Clin Ther, 1990, 12 Suppl B, 2 - 8 New approaches to serious infections in the surgical patient; Geelhoed GW; The primary treatment of serious surgical infections involves a surgical procedure--debridement, drainage, or diversion--coupled with the adjunctive use of antibiotic therapy . Antibiotics are administered as prophylaxis, as presumptive therapy, or as precise therapy . Prophylactic antibiotics must be nontoxic, inexpensive, and have a broad spectrum of activity . It is also important that they not interfere with the primary treatment or the host defense . Antibiotics for presumptive therapy must be active against a wide range of presumed pathogens, but they are chosen primarily for their efficacy and secondarily for their lack of toxic and immunosuppressive effects . Because surgical infections are polymicrobial, standard therapy has consisted of a combination of antibiotics; monotherapy with an agent that is less toxic but as effective as combination therapy is a promising new approach to treatment. Rev Alerg Mex, 1990 Jan-Feb, 37(1), 23 - 6 {Allergic conjunctivitis . Treatment and course}; Machado Pinto C et al.; A group of 74 patients with allergic conjunctivitis from the out patient service of allergy of the Hospital Pediatrico Provincial Docente Jose Luis Miranda, in Santa Clara, were studied . In this study are stressed the importance of the search for etiologic agents influencing the disease and the used diagnostic methods . Finally, the used treatments are pointed out . The most frequent were the strepto-staphylo-gamma vaccines, preventive measures, antibiotic drops, environmental measures and sodium cromoglycate drops . Treatment was dynamic, individual and associated with the ophthalmology and pediatric allergy specialties. Auris Nasus Larynx, 1990, 16(4), 223 - 6 Caldwell-Luc operation without facial swelling; Pradhan KA et al.; Postoperative facial swelling remains the most common complication of Caldwell-Luc operation . Over a period of 5 years 128 Caldwell-Luc operations were performed on 76 patients . We have been able to reduce the incidence of postoperative facial swelling to only 5% of all cases, by using a wide sublabial incision, gentle tissue retraction, and avoidance of antibiotic soaked pack after completion of surgery . In none of the cases post operative bleeding was severe enough to warrant antral packing . Only one case required packing 6 h after completion of surgery . This method reduces morbidity of the operation significantly, cuts short the hospital stay and hence a much better patient compliance is achieved. Eur Biophys J, 1990, 18(3), 159 - 64 Influence of net charge on the aggregation and solubility behaviour of amphotericin B and its derivatives in aqueous media; Mazerski J et al.; The poor solubility of polyene antibiotics in aqueous media limits their application in the therapy of systemic fungal infections . In the present paper we have demonstrated that the ionic state (net electrical charge) of the antibiotic molecule is an important factor in determining the aggregation and solubility properties of amphotericin B and its derivatives . A multi-step model of polyene self-association in aqueous media has been proposed as an explanation for the fact that some major differences are observed when aggregation is monitored by different techniques. Heart Vessels, 1990, 5(2), 102 - 6 Homograft valve durability: host or donor influence? Gonzalez-Lavin L, Spotnitz AJ, Mackenzie JW, Gu J, Gadi IK, Gullo J, Boyd C, Graf D. Antibiotic sterilized valves have been shown to function longer than those chemically sterilized; however, the reason remains obscure . Current hypotheses cite either retention of donor fibroblasts capable of repairing the grafted valve, or host fibroblast ingrowth into and onto the leaflet ground substance . A cryopreserved aortic homograft from a male donor was explanted from a female recipient after 10 months, and subjected to immunocytochemistry, tissue culture, and karyotyping . The leaflet bases exhibited normal morphology with an intact endothelium . The distal one-third of the leaflets was devoid of fibroblasts from the leaflet bases showed them to be of host origin . This homograft seems to have been implanted with an intact ground substance which allowed for host cell repopulation of the inner one-third of the leaflets . Perhaps donor cell viability in itself is not as important to durability as is preservation of the leaflet ground substance, but rather the presence of viable cells may be an index of the structural integrity of the collagen and elastic matrix. Pediatr Radiol, 1990, 20(3), 175 - 8 MRI of disc space infection in infants and children . Report of 12 cases; du Lac P et al.; The MR aspects of spondylodiscitis in pediatric patients were studied with a 0.5-Tesla supraconductive magnet: 12 patients were divided in two groups; acute disease (9) and period of sequelae (3) . The first group was divided into two subgroups according to the age and the clinical findings: infants (2) and children (7) . In infants, MR gave good visualization of the destruction of vertebrae and discs . Presuppurative abscesses appeared as light signals, their extent and position relative to the cord being clearly visualized in frontal and sagittal planes in T1-weighted images . In older children, there were a low vertebral signal and disappearance of the disc-vertebra borders on T1-weighted images and a high vertebral signal with a decreased and flattened disc signal on T2-weighted images . Frontal and sagittal planes were used . During the first month of antibiotic therapy, the follow-up scans showed no changes, and even disclosed a spread of the abnormal signal in the vertebral body . At the stage of sequelae, on T1 the spinal signal was normal with a decreased disc width and on T2 the disc signal was low while the vertebrae appeared normal. J Emerg Med, 1990 Jan-Feb, 8(1), 55 - 8 An atypical presentation of the Fitz-Hugh-Curtis syndrome; McCormick M et al.; We present an unusual case of the Fitz-Hugh-Curtis syndrome as manifested in a young woman with right upper quadrant pain . The presentation was atypical and misleading because of the presence of a colonic ileus and the lack of salpingitis by pelvic exam . Diagnosis was made by exclusion of other abdominal disease processes, the detection of Chlamydia trachomatis antibody from a cervical specimen, and a dramatic response to appropriate antibiotic therapy. Jpn J Antibiot, 1990 Jan, 43(1), 111 - 5 {Clinical studies of ceftibuten in the field of obstetrics and gynecology}; Doko F; Clinical studies on ceftibuten (CETB, 7432-S) were carried out in the field of obstetrics and gynecology . A total of 6 patients comprising 1 case of endometritis, 3 of bartholin's abscess, 1 of adnexitis and 1 of vulvar abscess was given 200-300 mg of CETB divided into 2 or 3 equal oral doses daily for 5 days . The clinical efficacy rate was 83 percent . Neither adverse reactions nor abnormal laboratory values were observed in any of the cases . From the results, it was concluded that CETB was an useful antibiotic in the field of obstetrics and gynecology. Mol Carcinog, 1990, 3(2), 54 - 67 Infection of rat liver epithelial cells with v-Ha-ras: correlation between oncogene expression, gap junctional communication, and tumorigenicity; De Feijter AW et al.; The role of v-Ha-ras oncogene in tumorigenesis in an in vitro/in vivo model system was studied by investigating the expression of the Ha-ras gene, gap junctional intercellular communication, and tumorigenicity as endpoints . Infection of a Fischer 344 rat liver epithelial cell line (WB 344) with a retrovirus containing the v-Ha-ras oncogene resulted in altered cell morphology and decreased contact sensitivity . Gap junctional intercellular communication in v-Ha-ras infected WB cells (WBHa-ras), assessed by fluorescence redistribution after photobleaching (FRAP), microinjection/dye transfer, and scrape-loading/dye transfer techniques, was markedly decreased compared with the level in control WB cells . Injection of 10(7) WBHa-ras cells into the portal vein of male F344 rats caused multiple focal hepatic lesions within 1 and 2 wk, merging to large invading tumors after 3 and 4 wk . Examination of the methylation pattern of the Ha-ras gene in WBHa-ras and control WB cells showed that the infected Ha-ras gene was relatively hypomethylated in comparison to the normal cellular Ha-ras gene, indicating a greater potential for expression . There was an increased level of Ha-ras mRNA in hepatomas as compared with both adjacent nontumor liver tissue and liver tissue obtained from normal animals . Three cell lines derived from three different primary hepatic tumors induced by an injection of WBHa-ras cells in a F344 rat displayed similar growth characteristics, levels of gap junctional communication, and methylation patterns as the original WBHa-ras cells . The results of these studies have established a strong positive correlation between expression of the Ha-ras oncogene, reduced gap junctional intercellular communication, decreased contact sensitivity, and tumorigenicity of the v-Ha-ras-infected rat liver epithelial cells. Eksp Onkol, 1990, 12(3), 61 - 2 {Role of intracellular pH in the development of resistance of leukemic cells to antineoplastic drugs}; Shestova OL et al.; Intracellular pH (pHi) of mouse lymphoid leukemia P388 cells was measured at the wavelength of 518 and 570 nm of fluorescein: pHi of rubomycin-sensitive P388 cells was higher than pHi of the cells resistant to this antitumour antibiotic (6.98 +/- 0.04 and 6.63 +/- 0.03, respectively, P less than 0.001) . The role of pHi is established during induction of the resistance of tumour cells to the antitumour drugs. Vestn Dermatol Venerol, 1990, (2), 67 - 8 {The prevention of pathospermia in patients with orchiepididymitis}; Glozman VN et al.; Spermatopathy persisting for a long time after therapy was detected in 48-60 per cent of the patients with gonorrheal orchiepididymitis . Intramuscular chymotrypsin, a proteolytic enzyme, in a dose of 2 mg twice daily (every 12 hrs) for 6-10 days, combined with an antibiotic, essentially (to 14.3-16.6 per cent) reduced the incidence rate of spermatogenesis disorders and alleviated the severity of these disorders vs . the patients treated with conventional therapy. Padiatr Grenzgeb, 1990, 29(1), 13 - 7 {Meningitis and hearing damage in children}; Hellmund S et al.; 1 . Meningitis is a noteworthy cause of postnatal sensorineutral hearing disorders in children . 2 . A monaural or binaural sensorineutral hearing disorder previously not noted was found in nine of fifty children with completely cured meningitis . 3 . The influence of various clinical factors (age and sex of child; type of pathogen; time from occurrence of initial symptoms until admission to hospital; time of commencement of therapy; period of temperature and period of hospitalization; neurologic complications, and type of antibiotic therapy) on the audition was studied . A cerebral predisposition elevated by meningitis was found to enhance the risk of contracting a hearing disorder . 4 . Damage to the hearing organ was attributed to meningitis rather than to gentamicin frequently used for therapy, as monoaural hearing disorders prevailed . 5 . The high incidence rate of hearing disorders of unknown origin justifies the demand that children with meningitis be referred to otological diagnosis immediately after discharge from hospital even if their audition is apparently normal . 6 . Feasible today, electrophysiological diagnosis provides unambiguous information on the function of the hearing organ. Klin Khir, 1990, (2), 31 - 2 {Prevention of postoperative suppurative complications in patients with inflammatory diseases of the large intestine}; Bashankaev NA et al.; The results of surgical treatment of 103 patients with inflammatory diseases of the colon were analysed . An unfavourable outcome was noted in presence before the operation of the disease complications, and deep metabolic disorders as well . A decrease in the level of serum albumins and hematocrit, increase in the leukocytic count and seromucoid level were prognostically informative . The use of endolymphatic antibiotic therapy in 66 patients operated on with increased risk for the development of complications permitted to reduce lethality after elective operations from 10% (in using the conventional methods of treatment) to 3.3%, after emergency operations--from 75 to 33.3%, respectively . The incidence of postoperative purulent complications has reduced significantly. Farmaco, 1990 Jan, 45(1), 131 - 5 Bile rifaximin concentration after oral administration in patients undergoing cholecystectomy; Verardi S et al.; Rifaximin, a new antibiotic derived from rifamycin SV, was measured in the cholecystic bile of 13 patients submitted to cholecystectomy, after oral administration of 1600 mg of the drug in the 48 hour preceding surgery . Rifaximin concentrations were quantified only in 6 patients and were at least five times lower than those detected with rifampicin, under similar experimental conditions . Results seem to indicate that rifaximin is virtually not absorbed through the intestinal mucosa after oral administration. Antibiot Khimioter, 1990 Jan, 35(1), 8 - 11 {Electrophoretic separation of spores of producers of kanamycin and tylosin}; Miliavskii EB et al.; The stages of spore development, the most favourable for electrophoretic separation of the spores, were studied in the cultures producing kanamycin and tylosin . The stage of sporulating was shown to be the optimal . The step-by-step procedure for preparing the spores for electrophoresis is described . There were observed distinctions in the fatty acid spectrum of the cells in the cultures grown from electrophoretic fractions of the spores with different antibiotic production capacity. Antibiot Khimioter, 1990 Jan, 35(1), 5 - 8 {Phosphate regulation of the processes of growth and biosynthesis of gentamicin in Micromonospora purpurea var . violaceae}; Abrasimovskii PI et al.; The influence of orthophosphate on isogenic strains of the gentamicin-producing organism with various levels of the antibiotic production was studied . An increase in the content of inorganic phosphate in the medium led to inhibition of the growth and gentamicin biosynthesis in all the strains: the low-active strains were more stable to the effect of the phosphate as compared to the highly active strains . Heterogeneity of the population of the strains was shown in respect of decreasing the growth rate and the level of the antibiotic biosynthesis inhibition in the presence of orthophosphate . Among the phosphate low-controllable forms there was a high number of low-active variants while among the clones with retarded growth and decreased production of the antibiotic there was a high number of productive variants . Inverse relationship between the antibiotic production level and the level of lability to the effect of inorganic phosphate was observed in the mutants of the gentamicin-producing organism. Antibiot Khimioter, 1990 Jan, 35(1), 30 - 2 {Early and late effects of the cytogenetic action of doxorubicin}; Klimova MIu et al.; Cytogenetic disorders in hemopoietic cells of the bone marrow were studied on mice CBA at early and late periods after exposure to MIDs of doxorubicin, an anthracycline antibiotic . It was shown that at the early period doxorubicin induced aberrations, mainly of the chromatid type, in the hemopoietic cells of the bone marrow . Instability of the genetic apparatus of the hemopoietic cells observed for 3 months of the experiment was likely to be the immediate cause of the disorders in hemopoiesis at the late periods after exposure to doxorubicin. Antimicrob Agents Chemother, 1990 Jan, 34(1), 128 - 33 Effect of concomitant administration of piperacillin on the dispositions of netilmicin and tobramycin in patients with end-stage renal disease; Halstenson CE et al.; The effect of piperacillin administration on the dispositions of netilmicin and tobramycin was assessed in 12 chronic hemodialysis patients . Six subjects each received netilmicin (2 mg/kg) or tobramycin (2 mg/kg) alone and in combination with piperacillin (4 g every 12 h for four doses) . Subjects also received a single dose of piperacillin (4 g) on a separate occasion . The serum concentration-versus-time profiles of netilmicin and tobramycin were biexponential . The terminal elimination half-life (t1/2 beta) of tobramycin was markedly reduced (59.62 +/- 25.18 {mean +/- standard deviation} versus 24.71 +/- 5.41 h) and total body clearance (CLP) was significantly increased in the presence of piperacillin (3.45 +/- 1.61 versus 7.16 +/- 1.64 ml/min) . In contrast, the t1/2 beta (41.80 +/- 13.24 versus 40.07 +/- 10.37 h) and CLP (5.11 +/- 2.15 versus 5.55 +/- 2.32 ml/min) of netilmicin were not significantly altered when netilmicin was administered in combination with piperacillin . No change in the central or steady-state volume of distribution of netilmicin or tobramycin was observed . The disposition of piperacillin in hemodialysis patients was not altered in the presence of either aminoglycoside antibiotic . Although no adjustment in netilmicin dosing is required, tobramycin should be administered more frequently when given concomitantly with piperacillin to hemodialysis patients to avoid prolonged periods of subtherapeutic concentrations. Res Commun Chem Pathol Pharmacol, 1990 Jan, 67(1), 17 - 30 Hemodynamic effects of a potassium ionophore, lonomycin A; Kaneko K et al.; Lonomycin A, an ionophorous antibiotic, exhibits a high transport rate for monovalent cations, especially potassium . The cardiovascular actions of lonomycin A were studied in anesthetized dogs . Lonomycin A administered intravenously at 30 micrograms/kg increased coronary blood flow slightly with relatively small alterations in other hemodynamic parameters . After 100 micrograms/kg, a slight and transient fall followed by an increase in blood pressure was observed . Coronary blood flow, cardiac output, left ventricular pressure, max dP/dt, and isometric ventricular segmental tension increased . Arterial venous O2 difference and total peripheral vescular resistance decreased . Above 300 micrograms/kg, dramatic alterations were produced in almost all hemodynamic parameters, and total peripheral vascular resistance was increased . Lonomycin A-induced positive inotropic action was partly inhibited by pretreatment with pindolol, however gradual shortening of the ventricular wall length was still observed . A positive chronotropic action induced by lonomycin A was inhibited by pindolol pretreatment in vivo . On the other hand, lonomycin A elicited a negative chronotropic effects in the isolated guinea-pig right atrium, concomitantly increasing resting tension . These results suggest that lonomycin A alone produces peripheral vascular dilation and effects cardiac functions, which are in turn modified by lonomycin A-induced cathecholamine release from nerve terminals. Int J Pediatr Otorhinolaryngol, 1990 Jan, 18(3), 257 - 62 A case of facial diplegia associated with acute bilateral otitis media; Edmond CV Jr et al.; A 32-month-old toddler developed facial diplegia in association with a bout of acute bilateral otitis media . After 28 days of antibiotic therapy and placement of tympanostomy tubes, the patient demonstrated 100% symmetrical recovery . A brief discussion of the pathophysiology is included. Arch Orthop Trauma Surg, 1990, 109(2), 94 - 6 Treatment of an old infection in a total hip replacement with an interim spacer prosthesis; Zilkens KW et al.; When treating a septic hip-joint prosthesis with bone loss of the proximal femur secondary to osteomyelitis, we implanted a specially designed prosthesis to act as a local antibiotic and spacer between the acetabulum and femur until the infection abated . Arthroplasty could then be carried out with no trouble and there was no recurrence of infection. Minerva Med, 1990 Jan-Feb, 81(1-2), 107 - 9 {Induced pemphigus and brucellosis}; Foti G et al.; A case of induced pemphigus occurring in a patient affected with a brucellosis is reported with emphasis on the definitive remission of the pemphigus after antibiotic therapy against brucellosis and in the absence of corticosteroid treatment . Attention is also drawn to a possible autoimmune mechanism of the pemphigus triggered by brucellosis. J Ophthalmic Nurs Technol, 1990 Jan-Feb, 9(1), 22 - 6 Diagnosis and treatment of chronic postoperative bacterial endophthalmitis; Brady SE et al.; Bacterial endophthalmitis has been recognized as a significant cause of chronic, delayed-onset inflammation following extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens implantation . The diagnosis of chronic postoperative bacterial endophthalmitis should be suspected in any case of chronic, refractory inflammation following ECCE . Although successful treatment may require surgical intervention in some cases, others may respond to antibiotic therapy alone. J Pharm Sci, 1990 Jan, 79(1), 37 - 42 Micellar modification of drug stability: analysis of the effect of hexadecyltrimethylammonium halides on the rate of degradation of cephaclor; Oliveira AG et al.; The intra- and intermolecular rates of degradation of cephaclor were determined with and without hexadecyltrimethylammonium bromide (CTABr) . Micellar-derived spectral shifts were used to measure the association of the ionic forms as well as to determine the effect of CTABr on the apparent acid dissociation constant of the antibiotic . The rate of degradation of cephaclor increased with detergent and was salt sensitive . Micellar effects were analyzed quantitatively within the framework of the pseudophase ion exchange model . All experimental data were fitted to this model which was used to predict the combined effects of pH and detergent concentration . Micelles increased the rate of OH- attack on cephaclor; most of the effect was due to the concentration of reagents in the micellar pseudophase . The intramolecular degradation was catalyzed 25-fold by micelles, and a working hypothesis to rationalize this effect is proposed . The results demonstrate that quantitative analysis can be utilized to assess and predict effects of detergents on drug stability. Food Chem Toxicol, 1990 Jan, 28(1), 21 - 8 Uptake of the naturally occurring 3-alpha-hydroxy isomer of T-2 toxin by a murine B cell hybridoma; Witt MF et al.; The uptake of the naturally occurring 3-alpha-hydroxy isomer of T-2 toxin (alpha-T-2 toxin) was investigated in a murine B cell hybridoma as a model for trichothecene-lymphocyte interactions . alpha-{3H}T-2 toxin was prepared by oxidation of T-2 toxin and reduction with {3H}NaBH4 followed by normal phase and reverse phase high-performance liquid chromatography . Uptake of alpha-{3H}T-2 toxin by hybridoma cells was both time- and concentration-dependent . The antibiotic anisomycin inhibited uptake of alpha-{3H}T-2 toxin by hybridoma cells, which suggests ribosomal involvement in the uptake mechanism . Uptake of alpha-{3H}T-2 toxin was also inhibited by verrucarin A, roridin A and deoxynivalenol, and the inhibition followed a trichothecene structure-activity rank similar to that established for protein synthesis inhibition and in vivo toxicity . The characteristics of uptake of alpha-{3H}T-2 toxin by isolated splenocytes were qualitatively similar to those of the hybridoma but accumulation at equilibrium was less . Accumulation of alpha-{3H}T-2 toxin by erythrocytes, cells lacking ribosomes, did not increase with time and was not affected by the presence of unlabelled toxin . The results suggested that specific accumulation and uptake of alpha-{3H}T-2 toxin by the murine B cell hybridoma and spleen cells were highly consistent with a model based on intracellular binding of T-2 toxin to ribosomes. Dtsch Tierarztl Wochenschr, 1990 Jan, 97(1), 39 - 42 {Progression and control of leptospirosis in a sow herd}; Waldmann KH; After a short review about etiology, epidemiology, clinical symptoms, diagnosis and therapy of leptospirosis the course and therapy of an acute leptospirosis outbreak in a breeding herd with nearly 240 sows is described . The microscopic agglutination test (MAT) served for diagnosis and was most reliable for estimation the actually stage of infection when used twice with an interval of several weeks . As causative agent serovar L . pomona was identified, whereby cross-reactions were seen to serovars L . grippotyphosa, L . bratislava and L . copenhageni . Therapy of all animals with Terramycin/LA (Pfizer) at three times with intervals of five days and doses of 20 mg oxytetracycline/kg b.w . distinctly reduced the incidence of abortion and stillborn or mummified pigs . Local irritations, relative to the intramuscular administration of oxytetracycline, mostly were low-graded and temporary . For the next months acute infections could not be registered . Probably due to infections from leptospires-reservoirs, maintained by numerous existing mice and puddles on the pasture-ground, leptospirosis occurred again six months later . Only another antibiotic therapy of the whole herd and simultaneous eradication of rodents as well as closing the pasture led to a long-termed control of leptospirosis in this herd. Hinyokika Kiyo, 1990 Jan, 36(1), 59 - 61 {A case of acute focal bacterial nephritis}; Noguchi Y et al.; Acute focal bacterial nephritis refers to a renal mass caused by acute focal infection . We report a case of acute focal bacterial nephritis, herein . The case was in a 56-year-old woman, who was hospitalized with the chief complaint of left flank pain, chills and fever . Intravenous pyelography suggested the presence of a mass in the upper pole of the left kidney . Ultrasonography showed a hypoechoic mass, CT scan revealed a round, low density mass . Antibiotic therapy resulted in resolution of symptoms, and a follow-up CT scan and ultrasonography showed complete resolution of the renal mass. J Antibiot (Tokyo), 1990 Jan, 43(1), 54 - 61 The absolute configuration of decilonitrose, a sugar component of decilorubicin, is undoubtedly 2,3,6-trideoxy-3-C-methyl-3-nitro-L-ribo-hexopyranose; Nishimura Y et al.; The absolute structure of decilonitrose, a sugar component of an antitumor antibiotic decilorubicin was decided to be 2,3,6-trideoxy-3-C-methyl-3-nitro-L-ribo-hexopyranose by synthesis of its methyl beta-glycoside starting from L-rhamnose through the 3-ulose . In the synthetic route, any configurational ambiguities do not exist. World J Surg, 1990 Jan-Feb, 14(1), 128 - 32 Pyogenic liver abscess; Bowers ED et al.; Experience with 34 patients with pyogenic liver abscess is reviewed to evaluate the impact of percutaneous drainage and duration of antibiotic therapy on results of treatment . Patients with shock, adult respiratory distress syndrome, disseminated intravascular coagulation, jaundice, severe hypoalbuminemia, and diabetes had a poor prognosis . Percutaneous drainage was used successfully in 4 of 6 patients, but its use did not affect mortality rate or length of hospital stay . Percutaneous drainage may be the procedure of choice for selected patients . Half of our patients received antibiotics for 2 weeks or less with no abscess recurrences in this group . Long-term antibiotics may not be necessary after adequate surgical or percutaneous abscess drainage. Mutat Res, 1990 Jan, 243(1), 75 - 80 Unequal SCE is a rare event in homologous recombination between duplicated neo gene fragments in CHO cells; Hellgren D et al.; The frequency of sister-chromatid exchange (SCE) was studied in Chinese hamster ovary (CHO) cell lines with stable insertions of the vector pIII-14gpt which contains 2 truncated neomycin resistance (neo) gene fragments . Recombination between regions of homology in the 2 fragments can restore a functional neo gene and make the cell resistant to the antibiotic G418, a neomycin analogue . Unequal SCE would be one of several possible mechanisms for this event . The observed spontaneous rate of formation of G418-resistant subclones was approximately 6.4 x 10(-6) per cell per generation, as compared to the estimated spontaneous frequency of 3 SCE per cell per generation . Given this SCE frequency, the probability of an SCE occurring in a target site of about 1600 bp (the distance separating the homologous regions in the neo fragments) would be about 8 x 10(-7) per cell per generation, or approximately one tenth of the estimated rate of recombination . Treatment of the cells with methyl methanesulfonate (MMS, 50 x 10(-6) M) induced about 80-90 SCE per cell, corresponding to a probability of 2 x 10(-5) SCE per 1600-bp target per cell . In the same cell culture, MMS treatment induced 4-8 x 10(-4) recombination events per cell giving rise to G418 resistance . Cells treated with HN2 (up to 4 x 10(-6) M) showed a significant increase in SCEs, but no change in the frequency of G418-resistant revertants . These results suggest that the 2 pathways leading to SCE and recombination respectively are uncoupled, and only a small fraction of the recombination events, if any, are due to unequal SCE in this system. Ann Thorac Surg, 1990 Jan, 49(1), 118 - 22 Disruption of the aortic anastomosis after heart-lung transplantation; Dowling RD et al.; Disruption of the aorta at the anastomotic site occurred in 4 of 66 consecutive heart-lung transplant recipients and was associated with a 100% mortality . In 3 of these patients, Candida either was cultured from the suture line or was seen in the wall of the aorta at postmortem examination . In 2 of these 3 patients, cultures of material from the donor trachea taken at the time of explanation grew Candida species . Two patients were seen with sudden massive hemorrhage on postoperative day 26 and postoperative day 28 . One patient experienced acute decompensation due to right ventricular outflow tract obstruction on postoperative day 30, and the remaining patient was seen 7 months postoperatively with obstruction of both the left main bronchus and the right pulmonary artery caused by extrinsic compression by an aortic pseudoaneurysm . A high index of suspicion should be maintained when transplanting lungs containing Candida species, as we believe there is substantial evidence of donor transmission of the fungal agents . We now include amphotericin B in our antibiotic prophylactic regimen in an attempt to prevent fungal infection because previous treatment has been uniformly unsuccessful . Furthermore, we wrap both the trachea and the aorta with omentum to lessen the likelihood of mediastinal spread of infection to the aortic suture line. Ann Allergy, 1990 Jan, 64(1), 21 - 5 Effect of intravenous gammaglobulin therapy in IgG2 deficient and IgG2 sufficient children with recurrent infections and poor response to immunization with Hemophilus influenzae type b capsular polysaccharide antigen; Silk HJ et al.; Nine children with recurrent sinopulmonary infections and normal IgG levels failed to improve after a 12-month period of prophylactic antibiotic therapy with trimethoprim-sulfamethoxazole . Five of these children had selective deficiency of IgG2 subclass, while the other four did not, but all nine children had a poor response to immunization with Hemophilus influenzae type b (Hib) capsular polysaccharide . Following the institution of intravenous immunoglobulin (IVIG) therapy, there was a significant decrease in the episodes of sinusitis and otitis media in all patients . Intravenous immunoglobulin therapy resulted in a significant increase in total serum IgG, IgG2, and IgG anti-Hib antibody levels . Discontinuation of IVIG therapy was followed by the return of recurrent infections . This preliminary study demonstrates that IVIG replacement therapy in children with recurrent infections and selective antibody deficiency is associated with a significant reduction in the frequency of sinopulmonary infections. J Trauma, 1990 Jan, 30(1), 49 - 54 Treatment of chronic osteomyelitis complicating nonunion and segmental defects of the tibia with open cancellous bone graft, posterolateral bone graft, and soft-tissue transfer; Esterhai JL Jr et al.; Forty-two consecutive patients with chronic osteomyelitis complicating persistent tibial nonunion and chronic osteomyelitis complicating tibial fracture with segmental bone loss were treated from January 1979 through December 1986 using a protocol including either open cancellous bone grafting (Friedlaender-Papineau technique), posterolateral bone grafting (Harmon technique), or local or microvascular soft-tissue transfer before cancellous bone grafting . Each patient had undergone surgical debridement and intravenous antibiotic therapy before inclusion in this study . Patients were classified using a staging system which included consideration of anatomic location of the infection within the bone; extent of bone involvement; quality of soft-tissue envelope and vascular integrity; and generalized host status . The overall success rate for arresting the osteomyelitis and healing the nonunion was 62% (26/42) . If the six patients who refused additional bone graft surgery, the one patient who represented poor patient selection, and the patient who refused ankle arthrodesis are eliminated, the success rate for healing of the nonunion and resolving the osteomyelitis in this difficult patient population is: open bone cell graft, 66% (12/18); soft-tissue transfer 87.5%, (7/8); and posterolateral bone grafting, 87.5% (7/8) . Use of a standardized classification system allows comparison of treatment results . Adequate debridement is crucial in treating osteomyelitis complicating established long bone fractures and nonunions . Determining the extent of debridement has proven to be the single most difficult aspect technically . Patient selection and pretreatment education are crucial . Caring for these patients is not only labor intensive and demanding of personnel and hospital resources, but demanding of the patients as well. FEBS Lett, 1990 Jan 1, 259(2), 286 - 8 Increased calcium permeability is not responsible for the rapid lethal effects of amphotericin B on Leishmania sp; Cohen BE et al.; The mode of action of the polyene antibiotic amphotericin B (AmB), the drug of choice for the treatment of systemic fungal infections and visceral leishmaniasis, is still unclear . An increase in intracellular Ca2+ concentration {( Ca2+}i), toxic in many cases, has been postulated as a possible lethal mechanism for AmB . Cell permeabilization to ethidium bromide (EB) was used as a criterion of viability . Kinetics of the DNA-EB fluorescent complex formation was studied in ergosterol-containing Leishmania promastigotes . Intracellular Ca2+ concentration was measured using quin-2 fluorescence in parallel aliquots . It is shown in this work that AmB can act as an efficient Ca2+ ionophore . However, the rapid permeabilization effect induced by AmB on these cells was not dependent on an increase in {Ca2+}i . On the contrary, it was found that leishmanicidal effect of AmB was enhanced in the absence of external calcium . Furthermore, A23187 a Ca2+ ionophore did not provoke cell permeabilization to EB. Gastroenterology, 1990 Jan, 98(1), 127 - 33 Utility of an algorithm in differentiating spontaneous from secondary bacterial peritonitis; Akriviadis EA et al.; To prospectively assess the value of an algorithm in differentiating spontaneous from secondary bacterial peritonitis, we performed serial paracenteses in 43 episodes of ascitic fluid infection (28 spontaneous and 15 secondary) in 40 patients . The algorithm involved identification of (a) secondary peritonitis associated with gut perforation, based on previously proposed criteria in patients with neutrocytic ascites (ascitic fluid total protein greater than 1 g/dl, glucose less than 50 mg/dl, and lactate dehydrogenase greater than the upper limit of normal for serum) and (b) separation of spontaneous from secondary peritonitis (unassociated with perforation) based on the response of the ascitic fluid cell count to antibiotic therapy . The perforation criteria had 100% sensitivity in detecting episodes of actual gut perforation; their specificity, however, was low (45%) . After 48 h of treatment the concentration of ascitic fluid neutrophils was below the baseline pretreatment value in all episodes of spontaneous peritonitis but in only two thirds of the patients with secondary peritonitis . This algorithm is useful in (a) identifying patients who have infected ascites associated with perforation of an intraabdominal viscus, and (b) differentiating spontaneous from nonperforation secondary peritonitis on the basis of the response of the ascitic fluid cell count to appropriate antibiotic therapy . The optimal time for repeat paracentesis in patients with infected ascites appears to be 48 h after initiation of treatment. J Comp Physiol {B}, 1990, 160(4), 381 - 8 Aldosterone regulates paracellular pathway resistance in rabbit distal colon; Hoffmann B et al.; Regulation of the paracellular pathway in rabbit distal colon by the hormone aldosterone was investigated in vitro in Ussing chambers by means of transepithelial and microelectrode techniques . To evaluate the cellular and paracellular resistances an equivalent circuit analysis was used . For the analysis the apical membrane resistance was altered using the antibiotic nystatin . Under control conditions two groups of epithelia were found, each clearly dependent on the light: dark regime . Low-transporting epithelia (LT) were observed in the morning and high-transporting epithelia (HT) in the afternoon . Na+ transport was about 3-fold higher in HT than in LT epithelia . Incubating epithelia of both groups with 0.1 mumol.l-1 aldosterone on the serosal side nearly doubled in LT epithelia the short circuit current and transepithelial voltage but the transepithelial resistance was not influenced . Maximal values were reached after 4-5 h of aldosterone treatment . In HT epithelia due to the effect of aldosterone all three transepithelial parameters remained constant over time . Evaluation of the paracellular resistance revealed a significant increase after aldosterone stimulation in both epithelial groups . This increase suggests that tight junctions might have been regulated by aldosterone . The hormonal effect on electrolyte transport was also dependent on the physiological state of the rabbit colon . Since net Na+ absorption in distal colon is, in addition to transcellular absorption capacity, also dependent on the permeability of the paracellular pathway, the regulation of tight junctions by aldosterone may be a potent mechanism for improving Na+ absorption during hormone-stimulated ion transport. Zentralbl Chir, 1990, 115(24), 1559 - 64 {Therapy of human thoracic actinomycosis}; Uschinsky K et al.; 9 cases of thoracic actinomycosis are analysed with regard to their antibiotic therapy . On account of sensibility of the bacteria and the pharmaco-kinetics of the antibiotics the therapy with Ampicillin in high doses is recommended for relatively short time . This therapy should be performed in any case before surgical measures. J Fr Ophtalmol, 1990, 13(6-7), 339 - 42 {Oculomotor paralysis and Lyme disease}; Bienvenot M et al.; Lyme disease is an infectious multi system disorder caused by the spirochete Borrelia Burgdorferi . Neurologic syndromes occurring during the second stage of the illness are common and the neurologic feature is extremely variable . We report a case of Lyme disease with diplopia . In contrast with most reported cases of ocular motor involvement in Lyme disease, no other systemic symptoms were detected . The serodiagnosis, although mildly positive, was confirmed by western blot antibodies analysis and evaluation of CSF antibodies . Symptoms readily vanished 3 days after the introduction of antibiotherapy . The efficacity of antibiotic therapy on the quality and timing of functional recovery justifies the use of this therapy. Arch Immunol Ther Exp (Warsz), 1990, 38(1-2), 79 - 86 Cell-mediated immunity and inflammatory processes in male infertility; Anderson DJ; Considerable evidence indicates that white blood cell concentrations are often elevated in semen of infertility patients, and that white blood cell products can affect sperm function in vitro . Furthermore, recent studies indicate that leukocytospermic semen samples exhibit poor motility characteristics and impaired ability to function in sperm penetration assays . We believe that the identification and quantification of white blood cells in semen should be an integral component of every semen analysis . If properly diagnosed, a significant number of infertility patients with leukocytospermia may benefit from antibiotic, antiviral, or anti-inflammatory drug treatments . Further studies should be directed at better defining the role of bacteria, viruses and other pathogens in leukocytospermia, and further understanding the effects of WBC products on sperm function. Turk J Pediatr, 1990 Jan-Mar, 32(1), 43 - 7 A case of late presenting chronic granulomatous disease; Yalcin I et al.; An eleven-year-old boy with a history of severe lung infection which had been resistant to antibiotic therapy for a period of six months demonstrated a functional leukocyte defect similar to that found in children with chronic granulomatous disease (CGD) . X-ray findings suggested a hilar mass, and granulomatous lesions developed on the thorax wall . The documentation of this case suggests that there may be a late presenting form of CGD. Yao Xue Xue Bao, 1990, 25(5), 326 - 9 {Effects of polyactin A on in vitro IL-2 production and responsiveness of human lymphocytes}; Hu QL et al.; The effects of a novel antitumor antibiotic polyactin A (PA) on in vitro IL-2 production and IL-2 responsiveness of human lymphocytes were investigated . The results show that PA in a concentration range from 0.01 to 100 micrograms/ml obviously augmented in vitro IL-2 production, IL-2 receptor expression and responsiveness to IL-2 of human lymphocytes in the presence of PHA, and that these enhancing effects of PA were dose-dependent . The results demonstrated the potentiating effect of PA on cellular immunity and suggested the suitable use of PA in clinical treatment of tumors . The possible application of PA to the treatment of immune disorders involving deficiency of IL-2 production and/or IL-2 responsiveness of lymphocytes is also considered. Vestn Dermatol Venerol, 1990, (9), 15 - 6 {The dynamics of the griseofulvin levels in the blood and skin of guinea pigs during its combined use with alpha-tocopherol}; Lashmanova AP et al.; Experiments with 120 guinea pigs have revealed that skin griseofulvin levels depend on blood griseofulvin level and reduce after a prolonged (for 3-4 weeks) administration of the antibiotic in a dose of 30 mg/kg . Reduction of P-450 system enzymes activities achieved with alpha-tocopherol slows down griseofulvin biotransformation rate and significantly elevates its blood serum and skin concentrations. Vestn Dermatol Venerol, 1990, (10), 70 - 3 {Undiagnosed early secondary syphilis with horny palmar and plantar papules}; Kovalev VM et al.; A 20-year-old female patient is described who contracted syphilis in a rape attempt . She consulted a dermatovenereologist twice but the disease was not diagnosed, for despite the fact that the patient had hard chancre fragments on the posterior adhesion of the vagina, polyscleradenitis, abundant roseolar eruption on the trunk skin, horny palmar and plantar papular efflorescence, erythematous syphilitic tonsillitis, she was not examined nor serological tests were carried out . The condition was diagnosed as callosity and acute respiratory viral disease, antihistaminic and antibiotic drugs were prescribed . The condition was diagnosed only in a month after the first visit to a doctor. Scand J Urol Nephrol, 1990, 24(4), 315 - 6 Mycobacterium fortuitum infection in a patient with a penile prosthesis . Case report; Edelstein H et al.; A 47-year-old male with a Mentor penile prosthesis presented with purulent drainage eight months after implantation . In addition to other organisms, routine cultures from the implant site yielded Mycobacterium fortuitum, an association never reported previously in the literature . Infection resolved with removal of the implant and antibiotic therapy. Int J Health Serv, 1990, 20(4), 561 - 72 The drug swindlers; Silverman M et al.; In a number of important developing nations--among them Indonesia, India, and Brazil--clinical pharmacologists and other drug experts are revealing mounting concern over the marketing of fraudulent drug products . These are shaped, colored, flavored, marked, and packaged to mimic the real product . They may contain the actual antibiotic or other drug indicated on the label, but so "cut" that the product provides only a small fraction of the labeled amount, or they may contain only useless flour or starch . At best, they are worthless . At the worst, they can kill . In most instances, it is believed that these "drugs" are produced and marketed by local or domestic fly-by-night groups and not by multinational pharmaceutical firms . Blame for these practices is placed on inadequate or unenforced laws, only trivial punishments, bribery and corruption, and the fact that generally "nobody inspects the inspectors." Biol Cell, 1990, 69(1), 27 - 33 Effects of cerulenin, an inhibitor of fatty acid synthesis on reconstitution of the dental basement membrane; Goldberg M et al.; When trypsin-dissociated enamel organs and dental papillae were recombined in the presence of cerulenin--an antibiotic which is a potent inhibitor of fatty acid synthesis--the newly synthesized basement membrane seemed defective in a dose-dependent manner . The three-dimensional relationship between the basement membrane components and the plasma membrane appears to be regulated in part by lipids. Br J Neurosurg, 1990, 4(5), 417 - 9 Bone flap replacement vs acrylic cranioplasty: a clinical audit; Aziz TZ et al.; A 5-year retrospective study comparing bone flap replacement with acrylic cranioplasty was carried out . There was no significant difference in the high infection rates associated with the two procedures . We suggest that antibiotic-impregnated acrylic cranioplasty may be the safest and best surgical procedure based on the orthopaedic experience with gentamicin-impregnated cement in joint replacement surgery. Vestn Dermatol Venerol, 1990, (7), 57 - 9 {The sociomedical efficacy of the enzyme therapy of gonorrhea patients}; Glozman VN; The study has involved 3702 male patients with gonorrhea . Of these 62 percent were fresh cases, 38 percent chronic ones; there were 218 patients (5.9 percent) with recurrences, of these 63.3 percent with new relapses and 36.7 percent with chronic ones . 85.3 percent of patients developed monorelapses . The recurrences were equally frequent after antibiotic therapy (50.2 percent) and after combined treatment (49.8 percent) . Proteolytic enzymes (chymotrypsin, trapsin 5 mg twice daily with a 12 hrs interval) in combination with an antibiotic were administered to 242 patients with gonorrhea complicated by epididymo-orchitis and with gonorrhea relapses . Etiologic cure was achieved in all of them; postgonorrheal conditions were recorded in 6-7 percent and depended on the antibiotic administered; in reference patients recurrences were recorded in 4.2-6.5 percent of cases, postgonorrheal conditions in 14-21.4 percent of cases . Enzymic therapy helped reduce the length of inpatient therapy of a patient by 5.93 days on an average in cases with orchidoepididymitis and by 14.64 days in gonorrhea relapses, with the economic effect per worker being 131.4 and 307.2 rubles, respectively. Eur J Clin Pharmacol, 1990, 39(2), 165 - 7 Effect of ponsinomycin on cyclosporin pharmacokinetics; Couet W et al.; The influence of treatment with ponsinomycin, a new macrolide antibiotic, on the pharmacokinetics of cyclosporin A has been studied in 10 renal transplant patients . The pharmacokinetics of cyclosporin A was investigated at steady state, before and during treatment with ponsinomycin . On average, the blood levels of cyclosporin A were doubled by the macrolide, possibly due to a decrease in elimination or/and to an increase in absorption . Ponsinomycin should be use very carefully in patients treated with cyclosporin A. Life Sci, 1990, 47(19), PL103 - 8 Bacitracin U.S.P . contains a factor that stimulates receptors for 5-hydroxytryptamine on rabbit aortic strips; deBlois D et al.; Bacitracin (BAC) U.S.P., obtained in the form of sterile powder, elicits dose-dependent and non-tachyphylactic contractions of the rabbit isolated aorta and of other rabbit vessels . The use of several pharmacologic antagonists suggests that BAC is a 5-hydroxytryptamine mimetic in aortic strips, since the antibiotic is competitively antagonized by methysergide and ketanserin with pA2 values compatible with an agonist action on the 5-HT2 receptors found in the aortic preparation . It remains to be determined whether bacitracin A, the chief constituent of BAC U.S.P., is the 5-HT agonist. Life Sci, 1990, 47(17), 1595 - 9 Protective effect of Sn-protoporphyrin against doxorubicin-induced perturbations of heme metabolism; Wissel PS et al.; The administration of doxorubicin, an anti-tumor antibiotic, to rodents resulted in an increase in heme oxygenase activity and a decrease in delta-aminolevulinate (ALA) synthase activity and in cellular heme and cytochrome P450 content in liver . Sn-protoporphyrin, a potent inhibitor of heme degradation both in vitro and in vivo, when administered to rodents prior to doxorubicin, mitigates the drug-induced toxic actions which are reflected by the drug-induced decreases of both cellular heme and cytochrome P450 content . Sn-protoporphyrin thus provides a pharmacological means of protecting against the toxic effects of doxorubicin and other drugs which enhance heme oxygenase activity and thus decrease cellular heme and cytochrome P450 content in vivo. Intensive Care Med, 1990, 16(6), 408 - 10 Postoperative respiratory failure due to acute eosinophilic pneumonia; St John RC et al.; A non-smoking 63-year-old man developed respiratory failure following surgical repair of a thoracoabdominal aortic aneurysm . He had severe hypoxemia and an elevated minute ventilation requiring prolonged mechanical support . Initial postoperative chest radiographs revealed new, transient, migratory infiltrates, and the patient received broad-spectrum antibiotic therapy . Chest radiographs subsequently demonstrated persistent, diffuse infiltrates, and bronchoalveolar lavage (BAL) analysis demonstrated significant eosinophilia (30%) with no evidence of infection . A diagnosis of acute eosinophilic pneumonia was made, and treatment with intravenous methylprednisolone resulted in rapid clinical improvement, and extubation . Acute eosinophilic pneumonia is not a previously recognized cause of postoperative respiratory failure and prolonged mechanical ventilation . It should be suspected in postoperative patients with unexplained diffuse lung infiltrates and acute respiratory failure. Surg Gynecol Obstet, 1990, 171 Suppl, 24 - 30 Aminoglycosides: assessing the potential for nephrotoxicity; Wilson SE; Although aminoglycosides have been a mainstay of antibiotic therapy in postsurgical infections, certain patients may be at risk for potential aminoglycoside induced toxicities . Aminoglycoside nephrotoxicity is one of the most frequent causes of iatrogenic renal failure . A narrow toxicity to therapeutic ratio, a relatively long serum half-life and concentration in the renal cortex all contribute to renal dysfunction . Patients at greatest risk for aminoglycoside-induced nephrotoxicity include the elderly, patients with pre-existing renal disease and those who are volume depleted . Calculations based on the results of a multicenter study demonstrate that the average additional cost incurred for each patient who had aminoglycoside-related nephrotoxicity was $2,501 . Methods are reviewed for prospectively assessing the potential for development of nephrotoxicity to identify patients for whom effective therapeutic substitutes for aminoglycosides should be sought. Acta Clin Belg Suppl, 1990, 13, 69 - 74 Caustic intoxication; Le Bon B et al.; After a retrospective study of 17 cases of caustic intoxication in the intensive care unit, the epidemiologic, pathophysiologic, clinic and therapeutic aspects are reviewed . The following procedure is suggested: early endoscopies, abstention of any gastric lavage, corticosteroids and empiric antibiotic therapy and the most early possible introduction of a parenteral nutrition. Int J Syst Bacteriol, 1990 Jan, 40(1), 28 - 33 Actinomadura fibrosa sp . nov . isolated from soil; Mertz FP et al.; A new species of the genus Actinomadura which belongs to the Actinomadura madurae group of Goodfellow et al . was isolated from soil collected in Togo, West Africa . Traditional taxonomic methods plus contemporary fatty acid analysis techniques were used to establish the position of this species . Both physiological characteristics and fatty acid composition differentiate this strain from previously described species . This culture produces a new polyether antibiotic . It is characterized by the production of white to pink aerial hyphae on a limited number of media . The aerial hyphae appear asporogenous, forming thick fibers and projections instead of true spores . The reverse side is a distinctive reddish orange . This organism is resistant to 5% NaCl and grows at temperatures between 20 and 45 degrees C . Whole cells contain meso-diaminopimelic acid, galactose, glucose, mannose, madurose, phosphatidylinositol, and diphosphatidylglycerol . The menaquinones detected were MK-9(H6) and minor amounts of MK-9(H8) . The name proposed for this new species is Actinomadura fibrosa; the type strain is strain NRRL 18348. Vopr Onkol, 1990, 36(8), 952 - 6 {The cytostatic action of the K+/H+ antiporter nigericin}; Margolis LB et al.; A decrease in pH in Ehrlich ascites carcinoma cells to 6.3 leads to intracellular DNA synthesis inhibition . The inhibitory effect was achieved in the course of incubation of cells at pH 6.2 as well as by the addition of low-dose K+/H+ antiporter antibiotic nigericin . DNA synthesis inhibition by nigericin was not associated with significant decrease in ATP level or mitochondrial membrane potential . The effect was mediated by a decrease in intracellular pH rather than by a decrease in intracellular potassium level or elevation in that of intracellular sodium which accompanied nigericin treatment. Scand J Infect Dis Suppl, 1990, 68, 23 - 30 Treatment of chlamydial infections; Mardh PA et al.; Antibiotic therapy of chlamydial infections means treatment of an intracellular parasite . That is, the antibiotic drug has to pass not only over the cell membrane of the organism but also over the cell membrane of the host cell and over the membrane lining the intracytoplasmatic vacuole, where the chlamydiae reproduce . To what extent antibiotic may induce "latent" chlamydial infections is badly defined . Beta-lactam antibiotics in certain concentrations may induce cell wall-deficient forms of chlamydiae . Still there is non-conformity in performing in vitro susceptibility tests and diversed opinions of how to interpret such tests . For several antibiotics there is a discrepancy between the result of in vitro susceptibility tests and therapeutic trials . There is a need for long term follow-up studies of the effect of antibiotic therapy of genital chlamydial infections . Just less than half of such infections in females are complicated, i.e., cases of endometritis/salpingitis . It is very difficult to differentiate uncomplicated from complicated genital chlamydial infections without invasive tests . Approximately 40% of chlamydial cervicitis cases has a concomitant PID . Thus all genital chlamydial infections in females should be treated as complicated. Prog Clin Biol Res, 1990, 341B, 221 - 8 Circadian periodicity of the time of onset of acute lower gastrointestinal bleeding; Ergun GA et al.; We investigated the chronobiological parameters of acute gastrointestinal (GI) bleeding in 51 patients able to time-specify the onset of bleeding within 30 min of occurrence . Bleeding was determined to be either from the upper or lower GI tract . The upper GI bleeding group consisted of 32 patients (22 male, 10 female) who bled from peptic ulcer disease (16), Mallory-Weiss tear (4), gastritis (3), esophageal varices (3), gastric neoplasm (2), Dieulafoy's lesion (1), and unknown (3) . The lower GI bleeding group consisted of 19 patients (9 male, 10 female) who bled from diverticulosis coli (5), hemorrhoids (2), arteriovenous malformations (2), colonic polyps (2), cecal ulcer (1), antibiotic-associated colitis (1), and unknown (6) . Rhythmicity was evaluated by inferential statistics . The time of onset of lower GI bleeding (34 episodes) displayed significant circadian periodicity (p = 0.014) with its peak at 1100 h . Single cosinor analysis revealed: MESOR-1.42 (95% CI = 0.86- 1.97); amplitude = 1.22 (0.44-1.99); phase angle = -165.12 (-201.66 -128.58) . Upper GI bleeding (42 episodes) displayed no circadian periodicity (p = 0.46) . When both upper and lower GI bleeding were evaluated together, no circadian rhythm was evident (p = 0.07) . We conclude that there is a circadian periodicity in the time of onset of only acute lower GI bleeding with its peak at 1100 h . The pacemaker of this periodicity remains unknown. Pediatr Hematol Oncol, 1990, 7(1), 3 - 12 Hepatosplenic candidiasis in children with cancer . Three cases in leukemic children and a literature review; Carstensen H et al.; Three children with acute leukemia presented with prolonged fever and neutropenia after cytostatic therapy, which was followed by abdominal pain, hepatomegaly, and hepatic dysfunction with raised serum alkaline phosphatase . Abdominal CT scan and ultrasound demonstrated multiple small lesions compatible with the hepatosplenic candidiasis syndrome . Liver biopsies showed microabscesses with a granulomatous appearance, but evidence of yeasts and pseudohyphae was present in 1 case only . Cultures were negative . Treatment with amphotericin B and 5-fluorocytosine was successful in two children . At autopsy, one child had signs of active infection . We reviewed the literature on 27 children with hepatosplenic candidiasis . Abdominal symptomatology and prolonged fever, despite antibiotic therapy, in a patient with previous or present neutropenia after cytotoxic exposure, should lead to a careful evaluation, including noninvasive imaging studies, open liver biopsy, and prompt aggressive antifungal treatment, the response to which requires close follow-up. Zentralbl Chir, 1990, 115(9), 553 - 61 {Therapy of osteomyelitis}; Wehner W; Exogenic post-traumatic bone infection has come strongly into focus of attention, as compared to haematogenic cases . Complex prophylaxis against such infection, therefore, is of great importance . The initial phase of bacterial osteomyelitis must be identified and must be followed by immediate action, as early treatment is absolutely essential . That is why the routes of infection, which depend on the extent of injury and on the mode of primary treatment, as well as all areas affected must be fully detected . Substantial therapeutic steps should include radical sanitation, stabilisation (especially fixateur externe), different variants of drainage, and autogenic spongiosa transplantation . New results have become available also in the context of supplementary specialised antibiotic therapy and coverage of soft tissue. Comp Biochem Physiol B, 1990, 96(2), 349 - 54 Transfection of cultured fish cells RBCF-1 with exogenous oncogene and their resistance to malignant transformation; Hayasaka K et al.; 1 . Plasmids bearing the G418-resistant gene neo were transfected into cultured fish cells RBCF-1 by electroporation at an efficiency comparable to that in NIH3T3 cells . 2 . Transfection of plasmids bearing both neo and activated human c-Ha-ras into NIH3T3 and RBCF-1 cells resulted in the malignant transformation of the former but not of the latter cells. Histochemistry, 1990, 94(1), 45 - 7 DNA-induced distamycin A fluorescence; Stockert JC et al.; The fluorescent properties of the antibiotic distamycin A were investigated in a range of materials including Trypanosoma cruzi epimastigotes, chicken erythrocytes, calf thymus DNA and synthetic polynucleotides using both microscopic and spectroscopic techniques . A bright blue-white fluorescence was observed from kinetoplast DNA and chromatin after treatment with distamycin A under ultraviolet (365 nm) excitation . Considerable enhancement of distamycin A fluorescence (emission peak at 455 nm under 320-340 nm excitation) was found in the presence of DNA and poly(dA-dT).poly(dA-dT) . We discuss a possible explanation for this unexpected fluorescent emission, as well as its implications for microscopic and fluorimetric studies. Jpn J Antibiot, 1990 Jan, 43(1), 81 - 8 {Clinical studies on cefteram pivoxil in the treatment of respiratory infections}; Yamaki K et al.; Cefteram pivoxil (CFTM-PI), a new ester type cephem antibiotic, was administered at a daily dose of 600 mg to 81 patients with respiratory infections . They included 4 cases of laryngopharyngitis, 5 cases of tonsillitis, 26 cases of acute bronchitis, 13 cases of pneumonia, 10 cases of chronic bronchitis, 1 case of diffuse panbronchiolitis, 14 cases of infected bronchiectasis and 8 cases of infected other chronic respiratory diseases . Clinical effects were excellent in 18 cases, good in 50 cases, fair in 7 cases, and poor in 6 cases, thus, the efficacy rate was 84.0% . Nausea was observed in 2 cases, and diarrhea, vertigo, or fever was observed in 1 case each . The elevation of GOT and GPT values were found in 4 cases and a slight elevation of total bilirubin value was found in 1 case . These adverse reactions, however, were slight in their grades . CFTM-PI appears to be a useful oral cephem antibiotic in the treatment of respiratory infections. J Int Med Res, 1990 Jan-Feb, 18(1), 1 - 15 Clinically relevant anti-epileptic drug interactions; Pisani F et al.; Anti-epileptic drugs frequently interact due to pharmacokinetic features (induction or inhibition of metabolism, production of active metabolites, low therapeutic indices) and the need for prolonged treatment with possible addition of other drugs to treat concomitant diseases . The most important pharmacokinetic interactions are those that inhibit phenytoin, carbamazepine and phenobarbitone metabolism and thus increase their toxicity . Drugs inhibiting metabolism include antibiotic macrolides, chloramphenicol, isoniazide, some sulphonamides, propoxyphene, cimetidine, valproic acid and sulthiame . Anti-epileptic drugs can induce hepatic microsomal enzymes and, therefore, may increase metabolism of corticosteroids, oral contraceptives, oral anticoagulants, cardiovascular agents, antibiotics, chemotherapeutic agents, psychotropic drugs and non-opiate analgesics, thereby reducing their efficacy . Advantageous pharmacodynamic interactions include synergism of ethosuximide plus valproic acid and of carbamazepine plus valproic acid . A pharmacodynamic mechanism may be responsible for the reduced sensitivity of chronically treated epileptics to some neuromuscular blockers. J Mol Cell Cardiol, 1990 Jan, 22(1), 13 - 22 Mediation by GTP gamma S and Ca2+ of inositol trisphosphate generation in rat heart membranes; Renard D et al.; The possibility, that a GTP-binding protein is involved in the transducing mechanism leading to the formation of inositol trisphosphate (InsP3) in heart was explored in rat heart ventricles . Accordingly, a crude membrane fraction was isolated from 3{H} inositol prelabelled rat heart ventricles . When incubated with the non-hydrolysable GTP analogues GTP gamma S and GMP-PNP, it produced InsP3 in a time- and concentration-dependent manner . GDP beta S and the aminoglycoside antibiotic neomycin were effective inhibitors of this activation . In the absence of GTP gamma S or GMP-PNP, no such formation occurred with Ca2+ concentration from 10 nM to 1 microM but formation tripled in relation to the control level when Ca2+ concentration was raised from 1 microM to 100 microM . GTP gamma S increased the Ca2+ sensitivity of InsP3 production towards more physiologically relevant concentrations occurring during diastole (100 nM) . These findings strongly suggest the presence in heart of a particulate Ca2(+)-dependent phospholipase C, whose activity is regulated by guanine nucleotides . This Ca2(+)-dependent phospholipase C observed in a cell free system was evidenced also in a multicellular system when altering the free Ca2+ concentrations around the physiological range . The results support the possibility that the enzyme might be activated during each cardiac cycle and thus produce two potential activators of cardiac contraction, namely InsP3 and diglycerides. Haematol Blood Transfus, 1990, 33, 362 - 7 Acute megakaryoblastic leukemia: a case report; Donhuijsen-Ant R et al.; We present a case of acute megakaryoblastic leukemia identified by electron microscopy and platelet-specific antibodies . The histological examination of bone marrow showed distinct myelofibrosis . In accordance with recent communications, low-dose cytosine arabinoside treatment (20 mg twice daily s.c . over 21 days) was initiated . The subsequent bone marrow examination showed a severe hypoplasia with persistent blasts . Amsacrine and VP-16 were given without success . Finally the patient died of septicemia without proof of pathogen uninfluenced by antibiotic and antiseptic therapy 6 weeks after diagnosis . Our case report confirms the poor prognosis of acute megakaryoblastic leukemia. Ann Med Interne (Paris), 1990, 141(1), 11 - 4 {Intravenous urography in acute pyelonephritis}; Baglin A et al.; Intravenous urography, systematically performed in 50 consecutive acute pyelonephritis patients, revealed abnormalities in 17 of them: in 12 cases (24%), treatment and follow-up were modified; in the other 5 cases (10%), the anomalies were insignificant . The nephrogram was normal for 33 patients (66%) . The frequency of significant abnormalities was higher in patients over 50 years of age (46.2%) than in those under 50 (16.2%) (p less than 0.05), and was also higher in patients remaining febrile for 3 days after the onset of an appropriate antibiotic therapy (66.6%) than in responsive patients (14.4%) (p less than 0.01) . Among the significant lesions, 10 were detectable by echography and another by abdominal X-ray . Thus, a population of women under 50 years of age with acute pyelonephritis can be selected for urography, as shown by these results, however, they must be confirmed before changing the systematic practice of urography. Rev Mal Respir, 1990, 7(2), 123 - 8 {Amoxicillin as a 1st choice: 275 acute focal pneumopathies treated on an outpatient basis}; Dautzenberg B et al.; From December 1986 to January 1988, 100 General Practitioners and Pneumologists working outside hospital included in open unmatched series 275 patients who were diagnosed as having pneumonia at home . The study consisted of 53.2% men with an average age of 49.3 plus or minus 19.3 . Their temperature on the first day (J1) was in 72.7% of cases greater than 38.5 degrees Centigrade . The doctors felt that the general state was good in 66.5% of the cases . Cough was present in 83.5% of cases but was dry in one out of every two . The patients received Amoxycillin in a dose of 2 grams per day orally (66.9%), or by injection (33.1%) . On the third day (J3) 90% of the patients had a temperature below 38.5 degrees Centigrade . Their general state was improved in 94.6% of cases . The diagnosis of pneumonia at home was confirmed radiologically on 219 of the films available, confirming the good specificity of the clinical diagnosis of pneumonia at home . Ten patients were hospitalised . The apparent treatment of Amoxycillin was given in 247 cases (89.8% of cases) . In 28 cases (10.2%) the treatment was changed by the addition or substitution of a Macrolide (15), or another antibiotic (5), and in 80 cases a change of treatment was not specified . 25 of these 28 cases were reviewed on the 14th day (J14) and no failures were observed after the change of treatment . In 247 patients in whom the treatment with Amoxycillin was followed 336 were reviewed on the 15th day and there had been four failures . Three were intolerant to the drug and there was one relapse.(ABSTRACT TRUNCATED AT 250 WORDS) Br J Clin Pract, 1990 Jan, 44(1), 17 - 21 Comparative evaluation of cefotaxime and cephamandole in the prevention of post-operative infective complications following emergency abdominal surgery; Ridley PD et al.; In previous published work we described 57 patients undergoing emergency abdominal surgery, prospectively randomised to receive either cefotaxime or cephamandole as a single-antibiotic, three-dose, peri-operative prophylaxis against post-operative infective complications . This earlier work suggested that cefotaxime might be more effective than cephamandole in preventing wound sepsis in emergency abdominal surgery . We describe here our findings in a further 63 patients undergoing emergency abdominal surgery who were similarly allocated into either a cefotaxime or cephamandole antibiotic group . Infective complications occurred in 12/32 (37 per cent) of the cefotaxime group and 15/31 (48 per cent) of the cephamandole group . Wound infections occurred in 5/32 (16 per cent) of the cefotaxime group and 9/31 (29 per cent) of the cephamandole group . The organisms cultured and their sensitivities are discussed in detail . The total of 120 patients studied in the two series showed wound infection to occur in 13 per cent of the 62 patients receiving cefotaxime and 30 per cent of the 58 patients receiving cephamandole . This difference reaches statistical significance (p less than 0.05) . Possible mechanisms to explain this finding are discussed . Again we found the regime of 4 g of cefotaxime given peri-operatively to be a simple, safe and effective single agent as prophylaxis for emergency abdominal surgery. Ann Otolaryngol Chir Cervicofac, 1990, 107(1), 35 - 41 {Otogenic thrombosis of the lateral sinus}; Heitzmann P et al.; Otogenic thrombosis of the lateral sinus, which has become rare since the use of antibiotics, nevertheless still poses diagnostic and therapeutic problems . Based on 4 cases treated at the University Teaching Hospital in Tours since 1982, the authors study the various clinical and paraclinical elements in the diagnosis, stressing the value of CT examination using contrast . Management is then proposed in diagramatic form: the indication for surgery depending on the efficacy of antibiotic therapy and internal jugular vein ligation being required in the event of septic emboli manifest cervical signs. Arch Virol, 1990, 115(3-4), 227 - 37 Establishment of transformed swine fibroblast cell lines using SV40 large T antigen; Choi CS et al.; Swine testicle cell lines were established by transformation of primary swine testicle (PST) cells with an SV40 plasmid (pSV3-neo), which contains genes conferring resistance to neomycin and expressing SV40 large T antigen . Plasmid DNA was transfected into PST cells using a lipofection system . Two related plasmids, pSV2-neo and pSV5-neo, failed to induce transformed cells . Cells transformed with pSV3-neo formed single colonies that were resistant to the antibiotic, G418, and expressed large T antigen . Upon two cycles of cloning by endpoint dilution method, three transformed clones, designated transformed swine testicle (tST)-3, tST-14 and tST-18, were selected and characterized in regards to cell replication and susceptibility to swine viruses . The resultant clones were compared with a counterpart non-transformed ST cell line (ATCC-ST) . The three tST cell lines showed longer or the same doubling times and higher saturation densities compared to ATCC-ST cells . These cells were free from a range of adventitious agents and supported the replication of porcine parvovirus (PPV), pseudorabies virus (PRV) and transmissible gastroenteritis virus (TGEV), comparable to ATCC-ST cells . All three cell lines have been maintained in continuous cultures for over 60 passages with no changes in growth characteristics . These findings indicate that lipofection with pSV3-neo is an efficient means for the introduction of exogenous DNA into porcine cells and for establishment of transformed immortalized cell lines. Cancer Chemother Pharmacol, 1990, 26(4), 257 - 62 A DNA topoisomerase II-independent route for novobiocin-mediated resistance to DNA binding agents; Smith PJ et al.; The coumermycin antibiotic novobiocin is currently under investigation as an agent that can modify the toxicity of various anti-cancer drugs, potentially via one of its many pharmacological effects: namely, the interference with type II DNA topoisomerase function . This paper investigates the ability of novobiocin to modify the cellular/nuclear accumulation and toxicity of two types of DNA binding agents (the minor groove ligand Hoechst 33342 and the intercalating anthracycline Adriamycin) . We report that novobiocin reduces the cytotoxicity of both agents and that this can be attributed to a reduction in cellular and, consequently, nuclear accumulation of these agents rather than to any effect on cellular export . The antibiotic was also active (at non-toxic concentrations) in delaying the progression of cells into S phase and G2 phase . This potential for novobiocin to effect rescue from toxicity by disturbance of the delivery of a drug to a potentially important intracellular target, together with the provision of an extended period of cellular recovery prior to the commitment of cells to G2 + M phase, should be recognised in the design of combination chemotherapy. Bull Hosp Jt Dis Orthop Inst, 1990 Spring, 50(1), 27 - 34 Application of freeze-dried amniotic membrane: a control trial at the donor site of split-thickness skin grafting; Waikakul S et al.; Sixty five patients (51 males and 14 females) underwent a control trial of freeze-dried amniotic membrane applied in the form of split-thickness skin grafts over an area from which skin had been surgically removed . The average size of the grafts was 15 x 20 cm . The patients were randomly divided into two groups . In the first group (36 patients), the membrane was applied at the upper half of the wound; in the second group (29 patients), the membrane was applied at the lower half of the wound . The remaining areas of the wounds were covered by antibiotic-impregnated fine-mesh greased gauze . Pain, infection, and the progress of healing were monitored . Covering the wound with the amniotic membrane had good results in terms of pain reduction, but the promotion of healing and the prevention of infection were not demonstrated . Hyperemia and hypertrophic scar responses to the membrane in some cases were considered as disadvantages. Intensive Care Med, 1990, 16(4), 252 - 5 Diarrhoea during enteral feeding in the critically ill: a comparison of feeds with and without fibre; Dobb GJ et al.; This randomised double-blind study examined the frequency of diarrhoea in intensive care unit patients given a fibre-containing feed, Enrich, and a fibre-free feed, Ensure . A daily 'diarrhoea score' was calculated from the frequency, volume and consistency of the stools . A score greater than 12 indicated diarrhoea, and greater than 50 severe diarrhoea . Ninety one patients met the criteria for participation: Enrich 45, Ensure 46 . The groups were similar in age, sex ratio, feed volume, antibiotic usage, upper gastro-intestinal bleeding prophylaxis and plasma albumin concentrations . Diarrhoea occurred in 16 patients given Enrich and 13 given Ensure, severe diarrhoea affecting 5 and 9 respectively (NS) . Forty seven of 343 (14%) Enrich feeding days and 51 of 342 (15%) Ensure feeding days were complicated by diarrhoea--severe diarrhoea: 8 and 12 feeding days (NS) . We conclude soy polysaccharide (21 g/L) did not reduce diarrhoea in intensive care unit patients given enteral feeds. J Comp Physiol {B}, 1990, 159(6), 777 - 88 Isolation of a crustacean N-acetyl-D-glucosamine-1-phosphate transferase and its activation by phospholipids; Horst MN; The N-acetyl-D-glucosamine-1-phosphate:dolichol phosphate transferase from Artemia has been partially purified and characterized . The enzyme is solubilized from crude microsomes using Triton X-100, and after detergent removal appears to be associated with phospholipids . Using dolichol phosphate and UDP-N-acetyl-D-glucosamine as substrates, the enzyme catalyzes the formation of dolichol-pyrophosphate-N-acetyl-D-glucosamine . The product identity has been verified by TLC and paper chromatography following mild acid hydrolysis . Under the incubation conditions used only one product is made, i.e., Dol-P-P-GlcNAc . The formation of product is linear with increasing amounts of added protein and with time of incubation . The enzyme requires magnesium ions for activity . Activity of the enzyme is stimulated 6-fold by exogenous dolichol phosphate and is also stimulated by added phospholipids, with optimal activity being obtained in the presence of mixtures of phosphatidylcholine and phosphatidylglycerol . Enzymatic activity is not increased upon addition of GDP-mannose or dolichol phosphate mannose . The enzyme is rapidly inactivated by exposure to several detergents, including Triton X-100 and deoxycholate . The activity is inhibited by tunicamycin and by the purified B2 homologue of this antibiotic . Other antibiotic inhibitors such as diumycin and polyoxin D have little effect on the enzyme . Both the microsomal and solubilized enzyme preparations are inactivated by 70% upon treatment with phospholipase A2; activity may be restored by addition of phospholipids . Following hydrophobic interaction chromatography on Phenyl Sepharose, gel filtration chromatography on Sepharose CL-4B indicated that the enzyme, purified 81-fold, contained phophatidylcholine and phosphatidyl-ethanolamine. Hum Pathol, 1990 Jan, 21(1), 118 - 21 Use of the polymerase chain reaction in the diagnosis of unsuspected herpes simplex viral pneumonia: report of a case; Geradts J et al.; A 30-year-old apparently immunocompetent woman presented with acute respiratory failure (acute respiratory distress syndrome) . No etiologic agent was found, and she died 2 weeks later despite antibiotic therapy . Postmortem examination of the lungs showed diffuse organizing alveolar damage with superimposed focal necrotizing peribronchiolar pneumonia . Cultures obtained from lung tissue were negative for virus, fungi, and bacteria . Histopathologic and electron microscopic studies showed that the necrotizing changes were consistent with herpesvirus infection . With the use of a new diagnostic tool, the polymerase chain reaction, a specific diagnosis of herpes simplex virus pneumonia was made, and other viral agents were excluded . The polymerase chain reaction is a sensitive, specific, and rapid technique that may greatly facilitate establishing an infectious etiology in cases of pneumonia. Arch Otolaryngol Head Neck Surg, 1990 Jan, 116(1), 49 - 53 Effect of topical fosfomycin on polymyxin B ototoxicity; Leach JL et al.; Fosfomycin is an antibiotic that has been found to reduce the ototoxicity of aminoglycoside antibiotics and cisplatin when systemically coadministered . Polymyxin B, an antibiotic frequently used in ototopical preparations, has been shown to be ototoxic in experimental studies . To investigate the effect of fosfomycin on polymyxin B ototoxicity, topical administration of the two agents into the middle ear cavity was performed . Two groups of chinchillas were used . One group received applications of polymyxin B alone, and the second group received polymyxin B combined with fosfomycin . It was found that application of polymyxin B produces severe damage to the cochlea . However, when polymyxin B was given in combination with fosfomycin, cochlear damage was dramatically reduced . It is likely that in clinical use, a combination of polymyxin B and fosfomycin would demonstrate reduced risk of ototoxicity. Eur J Cancer, 1990, 26(9), 932 - 6 Efficacy and tolerability of recombinant human granulocyte-macrophage colony-stimulating factor in patients with chemotherapy-related leukopenia and fever; Biesma B et al.; 30 patients with chemotherapy-related leukopenia (white cells 1.0 x 10(9)/l or lower) and fever (temperature 38.5 degrees C or higher) were treated in a double-blind randomised trial with standard antibiotics and 7 days of intravenously administered recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF, 2.8 micrograms/kg per day) or placebo . GM-CSF administration resulted in a faster percentage increase of peripheral neutrophil count after 2 and 3 days of treatment, except in patients treated with ablative chemotherapy and autologous bone-marrow transplantation . However, GM-CSF did not shorten the period of fever or antibiotic administration . No side-effects were observed; in particular tumour necrosis factor alpha and interleukin-6 did not increase in the 5 GM-CSF patients tested . These data suggest that a subgroup of patients with chemotherapy-related leukopenia and fever may benefit from GM-CSF treatment in view of the observed effects on neutrophil count. Lens Eye Toxic Res, 1990, 7(1), 39 - 47 Evaluation of a possible cocataractogenic potential of Ofloxacin; Wegener A et al.; Ofloxacin, a new antibiotic of the group of quinolones, was tested for its possible cocataractogenic potential . Two cataract models of the rat, the naphthalene cataract and the true diabetic cataract were used, cataract development in-vivo was monitored with the slit lamp microscope and documented with the Scheimpflug camera Topcon SL-45 . After a six weeks observation and treatment period, where Ofloxacin was dosed with 20 mg/kg body weight daily with a stomach tube, the animals were sacrificed and their lenses used for biochemical analyses . Although the results of Scheimpflug photography showed that the combination of the 2 cataract models together with the Ofloxacin treatment lead to higher densities in the cortical layer, a marked cocataractogenic potential could not be demonstrated . Also the biochemical data made it evident, that Ofloxacin has no obvious cocataractogenic potential, neither single nor in combination with 1 or 2 cataract models. Dermatologica, 1990, 181(1), 65 - 7 Contact dermatitis sparing the eruption of herpes zoster and its periphery; Katayama H et al.; A 63-year-old male developed allergic contact dermatitis with antibiotic ointment applied to the skin eruptions of herpes zoster . From the result of patch test, fradiomycin sulfate contained in the ointment was identified as the contact sensitizing antigen . Strangely, this contact dermatitis was confined to the area surrounding the sores, sparing the lesions and their periphery . We postulated that a decrease in Langerhans cell activity in the herpes zoster lesions and their peripheral area was primarily responsible for this phenomenon, since an important role of Langerhans cells in host defence against herpes virus infection has recently been demonstrated. Ir J Med Sci, 1990 Jan, 159(1), 2 - 5 Isotretinoin therapy for acne vulgaris: results in an Irish population; Buckley D et al.; The results of treatment of cystic and antibiotic-resistant acne vulgaris in 96 consecutive patients with the oral retinoid isotretinoin (13-cis-retinoic acid; Roacentane) are reported retrospectively . The results show that the drug, while toxic in the short term, is highly effective in clearing acne. Free Radic Res Commun, 1990, 8(2), 79 - 83 Effect of carminomycin on the viability of fibroblasts from patients with regular trisomy 21; Rozga B et al.; The sensitivity of three human fibroblast lines, trisomic with respect to chromosome 21, to an anthracycline antibiotic carminomycin was compared with that of a normal fibroblast line using a 51Cr release assay . It was found that for an intermediate antibiotic concentration (10 microM) the sensitivity of trisomic fibroblasts, of increased content of Cu,Zn-superoxide dismutase was lower . These results suggest a role for superoxide-mediated membrane damage in the cytotoxic action of anthracycline antibiotics. Cytometry, 1990, 11(2), 311 - 3 Flow cytometric competitive binding assay for determination of actinomycin-D concentrations; Saunders GC et al.; A single step, separation free competitive binding reaction between the fluorescent antibiotic mithramycin and actinomycin-D for common binding sites on DNA coated 10 microns diameter microspheres is described . The fluorescence of the microspheres is measured with a flowcytometer . In the presence of a constant amount of mithramycin, the microsphere fluorescence is inversely proportional to actinomycin-D concentration. Am J Public Health, 1990 Jan, 80(1), 50 - 3 An epidemiologic postmarketing surveillance study of prescription acne medications; Facklam DP et al.; After the Food and Drug Administration approved a topical antibiotic for the treatment of acne, we began a postmarketing surveillance study to measure the frequency of antibiotic-associated colitis and diarrhea in acne patients treated with topical antibiotics and low doses of oral antibiotics . Pharmacists recruited 13,465 patients who presented a prescription for an acne medication, and we obtained detailed information on the use of the medications, perceived acceptability, and the occurrence of new health events from 6,453 with computer-assisted telephone interviews . Three cases (less than 0.1%) of antibiotic-associated diarrhea and one case (less than 0.1%) of antibiotic-associated colitis were confirmed . We conclude that this methodology can provide further information about the safety of a drug once it is in customary use, at a fraction of the cost of Phase III clinical trials. Acta Chir Hung, 1990, 31(4), 279 - 87 Prognostic factors and treatment tactics in the surgery of liver abscesses; Jakab F et al.; The prognostic factors of 21 patients with pyogenic liver abscess were analyzed . It was stated that survival is unfavourably influenced by hyperbilirubinaemia, the mixed bacterial population, the associated diseases as well as the tumorous process . As a result of portal antibiotic perfusion, there was no difference in the mortality rates of multiple and solitary liver abscesses . Based on the analysis of the prognostic factors, the surgical tactics is developed, i.e . a need for surgical exposure is supported, which imposes three tasks: exposure of the abscess/es, management of the primary process inducing the abscess and introduction of a cannula for portal antibiotic perfusion . Besides some criteria, although the author do not have experience in this field, they suggest the use of percutaneous drainage controlled by echography or CT, basically because of the lower mortality rate. Drugs Exp Clin Res, 1990, 16(12), 611 - 4 Correlation between disc potency and zone size in temafloxacin activity in vitro; Reggio S et al.; A multi-test disc potency evaluation of a new fluoroquinolone, temafloxacin, has been prepared in order to evaluate the variation of the zone dimension with the disc antibiotic concentration . A direct correlation between these parameters has been demonstrated . All pathogens have been isolated in hospitalized patients. J Clin Pediatr Dent, 1990 Fall, 15(1), 42 - 5 PH of endodontic medicaments used in pediatric dentistry: effects of dyadic combinations; Anderson M et al.; The optimum pH of an endodontic medicament is close as possible to that of body fluids, i.e., around 7.2 as higher and lower pH's are likely to cause cellular necrosis of tissues in direct contact with the medicament . This study investigated the pH of various endodontic medicaments commonly used in pediatric dentistry, both singly and in the various combinations available for clinical use . The results showed that the pH ranged from a low of 2.90 +/- 0.02 for iodoform paste (Kri) to a high of 12.45 +/- 0.02 for calcium hydroxide (Calyxl) . Eugenol showed a pH of 4.34 +/- 0.05, formocresol 2.79 +/- 0.02, and a commercially-available antibiotic-corticosteroid paste (Ledermix) 8.13 +/- 0.01 . Addition of up to 50 percent (v/v) of Ledermix or 25 percent Kri respectively did not affect the pH of Calyxl significantly . Although the addition of up to 75 percent Kri to Ledermix caused a fall in pH, the changes are probably not significant clinically . Furthermore, the addition of 50 percent eugenol to formocresol increased its pH significantly . The optimum pH of an endodontic medicament is as close as possible to that of body fluids, i.e., around 7.2 . Higher and lower pH's are likely to cause cellular necrosis of tissues in direct contact with the medicament . However with the exception of calcium hydroxide there has been very little information available on the pH of endodontic medicaments commonly used in pediatric dentistry . Medicaments such as formocresol, eugenol and iodoform pastes have been extensively used for endodontic therapy yet very little attention has been given to their pH values.(ABSTRACT TRUNCATED AT 250 WORDS) Free Radic Res Commun, 1990, 11(4-5), 251 - 60 One-electron reduction of daunorubicin intercalated in DNA or in a protein: a gamma radiolysis study; Houee-Levin C et al.; The one-electron reduction of daunorubicin, an anthracycline antibiotic, intercalated in DNA or in the apoprotein of the riboflavin binding protein, was studied by gamma radiolysis . The two reduction mechanisms appear very similar to the one found for the non-intercalated drug . Hydrogen peroxide, which oxidizes non-intercalated hydroquinone daunorubicin with two electrons in one step (C . Houee-Levin, M . Gardes-Albert and C . Ferradin, FEBS lett., 173, 27-30, (1984)), reacts with daunorubicin hydroquinone in DNA but not in the protein . It appears thus that the site accessibility to hydrogen peroxide in DNA is better than in the protein . Biological consequences are discussed. J Basic Microbiol, 1990, 30(6), 455 - 60 Kinetics of secondary metabolite formation by wild type and mutant strains of Streptomyces griseus; Jacob HE et al.; In a particle containing medium, the kinetics of formation of secondary metabolites of a Streptomyces wild type and a mutant strain were determined by spectrophotometric measurements of the anthracyclinone pigments and by the analysis of antibiotic activity of the substances produced . The results were related to the physiological state of the culture derived from the oxygen supply . The total cultivation time was about 400 hours . The production of secondary metabolites started at the end of the logarithmic growth phase (after about 30 hours) . During the following cultivation remarkable differences between the two strains regarding the formation of pigments and antibiotics occurred . In the wild type strain producing daunomycinone glycosides and related compounds with antibiotic activity, these antibiotics are active as inhibitors (negative feedback) . Therefore, at a certain concentration of antibiotics, the de-novo formation of anthracycline molecules was impaired . In the mutant strain, as the result of a genetic change, the secondary metabolite production was shifted to nonglycosylated compounds . The production of these substances is not influenced by feedback inhibition as in the case of the wild type strain . From that reason the amount of pigment increased slightly throughout the course of the experiment . Under our experimental conditions the measurement of oxygen supply was a suitable indicator of the physiological state of culture. Acta Orthop Belg, 1990, 56(2), 463 - 75 Prosthesis-related infection . Etiology, prophylaxis and diagnosis (a review); Wymenga AB et al.; The recent literature concerning prosthesis-related infection is reviewed with respect to etiology, prophylaxis and diagnosis . Most prosthesis-related infections are initiated during operation by contamination with bacteria-carrying particles from the air as a result of dispersion of skin scales from individuals in the operating room . A small number of infections are caused by hematogenous seeding of bacteria . Glycocalyx, a slime layer produced by bacteria, plays an important role in the pathogenesis of infections, especially in the presence of biomaterial . Clean-air systems in combination with perioperative systemic antibiotics reduce prosthesis-related infections from 3 or 4 per cent to a few per thousand . The use of antibiotic-loaded bone cement is advised in high risk patients although further evaluation is needed . Physical examination of the patient, laboratory tests such as the E.S.R . and C-reactive protein, serial radiograms, isotope scanning techniques and joint aspiration can all help diagnose prosthesis-related infection . However definitive diagnosis is possible only by culturing several samples of material obtained from the interface during revision operation . A perioperative frozen section of interface tissue showing acute (more than 5 leucocytes per field) or severe chronic (more than 50 lymphocytes) inflammation is highly suggestive of sepsis. Lung, 1990, 168 Suppl, 737 - 40 Preventive effects of an immunostimulating product on recurrent infections of chronic bronchitis in the elderly; Debbas N et al.; The effect of an immunostimulating drug, OM-85 BV, was demonstrated on recurrent infection rates in 265 elderly patients with a defined state of chronic bronchitis, during a 6-month, double-blind, placebo-controlled trial . Patients receiving OM-85 BV presented less infections (p = 0.005) and a significantly reduced intake of antibiotics (p = 0.02) as compared to those receiving a placebo and the antibiotic intake was significantly reduced (p = 0.02). J Int Med Res, 1990 Jan-Feb, 18(1), 30 - 6 Double-blind, placebo-controlled multicentre trial of the efficacy and tolerance of morniflumate suppositories in the treatment of tonsillitis in children; Manach Y et al.; The efficacy and tolerability of morniflumate suppositories used together with phenoxymethylpenicillin were studied in a placebo-controlled, double-blind trial in 101 children with acute tonsillitis . Patients received a suppository containing 400 mg morniflumate or placebo twice daily for 4 days; all patients also received 1,500,000 IU/day phenoxymethylpenicillin . Response to treatment was assessed by clinical examination before and after 2 and 4 days' treatment . Efficacy was evaluated by resolution of oropharyngeal pain, congestion, fever, size and sensitivity of adenopathies, quality of life and duration of sleep . Body temperature fell rapidly after the start of treatment . There was also resolution of pharyngeal pain, earache, dysphagia and adenopathy . Spontaneous pharyngeal pain was present after 4 days in significantly (P = 0.03) fewer patients receiving morniflumate than receiving placebo . It is suggested that morniflumate combined with antibiotic therapy is an effective and well-tolerated treatment for tonsillitis in children. Am J Otolaryngol, 1990 Jan-Feb, 11(1), 18 - 22 Tonsillectomy under local anesthesia: a safe and effective alternative; Bredenkamp JK et al.; Tonsillectomy using local anesthesia (local tonsillectomy) is a safe and effective alternative to general anesthesia in the healthy cooperative teenage or adult patient . This retrospective analysis involved 64 local tonsillectomies performed over the past 7 years in a minor operating room using only local anesthesia with intravenous sedation . Operations were performed by residents in training as well as by experienced head and neck surgeons . Blood loss, morbidity, complications, and patient satisfaction were reviewed and compared with tonsillectomies done under general anesthesia . The average blood loss was 42 mL in the local tonsillectomy group with no cases of postoperative hemorrhage, compared with 198 mL in the general anesthesia group with two cases of postoperative hemorrhage . There was one major complication related to postoperative antibiotic use in the local anesthesia group, and follow-up interviews revealed that patients were satisfied with the procedure and would recommend and choose local anesthesia again . We conclude that local tonsillectomies have high patient acceptance and are associated with minimal morbidity and complications . Furthermore, they are cost-effective. Pediatr Infect Dis J, 1990 Jan, 9(1), 41 - 4 Cefaclor treatment of upper and lower respiratory tract infections caused by Moraxella catarrhalis; Oberlin JA et al.; A retrospective analysis of data from 18 clinical studies was performed to examine the effectiveness and safety of cefaclor in the treatment of upper and lower respiratory tract infections caused by Moraxella catarrhalis (previously called Branhamella catarrhalis) . Eighty-six percent of 56 evaluable patients had improvement in their symptoms of infections following therapy with cefaclor . There were no serious or life-threatening adverse drug experiences reported by any patient . Cefaclor appears to be an appropriate antibiotic for the safe and effective treatment of respiratory tract infections caused by M . catarrhalis. J Nucl Med, 1990 Jan, 31(1), 112 - 4 Indium-111 WBC detection of emphysematous gastritis in pancreatitis; Caruana V et al.; We present a case of emphysematous gastritis initially detected with 111In oxine-labeled white blood cell scintigraphy and subsequently confirmed by computed tomography . Early aggressive antibiotic and supportive therapy resulted in a successful clinical outcome. Proc Soc Exp Biol Med, 1990 Jan, 193(1), 73 - 9 Blood platelets and schistosome egg excretion; Ngaiza JR et al.; The eggs of helminths of the Schistosoma genus require to be extravasated in order to continue the life cycle of the parasite . The possible mode by which this takes place was investigated in a mouse model . Suppression of platelet activity in Schistosoma mansoni-infected mice by administering rabbit anti-mouse platelet serum or a selection of "antiplatelet drugs" resulted in a significant reduction of parasite egg excretion . This reduction was best achieved when antiplatelet agents were administered just before the onset of parasite egg excretion . The association between parasite eggs and platelets was illustrated in vivo and in vitro where platelet aggregates on egg surfaces were seen in both light and electron microscopy . In addition, eggs that had been isolated from infected mouse tissues induced platelet aggregation in whole mouse blood, and this was inhibited by preincubation with the beta-lactam antibiotic, ticarcillin . Isolated eggs were also capable of inducing ex vivo platelet aggregation in mice, which was dependent on presensitization with eggs . These data suggest a role for platelets in the extravasation and excretion of parasite eggs in schistosomiasis. Acta Vet Hung, 1990, 38(4), 263 - 70 Changes in the lipid peroxide status of broiler chickens in acute monensin poisoning; Salyi G et al.; The effect exerted by overdosage of monensin, an ionophore antibiotic, on the lipid peroxide status of broiler chickens was studied . Three-week-old broiler cockerels were given 150 mg monensin/kg body mass through a tube, and the malondialdehyde (MDA) concentration, glutathione peroxidase (GSH-Px) and catalase activity of the liver and breast muscle, and MDA concentration and GSH-Px activity of the blood plasma were determined . Liver MDA and catalase values rose rapidly and significantly during the experimental period . GSH-Px activity initially decreased, then tended to rise . Blood plasma and breast muscle variables did not change during the experiment . Acute monensin poisoning induced substantial enhancement of lipid peroxidation processes in the liver, while it did not appreciably affect the lipid peroxide status of the blood plasma and breast muscle . The role of the observed phenomenon in the rather complex pathogenesis of monensin poisoning is not known sufficiently . Further studies are needed to elucidate the problem. Drugs Exp Clin Res, 1990, 16(8), 407 - 16 Biliary elimination and hepatic disposition of a new fluoroquinolone, temafloxacin: experimental evaluation; Brogard JM et al.; Temafloxacin is a new quinolone derivative presently under evaluation . Its pharmacokinetic profile, and particularly its biliary elimination and hepatic disposition, remains undefined . The present study describes an experimental approach to this issue . Six isolated rabbit liver preparations were perfused for 3h (h) with reconstituted blood in a closed circuit; 10 mg of temafloxacin were added to the circulating blood at the onset of the procedure . Bile was recovered throughout the experiments and liver fragments were taken at the conclusion . Assays were carried out by high-performance liquid chromatography . Pharmacokinetic analysis was performed with reference to a monocompartmental open model . Under these conditions, the serum half-life of temafloxacin was 3.1 and the maximal biliary concentration of 19.3 +/- SEM 3.1 micrograms/ml was reached between 30 and 60 min; the cumulative biliary elimination (0-3 h) amounted to 92 +/- 16 micrograms (0.9% of the added dose) . Total and hepatobiliary clearances were calculated as respectively 134 and 2.38 ml/h and the hepatobiliary elimination rate as 0.0042 (h-1) . At the end of the procedure, 25.7 +/- 3.5% of the added dose of temafloxacin was still present in the circulating blood, and 13.7 +/- 2.4% in the liver . Degradation of the antibiotic in the perfusion device concerned only 2.4% of the dose . The percentage of temafloxacin undergoing hepatic biotransformation, determined by subtraction, was high (57.3%) . Under these experimental conditions, temafloxacin appears to be particularly stable in serum, poorly eliminated as parent compound in the bile, highly fixed in the liver and above all subject to a probable hepatic biotransformation . Extrapolation of these experimental data to other species or to the whole organism would be hazardous, but these results should stimulate studies on a possible hepatic metabolism of this new trifluoroquinolone in man. Biopolymers, 1990, 30(11-12), 1083 - 99 Restrained and unrestrained molecular dynamics simulations in the NVT ensemble of alamethicin; Fraternali F; Molecular dynamics simulations on the transmembrane antibiotic peptide alamethicin have been performed in the NVT ensemble (i.e., the number of particles N, the volume V, and the temperature T of the system are kept constant) . Results on the structure and conformational flexibility of this molecule are discussed and compared with previous experimental CD, x-ray, nmr data and theoretical computations on fragments analogues . An extensive study of structural and dynamic properties from H-bonding pattern analysis is presented . Evidences for a largely alpha-helix structure with some extent of freedom in the C-terminal region are found . Further, a partition of the molecule into three regions on the base of structural features and dynamic behavior has been proposed, and the correlation among the motions of the three regions is described. Ann Rech Vet, 1990, 21 Suppl 1, 79S - 86S {Establishment of posology: the case of antiparasitic agents}; Galtier P; As generally observed for all veterinary drugs, the dosage regimen of anti-parasitic drugs must take into account both the therapeutic efficacy and the hygienic value of animal food products . However, the target of these drugs is not the host animal but parasites characterized by their particular life cycle stages . Consequently, anti-parasitic agents are generally either slowly eliminated or used as slow-release formulations both of which contribute to an extended tissular presence . The determination of the optimal drug dosage regimen is based on the study of a dose-efficacy relationship, the determination of the route and the frequency of administrations . Among factors affecting the anti-parasitic drug dosage regimen, differences could be related to physiological variations, such as interindividual variability, age- and species-related changes in drug distribution, metabolism or elimination, nutritional status, gestation and lactation stages . Finally, drug interactions due to associated therapy (anti-inflammatory or antibiotic drugs) or the existence of chronic diseases (eg, parasitism) could modify the normal fate of drugs with consequences on both their therapeutic effectiveness and the persistence of drug residues. Pharmacology, 1990, 41(4), 231 - 6 Use of rifampin as an effective chemoprotectant and antidote against microcystin-LR toxicity; Hermansky SJ et al.; Microcystin-LR (MCLR) is a potent cyclic heptapeptide hepatotoxin that is produced by the blue-green algae, Microcystis aeruginosa . This organism forms blooms in freshwater lakes and ponds . Following ingestion of contaminated waters, deaths of wildlife and domestic animals frequently occur . Due to the lack of available methods and drugs for treating cases of poisoning with this toxin, development of an effective antidote to this toxin is needed . We have examined the ability of the semisynthetic antibiotic rifampin to prevent the toxicity of a lethal dose of MCLR in mice . A dose of 25 mg/kg rifampin given intraperitoneally coadministered with a lethal dose of MCLR (100 micrograms/kg) or given 30 or 60 min prior to the MCLR prevented deaths in all animals . Seventy-five percent of the mice were protected from lethality when 25 mg/kg rifampin was given 15 min after the administration of MCLR . The coadministration of 17.5 mg/kg rifampin prevented lethality in 50% of the mice treated with MCLR, while 25% of the mice survived when rifampin was administered 15 min after the MCLR . At 10 mg/kg rifampin the time to death following administration of MCLR was extended, but the animals did not survive . The results indicate that rifampin is an effective chemoprotectant and antidote against the toxicity of MCLR in mice which can be successfully administered after exposure to MCLR. Basic Life Sci, 1990, 56, 95 - 134 Computer-aided conformational analysis based on NOESY signal intensities; Andersen NH et al.; The basis for the development of a suite of programs that allow the user to determine motional features (the correlation time and the significance of segmental motion) and the optimum conditions for future experiments from a NOESY signal matrix is presented . This automated evaluation of NOESY data serves as the initial step of an iterative conformational analysis which uses the molecular model manipulation capabilities of modern graphics workstations . Incorporated in these programs is NOESYSIM, a calculation subroutine which uses a set of molecular coordinates (and a correlation time estimate) together with user entered experimental parameters (acquisition time, sweep width, mixing time and cycle repetition time) to generate an accurately calculated NOESY signal matrix reflecting those conditions and the specified conformational model . Conformational refinement then consists of iterative comparisons of the experimental signal matrix with a series (or systematically sampled set) of model coordinates corresponding to a dynamics' course, driven-minimization or torsional grid search . These procedures and developments are illustrated with examples including: solution conformations of prostanoids; studies of the folding preferences and media-dependent changes in conformation for peptide hormones; and the structure elucidation of a novel undecapeptide macrolide antibiotic (lysobactin) . For larger molecules, even constrained grid searches have too high a dimensionality and one must resort to distance-constraint based minimizations . A novel procedure for deriving more accurate distance constraints (corrected for secondary NOEs) is detailed and a new strategy for conformation elucidation, based on this procedure, is outlined. Med Pregl, 1990, 43(9-10), 375 - 7 {Acute epiglottitis}; Knezevic E et al.; The experience in treating 5 patients with acute epiglottitis at our Clinic, from 1986-1989, has been presented . The importance of setting an on-time diagnosis and the application of Urbason therapy has been pointed out . We have indicated the specification of this disease, which is a potentially fatal epiglottidean and supraglottic inflammation . All of these cases were successfully solved by suitable antibiotic and Urbason therapy without preliminary tracheotomy or intubation. Free Radic Res Commun, 1990, 11(1-3), 127 - 36 One-electron reduction of daunorubicin intercalated in DNA or in a protein: a gamma radiolysis study; Houee-Levin C et al.; The one-electron reduction of daunorubicin, an anthracycline antibiotic, intercalated in DNA or in the apoprotein of the riboflavin binding protein, was studied by gamma radiolysis . The two reduction mechanisms appear very similar to the one found for the non-intercalated drug . Hydrogen peroxide, which oxidizes non-intercalated hydroquinone daunorubicin with two electrons in one step (C . Houee-Levin, M . Gardes-Albert and C . Ferradin, FEBS lett., 173, 27-30, (1984}, reacts with daunorubicin hydroquinone in DNA but not in the protein . It appears thus that the site accessibility to hydrogen peroxide in DNA is better than in the protein . Biological consequences are discussed. Hinyokika Kiyo, 1990 Jan, 36(1), 1 - 6 {Antibody response to P-fimbriae of Escherichia coli in patients with genitourinary infections}; Kanai S et al.; The serum antibody response to P-fimbriae of Escherichia coli in patients with genitourinary infections was investigated with enzyme linked immunosorbent assay (ELISA) for P-fimbriae-specific IgG antibody . 1) Female patients with acute pyelonephritis had a significantly (P less than 0.01) higher titer of serum IgG antibody by ELISA, compared with patients with acute cystitis or control subjects . The prevalence of positive serum IgG antibody response was 65% in patients with acute pyelonephritis . 2) Patients with epididymitis with high fever had a significantly (P less than 0.01) higher titer of serum IgG antibody by ELISA, compared with patients with epididymitis without fever or control subjects