmt is inhibited by treatment of the factor with N-ethylmaleimide . In contrast to all other translocases tested to date, EF-Gmt is completely resistant to the inhibiting effect of fusidic acid when tested on its homologous ribosomes . It displays weak sensitivity to this antibiotic when assayed in the presence of heterologous E . coli ribosomes.

Nippon Jibiinkoka Gakkai Kaiho, 1990 Dec, 93(12), 2028 - 37
{Auricular hematoma--case report of ruptured othematoma and bibliographic review}; Yamasoba T et al.; Auricular hematoma is not rare condition and its prognosis has been considered to be good in Japanese textbooks . Recurrence of the hematoma, however, frequently occurs by use of simple aspiration or incision, and a pressure dressing . In this paper, we report a case of ruptured othematoma and review the biliographies concerning the pathology and treatment of othematomas . A 37-year-old man sustained a fist blow to his left ear at the beginning of May, 1989 . He was first seen with auricular hematoma on July 4, but refused a surgical treatment . The laceration of the skin overlying the hematoma occurred by once more fist blow on July 26, with the upper auricle divided into anterior and posterior parts . The auricular cartilage was broken into several pieces, some of which attached to the anterior side and the others to the posteriors side . Under general anesthesia, fibrin glue was applied to the dead space after irrigation, minimal debridement, and removal of the clots . Four horizontal mattress sutures were put through the entire pinna after the anterior skin was protected by fluffed gauze with antibiotic ointment and the posterior skin by buttons . The dressing was allowed to remain in place ten days and was then removed . Nine months after the operation the pinna appeared almost normal . In recent reports, the othematoma is considered to occur between the perichondrium and the cartilage, or within the cartilage . Various techniques have been applied to treat the othematoma, which are classified into three types: incision and drainage, pressure dressing with splinting mold, or with mattress suture . Treatment of choice is discussed, with reviewing the advantages and disadvantages of each method.

J Antimicrob Chemother, 1990 Dec, 26 Suppl E, 63 - 9
Efficacy and tolerance of cefpodoxime proxetil compared with co-amoxiclav in the treatment of exacerbations of chronic bronchitis; Periti P et al.; This European, multicentre trial evaluated the efficacy and tolerance of cefpodoxime proxetil in comparison with co-amoxiclav (amoxycillin plus clavulanic acid) in the treatment of acute exacerbations of chronic bronchitis . The study design was double-blind and double-placebo controlled . Doses of either 200 mg bd of cefpodoxime proxetil or 500 mg/125 mg tds amoxycillin plus clavulanic acid were given orally for 9.6 +/- 1.8 days . Two hundred and fifty-one patients were enrolled in 27 centres in West Germany, France, and Italy . The overall clinical efficacy was 97.2% in the cefpodoxime proxetil group compared with 94.7% in the co-amoxiclav group . Fifty-eight adverse events, mainly gastrointestinal, occurred in 42 patients with no significant difference between the groups . A significant difference in the number of resistant pathogens on pre-treatment culture to the advantage of cefpodoxime was noted . In our experience, both drugs were of similar value in the treatment of respiratory tract infections . Thus, cefpodoxime proxetil should be an effective antibiotic for the treatment of acute exacerbations of chronic bronchitis.

Blut, 1990 Dec, 61(6), 379 - 80
Improvement of pneumonia and arthritis in Felty's syndrome by treatment with granulocyte-macrophage colony-stimulating factor (GM-CSF); Lubbe AS et al.; A 63-year old man with Felty's syndrome and pneumonia of unknown origin was treated with GM-CSF . Granulocyte counts increased and arthritis-related symptoms improved under GM-CSF . Pneumonia was treated effectively with antibiotics only during or after GM-CSF application . This suggests, that antibiotic-resistant infections can be treated effectively in patients with Felty's syndrome when granulocyte counts are raised by GM-CSF.

Anat Rec, 1990 Dec, 228(4), 449 - 55
Calcium in the developing Ambystoma neural axis shown by 3H and fluorescent chlortetracycline and atomic absorption spectrometry; Moran DJ; The calcium ion has been implicated in the mediation of the morphogenetic movements that occur during neural tube formation . The present study identifies high levels of calcium in the neuroepithelium of the neural plate, folds, and tube . These levels are substantially higher than those discerned elsewhere in the embryo . The calcium is localized in morphogenetically active regions by using the antibiotic chlortetracycline (CTC) which chelates calcium and is demonstrated in this investigation by both autoradiography and calcium-linked fluorescence . The specificity of CTC reaction for calcium in the developing neural axis is confirmed by EGTA competition . A comparison of the actual calcium levels in the developing neural axis (dorsal) with equivalently weighted ventral tissues was obtained by atomic absorption spectrometry (AAS) . This method provides a total count of the calcium without any loss during tissue processing . For AAS, living tissues were precisely excised and immediately dessicated . Each tissue sample (dry weight 1.5 mg) was then solubilized for analysis . The spectrometric data reveal that the embryonic dorsal aspect forming the neural tube contains 57% more calcium than an equivalent weight of the ventral aspect.

Rev Prat, 1990 Dec 1, 40(28), 2600 - 3
{Management of children with sickle-cell disease}; Quinet B et al.; The management of children with sickle-cell disease in specialized centres may take place either during the intercritical phase of the disease or in the period of vaso-occlusive phenomena and acute complications . Without any doubt, a regular follow-up of these children, starting immediately after the diagnosis is made, improves the prognosis . Repeated visits enable the physician to inform the family and thereafter the child on the disease, its consequences and its transmission and to implement such prophylactic measures as preventive antibiotic therapy, specific immunizations and advice on hydration . As years go by, this monitoring is modified according to the patient's age, the course of the disease and the age-related complications . Acute accidents are frequent and often difficult to diagnose . In the immediate and well-adjusted management they require rehydration, rest, analgesics and antibiotics play a major role . The purpose of management is to avoid most complications and raise the child to adulthood in the best possible conditions.

J Clin Microbiol, 1990 Dec, 28(12), 2845 - 7
Fatal encephalitis caused by Dactylaria constricta var . gallopava in a snowy owl chick (Nyctea scandiaca); Salkin IF et al.; Dactylaria constricta var . gallopava (Cooke) Salkin et Dixon was found to cause fatal encephalitis in a 28-day-old, captivity-bred snowy owl chick (Nyctea scandiaca) . The previously healthy bird suddenly developed ataxia, severe torticollis, and extensor rigidity of the legs . Since the animal did not improve with antibiotic or vitamin-mineral supplement therapy, the chick was euthanized 5 days after the onset of neurologic signs . At necropsy, all tissues except the brain were grossly normal . Cultures inoculated with blood from the brain and heart yielded a dematiaceous mould that subsequently proved to be D . constricta var . gallopava . This is the first report of natural central nervous system infection caused by D . constricta var . gallopava in a snowy owl.

Br J Oral Maxillofac Surg, 1990 Dec, 28(6), 367 - 74
Gentamicin impregnated polymethylmethacrylate (PMMA) beads in the treatment of primary chronic osteomyelitis of the mandible; Grime PD et al.; Primary chronic osteomyelitis (chronic diffuse sclerosing osteomyelitis) of the mandible is an uncommon condition, probably arising as a consequence of infection with bacteria of low virulence, in which bone deposition rather than bone resorption occurs . These bacteria are most likely derived from skin or oral mucosa gaining access to bone from the periodontium or through the circulation . Furthermore, delayed hypersensitivity and ischaemic changes within bone may contribute to the inflammatory response, which once initiated is very difficult to eradicate . When the likely aetiological factors are considered a logical approach to management includes the surgical removal of affected bone and the topical application of a broad spectrum antibiotic to the resultant surgical bed.

Pediatr Infect Dis J, 1990 Dec, 9(12), 873 - 7
Epidemiology of acute respiratory infections in young children from Thailand; Sunakorn P et al.; A prospective evaluation of the epidemiology and presentations of acute respiratory infections in children younger than 5 years of age admitted to Children's Hospital Bangkok (1988 to 1989) was supported by the World Health Organization . There were 226 patients with the inclusion criteria: 1 to 5 years of age; duration of illness less than 2 weeks; no prior antibiotic therapy; and low socioeconomic status . The disease categories included: croup, 19 cases; bronchiolitis, 60 cases; and pneumonia, 147 cases . Pathogens isolated were: respiratory syncytial virus (40); parainfluenza III (1); influenza B (1); and adenovirus (1); bacterial infections were proved in 23 cases . No significant differences in clinical features between bacterial and viral pneumonia were found . Interstitial radiographic patterns were more common in viral pneumonia whereas alveolar patterns were more common in bacterial pneumonia . However, 91% of mixed radiographic patterns (interstitial and alveolar) in chest films were from viral pneumonia.

Kyobu Geka, 1990 Dec, 43(13), 1084 - 7
{Successful management of a ruptured infected aneurysm of the thoracic aorta: report of a case}; Gohra H et al.; A successful removal of the infected thoracic aortic aneurysm ruptured to the lung is reported . A 59-year-old man who had been suffering from high fever showed sudden hemoptysis and shock during antibiotic therapy . Immediately a so-called temporary bypass grafting from ascending aorta to descending aorta was placed with a woven Dacron prosthesis, and then aneurysmectomy with upper lobectomy of the left lung was carried out . Finally the graft was left as a permanent bypass graft . In addition, the left subclavian artery was reconstructed with a EPTFE graft . The patient is now well one year after operation.

Mol Reprod Dev, 1990 Dec, 27(4), 288 - 94
Culturing two- to eight-cell caprine embryos using domestic chicken eggs; Blakewood EG et al.; Early-stage caprine embryos were placed in the chick embryo amnion to determine if this culture method would support the development of embryos from a farm animal species . Following superovulation and natural mating, two- to eight-cell embryos were surgically collected from crossbred donor goats . Embryos were allotted to in vitro culture treatments across two different experiments (EXP) . In EXP-I, embryos allotted to Treatment A (control) were cultured in Ham's F-10 with 10% fetal calf serum and 1% antibiotic-antimycotic (HF-10) . Embryos in Treatment B were placed on a bovine fetal uterine fibroblast monolayer in HF-10, embryos allotted to Treatment C were agarose embedded and injected into the amniotic cavity of a day-4 chick embryo and those placed in Treatment D were co-cultured in HF-10 with day-15 caprine trophoblastic vesicles . In EXP II Treatments A, B, and C were the same; however Treatment D was omitted . EXP-I and EXP-II also differed in that chick embryo co-culture was for 72 hr in EXP-I but was extended to 96 hours in EXP-II . Additionally, the monolayer co-culture was limited to 96 hr in EXP-II; whereas, embryos in EXP-I remained on monolayer culture for 96 hr plus an additional 72 hr for subsequent embryo evaluation . Results indicate that the amniotic cavity of the developing chick embryo enhanced the development of two- to eight-cell caprine embryos through to hatching blastocysts when compared with that of the control medium alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Oral Surg Oral Med Oral Pathol, 1990 Dec, 70(6), 741 - 3
Dexamethasone as an adjunct in oropharyngeal obstruction in a patient with leukemia; Barrett AP; Incipient airway obstruction due to fulminating bacterial infection of pharyngeal tissues requires prompt and definitive intervention . A case is presented in which dexamethasone was a key adjunct to antibiotic therapy in averting this problem in a severely neutropenic patient with acute leukemia.

Am J Obstet Gynecol, 1990 Dec, 163(6 Pt 2), 2146 - 52
Factors affecting the enterohepatic circulation of oral contraceptive steroids; Orme ML et al.; Oral contraceptive steroids may undergo enterohepatic circulation, but it is relevant for only estrogens, because these compounds can be directly conjugated in the liver . Animal studies show convincing evidence of the importance of the enterohepatic circulation, but studies in humans are much less convincing . The importance of the route and the rate of metabolism of ethinyl estradiol are reviewed . Some antibiotics have been reported anecdotally to reduce the efficacy of oral contraceptive steroids, but controlled studies have not confirmed this observation . Although gut flora are altered by oral antibiotics, the blood levels of ethinyl estradiol are not reduced, and one antibiotic at least (cotrimoxazole) enhances the activity of ethinyl estradiol.

Chest, 1990 Dec, 98(6), 1322 - 6
Utility of fiberoptic bronchoscopy in nonresolving pneumonia; Feinsilver SH et al.; Although fiberoptic bronchoscopy (FOB) has been traditionally used to evaluate nonresolving pneumonia, its efficacy is unknown . We, therefore, reviewed FOB in 35 consecutive patients who had (1) a roentgenographic infiltrate, (2) cough, (3) either temperature greater than 38.1 degrees C, leukocytosis, sputum production, (4) symptoms present for at least ten days, and antibiotic therapy for at least one week . Known lung cancer and AIDS were excluded . Fiberoptic bronchoscopy was diagnostic in 86 percent (12/14) in whom a specific cause was found . No patient had endobronchial cancer . Two patients with nondiagnostic FOB and persistent systemic symptoms had open lung biopsy specimens showing Wegener's granulomatosis and bronchiolitis obliterans with organizing pneumonia (BOOP) . Twenty-one patients with nondiagnostic FOB had no final diagnoses other than community-acquired pneumonia . We conclude that FOB is extremely useful in finding a specific diagnosis for a nonresolving pneumonia when a specific diagnosis can be made . Fiberoptic bronchoscopy was most likely to yield a specific diagnosis in nonsmoking patients with multilobar infiltrates of long duration and could have been avoided in older, smoking, or otherwise compromised patients with lobar or segmental infiltrates with no decrease in diagnostic yield in our series.

Ann Thorac Surg, 1990 Dec, 50(6), 868 - 81
Treatment of postoperative infection of ascending aorta and transverse aortic arch, including use of viable omentum and muscle flaps; Coselli JS et al.; Postoperative infection of the ascending aorta and aortic arch in 40 patients was treated by antibiotic therapy alone (4 patients) or by operation and lifelong suppressive antibiotic therapy (36 patients) . Complications of infection included antibiotic-resistant infection, infected false aneurysm, rupture of suture line, aortocutaneous fistulas, aortic-right ventricular fistulas, arterial embolus, aortic valve insufficiency, aortobronchial fistula, mediastinal abscess, and chest wall problems . These were treated by a variety of operations including composite valve-graft replacement, graft replacement, patch-graft closure of false aneurysm, simple suture of disrupted suture lines and false aneurysm, and debridement of mediastinum and chest wall . The area of reconstruction was covered, and mediastinal dead space was reduced by mobilization of viable tissue, including local tissue and distant structures such as flaps of muscle and omentum . Thirty-three patients (83%) were early survivors, and 28 patients (70%) were alive and well at last follow-up 4 months to 6.5 years after operation.

J Neurosurg, 1990 Dec, 73(6), 962 - 4
Subarachnoid hemorrhage caused by a fungal aneurysm of the vertebral artery as a complication of intracranial aneurysm clipping . Case report; Piotrowski WP et al.; Intracranial aneurysms are an uncommon manifestation of fungal infection . A case is described in which the formation of an aneurysm followed an intracranial intraoperative Aspergillus infection attributable to a long period of preoperative antibiotic medication and immunosuppressive therapy with steroids.

J Clin Oncol, 1990 Dec, 8(12), 1998 - 2004
Early hospital discharge of children with cancer treated for fever and neutropenia: identification and management of the low-risk patient; Mullen CA et al.; Children with leukemia and solid tumors are often hospitalized for empiric broad-spectrum antibiotic therapy because of fever during periods of chemotherapy-induced neutropenia . Conventional practice dictates that parenteral antibiotics be continued until the patient is afebrile and has recovered from neutropenia, ie, until the absolute neutrophil count (ANC) exceeds 500 cells per cubic millimeter . However, the practice in our center has been to discontinue parenteral antibiotic therapy and discharge many such patients before resolution of neutropenia . Since the feasibility and safety of this approach has not been studied, we reviewed the records of 114 consecutive hospitalizations for fever and neutropenia in 61 patients during a 13-month period . Seventy-seven children (68%) were discharged to their homes while still neutropenic after they had been afebrile for 1 to 2 days on parenteral antibiotics, had negative blood cultures, appeared well, and usually had some evidence of bone marrow recovery . Five patients (4.4%) developed recurrent fever and required rehospitalization within 7 days of discharge . Only three of the 77 patients (3.9%) who were sent home with neutropenia had recurrent fever . Each had a brief and uneventful second hospitalization . Two of the 37 children discharged with an ANC over 500 cells per cubic millimeter required rehospitalization . A declining ANC and advanced malignancy were risk factors in predicting recurrence of fever following discharge . A rising monocyte count was a predictor of imminent recovery from neutropenia . These results suggest that "early" discharge of an afebrile yet still neutropenic patient is safe when the patient is in remission, has no evidence of serious infection, appears clinically stable, and has indications of bone marrow recovery . The conventional approach of routinely continuing the hospitalization until resolution of neutropenia may be unnecessary in such low-risk patients.

Arch Dis Child, 1990 Dec, 65(12), 1297 - 300
Roseola infantum and other syndromes associated with acute HHV6 infection; Irving WL et al.; Eight cases of acute human herpesvirus type 6 (HHV6) infection in infants were diagnosed serologically by the demonstration of IgM anti-HHV6 (8/8) and a significant change in total anti-HHV6 antibody titre (6/8) . Four infants were sufficiently ill to require admission to hospital and further investigations: one with encephalitis and three with gross hepatosplenomegaly, two of whom had evidence of simultaneous infection with another herpes-virus . The remaining four infants had an illness compatible with roseola infantum, although this diagnosis had not been made clinically . Sera from two of those infants with rash had been sent for analysis to exclude rubella because the infants' mothers were pregnant . The other two had received antibiotics when febrile, and the subsequent appearance of the roseola rash had raised the possibility of antibiotic allergy . The data suggest that there are clinical syndromes in addition to roseola infantum associated with the presence of IgM anti-HHV6, in which serological screening for evidence of acute HHV6 infection may be useful.

J Med Chem, 1990 Dec, 33(12), 3160 - 9
Arabinofuranosylpyrrolo{2,3-d}pyrimidines as potential agents for human cytomegalovirus infections; Krawczyk SH et al.; Protection of the 3'- and 5'-hydroxyl groups of the nucleoside antibiotic toyocamycin (1) with 1,3-dichloro-1,1,3,3-tetraisopropyldisiloxane was followed by (trifluoromethyl)sulfonylation of the 2'-hydroxyl group . A displacement of the resulting triflate ester moiety with lithium chloride, lithium bromide, sodium iodide, and lithium azide in hexamethylphosphoramide was followed by a removal of the disilyl moiety with tetra-n-butylammonium fluoride to afford the appropriate (2'-deoxy-2'-substituted-arabinofuranosyl)toyocamycin analogues 6a-d . Hydrolysis of the carbonitrile moieties of 6a-d with hydrogen peroxide gave the corresponding sangivamycin analogues (7a-d) . A reduction of the azido moiety of 6a and 7a with 1,3-propanedithiol furnished the corresponding amino derivatives (6e and 7e) . The antiproliferative activity of 6a-e and 7a-e was evaluated in L1210 cell cultures . None of these compounds caused significant inhibition of cell growth . Evaluation of these compounds for antiviral activity showed that all the toyocamycin analogues were active against human CMV, but of the sangivamycin analogues, only (2'-deoxy-2'-azidoarabinosyl)sangivamycin (7a) was active against this virus . None of the compounds were active against HSV-1 or HSV-2 . (2'-Deoxy-2'-aminoarabinofuranosyl)toyocamycin (6e) was studied more extensively and showed some separation between antiviral activity and cytotoxicity as measured by effects on DNA synthesis, cell growth, and cell-plating efficiency . Although 6e also was active against murine CMV in vitro, it was not active against this virus in infected mice . We conclude that arabinosylpyrrolopyrimidines have potential as antivirals, but no members of the current series are potent enough to show significant activity in vivo.

Riv Eur Sci Med Farmacol, 1990 Dec, 12(6), 359 - 66
{A new anti-inflammatory--analgesic--antipyretic for the treatment of acute disease of the bronchi }; Girbino G et al.; Sixty adult patients, 31 men and 29 women, aged 44 to 60, and affected by acute bronchitis of probable bacterial aetiology were randomly divided into 3 groups of 20 and treated respectively with: 1) morniflumate (one 700 mg tablet twice a day) + amoxicillin (one 1 g tablet twice a day); 2) feprazone (one 200 mg tablet twice a day) + amoxicillin (one 1 g tablet twice a day); 3) amoxicillin (one 1 g tablet twice a day) . Mean therapy duration was 9 days . The action of the drugs under study was assessed by objective chest examination and by evaluating the modifications of cough intensity and frequency, chest pain expectorating difficulty, amount of expectoration, body temperature . The overall assessments were completed by side-effect recording and by laboratory examinations carried out at the beginning and end of the study . Checks were made regularly on admission, and in the 3rd, 5th, 7th and last day of therapy . The above mentioned parameters showed a quicker regression of bronchial inflammation in the subjects treated also with the antiinflammatory drug compared to those treated only with the antibiotic . Furthermore, in the subjects treated with morniflumate such improvement was more rapidly achieved compared to those who received feprazone . The analgesic and antipyretic effects of morniflumate were also remarkable . All tested drugs were well tolerated.

Antibiot Khimioter, 1990 Dec, 35(12), 7 - 11
{Molecular cloning of chlortetracycline resistance gene from chlortetracycline producer Streptomyces aureofaciens}; Sezonov GV et al.; The chlortetracycline (CT) resistance gene ctr was cloned from S . aureofaciens 633, a strain producing the antibiotic . The 6.6-kb DNA Bam HI fragment containing the resistance gene was cloned with the plasmid vector pIJ699 . Comparison of the restriction maps of the cloned gene and the oxytetracycline (OT) resistance gene otrA from S . rimosus revealed their similarity which enabled identification of the cloned resistance gene as otrA . Investigation of the resistance determinants in S . aureofaciens 633 made it possible to identify a mtr gene(s) . It was demonstrated that introduction of a ctrA gene into S . lividance provided a simultaneous increase in the resistance of the recipient strain to CT and a number of macrolide antibiotics . The CT resistance determinants in S . lividans TK64 showed properties of exogenous induction by CT and the macrolide antibiotics similar to the properties of the mtr gene(s) of S . aureofaciens . Possible adaptation properties of mtr genes are discussed.

Antibiot Khimioter, 1990 Dec, 35(12), 26 - 9
{Development of the system for protoplast generation in Streptomyces aureofaciens strains--chlortetracycline producers}; Isaeva LM et al.; Conditions for preparation and regeneration of protoplasts in a commercial strain of the culture producing chlortetracycline and its derivatives were determined . The protoplasting level depended on the conditions of the mycelium cultivation and composition of a regeneration medium . Under the optimal conditions it amounted up to 10(6) protoplasts/ml . A mutant able to form regenerating protoplasts at a rate of 10(9) protoplasts/ml was isolated . An autoinhibition effect in regenerating protoplasts was observed . As a result ofprotoplast generationing, the morphological variation increased and the protoplast antibiotic activity changed within wide ranges . Variants with higher productivity in comparison to that of the initial strain were isolated . Stability of the inherited property of antibiotic production in the variants is being studied.

Antibiot Khimioter, 1990 Dec, 35(12), 14 - 7
{Cloning of grisin resistance gene gsr and the study of its functioning in Streptomyces griseus Kr . strain}; Sezonov GV et al.; S . griseus Kr . is a commercial strain producing grisin, an antibiotic of the streptothricin group used as a feed additive . It was shown earlier that genetic instability of the strain was very high which was evident from a high frequency of nonreverting Grn- Grns mutants . With densitographic analysis of chromosomal DNA electrophoregrams and DNA-DNA hybridization it was revealed that the molecular basis of the genetic instability of the S . griseus strain was deletion of a DNA fragment about 20 kb in size containing a grisin resistance gene . The resistance gene designated as gsr was cloned to S . lividans TK 64 within the plasmid vector pIJ699 . The restriction map of a cloned DNA fragment with a gsr gene was constructed and its similarity to that of a nat gene resistant to norseothricin, another streptothricin was observed . Introduction of a gsr gene within the multicopy plasmid pIJ699 into S . griseus 212, a highly productive strain synthesiing the antibiotic, led to an increase in its resistance and productivity . Proceeding from the preliminary data on possible linkage of a gsr gene and grisin biosynthesis genes, it appeared possible to use the cloned gene as a molecular probe in cloning the biosynthesis genes.

Zhonghua Shen Jing Jing Shen Ke Za Zhi, 1990 Dec, 23(6), 374 - 6, 386
{Non-operation management of 12 cases with brain abscess demonstrated by CT scan}; Long J; This paper reported 12 cases with brain abscess demonstrated by CT scan . Using antibiotic management without surgical intervention, in 10 cases the curative effects were satisfactory . The paper indicated that CT scan was very useful in prompt and correct diagnosis of brain abscess and with sequential CT scan medical therapy was feasible . It is significant in treatment of brain abscess especially for the patients who have a poor general condition, have the brain abscess located in important functional area or have multiple abscesses so that the operation is difficult for them.

Biochimie, 1990 Dec, 72(12), 885 - 7
MoMuLV-derived self-inactivating retroviral vectors possessing multiple cloning sites and expressing the resistance to either G418 or hygromycin B; Marty L et al.; To facilitate cloning procedures in recombinant murine leukemia virus-derived retroviruses, we have constructed vectors that both carry a polylinker with multiple restriction sites and express resistance to either G418 or hygromycin B . Our vectors are self-inactivating retroviruses that suppress interferences between LTR enhancers and internal promoters and avoid transcriptional stimulation of host cell genes . They can also be used as expression vectors in direct transfection assays, since no translation initiation codon lies between the 5' LTR and the cloning polylinker.

Dtsch Tierarztl Wochenschr, 1990 Dec, 97(12), 520 - 3
Supplementing salinomycin to diets for growing-finishing pigs; De Schrijver R et al.; Feeding experiments with growing-finishing pigs were carried out to study the effect of different dietary salinomycin concentrations upon animal performance . Besides a dietary treatment without antibiotic, three treatments consisted of 20/10 mg/kg, 40/20 mg/kg and 60/30 mg/kg salinomycin (the first and second number refer to the salinomycin content in grower and finisher diet, respectively) . Compared to the control group, feeding diets with 20 or 40 mg/kg salinomycin resulted in significantly higher weight gain in the grower period (25-45 kg body weight), while also feed conversion was lower (although not statistically significant) . In the finisher period (45-100 kg body weight) salinomycin had no significant effect upon weight gain or feed conversion efficiency, but the 20 and 30 mg/kg treatments yielded the best results . Considering the grower and finisher period together the dietary treatments 40/20 mg/kg and 60/30 mg/kg showed highest growth rate and most favourable feed conversion, although not statistically significant . Carcass characteristics (dressing percentage, carcass length, backfat thickness, percent meat) were not affected by dietary salinomycin supplementation.

Antimicrob Agents Chemother, 1990 Dec, 34(12), 2354 - 7
Intraoperative concentrations of ofloxacin in serum, bile fluid, and gallbladder wall tissue; Chin A et al.; To evaluate concentrations of ofloxacin in serum, bile fluid, and gallbladder wall tissue after intravenous administration, patients greater than or equal to 16 years old diagnosed with acute cholecystitis were randomly assigned to receive ofloxacin (400 mg) intravenously every 12 h or ceftazidime (2 g) intravenously every 8 h . Doses of each regimen were given preoperatively . Serum, bile fluid, and gallbladder wall tissue samples of consecutive patients in the ofloxacin group were obtained intraoperatively . The samples were frozen at -70 degrees C until analyzed by high-pressure liquid chromatography . Twenty-three patients (6 males and 17 females) were evaluated . The mean (+/- the standard deviation) ofloxacin concentrations in serum, bile fluid, and gallbladder wall tissue were 2.9 +/- 2.4 and 6.0 +/- 7.9 micrograms/ml and 3.1 +/- 2.9 micrograms/g, respectively . The mean number of doses each patient received before surgery was 5.3 +/- 3.0, and the mean delta time (time elapsed between last antibiotic administration and when intraoperative samples were obtained) was 9.6 +/- 7.5 h . The mean tissue-to-serum ratio was 1.2 +/- 0.5, and the mean bile-to-serum ratio was 2.3 +/- 1.4 . The mean serum ofloxacin concentrations were not statistically different from the concentrations in bile (P = 0.1) and tissue (P = 0.7) at the mean delta time . The study revealed that concentrations of ofloxacin in serum, bile fluid, and gallbladder tissue after intravenous dosing were adequate against susceptible organisms found in the biliary tract.

Jpn J Antibiot, 1990 Dec, 43(12), 2078 - 86
{Clinical evaluation of cefbuperazone in severe infections complicated with hematological disorders}; Mizuno H et al.; The efficacy and the safety of an antibiotic in cephamycin group, cefbuperazone (CBPZ), were investigated in 93 patients with severe infections complicated with hematological disorders . The efficacy evaluation was made in 85 cases with underlying hematological disorders including 49 cases (57.6%) of leukemia and 18 cases (21.2%) of malignant lymphoma . The overall efficacy rate was 50.6% of the 85 evaluable cases . The clinical efficacy rate for sepsis and suspected sepsis was 53.4% . The most frequently used group of antibiotics for combination therapy was aminoglycosides in 37 cases, in which an efficacy rate of 62.2%, a higher rate than the efficacy rate of 48.5% for all the combination therapy cases, was obtained . In 16 cases in which penicillins were used as combination drug, the efficacy rate obtained was low, 31.3% . Efficacy rates obtained for cases with different neutrophil counts at the start of therapies were as follows: 52.2% in 23 cases with neutrophil counts below 100/mm3, 46.2% in 13 cases with neutrophil counts between 100 and 499/mm3 and 51.3% in 39 cases with neutrophil counts equal to or above 500/mm3, thus no significant differences in efficacy rates were observed for patients with different neutrophil counts . These results appear to suggest that CBPZ, alone or in combination with other antibiotic such as aminoglycosides, may be quite useful in the treatment of severe infections in patients with hematological disorders.

Can J Microbiol, 1990 Dec, 36(12), 827 - 33
Two new mutant loci (smhB and lytD) in Escherichia coli which confer temperature-sensitive growth and lysis phenotypes; Dai D et al.; A temperature-sensitive mutation in the murH gene of Escherichia coli confers a lysis phenotype at the restrictive temperature . An extragenic suppressor of murH apparently representing a new locus at 12.5 min on the linkage map and designated smhB is described . The smhB mutation by itself also conferred a temperature-sensitive lysis phenotype . A mutation in another new locus designated lytD which arose spontaneously in the smhB mutant was mapped close to smhB at 12.7 min on the linkage map . The lytD mutation by itself conferred a temperature-sensitive lysis phenotype indistinguishable from that of the murH mutant . Thus, the suppression of lysis in the smhB murH and the smhB lytD double mutants suggests a mechanism involving the reciprocal suppression of the two individual lysis-causing mutant alleles . The suppressor activity of smhB was apparently relatively specific in that smhB failed to prevent lysis induced by either mutational (murE or murF) or antibiotic-induced blocks in peptidoglycan synthesis . This suggests that murH, smhB, and lytD may be functionally related.

Tierarztl Prax, 1990 Dec, 18(6), 653 - 7
{Enrofloxacin, a new drug for ornamental fish}; Reimlinger M et al.; The compatibility and efficacy of enrofloxacin (Baytril) a newly developed antibiotic belonging to the quinolones, were tested for five ornamental fish species (Herotilapia multispinosa, Pterophyllum scalare, Symphysodon discus, Brachydanio rerio and Melanochromis johanni) . The results prove that enrofloxacin has a high tolerance level for ornamental fishes and high efficacy against important bacterial diseases . 30 micrograms/l water over 5 hours are recommended for the treatment of ornamental fishes.

J Gen Microbiol, 1990 Dec, 136 ( Pt 12), 2405 - 12
A relaxed (rel) mutant of Streptomyces coelicolor A3(2) with a missing ribosomal protein lacks the ability to accumulate ppGpp, A-factor and prodigiosin; Ochi K; A relaxed (rel) mutant was found among 70 thiopeptin-resistant isolates of Streptomyces coelicolor A3(2) which arose spontaneously . The ability of the rel mutant to accumulate ppGpp during Casamino acid deprivation was reduced 10-fold compared to the wild-type . Analysis of the ribosomal proteins by two-dimensional PAGE revealed that the mutant lacked a ribosomal protein, tentatively designated ST-L11 . It was therefore classified as a relC mutant . The mutant was defective in producing A-factor and the pigmented antibiotic prodigiosin, in both liquid and agar cultures, but produced agarase normally . Production of actinorhodin, another pigmented antibiotic, was also abnormal; it appeared suddenly in agar cultures after 10 d incubation . Although aerial mycelium still formed, its appearance was markedly delayed . Whereas liquid cultures of the parent strain accumulated ppGpp, agar cultures accumulated only trace amounts . Instead, a substance characterized only as an unidentified HPLC peak accumulated intracellularly in the late growth phase, just before aerial mycelium formation and antibiotic production . This substance did not accumulate in mutant cells . It was found in S . lividans 66 and S . parvulus, but not in seven other Streptomyces species tested . The significance of these observations, and the relationship of the mutant to earlier rel isolates of Streptomyces is discussed.

Antibiot Khimioter, 1990 Dec, 35(12), 24 - 6
{Expression of cloned bialaphos resistance gene (bar) in Streptomyces strains}; Sezonov GV et al.; The object of the study was a strain of Streptomyces hygroscopicus producing bialaphos, an antibiotic used as a herbicide, which is promising and ecologically safe . Molecular cloning of a bialaphos resistance gene (bar) was performed in the recipient strain, S . lividans TK64, within the 2.0-kb DNA fragment with the plasmid pIJ699 . Introduction of a bar gene into another strain producing bialaphos, i.e . S . viridochromogenus Tu494, led to its higher constitutive resistance to bialaphos . The results confirmed the data on different regulation of bar (S . hygroscopicus) and pat (S . virido-chromogenus) resistance genes.

Practitioner, 1990 Dec, 234(1497), 1013 - 6
A request for an abortion; Walker A et al.; PIP: How to manage to abortion request by a hypothetical 30-year old married woman who states the she fears a deformed child because of taking an antibiotic combination, cotrimoxazole, containing trimethoprim is discussed by 3 physicians . The 1st doctor would confirm pregnancy with an exam and a laboratory test, schedule another consultation for counseling, and schedule a pelvic ultrasound if she decides to carry the pregnancy . If she wants an abortion, the physician would counsel her at length about her marriage and the emotional consequences of abortion . The 2nd physician would advise her that fetal abnormality from trimethoprim has not been reported in women . Since this doctor is personally opposed to abortion, she would refer the patient to another doctor to make the arrangements, and counsel her again afterward . The 3rd physician added the advice that 1-2% of all U.K . births are abnormal in some way . He would take steps to establish the precise gestational date, recommend an ultrasound scan at 18 weeks to cover himself legally and suggest that the patient's husband join in the counseling session to help bring out feelings about the marriage and the pregnancy .

Foot Ankle, 1990 Dec, 11(3), 168 - 71
Free tissue transfer and calcanectomy as treatment of chronic osteomyelitis of the os calcis: a case report; Anderson RB et al.; Chronic osteomyelitis of the os calcis presents a formidable management dilemma . Successful treatment requires aggressive surgical debridement of devitalized bone and soft tissue and appropriate antibiotic therapy . Difficulties arise, however, when radical debridement results in significant loss of weight-bearing bone . Recalcitrant osteomyelitis of the os calcis or major loss of bone secondary to debridement has been treated by amputation . Advances in microsurgical reconstruction now provide the opportunity for limb salvage in this situation.

AIDS, 1990 Dec, 4(12), 1283 - 6
A fluoroquinolone (DR-3355) protects human lymphocyte cell lines from HIV-1-induced cytotoxicity; Nozaki-Renard J et al.; HIV-1 infection of human CD4+ lymphocyte cell lines results in cell death . Treatment, but not pretreatment, of infected cells, with a fluoroquinolone antibiotic, DR-3355, protects a significant subfraction of cells from HIV-1-mediated cytolysis . All surviving cells have lost expression of the CD4 antigen, but do (MT-4) or do not (CEM) express viral antigens and produce infective virus . The rescued CEM and MT-4 cells are phenotypically stable and do not require continuous exposure to the drug for survival.

Acta Trop, 1990 Dec, 48(2), 89 - 94
Clinical implications of delayed growth of the Lyme borreliosis spirochete, Borrelia burgdorferi; MacDonald AB et al.; Lyme borreliosis, a spirochetal infection caused by Borrelia burgdorferi, may become clinically active after a period of latency in the host . Active cases of Lyme disease may show clinical relapse following antibiotic therapy . The latency and relapse phenomena suggest that the Lyme disease spirochete is capable of survival in the host for prolonged periods of time . We studied 63 patients with erythema migrans, the pathognomonic cutaneous lesion of Lyme borreliosis, and examined in vitro cultures of biopsies from the active edge of the erythematous patch . Sixteen biopsies yielded spirochetes after prolonged incubations of up to 10.5 months, suggesting that Borrelia burgdorferi may be very slow to divide in certain situations . Some patients with Lyme borreliosis may require more than the currently recommended two to three week course of antibiotic therapy to eradicate strains of the spirochete which grow slowly.

Surg Neurol, 1990 Dec, 34(6), 408 - 13
Magnetic resonance imaging and the nonoperative treatment of spinal epidural abscess; Hanigan WC et al.; This report describes three patients with spinal epidural abscess diagnosed by magnetic resonance imaging and treated nonoperatively . Prior to treatment, one patient was neurologically intact, one patient demonstrated a moderate neurological deficit, and one patient was severely paraparetic with loss of bladder and bowel control . Following identification of the pathogenic organism, antibiotic therapy was continued until the patients demonstrated clinical improvement and radiological resolution of the abscess . All patients remained stable or improved neurologically . Analysis of 33 previously reported patients treated with antibiotics suggests that nonoperative treatment may be a reasonable alternative therapy under certain clinical conditions . These include (1) identification of the pathogenic organism, (2) a stable neurological condition, (3) access to magnetic resonance imaging or computed tomography for potentially rapid reevaluation, and (4) appropriate neurosurgical consultation and nursing care . Nonoperative treatment may also be considered as a reasonable alternative for patients who have severe concurrent medical illness.

Arch Biochem Biophys, 1990 Dec, 283(2), 519 - 22
Conjugation of bleomycin with concanavalin A or immunoglobulin G increases its ability to destroy cell membranes; Voznesensky AI et al.; Hybrid molecules consisting of an address peptide and an active oxygen-generating fragment may be used for selective destruction of cells . We tested the possibility of using the antibiotic bleomycin (BLM) as an active oxygen-generating fragment of such a molecule . It was found that bleomycin can induce destruction of cell membranes . BLM-mediated cell destruction was inhibited by addition of catalase, superoxide dismutase, and OH . scavangers (mannitol and ethanol), suggesting that hydroxy radical is involved in the process . BLM can induce membrane impairment at the expense of electrons supplied by NADPH-cytochrome P450 reductase . Covalent binding of BLM to an address fragment (concanavalin A, immunoglobulin G) increases the ability of BLM to destroy erythrocyte membranes . The data obtained lead to the conclusion that BLM can be used as an active oxygen-generating fragment of a proposed cell-destroying hybrid molecule.

Ann Otol Rhinol Laryngol, 1990 Dec, 99(12), 941 - 4
Effect of bleomycin on hematoporphyrin derivative phototherapy of solid tumors; Jones GC et al.; Hematoporphyrin derivative phototherapy (HpD-PT) has been successfully used to localize and treat superficial squamous cell cancers . Bleomycin sulfate is a glycopeptide antibiotic that has antineoplastic properties against squamous cell cancers . Because both HpD-PT and bleomycin chemotherapy are accepted forms of treatment for squamous cell cancer and their cytotoxicity is mediated by singlet oxygen and oxygen radicals, we studied the possibility of enhancing the response of solid tumors to HpD-PT by combining this modality with systemic bleomycin chemotherapy in a murine tumor model . Bleomycin did not enhance HpD-PT significantly . Also, we are not confident that HpD-PT alone or in combination with other agents can eradicate solid tumors; it certainly did not in this syngeneic murine tumor model.

N Engl J Med, 1990 Nov 22, 323(21), 1438 - 44
Chronic neurologic manifestations of Lyme disease; Logigian EL et al.; BACKGROUND AND METHODS . Lyme disease, caused by the tick-borne spirochete Borrelia burgdorferi, is associated with a wide variety of neurologic manifestations . To define further the chronic neurologic abnormalities of Lyme disease, we studied 27 patients (age range, 25 to 72 years) with previous signs of Lyme disease, current evidence of immunity to B . burgdorferi, and chronic neurologic symptoms with no other identifiable cause . Eight of the patients had been followed prospectively for 8 to 12 years after the onset of infection . RESULTS . Of the 27 patients, 24 (89 percent) had a mild encephalopathy that began 1 month to 14 years after the onset of the disease and was characterized by memory loss, mood changes, or sleep disturbance . Of the 24 patients, 14 had memory impairment on neuropsychological tests, and 18 had increased cerebrospinal fluid protein levels, evidence of intrathecal production of antibody to B . burgdorferi, or both . Nineteen of the 27 patients (70 percent) had polyneuropathy with radicular pain or distal paresthesias; all but two of these patients also had encephalopathy . In 16 patients electrophysiologic testing showed an axonal polyneuropathy . One patient had leukoencephalitis with asymmetric spastic diplegia, periventricular white-matter lesions, and intrathecal production of antibody to B . burgdorferi . Among the 27 patients, associated symptoms included fatigue (74 percent), headache (48 percent), arthritis (37 percent), and hearing loss (15 percent) . At the time of examination, chronic neurologic abnormalities had been present from 3 months to 14 years, usually with little progression . Six months after a two-week course of intravenous ceftriaxone (2 g daily), 17 patients (63 percent) had improvement, 6 (22 percent) had improvement but then relapsed, and 4 (15 percent) had no change in their condition . CONCLUSIONS . Months to years after the initial infection with B . burgdorferi, patients with Lyme disease may have chronic encephalopathy, polyneuropathy, or less commonly, leukoencephalitis . These chronic neurologic abnormalities usually improve with antibiotic therapy.

J Biol Chem, 1990 Nov 15, 265(32), 20027 - 32
Reconstitution of steps in the constitutive secretory pathway in permeabilized cells . Secretion of glycosylated tripeptide and truncated sphingomyelin; Helms JB et al.; The constitutive secretory pathway has been reconstituted in mechanically permeabilized Chinese hamster ovary cells using two secretory markers, an acyltripeptide (N-octanoyl-Asn-Tyr-Thr-NH2) that is glycosylated at Asn in the endoplasmic reticulum and a truncated ceramide that is converted to sphingomyelin . Secretion of these bulk phase markers is dependent on cytosolic proteins and ATP . Secretion of both the glycosylated tripeptide and truncated sphingomyelin was inhibited at 15 degrees C . These results are taken as evidence that the vesicle flow to the plasma membrane (rather than artificial lysis of endoplasmic reticulum or Golgi cisternae) is required for the release of markers to the medium . Guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S), a nonhydrolyzable analogue of GTP, inhibited secretion, resulting in an accumulation of both the glycosylated tripeptide and truncated sphingomyelin in the semi-intact cell . Inhibition of secretion by GTP gamma S was not observed in the presence of the aminoglycoside antibiotic neomycin.

Nucleic Acids Res, 1990 Nov 11, 18(21), 6247 - 51
Generation of small mutation in large genomic fragments by homologous recombination: description of the technique and examples of its use; Tripodi M et al.; We have developed a technique of homologous recombination in bacteria which allows the mutagenesis of large genomic fragments cloned in cosmids . The desired mutation is first introduced into a plasmid clone and is then transferred to the appropriate cosmid clone by the means of double antibiotic selection coupled with phenotypic selection . We describe three different types of construct made by this technique.

JAMA, 1990 Nov 7, 264(17), 2251 - 8
Epidemiologic, clinical, and laboratory findings of human ehrlichiosis in the United States, 1988; Eng TR et al.; In 1988, the Centers for Disease Control and the Oklahoma State Department of Health identified 40 patients who had a fourfold or greater change in antibody titer in response to Ehrlichia canis . The median age of these patients was 42 years, 83% were male, 76% became ill between May and July, and 92% reported recent exposures to ticks . Patients resided in or were exposed to ticks in 14 states, including five where ehrlichiosis had not been reported before 1988 . Thirty-four patients (85%) were hospitalized, and many had serious complications, including acute respiratory failure (seven patients), encephalopathy (six patients), and acute renal failure (four patients) . Pulmonary infiltrates were demonstrated in 14 patients, cerebrospinal fluid pleocytosis was seen in 10 patients, and elevated levels of serum creatinine were demonstrated in eight patients . Two patients, both of whom had preexisting medical problems, died . Nonhospitalized patients received tetracycline therapy earlier in the course of their illness than hospitalized patients . There was no significant difference in the interval from initiation of antibiotic therapy to the first day of defervescence between patients treated with tetracyclines and those treated with chloramphenicol.

Nihon Kyobu Shikkan Gakkai Zasshi, 1990 Nov, 28(11), 1482 - 7
{A case of Aspergillus empyema with bronchopleural fistula}; Mukae H et al.; Pleural aspergillosis is not a common disease and we recently experienced a case of Aspergillus empyema with bronchopleural fistula . A 76 year-old man was admitted to our hospital with productive cough and fever . Chest X-ray films showed infiltration in the right lower and left middle field and rather lucent area (clearing) in the right lower lung . Antibiotic therapy was administered but no improvement was obtained . Chest CT scan and right bronchography revealed empyema in the right back portion and bronchopleural fistula in the right lower lobe . Needle aspiration biopsy was performed and Aspergillus fumigatus was isolated from pus . A diagnosis of Aspergillus empyema with bronchopleural fistula was made . We began intrapleural administration of miconazole and empyema was improved partially . For the complete treatment, right lower lobectomy and decortication were performed, but unfortunately he died of acute pneumonia 16 days after operation.

Am J Otol, 1990 Nov, 11(6), 406 - 10
Inner ear effects of topical gentamicin treatment in patients with Menière's disease; Bagger-Sjoback D et al.; Several efforts have been made to treat patients with Meniere's disease with ototoxic drugs . Lately the aminoglycoside antibiotic, gentamicin, has been favored . Several reports have proved its efficacy . In a series of 12 patients treated at the Karolinska Hospital in Stockholm, two patients failed to show improvement regarding their vertigo in spite of repeated courses of treatment . These patients both underwent labyrinthectomy where their vestibular sensory epithelia as well as portions of the cochlea were removed . The findings in these two cases were quite unanimous in that the vestibular sensory epithelia were retained showing advanced signs of degeneration . The organ of Corti in the cochlea was totally absent in all specimens examined . These findings indicate that gentamicin seems to affect the cochlea more than the vestibular sensory epithelia that also was clinically proven since both patients totally lost their hearing in the affected ear . Possible routes and actions of the drug in the inner ear are discussed.

Rev Fr Gynecol Obstet, 1990 Nov, 85(11), 615 - 7
{Thrombophlebitis of the ovarian veins . A case report . Review of the literature}; Janky E et al.; The authors report on one case of thrombophlebitis of the two ovarian veins complicated by thrombosis of the vena cava inferior after a septic abortion . The diagnosis suggested by the persistence of symptoms of a severe pelvic infection was confirmed using computerized axial tomography . Faced with a clot floating in the vena cava inferior, a Greenfield filter was placed subrenally and combined with antibiotic therapy and IV heparin therapy . Clinical symptoms resolved but the scanographic image of thrombosis of the vena cava persisted after 7 months of treatment . This is a rare disease which is currently easy to diagnose, thanks to computerized axial tomography and nuclear magnetic resonance.

Res Commun Chem Pathol Pharmacol, 1990 Nov, 70(2), 143 - 53
Effect of calvatic acid and its analogs on ornithine decarboxylase activity in tumour cells; Brossa O et al.; Calvatic acid (p-carboxyphenylazoxycyanide) is an antibiotic containing an azoxycyano group that displays carcinostatic activity . In the present work it has been shown that in AH-130 hepatoma and K562 leukemia cells the antibiotic, at low concentration, decreases ornithine decarboxylase (ODC) levels . The change depends on two summative effects of the drug, impairment of overall protein synthesis and inhibition of enzyme activity . Some analogs of calvatic acid have been tested in order to gain more insight into the structure-activity relationship . The decarboxylated derivative phenylazoxycyanide proved to be more effective in reducing protein synthesis and ODC activity in the whole tumor cells . The rapidly growing K562 cells displayed high sensitivity to this compound . Calvatic acid analogs devoid of the cyano group were less effective on the same parameters.

J Pediatr Surg, 1990 Nov, 25(11), 1113 - 6
Appendicitis in children: current therapeutic recommendations; Neilson IR et al.; Wound infection is the most common source of morbidity in appendicitis . Most recent pediatric series use protocols of preoperative antibiotics with aerobic and anaerobic coverage, intraoperative lavage, no peritoneal or wound drains, and continuation of antibiotics postoperatively with complicated appendicitis . There still remains controversy concerning skin closure and the duration of antibiotic therapy . We report the results of a prospective protocol followed over 2 years with 420 children . The protocol was designed to determine whether the skin could be closed primarily in all patients undergoing appendectomy . Preoperatively all patients received triple antibiotics (ampicillin, gentamicin, and clindamycin) that were continued postoperatively for two doses if there was a normal appendix or simple acute appendicitis, for at least 3 days with gangrenous appendicitis, and at least 5 days with perforated appendicitis . Antibiotics were continued if the patient remained febrile or had a white count greater than 10,000 . No drains were used and the skin was closed primarily . The overall infectious complication rate was 1.0% (4/420) . Among those with a normal appendix or simple acute appendicitis there were no infectious complications . Among those with gangrenous or perforated appendicitis there were 1.7% wound infections (2/117) and 1.7% intraabdominal abscesses (2/117) . Duration of hospitalization was 2.1 days (range, 1 to 5 days) after simple acute appendicitis and 6.9 days (range, 3 to 40 days) after gangrenous or perforated appendicitis . These results set new standards in terms of wound management, infectious complications, and length of hospital stay.

J Antibiot (Tokyo), 1990 Nov, 43(11), 1421 - 30
The structure of PA48009: the revised structure of duramycin; Hayashi F et al.; PA48009, a lanthionine-containing peptide antibiotic was isolated from the culture broth of Streptoverticillium griseoverticillatum PA-48009, and identified as duramycin . Determination of the structure using both Edman degradations and 2D NMR spectroscopy showed the need to revise the structure of duramycin given in literature . Duramycin (PA48009) was different from lanthiopeptin (Ro 09-0198, cinnamycin) only by a Lys/Arg exchange at position 2.

Zhong Xi Yi Jie He Za Zhi, 1990 Nov, 10(11), 648 - 51, 643
{Clinical study of soaked treatment of chronic osteomyelitis with herbal medicine}; Xu XZ; This paper represented 500 patients with chronic osteomyelitis who were treated with Chinese medicinal herbs, Gan-ling Immersion Formula, in which focuses were soaked in combination with other therapies from 1986-1989 . Healing rate was 83.2% . Effective rate was 98.0% . This therapeutic method was more effective for treating chronic osteomyelitis of the hand and the foot with shorter course . It was also good for treating refractory skin ulcer and scar, ilium osteomyelitis and sclerosing osteomyelitis . This method was immediately effective for acute attack of chronic osteomyelitis . Fistula in half of the patients could be closed within two therapeutic course . Most of the non-union and delayed-union of the bones could be unionized as chronic osteomyelitis was healed . Most dead bones could remove spontaneously, some could be absorbable, and seldom should be removed by operating on . These herbs are easy to get . The method was so simple and so safe that it could provide a new way of treating chronic osteomyelitis . Experiments showed Gan-ling Immersion Formula possessed relative strong anti-inflammation and external antibiotic effects.

Res Vet Sci, 1990 Nov, 49(3), 319 - 22
Assessment of respiratory diseases and therapeutic intervention by the forced oscillation technique in feedlot cattle; Gustin P et al.; The forced oscillation technique was used to study pulmonary function in bulls during naturally acquired pulmonary-gastrointestinal disease complex known as shipping fever and as it was treated with two different antibiotics . Fifteen double-muscled bulls of the Belgian White and Blue breed were investigated . Clinical, serological and pulmonary function values were recorded during and after naturally occurring respiratory disease . Total respiratory resistance (Rrs) and reactance (Xrs) were measured by the forced oscillation technique . The antibiotic ceftiofur (group A, n = 10) and oxytetracycline (group B, n = 5) were given over three days . A large increase of Rrs at low frequencies with a marked negative frequency dependence, an increase of the resonant frequency, and a decrease of Xrs were recorded in the initial stage of the disease . The parameters returned to normal values seven days later . Clinical evidence of recovery was more marked in group A than in group B . These results show that moderate shipping fever induces acute small and large airway obstruction which responds to appropriate antibiotic therapy.

J Periodontol, 1990 Nov, 61(11), 686 - 91
Efficacy of clindamycin hydrochloride in refractory periodontitis: 24-month results; Gordon J et al.; The purpose of this investigation was to evaluate the use of clindamycin hydrochloride in the treatment of adult refractory periodontitis . Thirty patients with a history of unsuccessful treatment with scaling, periodontal surgery, and the use of tetracyclines were entered into the study . Upon entry, the suspected refractory patients were scaled several times and then monitored for the presence of active disease by probing attachment level measurements performed in duplicate . Active disease was defined as a 3.0 mm or greater loss in attachment from the baseline examination or the occurrence of a periodontal abscess . When active disease was detected, patients were treated with scaling and clindamycin 150 mg qid for 7 days . Patients served as their own controls . Twenty four patients demonstrated further attachment loss following scaling alone and were treated with clindamycin hydrochloride . Scaling and clindamycin treatment decreased the incidence of active disease from an annual rate of 8.0% to 0.5% of sites per patient (P less than .001) . The mean time required to detect the first active site increased from 4.9 +/- 3.7 months following scaling alone to 16.7 +/- 7.6 months following scaling and clindamycin (P less than 001) . Active sites lost an average of 3.1 mm of probing attachment following scaling alone but "gained" back 2.0 mm at 6 months and 1.5 mm at 24 months post-antibiotic and scaling treatment . Bleeding on probing was significantly reduced (P less than .05) from 31.8% of sites pre-clindamycin treatment to 12.3% at 12 months and 17.9% of sites at 24 months post-clindamycin treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Br J Cancer, 1990 Nov, 62(5), 830 - 3
High-dose cytosine arabinoside plus etoposide as initial treatment for acute myeloid leukaemia: a single centre study; Parikh P et al.; In a single centre, 52 newly diagnosed patients with acute myeloid leukemia (AML) under the age of 56 years received induction chemotherapy commencing with high-dose cytosine arabinoside (Ara-C) and etoposide (Protocol BF11), followed by Ara-C, 6 thioguanine (6TG) . A total of 67% of patients entered remission using these drugs . An anthracycline was added for those patients not in remission . The overall remission rate (CR) was 86.5% (45/52), with a minimum follow-up of 90 days . Patients are hospitalised for relatively short periods, and consequently require less blood product and antibiotic support . Patients in continuing first remission following induction with Ara-C and etoposide are similar in number to those in continuing first remission who initially received an anthracycline . This would imply that the efficiency of Ara-C and etoposide in inducing long-term disease-term survival is comparable with anthracycline-containing regimens . We conclude that high-dose Ara-C and etoposide used in the first induction cycle for treating AML have good antileukaemic effect with acceptable toxicity.

J Intraven Nurs, 1990 Nov-Dec, 13(6), 347 - 51
Impact on patient care . 2652 PIC catheter days in the alternative setting; Markel S et al.; Management of parenteral therapies in the home or nonacute setting is essential . Peripherally inserted long-line catheters establish venous access in patients in a safe, cost-effective, and improved manner . Data were collected on 130 cases from 24 offices in 16 states . The most frequently occurring types of therapies used were antibiotic, pain control, and parenteral nutrition . Average length of therapy was 20.4 days . The major reasons for catheter removal other than completion of therapy (58%) were occlusion (14%), breakage (5%), and phlebitis (4%).

Am J Gastroenterol, 1990 Nov, 85(11), 1524 - 6
Primary abscess of the omentum; Lupovitch A et al.; A 65-yr-old man presented with upper abdominal pain and fever due to a primary abscess of the omentum . The finding of microscopic-size foreign particles within the abscess raised the possibility of antecedent clinically silent perforation of the bowel or appendix . Surgical resection and antibiotic therapy were curative.

Hepatology, 1990 Nov, 12(5), 1152 - 6
Endotoxin and the hyperdynamic circulation of portal vein-ligated rats; Mehta R et al.; Humoral factors may be responsible for the hyperdynamic circulation seen in portal hypertension . Endotoxin, a peripheral arteriolar vasodilator, has been proposed to mediate this hemodynamic picture . We examined the pathogenic role of endotoxin in portal vein-ligated rats, a prehepatic portal hypertensive model with a well-developed hyperdynamic circulation . To this end, we (a) administered oral neomycin, a poorly absorbable antibiotic, at doses of 50 and 100 mg/day for 7 days and found no evident splanchnic hemodynamic effects of a 2-log-fold reduction of cecal aerobic bacterial flora as assessed by the radioactive microsphere technique in portal vein-ligated rats studied in the postanesthesia awake state; (b) assayed endotoxin in arterial samples using a quantitative limulus assay and found no evidence of endotoxinemia in PVL rats; (c) induced a state of endotoxin tolerance by repeated daily intraperitoneal injections of low-dose endotoxin and found no amelioration of the hyperdynamic state in portal vein-ligated rats . Our results do not support the hypothesis that endotoxin plays a major pathogenic role in the hyperdynamic circulation of this experimental model.

Geriatrics, 1990 Nov, 45(11), 59 - 66
Infection control in the nursing home: the physician's role; Bentley DW et al.; Infection control in the nursing home or long-term care facility is an increasingly complex activity . The high rates (approximately 15%) and special risks (group activities, crowding) for nosocomial infection demand special attention by attending physicians . Some specific responsibilities include: recognition of infection; knowledge and use of basic infection control principles; appropriate antibiotic use; review of immunizations; facilitation of communications among office, hospital, and long-term care facility; and involvement with infection control program(s).

Obstet Gynecol, 1990 Nov, 76(5 Pt 2), 992 - 4
Fetal levels of tobramycin following maternal administration; Fernandez H et al.; A single dose of tobramycin 2 mg/kg was given intravenously to a woman who presented a 22-week heterotopic pregnancy with both intrauterine and ovarian gestations and two living fetuses . After excision of the adnexum, tobramycin levels were measured in the maternal serum and in the fetal fluids and tissues . Antibiotic levels were especially high in the fetal spleen and kidney.

Xenobiotica, 1990 Nov, 20(11), 1113 - 9
Autoinduction of rifabutin metabolism in man; Strolin Benedetti M et al.; 1 . The pharmacokinetics of the antimycobacterial agent rifabutin were studied in healthy volunteers, following single (450 mg) and repeated (450 mg once daily for 10 days) oral administration . 2 . After repeated administration, induction of metabolism was indicated by lower AUC and Cmin values, compared to the corresponding theoretical values . The elimination half-life was unchanged after repeated administration . 3 . Induction of presystemic extrahepatic metabolism, which seems to be important in the availability of rifabutin, should be mainly responsible for the decrease in the AUC observed, while induced systemic clearance (if any) should be of minor importance . 4 . Induction of presystemic extrahepatic metabolism after repeated administration has also been reported for rifampicin, an antibiotic agent with hepatic enzyme-inducing properties, which has a structure similar to rifabutin but a different pharmacokinetic profile.

Curr Genet, 1990 Nov, 18(4), 303 - 13
G418-resistance as a dominant marker and reporter for gene expression in Saccharomyces cerevisiae; Hadfield C et al.; Coding sequence cartridges for aminoglycoside phosphotransferase (APT) were isolated from bacterial transposon Tn903 . When incorporated into a heterologous gene construction utilising the PGK1 promoter and terminator, the heterologous APT gene provided a G418-resistance determinant that functioned efficiently as a dominant marker for yeast in both multiple- and single-copy . Transformant colonies on selective medium appeared rapidly, within 36-48 h, and growth rate of the transformed cells was normal . A simple and highly sensitive radiolabelling assay for APT enzyme activity was developed for use with crude cell protein extracts . Enzyme activity units were equated to the amount of APT protein present in the cells, and the APT protein was shown to be stable in yeast . Heterologous APT expression was 130-fold reduced compared with homologous PGK1 . This resulted from an estimated two-fold decrease in mRNA level and a 65-fold decrease in translation efficiency . The latter was unaffected by AUG sequence context change, but corresponded with a high frequency of minor codons in the APT-coding sequence . APT can be used as a semi-quantitative reporter of gene expression, whose useful features are in vivo detection via the G418-resistance phenotype and powerful cell-free assay.

Mol Immunol, 1990 Nov, 27(11), 1145 - 53
A protein structural change in aglycosylated IgG3 correlates with loss of huFc gamma R1 and huFc gamma R111 binding and/or activation; Lund J et al.; Glycosylated chimeric mouse-human anti-NIP IgG3 antibody produced by growth of the J558L mouse B cell plasmacytoma is characterised with respect to the single carbohydrate chain at Asn-297 in the CH2 domain indicating that the mouse cell glycosyl transferases dictate the pattern of glycosylation rather than the human CH region of the heavy chain . Additionally, three unusual alpha-galactose-containing oligosaccharides are reported . Only the Fc region has detectable carbohydrate . Aglycosylated anti-NIP IgG3 antibody has been produced by cell growth in the presence of the antibiotic tunicamycin . Functionally, whilst the glycosylated intact IgG3 interacts with human Fc gamma R111 expressed on human killer (K) cells to trigger antibody-dependent cellular cytotoxicity the aglycosylated intact IgG3 fails to trigger cell lysis, localising the site on IgG for triggering human Fc gamma R111 mediated functions to the CH2 domain . The monomeric aglycosylated trypsin Fc fragment inhibits human Fc gamma R1 recognition by U937 cells 115-fold less well (K50 = 2 microM) than does glycosylated Fc (K50 = 17 nM), confirming that aglycosylation disrupts the site for human Fc gamma R1 within the CH2 domain and indicating that the trypsin Fc fragments reflect the functional properties of the intact IgG glycoforms . Structurally, 1H NMR shows that the absence of carbohydrate at Asn-297 results in a small and localised protein structural change in the vicinity of the reporter group His-268 within the CH2 domain . The site on IgG for triggering human Fc gamma R111 mediated functions is then localised to the vicinity of His-268 . The profound impact of aglycosylation on human Fc gamma R1 recognition implies structural disruption of the proposed site for human Fc gamma R1 in the lower hinge region of IgG (residues 234-239), proximal to His-268.

Dent Update, 1990 Nov, 17(9), 390 - 1
Rampant caries revisited; Mackie IC et al.; This report describes a conservative and preventive approach to the treatment of a two-and-a-half-year-old girl who presented with a severely compromised dentition . Clinical management was complicated by the fact that the patient had a ventricular septal defect that would require prophylactic antibiotic cover for any extractions.

Otolaryngol Head Neck Surg, 1990 Nov, 103(5 ( Pt 2)), 884 - 6
First-line management of sinusitis: a national problem? Surgical update; Kennedy DW; Radical stripping of diseased sinus mucosa has been considered the correct surgical approach to chronic sinusitis on the basis that severe mucosal thickening was irreversible . Now, nasal endoscopy has disproved this belief by showing that chronic sinusitis is primarily a disease of obstruction, with inflammation as a secondary manifestation . Once obstruction is surgically corrected and ventilation restored, the mucosa may regain near-normal appearance and function . For chronic sinusitis that fails to respond to antibiotic therapy--and for recurrent acute sinusitis associated with abnormalities of the ostiomeatal complex--functional endoscopic sinus surgery offers the patient real hope of permanent relief from symptoms of sinusitis . Careful postoperative follow-up with endoscopic evaluation enhances effectiveness of this more recent approach to sinus surgery . The importance of presurgical evaluation via endoscopy and computed tomography cannot be overemphasized.

Clin Pharmacol Ther, 1990 Nov, 48(5), 481 - 9
In vivo tissue pharmacokinetics by fluorine magnetic resonance spectroscopy: a study of liver and muscle disposition of fleroxacin in humans; Jynge P et al.; Magnetic resonance spectroscopy of fluorine (19F) has been used to noninvasively study the in vivo pharmacokinetics of a model drug, fleroxacin (a fluoroquinolone antibiotic agent), in healthy human subjects . After oral administration, fleroxacin was detected in 19F magnetic resonance spectra from both liver and calf muscle and four magnetic resonance examinations were undertaken during a 24-hour period . By combining plasma analysis by high performance liquid chromatography with the magnetic resonance data, the following pharmacokinetic parameters (mean values) were obtained: tmax, 1.4, 4.6, and 5.6 hours in liver, plasma, and muscle, respectively; Cmax, 53, about 250, and about 60 mumol/L in plasma, liver, and muscle, respectively; t1/2, 4.4 hours (fast phase) and 10.8 hours (slow phase) in liver and 14.2 hours in plasma . The study documents for the first time the potential use of 19F magnetic resonance spectroscopy to noninvasively observe the time-related changes of a fluorine-containing drug in human tissues after oral administration.

Mycoses, 1990 Nov-Dec, 33(11-12), 543 - 7
Malassezia furfur colonization of neonates in an intensive care unit; Ahtonen P et al.; We studied Malassezia furfur colonization of neonates in the neonatal intensive care unit (NICU) and found that the rate was astonishingly high as compared to the previous studies . In very low birth weight (less than 1,000 g) infants we recorded a colonization rate of 80%, and 4% infants with a birth weight greater than 2,000 g . Under 10 day's hospitalization the rate was 11%, and it was 70% after 20 days spent in the unit . Among the infants with the birth weight less than 1,700 g, antibiotic therapy was recorded as a significant risk factor for colonization . In the infants with a greater birth weight, the colonization rate was independent from the risk factors studied . M . furfur colonization could not be linked with occurrence of any symptoms of signs recorded and colonization by M . furfur was so common in NICU that the predictive value of surveillance cultures is poor.

Enferm Infecc Microbiol Clin, 1990 Nov, 8(9), 568 - 71
{Antibody-coated bacteria and quantitative culture in sputum samples from patients with bronchiectasis}; Sala-Mateus C et al.; The results of the quantitative culture of sputum samples from patients with bronchiectasis were compared with those obtained in the same samples with the detection of antibody-coated bacteria (ACB), in the acute phase of the disease (group I), after antibiotic therapy (group II), and in the phase of clinical stability (group III) . In quantitative cultures at least one potentially pathogen species was isolated, at a concentration of greater than or equal to 10(6) colony forming units/ml in the 7 sputum samples from group I, in 4 of the 5 samples from group II, and in 10 of the 11 samples from group III . The immunofluorescence technique detected ACB in all samples from group I and group II, and in 10 of the 11 from group III . The sample from group III in which ACB were not detected was the same in which potentially pathogen organisms were not detected by culture.

An Esp Pediatr, 1990 Nov, 33(5), 429 - 34
{Neonatal osteomyelitis . Study of a series of 35 cases}; Coto Cotallo GD et al.; After a brief literature review, we analyze the results obtained with a retrospective study of 35 neonatal osteomyelitis diagnosed between 1-January-75 and 31-December-87 . The valuated frequency was of 0.40% alive newborns . Between the antecedents, we find previous neonatal sepsis in 68% of the cases . The clinical general findings were less apparent, emphasizing among the local symptoms the pain to passive mobilization and swelling . From acute phase reactants, this study rebounds the high sensitivity of C reactive protein and globular sedimentation rate . The most frequently germ isolated was S . aureus followed by K . pneumoniae . The osteomyelitic injure was unifocal in 71% of the cases and the femur was the most probable bone to be affected . At the initial treatment we associated a beta-lactamic antibiotic with an aminoglycoside one in all cases, with surgical removal in 94% . The mortality was null, but grave arthritic sequels appeared in 14% of the patients . Finally, we propose the employance of seriated quantification of C-reactive protein in the follow-up and control of therapeutic efficiency.

Antibiot Khimioter, 1990 Nov, 35(11), 37 - 8
{Pharmacokinetics of kanamycin during targeted delivery to the liver in erythrocyte ghosts in animals with experimental acute cholecystitis}; Zhumadilov ZhSh et al.; Pharmacokinetics of kanamycin was studied after its targeted delivery to the liver in autological erythrocyte ghosts on 25 noninbred dogs with experimental acute cholecystitis in comparison to the routine intravenous administration of the antibiotic in solution . Kanamycin concentrations in the tissues of the liver, pancreas, spleen, kidneys and lungs as well as in bile and blood serum were determined by the agar diffusion method 24, 48 and 72 hours after the last administration . It was found that the targeted delivery of kanamycin in blood shadows made it possible to provide high concentrations of the antibiotic for prolonged periods in the liver and biliary ducts and to more efficiently arrest the clinical manifestations of acute cholecystitis as well as normalize the laboratory indices . The data showed that using blood shadows as a reliable system for targeted delivery of antibiotics to the liver was advisable in purulent inflammatory affections of the biliary ducts.

Antibiot Khimioter, 1990 Nov, 35(11), 16 - 8
{Intravital estimation of doxorubicin accumulation in various types of cell cultures}; Bogush TA et al.; An extractionless procedure was developed for intravital quantitative estimation of doxorubicin (DR) accumulation in cell cultures with using fluorescence measurements . DR accumulation in a monolayer culture was evaluated by a decrease in the fluorescence of the incubation medium or by the total inhibition of the fluorescence of the cells and medium in the suspension medium . It was shown that there was a definite range of the doses from 3.10(-8) to 2.10(-6) M at which the accumulation kinetics recorded subsequently in one bottle for any two concentrations of the above ranges did not depend on the antibiotic dose . In this connection, the procedure was approved for quantitative estimation of DR accumulation in the same cells before and after modifying effects.

Zhonghua Wai Ke Za Zhi, 1990 Nov, 28(11), 647 - 8, 701
{Clinical study on the diagnosis and treatment of retrosternal infection after median sternotomy}; Zhang ZG; From June 1964 to Dec . 1989, 1228 patients underwent cardiovascular operations by median sternotomy approach in our hospital . 18 of them (1.4%) were complicated by retrosternal infections and were treated successfully . Of these 18, 3 were treated by conservative method (Group 1), that is, local debridement and drainage . The other 15 were managed by a radical technique (Group 2) which includes reopening of the chest, radical debridement of retrosternal mediastinum, primary sternal reclosure and continuous retrosternal irrigation with antibiotic solutions . There was no hospital death . The mean healing time of the infected wounds was 91 days in Group 1, and 24 days in Group 2 . Recurrence of wound infections was found in 2 cases in Group 1 . Primary healing was obtained in all patients but 1 in Group 2 after initial debridement . The authors considered that (1) Early radical debridement with continuous irrigation is very effective for management of retrosternal infection; (2) Radical debridement should be done as early as the diagnosis of infection is established.

Zhonghua Wai Ke Za Zhi, 1990 Nov, 28(11), 644 - 6, 701
{Mediastinal infection following open heart surgery}; Shang H; 31 cases of mediastinal infection occurred in 7164 patients who had undergone open heart surgery under CPB were reviewed in the period of 1981-1989 . The over-all incidence was 0.43% . Analysis of the clinical material showed that mediastinal infection was mostly associated with the following predisposing factors: (1) prolonged CPB time; (2) rethoracotomy; (3) open cardiac massage; (4) tracheostomy; (5) combined severe circulatory or/and respiratory complications . 28 patients were treated by mediastinal debridement and 27 of them were irrigated with 0.5% betadine or/and antibiotic solutions . Debridement was done a second time in 5 patients with smooth recovery . There were 15 deaths (48.4%), of which 4 were caused by rupture of cardiac or aortic incisions, 5 by multisystemic complications and 6 by severe infection . The mortality was significantly higher in the cases with combined circulatory or/and respiratory complications (72.2%) than in the cases of simple mediastinal infection (15.4%).

Cell Tissue Res, 1990 Nov, 262(2), 301 - 6
Filipin-sterol complexes in molluscan gill ciliated epithelial cell membranes: intercalation into ciliary necklaces and induction of gap junctional particle arrays; Stephens RE et al.; Freeze-fracture electron microscopy has been used in conjunction with the antibiotic filipin to investigate possible differences in the distribution of sterols in ciliary and somatic cell membranes of scallop and mussel gill epithelial cells . Contrary to previous reports, we find that filipin-sterol lesions can occur among the strands of the ciliary necklace but they are partially excluded from the smooth neck region above the necklace where the membrane is tightly apposed to the axonemal microtubules . No obvious differences in filipin-sterol lesions occur in the membranes of mussel gill cilia of varying mechanical sensitivity . Although abundant in the apical plasma membrane, filipin-sterol complexes are rare within the membranes of microvilli . Filipin-sterol lesions form outside the loosely parallel particle strands of septate junctions, sometimes increasing their relative orderliness . At sufficiently high density, filipin-sterol protrusions within the plasma membrane result in mass aggregation of gap junctions, possibly through recruitment of unorganized connexons.

J Toxicol Sci, 1990 Nov, 15 Suppl 3, 129 - 45
{Antigenicity study of cefpirome sulfate}; Inoue S et al.; Immunological properties of cefpirome sulfate (CPR) were examined . The immunogenicity and challenging ability of CPR were examined in guinea pigs by active systemic anaphylaxis (ASA) and homologous 4-hr passive cutaneous anaphylaxis (PCA) tests . The animals given CPR alone intraperitoneally for sensitization and their sera were negative for ASA or PCA reactions, like the results with reference substances, ceftazidime (CAZ) and cephalothin sodium (CET) . When each antibiotic plus Freund's complete adjuvant (FCA) was used for sensitization, ASA reactions were observed with CPR, cephaloridine (CER), CET, and cefazolin sodium (CEZ), and PCA reactions, with CPR and CET . CPR had the ability to challenge the ASA and PCA reactions . CER and CET also showed the ability to challenge ASA or PCA reactions, though at low incidences . The cross-reactivity of CPR with commercially available antibiotics was examined by heterologous PCA test and by passive hemagglutination test and its inhibition test . The antiserum used was from rabbits immunized with each antibiotic-ovalbumin conjugate plus FCA, and the antigen was each antibiotic-bovine serum albumin conjugate . CPR cross-reacted markedly with cefotaxime sodium (CTX) having the same side chain at position 7 and showed weak, unidirectional reactions with CAZ and CET . In the in vitro direct Coombs test, the positive reactions noted with CPR were stronger than those with latamoxef sodium, equal to those with CEZ and slighter than those with CTX, CET and benzylpenicillin potassium . In conclusion, in the safety evaluation of CPR, its antigenic potential may not be a problem, like the cases of other antibiotics.

J Toxicol Sci, 1990 Nov, 15 Suppl 3, 109 - 27
{Effects of cefpirome sulfate on male sexual development in rats}; Akaike M et al.; Cefpirome sulfate (CPR) was administered subcutaneously at 200, 500, and 1000 mg/kg/day to male rats for 5 weeks from 6 through 40 days of age and examinations were made to determine whether the antibiotic caused any detrimental effects on male sexual development when administered to juvenile rats . Cefotetan (CTT) was given at 1000 mg/kg/day as a positive control . Incrustation occurred at the injection site during administration in all treated groups . The CPR groups had no compound related changes in fertility, spermatozoa, and reproductive organs, while the CTT group showed decreased testicular weight, abnormal fertility and spermatozoa, and atrophied germinal epithelium of seminiferous tubules, atrophied epididymis, and decreased number of spermatozoa . From the results of this investigation, it may be concluded that CPR had no effects on male sexual development when administered to juvenile rats.

J Vet Intern Med, 1990 Nov-Dec, 4(6), 317 - 9
Severe neutropenia associated with griseofulvin therapy in cats with feline immunodeficiency virus infection; Shelton GH et al.; Griseofulvin administration was associated with the development of absolute neutropenia in six of seven (86%) cats with feline immunodeficiency virus (FIV) infection . The neutropenia was severe (less than 400 neutrophils/microliter) in four of the six affected cats, and one cat died from sepsis . Neutrophil counts returned to baseline values within 15 days after drug withdrawal in all surviving cats . No symptoms or hematologic abnormalities were observed in four normal (FIV-seronegative) cats treated with the same lot of griseofulvin at equivalent doses . Neutropenia recurred in two of two FIV-seropositive cats upon griseofulvin rechallenge . Cats with FIV infections appear to be at increased risk for griseofulvin-associated neutropenia . This phenomenon may be analogous to the increased frequency of antibiotic-induced neutropenias observed in humans infected with the human immunodeficiency virus.

J Pharm Pharmacol, 1990 Nov, 42(11), 758 - 62
Effect of recombinant human erythropoietin on new anaemic model rats induced by gentamicin; Nagano N et al.; The effects of recombinant human erythropoietin (r-HuEPO) on haematological parameters were studied in rats in which uraemia and anaemia had been induced by gentamicin, an aminoglycoside antibiotic and a nephrotoxic agent . After the occurrence of slight polycythaemia, the red blood cell count, haematocrit and haemoglobin concentration decreased by 20-30% compared with those of the control (saline-injected) rats . At the end of gentamicin treatment, the endogenous serum EPO level had decreased to about 40% compared with that of control rats . Gentamicin-treated rats showed marked elevation of blood urea nitrogen, extensive tubular necrosis in the kidney and haemosiderin deposition in the spleen . In the osmotic fragility test, the fragility of erythrocytes significantly increased compared with that of control rats . These findings indicate that the anaemia induced by gentamicin is due not only to a deficiency of EPO but also to an enhancement of fragility of erythrocytes in an azotaemic environment . The administration of r-HuEPO during anaemia markedly increased red blood cell count, haematocrit and haemoglobin concentration . It is suggested that a gentamicin-treated rat is a useful and convenient anaemic model and r-HuEPO is useful for treatment of anaemia in acute renal failure.

Otolaryngol Head Neck Surg, 1990 Nov, 103(5 ( Pt 2)), 870 - 4; discussion 874-5
The clinician's view of sinusitis; Stafford CT; Widespread underdiagnosis and inadequate treatment of acute sinusitis may be inferred from the prevalence of chronic sinusitis in the United States . Thus the otolaryngologist's role in the management of sinusitis goes beyond treatment of referred patients . It also includes the responsibility to educate referring physicians in improved diagnostic methods and earlier, more effective forms of therapy . While antral puncture is the sine qua non for determining specific diagnosis, standard radiographs and sound clinical judgment may offer practical alternatives . Early, aggressive antibiotic therapy (with ampicillin, amoxicillin, amoxicillin-clavulanate potassium, or appropriate cephalosporins), plus oral decongestants for symptomatic relief, provides therapeutic efficacy for acute sinusitis and should be considered the initial step toward prevention of chronic sinusitis.

Pacing Clin Electrophysiol, 1990 Nov, 13(11 Pt 1), 1367 - 70
Acute reversible diffuse conduction system disease due to Lyme disease; Rubin DA et al.; During the acute phase of Lyme disease, a 56-year-old man without previous heart disease developed complete heart block with alternating left and right bundle branch block pattern QRS complexes . Electrophysiological study performed in the acute phase revealed marked HV prolongation, although the level of heart block was at the atrioventricular node . The heart block was mildly symptomatic and resolved (as did the bundle branch block) with antibiotic therapy . Lyme disease may cause reversible His-Purkinje disease.

Pacing Clin Electrophysiol, 1990 Nov, 13(11 Pt 1), 1352 - 5
Infection of an implantable cardioverter defibrillator: management without removal of the device in selected cases; Taylor RL et al.; A case is presented in which an implantable cardioverter defibrillator (ICD) became infected in the abdominal wall pocket 5 weeks following implantation . There was no evidence clinically or by computed tomographic scan suggesting mediastinal extension of the infection . The infection was treated successfully by debriding the abdominal wall pocket followed by a combination of pocket irrigation with antibiotic solution, parenteral antibiotics, and long-term oral antibiotics . This conservative therapy was successful and avoided removal of the device.

Radiol Clin North Am, 1990 Nov, 28(6), 1223 - 35
Percutaneous biliary drainage for high obstruction; Barth KH; PBD is the preferred route of palliative drainage for patients with high biliary obstruction . The frequency of bifurcational obstruction in this setting requires familiarity with drainages from both the right and the left transhepatic approach . The preferred right transhepatic approach is fluoroscopically guided; on the left, ultrasonography is the guidance of choice . Large caliber drainage catheters are required, and dilatation of the necessary transhepatic tracts is extremely painful unless adequate inhalation anesthesia or, preferably, epidural anesthesia, is provided . Long-term biliary drainage requires a choice between internal-external external drainage catheters and endoprostheses that is made by considering the patient's life expectancy and his or her adjustment to a stent extending to the outside . The feasibility of corrective procedures if an internal-external drainage catheter or an endoprosthesis becomes blocked needs to be considered before definitive placement . The interventional radiologist becomes intimately involved in the follow-up care of patients and frequently has to direct appropriate patient evaluation . Familiarity with antibiotic regimens is important.

Childs Nerv Syst, 1990 Nov, 6(7), 397 - 9
Valvular infections in patients with hydrocephalus: preventive aspects; Viano JC et al.; Shunt infections in children have become a serious problem . In order to solve this, we have been using antibiotic therapy with Rifampicin (Rifampin) for the last 2 years; the dosage is 20 mg/kg per day 1 h before surgery and then for 48 h after the surgical procedure . We have had experience with 203 children operated on between January 1987 and December 1988 . The result was a significant decrease in the number of children with shunt infections . In 1980 we reported an incidence of 10%, while by 1988 the rate had gone down to 1%.

Gene, 1990 Oct 30, 95(1), 39 - 48
Genomic integration system based on pBR322 sequences for the cyanobacterium Synechococcus sp . PCC7942: transfer of genes encoding plastocyanin and ferredoxin; van der Plas J et al.; Synechococcus sp . PCC7942 recipient strains were constructed for the chromosomal integration of DNA fragments cloned in any pBR322-derived vector, which carries the ampicillin resistance (ApR) marker . The construction was based on the incorporation of specific recombination targets, the so-called 'integration platforms', into the chromosomal metF gene . These platforms consist of an incomplete bla gene (ApS) and the pBR322 ori separated from each other by a gene encoding an antibiotic (streptomycin or kanamycin) resistance (SmR or KmR) . Recombination between a pBR322-derived donor plasmid and such a chromosomal platform results with high frequency in restoration of the bla gene and replacement of the chromosomal marker (SmR or KmR) by the insert of the donor plasmid . The integration into the platform depends on recombination between pBR322 ori and bla sequences only and is therefore independent of the DNA insert to be transferred . The desired recombinants are found by selection for a functional bla gene (ApR) and subsequent screening for absence of the chromosomal antibiotic marker . Gene transfer with this integration system was found to occur efficiently and reliably . Furthermore, the presence of the pBR322 ori in the platform allowed for 'plasmid rescue' of integrated sequences . The system was applied successfully for the transfer of the gene encoding plastocyanin (petE1) from Anabaena sp . PCC7937 and for the integration of an extra copy of the gene encoding ferredoxin I (petF1) from Synechococcus sp . PCC7942 itself.

Schweiz Med Wochenschr, 1990 Oct 27, 120(43), 1575 - 83
{Neurosyphilis 1982-1989}; Stingl B et al.; We report the signs, symptoms, serological and CSF findings in 27 patients with syphilis and inflammatory involvement of the central nervous system . In 24 patients the neurosyphilis was symptomatic . Most patients did not report previous signs of early syphilis . A CSF pleocytosis was present in 25 patients (greater than 90%) and the CSF VDRL was reactive with a titer of 1:2 or above in 19 patients (70%) . The symptomatology seemed not to be atypical for neurosyphilis although a precise classification was often not possible and the diagnosis was seldom suspected on clinical grounds . In most patients the clinician can monitor the effectiveness of antibiotic therapy by simple laboratory parameters which reflect the activity of the inflammatory process . It is disquieting, however, to note how inconsistently this follow-up was performed.

Biochemistry, 1990 Oct 23, 29(42), 9994 - 10008
Two-dimensional 1H and 31P NMR spectra and restrained molecular dynamics structure of a covalent CPI-CDPI2-oligodeoxyribonucleotide decamer complex; Powers R et al.; CPI-CDPI2 is a synthetic analogue of CC-1065, which is a naturally occurring antitumor antibiotic . Assignment of the 1H NMR spectra of a CPI-CDPI2-oligodeoxyribonucleotide decamer, d-(CGCTTAAGCG)2, complex has been made by two-dimensional 1H/1H spectroscopy . The solution structure of the complex was calculated by an iterative hybrid relaxation matrix method combined with NOESY distance restrained molecular dynamics . Refinement proceeded in two steps in which the decamer was initially refined alone and then CPI-CDPI2 was added to the structure to allow initial estimates of drug-DNA contacts . A hybrid matrix/MD refinement was used to better take into account problems associated with spin diffusion . Thus the distances from the 2D NOESY spectra were calculated from the relaxation rate matrix which were evaluated from a hybrid NOESY volume matrix comprising elements from the experimental spectrum and those calculated from an initial structure . The hybrid matrix derived distances were then used in a restrained molecular dynamics procedure to obtain a new structure that better approximates the NOESY spectra . The resulting partially refined structure was then used to calculate an improved theoretical NOESY volume matrix which is once again merged with the experimental matrix until refinement is complete . The efficacy of CC-1065 has been attributed to its minor groove binding and alkylation to the N3 position of adenosine . CPI-CDPI2 appears to bind to the decamer in a similar manner . The effect of CPI-CDPI2 on the decamer's 1H and 31P spectrum was consistent with a minor groove binding motif with the drug alkylating at A17 with the CDPI rings oriented toward the 5'-end of the alkylated strand . In addition, the NMR data support one major adduct but also indicate the presence of a minor adduct . The latter could represent a drug alkylation of the DNA at a secondary site (or alternative orientation of the rings).

Biochemistry, 1990 Oct 23, 29(42), 9799 - 807
DNA-directed alkylating ligands as potential antitumor agents: sequence specificity of alkylation by intercalating aniline mustards; Prakash AS et al.; The sequence preferences for alkylation of a series of novel parasubstituted aniline mustards linked to the DNA-intercalating chromophore 9-aminoacridine by an alkyl chain of variable length were studied by using procedures analogous to Maxam-Gilbert reactions . The compounds alkylate DNA at both guanine and adenine sites . For mustards linked to the acridine by a short alkyl chain through a para O- or S-link group, 5'-GT sequences are the most preferred sites at which N7-guanine alkylation occurs . For analogues with longer chain lengths, the preference of 5'-GT sequences diminishes in favor of N7-adenine alkylation at the complementary 5'-AC sequence . Magnesium ions are shown to selectively inhibit alkylation at the N7 of adenine (in the major groove) by these compounds but not the alkylation at the N3 of adenine (in the minor groove) by the antitumor antibiotic CC-1065 . Effects of chromophore variation were also studied by using aniline mustards linked to quinazoline and sterically hindered tert-butyl-9-aminoacridine chromophores . The results demonstrate that in this series of DNA-directed mustards the noncovalent interactions of the carrier chromophores with DNA significantly modify the sequence selectivity of alkylation by the mustard . Relationships between the DNA alkylation patterns of these compounds and their biological activities are discussed.

Biochim Biophys Acta, 1990 Oct 23, 1087(2), 147 - 56
Genetic engineering, isolation and characterization of a truncated Escherichia coli elongation factor Tu comprising domains 2 and 3; Pieper U et al.; A deletion mutant of a plasmid born Escherichia coli tufA gene, which codes for a truncated elongation factor Tu comprising domains 2 and 3, has been constructed by genetic engineering . This gene was overexpressed in E . coli, and a polypeptide representing the truncated elongation factor Tu was isolated, purified to near homogeneity, crystallized and characterized physico-chemically as well as biochemically . Circular dichroism spectroscopy and limited tryptic digestion demonstrate that the isolated domain pair 2 and 3 behaves like an independent folding unit which adopts a similar secondary and most likely, tertiary, structure to that present in the intact elongation factor Tu . However, the isolated domain pair 2 and 3 does not interact with aminoacyl-tRNA or the antibiotic kirromycin, two ligands which were shown previously by cross-linking experiments to be in contact with amino acid residues located in domains 1 and 2, and domain 3, respectively . The results suggest that the isolated domain pair 2 and 3 by itself forms too few contacts with these ligands to form a stable complex . Furthermore, the data suggest that domain 1 in intact EF-Tu, in a subtle but nevertheless decisive manner, alters the conformation of the other two domains in such a way that all three domains cooperatively create a high affinity binding site for aminoacyl-tRNA and the antibiotic kirromycin.

Biochim Biophys Acta, 1990 Oct 23, 1087(2), 190 - 8
Expression and characterization of rat surfactant protein A synthesized in Chinese hamster ovary cells; McCormack FX et al.; Rat surfactant protein A (SP-A) was expressed in a Chinese hamster ovary (CHO-K1) cell line and characterized for biologic activity using assays for receptor binding and modulation of phospholipid secretion from isolated type II cells . The CHO-K1 cell line was cotransfected with separate plasmids encoding for the rat SP-A, dihydrofolate reductase and neomycin phosphotransferase, respectively . Antibiotic (Geneticin-G418)-resistant transformants were screened by ELISA for the secretion of recombinant SP-A into the media . Northern analysis of the transfected cell lines demonstrated the expression of both 1.6 kb and 0.9 kb mRNA species for SP-A, consistent with the proposed differential polyadenylation of the primary transcript . Amplification with methotrexate resulted in a dose-dependent increase in mRNA for SP-A and a 20-fold increase in the production of recombinant SP-A relative to untreated cells . Maximum production of SP-A was 370 micrograms of SP-A/l of media in a 4-day incubation . Recombinant SP-A was purified from the serum-free media of large scale cultures of transfected, amplified CHO cells by affinity chromatography on mannose-Sepharose . The recombinant SP-A migrated similarly to native SP-A by NaDodSO4-PAGE analysis under reducing and nonreducing conditions and under reducing conditions after digestion with N-glycanase . Recombinant SP-A effectively competed with 125I-native SP-A for binding to the high affinity receptor for SP-A on isolated plasma membranes from rat alveolar type II cells . The recombinant SP-A was as effective as native SP-A in the inhibition of secretion of phospholipid from isolated type II cells . We conclude that recombinant rat SP-A produced in Chinese hamster ovary cells is physically and functionally similar to native rat SP-A.

Biochemistry, 1990 Oct 16, 29(41), 9503 - 7
Determination of the major tautomeric form of the covalently modified adenine in the (+)-CC-1065-DNA adduct by 1H and 15N NMR studies; Lin CH et al.; (+)-CC-1065 is an extremely potent antitumor antibiotic produced by Streptomyces zelensis . The potent cytotoxic effects of the drug are thought to be due to the formation of a covalent adduct with DNA through N3 of adenine . Although the covalent linkage sites between (+)-CC-1065 and DNA have been determined, the tautomeric form of the covalently modified adenine in the (+)-CC-1065-DNA duplex adduct was not defined . A {6-15N}deoxyadenosine-labeled 12 base pair non-self-complementary oligomer, d(GGCGGAGTT*AGG).d(CCTAACTCCGCC) (asterisk indicates 15N-labeled base), containing the (+)-CC-1065 most preferred binding sequence 5'AGTTA, was synthesized and modified with (+)-CC-1065 . This {6-15N}deoxyadenosine-labeled 12-mer duplex adduct was then studied by 1H and 15N NMR . One-dimensional NOE difference and two-dimensional NOESY 1H NMR experiments on the nonisotopically labeled 12-mer duplex adduct demonstrate that the 6-amino protons of the covalently modified adenine exhibit two signals at 9.19 and 9.08 ppm . Proton NMR experiments on the {6-15N}deoxyadenosine-labeled 12-mer duplex adduct show that the two resonance signals for adenine H6 observed on the nonisotopically labeled duplex adduct were split into doublets by the 15N nucleus with coupling constants of 91.3 Hz for non-hydrogen-bonded and 86.8 Hz for hydrogen-bonded amino protons . Parallel 15N NMR experiments on the {6-15N}deoxyadenosine-labeled (+)-CC-1065-12-mer duplex adduct show a triplet-like signal around -276.9 ppm and coupling constants of 91.5 and 85.6 Hz.(ABSTRACT TRUNCATED AT 250 WORDS)

Dent Cadmos, 1990 Oct 15, 58(15), 70 - 2, 75-7
{Bacampicillin in dentistry . Clinical efficacy and tolerance}; Frigeri S et al.; The efficacy and tolerability of the Bacampicillin was evaluated on 80 patients (40 males and 40 females) with infectious pathology . This antibiotic was delivered at different dosage, alone or in association with Fans . The Authors report the statistical results showing the good therapeutical activity, at full dosage, with minor side effects.

Gene, 1990 Oct 15, 94(2), 217 - 22
A binding protein (p82 protein) recognizes specifically the curved heterochromatic DNA in Artemia franciscana; Benfante R et al.; DNA bending has been suggested to play a role in the regulation of gene expression, initiation of DNA replication, site specific recombination and DNA packaging . In Artemia franciscana (Phillopoda anostraca) cells we have revealed that an AluI DNA family of repeats, 113-bp in length, is the major component of the constitutive heterochromatin found in the species . By analysis of cloned oligomeric (monomer to hexamer) heterochromatic fragments and electrophoretic experiments we verified that the repetitive DNA shows a stable curvature that confers a solenoidal geometry to the double helix . Using the cloned monomeric fragment, as molecular probe, we describe the detection in an A . franciscana cell extract of a protein of 82 kDa (p82) that preferentially binds to heterochromatic DNA . This protein, purified of the other DNA binding proteins present in the crude cell extract, shows a greater affinity with the tandem copies of the AluI DNA fragment than with the monomer sequence . The binding of p82 protein to heterochromatic DNA is also drastically reduced in the presence of the antibiotic distamycin A, suggesting a role of the DNA curvature in the formation of the nucleoproteic complex.

Med Klin (Munich), 1990 Oct 15, 85(10), 577 - 80
{Sonographic percutaneous drainage of liver abscesses}; Gain T et al.; 13 patients with pyogenic liver abscess and five patients with amoebic abscess underwent percutaneous drainage of the abscesses using the Seldinger (n = 8) or trocar technique (n = 11) . The results showed that the trocar method was easier and faster to perform and well tolerated by the patients . No complications were observed despite of one case of transient peritonitis caused by a dislocated catheter . One patient with pyogenic liver abscess died of septic shock . All other patients were successfully treated, using local drainage and systemic antibiotic therapy.

FEBS Lett, 1990 Oct 15, 272(1-2), 99 - 102
Phosphatidylinositol 4,5-bisphosphate stimulates protein kinase C-mediated phosphorylation of soluble brain proteins . Inhibition by neomycin; Chauhan VP; Phosphatidylinositol 4,5-bisphosphate (PIP2) at 0.1 mol% activated the protein kinase C (PKC)-mediated phosphorylation of 87-, 55- and 47-kDa brain proteins . Neomycin, an aminoglycoside antibiotic that binds PIP2 with a high affinity, inhibited PIP2.PKC activity in a concentration-dependent manner . Low concentrations of neomycin (less than 2 mM) did not affect DG.PKC activity; however, 4 mM neomycin inhibited 50% of this activity . This inhibition of DG-stimulated activity at high neomycin concentration may be the result of its binding to Ca2+ and ATP in the assay system . These results suggest that PIP2 is a physiological activator of PKC, and show that neomycin can be an inhibitor of PIP2.PKC activity at concentrations where DG.PKC activity is not affected.

Eur J Immunol, 1990 Oct, 20(10), 2277 - 83
Suppression of B cell activation by cyclosporin A, FK506 and rapamycin; Wicker LS et al.; The effects of the immunosuppressants cyclosporin A (CsA), FK506 and rapamycin have been compared using murine B cells activated with a variety of mitogens . FK506 is a macrolide antibiotic that has been recently shown to inhibit T cell activation by a mechanism that appears similar to that of CsA . Rapamycin is a macrolide structurally related to FK506 whose mechanism of T cell suppression appears to be distinct from that of FK506 and CsA . While CsA and FK506 were found to preferentially inhibit B cell activation caused by stimuli which induce a rise in intracellular calcium, rapamycin partially inhibited activation by all stimuli tested, including those which are not associated with a calcium flux . All three compounds were found to inhibit cell cycle progression within the G1 phase; however, the rapamycin-sensitive event within G1 was completed earlier than the G1 events inhibited by CsA and FK506 . In addition, inhibition of anti-IgM-activated B cells with CsA and FK506, but not with rapamycin, resulted in cell death . These data suggest that although CsA, FK506 and rapamycin are all inhibitors of B cell activation, the inhibitory activity of rapamycin can be clearly distinguished from that of CsA and FK506 . Although the suppressive effects of CsA and FK506 on B cell proliferation were nearly identical in this study, their biological activities were distinguishable since FK506, but not CsA, could antagonize rapamycin-mediated suppression.

Khirurgiia (Mosk), 1990 Oct, (10), 109 - 12
{Galvanic current in the conservative treatment of acute pancreatitis}; Alekseenko AV et al.; Experiments were conducted on 42 adult dogs with a model of acute pancreatitis to study the degree of antibiotic storage in the pancreatic tissue in different variants of intralesional+ electrophoresis . Optimum concentration of the antibiotic was produced in transverse galvanization of the zone of the pancreas . Clinical observations over 63 patients with various forms of acute pancreatitis bear evidence that the method raises the efficacy of nonoperative treatment in the oedematous stage of the process and reduces the duration of treatment.

Khirurgiia (Mosk), 1990 Oct, (10), 105 - 8
{Conservative treatment of acute pancreatitis using intralesional electrophoresis}; Mironov VI et al.; Experimental data are discussed and experience in complex treatment of 102 patients with acute pancreatitis with the application of intralesional+ electrophoresis is analysed . It was demonstrated in experiments on 90 albino rats that in intralesional+ electrophoresis of radioactive++ 5-fluorouracil (5-FU), its concentration in the pancreas was 2.4-3-fold that in the group of animals in which only intraperitoneal injections of the agent were given . Intralesional+ 5-FU, antibiotic, and contrykal electrophoresis was applied in the clinic in 75 patients with edematous and in 27 patients with destructive pancreatitis . Intralesional+ electrophoresis had a favourable effect on the course of acute pancreatitis, but its efficacy was lower in destructive pancreatitis . Intralesional+ electrophoresis made it possible to lower the general therapeutic doses of these agents and to reduce the number of injections per 24 hours . Three fatal outcomes occurred.

Nihon Kyobu Shikkan Gakkai Zasshi, 1990 Oct, 28(10), 1353 - 8
{Pulmonary infiltration with eosinophilia possibly induced by cefotiam in a case of steroid-dependent asthma}; Irie M et al.; A 37-year-old female with refractory asthma taking betamethasone orally (1 mg/d), showed a fever of 38.5 degrees C, productive cough and dyspnea . The chest X-ray demonstrated diffuse infiltration in the left lower lung field . The WBC count was 16,000/mm3 with 6% eosinophils . She was treated with intravenous drip infusion of antibiotics (Cefotiam 2 mg/d and Sisomicin 150 mg/d) for 2 weeks, and her symptoms and the chest X-ray findings improved . However, at the end of the therapy eosinophilia was noticed . Sixteen days after the completion of antibiotic therapy, she again experienced fever, cough and dyspnea . The chest X-ray again demonstrated diffuse infiltrations in the left lower lung field . The total IgE level, histamine and circulating immune complex titers were elevated . The WBC count was 14,700/mm3 with 34% eosinophils . Although a sputum culture yielded no organisms, many eosinophils were observed in the sputum . There were no clinical or laboratory findings compatible with allergic broncho-pulmonary aspergillosis . After the administration of oral prednisolone (40 mg/d), the patient showed rapid improvement with resolution of all symptoms and normalization of the IgE, histamine and circulating immune complex levels . The chest X-ray revealed marked regression of the pulmonary infiltrations . A microscopic examination of a transbronchial biopsy specimen demonstrated moderate eosinophilic infiltrations . It was compatible with the diagnosis of pulmonary infiltration with eosinophilia . Treatment was performed with prednisolone . The result of a lymphocyte stimulation test was positive for Cefotiam . An in vitro test was performed to evaluate the diagnosis of drug allergy in this case.(ABSTRACT TRUNCATED AT 250 WORDS)

Nippon Kyobu Geka Gakkai Zasshi, 1990 Oct, 38(10), 2162 - 5
{Valve replacement in infective endocarditis with mycotic aneurysm}; Yoshida K et al.; We successfully performed craniotomy and mitral valve replacement on a patient with bacterial endocarditis and ruptured intracranial aneurysm . A 15-year-old woman with fever and heart murmur was admitted to another hospital . Infective endocarditis and mitral valve regurgitation was diagnosed and treated with antibiotics . About one month after admission the patient suddenly showed severe headache and hemiparesis . Brain CT demonstrated intracerebral and subarachnoidal hemorrhage . The patient was unconscious when transferred to Mitsui Memorial Hospital where cerebral angiography showed anterior cerebral aneurysm and echocardiography showed mitral valve vegetation . We judged the necessary mitral valve replacement could be delayed until the aneurysm had been stabilized . We therefore began treatment using a different antibiotic but, in spite of this, 10 days later the aneurysm had enlarged dramatically . As conservative treatment was ineffective, a clipping operation was done to prevent re-rupture at the time of mitral valve replacement which could not be delayed much longer . 10 days later, cerebral 4 vessel study was done which showed no abnormality . Mitral valve replacement was then done and the patient was discharged in good health 64 days after the valve replacement.

Thorac Cardiovasc Surg, 1990 Oct, 38(5), 291 - 4
Tricuspid valve endocarditis in the drug addict: a reconstructive approach ("vegetectomy"); Straumann E et al.; This report describes the case of a 24-year-old female heroin addict with large tricuspid valve vegetation, recurrent septic pulmonary emboli, and renal failure, due to immune-complex nephritis . The clinical course was initially complicated by acute hepatitis A . Because of recurrent emboli and persistent fever despite adequate antibiotic therapy she underwent excision of the vegetation ("vegetectomy") and tricuspid valvuloplasty . She was well at follow-up 12 months later with trivial tricuspid regurgitation shown by doppler-echocardiography . Kidney and liver function were normal . Right-heart endocarditis in drug addiction and therapeutic approaches are discussed . In selected cases "vegetectomy" and valvuloplasty offer a promising therapeutic alternative.

Hepatogastroenterology, 1990 Oct, 37(5), 528 - 9
Portal venous gas in a patient with diverticulitis; Haak HR et al.; Gas in the portal vein is a rare finding associated with a grave prognosis . We present a case of portal venous gas in a 34-year-old man with an abscess due to perforated-sigmoid diverticulitis and Escherichia coli sepsis . successfully treated with sigmoid resection and antibiotic therapy.

Clin Plast Surg, 1990 Oct, 17(4), 733 - 44
Refinements in lower extremity free flap surgery; Acland RD; This chapter recommends numerous factors that are significant refinements in approach and execution of lower extremity free flaps . I encourage a clear conceptual separation between the two essential phases of successful reconstruction of problem wounds: wound preparation and flap transfer . I have found that antibiotic beads maintain the sterility of temporary bony dead space . Due emphasis should be given to preparation of the surgeon, patient, and wound, allowing a nonemergency approach to lower extremity free flap coverage . The surgeon needs to be familiar with a variety of flaps beyond the usual workhorse group . Also, attention should be paid to perioperative warmth and hydration, and vessels affected by posttraumatic vessel disease must be avoided . A positive attitude toward the use of vein grafts whenever necessary is important . I also favor careful planning of the exact size and shape of the flap and length of the vessels along with use of a widely spatulated technique of end-to-side anastomoses.

CLAO J, 1990 Oct-Dec, 16(4), 269 - 72
Corneal infiltrates associated with disposable extended wear soft contact lenses: a report of nine cases; Mertz PH et al.; We report nine cases of corneal infiltrates and/or ulceration in patients using disposable extended wear contact lenses . None of the nine patients had worn the lenses more than the recommended 7 days . Cultures were performed on six of the patients; all cultures were negative . One of the six cultured patients had been treated with topical antibiotics prior to culture . All responded promptly to cessation of lens wear and topical antibiotic therapy . Although all of the infiltrates/ulcers were paracentral, none of the patients sustained any permanent visual loss.

Br J Anaesth, 1990 Oct, 65(4), 542 - 3
An unusual complication of brachial plexus sheath cannulation; Patterson KW et al.; A 20-gauge cannula placed via an interscalene approach in the left brachial plexus sheath of a healthy 18-yr-old male was used inadvertently for injection of 20 ml of antibiotic solution, despite clear labelling of the cannula and painful protest from the patient . The patient suffered no neurological sequelae . The treatment, possible causes and steps to avoid similar incidents are described.

Acta Orthop Scand, 1990 Oct, 61(5), 460 - 2
Short-term cefotaxime prophylaxis reduces the failure rate in lower limb amputations; Norlin R et al.; The effect of prophylaxis with a broad-spectrum antibiotic agent in lower limb amputations was studied in a prospective, randomized investigation of 38 patients . Nineteen received cefotaxime (Claforan) and 19 served as controls . Three patients died in the immediate post-operative period . In the treatment group, 15/18 healed compared with 10/17 controls (P less than 0.001) . We concluded that short-term cefotaxime prophylaxis increases the chances to achieve good stump healing.

Am J Physiol, 1990 Oct, 259(4 Pt 1), L230 - 7
Aldosterone regulation of basolateral potassium channels in alveolar epithelium; Illek B et al.; To reveal the regulatory mechanism of the mineralocorticoid aldosterone on basolateral K+ channels, the aldosterone-sensitive lung epithelium of Xenopus laevis was investigated in Ussing chambers under voltage-clamp conditions . Transepithelial measurements were supplemented by current fluctuation analysis of short-circuit current noise in nonstimulated and aldosterone-stimulated lung tissues . The addition of 10(-6) M aldosterone stimulated short-circuit current from 11.3 +/- 2.0 to 27.8 +/- 4.8 microA/cm2 (n = 11) within 4-5 h . In the presence of an alveolar-to-pleural K+ gradient, transepithelial K+ currents were induced by permeabilizing the apical membrane with the pore-forming antibiotic amphotericin B . When the local anesthetic lidocaine (25-1,000 microM) was added to the pleural solution, macroscopic K+ current was dose dependently depressed . Lidocaine induced a Lorentzian component in the power density spectra, and the corner frequency increased linearly with blocker concentration . Aldosterone treatment did not affect mean single K+ channel current, which was 1.5 +/- 0.12 pA corresponding to a 15-pS channel conductance, whereas the number of basolateral K+ channels doubled . We conclude that the basolateral K+ channels in alveolar epithelia are a target site of aldosterone action.

Am J Clin Pathol, 1990 Oct, 94(4), 426 - 8
Cerebrospinal fluid changes after 48 hours of effective therapy for Hemophilus influenzae type B meningitis; Bonadio WA et al.; Interval cerebrospinal fluid (CSF) analysis is often performed to assess efficacy of treatment for bacterial meningitis . The authors reviewed 101 cases of pediatric bacterial meningitis resulting from Hemophilus influenzae type b in which analysis of CSF occurred on admission and between 48 and 72 hours after initiation of parenteral antibiotic therapy; of these, only one patient had a positive repeat CSF culture . Of the 100 cases with sterile CSF on repeat culture, there was no instance of recrudescence of infection during hospitalization . The following characterized the interval changes in CSF profile of this group: 100 (100%) with persistence of pleocytosis; 14 (14%) with differential cell count conversion from polymorphonuclear neutrophil leukocyte (PMN) predominance to relative lymphocytosis; 96 of 98 (98%) with initial positive Gram-stained smear with negative results for organisms; 53 of 75 (71%) with normalization of initial hypoglycorrhachia; and 10 of 94 (11%) with normalization of initial abnormally elevated protein levels . The differences in mean values of CSF total white blood cell counts, percentage PMNs, and glucose and protein concentrations on presentation and between 48-72 hours of therapy were highly significant (P less than 0.0001) . After 48 hours of effective antibiotic therapy for H . influenzae type b meningitis, CSF pleocytosis and abnormally elevated protein concentration are usually preserved, whereas hypoglycorrhachia usually resolves; it is not uncommon for the differential cell count to convert from a PMN predominance to a relative lymphocytosis . Significant alteration in all CSF parameters associated with H . influenzae type b meningitis can occur after 48 hours of effective parenteral antibiotic therapy.

South Med J, 1990 Oct, 83(10), 1213 - 5
Duplex Doppler examination of a perinephric abscess in a renal transplant; Dempsey J et al.; Perinephric abscess has no characteristic ultrasonic appearance or location . Differentiation from urinoma, lymphocele, or hematoma depends on clinical and laboratory findings . Therapy consists of percutaneous catheter drainage, surgical drainage, and antibiotic therapy . Acute rejection is the most common cause of decreased diastolic flow during the immediate postoperative period . Acute tubular necrosis does not usually alter blood flow unless it is severe . Duplex doppler ultrasonic assessment of the renal transplant during the immediate postoperative period may provide a valuable baseline for comparison if complications develop . Baseline and follow-up ultrasonography to evaluate diastolic flow can help determine whether a posttransplant patient should receive emergency or conservative therapy for complications.

J Pharmacol Exp Ther, 1990 Oct, 255(1), 312 - 7
Nifedipine enhances amoxicillin absorption kinetics and bioavailability in humans; Westphal JF et al.; Intestinal absorption of aminopenicillins in vitro uses the dipeptide carrier system . Recent experiments have reported calcium ion to be a cellular mediator of the regulation of electrolyte transport through the enterocyte membrane, especially the Na/H exchange which is partly responsible for the proton gradient energizing the carrier system . In order to assess the in vivo relevance of these data, we studied, in healthy volunteers, the influence of nifedipine, a calcium channel blocking agent, on the intestinal uptake of amoxicillin, a commonly prescribed and well-absorbed aminopenicillin . Results obtained show that 1) intestinal absorption kinetics of amoxicillin follows a zero-order process, which further substantiates the existence of a saturable carrier-mediated process for this antibiotic in humans and 2) calcium channel blockade significantly enhances both absorption rate (by 70%) and bioavailability of amoxicillin (by 21.4%) without modifying its distribution or elimination . These findings might suggest that nifedipine could enhance amoxicillin intestinal uptake by stimulating its active transport.

Cornell Vet, 1990 Oct, 80(4), 329 - 38
Premature bovine parturition induced by ponderosa pine: effects of pine needles, bark and branch tips; Panter KE et al.; Three components of Ponderosa pine trees were administered via gavage to pregnant cows to determine their ability to induce premature parturition . When tips of branches, bark or needles were administered (2.7 kg/day) starting at 250 d of pregnancy, early parturition was induced in an average of 3.4, 5.0 and 9.1 d, respectively, compared to 31.8 d for water gavaged controls (P less than 0.01) . Less pine material was required to induce parturition with tips and bark (9.4 and 11.2 kg/cow, respectively) than with needles (25.0 kg/cow P less than 0.05) . Cows fed pine material retained fetal membranes longer after parturition; 13.0 d for needles, 10.5 d for bark and greater than 3.0 d for tips versus less than 0.5 d for controls (P less than 0.01) . However, 2 of the cows fed tips died within 48 hours after parturition with fetal membranes intact and the other 2 cows fed tips became depressed, pyrexic and emaciated . They survived after extended veterinary care with antibiotic and fluid therapy . Administration of pine materials modified serum progesterone concentration profiles; there was significant elevation in progesterone 1-3 days after pine material was administered . Subsequently, pine material induced a premature decline in progesterone levels prior to parturition, which occurred more rapidly in cows fed bark and tips suggesting a dose response relationship . Pine material also modified serum cortisol concentration profiles; the main difference was a prolonged elevation in cows receiving tips . Branch tips and bark from Ponderosa pine are more potent in inducing parturition than needles.

J Bacteriol, 1990 Oct, 172(10), 6048 - 53
Role of lipopolysaccharide in assembly of Escherichia coli outer membrane proteins OmpA, OmpC, and OmpF; Ried G et al.; Selection was performed for resistance to a phage, Ox2, specific for the Escherichia coli outer membrane protein OmpA, under conditions which excluded recovery of ompA mutants . All mutants analyzed produced normal quantities of OmpA, which was also normally assembled in the outer membrane . They had become essentially resistant to OmpC and OmpF-specific phages and synthesized these outer membrane porins at much reduced rates . The inhibition of synthesis acted at the level of translation . This was due to the presence of lipopolysaccharides (LPS) with defective core oligosaccharides . Cerulenin blocks fatty acid synthesis and therefore that of LPS . It also inhibits synthesis of OmpC and OmpF but not of OmpA (C . Bocquet-Pages, C . Lazdunski, and A . Lazdunski, Eur . J . Biochem . 118:105-111, 1981) . In the presence of the antibiotic, OmpA synthesis and membrane incorporation remained unaffected at a time when OmpC and OmpF synthesis had almost ceased . The similarity of these results with those obtained with the mutants suggests that normal porin synthesis is not only interfered with by production of mutant LPS but also requires de novo synthesis of LPS . Since synthesis and assembly of OmpA into the outer membrane was not affected in the mutants or in the presence of cerulenin, association of this protein with LPS appears to occur with outer membrane-located LPS.

Indian J Pathol Microbiol, 1990 Oct, 33(4), 339 - 43
Incidence of fungal infections in chronic maxillary sinusitis; Greval RS et al.; A study conducted on seventy-five cases of chronic maxillary sinusitis presenting at the E.N.T . Outpatients' Department of Dayanand Medical College, Ludhiana revealed the presence of fungi in 8 cases . The return fluids of proof puncture and antral lavage of the sinuses were subjected to standard extraction procedures . Methods of isolation and identification of the causal fungi are described . The role of fungi, particularly Aspergillus, as pathogen is discussed in the context of antibiotic and immuno-suppressive therapy and local predisposing factors.

Poult Sci, 1990 Oct, 69(10), 1713 - 7
The response of male chicken broilers to the dietary addition of virginiamycin; Proudfoot FG et al.; Two replicate trials, each involving 400 Arbor Acre male broiler chicks, were conducted to determine the effect of virginiamycin as a growth promoter when added to either the feed or drinking water . A control group received no growth promoter while one treatment group was provided a diet containing 11 mg of virginiamycin/kg . Another treatment group was provided drinking water containing virginiamycin in amounts calculated to ensure equivalent or one-half equivalent intake of the antibiotic . Virginiamycin supplementation had no significant (P greater than .05) effect on mortality or feed conversion ratios, regardless of the mode of administration . Body weights at 21 days of age but not at 42 days of age were significantly (P less than .05) heavier for broilers receiving virginiamycin via the drinking water . The inclusion of virginiamycin in the feed failed to improve body weights at either 21 or 42 days of age.

Mil Med, 1990 Oct, 155(10), 480 - 2
Evaluation of subclavian catheters in gynecologic cancer patients; Lee RB et al.; Sixty-eight semipermanent subclavian catheters were placed in 61 patients with gynecologic malignancies . The principal indicator for placement was chemotherapeutic administration . Other uses included blood transfusion, antibiotic infusion, and hyperalimentation . The minor complication rate of 21% included exit site infections and clotted, broken, and dislodged catheters . There were no acute surgical complications; i.e., bleeding or pneumothorax, but there was a 6% major complication rate, which included four cases of sepsis and a case of a broken intravascular catheter.

Am J Med, 1990 Oct, 89(4), 457 - 63
Risk factors for nosocomial pneumonia in the elderly; Harkness GA et al.; PURPOSE: Pneumonia is now the second most frequent hospital-acquired infection in acute-care facilities, and recent studies indicate that the incidence rate for nosocomial pneumonia in long-term-care facilities is of similar magnitude . The mortality rate is high, especially in the elderly . With prevention of this complication as an overall priority, this study was designed to determine the risk factors associated with nosocomial pneumonia in the elderly in both acute-care and long-term-care settings . PATIENTS AND METHODS: An epidemiologic case-control study was undertaken to compare patients or residents who developed radiographically confirmed pneumonia with control subjects who did not have and did not develop respiratory infection . Thirty-three cases were identified in the acute-care setting during the 18-week period, and 27 cases were identified in the long-term-care setting . Two matched controls were chosen for each case . Data collection involved review of the medical record and verification by medical personnel while the cases or controls were still institutionalized . Risk factor variables were analyzed using an odds ratio and 95% confidence interval calculation for matched triplets, and chi-square analysis . Selected risk factors were entered into a backward stepwise logistic regression to determine the best combination of risk factors for each setting . RESULTS: In the acute-care setting, current neurologic disease, current renal disease, deteriorating health, altered level of consciousness, disorientation, dependent bathing, dependent bowel function, dependent feeding, aspiration, difficulty with oropharyngeal secretions, and presence of a nasogastric tube were significant risk factors . In the long-term-care setting, deteriorating health, malnourishment, recent weight change, altered level of consciousness, disorientation, aspiration, difficulty with oropharyngeal secretions, suctioning, presence of a nasogastric or gastric tube, upper respiratory infection, inhalation therapy, increased confusion, and increased agitation were determined to be significant . Current pulmonary disease, previous infection, and antibiotic therapy were found not to be associated with the onset of nosocomial pneumonia . Through logistic regression, the best models for prediction of nosocomial pneumonia in the elderly were identified . In the acute-care setting, difficulty with oropharyngeal secretions and presence of a nasogastric tube were the best predictors . In the long-term-care setting, difficulty with oropharyngeal secretions, deteriorating health, and occurrence of an unusual event were the best combination of predictors . CONCLUSION: These data confirm prior findi

Hosp Pract (Off Ed), 1990 Oct, 25 Suppl 4, 13 - 9
Treatment of postpartum endometritis; Martens M et al.; In this study, cefoxitin alone (2 gm, every 8 hours) was generally sufficient to cure postpartum endometritis, even when the patient had received prophylaxis with a beta-lactam antibiotic . When single-agent therapy fails, addition of ampicillin usually results in a prompt clinical response.

Br J Dermatol, 1990 Oct, 123(4), 447 - 52
Linear IgA disease of adults: association with lymphoproliferative malignancy and possible role of other triggering factors; Godfrey K et al.; Seventy patients with linear IgA disease of adults were followed up for a mean of 8.5 years and all malignant diseases in this group were ascertained . There were three cases of lymphoproliferative malignancy, which constituted a significant excess over the 0.2 cases that would be expected by comparison with an age- and sex-matched population using National Cancer Registry statistics . In contrast, the non-lymphoid malignancy rate of 13% is almost identical to the expected 14% . A subgroup of 35 of the adult linear IgA disease patients were assessed with respect to the possible precipitating illnesses or drugs, as well as co-existing medical conditions . Almost one-third of patients described an event that was felt could possibly have triggered the linear IgA disease, the most frequent being non-steroidal anti-inflammatory or antibiotic drug therapy, trauma/burns and upper respiratory tract infections . However, it is difficult to determine how often the preceding event is coincidental, and how often, if at all, it is causal.

J Assoc Physicians India, 1990 Oct, 38(10), 787 - 9
Phycomycosis infection in acute leukaemia; Kumar L et al.; Fungal infections are increasingly being reported in patients with acute leukaemia on intensive induction chemotherapy protocols . The common fungi seen are candida, aspergillus and mucormycosis . We have seen 3 cases of mucormycosis over the last 4 years . All 3 patients had acute leukaemia-two had acute lymphoblastic and one acute myeloid leukaemia . All patients were in neutropenic phase after induction chemotherapy . Features suggestive of fungal infection were fever and development or progression of pulmonary infiltrates despite antibiotic therapy . Repeated body fluid cultures were negative in two patients . In the first patient, the diagnosis was confirmed after biopsy of a palatal mass; he was treated successfully with amphotericin-B . In two patients the diagnosis was confirmed at autopsy . A high degree of suspicion in febrile, neutropenic cancer patients on chemotherapy and early administration of amphotericin-B may improve the outcome . With dissemination, the prognosis is poor.

Clin Podiatr Med Surg, 1990 Oct, 7(4), 725 - 31
Puncture wounds and foreign body reactions; Krych SM et al.; Puncture wounds present a clinical dilemma when considering the amount of intervention . Through a logical and thorough history and physical examination a wound score is reached . This scoring system allows for a more objective approach to treatment . Although by no means perfect, wound score will help the clinician in decision making for this difficult clinical problem . Guidelines for the total score are as follows: 1 . If the total score is between 1 and 4, treatment is local cleansing and observation . 2 . If the total score is between 5 and 8, local cleansing, incision and drainage, and exploration for foreign body is performed with placement of drain . Oral antibiotic regimen is up to local standards of care . 3 . If the total score is 9 or more, incision and drainage are mandatory, and wound lavage, intravenous antibiotics, hospitalization, and immobilization are indicated.

J Biomol Struct Dyn, 1990 Oct, 8(2), 375 - 98
Two-dimensional nMR study of bleomycin and its zinc(II) complex: reassignment of 13C resonances; Williamson D et al.; Two-dimensional NMR experiments--one bond 1H-13C correlation spectroscopy and heteronuclear multiple bond correlation spectroscopy, both performed in the reverse detection mode--have been employed to unambiguously assign all of the 13C resonances of the antibiotic bleomycin and its zinc(II) complex . Previous 1H resonance assignments of bleomycin (Chen et al . (1977) Biochemistry 16, 2731-2738) were confirmed on the basis of homonuclear Hartmann-Hahn and homonuclear COSY experiments . The 13C assignments differ substantially from those previously obtained by other investigators (Naganawa et al., (1977) J . Antibiot . 30, 388-396; Dabrowiak et al., (1978) Biochemistry 17, 4090-4096) but are in agreement with those reported by Akkerman et al . (1988) (Magn . Reson . Chem . 26, 793-802) . The more recent study employed similar two-dimensional correlation experiments (performed in the direct detection mode) in conjunction with attached proton tests . Their study often required model compound data to identify carbonyls adjacent to aliphatic moieties . Previous 13C NMR studies of the structure, pH titration, and molecular dynamics of bleomycin and its zinc complex have been reinterpreted in terms of the revised assignments.

Biophys J, 1990 Oct, 58(4), 833 - 9
Nystatin-induced liposome fusion . A versatile approach to ion channel reconstitution into planar bilayers; Woodbury DJ et al.; A simple method is described for promoting and detecting fusion of liposomes with planar bilayer membranes . Liposomes containing ergosterol are doped with the pore-forming antibiotic nystatin, and the planar bilayer is kept ergosterol-free . Under these conditions, when a transbilayer salt gradient is applied, liposomes added to the high-salt side of the bilayer elicit the appearance of abrupt conductance jumps of 5-300 pS . The increase in conductance is transient, decaying back to baseline on the order of 10 s . Each of these "spikes" represents the fusion of a single liposome with the bilayer, resulting in the simultaneous insertion of many nystatin channels . Relaxation of the conductance back to baseline occurs because ergosterol, required for the integrity of the nystatin pore, diffuses away into the sterol-free planar bilayer after liposome fusion . When Torpedo Cl- channels are reconstituted into liposomes containing ergosterol and nystatin, fusion spikes are observed simultaneously with the appearance of Cl- channels . This method allows the calculation of the density of functional ion channels in a preparation of proteoliposomes containing reconstituted channel protein.

J Bacteriol, 1990 Oct, 172(10), 5844 - 51
Possible evolutionary relationships between streptomycin and bluensomycin biosynthetic pathways: detection of novel inositol kinase and O-carbamoyltransferase activities; Walker JB; Bluensomycin (glebomycin) is an aminocyclitol antibiotic that differs structurally from dihydrostreptomycin in having bluensidine (1D-1-O-carbamoyl-3-guanidinodeoxy-scyllo-inositol) rather than streptidine (1,3-diguanidino-1,3-dideoxy-scyllo-inositol) as its aminocyclitol moiety . Extracts of the bluensomycin producer Streptomyces hygroscopicus form glebosus ATCC 14607 (S . glebosus) were found to have aminodeoxy-scyllo-inositol kinase activity but to lack 1D-1-guanidino-3-amino-1,3-dideoxy-scyllo-inositol kinase activity, showing for the first time that these two reactions in streptomycin producers must be catalyzed by different enzymes . S . glebosus extracts therefore possess the same five enzymes required for synthesis of guanidinodeoxy-scyllo-inositol from myo-inositol that are found in streptomycin producers but lack the next three of the four enzymes found in streptomycin producers that are required to synthesize the second guanidino group of streptidine-P . In place of a second guanidino group, S . glebosus extracts were found to catalyze a Mg2(+)-dependent carbamoylation of guanidinodeoxy-scyllo-inositol to form bluensidine, followed by a phosphorylation to form bluensidine-P . The novel carbamoyl-P:guanidinodeoxy-scyllo-inositol O-carbamoyltransferase and ATP:bluensidine phosphotransferase activities were not detected in streptomycin producers or in S . glebosus during its early rapid growth phase . Free bluensidine appears to be a normal intermediate in bluensomycin biosynthesis, in contrast to the case of streptomycin biosynthesis; in the latter, although exogenous streptidine can enter the pathway via streptidine-P, free streptidine is not an intermediate in the endogenous biosynthetic pathway . Comparison of the streptomycin and bluensomycin biosynthetic pathways provides a unique opportunity to evaluate those proposed mechanisms for the evolutionary acquisition of new biosynthetic capabilities that involve gene duplication and subsequent mutational changes in one member of the pair . In this model, there are at least five pairs of enzymes catalyzing analogous reactions that can be analyzed for homology at both the protein and DNA levels, including two putative pairs of inositol kinases detected in this study.

Neurosci Lett, 1990 Sep 18, 117(3), 341 - 6
Cell modulation of hydrophobic tailed 16S acetylcholinesterase by intracellular calcium in rat superior cervical ganglion neurons; Verdiere-Sahuque M et al.; In primary cell cultures of rat superior cervical ganglia (SCG) the tailed asymmetric 16S molecular form of acetylcholinesterase (AChE) possesses hydrophilic (high-salt soluble, HSS) and hydrophobic (detergent extracted, DE) variants . Hydrophobic tailed acetylcholinesterase is associated with membranes through a glycolipid anchor . In the presence of tunicamycin, an antibiotic which inhibits protein glycosylation, the cellular amount of the hydrophobic DE 16S AChE is increased . Exposure of the cells to the calcium ionophore A 23187 leads to a decrease in DE 16S AChE and a correlated increase in hydrophilic HSS 16S AChE . These results suggest the existence of an endogenous processing of tailed AChE, transforming the hydrophobic variant into an hydrophilic one controlled through glycosylation and intracellular calcium.

FEMS Microbiol Lett, 1990 Sep 15, 59(3), 259 - 64
High transformation frequency of nonsporulating mutants of Streptomyces griseus; Daza A et al.; Three different bld mutants from S . griseus ATCC 10137 were isolated by nitrosoguanidine mutagenesis . They simultaneously lost the capability of antibiotic production and the formation of pigments . The three bld mutants were differently affected by different carbon sources . Two of these mutants showed a high efficiency of transformation with several plasmid vectors, in contrast to the low efficiency of transformation showed by the wild type . We showed that S . griseus ATCC 10137 and the three bld mutants possess an enzymatic activity that protects their DNAs against the digestion by SacI . Antibiotic and pigment production, and low transformability with plasmid DNA were together restored in spontaneous spo+ revertants.

J Biol Chem, 1990 Sep 5, 265(25), 14713 - 6
Sequence-specific double-strand breakage of DNA by neocarzinostatin involves different chemical mechanisms within a staggered cleavage site; Dedon PC et al.; Direct double-strand breaks in DNA have been implicated in cellular lethality of the antitumor antibiotic neocarzinostatin, but the mechanism of their formation has not been elucidated . Evidence is presented that neocarzinostatin causes sequence-specific direct double-strand breaks whose formation is strongly influenced by the activating thiol . Seven-fold more double-strand breaks result when glutathione rather than 2-mercaptoethanol is used to activate the drug to its putative diradical form, while the sequence specificity of cleavage remains the same . These data explain earlier inconsistencies in the ratios of double-strand to single-strand breaks obtained from in vitro and in vivo studies . Double-strand cleavage sites, occurring predominantly at GT steps, especially AGT.ACT, consist of trinucleotide sequences with a two-nucleotide 3'-stagger of the cleaved residues . The chemical structures of the cleavage sites suggest a model in which a neocarzinostatin-induced double-strand break results from abstraction of a C5' hydrogen atom from the T of ACT and the C4' hydrogen atom of the T of AGT by a single molecule of the diradical form of the drug . Single-strand breaks at these sites occur as separate events with attack at the C5' hydrogens . These findings permit the generalization that single-strand breaks produced by neocarzinostatin show a base preference but no clear sequence specificity, while bistranded lesions are sequence-specific in nature.

Klin Wochenschr, 1990 Sep 3, 68(17), 853 - 6
{The prognostic significance of lymphocyte subpopulations and macrophages in peripheral blood and in bronchoalveolar lavage in AIDS patients with suspected Pneumocystis carinii pneumonia}; Huhn C et al.; In 36 HIV seropositive patients with the clinical manifestation of AIDS and a suspected Pneumocystis carinii infection, lymphocyte subpopulations were analyzed in the peripheral blood (PBL) and compared with the results of the bronchoalveolar lavage (BAL) . Of those 36 patients, 29 showed a highly abnormal CD4/CD8 ratio in both the PBL and the BAL . The clinical course of these 29 patients was unpredictable . In seven patients, however, the CD4/CD8 ratio in the BAL was normal or only slightly altered, despite a highly abnormal CD4/CD8 ratio in the PBL . Five of these seven patients improved greatly during the clinical course . The positive outcome of the clinical course was even more strongly correlated with the number of macrophages in the BAL . Twelve of the 36 patients showed normal or only slightly changed numbers of macrophages in the BAL . Eleven of these twelve patients (92%) improved rapidly during antibiotic therapy, while the clinical course was unpredictable in patients with markedly reduced macrophage counts in the BAL.

J Comput Assist Tomogr, 1990 Sep-Oct, 14(5), 721 - 9
Gadolinium-enhanced MR in spinal infection; Post MJ et al.; The purpose of this study was to determine what advantages the use of paramagnetic contrast material might have in evaluating patients clinically suspected of having spinal infection . To determine this we prospectively examined with noncontrast and contrast magnetic resonance (MR) 33 such patients and correlated the MR diagnoses with clinical and pathologic data . Our results showed the following advantages of gadolinium-enhanced MR: it (a) provided excellent anatomical delineation of all epidural abscesses, routinely differentiating them from the adjacent compressed thecal sac even when this was not possible by noncontrast MR; (b) increased observer confidence in the diagnosis of disk space infection and osteomyelitis in patients with equivocal noncontrast MR; (c) localized those portions of paraspinal masses most likely to yield a positive percutaneous biopsy; and (d) identified active infections from those that had responded adequately to antibiotic therapy . We conclude that contrast MR is a valuable adjunct to noncontrast MR when diagnosis, anatomical clarity, and/or lesion activity requires further elucidation.

Arch Intern Med . 1990 Sep;150(9):1961.
Sulbactam-induced hyperpyrexia; Olivencia-Yurvati AH et al.; We describe a patient who experienced hyperpyrexia after the administration of ampicillin sodium-sulbactam sodium . This previously unreported complication did not occur with administration of ampicillin alone and could not be attributed to other medications, to diluents, or to an allergic reaction . Because of the evidence in this case, we believe that the sulbactam component of this antibiotic combination should be considered in the pathogenesis of drug-induced hyperpyrexia.

Diagn Microbiol Infect Dis, 1990 Sep-Oct, 13(5), 363 - 5
Wound infections after cesarean section with Mycoplasma hominis and Ureaplasma urealyticum . A report of three cases; Maccato M et al.; Mycoplasma hominis and Ureaplasma urealyticum were isolated from the surgical wounds of three patients who developed endometritis and a wound infection after cesarean section . In all patients, aspiration of the incision yielded a cloudy serosanguinous exudate . Gram stain of the fluid revealed numerous white blood cells but no bacteria . All patients responded to antibiotic therapy and local wound care.

Vestn Otorinolaringol, 1990 Sep-Oct, (5), 64 - 8
{Use of porous permeable titanium nickelide implants in surgery of the frontal and maxillary sinuses (a clinical-experimental study)}; Starokha AV et al.; The purpose of the investigation was to study the efficacy of closing the bone defect in facial walls of the frontal and maxillary sinuses, formed as a result of their purulent inflammation, by porous permeable titanium nickelide . Analysis of the experimental data (18 dogs) and clinical observations (20 patients in whom the anatomic structure and function of frontal and maxillary sinuses with osteomyelitis were restored by an antibiotic pooling implantation material) gives evidence that the material can be well used to reconstruct an organ with an infected wound . The porous structure of the bioinert graft facilitates the ingrowth of osteogenic tissues, which becomes packed in the bone matrix without any intermediate connective tissue layer.

Semin Respir Infect, 1990 Sep, 5(3), 215 - 25
Invasive techniques in the diagnosis of bacterial pneumonia in the intensive care unit; Chauncey JB et al.; Bacterial nosocomial pneumonia represents the greatest infectious risk for morbidity and mortality for patients requiring intensive care and mechanical ventilation . The occurrence of purulent respiratory secretions and new infiltrates on chest radiograph generally necessitates broad-spectrum antibiotic therapy due to the lack of a safe, reliable method of determining the presence or absence of bacterial pneumonia . This article reviews the currently available invasive techniques for the diagnosis of bacterial pneumonia in the intensive care patient, with particular emphasis on the bronchoscopic methods using protected specimen brushes and bronchoalveolar lavage . The reliability, risks, and techniques of the various procedures are compared and contrasted.

Fam Pract, 1990 Sep, 7(3), 175 - 80
Acute bronchitis: general practitioners' views regarding diagnosis and treatment; Verheij TJ et al.; A survey was conducted among 800 Dutch general practitioners to establish their views on the diagnosis and treatment of bronchitis and related disorders with reference to 12 theoretical patients . The answers of the 467 respondents (response rate 60%) showed no clear relationship between signs and symptoms of the patients and the diagnosis made . In the authors' opinion the diagnosis of pneumonia was made too often . The decision whether or not to prescribe an antibiotic for a coughing patient was based in part on the diagnosis made, but in part it was also made on the basis of the signs and symptoms, irrespective of the diagnosis . The authors have the impression that general practitioners tend to prescribe antibiotics too quickly to coughing patients . There is a need for guidelines for diagnosis and treatment of patients with acute bronchitis and related conditions.

Laryngorhinootologie, 1990 Sep, 69(9), 468 - 71
{Acute purulent parotitis as a sequela of alkylphosphate (E 605) poisoning}; Leuwer A et al.; Acute suppurative parotitis is a possible consequence of poisoning by organophosphates (E 605) . The endogenous accumulation of acetylcholine results--as in the acute pancreatitis caused by poisoning with organophosphates--in massive hyperemia and an increased secretory activity with leakage of saliva into the tissue, in an activation of the kallikrein-kinin system, the phospholipase A2, and, ultimately, in toxic tissue lesions caused by lysolecithin and the superoxide-radical anion . In spite of antibiotic therapy this is followed by bacterial inflammation . Treatment consists in the administration of aprotinin (Trasylol) and corticosteroids . In the case of abscess formation surgical drainage is necessary.

Radiol Med (Torino), 1990 Sep, 80(3), 219 - 29
{Magnetic resonance in the diagnosis of bone infections}; Dalla Palma L et al.; Skeletal infections represent a variety of clinical and pathological conditions in which both an early diagnosis and the precise evaluation of disease extent are very important in planning proper therapy . To determine MRI capabilities and limitations in the evaluation of skeletal infections 21 patients--12 with a clinical diagnosis of osteomyelitis of the lower limbs and 9 with a clinical diagnosis of spondyloscitis--were studied with this technique . All patients were examined with conventional X-rays; conventional tomography was performed in 3 cases, and CT in 6 . Signal intensities and morphological aspects were then evaluated with MRI . MRI diagnoses were compared with surgical findings or clinical follow-up, after antibiotic therapy: 19 true-positives were observed, together with 1 true-negative, 1 false-positive, and no false-negatives . MRI findings were correlated with those of conventional radiology: MRI identified the lesions and their nature in 100% of cases, whereas conventional radiology did the same in 85% of cases; in 50% of cases only the latter was able to define the nature of the process . Four patients underwent MRI follow-up . MRI was highly sensitive in determining the presence of lesions in an early stage and in demonstrating lesion regression . Moreover, MRI was able to identify the complications occurring in some cases of osteomyelitis and spondyloscitis . In all cases MRI allowed the extent of the disease to be accurately determined and, in osteomyelitis of the lower limbs, it was extremely useful to differentiate soft-tissue infections from bone marrow involvement.

Midwifery, 1990 Sep, 6(3), 146 - 54
Awareness among pregnant women of the effect on the fetus of commonly used drugs; Butters L et al.; Epidemiological studies have shown that pregnant women continue to take substantial quantities of drugs, particularly those readily available to them without prescription . Little is known of the attitudes and knowledge among pregnant women of the effects of these substances on the fetus . Awareness of the effects on the fetus of commonly used drugs, cigarettes and alcohol among 514 women in the postnatal wards of two maternity units in Glasgow was assessed by self completion questionnaire between October 1987 and April 1988 . Most of the women recognised that the fetus is most at risk of being harmed by drugs during the first 3 months of pregnancy . The majority felt it was safest not to smoke cigarettes and were aware of the adverse effects of smoking on fetal growth . Over half thought smoking was harmful while breastfeeding . Over half thought that alcohol should be avoided altogether in pregnancy and that drinking could harm the fetus . Most women considered alcohol harmful to the breast feeding baby . The majority of the women would opt for paracetamol containing analgesics only and only a small proportion would take one containing aspirin . Only half the study population would take a prescribed antibiotic . A generally high level of awareness of commonly used drugs was demonstrated although there are areas where further health education could be directed . The study has highlighted areas worthy of further research.

J Arthroplasty, 1990 Sep, 5(3), 277 - 9
Persistent infection after successful arthrodesis for infected total knee arthroplasty . A report of two cases; Schoifet SD et al.; Infection in total knee arthroplasty has been reported to range from 1.1% to 12.4% . The literature contains numerous articles on salvage procedures including antibiotic suppression, surgical debridement, resection arthroplasty, arthrodesis, reimplantation, and amputation . Of those knees not reimplantable, a successful arthrodesis is felt by many to give the most predictable long-term results . The majority of literature on arthrodesis for infected total knee arthroplasty concentrates on technical factors and techniques to facilitate fusion . A successful fusion is considered an end point of treatment.

J Antimicrob Chemother, 1990 Sep, 26 Suppl A, 29 - 36
Short-course cefotaxime compared with five-day co-amoxyclav in acute otitis media in children; Gehanno P et al.; This randomized, multicentre prospective study was undertaken to compare the efficacy and tolerance of a one day course of injectable cefotaxime with a five day oral course of co-amoxyclav (amoxycillin plus clavulanic acid) in the treatment of acute otitis media in children . The study was conducted in 116 patients between the ages of three months and 12 years . No significant difference in efficacy was observed between the two treatment groups, but tolerance to the treatments differed significantly . There were no unwanted side-effects in the cefotaxime group whereas 22% of children in the amoxycillin plus clavulanic acid group suffered side-effects (P 0.0007) . Short-course antibiotic therapy with cefotaxime appears to be a valuable alternative to conventional treatment regimens for acute otitis media in children.

Ann R Coll Surg Engl, 1990 Sep, 72(5), 313 - 4; discussion 314-5
A simple technique for successful primary closure after excision of pilonidal sinus disease; Williams RS; Primary closure after excision of postanal pilonidal sinus disease frequently has been complicated by wound break-downs . Healing by second intention takes many weeks and requires supervised wound care . A simple technique has been developed which has resulted in primary healing in 28 of 31 patients treated in a 5-year period . Sepsis and haematoma formation, the causes of wound breakdown after pilonidal sinus excision, have been prevented by preoperative preparation, prophylactic antibiotic administration, wound irrigation with povidone-iodine and simple skin closure over a Redivac suction drain for at least 4 days . This series suggests that primary closure can be successful using the technique described.

Infect Dis Clin North Am, 1990 Sep, 4(3), 361 - 76
Epidemiology in bone and joint infection; Gillespie WJ; The studies of community-acquired infection indicate the importance of the environment in which the host-pathogen interaction takes place . Whereas the high incidence rates at the extremes of life are compatible with a hypothesis of diminished immune competence, the varying rates of acute osteomyelitis during growth, and its predominantly metaphyseal site, suggest that further studies of the molecular biology of this rather specific infection would be revealing . Molecular biology has a role, too, in improving understanding of the epidemiology of resistance and pathogenicity in hospital-acquired infections . Although antibiotic prescription and other medical practices influence the environment profoundly, we should remember that we may be experiencing long-term trends beyond our present understanding . As more and more reconstructive bone and joint surgery is carried out, careful observational epidemiology remains a vital tool.

J Antibiot (Tokyo), 1990 Sep, 43(9), 1098 - 100
Amphotericin B O-methyl oxime . Synthesis and biological properties; Czerwinski A et al.; Synthesis and biological properties of amphotericin B O-methyl oxime are described . The presence of an intact hemiketal ring in the antibiotic molecule appeared to be essential for its biological activity.

J Antibiot (Tokyo), 1990 Sep, 43(9), 1082 - 8
Sequence determination of actagardine, a novel lantibiotic, by homonuclear 2D NMR spectroscopy; Kettenring JK et al.; By combination of several 1H NMR techniques, the sequence of actagardine has been elucidated . It has been shown that it is a tetracyclic 19-residue peptide antibiotic . It differs from the previously described lanthionine-containing peptide antibiotics belonging to the lantibiotic class.

J Antibiot (Tokyo), 1990 Sep, 43(9), 1077 - 81
Intermolecular stacking of gilvocarcin V tetraacetate as evidenced by nuclear magnetic resonance studies; Eguchi T et al.; The temperature-dependent and concentration-dependent 1H NMR studies as well as 13C-relaxation experiments on gilvocarcin V tetraacetate strongly suggest intermolecular stacking of the antibiotic solution.

J Antibiot (Tokyo), 1990 Sep, 43(9), 1064 - 8
Mechanism of action of atpenin B on Raji cells; Oshino K et al.; Atpenin B, a new antifungal antibiotic produced by Penicillium sp . FO-125, inhibited the growth of Raji cells (IC50, 30 microM) . The incorporation of {14C}leucine and {3H}thymidine into Raji cells was inhibited by atpenin B with IC50 values of 0.10 and 0.12 microM, respectively . The incorporation of {14C}palmitate into the cells was not inhibited but its incorporation into lipid fractions was inhibited by atpenin B (IC50, 0.13-0.24 microM) . Studies on the site of atpenin B action demonstrated that atpenin B decreases the cellular adenosine 5'-triphosphate (ATP) level in Raji cells with IC50 value of 0.020 microM, suggesting the inhibition of ATP-generating system by atpenin B.

J Am Vet Med Assoc, 1990 Sep 1, 197(5), 602 - 4
Bacterial epididymitis in two stallions; Held JP et al.; Two stallions had unilateral bacterial epididymitis attributable to S zooepidemicus infection . Diagnosis was based on bacterial isolation, WBC in the semen, higher than normal blood fibrinogen concentration, and leukocytosis with regenerative left shift . One horse had high seminal pH . Ultrasonography of the involved epididymides revealed changes consistent with the appearance of abnormal accumulation of exudate in the tail of the epididymis . Treatment included unilateral orchiectomy and antibiotic administration . In stallion 1, the infection persisted despite treatment . Treatment result was not available for stallion 2.

Br J Ophthalmol, 1990 Sep, 74(9), 528 - 31
Topical steroids in the treatment of central and paracentral corneal ulcers; Carmichael TR et al.; During an 18-month period a prospective randomised trial was conducted on 40 selected patients with bacterial corneal ulcers . Two groups were compared: one was treated with antibiotic only and the other with antibiotic plus steroid . Complications were similar in the two groups . No delay in healing rate of the ulcers was seen with the use of topical steroid . Two methods of assessing visual improvement are discussed, but it was not possible to demonstrate a difference in visual outcome between the two groups.

Zhonghua Yi Xue Za Zhi (Taipei), 1990 Sep, 46(3), 186 - 9
Pituitary abscess-A case report; Fu YM et al.; Two hundred and five cases of pituitary lesion were treated in Tri-Service General Hospital up to March 1989 . A case of pituitary abscess was diagnosed during operation . The primary clinical manifestations are consequent upon the pituitary dysfunction and the mass effect of the pituitary abscess . A pre-operative diagnosis of pituitary abscess is usually very difficult . Transsphenoidal drainage with an appropriate antibiotic coverage may provide an optimistic prognosis.

Z Gesamte Hyg, 1990 Sep, 36(9), 471 - 4
{Statistical analysis of the in-vitro action of combination antiviral agents}; Sandow D et al.; Similar to the chemotherapy of bacterial infections, with the advanced development of virostatics a combination of antiviral agents is supposed to be introduced into the causal treatment of viral illness . The present studies explain a method for in vitro testing of virostatic combinations in cell cultures . The principle of the method is based on the checkerboard-technique used to test antibiotic combinations . As example the combination of trisodium phosphonoformate with bromovinyl-2'-deoxyuridine, acyclovir or 2-hexadecylglycero-3-phosphocholine was tested against herpes simplex virus, type 1 . For evaluation of the test results the so-called reduction dose 50 (RD50) was introduced . The RD50 corresponds to this substance concentration, which reduces alone or in combination with a second virostatic the virus concentration used in the test system to its TCID50 . With analogy to the calculation of infectious doses the computation of the RD50 was performed by using the method of Spearman and Kaerber . The calculated values allow the comparability of the antiviral activity of substances and their combinations . Corresponding to testing of antibiotics the further analysis of combinations was carried out by calculation of fractional inhibitory concentration (FIC), synergy factors (SF), and the construction of isobolograms . In this way, indifferent, synergistic and antagonistic effects of substance combination should be determined.

Am J Physiol, 1990 Sep, 259(3 Pt 1), C450 - 4
Duramycin enhances chloride secretion in airway epithelium; Cloutier MM et al.; The effect of duramycin, a polypeptide antibiotic, on Cl- transport in canine tracheal epithelium mounted in Ussing chambers was studied . Over a narrow concentration range, duramycin increased short-circuit current (Isc) and net Cl- secretion and had no effect on mannitol flux when added to the mucosal bathing solution . The maximum increase in Isc was observed at a duramycin concentration of 2 X 10(-6) M and was associated with an increase in both unidirectional Cl- fluxes . Higher duramycin concentrations produced a decrease in Isc . Submucosal addition of duramycin had no effect on Isc except at high concentrations . Pretreatment of tissues with mucosal amiloride (10(-4) M) to reduce basal Na+ transport had no effect on the subsequent response to duamycin . In other tissues pretreated with 10(-3) M dibutyryl adenosine 3',5'-cyclic monophosphate (cAMP), duramycin produced a further increase in Isc and net Cl- secretion similar to its effect in nonpretreated tissues . In all instances the increase in Isc was entirely accounted for by an increase in net Cl- secretion . We conclude that duramycin increases Isc and Cl- secretion in airway epithelium . Although the mechanism of activation is not known, these data demonstrate that duramycin increases Cl- secretion by a pathway other than cAMP . An understanding of the mechanism of action of duramycin may further our understanding of Cl- secretion regulation in airway epithelium.

Obstet Gynecol, 1990 Sep, 76(3 Pt 2), 534 - 6
Amniotic membranes in the treatment of necrotizing fasciitis complicating vulvar herpes virus infection; Rothman PA et al.; Necrotizing fasciitis of the vulva developed in an immunocompromised patient with chronic myelogenous leukemia, apparently from secondarily infected herpes simplex lesions . In addition to surgical debridements and broad-spectrum intravenous antibiotic therapy, the wound was treated using specially prepared amniotic membranes as a wound dressing . The patient died on hospital day 65 because of complications of her immunocompromised state, with autopsy findings of disseminated cytomegalovirus . However, use of amniotic membranes as a wound dressing appeared to be beneficial.

Arch Tierernahr, 1990 Sep, 40(9), 871 - 83
{Occurrence of Fusarium strains and their mycotoxins on corn silage . 6 . Formation of zearalenone and trichothecenes (type A) by indigenous Fusarium isolates}; Lepom P et al.; A total of 399 indigenous Fusarium strains mainly isolated from silage maize were tested for the production of zearalenone and type A trichothecenes by thin-layer chromatography and biological assays . About 45% of the isolates examined were capable of producing different levels of zearalenone and trichothecene toxins on a cracked corn substrate . The majority of these strains (75%) produced zearalenone only and no trichothecenes type A . The results of the biological tests indicated a higher rate of toxin-positive extracts than chemical analysis . Isolates of nine out of seventeen Fusarium species examined produced one or several mycotoxins looked for . The most important toxin producers were F . culmorum and F . crookwellense (zearalenone) and F . sporotrichioides (trichothecenes type A), respectively . F . avenaceum, the species most frequently isolated from silage maize, produced neither zearalenone nor trichothecenes but avenacein Y a antibiotic compound . First results of a study of the production of type B trichothecenes have shown that indigenous F . culmorum isolates were capable of producing high levels of deoxynivalenol.

J Dent Assoc S Afr, 1990 Sep, 45(9), 397 - 400
Ludwig's angina: a case report and review; Dreyer AF et al.; A case of Ludwig's angina which developed after mandibular fractures in a 14-year-old male patient is reported . We emphasise the serious nature of this condition and the aggressive treatment it requires . It is important to recognise cases of Ludwig's angina at an early stage, as well as cases which are at risk of developing into true Ludwig's angina if treatment is delayed . Management should be aimed at maintaining an open airway by nasotracheal intubation or cricothyroidotomy, together with treatment of the infection by removal of the source, drainage of pus and parenteral antibiotic therapy . In addition, investigation and management of contributing medical conditions and timely specialist consultation are essential.

Int J Clin Pharmacol Ther Toxicol, 1990 Sep, 28(9), 361 - 8
Multiple-dose, double-blind, placebo controlled intravenous tolerance and pharmacokinetic study of trospectomycin sulfate (U-63, 366F) in healthy male volunteers; Peters GR et al.; Trospectomycin sulfate is a novel aminocyclitol antibiotic . This study evaluated the tolerance and the pharmacokinetics of multiple, intravenous doses of trospectomycin (TRO) in healthy male volunteers . Three groups of 10 volunteers were studied . Eight volunteers in each group were studied in a parallel design to receive trospectomycin (Group 1 = 250 mg, Group 2 = 500 mg, Group 3 = 750 mg) while 2 volunteers received placebo (normal saline) . Drug doses were administered in 30 ml volumes over 30 min every 8 h for 7 days (i.e . 21 total doses) . Evaluations of vital signs, side effects, and safety laboratory tests were made at regular intervals during the study . The most frequent medical events observed in the volunteers receiving trospectomycin were perioral/facial paresthesias (54%), pain at the i.v . infusion site (46%), dizziness/lightheadedness (58%), and GI symptoms (38%) . A statistically significant dose response relationship was observed for the incidence of perioral/facial paresthesias and pain at the i.v . infusion site (i.e., increased incidence with increased dose) . All the medical events were mild or moderate in severity and reversible following drug discontinuation . In the 500 and 750 mg trospectomycin groups, standing systolic blood pressure decreased significantly with the first dose of study drug . Elevated levels of SGPT were observed in 9 volunteers (1 in placebo, 3 in 250 mg, 1 in 500 mg, and 4 in 750 mg dose groups) . This study demonstrates that multiple intravenous trospectomycin doses up to 750 mg are reasonably well tolerated in healthy male volunteers . The concentration of trospectomycin in serum, measured with a sensitive HPLC assay, was less than 3 mcg/ml at 8 h postinfusion for all dose levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Biochem J, 1990 Sep 1, 270(2), 511 - 8
Environmentally induced differential amplification of mitochondrial populations; Tonsgard JH et al.; Resistance to the drug rutamycin, an inhibitor of mitochondrial ATPase, has been shown to be cytoplasmically inherited in a mouse fibroblast line (TL) on fusion of the cytoplast (enTL) with a nucleated recipient A9 {Lichtor & Getz (1978) Proc . Natl . Acad . Sci . U.S.A . 75, 324-328} . The cytoplasmic hybrid (cybrid) so formed may be readily grown in the presence {CY(+)} or absence {CY(-)} of rutamycin . The ATPase of TL mitochondria is similarly resistant to rutamycin whether grown in the presence or absence of antibiotic . The ATPase of CY(+) mitochondria is resistant to rutamycin, but CY(-) mitochondrial ATPase is sensitive to rutamycin . Nevertheless, CY(-) can be readily grown in rutamycin after a brief lag . The pH optima of mitochondrial ATPase are 8.0 for A9 and CY(-) cells and 7.5 for TL cells, whereas the pH optimum for CY(+) spans the optima of A9 and TL . The TL mitochondrial NADH-cytochrome c reductase is resistant to rotenone, whereas that of A9 mitochondria is sensitive to this agent . CY(-) and CY(+) mitochondria are sensitive and resistant respectively to rotenone . Growth of cybrids in rutamycin for 2 weeks results in a 2-3-fold increase in mitochondrial mass, measured on the basis of electron microscopic morphometry, mitochondrial membrane enzyme assays, mass of cardiolipin, and quantification of mitochondrial DNA . These data suggest that the cybrid harbours two populations of mitochondria and that the proportions of the two populations dramatically influence morphology, growth and mitochondrial phenotype in the cybrid . Selective pressure appears to induce these changes through the differential amplification of mitochondria.

Am J Obstet Gynecol, 1990 Sep, 163(3), 938 - 43
Placental transfer of cefazolin and piperacillin in pregnancies remote from term complicated by Rh isoimmunization; Brown CE et al.; Although the administration of prophylactic antibodies for intrauterine transfusion is controversial, little information is available regarding placental transfer of antibiotics administered to the mother, or whether the presence of hydrops affects this placental transfer . Sixteen intravascular intrauterine transfusions were performed in 10 patients . Seven (10 procedures) patients were given 2 gm of cefazolin before the procedure and samples were obtained by fetal vascular access . Three patients (six procedures) were given 4 gm of piperacillin and samples were similarly obtained . Specimens were obtained for fetal serum, maternal serum, and amniotic fluid antibiotic concentration . The mean serum cefazolin concentration in hydropic fetuses was 18.04 +/- 3.37 micrograms/ml, and in nonhydropic fetuses the concentration was 21.02 +/- 17.8 micrograms/ml (p = 0.72) . The mean fetal serum concentration of piperacillin was 22 +/- 12 micrograms/ml . The placental transfer of both drugs was similar . We conclude that the transplacental passage of these antibiotics is prompt and that the presence of hydrops does not significantly impair the passage of cefazolin.

Plant Mol Biol, 1990 Sep, 15(3), 407 - 20
Restoration of shooty morphology of a nontumorous mutant of Nicotiana glauca x N . langsdorffii by cytokinin and the isopentenyltransferase gene; Feng XH et al.; The shooty morphology of a nontumorous amphidiploid mutant of Nicotiana glauca Grah . x N . langsdorffii Weinm . was restored by cytokinins, whether exogenously applied or endogenously produced by transformation of the mutant with a transfer DNA (T-DNA) cytokinin-biosynthesis gene (isopentenyltransferase; ipt) . Auxins alone did not confer this effect . Similar transformation was not achieved for the parental species . In the case of transformation with the ipt gene, selection of the transformed tissues was based on its hormone-independent growth in the presence of the antibiotic kanamycin . Transformed tissues exhibited a shooty morphology, indistinguishable from that of wildtype genetic tumors N . glauca x N . langsdorffii . This altered phenotype was caused by the presence and constitutive expression of the ipt gene . The insertion and expression of this gene in transformed tissues was confirmed by using the polymerase chain reaction (PCR) technique as well as conventional molecular hybridization analysis . Expression of the ipt gene led to an elevated level of cytokinin in the transformed mutant tissues . This evidence supports the notion that genetic tumors are caused, at least in part, by elevated levels of cytokinin in interspecific hybrids.

Bol Asoc Med P R, 1990 Sep, 82(9), 419 - 22
Organophosphate poisoning; Rivera JA et al.; Organophosphate compounds insecticides are the most commonly associated with serious human toxicity . We reviewed the adult cases of organophosphate poisoning seen at HURRA from January 1986 to January 1990 . We had 14 cases, all male patients . The most common mode of exposure was by ingestion in a suicidal attempt, (8/14 cases) . The most common symptom observed was nausea (6/14 patients), and the most common sign was increased bronchial secretions (8/14 patients) . Laboratory abnormalities were similar to those previously reported in the literature: leukocytosis (10/14 cases), hyperglycemia (5/14 cases) and hypokalemia (4/14 cases) . Patients were treated following accepted guidelines . None of our patients developed seizures nor ventricular arrhythmias . One of our patients developed respiratory failure and required mechanical ventilation . Two patients developed pneumonic processes, requiring intravenous antibiotic therapy . The hospital stay of these two patients was prolonged (7 and 10 days respectively) . For the other 12 patients, the hospital stay ranged from 2 to 4 days . We had no mortality in our series . We were able to obtain follow-up interview by telephone with 10 of the 14 patients and we did not find any history of symptoms of delayed clinical toxicity.

Gene, 1990 Sep 1, 93(1), 79 - 84
Phosphate control of pabS gene transcription during candicidin biosynthesis; Asturias JA et al.; The pabS gene of Streptomyces griseus IMRU3570 encodes the enzyme p-aminobenzoic acid synthase, which synthesizes p-aminobenzoic acid (PABA), a precursor of the antibiotic candicidin (Cd) . The pabS transcript reached a peak at 12 h of incubation in batch cultures, preceding the formation of PABA synthase and the antibiotic itself . A decay of the pabS transcript was observed with an apparent half-life of 35 min . Inorganic phosphate (Pi; 7.5 mM) reduced the synthesis of the pabS transcript by 90-95%, and consequently the formation of PABA synthase and Cd . Thirty min after addition of 7.5 mM Pi, the cells synthesized only about 15% as much pabS transcript compared to control cultures . However, Pi stimulated two- to threefold total RNA synthesis . The 1.7-kb pabS transcript shown by Northern hybridization was greatly reduced in amount in cells grown in 7.5 mM phosphate . Pi-deregulated mutants, described previously, were impaired in the transcriptional control exerted by Pi . It is concluded that Pi control of PABA synthase and Cd biosynthesis is exerted by repression of formation of the pabS mRNA.

Gan To Kagaku Ryoho, 1990 Sep, 17(9), 1941 - 4
{A case of recurrent lung cancer complicated acute interstitial pneumonia, just after injected peplomycin}; Shimizu T et al.; A 77-year-old man with recurrent lung cancer was administered peplomycin (PEP) 15 mg 1A only one time, from a link in the chain of chemotherapy . But just after it was occurred dyspnea, and heard crepitus by auscultation . And it was recognized of ground glass appearance and air-bronchogram in the entire lung field by chest X-ray photograph, so made a diagnosis of acute diffuse interstitial pneumonia by clinical . He died two days after in spite of emergency treatment, that is high dose steroid, O2 flow etc . We discussed the acute pulmonary side effect of peplomycin which is one of the carcinostatic antibiotic, according to this clinical progress.

Ren Physiol Biochem, 1990 Sep-Oct, 13(5), 269 - 74
Calcium-dependent effect of gentamicin on glucose formation in isolated rabbit kidney-cortex tubules; Michalik M et al.; In contrast to the inhibition by gentamicin of glucose production from propionate, pyruvate and lactate in renal tubules incubated at 2.5 mM Ca2+, this antibiotic does not affect gluconeogenesis from propionate and lactate, and significantly stimulates this process from other substrates at 0.5 mM Ca2+ . This may be due to the gentamicin-induced increase of the cytosolic manganese content (from 1.7 to 2.7 nmol/mg protein), resulting in a stimulation of cytosolic phosphoenolpyruvate carboxykinase activity . At 2.5 mM Ca2+ the cytosolic Mn content (2.7 nmol/mg protein) seems to be high enough to accomplish activation of the enzyme.

J Ind Microbiol, 1990 Sep, 6(1), 43 - 8
Ammonium effects on streptonigrin biosynthesis by Streptomyces flocculus; Wallace KK et al.; A defined medium containing glucose and ammonium as the sole carbon and nitrogen sources was developed to support growth and streptonigrin production . In this defined medium, increased initial levels of ammonium resulted in increased growth suggesting that nitrogen is the growth limiting nutrient . In some cases, increased initial ammonium levels resulted in decreased specific streptonigrin productivity, suggesting that nitrogen regulatory mechanisms may adversely affect streptonigrin biosynthesis . This suggestion that nitrogen regulation adversely affects antibiotic biosynthesis is further supported by results from two studies in which the ammonium supply to the cells was controlled . In the first study, streptonigrin productivity and final titer were enhanced by the addition of an ammonium trapping agent . In the second experiment, when ammonium chloride was fed slowly throughout the course of cultivation, the production phase was lengthened and the maximum antibiotic concentration was enhanced compared to the batch controls containing either the same initial or the same total ammonium chloride levels . Although our results indicate streptonigrin production may be subject to nitrogen regulatory mechanisms, the effect of nitrogen on streptonigrin production cannot be strictly correlated to the extracellular ammonium concentration . In fact, we observed that when ammonium was depleted from the medium, streptonigrin production ceased.

Schweiz Med Wochenschr, 1990 Aug 25, 120(34), 1217 - 22
{Airport malaria: mini-epidemic in Switzerland}; Bouvier M et al.; Five cases of airport malaria were observed in Geneva in the summer of 1989 . All the patients lived within 2 km of Geneva-Cointrin International Airport . They were hospitalized between July 14 and August 2 for high fever . None had received a recent blood transfusion, an i.v . injection or traveled to a tropical country, except for one, a former pilot, whose last brief visit had been a year earlier . High minimum temperatures between July 6 and 10 in all likelihood allowed the survival of infected anopheles introduced by an aircraft . P . falciparum was identified in the blood smears of all the patients . Four had one or more symptoms of serious malaria and received intravenous treatment . In the fifth patient, treatment with cotrimoxazole for suspected acute pyelonephritis made diagnosis particularly difficult because the malaria infection was partially controlled by the antibiotic therapy . The time necessary for diagnosis of malaria varied from 5 to 31 days in the 5 cases . Airport malaria has been observed over the past twenty years in Europe, particularly in the summer, and is often serious because of late diagnosis and the type of plasmodium most frequently involved, P . falciparum . This diagnosis should be considered in patients with high fever of unknown origin, even when they have not travelled to an endemic zone.

J Chromatogr, 1990 Aug 3, 529(2), 265 - 75
Interfacing microbore and capillary liquid chromatography to continuous-flow fast atom bombardment mass spectrometry for the analysis of glycopeptides; Coutant JE et al.; This work describes a system to interface either microbore or packed capillary gradient liquid chromatography (LC) to fast atom bombardment mass spectrometry (FAB-MS) . The interface incorporates on-line ultraviolet detection and post-column matrix addition to enable independent optimization of both LC and FAB-MS . The glycopeptide antibiotic teicoplanin was chosen as a model system because this group of compounds places severe demands on the chromatographic separation and is difficult to analyze by FAB-MS . For both microbore and capillary LC, high-quality mass spectra of the major components in teicoplanin were obtained; however, the increased sensitivity of the capillary system allowed spectra to be obtained at low picomole concentrations . The sensitivity and ease of use make capillary LC the preferred system for use in LC-FAB-MS.

Neurosurgery, 1990 Aug, 27(2), 177 - 84
Spinal epidural abscess: a ten-year perspective; Hlavin ML et al.; A retrospective study of spinal epidural abscess spanning 10 years and encompassing 40 patients was done . Epidemiology, clinical features, laboratory findings, radiographic imaging, therapy, and outcome were examined and compared with previous series . An increasing incidence of the disease (up to 1.96 patients per 10,000 admissions per year) and an older, more debilitated population (67% having factors predisposing them to infection) were discovered . Over half of the population was studied with magnetic resonance imaging, which was found to be equally as sensitive (91%) as myelography with computed tomography (92%) . Magnetic resonance imaging offers the advantages of being noninvasive and able to delineate other entities, which makes it the imaging modality of choice . Preoperative paralysis and neurological deterioration from normal were identified as poor prognostic features . Of 7 patients with preoperative paralysis, 5 died, and the rest failed to recover neurological function . Eleven patients with initially normal neurological exams deteriorated in the hospital before surgical intervention . Eight of these patients were being treated with appropriate antibiotics; 2 became paralyzed despite more than 3 weeks of antibiotic therapy . Only 3 of these 11 patients recovered fully . Immediate surgical decompression combined with antibiotics remains the treatment of choice.

Arch Intern Med, 1990 Aug, 150(8), 1677 - 82
Ceftriaxone therapy of chronic inflammatory arthritis . A double-blind placebo controlled trial; Caperton EM et al.; To determine whether chronic inflammatory arthritis may respond to antibiotic therapy (implying a bacterial origin), we conducted a placebo-controlled, double-blind study . Sixty patients with inflammatory arthritis and antibody titers to Borrelia burgdorferi 1:64 or more were randomized to receive placebo (n = 20) or 2 g/d of ceftriaxone intravenously (n = 40) for 2 weeks . Two of 20 placebo- and 19 of 40 antibiotic-treated patients improved . At 1 month, the placebo-treated patients could elect to receive ceftriaxone . Altogether, 58 patients were treated with ceftriaxone and followed up for 13 to 24 months . Improvement was noted in 27 of the 58 antibiotic-treated patients . Patients with a wide diversity of inflammatory arthritis were studied . Response to ceftriaxone was seen in all groups, including 5 of 12 with rheumatoid arthritis, 5 of 8 with psoriatic arthritis, 3 of 5 with vasculitis, and 14 of 33 with less well-differentiated chronic inflammatory arthritis . In 16 of the 27 who responded to the antibiotic, the arthritis worsened 6 to 18 months after the initial response to ceftriaxone . Previous improvement of arthritis after oral antibiotic was a better predictor of response to ceftriaxone than either duration of disease or Lyme antibody titer . Side effects to ceftriaxone were frequent and included diarrhea (29/60) and acute allergic reactions (9/58) . We conclude that some patients may have an occult bacterial infection underlying their chronic inflammatory arthritis, and may respond to antibiotic therapy . The response to ceftriaxone in patients with even weakly reactive Lyme titers encourages further prospective placebo-controlled studies of antibiotics in various subsets of chronic arthritis.

J Bacteriol, 1990 Aug, 172(8), 4710 - 4
Cloning of a lincosamide resistance determinant from Streptomyces caelestis, the producer of celesticetin, and characterization of the resistance mechanism; Calcutt MJ et al.; Self-resistance has been investigated in Streptomyces caelestis (producer of the lincosamide antibiotic celesticetin), from which a lincosamide resistance determinant (clr) has been isolated on a 1-kilobase DNA fragment and cloned in Streptomyces lividans . The clr product is a specific methylase which produces a single residue of N6-monomethyladenine in 23S rRNA at position 2058, thereby rendering the 50S ribosmal subunit resistant to the action of lincosamides.

Arch Biochem Biophys, 1990 Aug 1, 280(2), 405 - 11
The effect of adriamycin and duramycin on calcium translocation in liposome systems modeled on the inner mitochondrial membrane; Kester MB et al.; Adriamycin (doxorubicin, AdM) is a potent antineoplastic agent which binds specifically and with high affinity to the acidic phospholipid cardiolipin (CL) {Goormaghtigh et al . (1980) Biochim . Biophys . Acta 597, 1} . Duramycin (DM), a polypeptide antibiotic, has been reported to interact selectively with phosphatidylethanolamine (PE) and monogalactosyldiacylglycerol {Navarro et al . (1985) Biochemistry 24, 4645} . The selectivity of DM-PE interaction was confirmed . AdM and DM were then used to explore the roles of CL and PE in Ca2+ translocation in a phosphatidylcholine (PC)/PE/CL liposome system modeled on the inner mitochondrial membrane with the following results: (i) AdM (100-400 microM) altered Ca2+ uptake by PC/PE/CL (4/4/1, mol/mol) liposomes in a concentration-dependent fashion which varied with temperature, external Ca2+ concentration, and liposome PE content . (ii) Addition of AdM was qualitatively equivalent to increasing temperature, Ca2+ concentration, or liposome PE content, and cooperative interactions among these parameters were observed . An increase in any one factor generally enhanced Ca2+ uptake; simultaneous increases in several factors inhibited uptake . (iii) Inhibition of Ca2+ uptake was correlated with efflux of Arsenazo III . (iv) Ca2+ uptake by PC/PE/CL liposomes is biphasic {Kester and Sokolove (1989) Biochim . Biophys . Acta 980, 127} . DM suppressed the PE-dependent slow phase and stimulated the PE-independent initial phase . Ca2+ uptake by PC/PE/CL liposomes in the presence of DM resembled uptake by PC/CL liposomes . These data confirm the ability of PE to enhance the slow, highly temperature-dependent component of CL-mediated Ca2+ translocation and suggest that this process is sensitive to lipid phase behavior.

Radiology, 1990 Aug, 176(2), 531 - 4
Occlusion of biliary endoprostheses: presentation and management; Lee MJ et al.; A retrospective review of 20 cases of endoprosthesis occlusion in 17 patients was performed . The average length of stent patency before occlusion was 3.7 months . Clinical manifestations included one or a combination of the following: cholangitis (n = 17), jaundice (n = 9), and leakage of bile or purulent material from the percutaneous insertion site (n = 6) . Eighteen of 20 episodes of endoprosthesis occlusion were successfully managed with normalization of biochemical parameters and alleviation of clinical manifestations . No therapy was attempted in two episodes of stent occlusion due to widespread metastatic disease . All 17 patients received intravenous fluid replacement and broad-spectrum antibiotic therapy . This was sufficient therapy to relieve symptoms in two cases of occlusion . Occluded stents were removed in the other 16 patients by means of radiologic (n = 10) or endoscopic (n = 6) methods . After the acute septic episode had subsided (2-5 days; mean, 3 days), new endoprostheses were percutaneously inserted in 10 cases of occlusion, long-term internal-external catheters were placed in five, and surgical bypass was performed in one . The authors conclude that endoprosthesis occlusion should not be considered a terminal event in patients with malignant biliary disease.

Chem Pharm Bull (Tokyo), 1990 Aug, 38(8), 2299 - 300
Isolation of cytotoxic substance, kalafungin from an alkalophilic actinomycete, Nocardiopsis dassonvillei subsp . prasina; Tsujibo H et al.; An alkalophilic actinomycete, strain OPC-553 regarded as Nocardiopsis dassonvillei subsp . prasina, produced the cytotoxic substance, TS-1, which showed a marked inhibitory activity against L5178Y mouse leukemic cell in vitro . The cytotoxicity of TS-1 on this cell was very strong and its ID50 was 0.018 micrograms/ml . Through direct comparison of its spectral data with those of an authentic sample, TS-1 was identified as the antifungal antibiotic, kalafungin, already isolated from the culture broth of Streptomyces tanashiensis . However, the isolation of kalafungin from an alkalophilic actinomycete and its cytotoxicity are reported for the first time in this paper.

Antibiot Khimioter, 1990 Aug, 35(8), 31 - 5
{Synthesis and biological activity of aminophenylphosphonic derivatives of levorin}; Belakhov VV et al.; Reactions of levorin, a polyenic macrolide antibiotic, with aromatic aldehydes and hypophosphorous acid resulted in formation of its amino phenylphosphonium derivatives . Physicochemical and biological properties of the derivatives were studied . The levorin amino phenylphosphonium derivatives were shown to be low toxic and have antifungal and antiviral activities.

Aust N Z J Ophthalmol, 1990 Aug, 18(3), 353 - 6
Subretinal fluid in the diagnosis of posterior scleritis; Tewari HK et al.; The etiology of subretinal mass lesions is very difficult to establish . A 28-year-old man presented to us with an area of choroiditis, which progressed, despite corticosteroid and antibiotic therapy, to an exudative retinal detachment, secondary glaucoma and a painful blind eye . To develop a means of identifying the cause of such lesions, we did a subretinal fluid tap prior to enucleation . Cytopathology showed only inflammatory cells and the final histopathological diagnosis was that of a granulomatous scleritis.

J Pediatr Psychol, 1990 Aug, 15(4), 459 - 75
Adherence issues in pediatric bone marrow transplantation; Phipps S et al.; The procedure of bone marrow transplantation entails a prolonged, aversive regimen in which adherence problems often develop, particularly with administration of oral antibiotic medications . A retrospective chart review revealed that 52% of pediatric patients evidenced significant adherence problems during the procedure . The highest rates of noncompliance were found in preschool and school-age children, with a surprisingly lower frequency in adolescents . Case summaries are presented to illustrate significant clinical issues and intervention strategies . These are discussed in terms of both their practical and theoretical significance regarding the determinants of adherence behavior.

Bol Med Hosp Infant Mex, 1990 Aug, 47(8), 589 - 92
{Spinal epidural abscess . Diagnosis of a case using nuclear magnetic resonance}; Zamora-Chavez A et al.; This is a case study of a six year old boy with a previous history of a contuse trauma of the cervical spinal region who later developed fever, stiffening of the neck, and signs of spinal compression . A descending myelography detected a lesion at C4 . The Nuclear Magnetic Resonance study of the area showed an anterior epidural mass extending from C5 to T1 which displaced the spinal cord . Surgery revealed an epidural abscess which was drained . The patient received parenteral antibiotic therapy.

Singapore Med J, 1990 Aug, 31(4), 341 - 4
Orbital complications of acute sinusitis; Elango S et al.; Orbital complications of sinusitis may occur either by spread along the venous system or by direct extension of infection between contiguous structures . The association between sinusitis and inflammation of the orbits has been known for centuries . But in the post antibiotic era there is a marked decline in the number of case reports in the literature . This paper presents 10 cases of sinusitis who had orbital complications . The classification of this disease complex as given by Chandler helps in planning the treatment . Groups I and II respond very well to antibiotics but in groups III, IV, V surgical intervention is necessary . Early identification and aggressive therapy reduces the morbidity of this disease.

Planta Med, 1990 Aug, 56(4), 392 - 4
{Triterpenoid sapogenins in the genus Grindelia}; Kreutzer S et al.; A saponin fraction has been isolated from the ethanolic extract of Grindeliae herba . The saponin fraction showed strong haemolytic activity . The saponins were detected after separation on TLC by their color reactions and Rf values as well as by their haemolytic activity on blood agar . After hydrolysis, the chemical reactions and Rf values of the sapogenins were described . The main sapogenin was isolated by preparative chromatography and its structure was elucidated by mass, 1H-NMR, 13C-NMR, IR, and UV spectra . The compound is a new natural triterpenoid sapogenin lactone and is named grindeliasapogenin D . Spectral evidence is presented to establish its structure as 2 beta,3 beta,16 alpha,23-tetrahydroxyoleanan-28,13 beta-olide . Two further sapogenins present in small amounts were identified chromatographically as oleanolic acid and bayogenin using authentic reference substances . The aerial parts of Grindelia robusta Nutt, and G . lanceolata Nutt . (Asteraceae) (as well as two commercial extracts) were also investigated with respect to their saponin fraction . The 3 sapogenins mentioned above were detected in all samples . The antibiotic potency of the crude drug is not associated with the saponin fraction but is at least partially due to the resin fraction.

J Pharm Sci, 1990 Aug, 79(8), 732 - 40
Stability and kinetics of degradation of imipenem in aqueous solution; Smith GB et al.; In weakly acidic solution, the broad-spectrum antibiotic imipenem undergoes complex oligomerization initiated by intermolecular carboxyl group attack on the beta-lactam group . In weakly alkaline solution, intermolecular reaction between the beta-lactam and formimidoyl groups occurs instead . Both beta-lactam and formimidoyl groups also hydrolyze at pH-dependent rates . Complex decomposition schemes were determined in kinetic studies at pH 4.0 and 9.0-9.5 using HPLC and mathematical models . The rates of the several initial reactions, calculated as functions of pH and imipenem concentration by fitting the models to kinetic data, fully account for imipenem decomposition rates throughout the neutral pH range.

J Chemother, 1990 Aug, 2(4), 247 - 51
Imipenem/cilastatin treatment of acute infections in AIDS/ARC patients; Giacometti A et al.; We studied the clinical efficacy and safety of imipenem, a broad spectrum beta-lactam antibiotic, in acute bacterial infections in 21 patients with AIDS or AIDS-related complex (ARC) . Imipenem/cilastatin was administered as a 30-min intravenous infusion using a dose of 500 mg/8 h . Bacterial pathogens were isolated before treatment in 80% of cases; 87.5% of all strains were susceptible to imipenem in vitro . Treatment resulted in rapid control of the infections in 80% of patients . Clinical and laboratory adverse reactions probably related to imipenem treatment were noted in 8 patients.

J Bioenerg Biomembr, 1990 Aug, 22(4), 493 - 507
Transport systems encoded by bacterial plasmids; Tisa LS et al.; A variety of bacterial functions are encoded on plasmids, extrachromosomal elements . Examples of plasmid-borne functions are antibiotic production and resistance, degradation of recalcitrant chemicals, virulence factors, and plant symbiotic properties . Several transport systems with diverse functions have recently been found to be carried on plasmids . These systems serve to either accumulate or extrude a compound from a cell . The focus of this review is to present a survey on several of these novel plasmid-borne transport systems emphasizing functions, components, and molecular genetics.

FEMS Microbiol Lett, 1990 Aug, 58(3), 279 - 83
Factors and markers of virulence in Escherichia coli from human septicemia; Cherifi A et al.; One hundred Escherichia coli isolates from human septicemia were characterized with respect to O serogroups 1, 2, 4, 6, 7, 8, 15, 18, 75 and 78, alpha-hemolysin, carboxylesterase B typing, cytotoxic necrotizing factor, F165 and CS31A fimbrial antigens, aerobactin production, colicins, and antibiotic sensitivity . A factorial analysis of correspondence and chi 2 tests indicated that most of E . coli isolates belonging to the studied O serogroups were positive for the virulence factors or markers alpha-haemolysin, carboxylesterase B2 type, cytotoxic necrotizing factor, F165 fimbrial antigen and were antibiotic-sensitive (Group I) . These characteristics differentiated them from E . coli isolates from other O serogroups which were generally antibiotic resistant and negative for the cited virulence factors and markers (Group II) . Aerobactin and colicin production did not differentiate the two E . coli groups . E . coli O serogroups 4 and 6 were highly represented in group I and were responsible for most of the differences between the two groups.

Eur J Pediatr, 1990 Aug, 149(11), 742 - 51
Cystic fibrosis, pathophysiological and clinical aspects; Neijens HJ et al.; Cystic fibrosis is a lethal, hereditary, until recently little understood disease, which leads to progressive functional disturbances in various organs, including the lungs, liver and pancreas . Knowledge of the genetic and cellular abnormalities is rapidly progressing, but therapy is still symptomatic and based on insufficiently controlled and short-term studies . At present the therapeutic approach aims to combat respiratory infections by optimal antibiotic therapy, combined with techniques to promote sputum evacuation . Additional measures attempt to optimise both nutritional state and physical condition . Median survival has improved from approximately 1 year to about 25 years during the past 3 decades . This article summarises present information on disease mechanisms and treatment.

Clin Otolaryngol, 1990 Aug, 15(4), 363 - 6
Chest infection following head and neck surgery: a pilot study; Morton RP et al.; This paper reports the results of a pilot study which examined factors associated with chest infection following head and neck surgery . The overall rate of chest infection was 11%, but was 20% in those patients having a tracheotomy . No infection developed in patients with an intact airway . Other factors which emerged as possibly important were the duration of surgery and heavy regular alcohol intake . We recommend that prophylactic antibiotics be continued for at least 48 h in patients requiring a tracheotomy as part of their head and neck surgery . This is against the trend of shorter antibiotic regimens recommended for prevention of wound infections.

Antimicrob Agents Chemother, 1990 Aug, 34(8), 1584 - 9
Enhanced action of amphotericin B on Leishmania mexicana resulting from heat transformation; Ramos H et al.; A comparative study of the effect of the polyene antibiotic amphotericin B (AmB) on the viability of Leishmania mexicana promastigotes before and after their transformation by heat into amastigotelike forms was carried out . The kinetics of cell death were followed by spectrofluorometry with the nucleic acid-binding compound ethidium bromide . It was found that the rapid killing effect that is exerted by AmB on Leishmania promastigotes was even faster after their transformation into amastigotelike forms . Binding studies of AmB to Leishmania membranes by circular dichroism indicated that heat transformation modified it from noncooperative to cooperative binding, decreasing the amount of antibiotic that bound to the membranes . Thus, the increased rate of ethidium bromide incorporation into transformed cells was not related either to the amount of AmB bound or to an increased amount of ergosterol in the membrane (the ergosterol/phospholipid ratio was four times smaller after heat shock) . An increase in the Mg2+ content of the external aqueous solution was able to prevent the AmB-induced incorporation of ethidium bromide into Leishmania promastigotes to a greater extent (Ki = 13.8 mM) than it was into heat-transformed cells (Ki = 64 mM), suggesting that there were significant changes at the Leishmania cell surface on heat transformation . The significance of these results for understanding the mechanism of action of AmB on sensitive organisms is discussed.

Antimicrob Agents Chemother, 1990 Aug, 34(8), 1535 - 41
Branched-chain fatty acids produced by mutants of Streptomyces fradiae, putative precursors of the lactone ring of tylosin; Huber ML et al.; Three branched-chain fatty acids (7-hydroxy-4,6-dimethylnona-2,4-dienoic acid {compound 1}, its 7-epimer {compound 2}, and 7-keto-4,6-dimethylnona-2,4-dienoic acid {compound 3}) and a ketone (9-hydroxy-6,8-dimethylundeca-4,6-dien-3-one {compound 4}) were isolated from the culture broth of mutants of Streptomyces fradiae which were blocked in the biosynthesis of the macrolide antibiotic tylosin . Two phenotypic classes of mutants of this organism which were blocked in the addition of mycaminose to tylactone (compound 6) accumulated these compounds . These compounds were not produced by mutants which were blocked in lactone synthesis, in steps beyond mycaminose addition, or by the wild-type strain . Synthesis of these compounds, like synthesis of tylosin, was inhibited by the addition of cerulenin . Compounds 1, 2, and 3 were partially interconvertible by these mutants; but they were not produced from the degradation of tylactone and they were not directly incorporated into tylosin by intact cells . The structures of compounds 1 and 2 were equivalent to that of a predicted intermediate (S . Yue, J . S . Duncan, Y . Yamamoto, and C . R . Hutchinson, J . Am . Chem . Soc . 109:1253-1255, 1987) in the biosynthesis of tylactone . The ketone (compound 4) reported previously (N . D . Jones, M . O . Chaney, H . A . Kirst, G . M . Wild, R . H . Baltz, R . L . Hamill, and J . W . Paschal, J . Antibiot . 35:420-425, 1982) appears to be the decarboxylation product of the intermediate following that represented by compound 1 . This represents the first report of the isolation of putative precursors of tylactone from tylosin-producing organisms.

Neth J Surg, 1990 Aug, 42(4), 105 - 9
Early complications after surgery for Crohn's disease; Simi M et al.; A group of 212 patients operated upon for Crohn's disease were studied and the early postoperative complications with related problems were assessed . The morbidity was 28.3 per cent, 60 patients had at least one complication, mainly of septic nature . The mortality was 3.3 per cent (7 patients), sepsis and deep vein thrombosis with pulmonary embolism were the most common causes of death . Postoperative complications were significantly higher (39.7%) (p less than 0.001) in patients with a pre-operative nutritional deficit and in those who had urgent surgery (44.4%) (p less than 0.001) . Among patients with pre-operative sepsis, the morbidity was also higher (34.6%), but was not significant . Peri-anastomotic complications (dehiscence, abscess, fistula, bleeding) were apparently more frequent (45.4%) in patients with histological residual Crohn's disease at macroscopically free resection margins although this contrasts with previous series . A proper pre-operative diagnostic approach, adequate peri-operative protein-caloric repletion, antibiotic therapy, prevention of thromboembolism and elective surgery, are still the primary tools in reducing the morbidity and mortality after surgery for Crohn's disease.

Int J Pediatr Otorhinolaryngol, 1990 Aug, 19(3), 277 - 83
Immediate correction of congenital nasal deformities; follow-up of 8 years; Sorri M et al.; A total of 4724 newborns was screened for congenital nasal deformities . Altogether 91 (1.9%) pathological, screening-positive cases were found . Because of refusal to participate, 3 pathological cases were lost leaving 88 cases . The first 55 screening positive newborns were left without treatment while an attempt was made by an otolaryngologist to correct the remaining 33 cases within a week from delivery . Eighty-two newborns of those who passed the screening tests were analyzed as a control group . In 1987, at the age of 8 years the case and control children were interviewed by mailed questionnaire and invited to be re-examined by an ENT-surgeon . Forty-seven of the not corrected, 21 of the corrected cases and 61 controls came to the re-examination . The luxated septal cauda tended to be straight both spontaneously as well as after active treatment . The few mid-septal pathologies (vomerine junction) in the corrected group were resistant to the treatment attempted . The mid-septal deformities found in the follow-up were connected with frequent antibiotic prescriptions but not respiratory infections . No increase in frequency of otitis media or sinusitis was noticed . The immediate treatment of nasal deformities did not significantly affect the clinical status of the nose at the follow-up . Thus the benefit of immediate treatment on nasal deformities in newborns and screening to find them remains questionable.

Cancer Res, 1990 Aug 1, 50(15), 4515 - 21
Thermal response of oncogene-transfected rat cells; Li GC et al.; Rat embryo cells or Rat-1 fibroblasts were transfected with either an activated c-myc or a c-Ha-ras from the T24/EJ bladder carcinoma, or they were cotransfected with both . A gene conferring neomycin or hygromycin resistance was also cotransfected so that independent cell lines could be selected by growth in medium containing the antibiotic . Certain isolates from cells transfected with only one type of oncogene were further transformed by exposure to 600 cGy of 250-kVp X-rays . Successful transfection and transformation were characterized by altered morphology, increased plating efficiency, shorter doubling time, longer life span, foci formation, anchorage-independent growth, and Southern and Northern hybridization analysis . The thermal response of these cells at different stages of oncogenic transformation was examined by exposing exponentially growing cells to 45 degrees C for 0 to 45 min and measuring cellular survivals using colony formation assay . We found that cells transfected with myc oncogene, singly or in combination with ras, were more sensitive to thermal stress . Aside from that, the cells' thermal sensitivity was not affected by the degree or the nature of transformation.

Virology, 1990 Aug, 177(2), 427 - 36
Immortalization of primary rat embryo cells by human papillomavirus type 11 DNA is enhanced upon cotransfer of ras; Cerni C et al.; Transfer of human papillomavirus type 11 (HPV11) DNA and a neo(r) marker into primary rat embryo cells (REC) led to colony formation in G418-selective medium . About 20% of HPV11 clones were eventually established in culture but displayed low growth rates . Cotransfection of HPV11 DNA and an activated ras oncogene led to formation of both drug-resistant flat colonies and phenotypically transformed clones which grew efficiently when expanded in culture . A number of transformants reverted to a flat, "normal" morphology shortly after isolation . Nontransformed clones expressed only HPV11 genes, while those maintaining a transformed phenotype transcribed both ras and HPV11 genes efficiently and were highly tumorigenic . Expression of HPV11 thus seems, necessary for induction of colony formation, but efficient long-term growth seems to require at least the transient presence of ras.

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