Neurology, 1994 Jul, 44(7), 1203 - 7 Comparison of intravenous penicillin G and oral doxycycline for treatment of Lyme neuroborreliosis; Karlsson M et al.; To compare the efficacy of oral doxycycline and IV penicillin G for the treatment of neuroborreliosis, we randomized consecutive patients with Lyme neuroborreliosis to receive either IV penicillin G (3 g q 6 h) or oral deoxycycline (200 mg q 24 h) for 14 days . All patients had antibodies against Borrelia burgdorferi in serum, CSF, or both, or had a positive CSF culture . Twenty-three patients randomized to penicillin G and 31 patients to doxycycline were included in the study . All patients improved during treatment, and there were no significant differences between the two treatment groups in patient scoring, CSF analysis, or serologic and clinical follow-up during 1 year . There were no treatment failures, although one patient in each treatment group was re-treated because of residual symptoms . In conclusion, oral doxycycline is an adequate and cost-effective alternative to IV penicillin for the treatment of Lyme neuroborreliosis. J Neurol Neurosurg Psychiatry, 1994 Jul, 57(7), 865 - 7 Jarisch-Herxheimer reaction in a patient with neurosyphilis; Zifko U et al.; A 40 year old man presented with progressive personality changes in the previous six months . Specific serological tests for syphilis in blood and CSF were highly positive and CSF sedimentation showed signs of an inflammatory process . Ten hours after the start of penicillin treatment a severe symptomatic Jarisch-Herxheimer reaction with alteration of level of consciousness, pupillary changes, and focal neurological signs developed . Jarisch-Herxheimer reaction may occur in various settings, particularly in the treatment of syphilis . Investigation of CSF before the treatment may predict a potential risk . Corticosteroid treatment has been suggested for prevention. Pediatrics, 1994 Jul, 94(1), 24 - 8 The incidence of prenatal syphilis at the Boston City Hospital: a comparison across four decades; Klass PE et al.; OBJECTIVE . To examine the incidence and epidemiologic correlates of congenital syphilis at an inner-city Boston hospital, and draw comparisons with the situation at the same hospital 40 years ago . DESIGN . Chart review and comparison with data collected in 1951 . SETTING . Maternity and pediatric services at Boston City Hospital . METHODS . A study conducted in 1951 on the maternity service of Boston City Hospital in which demographic data were collected on all women admitted in labor over a 5-month period was replicated . Serologic testing for syphilis was carried out on these women, and the demographic and medical correlates of positive maternal syphilis serology were examined . This study was repeated exactly 40 years later, using the cord blood screening for syphilis done routinely at delivery and a review of prenatal records . RESULTS . From a group made up largely of married white women in 1951, the study population shifted in 1991 to a group made up mostly of minority women, with 75% unmarried . In 1951, 24 patients were diagnosed with syphilis either before or during the pregnancy, giving a prevalence rate of 2.4% . In 1991, 25 of 647 women were diagnosed with syphilis, for a prevalence rate of 3.9% . The women with positive cord blood serologies had a higher rate of other sexually transmitted diseases and substance abuse . No symptomatic cases of congenital syphilis were seen in 1951 or in 1991, although at least 11 of the 26 infants born to mothers with positive serologies in 1991 received intravenous penicillin therapy . CONCLUSIONS . The continued prevalence of diagnosed syphilis in women at delivery reflects an inner-city epidemic of congenital syphilis that is tied to substance abuse, human immunodeficiency virus, and changing social patterns, as well to older problems of serologic screening, prenatal care, treatment failures, and maternal reinfection . It is essential that screening programs be maintained and improved in this high-risk population, and that infants born to mothers with positive serologies receive full and adequate treatment if there is any doubt at all about their infection status. J Neurol Sci, 1994 Jul, 124(2), 188 - 97 Dynamic changes of focal hypometabolism in relation to epileptic activity; Witte OW et al.; The interictal hypometabolism in patients with focal epilepsy is usually regarded as stationary . In this study we investigated to which extent the hypometabolism may depend on the activity of the epileptic focus . In focal penicillin-induced epilepsy in rats the epileptic focus is hypermetabolic . This focus is accompanied by hypometabolism in widespread areas of adjacent cerebral cortex . The experiments revealed that these metabolic alterations are transient . Data from a patient experiencing a focal seizure during PET scanning gave similar results . They showed that the transition from interictal to ictal activity was accompanied by the development of hypermetabolic epileptic focus and the dynamic enlargement of the surrounding hypometabolism . Both, the experimental and clinical data provide evidence that the cerebral hypometabolism may vary in size depending on the activity of the epileptic focus . It is hypothesized that in human PET studies the large interictal hypometabolism may prevent the identification of hyperactive interictal epileptic foci due to the partial volume effects resulting from the limited spatial resolution of PET cameras. Intensive Care Med, 1994 Jul, 20 Suppl 3, S14 - 20 Pharmacokinetic characteristics of piperacillin/tazobactam; Sorgel F et al.; Piperacillin/tazobactam is a new combination of a broad-spectrum penicillin and a beta-lactamase inhibitor . In studies in healthy volunteers, the pharmacokinetics of piperacillin combined with tazobactam were similar to those of piperacillin alone . In contrast, tazobactam administered with piperacillin achieved higher plasma concentrations and had a longer half-life than tazobactam administered alone . Intravenous infusion of 4.0 g piperacillin with 0.5 g tazobactam over 5 min resulted in mean maximum plasma concentrations of 380 micrograms piperacillin/ml and 35.3 micrograms tazobactam/ml; half-lives were 1.14 h for piperacillin and 0.92 h for tazobactam . Within 30 min of infusion, piperacillin/tazobactam achieves 16-85% of plasma concentrations in skin, muscle, lung, gallbladder, and intestinal mucosa . Plasma and tissue levels remain above the MIC90s of major pathogens for 2 h post administration . These findings show that piperacillin/tazobactam is truly synergistic combination which can be expected to be effective in treating a wide variety of infections in the clinical setting. Clin Exp Dermatol, 1994 Jul, 19(4), 321 - 3 Pre-septal cellulitis and facial erysipelas due to Moraxella species; Cox NH et al.; We describe a patient with an acute ulcerated pre-septal cellulitis with subsequent spread across the face, in whom conjunctival swabs demonstrated the presence of Moraxella species . Unusually, this organism was resistant to penicillin . Clinical improvement was only achieved when treatment with co-amoxiclav was commenced on the basis of the antibiotic sensitivities demonstrated by culture of this organism . Moraxella species are rare skin pathogens but may be underestimated as they usually respond to a wide range of antibiotics; they should be considered as a cause of facial cellulitis or erysipelas which responds poorly to conventional therapy. In Vitro Cell Dev Biol Anim, 1994 Jul, 30A(7), 420 - 4 Altered free calcium transients in pig kidney cells (LLC-PK1) cultured with penicillin/streptomycin; Bird SD et al.; The effect of a conventional antibiotic (penicillin/streptomycin) mixture on the widely used kidney epithelial cell line, LLC-PK1, was investigated by measuring growth and intracellular free calcium . Free calcium concentration was the same in cells cultured for 3 to 7 wk with ("plus") and without ("minus") antibiotics both at rest and when challenged with high (14 mM) external calcium . When exposed to vasopressin, minus cells exhibited significantly smaller calcium transients than plus cells . A similar difference existed for transients elicited by a calcium ionophore, 4-br-A23187 . After longer periods of culture (> 20 wk), minus cells grew slower than plus cells but on reaching confluence (minus cells took 1 day longer) the morphologies and viabilities were indistinguishable . The finding that culture with penicillin/streptomycin reversibly modified some properties of LLC-PK1 cells, at least partly through altered calcium homeostasis, is of importance for workers using this cell model to study drug effects and raises the general possibility of similar effects on other cultured cells. Clin Infect Dis, 1994 Jul, 19(1), 143 - 5 Bilateral pulmonary infiltrates in association with disseminated actinomycosis; Dontfraid F et al.; The most common infectious cause of bilateral upper-lobe pulmonary disease is tuberculosis . However, we recently encountered a patient with bilateral apical infiltrates and multiple soft-tissue abscesses caused by Actinomyces odontolyticus . Other findings included fever, weight loss, and leukocytosis, and the patient's only known source of immunosuppression was a long history of alcoholism . There was no history of diabetes, steroid use, or other chronic underlying disease . The diagnosis was made by culture of drainage fluid from one abscess . Therapy with intravenous penicillin G led to rapid clinical improvement and reduction in the infiltrates . To our knowledge, the presentation of pulmonary infection, with bilateral apical infiltrates due to A . odontolyticus has not been previously reported in the medical literature. Pharm Res, 1994 Jul, 11(7), 984 - 9 Drug binding by reservoirs in elastomeric infusion devices; Jenke DR; Drug binding by an elastomeric infusion device reservoir was assessed by measuring its ability to bind fifteen model solutes . Octanol/water (o/w) and hexane/water (h/w) partition coefficients were regressed against the reservoir's solute equilibrium binding constant to generate a binding model . The reservoir's drug binding ability was calculated with the model and drug partition coefficients, which were determined for seventeen commonly infused drugs including tobramycin, gentamicin, penicillin G, piperacillin, lidocaine, morphine, ceftriaxone, imipenem-cilastatin, amphotericin B, ticarcillin and clavulanate, pentamidine, vancomycin, foscarnet, desferoxamine, acyclovir, fluconazole and vinblastine . Formulations studied included 0.9% Saline and 5% Dextrose . With the exception of lidocaine, imipenem, vinblastine and fluconazole, octanol/formulation and hexane/formulation partition coefficients were too low to be measured for these drugs . Thus, the majority of the drugs, when reconstituted in 0.9% Saline or 5% Dextrose, will not be bound by the reservoirs . The magnitude of drug loss for the most highly bound species, fluconazole, is less than 2% . Therefore the reservoirs used in this study are essentially inert with respect to binding of the drugs evaluated in this study. Leber Magen Darm, 1994 Jul, 24(4), 171 - 3 {Acute segmental hemorrhagic penicillin-associated colitis in a 32-year-old patient}; Benz C et al.; We report on a 32-year old patient who developed acute abdominal cramps and bloody diarrhea two days after taking phenoxymethyl penicillin . After excluding other causes, we diagnosed an acute segmental hemorrhagic penicillin associated colitis . In this case report we discuss the literature on this diagnosis and present the etiology, course, prognosis, and differential diagnosis of this entity. Eur Respir J, 1994 Jul, 7(7), 1379 - 80 Skin lesions and an intrathoracic mass; Vasmel WL et al.; We describe a case of thoracic actinomycosis in a previously healthy man . The clinical features were a paramediastinal mass with skin lesions due to haematogenic dissemination . After parasternal mediastomy, the diagnosis was made . After treatment with penicillin, there was complete recovery. Rev Med Chil, 1994 Jul, 122(7), 795 - 802 {Mushroom poisoning in the IX region . Role of Amanita gemmata}; Sierralta A et al.; We report four episodes of mushroom poisoning that occurred between 1986 and 1990 in the province of Malleco . Twenty five of 36 individuals who ingested the mushroom became ill; they had an acute gastroenteritis that was followed in 7 by an acute hepatitis and in one by a massive upper gastrointestinal bleeding . Three subjects with fulminant hepatic failure and the subject with the massive bleeding died . Amanita gemmate (strain described as toxic in Chile since 1967) was found in two episodes and Amanita sp in one . The clinical picture is similar to that described for Amanita phaloides . The treatment is symptomatic but penicillin and silymarin may have an antitoxic action . The importance of warning the population about the existence of toxic mushrooms in Chile is emphasized. J Pediatr, 1994 Jun, 124(6), 859 - 62 Fatal pneumococcal septicemia in hemoglobin SC disease; Lane PA et al.; We retrospectively examined the medical and autopsy records of seven previously unpublished cases of fatal pneumococcal septicemia in children with hemoglobin SC disease . The earliest death occurred in a 1-year-old child who had congenital heart disease with cyanosis; the other children were aged 3 1/2 to 15 years . Only one child had received pneumococcal vaccine or prophylactic penicillin therapy . All seven children had an acute febrile illness and rapid clinical deterioration despite parenterally administered antibiotic therapy and intensive medical support . Erythrocyte pit counts in two patients were 40.3% and 41.7%, respectively (normal, < or = 3.6%) . Autopsy data from five cases showed marked splenic congestion without infarction in five, splenomegaly in four, and bilateral adrenal hemorrhage in three . These cases illustrate that functional asplenia predisposes some children with hemoglobin SC disease to the development of fatal septicemia after the age of 3 years . We conclude that pneumococcal vaccine should be administered to all children with hemoglobin SC disease and that acute febrile illnesses should be investigated promptly for the possibility of septicemia . The routine use of prophylactic penicillin therapy in infants and children with hemoglobin SC disease remains controversial. Clin Infect Dis, 1994 Jun, 18(6), 1004 - 6 Leptospirosis complicated by a Jarisch-Herxheimer reaction and adult respiratory distress syndrome: case report; Emmanouilides CE et al.; Leptospirosis, severe infection due to Leptospira interrogans, is a potentially lethal disease that causes multiple organ failure . In addition to hepatic, renal, and CNS involvement, which are classic complications of leptospirosis, the disease may also be complicated by adult respiratory distress syndrome . Treatment with penicillin may precipitate a severe Jarisch-Herxheimer reaction . The mechanisms of Leptospira-induced toxicity remain obscure . We report a near-fatal case of leptospirosis in a patient who developed a JHR and respiratory failure immediately after initiation of therapy. Lakartidningen, 1994 Jun 1, 91(22), 2255 - 6 {HIV spreads fast in Africa . Women and children especially, are at high risk}; Christenson B et al.; PIP: The HIV situation in Africa was very dismal in 1994, with about 10 million people infected . The causes of the rapid spread were the high incidence of sexually transmitted diseases (STDs), urbanization, and breakup of families because of migrations, since men often seek work at other places . In the age group of 15-19 years in Malawi, Uganda, and Zimbabwe, there were 5 HIV-infected women for 1 infected man, but in the 30-39 year age group, there 3 infected men for every 1 woman . A report from Kenya showed that 69% of boys and 25% of girls were sexually active, while 50% had more than 4 partners . Among 15-24 year old pregnant women, 36% had STDs . A study from the Ivory Coast indicated that HIV prevalence increased from 27% in 1987 to 53% in 1992 among patients who were seeking care for an STD in Abidjan . Among tuberculosis (TB) patients this increased from 16% to 35%, and among pregnant women from 7% in 1987 to 14% in 1992 . Another group, 745 prostitutes, were also studied in Abidjan . 48% were infected with HIV and 34% were infected both with HIV-1 and HIV-2 . It is estimated that 50-75% of HIV-infected people in Africa also had STDs, compared to 20% of the HIV-infected in Thailand and India and 5% in Brazil . It has been proven in a US cohort study that the treatment of STDs reduces the spread of HIV . In Gambia, Rwanda, Zaire, and Kenya, 50-100% of gonococcal isolates were resistant to penicillin and tetracycline, and 40% of women with symptoms of STD infection did not receive adequate treatment . A study from England indicated that both HIV and TB follow the same epidemiological patterns among men 30-39 and among women 20-29 years old . In developing countries HIV is the main risk factor for developing TB . About 4-5 million people have TB as a cofactor for HIV infection, of whom 80% are in Africa . In 1994 about 3% of TB cases were associated with HIV, which will increase to 10% by the year 2000 . Genitourin Med, 1994 Jun, 70(3), 196 - 9 An outbreak of a penicillin-sensitive strain of gonorrhoea in Sydney men; Rowbottom JH et al.; OBJECTIVE--To describe an outbreak of gonorrhoea caused by penicillin sensitive Wild type 1B2-Wt/1B2(FS), in homosexual men in Sydney . DESIGN AND SETTING--The study sample comprised all gonococcal isolates referred to the Gonococcal Reference Laboratory (GRL), New South Wales, Australia between 1 January 1990 and 30 June 1992 . Demographic data on Wt/1B2(FS) were sought by review of all request forms accompanying specimens to the GRL . Detailed review was undertaken of the clinical records of all men with gonorrhoea which had been differentiated by auxotype and serotype (A/S) from two large STD clinics in Sydney . MEASUREMENTS AND MAIN RESULTS--The first isolation of Wt/1B2(FS) was made in April 1990 and by the end of July 1992, 140 such isolates were identified in 131 patients . The male:female ratio was 130:1 suggesting male homosexual transmission, which was confirmed in 55 of 57 evaluable cases . There was a higher proportion of pharyngeal and anal infections among Wt/1B2(FS) isolates compared with all other male gonorrhoea . Demographic information showed that 60% of men with Wt/1B2(FS) were under the age of 30, and 80% lived in Central or Eastern Sydney . CONCLUSIONS--An outbreak of a penicillin sensitive strain of gonorrhoea has occurred in Sydney, primarily among gay men living in the inner city . The extent to which the outbreak represents an increase in the risk of HIV transmission is unclear. Appl Environ Microbiol, 1994 Jun, 60(6), 1705 - 10 Catabolism of lysine in Penicillium chrysogenum leads to formation of 2-aminoadipic acid, a precursor of penicillin biosynthesis; Esmahan C et al.; Penicillium chrysogenum L2, a lysine auxotroph blocked in the early steps of the lysine pathway before 2-aminoadipic acid, was able to synthesize penicillin when supplemented with lysine . The amount of penicillin produced increased as the level of lysine in the media was increased . The same results were observed in resting-cell systems . Catabolism of {U-14C}lysine by resting cells and batch cultures of P . chrysogenum L2 resulted in the formation of labeled saccharopine and 2-aminoadipic acid . Formation of {14C}saccharopine was also observed in vitro when cell extracts of P . chrysogenum L2 and Wis 54-1255 were used . Saccharopine dehydrogenase and saccharopine reductase activities were found in cell extracts of P . chrysogenum, which indicates that lysine catabolism may proceed by reversal of the two last steps of the lysine biosynthetic pathway . In addition, a high lysine:2-ketoglutarate-6-aminotransferase activity, which converts lysine into piperideine-6-carboxylic acid, was found in cell extracts of P . chrysogenum . These results suggest that lysine is catabolized to 2-aminoadipic acid in P . chrysogenum by two different pathways . The relative contribution of lysine catabolism in providing 2-aminoadipic acid for penicillin production is discussed. Arthritis Rheum, 1994 Jun, 37(6), 878 - 88 Treatment of Lyme arthritis; Steere AC et al.; OBJECTIVE . To test treatment regimens for Lyme arthritis . METHODS . Patients were randomly assigned to treatment with doxycycline or amoxicillin plus probenecid for 30 days . Patients who had persistent arthritis for at least 3 months after treatment with oral antibiotics or parenteral penicillin were given intravenous ceftriaxone for 2 weeks . RESULTS . Eighteen of the 20 patients treated with doxycycline and 16 of the 18 patients who completed the amoxicillin regimen had resolution of the arthritis within 1-3 months after study entry . However, neuroborreliosis later developed in 5 patients, 4 of whom had received the amoxicillin regimen . Of 16 patients (2 from the oral antibiotic study and 14 additional patients) who had persistent arthritis despite previous oral antibiotics or parenteral penicillin, none had resolution of the arthritis within 3 months after ceftriaxone therapy . The HLA-DR4 specificity and OspA reactivity were associated with a lack of response . CONCLUSION . Lyme arthritis can usually be treated successfully with oral antibiotics, but patients may still develop neuroborreliosis . Patients with certain genetic and immune markers may have persistent arthritis despite treatment with oral or intravenous antibiotics. Biol Chem Hoppe Seyler, 1994 Jun, 375(6), 373 - 8 Semisynthetic insulin analogues modified in positions B24, B25 and B29; Svoboda I et al.; New semisynthetic analogues of human insulin, modified in the C-terminal region of the B-chain, were prepared to refine our understanding of the importance of particular amino acid residues in the expression of hormone biological properties . The following insulin analogues were synthesized by trypsin-catalyzed peptide-bond formation between the C-terminal arginineB22 of des-octapeptide(B23-B30)-insulin and synthetic octapeptides with the epsilon-amino group of lysineB29 protected by a phenylacetyl group: {L-Lys(Pac)B29}insulin, {D-PheB24,B25,L-Lys(Pac)B29}insulin and {D-Phe(p-Et)B24, L-Lys(Pac)B29}insulin . Enzymatic deprotection using immobilized penicillin amidohydrolase yielded: human insulin, {D-PheB24,B25}insulin and {DPhe(p-Et)B24}-insulin . Biological in vitro potencies (specific binding to cultured human lymphocytes IM-9 and lipogenic potency in isolated rat adipocytes) of the semisynthetic analogues were estimated, ranging from 0.2 to 100% relative to porcine insulin. Ital J Neurol Sci, 1994 Jun, 15(5), 229 - 37 General paresis: neuropsychological and SPECT study of five cases; Farina E et al.; Although much less common than before the advent of the antibiotics, cognitive impairment due to general paresis can still be found in clinical practice . Five patients with general paresis underwent longitudinal neuropsychological assessment; on the occasion of the final evaluation, Single Photon Emission Tomography (SPECT) was also performed in four cases . The most frequent cognitive deficit at admission was long term spatial memory impairment, which was present in four patients . Only the two patients who received the highest dosage of intravenous penicillin therapy showed significant improvement at neuropsychological tests after treatment . SPECT findings included areas of cortical hypoperfusion and/or perfusion asymmetry in three out of four patients. Am J Vet Res, 1994 Jun, 55(6), 825 - 30 Disposition of penicillin G after administration of benzathine penicillin G, or a combination of benzathine penicillin G and procaine penicillin G in cattle; Papich MG et al.; Plasma concentration of penicillin G was evaluated in beef steers after administration of either a combination of benzathine penicillin G and procaine penicillin G in a 1:1 mixture at a dosage of 9,000 U/kg of body weight, IM (n = 5), 24,000 U/kg, IM (n = 5), or 8,800 U/kg, SC (n = 5), or benzathine penicillin G alone at a dosage of 12,000 U/kg, IM (n = 7) . Plasma concentration of penicillin G was measured by use of a high-performance liquid chromatography assay that had a limit of determination of 0.005 microgram/ml . At a dosage for this combination of 9,000 U/kg IM, and 8,800 U/kg, SC, which are approved label recommendations in Canada, and the United States, respectively, mean (+/- SEM) peak plasma concentration was 0.58 (+/- 0.15) and 0.44 (+/- 0.02) microgram/ml, respectively . Although plasma penicillin concentration was quantifiable for 7 days in the steers that received 9,000 U/kg, IM, and for 4 days in the steers that received 8,800 U/kg, SC, the concentration was < 0.1 microgram/ml in both groups after the first 12 hours . After administration of the combination at dosage of 24,000 U/kg, IM, there was an initial peak plasma concentration at approximately 2 hours; thereafter, plasma concentration decreased slowly, with half-life of 58 hours . Although plasma penicillin G concentration was quantifiable for 12 days at this dosage, concentration was < 0.1 microgram/ml after the first 48 hours . After the initial 48 hours, plasma concentration of penicillin was of similar magnitude and decreased at similar rate for the combination at dosage of 24,000 U/kg and for 12,000 U/kg of benzathine penicillin G alone.(ABSTRACT TRUNCATED AT 250 WORDS) Acupunct Electrother Res, 1994 Jun-Sep, 19(2-3), 129 - 40 Effect of electroacupuncture on the level of preproenkephalin mRNA in rat during penicillin-induced epilepsy; Wang BE et al.; Our previous studies have shown that seizure induced by injecting penicillin (0.24 mg/2 microliters) into hippocampus could be inhibited by electroacupuncture (EA) probably via decreasing enkephalin content in hippocampus . To determine whether this change reflected the peptide synthesis, preproenkephalin (PPE) mRNA was detected in hippocampus and some other limbic structures during seizure and after EA treatment by in situ hybridization . Four hours after injecting penicillin into hippocampus, PPE mRNA levels were significantly increased by 10 folds in entorhinal cortex, subiculum, CA1 area of hippocampus, amygdaloid nucleus and piriform cortex, whereas EA treatment apparently attenuated the seizure-induced increase of PPE mRNA in the areas mentioned above . The results indicated that EA may regulate the biosynthesis of PPE in hippocampus during seizure by an alteration in gene transcription. Biochem Med Metab Biol, 1994 Jun, 52(1), 27 - 35 Application of molecular genetics in public health: improved follow-up in a neonatal hemoglobinopathy screening program; Zhang YH et al.; Newborn screening for the hemoglobinopathies has been shown to reduce morbidity and mortality, particularly for sickle cell anemia, by facilitating initiation of penicillin prophylaxis by 4 months of age . The purpose of the current investigation was to determine whether molecular genetic follow-up testing could be introduced into a neonatal hemoglobinopathy screening program and, if successfully introduced, whether it would reduce time to diagnostic confirmation . Between July 1, 1991, and October 7, 1992, 518 original dried blood specimens were referred from the Texas Department of Health Neonatal Hemoglobinopathy Screening Program for molecular genetic follow-up testing . Allele-specific cleavage (ASC) after amplification with matched and mismatched polymerase chain reaction primers was compared to allele-specific oligonucleotide (ASO) hybridization . By November 2, 1992, molecular genetic analyses were definitive in 506, and agreement was observed between ASC and ASO hybridization in all specimens analyzed . Approximately 13% of those initially screened FS were considered probable S/beta-thal by DNA and RNA testing . Rapid molecular genetic analysis contributed to a substantial reduction of the mean age at confirmation by approximately 50%, to about 2 months of age . ASC is a reliable method for molecular genetic analysis of dried blood specimens, providing methodology which can be readily automated . An automated method is demonstrated that is based on microtiter plate technology and will significantly reduce labor intensity and costs, while increasing sample throughput . Even with current manual testing methods, DNA and RNA analysis of initial newborn screening specimens will reduce the age at confirmation well under 4 months, the age cut-off for effective initiation of penicillin prophylaxis. Aten Primaria, 1994 May 31, 13(9), 487 - 90 {Mycoplasma pneumoniae pneumonia: serologic study of a family outbreak in primary care}; Santos Lozano JM et al.; OBJECTIVE . To describe the clinical-radiological, epidemiological, therapeutic and evolutive characteristics of an outbreak of atypical Pneumonia in a family, which was serologically diagnosed by means of the technique of complement fixation of Pneumonia caused by Mycoplasma . DESIGN . A descriptive study . SETTING . An urban Health Centre . PATIENTS AND OTHER PARTICIPANTS . A family of 7 members, consisting of father, mother and five children . MEASUREMENTS AND MAIN RESULTS . Three presented Pneumonia caused by Mycoplasma pneumoniae, with the other family members remaining asymptomatic and serologically negative . The three cases evolved until cure . Treatment was with Macrolides in two of the cases and Penicillin in the other . Clinical-radiological dissociation existed in two of the patients . 33% had a secondary attack . CONCLUSION . The accessibility of Primary Care to microserological methods, together with the greater ease with which this level of Care can reach the family environment, allows for more precise knowledge of infectious epidemic outbreaks which occur in the community. J Biotechnol, 1994 May 31, 34(3), 259 - 68 High density cultivation of hybridoma in charged porous carriers; Ong CP et al.; A porous carrier whose surface is charged with polyethyleneimine (PEI) was evaluated for high-density cultivation of immobilized hybridoma cells . The carrier was used either in suspension or in fixed bed . For suspended carriers, the effect of carrier pore size, ion-exchange capacity (IEC), mixing intensity and inoculum concentration on the attachment and growth of HBs MAb-producing hybridoma cells in carrier CELLSNOW EX were studied . The carrier with 100 microns pore size was more efficient than that with 500 microns in supporting cell attachment . In addition, the amount of antibody which was detected by PHA (passive hemagglutination assay) was 4-times higher in 100 microns compared with 500 microns pore size . At low initial cell concentration, 2.8 x 10(5) ml-1, the attached cells did not grow in the first 7 d as indicated by a negligible glucose consumption . However, cell proliferation was observed at high inoculum, 9 x 10(5) ml-1 . Hybridoma cells were expected to attach faster to EX with high IEC than with low IEC but results showed no significant difference . A different hybridoma cell line producing monoclonal antibody (MAb) against penicillin-G-amidase was successfully cultivated in an axial-flow fixed bed containing CELLSNOW carriers . The specific glucose uptake rate as an indicator for cell activity was 24-times higher compared with conventional chemostat cultures . The CELLSNOW carriers offers many advantages over other carriers. Gene, 1994 May 27, 143(1), 79 - 83 The penicillin amidase of Arthrobacter viscosus (ATCC 15294); Konstantinovic M et al.; The nucleotide (nt) sequence of the gene encoding penicillin G amidase (PA) of Arthrobacter viscosus strain ATCC 15,294 was determined . The sequence contained an open reading frame of 2406 nt with a G+C content of 37% . The deduced amino-acid sequence shows significant homology with other so far identified beta-lactam amidases of Gram- bacteria. Pol Tyg Lek, 1994 May 16-30, 49(20-22), 472 - 4 {Treatment outcome of purulent meningitis in adults from material of the Clinic of Infectious Diseases AM in Lodz in the years 1990-1991}; Wrodycki W et al.; 81 patients (pts) with bacterial meningitis hospitalised in the Clinic for Infectious Diseases in the years 1990-1991 were treated according to two therapeutic schedules . First: young pts (under 40 years), without coexisting diseases obtained Penicillin G and aminoglycoside and/or synthetic penicillin . Second: pts over 40 years old with coexisting diseases or cases of recurrent meningitis were treated with third-generation cephalosporins and aminoglycoside and/or synthetic penicillin . The mortality was 16% in the study group . 11 of 13 pts with coexisting diseases died . Neurologic sequelae were found in 23% of pts . The complete recovery was obtained in 34% of pts, more often (35.9%) in a group treated with third--generation cephalosporins comparing to 29.4% with other antibiotic therapy. J Biotechnol, 1994 May 15, 34(2), 119 - 31 Segregated mathematical model for the fed-batch cultivation of a high-producing strain of Penicillium chrysogenum; Tiller V et al.; A new segregated mathematical model for the penicillin fed-batch process is presented and applied to the growth of the pellet-forming, industrially used high-producing strain Penicillium chrysogenum S2 . The model comprises two kinds of biomass (growing and producing, nongrowing and still producing), cell lysis, and complex medium as an important substrate for primary growth . In accordance with our experimental observation, product formation is not inhibited by glucose, but related to the growth rate . Maintenance metabolism is cell age-dependent . The model was verified with two sets of experimental data including exhaust gas measurements while keeping the estimated parameters almost constant . The presented model derived from that of Bajpai and Reuss (1980, 1981) does not describe our data properly . The particular influence of the pellet structure on the model is discussed . The necessity of new model assumptions (e.g., different kinds of biomass, non-constant maintenance coefficient) is explained by cell damage by lysis and shear forces, and the succeeding repair processes. Ann N Y Acad Sci, 1994 May 2, 721, 178 - 93 Improved expression of a hybrid Streptomyces clavuligerus cefE gene in Penicillium chrysogenum; Queener SW et al.; A hybrid cefE gene, encoding penicillin N expandase, was constructed by fusing the promoter sequences, Pcp, and terminator sequences, Pct from the Penicillium chrysogenum pcbC gene to the open reading frame (orf), cefEorf, from the Streptomyces clavuligerus cefE gene . The resulting hybrid gene, Pcp/cefE'orf/Pct, differed from a previously reported hybrid cefE gene contained on plasmid pPS65 . The latter gene, Pcp/cefE'orf/Sct, contained the Pcp sequences fused to the S . clavuligerus cefE orf still attached to the S . clavuligerus terminator sequences, Sct . The new hybrid gene was transformed into P . chrysogenum on plasmid vector pRH6 . Transformants were selected by phleomycin resistance conferred by a hybrid ble gene present on plasmid pRH6 . The hybrid ble gene was formed by attaching Pcp sequences to the ble orf . Among transformants obtained with pRH6, one exhibited a 70-fold higher level of activity of penicillin N expandase than the best transformant previously obtained from a 10-fold larger population of pPS65 transformants . The penicillin N expandase activity in pRH6 transformant, 9EN-5-1, was fourfold higher than the activity in the S . clavuligerus strain used as the source of the cefE orf and 75% of the activity observed in an industrial strain of Cephalosporium acremonium . Sequencing of the junctions of the heterologous DNA in Pcp/cefEorf/Pct uncovered a modification of the cefE open reading frame introduced during construction of the hybrid gene; the modified open reading frame is designated cefE'orf. Lab Invest, 1994 May, 70(5), 656 - 66 Defect of nephrogenesis induced by gentamicin in rat metanephric organ culture; Gilbert T et al.; BACKGROUND: In the rat, in utero exposure to gentamicin during early renal differentiation leads to a permanent nephron deficit . The aim of the present study was to analyze, in vitro, the potential direct effect of gentamicin on early nephrogenesis . EXPERIMENTAL DESIGN: We used paired rat metanephric organ cultures from 14 (F14) or 15-day-old (F15) fetuses . We measured gentamicin accumulation into explanted metanephroi and then assessed in vitro growth in the absence or presence of the drug . Glomerular labeling and counting were performed on the whole explant to analyze the effect of antibiotics on early nephrogenesis . RESULTS: Growth of F14 metanephric explants in the presence of 50 micrograms of gentamicin/ml was significantly reduced from 4 days onwards as compared to controls, whereas F15 explants grown with gentamicin displayed a normal in vitro development . After 6 days of culture, F14 and F15 explants had the same accumulation of gentamicin (1 microgram/mg protein) but the gentamicin content was 4 times larger in F15 explants . At both ages, gentamicin-exposed metanephric explants exhibited a significant reduction in their number of nephrons . However, the effects of 50 micrograms of gentamicin/ml on nephrogenesis were significantly more drastic on F14 than F15 explants (35% versus 18%) . When grown with 0.5 microgram of gentamicin/ml, F14 explants still exhibited a 16% defect in nephrogenesis as compared with controls, and about the same reduction was observed for cultures in the presence of 100 micrograms/ml of streptomycin and 100 IU/ml of penicillin . Incubation of F14 explants with streptomycin alone for 6 days had no effect on nephrogenesis . CONCLUSIONS: These results indicate that gentamicin induces a significant reduction in the number of nephrons in metanephric explants and that this effect is more important on less differentiated metanephroi . Metanephric organ culture combined with glomerular labeling represents a useful model to test the effect of various growth factors and other drugs on early nephrogenesis. Allergy, 1994 May, 49(5), 317 - 22 Immediate allergic reactions to amoxicillin; Vega JM et al.; A large group of patients with suspected allergic reactions to beta-lactam antibiotics was evaluated . A detailed clinical history, together with skin tests, RAST (radioallergosorbent test), and controlled challenge tests, was used to establish whether patients allergic to beta-lactam antibiotics had selective immediate allergic responses to amoxicillin (AX) or were cross-reacting with other penicillin derivatives . Skin tests were performed with benzylpenicilloyl-poly-L-lysine (BPO-PLL), benzylpenicilloate, benzylpenicillin (PG), ampicillin (AMP), and AX . RAST for BPO-PLL and AX-PLL was done . When both skin test and RAST for BPO were negative, single-blind, placebo-controlled challenge tests were done to ensure tolerance of PG or sensitivity to AX . A total of 177 patients were diagnosed as allergic to beta-lactam antibiotics . We selected the 54 (30.5%) cases of immediate AX allergy with good tolerance of PG . Anaphylaxis was seen in 37 patients (69%), the other 17 (31%) having urticaria and/or angioedema . All the patients were skin test negative to BPO; 49 of 51 (96%) were also negative to MDM, and 44 of 46 (96%) to PG . Skin tests with AX were positive in 34 (63%) patients . RAST was positive for AX in 22 patients (41%) and to BPO in just 5 (9%) . None of the sera with negative RAST for AX were positive to BPO . Challenge tests with AX were performed in 23 subjects (43%) to establish the diagnosis of immediate allergic reaction to AX, and in 15 cases (28%) both skin test and RAST for AX were negative . PG was well tolerated by all 54 patients . We describe the largest group of AX-allergic patients who have tolerated PG reported so far . Diagnosis of these patients can be achieved only if specific AX-related reagents are employed . Further studies are necessary to determine the exact extent of this problem and to improve the efficacy of diagnostic methods. Epilepsy Res, 1994 May, 18(1), 43 - 55 Afterpotentials of penicillin-induced epileptiform neuronal discharges in the motor cortex of the rat in vivo; Witte OW; Interictal spikes and sharp waves in the EEG are followed by intervals in which the excitability of the brain seems to be normal or decreased . Often interictal spikes even appear in rhythmical patterns with intervals in the order of 0.5-2 s . These observations suggest that intrinsic and synaptic inhibitory and excitatory processes are activated which outlast the duration of the interictal discharge . In the present study such afterpotentials were analyzed in penicillin foci of the rat motor cortex in vivo using intracellular recording techniques . Paroxysmal depolarizations (PDS) of neurons within the focus were followed by afterpotentials comprising several components . Fast afterpotentials with a duration of 640 ms were associated with a sevenfold increase in membrane conductance . The fast afterpotentials were depolarizing in the majority of recordings and had an average equilibrium potential of -62 mV . This equilibrium potential was Cl(-)-dependent and was not affected by intracellular EGTA or Cs+ . It is suggested that these afterpotentials represent GABAA responses . In 38% of the neurons slow afterhyperpolarizations with a twofold increase in membrane conductance and a duration of 2 s were observed . These afterhyperpolarizations had a reversal potential of -79 mV, were blocked by intracellular Cs+, were reduced in duration and amplitude by intracellular EGTA, and are suggested to present a combination of a GABAB response and a calcium-dependent potassium current . In addition, slow afterdepolarizations with a duration of about 1900 ms were registered in 16% of the recordings . It is concluded that afterpotentials with several intrinsic and synaptic components follow penicillin-induced PDS . Among these are giant Cl(-)-dependent potentials which probably represent GABAA responses, GABAB responses and a slow calcium-dependent potassium current . It is suggested that the depolarizing equilibrium potential of the Cl(-)-dependent component is due to intracellular Cl- accumulation which might favor transition to ictal discharges. Antimicrob Agents Chemother, 1994 May, 38(5), 1203 - 4 Penicillin concentrations after increased doses of benzathine penicillin G for prevention of secondary rheumatic fever; Currie BJ et al.; Plasma penicillin levels were studied 2, 3, and 4 weeks after intramuscular benzathine penicillin G (BPG) doses of 1,200,000, 1,800,000, and 2,400,000 U . Proportions of patients with penicillin levels above 25 ng/ml at each week increased with increasing BPG dose . Further studies of higher-dose BPG for rheumatic fever prophylaxis are required. J AOAC Int, 1994 May-Jun, 77(3), 565 - 70 Analysis of penicillin G in milk by liquid chromatography; Boison JO et al.; A liquid chromatographic (LC) method that was previously developed for penicillin G residues in animal tissues has been adapted to milk and milk products . After protein precipitation with sodium tungstate, samples are applied to a C18 solid-phase extraction cartridge, from which penicillin is eluted, derivatized with 1,2,4-triazole-mercuric chloride solution, and analyzed by isocratic liquid chromatography (LC) on a C18 column with UV detection at 325 nm . Quantitation is done with reference to penicillin V as an internal standard . Penicillin G recoveries were determined to be > 70% on standards fortified at 3-60 ppb . Accuracy approached 100% using the penicillin V internal standard . The detection limit for penicillin G residues was 3 ppb in fluid milk . Samples may be confirmed by thermospray/LC at concentrations approaching the detection limit of the UV method. J Exp Biol, 1994 May, 190, 141 - 53 Mobilization of shell calcium by the chick chorioallantoic membrane in vitro; Packard MJ; Two explants of shell were removed from each of several fertile eggs of domestic fowl at different times during incubation . The chorioallantoic membrane (CAM) was removed from one of the explants (SHELL ONLY) and was left in situ on the other (SHELL+CAM) . Explants were cultured for 24, 48 or 96 h at 37 degrees C and 5% CO2 in air in individual Petri dishes containing Dulbecco's modified Eagle's medium, bovine serum albumin, penicillin and streptomycin . Both SHELL+CAM and SHELL ONLY explants released calcium into the culture medium, but the former released considerably more calcium than the latter . More calcium was released by SHELL+CAM explants taken from older eggs than from younger ones, but the age of the donor eggs did not affect release of calcium by SHELL ONLY explants . In addition, release of calcium by SHELL+CAM explants exceeded that shown by SHELL ONLY explants for multiple 24 h intervals . However, the capacity for sustained release of calcium by SHELL+CAM explants declined with age and maturity of the CAM . Manipulations that lead to the death of the CAM abolish the capacity for SHELL+CAM explants to release more calcium than SHELL ONLY explants . Differential release of calcium by SHELL+CAM explants was not attributable to calcium present in the CAM at the onset of culture or to non-specific degradation of the shell by intracellular constituents released as a result of the death of the CAM . Taken in concert, these results indicate that the CAM mobilizes calcium from the eggshell during in vitro culture. Int J Gynaecol Obstet, 1994 May, 45(2), 169 - 74 Gonorrhea and chlamydial infections . ACOG Technical Bulletin Number 190-March 1994 (replaces No . 89, November 1985). {Whole embryo culture for detecting teratogen} He WG, Li HL, Zheng GY. Department of Obstetric and Gynecology, Second Teaching Hospital, N . Bethune University of Sciences, Medical ChangchunWhole embryo culture technique was used to study direct effects of Penicillin G, Thiadiazole, Actinomycin D and glucose solution of high concentration on the development and growth of rat embryos, without maternal and placental influence . Nine-and-a-half-day rat embryos were transplanted to culture flasks from the animal's wombs for in vitro culture, and the four chemicals were added to culture medium, respectively . Results showed all those chemicals could cause death and malformation of the embryos and retardation in embryonic development and growth cultured in vitro, with an apparent dose-effect relationship . The embryonic malformations caused by the chemicals were the same both in vitro culture and in vivo . Possible teratogenesis of the chemicals and survival of the malformed embryos were speculated based on the above dose-effect relationship. J Ind Microbiol, 1994 May, 13(3), 144 - 6 Inhibition of penicillin biosynthetic enzymes by halogen derivatives of phenylacetic acid; Martinez-Blanco H et al.; The effect of phenylacetic acid (PAA) and several analogs on the activity of isopenicillin N synthase (IPNS) and acyl-CoA: 6-APA acyltransferase (AT) from Penicillium chrysogenum Wis 54-1255 has been tested . Whereas the substitution on the ring of a hydrogen atom by hydroxy-, methyl- or methoxy- groups did not cause any effect, the presence of halogens (Cl or Br) at positions 3 and/or 4 of PAA strongly inhibited these two enzymes . The replacement of hydrogen atoms by fluorine in certain positions also caused inhibition, but to a lesser extent. Allerg Immunol (Paris), 1994 May, 26(5), 181 - 3 {Alimentary anaphylactic shock: implication of penicillin residues}; Kanny G et al.; The case of a 64 y.o . female is reported . She experienced formerly four anaphylactic shocks . Two shocks occurred after ingestion of pork and beef meat . Any food allergy to animal proteins was discarded . A high degree of sensitivity to penicillin G was proved by a positive prick test to penicillin G 1 Ul/ml, which induced a systemic reaction . RAST to penicillin G was class 4 . The leucocyte histamine release test showed a high level of spontaneous histamine release . A double blind, placebo controlled, oral challenge with penicillin mixed to milk induced wheezing and a fall of blood pressure at the cumulative dose of 20 Ul . The hypothesis of food induced anaphylaxis, linked to penicillin residues in meats, is highly plausible . The significance of the phenomenon of spontaneous histamine release is discussed . It might point to frequent ingestions of hidden penicillin residues in the diet. Biochim Biophys Acta, 1994 Apr 13, 1205(2), 199 - 206 The reaction of cephalosporins with penicillin-binding protein 1b gamma from Escherichia coli; Page MG; The kinetics of the reaction of purified penicillin-binding protein 1b gamma from Escherichia coli with cephalosporins suggest that the enzyme exists in two kinetically distinct conformations that are in slow equilibrium . One of these forms can effect rapid hydrolysis of some beta-lactams and it is only through its deactivation by conversion to the slower reacting form that complete inhibition can be achieved . With some cephalosporins and with penicillins having simple aromatic side-chains the reaction was slower and did not exhibit the same kinetic behaviour . This could be attributed to the rate of reaction being similar to the rate of conformation change and thus sets an upper limit on the isomerization rate. Ugeskr Laeger, 1994 Apr 11, 156(15), 2211 - 3 {Prevention of duodenal ulcer recurrence with penicillin}; Rune SJ et al.; The aim of this study was to test the hypothesis that infection with Helicobacter pylori is essential for recurrence of duodenal ulcer . We performed a randomized controlled trial of the relapse rate of duodenal ulcer during 12 weeks treatment with penicillin V or placebo in 170 out-patients from five centres . The relapse rate was 9% during treatment with penicillin and 50% with placebo, P < 0.0001 . It is concluded that infection with penicillin-sensitive bacteria, i.e . H . pylori, plays an important role for recurrence of duodenal ulcer disease . Penicillin V suppresses this infection but does not eradicate it. Genitourin Med, 1994 Apr, 70(2), 138 - 45 Sexually transmitted diseases in the history of Uganda; Lyons M; First noticed in Uganda in 1863 by a European explorer, sexually transmitted diseases (STDs) were cited as a major cause of morbidity and mortality throughout this century . In 1908 the venereal diseases campaign was launched marking the real introduction of western medicine . By the mid-1920s, the campaign was combined with the medical service but throughout the colonial period (1901-1962) venereal diseases were considered intractable . A 1991 survey revealed alarming incidence rates and in light of the importance of STDs as a co-factor in the transmission of HIV, it is of paramount importance to implement more effective control measuresPIP: Sexually transmitted diseases (STDs) were first noticed in Uganda in 1863 and have been a major cause of morbidity and mortality throughout this century . By the mid-1920s, the venereal diseases campaign introducing Western medicine was combined with the medical service, but throughout the colonial period (1901-1962) venereal diseases were considered intractable . A 1991 survey revealed alarming incidence rates . A recent retrospective study of sexually transmitted diseases over the period 1986-1990 at 9 sentinel sites (hospitals located along the major east-west trade axis) revealed that in some hospitals they accounted for 16% of all admissions . Testing for syphilis antibody during the National Serosurvey for HIV in 1988 revealed that 17.5% of random specimens were antibody positive . The Serosurvey also discovered that in some areas of Uganda 15-30% of those infected with HIV had a history of genital ulcer disease within the past 5 years; for example, 30% of the outpatients at Mulago's sexually transmitted diseases clinic present with genital ulcers . A most disturbing discovery is the fact that well over 90% of gonorrhea in Uganda is resistant to penicillin . AIDS had first been noticed by many practitioners during 1981-1982, and by 1985 it was declared to be epidemic . Many epidemiologists believe that AIDS was perhaps introduced by 45,000 Tanzanian soldiers during their occupation of the country in 1979 and 1980 . However, the long history of high incidence of other STDs combined with the fact that treatment never eliminated venereal diseases, better explain the wildfire spread of HIV . By June 1991, it was estimated that nearly 1.5 million Ugandans were infected with HIV, and that in some urban hospitals, like Mulago, about 40% of beds were occupied by patients with AIDS or AIDS-related illnesses . In light of the importance of STDs as a cofactor in the transmission of HIV, it is of paramount importance to implement more effective control measures . J Pediatr, 1994 Apr, 124(4), 649 - 53 Concentrations of procaine and aqueous penicillin in the cerebrospinal fluid of infants treated for congenital syphilis; Azimi PH et al.; Penicillin concentrations in cerebrospinal fluid (CSF) were measured at various hours and days of treatment in 163 infants undergoing therapy for congenital syphilis . The CSF levels were compared for three treatment regimens . Aqueous penicillin G (A-PEN), 100,000 U/kg per day, was used in 23 infant, and a dosage of 200,000 U/kg per day was used in 40 patients; procaine penicillin G (P-PEN), 50,000 U/kg per day, was used in 100 children . Mean CSF penicillin levels were 0.416, 0.493, and 0.077 microgram/ml, respectively, in the three treatment groups . The mean CSF penicillin concentration among the 63 infants treated with either of the A-PEN regimens (0.465 microgram/ml) was significantly greater than the mean concentration (0.077 microgram/ml) among those treated with P-PEN (p < 0.001) . Among those who received A-PEN, the difference in dosage was not associated with a significant difference in mean CSF penicillin concentration (p = 0.68) . All the specimens obtained from patients who received A-PEN, but only 82% of those from patients who received P-PEN, had treponemicidal concentrations (> or = 0.018 microgram/ml) . However, 33.3% (9/27) of specimens from infants who received P-PEN, tested between 18 and 24 hours after a dose, had CSF penicillin concentrations < 0.018 microgram/ml . These data suggest that administration of A-PEN may be the preferred therapy if CSF levels > 0.018 microgram/ml are desired, especially for infants with severe disease or congenital neurosyphilis. Med Hypotheses, 1994 Apr, 42(4), 261 - 4 Hoigné's syndrome: a procaine-induced limbic kindling; Araskiewicz A et al.; Procaine-induced limbic kindling may be a principal pathogenetic factor for the psychiatric symptoms of the acute non-allergic reaction to procaine penicillin (Hoigne's syndrome) . The syndrome develops with repeated injections of the drug and runs a rapidly spasmodic course . Its acute symptoms (anxiety, perceptual disturbances, sympathetic hyperactivity) are similar to those in temporal lobe and limbic system seizures and are also reminiscent of psychiatric complications following the repeated use of other local anesthetics (lidocaine, cocaine) . Compatible with the mechanisms of kindling are also possible predispositions to the occurrence of this reaction as well as the recurrent after-effects during follow-up . Penicillin, a second component of the injection may contribute to the development of kindling by its properties of antagonizing GABA neurotransmission. Antimicrob Agents Chemother, 1994 Apr, 38(4), 898 - 900 Susceptibilities of 177 penicillin-susceptible and -resistant pneumococci to FK 037, cefpirome, cefepime, ceftriaxone, cefotaxime, ceftazidime, imipenem, biapenem, meropenem, and vancomycin; Spangler SK et al.; MICs of six extended-spectrum cephalosporins (cefotaxime, ceftriaxone, ceftazidime, FK 037, cefpirome, cefepime), three carbapenems (imipenem, meropenem, biapenem), and vancomycin for 49 penicillin-susceptible (S), 77 penicillin intermediate-resistant (I), and 51 penicillin-resistant (R) pneumococci were determined by agar dilution . Compared with ceftazidime (MICs for 90% of strains tested {MIC90s} of 2.0, 16.0, and 16.0 micrograms/ml for S, I, and R strains, respectively), all other cephalosporins yielded lower MICs (MIC90s of 0.06 to 0.125, 0.5 to 1.0, and 1.0 to 2.0 micrograms/ml against S, I, and R strains, respectively) . All three carbapenems were very active, with MIC90s, even for R strains, of < or = 1.0 micrograms/ml . All strains were susceptible to vancomycin (MIC90 of 0.5 micrograms/ml). Wiad Lek, 1994 Apr, 47(7-8), 280 - 3 {Prophylactic use of ampicillin and sulbactam in colonic surgery}; Andziak P et al.; The purpose of the work was an evaluation of the effectiveness of ampicillin and sulbactam administered parenterally in the prophylaxis of infections in patients after colonic surgery . The group of patients treated with ampicillin and sulbactam was compared with the control group in which penicillin, gentamicin and metronidazole were given prophylactically . Surgical wound infections were found in the group receiving ampicillin and sulbactam in 20% of cases, and in the control group in 13.3% of patients . This difference was not statistically significant (p > 0.05) . In both groups infections of all perineal wounds were observed after abdominoperineal operations . No allergic reactions nor side effects were found in the group treated with ampicillin and sulbactam . Conclusion: Prophylactic administration of ampicillin and sulbactam in colonic surgery is similar in its effectiveness to prophylactic administration of penicillin, gentamicin and metronidazole. Bol Asoc Med P R, 1994 Apr-Jun, 86(4-6), 24 - 7 {Gastric syphilis . Report on first 2 cases in Cuba}; Castano Hernandez S et al.; Two 28 and 25 year old female patients were studied . Endoscopic analysis of their stomachs showed an hyperemic mammillation picture, neoplasia compatible, in the first patient, and an ulcerous lesion in the second one . Both findings were the result of a positive serological test to discard syphilis . All this, together with a cutaneous and epidemiological history, represented an assumed diagnosis of a secondary stage syphilis with gastric disorders . Although it was not necessary, one case was submitted to a specific spirochaeta stain, but results were negative . The true diagnosis resulted from a penicillin treatment, which provoked a cutaneous-visceral history regression as well as a diminishing in V.D.R.L . titles. J Chem Technol Biotechnol, 1994 Apr, 59(4), 371 - 6 Penicillin G extraction from model media using an emulsion liquid membrane: determination of optimum extraction conditions; Lee KH et al.; Penicillin G extraction by an emulsion liquid membrane (ELM) was investigated . The effects of surfactants, diluents, and carrier mixtures, together with their combined effects on the initial extraction rate and the emulsion stability were examined . Surfactants, diluents, and carriers used were Span80 (sorbitan monooleate)/ECA4360J (nonionic polyamine), n-butyl acetate/kerosene, and DOA (dioctylamine)/Amberlite LA-2 (secondary amine), respectively . The optimum extraction conditions were found to be 20% (v/v) of Span80 in ECA4360J as a surfactant, kerosene as a diluent and Amberlite LA-2 as a carrier. J Chem Technol Biotechnol, 1994 Apr, 59(4), 365 - 70 Penicillin G extraction from model media using an emulsion liquid membrane: a theoretical model of product decomposition; Lee KH et al.; To confirm the applicability for the extraction of penicillin G by an emulsion liquid membrane (ELM), the degree of decomposition of penicillin G during extraction was theoretically calculated . Decomposition was less than 1% provided that the initial sodium carbonate concentration in the internal phase was correctly determined, which proved the applicability of the ELM process . The procedure to determine the initial carbonate concentration in the internal phase was also described in order that the pH in the internal phase should be within the relatively stable range for penicillin G at the end of the extraction. J Biotechnol, 1994 Mar 15, 33(1), 71 - 85 Suboptimal control of fed-batch bioprocesses using phase properties; Diener A et al.; A new method for the evaluation of suboptimal feeding strategies for fed-batch bioprocesses is introduced . This method is based on a time-local optimization of the process dynamics . To include global effects into the optimization, the process has to be partitioned into several phases with different local extremality conditions . The penicillin bioprocess is used to illustrate the method . One advantage of the proposed method is that the evaluated control function appears as a feedback law . Simultaneously, the new method allows the inclusion of constraints on the process states and the use of very complex models . Due to the simplicity and stability of the numerical procedure the method is robust against external perturbation . Therefore, it is suited for use in on-line controls. Neurosci Lett, 1994 Mar 14, 169(1-2), 93 - 6 Anticonvulsant activity of the noradrenergic locus coeruleus system: role of beta mediation; Ferraro G et al.; Many experimental observations have demonstrated the modulatory role exerted by several neural structures and neurotransmitters on spontaneous and paroxysmal bioelectric activity of the hippocampus . Recently, the control exerted by locus coeruleus (LC) and its noradrenergic (NA) efferent pathway on different experimental models of epilepsy (e.g . cortical cobalt chronic epilepsy, amygdaloid and hippocampal kindling) was emphasised . On this basis, a series of experiments was performed to elucidate the functional role of LC-NA system on the hippocampal penicillin (PCN) focus and the type of adrenergic receptor involved . The experiments were carried out on 25 rats in which an epileptiform hippocampal focus was obtained through intrahippocampal PCN administration (100-200 I.U.) . In these conditions, LC, ipsilateral to PCN hippocampal focus, was stimulated before and after intraperitoneal (i.p.) administration of a beta-adrenergic receptor antagonist propranolol (2 mg/kg) . Results showed a significant reduction of hippocampal spiking frequency during LC stimulation; after i.p . propranolol injection, LC stimulation, at the same parameters, failed to induce any sort of modification of PCN hippocampal spiking frequency . Furthermore, intrahippocampal application of a beta-selective agonist 2-fluoro-noradrenaline (2-FNA) mimics the inhibitory effects of LC stimulation . All data suggest that the LC-NA system is able to induce a net reduction of hippocampal epileptiform focus and the inhibitory NA control involves the activation of adrenergic beta receptors. Sex Transm Dis, 1994 Mar-Apr, 21(2), 124 - 6 Treatment regimens of STD patients in Cameroon: a need for intervention; Trebucq A et al.; BACKGROUND AND OBJECTIVES: The management of patients with STDs is an important element in the fight against AIDS . To define effective STD control strategies a survey was carried out to understand the attitudes of STD patients and the treatment regimens they follow . STUDY DESIGN: The study was based on interviews with male patients with typical symptoms of urethritis leaving private pharmacies in Douala and Yaounde . Each case was asked to answer a questionnaire comprising the origin of the therapeutic choice, the nature and cost of the treatment and any advice received . RESULTS: Fifty-six men in Douala and 86 in Yaounde were recruited . The sources of prescription were dispensary (38%, 54%) private MD (9%, 15%) pharmacist (7%, 9%), diverse (46%, 21%) in Douala and Yaounde respectively . At least two medicines were recommended in three-quarters of the patients . The most frequently used antibiotics were aminoglycosides and penicillin . The cost of the treatment ranged from $3.50 to $110 . The more "medical" the initial visit, the higher was the cost of the prescribed treatment . In Douala only 49% of the prescribers advised the patients to treat their partners and condom promotion was done by 21% of the prescribers . CONCLUSION: This survey provides useful data on the care of patients with urethritis . Such surveys are simple, rapid, reasonable inexpensive (about $10,000) and contribute to the efficient design of STD control strategies . In addition, repeat survey to monitor the impact of the strategies are simple to carry out. Ear Nose Throat J, 1994 Mar, 73(3), 169 - 75 Surgical treatment and rehabilitation of prelingually and perilingually deafened children and adults with the nucleus multichannel cochlear implant; Garcia JM et al.; We began our program in September 1992, using the Nucleus 22 Channel Cochlear Implant . To date, we have operated on four patients, one child with congenital hearing loss, two prelinguistically deaf adults and one perilingually deaf adult . Our results have shown a significant increase in auditory and speech reception and perception skills in the child . The perilingually deaf adult is able to understand speech in open set speech discrimination testing and, although we do not expect open set speech discrimination in the prelinguistically deaf adults, to date their results have been satisfactory . The two prelingually deaf adults are in an audiological rehabilitation program . Their response in prosodic aspects of speech and lipreading ability with sound have improved significantly . The only surgical complication was an infection of the flap in the child, but it was treated satisfactorily with i.v . penicillin. Br Poult Sci, 1994 Mar, 35(1), 157 - 60 Inhibitory effect of penicillin on caecal urease activity in chickens fed on a low protein diet plus urea; Karasawa Y et al.; 1 . The effects of dietary penicillin on the urease activities of small intestine, large intestine, caecum and their contents, liver and kidney in chickens fed a diet containing 5 g/kg protein plus urea were examined . 2 . About 0.88 of the total urease activity determined was observed in intestinal contents, of which 0.95 of the activity was accounted for by caecal contents, 0.05 by colo-rectal contents and none by small intestinal contents . Intestinal tissues (caecum included), liver and kidney accounted for 0.03, 0.06 and 0.02, respectively, of the total urease activity . 3 . Dietary penicillin decreased urease activity to 0.17 in caecal contents and to 0.05 in colo-rectal contents of the corresponding control values (P < 0.01) . The urease activity of caecal tissue was lowered by penicillin to half that of control activity (P < 0.05) but none of the activities of other tissues were affected . 4 . It is concluded that, even when the urease activity is stimulated by dietary urea, 20 mg/kg dietary penicillin can strikingly lower it in the caecum, where most of the urease activity in the chicken body is to be found. Nippon Kyobu Geka Gakkai Zasshi, 1994 Mar, 42(3), 442 - 5 {A case of infantile thoracic actinomycosis involving the bronchocutaneus fistula}; Kobayashi K et al.; Pulmonary actinomycosis is rare at present . A 11-year-old girl complained of left anterior chest pain and chest wall swelling . A radiograph of the chest revealed a consolidation in the left upper lobe . Sputum cultures showed normal flora and sputum cytology was negative for malignant disease . On 16 days after admission, the infection involved the bronchocutaneous fistula . Surgery was necessary to curettage . Histopathological specimen of resected necrotic tissue showed typical "sulfur granule" of actinomycosis . We administered penicillin for 3 months and the consolidation disappeared. Dig Dis Sci, 1994 Mar, 39(3), 555 - 60 Childhood infections and the risk of inflammatory bowel disease; Wurzelmann JI et al.; Adults with inflammatory bowel disease from North Carolina were questioned during 1986 and 1987 to assess risk due to a variety of childhood infections and treatments with antibiotics . Responses were compared with those of neighbor controls . Persons with Crohn's disease were more likely to report an increased frequency of childhood infections in general (odds ratio 4.67, 95% CI 2.65-8.23) and pharyngitis specifically (odds ratio 2.14, 95% CI 1.30-3.51) . This was validated by an increased frequency of tonsillectomy (odds ratio 1.53, 95% CI 1.07-2.20) . Crohn's cases were more likely to report frequent treatment with antibiotics for both otitis (odds ratio 2.07, 95% CI 1.03-4.14) and pharyngitis (odds ratio 2.14, 95% CI 1.20-3.84) . Although Crohn's cases were more likely to report frequent exposure to penicillin (odds ratio 1.81, 95% CI 0.98-3.31), there did not appear to be excess risk conferred by penicillin after controlling for frequency of infections . Persons with ulcerative colitis also reported an excess of infections generally (odds ratio 2.37, 95% CI 1.19-4.71), but not an excess of specific infections or treatments with antibiotics . Persons who reported an increased frequency of infections tended to have an earlier onset of Crohn's disease (P < 0.0001) and ulcerative colitis (P = 0.04) . Finally, it was noted that urban living in childhood increased the risk for Crohn's disease . We conclude that childhood infections may be a risk factor for Crohn's disease and may presage the early onset of disease. Am J Respir Crit Care Med, 1994 Mar, 149(3 Pt 1), 815 - 7 Oral desensitization to rifampin and ethambutol in mycobacterial disease; Matz J et al.; The incidence of disease caused by Mycobacterium tuberculosis (including drug-resistant strains) and M . avium complex (MAC) is increasing . Hypersensitivity reactions to antimycobacterial agents are relatively uncommon, but when they occur they may result in cessation of therapeutic medications . We report our experience with rapid oral desensitization to ethambutol and rifampin in a group of 10 patients with mycobacterial disease who had experienced cutaneous hypersensitivity reactions to these drugs . An adaptation of the rapid oral desensitization protocol for penicillin was used, with the dosing intervals increased to account for the different kinetics of these drugs . Adverse reactions were few and easily treated without necessitating cessation of therapy . We conclude that oral desensitization to rifampin and ethambutol by our protocol is safe and effective, allowing these patients to proceed with an optimal antimycobacterial regimen. J Vet Intern Med, 1994 Mar-Apr, 8(2), 128 - 32 Tetanus in the horse: a review of 20 cases (1970 to 1990); Green SL et al.; The case records of 20 horses with tetanus referred to the Ontario Veterinary College-Veterinary Teaching Hospital between 1970 and 1990 were reviewed . The fatality rate was 75% . There was a strong association with previous vaccination and survival (P = .03) . Most of the animals had been injured an average of 9 days (range 2 to 21 days) prior to development of clinical signs . Hyperesthesia and prolapse of the third eyelid were the most common clinical signs . Treatment regimens varied during hospitalization; however, all horses received parenteral penicillin, tranquilizers, tetanus toxoid, and antitoxin . Five of the nonsurviving animals were given intrathecal tetanus antitoxin . One animal had seizures as a complication of intrathecal treatment . The prognosis was best for horses that (1) had been vaccinated prior to the injury, (2) responded to the phenothiazine tranquilizers, and (3) did not rapidly (over 24 to 48 hours) become recumbent . Considering the species susceptibility, potential for contaminated wounds, and the increased survival of vaccinated horses, yearly revaccination is recommended. Zhongguo Yao Li Xue Bao, 1994 Mar, 15(2), 155 - 7 {Alteration of dynorphin1-8 and leu-enkephalin in rat hippocampus during seizure and electroacupuncture}; Wang BE et al.; Immunocytochemical technics were used to evaluate the influence of penicillin-induced seizure and electroacupuncture treatment on dynorphin1-8 and leu-enkephalin immunoreactivity in hippocampus . It was found that 3 h after beginning of seizure there started a dramatic decrease in dynorphin1-8 in hilus, mossy fiber of hippocampus but an increase in hilus, mossy fiber of hippocampus but an increase in leu-enkephalin in subiculum, CA1 area of hippocampus and some other limbic structures . Electroacupuncture treatment decreased the leu-enkephalin immunoreactivity in the nuclei mentioned above and increased dynorphin1-8 immunoreactivity in hippocampus . The results show that epileptiform activity and electroacupuncture inhibitory effect on seizure may be related to the alteration of dynorphin1-8 and leu-enkephalin in the brain. Neuroscience, 1994 Mar, 59(2), 259 - 73 Hippocampal plasticity following epileptiform bursting produced by GABAA antagonists; Schneiderman JH et al.; The effects of epileptiform bursts on hippocampal excitability were examined in the CA3 region of guinea-pig hippocampal slices . Partial blockade of gamma-aminobutyric acidA (GABAA)-mediated inhibition by 500 IU/ml penicillin produced low frequency (2-4 Hz) "pro-convulsant" field potential oscillations . Normal spontaneous activity recovered less than 30 min after the penicillin was rinsed out providing bursting was prevented . Synchronized bursting rarely began on its own even after 1 h in penicillin 500 IU/ml, but could be initiated in most slices after one to eight all-or-none bursts were evoked by low-intensity, low-frequency (0.2-0.25 Hz) stimuli . Spontaneous bursting, once initiated, persisted for at least 1 h without further stimulation suggesting that a small number of bursts produced a long-lasting increase in excitability . Bursts disappeared more slowly than anticipated after convulsants were rinsed out and were followed by "post-burst" oscillations with different frequency characteristics than proconvulsant oscillations which persisted for at least 4 h . Selective augmentation of evoked N-methyl-D-aspartate excitatory postsynaptic potentials appeared to be the critical first step in the initiation of bursting . The specific N-methyl-D-aspartate antagonist, 2-amino-5-phosphonovaleric acid (50-100 microM), only partially suppressed pro-convulsant oscillations in partially disinhibited slices but completely prevented stimulus-triggered spontaneous bursting and prolonged hyperexcitability . Although N-methyl-D-aspartate receptors were necessary for the induction of bursting in partially disinhibited slices, they were not required to initiate bursting after more complete disinhibition . However, when 2-amino-5-phosphonovaleric acid was applied prior to and during perfusion with 2000 IU/ml penicillin, spontaneous bursts occurred at long, irregular intervals and lacked afterdischarges . These bursts rapidly disappeared upon penicillin washout and were not followed by persistent post-burst oscillations . N-methyl-D-aspartate antagonists applied only after bursts already established in penicillin blocked the afterdischarges but did not reduce the burst frequency . These observations indicate that epileptiform bursts can produce long-lasting, hippocampal hyperexcitability . The induction of these plastic changes requires N-methyl-D-aspartate receptor activation which then enhances both N-methyl-D-aspartate and non-N-methyl-D-aspartate receptor mechanisms . Furthermore, N-methyl-D-aspartate excitatory postsynaptic potentials can participate in triggering spontaneous bursts but this role is masked once plasticity has occurred . Partial disinhibition produces a pro-convulsant state which does not induce long-lasting changes in hippocampal excitability but renders the neuronal network vulnerable to develop persistent epileptiform bursting with small additional excitatory inputs.(ABSTRACT TRUNCATED AT 400 WORDS) No To Hattatsu, 1994 Mar, 26(2), 101 - 10 {Neurochemical approach to epilepsy}; Ito M; To elucidate the neurochemical mechanism of epilepsy, we investigated the role of neurotransmitter systems in the animal models of epilepsy, the mechanism of anticonvulsants and proconvulsants, the neurotransmitters in the CSF of children with epilepsy, and the new therapy for epilepsy . The main results are as follows . 1) In El mice, the increased activity of excitatory amino acids system in cortex and decreased activity of noradrenergic system in striatum and hippocampus were related to the increased seizure susceptibility . 2) GABA sensitivity was reduced in young DBA 2 J mice which are susceptible to audiogenic seizures . 3) Lower benzodiazepine receptor densities were found in hippocampus of 4 and 16 weeks-old tremor rats . GABA concentrations in the cerebral cortex and hippocampus of the tremor rats increased at 5 weeks-old and decreased at 15 weeks-old . These changes may be related to the absence-like seizures in tremor rats . 4) Anticonvulsant mechanism of ACTH may be due to antagonizing glutamate binding . Proconvulsant mechanism of thyroid hormone may be related to the decrease in number of cerebral cortical neuronal benzodiazepine receptors . Penicillin acts its proconvulsant effect through inhibiting GABA-gated chloride ion influx . 5) CSF GABA level in children with infantile spasms was lower than in controls . The combination of vitamin B6 and valproic acid is effective and safe therapy in the treatment of infantile spasms . Further investigations by the neurochemical approaches are necessary to understand the mechanisms of epilepsy and develop the new therapy. Southeast Asian J Trop Med Public Health, 1994 Mar, 25(1), 152 - 6 Recurrence of yaws outbreak in Thailand, 1990; Tharmaphornpilas P et al.; In November 1990, an outbreak of yaws was reported in a rural village of southern Thailand . A survey consisting of history taking, physical examination and blood tests for VDRL and TPHA was undertaken in the whole village and in the primary school of the village . A yaws case was defined as a person who had a positive VDRL confirmed by TPHA without history of other treponemal infection or post-treatment of yaws . Fifty-four cases, an attack rate of 23%, were found in the age range from 2 to 79 years old . The epidemic curve started with a few cases in 1989 and early 1990 with an increasing number of cases from June, and reached its peak in November . Half of the cases (53.7%) were children under 15 years . Male cases were higher than female (1.5:1) . A survey of 105 primary school students found an attack rate of 32% (34/105) and the prevalence was higher in younger classes . Benzathine penicillin injection was given to cases for treatment . From this investigation, the Ministry of Public Health was alerted about the recurrence of yaws . Strengthening health education and surveillance activities was recommended in adjacent districts and provinces . The extent of the problem was assessed through surveys among school children and expanded to their family members if cases of yaws were found. Nature, 1994 Feb 24, 367(6465), 750 - 3 Doughnut-shaped structure of a bacterial muramidase revealed by X-ray crystallography; Thunnissen AM et al.; The integrity of the bacterial cell wall depends on the balanced action of several peptidoglycan (murein) synthesizing and degrading enzymes . Penicillin inhibits the enzymes responsible for peptide crosslinks in the peptidoglycan polymer . Enzymes that act solely on the glycosidic bonds are insensitive to this antibiotic, thus offering a target for the design of antibiotics distinct from the beta-lactams . Here we report the X-ray structure of the periplasmic soluble lytic transglycosylase (SLT; M(r) 70,000) from Escherichia coli . This unique bacterial exomuramidase cleaves the beta-1,4-glycosidic bonds of peptidoglycan to produce small 1,6-anhydromuropeptides . The structure of SLT reveals a 'superhelical' ring of alpha-helices with a separate domain on top which resembles the fold of lysozyme . Site-directed mutagenesis and a crystallographic inhibitor-binding study confirmed that the lysozyme-like domain contains the active site of SLT. Brain Res Dev Brain Res, 1994 Feb 18, 77(2), 251 - 5 The effects of epileptic cortical activity on the development of callosal projections; Grigonis AM et al.; The effect of epileptic neural activity on the postnatal development of the corpus callosum was studied . Epileptiform activity was induced in the visual cortex of postnatal rabbits by continuous infusion of penicillin . Callosal projections of the occipital cortex were studied in rabbits aged at least 4 weeks . In these penicillin-exposed rabbits, the visual callosal projections extended through most of area 17 in a projection pattern characteristic of neonatal rabbits, rather than being restricted to a narrow callosal zone at the lateral border of area 17, as they usually are by this age . The results indicate that epileptic cortical activity stabilizes immature callosal projections which are normally eliminated during development . The maintenance of such immature and non-specific projections in the mature CNS may interfere with normal cortical functions and could underlie the cognitive deficits which have been observed following childhood epilepsy. Biochem J, 1994 Feb 15, 298 ( Pt 1), 189 - 95 Engineering and overexpression of periplasmic forms of the penicillin-binding protein 3 of Escherichia coli; Fraipont C et al.; Replacement of the 36 and 56 N-terminal amino acid residues of the 588-amino-acid-residue membrane-bound penicillin-binding protein 3 (PBP3) of Escherichia coli by the OmpA signal peptide allows export of F37-V577 PBP3 and G57-V577 PBP3 respectively into the periplasm . The modified ftsI genes were placed under the control of the fused lpp promoter and lac promoter/operator; expression of the truncated PBP3s was optimized by varying the copy number of the recombinant plasmids and the amount of LacI repressor, and export was facilitated by increasing the SecB content of the producing strain . The periplasmic PBP3s (yield 8 mg/l of culture) were purified to 70% protein homogeneity . They require the presence of 0.25 M NaCl to remain soluble . Like the membrane-bound PBP3, they undergo processing by elimination of the C-terminal decapeptide I578-S588, they bind penicillin in a 1:1 molar ratio and they catalyse hydrolysis and aminolysis of acyclic thioesters that are analogues of penicillin . The membrane-anchor-free PBP3s have ragged N-termini . The G57-V577 PBP3, however, is less prone to proteolytic degradation than the F37-V577 PBP3. J Chromatogr A, 1994 Feb 4, 660(1-2), 137 - 45 Perfusible and non-perfusible supports with monoclonal antibodies for bioaffinity chromatography of Escherichia coli penicillin amidase within its pH stability range; Kasche V et al.; Several monoclonal antibodies (mABs) have been prepared and immobilized for the biospecific isolation of penicillin amidase (PA) from Escherichia coli (EC 3.5.1.11), an enzyme without S-S bridges and a pH stability range of 4-9 . During the immobilization the fluorescence emission maxima of the mABs were found to change from 336 nm to ca . 350 nm . Only one of these mABs was found to be suitable for preparative bioaffinity chromatography of PA within the pH stability range . This mAB was immobilized on different spherical supports (Eupergit C 250 L and Sepharose) and one perfusible support (Knauer Quick Disc) and used for analytical and preparative bioaffinity chromatography . Under isocratic conditions the plate height for the perfusible biospecific adsorbent was found to be an order of magnitude lower than for the other supports . The different forms of this proteolytically processed bacterial enzyme could not be separated, however, by the biospecific adsorbents . At the mAB density used in the adsorbents (10-30 microM), less than 30% of the theoretical binding capacity of the immobilized mABs could be used to adsorb the enzyme. Genitourin Med, 1994 Feb, 70(1), 35 - 9 Gonococcal infection in Edinburgh and Newcastle: serovar prevalence in relation to clinical features and sexual orientation; Ross JD et al.; AIMS--The variable distribution of gonococcal serovars in different areas is well recognised but the factors that are important determinants of serovar prevalence are less clear . The aim of this study was to identify relevant clinical variables by comparing serovar prevalence in two cities over the same time period . METHODS--A prospective analysis of serovar prevalence was made between January and December 1992 in Edinburgh and Newcastle with respect to age, sex, sexual orientation, antibiotic sensitivity and presence of symptoms . RESULTS--224 infective episodes of gonorrhoea were studied . The serovar distribution varied between the two cities with serovar 1B-1 being more common in Edinburgh (20/91 cf . 4/133, p < 0.01) and serovar 1B-6 more common in Newcastle (26/133 cf . 2/91, p < 0.01) . Serovar 1A-2 was associated with heterosexual infection (35/114 in heterosexuals cf . 0/85 in homosexuals, p < 0.01) and was more sensitive to penicillin than average (39/39 1A-2 strains highly penicillin sensitive cf . 98/184 for all other strains, p < 0.01) whilst 1B-6 was mostly acquired through homosexual contact (22/26 cf . 63/142 for all other strains, p < 0.01) and tended to show reduced penicillin susceptibility (13/28 1B-6 strains less penicillin sensitive cf . 45/195 for all other strains, p < 0.01) . Infection with serovar 1A-2 was significantly less often symptomatic in heterosexuals than average (15/33 asymptomatic 1A-2 infections cf . 17/59 for all other serovars, p = 0.015) . Subgroup analysis of male heterosexual infections confirms an association between asymptomatic infection and serovar 1A-2 (2/14 asymptomatic 1A-2 infections cf . 1/72 for all other serovars, p = 0.02) . The distribution of infections over the year differed between the cities . CONCLUSIONS--A variety of factors including penicillin sensitivity and virulence may be important in determining the prevalence of gonococcal serovars within a given area. Antimicrob Agents Chemother, 1994 Feb, 38(2), 205 - 10 Penicillin-binding proteins are regulated by rpoS during transitions in growth states of Escherichia coli; Dougherty TJ et al.; Attention has been recently focused on the role of the rpoS (formerly katF) gene product as a regulator during the transition from the exponential growth phase to the stationary phase as well as during nutritional starvation . It has been demonstrated that RpoS is an alternate sigma factor which would bind to promoters of genes induced at these times . It was previously noted that rpoS mutants do not undergo a transition to short rods during entry into the stationary phase . Because of their well-established role in morphogenesis, we investigated the status of the penicillin-binding proteins (PBPs) in Escherichia coli wild-type and isogenic rpoS mutants . Samples from cultures of E . coli ZK126 and ZK1000 (rpoS::kan) were taken in the midlogarithmic, early stationary, and late (24 h) stationary phases . The increase in PBP 6 seen upon entry of the wild-type strain into the stationary phase was not observed with the rpoS::kan cells, even after 24 h . There was also a marked decrease of PBP 3 in wild-type stationary-phase cells; PBP 3 has a known influence on morphogenesis . This decrease in PBP 3 was found to be markedly affected by the disruption of rpoS . Similar observations were made after prolonged starvation of the two strains for either glucose or a required amino acid . Inasmuch as PBPs are involved in peptidoglycan synthesis, we also examined two properties of peptidoglycan, autolysis and cross-linkage, that might be altered by the PBP differences . However, neither of these properties, which are known to undergo changes in the stationary phase, appeared to be influenced by the status of RpoS. Ann Pharmacother, 1994 Feb, 28(2), 236 - 41 Prevention of anaphylactoid reactions in high-risk patients receiving radiographic contrast media; Wittbrodt ET et al.; OBJECTIVE: To review various pretreatment regimens for the prophylaxis of anaphylactoid reactions to radiographic contrast media (RCM) in high-risk patients . The proposed etiologies and risk factors for such reactions are also reviewed . DATA SOURCES: A MEDLINE search of the English-language literature was used to identify pertinent human studies and reviews . STUDY SELECTION: All studies comparing pretreatment regimens for anaphylactoid reactions to RCM were reviewed as well as studies comparing the incidence of anaphylactoid reactions between lower and higher osmolar RCM . DATA SYNTHESIS: The two types of reactions to RCM are dose-independent, unpredictable anaphylactoid (pseudoallergic or idiosyncratic) reactions and the dose-dependent, predictable physicochemical (intrinsic, nonidiosyncratic) reactions . Prophylaxis of the former type is targeted at stemming the effects of certain chemical mediators, primarily histamine . The use of lower osmolar RCM is associated with a lower incidence of anaphylactoid reactions compared with higher osmolar RCM, but is significantly more expensive . Risk factors for such reactions are a history of previous anaphylactoid reaction to RCM, asthma, and reaction to skin allergens or penicillin . Discontinuation of any beta-blockers before the procedure is suggested . Pretesting patients with a small amount of RCM has little predictive value for an anaphylactoid reaction . Various pretreatment prophylactic regimens have been studied . Almost all included a corticosteroid to target the inflammatory response and a histamine1 (H1)-antagonist to blunt the effects of histamine . In some clinical trials, ephedrine was added for bronchodilation and cimetidine for its antagonism at the histamine2-receptor . The few controlled clinical trials that have been performed show the combination of prednisone and diphenhydramine to be most beneficial in preventing anaphylactoid reactions to RCM . The addition of ephedrine or cimetidine to a pretreatment regimen remains controversial . CONCLUSIONS: More controlled clinical studies comparing various pretreatment regimens for high-risk patients need to be performed, especially in patients receiving lower osmolar RCM . Recommendations for high-risk patients who must receive RCM include use of a lower osmolar agent, pretreatment with a corticosteroid and an H1-antagonist, discontinuation of beta-blockers if the patient is taking any, and bedside availability of appropriate medications and equipment to treat anaphylaxis. Clin Infect Dis, 1994 Feb, 18(2), 250 - 2 Syphilitic osteitis in a patient with secondary syphilis and concurrent human immunodeficiency virus infection; Kastner RJ et al.; Destructive bone disease is a well-recognized complication of congenital and tertiary syphilis . Clinically significant osteitis and osteomyelitis are rare complications of primary or secondary syphilis in patients who are not infected with human immunodeficiency virus (HIV) . We report a case of an HIV-infected man who presented with symptomatic, left ulnar osteitis as the initial manifestation of secondary syphilis . The patient's clinical course was complicated by a pathological fracture, but he responded to high-dose intravenous penicillin G therapy and surgical intervention . Results of physical examination on follow-up at 15 months were normal, and a serofast (rapid plasma reagin {RPR}) titer of 1:4 and a markedly decreased uptake on bone scintigraphy were observed . Our case report suggests that bone disease can represent an atypical manifestation of early acquired syphilis and that HIV-positive patients who present with orthopedic complaints or bone lesions should be evaluated for the presence of syphilitic bone disease. Nippon Kyobu Geka Gakkai Zasshi, 1994 Feb, 42(2), 302 - 5 {A case of ruptured left ventricular aneurysm due to syphilitic myocarditis}; Minami T et al.; This case involved a 20-year-old male who on May, 14, 1992, lost consciousness while working and went into a state of shock . He was taken to a hospital, where cardiac tamponade was diagnosed . He was later transferred to this hospital . Based on the results of echocardiography, coronary arteriography and left ventriculography, a ruptured ventricular aneurysm was diagnosed . The patient underwent emergency surgery . Serologic tests for syphilis performed at admission were definitely positive . Histopathological examination of the wall of the ventricular aneurysm disclosed fibrous myocarditis and peripheral coronary endarteritis accompanied by infiltration of plasma cells and lymphocytes . Immunohistological study revealed treponeme in the histiocytes of the aneurysmal wall . The diagnosis was a ruptured ventricular aneurysm caused by syphilitic myocarditis . Since the advent of penicillin therapy, cardiovascular syphilis, particularly syphilitic myocarditis, has become a rare disease . The chief interest of this case is that treponeme was detected in the lesion of myocarditis. Am J Obstet Gynecol, 1994 Feb, 170(2), 516 - 21 A prospective, randomized, placebo-controlled trial of penicillin in preterm premature rupture of membranes; Ernest JM et al.; OBJECTIVE: Preterm premature rupture of the fetal membranes is common and frequently results in infectious complications . A prospective, randomized, controlled trial of penicillin versus placebo in preterm premature rupture of membranes is reported . The aim of the study was to determine if prophylactic antibiotics after preterm premature rupture of membranes would reduce infectious complications in the mother or neonate . STUDY DESIGN: Patients with preterm premature rupture of membranes between 21 and 37 weeks' gestation were randomized into a penicillin group that received 1 million units of benzylpenicillin intravenously every 4 hours followed by 250 mg of potassium phenoxymethyl penicillin (Pen-Vee K, Wyeth-Ayerst) orally twice daily or a placebo group before delivery . Latency period, infectious complications, and neonatal outcomes were studied . RESULTS: Patients with preterm premature rupture of membranes who received prophylactic penicillin had fewer infectious complications, including intraamniotic infection and postpartum endometritis (4 vs 11, p < 0.03), without adverse effects on the mother or fetus . CONCLUSION: Prophylactic penicillin in patients with preterm premature rupture of membranes reduces maternal infectious complications without adversely affecting the mother or newborn. J Bacteriol, 1994 Feb, 176(4), 973 - 84 The thioredoxin system of Penicillium chrysogenum and its possible role in penicillin biosynthesis; Cohen G et al.; Penicillium chrysogenum is an important producer of penicillin antibiotics . A key step in their biosynthesis is the oxidative cyclization of delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine (ACV) to isopenicillin N by the enzyme isopenicillin N synthase (IPNS) . bis-ACV, the oxidized disulfide form of ACV is, however, not a substrate for IPNS . We report here the characterization of a broad-range disulfide reductase from P . chrysogenum that efficiently reduces bis-ACV to the thiol monomer . When coupled in vitro with IPNS, it converts bis-ACV to isopenicillin N and may therefore play a role in penicillin biosynthesis . The disulfide reductase consists of two protein components, a 72-kDa NADPH-dependent reductase, containing two identical subunits, and a 12-kDa general disulfide reductant . The latter reduces disulfide bonds in low-molecular-weight compounds and in proteins . The genes coding for the reductase system were cloned and sequenced . Both possess introns . A comparative analysis of their predicted amino acid sequences showed that the 12-kDa protein shares 26 to 60% sequence identity with thioredoxins and that the 36-kDa protein subunit shares 44 to 49% sequence identity with the two known bacterial thioredoxin reductases . In addition, the P . chrysogenum NADPH-dependent reductase is able to accept thioredoxin as a substrate . These results establish that the P . chrysogenum broad-range disulfide reductase is a member of the thioredoxin family of oxidoreductases . This is the first example of the cloning of a eucaryotic thioredoxin reductase gene. J Bacteriol, 1994 Feb, 176(4), 966 - 72 Thermoinducible filamentation in Escherichia coli due to an altered RNA polymerase beta subunit is suppressed by high levels of ppGpp; Vinella D et al.; The Escherichia coli strain known as GC2553, FB8, UTH1038, or K12S (Luria), considered an F- lambda- wild-type strain, is shown here to carry a cryptic mutation, ftsR1, causing nonlethal filamentation during exponential growth in Luria-Bertani (LB) broth at 42 degrees C and the inability to grow in salt-free LB broth at 42 degrees C . The ftsR1 mutation is completely suppressed in genetic backgrounds which increase RelA-dependent synthesis of the nucleotide ppGpp, i.e., argS201 (Mecr) and alaS21 (Mecr) mutations, affecting aminoacyl-tRNA synthetases, or the presence of a plac-relA' plasmid . These backgrounds also confer resistance in LB broth to the beta-lactam mecillinam, an antibiotic which specifically inhibits penicillin-binding protein 2 and, in wild-type cells, causes an indirect block in cell division . Furthermore, the ftsR1 mutant (but not an isogenic ftsR+ strain) is sensitive to mecillinam in minimal glucose medium at 37 degrees C . Since the division block caused by mecillinam can be overcome by overproduction of the cell division protein FtsZ, we tested the effect of plasmid pZAQ (carrying the ftsZ, ftsA, and ftsQ genes) on the ftsR1 mutant; it suppressed the filamentation in LB broth and the mecillinam sensitivity on minimal glucose medium at 37 degrees C but not the growth defect in salt-free LB broth at 42 degrees C . Genetic analysis indicated that the full phenotype of the ftsR1 mutant is due to a single mutation in the rpoB gene (90 min), coding for the beta subunit of RNA polymerase; we call this allele rpoB369(Fts) . We propose that the rpoB369(Fts) mutation alters the specificity of the polymerase and that the mutant enzyme can recover normal activity in the presence of high salt concentrations or via interaction with the nucleotide ppGpp. Zhonghua Liu Xing Bing Xue Za Zhi, 1994 Feb, 15(1), 10 - 3 {Discovery and clinical investigation of Lyme disease in Beijing area}; Feng FP et al.; The investigation of Lyme disease in Beijing area is reported for the first time . The sera of 1314 local residents were examined by indirect immunofluorescent assay . 11.9% of them were seropositive to Borrelia burgdorferi . The principal vector was Haemapsysalis longicornis . Six strains of B . burgdorferi were isolated from ticks or patients using modified BSK medium . Spirochetes were found in 5 of 30 patients' skin biopsy samples . Penicillin or ceftriaxone was used to treat the patients, and the effective rates were 64% and 88%, respectively. Zhonghua Yi Xue Za Zhi, 1994 Feb, 74(2), 92 - 3, 127 {Relationship between Melkersson-Rosenthal syndrome and spirochetes infection}; Liu HG et al.; By using Warthin-Starry spirochete special stain method and a transmission electron microscope for the first time, we detected spirochetes separately in lesions of 23 cases of MRS and 5 cases of MRS . Their shapes and distributive places were described . 11 cases were treated by high dose of penicillin, and 10 were responsive . This result provided further basis for a conjecture that the attack of MRS may be related to the infection of spirochetes. Zhongguo Zhong Yao Za Zhi, 1994 Feb, 19(2), 76 - 7, 126 {Preliminary study on spraying penicillin on Ligusticum chuanxiong Hort.}; Xie DM; It has been proved that penicillin spray on Ligusticum chuanxiong can contribute to the growth of the plant in the following ways: cutting down the tissue water potential, strengthening the capability of sucking moisture, increasing the contents of chlorophyll and restraining its degradation to facilitate the formation of photosynthetic compounds, enriching the nutrition root and increasing the root-shoot ratio . All these help to keep the stem tuber rot under 5% so as to guarantee higher economic yield of the plant. Appl Microbiol Biotechnol, 1994 Feb, 40(6), 883 - 7 Utilization of side-chain precursors for penicillin biosynthesis in a high-producing strain of Penicillium chrysogenum; Eriksen SH et al.; Utilization of the side-chain precursors phenoxyacetic acid (POA) and phenylacetic acid (PA) for penicillin biosynthesis by Penicillium chrysogenum was studied in shake flasks . Precursor uptake and penicillin production were followed by HPLC analysis of precursors and products in the medium and in the cells . P . chrysogenum used both POA and PA as precursors, producing phenoxymethylpenicillin (penicillin V) and benzylpenicillin (penicillin G), respectively . If both precursors were present simultaneously, the formation of penicillin V was blocked and only penicillin G was produced . When PA was added at different times to cells that were induced initially for POA utilization and were producing penicillin V, the POA utilization and penicillin V formation were blocked, whereas the cells started utilizing PA and produced penicillin G . The blocking of the POA turnover lasted for as long as PA was present in the medium . If POA was added to cultures induced initially for PA utilization and producing penicillin G, this continued irrespective of the presence of POA . Utilization of POA increased concomitant with depletion of PA from the medium . Analysis of cellular pools from a growing cell system with POA as precursor to which PA was added after 48 h showed that the cellular concentration of POA was kept high without production of penicillin V and at a concentration comparable to the concentration in the medium . The cellular concentration of POA was higher than the concentration of PA that was utilized for penicillin G production. Brain Res, 1994 Jan 7, 633(1-2), 105 - 11 The role of excitatory amino acids in the generation of spontaneous hippocampal oscillations; Schneiderman JH et al.; We examined the role of N-methyl-D-aspartate (NMDA) and non-NMDA glutamate receptors in generating spontaneous CA3 field potential oscillations in the hippocampal slice . Non-NMDA EPSPs are responsible for a portion of the spontaneous activity recorded in standard perfusion medium . NMDA receptors are not activated when inhibition is intact, however, recurrent excitation via NMDA receptors accounts for an increasing proportion of the low frequency (2-4 Hz) rhythms produced as inhibition is progressively blocked by low concentrations of the GABAA antagonist, penicillin . Production of these rhythms involves complex interactions among NMDA, non-NMDA and GABAA receptors . NMDA EPSPs can drive the rhythm in the absence of non-NMDA receptors only when inhibition is suppressed by more than 50% . Otherwise non-NMDA EPSPs appear to be necessary to depolarize neurons before NMDA EPSPs can be activated. J Bacteriol, 1994 Jan, 176(1), 256 - 9 Artifactual processing of penicillin-binding proteins 7 and 1b by the OmpT protease of Escherichia coli; Henderson TA et al.; Penicillin-binding proteins (PBPs) were visualized in strains of Escherichia coli that carried mutations in one or more of the following protease genes: tsp, degP, ptr, and ompT . In the absence of a functional ompT gene, PBPs 1b alpha and 7 were not processed to the shortened forms 1b beta and 8, respectively . Cleavage of PBPs 1b alpha and 7 could be restored by introduction of a plasmid carrying the wild-type ompT gene . These PBPs were processed only after cell lysis or after membrane perturbation of whole cells by freeze-thaw, suggesting that the cleavage was a nonspecific artifact due to contact with OmpT, an outer membrane protease, and that such processing was not biologically significant in vivo . The degradation of other PBPs during purification or storage may also be effected by OmpT. CMAJ, 1994 Jan 1, 150(1), 37 - 41 Radioallergosorbent testing for penicillin allergy in family practice; Worrall GJ et al.; OBJECTIVES: To determine (a) the prevalence of patients supposedly allergic to penicillin who have a positive radioallergosorbent test (RAST) result for penicillin G or V and (b) the predictive power of family physicians' clinical judgement that a patient who is supposedly allergic to penicillin will have a positive RAST result . DESIGN: Prospective multicentre cross-sectional observational study . SETTING: Eleven primary care practices in Newfoundland; 10 were in a rural setting . PATIENTS: Of 110 consecutive adult patients with a supposed allergy to penicillin 97 agreed to participate in the study; 92 underwent RAST . INTERVENTIONS: Patients helped physicians complete a questionnaire and had a venous blood sample taken for the RAST . Physicians examined the clinical history and judged whether the patient was likely to have a positive RAST result . MEAN OUTCOME MEASURES: Rates of positive and negative RAST results for penicillin V and G . RESULTS: Of the 92 patients 8 had a positive RAST result and 84 a negative one . The positive predictive power of a "good" clinical history (e.g., urticaria, swollen eyes, tongue or lips, or an anaphylactic reaction witnessed by a physician) was low (10%); the negative predictive power of a "poor" clinical history (e.g., nausea, vomiting, diarrhea, fever, nonspecific rash or fainting) was 92% . CONCLUSIONS: Less than 10% of primary care patients with a supposed allergy to penicillin will have a positive RAST result . In addition, physicians' predictions of allergy in such patients are imprecise. Womens Health Issues, 1994 Spring, 4(1), 16 - 9 The political history of syphilis and its application to the AIDS epidemic; Amstey MS; The history of syphilis control from the mid-19th century through the present time is a strong argument for the need to enhance the public health efforts to find cases of human immunodeficiency virus (HIV) infection and to notify the partners of infected individuals . To do this, public policy must be changed to allow better case-finding (mandatory testing) and partner notification (mandatory reporting) . The history of syphilis is such that one person in 22 was infected in this country in 1918 . If we are to use this history to control the current HIV epidemic, control measures used for syphilis (before penicillin) are needed; these are equal attention to education, available health care, case-finding, and partner notification. Food Addit Contam, 1994 Jan-Feb, 11(1), 1 - 6 Depletion of penicillin G residues in tissues and injection sites of yearling beef steers dosed with benzathine penicillin G alone or in combination with procaine penicillin G; Korsrud GO et al.; The contribution of benzathine penicillin G to residues in tissues and injection sites of yearling beef steers was assessed by treating seven groups of five to seven steers with either benzathine and procaine penicillin G together or benzathine penicillin G alone . Steers were injected with a commercial combination of benzathine and procaine penicillin G according to the Canadian (intramuscular) or United States (subcutaneous) label dosages of 8600 and 8800 IU penicillin G/kg body weight, respectively . They were killed 14 or 30 days after the intramuscular injections, and 30 days after the subcutaneous injections . At the label withdrawal times, Canadian 14 days and United States 30 days, the levels in the injection sites for all of the treatments were 30-60 times above the Canadian and United States' Maximum Residue Limit of 50 micrograms/kg, while liver, kidney and gluteal muscle levels were below the Maximum Residue Limit . Other steers were injected intramuscularly with 24,000 IU benzathine/procaine penicillin G/kg body weight and slaughtered 8, 14 or 50 days after injection . Fifty-day injection site residues were 24 times the Maximum Residue Limit . Another group of steers was injected intramuscularly with benzathine penicillin G alone at 12,000 IU/kg body weight and slaughtered 14 days later . Penicillin G levels in the injection sites were 156 times the Maximum Residue Limit . The persistence of penicillin G residues at the injection sites in all the treatment groups appears to be attributable primarily to benzathine penicillin G . Visual inspection of muscle surfaces did not reliably reveal all injection site lesions in the underlying musculature. Microbiology, 1994 Jan, 140 ( Pt 1), 79 - 87 Alterations of murein structure and of penicillin-binding proteins in minicells from Escherichia coli; Obermann W et al.; Minicells, as compared with a whole cell preparation of a minA/B mutant of Escherichia coli, showed a number of changes in the structure of the murein sacculus . Minicell murein was enriched in LD-A2pm-A2pm crossbridges by about 66% and reduced in the amount of L-Ala-D-Glu dipeptide