Biochimie, 1987 Feb, 69(2), 131 - 6 Does streptomycin cause an error catastrophe? Fast R, Eberhard TH, Ruusala T, Kurland CG. We have examined the interpretation that streptomycin kills a bacterial culture by initiating the so-called error catastrophe . In particular, we asked whether the increased translational error rate induced by the antibiotic gives rise to an autocatalytic loss of functional fidelity of the devices responsible for gene expression, which ultimately causes the death of the culture . We have analyzed the performance characteristics of one of these devices, namely the ribosome in streptomycin-treated bacteria . We find that, although the treated ribosomes are constructed from error-containing proteins, they are not significantly different in elongation rate and fidelity from those ribosomes taken from untreated bacteria . We conclude that the bacteriocidal effect of streptomycin is not due to the initiation of an error catastrophe. Ann Surg, 1987 Feb, 205(2), 111 - 8 Proximal bile duct cancer . Quality of survival; Lai EC et al.; A retrospective study of 97 patients with proximal bile duct cancer treated at the University of California, Los Angeles Medical Center was conducted to determine the benefits of different operative treatments . Eighty-nine patients were divided into three treatment groups: Group I, curative resection (29 patients); Group II, palliative resection (13 patients) and bypasses (8 patients); and Group III, operative intubation (39 patients) . Two patients died before operation and six patients were treated without operation by percutaneous biliary decompression . High morbidity rate (53.8%) and mortality rate (69.2%) were encountered in 13 patients who had hepatic resection . Survival rates of the three treatment groups were comparable . For the 64 patients closely monitored after discharge, quality of survival was assessed according to six parameters: frequency of hospitalization for cholangitis; catheter-related problems; the percentage of days hospitalized; duration of jaundice; antibiotic requirements; and analgesic needs . Group I patients had the best qualitative survival, whereas Group II patients had the worst result when compared with either Group I (p less than 0.001) or Group III (p less than 0.005) . Curative resection is recommended when it can be done without a concomitant hepatic resection . When noncurable disease is found on examination, operative intubation after dilatation is the preferred palliative measure. Biochemistry, 1987 Jan 27, 26(2), 438 - 45 Biosynthesis of lasalocid A: biochemical mechanism for assembly of the carbon framework; Sherman MM et al.; Labeling experiments on the biosynthesis of the polyether antibiotic lasalocid A (1) using carboxylic acid precursors bearing 13C, 2H, and 3H labels at various positions established the following: (1) 2H or 3H at C-2 of propionate or 2H at C-2 of butyrate was partially retained at C-12 and C-14 of 1, respectively . (2) 2H at C-2 of propionate or at C-2 and C-3 of succinate did not label C-10 . These and earlier data {Hutchinson, C . R., Sherman, M . M., Vederas, J . C., & Nakashima, T . T . (1981) J . Am . Chem . Soc . 103, 5953; Hutchinson, C . R., Sherman, M . M., McInnes, A . G., Walter, J . A., & Vederas, J . C . (1981) J . Am . Chem . Soc . 103, 5956} are consistent with a hypothesis for the stereochemical control of lasalocid A biosynthesis, whose main tenets are that the configuration of C-12 and C-14 is determined by the stereoselectivity of the carbon chain forming condensation between acyl thio ester and 2-carboxyacyl thio ester intermediates and that the configuration of C-11 and C-15 results from the reduction of 2-keto thio ester intermediates with opposing stereospecificities. Science, 1987 Jan 16, 235(4786), 350 - 2 Epithelial wound healing enhanced by transforming growth factor-alpha and vaccinia growth factor; Schultz GS et al.; Epidermal regeneration following middermal injuries to skin requires both proliferation and migration of keratinocytes . Epidermal growth factor (EGF) stimulates the proliferation of keratinocytes in culture, and topical administration of EGF accelerates epidermal regeneration of partial thickness burns or split-thickness incisions in vivo . Transforming growth factor-alpha (TGF-alpha) and vaccinia growth factor (VGF) have substantial sequence homology with EGF, and all appear to bind to the same receptor protein . Whether TGF-alpha or VGF can affect epidermal wound healing in vivo is not known . The present studies show that topical administration of TGF-alpha or VGF in antibiotic cream to partial thickness burns (second degree) accelerated epidermal regeneration in comparison with untreated or vehicle-treated burns . Low levels of both TGF-alpha and VGF (0.1 microgram per milliliter) appeared to be more effective than EGF in stimulating epidermal regeneration . Regenerated epithelium from burns treated with TGF-alpha or VGF appeared normal histologically . This finding suggests that topical application of selected growth factors may be useful in accelerating healing of partial thickness injuries. Cancer, 1987 Jan 15, 59(2), 259 - 65 Concurrent radiotherapy and chemotherapy with cisplatin in inoperable squamous cell carcinoma of the head and neck . An RTOG Study; Al-Sarraf M et al.; In patients who have locally advanced and inoperable head and neck cancer, the achievement of initial local control (complete response) of the disease with initial definitive treatment with radiotherapy (RT) with or without chemotherapy, is an important prognostic factor for overall survival . Cisplatin 100 mg/M2-intravenously (IV) with hydration and mannitol diuresis was given every 3 weeks for three doses concurrently with definitive radiotherapy (followed by salvage surgery {if possible} for persistent disease) was activated by the Radiation Therapy Oncology Group (RTOG) in 1981 . One hundred thirty-four patients were initially registered and 124 were eligible and analyzed for this report . Eighty-two percent of the patients had Stage IV disease and greater than 50% of the primary sites were in oropharynx (39%), nasopharynx (22%), and oral cavity (18%) . Eighty-seven percent of the patients are known to have finished the planned RT greater than 6450 cGy and 60% received three courses of cisplatin . Overall, 60% finished the planned combined treatment . Complete response to initial treatment occurred in 69% and an additional one patient (1%) was rendered disease-free after radical node dissection . Severe toxicities were as follows: leukopenia, 11%; anemia, 8%; nausea and vomiting, 6%; stomatitis, 31%; and renal, 6% . One toxic death occurred when a nephrotoxic antibiotic was administered at the same time . All patients were evaluated for total disease and survival regardless of compliance to the treatment or the cause of death . At 1 year, an estimated 51% of the patients had their disease totally controlled and an estimated 66% were alive . Incidence of initial complete response by various patient characteristics also were analyzed . The authors concluded that the combination of cisplatin and radiotherapy is an effective and safe treatment in patients with advanced head and neck cancer and needs to be tested against radiotherapy alone. Hosp Formul, 1987 Feb, 22(2), 182 - 6 Altering aminoglycoside selection in a community hospital; Mioduch HJ et al.; The aminoglycoside antibiotics make up a large part of the pharmacy budget . A method developed by the pharmacy department in conjunction with the P & T Committee for implementing usage guidelines at a community hospital is presented . The program was designed to promote cost-effective therapy while maintaining safety and efficacy . After the program was implemented, both aminoglycoside use and expenditures were altered . The data indicate that by incorporating current medical information into an institution-specific program, it is possible to bring about a decrease in the cost of antibiotic therapy . This study suggests that interventions may be effective in community hospitals as well as in large teaching institutions. Klin Wochenschr, 1987 Jan 5, 65(1), 40 - 7 {Amphotericin B and flucytosine therapy of Aspergillus pneumonia and acute renal failure}; Staib F et al.; Kidney failure and pneumonia by Aspergillus flavus and A . fumigatus were found in a 56-year-old woman who had received antibiotic and corticoid treatment to control high fever . Her bloody tracheal secretion was a suspension of granule-like spore-free colonies of both Aspergillus species . Hemorrhages in mucous membranes and skin suggested a hematogenous dissemination of the fungi . Aspergillus spores in the soil of ornamental plants were assumed to be responsible for the inhalatory infection . The kidney function normalized rapidly under treatment by amphotericin B plus flucytosine and hemodialysis performed eight times . After 29 days of antimycotic treatment (amphotericin B 463 mg, flucytosine 150 g), besides normalization of the kidney function, healing of the pneumonia and bleeding from skin and mucal membranes took place . One and a half years later kidney function and blood parameters were found to be normal . In cases of Aspergillus pneumonia and kidney failure, a combined treatment by hemodialysis and amphotericin B plus flucytosine is recommended . In addition, there is discussion of the general importance of uremia and its influence on the mycotic infection. No To Shinkei, 1987 Jan, 39(1), 65 - 70 {Intracranial hemorrhage in infancy due to vitamin K deficiency: report of a case with multiple intracerebral hematomas with ring-like high density figures}; Nishio T et al.; It is well known that vitamin K deficiency is an important cause of the spontaneous intracranial hemorrhage in infancy . A 60-day-old male infant with spontaneous intracerebral hematomas due to vitamin K deficiency was presented . He was breast-fed . He had been medicated oral antibiotic agent for diarrhea and fever . Three days later he developed petechien, vomiting and twitching, and became drowsy . The blood studies showed anemia, and advance of ESR . He was administered of vitamin K immediately . CT scan was showed four intracerebral hematomas with niveau, which were surrounded by high-density rings . The ring-like figures were unique for this case . The reason may be next, we think . Under the states in which blood can separate easily with advance of ESR, blood clot would adhere to the wall of the hematomas . So these hematomas showed ring-like figures and had niveau in them . CT scan of this case was also interesting because there was little deviation in spite of the big hematomas . The reason of this may be that the brain of infancy is incomplete in myelination and contains much water, and that the possibility of bleeding due to vitamin K occurs slowly . We examined 84 cases of intracranial hemorrhage due to vitamin K deficiency from literatures, and they were all identified for the hemorrhage sites by CT scan . Subarachnoidal hemorrhage was in 72 cases (85.7%), subdural hemorrhage was in 41 cases (48.8%), intracerebral hematomas was in 36 cases (42.9%) and intraventricular hemorrhage was in 9 cases (10.7%) . In 52 cases the CT findings were described.(ABSTRACT TRUNCATED AT 250 WORDS) Acta Anat (Basel), 1987, 128(1), 76 - 9 Increase in cholesterol in the apical plasma membrane of uterine epithelial cells during early pregnancy in the rat; Murphy CR et al.; Freeze-fracture cytochemistry with the cholesterol-binding antibiotic filipin has been used to examine the plasma membrane of uterine epithelial cells at different stages of pregnancy in the rat . We find many more filipin-induced lesions on day 6 of pregnancy than on day 1 and suggest that this indicates a higher cholesterol content at this time . Since day 6 of pregnancy is the time at which blastocysts implant in the rat uterus, we consider the possible significance of an increased cholesterol content for implantation. Rev Infect Dis, 1987 Jan-Feb, 9(1), 88 - 96 Esophagitis in the immunocompromised host: role of esophagoscopy in diagnosis; Wheeler RR et al.; Thirty episodes of presumed infectious esophagitis in immunocompromised patients were investigated by means of esophagoscopy . Indications for esophagoscopy included dysphagia, odynophagia, and retrosternal pain . Factors potentially predisposing patients to esophagitis included previous exposure to radiation, recent cytotoxic chemotherapy, recent antibiotic therapy, corticosteroid therapy, and neutropenia . Sixteen of the 18 barium esophagograms done before esophagoscopy was performed revealed abnormalities; in 14 cases the results were consistent with infectious esophagitis . Abnormalities were noted during 27 of 30 esophagoscopy procedures . Visual findings were consistent with candidal esophagitis in 18 cases, with viral esophagitis in four, and with both in one . Specific infectious diagnoses were established by culture or histology in 17 episodes: 12 of candidal esophagitis, two of herpes simplex esophagitis, two of concomitant candidal and herpetic esophagitis, and one of enteroviral esophagitis . Specific noninfectious diagnoses were made in two episodes, and the esophagus was found to be normal in three . No specific diagnosis was made in eight episodes although visual examination indicated the presence of esophagitis . The only postesophagoscopy complications recorded were isolated episodes of spiking fever in three patients . In this compromised-host population with presumed infectious esophagitis, esophagoscopy resulted in a rapid and specific infectious diagnosis in 57% of episodes. Folia Microbiol (Praha), 1987, 32(1), 1 - 5 Production of quinomycin A in Streptomyces lasaliensis; Steinerova N et al.; In addition to lasalocid, an oligoether coccidiostatic compound, other compounds are synthesized by Streptomyces lasaliensis . Mutants producing either of two antibiotics, lasalocid A or quinomycin A (an antibiotic of quinoxaline character), were obtained by natural selection and by mutagenesis . Methods of isolation, purification and estimation of both compounds were established. J Int Med Res, 1987 Jan-Feb, 15(1), 49 - 56 Rifaximin, a rifamycin derivative for use in the treatment of intestinal bacterial infections in seriously disabled patients; Alvisi V et al.; This study reports the results of an evaluation of the effectiveness and tolerability of rifaximin, an intestinal topical antibiotic . It was administered using a nasogastric tube in patients with severe enterocolitis and bacterial superinfections causing intestinal inflammatory diseases and portosystemic encephalopathy . The drug proved highly effective clinically and produced neither local nor systemic side-effects. Can J Surg, 1987 Jan, 30(1), 42 - 4 The epidural opioid internalized system; Miller BJ et al.; For several years opioids have been given epidurally with success to control chronic intractable pain . The authors report their 2-year experience with internalization of the epidural catheter and injection port in 18 patients at University Hospital, Saskatoon . In all, 21 devices were used . All patients had metastatic cancer; 16 are now dead . The need for other medications was eliminated with 9 and reduced with 12 devices . In the patients who died, the devices were effective for 82% of their remaining life-span . They were able to spend 46% of this time at home . Blockage of the epidural end of the device was the most common mechanical problem, followed by leakage from the port . One patient suffered meningitis after 11 days as a result of subarachnoid placement of the catheter but responded to removal of the device and antibiotic therapy . The authors have been impressed with the excellent pain relief afforded to many of these patients, and their ability to enjoy life free of the sedative effects of other methods of narcotic administration. J Clin Oncol, 1987 Jan, 5(1), 75 - 82 High-dose cytosine arabinoside as the initial treatment of poor-risk patients with acute nonlymphocytic leukemia: a Leukemia Intergroup Study; Preisler HD et al.; Sixty-seven patients with newly diagnosed acute nonlymphocytic leukemia (ANLL) who were considered to be poor candidates for treatment with cytosine arabinoside (ara-C)/anthracycline antibiotic therapy were treated with high-dose ara-C (HDara-C) remission induction therapy . Thirty-four of the 67 patients had a hematologic disorder before developing acute leukemia or had a history of exposure to marrow toxins, 23 patients were greater than 70 years old, and 10 patients had medical problems that were felt to be a contraindication to therapy with an anthracycline antibiotic . Forty-two percent of patients entered complete remission (CR), whereas 22% failed to enter remission because of persistent leukemia . Treatment was associated with substantial toxicity varying from nausea and vomiting to irreversible cerebellar toxicity . Thirty-four percent of patients died during therapy . Poor performance status, a low serum albumin, and a low platelet count were associated with death during remission induction therapy, whereas a high pretherapy leukemic cell mass and a large number of residual leukemic cells in the marrow after six days of therapy were associated with treatment failure due to persistent leukemia. Am J Surg, 1987 Jan, 153(1), 125 - 9 Percutaneous cholecystostomy for acute cholecystitis in high-risk patients; Klimberg S et al.; Seventeen high-risk critically ill patients with suspected cholecystitis underwent percutaneous transhepatic cholecystostomy between 1981 and 1986 using Hawkins' needle guide system for gallbladder intubation . Acute cholecystitis was documented in 15 patients, including 1 with common bile duct obstruction . Two other patients had common bile duct obstruction secondary to metastatic cancer (one patient) and chronic pancreatic fibrosis (one patient) . There was rapid resolution of the signs and symptoms of cholecystitis, sepsis, or both in 16 of the 17 patients . One critically ill patient with positive findings on blood culture and an organism resistant to triple antibiotic therapy died soon after percutaneous cholecystostomy . In the entire group of 17 patients, there was no evidence of bile leaks or other catheter complications . Six patients subsequently underwent successful cholecystectomy and two underwent common bile duct exploration without complications . One patient underwent cholecystojejunostomy, and in three patients, the catheter was removed with no sequelae of cholecystitis . Two remaining patients had the catheter in place and were awaiting operation at last follow-up . Three of four patients who died within 30 days of percutaneous transhepatic cholangiographic cholecystostomy died either from the terminal malignant condition (two patients) or from arrhythmia (one patient with cirrhosis) . This review suggests that percutaneous cholecystostomy is a safe and effective procedure for resolving acute cholecystitis in high-risk patients . In addition, the technique of percutaneous transhepatic cholangiographic cholecystostomy appears well suited for percutaneous dissolution of stones, sclerosis of the gallbladder, or both in selected high-risk critically ill patients. J Vasc Surg, 1987 Jan, 5(1), 160 - 9 The impact of multiple operations on the importance of arterial wall cultures; Durham JR et al.; The present study reviewed arterial culture data from 172 patients undergoing major vascular reconstructions between July 1, 1977, and Dec . 31, 1984 . Prosthetic graft infection was documented in 0 of 97 cases (0%) with negative arterial cultures but in six of 75 cases (8%) with positive arterial cultures (chi 2 = 5.84; 0.01 less than p less than 0.025) . The data were reanalyzed after the patients were subdivided into two groups on the basis of the numbers of operations: group I (132 patients)--a culture obtained at initial vascular reconstruction--and group II (40 patients)--a culture obtained at a subsequent vascular reconstruction . Positive arterial cultures had no predictive value for graft infection among patients in group I (1 of 57 cases vs . 0 of 75 cases; chi 2 = 0.019), whereas the presence of positive arterial cultures was associated with a significant increase in the incidence of graft infection in group II patients (5 of 18 cases vs . 0 of 22 cases; chi 2 = 4.68; 0.025 less than p less than 0.05) . For group I patients, we believe that neither routine arterial culture nor long-term antibiotic therapy for patients with positive arterial cultures is indicated . For group II patients we recommend that routine arterial cultures should be obtained; perioperative antibiotics should be continued until definitive arterial culture information is available; and positive arterial cultures should be treated with a short course of high-dose intravenous antibiotics . Thereafter, long-term treatment of positive arterial cultures with oral antibiotics, although not statistically validated, is probably appropriate. J Fam Pract, 1987 Jan, 24(1), 35 - 8 An association between acute bronchitis and asthma; Williamson HA Jr et al.; The relationship between the common acute bronchitis syndrome and atopic disease was examined using a retrospective, case-control method . The charts of 116 acute bronchitis patients and of a control group of 60 patients with irritable colon syndrome were reviewed for evidence of previous and subsequent atopic disease or asthma . Bronchitis patients were more likely to have a previous history of asthma, a personal history or diagnosis of atopic disease, and more previous and subsequent visits for acute bronchitis . The main finding of the study was a tenfold increase in the subsequent visit rate for asthma in the acute bronchitis group . Thirty percent of patients with acute bronchitis made return visits for unresolved cough despite an 83 percent rate of antibiotic use . These findings challenge the common belief that the symptoms of acute bronchitis are solely infectious in origin and suggest the involvement of occult bronchospasm. Infection, 1987, 15(5), 378 - 80 Clinical course of an exacerbated pulmonary infection in a girl with cystic fibrosis (CF); Dockter G; The treatment of severe pulmonary infection in young CF-adults depends on age, clinical course, bacterial colonization of the lung, susceptibility pattern and state of nutrition . Besides specific antibiotic therapy, enzyme replacement and physiotherapy, high caloric nutrition, continuous oxygen insufflation and early mobilisation are the main tools in the treatment of an exacerbated pulmonary infection with respiratory insufficiency. Clin Neurol Neurosurg, 1987, 89(4), 269 - 70 Rapidly growing head circumference as an isolated presenting symptom of brain abscesses in an infant; Lahat E et al.; A rapid and excessive enlargement in occipito frontal circumference (OFC) as the only manifestation of multiple cerebral abscesses in infancy is extremely rare . A 2-month-old asymptomatic infant presenting with increasing OFC is described . Surgical drainage of the cerebral abscesses followed by prolonged antibiotic therapy resulted in complete recovery. Ann Chir Gynaecol, 1987, 76(3), 139 - 44 Early endocarditis following open-heart surgery--importance of surgical treatment; Verkkala K et al.; Nine cases of proven early form of endocarditis occurred after open-heart surgery . Eight of these occurred after valve surgery with an incidence 0.7% while one complicated correction of Fallot's tetralogy . Sternal wound infection preceeded endocarditis in two cases and respiratory tract infection in one case . In these three patients, the infection was caused by the same bacteria as the subsequent postoperative endocarditis . In only one patient were there no signs of infection during the immediate postoperative course . A new cardiac murmur suggesting prosthetic malfunction was a clear indication for early reoperation in five patients; four of them survived . In one patient with a paravalvular leakage the decision to operate was delayed with fatal outcome . Generally, in patients without signs of prosthetic valve malfunction or other prosthetic complication the indication and timing of surgery is problematic . In our series the antibiotic therapy was continued over two months in three patients . Two of them died while the third patient was operated on successfully. Vet Med Nauki, 1987, 24(7), 32 - 6 {Pharmacological research on ophthalmic drug lamellae containing gentamycin sulfate in laboratory and agricultural animals}; Vangelov S et al.; The in vitro and in vivo solubility of ocular drug lamellae, containing 1.5 and 3 mg gentamycin sulphate, was followed up . It was found that those that contained lower amount of the antibiotic disintegrated in the eyes of rabbits, lambs, and sheep for 30-40 minutes, while lamellae having 3 mg gentamycin disintegrated for 45-50 minutes . It is stated that such ocular lamellae are well tolerated by the conjunctiva of the animal species referred to . With the application of one lamella with 3 mg gentamycin sulphate therapeutic concentrations of the antibiotic in the lacrimal secretion are found up to the 24 th hour with cows, sheep, and lambs, and up to the 48h hour with rabbits. Intensive Care Med, 1987, 13(6), 419 - 21 Psittacosis: diagnosis and management of severe pneumonia and multi organ failure; Wainwright AP et al.; Two patients were admitted directly to our Intensive Care Unit in acute respiratory failure due to pneumonia with septicaemic shock, renal and hepatic impairment . Sputum and blood cultures failed to grow any organisms and despite broad spectrum antibiotic therapy for 7 days, neither patient improved . Diagnosis of the rare pneumonic form of psittacosis was made following a raised titre . After treatment with tetracyclines, both patients made a rapid recovery . Retrospective direct questioning revealed that they had close contact with psitacine birds. Antonie Van Leeuwenhoek, 1987, 53(3), 191 - 6 In vitro tetracycline susceptibility of Chlamydia trachomatis in clinical specimens; Hsu AH et al.; A novel approach to determine the tetracycline susceptibility of Chlamydia trachomatis directly from specimens without cell culture propagation and adaptation has been explored . Out of a total of 1290 genital specimens from a sexually transmitted disease clinic, 211 (16.4%) were positive for C . trachomatis . A tetracycline concentration of 0.032 microgram/ml completely inhibited the appearance of inclusions in all of the 211 positive specimens . Of the positive specimens, 120 (56.9%) and 18 (8.5%) respectively showed the presence of 1 to 9 and 100 or more inclusions per microtiter well in antibiotic free medium . Other antibiotics are being tested in the same manner. Acta Obstet Gynecol Scand, 1987, 66(3), 201 - 4 Early complications after induced first-trimester abortion; Heisterberg L et al.; Complications subsequent to 5,851 consecutively induced first-trimester abortions during the period 1980-85 were analysed . Three hundred and fifty-six abortions (6.1%) led to complications requiring hospital admission . According to bivariable analysis, women below 25 years of age, women with parity 0, women with no spontaneous and with no induced abortions, and women in gestational week 8 had significantly higher postabortal complication rates than women 25 years of age and older (p less than 0.001), women with previous births (p less than 0.0001), women with spontaneous abortions (p less than 0.005), women with induced abortions (p less than 0.005), and women in other gestational age groups (p less than 0.0005) . The mean stay in hospital per complicated abortion was 5.3 days . It was discussed whether the administration of prophylactic antibiotics to women with a history of pelvic inflammatory disease and young women completing their first pregnancy could reduce the complication ratePIP: The number of complications subsequent to 1st trimester abortion performed during the past 6 years at the Department of Gynecology and Obstetrics, University Hospital, Copenhagen, at Hvidovre, were evaluated . The associations between the women's age, obstetric history, gestational age, and the rate of early postabortal complications were analyzed . The number of hospital days spent because of such complications was calculated . All 1st trimester abortions performed at University Hospital during the January 1980 to November 1985 period were included . All procedures were performed under general anesthesia by dilatation with Hegars dilators and vacuum aspiration after cleansing of the perineum and vagina . Following aspiration, blunt curettage was performed to ensure that the uterine cavity was empty . Intravenous doses of methylergometrin 0.2 mg were administered . 85% of the women were discharged the same day and 15%, mostly for social reasons, on the following day . 5851 1st trimester abortions were performed . 356 abortions (6.1%) were complicated by 1 or several of the following complications: pathologic bleeding with or without recurettage; temperature; pelvic inflammatory disease (PID) requiring antibiotic therapy; uterine perforation; cervical injury requiring suture; continued pregnancy; and readmission without therapy . The distribution of complications in the 356 women showed significantly more complications in women in the age groups younger than 19 and 20-24 years than in other women . For 353 women, the distribution showed significantly more complications in women with parity 0 vis-a-vis parity greater than 1 . In 353 and 354 women, respectively, there were significantly more complications in women with no previous spontaneous or induced abortion than in women with 1 or more spontaneous or induced abortions . In 356 women the distribution showed significantly more complications in women in gestational week 8 than in other women . Only 1 woman required blood transfusion because of perioperative bleeding . 1889 hospital days were registered following 356 complicated abortions . The total complication rate of 6.1% compares favorably with the results of recent large investigations of abortion populations . Intensive Care Med, 1987, 13(5), 342 - 6 Early onset pneumonia: a multicenter study in intensive care units; Langer M et al.; A prospective multicenter study concerning the incidence, onset time, risk factors and mortality of pneumonia was carried out by the Intensive Care Units Collaborative Group for Infection Control in Lombardy, Northern Italy . Out of 1304 patients admitted over 3 months in 16 intensive care units (ICUs), 441 met the criteria for the protocol (no previous pulmonary infection or irreversible terminal illness, ICU stay greater than 48 h) . The incidence of acquired pneumonia was 21.3% (94/441), with 54.2% of cases diagnosed within 4 days of admission (early onset pneumonia) . Impairment of airway reflexes on admission and more than 24 h respiratory assistance were shown as significant risk factors (RR) for early onset pneumonia (respectively RR = 12.4, with 95% confidence interval (CI) = 5.3-28.9 and RR = 3.3, with 95% CI = 1.8-5.9) . A suggested pathogenetic mechanism is aspiration of oropharyngeal contents at the onset of acute illness, due to depression of protective reflexes with delayed clearance of bacterial contamination . No protection was offered by routinely applied prophylactic antibiotic therapy. Vet Med Nauki, 1987, 24(1), 64 - 71 {Apramycin blood concentrations and distribution in the body of calves after different methods of administration}; Shikha I; The serum concentrations of apramycin in calves were studied after i/v application at the rate of 20 mg/kg body mass, after i/m injection at 20-40 mg/kg b . m., and after oral administration (with milk) at 40 mg/kg b . m . in terms of establishing certain pharmacokinetic parameters . It was found that at i/v route of application the concentrations of the antibiotic ranged above 2 micrograms/cm3 within the interval from the 15th min up to the 8h hour . The time of half-distribution (t1/2 alpha) was 0.28 h, while the biologic half-life of half-elimination (t1/2 beta) was 2.31 h . After muscular application of apramycin at 20 and 40 mg/kg it was rapidly adsorbed at the site of injection; the maximum concentrations were 99 micrograms/cm3 and 202 micrograms/cm3, resp., from the first to the second hour . Levels above 2 micrograms/cm3 were found in the blood serum in the course of 8 to 10 hours when the antibiotic was applied at 20 mg/kg b . m., and they have persisted for more than 12 hours when it was administered at the rate of 40 mg/kg . The biologic half-life (t1/2 beta) was 1.63 h and 1.97 h, respectively . Following the oral administration of the antibiotic at 40 mg/kg subtherapeutic levels were established up to the 24 th hour, with the exception of the interval of the 6 th to 8 th when the concentrations were below the minimum therapeutic one (2 micrograms/cm3).(ABSTRACT TRUNCATED AT 250 WORDS) Vet Med Nauki, 1987, 24(1), 57 - 63 {Changes in amoxicillin pharmacokinetics in white rats with experimentally damaged kidneys and liver}; Lashev L et al.; The blood level and the basic pharmacokinetic parameters (kel, Cop, T 1/2, AUC) of amoxicillin trihydrate were studied following its oral application to albino rats with experimentally injured kidneys (potassium chromate) and liver (tetrachloromethane) . It was found that the impairment of these organs changed the extent of absorption, distribution, and excretion of the antibiotic. Rev Neurol (Paris), 1987, 143(3), 182 - 8 {Meningoradiculitis after a tick bite . Study of 31 cases}; Hirsch E et al.; A retrospective study covering a period of 20 years identified reports on 31 cases of meningoradiculitis of the Garin-Bujadoux-Bannwarth type (MRGBB) . Clinical, biological, electromyographic characteristics and course of the disease were studied . The most recent cases (n = 8) in 1984 and 1985 had serological tests for Borrelia Burgdorferi and half of the cases had negative results . Conversely, in some patients with meningoradiculitis, even in the absence of a tick bite or of migrating chronic erythema, serology was positive for Borrelia Burgdorferi antigen . The efficacy of antibiotic therapy against pain and on the quality and time of functional recovery justifies the use of this therapy under these two circumstances. Arch Orthop Trauma Surg, 1987, 106(3), 144 - 51 Chronic sclerosing osteomyelitis of the clavicle . A manifestation of chronic recurrent multifocal osteomyelitis; Jurik AG et al.; The cases of five children/adolescents and two young adults with unilateral chronic osteomyelitis of the clavicle are reported . The clinical course was prolonged and characterized by intermittent periods of exacerbation followed by improvement . Extensive investigations revealed no causative organisms and the disease seemed resistant to antibiotic therapy . The only laboratory abnormality was elevated ESR, present in five cases . Osteomyelitis of other bones was detected in four cases and pustulosis palmoplantaris in two, suggesting that the disease is a manifestation of chronic recurrent multifocal osteomyelitis. Soc Sci Med, 1987, 24(8), 689 - 95 Why we seek treatment here: retail pharmacy and clinical practice in Maiduguri, Nigeria; Igun UA; This study based on interviews with 418 persons treated for various health problems at two retail pharmacies in Maiduguri, Nigeria, sought to know why the population uses the retail pharmacies as outpatient clinics . The most frequent reasons given by the respondents for their use is 'expeditious action in consultation and treatment' . This is followed by 'efficacy of treatment given' and 'convenience' (nearest source) . There was no significant relationship between the reasons given and demographic background factors except age . The single most important advantage of retail pharmacy treatment over hospital treatment cited by respondents is 'expeditious treatment' . This is followed by 'availability of unadulterated drugs at all times' . The majority of respondents were in the habit of using retail pharmacies whenever they have illness episodes . Relatives and friends constituted the social network of significant influence over the decision to seek treatment at the particular retail pharmacy . The range of health problems reported for treatment was very wide with malaria as the most frequently reported . But the most frequent treatment given is antibiotic chemotherapy by injection or orally. Jpn J Antibiot, 1987 Jan, 40(1), 145 - 69 {General pharmacological studies on isepamicin sulfate (HAPA-B)}; Shibata K et al.; General pharmacological properties of isepamicin sulfate (HAPA-B), a new aminoglycoside antibiotic, were studied in animals and the results obtained were summarized below . Intramuscular injections of HAPA-B at doses of 500 mg/kg inhibited the writing response induced by acetic acid, and at doses of 1,000 mg/kg, caused muscle relaxation, respiratory depression, suppression of spontaneous motor activity and prolongation of thiopental anesthesia . Anticonvulsive action and the effect on the rectal temperature were not observed . Intravenous Intravenous HAPA-B showed no significant effect on the general behavior and the function of the central nervous system at doses of 100 mg/kg . Intravenous injections of HAPA-B to anesthetized dogs resulted increases in the femoral arterial blood flow at doses of 12.5 mg/kg, decrease in the blood pressure and increase in the respiratory rate at doses of 25 mg/kg, and increase in the carotid arterial blood flow at doses of 50 mg/kg . Apparent changes were not recognized in the heart rate and electrocardiograms . In conscious rabbits, intravenous HAPA-B produced increases in the heart rate without significant changes of the blood pressure and electrocardiograms at doses of 100 mg/kg . Spontaneous beatings of isolated atria were depressed by HAPA-B in concentrations of 3 X 10(-4) to 10(-3) g/ml . The HAPA-B inhibited the gastric secretion at intramuscular doses of 500 mg/kg or intravenous doses of 100 mg/kg, and depressed charcoal transport through small intestine and the spontaneous movement of isolated ileum at intramuscular doses of 1,000 mg/kg and at concentrations of 3 X 10(-4) to 10(-3) g/ml, respectively . No irritative effect was found on the gastric mucous membrane . Intravenous HAPA-B inhibited the response of nictitating membrane to pre and post ganglionic stimulations of cervical sympathetic nerve at doses of 100 mg/kg . In in vitro test, HAPA-B inhibited nonspecifically the constrictive responses of trachea, aorta, stomach, ileum and vas deferens to various agonists in concentrations of 3 X 10(-4) to 10(-3) g/ml . Spontaneous movements of uteri of estrous or pregnant animals were depressed by HAPA-B at intravenous doses of 50 to 100 mg/kg and in in vitro at concentrations of 10(-4) to 3 X 10(-4) g/ml . Antidiuretic effect was also observed at intramuscular doses of 250 mg/kg . HAPA-B increased the length of the whole blood clotting time and raised the plasma glucose level at intramuscular doses of 1,000 mg/kg and inhibited the platelet aggregation induced by ADP in vitro at concentrations of 10(-3) g/ml.(ABSTRACT TRUNCATED AT 400 WORDS) Int J Clin Pharmacol Res, 1987, 7(1), 51 - 8 Study on pulmonary, prostatic and renal (medulla and cortex) distribution of sagamicin at different time intervals; Fraschini F et al.; In order to assess the therapeutic activity of an antibiotic, not only its serum kinetics but also its kinetics in the peripheral tissues must be determined, thus evaluating the specific power of penetration of the drug . Sagamicin is an aminoglycosidic basic antibiotic closely related to gentamicin and its penetration rate into lungs, kidney and prostate, together with its serum concentrations time-course, were investigated . The findings obtained showed that this antibiotic attained a good distribution in the peripheral tissues, where it easily reached therapeutic levels. Int J Clin Pharmacol Res, 1987, 7(1), 33 - 7 Digitoxin elimination in healthy subjects taking ampicillin; Lucena MI et al.; The present study was carried out to evaluate the changes in digitoxin kinetics during ampicillin administration . Subjects were informed of the nature of the study and the treatment was applied to those who gave their written consent . Six healthy volunteers received a single oral dose of 1.0 mg of digitoxin . Three days later, they were given orally ampicillin trihydrate, 500 mg four times daily, for five consecutive days . Blood samples were taken at 24, 36, 48, 60, 72, 96, 120, 144, 168 and 192 hours after digitoxin . Compliance with ampicillin regimen was verified by fluorimetric measurement of serum ampicillin . Concentrations of serum digitoxin were determined by radioimmunoassay . The mean digitoxin elimination half-life changed from 162.8 +/- 12.9 h before to 181.3 +/- 10.1 h (mean +/- s.e . mean) after ampicillin . These differences were not significant . No consistent evidence of a kinetic interaction between digitoxin and the broad-spectrum antibiotic ampicillin was found. Chemotherapy, 1987, 33(2), 85 - 92 Multiple-dose pharmacokinetics in serum and sputum of sagamicin administered intramuscularly to patients; Fraschini F et al.; Sagamicin is an aminoglycosidic antibiotic produced by Micromonospora sagamiensis, chemically related with gentamicin . Single- and multiple-dose pharmacokinetics have been investigated in patients affected by bronchopulmonary infections treated with 60 mg sagamicin i.m . every 12 h . The two concentration-time curves for sputum and serum are parallel; while there is no evidence of accumulation in the serum at the 7th day of treatment, sagamicin concentrations in the sputum are significantly higher on the 7th day, and this is also confirmed by a remarkable difference between the two AUC values . The good penetration power of sagamicin into sputum makes this antibiotic useful for the treatment of infections of the respiratory tract. Antibiot Med Biotekhnol, 1987 Jan, 32(1), 15 - 20 {Polymorphism of a culture of Streptomyces olivocinereus, the producer of heliomycin}; Sokolova ZG et al.; Polymorphism of the heliomycin-producing organism S . olivocinereus was studied and not less than 5 stable spontaneous variants differing in their differentiation levels were detected . Variant I (the main type) had the most developed cultural and morphological features characteristic of the whole population: abundant aerial mycelium with all specific subsequent stages of the development terminated by heavy sporulation and formation of long spiral spore chains . The other variants markedly differed from variant I . In variant III grey aerial mycelium (the final stage of differentiation) formed only at the colony margin . In variant IV it formed with a significant delay as a thin layer . In variant II it was very scanty and in variant V it differed by its pigmentation . Sporulation in variants II, III, IV and V was scanty and the character of the spore chains differed from that of the main type . Capacity for heliomycin production in the variants correlated with the level of morphological differentiation: the antibiotic activity of the highly differentiated variant I was the highest, while the low differentiated variant II was practically inactive. Neurochirurgie, 1987, 33(1), 71 - 3 {Lumbar extradural Brucella abscess without spondylitis . Apropos of a case}; Scuccimarra A et al.; One case of lumbar extradural abscess of brucellar etiology without spondylodiscitis is described . The recovery was obtained only with antibiotic therapy. J Antibiot (Tokyo), 1987 Jan, 40(1), 73 - 6 Biological effects of acetomycin . I . Activity against tumor cells in vitro and in vivo; Mamber SW et al.; The antibiotic acetomycin was active in vitro against HCT-8 human colon adenocarcinoma cells (IC50, 1.5 microgram/ml) and L1210 murine leukemia cells (IC50, 2.2 micrograms/ml) . Acetomycin also had marked activity in the human tumor stem cell assay, with a 33% overall response rate (less than or equal to 30% survival) against 49 primary tumors . However, acetomycin was inactive in four in vivo tumor assay systems (L1210 and P388 leukemias, B16 melanoma and the MX-1 mammary xenograft system) . This lack of in vivo activity may result from metabolic inactivation of acetomycin. Drugs Exp Clin Res, 1987, 13(2), 105 - 14 Ceftazidime: experimental and clinical evaluation of biliary elimination; Brogard JM et al.; During a 3-h perfusion of five isolated rabbit liver preparations, 1.4% of 10 mg of ceftazidime added to the circulating blood was eliminated in the bile and 0.9% was metabolized or inactivated in the liver . Five normal subjects were given 2 g of ceftazidime intravenously; antibiotic concentration in the aspirated duodenal fluid rose progressively during the 4 h of the investigational period to a maximal mean level of 21.3 +/- s.e.m . 9.2 micrograms/ml and 0.05% of the dose given was recovered during this period . The same dose was given to 12 cholecystectomized patients fitted with a Kehr drain . An average peak value of 36.3 +/- 4.0 micrograms/ml was reached in the collected bile during the second hour after drug administration . The 12-h biliary recovery was 0.21% of the dose given . Ceftazidime concentrations in choledochal and gallbladder bile sampled peroperatively in 10 patients 1 h after intravenous administration of 2 g of ceftazidime were 78.3 +/- 12.0 and 17.9 +/- 7.5 micrograms/ml respectively . These data compare favourably with the results of the authors' studies on the biliary elimination of 15 other beta-lactams and are consistent with a possible beneficial effect of ceftazidime in the treatment of biliary tract infections. Radiologe, 1987 Jan, 27(1), 20 - 4 {Microabscesses of the spleen in patients with acute leukemia}; Schmidt H et al.; Eight patients with acute myelogenous leukemia in complete remission after induction chemotherapy developed septic fever . Fever was unresponsive to broad-spectrum antibiotic therapy . Ultrasonography showed multiple 0.5-2 cm in diameter, anechoic densities and some 1-3 cm "target" appearances in spleen and liver . Computed tomography demonstrated multiple, round, 0.5-2 cm areas of diminished attenuation in spleen and liver, which did not enhance like the surrounding parenchyma . These microabscesses increased in size and number without equivalent antifungal therapy and decreased or disappeared after specific treatment . Candida-infection was confirmed by histologically from liver specimens in four patients, fungal organisms were seen microscopically an liver-biopsy in one patient and at autopsy one patient was found to have candida disseminated to the spleen, liver, kidneys, lung and CNS. Radiat Res, 1987 Jan, 109(1), 47 - 57 Bile loss in the acute intestinal radiation syndrome in rats; Geraci JP et al.; The effects of bile duct ligation (BDL), choledochostomy, bile acid sequestering within the intestinal lumen by cholestyramine, and fluid and electrolyte replacement on survival time and development of diarrhea after whole-body exposure to doses of ionizing radiation that result in death from acute intestinal injury were studied . BDL significantly prolonged survival and delayed the onset of diarrhea after exposure to 137Cs gamma rays, fission neutrons, or cyclotron-produced neutrons in the range of doses that produce intestinal death or death from a combination of intestinal and hematopoietic injuries . Cannulation of the bile duct with exteriorized bile flow (choledochostomy) to protect the irradiated intestine from the mucolytic action of bile salts did not duplicate the effect of BDL in increasing survival time . Choledochostomy without fluid replacement eliminated the occurrence of diarrhea in 15.4 Gy irradiated rats . Diarrhea did occur in irradiated animals with choledochostomy if they received duodenal injections of fluid and electrolytes to replace the fluid lost as a result of bile drainage . Duodenal injection of fluid and electrolytes, however, had no significant effect on survival time in irradiated rats . In contrast, injection of fluid and electrolytes into the peritoneal cavity of irradiated rats resulted in an increase in survival time that was comparable to that observed after BDL . Addition of antibiotics to the peritoneally injected fluid and electrolytes further increased survival time (up to 9 days) . This survival time approached that seen in animals receiving the same radiation dose but which had the intestine exteriorized and shielded to minimize radiation injury to the intestine . Postmortem histological examinations of the irradiated small intestine showed mucosal regeneration in these long-term survivors receiving fluid and antibiotic therapy . In contrast, duodenal injection of cholestyramine post irradiation to bind bile acids had no effect on survival time or diarrhea incidence . The conclusions from these experiments are that BDL prolongs survival and postpones the onset of diarrhea in irradiated rats dying from acute intestinal injury primarily by slowing down the loss of fluid and electrolytes and that bile acids play no significant role. Surgery, 1987 Jan, 101(1), 15 - 9 Moxalactam as single-agent prophylaxis in the prevention of wound infection following colon surgery; Hinchey EJ et al.; A single agent systemic antibiotic (moxalactam) when used prophylactically in patients undergoing colon surgery was associated with a wound infection rate comparable to that achieved by a combination of oral neomycin and intravenous metronidazole . The data obtained demonstrated that the reduced infection rate was not the result of a reduction in the bacterial content of the colon alone but due to the prophylactic agents used for elective colon surgery. G Batteriol Virol Immunol, 1987 Jan-Dec, 80(1-12), 225 - 30 {Cefonicid toxicity . I . Effects on the reactivity of the specific immune system}; Gariglio M et al.; The degree of toxicity of the antibiotic Cefonicid on the cellular reactivity of the immune system was evaluated . The effects on some lymphokine (IL-2 and IFN-gamma) production and the degree of proliferation of splenic lymphocytes following mitogen stimulation have been considered . Our results show that Cefonicid does not impair the immune response, except at very high doses (500 micrograms/ml). J Microencapsul, 1987 Jan-Mar, 4(1), 39 - 46 Streptomycin sulphate microspheres: dissolution rate studies and release kinetics . I; Gurkan H et al.; Targeting of drugs by microspheres, nanoparticles and liposomes is intended to increase the selective targeting to specific organs and to reduce their side effects . Streptomycin sulphate, a tuberculostatic antibiotic, is used as the active principle in this study . The aim is to accumulate the loaded microspheres in the lungs . The release of drugs associated with microsphere carriers has been found to be dependent on a number of factors . The aim of the investigation was to study the influence of the extent and nature of cross-linking, the type and the amount of the matrix material on the release characteristics of streptomycin sulphate microspheres . Human serum albumin and gelatin (Type B) were used as two different matrix materials . The crosslinking agents used were 2,3-butanedione and formaldehyde at different concentrations, and variable duration times . The in vitro release of streptomycin sulphate from microspheres is characteristically biphasic, with an initial fast release (the 'burst effect'), followed by a much slower release . Alteration in the characteristics of drug-loaded microspheres result in significant changes in the second (slow) phase of release . The release profiles of the different formulations has been studied and evaluated kinetically. J Ocul Pharmacol, 1987 Fall, 3(3), 191 - 7 The suppression of acute corneal inflammation by Bredinin; Carter JM et al.; This study tested the effect of Bredinin, a nucleoside antibiotic of fungal origin, on experimentally induced acute inflammation of the rabbit cornea . Inflammation was produced by abrasive removal of a 9 mm disk of corneal epithelium . In the dose-response experiments, one eye of each rabbit was treated topically with Bredinin, and the other eye with vehicle immediately after deepithelialization . The acute inflammatory leukocytes in tear film samples were counted at various times and the corneas were examined histologically at the end of the study . A paired t-test revealed that the numbers of acute inflammatory leukocytes after 5 hours were significantly less in the Bredinin-treated eyes, compared with the untreated eyes . The timing of drug-treatment was important; Bredinin was most effective in suppressing acute ocular inflammation when administered at, or within, one hour of the inflammatory stimulus . Histologic analysis demonstrated fewer acute inflammatory leukocytes on the ocular surface and in the stroma of the Bredinin-treated eyes, compared with the untreated eyes . No obvious corneal toxicity was noted, and the drug-treated eyes appeared less inflamed than the control eyes . The results of this study demonstrate the capacity of Bredinin to suppress the entry of inflammatory leukocytes into the tear film and suggest that this drug may have potential for use as a topical anti-inflammatory agent. Zentralbl Chir, 1987, 112(24), 1538 - 44 {Emergency interventions in complicated colonic diverticulosis}; Wehrli H et al.; An account is given in this paper of 480 patients who had been hospitalised for colonic diverticulosis or diverticulitis in the surgical department of the Municipal Waid Hospital of Zurich, between 1970 and 1986 . Laparotomy had to be performed on 219 of them (45.6 per cent), among them 84 emergency interventions . The average age of these patients was 70.7 years . Indications for emergency surgery included diffuse or locally delimited peritonitis with abscess development in 72 patients, ileus in ten cases, and massive colon haemorrhage in two . The latter two cases were handled with good success by subtotal colectomy with ileorectostomy and, one of them with the source of bleeding known, by colotomy and suturing of that source of bleeding . Sigmaincontinence resection according to Hartmann has been considered the optional approach since 1977 to diffuse peritonitis and to many cases of ileus (n = 39) . In more recent time, anastomosis has been used as primary approach to some patients who survived fibrinous abdominal peritonitis (n = 4) . The mortality rate associated with drainage operations according to expectation, has been clearly higher than that following resection, the comparable figures being 32.3 and 17.2 per cent . That has been attributable to non-removal of the septic focus . After all, nowadays combined antibiotic therapy is commonly used for seven to ten days for simultaneous control of both aerobic and anaerobic pathogens . This has become routine practice and involves aminoglycoside, metronidazole, and ampicillin . Overall mortality associated with emergency interventions is clearly higher than that after planned operations, the figures being 22.6 and 4.4 per cent.(ABSTRACT TRUNCATED AT 250 WORDS) Drug Chem Toxicol, 1987, 10(3-4), 237 - 56 Comparative vestibular toxicity study with 3-O-demethylfortimicin A disulfate and gentamicin sulfate in cats; Yang CL et al.; 3-O-demethylfortimicin A disulfate (ODMF), a novel aminocyclitol antibiotic, was administered subcutaneously for three months to groups of male and female cats at 15, 30 or 60 mg base/kg/day . Gentamicin sulfate (GS) at doses of 6 and 13 mg base/kg/day served as a reference compound . Signs of vestibular toxicity were considered to include persistent unsteady gait and stance, impaired righting reflex and abnormally diminished postrotatory vestibular nystagmus . Renal toxicities produced by ODMF and GS were also determined and compared . ODMF at 15 and 30 mg base/kg/day produced no signs of vestibular toxicity, while a dosage of 60 mg base/kg/day of ODMF produced vestibular toxicity in 7/10 cats . Three affected male cats died or were killed in moribund condition between study days 49 and 64 . Vestibular toxicity was observed in 10/10 cats treated with GS at 13 mg base/kg/day and in 3/10 cats at 6 mg base/kg/day . All ten cats treated with GS at 13 mg base/kg/day died or were killed in moribund condition between study days 30 and 81 . The deaths and moribundity in cats treated with ODMF or GS were attributed to renal toxicity . The vestibular toxicity and nephrotoxicity produced by ODMF and GS were more severe in male cats than in females . In conclusion, ODMF given at doses up to 60 mg base/kg/day for three months induced comparatively less vestibular toxicity and renal pathology than did GS at a dose of 13 mg base/kg/day. Jpn J Ophthalmol, 1987, 31(2), 218 - 29 Immunosuppressive effects of polynactins (tetranactin, trinactin and dinactin) on experimental autoimmune uveoretinitis in rats; Tanouchi Y et al.; Macrotetrolide antibiotic polynactins {dinactin, trinactin and tetranactin (1:4:5)} are hydrophobic cyclic esters produced by Streptomyces aureus . Polynactins (PN) and their major component tetranactin (TN) delayed or suppressed the onset of S-antigen-induced experimental autoimmune uveoretinitis (EAU) in Lewis rats . Termination of treatment with PN or TN before day 14 of immunization resulted in a delayed onset of EAU in many animals . Thus, the immunosuppressive effect of PN and TN was not lasting . PN and TN suppressed anti-S-antigen antibody formation . Skin hypersensitivity tests indicated suppression by PN of the delayed-type rather than Arthus type hypersensitivity to S-antigen . PN, TN and trinactin all inhibited 3H-thymidine incorporation into concanavalin A-treated lymphocytes at the early stage of cell activation . For each drug, 50% inhibition was obtained at about 0.1 ng/ml . Under the incubation condition that the cells were exposed to TN for 21 hours, cell viability remained unchanged up to 100 ng/ml of TN . It is evident that PN and TN suppress T-lymphocyte proliferation without cell injury . These results suggest that PN and TN inhibit the onset of EAU primarily through the suppression of cell-mediated immunity but also by affecting humoral immunity. Eur J Drug Metab Pharmacokinet, 1987 Jan-Mar, 12(1), 50 - 7 Troleandomycin effects on methylprednisolone and methylprednisone interconversion and disposition in the rabbit; Ebling WF et al.; A study of the effects of troleandomycin (TAO) on the disposition of intravenous methylprednisolone in rabbits was performed in order to develop an animal model to further evaluate the mechanism of TAO/steroid beneficial effects in severe asthma . The plasma concentration-time profiles of methylprednisolone and methylprednisone were determined in the presence and absence of single and multiple dose TAO regimens . Pharmacokinetic analysis revealed a significant decrease in total plasma clearance of methylprednisolone in the presence of multiple dose TAO . Alterations in the disposition of the reversible metabolite, methylprednisone, were also observed . The TAO-methylprednisolone interaction may involve decreasing the degree of interconversion between the steroid and its reversible metabolite . TAO also decreases metabolite turnover more than three-fold . The antibiotic does not cause marked deviation from linear biexponential elimination of methylprednisolone as observed in man . The rabbit may serve as a useful animal model for further studies of the TAO/methylprednisolone interaction. Eur J Clin Pharmacol, 1987, 31(6), 701 - 4 Effect of miocamycin on theophylline kinetics in children; Principi N et al.; The interaction between a new macrolide antibiotic, miocamycin, and theophylline was evaluated in a single cross-over study in 5 asthmatic children . Each patient received a single dose of theophylline (4.3 mg/kg) delivered in 15 min using a constant-rate infusion pump, immediately before and after a 10 day course of miocamycin 17.5 mg/kg b.d . The pharmacokinetics of theophylline were calculated for each phase of the study . The elimination rate constant (3.92 vs 3.74 h-1), the mean total body clearance (1.71 vs 1.8 ml X min X kg-1) and the mean apparent volume of distribution (0.57 vs 0.581 X kg-1) did not differ . The result can be explained by the inability of the antibiotic to form inactive cytochrome P-450 metabolite complexes which can interfere with the metabolism of theophylline . Thus, miocamycin can safely be administered to asthmatic children requiring theophylline treatment, when they have an infection due to susceptible pathogens. Am J Med, 1987 Jan, 82(1), 73 - 8 Pneumocystis carinii pneumonia . Review of 53 cases; Peters SG et al.; Between 1976 and 1983, 53 cases of Pneumocystis carinii pneumonia were documented at the Mayo Clinic . Underlying diseases included leukemia in 15 patients, lymphoma in nine, nonhematologic malignancies in five, acquired immune deficiency syndrome in two, an various inflammatory diseases treated by corticosteroids in 16 patients . Cytotoxic drugs with corticosteroids were used in 68 percent of patients, whereas 23 percent received corticosteroids alone . Clinical features consisted of progressive dyspnea (74 percent), cough (55 percent), and fever (62 percent), with normal findings on examination (43 percent), or crackles (53 percent) . Arterial oxygen tension and oxygen saturation were 48.6 +/- 12.8 mm Hg and 81.2 +/- 6.5 percent, respectively . Chest roentgenographs exhibited diffuse alveolar and interstitial infiltrates with predominantly perihilar distribution . The diagnostic rates for open lung biopsy and bronchoscopy were 97 percent and 62 percent, respectively . Clinical improvement and survival following appropriate therapy were noted in 22 patients (41.5 percent), whereas the remaining 31 patients died within four weeks of hospitalization . When survivors were compared with nonsurvivors, there was no difference in mean age, leukocyte counts, arterial oxygen tension, or duration of symptoms before treatment . A coexisting pulmonary infection was identified more frequently in nonsurvivors (51.6 percent) than in survivors (22.7 percent, p = 0.01) . The mortality from P . carinii pneumonia alone was 47 percent, whereas 76 percent of those with coexisting infection died . Despite antibiotic therapy and potentially effective chemoprophylaxis, P . carinii pneumonia remains a significant and life-threatening complication of diseases or treatments associated with immune suppression. Scand J Infect Dis Suppl, 1987, 52, 40 - 5 Pharmacokinetic and clinical evaluation of imipenem/cilastatin in children and neonates; Begue PC et al.; Imipenem, a new carbapenem (thienamycin) beta-lactam antibiotic which is clinically used in a 1:1 combination with cilastatin, an inhibitor of renal metabolism of imipenem, was evaluated in 25 patients; 11 children and 14 neonates . A mean daily dose of 60 mg/kg was given to children and the dose in neonates was 50 mg/kg . Clinically, 21 patients were cured, two failed to respond to treatment and two were not evaluable . Pharmacokinetic studies were performed in the 11 children and in 10 of the neonates . The mean elimination half-life of imipenem was 0.87 h in children and 2.1 h in neonates . The mean cilastatin elimination half-life was 0.73 h in children and 5.1 h in neonates . This difference in half-life between children and neonates is similar to the one noted between healthy adults and adults with renal insufficiency . No accumulation of imipenem was seen in neonates studied on the first and fifth days of treatment. Scand J Infect Dis Suppl, 1987, 52, 15 - 9 Imipenem/cilastatin treatment of lower extremity skin and soft tissue infections in diabetics; Calandra GB et al.; The efficacy and safety profile of imipenem/cilastatin was investigated in 94 patients with diabetes mellitus with infections of the lower extremity . Ninety-eight percent of the pathogens were susceptible to imipenem; this was higher than to other antibiotics tested . Ninety-two percent of the patients were cured (47%) or improved (45%) . Bacterial eradication was achieved for 79% of the pathogens . Adverse experiences were similar to those reported previously . Imipenem-cilastatin proved to be a very effective antibiotic with a good safety profile for use in diabetic patients with lower extremity infections. Clin Ther, 1987, 10 Suppl A, 59 - 65 Measurement of C-reactive protein to compare ceftizoxime versus cefoxitin/doxycycline therapy for septic pelvis: a preliminary report; Mercer LJ et al.; C-reactive protein (CRP), a biological marker of inflammation, may be a useful indicator of therapeutic response in patients with septic pelvis . In a study comparing ceftizoxime and cefoxitin/doxycycline in patients with septic pelvis, quantitative CRP levels were closely correlated with the responses and failures of therapy . The results of this study showed the two antibiotic regimens to be equally effective, with 23 of 25 patients in each treatment group achieving a satisfactory response . The fact that ceftizoxime was effective in four of five patients with Chlamydia trachomatis in cervical isolates suggests that intravenous therapy for the acute infection can be accomplished without the addition of an antichlamydial agent . Upon discharge from the hospital, patients can continue therapy with an oral drug that is specifically active against Chlamydia. Invest New Drugs, 1987, 5(2), 171 - 6 Phase I and pharmacokinetic study of high volume intraperitoneal aclacinomycin-A (Aclarubicin); Kerr IG et al.; Aclacinomycin-A (Aclarubicin) is a relatively new anthracycline antibiotic with potential activity against ovarian cancer . Eight patients with various malignancies (4 ovary, 1 breast and ovary, 1 breast, 1 colon, 1 leiomyosarcoma) and intraperitoneal disease were treated in a Phase I trial with escalating doses of intraperitoneal Aclacinomycin . Drug treatments were administered through a peritoneal catheter in a 2 liter fluid volume (1.5% Dianeal) . Seventeen cycles were administered with doses ranging from 25 to 75 mg of Aclacinomycin . Pharmacokinetic studies were carried out in 7 patients . Although high concentrations of Aclacinomycin could be obtained in the peritoneal cavity no drug was detected in the plasma . The major dose-limiting toxicity was chemical peritonitis . Two patients had reduction in the amount of ascites . The recommended dose for Phase II trials is Aclacinomycin 50 mg in 2 liters given every 2 weeks. Chemotherapy, 1987, 33(4), 291 - 6 Effect of prophylactic intravenous ceftriaxone in maxillofacial surgery; Stoll P; Cephalosporins are commonly used in maxillofacial surgery because they achieve high concentrations in bone . Prophylactic antibiotic therapy was given to 65 patients undergoing diverse surgical procedures . 20 patients received cefotiam in 2 doses of 2 g for 5 days; 15 patients received cefotiam in 2 doses of 2 g only perioperatively . No difference was found between these two groups with respect to prophylactic protection against infection . A further 15 patients received ceftriaxone in a single dose of 2 g preoperatively . Since we found that local infection and febrile morbidity was not significantly different even in the 'one-shot' group, we investigated the effect of 'low-dose' prophylaxis with only 1 g ceftriaxone preoperatively in another 15 patients . We found that this dose was sufficient to prevent infection in patients. Postgrad Med, 1987 Jan, 81(1), 131 - 2, 135-6 Nosocomial and nursing home-acquired pneumonia . Recent therapeutic advances; Roselle GA; In recent years, new broad-spectrum antibiotics have become available for the treatment of complex pneumonia . Used with care, these agents may allow effective monotherapy of difficult-to-treat pulmonary infections, with the added benefit of decreased toxicity in comparison with the more traditional multiple-drug combinations . The newer antibiotics are relatively expensive, but cost of their use can be justified by their reduced toxicity (in comparison with some antibiotic combinations) and by the avoidance of additional laboratory fees for routine drug monitoring . It is hoped that the major benefits that can accrue with proper use of the newer agents will not be outweighed by problems resulting from their indiscriminate use, such as increased bacterial resistance and exorbitant healthcare costs. J Am Dent Assoc, 1987 Jan, 114(1), 65 - 8 Severe infections of the head and neck resulting from gas-forming organisms: report of case; Schroeder DC et al.; A case of severe infection of the head and neck associated with gas-forming organisms in a patient with fractures of the mandible is presented . Selected aspects of antibiotic therapy are discussed. J Cell Physiol, 1987 Jan, 130(1), 51 - 7 Mouse Balb/c3T3 cell mutant with low epidermal growth factor receptor activity: induction of stable anchorage-independent growth by transforming growth factor beta; Kuratomi Y et al.; A mutant clone (MO-5) was originally isolated as a clone resistant to Na+/K+ ionophoric antibiotic monensin from mouse Balb/c3T3 cells . MO-5 was found to show low receptor-endocytosis activity for epidermal growth factor (EGF): binding activity for EGF in MO-5 was less than one tenth of that in Balb/c3T3 . Anchorage-independent growth of MO-5 was compared to that of Balb/c3T3 when assayed by colony formation capacity in soft agar . Coadministration of EGF and TGF-beta efficiently enhanced anchorage-independent growth of normal rat kidney (NRK) cells, but neither factor alone was competent to promote the anchorage-independent growth . The frequency of colonies appearing in soft agar of MO-5 or Balb/c3T3 was significantly enhanced by TGF-beta while EGF did not further enhance that of MO-5 or Balb/c3T3 . Colonies of Balb/c3T3 formed in soft agar in the presence of TGF-beta showed low colony formation capacity in soft agar in the absence of TGF-beta . Colonies of MO-5 formed by TGF-beta in soft agar, however, showed high colony formation capacity in soft agar in the absence of TGF-beta . Pretreatment of MO-5 with TGF-beta induced secretion of TGF-beta-like activity from the cells, while the treatment of Balb/c3T3 did not induce the secretion of a significant amount of TGF-beta-like activity . The loss of EGF-receptor activity in the stable expression and maintenance of the "transformed" phenotype in MO-5 is discussed. J Basic Microbiol, 1987, 27(8), 449 - 55 Development of a plasmid-cloning system for Streptomyces viridochromogenes Tü494; Strauch E et al.; A plasmid-cloning system was developed for Streptomyces viridochromogenes Tu494, a producer of the tripeptide antibiotic phosphinothricyl-alanyl-alanine (PTT) . Parameters affecting protoplast formation and transformability of S . viridochromogenes were investigated in detail . A procedure giving rise to transformation efficiencies of 10(4)-10(5) transformants per microgram DNA was worked out . Several Streptomyces plasmid vectors such as pIJ350, pIJ61, pEB2, pGM4 and pSW2 were tested in S . viridochromogenes . Some of these vectors (pGM4, pEB2) showed a high copy number, whereas the copy number of others (pIJ350, pIJ61 and pSW2) was markedly lower . Under non-selective conditions some of the vectors (pIJ350, pEB2) were not stably maintained, in contrast to the vectors pGM4 and pSW2 which did not require any selection pressure for stable maintenance . Therefore, the plasmid vectors pGM4 and pSW2 derived from endogenous replicons of Streptomyces ghanaensis strains represent appropriate plasmid vehicles for cloning experiments in S . viridochromogenes. Acta Biochim Pol, 1987, 34(4), 369 - 76 Pleiotropic effect of anticapsin on HeLa S3 cells; Woynarowska B et al.; Anticapsin, the terminal epoxyaminoacid moiety of tetaine, inhibits irreversibly growth of HeLa S3 cells . The antibiotic decreases to a similar extent incorporation of 3H-labelled precursors into nucleic acids and protein in intact cells: inhibition of protein synthesis prevails on prolonged incubation . Also incorporation of {3H}dTTP and {3H}UTP is inhibited in the presence of anticapsin into permeabilized cells . These effects, however, are not due to the interference with DNA or RNA polymerases since anticapsin only slightly suppresses RNA polymerase activity and has no effect on DNA polymerase in the cell-free systems . The results indicate that the mechanism of antiproliferative action of anticapsin in HeLa S3 cells differs from that of tetaine and imply that inhibition of protein synthesis might be the primary effect of anticapsin. Vet Med Nauki, 1987, 24(10), 28 - 35 {Pharmacokinetic research and the ultrastructural changes in the lungs of white rats after aerosol administration of a high dose of kanamycin sulfate}; Feodorov V et al.; Studied is kanamycin sulphate "Pharmachem", substance with activity 750 UI/mg, applied on albino rats in the form of water aerosol . The experiments are carried out in aerosol camera of flow-dynamic type with capacity 450 l at exchange of the air 60 l/min with aerosol apparatus of pneumatic type, for 10 min and staying in the aerosol cloud another 10 min . It is established that the kanamycin sulphate, after aerosol application on albino rats in dose of 50000 UI/m3, passes in the blood and is found out in the serum yet in the first hour (1.75 +/- 0.23 mg/cm3 serum) . The maximal quantities of antibiotic are established in the first hour in the lungs (52.1 +/- 11.4 micrograms/g) and the antibiotic is detained in therapeutical concentrations for 240 h (0.1 +/- 0.03 micrograms/g) . The content of the kanamycin in the kidneys is in the limits from 0.1 +/- 0.02 to 1.69 +/- 0.17 micrograms/g . At the electronic-microscopic tests of the lungs is observed hyperemia and destruction of the lamella corpuscles, which processes up to the 120th hour gradually calmed down. Drugs Exp Clin Res, 1987, 13(12), 737 - 9 Toxic effects on rabbit kidney cell cultures of a new aminoglycoside; Viano I et al.; In this study the cellular toxicity of two aminoglycosides (gentamicin and dactimicin) have been evaluated using rabbit kidney cell cultures . The correlation between toxic effect and antibiotic concentration, and between toxic effect and the period of contact have been evaluated . The toxic effect was measured in rabbit kidney cell cultures by means of the release of N-acetyl-beta-glucosaminidase . This enzyme was chosen in order to establish a correlation between in vitro and in vivo results . Gentamicin clearly shows in both tests a non-linear correlation between cellular toxicity and concentration or period of contact . Dactimicin, a new aminoglycoside probably less toxic than others, also shows in both tests a non-linear correlation between cellular toxicity and concentration or period of contact, but the release of enzyme was significantly reduced during the treatment of the cell cultures with this aminoglycoside. Eye, 1987, 1 ( Pt 5), 581 - 4 Day case strabismus surgery without post-operative ocular medication . A masked randomised study; Hagan MC et al.; A masked, randomised study was designed to test the hypothesis that day case strabismus surgery and the absence of post-operative topical medication is a plan of management that does not compare unfavourably with discharge from hospital on the day after surgery with topical antibiotic and anti-inflammatory therapy for 14 days . The results indicate that patients who have day case surgery do not have more complications than overnight stay patients and that their inflammation and discomfort settle just as quickly without topical therapy . Medical, social and financial benefits of day case surgery are noted. Ann Otolaryngol Chir Cervicofac, 1987, 104(8), 625 - 31 {Laryngeal dyspnea of infectious origin in the adult . Apropos of 54 cases}; Perrin A et al.; Principal etiologies in 54 patients with acute laryngeal dyspnea of infectious origin were epiglottitis (35 cases), glotto-subglottal laryngitis (8 cases) and adjacent infections (9 cases) . These cases are reviewed together with the relevant published literature and various conclusions drawn . The affection is serious (35 deaths out of 425 cases in the literature), and requires careful examination, immediate treatment and routine hospital care under surveillance . Apart from cases where the condition of the patient necessitates urgent intubation, those cases with rapidly evolving signs over 24 hours must be admitted to intensive care since worsening of dyspnea can lead to delayed decompensation . Wide spectrum antibiotic therapy is necessary for patients with epiglottitis and adjacent infective ulcerations since many germs may be implicated, while for the always benign glotto-subglottal laryngitis Amoxicillin + clavulinic acid is sufficient. Vet Med Nauki, 1987, 24(9), 52 - 5 {Treatment of puerperal endometritis in cows by the intra-arterial injection of drugs}; Venev S; Cured were 59 cows, affected by puerperal catarrhal suppurative endometritis, by intra-aortic and uterine infusion of procaine and antibiotic solutions . A good curative and biological effect was reached . The aortic-treated animals were fertilized at average independence and service periods--accordingly 43.52 and 57.31 days, for the uterine treatment--accordingly 51.67 and 78 days. Vet Med Nauki, 1987, 24(8), 64 - 8 {Embryotoxic and teratogenic effects of Pharmachim's lincomycin hydrochloride}; Chakurov R et al.; Tested was the teratogenic and embryotoxic action of linkomycin hydrochloride with both placental and nonplacental animals . It was found that when applied twice, orally, to albino rats on the 4th day of pregnancy at the rate of 250 mg/kg body mass (=5 ED50), and once to chick embryos at 50 mg per egg the antibiotic raised the percent of pre- and postimplantation loss of embryos . In a series of applications (oral) from the 3rd up to the 19th day at 50 mg/kg body mass to rats as well as in a single application to chick embryos at 10, 20, and 50 mg per egg linkomycin showed no teratogenic effects. Vet Med Nauki, 1987, 24(8), 55 - 63 {Toxicological and pharmacokinetic research on lincomycin hydrochloride in broiler chickens and layer hens}; Chaleva E et al.; Tested was the activity of linkomycin hydrochloride at the rate of 820 IU/mg . The LD50 of the preparation was found to exceed 12.0 g/kg body mass at intracrop application to broiler birds . When offered with the drinking water or the feed in amounts that were 3 to 5 times higher than the therapeutic ones for broilers in the course of 45 days it did not cause mortality nor induced changes in the white and red blood cell counts, in the total protein, and in the levels of urea, blood sugar, AlT, and AcT . Neither were there any structural changes in the internal organs . Upon the single intracrop treatment of broilers with linkomycin at 50 and 100 mg/kg most of the amount introduced was established in the blood serum at the second hour and up to the 6th and 8th hour, respectively . Studies on the effect of age on the serum concentrations at this route of introduction revealed that the preparation was absorbed at higher rates in the broilers than in the layers, while with the persistence of the levels there were no essential differences . At the single oral administration with broilers in amounts of 100 mg/kg linkomycin was chiefly retained in the kidneys, liver, and lungs as well in the content of the small and large intestines . At intracrop application to layers in doses of 100 mg/kg in the course of 7 days the antibiotic was excreted with the eggs at the time of treatment and in the course of 4 days later in bacteriostatic concentrations of 0.6-5.9 micrograms/cm3. Chromosoma, 1987, 96(1), 26 - 32 Regional assignment of the gene for diphtheria toxin sensitivity using subchromosomal fragments in microcell hybrids; Hayes H et al.; Human x mouse microcell hybrids resistant to G418 were constructed between mouse hepatoma cells and human x mouse whole cell hybrids containing only intact human chromosome 5 and 22 with an integrated neor-gene . Among these, microcell hybrid BG15 produced four subclones, BG15-4, BG15-6, BG15-7 and BG15-9, which contained variously sized complements of human chromosome 5 . BG15-6 contained an intact human chromosome 5, BG15-7 a deleted human chromosome 5 (5pter-q22) and BG15-4 and BG15-9 a translocation between parts of human chromosome 5 (pter-qter? and pter-q23, respectively) and a mouse chromosome . Southern DNA blot analysis showed that the human dihydrofolate reductase (DHFR) gene was present in all four subclones, whereas the human homolog of the v-fms gene was present in BG15-4 and 15-6, but absent from BG15-7 and 15-9 . BG15-4, 15-6 and 15-9 were sensitive to diphtheria toxin, and only BG15-7 was resistant to the toxin . We used these microcell hybrids to restrict further the regional location of the gene for diphtheria toxin sensitivity to the q23 region of human chromosome 5. Arch Gynecol Obstet, 1987, 241(3), 177 - 82 Serum CRP in the diagnosis and treatment of pelvic inflammatory disease; Hemila M et al.; The usefulness of serum C-reactive protein (CRP) measurement was studied in a population of 152 patients admitted to a gynaecological emergency unit . Fifty-one of 55 patients with PID had raised (over 10 mg/l) (13-270 mg/l) CRP levels with a mean of 76.1 mg/l . CRP was elevated (12-40 mg/l) in 2 of 18 patients with threatened abortion with successful outcome, in 8 of 28 patients with incomplete abortion, and in 2 of 16 patients with ectopic pregnancy . Furthermore, 6 of 35 patients with noninfectious disorders (ovarian cyst, uterine fibroid, unexplained pelvic pains) had slightly elevated (12-59 mg/l) CRP levels . Thus, in this series a CRP greater than 10 mg/l had good sensitivity (93%) and specificity (83%) in the diagnosis of PID . Furthermore, CRP levels became normal much sooner than did erythrocyte sedimentation rate following effective antibiotic therapy, suggesting that it is useful in monitoring therapeutic response. Vutr Boles, 1987, 26(5), 105 - 8 {Risk factors and the prevention of status asthmaticus in bronchial asthma patients}; Petrov D et al.; For a 10 year period 1005 patients with bronchial asthma were treated . 203 (20.19%) of these patients, from 17 up to 71 years of age (mean age 44.2 years) and duration of the disease from 2 up to 28 years, had been in asthmatic state . For this 10 year period 72 (35.46%) of these 203 patients had been in asthmatic state from 2 to 7 times with an interval of 1.5 to 3.5 years . The asthmatic state is a frequent and severe complication of bronchial asthma sometimes with lethal outcome . As risk factors for the development of asthmatic state in asthmatic patients can be pointed out the insufficient treatment of the asthmatic attacks before admittance to the hospital, ill founded corticosteroid treatment and late search for medical help . The antibiotic therapy in patients with an asthmatic attack due to pulmonary infection influences favourably the bronchial obstructive syndrome and is the best prophylaxis of asthmatic state parallel with founded corticosteroid treatment, well organized prophylactic medical care and improvement of the medical knowledge of asthmatic patients. Pharmacotherapy, 1987, 7(5), 188 - 90 Spiramycin in the treatment of cryptosporidiosis; Pilla AM et al.; Spiramycin, a macrolide antibiotic, has been advocated for the treatment of cryptosporidiosis . The disease most commonly occurs in patients with AIDS and can be debilitating, as diarrhea and malnutrition may be contributing factors in the death of these patients . Until recently, treatment for cryptosporidiosis has been largely symptomatic . Response rates with drug therapy such as metronidazole, quinidine-clindamycin, and pentamidine have been extremely poor . Although response to spiramycin has appeared promising, there have been several reported cases of treatment failure . Further investigation with the agent is advocated to determine its role in the treatment of cryptosporidiosis. Drugs Exp Clin Res, 1987, 13(9), 539 - 46 Concentration and time dependence of amphotericin B-induced permeability changes across plasma membrane vesicles from Leishmania sp; Cohen BE et al.; The main purpose of this paper is to show that the polyene antibiotic amphotericin B may form two types of channels in plasma membrane vesicles from Leishmania sp.: ionic and aqueous . The experimental design was to follow the light scattering changes of a suspension of membrane vesicles under an osmotic shock . The results show that a low concentration of amphotericin B(0.2 to 0.8 microM) led to an enhancement of urea and salt permeability without affecting the total osmotic response of Leishmania vesicles . Such an increment of solute permeability induced by low concentrations of amphotericin B was 100% blocked by tetraethylammonium . Low concentrations of amphotericin B were also able to induce an enhancement of glucose permeability but only after Leishmania membrane vesicles were incubated for 15 min with the antibiotic, previous to mixing . On the other hand, high amphotericin B concentrations (greater than 0.8 microM) induced a decrease in the total extent of shrinkage of membrane vesicles immediately after its mixing with urea solutions . At this high concentration of amphotericin B the blocking of tetraethylammonium was reduced by 50% . These results support the authors' previous conclusion (1) that in ergosterol-containing membranes, amphotericin B may form two different types of channels differing in internal diameter. Allerg Immunol (Paris), 1987 Jan, 19(1), 13 - 7 The viral factor in childhood asthma; Oehling A et al.; Independently of the important role the infections bacterial factor plays in childhood asthma, many authors have considered the virus the primary triggering factor of bronchospasm . This latter factor has been so exaggerated that some authors have even conceded it the maximum importance . In studies carried out with a more numerous population than in those works presented so far, controlling the presence of antibodies during the crisis and a week later in serum from asthmatic children, the authors found that only 13.5% presented specific antibodies against one or two of the sixteen viral antigens studied . These children at the same time developed a bacterial infection which remitted with antibiotic therapy, with the consequent disappearance of the asthma . In etiopathological studies realized in 700 children it was equally confirmed that the bacterial factor was involved in 90% of the cases, in the sense of a sinopulmonary syndrome . More profound studies are needed to clarify this point which is held in little consideration by many clinicians. Arq Gastroenterol, 1987 Jan-Mar, 24(1), 30 - 5 {Acute emphysematous cholecystitis . Report of a case and review of the literature}; Waisberg J et al.; The authors report a case of acute emphysematous cholecystitis (AEC) operated on at the University Hospital of ABC Medical School (Sao Paulo), with a review of the literature . The infrequency of this finding and the participation of local ischemic factors, associated with secondary infection by gas forming bacteria are pointed out . The authors emphasize the importance of considering this entity potentially more severe than acute non-emphysematous cholecystitis (AnEC) because in AEC gallbladder gangrene is 30 times higher and perforation occurs 5 times more frequently than in AnEC . Besides, the patient with AEC may shows no clinical signs of severity, as in the case reported, where gallbladder gangrene was seen at surgery . In AEC, diagnosis is established usually when the plain abdominal X-ray shows gas within the gallbladder or in its walls . The best results are obtained with cholecystectomy and antibiotic therapy. Adv Exp Med Biol, 1987, 224, 93 - 115 Pathogenesis and significance of urogenital mycoplasmal infections; Cassell GH et al.; U . urealyticum and M . hominis can no longer be considered as harmless commensals of the lower genitourinary tract . Both can produce disease in humans . Diagnosis and management of infections due to these organisms must be based upon isolation of the organisms from the affected site and preferably the number of organisms present . Due to the frequent resistance of both organisms to tetracycline, treatment must be based upon appropriate antibiotic sensitivities . For a more detailed description of the basic biology of these organisms and isolation and identification and treatment, the reader is referred to several recent reviews. Curr Genet, 1987, 12(5), 305 - 10 Phenotypic suppression and nuclear accommodation of the mit- oxi1-V25 mutation in isolated yeast mitochondria; Zagorski W et al.; Phenotypic suppression by the antibiotic, paromomycin, of the mitochondrial oxi1- -V25 mutation, a mutation which arrests by premature ochre codon the synthesis of the cox II subunit, was studied in isolated yeast mitochondria competent in translation . This antibiotic is known to suppress the mutation in vivo (Dujardin et al . 1984) and allowed in vitro, at concentrations of 20-1100 micrograms per ml . the synthesis of the cox II subunit . This strongly suggests that phenotypic suppression of mit- mutations is due to the direct action of paromomycin on mitochondrial ribosomes . The effect of paromomycin bears a resemblance to the function of the omnipotent nuclear suppressor mutation R705 . The nuclear suppression was expressed in isolated mitochondria; suppressor mutation influenced the structure of the mitoribosome . Therefore, it appears that mitoribosomes are indeed the common target in the phenotypical and genetic nuclear suppression of the oxi1-V25 mutation. Ciba Found Symp, 1987, 130, 229 - 46 Gene therapy: efforts at developing large animal models for autologous bone marrow transplant and gene transfer with retroviral vectors; Eglitis MA et al.; Two new large animal models, non-human primates and fetal sheep, have been developed in an effort to determine the feasibility of using retroviruses for gene therapy . The retroviral vectors N2 and SAX have been used to introduce the genes for neomycin phosphotransferase (neoR, conferring resistance to the antibiotic G418) and human adenosine deaminase (ADA; EC 3.5.4.17), respectively . Varying levels of human ADA activity have been detected in six of the eight SAX-treated monkeys analysed . In the monkey with the greatest activity, human ADA levels approximately 0.5% of endogenous monkey ADA levels were detected . By in situ hybridization, roughly one in 100 bone marrow cells were found to express vector DNA . Sheep have been used for studies of the infectability of fetal blood progenitors in vivo . Blood cells were treated with the N2 vector at the 96th day of gestation, and marrow cells were assayed for the presence of G418-resistant haematopoietic progenitors, starting from one week after birth (62 days after treatment) . Up to 33% of colony-forming progenitors were drug resistant initially and, although the proportion of resistant colony-forming units declined, a level of 10% has been found 153 days after transplantation . Human bone marrow has also been treated with the N2 vector, resulting in 1-2% G418-resistant progenitors. Acta Anaesthesiol Belg, 1987, 38(4), 333 - 9 Complications of splenectomy; Shatney CH; During the last three decades it has become clear that removal of the spleen, for any reason, is not a benign procedure . In both adults and children splenectomy places the patient at significantly higher risk of overwhelming infection, compared to the normal population . The risk of the post-splenectomy septic syndrome is lifelong and is not eliminated by the administration of polyvalent pneumococcal vaccine . Thus far, the reported rate of overwhelming sepsis in asplenic individuals has ranged from 2.5-13.5% . As more long-term follow-up data become available, it is likely that the true incidence will be 5-10% . In addition to this late complication, splenectomy increases the frequency of adverse events, including death, in the immediate postoperative period . Infections, particularly pulmonary and abdominal sepsis, constitute the majority of the complications . The mortality rate from postoperative sepsis is substantial . Atelectasis, pancreatitis/fistula, pulmonary embolism and bleeding at the operative site are also relatively common occurrences following splenic removal . These alarming statistics have spurred surgeons to change their attitudes concerning splenectomy for trauma, both accidental and iatrogenic . Nonoperative management of hemodynamically stable patients with isolated splenic injury and splenorrhaphy in patients requiring laparotomy are now firmly entrenched in the surgical armamentarium . Patients in whom splenectomy is necessary are given polyvalent pneumococcal vaccine and are instructed to seek early medical attention for febrile illnesses . Splenic autotransplantation and lifelong prophylactic antibiotic therapy have been used in some centers, but their clinical value remains to be proven. Ann Biol Clin (Paris), 1987, 45(6), 673 - 9 {Current role of amphotericin B in the treatment of deep mycoses}; Dei-Cas E et al.; Amphotericin B (Am . B), a polyene heptaene, is an antifungal antibiotic substance produced by Streptomyces nodosus, a telluric actinomycetal from Venezuela . Although it is a very toxic substance and its pharmacokinetic is not completely known, Am . B is yet the former antifungal substance utilised against number of pathogenic agents of systemic mycoses . Am . B binds irreversibly to sterols of fungal cytoplasmic membranes causing a leak of potassium and other impairments leading the fungal cell to death . Further, Am . B might to induce an enhancement of humoral and cellular immunity . After intravenous perfusion, 95 per cent of Am . B binds to plasma lipoproteins . Only a low proportion of the Am . B serum level is detected in the CSF . Distribution of Am . B to extravascular inflammatory fluids and secretions might be letter . Am . B might be eliminated essentially by biliary way . Am . B toxic effects are very frequent . Generalized reactions are observed to the earlier doses . Toxic visceral, above all, nephrotoxic manifestations, appearing later . Recent results, from experimental and human infections suggest that Am . B encapsulated in liposomal vesicles is more active, less toxic and more easily administered. Clin Ther, 1987, 10 Suppl A, 66 - 71 Treatment of nosocomial aspiration pneumonia and soft-tissue infections in diabetic patients; Venezio FR; Nosocomial aspiration pneumonia and infections of soft tissue are most often caused by mixed aerobic and anaerobic pathogens . Single-agent therapy with a beta-lactam antibiotic is tending to replace combination therapy because it is as effective and less toxic . Important considerations in choosing among the beta-lactam antibiotics include a long pharmacologic half-life, permitting less frequent administration, and cost per gram. Biomed Pharmacother, 1987, 41(5), 233 - 7 Clinical studies of aclacinomycin A (ACM); Majima H et al.; Aclacinomycin A (ACM) is a new anthracycline antibiotic, isolated from Streptomyces galilaeus . This agent is presenting major chemical differences from the conventional anthracycline DNR and ADM, as a class II anthracyclines which inhibit more RNA than DNA . In clinical studies, good CR responses ranging about 30% in AML patients depend upon their background . Toxicities consisted of mainly upper GI tract and bone marrow . Cardiac toxicities, especially late cumulative effects are not reported . Some responses noted in malignant lymphomas and breast carcinoma, but needed further studies, including possibility of cross resistance and differentiation effects. Drugs Exp Clin Res, 1987, 13(6), 345 - 51 Antitumor activity of new N-substituted daunorubicin derivatives; Mazerska Z et al.; The biological properties of two new structural groups of modification products of daunorubicin, the N-glycosyl and enamino derivatives, were investigated . The activities of the compounds were characterized in vitro (yeasts and leukaemia cells) and in vivo (L1210 leukaemia in mice) . Among the compounds studied DR-19, N-(1-carboethoxypropen-1-yl)daunorubicin, exhibited activity comparable with that of the parent antibiotic . The correlation coefficients calculated showed good correlation between in vitro tests . In vitro activity and potency (reciprocal of optimal dose) in mice leukaemia were also correlated . However, no correlation between the in vitro activity and activity in mice leukaemia (increase of life span) was observed. Arkh Patol, 1987, 49(4), 3 - 9 {Role of opportunistic fungi in human pathological anatomy}; Khmel'nitskii OK et al.; The role of opportunistic fungi (OF) in modern human pathology is discussed in connection with the increased incidence of mycotic infections caused by these organisms . Due to a complex of biological properties, OF are able to survive both in the environment and in human body, exhibiting their pathogenic potential when the body defenses are compromised . The highest frequency of infections caused by OF is encountered in the presence of risk factors (immunodeficiencies, endocrinopathies, oncological and hematological diseases, organ transplantation, antibiotic and corticosteroid therapy, infancy and pregnancy) . The spectrum of lesions caused by OF encompasses practically all organs and systems . Being a secondary process, mycotic infection may either have no influence on the primary process, or aggravate it . In most severe cases it may overbalance the importance of the underlying disease . Cytohistological methods play a special role in the diagnosis of mycotic infections, as they are able to reveal the invasive process, evaluate its extent and the characteristics of host defense responses. Respiration, 1987, 51 Suppl 1, 42 - 51 Ambroxol for the prevention of chronic bronchitis exacerbations: long-term multicenter trial . Protective effect of ambroxol against winter semester exacerbations: a double-blind study versus placebo; Olivieri D et al.; In a 6-month, double-blind multicenter trial conducted over the winter, the effects of daily administration of ambroxol retard (75 mg) were compared with those of placebo in preventing exacerbations and improving symptoms and clinical signs in chronic bronchitis patients . The trial was completed by 110 patients in the ambroxol group and by 104 in the placebo group . Initially, there were no significant differences between the groups . By the end of the 2nd month of treatment, 67.2% of the ambroxol group had had no exacerbations compared to 50.4% in the placebo group . At the end of the 6-month trial, 45.5% of the treatment group had had no exacerbations, compared to only 14.4% of the control group . These differences were statistically significant . Patients in the treatment group lost significantly fewer days through illness (442) and had fewer days when they needed antibiotic therapy (371) compared to the placebo group patients (837 and 781) . Ambroxol also produced statistically significant symptomatic improvement, measured as difficulty in expectoration, coughing, presence of dyspnea and the auscultatory signs as compared to controls . Since ambroxol was well tolerated and compliance was good, it appears like a drug of choice for pharmacological prophylaxis of chronic bronchitis. J Chronic Dis, 1987, 40(7), 651 - 60 Prescription drug use among diabetics--a population study; Isacson D et al.; Diabetes mellitus is a multifaceted disease which intervenes in the personal lives of those afflicted in many different ways . In this study prescription drug use among diabetics was analyzed in order to shed light on the characteristics of diabetic morbidity . Prescription drug use among diabetics and non-diabetics in a total population of 21,000 inhabitants in a defined geographic area were studied . The diabetic population was categorized according to the type of treatment received: insulin treatment, oral anti-diabetic treatment or dietary treatment or dietary treatment only . The pattern of prescription drug use differed between diabetics and non-diabetics and important differences were observed also between diabetics according to type of treatment . Drug use among those treated with insulin and those treated orally was substantially higher than among non-diabetics while the difference between diabetics on dietary regimen and non-diabetics was much smaller . All three treatment groups had considerably higher consumption of cardiovascular drugs than non-diabetics . Additional findings include more frequent antibiotic use among diabetics treated orally and on diet only than among non-diabetics . The use of these drugs was also common among insulin treated diabetics but did not differ significantly from among non-diabetics . Use of psychotropics was more common among diabetics treated with insulin and orally than among non-diabetics. Br J Neurosurg, 1987, 1(3), 343 - 51 Experience with 'open evacuation of pus' in the treatment of intracerebral abscess; Maurice-Williams RS; Twenty-seven of 29 consecutive patients with brain abscess were treated by 'open evacuation of pus' . This technique involves wide exposure of the brain so that the abscess capsule may be incised and cleared of pus under direct vision . The empty capsule is left in situ after antibiotic irrigation and the wound is closed without drainage . Of the 27 patients, one died (3.7%), two were partly disabled and 24 (88.9%) were left with no neurological disability caused by the abscess . In only one case was a further operation required to remove pus which had reformed after an adequate primary clearance . There were no cases of wound sepsis or of late recurrence of the abscess . The author believes that 'open evacuation of pus' is the most satisfactory surgical technique for an intracerebral abscess. Ophthal Plast Reconstr Surg, 1987, 3(1), 1 - 7 Orbital cellulitis with periosteal elevation; Lemke BN et al.; Computerized tomography scan evidence of periosteal elevation in patients with orbital cellulitis is interpreted in the current medical literature as an indication of subperiosteal abscess . We present three such cases in which surgical drainage yielded clear fluid or granulation tissue rather than pus . A fourth case resolved on antibiotic therapy alone . Cases of periosteal elevation that resolve without surgery may represent inflammatory effusion, infections of lesser virulence, or propagation of granulation tissue rather than true abscesses . We suggest that periosteal elevation seen in patients with orbital cellulitis should represent a relative rather than an absolute indication for drainage surgery. Arch Immunol Ther Exp (Warsz), 1987, 35(5), 699 - 724 Biosynthesis of benzylpenicillin by Penicillium chrysogenum and its Golgi apparatus; Kurylowicz W et al.; The fine structure of high and low-yield mutants of Penicillium chrysogenum producing 10,000 and 100 units of benzylpenicillin was compared . The cells of both mutants showed typical eukaryotic ultrastructure . The Golgi vesicles, present in largest number in cells of high-yield mutant, fuse with the cell membrane and play an important role in the transport of benzylpenicillin from the cytoplasm to the cell environment . Benzylpenicillin was localized in cells of the high-yield mutant by means of enzymatical and immunological methods . The results indicate that benzylpenicillin is stored in the vesicles of the Golgi apparatus . The Golgi vesicles isolated from the protoplasts of high-yield mutant showed activities of enzymes of the pathway of benzylpenicillin biosynthesis i.e., delta-/L-alpha-aminoadipyl/-L-cysteinyl-D-valine synthetase, isopenicillin N synthetase, phenylacetyl: coenzyme A ligase, and acyl-exchange activity . Cell-free biosynthesis of antibiotic by the native Golgi vesicles was investigated in a well-defined reaction mixture . The native Golgi vesicles produced antibiotic in amount corresponding to 320 nmol.mg protein-1.h-1 . The activity yield of the calcium alginate immobilized Golgi vesicles was 44% . Moreover, a hypothetical scheme for localization of the enzymes of pathway of benzylpenicillin biosynthesis in the cells of high-yield mutant is presented. Clin Ther, 1987, 9(5), 512 - 22 Efficacy of a new intravenous immunoglobulin preparation in primary immunodeficient patients; Ochs HD et al.; The safety and efficacy of a new second-generation intravenous immunoglobulin manufactured using ion-exchange chromatographic methods was studied in 17 patients with primary immunodeficiency . In assessing safety, the incidence of adverse reactions during the first 48 hours after each infusion and long-term changes in laboratory values were considered . Efficacy was determined by the number of acute and new chronic infections as well as by the number of prescriptions filled for antibiotics . These results were compared with those reported for similar preparations . Results showed a low (4.4%) incidence of acute adverse reactions, and no serious reactions or significant changes were noted in any of the laboratory test results . The incidences of infection and antibiotic usage were as low as or lower than those reported with other preparations . Thus we conclude that this new intravenous immunoglobulin product is a safe, effective prophylactic treatment for patients who have primary immunodeficiency. Eur J Nucl Med, 1987, 13(3), 121 - 4 Intestinal accumulation of 111In-granulocytes in patients studied because of occult infection; Syrjala MT et al.; 111In-granulocyte scintigraphy was performed on 245 patients in whom a localized infection was suspected . In 123 patients scintigraphy was positive and of these 35 (28%) had intestinal accumulations of 111In-granulocytes . Specific local causes for the intestinal uptake of radioactivity were antibiotic associated colitis (eight patients), local pyogenic bowel infection (four patients), systemic disease (two patients), bowel necrosis (two patients), colonic cancer (one patient) and Stevens-Johnson's syndrome (one patient) . Nonspecific mechanisms of bowel accumulation were desquamation of labelled granulocytes (12 patients) and bleeding (two patients) . In three cases the mechanism of colonic accumulation of granulocytes was not revealed . These results show that unexpected accumulations of labelled granulocytes in the gut is not a rare phenomenon and is often due to clinically significant intestinal inflammation or other disease, especially in patients who do not have signs of respiratory, pancreatic or oesophageal inflammation causing desquamated granulocytes to accumulate in the gut. C R Acad Sci III, 1987, 304(12), 325 - 9 {A statistical model for interpreting the antibiogram}; Scavizzi M et al.; Up to now, to interpret antibiotic susceptibility tests, the common practice has been to use: first, breakpoints without any quantitative justification, secondly, concordance curves between the different measurement techniques; these are not well adapted to the heterogeneous character of bacterial populations . We hereby propose another method: it is based on a global data analysis for each bacterial species, each antibiotic family and each measurement technique . So, we have drawn up a new model for the interpretation, both global and data-processed; it is based on qualifying classes, which are obtained and interpreted by hierarchical ascendent classification, principal components analysis, and comparison with pharmacological data . It can be used by any biologist . What is more, justified breakpoints with a numerical risk and quality control are defined . There are also some additional uses: evaluation of the effect of new antibiotics, standardization of new measurement techniques, detection of the emergence of new bacterial resistance in patients, guidance for research into unknown resistance mechanisms and characters. Eksp Onkol, 1987, 9(1), 37 - 40 {Cytotoxic factors of neutrophils in rats with 7,12-dimethylbenz{a}anthracene-induced sarcoma}; Cherdyntseva NV; A study of intraleukocyte cytotoxic system and phagocytic function of granulocytes was carried out in rats with 7,12-dimethylbenz(a)anthracene-induced sarcoma . There were no distinctive alterations of microbicidal factors of polymorphonuclear neutrophils (PMN) at the initial stage of the tumour growth . The inhibition of some antibiotic neutrophil factors at later stages of the tumour growth in rats was compensated by preferential activity of others . The essential impairments of both the oxygen-dependent and oxygen-independent mechanism of cytotoxicity of PMN at the terminal stage of sarcoma growth were detected . At the same time the phagocytic activity of neutrophils was depressed. Aviat Space Environ Med, 1987 Jan, 58(1), 83 - 5 Implications of emerging isoniazid resistance in Mycobacterium tuberculosis in Korea; Berliner DS et al.; In 1981, the Korean National Institute of Health (KNIH) reported that 17% of all tuberculosis patients had primary resistance to isoniazid while an additional 17% acquired isoniazid resistance during chemotherapy . This 34% isoniazid resistance rate in the Republic of Korea, where an estimated 6-8% of the total population have active tuberculosis, poses significant concerns regarding management of U.S . military health care beneficiaries who develop tuberculosis or have tuberculosis skin test conversion while residing in or after departure from Korea . To address this issue, the prevalence of Korean acquired isoniazid resistance was estimated in U.S . beneficiaries by performing antibiotic sensitivities on all positive cultures from October 1981 through December 1982 . Of 42 patient isolates, six were isoniazid resistant (14.3%) . When the data was analyzed further, it was determined that as many as 9.5% of those U.S . beneficiaries infected had primary isoniazid resistance . This is higher than the most recent U.S . population-based drug resistance study, in which 6.9% of tuberculosis patients had primary drug resistance . This data comparison points toward the need for judicious management of Korean acquired infections and skin test conversions . Emphasis is on criteria necessary to warrant use of chemotherapeutic agents other than isoniazid to prevent further introduction of resistant organisms into locales where isoniazid resistance is not as prevalent as reported in Korea. Gene, 1987, 54(1), 73 - 81 Selectable genes for transformation of the fungal plant pathogen Glomerella cingulata f . sp . phaseoli (Colletotrichum lindemuthianum); Rodriguez RJ et al.; Glomerella cingulata f . sp . phaseoli (Gcp) was transformed using either of two selectable markers: the amdS + gene of Aspergillus nidulans, which encodes acetamidase and permits growth on acetamide as the sole nitrogen source and the hygBR gene of Escherichia coli which encodes hygromycin B (Hy) phosphotransferase and permits growth in the presence of the antibiotic Hy . The amdS+ gene functioned in Gcp under control of A . nidulans regulatory signals and hygBR was expressed after fusion to a promoter from Cochliobolus heterostrophus, another filamentous ascomycete . Protoplasts to be transformed were generated with the digestive enzyme complex Novozym 234 and then were exposed to plasmid DNA in the presence of 10 mM CaCl2 and polyethylene glycol . Transformation occurred by integration of single or multiple copies of either the amdS+ or hygBR plasmid into the fungal genome . There was no evidence of autonomous