Antibiotics

Berl Munch Tierarztl Wochenschr, 1989 Sep 1, 102(9), 303 - 10
{Entropion in newborn lambs}; Lamprecht H et al.; The Entropion in newborn lambs could be proved so far in 8 sheep-breeds and 7 cross-breeds out of 33 flocks in the Federal Republic of Germany . In our patients the Entropion was found at the lower eyelid only . The owners of the animals often mistake the Entropion for an ophthalmia . An early diagnosis and an early beginning of the therapy keep the expenditure of treatment small and shorten the period of treatment; therefore examination is commendable within a short time after birth . Female lambs get clearly more often affected than male ones (Gynecotropia) . In small pure-bred flocks with only one breeding-ram (and also in breeds with a limited population) the percentage of suffering lambs is higher than in large and crossed flocks with several rams and in large populations (except the breed "Heidschnucke") . In agreement with the literature it must be supposed that different genes are responsible for the Entropion . The selection of ill animals and those which are suspected of transmitting the disposition is evidently appropriate to lower the number of attacks of illness within a population considerably . All 47 affected eyes of 32 lambs were treated . Low degrees of Entropion were healed by repeated manual eversion plus application of antibiotic eye-ointment . In middle and high degrees of Entropion the application of Michel-wound-clamps on 23 of 26 eyes was successful; antibiotic eye-ointment was applied here, too; additionally these lambs prophylactically got 2000 I.U . of Tetanus-antitoxin.(ABSTRACT TRUNCATED AT 250 WORDS)

Am J Vet Res, 1989 Sep, 50(9), 1486 - 8
Treatment of Brucella melitensis infection in mice by use of liposome-encapsulated gentamicin; Hernandez-Caselles T et al.; Liposomes with entrapped gentamicin were used to treat mice with infection attributable to Brucella melitensis . Liposomes bearing positive charge and formed by egg yolk lecithin, cholesterol, and stearylamine were effective in the elimination of B melitensis residing in liver and spleen . Negatively charged liposomes, formed by egg yolk lecithin, cholesterol, and dicetyl phosphate were also effective in suppression of the infection in liver, but were less so in suppression of the infection in the spleen . Free gentamicin was less effective than the encapsulated antibiotic . At 20 hours after administration of gentamicin encapsulated in liposomes, the gentamicin concentrations in liver and spleen were similar, regardless of the charge of the liposomes--neutral, positive, or negative . However, positively charged liposomes were more efficient than were other liposome types for the treatment of brucellosis caused by B melitensis.

J Neurol, 1989 Sep, 236(6), 322 - 8
Meningoradiculitis and encephalomyelitis due to Borrelia burgdorferi: a follow-up study of 72 patients over 27 years; Kruger H et al.; In 1987, follow-up studies were conducted on 72 patients who had had meningoradiculitis and encephalomyelitis (8 patients) due to Borrelia burgdorferi 5-27 years previously . These patients had not been treated with antibiotics, either during the acute disease or during the interval prior to follow-up studies . The patients had exhibited the typical symptoms of Bannwarth's syndrome during the acute phase . At the follow-up studies, 33 patients showed no, and 23 only mild, clinical residual symptoms including normal CSF findings and low-positive serum IgG borrelia antibody titres (IFT; ELISA) . Three patients without sequelae exhibited persistent intrathecal secretion of oligoclonal B . burgdorferi-specific CSF IgG antibodies (Immunoblot; positive borrelia CSF IgG antibody titres) . Thirteen patients exhibited mild-to-medium sequelae with persistent intrathecal formation of oligoclonal B . burgdorferi-specific CSF IgG antibodies, up to 21 years after the acute illness . This persistence can be interpreted as an "immunological scar syndrome" . Our follow-up studies appear to indicate that neurological manifestations of B . burgdorferi infections are generally (with few exceptions) of a benign nature . Most patients can be classified as having been cured without antibiotic therapy . No late manifestations of chronic progressive CNS borreliosis comparable to that of neurosyphilis have been seen following acute untreated neuroborreliosis.

In Vitro Cell Dev Biol, 1989 Sep, 25(9), 800 - 5
The application of renal cells in culture in studying drug-induced nephrotoxicity; Williams PD; Kidney cells in culture represent one of many in vitro approaches for studying drug-induced nephrotoxicity . Potential advantages of cell culture systems compared to more traditional in vitro models include a) the ability to examine direct effects at the cellular level, b) extended viability, c) ability for long-term storage, and d) capabilities for automation . Primary cultures of kidney tubules as well as cell lines of kidney origin are currently under evaluation as model systems for the assessment of nephrotoxicity . The application of two renal cell systems, rabbit primary proximal tubule cultures and the pig kidney cell line, LLC-PK1, in studying mechanisms of drug-induced nephrotoxicity is described in this communication . Potentially valuable insights into the renal pathogenesis associated with the antitumor agent, cis-diamminedichloroplatinum II, and the aminoglycoside antibiotic, gentamicin, have been obtained utilizing these renal cell models . Challenges in renal cell culture involve the characterization and maintenance of differentiated properties and the development of technologies to a) study bidirectional transport-toxicity of drugs, and b) provide a dynamic vs . static fluid environment as in vivo . Despite these unique challenges as well as the universal challenges involved in extrapolating any in vitro data to the in vivo situation, recent studies indicate that renal cells in culture are useful in the elucidation of mechanisms of drug-induced renal injury.

In Vitro Cell Dev Biol, 1989 Sep, 25(9), 776 - 83
Primary cultures of rabbit renal proximal tubule cells: I . Growth and biochemical characteristics; Aleo MD et al.; Before the usefulness of a new in vitro model can be ascertained, the model must be properly defined and characterized . This study presents the growth rate and biochemical characteristics of rabbit renal proximal tubule cells in primary culture over a 2-wk culture period . When grown in a hormonally defined, antibiotic-free medium these cells form confluent monolayer cultures within 7 d after plating . Multicellular dome formation, an indicator of transepithelial solute transport, was expressed after confluent cultures were formed . The activity of the cytosolic enzyme, lactate dehydrogenase, and the lysosomal enzyme, N-acetyl-glucosaminidase, increased 14- and 2-fold during the first 8 d of culture, respectively . In contrast, the activity of a brush border enzyme, alkaline phosphatase, decreased 85% within the first 8 d of culture . Release of these enzyme markers into the culture medium, which are routinely used to measure cytotoxicity, stabilized after 8 d in culture . The ratio of cellular protein to DNA changed according to the state of cellular growth . Values rose from 0.035 mg protein/micrograms DNA in preconfluent cultures to 0.059 mg protein/micrograms DNA in confluent cultures . These results document the characteristics of a primary proximal tubule cell culture system for future studies in in vitro toxicology.

Fam Pract, 1989 Sep, 6(3), 210 - 6
Health complaints and drug consumption during the first 18 months of life; Hakansson A; Medical events of the first 18 months of life were studied in a group of 129 infants . Their medical files held at the child welfare clinic and at the surgery of the district physician as well as at the ear, nose and throat and paediatric departments were scrutinized . The parents were interviewed when their infants had reached an age of 18 months . The 129 infants were brought to the district nurse or doctor on a total of 2804 occasions . The majority of these visits were routine health checks . During the period in question, 57% needed medical attention for upper respiratory tract infection and 29% for acute otitis media . Most of the infants had been given the non-prescription remedies paracetamol and nose drops . Altogether 64% had received some form of antibiotic . A positive correlation was found between the number of visits as a patient made by the mother during her pregnancy and the number of visits on behalf of her baby during its first 18 months.

Eur J Epidemiol, 1989 Sep, 5(3), 355 - 62
Traveller's diarrhea among Austrian tourists to warm climate countries: II . Clinical features; Kollaritsch H; The syndrome "Traveller's Diarrhea" (TD) is important for tourists travelling to warm-climate countries . In this study a worldwide survey on the clinical features of enteritis among 1,455 Austrian tourists is reported . The clinical parameters of TD show that this disease exhibits a very uniform clinical course which is not influenced by different regions with considerable differences in aetiology or by travel-associated parameters such as accommodation, travel style and individual dietary hygiene: TD starts mainly at the end of first week of the stay and the average duration of illness is 3.6 +/- 2.7 days . Watery and mucous stools were reported by 99% of patients with a frequency of 4 bowel movements per day, while bloody diarrhea occurred very rarely . However, 57.2% of patients suffered from abdominal cramps, less than one third of patients reported nausea and/or vomiting and fever accompanied the acute disease in 13% . Symptoms indicate that TD should not be considered a severe disease . The diarrheal illness will show the characteristics of an enteroinvasive disease only in rare cases . Treatment of TD is discussed: symptomatic or other non-antibiotic agents are preferable as antibiotics will only occasionally be necessary for treatment of an illness with a self-limiting character . For prophylaxis of TD, the preferable way to resolve the problem of TD in international travel, very few effective preparations are currently available, emphasizing the need for extensive research in this field.

J Am Vet Med Assoc, 1989 Sep 1, 195(5), 603 - 5
Field trial of theophylline in cattle with respiratory tract disease; McKenna DJ et al.; A field trial was conducted to determine the efficacy of theophylline in relieving respiratory distress associated with bovine respiratory disease complex (shipping fever) . Theophylline (as aminophylline capsules) was administered PO at a dosage of 28 mg/kg of body weight daily for 3 days to 20 calves with naturally acquired disease . Twenty similarly affected calves from the same group were given a placebo, and all calves were administered antibiotics concurrently . Respiratory rate and rectal temperature decreased and physical appearance improved in both groups of calves and was attributed to antibiotic administration or to natural remission of the disease . Five of the calves administered theophylline died; however, no calves administered the placebo died . Plasma theophylline concentration was greatly increased, compared with that determined in clinically normal calves in a pilot study . Bovine respiratory tract disease and/or concurrent antibiotic administration appear to cause such a rapid accumulation of lethal concentration of theophylline that its use should be restricted to hospitals capable of monitoring plasma theophylline concentration.

Biopolymers, 1989 Sep, 28(9), 1585 - 96
Aggregation of amphotericin B in the presence of gamma-cyclodextrin; Kajtar M et al.; The macrolide antibiotic amphotericin B (AmB) forms an inclusion complex with gamma-cyclodextrin (gamma-CDx), resulting in a molecularly dispersed state of the drug . The state of aggregation of AmB in different solvents has been studied by absorption (uv-vis) and CD spectroscopy . While in aqueous solutions AmB forms colloid-like multimolecular aggregates, in the presence of gamma-CDx true solutions can be prepared, which show similar spectral properties as AmB dissolved in organic solvents . The AmB-gamma-CDx complex can be isolated as an amorphous, stable, water-soluble powder, indicating that gamma-CDx is a good carrier for the solubilization of this antibiotic . Using gamma-CDx as a carrier, the danger of precipitation of the drug during parenteral or intravenous administration can be largely reduced.

Proc Natl Acad Sci U S A, 1989 Sep, 86(17), 6626 - 9
K+/H+-antiporter nigericin arrests DNA synthesis in Ehrlich ascites carcinoma cells; Margolis LB et al.; Acidification of the cytoplasm of Ehrlich ascites carcinoma cells to pH 6.3 arrests DNA synthesis in these cells . Such an effect can be achieved by incubating the cells at pH 6.2 or by adding low concentrations of the K+/H+ antiporter, the antibiotic nigericin, at neutral pH . Glucose and anaerobiosis potentiate the nigericin effect . The inhibition of DNA synthesis by nigericin occurs without any significant decrease in the ATP concentration and in the mitochondrial membrane potential . The DNA synthesis inhibition is caused neither by a decrease in the intracellular {K+} nor by an increase in the intracellular {Na+} accompanying the nigericin effect (at least at low concentrations of the antibiotic) . Nigericin should thus be regarded as a type of a cytostatic primarily affecting intracellular pH.

Proc Natl Acad Sci U S A, 1989 Sep, 86(17), 6587 - 91
Crystal structure analysis of auromomycin apoprotein (macromomycin) shows importance of protein side chains to chromophore binding selectivity; Van Roey P et al.; The crystal structure of macromomycin, the apoprotein of the antitumor antibiotic auromomycin, has been determined and refined at 1.6-A resolution . The overall structure is composed of a flattened seven-stranded antiparallel beta-barrel and two antiparallel beta-sheet ribbons . The barrel and the ribbons define a deep cleft that is the chromophore binding site . The cleft is very accessible and in this structure is occupied by two 2-methyl-2,4-pentanediol and two water molecules . The overall shape of the binding site is similar to that of the analogue actinoxanthin . Highly specific side chains that are not conserved between different analogues extend into the binding site and may be important to the chromophore binding specificity.

East Afr Med J, 1989 Sep, 66(9), 607 - 10
Evaluation of prophylactic use of tetracycline after evacuation in abortion in Harare Central Hospital; Seeras R; PIP: The purpose of this randomized, controlled study was to determine the efficacy of tetracycline as a prophylactic antibiotic therapy in treating nonseptic, incomplete abortion patients in Zimbabwe . In 1984, the gynecology emergency unit of Harare Central Hospital admitted 3240 cases of incomplete abortion, of which 2891 were nonseptic on admission . For this prospective study, patients presenting with nonseptic, incomplete abortion (n = 140) from February through May 1985 were recruited at Harare Central . These patients were randomly divided into treatment and control groups, and all patients received aseptic evacuation procedures . Following evacuation, the treatment group (n = 62) was given tetracycline (500 mg 4 times daily to be taken for a week) . The remainder (n = 78) acted as controls . Diagnosis for sepsis, based on defined parameters, was performed a week later by the author, who did not know the group to which the patient belonged . The majority of the patients in both groups were 15-24 years old and of parity 1-4 . An overall sepsis rate of 35.6% was obtained in this study . No significant difference in sepsis rates between treatment and control groups was noted . The apparent higher proportion of sepsis recorded in the treatment group (25/62, or 40.32%) in comparison to the control group (23/78, or 29.5%) was not significant . Although all patients insisted they took their drugs as instructed, further questioning and counting of remaining capsules revealed that the majority (82.6%) had not taken any or part of the course; the patients who did complete the course had not followed the instructions properly . Thus, the lack of significant reduction in the sepsis rate with the use of prophylactic tetracycline was thought to be due to poor compliance . The author argued that this was due to the young age, low socioeconomic status, and lack of understanding of the regimen among the patients . Thus, it is suggested that tetracycline treatment be replaced with a cheap, single-dose, hospital-administered prophylaxis regimen, such as doxycycline, that covers a wide range of organisms .

J Cardiovasc Surg (Torino), 1989 Sep-Oct, 30(5), 782 - 5
Brucella endocarditis . Report of one case and review of the literature; Valliattu J et al.; We report a case of brucella endocarditis on a native aortic valve causing severe aortic regurgitation, uncontrolled heart failure and disseminated intravascular coagulopathy . The diagnosis was proven by positive serology, isolation of Brucella melitensis from preoperative blood cultures and excised valve . The patient was successfully treated with valve replacement and specific antibiotic therapy.

Genetics, 1989 Sep, 123(1), 81 - 95
Nonrecombinant meiosis I nondisjunction in Saccharomyces cerevisiae induced by tRNA ochre suppressors; Louis EJ et al.; The presence of the tRNA ochre suppressors SUP11 and SUP5 is found to induce meiosis I nondisjunction in the yeast Saccharomyces cerevisiae . The induction increases with increasing dosage of the suppressor and decreases in the presence of an antisuppressor . The effect is independent of the chromosomal location of SUP11 . Each of five different chromosomes monitored exhibited nondisjunction at frequencies of 0.1%-1.1% of random spores, which is a 16-160-fold increase over wild-type levels . Increased nondisjunction is reflected by a marked increase in tetrads with two and zero viable spores . In the case of chromosome III, for which a 50-cM map interval was monitored, the resulting disomes are all in the parental nonrecombinant configuration . Recombination along chromosome III appears normal both in meioses that have no nondisjunction and in meioses for which there was nondisjunction of another chromosome . We propose that a proportion of one or more proteins involved in chromosome pairing, recombination or segregation are aberrant due to translational read-through of the normal ochre stop codon . Hygromycin B, an antibiotic that can suppress nonsense mutations via translational read-through, also induces nonrecombinant meiosis I nondisjunction . Increases in mistranslation, therefore, increase the production of aneuploids during meiosis . There was no observable effect of SUP11 on mitotic chromosome nondisjunction; however some disomes caused SUP11 ade2-ochre strains to appear white or red, instead of pink.

Clin Lab Med, 1989 Sep, 9(3), 481 - 500
Genital Chlamydia infections; Ehret JM et al.; The past decade has seen a breakthrough in laboratory methods for the diagnosis of chlamydial infections . Antigen detection methods have made screening for C . trachomatis available in most clinical laboratories . These methods are highlighted and evaluated . Current culture methods and the antibiotic susceptibility of C . trachomatis are also discussed.

South Med J, 1989 Sep, 82(9), 1147 - 52
Lyme disease: a confusing multisystem borreliosis; Lane KL et al.; Lyme disease, a tick-borne infection caused by the spirochete Borrelia burgdorferi, involves many organ systems . Three clinical stages of involvement have been described; patients with the disease may have cutaneous, arthritic, neurologic, or cardiac symptoms, or a constellation of manifestations . Specific antibody testing and antibiotic agents are available for Lyme disease, but a high index of suspicion must be exercised to recognize atypical manifestations.

Respir Med, 1989 Sep, 83(5), 429 - 31
Long term venous access using a totally implantable drug delivery system in patients with cystic fibrosis and bronchiectasis; Ball AB et al.; A completely implantable, subcutaneous, venous access system (Port-a-Cath) has been used for antibiotic therapy in 26 patients with cystic fibrosis or bronchiectasis over a period of 45 months . During this period there were ten complications in eight patients and in four patients all or part of the system had to be replaced . Nevertheless, the actuarial median functional survival of the implanted system exceeded 30 months . The Port-a-Cath system provides longer periods of venous access and has a lower complication rate than conventional, percutaneous central venous lines.

Clin Exp Dermatol, 1989 Sep, 14(5), 380 - 1
Recurrent blistering distal dactylitis of the great toe associated with an ingrowing toenail; Telfer NR et al.; We report a case of recurrent blistering distal dactylitis in a child . Although the skin returned to normal following antibiotic therapy, blistering later recurred . This recurrence was probably related to an associated ingrowing nail affecting the same digit.

Antibiot Khimioter, 1989 Sep, 34(9), 687 - 91
{Individual schedule of administration of aminoglycosides with reference to anatomo-physiological and pathological factors}; Firsov AA et al.; Potentiality of designing individual dosage of sisomicin and gentamicin in regard to "patient factors" was estimated . 62 adult patients with various pulmonary diseases at the background of volemic disorders of diverse degrees were treated with the aminoglycosides under monitoring of their blood levels . Concentrations of sisomicin and gentamicin in serum 1, 3 and 6 hours after their single administration in a dose of 1 mg/kg were determined by HELC . The antibiotic pharmacokinetics was characterized by pronounced individual variability . The ratio of the difference between the upper and lower confidence limits to the average values of the steady-state volume of distribution, the total clearance and the mean residence time amounted to 70, 60 and 57 per cent respectively . To elucidate the cause of the variability multiple correlation analysis of the pharmacokinetic parameters by the "patient factors" was performed . The highest coefficient of the multiple correlation (r = 0.690) defined relation between the aminoglycoside concentration 1 hour after the injection and the hematocrit, globular volume and phase of the volemic disorders which was expressed in coded variables . The coefficient of the multiple correlation between the total clearance and the body surface area, concentrations of creatinine and urea in serum, hematocrit, circulating blood volume and the phase of the volemic disorders was equal to 0.439 . Therefore, the consideration of the above factors allowed to explain only 20 per cent of the observed individual variability of the pharmacokinetic parameters . In this connection mediated prediction of total clearance and subsequently individual dosage of the aminoglycosides by the "patient factors" was expedient only until the primary data on the pharmacokinetic monitoring were obtained.

Antibiot Khimioter, 1989 Sep, 34(9), 682 - 4
{Quantitative analysis of rifampicin and 25-desacetylrifampicin in the plasma using high performance liquid chromatography}; Manuilov KK et al.; A procedure for determination of rifampicin and 25-desacetylrifampicin in plasma by HPLC was developed . The plasma proteins are precipitated by acetonitrile and the supernatant layer (50 microliters) is used for the assay under isocratic conditions on an analytical column 250 x 4.6 mm in size containing the reversed phase sorbent (C18) . The size of the precolumn is 50 x 4.6 mm . An UV detector (at lambda 335 nm) is used . For preparing the mobile phase 630 ml of methanol and 370 ml of 0.058 M sodium nitrite solution are mixed . The flow rate of the mobile phase is 40.7 ml/min . The assay duration is about 10 min . The retention time is 9.6 min for rifampicin and 6.5 min for 25-desacetylrifampicin . The minimum detectable amount of the antibiotic and its metabolite is 0.10 micrograms/ml . The standard curves of rifampicin and 25-desacetylrifampicin are linear within the concentration ranges of 0.5-100 and 0.5-10 micrograms/ml respectively . The procedure is useful in studies on pharmacokinetics of rifampicin and 25-desacetylrifampicin.

Horm Metab Res, 1989 Sep, 21(9), 489 - 93
Actinomycin D inhibits the rapid increase in translatable calcitonin mRNA provoked by acute calcium stimulation; Segond N et al.; Calcium, injected to rats, elicits a rapid increase in translatable calcitonin mRNA, by acting probably at the post-transcriptional level, as no change in calcitonin mRNA could be detected by hybridization assay . In this study we have measured calcitonin mRNA extracted from rats subjected or not to acute hypercalcemia and pretreated or not with actinomycin D . Calcitonin mRNA was quantified by its ability to direct the synthesis of calcitonin (CT) precursors in a cell free system and by hybridization to a 32P cDNA probe specific for CT mRNA . Actinomycin D, injected 5 hours before calcium administration, decreased the incorporation of 3H adenine in liver and thyroid, but did not inhibit the rise in plasma levels of calcium and CT (measured by radioimmunoassay) . The antibiotic was able to inhibit the eightfold increase in translatable mRNA elicited by calcium administration in the control animals . Hybridizable CT mRNA levels were not modified by the treatments . Thus the increase in translatable CT mRNA after calcium stimulation is independent of CT secretion and is probably due to post-transcriptional modifications involving the expression of other gene(s).

EMBO J, 1989 Sep, 8(9), 2717 - 25
Structure and deduced function of the granaticin-producing polyketide synthase gene cluster of Streptomyces violaceoruber Tü22; Sherman DH et al.; A 6.5 kb region of DNA from Streptomyces violaceoruber, which contains polyketide synthase (PKS) genes for production of the benzoisochromane quinone moiety of the antibiotic, granaticin, was cloned and sequenced . Of six open reading frames (ORFs) identified, four (ORFs 1-4) would be transcribed in one direction and two (ORFs 5 and 6) divergently from ORFs 1-4 . ORF1 and ORF2, which show evidence for translation coupling, encode (deduced) gene products which strongly resemble each other and the Escherichia coli fatty acid ketoacyl synthase (condensing enzyme), FabB . We conclude that ORF1 (which contains a characteristic cysteine residue) functions as a condensing enzyme, possibly as part of a heterodimeric protein including the product of ORF2 . The predicted ORF3 gene product strikingly resembles acyl carrier proteins (ACPs) of fatty acid synthase (FAS), particularly in the region of the active site motif, while the predicted ORF5 and ORF6 gene products resemble known oxidoreductases, suggesting that they function as reductive steps required during assembly of the granaticin carbon skeleton . Comparison of the deduced ORF4 gene product with available protein databases failed to elucidate its potential function . The overall conclusion is that the granaticin-producing PKS would consist of at least six separate enzymes involved in carbon chain assembly, thus resembling a Type II, rather than a Type I, FAS.

J Clin Microbiol, 1989 Sep, 27(9), 2115 - 7
Comparison of three kinds of blood and two incubation atmospheres for cultivation of Bordetella pertussis on charcoal agar; Hoppe JE et al.; We compared the growth of Bordetella pertussis strains (n = 32) on antibiotic-free and cephalexin (40 micrograms/ml)-containing charcoal agar supplemented with 10% defibrinated horse blood, defibrinated sheep blood, or anticoagulant-containing human blood . Plates were incubated either in air or in an atmosphere with 5 to 10% CO2 . As assessed by mean colony numbers and rapidity of growth, normal air was preferable to CO2 enrichment for incubation . Growth on horse blood agar was more abundant and more rapid than on sheep blood agar, but the difference in general was not statistically significant . Human blood was clearly inferior to both horse and sheep blood.

J Virol, 1989 Sep, 63(9), 3829 - 36
Cloning and expression of foreign genes in vaccinia virus, using a host range selection system; Perkus ME et al.; A simple selection system has been developed for the cloning and expression of open reading frames in vaccinia virus . The selection system is based on a conditional lethal (host range) mutant of vaccinia virus . A deletion mutant of the vaccinia virus WR strain was generated by insertion of the neomycin resistance gene from transposon Tn5 and selection with the antibiotic G418 . This deletion recombinant, vP293, lacked approximately 21.7 kilobases of DNA beginning 3.8 kilobases from the left end of the genome, vP293, was capable of plaquing on primary chicken embryo fibroblasts and two monkey cell lines (BSC-40 and Vero) but was defective in replication in the human cell line MRC-5 . Insertion of the host range gene K1L into vP293 restored the ability to grow on MRC-5 cells . A series of plasmids were constructed which in addition to the K1L gene contained a vaccinia virus early-late promoter, H6, followed by a unique polylinker sequence, translational initiation and termination signals, and an early transcription termination signal . These plasmids, pHES1 through 4, allowed for rapid single-step cloning and expression of any open reading frame when recombined in vivo with vP293 and scored for growth on MRC-5 cells.

Derm Beruf Umwelt, 1989 Sep-Oct, 37(5), 183 - 5
{The dangers of olaquindox . Photoallergy, chronic photosensitive dermatitis and extreme increased photosensitivity in the human, hypoaldosteronism in swine}; Schauder S; The antibiotic olaquindox, an ingredient added to porker feed to increase overall performance, caused a photoallergic contact eczema and subsequently a chronic photosensitive dermatitis with increased UV-A- and UV-B-sensitivity in a breeder of small pigs . Through the use of sun creams he developed an additional (photo)allergic contact eczema to the sunscreens contained in the creams.

Rev Med Chil, 1989 Sep, 117(9), 1023 - 8
{Abdominal actinomycosis: review apropos of 3 cases}; Martinez J et al.; Actinomycosis is a chronic bacterial infectious disease, characterized by multiple abscesses, draining sinuses and abundant dense fibrous tissue . The intra-abdominal variety is rarely found and difficult to diagnose . We report three cases of intra-abdominal actinomycosis successfully treated by surgery and by longterm antibiotic therapy . One patient had a liver actinomycosis and two had ileo-caecal disease . Pertinent literature is reviewed.

G Chir, 1989 Sep, 10(9), 505 - 7
{Infections caused by central venous catheter used in surgery}; Mancini S et al.; The central venous catheters, now usually adopted in surgical patients, present some potential septic risks, and the longer the catheter is in place, the more dangerous it is . The authors report their experience on 130 central venous catheters, out of which 96 were used for TPN administration and 34 for monitoring purposes . The catheters were introduced through subclavian, internal jugular or basilic veins, in accordance with a standardized technique . The observed infection percentage, caused by the catheters, was 7.7%; the infection was easily controlled by the catheter removal and a proper antibiotic therapy . The only death, surely due to sepsis, was caused by Candida fungus in an immunosuppressed female patient . Therefore the authors stress the importance to prevent septic complications in order to avoid fatal ones.

Indian J Exp Biol, 1989 Sep, 27(9), 757 - 60
Precocious desynapsis of XY-bivalent in mouse germinal cells: influence of mitomycin C on tumour-bearing and normal mice; Dey D et al.; A comparative study on the cytotoxic potential of anticancer-antibiotic mitomycin C has been made on tumour-bearing and normal mice considering precocious desynapsis of sex bivalent as parameter . The study indicates a strikingly differential effect of the drug on the phenomenon in two different types of mice . The administration of mitomycin C at therapeutic dose although enhances the frequency of precocious desynapsis of XY-bivalent in non-tumour (normal) mice to a significant extent (compared to control), the same drug at the same dose fails to produce a similar effect on tumour-bearing specimens . Discussions have been made on: (i) the probable cause for this differential effect, (ii) the mechanism of mitomycin action on precocious desynapsis of sex bivalent and, (iii) the possible significance of the findings in relation to cancer chemotherapy.

Rev Med Interne, 1989 Sep-Oct, 10(5), 413 - 9
{Candida spondylodiscitis . Report of 2 personal cases and 28 cases from the literature}; Collet P et al.; Vertebral osteomyelitis caused by Candida spp . has recently been described and seems to be rare since only 30 cases have been published so far . Its clinical, laboratory and radiological features are identical with those on non-tuberculous bacterial spondylitis . It develops in subjects with poor general condition who underwent multiple surgical operations or received prolonged antibiotic therapy . The finding of Candida at needle biopsy of the since clinches the diagnosis . Serological tests might provide an earlier diagnosis and, above all, enable therapeutic effectiveness to be evaluated . In 27 of the 30 cases reported here, cure was obtained by prolonged infusions of antifungal drugs, chiefly amphotericin B and/or 5-fluorocytosine.

Antimicrob Agents Chemother, 1989 Sep, 33(9), 1592 - 9
Growth phase dependency of chromatin cleavage and degradation by bleomycin; Moore CW et al.; Preferential cleavage of Saccharomyces cerevisiae chromosomes in internucleosomal (linker) regions and nonspecific degradation of chromatin by an anticancer antibiotic which degrades DNA were investigated and found to increase in consecutive stages of growth . Cleavage of DNA in internucleosomal regions and intensities and multiplicities of nucleosomal bands were dependent on drug concentration, growth phase of the cells, and length of incubation . Cellular DNA was least degraded during logarithmic phase . After cells progressed only one generation in logarithmic phase, low concentrations (6.7 x 10(-7) to 3.4 x 10(-6) M) of bleomycin produced approximately three to seven times more DNA breaks . Internucleosomal cleavage was highest, and the most extended oligonucleosomal series and extensive chromatin degradation were observed during stationary phase . It is concluded that the growth phase of cells is critical in determining amounts of the highly preferential cleavage in internucleosomal regions and overall breakage and degradation of DNA . Mononucleosomal bands were most intense, indicating the greatest accumulation of DNA of this size . Mean mononucleosomal lengths were 165.9 +/- 3.9 base pairs, in agreement with yeast mononucleosomal lengths . As high-molecular-weight chromatin was digested by bleomycin, oligonucleosomes and, eventually, mononucleosomes became digested . Therefore, it is also concluded that bleomycin degradation of oligonucleosomes and trimming of DNA linker regions proceed to degradation of the monosomes (core plus linker DNA).

J Bacteriol, 1989 Sep, 171(9), 4792 - 8
An Escherichia coli mutant resistant to phleomycin, bleomycin, and heat inactivation is defective in ubiquinone synthesis; Collis CM et al.; A mutant of Escherichia coli, selected for resistance to the antibiotic and antitumor agent phleomycin, has been characterized, and the phleomycin resistance determinant has been identified . The mutant is equally resistant to bleomycins . The resistance to phleomycin is strongly dependent on the nature of the C-terminal amine of the drug, with the greatest resistance being shown to phleomycins and bleomycins with the most basic terminal amines . The mutation also confers resistance to the lethal effects of heating at 52 degrees C . Other characteristics of the phleomycin-resistant strain include a slow growth rate, an inability to grow on succinate as the sole carbon source (Suc- phenotype), cross resistance to aminoglycoside antibiotics, and a slight sensitivity to hydrogen peroxide, methyl methanesulfonate, and gamma-irradiation . Some of these characteristics, together with mapping data, suggested that the phleomycin resistance and Suc- determinant probably lies within the ubiF gene coding for an enzyme effecting a step in the biosynthesis of ubiquinone . The phenotypes of known mutants defective in this and other steps of the ubiquinone pathway were found to be closely similar to those of the original phleomycin-resistant strain.

J Immunol, 1989 Sep 1, 143(5), 1580 - 3
FK-506, a potent novel immunosuppressive agent, binds to a cytosolic protein which is distinct from the cyclosporin A-binding protein, cyclophilin; Siekierka JJ et al.; A novel macrolide antibiotic, FK-506, isolated from Streptomyces tsukubaensis, has been shown to be a potent immunosuppressive agent in vivo and in vitro . FK-506 shares a number of immunosuppressive properties with the cyclic peptide, cyclosporin A (CsA), although 10 to 100 times more potent in this regard . These similarities suggest that both agents may share a similar mechanism(s) of action at the biochemical level . We have identified a cytoplasmic binding protein for FK-506 in the human T cell line, JURKAT, using {3H}FK-506 . The FK-506 binding protein has a mr of 10 to 12 kDa (as determined by gel filtration), is heat stable and does not bind CsA . This contrasts with the CsA binding protein, cyclophilin, in that cyclophilin is heat labile and has a mr of 15 to 17 kDa . Our data suggest that FK-506 binds to a low m.w . protein(s) in JURKAT cells, which is distinct from cyclophilin . This protein may mediate the immunosuppressive effects of FK-506 in T cells . In addition, our results suggest that the immunosuppressive activity of FK-506, as with CsA, is mediated by an intracellular mechanism.

Minerva Chir, 1989 Aug 31, 44(15-16), 1825 - 9
{Considerations on the pre- and peri-operative preparations in surgery of the colon}; Pira L; The type and frequency of local postoperative complications after 265 elective colon-rectal operations occurring in 262 patients are described . The orthograde enema, which causes discomfort to the patients and a considerable amount of work for the nursing staff can be waived . Since the results obtained (11.5% local postoperative complications) are regarded as satisfactory and display no marked differences from the incidence with orthograde enema, the case for the combination of pre- and postoperative antibiotic infection prophylaxis is substantiated.

Biochemistry, 1989 Aug 22, 28(17), 7097 - 101
Conformation and reactivity changes induced by N-methylkirromycin (aurodox) in elongation factor Tu; Balestrieri C et al.; Kirromycin and related antibiotics inhibit protein synthesis in bacteria by acting on elongation factor Tu (EF-Tu) . We have studied the effects of N-methylkirromycin (aurodox) on some molecular properties of this protein . The binding of the antibiotic causes a dramatic variation in the protein fluorescence emission spectrum with the appearance of a new maximum at around 340 nm . Addition of aurodox to trypsinized EF-Tu resulted in an emission spectrum similar to that of the denatured intact factor . Fluorescence lifetime analysis performed by a multifrequency phase fluorometer indicated that the fluorescence emission of the factor is heterogeneous with the major component having a lifetime near 4.8 ns in the absence and 6.6 ns in the presence of the antibiotic . These results were interpreted in terms of an antibiotic-induced environmental modification of the unique tryptophan residue of the protein leading to an increase in its quantum yield . However, aurodox did not modify the solvent exposure of this residue, as judged by fluorescence quenching experiments . Moreover, 1-anilino-8-naphthalenesulfonate (ANS) binding studies, as well as analysis of the protein reactivity toward the sulfhydryl group reagent 5,5'-dithiobis(2-nitrobenzoate) (DTNB), showed that, in the presence of aurodox, the behavior of the EF-Tu-GDP complex nears that of EF-Tu.GTP . These results strongly support the hypothesis that aurodox not only confers a "GTP-like" conformation to the EF-Tu.GDP complex but also produces a less stable folding of the protein around the tryptophan residue that may contribute to the multiple functional effects of this antibiotic.

Pol Tyg Lek, 1989 Aug 21-28, 44(34-35), 792 - 4
{Cefoperazone in the treatment of infections in newborn infants}; Krzeska I et al.; The authors evaluated clinically cefoperazone (Cefobid-Pfizer)--an antibiotic of the III generation of cephalosporins--administering it in the form of monotherapy to 32 infected neonates and premature babies . A complete recovery was achieved im 25 neonates, i.e . 78.1%, out of which 76.5% were generalized infections . The result of therapy was doubtful in the remaining 7 babies (21.9%) . The drug was changed or the second antibiotic added . No decidedly unfavourable results (deaths) or adverse reactions necessitating withdrawal of the drug were observed . The authors compare this favourable results with the mortality rate of neonates prior to the introduction of the II and III generation cephalosporins . It was about 14%, then . Therefore, both +antibiotic monotherapy and cefoperazone enabling its use are worth wide popularization in neonates and small babies.

Tijdschr Diergeneeskd, 1989 Aug 15, 114(15-16), 829 - 38
{Escherichia coli mastitis in cattle . I . Clinical diagnosis and epidemiological aspects}; Schukken YH et al.; The diagnostic aspects, incidence, risk factors and prevention of coliform mastitis are reviewed in the present paper . It is concluded that it is not possible to establish an accurate diagnosis of coliform mastitis, which is based on a specific clinical symptom differentiating it from other forms of mastitis . Not any single symptom or combination of symptoms is specific for coliform mastitis . The importance of coliform mastitis in dairy cattle showed a marked increase during the last few decades . Successful programmes for the prevention of mastitis reduced the importance of contagious organisms, but the overall incidence of mastitis has remained unchanged; therefore, the proportion of cases of coliform mastitis increased . The observation that coliform micro-organisms are common bacteria causing mastitis in herds with low bulk milk somatic cell counts implies that the future of the dairy industry will be associated with particular risks . Factors involving the risk of coliform mastitis are divided into cow level factors and herd level factors . The most important cow level factors were: leaking milk in between milkings, lesions of the teats and a reduced capacity of the immune system . Risk factors on the herd level include: the bedding material, the design of cubicles, exposure to daylight in summer-time, exposure to dirt and the use of dry-cow therapy . The possible role of antibiotic dry-cow treatment and teat dipping in colonisation resistance is discussed . Preventive programmes designed to reduce the incidence of coliform mastitis have not been very successful so far.

Cancer, 1989 Aug 15, 64(4), 806 - 11
Nodular form of bleomycin-related pulmonary injury in patients with osteogenic sarcoma; Santrach PJ et al.; Bleomycin (BLEO), an antitumor antibiotic effective against a variety of malignancies, has been associated classically with a pulmonary toxic reaction producing diffuse interstitial fibrosis . However, BLEO-related pulmonary nodules have been reported recently, mostly in children and young adults treated for germ cell tumors . A different, apparent hypersensitivity reaction with prominent eosinophilic infiltrates has been seen in other patients . This report details the clinical history, radiographic features, and histopathologic condition of three patients with osteogenic sarcoma in whom pulmonary nodules developed during the course of their multiagent, BLEO-containing chemotherapy . The predominant histopathologic lesion was bronchiolitis obliterans-organizing pneumonia (BOOP); one patient had a significant eosinophilic infiltrate also . Pulmonary lesions developed in all of these patients after relatively low doses of BLEO (less than 200 mg) . All of these patients underwent open lung biopsy to establish the diagnosis . Reported cases of BLEO-induced pulmonary injury other than diffuse fibrosis are reviewed and comparisons are made with those in the current report . Also, suggestions are made for the management of these patients.

Nippon Geka Gakkai Zasshi, 1989 Aug, 90(8), 1274 - 7
{Mycotic abdominal aneurysm requiring emergency operation due to sudden thrombotic obstruction: a case report}; Enomoto S et al.; A 59-year-old man was admitted with history of low grade fever, general malaise and low back pain . Physical examination showed a pulsatile mass in the mid-abdomen . There were slight leucocytosis, elevated BSR and CRP . Abdominal ultrasonography, CT and MRI revealed an abdominal aneurysm within which there was an intimal flap and thrombus . Though blood culture was not positive, antibiotic therapy was initiated on the presumption of a mycotic abdominal aneurysm . Six days after admission, he complained of numbness in the lower extremities and both femoral pulsations were not palpable . Emergency surgery was undertaken . The aneurysm was adhered to the IVC and the ileum and there was a large thrombotic mass in it . Aneurysmectomy and Y-graft interposition were done uneventfully . Pathology revealed marked thickness of the aorta and infiltration of lots of inflammatory cells . The culture of aneurysmal wall was negative . This is the very rare case because of sudden thrombotic occlusion of the mycotic abdominal aneurysm . Several important features of this disease have been also discussed.

Jpn J Antibiot, 1989 Aug, 42(8), 1745 - 50
{Clinical studies on cefteram pivoxil in pediatrics}; Yokoyama M et al.; Cefteram pivoxil (CFTM-PI), a newly developed oral cephem antibiotic was administered to treat 16 children with various infections . The results were summarized as follows . 1 . The clinical responses were "excellent" in 7, "good" in 5, "fair" in 3 and "poor" in 1, with 75.0% efficacy rate . 2 . No side effects and no abnormal laboratory findings were observed.

Jpn J Antibiot, 1989 Aug, 42(8), 1720 - 6
{Clinical evaluation of cefpiramide for infections in leukemia and related disorders}; Nakagawa H et al.; Forty one patients with infections associated with leukemia and related disorders were treated with cefpiramide (CPM) . In 26 patients among them, we were able to evaluate the effectiveness of CPM against infections . Fifteen patients were not evaluated, because 6 patients were subjected to additional therapy such as gamma-globulin and other antibiotics, 5 were prophylactically treated, 2 had fever episode which were retrospectively reviewed to be originated from tumor mass, 1 received too short a duration of administration of CPM (2 days) to evaluate its effectiveness, and 1 with whom no precise data were recorded . Excellent responses were observed in 10 patients (38.5%) and good responses in 6 (23.1%) among these 26, with a total efficacy rate of 61.5% . Whereas, we found only one patient who showed an unfavorable side effect out of 31 patients including the 26 and 5 other patients who were prophylactically treated . The side effect observed was a mild bleeding tendency occurred in 77 years old female at 11 days after CPM was administrated . The bleeding tendency was easily diminished with the cessation of CPM treatment and a parenteral use of vitamin K . These results suggest that CPM is an effective and safe antibiotic for the treatment of infections in patients with leukemia and related disorders.

Nippon Kyobu Geka Gakkai Zasshi, 1989 Aug, 37(8), 1565 - 9
{Poststernotomy mediastinitis treated by early surgical intervention}; Oku T et al.; Poststernotomy mediastinitis in 67-year-old female was successfully treated by early operation after coronary artery revascularization using bilateral internal mammary arteries and gastroepiploic artery . Wider debridement including sternum, ribs, mediastinal fat and connective tissues, and transfer of rt-pectoralis major muscle flap into the mediastinum to obliterate the dead space was performed . The sternal wound was primarily closed without postoperative irrigation . The sternum was stayed open without using any artificial substitute . In conclusion, the early diagnosis and operation is the key for successful treatment of poststernotomy mediastinitis . Wider debridement including sternum and ribs with perioperative lavage by diluted povidone-iodine solution and antibiotic solution should be done aggressively, and the transfer of the major pectoral muscle flap and skin closure without postoperative irrigation is an effective method of choice . Additional reconstruction of anterior chest wall should be considered if necessary, when the inflammatory process is subsided.

Helv Chir Acta, 1989 Aug, 56(3), 365 - 7
{Is there a thrombophlebitis or subcutaneous lymphangitis of the penis?}; Von Rutte B; Twelve patients suffering from subcutaneous dorsal induration of the penis were investigated . The diagnosis of a lymphangitis or thrombophlebitis depends on clinical features . It is of nonvenereal origin, and the treatment, if necessary, consists in local or systemic antiinflammatory or antibiotic therapy.

Int J Clin Pharmacol Ther Toxicol, 1989 Aug, 27(8), 388 - 91
Epirubicin high-dose therapy in advanced breast cancer: preliminary clinical data . Epirubicin as a single agent in breast cancer; Neri B et al.; Of the new anthracycline derivatives, epirubicin is the antibiotic whose antitumor activity is comparable to that of doxorubicin while its cardiotoxicity is reduced by half . We therefore incorporated into our continuing study on anthracycline antitumor effects and toxicity a group of 22 evaluable patients, mean age 52 years, with advanced breast cancer, all of whom had previously undergone chemotherapy, radiotherapy and/or hormonal therapy . Epirubicin was administered at a dose of 120 mg/M2 every 3 weeks, for a maximum of 10 such cycles . The left ventricular ejection fraction (LVEF), determined by radionuclide ventriculography, was measured periodically in all patients . We observed 2 complete responses and 13 partial responses (CP + PR = 69%) of 61 weeks' mean duration; in 3 cases lesions remained stationary while the disease progressed in 4 patients . No patients died of acute toxicity . The main side effects were severe alopecia in 82% of the subjects and moderate degrees of nausea without vomiting in 41% . After 6 treatment cycles, 4 patients showed mild cardiotoxicity and at an epirubicin cumulative dose of 1,200 mg/M2 2 patients developed congestive heart failure (CHF) . Hematological toxicity was in no case so severe as to require a reduction in the dose but only a postponement of treatment by 3 to 5 days in 9% of cycles . Without increasing hematological or cardiac toxicity, epirubicin, at a dose of 120 mg/M2, has shown itself to be a highly effective agent against advanced breast cancer.

Spine, 1989 Aug, 14(8), 808 - 11
Gunshot wounds to the spine associated with a perforated viscus; Roffi RP et al.; The cases of 42 patients with low-velocity gunshot wounds to the spine with an associated perforated viscus were reviewed . All viscus perforations occurred prior to the spinal injury . There were a total of 51 perforations, including 14 of the colon, 15 of the small bowel, 15 of the stomach, five of the esophagus, and two of the pharynx . All patients had significant neurologic deficits, with 23 patients suffering a complete neurologic injury . Average clinical follow-up was 18 months (range: 4-64 months) . Only three patients developed documented spinal or paraspinal infections . One case of acute meningitis occurred after an isolated stomach perforation, while two other patients developed psoas abscesses after colon injuries . The roles of initial antibiotic therapy and of early bullet removal were evaluated in regard to infection . An extended course of broad spectrum antibiotics combined with bedrest appeared to significantly reduce the risk of spinal or paraspinal infection as compared with a previous study . Early bullet removal did not appear to be a significant factor in the prevention of infection . Prospective studies are needed to accurately delineate the role of initial antibiotic therapy for the prevention of spinal infection in these injuries.

J Pharm Sci, 1989 Aug, 78(8), 648 - 51
Non-micelle forming bile acids increase biliary gentamicin excretion in the rat; Oehler R et al.; To investigate whether non-micelle forming bile acids are able to increase biliary gentamicin excretion, male Sprague-Dawley rats were anesthetized with pentobarbital and fitted with a biliary fistula . After a control period of 30 min, dehydrocholate, taurodehydrocholate, or norursodeoxycholate were administered iv at doses of 2 or 10 mumol.min-1.kg-1 . Taurodehydrocholate increased bile flow and biliary gentamicin clearance similarly in a dose-dependent fashion . Its unconjugated analogue, in contrast, increased gentamicin clearance fourfold, while increasing bile flow only 1.6-fold . This suggests that other than purely osmotic phenomena were involved . This effect was even more marked for the short-chain bile acid, norursodeoxycholate . At a dose of 2 mumol.min-1.kg-1 it increased bile flow by 30%, but gentamicin clearance by 210%; a similar discrepancy between choleresis and gentamicin clearance was observed at the higher dose tested . It may be concluded that conjugated triketo bile acids increase biliary gentamicin clearance by osmotic choleresis . Unconjugated triketo bile acids and nor-bile acids, to an even greater extent, increase gentamicin clearance much more markedly than bile flow; other effects, such as the putative cholahepatic shunt pathway, are responsible for this phenomenon . This novel therapeutic principle might be useful in achieving therapeutic biliary antibiotic concentrations or in treating gentamicin intoxication in patients with renal insufficiency.

Geriatrics, 1989 Aug, 44 Suppl A, 28 - 31
Treatment of nosocomial pneumonia: monotherapy versus combination therapy; Greco T; Pneumonia accounts for 15% of all nosocomial infections, and mortality case rates are as high as 60% . Aspiration of oropharyngeal flora is the most common antecedent to nosocomial pneumonia . Patients with chronic lung disease, depressed levels of consciousness, or who are intubated are at increased risk of developing pneumonia . We conducted two comparative, prospective studies using monotherapy with third-generation cephalosporins--the first comparing cefoperazone with combination therapy, and the second comparing cefoperazone monotherapy with ceftazidime monotherapy--for the treatment of nosocomial pneumonia in mildly to moderately ill patients . We found that both cefoperazone monotherapy and ceftazidime monotherapy were as effective as standard two-drug combinations (clindamycin/gentamicin or cefazolin/gentamicin) . When total antibiotic costs were compared, cefoperazone monotherapy was the least expensive regimen.

J Pediatr Surg, 1989 Aug, 24(8), 729 - 32
Cholangitis after the Kasai operation for biliary atresia; Rothenberg SS et al.; One hundred seventy-nine episodes of cholangitis in 28 consecutive patients having a Kasai operation for biliary atresia during the past 3 1/2 years were analyzed . The diagnosis was made primarily on the basis of unexplained fever (greater than 38.0 degrees C) . An increase in serum bilirubin or a decrease in bile volume and in bile bilirubin concentration were often confirmatory, but other laboratory data including serum hepatic enzymes and blood and bile culture data were of little or inconsistent value . All patients were treated with systemic antibiotics . The best results were obtained with third-generation cephalosporins or imipenemcilastatin with the addition of aminoglycosides in recalcitrant cases . Antibiotic therapy was modified if defervescence did not occur within the first 24 hours . Cholangitis refractory to antibiotics was aggressively treated with pulse steroid therapy, and in some cases, operative intervention, both with good clinical success (60% and 73%, respectively).

Int J Cardiol, 1989 Aug, 24(2), 173 - 7
Efficacy of aortic balloon valvoplasty: direct measurement of orificial area in a model with pulsatile flow; Sprigings DC et al.; The efficacy of balloon valvoplasty of calcific aortic stenosis remains controversial . We studied, therefore, 5 human aortic valves obtained at necropsy in a positive-displacement pulse duplicator which delivered stroke volumes of 40-100 ml with a quasiphysiological waveform of flow . All valves had three leaflets without commissural fusion and were preserved in antibiotic solution before study . Orificial area was planimetered from videotape of opening of the valve and varied with flow in all cases . Valvoplasty with a 20 mm diameter balloon had no effect on the orifice of the normal valve but increased the orifice of 2 mildly calcified valves from 0.70-1.77 cm2 (range) at baseline to 1.06-1.95 cm2 . In 2 valves with severe calcification of the leaflets, the orifice was increased from 0.31-0.82 cm2 to 0.73-1.07 cm2 . Dual balloon valvoplasty achieved a variable but small further increase in orificial area . No valve showed tears of the leaflets or fracture of calcific deposits after valvoplasty . We conclude that balloon valvoplasty can acutely increase orificial area, independently of any change in stroke volume . In valves without commissural fusion, its mechanism appears to be an increase in the pliability of the leaflets which does not require macroscopic fracture of calcific deposits.

Urology, 1989 Aug, 34(2), 89 - 92
Conservative management of renal carbuncles in children; Whitfield JD et al.; Renal carbuncles have traditionally been treated with surgical drainage and appropriate antibiotic therapy . Recently, 2 pediatric patients with well-documented renal carbuncles were treated with antibiotic therapy alone . Close follow-up documented complete resolution in both cases . Late studies showed no evidence of renal scarring or functional compromise.

Ann Emerg Med, 1989 Aug, 18(8), 856 - 62
Analysis of emergency department management of suspected bacterial meningitis; Talan DA et al.; Previous studies of emergency department management of bacterial meningitis have indicated that there are often long delays before initiation of antibiotics . The purpose of our study was to determine whether these delays were related to specific aspects of patient management . From 1981 through 1988, we retrospectively reviewed the medical records of 122 patients primarily evaluated in the ED and admitted for suspected bacterial meningitis at a university (55) and a community (67) hospital . The median time (interquartile range) from ED registration until initiation of antibiotics (time to antibiotics) was 3.0 hours (1.6 and 4.3 hours, respectively) (total range, 0.5 to 18 hours) . The time to antibiotics was not significantly related to the time of ED registration . Ninety percent of the total time to antibiotics occurred after the initial physician encounter . Time to antibiotics was significantly (P less than .00005) longer for patients in whom computed tomography scan and/or laboratory analysis of cerebrospinal fluid preceded initiation of antibiotics compared with patients in whom antibiotic administration was not contingent on the results of these procedures (4.3 {3.2 and 6.0} versus 1.9 {1.2 and 3.4} hours, respectively) . Also, time to antibiotics was significantly (P less than .00005) longer for patients in whom antibiotics were initiated on the ward as compared with in the ED (4.5 {3.5 and 6.8} versus 2.2 {1.4 and 3.5} hours, respectively) . We conclude that long delays exist in the ED before initiation of antibiotics for cases of suspected bacterial meningitis, and that in general these delays appear to be physician generated and to a great extent potentially avoidable.

J Surg Res, 1989 Aug, 47(2), 183 - 8
Glucan enhances survival in an intraabdominal infection model; Bowers GJ et al.; The immunomodulator glucan exists in two forms, particulate (glucan-P) and soluble (glucan-F) . Both preparations of glucan, either alone or in combination with antibiotic therapy, were evaluated for their ability to augment survival in rats following cecal ligation and puncture (CL/P) . Adult male rats were infused once daily for 5 consecutive days with either glucan-P (10 mg/kg), glucan-F (10 mg/kg), or 5% (w/v) dextrose in water . Three days later all rats underwent CL/P . Postoperatively, the rats received (a) no therapy, (b) saline (1 ml subcutaneously every 12 hr) or (c) ampicillin (33 mg/kg subcutaneously every 12 hr) for 7 days . Without any associated pre-or postoperative treatment, CL/P was associated with an 85% 7-day mortality . Neither glucan preparation alone significantly altered this mortality . Administering ampicillin postoperatively decreased the mortality to 53% (P less than 0.001 vs untreated controls) . When postoperative ampicillin therapy was combined with preoperative glucan treatment, the mortality was reduced even further (26% for glucan-P, 21% for glucan-F; P less than 0.02 vs ampicillin-treated controls) . We conclude from these results that (i) neither glucan preparation alone effectively enhances survival following CL/P when using the doses and administration schedule employed herein, (ii) both glucan-P and glucan-F do act synergistically with antibiotics to enhance survival in this rat model of polymicrobial sepsis, and (iii) in this particular model, nontoxic glucan-F is as efficacious as glucan-P.

J Am Acad Dermatol, 1989 Aug, 21(2 Pt 2), 410 - 3
Leukemia cutis presenting as a scrotal ulcer; Zax RH et al.; A patient with acute nonlymphocytic leukemia developed a painful scrotal ulcer thought initially to be caused by infection . The lesion failed to heal with oral antibiotic therapy and local wound care . Histopathologic examination of a biopsy specimen revealed an infiltrate of leukemic cells . This cutaneous lesion heralded the relapse of acute myelogenous leukemia . A review of the literature indicates that acute nonlymphocytic leukemia rarely presents as an ulcer or on the genitalia, thus emphasizing the uniqueness of this case regarding morphology, and site of presentation . To our knowledge, this is the first case of leukemia cutis presenting as a scrotal ulcer . Therefore leukemia cutis should be added to the differential diagnosis of chronic genital ulcers . Also, because a variety of skin lesions may signify the relapse of leukemia, any skin lesion in a patient with leukemia should be examined by biopsy.

Chest, 1989 Aug, 96(2), 419 - 20
Reversion of mitral valve preclosure in acute aortic insufficiency secondary to infective endocarditis; Rozich JD et al.; A 59-year-old man presented with culture-negative endocarditis . Serial echocardiographic/Doppler studies disclosed progressive aortic insufficiency with resultant premature closure of the mitral valve . At the time the patient developed PMVC he was considered for emergent aortic valve replacement; ultimately, however, he was deemed inoperable because of his underlying medical problems . Surprisingly, the patient gradually improved on antibiotic therapy alone, with subsequent hemodynamic stabilization and reversion of the PMVC . This case represents the first description of reversion of PMVC in a medically treated patient with severe aortic insufficiency secondary to infective endocarditis, and underscores the importance of basing management decisions concerning aortic valve replacement in infective endocarditis upon the entire constellation of clinical findings rather than a single echocardiographic sign.

J Neurochem, 1989 Aug, 53(2), 442 - 7
Characterization of the effect of monensin on gamma-amino-n-butyric acid release from isolated nerve terminals; Sitges M; The action of the polyether antibiotic monensin on the release of gamma-{3H}amino-n-butyric acid {( 3H}GABA) from mouse brain synaptosomes is characterized . Monensin enhances the release of this amino acid transmitter in a dose-dependent manner and does not modify the efflux of the nontransmitter amino acid alpha-{3H}aminoisobutyrate . The absence of external Ca2+ fails to prevent the stimulatory effect of monensin on {3H}GABA release . Furthermore, monensin is less effective in stimulating {3H}GABA release in the presence of Ca2+ . The releasing response to monensin is absolutely dependent on external Na+ . The blockade of voltage-sensitive Na+ or Ca2+ channels does not modify monensin-induced release of the transmitter . Also, the blockade of the GABA uptake pathway fails to prevent the stimulatory effect of monensin on {3H}GABA release . Although monensin markedly increases Na+ permeability in synaptosomes, these data indicate that the Ca2+-independent monensin-stimulated transmitter release is not mediated by the Na+-dependent uptake pathway . It is concluded that the entrance of Na+ through monensin molecules inserted in the presynaptic membrane might be sufficient to initiate the intraterminal molecular events underlying transmitter release.

J Med Assoc Thai, 1989 Aug, 72(8), 465 - 8
Pulmonary sequestration: ultrasonographic visualization of feeding artery; Tritrakarn A; An intralobar pulmonary sequestration was diagnosed by ultrasonography in a child presenting with chronic respiratory infection . Chest radiograph showed multicystic infiltration in the left lung base . This was diagnosed as cystic bronchiectasis and failed to clear up in spite of adequate antibiotic therapy . Ultrasound (real-time) examination suggested pulmonary sequestration, and an aberrant blood supply was demonstrated . Subsequent angiography, surgery and pathological examination of the resected segment confirmed the diagnosis.

J Reprod Med, 1989 Aug, 34(8 Suppl), 605 - 9
Pelvic inflammatory disease; Spence MR; Pelvic inflammatory disease (PID) is a genital tract infection that affects a predominantly young and sexually active population . While its exact pathogenesis has yet to be determined, it appears to be caused by several micro-organisms that develop in response to one or more of the following: foreign bodies, such as intrauterine contraceptive devices, retained tampons and douching solutions, and surgery, such as endometrial biopsy and hysterosalpingography . The most common risk factor for PID is multiple sexual partners . The disease is associated with infertility, sterility and adverse pregnancy outcomes . Management calls for aggressive antibiotic therapy and the temporary suspension of sexual activity.

Br J Surg, 1989 Aug, 76(8), 821 - 4
Surgical management of neutropenic enterocolitis; Koea JB et al.; Three cases of histologically confirmed neutropenic enterocolitis, each presenting as an acute abdomen in patients with leukaemia are presented . All three patients presented with fever and abdominal pain within 14 days of completing a course of chemotherapy . Signs of peritonitis localized to the right iliac fossa developed in each patient, in spite of aggressive antibiotic therapy and bowel rest . All three patients were found to have non-viable caecum at laparotomy and were treated by right hemicolectomy . Primary ileocolic anastomosis was performed in one patient, who recovered following a stormy postoperative course owing to sepsis . Two patients underwent formation of an ileostomy with distal mucous fistula and each recovered with minimal postoperative complications; secondary anastomosis was performed electively in both cases . The difficulty in diagnosing neutropenic enterocolitis preoperatively is discussed and the place of non-operative management is reviewed but we recommend surgical intervention as a means of ensuring removal of a localized septic focus until marrow regeneration occurs.

Neurology, 1989 Aug, 39(8), 1118 - 20
Latent Lyme neuroborreliosis: presence of Borrelia burgdorferi in the cerebrospinal fluid without concurrent inflammatory signs; Pfister HW et al.; Borrelia burgdorferi, the etiologic agent of Lyme borreliosis, was isolated from the CSF of a patient with elevated serum IgG antibody titers against B burgdorferi and a history of multiple tick bites . The absence of concurrent inflammatory signs of CSF as well as intrathecal antibody production indicates a phase of latent Lyme neuroborreliosis in which no tissue infection or reaction has yet occurred . Bilateral tinnitus was the only clinical symptom in this patient . The persistence of the bilateral tinnitus after antibiotic therapy did not support a causal relationship between this symptom and the borrelial infection.

J Bone Joint Surg Am, 1989 Aug, 71(7), 994 - 1004
Reconstruction of large diaphyseal defects, without free fibular transfer, in Grade-IIIB tibial fractures; Christian EP et al.; Eight Grade-IIIB tibial fractures that were associated with large soft-tissue and segmental diaphyseal defects, averaging ten centimeters in length, were successfully reconstructed without the use of a free fibular transfer . A free tissue flap was the preferred form of soft-tissue coverage . The osseous reconstruction was accomplished by using a massive amount of autogenous cancellous bone graft . Beads that were made from polymethylmethacrylate and impregnated with two antibiotics at the time of operation were used as soft-tissue spacers to preserve the volume of the diaphyseal defect for later receipt of the cancellous bone graft . The beads prevented the soft-tissue flap from collapsing into and adhering to the site of the tibial defect . The beads also served as vehicles for local delivery of the antibiotics that they contained . When the soft-tissue flap had healed, the beads were replaced with cancellous graft . All of the tibiae healed . The time to healing averaged nine months . The average duration of external fixation was 5.5 months . One deep infection developed, but resolved after debridement and antibiotic therapy . This conservative technique is safe and reliable for patients who have sustained a high-energy tibial fracture and a large segmental diaphyseal defect.

Transplantation, 1989 Aug, 48(2), 266 - 71
Biopsy diagnosis and clinical outcome of persistent focal pulmonary lesions after marrow transplantation; Crawford SW et al.; We reviewed the results of all percutaneous fine needle aspirations (FNA) and open lung biopsies (OLB) after bone marrow transplantation at our center (1984-1987) for the evaluation of focal lung lesions that developed or persisted despite antibiotic administration . We sought to determine the prevalence and types of infections, the yield of diagnostic procedures, and the clinical outcome of these focal lesions . Infection was documented in 78% (18/23) of all lesions and was fungal in each case . FNA detected fungal lung infection with a sensitivity of 67% (10/15) but had a negative predictive value of only 50% (5/10) . Complications occurred in 15% of FNA . OLB without prior FNA was performed in 6 cases and demonstrated fungal infections in 5 . Overall, seven of the 18 patients with localized invasive fungal lung disease recovered after antifungal therapy . This study demonstrates that focal lung lesions that develop or persist despite antibiotics after BMT are most often fungal . FNA may safely identify these localized infections in selected patients and with appropriate treatment recovery may be achieved.

Emerg Med Clin North Am, 1989 Aug, 7(3), 667 - 82
Toxicologic causes of acute abdominal disorders; Mueller PD et al.; A variety of drugs and toxins can produce severe abdominal pain and, in some cases, a surgical abdomen . Toxins can be classified according to mechanisms of injury: 1 . Corrosives often produce severe gastroenteritis and may result in gastric or esophageal perforations . Examples of corrosive substances include aspirin, iron, mercury, acids and alkali . 2 . Drugs may cause intestinal ileus or obstruction by pharmacologic actions (i.e., anticholinergic drugs and narcotics) or by mechanical obstruction (charcoal and drug bezoars) . 3 . Abdominal pain simulating an acute abdomen may result from systemic effects of black widow spider envenomation or intoxication with heavy metals such as lead and arsenic . 4 . Ischemic bowel disease may occur from use of vasoconstrictor drugs, such as ergotamines, amphetamines and cocaine, or may follow treatment with catecholamines or digitalis in critically ill patients . Small bowel ischemia is life-threatening and may require bowel resection . 5 . Many drugs cause abdominal pain by directly injuring abdominal organs, such as the liver and pancreas . Antibiotic-associated colitis may present with abdominal pain and inflammatory diarrhea . Consideration of drugs and toxins plays an important role in the differential diagnosis of the acute abdomen.

Fiziol Zh SSSR Im I M Sechenova, 1989 Aug, 75(8), 1095 - 101
{The effect of neomycin on the contractile activity of the skeletal muscles in the frog}; Danilenko MP et al.; Neomycin, a selective inhibitor of the phosphoinositide metabolism, depending on its concentration and the incubation time, depressed the K+-contractures and contractions of m . sartorius R . ridibunda caused by a single or a tetanic electrostimulation . In the experiments on m . rectus abdominis, neomycin inhibited the Ach- and oubaine contractures but not the K+ ones . The contractures of both muscles induced with caffeine did not change in presence of the above antibiotic . The data obtained suggest a participation of phosphoinositides contractions of skeletal muscles induced by excitation of the plasma membrane.

Antibiot Khimioter, 1989 Aug, 34(8), 620 - 4
{Pharmacokinetics of azlocillin in critical conditions: an individualized schedule of drug administration in relation to anatomo-physiologic and pathologic factors}; Firsov AA et al.; Azlocillin pharmacokinetics was studied after a single intravenous injection of the antibiotic in a dose of 4 g in 20 patients in critical state . To elucidate the causes of significant individual variability of the antibiotic pharmacokinetics observed in the patients, multiple correlation analysis of the main pharmacokinetic parameters i . e . the area under the concentration/time curve, total clearance, steady-state volume of distribution and mean residence time was performed in regard to the "patient factors" such as sex, age, the volumes of transfused liquid, blood, plasma and blood substitutes, hemoglobin levels, erythrocyte count and ESR . Adequate correspondence of the predicted by the "patient factor" values of the areas under the concentration/time curve and the total clearance to the actually determined values was observed . Correspondence of the predicted values to the steady-state volume of distribution and the mean residence time to the actually determined values was satisfactory . A procedure for design of azlocillin individual dosage regimens based on calculating individual clearance by the "patient factors" is described.

Surg Neurol, 1989 Aug, 32(2), 105 - 10
Craniotomy improves outcome in subdural empyema; Feuerman T et al.; Renewed uncertainty regarding the best technique of surgical therapy (burr holes versus craniotomy) for subdural empyema prompted a review of the experience with this disease entity at UCLA . Based on data obtained from this review and from studies previously published in the literature, the keys to optimal outcome are rapid diagnosis, craniotomy with total removal of pus, and appropriate antibiotic therapy . The clinical syndrome of subdural empyema can overlap that of other intracranial infections; infants and young children present with a different syndrome than older children and adults . Computed tomography scanning is nearly always diagnostic but may be equivocal or normal; magnetic resonance imaging may become the diagnostic study of choice . Multiple organisms are often cultured, which requires multiple drug therapy.

Antimicrob Agents Chemother, 1989 Aug, 33(8), 1393 - 4
In vitro studies of Chlamydia trachomatis susceptibility and resistance to rifampin and rifabutin; Treharne JD et al.; Although rapid emergence of antibiotic-resistant mutants of Chlamydia trachomatis occurs when the organism is grown in subinhibitory concentrations of rifampin, no such mutants could be demonstrated when the organism was propagated under the same conditions in subinhibitory levels of the related drug rifabutin.

J Gen Virol, 1989 Aug, 70 ( Pt 8), 2171 - 7
Retention and expression of the left end subfragment of the herpes simplex virus type 2 BglII N DNA fragment do not correlate with tumorigenic conversion of NIH 3T3 cells; Kessous-Elbaz A et al.; Cotransfection experiments have been carried out using recombinant plasmids pAG60, conferring resistance to antibiotic G418, and pXho3 which contains the left end subfragment (map coordinates 0.583 to 0.596) of the transforming herpes simplex virus type 2 BglII N DNA fragment and encodes the 36K polypeptide associated with the viral ribonucleotide reductase activity . Several NIH 3T3 cell clones resistant to G418 and having morphological changes commonly observed for transformed NIH 3T3 cells were isolated and examined for the presence and stable retention of the viral sequences . Seven of the clones that retained the transfected viral sequences were analysed for the expression of the 36K polypeptide and the tumorigenic phenotype . The results gathered from these studies show that neither the retention of the viral DNA nor the expression of the 36K polypeptide correlated with tumorigenic conversion of these cells.

Cardiovasc Res, 1989 Aug, 23(8), 709 - 14
Uneven host tissue ongrowth and tissue detachment in stent mounted heart valve allografts and xenografts; Maxwell L et al.; Following explanation from the mitral position because of primary tissue failure, 30 human antibiotic sterilised stent mounted aortic valve allografts and 28 glutaraldehyde treated porcine xenografts were examined for evidence of tissue detachment from the stents . These grafts had been in situ for 34 to 166 months . Graft detachment had occurred from one or two stent posts with displacement of the commissures and central valvular incompetence in 12 (67%) of 18 allografts supported on rigid stainless steel stents, in six (50%) of 12 allografts mounted on flexible acetal copolymer stents, but in only one (4%) of 28 xenografts mounted on polypropylene stents . In regions of detachment the aortic remnant of the graft was infiltrated by components of blood and phagocytic cells which had removed not only fibrin but also graft tissue . Detachment did not occur from stent posts where the graft margin had become coated by collagenous host tissue . This intimal fibrous sheath appeared not only to strengthen the attachment of the graft but also to limit the entry of fibrin and phagocytes into the graft tissue.

Contact Dermatitis, 1989 Aug, 21(2), 79 - 82
Erythroderma due to ribostamycin; Puig LL et al.; A 48-year-old man became erythrodermatous after intramuscular administration of ribostamycin, an aminoglycoside antibiotic in the same family as neomycin . Patch tests were positive to ribostamycin and neomycin, as well as to mercurials . There was no mercurial preservative in the injection solution . A lymphocyte transformation test was positive for ribostamycin and tobramycin, but not for gentamycin . Diagnostic and structure-activity relationship aspects of the case are discussed.

Endod Dent Traumatol, 1989 Aug, 5(4), 188 - 92
Effects of combining Ledermix and calcium hydroxide pastes on the diffusion of corticosteroid and tetracycline through human tooth roots in vitro; Abbott PV et al.; A 50:50 mixture of a corticosteroid/antibiotic paste and calcium hydroxide has been used clinically as a root canal dressing agent . This study investigated the effect on the release and diffusion of the corticosteroid and antibiotic components of Ledermix paste when it was mixed with a calcium hydroxide-methyl cellulose paste . The release rates of the trace molecules were lower when the mixture was used compared with release from Ledermix alone . The results indicated that this combination of materials, when used a long-term intracanal dressing, was likely to be more effective than Ledermix alone.

Enferm Infecc Microbiol Clin, 1989 Aug-Sep, 7(7), 364 - 7
{Neutropenia secondary to cefotaxime use}; Burgaleta C et al.; Agranulocytosis is an uncommon complication of beta-lactam antibiotic therapy . Two patients who developed absolute neutropenia and anemia after having received 168 g of cefotaxime are reported . There was fever and rash, and hematologic recovery too place 10 and 6 days after withdrawal of the drug . The bone marrow culture showed that the incubation of cells with cefotaxime (10 micrograms/ml) induced a 26 +/- 1% inhibition of the formation of granulocytic colonies (CFU-GM) in controls and a 47% and 48% inhibition, respectively, in the two patients with neutropenia . When serum was added to the culture, the control serum improved the in vitro granulopoietic response, while the serum from the first patient inhibited in 77 +/- 1.5% the formation of CFU-CM in the control marrow . The need for the monitoring of peripheral blood cells in patients receiving long term treatment with beta-lactam antibiotics emphasized, as we have shown the suppressor effect of cefotaxime on the hematopoietic precursors and the effect of an autoimmune mechanism in some cases.

Ophthalmology, 1989 Aug, 96(8), 1194 - 7
Bilateral keratitis in Lyme disease; Kornmehl EW et al.; Lyme disease, caused by the spirochete Borrelia burgdorferi, has ophthalmic manifestations . The authors describe two cases of Lyme keratitis characterized by multiple focal, nebular opacities at varying levels of the stroma which may progress to edema, neovascularization, and scarring . Close observation, in addition to systemic antibiotic therapy, may be sufficient if the visual axis is not involved, and the patient is asymptomatic.

J Chromatogr, 1989 Jul 28, 475, 353 - 61
Isolation of drug residues from tissues by solid phase dispersion; Barker SA et al.; A new method based on solid phase dispersion of tissue for the subsequent isolation of drugs is reported . By blending tissues with a polymeric phase bound to a solid support one obtains a semi-dry material which can be used as a column packing material from which one can isolate drugs in a stepwise fashion based on the solubility characteristics of the drugs in this matrix . The applicability of this approach for multidrug residue extraction from a single sample is demonstrated for compounds representing the organophosphate, benzimidazole anthelmintic and beta-lactam antibiotic drug classes.

Biochim Biophys Acta, 1989 Jul 24, 983(1), 15 - 22
Duramycin effects on the structure and function of heart mitochondria . I . Structural alterations and changes in membrane permeability; Sokolove PM et al.; The polypeptide antibiotic duramycin has been reported to interact specifically with two lipids: phosphatidylethanolamine (PE) and monogalactosyldiacylglycerol (Navarro et al . (1985) Biochemistry 24, 4645-4650) . PE is a major component of mitochondrial membranes . Duramycin was used to examine the role of PE in maintenance of mitochondrial structure and membrane permeability properties with the following results: (1) Duramycin addition to isolated rat heart mitochondria produced abrupt organelle contraction which was followed, depending on composition of the suspending medium, by pronounced swelling . The most notable morphological effect of the antibiotic was ruffling or crenelation of the outer membrane, which resulted ultimately in its separation from the inner membrane . (2) Low concentrations (less than 5 microM) of the antibiotic selectively increased the permeability of the mitochondrial inner membrane to cations and small solutes . This effect was blocked by atractyloside, a highly specific inhibitor of the adenine nucleotide translocator, by palmitoyl coenzyme A, by N-ethylmaleimide, and by AMP, ADP and ATP but not GDP or GTP, implicating the adenine nucleotide translocator in the selective permeability increase . (3) Higher concentrations of duramycin induced a more generalized permeability increase which was not subject to inhibition by compounds capable of interacting with the adenine nucleotide translocator.

FEBS Lett, 1989 Jul 17, 251(1-2), 167 - 72
'Perforated patch recording' allows long-term monitoring of metabolite-induced electrical activity and voltage-dependent Ca2+ currents in pancreatic islet B cells; Falke LC et al.; We describe the application of 'perforated patch recording' using the pore-forming antibiotic nystatin, to monitor the electrical activity and underlying ionic currents of rat and human pancreatic islet B cells . We demonstrate that glucose-induced electrical activity is seen even in single B cells during current-clamp recordings lasting hours 'L-type' Ca2+-channel currents can also be monitored over this period of time . This technique may prove useful in examining hormone and neurotransmitter modulation of electrical activity in B cells, while minimizing the effects of cytoplasmic 'wash-out'.

Cancer Lett, 1989 Jul 15, 46(2), 153 - 7
Potentiation of cisplatin antitumor activity on L1210 leukemia s.c . by sparsomycin and three of its analogues; Zylicz Z et al.; Sparsomycin (Sm) is a known antibiotic derived from Streptomyces . Its potential antitumor activity stimulated the search for a synthetic production method and the development of new derivatives . In a recent screening investigation, three Sm analogues appeared to be more active and considerably less toxic than the parent drug . Sparsomycins became especially interesting when it was shown that Sm potentiates the antitumor activity of cisplatin . In the present study Sm and its three promising analogues: deshydroxy-Sm (dSm), ethyl-deshydroxy-Sm (EdSm) and n-pentyl-Sm (PSm) were studied for their cisplatin potentiating effect . The experiments were performed on CD2F1 mice inoculated with 10(6) L1210 cells s.c . Sparsomycins were administered i.p . 3 h before cisplatin on days 1, 5 and 9 . Three of the drugs, Sm, dSm and PSm, showed no potentiating effect in this tumor model . At a dose of 10 mg/kg, EdSm potentiated cisplatin antitumor activity 2.8 times (P less than 0.01) without an increase in weight loss . These results warrant further investigation.

Biochem J, 1989 Jul 15, 261(2), 445 - 50
Polymyxin B diminishes blood flow to brown adipose tissue and lactating mammary gland in the rat . Possible mechanism of its action to decrease the stimulation of lipogenesis on refeeding; Tedstone AE et al.; Polymyxin B, a cyclic decapeptide antibiotic, increased blood glucose and lactate, and inhibited the stimulation of lipogenesis in interscapular brown adipose tissue and lactating mammary gland of starved-refed virgin and lactating rats respectively . Lipogenesis was not inhibited in white adipose tissue or liver . The antibiotic increased the haematocrit . The relative blood flow to brown adipose tissue and lactating mammary gland was decreased by polymyxin B, and this was accompanied by a decrease in tissue ATP content . In vitro polymyxin B did not affect glucose utilization or conversion into lipid, nor the stimulation by insulin of these processes in brown-adipose-tissue slices . Treatment of rats in vivo with polymyxin B resulted in decreased utilization of glucose in vitro in brown-adipose-tissue slices . Similarly, acini from mammary glands of polymyxin B-treated lactating rats had decreased rates of conversion of {1-14C}glucose to lipid . It is concluded that the effects of polymyxin B may be brought about by decreases in tissue blood flow . The possibility that these effects are secondary to inhibition of glucose utilization cannot be ruled out.

Hosp Pract (Off Ed), 1989 Jul 15, 24(7), 93 - 100, 103-4, 107-10
Combating infections in neutropenic patients; Pizzo PA; In febrile neutropenic patients, most of whom have cancer, immediate, albeit empiric, antibiotic therapy reduces infectious morbidity and mortality . With respect to definitive therapy, it is stressed that isolate patterns are changing, even as new antibiotics are becoming available . Issues such as single-agent versus combination therapy, as well as preventive strategies, are reviewed.

Biochim Biophys Acta, 1989 Jul 10, 982(2), 245 - 52
Interaction of amphotericin B and its N-fructosyl derivative with murine thymocytes: a comparative study using fluorescent membrane probes; Henry-Toulme N et al.; The polyene antibiotics amphotericin B (AmB) and N-(1-deoxy-D-fructos-1-yl)amphotericin (N-Fru-AmB) have different activity towards murine thymocytes (N-Fru-AmB is less toxic but is a potent immunomodulator) . The interactions of the drugs with these cells have been studied by fluorescence methods . Fluorescence energy transfer from 1-{4-(trimethylammonio) phenyl}-6-phenylhexa-1,3,5-triene, p-toluenesulfonate (TMA-DPH) to polyenes was used to follow the binding of the two drugs to the plasma membrane . The results, confirmed by circular dichroism measurements, indicate that at saturation the ratio AmB bound/plasma membrane lipid is low (less than 1 molecule of polyene for 170 lipids) . The slightly higher binding of AmB as compared to N-Fru-AmB demonstrates that affinity of the antibiotic for plasma membrane does not account for the activity of the polyenes towards lymphocytes . The effect of the two polyenes on membrane fluidity was studied by steady-state fluorescence anisotropy . The results suggest that AmB strongly perturbs the structure of the membrane whereas only a slight decrease of the anisotropy is observed with N-Fru-AmB in the range of concentration where the biological activity has been demonstrated . Polyene location was further investigated by comparing the energy transfer efficiency obtained with TMA-DPH and with the parental compound 1,6-diphenylhexa-1,3,5-triene, p-toluene sulfonate (DPH) . While AmB binds to plasma membrane, as well as to intracellular structures, N-Fru-AmB seems to accumulate into the cell and bind to intracellular membrane structures.

Biochim Biophys Acta, 1989 Jul 7, 1008(2), 234 - 42
Inhibition of rat growth hormone promoter activity by site-specific DNA methylation; Gaido ML et al.; The effect of methylation on rat growth hormone (rGH) promoter activity was determined in GH3 cells by measuring rGH-Neo and rGH-CAT fusion gene expression with or without prior in vitro treatment with the site-specific DNA methyltransferases, M-BsuE and M-HhaI . To assay for rGH-promoter-specific effects of DNA methylation, RSV-Neo and RSV-CAT activities with or without M-BsuE, M-HhaI and M-HpaII treatment were measured in parallel cultures of GH3 cells . GH1-Neo and RSV-Neo fusion gene expression was inhibited by in vitro methylation from 44 to 83% as measured by the number of Geneticin-resistant GH3 cell colonies . Methylation of the GH1 promoter by M-BsuE exhibited some selective inhibition of Neo expression as determined by colony numbers, although extensive methylation of non-promoter DNA in GH1-Neo and RSV-Neo by M-HhaI and M-HpaII also inhibited Neo expression . Southern blot analysis of genomic DNA isolated from the Geneticin-resistant GH3 cells indicated that Geneticin-resistance was accompanied by demethylation of the BsuE (ThaI) sites in stably incorporated GH1-Neo DNA but not RSV-Neo DNA . Transient expression of the CAT gene in GH3 cells was selectively inhibited by 60% upon methylation of two BsuE (ThaI) sites in the GH1 promoter of GH1-CAT by M-BsuE . The data demonstrate, for the first time, to our knowledge, a direct effect of DNA methylation on the activity of the rat growth hormone promoter.

FEBS Lett, 1989 Jul 3, 250(2), 323 - 7
Sequence selective binding of ditrisarubicin B to DNA: comparison with daunomycin; Fox KR et al.; DNase I footprinting has been used to examine the sequence selective binding of ditrisarubicin B, a novel anthracycline antibiotic, to DNA . At 37 degrees C no footprinting pattern is observed, the drug protects all sites from enzymic cleavage with equal efficiency . At 4 degrees C a footprinting pattern is induced with low drug concentrations which is different from that produced by daunomycin . The best binding sites contain the dinucleotide step GpT (ApC) and are located in regions of alternating purines and pyrimidines.

Z Orthop Ihre Grenzgeb, 1989 Jul-Aug, 127(4), 471 - 3
{5 years' infection statistics of an orthopedic clinic--pathogen spectrum, resistance status, therapeutic consequences}; Braun M; In 1983 we started our statistical control for postoperative infections . The data are checked every half year . Most common bacteria was Staph . aureus followed by Staph . epidermidis . We found a difference in the spectrum of bacteria between our postop . patients and the referred cases . A surgeon related control and our new operating theatres reduced the infection rate from 2.2% to 0.8% . For our total joint replacements we additionally used perioperative antibiotics . The change in the antibiotic from Cefoxitine to Cefacedone reduced the infection rate from 4.7% to 0.8% . The permanent control of bacteria and of their resistance to antibiotics allows us to reduce the number of drugs used and to simplify treatment without loosing efficiency of therapy . This is--in a double sense--a good way for reducing costs.

Jpn J Antibiot, 1989 Jul, 42(7), 1477 - 87
{Clinical studies of cefpodoxime proxetil in pediatric field}; Kimura S et al.; Clinical studies of cefpodoxime proxetil (CPDX-PR), a new cephem antibiotic, were carried out in 60 patients in the pediatric field . The overall efficacy rate on 54 patients with various infections was 98.1%, and few side effects, all of them very mild, were developed in 6 of 60 patients (10%) . It was concluded that CPDX-PR was one of the most useful antibiotics in the pediatric field because of the high efficacy rate and the safety.

J Antimicrob Chemother, 1989 Jul, 24(1), 45 - 51
Gentamicin and low dose piperacillin in febrile neutropenic patients; Boughton BJ et al.; One hundred and twenty-seven febrile neutropenic patients were randomized to receive empirical antibiotic therapy with intravenous gentamicin and 12 g/day or 8 g/day piperacillin . Despite a high incidence of Hickman catheter infections by antibiotic-resistant bacteria, there was an overall response in 56% of patients and no difference in the numbers responding to each antibiotic regimen . In addition, the duration of fever was not significantly different in the two groups of patients . The majority of the unresponsive patients responded to the addition of further antibiotics and there were only two infection related deaths . The results suggest that high dose antibiotics are not essential for the initial empirical therapy in febrile neutropenic patients.

J Clin Immunol, 1989 Jul, 9(4), 279 - 86
Immunoglobulin levels in saliva in individuals with selective IgA deficiency: compensatory IgM secretion and its correlation with HLA and susceptibility to infections; Norhagen G et al.; Total levels of IgA, IgM, and IgG were measured in unstimulated whole saliva and serum from 63 individuals with selective IgA deficiency . Values were compared with the incidence of upper respiratory tract infections, antibiotic treatments (necessitated by upper respiratory tract infection), and HLA antigens . A statistically significant increase in salivary IgM and IgG levels was noted in individuals with selective IgA deficiency compared to healthy normal individuals . Healthy individuals with selective IgA deficiency did not have increased concentrations of salivary IgM compared to infectious-prone patients . Nor was there any correlation found between proneness to infections and HLA antigens or between salivary IgM or IgG levels and HLA antigens in this patient material.

Infection, 1989 Jul-Aug, 17(4), 245 - 6
Influence of milk on the bioavailability of doxycycline--new aspects; Meyer FP et al.; This study was conducted to examine the pharmacokinetics of doxycycline in nine healthy volunteers who had fasted overnight . Single-dose cross-over design was used . Each subject received orally 0.2 g doxycycline . The subjects swallowed the antibiotic capsules with 300 ml of water or 300 ml of fresh milk . Simultaneous ingestion of milk diminished the peak plasma concentration by 24% and the absorption by 9-53% (mean 30%) . It is concluded that, like the other tetracyclines, doxycycline should not be administered together with milk.

Fundam Appl Toxicol, 1989 Jul, 13(1), 146 - 55
Differential effects of cefmetazole sodium on the reproductive system of infant and pubertal male rats; Moe JB et al.; The effects of cefmetazole (CMZ), a cephem antibiotic which contains the N-methyltetrazolethiol (NMTT) side-chain moiety, were compared in infant (6-42 days of age) and pubertal (6-10 weeks of age) male Sprague-Dawley rats . High doses of either CMZ or free NMTT caused reductions in testicular weight and delayed maturation of spermatogenic germ cells in the testes of infant rats, implicating NMTT as the active component in causing these effects . Pubertal rats expressed neither of these effects, even when treated with doses of CMZ far in excess of those used in infant rats . The effects of CMZ and NMTT on testicular weights and histologic features of testes of rats treated as infants were mainly reversed when these animals were examined 35 and 70 days after cessation of treatment . All reproductive functional parameters were normal in mating studies using male rats which had been treated with CMZ or NMTT as infants and allowed to recover . Because of the species differences in rates of sexual maturation and the greater rate at which rats metabolize CMZ to NMTT, the relevance to humans of the testicular effects of CMZ in infant rats is unknown.

Eur J Haematol, 1989 Jul, 43(1), 15 - 21
Prognostic significance of peripheral blood S + G2/M phase size in adult acute non-lymphoblastic leukaemia; Guerci A et al.; Flow cytometric analysis of peripheral blood (PB) S + G2/M phase size was performed in 73 adult patients with untreated acute non-lymphoblastic leukaemia, to assess whether the results may correlate to response rate and patient prognosis . All patients were treated with the same induction chemotherapy regimen: ARA-C alone or in combination with an anthracycline antibiotic . Pretreatment PB S + G2/M phase size is significantly correlated to induction response rate (p less than 0.02), duration of response (p less than 0.02) and duration of survival . Patients with low PB S + G2/M phase size experience a longer survival, in patients over and below 50 yr (p less than 0.001) . Lastly, early deaths tend to be more frequent in the high median age and high PB S + G2/M phase size group . Our study suggests that PB S + G2/M phase size has prognostic significance in obtaining response and duration of survival.

Br J Ophthalmol, 1989 Jul, 73(7), 576 - 8
Eyelid swelling and erythema as the only signs of subperiosteal abscess; Rubin SE et al.; On clinical grounds it is usually easy to distinguish between preseptal cellulitis, a cutaneous infection not threatening to vision, and orbital cellulitis, a potentially vision threatening infection of the orbital tissues generally arising from paranasal sinusitis . We recently cared for two patients with a clinical diagnosis of preseptal cellulitis who had CT scan evidence of subperiosteal abscess . Antibiotic therapy alone resulted in clinical resolution in each case.

J Antibiot (Tokyo), 1989 Jul, 42(7), 1088 - 99
Selection of a specifically blocked mutant of Streptomyces cinnamonensis: isolation and synthesis of 26-deoxymonensin A; Ashworth DM et al.; Streptomyces cinnamonensis produces the polyether ionophore antibiotic monensin A . Following a single round of mutagenesis by UV light, a derivative of this strain has been isolated, which secretes a new metabolite identified as 26-deoxymonensin A (3) . The structural elucidation of the new metabolite followed from a spectroscopic analysis, and its identity was proven conclusively following a comparison to 26-deoxymonensin A (3) obtained synthetically from monensin A . The preparation of labelled forms of 3 is described, together with incorporation experiments using the parent strain of S . cinnamonensis . Only very low levels of incorporation of 3 into monensin A were observed.

J Comput Assist Tomogr, 1989 Jul-Aug, 13(4), 656 - 8
Septic thrombosis of the portal vein: CT and clinical observations; Lim GM et al.; The CT and clinical findings were reviewed in seven patients with septic thrombosis of the portal vein (STPV) . Of the seven patients, five had associated pyogenic liver abscesses . Five of seven patients presented de novo with STPV without a clinically obvious extrahepatic source of intraabdominal infection . All seven patients were successfully managed nonsurgically with intravenous antibiotics and in two patients percutaneous drainage of hepatic abscesses . Serial follow-up examinations in five patients demonstrated complete resolution of portal venous thrombus in three patients and progression to cavernous transformation in two . When diagnosed early by CT or sonography, STVP may have a more benign clinical course following appropriate antibiotic therapy.

J Cell Biol, 1989 Jul, 109(1), 285 - 93
Induction of in vitro differentiation of mouse embryonal carcinoma (F9) and erythroleukemia (MEL) cells by herbimycin A, an inhibitor of protein phosphorylation; Kondo K et al.; Herbimycin A is one of the benzenoid ansamycin antibiotics isolated from a culture of Streptomyces species (Omura, S., A . Nakagawa, and N . Sadakane . 1979 . Tetrahedron Lett . 1979: 4323-4326) . Recent studies have shown that the antibiotic not only inhibits the phosphorylation of p60src in Rous sarcoma virus- (RSV) infected cells, but also reverses the cellular phenotypes acquired by transfection with tyrosine kinase oncogenes (Uehara, Y., M . Hori, T . Takeuchi, and H . Umezawa . 1985 . Jpn . J . Cancer Res . 76:672-675; Uehara, Y., M . Hori, T . Takeuchi, and H . Umezawa . 1986 . Mol . Cell . Biol . 6: 2198-2206; Uehara, Y., Y . Murakami, S . Mizuno, and S . Kawai . 1988 . Virology . 164: 294-298) . These studies and other evidence indicate that the antibiotic inhibits a reaction(s) closely associated with the function of cellular tyrosine kinases . We have found that herbimycin A is an effective inducing agent capable of triggering differentiation in two typical mouse in vitro differentiation systems, which have been considered to be quite different in their mechanism of induction: endoderm differentiation of embryonal carcinoma (F9) cells and terminal erythroid differentiation of erythroleukemia (MEL) cells . The results suggest that there is a common step in the intracellular differentiation cascade which is, directly or indirectly, associated with phosphorylation at specific (tyrosine) residues of cellular proteins . The significance of this finding with respect to the molecular mechanism of in vitro differentiation is discussed.

Postgrad Med, 1989 Jul, 86(1), 79 - 81, 84, 89
Pyomyositis in patients with diabetes . Computed tomography as a key to diagnosis; Brown RL; Pyomyositis rarely occurred in nontropical climates in the past but is becoming increasingly recognized in temperate climates . Nevertheless, this diagnostic possibility is often not immediately recognized . Pyomyositis should be considered in diabetic patients with lower-extremity cellulitis who do not respond to presumptively appropriate therapy . A high index of suspicion and documentation with appropriate imaging techniques, aggressive surgical intervention, and adjunctive antibiotic therapy are the keys to prompt resolution without sequelae . The patients in this report were diabetic adults who responded to appropriate therapy after computed tomographic scans, surgical exploration, and cultures established the diagnosis.

J Thorac Cardiovasc Surg, 1989 Jul, 98(1), 48 - 55; discussion 55-6
Durability of the viable aortic allograft; Angell WW et al.; Of 581 aortic allografts implanted since 1967, 421 were analyzed for structural deterioration . This series is unique in that it includes patients from the early allograft experience . All allografts were cleanly procured, antibiotic sterilized, and either stored at 4 degrees C for up to 8 weeks or frozen to liquid nitrogen temperatures with cryopreservation to preserve the viable cusp fibroblasts . There were 25 frozen mounted aortic valves with a median time to valve failure of 12.1 years, which was not significantly different from the 12.5-year period for 114 fresh free-sewn aortic valves . The median time to valve failure was 6.6 years for 90 fresh-mounted aortic valves and 8.6 years for 192 fresh-mounted mitral valves (p = 0.05) . The difference between all mounted and unmounted grafts was significant (p = 0.0001) . In all groups, viable fibroblasts were present in specimens explanted up to 5 years after the operation . All specimens returned after more than 10 years were almost totally acellular . Evidence of increased collagen, suggesting that the fibroblasts survive implantation and then gradually die, was present in all specimens . This series suggests that durability of the unmounted viable allograft for aortic valve replacement is greater than for other types of tissue valves . Pre-mounted allografts for aortic or mitral valve replacement have a median survival of 8 years and are not more durable than other tissue valves.

Am J Emerg Med, 1989 Jul, 7(4), 413 - 6
Emergency presentation of coalescent mastoiditis; Rogers SM et al.; Since the introduction of sulfonamides in the late 1930s, coalescent mastoiditis is an uncommon complication of otitis media . Swelling, erythema, and tenderness over the mastoid area with associated anterior displacement of the auricle are classic signs and symptoms of coalescent mastoiditis with formation of a subperiosteal abscess . Early recognition of this entity is essential to prevent its complications . Prompt otolaryngologic consultation is indicated and inpatient antibiotic therapy should be begun . Surgical treatment is also needed and may obviate further complications.

J Assoc Physicians India, 1989 Jul, 37(7), 469 - 70
Fatal pancytopenia in falciparum malaria; Arya TV et al.; Various pernicious syndromes in Plasmodium falciparum infection are being reported with increasing frequency from tropical countries . A rare case of fatal pancytopenia associated with falciparum malaria is described . The patient developed fulminant aspiration bronchopneumonia which was unresponsive to antibiotic therapy and contributed to the development of adult respiratory distress syndrome . He also had severe uncontrolled gastrointestinal bleeding and possibly an intracerebral haemorrhage . Anaemia and thrombocytopenia are well known in malaria but severe leucopenia is very rare and pancytopenia has not been reported.

Mol Endocrinol, 1989 Jul, 3(7), 1090 - 8
Transforming growth factor beta 1: importance of glycosylation and acidic proteases for processing and secretion; Sha X et al.; The role of glycosylation of the transforming growth factor-beta 1 (TGF-beta 1) precursor was investigated by treating a transfected Chinese hamster ovary (CHO) cell line expressing high levels of recombinant TGF-beta 1 (TGF-beta 3-2000 cells) with a series of glycosylational inhibitors . Tunicamycin, a nucleoside antibiotic which prevents the formation of the dolichol intermediate necessary for oligosaccharide addition of the nascent polypeptide chain, appeared to block secretory exit and led to an increase in the cellular associated, nonglycosylated pro-TGF-beta 1 form . 1-Deoxymannojirimycin and swainsonine, inhibitors of the mannosidases I and II, respectively, blocked complete glycoprotein processing of the TGF-beta 1 precursor as judged by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and by sensitivity to glycosidases . However, the abnormal TGF-beta 1 polypeptides containing the altered carbohydrate side chains were secreted readily by the CHO cells . In contrast, inhibitors of the glucosidases at the first step in glycoprotein remodeling, 1-deoxynojirimycin and castanospermine, markedly inhibited secretion of the TGF-beta 1 polypeptides from transfected CHO cells . In all cases, these inhibitors did not appear to affect proteolytic processing of the TGF-beta 1 polypeptides . Furthermore, inhibitor treatment did not affect mannose-6-phosphorylation of the TGF-beta 1 polypeptides . These results suggest that glycosylation and early stage remodeling of oligosaccharide side chains are necessary for secretion of TGF-beta 1 . Treatment of the transfected CHO cells with weak bases (NH4Cl and chloroquine), or a monovalent ionophore (monensin), prevented proteolytic processing of the TGF-beta 1 precursor indicating that cleavage occurs by proteases in an acidic cellular compartment.

Chirurg, 1989 Jul, 60(7), 479 - 8
{Extra-anatomic bypass as therapy of infected bacterial (mycotic) infrarenal aortic aneurysm . A comparative, literature supported analysis}; Belz J et al.; Based on a review of the literature we compared the results of various operative procedures for infrarenal bacterial infected (mycotic) aortic aneurysms . We conclude that the preferred therapy involves the placement of an extraanatomic bypass, resection of the aneurysm and thorough debridement of infected tissue . Obligatory is appropriate systemic antibiotic therapy . The mortality rate has been substantially reduced since the introduction of this therapeutic concept.

Occup Med, 1989 Jul-Sep, 4(3), 463 - 71
Hand infections seen in the industrial clinic; Kasdan ML et al.; Following a few basic principles will help the industrial physician in managing hand infections . They are: (1) recognizing the infection early; (2) drainage and/or debridement; (3) identifying the organism; and (4) antibiotics . Following the course of a wound is extremely important . The infected wound that does not respond to surgery and antibiotics may need to be re-explored and cultured again . The wound that heals well without antibiotics or on the wrong antibiotic may be left alone . That is, antibiotics can be withheld or stopped.

Radiol Clin North Am, 1989 Jul, 27(4), 743 - 52
CT of diverticulitis . Diagnosis and treatment; Neff CC et al.; Diverticulitis can be detected accurately by computed tomography (CT) and staged according to an established system that is meaningful to both radiologists and surgeons . Diverticulitis limited to the wall of the sigmoid colon or small diverticular abscesses contained within the pericolic mesentery generally respond well to antibiotic therapy; larger abscesses must be drained . CT-guided catheter drainage is an effective method to treat these large diverticular abscesses . Overall management is simplified since one-stage sigmoid resection can be performed electively on a nonseptic patient . High-risk patients may be spared surgery entirely in selected cases.

Pediatr Pol, 1989 Jul, 64(7), 456 - 66
{Studies of the effect of gentamicin on the kidneys of healthy young rats . II . Studies of renal parenchyma of experimental animals in the light and electron microscopy after gentamicin load}; Rymgayllo-Katska M; Gentamicin was given to rats in the doses and intervals equivalent to those used in patients . This resulted in the morphologic changes in the animal kidneys . The severity of them was directly related to the dose of antibiotic . The morphologic changes--vacuolar degeneration in the epithelial cells of the proximal tubule, the inflammatory infiltrates in the interstitial tissue and the increased number of lysosomes with myelinic structures as well as mitochondrial oedema, the increased number of peroxysomes in the epithelial cells of the proximal tubules indicate the toxic influence of gentamicin on the proximal tubule . The disappearance of the morphologic and functional changes after the withdrawal of gentamicin indicates reversibility of them.

J Mol Recognit, 1989 Jul, 2(1), 6 - 17
Molecular recognition between oligopeptides and nucleic acids . Sequence specific binding of (4S)-(+)- and (4R)-(-)-dihydrokikumycin B to DNA deduced from 1H NMR, footprinting studies and thermodynamic data; Lee M et al.; The sequence specific binding of the antibiotic (4S)-(+)-dihydrokikumycin B and its (4R)-(-) enantiomer, {(S)-1 and (R)-1, respectively} to DNA were characterized by DNase I and MPE footprinting, calorimetry, UV spectroscopy, circular dichroism, and 1H NMR studies . Footprinting analyses showed that both enantiomers {(S)-1 and (R)-1} bind to AT-rich regions of DNA . 1H NMR studies (ligand induced chemical shift changes and NOE differences) of the dihydrkikumycins with d-{CGCAATTGCG}2 show unambiguously that the N to C termini of the ligands are bound to 5'-A5T6T7-3' reading from left to right . From quantitative 1D-NOE studies, the AH2(5)-ligand H7 distance of complex A {(S)-1 plus decamer (which is bound more strongly)} and complex B {(R)-1 and decamer} are estimated to be 3.8 +/- 0.3 A and 4.9 +/- 0.4 A, respectively . This difference in binding properties is reflected in the thermodynamic profiles of the two enantiomeric ligands determined by a combination of spectroscopic and calorimetric techniques . The binding free energies (delta G degrees) of (S)-1 and (R)-1 to poly d(AT).poly d(AT) at 25 degrees C are -31.8 and -29.3 kJ mol-1, respectively while the corresponding binding enthalpies (delta H degrees) are -11.3 and -0.8 kJ mol-1 . These data permit the construction of models for the binding of the enantiomeric dihydrokikumycins to DNA and account for the more efficient binding of the natural (S) isomer to DNA.

Chir Organi Mov, 1989 Jul-Dec, 74(3-4), 93 - 9
{Septic arthritis in children}; Pavanini G et al.; Seventy-five cases of children affected with septic arthritis for a total of 85 joints were followed-up after an average of 6 years and 9 months and evaluated according to Rigault clinical and radiographic criteria . Prognosis of the disease was related to age (less favorable results during neonatal age), to the joint affected (the hip and shoulder obtained the worst results, the knee the best), and to delay in diagnosis . Early and suitable surgical treatment associated with systemic antibiotic therapy is required.

Trans R Soc Trop Med Hyg, 1989 Jul-Aug, 83(4), 458 - 60
The black death past and present . 1 . Plague in the 1980s; Butler T; This paper considers firstly the epidemiology of plague in the 1980s . The largest number of cases occurred in Tanzania . Most cases were in children and young adults; in the USA the male:female ratio was about 2:1 . Plague had a seasonal distribution . Almost all cases arose from bites of infected rodent fleas, and Rattus spp . were the most important reservoir hosts . Virulence is linked with the presence of a 45 MDa plasmid . The predominant clinical form of plague is bubonic, followed by septicaemic, meningitic and pneumonic . For treatment, streptomycin is the antibiotic of choice, with tetracycline and chloramphenicol as alternatives . Treatment given on the first 1-2 d of illness is highly effective, and resistance is not a problem . Rodent control, insecticide application, and avoidance of contact with rodents and their fleas remain the prime means of control . Plague vaccine is not in general use.

Pediatr Med Chir, 1989 Jul-Aug, 11(4), 397 - 402
{Polyserositic syndromes and/or sectorial dysventilation with platelet activation induced by immunoallergic etiopathogenesis}; De Luca L; The author from a study of 5 dysventilatorial syndromes (bronchiolitis-PNX, pneumomediastinal aerial cystis of lung) and 5 polysierositic syndromes pleuritis and peritonitis) evices that all these syndromes show in the anamnesis or in present a viral infection from influenzal virus or rubeola . In addition to that, the Authors shows the presence of a food allergy asserted by RAST and/or Skin Prick Tests or FBST (Food Bronchostimulation test) and the introduction of a food allergen during the viral infection, and a great platelet's activation . The Author, besides, shows the association normal VES and normal neutrophil cells in the dysventilatorial syndrome and high VES, and high neutrophil cells in the polysierositic syndromes; in all cases the negativity of culture exams . Starting from these points she worked out a new etiopathogenetic theory: the viral localization on the Peyer's plates cause the expression on the epithelial surface of the gut's cells of SELF HLA II type recognition . The food allergens' introduction causes a great reaction of II, III, IV, VI type which involves the bronchus, alveolus, and the serous epithelium by PAF activation, in all cases and in the polisierositic syndrome a neutrophil activation as well . The author advices to prize the importance of cortisone therapy and of exclusion of food allergen by diet, besides advices the antibiotic therapy for covering only.

Mikrobiol Zh, 1989 Jul-Aug, 51(4), 3 - 7
{The use of fast electrons with different energies in the selection of Streptomyces kanamyceticus}; Podgorskaia ME et al.; It is shown on the prototrophic strain Streptomyces kanamyceticus that relative biological activity of neutrons is higher than that of gamma rays and depends on the bundle energy . The mutagenic efficiency of superfast neutrons is 2-3 times as high as the effect of neutrons with the energy of 1.4-1.6 MeV . The antibiotic production trait in the obtained variants of S . kanamyceticus is established to be unstable . Variants obtained under the effect of superfast neutrons are more stable . The promising strains are obtained for the further breeding.

Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1989 Jul-Sep, 38(3), 259 - 64
{The advantages of Reprimum therapy in pulmonary sarcoidosis and other granulomatous diseases}; Anastasatu C et al.; In sarcoidosis and other granulomatous non-caseous diseases, the election treatment is immunosuppressive, mainly with cortisones that ensure more than 70% lasting remissions . Continuous use of cortisones for a long time (8-30 months) in high doses leads to serious side effects: gastric and intestinal ulcers, obesity, osteoporosis, suprarenal dysfunction, sensitivity to infections . Good results and elimination of the important side effects were obtained by treatment with Reprimum--a semisynthetic antibiotic with a wide spectrum and immunosuppressive properties--administered alone or with prednisone in small doses (15-20 mg once) in 6 weeks' series: 2 weeks--Reprimum 10/mg/kg daily +/- prednisone and for other 4 weeks--Reprimum 15 mg/kg twice a week +/- prednisone followed by two weeks' break . In 75 patients with histopathologically confirmed sarcoidosis (of whom 7-9.3% with outside-the-lung situs, too), the treatment with Reprimum gave: 94.7% lasting remission, only 5.3% failures, reduction of the treatment period to 6-12 months and the absence of any important side reaction . In other 37 sarcoidosis cases, failures of cortisone therapy (of which 11-30% relapses after 2-6 years), the treatment with Reprimum together with prednisone allowed recovery of 29 patients (78.4%) . The same treatment with Reprimum, used in 22 patients with immunosuppressive treatment indication (dermatomyositis, Kaposi's syndrome, thrombocytopenias, nodose periarteritis, silicosis), of whom 18 (81.8%) were failures of the cortisone therapy, healed 20 of these cases (90.9%) . Reprimum immunosuppressive property acts at the level of T4+ lymphocyte, involved in sarcoidosis pathogenesis . The functional blockage of T4+ lymphocyte can be also achieved by cyclosporine A.(ABSTRACT TRUNCATED AT 250 WORDS)

J Reprod Med, 1989 Jul, 34(7), 468 - 74
Endoscopy in the diagnosis of genital tuberculosis; Merchant R; From 1977 to 1986, endoscopy (laparoscopy, cystoscopy and hysteroscopy) was used in the evaluation of women for pelvic tuberculosis . Among 687 cases of diagnostic laparoscopy, pelvic tuberculosis was suspected in 101 (14.7%) from the appearance alone . The appearance was correlated with other criteria for the diagnosis . Definitive evidence was found in 70 cases . All 101 patients were placed on an antibiotic . Seventy-three patients reported for follow-up for more than two years . Of them, six (8.2%) were judged to be cured . Thirty-eight (52.05%) improved as determined by second-look laparoscopy and/or negative histopathology or hysterosalpingographic evidence . Eleven women (15.06%) had an intrauterine pregnancy; nine delivered normally, and two underwent termination of pregnancy for medical reasons . There were three tubal pregnancies (4.1%) . In 15 cases (20.5%) the disease remained stationary.

Stomatologiia (Sofiia), 1989 Jul-Aug, 71(4), 1 - 5
{On the problem of diagnostics and treatment of herpetic infection in the oral cavity}; Atanassov N et al.; A clinical case of herpetic manifestation in the mouth is described as a grave gingivostomatitis in a child aged 12 . Chronology and symptomatics of the disease are analyzed in details as well as the difficulties both in diagnostics and treatment . Some important moments are discussed that usually aggravate the clinical picture and the treatment of similar conditions--including an antibiotic from penivillin group in the treatment, the presence of cutting teeth with inflammatory alterations around them, extraction . All possible diseases in the oral cavity are analyzed that could give a similar symptomatics as well as the tactics of the stomatologist until making the final diagnosis . The diagnosis was ex juvantibus elucidated Symptomatic treatment was carried out and paraclinical examinations performed enabling the authors to make the diagnosis recurrent herpetic infection with not typical course upon the oral mucosa induced by the virus of herpes simplex, type I.

J Pediatr Health Care, 1989 Jul-Aug, 3(4), 224 - 7
Mupirocin: a new topical therapy for impetigo; Putnam CD et al.; Mupirocin is a new, topical antibiotic effective for the treatment of impetigo . It has a unique structure, mechanism of action, and water-miscible formulation . When it is applied to an infected area three times daily, clinical improvement should be seen in 85% to 100% of patients within 3 to 5 days . It is associated with a low incidence of adverse effects and cross-resistance . Further studies are necessary to define the exact role of mupirocin in treating other primary and secondary cutaneous infections.

J Natl Cancer Inst, 1989 Jun 21, 81(12), 945 - 8
Tumorigenicity of human mesothelial cell line transfected with EJ-ras oncogene; Reddel RR et al.; We performed this study to determine whether human mesothelial cells are capable of undergoing neoplastic change in vitro and to observe their interaction with the activated c-Ha-ras (HRAS1) oncogene EJ-ras, which has a role in the development of many malignant human tumors . Mesothelial cells are presumed to be the progenitor cells of malignant mesothelioma, a cancer strongly correlated with asbestos exposure . Previously, we established a non-tumorigenic cell line, MeT-5A, from normal human mesothelial cells after transfection with a plasmid containing the simian virus 40 (SV40) early-region genes . In the present study, we performed transfection of a plasmid containing the EJ-ras gene and the neomycin-resistance gene into these cells and selected a population resistant to G418, a neomycin analogue . Cells from this cell line formed rapidly growing sc tumors in NIH Swiss athymic nude mice, but untransfected with the vector DNA and selected for G418 resistance formed no tumors . The tumors formed by EJ-ras-transfected cells were established in vitro, and cells from these tumor cell lines exhibited a characteristic altered morphology . The cells had the same isoenzyme phenotype as the parent cells, and they expressed the mutant EJ-ras p21 protein . This first demonstration of malignant transformation of human mesothelial cells in vitro may permit molecular analysis of mesothelial carcinogenesis.

Biochem Biophys Res Commun, 1989 Jun 15, 161(2), 720 - 5
Use of a shuttle vector for the transformation of the white rot basidiomycete, Phanerochaete chrysosporium; Randall T et al.; A novel shuttle vector based spheroplast transformation system for the lignin degrading filamentous fungus P . chrysosporium is described . The transformation vector, designated pRR12, consists of the yeast integration plasmid YIp5, a putative autonomous replication sequence (ars) of P . chrysosporium, and a 2.2 kb PvuII fragment carrying kanr determinant from plasmid pNG35, which confers resistance against both kanamycin and the related antibiotic G418 . Two different strains of P . chrysosporium (ME446 and BKM-F) were transformed to G418 resistance using vector pRR12 . Approximately 20 transformants per micrograms of vector DNA were obtained . The transforming vector pRR12 could be recovered from the total DNA of transformants by E . coli transformation, albeit at a low frequency.

Klin Wochenschr, 1989 Jun 15, 67(12), 621 - 6
{Rapidly progressing glomerulonephritis . Spontaneous course and differential therapy with special reference to the infection-associated form}; Metz-Kurschel U et al.; Since 1971 we observed 31 patients with histologically proven rapidly progressive (crescentic) glomerulonephritis . At the onset of therapy 16 patients presented with end stage renal failure, the others with impaired renal function . 21 patients received combined immunosuppressive therapy, consisting of prednisone, cyclophosphamide and azathioprine . 8 patients were treated with membrane plasmapheresis, additionally . 10 patients received no specific therapy . After 5 years 13 patients were on hemodialysis, 4 had impaired renal function and 10 patients were dead . Two patients died due to the progression of underlying diseases, the others were lost following infectious diseases . There was no additional positive effect in the group treated with membrane plasma separation compared with patients treated only immunosuppressive . Only in 4 patients without specific therapy normalization of renal function occurred . In these patients RPGN appeared after an infectious disease . We conclude that an infectious disease associated RPGN is an own entity of glomerulonephritis that has a very good prognosis and needs only antibiotic therapy.

Biochim Biophys Acta, 1989 Jun 15, 1012(1), 29 - 35
Intracellular degradation of bleomycin hydrolase in two Chinese hamster cell lines in relation to their peplomycin susceptibility; Nishimura C et al.; The Chinese hamster lung (V79) cell was intrinsically 10-times more resistant to peplomycin, a bleomycin-related antitumor antibiotic, than the Chinese hamster ovary (CHO) cell . This may be associated with the 3-times higher levels of recovery of bleomycin hydrolase activity of the V79 cell . The degradation of bleomycin hydrolase molecules in both V79 and CHO cells was examined using a monoclonal antibody specific for the enzyme . Labelling experiments showed that the bleomycin hydrolase in CHO cells was less stable than the comparable enzyme in V79 cells, and that 48 kDa subunits comprising bleomycin hydrolase (a homohexameric enzyme) molecules were degraded into 31 kDa forms in both cell lines . The 105,000 X g pellet (microsomes) fraction obtained after subcellular fractionation of CHO cells contained both 48 kDa subunit and 31 kDa forms of bleomycin hydrolase, while the 105,000 X g supernatant cytosol fraction yielded only 48 kDa subunit forms of the enzyme . Moreover, bleomycin hydrolase activity of both V79 and CHO cells was almost entirely recovered from the cytosol fraction . These results suggest that degradation of the 48 kDa subunit form of bleomycin hydrolase in these two lines of cultured cells into the 31 kDa form occurs on the plasma membrane or the endoplasmic reticulum, with which the resulting large number of bleomycin hydrolase molecules or degraded forms of the enzyme that have lost enzymatic activity are associated.

FEBS Lett, 1989 Jun 5, 249(2), 333 - 6
Amino acid substitutions in mitochondrial ATP synthase subunit 9 of Saccharomyces cerevisiae leading to venturicidin or ossamycin resistance; Galanis M et al.; A series of mitochondrially inherited mutants of yeast has been analysed, which were previously identified as showing resistance to the antibiotics venturicidin or ossamycin and whose mutations showed tight linkage to oligomycin-resistance alleles affecting subunit 9 of the mitochondrial ATP synthase . DNA sequence analysis of the oli1 gene of these mutants has been used to define the nature of amino acid substitution in the subunit 9 protein . In the case of the two venturicidin-resistant mutants, mutations affect amino acids on the N-terminal stem of the protein, namely Gly25----Ser (venR ossS oliR) and Ala 27----Gly (venR ossS oliS) . The mutations found in the two ossamycin-resistant mutants affect amino acids on the C-terminal stem of the protein; namely Leu53----Phe (vanS ossR oliR) and Leu57----Phe (venS ossR oliS) . These results allow us to further develop a fine structure map of domains within the subunit 9 protein involved in antibiotic interaction.

P N G Med J, 1989 Jun, 32(2), 117 - 22
Management of childhood haematogenous osteomyelitis in a rural Papua New Guinean hospital; Van Gurp G et al.; Haematogenous osteomyelitis, especially in its more common chronic stage, is an important cause of morbidity in children in the Southern Highlands Province . Hospital stays are lengthy and the incidence of fractures is high . While awaiting, or in the absence of, culture and sensitivity results, cloxacillin 200 mg/kg/day plus probenecid 40 mg/kg/day is an appropriate first choice antibiotic when it is available . Antibiotic therapy in chronic disease should be limited to the specific settings of associated soft tissue infection; pre- and post-sequestrectomy; and radiological signs of ongoing bone necrosis and systemic signs of active infection . Surgical drainage of subperiosteal pus and possibly the medullary canal is required in all but the very early (less than 48 hours) cases of acute osteomyelitis that sometimes respond to antibiotics alone . Sequestrectomy should be reserved for cases where a sequestrum and adequate involucrum can be seen on X-ray . Effective management of this disease is possible only if ongoing communication exists between hospital-based medical staff and the staff of health centres or subcentres, including the network of aid post orderlies and their supervisors . Since the majority of patients present to facilities other than hospitals, any campaign directed at improving management must involve co-workers in rural areas, namely the health extension officer, nurse and aid post orderly . Only in this way can we hope to achieve earlier appropriate treatment and more systematic long-term follow-up.

Pathol Biol (Paris), 1989 Jun, 37(5 Pt 2), 638 - 42
{Bone diffusion of cefotiam in men}; Farinotti R et al.; A 2g single dose of cefotiam was given by rapid intravenous injection to 17 patients undergoing total hip replacement as a prophylaxis . The concentrations of the antibiotic in plasma and femoral head (cancellous bone, cortical bone and capsule) were measured at different time (40 to 250 minutes) following the injection of the drug . Evaluation was done by liquid chromatography . Mean antibiotic concentrations were 70.5 micrograms/ml, 41.4 micrograms/g, 16.9 micrograms/g and 8.1 micrograms/g respectively in plasma, capsule, cancellous and cortical bones . 240 minutes following the injection, mean concentrations of cefotiam were higher than 2.3 micrograms/ml in plasma and 1.8 micrograms/g in bone . Diffusion in cancellous bone is twofold high as in cortical bone and elimination half lif is higher in bone than in plasma (248.8 minutes versus 59.6 minutes in plasma) . These results suggest that a 2g intravenous bolus injection of cefotiam given at the induction of anaesthesia should provide an effective prophylaxis during total hip replacement.

Minerva Stomatol, 1989 Jun, 38(6), 653 - 5
{Use of miocamycin in infections of the oral cavity}; Fiorentini F et al.; The results of clinical experimental with a new antibiotic, Miocamycin (Macroral Zambeletti), are reported . 300 patients suffering from the most varied infections of the oral cavity were treated . In view of its utility and the lack of side-effects, it is concluded that this antibiotic may be used with peace of mind in odontostomatological pathology.

J Antibiot (Tokyo), 1989 Jun, 42(6), 952 - 9
Biological activities of IC201 ((3S,8E)-1,3-dihydroxy-8-decen-5-one), a low molecular weight immunomodulator produced by Streptomyces; Mizutani S et al.; IC201 was found in cultured broth of Streptomyces cirratus as an antitumor antibiotic which was effective in retarding growth of the established solid tumor of Ehrlich carcinoma by treatment starting 8 days after tumor inoculation . It retarded growth of the established solid tumor of IMC carcinoma but had no cytotoxicity at 100 micrograms/ml . IC201 treatment kept NK cell activity of tumor-bearing mice at normal level and stimulated cytostatic activity of peritoneal macrophages . It stimulated phagocytosis of yeast and phorbol myristate acetate-elicited superoxide production by peritoneal macrophages . The addition of IC201 to P388D1 cell cultures enhanced release of interleukin 1 (IL-1) into cultured supernatant but it affected lipopolysaccharide-induced IL-1 production . Although the addition to macrophage-depleted cultures did not show any stimulatory effect, mixed lymphocyte culture reaction was augmented in cultures using spleen cells as stimulator cells taken from mice given IC201 . Results indicate that IC201 primarily activates macrophages and the activation may cause modulation of immune responses.

Invest Ophthalmol Vis Sci, 1989 Jun, 30(6), 1055 - 61
Pharmacokinetics of intravitreal injection . Assessment of a gentamicin model by ocular dialysis; Ben-Nun J et al.; Intravitreal drug administration is the treatment of choice for bacterial endophtalmitis, but improved knowledge of vitreal pharmacokinetics is essential for the development of optimal antibiotic regimes . We used our recently developed sampling device to estimate vitreal gentamicin concentrations for up to 30 hr after an intravitreal bolus injection of gentamicin . The device is based on the principle of dialysis, whereby a constant flow rate of dialysate through a loop of dialysis fiber in the vitreous attains a gentamicin concentration proportional to the intravitreal gentamicin level around the fiber . The dialysate is continuously recovered and the collected samples then assayed for gentamicin . Normal cat eyes and those with induced bacterial endophthalmitis formed the two groups tested . Concentration-time data fitted well to an open single compartment pharmacokinetic model that incorporated the processes of transfer of drug from the injection site to the sampling site (a function of diffusion within the vitreous), and the elimination from the sampling site (a function of elimination from the vitreous) . The initial phase of transfer between the injection and sampling site was rapid and rates were comparable in the two groups . Elimination rate constants were uniformly greater in infected eyes than in controls (0.107 hr-1 compared to 0.055 hr-1) . Aqueous humor gentamicin concentrations in control eyes varied between 3 and 6 times those found in fellow infected eyes at the end of each experiment . Accelerated elimination of gentamicin from the vitreous body of eyes with endophthalmitis may be explained by increased permeability of the blood-retinal barrier.

Khirurgiia (Mosk), 1989 Jun, (6), 58 - 61
{Value of correcting microcirculatory disorders of inflammatory foci in the treatment of infection}; Shoikhet IaN et al.; Experience in the treatment of 94 patients with sepsis is discussed . Studies showed that microcirculatory disorders occurring around the inflammatory focus are among the main causes of insufficient efficacy of antibiotic therapy . For correction of the microcirculatory changes, the authors suggest (in addition to vasodilators, inhibitors of proteases and heparin used earlier for this purpose) transfusion of chilled plasma which is a antithrombin-III donator . As the result of such treatment mortality reduced from 45.8 to 16.7%.

Gaoxiong Yi Xue Ke Xue Za Zhi, 1989 Jun, 5(6), 320 - 3
{Diagnosis and treatment of adult polycystic kidney disease}; Tan LB et al.; A review of 20 polycystic kidney disease patients in admitted to Kaohsiung Medical College Hospital is herein reported . In this series 60% of the patients were in the fourth to sixth decades of life at the time of diagnosis . The average age was 50 years . The disease was generally more commonly found in the females than in male subjects . Flank pain and gross hematuria was the most common presenting symptom in these cases . In 70% of the patients hypertension were noted, besides 55% of patients have associated liver cysts and 9% of the patients have associated pancreatic cystic diseases . In a comparison of ultrasonography, CT scans, renal angiography, intravenous pyelography and retrograde pyelography in the evaluation of polycystic kidney disease, it was found that CT scans and ultrasonography had more than a 90 per cent diagnostic accuracy rate, while intravenous pyelography had only a 30 percent accuracy rate . Because of improved treatments such as antibiotic and hemodialysis techniques the five-year survival rate of patients, with polycystic kidney diseases, may be increased.

Indian J Med Res, 1989 Jun, 90, 197 - 202
Mitoxantrone & adriamycin cytotoxicity enhanced by reserpine in human chronic myeloid leukaemia cells; Chitnis MP et al.; The effect of reserpine was studied alone and in combination with anticancer drugs on human chronic myeloid leukaemia (CML) cells . To study the effect of reserpine on anthracycline antibiotic adriamycin and anthracenedione mitoxantrone the extent of 3H-thymidine incorporation into the DNA was taken as the measure of cytotoxicity . The results indicate that reserpine enhances the cytotoxicity of mitoxantrone and adriamycin in mildly toxic concentrations (1 and 10 micrograms respectively), in CML cells . The mechanism of enhancement in drug sensitivity by reserpine in CML cells is due to enhanced intracellular accumulation of drug.

Rev Esp Enferm Apar Dig, 1989 Jun, 75(6 Pt 1), 545 - 52
{Non-excisional treatment of spontaneous rupture of the esophagus}; Arconada JA et al.; We present 7 personal cases of Boerhaave syndrome, 6 treated surgically and one managed with conservative measures . Boerhaave's syndrome is one of the most serious gastro-intestinal perforation pictures . Although its frequency is scant, because of its seriousness it is important to be aware of it for early diagnosis . While a prompt diagnosis is important in any pathology, it is even more so in this syndrome since there is a clear relationship between the time lapse from perforation to the onset of treatment and the rate of survival . Although we present one case cured medically, this is exceptional and treatment is eminently surgical and should be as early as possible . The technique that provides the best results and an excellent morbimortality rate in relation to efficacy is primary suture followed by a fundal patch . In delayed cases with patients in deteriorated condition, other techniques can be considered . Due to its initial severity and a tendency to postoperative complications, the patient should be closely controlled, and correct antibiotic therapy and complete parenteral support nutrition are very important in treatment.

Ann Thorac Surg, 1989 Jun, 47(6), 799 - 805; discussion 804-5
Viable and nonviable aortic homografts in the subcoronary position: a comparative study; Bodnar E et al.; One hundred fifty-five freeze-dried, 63 frozen, and 337 Hanks'-antibiotic solution preserved or nutrient-antibiotic solution preserved homografts used for isolated aortic valve replacement have been followed for 1 to 20 years (mean, 5.3 years), a total of 2,931 patient-years of follow-up information . Overall survival, valve-related death, primary tissue failure, failure due to surgical technical error, infective endocarditis, and overall event-free survival have been assessed and compared . Overall survival 20 years after operation was 51.6% +/- 8.1% with a low incidence of sudden death . The method and length of preservation did not have any effect on the long-term performance or the mode of failure of the homografts . The rate of primary tissue failure was apparently higher with valves preserved in a solution containing calf serum, but the difference was not significant . It is concluded that long-term patient survival and quality of life after aortic valve replacement with a homograft are excellent . The current study, however, could not verify the existence of a significant difference between the three assessed methods of homograft preservation . Furthermore, it could not prove the importance of cellular viability or the existence of clinically significant immunological factors other than the calf serum content of the nutrient medium.

J Endocrinol, 1989 Jun, 121(3), 537 - 44
A peptidase activity from primate liver that inactivates oxytocin in vitro: purification and partial characterization; Krishna GS et al.; An aminopeptidase from monkey (Macaca radiata) liver, inactivating oxytocin in vitro and located predominantly in the lysosomal and microsomal fractions, was purified by chromatography on Bio-Gel HTP, DEAE-Sephacel and nickel ion chelate gel and gel filtration on Sephacryl S300 . Absence of binding to nickel ion chelate gel indicated the absence of exposed histidine and thiol residues on the enzyme . The enzyme appeared to be a high molecular weight (Mr 106,000) monomeric protein . It was sensitive to inhibition by metal chelators and was found to be a zinc metalloprotein by atomic absorption spectrophotometry . Divalent metal ions Ni2+ and Co2+, and sulphydryl activators glutathione and 2-mercaptoethanol had activating effects, while 4-chloro mercuribenzoate, amino acids with large hydrophobic side chains and L-cystine, beta-lactam antibiotic cloxacillin and peptidase inhibitor amastatin had inhibitory effects on the enzyme activity . The enzyme was most active against S-benzyl L-cysteine 4-nitroanilide substrate . The properties of the enzyme were distinct from those of the well-characterized alanine and leucine aminopeptidases (EC 3.4.11.2 and EC 3.4.11.1 respectively) of liver, and of primate placental cystine aminopeptidases (EC 3.4.11.3).

J Neurol Sci, 1989 Jun, 91(1-2), 215 - 26
Myositis caused by Borrelia burgdorferi: report of four cases; Reimers CD et al.; Myositis was proven histopathologically in 4 patients (age range 36-66 years) who suffered from early or late stages of Borrelia burgdorferi infection . Muscle weakness was present in 3 patients, 1 complaining of additional myalgias . One man came to medical attention because of skin discoloration and swelling of one leg . Deep biopsy from skin, fascia and muscle revealed acrodermatitis chronica atrophicans, panniculitis, fasciitis, and myositis, respectively . Creatine kinase was slightly elevated in 3 cases and normal in one . Infiltrates were found in the perimysium and within the muscle bundles, mainly around small vessels . The infiltrates consisted of many B cells and T4 lymphocytes with fewer cytotoxic T cells, suggesting that Borrelia myositis might be due to a local immune response to unknown Borrelia antigens . Cultivation of Borrelia from muscle was not successful . Antibiotic therapy cured the myositis.

J Antibiot (Tokyo), 1989 Jun, 42(6), 968 - 76
Biological properties of streptonigrin derivatives . III . In vitro and in vivo antiviral and antitumor activities; Take Y et al.; Antitumor antibiotic streptonigrin (STN-COOH) is a potent inhibitor of avian myeloblastosis virus (AMV) and human immunodeficiency virus reverse transcriptases . The carboxyl group at 2'-position of STN-COOH was modified to give esters, hydrazide, amides and amino acid derivatives for biological studies . Against AMV reverse transcriptase, the hydrazide, amides and amino acid derivatives showed inhibitory activity, which compared favorably to that of STN-COOH, with the ID50 values ranging 2-8 micrograms/ml . In contrast, the esters lacked this activity except for those having a dimethylamino group in the substituent . Splenomegaly caused by Friend leukemia virus infection was significantly inhibited by STN-COOH and STN-COO(CH2)3N(CH3)2, but not STN-CONH(CH2)3N(CH3)2 . Doxorubicin-resistant murine lymphoblastoma L5178Y cells showed collateral sensitivity to both STN-COOH and STN-COO(CH2)3N(CH3)2 not only in vitro but also in vivo.

J Antibiot (Tokyo), 1989 Jun, 42(6), 944 - 51
A resting cell system for efrotomycin biosynthesis; Nielsen JB et al.; Efrotomycin, a modified polyketide antibiotic with utility as a growth permittant in the animal industry, is produced by Nocardia lactamdurans . A resting cell system has been developed to facilitate biosynthetic studies . Washed cells harvested from oil-based medium at 64 hours and resuspended in buffer produce up to 700 mg/ml efrotomycin in 60 hours when supplemented with a carbon source, optimally glucose . No evidence of carbon or nitrogen repression was observed . Productivity declines progressively with cell age but becomes less dependent on ongoing protein synthesis . The protein synthesis dependent and independent systems were used to study carbon utilization, incorporation of labeled precursors and to examine inhibitors of efrotomycin biosynthesis . A system derived from an efrotomycin non-producer was used to examine the glycosylation of the aglycone, aurodox, to efrotomycin through a monosaccharide form, 6'-deoxyallosyl aurodox.

Transfusion, 1989 Jun, 29(5), 421 - 3
Granulocyte transfusion therapy in a child with chronic granulomatous disease and multiple red cell alloantibodies; Depalma L et al.; A 7-year-old, 17-kg child with chronic granulomatous disease and nocardial pneumonia and osteomyelitis did not respond to antibiotic therapy and developed multiple red cell (RBC) alloantibodies (anti-c, -E, and -Jka) . To provide daily granulocyte concentrates, a method was devised to reduce the number of incompatible RBCs per transfusion . Leukapheresis was done with hydroxyethyl starch, and the apheresis product was allowed to sediment by gravity in a plasma expressor for 90 minutes . The leukocyte-rich plasma was separated from the sedimented RBCs by transfer to a satellite bag, and the volume of the product was reduced by centrifugation to approximately 80 ml . RBC content was reduced from 29 +/- 7 to 2.5 +/- 1.0 ml (n = 22, p less than 0.01) and was accompanied by a 70 percent recovery of white cells (range, 49-90%) . The final product contained 1.6 +/- 1.0 X 10(10) granulocytes . There were no clinical or laboratory signs of hemolysis during the course of 46 granulocyte transfusions, 37 of which were derived from c-, E-, or Jka-positive donors . The size of most apheresis donor pools is insufficient to provide phenotypically matched granulocyte concentrates daily for patients with RBC alloimmunization . The rapid, simple method described here may allow daily therapy with mismatched concentrates to be administered safely to such patients.

Clin Orthop, 1989 Jun, (243), 48 - 56
Open joint injuries . Classification and treatment; Collins DN et al.; Experience with wounds involving the major joints of the lower extremity suggests that the extracapsular soft tissues and the intracapsular structures should be considered individually to assess accurately the magnitude of injury and to provide a prognosis . A classification scheme is proposed to characterize the areas and types of injury . Type I open joint injuries are single penetrations without extensive soft-tissue damage, permitting uncomplicated joint and wound closure . Type II injuries are single or multiple penetrations with extensive soft-tissue disruptions (flaps, avulsions, degloving), often requiring secondary operations to attain closure . Type III injuries are open periarticular fractures with extension through the adjacent intraarticular surface . Type IV injuries are open dislocations or those with associated nerve or vascular injury requiring repair . The extent of intraarticular injury further subdivides Types I, II, and III . The prognosis for functional impairment correlates with the severity of injury . The cornerstones for successful management are debridement, antibiotic therapy, properly timed and performed joint closure, and aggressive treatment of the associated bony injury.

Clin Orthop, 1989 Jun, (243), 169 - 71
Hemophilus parainfluenzae complicating total knee arthroplasty . A case report; Pravda J et al.; Infections are an unfortunate but well-known complication of prosthetic joint replacements . Prophylactic antibiotics have been prescribed to help combat infections in total joint arthroplasties . A 78-year-old woman with a cemented total knee replacement developed a Hemophilus parainfluenzae infection following routine root canal dental surgery . The infection was successfully treated with arthroscopic irrigation and antibiotic therapy.

Obstet Gynecol Clin North Am, 1989 Jun, 16(2), 417 - 30
Pneumonia and pulmonary tuberculosis in pregnancy; Maccato ML; Successful treatment of pneumonia in pregnancy requires aggressive supportive therapy and effective antibiotic coverage . Prevention is crucial in dealing with aspiration pneumonia . A high index of suspicion should be maintained for pulmonary tuberculosis in the obstetrical population.

Obstet Gynecol Clin North Am, 1989 Jun, 16(2), 363 - 71
Postpartum endometritis; Cox SM et al.; Despite the widespread use of prophylactic antibiotics, postpartum endometritis remains a common complication following cesarean section . Metritis is generally polymicrobial and responds to a wide variety of antibiotic regimens . During the past decade, single agents have been shown to be safe and efficacious . The pathogenesis, diagnosis, and treatment options for endometritis are reviewed.

Mol Gen Genet, 1989 Jun, 217(2-3), 362 - 9
The paromomycin resistance mutation (parr-454) in the 15 S rRNA gene of the yeast Saccharomyces cerevisiae is involved in ribosomal frameshifting; Weiss-Brummer B et al.; The leaky expression of the yeast mitochondrial gene oxi1, containing a framshift mutation (+1), is caused by natural frameshift suppression, as shown previously (Fox and Weiss-Brummer 1980) . A drastic decrease in the natural level of frameshifting is found in the presence of the parr-454 mutation, localized at the 3' end of the 15 S rRNA gene . This mutation causes resistance to the antibiotic paromomycin in the yeast strains D273-10B and KL14-4A (Li et al . 1982; Tabak et al . 1982) . The results of this study imply that in the yeast strain 777-3A this mutation alone is sufficient for restriction of the level of natural frameshifting but is insufficient to confer resistance to paromomycin . A second mutation, arising spontaneously with a frequency of 10(-4) leads, in combination with the parr-454 mutation, to full paromomycin resistance in strain 777-3A.

Kinderarztl Prax, 1989 Jun, 57(6), 263 - 70
{Contribution of the pediatrician in the early diagnosis of eye diseases . 2}; Zintl E et al.; Cataract, glaucoma, retinoblastoma and stenoses of the lacrimal passages are diseases that a carefully examining pediatrician will be able to detect at his work in the child-welfare centre or during his outpatient consulting hours . The timely treatment of the cataract (operation and subsequent optical correction) and of the infantile glaucoma (mostly fistulizing operation) is crucial to the future development of the virus . Retinoblastomas that often only at an advanced stage are identified and then will be remarkable by a greyish white pupillary reflex ("amaurotic cat's eye") in many cases make enucleation indispensably necessary . The frequently occurring stenoses of the lacrimal passages are to be pretreated with local antibiotic therapy and eliminated by subsequent probing.

Conn Med, 1989 Jun, 53(6), 335 - 7
Treatment of Lyme disease; Schoen RT; Lyme disease, a tick-transmitted spirochetal infection, can be divided into three stages that can overlap or occur alone . The goals of antibiotic therapy in stage one are to shorten the duration of early disease and to prevent the development of later stages of the illness . This can usually be accomplished with oral antibiotic therapy . Later stages of the illness are frequently more difficult to treat, requiring prolonged oral or intravenous antibiotic therapy.

J Assoc Physicians India, 1989 Jun, 37(6), 376 - 8
Posterior fossa abscesses . A review of 33 cases; Unnikrishnan M et al.; Thirty three cases of posterior fossa abscesses seen over a period of 20 years are reviewed . 84.8% of these were secondary to otogenic disease . Two abscesses were due to tuberculosis and one due to actinomycotic infection . The overall mortality was 12.1% . Total excision of the abscess with appropriate antibiotic therapy was associated with an operative mortality of 3.4%.

Cardiovasc Res, 1989 Jun, 23(6), 498 - 504
Oxidative damage in selenium deficient hearts on perfusion with adriamycin: protective role of glutathione peroxidase system; Nakano E et al.; The protective effects of the glutathione peroxidase system against functional damage induced by perfusion of isolated hearts with adriamycin, an anthracycline antibiotic, were studied . We used selenium deficient rats, in which cardiac glutathione peroxidase activity was only 3% of control rats . Both contractile tension and coronary flow decreased during perfusion with the antibiotic . The degree of decline was significantly greater in the selenium deficient hearts than in the control hearts . The increase in malondialdehyde, a product of lipid peroxidation, induced by adriamycin perfusion was more evident in selenium deficient hearts, though the level of reduced glutathione was well maintained . Isolated mitochondrial function also decreased after aerobic adriamycin perfusion and the decrease was greater in selenium deficient rats . These observations indirectly suggest that the decrease in cardiac function induced by adriamycin is protected by the glutathione peroxidase system and that the decrease may be due, at least in part, to damage to the mitochondria caused by oxygen radicals generated by adriamycin.

Biomed Environ Sci, 1989 Jun, 2(2), 160 - 6
Inability of nitrendipine to protect against gentamicin nephrotoxicity in the rat; Kacew S; Daily sc injection of gentamicin (100 mg/kg) for 4 days produced a significant decrease in the activities of renal cortical Na+,K+-ATPase and alkaline phosphatase . The observed reduction in renal functional enzymatic markers was associated with significant elevation in sphingomyelin, phosphatidylserine, phosphatidylglycerol, phosphatidylinositol, phosphatidylcholine, and total phospholipid . Gentamicin significantly decreased the activity of renal phospholipase C . Nitrendipine (25 mg/kg/day) for 7 days po for 4 days alone did not markedly alter the activities of kidney phospholipase C, alkaline phosphatase, and Na+,K+-ATPase or tissue phospholipid levels . Daily administration of nitrendipine for 3 days followed by concurrent treatment of nitrendipine and gentamicin failed to prevent antibiotic-induced renal histopathologic changes, phospholipidosis, or decrease in alkaline phosphatase . However, in rats simultaneously given nitrendipine and gentamicin the activity of Na+,K+-ATPase returned to control values, indicating a selective blocking action for nitrendipine . The inability of nitrendipine to prevent gentamicin-induced renal phospholipidosis or decreases in enzymatic function markers was associated with significantly elevated tissue aminoglycoside levels when compared to values seen in rats given only the antibiotic . Evidence suggests that nitrendipine is not effective in lowering the concentration of gentamicin in renal cortex . The effectiveness of an agent in providing protection against aminoglycoside nephrotoxicity may be associated with the ability of the drug to lower renal gentamicin content.

Mol Gen Genet, 1989 Jun, 217(2-3), 378 - 83
Transport across the outer membrane of Escherichia coli K12 via the FhuA receptor is regulated by the TonB protein of the cytoplasmic membrane; Schoffler H et al.; Point mutations in the "TonB box" of fhuA were suppressed by point mutations in the tonB gene, suggesting both a functional and physical interaction between the FhuA receptor protein in the outer membrane and the TonB protein in the cytoplasmic membrane of Escherichia coli K12 . Mutations in fhuA were classified into four types according to the extent by which they impaired mutant cells in their growth on ferrichrome as sole iron source and in their sensitivity to the antibiotic albomycin and to colicin M . The tonB mutation with a glutamine to leucine replacement at position 165 was less efficient in restoring the FhuA functions than the glutamine to lysine exchange at the same position . The better the coupling between FhuA and TonB the poorer was the inhibition of phage T1 binding to FhuA by ferrichrome . A working model is proposed in which the TonB protein assumes different conformations in response to the energized state of the cytoplasmic membrane and thereby allosterically regulates the activity of the FhuA receptor . This model implies an intermembrane coupling between two proteins in adjacent membranes.

Aust Paediatr J, 1989 Jun, 25(3), 138 - 42
Morbidity from acquired cytomegalovirus infection in a neonatal intensive care unit; Weston PJ et al.; In a prospective study of transfused neonates, 32 of 262 infants were viruric at greater than 20 days of life . Of 212 neonates whose early status was known, postnatally acquired infection was proven in 21, two of whom were seronegative at birth and were thought to have transfusion-acquired cytomegalovirus (CMV) . Maternal transmission of CMV is important in this population as there was 91% seropositivity for CMV at birth among the 21 babies who acquired CMV compared with 55% positivity among 150 babies who did not shed CMV (P less than 0.01) . Significantly increased morbidity (increased length of stay in hospital, increased use of antibiotics, and longer duration of antibiotic administration) was found in babies with acquired CMV compared with matched controls who did not become viruric . Significant morbidity and mortality was not restricted to the two seronegative babies with transfusion-acquired CMV . The cost of providing CMV antibody negative blood for this neonatal unit would be less than the cost of providing the extended hospital care needed by the two babies with transfusion-acquired CMV found during this 3 year study.

In Vitro Cell Dev Biol, 1989 Jun, 25(6), 535 - 43
Clonal populations of the mouse mammary cell line, COMMA-D, which retain capability of morphogenesis in vivo; Danielson KG et al.; Clonal populations were isolated from the mouse mammary cell line, COMMA-D, by transfection with a dominant-selectable gene, pSV2Neo, which confers resistance to the antibiotic, G418 . Seven of twenty-four clones isolated retained the ability of the parental line to repopulate cleared mammary fat pads in vivo as ductal-alveolar hyperplasias . Two sublines designated CDNR2 and CDNR4 retained hyperplastic growth potential after multiple passages in vitro with low incidence of tumor formation . A third subpopulation, CDNR1, contained a single integration site for the pSV2Neo plasmid indicating a bonafide clonal origin for this subline . CDNR1 cells displayed heterogeneous growth phenotypes in vivo including hyperplasia, adenocarcinoma, and bone formation . Functional differentiation of CDNR1 cells organized as alveolarlike structures in vivo or on floating collagen gels in vitro was observed as determined by immunoperoxidase staining for the milk-specific protein, casein . Overall, the results indicate that a subset of cells from the COMMA-D cell line may be functionally analogous to stem cells existing in the mammary gland.

J Virol, 1989 Jun, 63(6), 2592 - 7
Development and characterization of an Fv-1-sensitive retrovirus-packaging system: single-hit titration kinetics observed in restrictive cells; Boone LR et al.; We have constructed an RNA-packaging-deficient mutant of N-tropic murine leukemia virus WN1802N by removal of 330 nucleotides located between the upstream long terminal repeat and the start of the gag gene region . Transfection into mink CCL64 cells produced a cell line capable of packaging retrovirus vectors into ecotropic, Fv-1 N-tropic virions . Using retrovirus vectors that confer resistance to the antibiotic G418, we demonstrated that the magnitude of restriction in BALB/3T3 and SIM.R cells (both Fv-1b/b) and in RFM/3T3 cells (Fv-1nr/nr) is approximately 100-fold compared with that in AKR or NIH 3T3 cells (both Fv-1n/n) . Furthermore, titration kinetics were single hit in restrictive cells . Colonies of antibiotic-resistant cells recovered after infection of genotypically restrictive cultures were phenotypically restrictive when reinfected, ruling out selection of stably nonrestrictive subpopulations . These results suggest that the ability to infect some fraction of cells in a genotypically restrictive culture does not require specific abrogation and that multihit kinetics may not be an essential feature of Fv-1 restriction.

J Clin Invest, 1989 Jun, 83(6), 2003 - 7
Mithramycin blocks protein binding and function of the SV40 early promoter; Ray R et al.; Specific interactions between DNA and transcription factors are necessary for transcription initiation . These interactions provide a potential target for the selective inhibition of eukaryotic gene expression . Mithramycin is a DNA binding antibiotic which, in the presence of Mg2+, binds G-C containing sequences in the minor groove . The SV40 early promoter contains six G-C decanucleotide sequences, which are binding sites for the transcriptional activating factor, Sp1 . Each of the six Sp1 binding sites of this promoter is protected from DNAse 1 digestion by mithramycin binding . Mithramycin binding to the G-C rich sequences in the SV40 early promoter prevents subsequent protein binding to these sequences . The gel retardation of the SV40 early promoter fragment incubated with a HeLa cell extract is completely abrogated by pretreatment of the DNA fragment with mithramycin . The functional significance of mithramycin binding is reflected in the ability of mithramycin to block promoter function . Mithramycin inhibits promoter dependent transcription in an in vitro runoff transcription system in a concentration dependent manner . This suggests that mithramycin prevents transcriptional activation of the SV40 early promoter by blocking binding of transcriptional activating proteins to G-C rich promoter regions.

Minerva Pediatr, 1989 Jun, 41(6), 319 - 22
{Clinical considerations on cases of pneumonia caused by mycoplasma}; Massolo F et al.; Personal experience of a series of mycoplasma-induced pneumoniae is reported . The importance of early diagnosis for the purpose of speedy target antibiotic therapy is reiterated . Stress is laid on the absence of complications in all patients studied.

Aust Paediatr J, 1989 Jun, 25(3), 164 - 7
Supplemental nasogastric feeding in cystic fibrosis patients during treatment for acute exacerbation of chest disease; Daniels L et al.; The use of overnight, nasogastric, nutritional supplementation during hospitalization of children with cystic fibrosis (CF) receiving antibiotic therapy for acute exacerbations of respiratory disease was evaluated in 11 children (mean age = 7.75 years) . Supplementary feeding significantly increased inpatient energy intake from 116 +/- 30% to 165 +/- 30% (P less than 0.001) of recommended dietary allowance with minimal effect on oral intake . It also resulted in significantly improved weight gains but neither increased energy intakes nor weights were sustained at short-term (mean = 5.7 weeks) or long-term (mean = 21.6 weeks) follow-up . The notion that short bursts of nasogastric feeding for inpatients with CF improve growth status is not supported . However, the study did show that treatment of chest infections alone does not positively affect spontaneous oral energy intake.

South Med J, 1989 Jun, 82(6), 719 - 22
Osteomyelitis of the skull base; Farrior J; Osteomyelitis of the temporal bone often begins with minor trauma and results in a persistent external otitis . I report my experience with ten patients managed with combined medical and surgical therapy, and discuss the progression of the disease process and how it affects the duration of antibiotic therapy and the indications for planned surgical debridement . Early recognition of osteomyelitis of the temporal bone, combined with the aggressive use of long-term antibiotic therapy, in addition to planned surgical debridement, will reduce morbidity and potential mortality.

Infect Immun, 1989 Jun, 57(6), 1765 - 72
Isolation of Rickettsia prowazekii with reduced sensitivity to gamma interferon; Turco J et al.; The growth of Rickettsia prowazekii Madrid E was monitored in mouse L929 cells subcultured for several weeks in the presence of gamma interferon (IFN-gamma) to determine whether the rickettsiae would be eliminated from or would persist in these cultures . R . prowazekii exhibited two distinct patterns in these IFN-gamma-treated cultures . In some cases, IFN-gamma-induced inhibition of rickettsial growth led to elimination of the rickettsiae from the L929 cell cultures; in other cases, the initial inhibition of rickettsial growth was followed by establishment of a persistent rickettsial infection in the IFN-gamma-treated L929 cells . During the first 3 days after infection, the growth rate of the L929 cells was significantly lower and higher percentages of the cells were killed in the IFN-gamma-treated, R . prowazekii-infected cultures than in the untreated, R . prowazekii-infected cultures or the mock-infected cultures, whether treated or untreated . This suppression of cell growth occurred in the infected, IFN-gamma-treated cultures that eventually exhibited the elimination pattern as well as the IFN-gamma-treated cultures that became persistently infected . It was not possible to predict the outcome of a particular infection from the early growth pattern of the culture . It was determined that the L929 cells in the persistently infected, IFN-gamma-treated cultures had not lost the ability to respond to IFN-gamma . These cells, after treatment with an antibiotic to eliminate the persistent rickettsiae, retained the ability to inhibit both the replication of vesicular stomatitis virus and the growth of R . prowazekii Madrid E after treatment with IFN-gamma . In contrast, rickettsiae isolated from two persistently infected, IFN-gamma-treated cultures were less sensitive than R . prowazekii Madrid E to the antirickettsial effects of IFN-gamma in standard L929 cells . The maintenance of the phenotype of these altered rickettsiae during plaque purification and passage in the absence of IFN-gamma suggests an alteration at the genetic level rather than phenotypic adaptation.

Can J Physiol Pharmacol, 1989 Jun, 67(6), 546 - 52
Influence of gramicidin S on cardiac membrane Ca2+/Mg2+ ATPase activities and contractile force development; Zhao DY et al.; The effects of gramicidin S (GS), an antibiotic, on the rat heart membrane ATPases and contractile activity of the right ventricle strips were investigated . GS inhibited sarcolemmal Ca2+-stimulated ATPase (IC50 = 3 microM), Ca2+/Mg2+ ATPase which is activated by millimolar Ca2+ or Mg2+ (IC50 = 3.4 microM), and sarcoplasmic reticulum Ca2+-stimulated ATPase (IC50 = 6 microM) . The type of inhibition for the sarcolemmal Ca2+/Mg2+ ATPase by GS was apparently uncompetitive, while that for Ca2+-stimulated ATPases in sarcolemma or sarcoplasmic reticulum was of mixed type . Other ATPases, including mitochondrial ATPase, sarcolemmal Na+-K+ ATPase, and myofibrillar ATPase, were not inhibited by this agent . GS also decreased the rat right ventricle maximum force development (half-maximal inhibitory concentration was 2-4 microM), maximum velocity of contraction, and maximum velocity of relaxation . The resting tension was increased by GS to over 200% . The contractile actions of GS were mostly irreversible upon washing the muscle 3 times over a 10-min period . Decreased Ca2+, Mg2+, Na+, K+ concentrations in the perfusate increased the effects of GS . These findings showed that GS was a potent inhibitor of divalent cation ATPases of heart sarcolemma and sarcoplasmic reticulum and it is suggested that these membrane effects may explain the cardiodepressant action of this agent.

Anasth Intensivther Notfallmed, 1989 Jun, 24(3), 147 - 52
{Pneumonia in artificially ventilated patients: the significance of Gram preparation und bronchoscopic specimen collection methods in diagnosis and therapy}; Konrad F et al.; The value of the Gram preparation of tracheal secretion compared to bacterial culture was checked in 48 patients with lower respiratory tract infections under mechanical ventilation with regard to antibiotic therapy . In 20 patients attention was also paid to the information value of a bronchial secretion obtained bronchoscopically using a brush . In 34 patients (71%) there was an exact agreement between the result of the Gram preparation and that of the culture . The antibiotic therapy initially administered on the basis of the Gram preparation from the tracheal secretion had to be corrected in 6 patients (12.5%) according to the culture and resistance results and in 6 patients (12.5%) because clinical improvement had not occurred after three days . Only 67% of the bacteria found in the tracheal secretion were isolated also with the bronchoscopic brush technique . The antibiotic therapy was not altered on the basis of the result obtained by bronchoscopy in any case . We conclude that for calculated antibiotic therapy Gram preparation has great significance . Bronchoscopic methods of obtaining material did not influence antibiotic therapy in bacterial pneumonia.

Arch Intern Med, 1989 Jun, 149(6), 1350 - 3
Trimethoprim inhibition of the renal clearance of procainamide and N-acetylprocainamide; Vlasses PH et al.; To test the effect of trimethoprim (an antibiotic commonly administered with sulfamethoxazole) on the disposition of the antiarrhythmic procainamide hydrochloride and its active metabolite N-acetylprocainamide, 10 healthy men received 1 g of procainamide hydrochloride orally on two occasions, coadministered with placebo or trimethoprim (100 mg twice a day for 2 days before and then 200 mg with the procainamide dose) . Trimethoprim decreased the mean (+/- SD) renal clearance by 45% after the dose of procainamide was administered (487 +/- 129 vs 267 +/- 123 mL/min) and that of N-acetylprocainamide by 26% (275 +/- 78 vs 192 +/- 82 mL/min) compared with placebo . The mean area under plasma concentration--time curve 0 to 12 hours after dosing increased 39% for procainamide (19.8 +/- 4.8 vs 27.6 +/- 7.2 mg.h/L) and 27% for N-acetylprocainamide (9.1 +/- 2.1 vs 11.4 +/- 2.8 mg.h/L) . The corrected QT electrocardiographic interval at 2 hours after the procainamide dose was 0.40 +/- 0.02 second with placebo and 0.43 +/- 0.03 second with trimethoprim . Trimethoprim may increase procainamide and N-acetylprocainamide plasma concentrations, resulting in increased pharmacodynamic response apparently caused by the competition for renal tubular cationic secretion.

Biochemistry, 1989 May 30, 28(11), 4540 - 2
Oxygen transfer from the nitro group of a nitroaromatic radiosensitizer to a DNA sugar damage product; Kappen LS et al.; Mechanisms based on one-electron oxidation appear incomplete in explaining cellular radiosensitization by nitroaromatic compounds such as misonidazole . Evidence is presented for a novel mechanism that may be involved in enhancing DNA strand breakage due to a variety of agents, including ionizing radiation, that generate carbon-centered radicals on DNA deoxyribose . Under anaerobic conditions the carbon-centered radical generated selectively at C-5' of deoxyribose of thymidylate residues in DNA by the antitumor antibiotic neocarzinostatin reacts with misonidazole to produce a DNA damage product in the form of 3'-(formyl phosphate)-ended DNA . In an 18O-transfer experiment we find that the carbonyl oxygen of the activated formyl moiety (trapped as formyl-Tris) is derived from the nitro group oxygen of misonidazole . This result strongly supports a mechanism in which a nitroxide radical adduct, formed by the addition of misonidazole to the radical at C-5' of deoxyribose, cleaves between the N and O so as to form an oxy radical precursor of the formyl moiety and a two-electron reduction species of misonidazole.

Schweiz Rundsch Med Prax, 1989 May 23, 78(21), 614 - 6
{Articular involvement in Swiss patients with a Borrelia burgdorferi infection--report of 8 cases}; Gerster JC; Eight cases of Lyme's arthritis are reported . In four of them, they are related to an erythema chronicum migrans, in two to an acrodermatitis atrophicans . In two cases, there was no cutaneous manifestation, but the serology was strongly positive for Borrelia burgdorferi, and there was rapid relief of the pain with antibiotic therapy . It is suggested that Lyme's arthritis is not rare in Switzerland and that it must be searched for in every case of arthritis of unknown etiology, especially when there is a history of cutaneous involvement . The arthritis is cured by antibiotics.

Presse Med, 1989 May 20, 18(20), 1010 - 13
{Treatment of homozygote beta thalassemia in Algiers . A 5-year follow-up of 66 patients}; Adjrad L et al.; During the years 1982-1987, 66 patients with homozygous beta-thalassaemia were treated at the blood transfusion centre of Algiers . The patients, aged from 1 to 23 years in 1982, came from 48 families, 30 of which were issued from consanguinous unions . The patients fell into three groups according to the early institution and quality of treatment (blood transfusions, antibiotic therapy, desferrioxamine given when available) . The beneficial clinical effects observed (satisfactory growth and development, reduction of splenomegaly and hypersplenism, attenuation of craniofacial malformations, performance at school) seemed to be directly related to the mean haemoglobin level prior to transfusion and to the early institution of treatment . Four patients died of anaemia and haemochromatosis . The incidence of viral contamination was 27.5 per cent for the hepatitis B virus and nil for the human immunodeficiency virus.

Nature, 1989 May 18, 339(6221), 223 - 6
Brefeldin A implicates egress from endoplasmic reticulum in class I restricted antigen presentation; Nuchtern JG et al.; Most antigens must be processed intracellularly before they can be presented, in association with major histocompatibility complex (MHC) molecules at the cell surface, for recognition by the antigen-specific receptor of T cells . This processing appears to involve cleavage of protein antigens to smaller peptides . Only certain fragments of any protein can serve as T-cell epitopes and this is, at least in part, determined by the requirement that peptides be able to bind the MHC molecules . Class I restricted antigens are derived from proteins, such as viral antigens, that are synthesized within the presenting cell . Many of these antigens are cytosolic proteins and recent evidence suggests that it is in the cytosol that these proteins are processed to produce either the antigenic peptides or processed intermediates . How and where these processed cytosolic antigens cross the membrane of the vacuolar system and bind to the extracellular domain of the class I molecule is not known but one obvious site for this process is the endoplasmic reticulum (ER), because this organelle is specialized to translocate proteins across the membrane from the cytosol into the secretory system . Based on this model, we reasoned that if we could pharmacologically block the movement of proteins out of the ER, endogenous antigen presentation would cease . An agent which causes such an effect is available--the fungal antibiotic Brefeldin A (BFA) . Consistent with the above hypothesis, we report that BFA completely abolishes the ability of a cell to present endogenously synthesized antigens to class I restricted cytotoxic T cells.

Rev Prat, 1989 May 18, 39(15), 1294 - 9
{Clinical manifestations of Lyme disease}; Veyssier P; Lyme disease can be divided into three phases; (1) a primary phase where the inconstant erythema migrans predominates; (2) a secondary phase, sometimes revealing the disease, with isolated or associated cutaneous and cardiac signs and articular or neurological manifestations responding to antibiotics, and (3) a tertiary phase with cutaneous, articular and above all neurological signs which are chronic and sometimes severe . A better knowledge of this infection has enabled some rheumatological or neurological manifestations to be explained . Clinicians should be aware of this, since these disorders are amenable to antibiotic therapy . Conversely, multivisceral symptoms should not be ascribed to Lyme disease without strong positive arguments.

Med J Aust, 1989 May 15, 150(10), 599 - 601
Legionella longbeachae pneumonia: report of two cases; Lim I et al.; Legionella longbeachae serogroup 1 was isolated from the respiratory secretions of two patients with community-acquired pneumonia . One patient had a mild infection without evidence of the involvement of other organs and recovered, in spite of inappropriate antibiotic therapy . The other patient was severely-ill on presentation with multisystem failure and died soon after admission to hospital . The organisms were identified by the immunofluorescence technique and by quantitative DNA-hybridization studies . The sources of the infection in these patients are unknown as the organism has never been isolated from the SA environment.

Arch Biochem Biophys, 1989 May 15, 271(1), 21 - 32
Regulation of polyphosphoinositide synthesis in cardiac membranes; Quist E et al.; The relative distribution of phosphatidylinositol (PI) and phosphatidylinositol-4-phosphate (PIP) kinase activities in enriched cardiac sarcolemma (SL), sarcoplasmic reticulum (SR), and mitochondrial fractions was investigated . PI and PIP kinase activities were assayed by measuring 32P incorporation into PIP and phosphatidylinositol 4,5-bisphosphate (PIP2) from endogenous and exogenous PI in the presence of {gamma-32P}ATP . PI and PIP kinase activities were present in SL, SR, and mitochondrial fractions prepared from atria and ventricles although the highest activities were found in SL . A similar membrane distribution was found for PI kinase activity measured in the presence of detergent and exogenous PI . PI and PIP kinase activities were detectable in the cytosol providing exogenous PI and PIP and Triton X-100 were present . Further studies focused on characterizing the properties and regulation of PI and PIP kinase activities in ventricular SL . Alamethacin, a membrane permeabilizing antibiotic, increased 32P incorporation into PIP and PIP2 4-fold . PI and PIP kinase activities were Mg2+ dependent and plateaued within 15-20 min at 25 degrees C . Exogenous PIP and PIP2 (0.1 mM) had no effect on PIP and PIP2 labeling in SL in the absence of Triton X-100 but inhibited PI kinase activity in the presence of exogenous PI and Triton X-100 . Apparent Km's of ATP for PI and PIP kinase were 133 and 57 microM, respectively . Neomycin increased PIP kinase activity 2- to 3-fold with minor effects on PI kinase activity . Calmidazolium and trifluoperazine activated PI kinase activity 5- to 20-fold and completely inhibited PIP kinase activity . Quercetin inhibited PIP kinase 66% without affecting PI kinase activity . NaF and guanosine 5'-O-(3-thiotriphosphate) had no effect on PI and PIP kinase activities, indicating that these enzymes were not modulated by G proteins . The probability that PIP and PIP2 synthesis in cardiac sarcolemma is regulated by product inhibition and phospholipase C was discussed.

Science, 1989 May 12, 244(4905), 697 - 9
Calicheamicin gamma 1I and DNA: molecular recognition process responsible for site-specificity; Zein N et al.; Calicheamicin gamma 1I is a recently discovered diyne-ene-containing antitumor antibiotic that cleaves DNA in a double-stranded fashion, a rarity among drugs, at specific sequences . It is proposed that the cutting specificity is due to a combination of the complementarity of the diyne-ene portion of the aglycone with DNA secondary structures and stabilization by association of the thiobenzoate-carbohydrate tail with the minor groove.

Klin Wochenschr, 1989 May 2, 67(9), 506 - 10
{Sweet syndrome in chronic myeloid leukemia}; Rauh G et al.; A 31-year-old woman with chronic myeloid leukemia developed bullous skin changes not responding to antibiotic therapy . A biopsy showed a sterile predominantly neutrophilic infiltrate consistent with Sweet's syndrome . These skin changes responded well to methylprednisolon . Seven months later the patient died in a blast crisis.

Pathol Biol (Paris), 1989 May, 37(5), 468 - 71
{Treatment of osteo-articular infections with ofloxacin . Preliminary study}; Brouqui P et al.; Twenty-three patients with osteoarthritis were treated by ofloxacin . Antibiotic association was used for 22 patients . Five patients have had osteomyelitis without foreign material . Four of them recovered . Seventeen patients carried foreign material . Evaluation are in progress for 5 of them . In the 12 remaining patients, 8 recovered at a mean duration follow-up of 6 months . One patient have had arthralgia that may be attributable to the treatment . The mean duration of treatment was 6 months for the foreign material group of patient, and 3 for the other.

J Mol Cell Cardiol, 1989 May, 21(5), 433 - 6
Doxorubicin-induced calcium release from cardiac sarcoplasmic reticulum vesicles; Kim DH et al.; Doxorubicin, an anthracycline glycoside antibiotic which has been widely used for treatment of several types of cancer (Goormaghtigh and Ruysschaer, 1984), displays a clinically important cardiac toxicity (Young et al., 1981) that can be dissociated from the antitumor activity . Although the main sites of toxicity have been postulated to be on the muscle membranes (Goormaghtigh and Ruysschaer, 1984; Harris and Doroshow, 1985), no information is available for a direct doxorubicin effect on the Ca2+ fluxes in cardiac sarcoplasmic reticulum (SR) . Previous studies have shown that micromolar doxorubicin triggers Ca2+ release from skeletal SR vesicles (Zorzato et al., 1985) . The objective of this study was to examine the effect of doxorubicin or caffeine on Ca2+ fluxes in cardiac SR in the presence of various Ca2+ release inhibitors . Addition of either doxorubicin (C1/2 = 5 microM), or caffeine (C1/2 = 0.8 mM) triggered Ca2+ release from canine cardiac SR loaded with 45Ca2+ in the presence of 2 mM ATP . The maximal amount of Ca2+ release triggered by doxorubicin (38% of the total loaded Ca2+) was significantly higher than that released by caffeine (25%) . Plots of the amount of Ca2+ release triggered by 20 microM doxorubicin or 2 mM caffeine vs . free Ca2+ concentration were a bell-shaped, with maximal Ca2+ release at 0.2 microM Ca2+ . Ca2+ release triggered by either 20 microM doxorubicin or 2 mM caffeine was inhibited by ruthenium red (0.1 to 2 microM), ryanodine (1 to 100 microM) or tetracaine (0.1 to 1 mM), whereas 2 mM caffeine did not further activate Ca2+ release triggered by 50 microM doxorubicin, suggesting that the drugs may share the same Ca2+ release channel.

J Med Assoc Thai, 1989 May, 72(5), 243 - 9
Lethal midline granuloma and lymphoproliferative disorders; Atichartakarn V et al.; Seventeen patients, who presented with unhealing ulcers or destructive lesions of the upper aero-digestive tract at Ramathibodi hospital from 1977 to 1985 were reported . Lesions caused by infection, Wegener's granulomatosis or non-hematopoietic malignancy were excluded . A spectrum of histopathologic findings were evident in our patients, ranging from acute and chronic inflammatory changes with or without necrosis, polymorphic reticulosis or lymphamatoid granulomatosis, and malignant lymphoma of the non-Hodgkin's type (NHL) . Although some initial histopathologic findings were non-specific, evidence of lymphoproliferative disorders finally emerged . These malignant lymphoid cells had a predilection for the GI tract and skin . Lymphoma staging should thus be done . Bleeding from the lesion, treatment-induced leucopenia, and sepsis were common in these patients . Early aggressive treatment including adequate antibiotic coverage for superimposed infection, improved nutritional status, and early radiation to the primary lesion are suggested for those diseases.

J Int Med Res, 1989 May-Jun, 17(3), 254 - 61
The use of a biocompatible orthopaedic polymer in the treatment of loose total hip prostheses; Schmitt-Fournier JA et al.; Seventeen cases of loose total hip prostheses were treated with biocompatible orthopaedic polymer, an osteoconductive co-polymer . Biocompatible orthopaedic polymer permits improved stability and secondary bone repair and may also act as a vehicle for adjunctive antibiotic therapy . The available forms of biocompatible orthopaedic polymer and their methods of application are described and the results obtained with their use are compared with the pre-operative clinical observations . Of the 17 patients studied, pain disappeared in 14, unlimited walking became possible in seven, while another eight patients were subsequently able to walk for over 300 m . Mobility became normal in 13 cases; full weight bearing on one leg became possible in 12 cases and became normal in another four . Radiological examination showed the development of a bony interface between the cortex and the prosthesis as the radiolucent biocompatible orthopaedic polymer material was converted into bone . It may, therefore, be concluded that, in this indication, biocompatible orthopaedic polymer appears to be an active interface for stabilizing loose total hip prostheses.

J Natl Med Assoc, 1989 May, 81(5), 533 - 7
Thoracic empyema: a five-year experience at Queens Hospital Center; Nkongho A et al.; A retrospective analysis of 48 cases of thoracic empyema is presented along with a management protocol, which includes empiric antibiotic therapy or combinations thereof and an aggressive primary surgical procedure that results in minimal morbidity and mortality . In this series, there were eight deaths (16.6%) . The contributing etiologic agents, however, have shifted from traditional causes, such as posttonsillectomy, postdental extractions, and bronchiectasis, to stupor caused by excessive alcoholism and drug addiction, also involving direct access through injectables into the cardiovascular system.

J Periodontol, 1989 May, 60(5), 285 - 91
The effect of ofloxacin on experimental periodontitis in hamsters infected with Actinomyces viscosus ATCC 15987; Kametaka S et al.; Syrian hamsters were infected with Actinomyces viscosus ATCC 15987 by inoculation into the oral cavity to induce experimental periodontitis . The effect of an antibiotic, ofloxacin (OFLX), on the experimental periodontitis was examined . In Group A, OFLX gel was applied daily to the gingival mucosa, 2 weeks after bacterial inoculation . Groups B and C were an infected control and a noninfected control, respectively . The hamsters in these three groups were fed a powdered high-sucrose diet . The hamsters in Group D, also a noninfected group, were fed an ordinary solid diet . Salivary occult blood test, evaluation of gingival and plaque index, measurement of alveolar bone loss, bacterial examination, and histological observation were performed 11 weeks after infection . Group B exhibited significantly higher levels of gingival index, plaque index, and alveolar bone loss than the noninfected controls . Severe inflammation of the gingivae, formation of gingival pockets, migration of many inflammatory cells, and obvious bone loss were also observed in Group B . However, these inflammatory changes were milder in Group A, which was treated with OFLX.

J Pediatr Surg, 1989 May, 24(5), 491 - 3
Pulmonary septic emboli mimicking metastatic rhabdomyosarcoma; Stine KC et al.; Central venous catheters have proven to be an important aid for the care of pediatric patients with malignancies receiving chemotherapy . A rare complication of such catheters is pulmonary septic emboli . This report describes a 15-year-old white girl with rhabdomyosarcoma who developed pulmonary nodules while on chemotherapy . These lesions appeared to be metastatic rhabdomyosarcoma . However, an excisional biopsy showed the lesions to be septic emboli . The patient was placed on antibiotic therapy and responded well . She was able to continue with her "front-line" therapy because the nodules were confirmed not to be metastatic disease.

J Reprod Med, 1989 May, 34(5), 376 - 8
Right subhepatic abscess after cesarean section . A case report; Harper AK et al.; A right subhepatic abscess complicated a case of cesarean delivery . The absence of an obvious pelvic infection or nongynecologic etiology of the abscess made the case particularly unusual . Broad-spectrum antibiotic therapy and percutaneous abscess drainage under the guidance of computed tomography resulted in a satisfactory resolution of the abscess.

Acta Cytol, 1989 May-Jun, 33(3), 397 - 402
"Repair cells" in equine uterine cytologic and histologic specimens; Freeman KP et al.; Cells resembling those known as "repair cells" in gynecologic cytology specimens from women were identified in uterine cytology specimens from infertile mares treated with antibiotics using indwelling uterine catheters . This prompted a study of the effect on the equine uterus of indwelling catheterization without antibiotic infusion, using light microscopic examination of cytologic and biopsy specimens and electron microscopic examination of biopsy specimens . Cytologic and biopsy specimens had features within normal limits at the start of the study . Following five days of indwelling catheterization, neutrophils were present in both cytologic and biopsy specimens . In cytologic specimens, numerous groups of "repair cells" were present; similar cells in biopsy specimens indicated this was a focal reaction . The large nuclei and prominent nucleoli of the "repair cells" suggested cellular proliferation or regeneration . However, this was contradicted by the ultrastructural sparsity of ribosomes, endoplasmic reticulum, Golgi apparatus and mitochondria . Inflammation and "repair cells" were not present in cytologic or biopsy specimens collected 40 days after the start of the study . Although these cells may be a component of a repair process, our results support the hypothesis that "repair cells" in human and equine gynecologic cytology specimens are injured, rather than regenerating, cells . The term dysphaneroplastic (Greek: "abnormal cytosol development") is proposed to describe these cells since the cytoplasm does not reflect the features of cellular activity suggested by the nuclear appearance.

J Antibiot (Tokyo), 1989 May, 42(5), 691 - 700
Structural elucidation of aculeximycin . I . Further purification and glycosidic bond cleavage of aculeximycin; Murata H et al.; A new insecticidal antibiotic, aculeximycin (ACM), was produced by an actinomycete identified as Streptosporangium albidum . ACM has been successfully isolated from culture filtrate by a combination of Diaion HP-20, Amberlite CG-50, reversed phase silica gel and Sephadex LH-20 chromatographies . It was found that ACM is a basic glycosidic antibiotic with a molecular weight of 1,672 including five monosaccharide units, three double bonds and a hemiketal ring by preliminary spectral analyses . Treatment of ACM with 1,8-diazabicyclo{5,4,0}undecene-7 caused a glycosidic bond cleavage to give aculexitriose, pseudoaglycones I and II.

Arch Phys Med Rehabil, 1989 May, 70(5), 410 - 1
Gluteal abscess causing sciatica in a patient with systemic lupus erythematosus; Shames JL et al.; Low back pain and sciatica may be caused by pathology remote from disc and lumbosacral vertebral segments . We report on a 59-year-old patient with systemic lupus erythematosis whose history illustrates this point . The patient was evaluated and diagnosed to have a septic arthritis of the wrist and lumbar spinal stenosis, for which she was treated . The patient's failure to respond to therapy led to further evaluation . A massive gluteal abscess was identified and drained, and with appropriate antibiotic therapy, the patient recovered . Patients with lupus have increased likelihood of infection, and their evaluation should include a search to discover unusual locations in cases that are unresponsive to standard and seemingly appropriate therapy.

Am J Dis Child, 1989 May, 143(5), 543 - 5
Tracheobronchial foreign bodies . A persistent problem in pediatric patients; Puhakka H et al.; Extraction of a foreign body from the tracheobronchial tree was accomplished for 83 children . The mean age was 1 year 9 months for the 27 girls and 3 years 1 month for the 56 boys; 46 children (55%) were younger than 2 years of age . Sixteen (19%) of the foreign bodies were radiopaque, and 35 (42%) were either verified or suspected radiologically before endoscopy . Forty-one foreign bodies (49%) were situated in the right bronchial tree . Extraction was successful in 81 children (98%) and was performed on 50 children (60%) during the first 24 hours . Twenty-five (30%) of the foreign bodies were peanuts . Three children experienced a residual foreign body, without serious complications . We believe that an open tube bronchoscopy should be performed whenever abnormal stridor or cough is observed in a healthy child and when appropriate antibiotic therapy is unsuccessful.

Am J Clin Pathol, 1989 May, 91(5), 612 - 6
Fatal Streptobacillus moniliformis infection in a two-month-old infant; Sens MA et al.; Streptobacillus moniliformis is an uncommon human pathogen contracted from exposure to rodents . It usually produces a mild, protracted illness (rat-bite fever, Haverhill fever, erythema arthriticum epidemicum) that has either a favorable response to antibiotic therapy or spontaneously resolves . This report describes a fatal case of Streptobacillus moniliformis in an infant bitten by a wild rat . The autopsy findings included an interstitial pneumonia, fibrinous endocarditis, mild mononuclear meningitis, hepatosplenomegaly and lymphadenopathy, erythrophagocytosis, and sinusoidal mononuclear cell infiltrates in regional lymph nodes and the liver . To the authors' knowledge, this is the first report of the autopsy pathology findings of this agent.

Virology, 1989 May, 170(1), 227 - 37
Rifampicin prevents virosome localization of L65, an essential vaccinia virus polypeptide; Miner JN et al.; In contrast to its irreversible effect on the Escherichia coliRNA polymerase beta-subunit, the antibiotic rifampicin reversibly inhibits vaccinia virus morphogenesis at a step during the formation of immature viral particles . The protein affected by the presence of rifampicin is L65, a major late vaccinia polypeptide to which mutations that confer rifampicin resistance have been mapped . We now provide evidence using a monospecific anti-L65 serum in concert with immunofluorescence and sucrose gradient analysis that the mechanism of action of rifampicin on vaccinia virus replication involves the inhibition of localization of L65 to the viral factories (virosomes) thereby blocking further development . Studies on the expression and distribution of L65 during the infection cycle reveal that L65 is a stable, nonglycosylated late protein associated with virions . These results are discussed in relationship to the possible in vivo functions of the L65 protein.

Proc Natl Acad Sci U S A, 1989 May, 86(9), 3006 - 10
Unstable Hoogsteen base pairs adjacent to echinomycin binding sites within a DNA duplex; Gilbert DE et al.; The bisintercalation complex present between the DNA octamer {d(ACGTACGT)}2 and the cyclic octadepsipeptide antibiotic echinomycin has been studied by one- and two-dimensional proton NMR, and the results obtained have been compared with the crystal structures of related DNA-echinomycin complexes . Two echinomycins are found to bind cooperatively to each DNA duplex at the CpG steps, with the two quinoxaline rings of each echinomycin bisintercalating between the C.G and A.T base pairs . At low temperatures, the A.T base pairs on either side of the intercalation site adopt the Hoogsteen conformation, as observed in the crystal structures . However, as the temperature is raised, the Hoogsteen base pairs in the interior of the duplex are destabilized and are observed to be exchanging between the Hoogsteen base pair and either an open or a Watson-Crick base-paired state . The terminal A.T base pairs, which are not as constrained by the helix as the internal base pairs, remain stably Hoogsteen base-paired up to at least 45 degrees C . The implications of these results for the biological role of Hoogsteen base pairs in echinomycin-DNA complexes in vivo are discussed.

Pathol Biol (Paris), 1989 May, 37(5), 485 - 90
{Clinical and pharmacokinetic study of imipenem/cilastatin in children and newborn infants}; Begue P et al.; Imipenem, a new carbapenem (thienamycin) beta lactam antibiotic which is clinically used in a 1:1 combination with cilastatin, an inhibitor or renal metabolism of imipenem, was evaluated in 25 patients; 11 children and 14 neonates . A mean daily dose of 60 mg/kg was given to children and the dose in neonates was 50 mg/kg . Clinically, 21 patients were cured, two failed to respond to treatment and two were not evaluable . Pharmacokinetic studies were performed in the 11 children and in 10 of the neonates . The mean elimination half-life of imipenem was 0.87 h in children and 2.1 h in neonates . The mean cilastatin elimination half-life was 0.73 h in children and 5.1 h in neonates . This difference in half-life between children and neonates is similar to the one noted between healthy adults and adults with renal insufficiency . No accumulation of imipenem was seen in neonates studied on the first and fifth days of treatment.

J Antimicrob Chemother, 1989 May, 23(5), 701 - 10
The influence of cefoperazone, cefotaxime, ceftazidime and aztreonam on phagocytosis by human neutrophils in vitro; Lingaas E et al.; The uptake and intracellular breakdown of Escherichia coli by human neutrophils was studied under the influence of cefoperazone, cefotaxime, ceftazidime and aztreonam . Non-opsonized as well as serum- and IgG-opsonized bacteria were used, and bacteria and neutrophils were exposed both separately before phagocytosis and together during uptake and in the postingestion phase . Preincubation of the neutrophils with the drugs stimulated their subsequent uptake of untreated serum-opsonized and non-opsonized E . coli in an antibiotic-free medium . With serum-opsonized bacteria this stimulating effect was reversed when the drugs were also present during phagocytosis . The uptake of IgG-opsonized bacteria was largely unaffected both after preincubation of the neutrophils and when the antibiotics were present during phagocytosis . With all four drugs, pre-exposure of bacteria before IgG-opsonization gave a much higher uptake than exposure after IgG-opsonization . Contrary to this, preincubation of the bacteria followed by serum-opsonization inhibited (cefotaxime, ceftazidime) or did not influence (cefoperazone, aztreonam) subsequent uptake in the absence of the drugs . The release of bacterial breakdown products from the cells in the postingestion phase was also inhibited by cefotaxime and ceftazidime after serum-opsonization . With non-opsonized and IgG-opsonized bacteria, however, a stimulation of intracellular breakdown was induced by the presence of these drugs during phagocytosis . Aztreonam and cefoperazone did not significantly influence this phase of phagocytosis . These observations suggest that the drugs bind to both neutrophils and bacteria in an individual manner and modify the binding and function of opsonins.

Arzneimittelforschung, 1989 May, 39(5), 620 - 5
{Efficiency of homeopathic preparation combinations in sinusitis . Results of a randomized double blind study with general practitioners}; Wiesenauer M et al.; In a controlled randomized double-blind trial carried out by 47 physicians in private practice with totally 152 patients with sinusitis the therapeutic success of the following homeopathic drug preparations was investigated: Group A: combination of luffa operculata D4, kalium bicromicum D4 and cinnabaris D3 . Group B: combination of kalium bicromicum D4 and cinnabaris D3 . Group C: luffa operculata D4 . Group D: placebo . Criteria for the therapeutic result were headache, blocked nasal breathing, trigeminal tenderness, reddening and swelling of nasal mucosa and postnasal secretion . There was no remarkable difference in the therapeutic success among the investigated homeopathic drug combinations nor between the active drugs and placebo . Averaged over all four groups 81% of the patients with acute sinusitis and 67% of the patients with chronic sinusitis recovered . In the literature comparable therapeutic results are reported for antibiotic therapy, decongestant nose drops and for the drainage of nasal cavities.

J Biochem (Tokyo), 1989 May, 105(5), 751 - 5
Binding site of cerulenin in fatty acid synthetase; Funabashi H et al.; An antibiotic cerulenin, (2R, 3S)-2,3-epoxy-4-oxo-7,10-trans,trans- dodecadienamide, irreversibly inhibits fatty acid synthetase from Saccharomyces cerevisiae . Three moles of cerulenin were bound to 1 mol of the enzyme with concomitant loss of its activity . Pretreatment of the enzyme with iodoacetamide reduced the amount of cerulenin bound to the enzyme . Since iodoacetamide is known to specifically bind to the cysteine residue on the condensing reaction domain, cerulenin is considered to bind to the same domain . Tryptic digestion of the {3H} cerulenin-treated enzyme gave a radioactive peptide; its amino acid composition was Asx 1, Thr 1, Ser 1, Glx 2, Pro 1, Gly 1, Ala 1, Val 1, Ile 1, and Leu 2 . This composition included all the amino acids of the condensing reaction site (Thr-Pro-Val-Gly-Ala-Cys) previously reported by Kresze et al . (Eur . J . Biochem., 79, 181 {1977} except for Cys . When the enzyme was treated with {3H}cerulenin and digested successively with trypsin and carboxypeptidase P, a {3H} cerulenin-cysteine adduct was isolated as the sole product . This was identified with the adduct chemically synthesized from non-labeled cerulenin and cysteine, and its structure was elucidated by 1H-, 13C-NMR, and fast atom bombardment mass spectrometry . These results indicate that cerulenin, forming a hydroxylactam ring, reacts at its epoxide carbon (C-2 position) with the SH-group of the cysteine residue in the condensing reaction domain of yeast fatty acid synthetase.

Jpn J Antibiot, 1989 May, 42(5), 1233 - 55
{Clinical evaluation of roxithromycin in odontogenic infection}; Sasaki J et al.; The clinical effectiveness and safety of roxithromycin (RU 28965, RU), a new macrolide antibiotic, were compared with those of josamycin (JM) using a double-blind method in the treatment of orofacial odontogenic infections . The diseases covered in this study were periodontal infections, pericoronal infections and osteitis of jaws . Drugs were administered for 3 to 7 days at daily doses of 300 mg (RU) and 1,200 mg (JM) . A total of 270 cases was evaluated in this study . Results obtained are summarized as follows: 1 . The clinical efficacy was evaluated through the judgement of doctors in charge of 247 cases (128 in the RU group and 119 in the JM group) and by a committee on the 3rd day of treatment in 243 cases (126 in the RU group and 117 in the JM group) . Clinical efficacy rates according to the committee judgement were 78.6% for the RU group and 82.1% for the JM group . As for the evaluation through the doctors' judgement, they were 79.7% for the RU group and 73.1% for the JM group . There was no significant difference in clinical effectiveness between 2 groups according to these 2 methods of judgement . 2 . Some side effects were observed in 4 cases (2.9% out of 136) treated with RU and in 3 cases (2.4% out of 126) treated with JM . No severe symptoms were observed . Abnormal changes in laboratory test values were noted among 7.9% in the RU group and 4.0% in the JM group . There were no significant differences in their safety between the 2 groups . 3 . In terms of clinical usefulness, there were no significant differences between the 2 groups as well . From these results, it has been concluded that RU (daily dose 300 mg) is as effective as JM (daily dose 1,200 mg) in the treatment of orofacial odontogenic infections.

Clin Ther, 1989 May-Jun, 11(3), 341 - 62
Double-blind, placebo-controlled clinical evaluation of guaimesal in outpatients; Jager EG; One hundred and forty outpatients, males and females aged 14 to 70 years, with acute febrile bronchitis, afebrile chronic bronchitis, or flares of chronic bronchitis were treated for seven days with one soft gelatin capsule (500 mg) of guaimesal thrice daily or matching placebo . No other potentially interfering treatment (antibiotic, antipyretic, or anti-inflammatory) was administered concomitantly . Before and after treatment, vital capacity, residual volume, and maximum expiratory volume per second were measured and recorded . Both before treatment and after 2, 4, and 7 days of treatment, body temperature was measured and cough frequency and intensity as well as expectorate amount and fluidity were scored and recorded along with the total symptom score . At the end of treatment, the overall clinical efficacy was rated and recorded . Potential side effects were monitored by questioning the patients; general safety (laboratory tests) was not monitored . All data were analyzed according to multivariate, parametric, and nonparametric statistical methods and stratified by treatment, sex, age, and diagnosis . For each monitored symptom and sign, guaimesal exhibited a favorable effect which was significantly greater in extent and significantly faster in recovery rate than that associated with spontaneous recovery . Within two days from the start of therapy, fever, cough frequency and intensity, and expectorate fluidity had significantly improved . By the fourth day the expectorate amount had significantly decreased . Further improvement was noted at subsequent times of observation . After a week, according to the spirometric parameters, the respiratory function was restored to a considerable extent . Overall, 75.7% of the patients receiving guaimesal experienced complete or almost complete recovery within the period of observation . With placebo, occasional improvement was seen for cough intensity and for expectorate amount, and this improvement was significantly less in extent and significantly slower than that recorded with guaimesal . Overall, 8.6% of placebo-treated patients experienced a clinically detectable degree of recovery . The subjective tolerance of guaimesal was comparable to that of placebo in terms of both the frequency and the nature of the side effects . Mild, transient gastric effects were reported by 11.4% of patients receiving guaimesal and by 8.6% of patients receiving placebo . These effects did not require a variation of dose or specific treatment.(ABSTRACT TRUNCATED AT 400 WORDS)

Obstet Gynecol Surv, 1989 May, 44(5), 355 - 60
Potential use of C-reactive protein determinations in obstetrics and gynecology; Chaisilwattana P et al.; C-reactive protein (CRP) is an acute-phase protein synthesized by the liver during the course of a large number of diseases . During gestation and parturition, progressively increasing numbers of gravida develop elevated levels up to 32, 48 to 80 per cent, respectively) . These elevations in pregnancy, the nonspecificity of the test, and the inability to function as a reliable marker of fetal and/or maternal infectious morbidity have obscured the pragmatic utility of CRP determinations in both obstetrics and gynecology . Because of its biophysical kinetics, C-reactive protein determinations are best used as a monitoring parameter after the documentation of infection rather than as a diagnostic indicator of infection . They can provide valuable end titration points for termination of parenteral antibiotic therapy.

J Bacteriol, 1989 May, 171(5), 2906 - 8
appR gene product activates transcription of microcin C7 plasmid genes; Diaz-Guerra L et al.; Microcin C7 (MccC7) is encoded by Escherichia coli plasmid pMccC7 . However, some strains of E . coli K-12 carrying this plasmid do not produce this antibiotic . Here we show that these strains differ in the gene locus appR . This chromosomal gene product controls MccC7 production by activating the transcription of some, but not all, MccC7 plasmid genes.

AJR Am J Roentgenol, 1989 May, 152(5), 991 - 4
Pneumatosis intestinalis in bone-marrow transplantation patients: diagnosis on routine chest radiographs; Bates FT et al.; We report seven cases of pneumatosis intestinalis that was initially detected on routine chest radiographs made in adult bone-marrow transplantation patients . The cases were collected over a 13-month period . The chest radiographs generally underestimated the extent of the pneumatosis, as subsequently seen on plain abdominal films . However, the portions of bowel most extensively involved were those seen on the chest radiographs (transverse colon, hepatic and splenic flexures, stomach) . One patient had pneumoperitoneum also . Pneumatosis developed within 6-293 days after transplantation . The cause of pneumatosis intestinalis was multifactorial . Three patients were asymptomatic . Clinical management of all seven patients was altered because of the detection of pneumatosis . The dose of steroids was increased in three patients to treat graft-vs-host disease, antibiotic drugs were given to three patients for enteric pathogens, and bowel rest was prescribed for one patient with mucosal injury from intense chemotherapy and radiation therapy . These cases show that the chest radiograph makes early diagnosis of pneumatosis intestinalis possible in posttransplantation patients.

Cleve Clin J Med, 1989 May, 56(3), 311 - 5
Omentum graft for intractable subdural empyema; Barnett GH et al.; A subdural empyema developed in a young man after craniotomy for evacuation of a hematoma in a sylvian fissure arachnoid cyst and the subdural space . Despite prolonged systemic and subdural antibiotic administration and a debridement of the subdural space, infection persisted, as evidenced by persistent fever, an elevated white blood cell count, and an extremely low cerebrospinal fluid glucose level . The infection was cured after a second debridement operation where microsurgically revascularized free omentum was used to obliterate the cyst and to cover the cerebral hemisphere in the craniotomy defect . The use of vascularized free omentum may prove useful in cases of refractory cranial wound infection and cerebrospinal fluid fistulas.

Mol Biol Evol, 1989 May, 6(3), 213 - 25
Effects of carriage and expression of the Tn10 tetracycline-resistance operon on the fitness of Escherichia coli K12; Nguyen TN et al.; We have been examining the consequences of alternative modes of regulation of plasmid-borne, Tn10-encoded tetracycline resistance for the fitness of Escherichia coli . In a tetracycline-free environment, we measured the effects on fitness that were caused by (1) maximally induced expression of the resistance operon, (2) low-level constitutive expression of the resistance protein, (3) residual expression of the repressed resistance operon, (4) carriage of the resistance operon, (5) the remainder of the plasmid genome, and (6) hyperexpression of the repressor protein . We observed large reductions in fitness that were associated with induction and with constitutive expression of the tetracycline-resistance protein, but there was no discernible effect of hyperexpression of the repressor protein . We also observed a small reduction in fitness associated with the remainder of the plasmid genome . However, any reductions in fitness that were caused by residual expression and by carriage of the repressed operon were not more than 0.3% . We conclude that tight gene regulation has eliminated antagonistic pleiotropic effects of the resistance gene on fitness, so that possession of an inducible Tn10-encoded tetracycline-resistance operon imposes essentially no burden in the absence of antibiotic.

Am J Physiol, 1989 May, 256(5 Pt 1), E662 - 7
Polymyxin B inhibits stimulation of glucose transport in muscle by hypoxia or contractions; Henriksen EJ et al.; Glucose transport can be stimulated via two separate pathways in muscle . One is activated by insulin, the other by contractile activity and hypoxia . Polymyxin B, a cationic antibiotic that displaces Ca2+ from anionic phospholipids, is reported to selectively inhibit the stimulation of glucose transport by insulin in muscle . A purpose of the present study was to determine whether the inhibition by polymyxin B is actually restricted to insulin . We found that polymyxin B (250 micrograms/ml) significantly inhibited the stimulation of glucose transport in rat skeletal muscles not only by insulin and vanadate but also by hypoxia, electrical stimulation, and K+ . Polymyxin B also decreased the tension developed in response to electrical stimulation or K+ . Although polymyxin B inhibited the increase in sugar transport activity induced by insulin and hypoxia, it had no inhibitory effect on sugar transport after it had been stimulated by these agents . These results show that the inhibitory effect of polymyxin B on the stimulation of glucose transport is not specific for insulin action . They suggest that polymyxin B inhibits a step that is common to the two pathways for stimulating glucose transport in skeletal muscle.

JPEN J Parenter Enteral Nutr, 1989 May-Jun, 13(3), 324 - 5
Hazards of small amounts of heparin in a patient with subclinical vitamin K deficiency; Shah MC et al.; The use of small amounts of a dilute solution of heparin (less than or equal to 100 IU) to keep indwelling intravenous needles or catheters patent for intermittent venous access either for intravenous therapy or timed blood sampling is a common clinical practice . It is considered safe since the amount of heparin required is much less than that required for heparinization . Herein, we describe a 13-yr-old patient with malabsorption who developed clinically significant bleeding shortly after a diagnostic test which required multiple small injections of heparin for intermittent venous access (total amount of heparin administered was 600 units over 5 hr) . The coagulopathy was corrected by a single dose (10 mg) of parenteral vitamin K . As our patient had multiple risk factors for the development of vitamin K deficiency including malabsorption, decreased food intake, and antibiotic use, we postulate that the small amount of heparin precipitated the coagulopathy by increasing the antiprotease activity of antithrombin III on abnormal factors X and II formed in the vitamin K deficient state . We would therefore recommend administration of vitamin K to patients who are at risk of developing vitamin K deficiency before using even small amounts of heparin.

Izv Akad Nauk SSSR Biol, 1989 May-Jun, (3), 394 - 400
{Antibody interaction with the amphotericin channel}; Kolomytkin OV et al.; The monoclonal antibodies against asymmetric channel formed in the lipid bilayer of polyene antibiotic amphotericin B and cholesterol after addition of the antibiotic to the compartment from the cis side of the membrane were obtained . The effect of the antibodies on ion conductance of the channel depends on the distribution of cholesterol in the membrane . When cholesterol was present on both sides of the lipid bilayer, three antibody molecules bound to the channel from the trans side of the membrane, thus markedly increasing the lifetime of the open state of the channel . When cholesterol was present in the cis monolayer only, the antibodies, added to the trans compartment of the cell, reduced the membrane conduction.

Klin Wochenschr, 1989 Apr 17, 67(8), 452 - 5
Treatment of secretory diarrhea in AIDS with the somatostatin analogue SMS 201-995; Fuessl HS et al.; We have observed two patients with AIDS suffering from severe watery diarrhea refractory to conventional medical treatment . In the first patient the reason for the diarrhea could not be revealed in spite of extensive investigations; however, the clinical picture suggested cryptosporidia infection . In the second patient cytomegalovirus could be shown in colonic biopsy specimens . After failure of several attempts of symptomatic, antibiotic, and antiviral therapy, the long-acting somatostatin analogue SMS 201-995 was administered to the patients subcutaneously in a dose between 2 x 50 micrograms and 3 x 100 micrograms/day . This treatment resulted in a prompt reduction of stool volume and bowel motions . Somatostatin may be a useful addition to the symptomatic treatment of refractory diarrhea in AIDS.

Cancer Res, 1989 Apr 15, 49(8), 1983 - 8
Interaction of CC-1065 and its analogues with mouse DNA and chromatin; Moy BC et al.; CC-1065 is a potent antitumor antibiotic which is cytotoxic to P388 and L1210 leukemia cells in vitro and in vivo . CC-1065 covalently binds to calf thymus DNA preferentially to adenine-thymine regions at N3 of adenine . Here, we compare CC-1065 interaction with P388-derived chromatin, DNA, and histones as measured by electronic absorption and circular dichroism . Two CC-1065 analogues (U-71,184 and its enantiomer, U-71,185) which show different biological activities from CC-1065 were also studied . The shape and temporal behavior of the induced circular dichroism curves generated by CC-1065 or its analogues bound to chromatin were similar to CC-1065 plus DNA . This suggested that CC-1065 and its analogues bind to the minor groove of chromatin DNA in a manner similar to calf thymus DNA . However, the binding of CC-1065 and its analogues to DNA induced a more intense circular dichroism band than binding to chromatin . The order of interaction for both chromatin and DNA was CC-1065 greater than U-71,184 greater than U-71,185 . In contrast to the essentially irreversible binding to DNA after 24-h incubation, binding to chromatin was primarily a reversible interaction, the degree of reversibility being U-71,185 greater than U-71,184 = CC-1065 . CC-1065 binds weakly and nonspecifically to histones.

Arch Biochem Biophys, 1989 Apr, 270(1), 50 - 61
Inhibition of glyceraldehyde-3-phosphate dehydrogenase by pentalenolactone: kinetic and mechanistic studies; Cane DE et al.; Incubation of rabbit muscle glyceraldehyde-3-phosphate dehydrogenase (GAPDH) with the antibiotic pentalenolactone (1) resulted in time-dependent, irreversible inhibition of GAPDH . The kinetics of inactivation were biphasic, exhibiting an initial rapid phase and a slower second phase . Pentalenolactone methyl ester (2) also irreversibly inactivated GADPH, albeit at a slower rate and with a higher KI . The substrate glyceraldehyde-3-phosphate (G-3-P) afforded protection against inactivation by 1, whereas the presence of NAD+ in the incubation mixture stimulated the inactivation by increasing the apparent affinity of the enzyme for the inhibitor . In steady-state kinetic experiments, 1 acted as a competitive inhibitor of GAPDH with respect to G-3-P but exhibited uncompetitive inhibition with respect to NAD+ . Inactivation of NAD+-free apo-GAPDH by 1 showed simple pseudo-first-order kinetics . By titrating the free thiol residues of partially inactivated GAPDH, it was found that both pentalenolactone and pentalenolactone methyl ester react with all four Cys-SH residues of the tetrameric GAPDH.

Am J Surg, 1989 Apr, 157(4), 423 - 7
Perforated typhoid enteritis: operative experience with 108 cases; Meier DE et al.; A retrospective review of 108 consecutive patients with perforated typhoid enteritis managed operatively over a 4-year period at Baptist Medical Centre, Ogbomoso, Nigeria is presented . There were 75 males and 33 females with an average age of 19.7 years . Presenting symptoms were fever, abdominal pain, vomiting, and either diarrhea or constipation . One hundred patients (93 percent) underwent debridement of the perforation and two-layer bowel closure . Postoperative morbidity included intraabdominal abscess, wound dehiscence, and subsequent bowel perforation . Most of the 35 deaths (32 percent mortality) were attributed to overwhelming sepsis which progressed despite aggressive operative management and antibiotic administration . The key to improved survival in this deadly disease lies not in a better operation or improved perioperative care but in the prevention of typhoid fever by providing safe drinking water and improved sanitation methods for all of the global community.

S Afr Med J, 1989 Apr 1, 75(7), 327 - 31
Observations on the bite of the southern burrowing asp (Atractaspis bibronii) in Natal; Tilbury CR et al.; The burrowing asp, Atractaspis bibronii, causes a significant proportion of cases of snakebite near Empangeni, Natal . Data from 8 cases are presented . All were in rural Zulus, and the bites were usually inflicted on the foot during summer nights, in or near the patient's home . There was no sexual bias, but over 50% of the victims were under 14 years of age . Envenomation was mild, characterised by moderate to intense pain and localised swelling, regional lymphadenopathy with occasional discoloration, blistering or necrosis at the bite site . Neurological signs were absent, but symptoms of headache, painful eye movements, dry mouth and hoarseness were recorded . Minor haematological abnormalities were detected in a few patients . Treatment involved analgesics and limb elevation, with antibiotic cover and intravenous fluids when necessary . Antivenom is not effective and was not used . There were no deaths.

Laryngoscope, 1989 Apr, 99(4), 389 - 92
Epiglottitis in AIDS patients; Rothstein SG et al.; Adult epiglottitis in patients with acquired immunodeficiency syndrome has not been previously reported . A pale, floppy epiglottis with supraglottic edema, cervical lymphadenopathy, a normal to low white blood count without a shift to the left, and rapidly progressive airway obstruction characterize this entity . In this small series of patients, conservative medical management was not successful, and aggressive airway intervention with appropriate intravenous antibiotic therapy was necessary.

Laryngoscope, 1989 Apr, 99(4), 373 - 5
The early signs and symptoms of neurotologic complications of chronic suppurative otitis media; Schwaber MK et al.; The delay in the diagnosis of neurotologic complications of chronic suppurative otitis media has been explained in a number of ways, including antibiotic suppression, surgical drainage, and a lowered index of clinical suspicion because the problem is relatively rare today . Twelve cases of neurotologic complications of chronic suppurative otitis media were reviewed to determine the early and late findings that should raise the physician's index of suspicion . Purulent, malodorous drainage, headache, and fever were the significant early findings . Altered mental status was a late finding, and usually indicated established intracranial infection . By drawing attention to the early findings, we hope to lower the morbidity and mortality associated with these complications.

J Urol . 1989 Apr;141(4):949.
Abscess of corpus cavernosum; Sater AA et al.; A rare case of abscess of the corpus cavernosum is described . The patient was treated successfully by surgical drainage and antibiotic therapy . A right penile deviation and a relatively poor erection were reported by the patient 6 weeks postoperatively but he did not require further surgery . The possible causes, diagnosis and treatment of this rare disease are discussed.

J Urol, 1989 Apr, 141(4), 921 - 2
Management of acute hydronephrosis of pregnancy by ureteral stenting: risk of stone formation; Goldfarb RA et al.; Acute hydronephrosis of pregnancy has long been managed with ureteral stenting . Although many articles have been published recently concerning stent incrustation none has addressed the etiology . We report a case of accelerated incrustation due to the hypercalciuric state of pregnancy . We propose conservative management with hydration, calcium restriction and close monitoring for infections and stone debris . Antibiotic suppression and stent changes should not be used routinely but rather they should be individualized.

Med Trop (Mars), 1989 Apr-Jun, 49(2), 145 - 8
{Pelvic infection: diagnostic and therapeutic approach}; De Muylder X; Pelvic infection is one of the most frequent diseases in the developing countries . Without laparoscopy, diagnosis based on number of symptoms and present clinical manifestations can be established . Each step (uncomplicated salpingitis, salpingo-peritonitis, pelvic abscess, ruptured abscess) implies a specific curative target with levels of care, surgical treatment and antibiotic therapy adapted to it.

Antimicrob Agents Chemother, 1989 Apr, 33(4), 448 - 51
Total extraction of aminoglycosides from guinea pig and bullfrog tissues with sodium hydroxide or trichloroacetic acid; Fox KE; In most experiments when aminoglycoside antibiotic (AG) tissue levels are measured, the AG is extracted into buffered media . The data from this study reveal that buffer extraction results in only partial recovery of AG from tissues and that total recovery can be obtained after NaOH or trichloroacetic acid treatment . Tissues studied here included the whole bullfrog and guinea pig kidney and cochlear tissues after in vivo drug treatment . The AGs used were kanamycin, tobramycin, and gentamicin . Drug concentrations were determined by enzymatic assay and, in the case of tobramycin, also 3H-labeled radioactivity . Only a fraction of total concentration of AG in tissue was released into the supernatants of tissue homogenates . However, the remainder was recovered after NaOH solubilization of the residual pellet . Also, it was found that the G released from the pellet by NaOH was associated with protein . By contrast, trichloroacetic acid precipitation of tissue protein immediately released the drug into the supernatant.

Rev Gastroenterol Mex, 1989 Apr-Jun, 54(2), 79 - 82
{Preparation of the colon for elective surgery}; Juarez Diaz F et al.; Mechanical bowel preparation and antibiotic therapy have been conclusive to decrease morbi-mortality in elective colon surgery . Two methods were compared: the traditional laxative and three days solution enemas method, and the 3-6 hours total intestinal irrigation method . We evaluated the patient's acceptance, intraoperative bowel preparation, and postoperative . We included 31 patients distributed in both groups and with similar procedures . Our results showed up 80% effectiveness in colon cleaning on both methods; 100% patients accepted the irrigation method which had 6.6% postoperative mobility, the enemas method had 18.7% . Therefore, we concluded that total intestinal irrigation method is quick, safe and effective in elective colon surgery.

Nippon Sanka Fujinka Gakkai Zasshi, 1989 Apr, 41(4), 461 - 6
{Treatment of threatened premature labor due to subclinical intrauterine infection}; Sanjoh N et al.; Recent reports reveal that some threatened premature labors (tpl) are caused by intrauterine infections . And the prognosis of tpl due to intrauterine infections are worse than tpl due to other factors because of lower sensitivity to the beta-stimulants . So we examined the relationship between tpl and intrauterine infections retrospectively by obtaining intracervical cultures of inpatients who suffered from tpl, and prospectively by getting intracervical cultures from healthy pregnant women at a gestational age around 20 weeks, and divided them into two groups--the infectious group and non-infectious group--and studied the tpl rate . The patients who had positive bacterial cervical cultures were again divided into two groups . One group had antibiotics administered orally and the other had none . The tpl rate was observed . The results are: 1 . Thirty two point six percent of tpl inpatients were found to be infected intracervically . No statistical significance was noted in the microbodies detected . 2 . Three cases of premature labor at less than 35 gestational weeks were observed in the infected group . 3 . The majority of infected group showed high CRP levels, and the study of Preterm Labor Score (PLS) showed that most cases over 4 points of PLS were infected . 4 . In a prospective study, 18 of 100 healthy pregnant women showed positive intracervical bacterial cultures . The tpl rates were 44.4% in all of the infected group . Twenty two point two percent of tpl rate in the antibiotic administration group and 66.7% in the non-administration group (p less than 0.01) . And the non-infected tpl rate was 11.0% (p less than 0.01), or only 9 cases out of 82.(ABSTRACT TRUNCATED AT 250 WORDS)

J Trop Med Hyg, 1989 Apr, 92(2), 102 - 3
Severe reversible myopathy due to typhoid; Mody GM et al.; An 18-year-old Black male presented to hospital with a fever and inability to walk due to severe proximal myopathy . He was found to have typhoid, and marked elevation of the creatine phosphokinase with myoglobinuria was recorded . After appropriate antibiotic therapy the creatine phosphokinase level returned to normal and the patient made a complete recovery . Although neuropsychiatric manifestations have been commonly recorded in typhoid, the complication of a myopathy has not been frequently noted.

Jpn J Antibiot, 1989 Apr, 42(4), 938 - 47
{Effects of ceftriaxone on severe infectious complications in hematological disorders . Tohkai Research Group on Infections in Hematological Disorders}; Mitomo Y et al.; Ceftriaxone (CTRX), a new long acting antibiotic in the 3rd generation cephem group, was administered intravenously once or twice a day in daily doses of 1-6 g for at least 3 days to 86 patients with severe infections complicating hematopoietic disorders . Underlying diseases were acute leukemia in 41 cases, chronic leukemia in 3 cases, malignant lymphoma in 19 cases, myeloma in 7 cases and others . Most patients (55 cases) suffered from sepsis or suspected sepsis . As for efficacy rates classified by underlying diseases, the treatment was effective in 61.0% of patients with acute leukemia . As for efficacy rates classified by infections, the treatment was effective in 60.0% of patients with sepsis . No side effects were noted except rash in 2 patients . Abnormal hepatic functions were recognized in 3 patients but were not attributed to the agent in any case . The results indicate that CTRX is a safe and useful antibiotic for the treatment of severe infections accompanied by hematopoietic disorders.

Dermatol Clin, 1989 Apr, 7(2), 259 - 68
Systemic candidiasis; Ray TL; Systemic candidiasis is a disease of increasing incidence and proportions, which appears to be associated with the advances in modern medicine . It involves primarily patients with severe debilitating and malignant disease who are receiving immunosuppressive, cytotoxic, antimetabolite, and antibiotic therapy . Side effects of these otherwise major therapeutic agents predispose patients to opportunistic fungal infections, of which candidiasis is the most common . The high morbidity and mortality of disseminated candidiasis in neutropenic patients are difficult obstacles to obtaining the optimal, if not full, potential of modern chemotherapy for cancer . The inability to diagnose early invasive and systemic candidiasis is a major handicap that delays timely initiation of antifungal therapy . The paucity of highly efficacious antifungal agents with low toxicity severely limits the ability to successfully cure systemic fungal infections in cancer patients . Aggressive research into the basic biology of Candida spp . is necessary for directing the development of better diagnostic methods and improved antifungal drugs.

Mol Gen Genet, 1989 Apr, 216(2-3), 230 - 8
Export and activity of hybrid FhuA'-'Iut receptor proteins and of truncated FhuA' proteins of the outer membrane of Escherichia coli; Schultz G et al.; The FhuA protein in the outer membrane of Escherichia coli serves as a multifunctional receptor for the phages T5, T1, phi 80, for colicin M, for ferrichrome (Fe3+-siderophore) and for the structurally related antibiotic, albomycin . To determine structural domains required for these receptor functions and for export, a fusion protein between FhuA and Iut (receptor for Fe3+-aerobactin and cloacin DF13) was constructed . In the FhuA'-'Iut hybrid protein, 24 amino acids of FhuA were replaced by 19 amino acids, 18 of which were from Iut . The number of plaque forming units of phage T5 and T1 on cells expressing FhuA'-'Iut was nearly as high as on cells expressing plasmid-encoded wild-type FhuA . However, 10(7)-fold higher concentrations of phage phi 80 and 10(3) times more colicin M were required to obtain a zone of growth inhibition . Truncated FhuA' proteins in which the last 24 amino acids at the carboxy-terminus were replaced by 16 (FhuA'2) or 3 (FhuA'T) amino acids could hardly be detected on polyacrylamide electrophoretograms of outer membrane proteins, due to proteolytic degradation . Sensitivity of cells expressing FhuA'2 to phage T5 and T1 was reduced by several orders of magnitude and sensitivity to phage phi 80 and colicin M was totally abolished . In contrast, cells expressing FhuA'T were nearly as sensitive to pahge T5, T1, and phi 80 and to colicin M as cells containing FhuA'-'Iut . None of the constructs could grow on ferrichrome as sole iron source and none was sensitive to albomycin.(ABSTRACT TRUNCATED AT 250 WORDS)

J Chir (Paris), 1989 Apr, 126(4), 265 - 73
{Sacro-rectopexy by a posterior intersphincteric approach with anteroposterior perineoplasty and mucosal resection . Therapeutic proposal in descending peritoneum syndrome . Apropos of 23 cases}; Costalat G et al.; We report the results of a procedure aimed at correcting the disorders of rectal and perineal tone responsible for the descending perineum syndrome (DPS) . The procedure, carried out by the perineal approach, combines a posterior intersphincteric sacro-rectopexy, an anterior perineoplasty via a pre-anal levator myorraphie, a posterior perineoplasty using a post anal repair technique and a mucosal resection aimed at freeing the anal canal . 22 F and 1 M, mean age 68 years, with DPS were operated on . Digitised rectography demonstrated pathological perineal descent (greater than 3 cm) in all cases and posterior rectal angulation at rest of more than 25 degrees (normal less than 10 degrees) confirming an important deterioration in perineal tone . Results after a mean follow up of 12 months (6 to 30 months) were excellent, with objective improvement in rectal bleeding, pain, mucosal prolapse and anal incontinence . In spite of an almost constant return to normal in the number of stools and their facility of evacuation improvement in the dyschesic syndrome (78% of patients) was subjectively variable . Improvement was judged to be very good in 34%, good in 33%, fair in 11% . Healing of mucosal lesions: solitary ulcer (n = 2), rectal inflammation (n = 2), ulcerated mucosal prolapse (n = 3) occurred in all cases within 1 month . Post operative rectography demonstrated a significant decrease in posterior rectal angulation and ano-coccygeal distance confirming the efficacy of the anatomical correction . No serious complications, in particular, infections, were noted under appropriate prophylactic antibiotic cover (Piperacillin) continued up to D5.(ABSTRACT TRUNCATED AT 250 WORDS)

Radiol Med (Torino), 1989 Apr, 77(4), 405 - 7
{Cholangitis and percutaneous biliary drainage}; Audisio RA et al.; The binomial PTBD-cholangitis often stands under different and sometimes even opposite relations . Among its indications the procedure lists, the treatment of cholangitis which, on the other hand, may be itself a complication of biliary drainage . The present work proposes a critical review of cholangitis-PTBD correlations, from an ordinary clinical-radiological point of view . Different pathogenetic hypothesis of cholangitis (inflammation, cholestasis, surgical manipulation) are discussed together with risk factors (impaired macrophagic-phagocytic system, immunosuppression, wide neoplastic liver involvement, multiple intrahepatic ductal obstructions, chronic liver diseases, aged patients, etc.) . The authors also report about prevention and treatment of septic complications which must be carried out following technical and therapeutic strategies, such as chemoprophylaxis and focused antibiotic therapy according to bile culture samples, slow injection of small amounts of contrast medium, peripheral branches approach, gentle handling of catheters and guidewires, flushing with saline solutions and brushing of the catheter itself, and finally use of large gauge catheters in the presence of bile sludge.

J Antimicrob Chemother, 1989 Apr, 23 Suppl D, 109 - 17
Comparative efficacy and safety of cefmetazole or cefoxitin in the prevention of postoperative infection following vaginal and abdominal hysterectomy; Roy S et al.; We evaluated three 1-g doses of cefmetazole in comparison with the standard three 2-g doses of cefoxitin for prophylaxis in vaginal or abdominal hysterectomy to determine efficacy and safety . The antibiotics were administered intravenously 30-90 min before the incision and were followed with additional intravenous doses 8 and 16 h or 6 and 12 h later, respectively . The patients received povidone-iodine vaginal preparations before surgery; vaginal packs, when used, contained no antibiotic agents . Vaginal cultures were obtained before the vaginal preparation, at the time of discharge from hospital and when there was a suggestion of operative site infection . The activity of both antibiotics against these organisms was tested . Patient demographic characteristics and surgical procedures were similar in each treatment group . The difference between the primary failure rates with the two antibiotics (2 of 35 (5.7%) with cefmetazole and 2 of 16 (12.5%) with cefoxitin) did not reach statistical significance, and results were similar for the two routes of hysterectomy . Cefmetazole was more active than cefoxitin against the majority of the aerobic and anaerobic organisms recovered, although approximately 20-30% of the isolates showed resistance, or intermediate sensitivity, generally to both antibiotics.

Arch Biochem Biophys, 1989 Apr, 270(1), 363 - 73
Biosynthesis of 9-beta-D-arabinofuranosyladenine: hydrogen exchange at C-2' and oxygen exchange at C-3' of adenosine; Suhadolnik RJ et al.; The data presented here describe new findings related to the bioconversion of adenosine to 9-beta-D-arabinofuranosyladenine (ara-A) by Streptomyces antibioticus by in vivo investigations and with a partially purified enzyme . First, in double label in vivo experiments with {2'-18O}- and {U-14C}adenosine, the 18O:14C ratio of the ara-A isolated does not change appreciably, indicating a stereospecific inversion of the C-2' hydroxyl of adenosine to ara-A with retention of the 18O at C-2' . In experiments with {3'-18O}- and {U-14C}-adenosine, {U-14C}ara-A was isolated; however, the 18O at C-3' is below detection . The adenosine isolated from the RNA from both double label experiments has essentially the same ratio of 18O:14C . Second, an enzyme has been isolated and partially purified from extracts of S . antibioticus that catalyzes the conversion of adenosine, but not AMP, ADP, ATP, inosine, guanosine, or D-ribose, to ara-A . In a single label enzyme-catalyzed experiment with {U-14C}adenosine, there was a 9.9% conversion to {U-14C}ara-A; with {2'-3H}-adenosine, there was a 8.9% release of the C-2' tritium from {2'-3H}adenosine which was recovered as 3H2O . Third, the release of 3H as 3H2O from {2'-3H}adenosine was confirmed by incubations of the enzyme with 3H2O and adenosine . Ninety percent of the tritium incorporated into the D-arabinose of the isolated ara-A was in C-2 and 8% was in C-3 . The enzyme-catalyzed conversion of adenosine to ara-A occurs without added cofactors, displays saturation kinetics, a pH optimum of 6.8, a Km of 8 X 10(-4) M, and an inhibition by heavy metal cations . The enzyme also catalyzes the stereospecific inversion of the C-2' hydroxyl of the nucleoside antibiotic, tubercidin to form 7-beta-D-arabinofuranosyl-4-aminopyrrolo{2,3-d}pyrimidine . The nucleoside antibiotic, sangivamycin, in which the C-5 hydrogen is replaced with a carboxamide group, is not a substrate . On the basis of the single and double label experiments in vivo and the in vitro enzyme-catalyzed experiments, two mechanisms involving either a 3'-ketonucleoside intermediate or a radical cation are proposed to explain the observed data.

Urology, 1989 Apr, 33(4), 282 - 4
Successful implantation of penile prostheses in organ transplant patients; Kabalin JN et al.; We present our experience with implantation of penile prostheses in 6 organ transplant recipients, including 2 patients after renal transplantation and 4 patients after cardiac transplantation . We have seen no problems related to prosthesis surgery in this patient population, and in particular have experienced no infectious complications . All patients received strict perioperative antibiotic and steroid coverage . We conclude that erectile impotence in the male organ transplant patient can be successfully treated with penile prosthesis surgery without incurring undue morbidity and with considerable benefit in terms of quality of life in a generally young patient population.

J Urol, 1989 Apr, 141(4), 926 - 7
Xanthogranulomatous pyelonephritis in a renal allograft: a case report; Jones BF et al.; We report a case of xanthogranulomatous pyelonephritis in a renal allograft . The kidney was not removed and there was an initial response to antibiotic therapy, with amelioration of toxicity and improvement in renal function . However, the kidney failed 10 months later in association with histological changes of chronic rejection.

Gastroenterology, 1989 Apr, 96(4), 1079 - 86
Interaction of enteropathogenic Escherichia coli 0111 with rabbit intestinal mucosa in vitro; Embaye H et al.; A model system using rabbit intestinal mucosal explants has been developed to examine the characteristic ultrastructural damage to the brush border induced by enteropathogenic Escherichia coli 0111 . In this model, as in others, bacterial adherence to the microvillous membranes occurred in two morphologically distinct stages . Initial attachment of enteropathogenic strains of E . coli to ileal mucosa appeared to be a goblet cells and the mucous layer covering the microvilli . The next stage involved binding of enteropathogenic strains of E . coli to the bases of the microvilli that became elongated and vesiculated . Eventually, large areas of brush border effacement occurred with close apposition between bacterial and enterocyte membranes, leading to cup and pedestal formation . With a relatively large inoculum of bacteria (10(8) cfu/ml) these changes occurred within 4 h, but even with much lower inocula (10(5) cfu/ml) localized areas of damage were seen within 8 h . Although the bacteriostatic antibiotic tetracycline (700 mg/L) inhibited bacterial replication, it did not prevent the characteristic damage produced by enteropathogenic strains of E . coli . Enteropathogenic strains of E . coli 0111 were able to produce attaching effacement to gastric, duodenal, jejunal, ileal, and colonic mucosa.

Eur J Drug Metab Pharmacokinet, 1989 Apr-Jun, 14(2), 169 - 75
Pharmacokinetic and nephrotoxic study of gentamicin in rabbits using a new dosage regimen; Trapote MA et al.; Currently, in certain clinical situations there is an increasing trend towards using dosage regimens involving aminoglycoside antibiotics based on the administration of a single dose of the drug per day instead of administering the same amount in two or three administrations . The aim of the present study was to discover the pharmacokinetic profile and the nephrotoxic potential of this new form of administration in experimental animals receiving gentamicin . The study was conducted on two groups of rabbits, one of which received a single dose of the drug at 7 mg/kg i.v . and the other 7 mg/kg administered every 12 hours, allometrically equivalent to gentamicin dosing at 5 mg/kg every 24 hours to human subjects . The number of doses administered was 20 . From the pharmacokinetic point of view, the results point to the existence of a significant degree of accumulation of the antibiotic in renal cortex as a result of the dosage regimen, no important modifications occurring in the pharmacokinetic parameters of gentamicin calculated from its plasma kinetics . This shows that the two compartment model employed predicts drug levels in accessible tissues but not in deep ones where gentamicin is accumulated for long periods of time . From the toxicological point of view, the treatment caused appreciable damage of the renal tubules during the first phases of the treatment which was not detectable from the serum creatinine levels or the kinetic behaviour of the aminoglycoside.

J Med Chem, 1989 Apr, 32(4), 774 - 8
Synthesis, DNA-binding properties, and antitumor activity of novel distamycin derivatives; Arcamone FM et al.; A group of potential alkylating agents have been synthesized that are structurally related to the oligopeptide antiviral antibiotic distamycin . All derivatives form complexes with native calf-thymus DNA but compounds 2, 3, and 6 give rise to covalent adducts . Cytostatic activity against both human and murine tumor cell lines in vitro is displayed by the new compounds . Compounds 3 and 4 are active on melphalan-resistant L1210 leukemia in mice.

J Hosp Infect, 1989 Apr, 13(3), 261 - 6
Randomised study of prophylactic parenteral sulbactam/ampicillin and cephazolin in biliary surgery: significant benefit in jaundiced patients; Morris DL et al.; Two hundred consecutive patients undergoing biliary-tract surgery were entered into a randomized trial of prophylactic single dose cephazolin or sulbactam/ampicillin . There was no overall difference in the infection rates between the two antibiotic groups, but in the group of patients with jaundice there was an excess of wound infections in the cephazolin group compared to the sulbactam/ampicillin group (35% vs . 14%) . We conclude that sulbactam/ampicillin is a satisfactory prophylactic agent for use in biliary-tract surgical sepsis, and that it may be superior to cephazolin in jaundiced patients.

Mil Med, 1989 Apr, 154(4), 180 - 4
Effect of polymyxin B on hemoglobin-mediated hepatotoxicity; Marks DH et al.; In previous studies, enhanced toxicity of hemoglobin when combined with endotoxin has suggested a specific binding site . This binding may take place even when endotoxin-free hemoglobin is administered, due to some low levels of endotoxin usually present in the portal vein . To test this hypothesis, we administered endotoxin-free, stroma-free human hemoglobin (SFH) to rabbits in doses shown previously to be hepatotoxic or lethal . A second group of rabbits received the anti-endotoxin antibiotic polymyxin B (PB) to inactivate endotoxin, followed by a dose of SFH . A control group received intravenous PB alone . There was no differences in the incidence of hepatotoxicity among these three groups . To show the binding interactions of endotoxin with PB and endotoxin with hemoglobin, an experiment using toluidine blue was performed . According to this study, specific binding of hemoglobin with endotoxin did not occur . Our results do not agree with previous suggestions that hemoglobin-mediated hepatotoxicity is due to the interaction in vivo of hemoglobin with low levels of endogenous endotoxin.

Cancer Res, 1989 Apr 1, 49(7), 1746 - 51
Secretion, glycosylation, and phosphorylation of rat-specific, transformation-associated proteins in Moloney murine sarcoma virus-transformed rat cells; Li WJ et al.; Previously, we detected, by monoclonal antibody, three Moloney murine sarcoma virus (Mo-MSV)-activated intracellular transformation-associated proteins (TAP), (P66, P63, and P60) in several Mo-MSV-transformed rat cell lines (Chan et al., Biochem . Biophys . Res . Commun., 134: 1223-1230, 1986) and found the release of TAP into the extracellular medium with a change from three intracellular polypeptides to two extracellular polypeptides (P68 and P64) (Li et al., Virology, 156: 91-100, 1987) . Since then, we have further analyzed TAP in terms of their secretion, glycosylation, and phosphorylation in a temperature-sensitive Mo-MSV-transformed normal rat kidney (NRK) cell line, the 6M2 line, and found these results . Extracellular TAP were detected by immunoblotting and immunoprecipitation techniques as two polypeptides (P68 and P64) . The secretion of TAP was rapid, with a 50% secretion rate of 78 min . Both intracellular (except for P63) and extracellular TAP were glycosylated . As a result of inhibition of glycosylation by the antibiotic tunicamycin, a fourth intracellular TAP (P58) and a third extracellular TAP (P60) were found . The new results suggest that the intracellular TAP were probably changed from four polypeptides (P66, P63, P60, and P58) to three (P66, P63, and P60) during the glycosylation process . Likewise, the three extracellular TAP were changed to two (P68 and P64) as a result of further glycosylation and subsequent secretion into the extracellular medium . Inhibition of glycosylation by tunicamycin (0.5 microgram/ml) reduced the TAP secretion rate by about 39% . Extracellular TAP (P68 and P64) as well as P85gag-mos and P58gag were found to be phosphoproteins.

Jpn J Antibiot, 1989 Apr, 42(4), 983 - 1013
{Clinical evaluation of clarithromycin in treatment of acute dental infections . Comparative double-blind study using josamycin as the control}; Sasaki J et al.; In order to objectively evaluate the usefulness of clarithromycin (TE-031, A-56268), a new oral macrolide antibiotic, in the treatment of acute dental infections, a double-blind comparative clinical trail was conducted using josamycin (JM) as the control drug . TE-031 was administered at a daily dosage of 400 mg in 2 divided doses, and JM was given at a daily dosage of 1,200 mg in 3 divided doses . The administration period was, as a rule, 7 days . A total of 302 patients were administered with the test substances (TE-031 and JM), and the clinical efficacy was evaluated by investigators for 284 patients and by a committee using a score method for 273 patients . Efficacy rates as evaluated by the investigators were 77.2% (105/136) in the TE-031 group and 69.6% (103/148) in the JM group . Efficacy rates as evaluated by the committee by the score method were 86.0% (111/129) in the TE-031 group and 80.6% (116/144) in the JM group . The differences between the 2 drug groups were not statistically significant . The investigators' evaluation of the clinical efficacy in the treatment of osteitis of the jaw gave an efficacy rate of 83.0% (44/53) in the TE-031 group and 64.7% (33/51) in the JM group . The efficacy rate in the TE-031 group was statistically higher than that in the JM group . Side effects were recorded in 7 patients (4.8%) in the TE-031 group and 3 patients (2.0%) in the JM group, while abnormal laboratory test values were detected in 3 cases each in the TE-031 and JM groups . None of these differences were statistically significant . The usefulness rates ("satisfactory" plus "very satisfactory" cases) were 73.9% in the TE-031 group and 70.3% in the JM group and were thus almost the same for the 2 drug groups . On the basis of the above results, TE-031 was concluded to be a useful drug in the treatment of acute dental infections and is expected to be able to achieve almost identical clinical efficacy as JM at only one-third of the usual dosage of JM.

Jpn J Antibiot, 1989 Apr, 42(4), 973 - 82
{Penetration of clarithromycin to saliva and its effect on normal salivary bacterial flora}; Morihana T et al.; Clarithromycin (TE-031, A-56268), a new macrolide antibiotic, was administered to rats, and the distribution of the drug in the submandibular gland was studied using microautoradiography . The study revealed good accumulation of 14C-TE-031 in both the acini and the excretory ducts . TE-031 was administered to each of 3 healthy male volunteers in a single dose of 300 mg, and its concentrations in the serum and saliva was detected . Mean values of various pharmacokinetic parameters were as follows for the serum and saliva, respectively . Cmax 1.49 micrograms/ml and 1.93 micrograms/ml; Tmax 2.91 hours and 2.66 hours; T 1/2 6.31 hours and 4.15 hours; AUC 18.58 micrograms.hr/ml and 17.70 micrograms.hr/ml . Regarding the salivary bacterial flora, the total bacterial count decreased as the salivary TE-031 concentration increased, but it recovered to the initial level in 12 hours after administration . During the 24-hour period following an administration of TE-031, the salivary bacteria did not acquire resistance to the drug . Therefore, TE-031 is an antibiotic which exerts little effect on the normal salivary bacterial flora in short-term administration . Although the results differed among the individuals, the penetration of TE-031 to saliva was superior to that to the serum . Thus, TDM of TE-031 using salivary samples is possible.

G E N, 1989 Apr-Jun, 43(2), 112 - 5
{Ascaris hepatic abscess}; Marcano A et al.; An 18 months old infant with hepatic abscesses was studied . Ultrasonographic examination of the liver revealed 2 abscesses in the right lobe of the liver containing elongated hyperecogenic structures compatible with ascaris lumbricoides . Antibiotic and antihelmintic treatment was followed by complete clinical recovery.

Endod Dent Traumatol, 1989 Apr, 5(2), 98 - 104
Barriers to diffusion of Ledermix paste in radicular dentine; Abbott PV et al.; Freshly extracted human single-rooted teeth with a single root canal were used to study the effects of 2 irrigation regimens and the effect of cementum on the diffusion of corticosteroid and antibiotic tracer molecules from Ledermix paste placed in the pulp space . An irrigation regime that combined the use of 15% EDTAC and 1% NaOCl resulted in a significant increase in the permeation of the trace molecules through dentine compared with teeth that were irrigated with Savlon solution . Mechanical removal of the cementum also resulted in a significant increase in the permeation of the trace molecules . This study demonstrated that neither the smear layer nor the cementum were complete barriers to diffusion . The data obtained appeared to be of clinical relevance and provided further understanding of the dynamics of drugs in tooth roots.

Endod Dent Traumatol, 1989 Apr, 5(2), 92 - 7
The release and diffusion through human coronal dentine in vitro of triamcinolone and demeclocycline from Ledermix paste; Abbott PV et al.; Crowns from freshly extracted human third molar teeth were used to quantify the release and diffusion of corticosteroid and antibiotic tracer molecules from Ledermix paste used as an indirect pulp-capping agent . These molecules readily diffused through dentine and reached a peak rate of diffusion at 2 h . The rate then decreased exponentially with time . The concentrations of the drugs in the dentine were calculated; this showed that a gradient existed from the cavity floor to the pulp space . The data obtained appeared to have clinical relevance and helped explain the therapeutic benefits of this medicament when used as an indirect pulp-capping agent.

J Pak Med Assoc, 1989 Apr, 39(4), 94 - 7
Reliable and realistic approach to sensitivity testing; Hafiz S et al.; Antibiotic testing by Disc was compared with Break-Point method using 535 clinical isolates; Disc sensitivity method was carried out in the routine way using the disc provided by pharmaceutical company . Break-point sensitivity was done by incorporating the substrate into solid medium, the results obtained showed greater resistance by Break-point which appears to be more realistic in the light of indiscriminate usage of antibiotic . The method is simple, cost effective, reliable and realistic (JPMA 39 : 94, 1989).

Ther Umsch, 1989 Apr, 46(4), 245 - 9
{Gonococcus-associated arthritis}; Bodmer K; The various forms of arthritis associated with a gonococcus infection are pathogenetically and clinically differentiated . Whereas an infectious systemic process with different clinical symptoms is said to be underlying the arthritis-dermatitis syndrome as well as the septic GO-arthritis, the third form is para-infectious reactive arthritis . It is often difficult to diagnose an infectious GO-arthritis, as direct evidence of the virus found in joint and blood is rarely positive, so that the diagnosis can be affirmed or negated on the basis of clinical facts of the reaction of arthritis after an appropriate antibiotic therapy . Differential diagnostic considerations may help to find the correct diagnosis in view of an acute urethritis arthritis.

Oncogene, 1989 Apr, 4(4), 457 - 64
Expression of v-src arrests murine glial cell differentiation; Trotter J et al.; A replication-defective retroviral vector carrying the v-src oncogene and the gene for neomycin resistance was used to infect neurone- and fibroblast-depleted embryonic mouse brain cells in vitro . Cells resistant to the antibiotic G418 were obtained and continually passaged . Several cell lines were isolated which express high levels of v-src mRNA and v-src tyrosine kinase activity . The antigenic marker profile of either the pooled cells from an individual infection or sublines isolated from individual foci showed the cells to be immature glia: most cells expressed vimentin, A2B5 antigen and/or J1/tenascin glycoproteins, but not fibronectin . Sublines expressed different antigen profiles suggesting that the immortalised cells were derived from glial cells of different phenotypes . The cell lines expressed the 120 and 140 but not the 180 kd components of N-CAM as well as voltage-activated potassium channels, typical for glial cells . 01 antigen-positive oligodendrocytes were never observed in the lines or sublines after long term passage (over 1 year), but some cells expressed glial fibrillary acidic protein, a marker for mature astrocytes . Thus, expression of v-src in murine glial cells appears to arrest their development and prevent their differentiation.

Arch Biochem Biophys, 1989 Apr, 270(1), 294 - 301
Effects of puromycin and hydroxynorvaline on net production and intracellular degradation of collagen in human fetal lung fibroblasts; Barile FA et al.; Amino acid substitutions in collagen that impair folding of the triple helix result in significant increases in intracellular degradation of newly synthesized collagen . We have studied the effects of agents that cause other kinds of defects in collagen: hydroxynorvaline, a threonine analog that interferes with association of pro-alpha chains; and puromycin, an antibiotic that causes premature release of nascent polypeptides . cis-Hydroxyproline and cycloheximide, whose effects on collagen synthesis and degradation have already been studied and reported, were employed as reference compounds . Human fetal lung fibroblasts were used in these experiments . All the agents inhibited total protein production, and all except cycloheximide inhibited percentage collagen production . Intracellular collagen degradation was increased in cultures exposed to puromycin, hydroxynorvaline, and cis-hydroxyproline, but not in cultures exposed to cycloheximide . These results suggest that pro-alpha chains that were either unassociated (due to hydroxynorvaline) or shortened (due to puromycin) were recognized as abnormal and degraded to the same extent as chains that contained cis-hydroxyproline . However, the increases in degradation could not account completely for the decreases in collagen production (except when cis-hydroxyproline was used at low concentrations) . These findings indicate that, in addition to rendering newly synthesized procollagen molecules or partial polypeptide chains more susceptible to intracellular degradation, puromycin, hydroxynorvaline, and cis-hydroxyproline significantly inhibited collagen synthesis.

Mutat Res, 1989 Apr, 211(2), 205 - 14
Ability of structurally related polycyclic aromatic carcinogens to induce homologous recombination between duplicated chromosomal sequences in mouse L cells; Bhattacharyya NP et al.; To investigate the role of DNA damage in the induction of homologous recombination in mammalian cells, a series of structurally related, polycyclic aromatic carcinogens, i.e., 1-nitrosopyrene (1-NOP), N-acetoxy-2-acetylaminofluorene (N-AcO-AAF), and 4-nitroquinoline 1-oxide (4-NQO), were compared for their ability to cause intrachromosomal homologous recombination between two herpes simplex virus thymidine kinase (Htk) genes stably integrated in the genome of a tk- mouse L cell strain 333 M . Each Htk gene contains an 8-bp XhoI linker inserted at a unique site so that expression of a functional Htk enzyme requires a productive recombinational event between the two nonfunctional genes . Each carcinogen caused a dose-dependent increase in the frequency of recombination . The results were compared to what had been found previously for a structurally related carcinogen, (+/-)-7 beta, 8 alpha-dihydroxy-9 alpha, 10 alpha-epoxy-7,8,9,10-tetrahydrobenzo{a}pyrene (BPDE) . As a function of concentration, BPDE was the most active agent, followed by 4-NQO, and 1-NOP, and then N-AcO-AAF . When compared on the basis of equal cell killing, the most efficient carcinogen was 1-NOP, followed by N-AcO-AAF and BPDE, and then 4-NQO . Use of tritium-labeled compounds to determine the frequency of recombination as a function of the number of adducts initially bound to DNA showed that the most effective agent was BPDE, followed by 1-NOP and 4-NQO, and then N-AcO-AAF (ratio, 6.6:2.5:1.8:1.0) . To determine if these differences in recombinagenic effectiveness reflected different rates of removal of the adducts from DNA, we measured the percentage of DNA adducts removed during the 24-h period post treatment and found that 1-NOP, 4-NQO and N-AcO-AAF residues were removed at approximately the same rate, i.e., 25%-30% off . Cellular analysis of a series of independent recombinants indicated that approximately 82% of the recombinational events induced by each agent were consistent with gene conversion . DNA-DNA hybridization analysis confirmed this, and showed that each recombinant tested contained an XhoI-resistant (wild-type) Htk gene; with the majority retaining the Htk gene duplication, consistent with nonreciprocal transfer of wild-type genetic information . In the rest, only a single copy of the Htk gene remained, reflecting a single reciprocal exchange within a chromatid or a single unequal exchange between sister chromatids.

An Med Interna, 1989 Apr, 6(4), 197 - 8
{Round pneumonias}; Mejia Molina P et al.; Two cases of pneumonia in which the initial radiologic sign was the solitary nodule are presented . The symptoms associated permitted the infectious origin . The clinical and radiological evolution after antibiotic therapy supported the diagnosis of rounded pneumonia . We highlight the need to discard benign lesions causing the solitary nodule, before trying to diagnose other diseases.

J Mol Recognit, 1989 Apr, 1(4), 184 - 92
Differences between sites of binding to DNA and strand cleavage for complexes of bleomycin with iron or cobalt; McLean MJ et al.; The sequence specificity of bleomycin A5 and of its light-activated cobalt complex were compared by examining the relative cleavage of each strand of two DNA fragments by either species . Significant differences between the two metallobleomycins were observed . The iron-bleomycin (Fe-BLM) complex cleaved the DNA molecules preferentially at dinucleotides GpT and GpC, whereas the light-activated cobalt-bleomycin complex (Co-BLM) showed a preference for cutting at the dinucleotide GpA in addition to cleavage at every GpT dinucleotide . Further, new sites of preferential cleavage were noted for Co-BLM in regions of the DNA where enhanced reaction with DNAaseI can be observed in the presence of the antibiotic . No differences in the cutting behaviour of the Fe-BLM were evident upon irradiation of the reaction mixture . A reduction in the relative efficiency of cutting at GpC sequences by Co-BLM is responsible for the previously observed diminution of double-strand breaks under conditions of photoactivated cleavage . The results are discussed in terms of the likely production of highly reactive, diffusible cutting elements in the light activated reaction which cause cleavage of the DNA in regions where the antibiotic is not bound.

Aust Paediatr J, 1989 Apr, 25(2), 83 - 5
Evaluation of direct and buffy coat films of peripheral blood for the early detection of bacteraemia; Rodwell RL et al.; During an 8 month period, 298 evaluations of direct and buffy coat films of peripheral blood for the detection of bacteraemia were undertaken in 287 infants (243 less than 24 h of age and 55 aged between 2 days and 30 days) . Bacteraemia was diagnosed by simultaneously drawn aerobic and anaerobic blood cultures . Intracellular organisms were observed in both the direct and buffy coat films of only four of 24 infants with bacteraemia, giving a sensitivity of 17%, specificity of 100% and positive and negative predictive values of 100% and 93%, respectively . Of 12 infants with bacteraemia on the first day of life, eight were asymptomatic when studied, and none of the 12 had positive smears . As two of four infants with positive smears died, it is concluded that in fulminating sepsis the tests seem to correlate with the degree of illness and may give useful information as to the causative organism and the choice of antibiotic . However, as a screening test, the present methodology lacks sensitivity and cost-effectiveness.

Antiviral Res, 1989 Apr, 11(3), 119 - 25
Inhibition of HIV replication by liposomal encapsulated amphotericin B; Pontani DR et al.; This report shows the potential of using a liposomal encapsulated preparation of amphotericin B (a polyene macrolide antibiotic) for the in vitro inhibition of HIV . There was no significant difference between the effective doses of the free form of drug when compared to the liposomal encapsulated preparation in inhibiting the growth of HIV . Virus expression was suppressed at a concentration of 5-10 micrograms/ml of the drugs . The liposomal preparation showed greatly reduced cytotoxicity in experiments using cultures of murine leukocytes . These results show the potential usefulness of liposomal encapsulated drugs in the treatment of patients with AIDS or AIDS related complex.

Biochem Biophys Res Commun, 1989 Mar 31, 159(3), 1165 - 70
Amphotericin B-induced changes in renal membrane permeation: a model of nephrotoxicity; Schell RE et al.; As part of an investigation into the nephrotoxic effects of the polyene antibiotic Amphotericin B we have studied its effects on the ion permeability of purified renal brush border membrane vesicles . Membrane potentials were measured using a potential sensitive carbocyanine dye, and ion permeabilities were calculated from the constant field equation . Amphotericin B significantly altered the ionic permeability sequence of isolated membranes and caused a selectivity for increasing the permeation of anions . Permeability changes induced by 2.0 micrograms/ml Amphotericin B resulted in an estimated hyperpolarization of the membrane from -50 mV to -72 mV . In addition, the kinetic parameters of Na+ dependent transport of organic metabolites were examined . The maximum change in fluorescence was decreased significantly in the presence of Amphotericin B . These results suggest that the ionic state of the renal cell membrane is significantly altered by the presence of Amphotericin B.

Schweiz Rundsch Med Prax, 1989 Mar 28, 78(13), 372 - 5
{Dyspnea, cough, febrile state}; Steurer J et al.; A 71-year old man was admitted because of increasing dyspnea and fever . Myelomonocytic leukemia was diagnosed on blood films . Diffuse bilateral pulmonary infiltrates detected on chest radiographs were related to the febrile state . Because leukemic infiltrates as well as pneumonia were possible causes for the pulmonary lesions antibiotic therapy followed by prednisone on the same day was initiated . An unusually rapid improvement of the pulmonary infiltrates within 4 days was indicative of a leukemic infiltrate . The patient died a few days later and the diagnosis of diffuse leukemic pulmonary infiltrates was confirmed at autopsy.

J Am Vet Med Assoc, 1989 Mar 15, 194(6), 797 - 9
Eumycotic mycetoma caused by Pseudallescheria boydii in a dog; Allison N et al.; Abdominal eumycotic mycetoma caused by Pseudallescheria boydii was diagnosed in a 3-year-old male Siberian Husky . The dog was examined because of weight loss and signs of depression . Initially, pyrexia was the only clinical finding . Antibiotic and corticosteroid treatment was ineffective . Two weeks later, the dog's appetite had decreased, it had vomited a few times, and the caudal portion of the abdomen was sensitive to palpation . Hematologic and serum biochemical abnormalities consisted of anemia, leukocytosis, hypoglycemia, hypoalbuminemia, hyperglobulinemia, and high alkaline phosphatase activity . One week later, the dog's condition continued to worsen, and testicular swelling was observed . The dog was castrated . Microscopic examination of specimens obtained at surgery revealed pyogranulomatous periorchitis with mycetoma granules . Ketoconazole treatment was initiated and continued until the dog died one month later . Necropsy revealed multifocal duodenal ulcers, with transmural pyogranulomatous enteritis, pancreatitis, and peritonitis . This case is unique because the etiologic agent apparently entered via the intestinal tract rather than by contamination of an external wound.

Ugeskr Laeger, 1989 Mar 13, 151(11), 697 - 8
{Infectious conjunctivitis . The tear leukocyte esterase reaction (TLE) as a diagnostic aid}; Norn MS; Lacrimal fluid is absorbed on a cottonwool swab . This swab is pressed on the test field for leukocyte esterase on the stix . The colour change is read after exactly one minute . The sensitivity of the test is 90% and the specificity is 98% as assessed on 94 cases of infectious conjunctivitis and 439 normal individuals . The test is suitable for assessing cases of conjunctivitis in view of antibiotic therapy, control of contact lenses etc.

Cas Lek Cesk, 1989 Mar 10, 128(11), 326 - 31
{Electric stimulation of auditory nerve fibers . Experimental study}; Syka J et al.; The authors tested in animal experiments the effectiveness of electrical stimulation of acoustic nerve fibres . To guinea pigs platinum-iridium electrodes were implanted in the round window of the cochlea . The receptors of the inner ear were functionally eliminated by the local application of the ototoxic antibiotic gentamicin . Cortical responses produced by electric stimulation of the contralateral ear and acoustic stimulation of the ipsilateral intact ear were recorded . The threshold for producing a cortical response by the electric stimulus was lowest at the frequency of 0.5 kHz and rose with the rising frequency . This relationship was the same for extracochlear and intracochlear stimulation, the absolute threshold values of the current in the same animal were, however, as a rule lower on intracochlear stimulation . The dynamic range of responses to electrical stimulation (difference between threshold intensity of the current and the intensity which produces a painful response of the animal) was 6-20 dB, as compared with 80-100 dB of the dynamic range for acoustic stimulation . The results of the experiments were used in the preparation of the Czechoslovak cochlear neuroprosthesis and serve as a basis for the further development of the implant.

Biochemistry, 1989 Mar 7, 28(5), 1993 - 2000
A premelting conformational transition in poly(dA)-Poly(dT) coupled to daunomycin binding; Herrera JE et al.; Circular dichroism and UV absorbance spectroscopy were used to monitor and characterize a premelting conformational transition of poly(dA)-poly(dT) from one helical form to another . The transition was found to be broad, with a midpoint of tm = 29.9 degrees C and delta HVH = +19.9 kcal mol-1 . The transition renders poly(dA)-poly(dT) more susceptible to digestion by DNase I and facilitates binding of the intercalator daunomycin . Dimethyl sulfoxide was found to perturb poly(dA)-poly(dT) structure in a manner similar to temperature . These combined results suggest that disruption of bound water might be linked to the observed transition . A thermodynamic analysis of daunomycin binding to poly(dA)-poly(dT) shows that antibiotic binding is coupled to the polynucleotide conformational transition . Daunomycin binding renders poly(dA)-poly(dT) more susceptible to DNase I digestion at low binding ratios, in contrast to the normal behavior of intercalators, indicating that antibiotic binding alters the conformation of the polynucleotide . The unusual thermodynamic profiles previously observed for the binding of many antibiotics to poly(dA)-poly(dT) can be explained by our results as arising from the coupling of ligand binding to the polynucleotide conformational transition . Our data further suggest a physical basis for the temperature dependence of DNA bending.

Acta Paediatr Scand, 1989 Mar, 78(2), 331 - 4
Non-tropical pyomyositis in children--with report of severe neurological complications; Brik R et al.; Pyomyositis appears to occur rarely in temperate climate areas, compared with the incidence of the disease in the tropics . Three young adults with pyomyositis have previously been described in Israel, two of them were newly arrived Ethiopian immigrants . We report three Israeli children with pyomyositis, who presented initially with nonspecific abdominal pain; in one child the course was complicated by spinal cord compression due to extension of the infected mass into the spinal canal . All three patients attained full recovery after antibiotic therapy and surgical drainage . Computed tomography was most valuable in establishing the diagnosis and defining the extent of the process.

J Am Vet Med Assoc, 1989 Mar 1, 194(5), 690 - 1
Pyometra involving uterus masculinus in a cat; Schulman J et al.; A neutered male cat with a history of intermittent antibiotic-responsive fever and strangury had pyometra involving uterus masculinus . The infected structure was removed, and episodes of infection and strangury ceased.

Dev Biol, 1989 Mar, 132(1), 174 - 8
Relationship between the M42 antigen of mouse sperm and the acrosome reaction induced by ZP3; Leyton L et al.; A murine monoclonal antibody, M42 mAb, directed against 200/220 Kd protein of mouse sperm, has been employed to study the molecular events of gamete interaction . We have reported previously that M42 mAb blocks mouse fertilization in a zona-dependent manner; the reagent specifically inhibits physiologically induced (zonae), but not pharmacologically induced (A23187), acrosome reactions in mouse sperm . Using solubilized mouse zonae pellucidae and purified ZP3, we demonstrate that M42 mAb inhibits acrosome reactions (ARs) induced by ZP3 to the same extent as those induced by total zonae . We have also studied AR inhibition using the fluorescent antibiotic chlortetracycline (CTC), which permits visualization of three different acrosomal patterns during the AR . In the presence of M42 IgG, greater than 70% of capacitated sperm treated with zonae are arrested in the acrosome-intact state (B-pattern), in contrast to the majority of sperm (60-70%) in the absence of M42 IgG, which progress through the intermediate phase (S-pattern) to the fully acrosome-reacted (AR-pattern) state . Incubation of sperm with zona proteins modified by incubating eggs with phorbol esters arrests sperm in the S-pattern (Y . Endo, R.M . Schultz, and G.S . Kopf, 1987, Dev . Biol . 119, 199-209) . We show that once sperm have reached such a state, M42 mAb no longer exerts an inhibitory effect . The addition of unmodified ZP to S-pattern sperm permits the completion of the acrosome reaction . These results indicate that M42 mAb blocks an early step in the AR cascade and that M42 mAb is unable to prevent subsequent events of this cascade once it has been initiated.

Obstet Gynecol, 1989 Mar, 73(3 Pt 1), 317 - 21
Genital Chlamydia trachomatis infections in patients with abnormal cervical smears: effect of tetracycline treatment on cell changes; Mecsei R et al.; A group of 1760 women aged 14-35 years were examined for the concurrent presence of Chlamydia trachomatis and cellular atypia of cervical smears . Positive tests for C trachomatis were found in 126 women (7.2%) . Cell changes were found in 85 women (4.8%), and 25 of these were C trachomatis-positive . Slight cellular atypia was the major finding in the smears from 22 of the C trachomatis-positive women, whereas three patients had more pronounced cell changes . Smears reverted to normal in 18 of the 23 patients who returned for tetracycline treatment and follow-up cytology . All 18 patients had smears showing slight cellular atypia prior to therapy . In five patients who also had cellular changes suggesting a human papillomavirus infection, the smears did not revert to normal after antibiotic therapy during the observation period . These findings suggest that patients with C trachomatis and mild cellular atypia should have antibiotic therapy and repeat smears taken before further treatment is considered . More advanced cellular atypia is unlikely to be caused by C trachomatis.

Mol Biol (Mosk), 1989 Mar-Apr, 23(2), 605 - 11
{Interaction of carminomycin with DNA according to data of laser polarized fluorescence}; Zozulia VN et al.; Anti-tumour antibiotic carminomycin interaction with chicken erythrocyte DNA is studied in aqueous-salt solutions by the laser polarized fluorescence method . Fluorescence quenches almost equally effectively during the antibiotic absorption on native (nDNA) and denatured (dDNA) DNAs, but the polarization degree of residual fluorescence differs about two times . Carminomycin binding to dDNA is characterized by one interaction type with a large density of occupancy sites - one antibiotic molecule per base pair . Carminomycin forms two types of complexes with nDNA, differing significantly with binding constants . Strong binding, intercalation, is saturated at one carminomycin molecule per 3 base pairs independently on the solution ionic strength . The weaker, external, interaction is characterized by the binding constant being by two orders of magnitude lower than that for intercalation, and the external interaction contribution is negligible.

Rinsho Ketsueki, 1989 Mar, 30(3), 392 - 5
{Seizure and tremor occurring in acute leukemia patients treated with imipenem/cilastatin}; Fujishita M et al.; We report here four patients with acute leukemia, who developed seizure or tremor following treatment with imipenem, a new broad-spectrum antibiotic . All four patients had no renal dysfunction and recovered after discontinuation of the drug . Two patients who developed seizure had a past history of cerebral hemorrhage with symptoms of meningitis in one and the other had received frequent intrathecal injections of methotrexate . Seizure also occurred in another patient who was given multiple intrathecal injections of methotrexate . The remaining old patient developed tremor after the first administration of imipenem which did not progress to convulsion . Cerebral hemorrhage or meningitis is known to predispose patients for convulsion following imipenem treatment . In addition, the present study suggests that central nervous system damage related with intrathecal injections of methotrexate may be a predisposing factor . Thus, imipenem should be given with caution to acute leukemia patients who often have risk factors for developing imipenem-related complications.

Ann Ophthalmol, 1989 Mar, 21(3), 100 - 2
Ocular human bite; Aguirre Vila-Coro A et al.; We report on a case of an ocular bite occurring during a rape attempt . The patient suffered a conjunctival laceration and a stab injury in the upper eyelid, the point of entry of a severe deep infection that caused limitations in extraocular motility . Antibiotic therapy resulted in a complete cure . Psychopathologic considerations about intentional eye injuries are discussed.

J Antimicrob Chemother, 1989 Mar, 23(3), 433 - 9
Comparison of three different regimens in the treatment of acute brucellosis: a multicenter multinational study; Acocella G et al.; The present study was undertaken to evaluate efficacy, safety and patient acceptability of three antibiotic regimens for the treatment of acute brucellosis . Six different centres were involved: three in France, one in Greece and two in Spain . The regimens were: oral rifampicin 900 mg/day plus oral doxycycline 200 mg/day for 45 days (A), oral doxycycline 200 mg/day for 45 days plus im streptomycin 1 g/day for 21 days (regimen B) {corrected} and the WHO regimen (C) combining oral tetracycline 2 g/day for 21 days plus im streptomycin, 1 g/day, for 14 days . Regimens A and B were randomly allocated in all centres, while regimen C was allocated only in two centres . All patients were suffering from acute brucellosis clinically and biologically proven . 143 patients were allocated for treatment and analysed . Their mean age was 41 years (range 13-70), 49 were female and 94 male, and their mean weight was 64 kg (range 35-98) . Among these patients, 14% had localized disease (nine orchitis, eight osteo-articular involvement and one pleural effusion), but there was no statistical difference between the three regimens in regard to this localized disease . Forty-five per cent of the patients had positive blood cultures . The cure rate with regimen A was 95%, 96% with regimen B and 59% with regimen C . Thus regimen A presented the same efficacy rate as regimen B, but regimen C cannot be regarded as the treatment of choice for acute brucellosis.

Antimicrob Agents Chemother, 1989 Mar, 33(3), 391 - 3
Penetration of pefloxacin into bronchial secretions; Bonmarchand G et al.; Twelve patients, intubated for acute exacerbation of chronic obstructive pulmonary disease, received six intravenous doses of 400 mg of pefloxacin at 12-h intervals . Samples of blood and bronchial secretions were taken simultaneously, before the injection and at 0.5, 3, 6, 9, and 12 h after the end of the sixth infusion . There was a large variation in pefloxacin levels in both serum and bronchial secretions . The mean concentrations of pefloxacin in bronchial secretions ranged from 6.51 to 11.1 micrograms/ml and were higher than the corresponding concentrations in serum at all times . Of 61 bronchial specimens, 48 (79%) contained more than 8 micrograms of the antibiotic per ml.

Wis Med J, 1989 Mar, 88(3), 11 - 3
Brucellosis: an unusual cause of a child's fever of unknown origin; Chusid MJ et al.; A 3-year-old Wisconsin native with the symptoms of chronic fever, hepatosplenomegaly, and inability to walk, was found to have an elevated anti-Brucella titer . Blood and bone marrow cultures grew Brucella melitensis, biotype 3 . This infection was likely acquired during a trip to Mexico several months earlier during which the child had ingested raw milk . The patient's father was also discovered to have brucellosis . Both were successfully treated with antibiotic therapy . Although brucellosis has been almost totally eradicated in the United States, in the appropriate setting it should be considered as a possible cause of fever of unknown origin in a child.

J Reprod Med, 1989 Mar, 34(3), 247 - 9
Postabortal paracervical abscess as a complication of paracervical block anesthesia . A case report; Mercado AO et al.; A paracervical abscess occurred after paracervical block anesthesia was administered for induced abortion in an 18-year-old multigravida . She presented with vaginal, low abdominal and low back pain and with nausea, vomiting, chills and fever . Incision and drainage of the abscess were performed and a vaginal drain inserted under antibiotic coverage . Cultures of the abscess contents revealed multiple anaerobic organisms . Laparoscopy showed normal pelvic organs, and the peritoneal fluid cultures were negative . Postoperatively the patient became afebrile and was discharged after three days on antibiotics . To our knowledge, this case report is the first one on paracervical abscess as a complication of induced abortion with paracervical block anesthesia.

Head Neck, 1989 Mar-Apr, 11(2), 132 - 6
Effect of prior radiotherapy on postsurgical wound infection; Johnson JT et al.; Radiotherapy causes both epithelial and endothelial damage acutely with the subsequent development of interstitial and perivascular fibrosis . These effects may lead to decreased blood flow, delayed wound healing, and a delay in achieving normal wound tensile strength . In a retrospective study of wound infections that developed in 23 of 354 patients (6%) accrued in a series of prospective, randomized antibiotic trials, the incidence of wound infection in patients receiving prior radiotherapy (7.6%) was not statistically different from the incidence of wound infection observed in patients who had had no prior radiotherapy (6.3%) . Wound infection that developed in patients after radiotherapy tended to be associated with increased hospitalization, an increased rate of fistulization, and more frequently required secondary surgical repair . It is concluded that major head and neck procedures can be accomplished without an absolute increase in the incidence of wound infection . However, when postoperative complications occur, it may result in a significant increase in morbidity.

Orthop Rev, 1989 Mar, 18(3), 321 - 4
Scapular osteomyelitis . An unusual complication following subacromial corticosteroid injection; Buckley SL et al.; Impingement syndrome is a common disorder of the shoulder . Most patients respond to conservative treatment consisting of rest, ice/heat, anti-inflammatory agents, and physical therapy . Subacromial corticosteroid injection may be used when other forms of conservative treatment fail . A case is reported involving a 29-year-old man who developed scapular osteomyelitis following subacromial corticosteroid injection . Successful treatment consisted of surgical debridement followed by a combination of intravenous and oral antibiotic therapy . Strict adherence to aseptic technique is emphasized for performing subacromial corticosteroid injectionPublication Types:

Case Reports

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