Infect Immun, 1989 Apr, 57(4), 1248 - 54 Penicillin-binding proteins and peptidoglycan of Treponema pallidum subsp . pallidum; Radolf JD et al.; Penicillin-binding proteins (PBPs) of Treponema pallidum subsp . pallidum (T . pallidum) were characterized by using {3H}penicillin G and a conjugate consisting of ampicillin and 125I-labeled Bolton-Hunter reagent . Both antibiotics specifically radiolabeled proteins with molecular masses of 94, 80, 63, and 58 kilodaltons (kDa); 125I-labeled Bolton-Hunter reagent-ampicillin also radiolabeled several polypeptides with lower molecular masses . The 94- and 58-kDa proteins demonstrated the highest binding affinities for {3H}penicillin G and were radiolabeled at concentrations of 8 and 40 nM, respectively . Radiolabeling of PBPs was detectable after 1 min of incubation in 1 microM {3H}penicillin G and was nearly maximal within 10 min . The rapidity of penicillin binding contrasted with the observation that only 40% of virulent treponemes became immobilized during prolonged incubation in vitro with a much higher concentration (1 mM) of unlabeled penicillin . Two lines of evidence indicated that most, if not all, of the PBPs are integral cytoplasmic membrane proteins: (i) preincubation of organisms in 0.1% Triton X-100 solubilized nearly all of the outer membranes but did not affect radiolabeling of PBPs, and (ii) except for the 80-kDa protein, the PBPs partitioned into the detergent phase following extraction with the nonionic detergent Triton X-114 . The presence of peptidoglycan in T . pallidum was confirmed by the detection of muramic acid in the sodium dodecyl sulfate-insoluble, proteinase K-resistant residue obtained from Triton X-114-extracted organisms. Wiad Lek, 1989 Apr 1, 42(7), 473 - 5 {Retinitis in multiple sclerosis}; Lisiewicz J et al.; A 37-year-old man treated since 6 years for multiple sclerosis is described because retinitis developed in an exacerbation of the disease . Retinitis was treated successfully with penicillin and hydrocortisone. Allergy, 1989 Apr, 44(3), 199 - 203 Penicillin-allergic patients react to penicillin-modified "self"; Bell SJ et al.; Penicillin G (PNG) has been demonstrated to elicit T-cell responsiveness in vitro in allergic patients by means of a lymphocyte transformation test (LTT) . As it was not clear how, or in what form, the stimulatory PNG determinants were inducing cellular proliferation, we compared the immune response elicited by different PNG preparations . Peripheral blood lymphocytes (PBL) of patients with proven PNG allergy were isolated, and proliferative responsiveness to soluble PNG alone, soluble PNG-protein conjugates (BPO-HSA, BPO-PL, BPO-HEX), and non-reactive penicilloate salts, was evaluated . An autologous mixed lymphocyte culture (MLC) using penicilloylated stimulator cells, was used to test responsiveness to membrane-bound PNG . We found that the addition of either 1000 micrograms/ml of potentially-reactive PNG to cell cultures, or of penicilloylated autologous cells was stimulatory, whereas non-reactive PNG salt, and soluble PNG conjugates were not stimulatory . Considering current and earlier findings, it appears that T cell immunity in these patients is directed towards PNG-modified "self", as PNG-modified autologous cells are potent stimulators in PNG-allergic individuals. J Cardiothorac Anesth, 1989 Apr, 3(2), 168 - 71 Hemodynamic changes after nafcillin administration during coronary artery bypass surgery; Casthely PA et al.; The hemodynamic response to nafcillin administration was studied in 45 patients with good left ventricular function and no known history of hypersensitivity to penicillin during coronary artery bypass grafting (CABG) . Group I (15 patients) received 1 gram of nafcillin in 10 mL of saline as an intravenous (IV) bolus, group II (15 patients) received 1 gram of nafcillin in 50 mL of saline as a slow IV infusion over 15 minutes, and group III (15 patients) did not receive nafcillin . Hemodynamic variables and plasma histamine and catecholamine levels were measured before and after nafcillin administration, after 500 mg of CaCl2, and after 0.1 mg of phenylephrine . Bolus nafcillin administration produced profound hypotension secondary to vasodilatation with significant increases in cardiac index and decreases in systemic and pulmonary vascular resistances . Cardiac index increased from 3.15 +/- 0.3 L/min/m2 to 5.75 +/- 0.25 L/min/m2 (P less than 0.005) one minute after nafcillin administration, and remained at 5.1 +/- 0.35 L/min/m2 after administration of CaCl2 (P less than 0.005) . All hemodynamic parameters returned toward control values after administration of 0.1 mg of phenylephrine, IV . Plasma epinephrine, norepinephrine, and histamine levels increased more than 100% . In group II, cardiac index increased, while systemic and pulmonary vascular resistances and mean arterial pressure decreased . However, these changes were less significant than those found in group I.(ABSTRACT TRUNCATED AT 250 WORDS) Mol Gen Genet, 1989 Apr, 216(2-3), 492 - 7 Amplification of the isopenicillin N synthetase gene in a strain of Penicillium chrysogenum producing high levels of penicillin; Smith DJ et al.; The isopenicillin N synthetase (IPNS) gene has been isolated from wild-type Penicillium chrysogenum and used as a probe to detect the equivalent gene on Southern blots of genomic DNA from a mutant producing high levels of penicillin . The IPNS gene in this strain is contained within a region of DNA of wild-type restriction pattern that extends for at least 39 kb and is present at between 8 and 16 copies . The steady state level of IPNS mRNA in the mutant producing high levels of penicillin is between 32- and 64-fold of that of the wild type, suggesting that the rate of transcription of some or all of the copies has been increased . In addition we have also shown that both the IPNS mRNA and enzyme is present throughout the growth phase in both strains under the culture conditions used . IPNS enzyme activity is greatly increased in the strain with the high penicillin titre. Mol Gen Genet, 1989 Apr, 216(2-3), 340 - 6 A cell division regulatory mechanism controls the flagellar regulon in Escherichia coli; Nishimura A et al.; The formation of flagella in various thermosensitive (Ts) cell division mutants of Escherichia coli was examined at the nonpermissive temperature . The number of flagella per unit cell length decreased sharply after shifting the culture temperature from 30 degrees to 40 degrees C in the following Ts mutants: ftsC108, ftsD1033, ftsE1181, ftsF1141, ftsG29, ftsZ84, parA110, dnaB42, nrdB, and dnaG . It was found that transcription of genes responsible for the formation and/or function of flagella (hag, fla, mot, che) decreased significantly at 40 degrees C . However, in the ftsI730 mutant at the nonpermissive temperature, or in penicillin G treated wild-type cells, cell division was blocked but formation of flagella continued . Moreover, when the cfcA1 mutation, of a gene involved in coordinating DNA replication and cell division, was introduced into the dnaB42 mutant strain, inhibition of cell division and also of formation of flagella at 40 degrees C was relaxed . These results indicate that the flagellar regulon is under the control of a cell division regulatory mechanism. Am J Physiol, 1989 Apr, 256(4 Pt 2), F596 - 609 Operational modes of the organic anion exchanger in canine renal brush-border membrane vesicles; Steffens TG et al.; This study delineates the various operational modes catalyzed by the organic anion exchanger present in the canine renal brush-border membrane . The experiments examined the carrier-mediated effects of various organic and inorganic anions on the transport of either p-{3H}aminohippuric acid ({3H}PAH) or 36Cl- . {3H}PAH countertransport was significantly stimulated by PAH, urate, Cl-, Br-, HCO3-, and by a pH gradient . This pH stimulation remained in the absence of HCO3- (i.e., under N2), implying PAH-OH- exchange . Furosemide, bumetanide, penicillin, and probenecid inhibited countertransport of {3H}PAH . Likewise, the above anions produced cis inhibition of {3H}PAH transport . The cis and trans effects of SO4(-2) and formate were minimal . 36Cl- countertransport was stimulated by PAH, Cl-, Br-, HCO3-, formate, and by a pH gradient that was effective even in the absence of HCO3- (i.e., under N2), implying Cl- -OH- exchange . Cl- -OH- and Cl- -Cl- exchange was inhibited by PAH . In each instance, the trans-stimulation of 36Cl- efflux was insensitive to maneuvers that created an inside-positive membrane potential, demonstrating electroneutral mediated exchange . We conclude that the organic anion transporter can operate in three distinct exchange modes: organic-organic, organic-inorganic, and inorganic-inorganic. J Biol Chem, 1989 Mar 5, 264(7), 3680 - 4 delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine synthetase from Aspergillus nidulans . The first enzyme in penicillin biosynthesis is a multifunctional peptide synthetase; van Liempt H et al.; A multienzyme catalyzing the formation of delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine, the first free intermediate in penicillin biosynthesis, was detected in an assay measuring the formation of tripeptide from L-{U-14C}valine in the presence of L-alpha-aminoadipic acid, L-cysteine, ATP, Mg2+ ions, and dithioerythritol . Enzyme was extracted from dry mycelium using a buffer with a high glycerol concentration and thiol protective agent to stabilize enzyme activity . In five steps the enzyme was purified 118-fold . It catalyzed ATP-pyrophosphate exchange in dependence of all three constituent amino acids, and the enzyme could be amino-acylated with L-{14C}valine . The molecular weight of the protein both native (in gel filtration chromatography) and denatured (polyacrylamide gel electrophoresis) was about 220 kDa . These data suggest that delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine synthetase consists of a single polypeptide chain and a multienzyme thiotemplate mechanism for the reaction sequence is postulated. Patol Fiziol Eksp Ter, 1989 Mar-Apr, (2), 43 - 5 {Depression of penicillin-evoked seizure discharges of cerebrospinal neurons by magnesium ions}; Kornilov OV et al.; In experiments on narcotized spinal cats perfusion of the lumbosacral segments of the spinal cord with penicillin (50 mmol/l) containing artificial cerebrospinal fluid led to the appearance of spontaneous negative small potentials in the dorsal roots and spontaneous repetitive bursts of impulses in the ventral roots of the perfused segments . The epileptogenic activity of penicillin was reduced or completely blocked if administration of the penicillin containing cerebrospinal fluid was preceded by 20-30 minute perfusion of the central canal of the lumbosacral segments with cerebrospinal fluid containing a high concentration of magnesium ions. Mt Sinai J Med, 1989 Mar, 56(2), 97 - 8 Overwhelming postsplenectomy infection in patients with thalassemia major; Golematis B et al.; The efficacy of pre- and post-operative protection against overwhelming postsplenectomy infection was evaluated in a prospective study of 98 patients with thalassemia major . All patients were vaccinated four to ten weeks pre-operatively with a polyvalent antipneumonococcal vaccine; after their discharge from the hospital they received 1,000,000 units (625 mg) of oral penicillin daily for one to two years and have been closely followed up since then . The incidence of overwhelming infection among our patients was 1.02% . This very low incidence suggests that vaccination and prophylactic penicillin administration, combined with careful follow-up, provide adequate protection against overwhelming infection in splenectomized patients with thalassemia major. Jpn J Antibiot, 1989 Mar, 42(3), 766 - 72 {Clinical efficacy of sulbactam/ampicillin in the field of pediatrics}; Ogura H et al.; Sulbactam (SBT) is a new derivative of the basic penicillin nucleus . It effectively and irreversibly inhibits several important bacterial beta-lactamases and displays synergistic effects against the resistant organisms when co-administered with ampicillin (ABPC) . SBT/ABPC, which is a fixed combination of SBT and ABPC in a 1:2 ratio, was studied for clinical efficacy in the field of pediatrics . Patients treated were infants and children ranging from 12 days to 13 years and 2 months old suffering from acute tonsillitis in 2 cases, acute bronchitis in 2 cases, septicemia in 2 cases, acute enteritis, acute pyelonephritis and osteomyelitis in 1 case each, a total of 9 cases . SBT/ABPC was administered 100-300 mg/kg in daily doses and durations of treatment ranged from 4 to 17 days . Clinical results were "excellent" in 6 and "good" in 2: the efficacy rate was 88.9% or 8 cases out of 9 . Neither clinical side effects nor abnormal laboratory findings obviously attributable to SBT/ABPC were observed in any cases. J Med Assoc Thai, 1989 Mar, 72(3), 132 - 7 Treatment of sexual contacts of syphilitic pregnant women; Phaosavasdi S et al.; Between August 1984 and May 1985, 197 syphilitic pregnant women were diagnosed at the antenatal clinic, Department of Obstetrics & Gynaecology, Faculty of Medicine, Chulalongkorn University . One hundred and sixty-nine male sexual contacts were serologically tested for syphilis and seventy-eight cases were found positive . Twenty-eight cases refused to be tested . Thirty-two syphilitic male contacts had cerebrospinal fluid tests and four were found to be abnormal . Fifty-three cases or 67.9 per cent of 78 syphilitic male consorts did not complete a full diagnostic and treatment protocol . They preferred to be treated with benzathine penicillin G 2.4 million units intramuscularly for 3 consecutive weeks . After this treatment no patient agreed to a repeat spinal tap . This behavioral attitude concurred with their socioeconomic background . All were from a low socioeconomic group and lacked health knowledge . This made it difficult to work with them and contributed to inadequate management of their disease. J Vet Pharmacol Ther, 1989 Mar, 12(1), 37 - 45 Concentrations of sulphadimidine, oxytetracycline and penicillin G in serum, synovial fluid and tissue cage fluid after parenteral administration to calves; Bengtsson B et al.; Drug concentrations in serum, synovial fluid and tissue cage fluid (TCF) in calves were measured after single i.m . doses of oxytetracycline hydrochloride (OTC), procaine penicillin G (PPG) and potassium penicillin G (KPG) and single i.v . doses of sulphadimidine (SDM) and OTC . For all drugs, concentration-time curves in serum and synovial fluid were not identical but they had similar profiles, with peak levels occurring at about the same time . Concurrent concentrations were lower in synovial fluid than in serum . For each drug, elimination half-lives from synovial fluid and from serum were similar, except for penicillin G after KPG administration which had a significantly longer half-life from synovial fluid than from serum (P less than 0.05) . Of the two penicillin G preparations, PPG gave a significantly higher synovial fluid:serum area under curve (AUC) ratio than did KPG; 0.76 +/- 0.10 and 0.54 +/- 0.12, respectively (P less than 0.05) . For OTC, the synovial fluid:serum AUC-ratio was 0.33 +/- 0.12 after i.m . and 0.34 +/- 0.08 after i.v . administration . Drug concentration-time curves of TCF had different profiles compared with serum, with relatively low and delayed peak levels and slow elimination from TCF . TCF:serum AUC-ratios did not differ significantly for i.m . and i.v . administration of OTC; 0.10 +/- 0.10 and 0.19 +/- 0.03 respectively (P greater than 0.05) . Potassium penicillin G (KPG), however, gave a significantly higher TCF:serum AUC-ratio than PPG; 0.55 +/- 0.21 and 0.19 +/- 0.07, respectively (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) J Vet Pharmacol Ther, 1989 Mar, 12(1), 31 - 6 The concentration of penicillin in bovine conjunctival sac fluid as it pertains to the treatment of Moraxella bovis infection . (II) Topical application; Abeynayake P et al.; Sodium benzyl penicillin, procaine penicillin and benethamine penicillin were applied into the bovine conjunctival sac as an aqueous solution or in ointment form in order to study the concentration-time profiles . The series of treatments was repeated in five animals in a random sequence . Penicillin concentration in conjunctival sac fluid (CF) was determined using the agar-well-diffusion assay technique . The data obtained were transformed to linear regression slopes . Similarity of the slopes within treatments (in five different eyes) enabled the construction of four common lines by co-variance analysis to represent each treatment . The regression coefficients of the four common lines were then compared to study the difference between treatments . Topical application of 5,000 iu sodium benzylpenicillin in aqueous solution at a concentration isotonic with 0.9% saline, produced a duration of therapeutic concentration (DTC) in CF of 12.6 +/- 1.5 h . When the same salt or other less water-soluble ones were formulated at the same concentration in an ointment base, the DTC was significantly prolonged . For all treatments, peak concentrations in CF were recorded at the first sampling and ranged between 7 iu/ml and 14 iu/ml . Sodium benzylpenicillin or procaine penicillin, both in the ointment base, produced DTCs of 38.8 +/- 2.1 h and 37 +/- 4.0 h, respectively, while the ointment formulation of benethamine penicillin produced a DTC of 56 +/- 4.5 h . The prolonged duration observed in the eye ointments can be partly accounted for by the viscous nature of the base . Other differences may be dependent on relative water solubility of each penicillin product and complexity of the surface mucosae of the eye. Nippon Shishubyo Gakkai Kaishi, 1989 Mar, 31(1), 176 - 83 {Connective tissue attachment to root surfaces in periodontal disease . Initial attachment of human gingival fibroblasts}; Fujii T et al.; We studied the effect of periodontal treatment (scaling, SC; root planning, RP; scaling followed by citric acid, SC + CA; and root planing followed by citric acid, RP + CA) of periodontally diseased root surfaces on the initial attachment of human gingival fibroblasts in vitro . Root slices were prepared from surgically extracted human normal and periodontally involved teeth . Each treated root slice was placed in a well of a 24-well plate containing a PBS-antibiotic solution (penicillin, 200 units/ml; streptomycin, 200 micrograms/ml) for 1 hr . at 4 degrees C . Then, to each well was added 1 x 10(4) cells in 1 ml of alpha-MEM, and the plates were incubated for 24 hr . After the root slices were fixed and stained, the morphological changes and the numbers of attached cells were determined under a dissecting microscope . The fibroblasts on the controls (untreated normal roots) and the RP-roots appeared spindle-shaped with a few cell processes . The cells on the SC-roots were rounded or slightly elongated . The cells on the roots treated with citric acid (SC + CA and RP + CA) had were flat and seemed well attached to the surface . The number of cells attached on RP- and RP + CA-roots was increased to the control level, but those on SC- and SC + CA-roots were showed about 60% of the control . No significant differences in the numbers of cells were found between RP and RP + CA treatment or between SC and SC + CA treatment.(ABSTRACT TRUNCATED AT 250 WORDS) Blood Rev, 1989 Mar, 3(1), 29 - 44 The presentation, management and prophylaxis of sickle cell disease; Davies SC et al.; Sickle cell disease (SCD) is encountered in all parts of the world where plasmodium falciparum has been endemic and has spread by migration to the temperate countries of the world resulting in a heavy caseload in Northern Europe and the United States . These patients in the temperate climates manifest most of the clinical problems associated with SCD in Tropical Africa and the West Indies . There are, however, differences between the groups in both the frequency and presentations of the clinical syndromes . The clinical management of SCD is discussed with particular reference to the potentially fatal sequestration syndromes: splenic, hepatic, 'the girdle syndrome' and 'the chest syndrome' . In all clinical situations encountered in SCD blood transfusions should be by isovolaemic exchange unless there is a marked fall in haematocrit (less than 5 g/dl) as may occur with sequestration and aplasia . The criteria for exchange transfusion in the chest syndrome are a pAO2 of less than 60 mm Hg while breathing air or a rapidly deteriorating clinical picture . Analgesia for vaso-occlusive sickle pain should be adequate and freely available which often requires the parental administration of opiates . We have delineated a small sub-group (6%) of SCD patients, 'the non-copers', who manifest a high demand for analgesia . The prospects for cure, and the techniques and issues for antenatal diagnosis are reviewed demonstrating the importance of education and counselling . The significant reduction in mortality and morbidity of children with SCD taking penicillin prophylaxis is emphasised with the need for its early institution. Toxicol Lett, 1989 Mar, 46(1-3), 45 - 54 Aetiology of nephrotoxic damage to the renal interstitium and tubuli; Fillastre JP et al.; The kidney is particularly susceptible to the deleterious effects of drugs, and drug-induced nephropathies are now fairly well understood . All the components of the renal parenchyma can be affected, but we have focused our attention on tubulointerstitial nephropathies . All of the pathophysiological mechanisms are not known, but it is possible to describe two types of renal alteration . The first is due to a direct toxic action by, for example, antibiotics, contrast media, nonsteroidal antiinflammatory agents, antalgics and analgesics . The second type of alteration appears to be due to immunoallergic reactions to, for instance, penicillin and its derivatives, rifampin, sulphonamides and phenindione . We also underline the risk factors that favour the occurrence of renal complications and the means that can be used to prevent them. Vet Clin North Am Food Anim Pract, 1989 Mar, 5(1), 203 - 15 Llama dermatology; Rosychuk RA; As llamas become more common in North America, veterinarians will be called on ever more frequently to deal with their dermatologic problems . Adherence to the basic tenets of the thorough dermatologic work up, including history, physical examination, skin scrapings, cytological examinations, fungal culture, skin biopsies, and assessing response to judiciously chosen trial therapies will offer the best opportunity of arriving at proper diagnoses . Special attention must be paid to the fact that llama skin bears some histological differences that may prove confusing to the uninitiated . A mild degree of hyperkeratosis, a prominent vascular plexus in the superficial dermis that is associated with mild perivascular mononuclear cell accumulations, and regional differences in sebaceous gland size and numbers, all are considered normal findings . Ectoparasites, including sarcoptic mange, chorioptic manage, and pediculosis, appear to be the most common causes of pruritus in the llama . Although ivermectin therapy would appear to be very effective for the treatment of scabies and, indeed, may work well against sucking lice, chorioptic mange and biting lice usually do not respond to this medication . Corticosteroids can be used to treat pruritus in the llama nonspecifically, using the anti-inflammatory dosages established in other species . These drugs are used most appropriately for the management of the allergies that we suspect occur in this species, until better alternative therapies can be developed . Variably pruritic focal areas of alopecia, exudation, and crusting suggest differential diagnoses including bacterial folliculitis and furunculosis, dermatophilosis, dermatophytosis, and coccidioimycosis . The diagnosis of bacterial problems often is made by assessing response to antibiotic therapy . Topical disinfectants and/or systemic penicillin or trimethoprim-sulfadiazine are indicated . Dermatophilosis is treated by cleaning and drying the leasions, applying topical antibiotics, and, occasionally, using parenteral penicillin and streptomycin . Dermatophytosis usually is treated with topical antibiotics only . Captan is one of several therapies of choice . There is no therapy presently available for coccidioidomycosis in the llama . Perhaps most perplexing is the fact that one of the most common dermatopathies seen in the llama is an idiopathic keratinizing disorder that, in some cases, is responsive to zinc supplementation . We have no real idea of the pathogenesis of this problem and recognize that some affected animals will not respond to supplementation.(ABSTRACT TRUNCATED AT 400 WORDS) Pediatr Dent, 1989 Mar, 11(1), 52 - 4 Pediatric recurrent sialectasis: case report; Opinya GN et al.; A 2 1/2-year-old female presented to the Department of Paediatrics with a fever (38.2 degrees C) and bilateral swelling of the parotid salivary glands . A month later, she presented with similar signs and symptoms . Three months later the patient had a third attack and was referred to the Paediatric Dental Department . A clinical examination and sialography showed a normal Stensen's duct . The parenchyma of the right parotid had a combination of punctate lesions (1-2 mm in diameter) and globular lesions (3 mm in diameter) . In the left parotid there were punctate lesions approximately 1 mm in diameter . The patient was managed with antipyretics (acetaminophen) and penicillin . This condition should be referred to as sialadenitis pediatrica as it presents as a clinical entity with signs and symptoms of swelling and pyrexia in the absence of sialography and histological findings . It is referred to as sialectasis after histological and sialographic observations detect lesions affecting the parenchyma of the salivary glands. J Med Assoc Thai, 1989 Mar, 72(3), 167 - 71 Prospective study of cutaneous drug reactions; Puavilai S et al.; One hundred and seventy-five patients with cutaneous drug reactions were studied with regard to age, sex, possible causative drugs and clinical course of the reactions . The age of the patients ranged from 3 to 78 years old, with the common occurrence between the age of 20 to 30 years . Females outnumbered males at a proportion of 1.8:1 . The maculopapular rash was the most common reaction, which accounted for 42.9 per cent of the patients . Fixed drug eruption and Stevens-Johnson syndrome were the second and third common occurrences . The eruptions were attributed to 45 drugs, the three most common causative drugs were ampicillin, penicillin and trimethoprim-sulphamethoxazole . Ampicillin was the most common drug that caused maculopapular rash whereas tetracycline and trimethoprim-sulphamethoxazole were responsible for fixed drug eruption and Stevens-Johnson syndrome respectively . The drug eruption occurred within a few minutes to 3 weeks of beginning therapy . The eruptions lasted from 3 to 30 days depending on the type of reactions. No To Shinkei, 1989 Mar, 41(3), 293 - 8 {Acute effect of penicillin G on feline models of focal epilepsy}; Tanaka S et al.; Penicillin is well known as a potent convulsive agent . A cortical topical, intracerebral or systemic administration of penicillin produces abnormal and paroxysmal activity which may lead to seizure, and has been used in the investigation of the mechanisms of epilepsy . This is a report on the studies of an acute effect of potassium penicillin G on two models of experimental focal epilepsy: a) amygdaloid kindling model, and b) kainic acid-induced limbic seizure model . Twelve adult cats for amygdaloid kindling model (kindling group), six for KA-induced limbic seizure model (KA group) and four for a control group were prepared for this study . In kindling group, after completion of kindling procedure, 40-60 X 10(4) unit/kg of potassium penicillin G (PC), dissolved in sterilized normal saline, was injected intraperitoneally during an interictal period . In KA group, 1 micrograms of KA was injected into the left amygdala . Limbic seizures occurred frequently during the initial 5 hours but subsided completely within 3 days . After a latent period, spontaneous secondarily generalized convulsion occurred from 30 to 60 days after KA injection . The cats were completely normal in their behavior during the interictal period . During the interictal stage after the first generalized convulsion has been observed, 15-20 X 10(4) unit/kg of PC was injected intraperitoneally . In the control group, 40-60 X 10(4) unit/kg was injected intraperitoneally . Electroclinical observations were continued until 5 hours after PC injection in three groups . In the control group, no cats developed generalized convulsion . In the kindling group, 4 of 12 cats developed focal amygdaloid seizures with secondary generalization by nearly the identical doses required in the control group.(ABSTRACT TRUNCATED AT 250 WORDS) Mol Gen Genet, 1989 Mar, 216(1), 91 - 8 Cloning, sequence analysis and transcriptional study of the isopenicillin N synthase of Penicillium chrysogenum AS-P-78; Barredo JL et al.; A gene (ips) encoding the isopenicillin N synthase of Penicillium chrysogenum AS-P-78 was cloned in a 3.9 kb SalI fragment using a probe corresponding to the amino-terminal end of the enzyme . The SalI fragment was trimmed down to a 1.3 kb NcoI-BglII fragment that contained an open reading frame of 996 nucleotides encoding a polypeptide of 331 amino acids with an Mr of 38012 dalton . The predicted polypeptide encoded by the ips gene of strain AS-P-78 contains a tyrosine at position 195, whereas the gene of the high penicillin producing strain 23X-80-269-37-2 shows an isoleucine at the same position . The ips gene is expressed in Escherichia coli minicells using the lambda phage PL promoter . Some similar sequence motifs were found in the upstream region of the ips gene of P . chrysogenum when compared with the upstream sequences of the ips genes of Cephalosporium acremonium and Aspergillus nidulans . Primer extension studies indicated that the start of the mRNA coincides with a T in position -11 which is located in a conserved pyrimidine-rich sequence, near two CAAG boxes . Clones of P . chrysogenum Wis 54-1255 transformed with the ips gene showed a five-fold higher isopenicillin N synthase activity than the untransformed cultures. Infect Immun, 1989 Mar, 57(3), 870 - 4 Characterization of gamma interferon-mediated cytotoxicity to chlamydia-infected fibroblasts; Byrne GI et al.; Addition of murine recombinant gamma interferon (IFN-gamma) to mouse fibroblast cultures infected with Chlamydia psittaci was found to induce a cytotoxic response that was dependent on the concentration of IFN-gamma added and the multiplicity of infection given . No cytotoxicity was observed for uninfected cells treated with IFN-gamma, nor did infection alone elicit cytotoxicity . Cytotoxicity was detected only if IFN-gamma was present for at least the first 18 h of a 30-h incubation period . Cytotoxic activity was not observed when infected cells were treated with 50 micrograms of chloramphenicol per ml, a drug which inhibits differentiation of infectious elementary bodies to noninfectious reticulate bodies . Cytotoxic activity was restored if addition of chloramphenicol was delayed until 18 h postinfection . Addition of 100 U of penicillin per ml to infected host cells reduced but did not abolish cytotoxic activity . Treatment of host cells with as little as 0.2 microgram of cycloheximide per ml inhibited cytotoxicity without interfering with chlamydial growth . When addition of cycloheximide was delayed until 12 h after infection and IFN-gamma treatment, cytotoxicity was restored . These data indicate that IFN-gamma functions as a cytotoxic cytokine against chlamydia-infected fibroblasts . Cytotoxicity was found to be dependent on chlamydial multiplicity of infection, differentiation of chlamydiae to the metabolically active form, and host cell protein synthesis. J Bacteriol, 1989 Mar, 171(3), 1394 - 401 Preparation and characterization of monoclonal antibodies against native membrane-bound penicillin-binding protein 1B of Escherichia coli; Den Blaauwen T et al.; We prepared monoclonal antibodies against penicillin-binding protein 1B (PBP 1B) of Escherichia coli to study the membrane topology, spatial organization, and enzyme activities of this protein . The majority of the antibodies derived with PBP 1B as the immunogen reacted against the carboxy terminus . To obtain monoclonal antibodies recognizing other epitopes, we used PBP 1B lacking the immunodominant carboxy-terminal 65 amino acids as the immunogen . Eighteen monoclonal antibodies directed against membrane-bound PBP 1B were isolated and characterized . The epitopes recognized by those monoclonal antibodies were located with various truncated forms of PBP 1B . We could distinguish four different epitope areas located on different parts of the molecule . Interestingly, we could not isolate monoclonal antibodies against the amino terminus, although they were specifically selected for . This is attributed to its predicted extreme hydrophilicity and flexibility, which could make the amino terminus very sensitive to proteolytic degradation . All antibodies reacted against native PBP 1B in a dot-blot immunobinding assay . One monoclonal antibody also recognized PBP 1B in a completely sodium dodecyl sulfate-denatured form . This suggests that all the other monoclonal antibodies recognize conformational epitopes . These properties make the monoclonal antibodies suitable tools for further studies. Anal Biochem, 1989 Feb 15, 177(1), 165 - 7 Iodometric method for detection of beta-lactamase activity in yeast cells carrying ampicillin resistance gene in chimeric plasmids; Kuo SS et al.; In order to determine whether an ampicillin resistance gene in a chimeric plasmid is active in transformed yeast cells, it is necessary to have a simple and quick assay procedure . We describe here a procedure for achieving this goal using an iodometric color reaction . This method is based on the fact that the ampicillin resistance gene product, beta-lactamase, can hydrolyze penicillin G and release a reducing product, which can be visualized by the discoloration of a dark blue iodine-starch complex . We have improved this method so that the assay can be carried out on agar plate and in liquid culture . It permits the detection of the beta-lactamase enzyme activity in yeast liquid culture at a concentration as low as 1 X 10(5) cells/ml within 12 h . This method is especially useful for certain yeast transformation systems, such as industrial yeast cultures, where the transformants can be selected only by drug resistance. Ann Intern Med, 1989 Feb 15, 110(4), 304 - 12 Diagnostic tests for patients with suspected allergic disease . Utility and limitations; VanArsdel PP Jr et al.; STUDY OBJECTIVE: To evaluate the clinical efficacy of diagnostic tests used for persons with suspected allergic disease . DESIGN: Information synthesis based on historical review of developments in the understanding of the pathophysiology of allergic diseases and on selected recent literature on efficacy of specific diagnostic tests . MAIN RESULTS: Skin testing is most effective when based on clues from the patient's history . The sensitivity and specificity of skin testing methods are compared: skin prick testing alone is often sufficient to identify or exclude immunoglobulin E (IgE)-mediated hypersensitivity, including food allergy . Except for penicillin and certain macromolecules, skin testing is not useful for evaluating drug allergy . Skin test titration may be useful for determining the starting dose for immunotherapy; otherwise it is rarely necessary . The patch skin test helps identify the cause of allergic contact dermatitis . Bronchial provocation testing is useful in special cases . Oral provocation testing may be used to identify allergy or other intolerance to suspected foods, food additives, and certain drugs . Provocation testing is time-consuming and requires special precautions . In-vitro methods for identifying allergen-specific IgE are especially useful when skin testing is unreliable, equivocal, or cannot be done . In-vitro tests should be used as adjuncts to the clinical interview and examination . CONCLUSIONS: Tests that are effective for identifying allergenic substances usually can be determined from a careful patient interview . Clinicians should be aware of nonspecific test results and allergy tests of unproven effectiveness. Ann Thorac Surg, 1989 Feb, 47(2), 305 - 7 Pleuropulmonary actinomycosis associated with a systemic-to-pulmonary artery fistula and contralateral metastatic back mass; Miller AR et al.; We report a case of systemic-to-pulmonary artery fistula associated with thoracic actinomycosis and with metastatic hematogenous dissemination to the soft tissues of the back . The difficulty in diagnosing thoracic actinomycosis may predispose to the increased incidence of hematogenous spread of this disease . Although resection of pulmonary tissue including the infectious mass was required in previous cases, resection of the pleural mass alone was curative in this patient when combined with penicillin therapy. J Allergy Clin Immunol, 1989 Feb, 83(2 Pt 1), 381 - 5 Cross-reactivity between penicillins and cephalosporins: clinical and immunologic studies; Blanca M et al.; Nineteen well-characterized penicillin-allergic patients were investigated for their sensitivity to cephalosporins containing potentially cross-reactive side chains . All patients were administered cephamandole parenterally and, if this was tolerated, a course of oral cephaloridine was administered . Only two patients responded to the cephamandole; none of the remaining patients reacted to cephaloridine . Benzylpenicilloyl RAST-inhibition studies with sera from three subjects who had not reacted to the cephalosporins demonstrated that cephamandole linked to proteins was capable of recognizing benzylpenicilloyl-specific IgE antibody . It is concluded that consideration of side chain structures can help to predict possible cross-reactions between penicillins and cephalosporins, but carefully controlled challenge tests are advisable before penicillin-allergic patients are treated with cephalosporins . In relation to cross-reacting potential, in vitro experimental studies are difficult to interpret and may in some circumstances overestimate the risk. Am J Obstet Gynecol, 1989 Feb, 160(2), 508 - 9 The effect of pretreatment with magnesium sulfate on the initiation of seizure foci in anesthetized cats; Koontz WL et al.; The therapeutic effect of magnesium sulfate remains unknown . Its role as an anticonvulsant is controversial . The effect of pretreatment with parenteral magnesium sulfate on the ability to initiate penicillin-induced seizure foci in anesthetized cats was studied . All animals in the experimental group achieved serum magnesium levels of greater than 10 mg/dl . No significant difference in epileptic spike frequency between the experimental and control groups was demonstrated. Exp Neurol, 1989 Feb, 103(2), 179 - 85 Role of endogenous adenosine in recurrent generalized seizures; Eldridge FL et al.; We induced generalized seizures by cortical injection of penicillin in anesthetized, paralyzed cats . After they had developed recurrent ictal-interictal ECoG cycling and fictive tonic-clonic motor convulsions (status epilepticus), we studied the effect of systemically administered neuropharmacological agents on the seizure cycling . Antagonists of adenosine receptors, theophylline and 8-cyclopentyltheophylline, increased the cycle period due to marked prolongation of duration of ictal discharge, often to more than 30 min . Dipyridamole, an inhibitor of adenosine reuptake, lengthened the interictal phase of the seizure with no effect on ictal duration . Antagonists of gamma-aminobutyric acid and opioid peptides had no effect on either ictal or interictal phases nor did the nonspecific neural excitant, doxapram . These findings suggest that a major mechanism of ictal-interictal cycling during status epilepticus is the alternating accumulation during the ictal phase and clearance during the interictal phase of the inhibitory neurochemical, adenosine. Yakugaku Zasshi, 1989 Feb, 109(2), 119 - 26 {Adverse drug interactions between pyridonecarboxylic acids and nonsteroidal antiinflammatory drugs: convulsion after oral or intracerebral administration in mice}; Hirai S et al.; Comparing with other pyridonecarboxylic acids (PCAs), the neurotoxicity of (+/-)-7-(3-amino-1-pyrrolidinyl)-6-fluoro-1-(2,4-difluorophenyl)-1,4- dihydro-4-oxo-1,8-naphthyridine-3-carboxylic acid p-toluenesulfonate hydrate (T-3262), which is a new PCA, was investigated in mice in a combination with fenbufen (FBF) . T-3262, ofloxacin (OFLX) and nalidixic acid (NA) did not produce convulsion, but enoxacin (ENX) and norfloxacin (NFLX) produced it after an oral administration with FBF . The intracerebral injection of drugs alone to mice revealed that both FBF and 4-biphenylacetic acid (BPAA), which is principally responsible for FBF's antiinflammatory action, scarcely had convulsant activity . While all the PCAs had convulsant activity and the order of potency was as follows; NFLX greater than ENX greater than OFLX greater than penicillin G potassium greater than the free base of T-3262 (T-3262 base) greater than or equal to NA . When orally pretreated with BPAA, the convulsive threshold was scarcely lowered for T-3262 base and OFLX, but for ENX and NFLX it was lowered to about 1/300 and 1/100 of the respective activity . As the result, convulsant activities of ENX and NFLX were greatly potentiated, and their potencies became almost equal . The adverse drug interactions between T-3262 and FBF were scarcely observed in mice. J Med Assoc Thai, 1989 Feb, 72(2), 101 - 8 Effectiveness of benzathine penicillin regimen in the treatment of syphilis in pregnancy; Phaosavasdi S et al.; The intramuscular injection of benzathine penicillin G 2.4 million units weekly for 3 consecutive weeks to syphilitic pregnant women was again confirmed to be clinically effective for prevention of their neonates from congenital syphilis and well accepted as treatment for syphilis in pregnancy . It was administered to 184 cases, or 93.5 per cent, of 197 syphilitic gravidas . It was found that pregnancy outcomes in terms of abortion, stillbirth, prematurity, full term delivery, neonatal birth weight, macroscopic examination of the placenta and general physical examination of the neonate were clinically useful as a parameter to evaluate the effectiveness of the therapy for the infant . Clinical symptoms and signs in the mother, serological tests for syphilis in the gravida and cord blood of the newborn, and placental weight were not useful in the evaluation of adequacy of treatment of our study group. No To Shinkei, 1989 Feb, 41(2), 193 - 8 {Suppressive effect of GABA-containing liposomes on kindled convulsion}; Mori N et al.; gamma-aminobutyric acid (GABA), a major neurotransmitter in the mammalian brain, may be natural mediator of defence against epileptic activities . When given peripherally, however, GABA itself can cross the blood-brain barrier (BBB) insufficiently . Liposomes (LIPO), being composed of lipid bilayers in which various compounds can be entrapped, have been shown to cross the BBB . Recently, Loeb et al . demonstrated that intraperitoneal injection of GABA entrapped within LIPO (GABA-L) significantly suppresses penicillin- or isoniazid-induced seizures in rats . In the present study, we examined the effect of intraperitoneally administered GABA-L on the kindled amygdala (AM) seizures in addition to the comparative uptake of radioactivity by brain following intraperitoneal administration of 3H-GABA-L or 3H-GABA in rats . Expt . I: Anticonvulsant effect of GABA-L Twelve male Wistar rats weighing 250-300 g were used . Bipolar electrodes made of twisted stainless steel wire 0.2 mm in diameter were implanted into the left AM . All the animals were kindled at the left AM until a stable kindled seizure was evoked for at least five successive days . Subsequently, the stimulus intensity was gradually reduced and the last intensity to induce the kindled seizure was designated as the generalized seizure triggerring threshold (GST) . GABA was dissolved in deionized water at a concentration of 0.5 g/ml . GABA-L and LIPO were prepared as follows . 80 mumoles L-alpha-phosphatidylcholine, 22.8 mumoles stearylamine and 11.4 mumoles cholesterol were dissolved in chloroform . After chloroform was removed under a stream of nitrogen gas, dried thin film of phospholipids was formed.(ABSTRACT TRUNCATED AT 250 WORDS) Klin Monatsbl Augenheilkd, 1989 Feb, 194(2), 88 - 96 {Bilateral acute confluent disseminated choroiditis in Borrelia burgdorferi infection}; Wilk CM et al.; Two patients with bilateral extensive confluent choroidal lesions, exudative retinal detachments, positive lyme serology and a typical history are documented: A 32-year-old woman presented 14 days after a "flu-like" illness with bilateral acute extensive choroidal lesions and exudative retinal detachments (OD from 5 to 8:30 o'clock, OS from 5 to 8 o'clock, both including the macula) accompanied by a mild lymphocytic meningitis . The laboratory work-up revealed increased serum and CSF titers of antibodies against Borrelia burgdorferi (Lyme immunofluorescent test (IFT) and Lyme-IgM IFT) which declined after a 14-day treatment with doxycycline (200 mg/d), CSF titers non-detectable (serum IgG: from 1:640 to 1:320, serum IgM: from 1:40 to 1:20) . A distinct improvement with visual acuity increasing from OD 0.2/OS 0.3 p to OD/OS 0.8 p was observed after seven days of treatment . A 40-year-old man with a 14-day history of tick-bite developed the same, though more severe ocular findings and a lymphocytic meningitis . The serological work-up revealed increased antibody titers against Borrelia burgdorferi (ELISA); the IgM titer was normal . After a 10-day treatment with penicillin, antibody titers against the spirochete decreased slightly and the patient's neurologic and ophthalmologic status improved dramatically . Five weeks after admission visual acuity was OD/OS 0.5 (compared to OD/OS 0.1) and has remained at 0.8 p (OD/OS) since the ninth week after onset . The clinical course of the disease and the decreasing lyme serology strongly suggest an infection with Borrelia burgdorferi . The authors propose thorough laboratory work-ups including tests for Lyme disease in selected patients with diffuse choroidal lesions. Int J Pediatr Otorhinolaryngol, 1989 Feb, 17(1), 51 - 5 Actinomycosis of the middle ear; Olson TS et al.; Actinomycosis is an uncommon infection of the middle ear . Only 21 cases of actinomycosis of the middle ear have been reported in the English literature prior to this paper . The offending organism is Actinomyces israelii, which is an anaerobic, filamentous organism that is difficult to grow in culture . The infection is chronic and is seldom diagnosed prior to tympanomastoidectomy . The identification of small, yellow, glue-like masses, which are called sulfur granules, is often the key to making the diagnosis of actinomycosis of the middle ear . Following tympanomastoidectomy, penicillin is given orally for 3-6 months. Tex Med, 1989 Feb, 85(2), 36 - 43 Penicillin allergy: a review; Arreaza EE; Penicillin allergy has been extensively studied and has become a prototype for the study of allergic drug reactions . A significant number of patients have been incorrectly labeled as allergic to penicillin and therefore are denied this effective, nontoxic, and relatively inexpensive antibiotic . On the other hand, penicillin is by far the most common cause of allergic drug reactions and the leading cause of anaphylaxis in the United States . We have the tools to identify patients at a high risk of anaphylaxis from penicillin and should therefore be able to decrease the incidence of penicillin-related anaphylaxis and fatalities and to avoid denying the benefits of penicillin to a large segment of the population that has been labeled as penicillin allergic. Hindustan Antibiot Bull, 1989 Feb-May, 31(1-2), 25 - 8 Affinity and hydrophobic interactions of penicillin amidase; Mali RS et al.; Binding of penicillin amidase from E . coli 436 to aniline-, benzylamine- and phenylethylamine-Sepharose was studied . Binding of the enzyme to aniline-Sepharose was exclusively due to hydrophobic interactions . Benzylamine-Sepharose binds the enzyme due to affinity interactions in the absence of ammonium sulphate and due to hydrophobic interactions in the presence of ammonium sulphate . A conformational change in the penicillin amidase molecule due to ammonium sulphate there by exposing the side chain binding site as a hydrophobic core is suggested. Fundam Appl Toxicol, 1989 Feb, 12(2), 252 - 7 Two-year toxicity and carcinogenicity studies of ampicillin trihydrate and penicillin VK in rodents; Dunnick JK et al.; Toxicology and carcinogenesis studies of ampicillin trihydrate and penicillin VK, two widely used beta-lactam antibiotics, were performed in F344/N rats and B6C3F1 mice . In these studies ampicillin trihydrate was administered for 2 years to rats at doses of 0, 750, or 1500 mg/kg and to mice at doses of 0, 1500, or 3000 mg/kg, and penicillin VK was administered to rats and mice at doses of 0, 500, or 1000 mg/kg . Both drugs were administered by oral gavage in corn oil . Toxic lesions of the stomach were seen in rats and mice after ampicillin trihydrate administration and in mice after penicillin VK administration . In male rats that received ampicillin trihydrate there was a marginal increase in incidence of mononuclear cell leukemia and pheochromocytomas of the adrenal gland medulla . There was no evidence for carcinogenic activity in female rats or male and female mice after ampicillin trihydrate administration or in rats and mice after penicillin VK administration. Electroencephalogr Clin Neurophysiol, 1989 Feb, 72(2), 140 - 6 Electroencephalographic features of midline spikes in the cat penicillin focus and in human epilepsy; McLachlan RS et al.; We used EEG and ECoG to analyze and compare surface fields of interictal spikes from penicillin foci located on the mesial cortex of cats and from patients with midline spikes . Findings from the experimental model predicted results of the human study . When the field of a mesial cortical focus extended over the convexity, cortical scalp-recorded epileptiform discharges could be vertex negative, positive over the lateral convexity or a combination of these two in a surface dipole . Associated clinical features were in agreement with previous reports . We point out pitfalls in interpreting EEG recordings from patients with midline epileptogenic foci. Schweiz Med Wochenschr, 1989 Jan 21, 119(3), 81 - 3 {Atrioventricular block in Lyme carditis}; Roelli H et al.; Lyme disease, due to infection with Borrelia burgdorferi transmitted by ticks, is most frequently manifested by arthritis and neurological complications . In approximately 8% of cases, however, carditis, usually reflected in AV block, is the leading symptom . The case histories of 2 males and 1 female aged 23 to 37 years with AV block caused by Borrelia burgdorferi are presented . Main symptoms were exertional dyspnea, palpitations, dizziness and syncope . One patient was treated with diclofenac and two with penicillin . The course was uniformally benign and cardiac abnormalities disappeared within 1-3 weeks. Nord Med, 1989, 104(3), 76 - 7,84 {Penicillin allergy}; Slrensen HT et al.; Patients are often labelled "allergic to penicillin" without adequate reason . Since penicillins are frequently the drugs of choice, this label should not be accepted lightly . The allergic reactions to penicillins are of immediate, accelerated, or delayed-type hypersensitivity . The most serious reactions are those of acute- and accelerated-type, which are both IgE mediated . Ideally, patients suspected of being allergic to penicillins should be tested in succession with RAST, skin testing, and per-oral provocation . Patients with serious infections and documented penicillin allergy should undergo desensitisation . Patients with penicillin allergy have a slightly increased risk of reactions to cephalosporins. Stereotact Funct Neurosurg, 1989, 52(1), 18 - 25 Effects of corpus callosum stimulation on the morphology and frequency of epileptic bursts in the feline topical penicillin generalized model; Cukiert A et al.; Twelve cats were stimulated at the rostrum of the corpus callosum while full epileptic activity was recorded after topical application of penicillin on the cortex bilaterally . Electrocorticography was performed bilaterally . In 6 animals the electrode position was checked by evoked potentials . Stimulation parameters ranged from 0.5 to 1,000 Hz, from 2 to 10 mA, and from 0.5 to 5.0 ms . No significant modification was found in frequency, synchrony, and morphology of the epileptic bursts and spikes, suggesting that callosal stimulation, at least using this model, is ineffective in reducing epileptic activity. J Clin Microbiol, 1989 Jan, 27(1), 215 - 6 Endocarditis caused by relatively penicillin-resistant Stomatococcus mucilaginosus; Pinsky RL et al.; We report a case of Stomatococcus mucilaginosus endocarditis in which the isolate was relatively resistant to penicillins and cephalothin . The patient was treated successfully with vancomycin and valve replacement. Exp Neurol, 1989 Jan, 103(1), 105 - 9 The convulsant effects of kainic acid microinjections into cerebral cortex are concentration but not laminar dependent; Chatt AB et al.; The direct excitatory glutamate analog, kainic acid, when injected into different layers of the cat visual cortex, has two effects on this tissue that are fundamentally different from those exerted by the disinhibitory agents penicillin, bicuculline, and strychnine . First, both concentration-dependent suppression and convulsant activity was seen . Second, these concentration-dependent influences were produced effectively in each cortical layer challenged despite a reported preferential localization of kainic acid receptors to layer 6 . In contrast, the disinhibitory agents generally produce only convulsant effects, do so in a laminar-specific manner, and at significantly lower concentrations in intact brain (i.e., 50 microM vs 15 mM) . These results suggest that kainic acid, in the concentrations employed here, has a generalized excitatory effect on all cortical circuitry and that it's convulsant influences are nonspecific and less potent than those of the inhibitory blockers . Further, a common neural trait shared by these different modes of epileptogenesis is discussed. Epilepsia, 1989 Jan-Feb, 30(1), 7 - 16 Anticonvulsant drugs selectively affect kindled and penicillin epilepsy, especially during seizure-prone sleep or awakening states in cats; Shouse MN et al.; Carbamazepine (CBZ) selectively suppressed kindled convulsions, whereas ethosuximide (ESM) suppressed spike-wave activity accompanying systemic penicillin epilepsy in cats . Evoked potential data indicated that CBZ acted at the thalamic level, whereas ESM acted at cortex . Reduction of seizures and thalamic or cortical excitability occurred throughout the sleep-wake cycle, but effects were most pronounced in seizure-prone sleep or awakening states . These findings extend previous work showing differential antiepileptic drug (AED) effects on temporal lobe and absence seizures . The results are also consistent with recent work suggesting that thalamocortical pathways provide a final common pathway for the manifestation of sleep and awakening epilepsy and also reflect a chronic, latent pathophysiology. Am J Clin Pathol, 1989 Jan, 91(1), 95 - 7 Spirochetes in the spleen of a patient with chronic Lyme disease; Cimmino MA et al.; A 54-year-old man had intermittent evening fever, arthralgia, transient erythematous macular eruption on the skin, and splenomegaly of two year's duration . Immunofluorescence tests for Borrelia burgdorferi serum antibodies had positive results, but G-penicillin treatment was ineffective . Splenectomy with lymph node biopsy was performed to rule out lymphoproliferative disorders . Borrelia-like spirochetes were identified histologically in the spleen; this finding was consistent with persistence of B . burgdorferi organisms in inner organs in chronic Lyme disease. Vestn Dermatol Venerol, 1989, (8), 14 - 9 {Improved specific and prophylactic treatment methods for pregnant women and the children delivered by mothers infected with syphilis}; Borisenko KK et al.; Uninterrupted methods of specific and prophylactic treatment of pregnant women and children, born from syphilitic mothers, were offered . A new preparation--novocainic salt of benzyl penicillin was used in specific and prophylactic treatment of pregnant women. Int Arch Allergy Appl Immunol, 1989, 89(2-3), 162 - 8 Disposition and immunogenicity of penicillin in the rabbit; Christie G et al.; The immunogenicity, disposition and irreversible protein binding of benzylpenicillin (BP) were studied in male New Zealand White rabbits . There was an increase in IgG anti-benzylpenicilloyl (BPO) antibody activity, as detected by enzyme-linked immunosorbent assay (ELISA) following daily intramuscular administration (for 4 consecutive days) of BP (2.7 and 1.6 mmol/kg) freshly dissolved in 0.15 M NaCl . Antibody activity reached a maximum approximately 14 days after the last injection . There was a smaller immune response when a dose of 270 mumol/kg was administered . The specificity of the IgG antibody response for the BPO determinant was confirmed by inhibition of binding by BPO-aminocaproate . {3H}BP, administered intravenously to rabbits at a dose of 2.7 mmol/kg was rapidly cleared from plasma, and unchanged BP was not detected at 1 h . After 3 h, irreversible binding accounted for less than 0.004% of the dose bound per milliliter of plasma, and this represented all the radioactivity present in plasma at this time . Covalent binding of BP to plasma proteins, in vitro, after 3 h was of the same magnitude for rabbit, rat and human plasma . Therefore, BP can induce a specific antibody response in the rabbit in contrast to the lack of immunogenicity observed previously in the rat. Ann Chir, 1989, 43(5), 388 - 90 {Retroperitoneal perforation of duodenal ulcer responsible for abscess}; Camilleri L et al.; The authors report a case of retroperitoneal perforation of a duodenal ulcer . This is a rare condition which is exceptionally responsible for abscess formation . If often has a poor prognosis . In the present case, the abscess was infrahepatic . The diagnosis of the origin of the abscess was established by radiological opacification via percutaneous puncture . Surgical drainage and irrigation performed via an extraperitoneal approach centered over the cavity, combined with triple-agent antibiotic therapy (penicillin, gentamicin, metronidazole) ensured collapse followed by sterilisation of the abscess cavity . The ulcer was cured by medical treatment . This case differs from the published case in terms of the diagnostic procedures classically used (upper gastrointestinal endoscopy and small bowel series), the infrahepatic site of the abscess and the extraperitoneal surgical treatment which avoided dissemination to the peritoneal cavity. Vestn Dermatol Venerol, 1989, (3), 74 - 5 {The level of penicillin in the blood serum during treatment of gonococcal infection with various doses of bicillin-3 and its combination with etamid}; Budiev AIu et al.; Bicillin-3 has been administered to patients with new gonorrheal urethritis in doses of 3,000,000 U, 2,400,000 U, and 2,400,000 U + ethamide . The latter combination has proved to be the most effective. Zhonghua Nei Ke Za Zhi, 1989 Jan, 28(1), 11 - 4, 60-1 {Pneumococcal pneumonia: a report of 100 cases}; Zhang XP et al.; This paper reports 100 cases of etiologically proved pneumococcal pneumonia . It is shown that Gram's stain smear and culture of sputum are still useful in the diagnosis of the disease but are easily influenced by antibiotics . Whereas coagglutination, a newly developed procedure in detecting pneumococcal capsular antigens, is relatively independent to antibiotic therapy . Moreover, it is rapid, convenient and sensitive . Both Gram's stain smear and coagglutination may confirm early diagnosis and are valuable in the initial treatment of the disease . If unhospitalized patients with acute pneumonia are checked routinely with these methods and samples are collected before administration of antibiotics, etiological diagnosis of pneumococcal pneumonia will be confirmed in more cases . The data from 100 cases of pneumococcal pneumonia demonstrates that pneumococcal pneumonia remains the most common type of community-acquired pneumonias in this country . Its clinical manifestations have not changed greatly since 1950s but the age of the afflicted tents to be greater especially in those with underlying diseases . There are two common types of roentgenographic manifestations, i.e., lobar consolidation and bronchopneumonia, the former is still overwhelming in those under sixty and the later is more frequently seen in those over sixty . Penicillin G showed good clinical effects in treating pneumococcal pneumonia and all the 57 strains tested were sensitive in vitro . Therefore, penicillin G is still the drug of first choice in treating pneumococcal pneumonia. Ophthalmic Res, 1989, 21(2), 118 - 25 Effects of gentamycin and chloramphenicol on the transparency of cultured rat lenses; Saar I et al.; The effect of the antibiotics gentamycin and chloramphenicol on lens opacity was studied in an organ culture system . Opacity was monitored by split laser beam . Both antibiotics enhanced the onset of opacity in the cultured lenses under a variety of conditions . For instance, treatment with 5.0 mg/ml gentamycin for 60 min caused initial opacity after 4.8 +/- 1.3 days as opposed to untreated lenses at which initial opacity appeared after 18.1 +/- 2.99 days . Exposure to 20 mg/ml chloramphenicol for 60 min caused initial opacity after 4.6 +/- 1.51 days . Continuous exposure to penicillin and streptomycin (0.1 mg/ml each) did not enhance the onset of opacity. Dermatol Monatsschr, 1989, 175(4), 232 - 41 {Syphilis in HIV infection . 2 cases of neurosyphilis}; Breustedt W et al.; In HIV-infected people the course of syphilis is altered and aggressive . Besides seronegativity Neurosyphilis can manifest premature and as a outcome of failed penicillin-therapy in secondary syphilis . Two cases of neurosyphilis are reported and discussed . The usefulness of spinal fluid analysis is pointed out . Recommendations for diagnostics and therapy are given. Probl Tuberk, 1989, (3), 42 - 5 {Method of intrapulmonary therapy of lung diseases using needle jet injector}; Provotorov VM et al.; A procedure for intrapulmonary endolymphatic therapy is described . Transthoracic intrapulmonary administration of antibiotics was performed with a needle jet injector (NJI-1) . Pharmacokinetics of penicillin after its transthoracic intrapulmonary administration to patients was studied . Investigation of elimination of the antibiotics after their administration with NJI-1 showed that the main part of the antibiotics (up to 70 per cent) accumulated in the endolymphatic system of the lungs . Favourable clinical effects of the antibiotic needle jet injection were observed in the patients with acute nonspecific pulmonary diseases: decreased hospitalization terms and lower total course doses of the antibiotics. Jikken Dobutsu, 1989 Jan, 38(1), 11 - 5 {Individual differences in PCA response in the guinea pig}; Yoshida J et al.; Experiments were carried out to determine the cause of individual differences in the passive cutaneous anaphylaxis (PCA) response in guinea pigs . The intensity of 4-h homologous PCA produced by anti-penicillin G serum was not markedly different among eight reactive sites on the back of a specified animal, whereas considerable individual differences were observed in the PCA response, even at a specified reactive site . PCA was significantly inhibited by an antihistaminic agent, promethazine, and the tissue histamine content was significantly reduced after PCA, suggesting histamine release as a mediator . The intensity of PCA in individual animals was highly correlated with that of the histamine-induced cutaneous reaction elicited at a site adjoining the PCA but was unrelated to skin histamine content . These results suggest that the difference in susceptibility to histamine has a considerable effect on individual differences in the PCA response in guinea pigs. Arthroscopy, 1989, 5(1), 79 - 83 Gas-gangrene following arthroscopic surgery; Ketterl R et al.; An arthroscopic anterior cruciate ligament repair was followed by gas-gangrene and the development of a compartment syndrome . Treatment consisted of extensive fasciotomy, debridement, and antibiotic therapy with penicillin G, cefotiam, and metronidazole . The patient was also treated with five sessions of hyperbaric oxygen in a pressure chamber for a duration of 2 h per session . This therapeutic regimen resulted in the preservation of a functionally intact extremity despite severe complication. Arch Microbiol, 1989, 153(1), 43 - 6 Osmolability of Escherichia coli and modification of {125I}ampicillin-binding by competence induction for uptake of transforming DNA; Fischer E; The regimen conferring competence for uptake of transforming DNA is shown to render Escherichia coli osmolabile . Three different K-12 strains were exposed to the standard procedure of competence induction, i.e . incubation in the presence of 0.1 M Ca2+ or Mg2+ for 50 min at 0 degrees C, interrupted by a heat shock for 5 min at 37 degrees C . Upon osmotic challenge of competent cells formation of protoplasts was observed in approximately 2% of the treated cells . Incubation of competent cells of strain W1485 in phosphate-buffered saline for 1, 2, and 3 h reduced the viable counts to 67, 58, and 41%, respectively . Competence induction with divalent cations altered the affinity of penicillin-binding proteins (PBPs) for {125I}ampicillin . In isolated cell envelopes the presence of Ca2+ and Mg2+ stimulated the binding of {125I}ampicillin to PBPs 1, 3, 4, 5, and 6, whereas the binding to PBP 2 remained unchanged . The binding to PBP 1 C was inhibited by 0.23 M Ca2+ . In living cells the binding to PBPs 1, 3, and 4 was enhanced, while the binding to PBP 8 was inhibited . Newly {125I}ampicillin-labelled proteins of Mr 55,000 and 45,000 were apparent, especially after competence induction with Ca2+ . Interaction of divalent cations with PBPs is suggested to contribute to osmolability of competent cells . Disintegration of the cell wall may be necessary for uptake of transforming DNA. Biomed Pharmacother, 1989, 43(6), 409 - 13 Neurological manifestations of Lyme disease and treatments; Lecomte F et al.; Lyme disease is a multi-systemic infection due to B . burgdorferi, with neurological manifestations observed in its second and third stages . Except for the suggestive triad meningitis--radiculoneuritis--facial palsies, the diagnosis is often difficult because of the pleiomorphism of neurological manifestations . These can be localized or diffuse, with central involvement, meningitis or peripheral manifestations . Past history, cerebrospinal fluid (CSF) examination, immuno-assays for specific antibodies in serum and especially CSF are helpful in diagnosis . Betalactam antibiotics (penicillin G, amoxicillin, and third generation cephalosporins) are the most effective treatment with good results in the early and acute stages of neurological disease. Soc Sci Med, 1989, 29(8), 975 - 82 Management of pneumonia in India and Indonesia; Edmundson WC et al.; Although the death rates from neonatal tetanus have been lowered and the death rates from childhood diarrhoea are becoming lower in India and Indonesia, death rates from pneumonia have not yet begun to fall . Pneumonia has become the greatest killer of children and the most important cause of preventable death . The reason for this relative rise in significance may lie in the failure to realize that the majority of the most acute cases of respiratory illness are not viral but rather bacterial infections which rapidly respond to appropriate antibiotic therapy . This paper reviews recent research on the aetiology of pneumonia; it examines age distribution and regional variation in morbidity and mortality; and it concludes by suggesting appropriate pneumonia treatment and case management guidelines . The essential priority is to make procaine penicillin available to children presenting with cough and a respiratory rate over 50 breaths per minute . This alone would substantially reduce the number of child deaths in India and Indonesia. Revmatologiia (Mosk), 1989 Jan-Mar, (1), 28 - 32 {Therapeutic effectiveness of D-penicillamine in ankylosing arthritis of the spine in relation to the degree of pathological changes in the joints}; Bernatska K et al.; On the basis of biochemical indices the anthors assessed the efficacy of a 6-month treatment with D-penicillin in 49 patients with ankylosing arthritis of the spine who did not respond to nonsteroid antiinflammatory drugs . Improvement in the movements of the spine was observed in patients with less marked roentgenological changes. Rev Neurol (Paris), 1989, 145(5), 362 - 8 {Neurologic forms of Lyme disease . 12 cases}; Viader F et al.; Twelve cases of Lyme's disease with neurological complications are reported . Seven patients had meningoradiculitis of the Garin-Bujadoux-Bannwarth type, with facial palsy in 2 cases . In 1 case the radiculitis involved only the cauda equina . Two more patients had meningomyelitis . Of the remaining 3, 1 had subacute inflammatory polyneuritis with albumino-cytologic dissociation, 1 had probable dorsal epiduritis, and the last one developed parkinsonism and communicating hydrocephalus after an otherwise classical meningoradiculitis . Three patients recalled a tick bite but only one a cutaneous eruption . No arthritis or cardiac involvement were observed . In 2 cases the CSF contained pseudo-neoplastic cells . Severe pain was a prominent feature in most cases . Pain consistently and rapidly improved on high-dose intravenous penicillin, while other signs or symptoms (e.g . paresthesias or fatigue) often lasted several months . Parkinsonism and hydrocephalus were not influenced by penicillin, and both required specific therapy . Isolated neurological (both central and peripheral) involvement is not unusual in Lyme's disease and may give rise to a wide range of signs and symptoms . This diagnosis is to be considered even when other features of Borrelia burgdorferi infection are lacking. Arzneimittelforschung, 1989 Jan, 39(1A), 149 - 56 {Functional implication of calcium ions in epileptic seizures . Antiepileptic effects of organic calcium antagonists}; Speckmann EJ et al.; In animal experiments, focal epileptic activity and tonic-clonic seizures were induced by local application of penicillin and repeated intraperitoneal injections of pentetrazol (PTZ), respectively . With epileptic activity neocortical and hippocampal neurons showed typical paroxysmal depolarization shifts . Experimental findings indicate that a calcium inward current and calcium dependent membrane currents participate in the generation of these events . Paroxysmal depolarizations were depressed by intra- and extracellular applications of the organic calcium channel blockers N,N-dimethyl-N-(4-cyan-4-(3,4,5-trimethoxyphenyl)-5-methyl-hexyl)- N-(beta- 3,4-dimethoxyphenylethyl)-ammonium-chloride-monohydrate (D 890) and verapamil . The same depressive effect was exerted by flunarizine in hippocampal but not in neocortical neurons . Paroxysmal depolarizations were enhanced by intracellular injections of the calcium agonist methyl 1,4-dihydro-2,6-dimethyl-3-nitro-4-(2-trifluoromethylphenyl)-pyridine-5- carboxylate (Bay K 8644) and of the calcium chelator ethyleneglycol-bis(aminoethylether)N,N,N',N'-tetraacetate (EGTA) . Focal seizure activity of the neocortex was reduced and often abolished by intracerebroventricular perfusion of verapamil, with the frequency of occurrence of epileptic discharges being decreased . Generalized tonic-clonic seizures were depressed to a great extent and often abolished during an intracerebroventricular verapamil perfusion . Simultaneously, the negative shift of the DC potential evoked by the PTZ injections turned over to a positive displacement . In non-epileptic preparations, organic calcium antagonists had no depressive effects on neuronal bioelectrical activity. Padiatr Padol, 1989, 24(1), 63 - 8 {Therapy problems of Lyme borreliosis}; Schmutzhard E; The treatment of the various stages of Lyme Borreliosis is discussed in detail: for the first stage Phenoxymethylpenicilline or Doxycyclin are to be recommended . For the second stage either high dose i.v . Penicillin G or, even better, Ceftriaxone 1 g i.v.b.i.d . should be recommended . Due to the high rate of treatment failure with Penicillin G in third stage Lyme Borreliosis Ceftriaxone has to be given in these instances . A further alternative might be Imipenem i.v. FEMS Microbiol Lett, 1989 Jan 1, 48(1), 75 - 9 Functioning of the cloned phage MS2 lysis protein in Escherichia coli impaired in murein synthesis; Ursinus-Wossner A et al.; The mode of action of the phage MS2 lysis protein seems not to involve a direct interaction with the murein synthesis machinery as is the case for lysis induced by beta-lactam antibiotics . Mutants with defects in various penicillin-binding proteins, which are involved in murein synthesis, were found to show normal lysis sensitivity towards the cloned MS2 lysis protein . In addition, both processes, longitudinal growth of the murein sacculus in the presence of furazlocillin, cephalexin and nalidixic acid as well as spherical growth in the presence of mecillinam were sensitive to the phage lysis protein . No change in the capacity of the binding proteins to bind 14C-labelled penicillin G was observed in the presence of the MS2 lysis gene product. Genitourin Med, 1989 Jan, 65(1), 4 - 7 Eradication of endemic syphilis in Bosnia; Arslanagic N et al.; The control of syphilis in Bosnia was organised and started by Professor Ernest Grin in 1948 and continued to the end of 1951 . Regardless of the clinical picture, the treatment of endemic syphilis consisted of an oil suspension of penicillin with aluminium monostearate (PAM) 3.6 to 4.2 MIU for adults in six or seven intramuscular injections of 0.6 MIU every day or 1.2 MIU every other day . Today endemic syphilis in Yugoslavia is only historic fact. Rev Infect Dis, 1989 Jan-Feb, 11(1), 142 - 51 Erythema migrans: a chronicle; Dammin GJ; Arvid Afzelius first described and named erythema migrans (EM), a clinical entity that he assumed to be caused by an agent transmitted by the bite of a tick (Ixodes reduvius) . Certain neurologic, cutaneous, and other syndromes observed in Europe were recognized in the 1920s and 1930s to be disabling sequelae of EM . In the 1940s and 1950s the effectiveness of penicillin as therapy for EM was demonstrated . In 1968 the first patient with EM and neurologic sequelae in North America benefited from treatment with penicillin . In 1975, an epidemic arthropathy appeared in the area of Lyme, Connecticut . Despite resemblance to EM (the initial appearance of cutaneous lesions), the complex was called Lyme disease because of the occurrence of cardiac, neurologic, and arthritic sequelae . The vector of Lyme disease, Ixodes dammini--a tick that harbors agents that cause Lyme disease and babesiosis--was identified and characterized in 1979 . The spirochete that causes Lyme disease was designated Borrelia burgdorferi . The North American and European species of spirochete and the clinical syndromes to which they are related are described. J Bacteriol, 1989 Jan, 171(1), 558 - 60 Nucleotide sequence of the rodA gene, responsible for the rod shape of Escherichia coli: rodA and the pbpA gene, encoding penicillin-binding protein 2, constitute the rodA operon; Matsuzawa H et al.; The rodA gene, which is responsible for the rod shape of Escherichia coli, was located 5 nucleotides downstream of another rod-shape-determining gene, pbpA, encoding penicillin-binding protein 2 . The coding region for the RodA protein was 1,110 base pairs in length . Two plasmids, carrying a rodA-lacZ gene fusion with and without the pbpA promoter upstream of the gene fusion, were constructed . On the basis of the difference between the expression levels of the beta-galactosidase activity dependent on and independent of the pbpA promoter, we concluded that the pbpA and rodA genes constitute a single transcriptional unit called the rodA operon. Stereotact Funct Neurosurg, 1989, 53(3), 202 - 8 Unilateral topical cortical application of penicillin: electrographic aspects . A new complement to an old model; Cukiert A et al.; In 7 cats 800 IU of penicillin were applied diffusely over one hemisphere on the exposed neocortex . After 40 min all animals showed bilateral and synchronous burst discharges with a higher amplitude at the hemisphere where the penicillin had been applied . These data fill a gap in the literature concerning feline generalized penicillin epilepsy, in which penicillin is applied bilaterally on the exposed neocortex. Med Pregl, 1989, 42(9-10), 339 - 41 {Neurolues--clinical characteristics, diagnosis and therapy}; Dulovic O et al.; A female patient with neurolues was presented in this paper . The disease started 25 years after primoinfection by neurologic disturbances which corresponded to classic neurolues with the signs of meningovascular and parenchymatous disease . The diagnosis was confirmed by positive serologic tests, computerized brain tomography--whereby syphilomas were found in the brain and by histopathologic survey of one of peripheral syphilomas . Antibiotic therapy with high penicillin doses was initiated but without more significant clinical effects, it only led to negativization of serologic tests . The patient died after two months . Serologic tests to syphilis should be temporarily repeated in all patients suspective of neurolues, in order to initiate or repeat the previously employed therapy. Vestn Dermatol Venerol, 1989, (12), 23 - 7 {Treatment efficacy in patients with secondary recurrent and latent early syphilis based on a new abbreviated method}; Borisenko KK et al.; The authors analyze the findings of clinical and serological follow-up of 370 patients with secondary relapsing and early latent syphilis treated with a new rapid method . This method consists in intramuscular injections of water-soluble penicillin in high daily doses (4,000,000, 6,000,000, 8,000,000 U) made for 3-4 weeks . The follow-up period of 1-6 years has confirmed a high therapeutic efficacy of this method. Acta Otorhinolaryngol Belg, 1989, 43(4), 373 - 9 {Gentleness in ENT: optimalization of drug therapy}; Sternon J; Presentation of 5 drug strategies relating to the realm of E.N.T . permitting a therapeutic approach both effective and comfortable . 1 . Avoidance of oto-toxic antibiotics and antiseptics, especially in case of underlying pathology . 2 . Reasoning for endonasal administration of topical (corticoids, vaso-constrictors, anticholinergics) and systemic (Suprefact, Minrin, Miacalcic, Diergo) drugs . 3 . Importance of oral administration of a new mucolytic, Surbronc which improves the muco-ciliary clearance by means of an increased synthesis of the "Surface Tension Lowering Substance" . 4 . Avoidance of abusive tonsillectomies in recurrent pharyngo-tonsillitis failing to penicillin treatment, due to the "indirect pathogenic phenomenon" . 5 . Optimalization of nonmorphinic oral analgesics with acetaminophen (in monotherapy or in association) and morphinic ones by anticipative and repetitive administration. Arch Exp Veterinarmed, 1989, 43(4), 533 - 9 {The absorption behavior of chemotherapeutics after intrauterine administration in cattle}; Golbs S et al.; The uterus of cattle is an organ of excellent absorptive properties, as has been demonstrated by the examples of a sulphonamide and of penicillin . This is true for all cyclic phases . Absorption was somewhat delayed, when animals were in di-oestrus or pro-oestrus . A comparison between rates of absorption by clinically intact and pathomorphologically altered uteri showed absorption of Solupront and Ursopen 40,000 to be much faster in cases of disease . Experimental results as well as knowledge so far obtained on protein binding capacity are likely to support the conclusion that in the pathologically altered uterus bacteriostatic effects of sulphonamides are low due to the high amount of p-aminobenzoic acid which is present as a direct antagonist in pus and cellular detritus. Dermatol Monatsschr, 1989, 175(11), 685 - 90 {Chronic atrophic acrodermatitis}; Kosbab R et al.; All the 18 patients with acrodermatitis chronica atrophicans (ACA) showed the specific borrelia antibody at the indirect immunofluorescence assay . The patients exhibited a large spectrum of arthritic and neurologic complaints besides the typical cutaneous symptoms . Changes of proteins, of liver-typical parameters and of the electrocardiogram are also assigned to the Lyme-borreliosis . The penicillin therapy - three times accompanied by a Jarisch-Herxheimer-reaction - led to regression of the clinical changes . The secessions of borrelia-antibody-titers happens only very delayed . That is why it can not be used for the direct therapy control . The increased documented polysymptomatic of Lyme-borreliosis requires a wider knowledge and the country-wide possibility of specific diagnostic. Exp Brain Res, 1989, 78(3), 646 - 8 Calcium-dependent potassium current following penicillin-induced epileptiform discharges in the hippocampal slice; Domann R et al.; Penicillin-induced paroxysmal depolarization shifts (PDS) are followed by prolonged afterhyperpolarizations of about 2 seconds duration . Intracellular injection of EGTA blocked a late component of the afterhyperpolarizations; an early one lasting up to one second was only slightly reduced by EGTA . It is concluded that afterhyperpolarizations following penicillin-induced PDS comprise different components: an initial one lasting up to one second which is not Ca2+-dependent and a slow one lasting up to two seconds which is caused by a Ca2+-dependent K+ current. Henry Ford Hosp Med J, 1989, 37(2), 76 - 8 Recurrent leukemia cutis in acute myeloblastic leukemia; Girgis RE et al.; We report the case of a 64-year-old female with acute myeloblastic leukemia (French-American-British classification: M2) who developed two specific cutaneous manifestations during her illness . She presented with extensive cellulitis involving the face, neck, and upper chest wall . While the cellulitis resolved with antibiotic therapy, a fungating ulcerated nodule remained on the lower lip which proved to be leukemic on biopsy . Concomitant blood and bone marrow findings were diagnostic of acute myeloblastic leukemia . The lip lesion cleared with a course of chemotherapy . An erythematous macular rash subsequently developed over the lower trunk which was thought to be an allergic reaction to the penicillin treatment . However, biopsy results were consistent with leukemia cutis . A repeat bone marrow examination revealed excessive blasts . Our observations emphasize the various presentations of leukemia cutis and the need to biopsy any cutaneous lesion of unclear etiology in the setting of acute leukemia. Eye, 1989, 3 ( Pt 4), 460 - 2 Actinomycetic corneal ulcer; Singh M et al.; A rare case of keratoactinomycosis developing in the absence of any known ocular trauma is described . It showed a dramatic response to penicillin therapy . Steroids should be cautiously used in the presence of active corneal disease . This case highlights the importance of repeated examination of corneal scrapings. Neuroscience, 1989, 31(3), 593 - 603 Excitatory amino acid blockers differentially affect bursting of in vitro hippocampal neurons in two pharmacological models of epilepsy; Schneiderman JH et al.; The role of excitatory amino acid neurotransmitters in generating two distinct types of epileptiform discharge in the CA3 region of hippocampal slices was examined in the guinea-pig using a variety of different excitatory amino acid blockers . In magnesium-free medium the N-methyl-D-aspartate receptor antagonist, DL-aminophosphonovaleric acid, and the putative N-methyl-D-aspartate channel blockers phencyclidine and ketamine, reduced the amplitude and duration of spontaneous bursts and blocked their afterdischarges . In marked contrast none of these compounds significantly depressed spontaneous bursts recorded in the presence of 2 mM Mg2+ and penicillin . This was confirmed for individual slices where Mg2+-free bursts had previously been suppressed by the same concentration of blocker . Therefore, the N-methyl-D-aspartate receptor mechanism does not contribute significantly to the generation of this type of epileptiform discharge . The channel blockers lost their effect on Mg2+-free bursts in the presence of penicillin; however, the receptor blockers did not . This is probably due to the unique mechanisms of action of the channel blockers . This implies that different types of N-methyl-D-aspartate blockers might be effective anticonvulsants only in specific conditions . While the non-specific excitatory amino acid blocker, kynurenic acid, was effective against both burst types it appeared to suppress them by different mechanisms . Kynurenic acid depressed the amplitude and duration of Mg2+-free bursts but its only effect on penicillin bursts was to reduce their frequency . This suggests that neither N-methyl-D-aspartate nor non-N-methyl-D-aspartate receptors play a major role in the production of the paroxysmal depolarizing shift resulting from the block of GABA-mediated inhibition by penicillin . However, these receptors may be involved in generating the spontaneous activity which triggers the bursts. Chemotherapy, 1989, 35(2), 140 - 5 Ceftriaxone for the treatment of primary and secondary syphilis; Schofer H et al.; In a multicenter, open, randomized, prospective, comparative study, 28 patients with primary (n = 9) or secondary (n = 19) syphilis were treated with either ceftriaxone or penicillin G . 14 patients received ceftriaxone 4 x 1 g i.m . every 2 days . 14 other patients were treated with penicillin G 1 million IU i.m . daily for 15 days (standard therapy of primary and secondary syphilis) . To avoid Herxheimer reaction we applied prednisolone 50-100 mg i.m . before specific treatment . Diagnosis was confirmed by clinical symptoms, dark-field microscopy and serological tests (VDRL titer, TPHA test and 19s-IgM-FTA-abs test or SPHA test) . Follow-up examinations during therapy were repeated on days 2, 4, 6 (dark-field microscopy, physical examination) and day 14 (VDRL titer) . To evaluate therapeutic efficacy, serological controls were repeated 1, 2, 3, 6 and 12 months after therapy (VDRL, SPHA) . In all patients, a marked decline (minimum 2-dilution decrease) in VDRL titer and resolution of clinical symptoms were noted . An adverse reaction was seen in 1 patient of the clemizol-penicillin G group (allergic penicillin exanthema) . There were no adverse reactions to ceftriaxone . Summing up, there was no detectable difference in clinical and serological response to syphilis treatment either with ceftriaxone or penicillin G . Ceftriaxone, thus can be regarded as an equivalent alternative to penicillin G in the treatment of primary and secondary syphilis. J Bacteriol, 1989 Jan, 171(1), 114 - 9 Mechanism of pneumococcal cell wall degradation in vitro and in vivo; Garcia-Bustos J et al.; We compared the products of autolytic amidase-catalyzed wall degradation in vivo (in penicillin-induced lysis) and in vitro . Pneumococci labeled in their cell wall stem peptides by radioactive lysine were treated with penicillin, and the nature of wall degradation products released to the medium during lysis of the bacteria was determined . At early times of lysis (20% loss of wall label), virtually all the radioactive peptides released (greater than 94%) were of high molecular size and were still attached to glycan and teichoic acid . At times of more extensive bacterial lysis (56%), progressively larger and larger fractions of the released peptides became free, i.e., detached from glycan and teichoic acid . Analysis of the nondegraded residual wall material by high-resolution high-pressure liquid chromatography revealed that this in vivo-triggered autolysis did not involve selective hydrolysis of some of the chemically distinct stem peptides . Parallel in vitro experiments yielded completely different results . Purified pneumococcal cell walls labeled with radioactive lysine were treated in vitro with low concentrations of pure amidase, and the nature of wall degradation products released during limited hydrolysis and after more extensive degradation was determined . In sharp contrast to the in vivo experiments, the main products of in vitro hydrolysis were free peptides . After a short treatment with amidase (resulting in a 20% loss of label), the material released was enriched for the monomeric stem peptides . At all times of hydrolysis (including the time of extensive degradation), only a relatively small fraction of the released wall peptides was covalently attached to glycan and teichoic acid components (17% as compared with 40% in the intact cell wall) . We propose that the in vivo-triggered amidase activity first attacks the amide bonds in some strategically located (or unprotected) stem peptides that hold large segments of cell wall material together . The observations indicate that the in vivo activity of the pneumococcal autolysin is under topographic constraints. EMBO J, 1989 Jan, 8(1), 317 - 23 The Escherichia coli lov gene product connects peptidoglycan synthesis, ribosomes and growth rate; Bouloc P et al.; Mecillinam, a beta-lactam antibiotic which binds specifically to penicillin-binding protein 2 (PBP2), blocks lateral cell-wall elongation, induces spherical morphology and ultimately kills bacteria . We describe here a new mecillinam-resistant mutant of Escherichia coli, the lov mutant . It possesses active PBP2, as evidenced by its rod shape in the absence of mecillinam (but not in its presence), its ability to filament when septation is inhibited, and its penicillin-binding ability . The lov mutant grows slowly but seems to regulate its macromolecular parameters properly: cell volume, RNA content (ribosome concentration), and DNA content are appropriate for the growth rate, and the growth yield is identical to that of wild type . The lov mutation is located at 41 min on the E.coli genetic map and is recessive . Certain rpsL (StrR) mutations suppress the lov mutant's mecillinam resistance . The allele specificity of the suppression suggests that the lov gene product may interact directly with the ribosomes . The lov gene product thus seems to define a link between PBP2 (the mecillinam target) and the ribosomes; we propose that this link is involved in transmitting information on the growth rate (ribosome concentration) to the peptidoglycan synthesizing apparatus. Shoni Shikagaku Zasshi, 1989, 27(2), 313 - 6 {Evaluation of cytotoxicity of VLC Dycal in tissue culture for clinical use}; Kaga M et al.; The purpose of this study was to evaluate the VLC Dycal (visible light cured composite-calcium hydroxide material) to see whether it is suitable or not as a direct or indirect pulp capping agent for clinical use by means of the cell culture test . Two light cured composite resins, P-30 and Silux, and also Dycal and Ca(OH)2 were used as a control for a comparative cytotoxicity test with VLC Dycal . All test materials were put into the glass tubes (4 mm diameter X 1 mm high), then illuminated for 10, 20, 30, 40, 50 and 60 seconds through a matrix strip with direct contact with a Prisma-light source (L.D . Caulk), just before testing . Fibroblasts, 5 ml of 1 X 10(5) cells per ml in Eagle's MEM medium with 10% FCS, penicillin (100 U/ml) and streptomycin (100 micrograms/ml) were evenly seeded on a cover glass in a tissue culture dish and incubated for 24 hours at 37 degrees C in a humidified atmosphere of a 5% CO2 in air . After 24 hours, the medium was replaced with 5 ml of agar overlay medium consisting of 10% FCS, Eagle's MEM medium and 1.5% agar . Glass tubes (n = 8) filled with the test materials were placed at the center of the agar, and incubated for 24 hours in 5% CO2 in air at 37 degrees C . After 24 hours of incubation, the cover glass was removed and the cells were fixed in 10% neutral formalin and then stained by H.E . to differentiate the areas of affected and unaffected cells beneath the test specimens . The affected area was quantitatively determined using an image analysis system.(ABSTRACT TRUNCATED AT 250 WORDS) Vestn Dermatol Venerol, 1989, (12), 20 - 3 {The effect of nicotinamide and nicotinic and ascorbic acids on the penicillin concentration in the blood serum and tissues of rabbits}; Bednova VN et al.; Measurements of penicillin concentrations in the blood sera and tissues of rabbits have revealed a reduction of this antibiotic levels as the doses of injected ascorbic acid grew . A combination of benzylpenicillin with ascorbic and nicotinic acids improved penicillin penetration into experimental animals' tissues. Vojnosanit Pregl, 1989 Jan-Feb, 46(1), 3 - 6 {Changes in acid mucopolysaccharide levels in the central nervous system of rats during convulsions induced by penicillin}; Dragic S; Examined are changes in the acid mucopolysacharides contents (AMPS) in the brain of rat after I . P . application of 2 X 10(6) iu/kg of Na benzyl penicillin inducing epileptic-convulsive phenomenon with grand mal . Decreased AMPS were found in all examined cerebral regions except in cerebellum . Statistically highly significant decrease was found in hippocampus, hypothalamus and septum (p less than 0.001) . Intensive cerebral metabolism during convulsions is considered to be a cause of decreased AMPS . Changes were marked in hippocampus due to its common vulnerability in relation to epileptic discharge. Dermatol Monatsschr, 1989, 175(1), 1 - 7 {Drug-induced pemphigus diseases}; Civatte J; An overview is given on pemphigus diseases induced by certain drugs . Well known inducers are D-penicillamine, and pyritinol-chlorhydrate . Besides that in some rather rare cases other drugs were connected to pemphigus induction: rifampicin, INH, etambutol, practolol, propranolol, phenylbutazone, aurothiomalate, ibuprofen, heroin, penicillin, ampicillin, captopril, thiopromine, alpha-mercaptopropionylglycine and piroxicam. J Am Dent Assoc, 1989 Jan, 118(1), 59 - 60 "Red man syndrome" with vancomycin: report of case; Pearson DA; Vancomycin is a recommended alternative prophylactic antibiotic for penicillin-allergic patients with prosthetic mitral valves . During the course of recommended treatment, a drug reaction known as "red man syndrome" was encountered . Because vancomycin is appropriate for some dental situations, the general practitioner should be acquainted with its use and possible side effects. Microbiol Immunol, 1989, 33(1), 69 - 74 Penicillin amidohydrolases in fungal autolysis; Alfonso C et al.; The production of penicillin G and penicillin V amidohydrolases or acylases (E.C.3.5.1.11) was studied during the autolysis of filamentous fungi in a mineral medium, and in the same medium with phenoxyacetic acid as inducer . In all the studied fungi, enzymes showing penicillin G and penicillin V amidohydrolase activities were found . Generally, an increase of these activities during fungal autolysis was observed . The presence of phenoxyacetic acid in the medium did not increase these activities . The activities found in the culture fluids were generally higher than that found in the mycelial extracts . Under these conditions, beta-lactamases (penicillinases) were not found . The fungi Alternaria alternata, Fusarium culmorum, Penicillium oxalicum, and the species Penicillium 222 were chosen to study penicillin G and penicillin V acylases . The enzymes were precipitated with tannic acid from the culture fluid of their autolyzed cultures . Some kinetic constants of these activities were determined. Antibiot Khimioter, 1989 Jan, 34(1), 3 - 6 {Lipids of initial and mutant cultures of Penicillium chrysogenum, producers of penicillin}; Konova IV et al.; Comparative investigation of lipogenesis in 2 initial and 4 mutant strains of Penicillium chrysogenum showed that there were no noticeable differences in the composition of the lipid fatty acids in these strains . Certain shifts in the ratio of definite lipid fatty acids in the mutant strain deficient by synthesis of lysine and isoleucine (increased contents of oleic acid) were revealed . A marked influence of the physiological conditions on lipogenesis in the mutant with multiple deficiency by amino acids, vitamins and nucleotides was observed. J Med, 1989, 20(1), 65 - 72 Branhamella catarrhalis pneumonia in non-immunocompromised pediatric patients: report of three cases and review of the literature; Keren G et al.; Branhamella catarrhalis (B.c.) is found as a commensal in the upper respiratory tract of a healthy individual . We report three pediatric patients with bronchopneumonia allegedly caused by B . catarrhalis . All of them were intubated and on a mechanical ventilation (following either elective surgery or trauma) while the infection developed . Although B . catarrhalis has been thought to be penicillin sensitive, an increased frequency of beta-lactamase producing B . catarrhalis has been noted recently . beta-lactamase positive B . catarrhalis is uniformly resistant to ampicillin and its susceptibility to the cephalosporins is quite variable . All the isolated strains were found susceptible to vancomycin . The three patients improved while being on therapy with vancomycin and peripheral airway cultures became sterile. Infect Immun, 1989 Jan, 57(1), 36 - 40 Phospholipase A activity associated with the growth of Rickettsia prowazekii in L929 cells; Winkler HH et al.; Cultured L929 cells infected with Rickettsia prowazekii had a greatly increased rate of hydrolysis of fatty acid from the oleic acid-radiolabeled phospholipids of the host cell membranes . The incorporation of fatty acid into phospholipid in an infected cell was only moderately inhibited relative to a mock-infected cell . Thus, even if the release of fatty acid from phospholipid represented a steady state between hydrolysis and resynthesis of phospholipids, the increase in release of fatty acid was due principally to increased phospholipase A activity . The increased rate of hydrolysis did not occur only late in the rickettsial infection; this activity began early in infection and continued throughout the course of infection . The addition of tetracycline or chloramphenicol (antibiotics which inhibit rickettsial protein synthesis) to the infected cells caused a rapid and total abatement of this increased rate of phospholipid hydrolysis . In contrast, high concentrations of penicillin affected the morphology of the intracellular rickettsiae, but did not inhibit the phospholipase activity . This phospholipase A activity clearly damages the host cell during the rickettsial infection and may represent the activity by which R . prowazekii escapes from the host cell. Rev Med Univ Navarra, 1989 Jan-Mar, 33(1), 19 - 22 {Lymphocytic meningoradiculitis (Bannwarth's syndrome) . Neurologic involvement of Lyme disease}; Maravi Petri E et al.; We describe a patient with Lyme's disease who showed neurologic symptoms of meningoradiculitis (Bannwarth's syndrome) and had no previous history of exposure to tick bite or chronic erythema migrans . He had longterm fever and bilateral facial paralysis . Antibody titres for Borrelia Burgdorferi in serum and cerebrospinal fluid (CSF) were increased . The CSF changes showed an intrathecal production of immunoglobulins (presence of plasmatic cells and immunoblasts; IgG-CSF: IgG-serum ratio much higher than albumin-CSF: Albumin serum ratio, according to Reiber's diagram; presence of oligoclonal bands) . Therapeutic response to high doses of penicillin was resolutive . The second day of treatment the patient developed uveitis, that was treated with corticoids. Shoni Shikagaku Zasshi, 1989, 27(4), 854 - 63 {Correlation between the illumination time and cytotoxicity of light-cured composite resins}; Ito Y et al.; This study was undertaken to compare the relative cytotoxicity of light cured composite resins, and the cytotoxic reduction of light cured composite resins by illumination time by means of in vitro cell culture test . Light cured composite resins (P-30, Silux, Occlusin, Graft LC, Litefil A, Photo Clearfil A, Palfique light and Herculite XR) were filled into glass tubes (4 mm inner dia . x 1 mm high), then illuminated for 0, 10, 20, 30, 40, 50 and 60 seconds through a matrix strip with direct contact ot an Optilux light source (3M), just before testing . Fibroblasts, 2 ml of 1 x 10(5) cells/ml in Eagle's MEM medium supplemented with 10% FCS, penicillin (100 U/ml) and streptomycin (100 micrograms/ml) were evenly seeded on a cover glass in a tissue culture dish and incubated for 24 hours at 37 degrees C in a humidified atmosphere of 5% CO2 in the air . After 24 hours of incubation, the medium was replaced with 2 ml of agar overlay medium consisting of 10% FCS, Eagle's MEM medium and 1.5% agar . Glass tubes (N = 8) filled with the light cured composite resins were placed at the center of the agar, and incubated for 24 hours in 5% CO2 in air at 37 degrees C . After 24 hours of incubation, the cover glass was removed and the cells were fixed in a 10% neutral formalin, then stained with toluidine blue (pH = 9.3) to differentiate the areas of affected and unaffected cells beneath the test specimens . The affected area was quantitatively determined using an image analysis system . The results indicated that there was a high significant reduction in the cytotoxicity of any of the light cured composite resins except Palfique light when light was illuminated . All of the uncured light-cured composite resins revealed a high magnitude of cytotoxicity . However, when composite resin was illuminated, the cytotoxcity of the resin was dramatically reduced, and the longer the light illumination time became, the lesser the cytotoxicity was shown . Palfique light showed a much higher magnitude of cytotoxicity at any light illumination time than any other composite resins . heruclite XR showed less cytotoxicity than Palfique light, however at 60 seconds illumination the cytotoxicity was still shown . The cytotoxicity of composite resins was completely eliminated with illumination times of 50 seconds for P-30, and 60 seconds for Silux . The cytotoxicity of Graft LC, Occlusin and Photo Clearfil A was eliminated with 20 secondlight illumination which showed the least cytotoxicity among the light cured-composite resins tested.(ABSTRACT TRUNCATED AT 400 WORDS) Arch Inst Pasteur Alger, 1989, 57, 213 - 48 {Activity of cefotaxime and ceftriaxone and of imipenem, pefloxacin and norfloxacin on 13 species of bacteria}; Rahal K; A first comparative in vitro study of Cefotaxime and Ceftriaxone activities on thirteen species of Algerian bacteria is done . These two third generation Cephalosporins have the same activity . A second comparative study of two Quinolones (Pefloxacin, Norfloxacin ) and a Penicillin (Imipenem) is done . Imipenem give satisfying results and is very stable against beta lactamases . In vitro Norfloxacin has a better activity than Pefloxacin. Int Arch Allergy Appl Immunol, 1989, 90(4), 320 - 5 Demonstration of human, rye grass pollen extract-specific, helper and suppressor stimulating activity of modified allergens by effects on in vitro hapten-specific antibody production; Wheeler AW et al.; An in vivo system is described in which penicilloyl antibody was produced from peripheral leucocytes of a grass pollen-sensitive patient who had received penicillin therapy, by challenge of the cells with penicilloyl-grass pollen extract conjugate . Incubation of these leucocytes with a number of modified preparations of grass pollen extract with various T-cell-stimulating properties was shown to affect penicilloyl antibody production . Both chymotryptically fragmented rye grass pollen extract and a conjugate of f met-leu-phe and rye grass pollen extract enhanced penicilloyl-specific antibody similarly to the enhancement induced by unmodified extract, though at high concentration some suppression was seen . A conjugate of polysarcosine and rye grass pollen extract, previously shown to cause antibody suppression in mice, was similarly suppressive for penicilloyl-specific antibody . The system therefore shows potential for the evaluation of the effects of modified allergen treatment on antibody levels via T-cell mechanisms. Folia Haematol Int Mag Klin Morphol Blutforsch, 1989, 116(3-4), 451 - 4 Antioxidants for bone marrow cryopreservation; Matthes G et al.; Addition of antioxidants into the preservation solution improved the cryoprotection of human bone marrow cells . The viability was studied by the growth of GM-CFC in agar culture before and after storage at -196 degrees C . All used antioxidative drugs (selenomethionine, methionine, tocopherol, penicillin/Fe++) increased the tolerance of the stem cells to freezing and thawing and elevated the number of surviving GM-CFC up to the twofold in comparison with that of controls . More immature colony forming cells were especially protected. Zhongguo Yao Li Xue Bao, 1989 Jan, 10(1), 78 - 81 {Changes in degranulation and histamine release from mast cells in rats sensitized by penicilloyl-protein}; Zhao ZJ et al.; In this paper, the mechanism of the penicillin G anaphylactic reaction was studied . Rats were sensitized to penicilloyl (BPO)-protein . The incidences of anaphylactic reaction and death were 100 and 40%, respectively . After being challenged, the degranulation rates of rat cranial periosteous and peritoneal mast cells were 91 +/- 5 and 44 +/- 10%, respectively . In the control group, they were 11 +/- 5 and 7 +/- 2%, respectively . The histamine release rates from sensitized and control rat peritoneal mast cells were 13 +/- 2 and 3.0 +/- 0.4%, respectively . The passive cutaneous anaphylaxis (PCA) test demonstrated that the antibody titers in sensitized serum were 16-32. Wien Med Wochenschr, 1988 Dec 31, 138(23-24), 613 - 6 {Neuroborreliosis}; Riedmann G et al.; The principles of certain clinical symptoms first described at the beginning of the century are rediscovered again: Erythema chronicum migrans after tick-bite followed by numerous neurological manifestations . Meningopolyneuritis Garin-Bujadoux-Bannwarth is recognized to be a central nervous system-manifestation of Borrelian infection transmitted by tick-bites . In a period of 2 years we evaluated 15 patients with diagnosis neuroborreliosis . There is a good improvement after treatment with penicillin or ceftriaxone but there are also some cases with recidives and permanent lesions . We can also present a case report of a progressive borrelian encephalomyelitis. JAMA, 1988 Dec 16, 260(23), 3466 - 9 AIDS, autopsies, and abandonment; Ratzan RM et al.; KIE: The obligation of the medical profession to ensure that autopsy is available for AIDS patients is analyzed from the historical perspective of the risk and sacrifice inherent in medicine and the ethical obligations and responsibilities of physicians . Inappropriately avoiding autopsies in AIDS patients causes potential harm to the decedent, the loss of all benefits derived from autopsies, and harm to the professional status of physicians . The practice of medicine now requires doctors to take personal risks for their patients, as it did up until the advent of penicillin, and presents challenges of conscience and dedication for all who strive to heal . Q J Med, 1988 Dec, 69(260), 961 - 71 Pneumococcal bacteraemia in adults in a low socio-economic urban population; Feldman C et al.; Between January 1984 and December 1985, 183 adult patients, subsequently shown to have pneumococcal bacteraemia, were admitted . Of these infections, nine were caused by penicillin-resistant strains, and three of these were resistant to other antibiotics . The organisms from 150 patients were serotyped/grouped . The primary site of infection was lung in 90 per cent of patients . Among the patients with pneumonia, those with serovar 3 strains accounted for most intensive care unit admissions, most cases requiring inotropic drugs, and mechanical ventilation and had the highest complication rate and mortality . Findings which predicted the need for intensive care included higher age, elevated concentrations of serum urea, creatinine, and phosphate and lower levels of total serum protein, albumin and calcium . Twenty-four patients died of whom 23 had pneumonia