J Assoc Off Anal Chem, 1989 Mar-Apr, 72(2), 235 - 7 Determination of maduramicin by liquid chromatography with atomic absorption spectrometric detection; Johnson NA; A liquid chromatograph was interfaced to an atomic absorption spectrometer for the detection and quantitation of maduramicin in feed matrixes at the 1-8 ppm level . Ionophores in general form strong 1:1 products with various metal cations, yielding complexes that are insoluble in water but very soluble in organic solvents . Maduramicin, a carboxylic, polyalcohol, polyether antibiotic, is labeled with the sodium cation and analyzed by atomic absorption spectroscopy (AAS) . The lower limit of detection is approximately 100-200 ng maduramicin sodium salt . Feeds containing 1-8 ppm maduramicin are extracted with acetone, the extract is passed through an alumina column, the column is eluted with acetonitrile-water (90 + 10), and the eluate is analyzed for maduramicin by liquid chromatography-AAS after concentration and conversion of maduramicin to the sodium salt . Recoveries of maduramicin averaged 89.5% . Liquid chromatography with AAS detection has been shown to be a sensitive and highly specific technique for the determination of ionophores in general and maduramicin in particular. J Antibiot (Tokyo), 1989 Mar, 42(3), 389 - 97 Synthesis of new analogs of echinocandin B by enzymatic deacylation and chemical reacylation of the echinocandin B peptide: synthesis of the antifungal agent cilofungin (LY121019); Debono M et al.; The antifungal antibiotic, echinocandin B (ECB), was modified by a sequential procedure in which the initial step involved enzymatic removal of the native N-linoleoyl group from the N-terminus using an Actinoplanes utahensis culture . The resulting product, ECB nucleus, was reacylated using active esters or acid halides of various substituted acids to give a series of ECB analogs . These analogs possessed anti-Candida activity both in vitro and in vivo (mice) . Other studies have shown that one of these, cilofungin, the 4-n-octyloxybenzoyl-ECB analog (LY121019), has excellent anti-Candida activity, low toxicity and is superior to other available antifungal antibiotics. J Antibiot (Tokyo), 1989 Mar, 42(3), 382 - 8 Deacylation of echinocandin B by Actinoplanes utahensis; Boeck LD et al.; Echinocandin B (ECB) is a lipopeptide antifungal agent produced by several species of Aspergillus . The lipid side chain of cyclic lipopeptides is known to be an important determinant of their antibiotic activity and toxicity . Deacylation of another lipopeptide antibiotic, A21978C, had formerly been accomplished with Actinoplanes utahensis . In spite of the structural dissimilarities between the peptide cores and acyl side chains of A21978C and ECB, A . utahensis also removed the linoleoyl acyl unit from the amino terminus of ECB to yield the bioinactive cyclic peptide core, or "nucleus" . The ECB nucleus, which contained a new titratable group at the N-terminus, was subsequently employed for chemical reacylation with other side chains to yield a variety of novel ECB analogs . One of these, cilofungin (LY121019), containing an N-(4-n-octyloxybenzoyl)acyl unit, is currently undergoing clinical evaluation. J Antibiot (Tokyo), 1989 Mar, 42(3), 357 - 60 Structure elucidation of ficellomycin; Kuo MS et al.; The structure of ficellomycin, an antibiotic previously discovered by Argoudelis et al., is elucidated as valyl-2-{4-guanidyl-1-azabicyclo{3.1.0}hexan-2-yl}glycine (1) by NMR, MS, and derivatization studies . The 1-azabicyclo{3.1.0}hexane moiety in 1 represents an unusual ring system making ficellomycin a unique natural product compound. Br J Ophthalmol, 1989 Mar, 73(3), 205 - 8 Orbital cellulitis: review of 23 cases from Saudi Arabia; Hodges E et al.; We studied a total of 23 patients with orbital cellulitis and/or orbital abscess over a period of four years in Saudi Arabia . The study showed a high rate of abscess formation (12/23) and surgical intervention (17/23) . Twelve out of 23 patients were 18 or more years of age . Furthermore, 12 of 23 (52%) patients had blind eyes on admission and remained blind after treatment, and one patient died of cavernous sinus thrombosis . Only 7/23 (30%) had a predisposing cause of primary sinus disease . This study of orbital cellulitis in a developing country presents a variation in disease pattern from previous reports and suggests that delay in the initiation of antibiotic therapy may lead to serious complications which may be life threatening . The course and outcome of orbital cellulitis may vary, depending on the predisposing factor, time of onset, associated systemic disease, or delay in initiation of treatment. Rev Esp Enferm Apar Dig, 1989 Mar, 75(3), 281 - 3 {Biliary peritonitis after hepatic biopsy: favorable course with conservative medical treatment}; Planas R et al.; In a 53-year-old woman a percutaneous liver biopsy was performed with tru-cut to study persistent hypertransaminasemia . The patient did not present extrahepatic cholestasis . Immediately after biopsy the patient had a picture of biliary peritonitis that evolved favorably with conservative medical treatment, including hemodynamic resuscitation, antibiotic therapy, analgesic treatment and monitoring by the resuscitation service . A review is made of the literature on this complication of liver biopsy and treatment is discussed. Conn Med, 1989 Mar, 53(3), 139 - 41 Pancreatic tuberculous abscess; Meinke AK; Pancreatic tuberculous abscess is rare and has been reported only in the past five years . An association with the acquired immune deficiency syndrome (AIDS) is suggested . Extensive drainage and appropriate antibiotic therapy is recommended . Intrapancreatic abscesses should be cultured for M . tuberculosis and, if identified, the patient should be studied for human immunodeficiency virus (HIV) infection. Protein Eng, 1989 Mar, 2(6), 399 - 405 Crystallographic phases through genetic engineering: experiences with colicin A; Tucker AD et al.; Colicins are antibiotic proteins that kill sensitive Escherichia coli cells . The structure of the pore-forming fragment of colicin A has been solved to 2.5 A resolution using the techniques of X-ray crystallography and genetic engineering . Site-directed mutagenesis was used to construct a number of cysteine-containing mutant proteins, one of which yielded an excellent mercurial derivative . Our experiences suggest strategies for obtaining useful heavy-atom derivatives for protein crystallography using genetic engineering techniques. Ophthalmology, 1989 Mar, 96(3), 289 - 92 Outpatient topical use of povidone-iodine in preparing the eye for surgery; Apt L et al.; Povidone-iodine 5% solution placed on the eye immediately before ophthalmic surgery within the preoperative preparation significantly reduces the conjunctival bacterial flora . In 40 patients undergoing ophthalmic surgery, the authors compared the outpatient use of povidone-iodine for 3 days before surgery with a 3-day course of a combination antibiotic ophthalmic solution (Neosporin) placed on the other eye . All patients also received topical povidone-iodine on the operating table directly preceding surgery . Cultures taken just before preparation of the operative field showed a similar reduction of bacteria by each regimen . Cultures taken after preparation but before commencement of surgery showed a further reduction for both regimens, but more for eyes previously treated with the antibiotic (P less than 0.02) . To minimize the conjunctival bacterial flora before surgery, the authors continue to recommend instillation of a broad-spectrum antibiotic for 3 days before surgery, followed by application of povidone-iodine solution to the eye immediately before surgery within the preoperative preparation. Bone Marrow Transplant, 1989 Mar, 4(2), 163 - 6 Anthracyclines added to the conditioning regimen for allogeneic bone marrow transplantation are associated with a slower haematopoietic recovery; Van der Lely N et al.; Factors which may influence haematopoietic recovery after allogeneic bone marrow transplantation were analysed . Forty-six evaluable patients transplanted with lymphocyte-depleted marrow for acute lymphoblastic leukaemia, acute non-lymphoblastic leukaemia, chronic myeloid leukaemia, myelodysplastic syndrome and severe aplastic anaemia were studied . The median time for platelet recovery to greater than or equal to 20 and to greater than or equal to 50 x 10(9)/l was 21 (9-72) and 26 (11-86) days respectively . The neutrophil recovery to greater than or equal to 0.5 x 10(9)/l and the leucocyte recovery to greater than or equal to 1.0 x 10(9)/l was 19 (8-47) and 18 (6-47) days respectively . No relation was found between the number of infused granulocyte-macrophage colony-forming cells, erythroid burst-forming cells, diagnosis, graft-versus-host disease, antibiotic administration and recovery . Addition of a continuous 6-day infusion of anthracyclines to the conditioning regimen delayed the median recovery of platelets, neutrophils and leucocytes by 7-9 days . Fever during aplasia also inhibited haematopoietic recovery . It is speculated that leakage of intracellular anthracyclines after bone marrow infusion or fever secondary to anthracyclines-induced oromucositis is responsible for the delayed bone marrow recovery. N J Med, 1989 Mar, 86(3), 211 - 2 Success of ceftizoxime in E . coli ventriculitis; Coant PN et al.; The results of this single case report suggest that ceftizoxime may be an excellent antibiotic in the therapy of E . coli meningitis with ventriculitis. J Thorac Cardiovasc Surg, 1989 Mar, 97(3), 342 - 50 Orthotopic transplantation after implantation of a Jarvik 7 total artificial heart; Cabrol C et al.; A total artificial heart was used to support the circulation in 33 heart transplantation candidates who were expected to die before procurement of a donor heart . Twelve of these patients (mean age 35 +/- 10 years) underwent cardiac transplantation . Another patient is still being supported with the total artificial heart 90 days after implantation . The other 20 patients died during mechanical support because their condition could not be stabilized for transplantation, despite blood flow restoration . Fifty-six percent of the patients younger than 40 years underwent successful transplantation and six of nine patients are long-term survivors . By comparison, in the older group, 17.6% of patients underwent transplantation and one of three survived long term . Forty-four percent of patients in the acute decompensation group had successful transplantation and four of seven patients are long-term survivors . In the chronic decompensation group these figures were 29.4% and three of five patients . All patients who were heavily immunosuppressed (n = 4) died of sepsis . Transplantation was considered and performed only when the patient's condition was correct and stable . In six patients an infection developed in the immediate posttransplant period . Three of the infections were resolved with antibiotic therapy . One originated in the mediastinum and is still unresolved, although the patient's condition is improving . Another patient died of an anoxic coma caused by ventilatory problems . There were two late deaths at 14 and 19 months, one resulting from a combination of toxoplasmosis and rejection and the other from a Kaposi sarcoma caused by azathioprine treatment.(ABSTRACT TRUNCATED AT 250 WORDS) Z Stomatol, 1989 Mar, 86(1), 23 - 7 {A new concept for preparing lyophilized cartilage and its use in patients with dentogenous cysts--preliminary report}; Puelacher W et al.; Under sterile conditions human costal cartilage is explanted, stripped of perichondrium, deep-frozen and lyophilized for 72 hours . Then single grafts are packaged and gas sterilized . 8 hours before implantation grafts are rehydrated in an antibiotic solution . 19 extensive dentogenous cysts were packed with lyophilized bruised cartilage . Healing was uncomplicated in all cases . A definitive assessment of ossification is not yet possible. Taehan Chikkwa Uisa Hyophoe Chi, 1989 Mar, 27(3), 279 - 86 {A case report of odontogenic infection leading to fatal mediastinitis}; Lee SH et al.; Mediastinitis can be life-threatening complication of oral and maxillofacial surgery . Mediastinitis from odontogenic deep cervical infection is extremely rare in the era of antibiotic drugs . Such complication is subjected to the ravages of a gas-forming anaerobic infection . We have encountered such a case, with a rapid spread of the inflammatory process into the mediastinum resulting in a number of local and systemic complications . The submandibular fascial spaces served as a pathway for the propagation of an overwhelming infection along cervical planes in a posterior direction to the lateral pharyngeal spaces and then to the retropharyngeal spaces, the mediastinum . Despite massive antibiotic therapy, general supportive care and surgical drainage, the patient died. Genes Dev, 1989 Mar, 3(3), 415 - 29 Unusual transcriptional and translational features of the aminoglycoside phosphotransferase gene (aph) from Streptomyces fradiae; Janssen GR et al.; The aminoglycoside phosphotransferase gene (aph) from the neomycin producer Streptomyces fradiae encodes an enzyme (APH) that phosphorylates, and thereby inactivates, the antibiotic neomycin . Two promoters were identified upstream of and oriented toward the aph coding sequence . One promoter (aphp1) initiated transcription at the A of the ATG translational initiation codon, or one to two bases upstream . Mutations made in this promoter region identified functionally important nucleotides and verified that the aphp1 transcript was translated to yield the APH protein, despite the lack of a conventional ribosome binding site . A second aph promoter, aphp2, initiated transcription 315 bp upstream of the translational initiation codon but gave transcripts that appeared to terminate before reaching the coding sequence . Multiple transcriptional initiation sites (pA1-pA5) were identified also in the aph regulatory region oriented in the opposite direction to aph transcription . Promoters for the pA2 and pA4 transcripts overlap with aphp1 such that down-promoter mutations in aphp1 also reduce transcription from the overlapping pA promoters. Biophys Chem, 1989 Mar, 33(1), 11 - 7 Specific interactions between DNA left-handed supercoils and actinomycin D; Leoni L et al.; The interactions between the natural cyclopentapeptide antibiotic actinomycin D (ACT) and circular pBR322 DNA have been studied by freezing the topological state of the DNA in the complex by topoisomerase I reaction . Both supercoiled and relaxed DNAs, in the complexes at low antibiotic/DNA base-pair ratios, showed a dramatic decrease in linking number that cannot be explained by taking into account only the generally accepted unwinding of 28 degrees for each ACT molecule bound . Recent results derived from the crystallographic analysis of the complex between GpC and ACT suggest that ACT could mediate non-covalent cross-links between distant sections of DNA . Bridges between ACT and different sections of the pBR322 double helix could also explain our results . Two-dimensional gel electrophoresis of ACT-relaxed pBR322 DNA complexes reveals that all supercoils induced by ACT are negative . Two models of the complexes which correspond to the stabilization of DNA crossing by one or two molecules of ACT are proposed . In both cases the ability of ACT to stabilize only DNA left-handed supercoils is derived from the chirality of ACT, when it interacts with DNA. Ann R Coll Surg Engl, 1989 Mar, 71(2), 97 - 100 Preincisional intraparietal Augmentin in abdominal operations; Pollock AV et al.; A total of 624 consecutive eligible patients undergoing abdominal operations received a single preoperative dose of amoxycillin/clavulanic acid (1.2 g Augmentin) for the prophylaxis of surgical wound infection . They were randomised to have the antibiotic injected intravenously at induction of anaesthesia (n = 328) or infiltrated subcutaneously along the line of the proposed incision (n = 296) . The incidence of wound infections was considerably lower in the group given the antibiotic into the abdominal wall (8.4% compared with 15.9%--chi 2 = 7.90, P = 0.005) . No significant differences were found in the incidence of other major or minor infective or non-infective postoperative complications between the groups . It is concluded that preincisional intraparietal injection is more effective than intravenous injection of Augmentin for the prophylaxis of surgical wound infection. Am J Physiol, 1989 Mar, 256(3 Pt 1), C584 - 90 Membrane site of action of CO2 on colonic sodium absorption; Charney AN et al.; Increases in ambient CO2 tension increase colonic sodium absorption by increasing mucosal to serosal sodium flux . We examined the membrane site of CO2 action by utilizing the polyene antibiotic nystatin to create aqueous pores in the apical membrane . Under these conditions, the basolateral rather than the apical membrane is rate limiting for sodium absorption . Pairs of stripped rat distal colonic segments were mounted in modified Ussing chambers in a Ringer-HCO3 solution gassed with either 3% CO2-97% O2 or 11% CO2-89% O2 . Mucosal-to-serosal 22Na and 36Cl fluxes were measured under short-circuited conditions, and ouabain-sensitive absorption was calculated before and after the addition of mucosal nystatin 300 U/ml . Ouabain-sensitive sodium absorption was fivefold greater at 11% CO2 than at 3% CO2 before nystatin addition . Nystatin increased short-circuit current (Isc), transcolonic conductance (Gt) and ouabain-sensitive sodium absorption at 3% CO2 but only increased Isc and Gt at 11% CO2 . The levels of sodium absorption at 3% and 11% CO2 after nystatin were equal and identical to the level measured at 11% CO2 in the absence of nystatin . Ouabain-sensitive chloride absorption was similar at 3% and 11% CO2 in the absence of nystatin and was not affected by nystatin addition . These findings suggest that ambient CO2 tension affects colonic sodium absorption by a selective action at the apical membrane. Antibiot Khimioter, 1989 Mar, 34(3), 209 - 12 {Experimental study of histamine-liberating properties of eremomycin}; Filippos'iants ST et al.; Eremomycin, a new glycopeptide antibiotic showed the same as ristomycin, polymyxins B and M and kanamycin histamine liberating properties . Liberation of endogenic histamine induced destructive lesions on the mucosa of the gastrointestinal tract . The most pronounced lesions were observed after intraperitoneal administration of the antibiotic . When eremomycin was administered intravenously or subcutaneously the affection of the gastrointestinal tract epithelium was less pronounced . After subplantar administration of the antibiotics pad edema in albino rats was observed . The most pronounced edema was after the use of ristomycin and the polymyxins . After the use of eremomycin and kanamycin it was at the average 2 times less pronounced . Preliminary administration of dimedrol decreased intensity of the pad edema induced by the antibiotics. Cancer Res, 1989 Feb 15, 49(4), 996 - 1000 Induction by the guanosine analogue oxanosine of reversion toward the normal phenotype of K-ras-transformed rat kidney cells; Itoh O et al.; Oxanosine, a guanosine analogue antibiotic, altered the "transformed" morphology of rat kidney cells integrating a temperature-sensitive K-ras gene into "normal" morphology at 34 degrees C, a permissive temperature . Oxanosine also increased the cellular content of fibronectin to the normal level . The cells under these conditions had lower levels of guanine nucleotides and unstable and less palmitylated Mr 21,000 protein (K-ras gene product, referred to as p21) . These changes in p21 were the same as those which occurred to p21 in the cells cultured in the absence of oxanosine at 39.5 degrees C, a nonpermissive temperature. Biochim Biophys Acta, 1989 Feb 13, 979(1), 105 - 12 Binding of neomycin to phosphatidylinositol 4,5-bisphosphate (PIP2); Gabev E et al.; Schacht (Schacht, J . (1976) J . Neurochem . 27, 1119-1124) demonstrated that neomycin, an aminoglycoside antibiotic, binds with high affinity to phosphatidylinositol 4,5-bisphosphate (PIP2) . We investigated the binding of neomycin to PIP2 by making electrophoretic mobility measurements with multilamellar bilayer vesicles and surface potential measurements with monolayers . The bilayers and monolayers were formed from mixtures of PIP2 and egg phosphatidylcholine (PC) in 0.1 M KCl at pH 7 . Neomycin does not bind to PC; 10(-3) M neomycin affects neither the zeta potential of PC vesicles nor the surface potential of PC monolayers . In contrast, 10(-6) M neomycin reduces the magnitude of the zeta potential of PC/PIP2 vesicles (5, 9, and 17 mol% PIP2) and the surface potential of monolayers (17 mol% PIP2) to less than 50% of their initial values . The electrophoretic mobility results indicate that neomycin forms an electroneutral complex with PIP2; high concentrations (greater than 10(-4) M) of neomycin reduce the zeta potential of the PC/PIP2 vesicles to zero . We could describe our data with the Gouy-Chapman-Stern theory assuming the intrinsic association constant of the 1:1 neomycin-PIP2 complex is 10(5) M-1 . Neomycin is widely used in cell biology to interfere with the generation of second messengers; we discuss the relevance of our results to these studies . Specifically, 10(-6) M neomycin binds greater than 50% of the PIP2 in a bilayer or monolayer but 10(-5)-10(-3) M neomycin is required to affect the turnover of PIP2 in permeabilized platelets, mast cells, and sea urchin eggs . This result is consistent with a hypothesis that most of the PIP2 in the inner leaflet of these plasma membranes is not accessible to neomycin because it is associated with proteins. J Biol Chem, 1989 Feb 5, 264(4), 2024 - 8 Amphomycin inhibits mannosylphosphoryldolichol synthesis by forming a complex with dolichylmonophosphate; Banerjee DK; The inhibitory effect of the lipopeptide antibiotic amphomycin on the mechanism of mannosylphosphoryldolichol biosynthesis by calf brain rough endoplasmic reticulum membranes has been studied extensively . Calf brain rough endoplasmic reticulum membranes when incubated with varying concentrations of GDP-mannose in the presence and absence of amphomycin showed no significant difference in apparent Km for GDP-mannose (1.08 and 1.37 microM, respectively) . However, the Vmax was reduced to 0.17 pmol/mg protein/min in the presence of amphomycin as compared with 1.86 pmol/mg protein/min in its absence . On the other hand, when mannosylphosphoryldolichol synthase activity was measured in the presence of amphomycin and as a function of dolichylmonophosphate (Dol-P) concentrations, the shape of the substrate velocity curve changed from a rectangular hyperbola to a sigmoid . The Hill coefficients (n) for this reaction were calculated to be 2.02 and 1.22 in the presence and absence of the antibiotic and the corresponding Km values for Dol-P were found to be 333 and 47.3 microM, respectively . In separate experiments when radiolabeled antibiotic was reacted with Dol-P in the presence of Ca2+, a complex was formed . The complex formation was dependent on both Ca2+ in the reaction mixture and fatty acid residue on the antibiotic . Similar complex formation was also observed with undecaprenylmonophosphate . No such complex, however, was formed with dolichylpyrophosphate, with undecaprenylpyrophosphate, or with their free alcohols (dolichol or undecaprenol) . Furthermore, when an equimolar mixture of Dol-P and phosphatidylserine was reacted with the antibiotic under identical conditions, the complex formation was observed selectively with Dol-P . These data demonstrated that amphomycin interacted with the active site of the glycosyl-carrier lipid (Dol-P), thereby preventing its participation at the enzymatic reaction. J Am Osteopath Assoc, 1989 Feb, 89(2), 207 - 10 Facial nerve palsy secondary to acute otitis media; Henderson PE et al.; Acute otitis media is diagnosed commonly in the pediatric population . Numerous complications, one of which is facial palsy, may result . Facial paralysis may be the initial complaint in the child in whom acute otitis media later develops on the affected side, as was true in the case reported here . Dehiscence of the fallopian canal, physiologic canaliculi along the facial nerve to the periphery, and host resistance play an integral part in the development of facial nerve palsy from acute otitis media . The two most effective neurodiagnostic studies are the nerve excitability test and electromyography . The author also recommends daily acoustic reflex testing for denervation or reinnervation . Specific indications for conservative therapy (myringotomy, antibiotic, and decongestant) as well as for surgical intervention are discussed . The treatment in the present case was particularly conservative . It included only a broad-spectrum antibiotic, with good results. Can Assoc Radiol J, 1989 Feb, 40(1), 43 - 4 Diagnosis of Legionella lung abscess by percutaneous needle aspiration; Dobranowski J et al.; Pneumonia is a life-threatening infection of immunocompromised patients, and accurate identification of the causative agent is essential for early initiation of appropriate antibiotic therapy . Percutaneous needle aspiration was used to identify Legionella pneumonia after sputum and bronchoscopy specimens had failed to provide a diagnosis in a 13-year-old leukemic patient with a lung abscess . We believe this is the first report of a child with this disease diagnosed in this way. Surg Neurol, 1989 Feb, 31(2), 149 - 54 Intracranial mycotic aneurysm associated with transsphenoidal surgery to the pituitary adenoma; Onishi H et al.; A case is reported in which a mycotic aneurysm of the supraclinoidal portion of the internal carotid artery formed as the result of suprasellar infection following transsphenoidal surgery . The source of infection was thought to be a maxillary sinusitis . The aneurysm was treated with systemic antibiotic therapy and disappeared 4 months after the operation . Repeated angiography showed the whole course from the formation to the disappearance of the aneurysm and was valuable in the treatment of intracranial mycotic aneurysms. J Craniomaxillofac Surg, 1989 Feb, 17(2), 92 - 5 Necrotizing fasciitis of the middle third of the face . A case report; Kubo S et al.; A 48-year-old man with necrotizing fasciitis in the right middle third face is presented . The patient had uncontrolled diabetes mellitus and liver cirrhosis . The condition was controlled by early diagnosis, prompt surgical management and adjunctive broad spectrum antibiotic cover after entering hospital, the curettage of the necrotizing tissue of the right cheek was especially effective. Ann Thorac Surg, 1989 Feb, 47(2), 300 - 1 Homograft aortic root replacement to correct infective endocarditis requiring seven open cardiac procedures; Saldanha RF et al.; Infective endocarditis, presumably from a septic dental focus, affecting the aortic valve was seen as acute aortic regurgitation in a 20-year-old woman . Seven open cardiac procedures for replacement of the aortic valve and left ventricular outflow tract were performed over the subsequent 6 years . Aortic root replacement using a fresh antibiotic-sterilized homograft was performed as the last definitive operative procedure . This article is presented to highlight (1) the use of homograft aortic root replacement for extensive involvement of aortic valve and left ventricular outflow tract in cases of infective endocarditis and (2) the feasibility of multiple sternal reentries when indicated. Med Care, 1989 Feb, 27(2), 194 - 203 Bug/drug resistance . Sometimes less is more; Phelps CE; Increased use of antibiotics in any community increases the risks that future bacterial strains will resist the effects of current antibiotics . The consequences of a resistant bacterial strain include costs for more expensive and powerful drugs, additional hospital days, and on rare occasion, death . A key to understanding the importance of this problem is better knowledge about the rate that resistance increases and persists as antibiotic use rates increase . Using the scant evidence available in the literature, this study conducts a sensitivity analysis to calculate the unrecognized costs of antibiotic use annually in the United States under various possible circumstances . For the estimated 150 million annual antibiotic prescriptions, the unrecognized costs appears to be at least $.1 billion, and they may exceed $30 billion in the worst case . The estimates of the burden caused by bacterial resistance to antibiotics depend heavily on unknown parameters, including the rate that resistance occurs, the dose-resistance patterns through time, the frequency of inappropriate use of antibiotics, and the frequency with which death occurs due to a resistant bacterial infection . New studies in each of these areas are needed to improve our understanding of the extent of the resistance problem. Exp Hematol, 1989 Feb, 17(2), 130 - 7 Development of neomycin-resistant WEHI-3B D+ murine cells as an in vivo model of acute nonlymphocytic leukemia; Gamba-Vitalo C et al.; pSV2 neomycin DNA was electroporated into exponentially growing WEHI-3B D+ cells, and clones containing integrated pSV2 neomycin DNA were selected by treatment with the antibiotic Geneticin . Southern analysis after Eco RI or Bam HI and Hind III digestion demonstrated that two clones, Y1 and Y2, stably incorporated a single copy of intact pSV2 neomycin DNA into different sites . Exposure of parental WEHI-3B D+ cells to retinoic acid, aclacinomycin A, or adriamycin resulted in their differentiation to mature granulocytic cells . Clone Y1 had growth kinetics and numbers of differentiated cells comparable to those of the parental line when exposed to these differentiation-inducing agents . Furthermore, this clone was leukemogenic in BALB/c mice . The disease presented as a moderate anemia, a peripheral blood granulocytosis, a shift in the differential to immature granulocytic forms, and a thrombocytopenia . Although there was no change in bone marrow cellularity, in situ hybridization to identify the presence of the neomycin resistance gene mRNA indicated infiltration of leukemia cells (up to 30%) into this tissue compartment . The observed hematological parameters were indicative of a late stage of disease resembling human acute nonlymphocytic leukemia . Clone Y1, therefore, would appear to be an in vivo model of acute nonlymphocytic leukemia that may be useful for the development of therapeutic strategies to more successfully treat these diseases . Because we have demonstrated that this line is capable of differentiation in vitro and can be stably carried in vivo, it would also be useful for the identification of therapeutic agents capable of initiating the differentiation of leukemia cells in situ. Clin Orthop, 1989 Feb, (239), 12 - 8 The halo skeletal fixator . Principles of application and maintenance; Botte MJ et al.; The halo skeletal fixator, originally developed for use in patients with poliomyelitis, is now widely used with many types of cervical spine instabilities . Despite its demonstrated effectiveness, certain problem areas, including pin loosening and infection, have been identified . These problems have subsequently inspired detailed studies of skull osteology, biomechanics of pin fixation, and comparisons of techniques of application . Based on these studies, specific recommendations concerning the application and maintenance of the halo have developed . Anterior pin sites should be located in the safe zone approximately 1 cm superior to the orbital rim, cephalad to the lateral two-thirds of the orbit, and below the greatest circumference of the skull . The optimal posterior pin sites are located posterolaterally, diagonal to the corresponding contralateral anterior pins . Pins should be inserted perpendicular to the skull, tightened to eight inch/pounds (0.90 Newton-meter), and retightened once at 48 hours . A subsequent loose pin may be retightened once to eight inch/pounds if resistance is met; otherwise, it should be removed and a new one placed in a different location . Infected pins require antibiotic therapy, wound care, and possibly pin-site change and wound debridement. Wei Sheng Wu Xue Bao, 1989 Feb, 29(1), 63 - 7 {A study on indolepyruvic acid methyltransferase in chuangxinmycin-producing strain}; Cao J et al.; The indolepyruvic acid methyltransferase, perhaps which is active in the biosynthetic pathway of the antibiotic chuangxinmycin, has been detected and partially purified from cell-free extracts of Actinoplanes jinanensis n . sp., This enzyme catalyzes the transfer of a methyl group from S-adenosylmethionine to indolepyruvic acid . The methyltransferase has been purified 60-fold by ammonium sulfate fractionation and DEAE-cellulose column chromatography . The enzyme optimal substrate is indolepyruvic acid . The enzyme has a pH optimum of 7.5 . The double reciprocal plots gave Km values of 4.0 X 10(-5) mol/L for S-adenosylmethionine and 1.8 X 10(-7) mol/L for indolepyruvic acid . A molecular weight of 55000 +/- 5000 has been determined by Sephadex G-150 gel filtration. Res Microbiol, 1989 Feb, 140(2), 151 - 8 Effect of trimethoprim/sulphamethoxazole and hyperbaric oxygen on experimental Spiroplasma mirum encephalitis; Bastian FO et al.; This study was undertaken to determine the susceptibility of experimentally induced Spiroplasma mirum infection in the rat to trimethoprim/sulfamethoxazole (TMP/SMX) in combination with hyperbaric oxygen (HBO) . One-day-old Fisher 344 rats were intracerebrally inoculated with the GT-48 strain of S . mirum and were exposed to regimens employed combined antibiotic and HBO treatments . The exclusive use of TMP/SMX produced a significant reduction in mortality (P less than 0.0001) and an absence of clinical signs of infection . HBO in combination with TMP/SMX showed similar effect on mortality and no evident clinical disease . The addition of HBO did result in a significant decrease in spiroplasma brain titres but was no more effective in preventing the spiroplasma-induced fatal microcystic encephalopathy than when the antibiotics were used alone . The exclusive use of HBO produced a catastrophic mortality rate in the spiroplasma-infected rats, which is contrary to the effect of HBO on conventional bacterial infections. Gaoxiong Yi Xue Ke Xue Za Zhi, 1989 Feb, 5(2), 122 - 5 {Laryngeal tuberculosis simulating epiglottitis--a case report}; Chiang CY et al.; Adult epiglottitis is an otolaryngological emergency . Under proper antibiotic therapy, however, most cases recover rapidly . This is a report of a case in which clinical findings indicated acute epiglottitis, but which showed no improvement with antibiotic therapy when treated by a local medical doctor for three weeks . Following the immediate application of a fiberoptic and microscopic direct laryngoscope with biopsy, an accurate diagnosis was established, i.e . laryngeal tuberculosis . After receiving the appropriate antituberculous therapy for just one week, the patient's symptoms improved dramatically. J Mol Cell Cardiol, 1989 Feb, 21 Suppl 1, 79 - 83 Adaptation of cardiac contractile function to conditions of chronic energy deficiency; Kapelko VI et al.; Left ventricular (LV) contractile function and pump function were depressed in isolated working hearts from rats treated with either guanidinopropionic acid (GPA), an inhibitor of creatine influx, or the anthracycline antibiotic, adriamycin, for 6 and 10 weeks, respectively . In both groups of treated animals myocardial phosphocreatine content was lower than in control hearts, while ATP content was unchanged . Hearts of treated animals exhibited only a minor depression of cardiac output with a submaximal pressure load or during volume overload . However, at maximal pressure load GPA- and adriamycin-treated hearts performed 43% and 37% less pressure-volume work than control hearts . These changes were due both to decreased LV pressure development and diminished cardiac output . LV diastolic stiffness was significantly higher at the submaximal pressure load and the LV filling pressure area, which reflected LV filling, was lower in hearts of both treated groups . The differences in both indices were exaggerated when the maximal pressure load was applied . Limited LV filling due to incomplete myocardial relaxation appeared to represent the underlying cause of cardiac failure when afterload was increased . These results may be explained if adaptation of cardiac contractile function in some chronic cardiac diseases arises from a limited energy supply to the myofibrils. Antibiot Khimioter, 1989 Feb, 34(2), 94 - 8 {Use of Streptomyces sp . 26-115 protoplasts inactivated by heating in fusion experiments}; Orlova TI et al.; When heated at 55 degrees C for 30 or 60 minutes protoplasts of auxotrophic mutants of Streptomyces sp . 26-115 producer of actinomycin C (active and inactive variants) lost their capacity for regeneration . The protoplasts heated at at 55 degrees C for 30 minutes and not for 60 minutes maintained some ability to yield recombinants on fusion under the effect of PEG 6000 . Unlike the parent active strain, the colonies formed by the spores of the prototrophs yielding on fusion of the intact protoplasts showed wide ranges of antibiotic activity against M . flavus while a significant part of the colonies was inactive . The use of the inactive variant protoplasts heated at 55 degrees C for 30 minutes in the fusion procedure increased the proportion of the inactive variants. Antibiot Khimioter, 1989 Feb, 34(2), 123 - 5 {Protective action of rifampicin in experimental rabies infection of albino mice}; Zubovich IK et al.; The paper presents the results of the experimental study of the action of rifampicin on the process of rabies infection in albino mice contaminated with 1-10 LD50 of the fixed rabies virus . Exposure to rifampicin in doses of 250 and 500 micrograms/mouse (35-70 mg/kg) resulted in survival of 66.7 and 83.4 per cent of the animals respectively while in the controls it did not exceed 16.6 and 25.0 per cent . The average life-span of the albino mice treated with the antibiotic increased 1.6-2.4-fold in comparison with the controls . The chemotherapeutic index of rifampicin representing the ratio of the maximum tolerance dose to the minimum dose providing the protective action was equal to 20 . The protective action was observed either after administration of the antibiotic according to the treatment-and-prophylaxis scheme or after administration of its 2- or 3-fold dose once a day immediately after the contamination. Antibiot Khimioter, 1989 Feb, 34(2), 120 - 3 {Penetration of cefazolin and methicillin into tissues of rats with aseptic inflammation}; Agapitova IV; Penetration of cefazolin and methicillin into the tissues of rats with aseptic inflammation was studied . Free cefazolin was shown to be present in blood serum and tissues in higher concentrations than methicillin . The level of cefazolin penetration in all the tested tissues was higher than that of methicillin . Elimination of the antibiotic from the focus of the aseptic inflammation was markedly retarded as compared to that from blood serum . It was suggested that the tissue binding of the antibiotics influenced the rate of their elimination from the tissues. Burns Incl Therm Inj, 1989 Feb, 15(1), 27 - 30 Evidence that 1 per cent Meshushit ointment prevents progressive dermal ischaemia of experimental deep partial skin thickness burns: a preliminary, quantitative controlled study; Kaufman T et al.; This study quantitatively assessed the topical effects of Meshushit, a new herbal compound, on the healing process of experimental deep partial skin thickness burns over 27 days . To symmetrical circular burns were inflicted on the back of 15 animals by aluminium templates . The Meshushit and its control vehicle containing 0.1 per cent gentamycin or the control vehicle plus antibiotic alone, were applied topically to randomly selected burns at equal time intervals . Epithelialization and contraction were assessed on postburn days 6, 10, 15, 18, 22 and 27 using a computerized planimeter . The newly formed granulation tissue was assessed histologically on postburn day 27, while the hair follicles were counted in the same sections . Student's t test was used to differentiate the rates of contraction and epithelialization; hair follicle counts and the thickness of the newly formed granulation tissue . None of the animals died during the experiment . The epithelialization and contraction rates did not differ significantly between the test groups . The Meshushit-treated wounds showed a significantly thicker granulation tissue layer as compared to its control (828.72 +/- 46.39 microns vs . 540.78 +/- 37.81 microns, P less than 0.01) . The count of hair follicles was significantly higher in the Meshushit-treated burns (23.38 +/- 1.84 vs . 3.76 +/- 0.35, P less than 0.001) . It is concluded that the herbal Meshushit ointment enhanced the newly formed granulation tissue and preserved better the hair follicles in the present burn wound model . It is suggested that these findings are due to the preservation of the dermal microcirculation. Aust Dent J, 1989 Feb, 34(1), 60 - 8 Refractory chronic periodontitis: effect of oral tetracycline hydrochloride and root planning; Papli R et al.; Refractory chronic periodontitis of 16 patients was treated by root planing and adjunctive tetracycline hydrochloride therapy . The antibiotic was taken orally one hour before root planing and continued for six days at a dosage of 250 mg six hourly . The clinical data for each patient were recorded as the number of probing depths in each of the 1-3 mm, 4-6 mm and 7-10 mm ranges . The Multivariate Analysis of Variance (MANOVA) procedure for repeated measurements was used to analyse the data . The results demonstrated that the number of sites with probing depths of 4-6 mm and 7-10 mm associated with incisors, canines, premolars and molars decreased with a corresponding increase in the number of sites in the 1-3 mm range . Incisor and canine teeth showed a better response to treatment than premolars, which responded better than molars . The cases were followed for varying periods of time from six months to two years following antibiotic therapy . The probing depth reduction achieved following root planing and tetracycline hydrochloride therapy was maintained during this review period. Klin Med (Mosk), 1989 Feb, 67(2), 108 - 12 {Clinico-immunologic effectiveness of chlorophyllypt in the treatment of acute destructive pneumonia}; Simvolokov SI et al.; An attempt has been made to replace antibiotics by chlorophyllypt (0.25 per cent solution in physiological sodium chloride solution administered by intravenous drip) . The clinical, laboratory and X-ray parameters in 22 patients treated by this drug normalized in earlier terms than those in 19 patients who received the traditional antibiotic therapy . Chlorophyllypt was found to have the immunocorrective effect manifested by the normalization of the T-lymphocyte number and their theophylline-resistant subpopulation . No such an effect was achieved when broad-action antibiotics were used. J R Coll Surg Edinb, 1989 Feb, 34(1), 13 - 6 Systemic plus local metronidazole and cephazolin in complicated appendicitis: a prospective controlled trial; el-Sefi TA et al.; Appendicectomy was performed on 100 patients with complicated appendicitis through a grid-iron incision . All patients received systemic metronidazole and cephazolin sodium which started preoperatively and continued postoperatively for 5 days . At operation, patients were allocated randomly to receive either local instillation of metronidazole and cephazolin intraperitoneally and interparietally (group A) or no local antibiotic therapy (group B) . All wounds were closed primarily without drainage . Postoperative wound sepsis occurred in four (8%) of the 50 patients in group A and in 17 (34%) of the 50 patients in group B . One patient in group B developed pelvic abscess in addition to wound sepsis . The mean duration of postoperative hospital stay was 6.6 days (s.d . 2.98) in group A and 8.7 days (s.d . 5.55) in group B . These differences were statistically significant . No adverse reaction was noted . The conclusion of this study is that a single peroperative instillation of metronidazole and cephazolin into the peritoneum and wound layers is a safe and valuable adjunct to the perioperative systemic administration of these drugs in significantly reducing postoperative sepsis and duration of hospital stay in complicated appendicitis. Pediatr Infect Dis J, 1989 Feb, 8(2), 75 - 8 A multicenter therapeutic study of 1100 children with brucellosis; Lubani MM et al.; A 6-year multicenter therapeutic study was performed on 1100 children with brucellosis in order to compare several antibiotic combinations and duration of treatment . The patients were randomized to receive oral therapy with oxytetracycline, doxycycline, rifampin and trimethoprim-sulfamethoxazole (TMP/SMX) either alone or in combination with each other or combined with streptomycin or gentamicin injections . The patients were also randomized into three groups based on the duration of oral therapy: 500 patients were treated for 3 weeks; 350 for 5 weeks; and 250 for 8 weeks . When intramuscular aminoglycosides were used, streptomycin was given for 2 weeks and gentamicin for 5 days . In oral monotherapy oxytetracycline, doxycycline and rifampin showed comparable results with low relapse rates (less than or equal to 9%) and no statistically significant differences were found among 3-, 5- or 8-week durations of therapy . TMP/SMX alone showed an unacceptably high relapse rate (30%) with all durations of therapy . In combined oral therapy rifampin plus oxytetracycline, rifampin plus TMP/SMX and oxytetracycline plus TMP/SMX showed comparable results with low relapse rates ranging from 4 to 8% in patients receiving therapy for 3 or 5 weeks, no relapses occurred in patients treated for 8 weeks . When oral monotherapy was combined with either streptomycin or gentamicin, very few relapses were seen, irrespective of the duration of treatment.(ABSTRACT TRUNCATED AT 250 WORDS) Orthopedics, 1989 Feb, 12(2), 245 - 8 Subacute osteomyelitis presenting as bone tumors; Juhn A et al.; The problem of the differential diagnosis between subacute osteomyelitis and primary bone tumors is a difficult one . Presenting symptoms, duration of disease, laboratory data, and location of the pathologic process are of little assistance . The authors reviewed eight typical cases . Preoperative diagnosis included benign and malignant bone tumors, as well as osteomyelitis; but the final diagnosis of osteomyelitis was made only after open biopsy and culture . The presenting symptoms and signs included: pain, usually dull; soft tissue mass; and, rarely, low grade fever . The radiographic features were usually a lytic area with various degrees of sclerotic reaction . White blood count and sedimentation rate were not helpful . The treatment, including surgical curettage and appropriate antibiotic therapy, resulted in resolution of the process and healing of the bony defects. Endod Dent Traumatol, 1989 Feb, 5(1), 11 - 22 Prognosis of root-fractured permanent incisors--prediction of healing modalities; Andreasen FM et al.; A population of 85 patients, comprising 95 root-fractured permanent incisors followed up to 11 years, was studied prospectively for the type of fracture healing that occurred (i.e . union of the fragments by interposition of hard tissue (HT) or connective tissue (CT), or nonunion characterized by interposition of granulation tissue between the fragments (GT)) . Initial treatment was provided according to established treatment guidelines by the attending oral surgeon at the emergency room . Follow-up examination and treatment were provided by 2 of the authors . It appeared that GT could be diagnosed after approximately 3 weeks, while HT or CT could be diagnosed approximately 6 weeks after trauma . Many factors considered one at a time were found to have a significant or nearly significant effect on the type of fracture healing that occurred . However, a multivariate regression analysis revealed that the following factors were significantly related to fracture healing by HT: a large diameter of the apical foramen and severity of luxation of the coronal fragment (concussion/subluxation greater than lateral luxation greater than extrusion); fracture healing by CT: the presence of restorations in the injured teeth at the time of injury and the presence of marginal periodontal disease; and fracture nonhealing by GT: type of fixation (i.e . orthodontic band fixation versus acid etch or no fixation), antibiotic therapy, a constricted apical foramen, increased loosening of the coronal fragment, and stage of root development (GT never occurred in teeth with open apices) . It was previously demonstrated following luxation injuries that type of luxation, stage of root development and type of fixation (orthodontic bands versus acid etch or no fixation) determined the prognosis of pulp survival . It therefore appears that the general factors that are able to predict the type of healing seen after root fracture are the same as those after luxation injuries, supporting the hypothesis that root fractures are another form of luxation injury, this time of only the coronal fragment. Int J Gynaecol Obstet, 1989 Feb, 28(2), 133 - 6 Pelvic inflammatory disease and the intrauterine contraceptive device; Wright EA et al.; The relationship between the use of intrauterine contraceptive device (IUD) and pelvic inflammatory disease (PID) was examined in 1054 patients who were seen at the Family Planning Clinic of Jos University Teaching Hospital and were followed up . The overall risk of PID developing in women wearing the IUD was minimal: 62 out of 1054 (5.9%) . The rates, however, varied for the 6-month periods studied . The incidence of PID decreased as the period of usage increased . The greater number of patients developed PID less than 3 months from the date of IUD insertion . When PID occurred it was usually of mild or moderate intensity and the response to antibiotic therapy was very encouraging . There was no relationship between the parity of the patients and the development of PID . Even though there is a definite link between the use of IUD and the development of PID it does not obliterate the benefits which the use of IUD provide for the majority of its patrons; and so the use of IUD should continuePIP: 1054 women who were attending the Family Planning Clinic of Jos University Teaching Hospital (Nigeria) were studied for possible causes of pelvic inflammatory disease (PID) over the May 1983-December 1985 period . 697 women were wearing a Lippes Loop and 357 were wearing a T Cu 200 . The IUDs had been inserted by trained nurses using an aseptic technique after careful screening to exclude existing PID . PID was diagnosed primarily by clinical means; fever, acute pelvic pain, vaginal discharge, pelvic tenderness or mass, and a raised white cell count were the symptoms . 62 patients developed PID, 35 with moderate or severe PID needing admission and the remaining 27 with mild PID . The overall incidence of PID in IUD users was 5.9% . During the same period 8 patients developed PID among 533 clients using oral contraceptions . An incidence of 1/30 was recorded for hospitalization of IUD wearers and 1/76 for non-IUD users, giving an incidence 2.5 times greater in IUD wearers . Only 44 patients (4.2%) had used the IUD for over 2 years; only 1 of these patients developed PID, a severe case . There was a decline in the number of patients who developed PID with increased duration of use and the relationship between PID and increased duration of use was significant . The response to chemotherapy was dramatic; only 1 course of therapy was necessary for all patients but 2 who required a subsequent course of tetracycline for complete resolution . There was no relationship between the parity of patients and their developing PID . J R Coll Gen Pract, 1989 Feb, 39(319), 65 - 6 What influences doctors' prescribing? Sore throats revisited; Pitts J et al.; An audit of two practices in 1987 revealed a wide range of antibiotic prescribing for acute sore throat among the general practitioners . The data were presented at a postgraduate meeting and recommendations were made for a practice policy on antibiotic prescribing . The results of studies that looked at the objectives of treatment were included at that meeting . This paper presents a re-evaluation of the same doctors' antibiotic prescribing one-year later . Changes had occurred in the range and costs of drugs chosen, but individual doctors' prescribing rates remained broadly similar, in other words it was easier to influence what, but not whether, a doctor prescribes for this clinical condition . The existence of a prescribing 'threshold' within the individual doctor is supported. Mol Microbiol, 1989 Feb, 3(2), 215 - 20 Mistranslation induces the heat-shock response in the yeast Saccharomyces cerevisiae; Grant CM et al.; The synthesis of heat-shock proteins can be triggered by a variety of stress-inducing conditions . Here we show that translational misreading caused by growth in the presence of the aminoglycoside antibiotic paromomycin will induce the heat-shock response in the yeast Saccharomyces cerevisiae . This was demonstrated (i) by the acquisition of thermotolerance, and (ii) by elevated levels of expression of the heat-shock protein, hsp70 . In addition, transcription of the ubiquitin gene (UB14) was increased in paromomycin-grown cells . Control experiments with the protein synthesis inhibitor cycloheximide (which does not induce translational misreading) demonstrated that the response was not due to inhibition of protein synthesis per se . These observations strongly suggest that the synthesis of abnormally high levels of aberrant proteins is the trigger of the heat-shock response in this simple eukaryote. Mol Pharmacol, 1989 Feb, 35(2), 257 - 64 Theoretical study of the protonation and tautomerization of adenosine, formycin, and their 2-NH2 and 2-F derivatives: functional implications in the mechanism of reaction of adenosine deaminase; Orozco M et al.; A quantum chemical study of adenosine, formycin, and their 2-NH2 and 2-F derivatives is performed . The tautomerism of neutral and protonated species as well as the protonation of adenosine, formycin, and their derivatives are theoretically studied using semiempirical MNDO and AM1, as well as ab initio STO-3G methods . Calculations have been performed on a reduced model, in which the ribose moiety has been substituted by a hydroxy-methyl group . Results indicate that adenosine is mainly protonated at the N1 atom, whereas formycin can be protonated on N1 or N3, depending on the tautomeric form (N8-H or N7-H) . The quantum chemical study of the N1-protonated molecules shows that a second protonation of adenosine is mainly on the N3 atom, whereas formycin can be protonated on N8 or N3, depending on the tautomeric form . On the other hand, results indicate that the protonation of formycin and its derivatives at the N1 atom leads to a change in their tautomeric preference from N7-H to N8-H . The importance of both tautomerism and protonation reactions in the mechanism of action of adenosine deaminase is studied by means of a quantitative structure activity relationships strategy . Significant correlations were found between several electronic parameters and the logarithm of the maximum rate of deamination (log Vm) of the studied compounds . For formycin and its derivatives, it was necessary to consider their N8-H tautomeric forms . The electronic parameters giving good correlations were as follows: energy of the minimum of the ab initio molecular electrostatic potential on N1, net charge over purine (pyrazolo-pyrimidine) and pyrimidine rings, and the N1 protonation energy . It must be noted that all these parameters are informative in relation to a proton attack . Adenosine and purine ribosides have been studied largely because of their high biological relevance . They are constituents of nucleic acids, intermediates in secondary metabolism, neuromodulators, and neurohormones . Their analogues have been extensively used because of their wide range of pharmacological effects (1) . Formycin A (Fig . 1) is one of the most studied analogues of adenosine . It is a natural product extracted from Nocardia interforma (2) with proven antiviral (3-5), antibiotic (2), immunodepressant (6), antitumor (6), and antimetabolic (5) activities. J Allergy Clin Immunol, 1989 Feb, 83(2 Pt 1), 393 - 400 Hypodense eosinophilic granulocytes in normal individuals and patients with asthma: generation of hypodense cell populations in vitro; Kloprogge E et al.; Eosinophils from normal nonatopic healthy volunteers (195 +/- 106 cells per microliter) were isolated by centrifugation over a discontinuous Percoll gradient, under isotonic conditions, with a recovery of 46.5 +/- 26.2% from whole blood (n = 21; mean +/- SD) . More than 90% of the eosinophils (purity greater than 93%) with a density between 1.095 to 1.105 gm/ml were defined normodense . Less than 10% of the eosinophils had a density less than 1.095 gm/ml and were defined hypodense . Isolation of eosinophils of patients with atopic asthma revealed a cell population with 65% to 70% hypodense cells that was independent of the total eosinophilic cell count . In vitro activation of normodense eosinophils, measured by an increase in superoxide production, induced quantities of hypodense eosinophils in the range found in patients with asthma . The amount of hypodense eosinophils induced by different stimuli was in the same order as the increase in superoxide production (antibiotic calcium ionophore A23187 greater than serum-treated zymosan greater than platelet-activating factor greater than N-formyl-methionyl-leucyl phenylalanine) . During the stimulation of the normodense cells, no secretion of eosinophilic peroxidase or arylsulfatase B could be measured, even though hypodense eosinophils were produced . Enzymatic activity of arylsulfatase B within the eosinophils remained the same, before and after stimulation . The enzymatic activity of eosinophilic peroxidase in normodense eosinophils (16.6 +/- 9.7 micrograms/10(6) cells) did not change in the normodense fraction but was increased in the induced hypodense cells (34.0 +/- 8.4 micrograms/10(6) cells; n = 7; mean +/- SD; p less than 0.01) after stimulation.(ABSTRACT TRUNCATED AT 250 WORDS) Arch Biochem Biophys, 1989 Feb 1, 268(2), 659 - 66 The effect of equisetin on energy-linked reactions in Rhodospirillum rubrum chromatophores; Nyren P et al.; Light-induced proton uptake, light-induced carotenoid absorbance shift, photophosphorylation, and hydrolysis of Mg-ATP, Ca-ATP, and PPi in Rhodospirillum rubrum chromatophores are shown to be inhibited by the antibiotic equisetin . The Mg- and Ca-ATPase activities of purified F0F1-ATPase are inhibited by equisetin . In contrast, only the Ca-ATPase activity of purified F1-ATPase is decreased by equisetin, whereas the Mg-ATPase is stimulated . Both equisetin and N,N'-dicyclohexylcarbodiimide (DCCD) inhibit the hydrolytic activity of the purified H+-PPase but not the hydrolytic activity of soluble PPase from R . rubrum and yeast . The I50 for the PPi hydrolysis is near 20 microM for both equisetin and DCCD . The action of equisetin on membranes is compared to the effect of Triton X-100 and carbonyl cyanide p-trifluoromethoxyhydrazone . On the basis of these new data, equisetin is proposed to act nonspecifically on membranes and hydrophobic domains of proteins. Jpn J Antibiot, 1989 Feb, 42(2), 401 - 10 {Clinical efficacy of clarithromycin in the field of pediatrics}; Ogura H et al.; A new macrolide antibiotic, clarithromycin (TE-031, A-56268), was studied for its clinical efficacy in the field of pediatrics . Patients treated were infants and children ranging from 2 months to 11 years old suffering from acute bronchitis in 5 cases, acute tonsillitis in 2 cases, Mycoplasma pneumonia in 2 cases, pertussis in 6 cases, scarlatina in 1 case and acute enteritis in 2 cases, a total of 18 cases . TE-031 was administered 19.7-43.5 mg/kg in daily doses and lengths of treatment ranged from 4 to 19 days . As regards to its clinical efficacy, good or excellent results were obtained in all cases: excellent in 11 cases and good in 7 cases . No clinical side effects nor abnormal laboratory test values obviously attributable to TE-031 were observed. Kansenshogaku Zasshi, 1989 Feb, 63(2), 98 - 102 {Use of Rokitamycin dry syrup in cases of upper deep cervical lymphadenitis and otitis media with exudatives}; Mukai S et al.; Dry syrup of Rokitamycin (RKM.DS), a new macrolide antibiotic with 16-membered ring developed by Toyo Jozo Co., Ltd., was used on cases of upper deep cervical lymphadenitis (UDCL) and of otitis media with exudatives (OME) likely caused by chlamydia infections, and its clinical effects were investigated . 1) In four cases of UDCL (C . psittaci infections), daily doses of 20.0-28.6 mg/kg were administered for 10-42 consecutive days and good efficacies were observed with two cases of excellent results and two cases of good results . 2) In one case of OME (C . trachomatis infection) a daily dose of 30.0 mg/kg was administered for 15 consecutive days and good effectiveness was observed . 3) No side effect was observed in any of the cases . From the above results, it became clear that RKM.DS could effectively used as a therapeutic agent for UDCL and OME in children. J Urol, 1989 Feb, 141(2), 364 - 6 Continuous venous access in children with urological diseases; Springer JC et al.; The placement of multipurpose silicone right atrial catheters for continuous venous access in children with complex urological diseases has become increasingly necessary . Between September 1985 and September 1987, 26 children with a variety of urological diseases required long-term central venous access, primarily for delivery of chemotherapy and blood products in 13 patients with malignancies, hemodialysis access in 7 undergoing renal transplantation, total parenteral nutrition in 5 (2 of whom were born with cloacal exstrophy), and fluid and antibiotic administration in 1 with dermatomyositis and acute pyelonephritis . Patient age at catheter placement ranged from 1 day to 15 years . A total of 11 complications was encountered during 4,500 catheter days: 10 were mechanical and 1 was infectious in nature . These complications led to replacement of the catheter in 3 patients and the remainder were managed successfully nonoperatively . The surgical techniques involved in placement of these catheters are discussed . The catheters not only allowed many of these patients to receive treatment on an outpatient basis but also ensured their survival . Our favorable experience with prolonged venous access in children should encourage urologists to include these techniques in their armamentarium. Dent Cadmos, 1989 Jan 31, 57(1), 74 - 7 {The use of Josamycin in dental pathology}; Debernardi C et al.; Authors evaluated the clinical results of the use of Josamycin in odontostomatology . The clinical trial has been carried out on 42 patients with acute bacterial infections . Josamycin appeared a very safe and effective antibiotic. N Engl J Med, 1989 Jan 19, 320(3), 133 - 7 Rapid emergence of a focal epidemic of Lyme disease in coastal Massachusetts; Lastavica CC et al.; We describe a focal epidemic of Lyme disease, which spread from a nature preserve and affected an adjacent community of permanent residents in coastal Massachusetts . The attack rate from 1980 through 1987 was 35 percent among 190 residents living within 5 km of the nature preserve and was greatest (66 percent) among those living closest to the preserve . The risk of infection bore little relation to sex or age . Late Lyme disease, which clustered near the preserve, occurred mainly in residents infected early in the epidemic who did not have a history of erythema migrans and did not receive antibiotic therapy . All the residents with serologic evidence of infection had early or late clinical manifestations of Lyme disease, or both, during the period of study . The seasonal risk of infection was bimodal--greatest in June, with a secondary peak in October--and corresponded to periods of increased transmission . In the nature preserve, the density of the vector tick, Ixodes dammini, exceeded that in other New England sites . The zoonosis rapidly became endemic, and the severity of its impact correlated with the abundance of deer . This epidemic of Lyme disease demonstrated that outbreaks can be focal and can spread rapidly within a community of permanent residents. Biochim Biophys Acta, 1989 Jan 16, 978(1), 97 - 104 Interaction of trichorzianines A and B with model membranes and with the amoeba Dictyostelium; el Hajji M et al.; Trichorzianines A (TA) and B (TB) are microheterogeneous mixtures of antibiotic nonadecapeptides of the peptaibol class which interact with lipidic membranes and modify their permeability properties . The TB differ from the TA by replacement of the Gln-18 by a Glu, giving rise to a C-terminal negative charge at neutral pH . The role of this charge on the trichorzianine-lipid interaction was investigated with model membranes by fluorescence spectroscopy and the results were correlated with the biological activity toward the amoeba Dictyostelium discoideum . The interaction of the acidic trichorzianine TB IIIc (Glu-18) with phospholipid bilayers and the subsequent induced permeability were weaker than that exhibited by the uncharged TA IIIc (Gln-18) and MeTB IIIc (TB IIIc monomethyl ester) . The unfavourable effect of the negative charge in TB IIIc was strongly enhanced by incorporation of cholesterol in the bilayer . Similarly, TA IIIc as well as MeTB IIIc induced growth inhibition and lysis of the amoeba Dictyostelium at four times lower concentrations than TB IIIc . The results suggested that the interaction of trichorzianines with the phospholipid bilayer and the subsequent modifications of permeability were involved in the inhibitory properties and cell lysis induced by trichorzianines toward Dictyostelium. Cancer Res, 1989 Jan 15, 49(2), 331 - 4 Induction of erythroid differentiation of K562 human leukemic cells by herbimycin A, an inhibitor of tyrosine kinase activity; Honma Y et al.; Herbimycin A, a benzoquinonoid ansamycin antibiotic, is found to reduce intracellular phosphorylation by tyrosine protein kinase . The human chronic myelogenous leukemia cell line K562 expresses a structurally altered c-abl protein with tyrosine kinase activity . When K562 cells are induced to undergo erythroid differentiation by hemin, reduction in the intracellular level of tyrosine phosphorylation occurs . In order to understand the relationship between induction of differentiation and reduction of tyrosine phosphorylation by the c-abl gene product, the effect that herbimycin A, a selective inhibitor of intracellular tyrosine kinase activity, exerts on the differentiation of K562 cells was examined . Reduction of tyrosine phosphorylation in K562 cells by herbimycin A was observed within 1 h . Noncytotoxic concentrations of herbimycin A induced erythroid differentiation of K562 cells but not of murine erythroleukemia 745A cells . The other human myeloid leukemia cell lines (HL-60, THP-1, and U937) tested were not induced to undergo cell differentiation by this antibiotic . Herbimycin A and the other well-known inducers such as hemin, butyric acid, Adriamycin, and 1-beta-D-arabinofuranosylcytosine had additive or more than additive effects on induction of erythroid differentiation of K562 cells . With respect to inhibition of cell growth, the sensitivity of K562 cells to herbimycin A was highest in the human leukemia cell lines we tested . Noncytotoxic concentrations of herbimycin enhanced the antiproliferative effect of Adriamycin or 1-beta-D-arabinofuranosylcytosine on K562 cells . Combination therapy with herbimycin A and its derivatives may be considered for use in the treatment of some types of leukemia where tyrosine kinase activities are implicated as determinants of the oncogenic state. Nature, 1989 Jan 5, 337(6202), 93 - 6 Structure of the membrane-pore-forming fragment of colicin A; Parker MW et al.; Colicins are antibiotic proteins produced by and active against sensitive Escherichia coli and closely related bacteria . They can adsorb to specific receptors located at the external surface of the outer membrane of sensitive cells, and are then translocated to their specific targets within these cells . The largest group of colicins comprises those which can form voltage-dependent channels in membranes, thereby destroying the cell's energy potential . Colicin molecules are organized in structural domains, each domain carrying one function associated with the toxin's lethal activity . The pore-forming activity seems to be located at the carboxyl terminus . A thermolytic fragment comprising amino acids 389-592 from colicin A has pore-forming properties very similar to those of the entire molecule . This fragment is soluble in aqueous medium and spontaneously inserts into lipid bilayers . We have determined the structure of the pore-forming fragment of colicin A by X-ray crystallography and refinement at 2.5 A resolution . The protein consists of ten alpha-helices organized in a three-layer structure . Two of the helices are completely buried within the structure and form a hydrophobic hairpin loop similar to that proposed for signal sequences which function in translocation . We present a model for insertion of the protein into lipid bilayers the features of which may be applicable in other biological systems involving protein insertion or translocation across membranes. J Biol Chem, 1989 Jan 5, 264(1), 157 - 67 Characteristics of bile acid-mediated Ca2+ release from permeabilized liver cells and liver microsomes; Combettes L et al.; Saponin-treated liver cells and a microsomal fraction were used to characterize the mechanism of the Ca2+ release induced by different bile acids . The saponin-treated cells accumulated 0.8-1 nmol/mg of protein of the medium Ca2+ in a nonmitochondrial, high affinity, and inositol (1,4,5)-trisphosphate (Ins(1,4,5)P3)-sensitive Ca2+ pool . Three of five bile acids tested, lithocholate and the conjugates taurolithocholate and taurolithocholate sulfate, released 85% of the Ca2+ pool within 45-60 s and with ED50 from 16 to 28 microM . Ins(1,4,5)P3 released 80% from the same Ca2+ pool with an ED50 of 0.3 microM . The Ca2+-Mg2+-ATPase inhibitor vanadate (1 mM) had no effect on the Ca2+ released by the bile acids and Ins(1,4,5)P3 . The Ins(1,4,5)P3-binding antibiotic neomycin (1 mM) and the receptor competitor heparin (16 micrograms/ml) abolished the releasing effect of Ins(1,4,5)P3 but had no effect on the bile acid-mediated Ca2+ release . The 45Ca2+ accumulated by the microsomal fraction (8 nmol of 45Ca2+/mg of protein) was released by the bile acids within 45-90 s and with an ED50 of 17 microM . In contrast, the bile acids had no effect on the Ca2+ permeability of other natural and artificial membranes . The resting 45Ca2+ influx of intact cells (0.45 nmol/mg of protein/min), the 45Ca2+ accumulated by mitochondria (2-13 nmol of 45Ca2+/mg of protein), and the 45Ca2+ trapped in sonicated phosphatidylcholine vesicles (5 mM 45Ca2+) were not altered by the different bile acids . These results suggest that the Ca2+ release initiated by lithocholate and its conjugates results from a direct action on the Ca2+ permeability of the Ins(1,4,5)P3-sensitive pool . It is not mediated by Ins(1,4,5)P3 or via activation of the Ins(1,4,5)P3 receptor, and it is specific for the membrane of the internal pool. Acta Neuropathol (Berl), 1989, 77(3), 307 - 13 Complement-derived polypeptide C3adesArg as a mediator of inflammation at the blood-brain barrier in a new experimental cat model; Hollerhage HG et al.; The effect of the complement-derived polypeptide C3adesArg as a mediator of inflammation in the central nervous system was examined . Twenty-five anesthetized cats received 4 mg of this polypeptide by intraventricular injection, 20 cats who served as controls received saline . Cerebrospinal fluid (CSF) was sampled 3 h after intraventricular injection and the brains were removed . For assessment of the permeability of the blood-brain barrier the CSF penetration of four antibiotics, which were given intravenously was measured . Five control animals were employed for each antibiotic (tobramycin, ampicillin, imipenem, fosfomycin), whereas six C3adesArg-treated animals were used for each antibiotic and seven for tobramycin . Besides CSF levels of glucose, the prostanoids 6-keto-prostaglandin F1 alpha, thromboxane B2 and prostaglandin E2 were measured . The morphological examinations in the CSF sediments and histological brain sections in the C3adesArg-treated animals disclosed a distinct inflammation with leptomeningeal and perivascular infiltration of polymorphonuclear granulocytes compared to normal findings in the controls . The CSF/serum ratios of all of the antibiotics were markedly elevated compared to controls, indicating a blood-brain barrier disruption . The levels of all prostanoids were significantly higher in the treatment group than in the control group, whereas the glucose levels were lower . These findings are in accordance with a granulocytic meningitis as seen in some infections at the acute stage . It is concluded that C3adesArg acts as a mediator of inflammation in the central nervous system. Am J Vet Res, 1989 Jan, 50(1), 154 - 7 Serum and tissue fluid norfloxacin concentrations after oral administration of the drug to healthy dogs; Walker RD et al.; Norfloxacin, a 4-quinolone antibiotic, was administered orally to 4 healthy dogs at dosages of 11 and 22 mg/kg of body weight, every 12 hours for 4 days, with a 4-week interval between dosing regimens . Serum and tissue cage fluid (TCF) norfloxacin concentrations were measured at 0, 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, and 12 hours after the first and seventh dose of each dosing regimen . When administered at a dosage of 11 mg/kg, the mean peak serum concentration (Cmax) was 1.0 microgram/ml at 1 hour, the time of mean peak concentration (Tmax) after the first dose . After the seventh dose, the Cmax was 1.4 micrograms/ml at Tmax of 1.5 hours . The Tmax for the TCF concentration was 5 hours, with Cmax of 0.3 microgram/ml and 0.7 microgram/ml after the first and seventh dose, respectively . When administered at a dosage of 22 mg/kg, the serum Tmax was 2 hours after the first dose, with Cmax of 2.8 micrograms/ml . After the seventh dose, the serum Tmax was 1.5 hours, with Cmax of 2.8 micrograms/ml . The Tmax for the TCF concentration was 5 hours after the first and seventh doses, with Cmax of 1.2 micrograms/ml and 1.6 micrograms/ml, respectively . After the seventh dose, the serum elimination half-life was 6.3 hours for a dosage of 11 mg/kg and was 6.7 hours for a dosage of 22 mg/kg . For serum concentration, the area under the curve from 0 to 12 hours (AUC0----12) was 8.77 micrograms.h/ml and 18.27 micrograms.h/ml for dosages of 11 mg/kg and 22 mg/kg, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) J Wildl Dis, 1989 Jan, 25(1), 118 - 21 Vertebral osteomyelitis and suspected diskospondylitis in an Atlantic bottlenose dolphin (Tursiops truncatus); Alexander JW et al.; A 21-yr-old male Atlantic bottlenose dolphin (Tursiops truncatus) was performing at an aquatic park when it developed a soft tissue swelling anterior to the flukes . Subsequent radiographic evaluation revealed the animal to have vertebral osteomyelitis and suspected diskospondylitis . The case was successfully managed with long-term antibiotic therapy. J Pediatr Ophthalmol Strabismus, 1989 Jan-Feb, 26(1), 39 - 43 Conservative management of congenital nasolacrimal duct obstruction; Nucci P et al.; Fifty-nine children 1 to 24 months of age with congenital nasolacrimal duct obstruction (CNDO) were treated with local hydrostatic massage and antibiotic eye drops . Children 1 to 12 months of age showed a cure rate of 93.3%; only two of them underwent nasolacrimal probing . Children 13 to 24 months of age had a cure rate of 79.3%, and six underwent probing . The initial probings were successful in both age groups . Fifty-one children (86.4%) were thus spared nasolacrimal probing. J Pediatr Ophthalmol Strabismus, 1989 Jan-Feb, 26(1), 21 - 7 Medical management of orbital subperiosteal abscess in children; Rubin SE et al.; The traditional treatment of subperiosteal orbital abscess consists of surgical drainage and antibiotic therapy . We successfully treated with antibiotics alone nine children (age range 26 months to 12 years) with clinical signs and symptoms of orbital cellulitis and computerized tomographic (CT) evidence of subperiosteal abscess and contiguous ethmoid sinusitis . Two additional patients successfully treated with nonsurgical therapy were identified retrospectively . All patients were admitted to the pediatric service with normal vision . Their visual function was assessed twice daily during the early stages of their illness . All patients improved with intravenous antibiotic therapy . One additional patient required surgical drainage for persistent pain after 1 week of slow but steady clinical improvement . All other patients were clinically cured with medical therapy alone . Five of the medical "cures" had posttreatment CT, which documented the resolution . No patient had a recurrence . We conclude that orbital subperiosteal abscess, like some other abscesses located elsewhere, may be amenable to non-surgical treatment, or that these patients may have had a phlegmon rather than an abscess and the currently accepted CT criteria for diagnosis of a subperiosteal abscess may require modification . We recommend that children with a subperiosteal abscess from contiguous ethmoidal sinusitis who have no evidence of compromised optic nerve function be given a trial of intravenous antibiotic therapy prior to consideration of surgical drainage. Hear Res, 1989 Jan, 37(2), 123 - 7 Acoustic responses recorded from the saccular bundle on the eighth nerve of the guinea pig; Didier A et al.; Previous studies have demonstrated the existence of acoustic responses from the saccule in guinea pigs for stimulus intensities above 75 dB SPL . It is well known that the saccule receives a double afferent innervation: a bundle of the superior branch of the eighth nerve reaches its anterior part and another bundle of the inferior branch innervates its posterior part . These two bundles join just at the exit of the internal auditory meatus . An electrophysiological experiment was performed to investigate whether saccular acoustic responses could be similarly recorded from both bundles . Recordings from an electrode tip of 0.2 mm diameter were obtained in normal animals and also in animals with a complete and selective destruction of the cochlear sensory epithelium induced by treatment with an ototoxic antibiotic combined with a loop diuretic . In both normal and treated animals acoustic responses with the peculiar very short latency were specifically recorded in the area of the junction of the two bundles, they were of maximal amplitude on the bundle of the inferior branch . These data confirm in a more direct way the saccular origin of the short latency acoustic responses and indicate that they are probably conveyed in both saccular nerve bundles but mostly in that of the inferior branch of the eighth nerve . Finally these data show unequivocally that saccular acoustic responses exist in normal guinea pig ears. Biull Eksp Biol Med, 1989 Jan, 107(1), 43 - 5 {Lowering of adriamycin toxicity by its combined administration with a copper Cu-2 complex}; Bogush TA et al.; Cu-2, a new Soviet copper-complexed cytostatic, decreased acute and hematologic toxicity after lethal doses of adriamycin (AD) were given to male CBA mice . Cu-2 (3.5 mg/kg) was first injected 10 minutes after AD was given, and a second injection followed 50 minutes after the first . Relative to controls given AD alone, the mortality of Cu-2 treated mice was decreased and their lifespan increased . Leukopenia also was less pronounced and of shorter duration . The observed effect of Cu-2 may be related to its superoxide dismutase activity, which may inactivate free radical by-products of AD metabolism known to contribute significantly to the toxicity of this anti-cancer antibiotic. Surgery, 1989 Jan, 105(1), 51 - 6 Large bile duct stones treated by endoscopic biliary drainage; Kiil J et al.; One hundred five patients with obstructive jaundice and cholangitis (49 patients), referred for diagnostic endoscopy, were found to have inextractable bile duct stones . Median age was 76 years and three quarters were more than 72 years of age . Insertion of an endoprosthesis with or without a sphincterotomy relieved jaundice in 94% and settled cholangitis in 90% . Antibiotic cover during the procedure seems essential inasmuch as pyrexia and septicemia occurred in 6 of 57 cases where it was not given . One case was lethal . Another patient died of acute pancreatitis . The patients were old . One quarter died before the follow-up, 1 to 5 years after the initial intervention . The results indicate that the combination of endoscopic sphincterotomy, insertion of an endoprosthesis, and, if feasible, stone extraction on a later occasion when the acute phase of the illness had subsided brought the disease sufficiently under control among three quarters of the patients with large common duct stones or stenoses in the biliary tract . One quarter of the patients were treated surgically . This was accomplished without mortality, but morbidity was not negligible . A policy with a surgical approach restricted to selected cases with persistent symptoms in spite of sufficient endoscopic drainage is recommended. Plast Reconstr Surg, 1989 Jan, 83(1), 85 - 9, 97-9 Salvage of jeopardized total-knee prosthesis: the role of the gastrocnemius muscle flap; Greenberg B et al.; Total-knee arthroplasty has provided many patients with excellent long-term functional results . However, exposure of a total-knee replacement usually eventuates in failure . The relatively superficial location of the prosthesis, the need for early active motion, previous surgical incisions, and a variety of systemic factors may militate against early wound healing . Restoration of well-vascularized soft-tissue cover can salvage an otherwise disastrous situation . The authors recommend early operative intervention upon observation of wound breakdown, devitalized skin edges, or significant subcutaneous infection leading to necrotic overlying skin . The operative procedure found to salvage the majority of prostheses consists of adequate debridement, antibiotic irrigation (of the joint, if exposed), and coverage with a well-vascularized muscle flap, preferably the medial gastrocnemius muscle . The operative technique and ultimate long-term outcome are reviewed based on experience with 10 consecutive patients presenting with a jeopardized knee prosthesis . Follow-up ranged from 1 to 6 years . Representative case histories are presented. Acta Pol Pharm, 1989, 46(1), 70 - 3 {Studies on the pharmaceutical availability of chlortetracycline hydrochloride in selected ointment bases}; Gadomska-Nowak M et al.; Influence of non-ionic tensides on liberation of chlorotetracycline hydrochloride from ointment bases was investigated . Non-ionic tensides were found to enhance liberation of chlorotetracycline hydrochloride from lipophilic ointment bases, while liberation of this antibiotic from hydrophilic ointment bases proved to be depressed. Rev Stomatol Chir Maxillofac, 1989, 90(6), 428 - 37 {Gangrenous cervicofacial cellulitis of dental origin . Apropos of 11 cases}; Romain P et al.; The authors study the gangrenous cellulitis epidemiology, about 11 cases in a series of 118 odontogenic cellulitis . They insist on the frequency of the gangrenous development in old patients, and the importance of an early adapted antibiotic therapy for the vital and functional prognosis . A large surgery procedure is also necessary . At last, the ulterior treatment is depending all the more on the general signs evolution, as the local aspect. J Med, 1989, 20(3-4), 241 - 50 Primary culture of marrow core in collagen gels: modulation and transformation of endosteal cells . I . Morphologic observations; Islam A et al.; It has been shown that collagen gels can be used as a culture matrix for the growth and proliferation of a variety of stromal and hemopoietic cellular elements . Since collagen is a physiologic matrix and allows the simultaneous growth and proliferation of a variety of cellular elements in three dimensional fashion, we used this method to culture 2 to 3 mm segments of trephined bone marrow . The gels were constantly bathed by RPMI 1640 medium containing fetal calf serum and antibiotic . Modulation, migration and transformation of endosteal cells were apparent under phase contrast microscopy and were confirmed in histologic sections . This study demonstrates for the first time that human marrow endosteal cells - the cells which line the bony trabeculae - are inducible and capable of modulation and transformation into stromal (fibroblast-like, macrophage-like, and fat-containing cells) and hemopoietic (round or spheroidal blast-like) cells . This report provides further evidence that endosteal cells can be considered the fixed (reserve) totipotential stem cells in the human bone marrow and are the equivalent of embryonal level undifferentiated mesenchymal cells which are capable of giving rise to the many different cell types that constitute the hemopoietic organ, i.e., bone marrow. J Gynecol Obstet Biol Reprod (Paris), 1989, 18(5), 627 - 34 {Isolation of Chlamydia trachomatis from the endometrium and endometritis . Apropos of a series of 42 patients}; Zorn B et al.; Most studies have been concerned with recovering Chlamydia trachomatis (CT) from the endocervix on the one hand and from the adnexae on the other hand and consider its relationship to infection of the upper genital tract . Our work is concerned with the endometrium . 42 women were examined: 22 of them had salpingitis (group I), 14 were considered possibly to have endometritis with a risk of infection with CT, or had cervicitis (group II), and 6 were in the control group (group III) . Samples were taken from the endometrium that had been removed for histological examination and for searching for CT in cultures . These samples were taken routinely at the initial examination and then again 10 and/or 40 days later for women in groups I and II . These latter were all treated systemically with cyclines . A high incidence of endometrial infection with CT was found (17%) . The recovery of CT from the endometrium was correlated with the presence of an intra-uterine device, with purulent discharge, with evidence of CT in the cervix, and with anti-chlamydia serology higher than or equal to 1/128 . CT infection of the endometrium gave late lesions of endometritis which persisted in spite of the antibiotic therapy that had been given. Infection, 1989, 17 Suppl 1, S25 - 6 {Enoxacin concentration in bone tissue}; Adam D et al.; For successful treatment of bacterial osteomyelitis the administered antibiotic must reach sufficiently high concentrations in bone tissues . Therefore concentrations of enoxacin in bone in ten patients requiring hip surgery were measured . To prevent a postoperative infection, 400 mg enoxacin b.i.d . for two days were administered . On an average 120 (90-210) min after the final dose samples of venous blood and bone tissue were taken . The bone pieces were divided into corticalis and spongiosa . Using a bio-assay-method the following concentrations were found: (mean +/- S.D.): serum 2.88 ( +/- 0.90) mg/l, corticalis 5.90 ( +/- 0.79) mg/kg, spongiosa 3.95 ( +/- 1.01) mg/kg . Thus enoxacin reaches higher levels in bone tissue than in serum. Biomed Biochim Acta, 1989, 48(7), 377 - 86 Complementarity of infrared linear dichroism and X-ray diffraction analysis as demonstrated by the study of a DNA-drug complex; Pohle W et al.; Infrared linear dichroism and X-ray diffraction analysis on oriented films and fibres, respectively, were used simultaneously to elucidate structural characteristics of a DNA-drug complex (the drug was the anticancer antibiotic violamycin BI, an anthracycline derivative) . First, the parameters accessible by the two methods are briefly explained; then, attempts to inter-correlate the data from both lines of investigations are made, which demonstrate that they support and supplement each other favourably concerning several structural aspects . This holds, in particular, for results regarding the conformational flexibility of DNA in complexes and the relative amounts of intercalated and outside-bound drug molecules . Thus, the study represents an example for a successful combined application of two physical methods to one biochemical problem. Zentralbl Chir, 1989, 114(16), 1072 - 80 {The subphrenic abscess . Surgical and/or percutaneous drainage}; Humann B et al.; The results indicate that the low risk percutaneous drainage of subphrenic abscesses is only feasible in carefully selected patients . The surgical intervention remains the method of choice for the drainage of subphrenic abscesses in conditions such as multiple and complicated abscesses, unfavourable access to the abscess cavities or other pathological conditions . An early and decisive diagnosis is crucial for effective treatment of subphrenic abscesses either by percutaneous drainage or surgical intervention and antibiotic therapy. Eur Biophys J, 1989, 17(3), 151 - 8 Interaction of filipin with dimyristoylphosphatidylcholine membranes studied by 2H-NMR, circular dichroism, electronic absorption and fluorescence; Milhaud J et al.; Interaction of the pentene antibiotic filipin with dimyristoylphosphatidylcholine (DMPC) membranes has been monitored by 2H-NMR, circular dichroism (CD), electronic absorption and fluorescence in the temperature range 10 degrees to 60 degrees C . Interaction appears to depend on whether filipin is added before or after membrane formation and also upon the temperature of the system . When filipin is added to preformed DMPC large unilamellar vesicles (LUV), the association constants, as determined by electronic absorption are 39 x 10(3) M-1, 15 x 10(3) M-1 and 0.6 x 10(3) M-1 at 15 degrees, 30 degrees and 50 degrees C, respectively . Under identical conditions, CD spectra of bound filipin exhibit features characteristic of an aggregation over the whole temperature range . When filipin is incorporated in membranes during their preparation, the 2H-NMR spectra of deuterated DMPC indicate that the drug has a slight disordering effect on the lipid matrix below the temperature, Tc, of the gel-to-fluid phase transition and above Tc + 11 degrees C . Between these two temperature boundaries the system consists of two lipid regions of very different dynamic properties . One of the regions, which is attributed to a filipin-lipid complex, has the properties of gel-like lipids whereas the other has those of fluid-like lipids . The latter domain is however more ordered than the pure lipid at corresponding temperatures.(ABSTRACT TRUNCATED AT 250 WORDS) Chemotherapy, 1989, 35(5), 330 - 2 Pharmacokinetics of miocamycin in patients with liver cirrhosis; Miglioli PA et al.; The pharmacokinetics of miocamycin, a new macrolide antibiotic, was studied in 6 healthy controls and 6 patients with compensated liver cirrhosis . The results indicate that in chronic liver disease the kinetics of the drug is altered . Therefore, a dosage adjustment of miocamycin is recommended when dealing with these patients. Eur J Clin Pharmacol, 1989, 36(5), 521 - 4 The excretion of ketorolac tromethamine into breast milk after multiple oral dosing; Wischnik A et al.; We have studied the transfer of the analgesic ketorolac tromethamine into breast milk in ten women aged between 22 and 35 years . Ketorolac administration was started between 2 and 6 days after delivery . The breast milk was not fed to the infant because of maternal antibiotic use (6 patients) or because of jaundice of the baby . 10 mg of ketorolac was given four times daily for two days . Plasma and milk samples were collected on the two dosing days and on the first day after dosing . The plasma and milk were assayed for ketorolac concentrations by HPLC: the quantification limits were 10 ng.ml-1 and 5 ng.ml-1 respectively . The maternal plasma concentrations were within established ranges for ketorolac . In four patients the concentration of ketorolac in the milk was never above 5 ng.ml-1 . At 2 h after dosing on both Days 1 and 2 there were quantifiable concentrations of ketorolac in the milk . The range was 5.2 ng.ml-1 to 7.9 ng.ml-1 . The ratio of breast milk: plasma concentrations of ketorolac ranged from 0.015 to 0.037 . The maximum potential amount of ketorolac that an infant may be exposed to daily could range from 3.16 mg to 7.9 mg, assuming a consumption of between 400 ml and 1 l of breast milk . On a weight-adjusted basis this is equivalent to between 0.16% and 0.40% of the total daily maternal dose. Ophthalmology, 1989 Jan, 96(1), 62 - 7 The treatment of postoperative endophthalmitis . Results of differing approaches to treatment; Stern GA et al.; The authors treated 26 patients with postoperative endophthalmitis over a 4-year period, between 1983 and 1986 . Nineteen patients were culture-positive and seven were culture-negative . All patients received intravitreal antibiotics as part of their treatment regimen . Culture-negative patients generally responded well to a single intravitreal antibiotic injection . Five of seven (71.4%) culture-positive patients who were treated with a single intravitreal antibiotic injection and no vitrectomy suffered either a recurrence of their infection or did not respond to treatment . Four of five patients who received a vitrectomy in addition to a single intravitreal antibiotic injection were cured of their infections; the one patient who received repeated intravitreal antibiotic injections alone and all six patients who received repeated intravitreal antibiotic injections in combination with vitrectomy were cured of their infections . Although the intravitreal injection of antibiotics provides an extremely high initial level of antibiotics inside the eye, a single intravitreal antibiotic injection may only partially treat bacterial endophthalmitis . In culture-negative cases, a single intravitreal injection of antibiotics appears to be sufficient treatment . In culture-positive cases, a higher cure rate is achieved with an aggressive approach which includes the use of repeated intravitreal antibiotic injections and/or vitrectomy. Virology, 1989 Jan, 168(1), 31 - 9 Retroviral-mediated transfer and expression of hepatitis B e antigen in human primary skin fibroblasts and Epstein-Barr virus-transformed B lymphocytes; Raney AK et al.; Previously, an amphotropic retroviral expression system coding for the neomycin resistance gene was developed and used to synthesize hepatitis B e antigen (HBeAg) and hepatitis B core/e antigen (HBc/eAg) in transfected mouse NIH 3T3 fibroblasts (A . McLachlan et al., 1987, J . Virol . 61, 683-692) . In the present study, these transfected cell lines were infected with a helper amphotropic murine leukemia virus resulting in the production of infectious recombinant retrovirus . The recombinant retrovirus was examined for its capacity to transmit resistance to the antibiotic, G418, and to express hepatitis B virus antigens in mouse NIH 3T3 fibroblasts, human primary skin fibroblasts, and Epstein-Barr virus (EBV)-transformed B lymphocytes . A mouse NIH 3T3 fibroblast clone was generated which produced recombinant retrovirus with the capacity to transmit HBeAg expression to these murine and human cell lines . In contrast, it was not possible to transmit HBc/eAg synthesis efficiently to these cell lines by recombinant retroviral infection . The difference between the efficiencies of transmission of HBeAg and HBc/eAg expression by recombinant retroviral-mediated infection was not predicted as the expression vector coding for HBc/eAg synthesis differs only by the deletion of approximately 90 nucleotides of HBV DNA sequence from the vector coding for HBeAg synthesis. Arch Orthop Trauma Surg, 1989, 108(5), 308 - 13 Flucloxacillin compared with cefazolin in short-term prophylaxis for clean orthopedic surgery; Van Meirhaeghe J et al.; Two-hundred and fifty-two patients were included in a prospective, randomized, double-blind trial comparing the efficacy of flucloxacillin with that of cefazolin for clean orthopedic surgery . The preventive antibiotic regimen consisted of three 1-g injections perioperatively . There were 126 patients in each group, and the follow-up period was at least 6 months . Two deep (1.6%) and five superficial (4.0%) infections occurred in the flucloxacillin group . Three deep (2.4%) and five superficial (4.0%) infections developed in the cefazolin group. Gynecol Obstet Invest, 1989, 28(1), 19 - 22 Use of cefuroxime in preventing postcesarean infection in high-risk patients; Moberg PJ et al.; Prophylactic antibiotic therapy is accepted for prevention of postceasarean infection in certain risk groups . Of the antibiotic regimens presented none appears superior . Patients having a cesarean section (CS) more than 6 h after membrane rupture were given three doses of cefuroxime (1.5 g every 8th hour) in a prospective study . This prophylaxis was as efficacious as a 7-day treatment with cefuroxime and cefadroxil . The infection rate was 21% which should be compared to approximately 50% when no prophylaxis was given . Patients with membrane rupture of less than 6 h and having a most urgent CS received the same 24-hour prophylaxis . No postoperative infection was recorded . Women having a CS with an ongoing uterine infection were treated with cefuroxime alone or combined with metronidazole . All but one (91%) had an uneventful recovery. Life Sci, 1989, 44(19), 1351 - 62 Antihypertensive compounds with potent protein kinases inhibitory activity; Hachisu M et al.; A new indorocarbazole antibiotic SF2370 has been found in the culture broth of Actinomadura sp.; it has also been found to have the activities of antihypertension and diuresis . Derivatives of SF2370, NA0344, NA0345 and NA0346, when injected (0.1-1 mg/kg i.v.) significantly lowered the blood pressure of anesthetized normotensive rats and showed a long lasting antihypertensive action . In the case of p.o . administration to conscious restrained SHRs, measurement of blood pressure by the plethysmographic method indicated that 10 mg/kg of the compounds was enough to lower the blood pressure; the antihypertensive activities were found to remain more than 12 hrs after oral administration . By studying of the mode of antihypertensive action, these compounds dose dependently relaxed the isolated aortic preparation contracted by norepinephrine . In addition, it was found that protein kinase C activity of mice brain was inhibited by the compounds; the IC50 values were in the range of 0.062-0.20 microM . Moreover, a superprecipitation of actomyosin from smooth muscle of chicken gizzard was inhibited by the compounds, having an IC50 values of 0.31-0.72 microM. Zentralbl Chir, 1989, 114(11), 730 - 9 {A simple point score for definition of the risk of postoperative complications}; Grundmann R et al.; During a 5-year-period we recorded prospectively 5,823 patients who had undergone general surgery and documented the postoperative complications as wound infection, pneumonia, reoperations and death . A score including all these complications was developed to evaluate the risk of an operation more exactly than using the wound infection rate alone . This method seems to provide a continuous monitoring and the comparison of the complication risks of certain operations within a quality assurance program . For gastric and colon surgery we found a correlation between postoperative antibiotic use and score, but not between score and postoperative hospitalization time. Pathology, 1989 Jan, 21(1), 5 - 10 Differences between heart valve allografts and xenografts in the incidence and initiation of dystrophic calcification; Maxwell L et al.; Following surgical removal because of primary tissue failure, 30 antibiotic-sterilized human aortic valve allografts and 27 glutaraldehyde-treated porcine aortic valve xenografts were examined for macroscopic and microscopic evidence of dystrophic calcification . These grafts had been mounted on stents and used for from 34 to 166 months to replace diseased mitral valves . After explantation the grafts were carefully examined then prepared for light microscopy, for transmission electron microscopy and for energy dispersive X-ray microanalysis . Gross calcification occurred significantly (p = 0.002) more frequently in xenografts (89%), and was more extensive than in allografts (53%) . Calcification usually appeared as nodular excrescences on the cusps, although occasionally it formed plates within them . This reduced tissue pliability and was usually associated with either valvular stenosis or regurgitation . The calcified deposits contained calcium and phosphate in ratios approaching those of hydroxyapatite . In xenograft valves the smallest discrete deposits of calcification were spherical and usually associated with membranous debris of porcine donor fibroblasts, but allografts did not contain donor cell remnants and early calcification was linearly arranged along collagen fibres. Endocr Res, 1989, 15(1-2), 101 - 15 Steroidogenesis activator polypeptide may be a product of glucose regulated protein 78 (GRP78); Mertz LM et al.; Cholesterol side-chain cleavage is sensitive to antibiotic inhibitors of protein synthesis, suggesting that a labile protein may play a regulatory role in this process . We have previously characterized such a factor--steroidogenesis activator polypeptide (SAP) . Given the low molecular weight of SAP (Mr 3215), a SAP precursor has been sought . Using immunoblotting techniques with two polyclonal antisera directed against portions of the SAP sequence, a single protein of apparent Mr 82,000 (p82) can be detected in rat adrenocortical tissue . Our data suggest that adrenal p82 is most likely the widely-distributed minor heat shock protein, glucose regulated protein 78 (GRP78) . The two proteins share biochemical attributes, including pI (5.2) and ATP affinity, and the reported amino acid sequences for SAP and for the carboxyl-terminal end of GRP78 are nearly identical . We propose that SAP is cleaved from GRP78--or a cognate protein--and that this proteolysis is regulated in a manner characteristic of steroidogenic tissues. Eksp Onkol, 1989, 11(4), 74 - 6 {Pharmacokinetic validation of the antitumor efficacy of aclarubicin administered by various routes in CBF1 mice with Ca 755 carcinoma}; Viadro MM et al.; Aclarubicin was established to be more active against murine mammary gland carcinoma Ca 755 after its intravenous injection as compared to oral administration . Pharmacokinetics of aclarubicin and its biologically active metabolites MA 144 N1, MA 144 T1 and MA 144 M1 was studied by HPLC in the tumour tissues . Not only quantitative but also qualitative differences in the ratios of the unchanged antibiotic and its metabolites in tumour Ca 755 were detected after aclarubicin administration by these methods . Diverse therapeutic activity was shown to be due to these differences. Ann Chir, 1989, 43(5), 363 - 6 {Splenectomy in chronic idiopathic thrombopenic purpura in adults . Apropos of 49 cases}; Melki J et al.; The authors reviewed the case files of 49 adult patients undergoing splenectomy for chronic idiopathic thrombocytopenic purpura at the Centre Henri Becquerel between 1970 and 1987 . Although the postoperative course was straightforward in 83.7% of cases, one reoperation for subphrenic abscess was necessary and there was one postoperative death . Remission from thrombocytopenia was obtained in 87.5% of the patients, but only transiently in 8.5% of them . No preoperative predictive factors could be demonstrated . An early postoperative rise in the platelet count to more than 500 G/litre appears to ensure a good subsequent result . Secondary infectious complications are not exceptional and can be fatal (one death in our series); they require prophylaxis by anti-pneumococcal vaccination . The place of prophylactic antibiotic therapy has yet to be defined. Ann Chir, 1989, 43(5), 343 - 7 {Perforation of the cervical esophagus and hypopharynx complicating surgery by an anterior approach to the cervical spine}; Roche M et al.; Difficult diagnostic and therapeutic problems are raised by perforations of the cervical oesophagus or hypopharynx in patients undergoing surgery to the cervical spine via an anterior approach . Based on their experience of three recent cases, the authors review the diagnostic approach, based on clinical examination and diatrizoate sodium oesophageal series, and propose conservative treatment consisting of surgical drainage with or without suture of the perforation and without removal of the osteosynthesis material, appropriate antibiotic therapy and hypercaloric enteral nutrition via nasogastric tube . The prevention of this complication is based on correct use of surgical retractors. J Ocul Pharmacol, 1989 Summer, 5(2), 119 - 25 Influence of ophthalmic ointments on the penetration of pilocarpine drops; Ellis PP et al.; To evaluate the influence of prior administered ointments upon the intraocular penetration of drops, we applied either a combination antibiotic ointment, a combination antibiotic-steroid ointment, or a lubricant ointment at different time periods before instillation of 2% pilocarpine drops into rabbit eyes . The level of pilocarpine measured in aqueous humor at one hour was compared to the level achieved in eyes without ointment application . No change was found in pilocarpine levels following application of the lubricant ointment . Pilocarpine concentrations were significantly lower (38%-48%) in animals receiving the antibiotic ointment at 5 or 15 minutes before pilocarpine drops . Pilocarpine levels also were decreased significantly when the steroid-antibiotic ointment was applied 15, 30 or 60 minutes before the drops . To verify these effects at other time periods, ointments were applied 15 minutes before pilocarpine drops and aqueous humor samples aspirated at 30 minutes or two hours . A 22% decrease in aqueous humor pilocarpine was found at 30 minutes with both the antibiotic and steroid-antibiotic combination; no effect was observed at two hours . To determine the influence of each drug component within the ointment on the penetration of pilocarpine, solutions of dexamethasone, neomycin, bacitracin and polymyxin B were mixed individually with pilocarpine drops and applied into the animal eyes . Bacitracin and polymyxin B significantly reduced one-hour pilocarpine levels in aqueous humor; however, no significant effect was observed with either neomycin or dexamethasone. Scand J Thorac Cardiovasc Surg, 1989, 23(2), 181 - 4 Thoracic actinomycosis; Jensen BM et al.; Nine cases of thoracic actinomycosis treated in the period 1966-1987 are reported . Three of the patients presented with a clinical picture of empyema and six were admitted for suspected primary pulmonary neoplasm . No case was correctly diagnosed preoperatively . The final diagnosis was based on direct microscopy (2) or culture (1) of drained pus in the empyema cases and on histologic examination of resected tissue in the others . In one case the correct diagnosis was missed when a palpable tumour mass was not extirpated at exploratory thoracotomy, and was made only when clinical deterioration necessitated a second operation . Good clinical results can be expected from surgical eradication of an intrathoracic focus of actinomycosis in conjunction with appropriate antibiotic therapy. Biomed Sci Instrum, 1989, 25, 251 - 9 Data acquisition and processing system for drug release characterization by thin layer chromatography; Ryoo JP et al.; Samples of an antibiotic released from an ocular insert in an in vitro test are characterized by thin layer chromatography (TLC) . Conventional characterization methods include cutting and weighing strip chart paper peak profiles obtained with a scanning densitometer for spotted TLC plates, and relating peaks for unknowns to peaks for standards on the basis of relative weights . A data collection and processing system is described in which the data collection and processing is highly automated utilizing a specially developed software program . A Kontes densitometer (Model 800) and a personal computer (IBM PC-AT or Zenith-248) are interfaced using a Keithley 570 data acquisition system . Two BASIC software programs were developed to provide quantitative evaluation of chromatograms of an antibiotic (tylosin tartrate); the first program generates chromatograms on the computer screen through initiating controlled operation of a scanning densitometer for TLC plate analysis, and the second program processes the data providing quantitative analysis of the spectral output through a peak detection and peak integration routine . The approach represents a new general, versatile, quick and effective method to characterize TLC samples for various numbers of peaks for unknowns and standards for different concentration levels. Biomed Pharmacother, 1989, 43(1), 37 - 41 Ursodeoxycholic acid therapy in the treatment of biliary atresia; Nittono H et al.; The prognosis of operated biliary atresia in the cases with bile excretion chiefly depends upon the prevention of ascending cholangitis . An antibiotic is therefore intravenously administered during the early postoperative phase, but cannot be used over a long period . In the cases showing satisfactory bile excretion after operation, ascending cholangitis is rare because of rapid disappearance of jaundice . Regarding this, the authors prescribed ursodeoxycholic acid (UDCA) at 10-15 mg/kg/day to 6 infants with biliary atresia