Z Kinderchir, 1982 Apr, 35(4), 140 - 4 {Post-splenectomy infections and Pneumococcus vaccination in paediatric surgery (author's transl)}; Belohradsky BH et al.; Morbidity and lethality rates in pneumococal infections are higher among children with underlying diseases associated with restricted or absent splenic function . Vaccination with polyvalent vaccine is indicated in all children who are more than 2 years old and who have been splenectomized or have a congenital asplenia . Since protection by vaccination is 80% only, we combine the vaccination with penicillin prophylaxis for at present at least three to five years after splenectomy and draw the express attention of parents and family physicians to the limited nature of protection afforded by vaccination . An increase in the immunogenicity of polysaccharid antigen vaccine might lead to successful vaccination of children below 2 years of age who are notable for a particularly high risk of infection . First reports have been published in literature on the possibility of re-implantation of splenic tissue after post-traumatic rupture (17, 27, 28) so that it may become possible to employ this method additionally to pneumococcus vaccination . In case of haematological indication for splenectomy this should be postponed as far as possible until the child has completed his fifth year of life. Tohoku J Exp Med, 1982 Apr, 136(4), 439 - 46 Studies on recovery of liver function of operated biliary atresia; Chiba T et al.; Serial liver function studies were analyzed in 42 biliary atresia patients who had undergone portoenterostomy . Values for serum bilirubin, ZTT, TTT, and gamma globulin returned to normal levels three months after operation in patients with good bile excretion . These tests remained abnormal in those with poor bile output . Alkaline phosphatase and serum transaminase values remained high during the early postoperative period, requiring a much longer duration to return to normal . The biological activity of sulfobenzyl penicillin (SBPC) in the serum and bile was determined by serial broth dilution in 15 children with biliary atresia . Eleven patients were studied 10 days to 2 weeks after an apparent successful portoenterosotomy while four others were clinically well and anicteric three to four years postoperatively . The biliary concentration of SBPC was very low despite good bile output during the early postoperative period . The SBPC levels increased three time during the remote postoperative period . The bile concentration of SBPC is lower than normal, however, and it seems that the ability of the liver to excrete this material may never reach normal levels despite apparent good clinical hepatic function. Ann Intern Med, 1982 Apr, 96(4), 502 - 4 Penicillin-binding proteins in bacteria; Tomasz A; The last 5 to 6 years have witnessed an outburst of renewed interest in the beta-lactam antibiotics . One of the main factors contributing to this was the introduction of the simple and powerful technique of sodium dodecyl sulphate electrophoresis for the identification of bacterial membrane components--penicillin binding proteins--that bind radioactive penicillin and most likely represent the primary biochemical targets of penicillin action in the bacterial cell . Application of this technique has led to a remarkable number of novel observations that have substantially modified our view of the mode of action of beta-lactam antibiotics. Hosp Pharm, 1982 Apr, 17(4), 202 - 4, 209-11 A multihospital medication allergy audit: a means to quality assurance; Hoffmann RP et al.; Seventeen community hospitals within the 16 division of the Sisters of Mercy Health Corporation cooperatively participated in a medication allergy audit program . Initial and follow-up audits were conducted at each hospital to determine whether allergy information for penicillin- or aspirin-sensitive patients was appropriately communicated to the pharmacist . A total of 483 patient records were reviewed during each audit which corresponded to 12% of each hospital's average patient census . In the initial audit, the overall acceptance rate for the combined hospitals was 62.3% . Following the first audit, each hospital undertook corrective follow-up measures in an attempt to improve its results . In the second audit, the overall acceptance rate improved significantly to 78.9% . It is concluded that this auditing process followed by corrective follow-up measures was an effective mechanism for improving the communication of patient allergy information and is a means to quality assurance . Future audits will be necessary to determine whether the beneficial effects produced will be sustained or improved. Nouv Presse Med, 1982 Mar 6, 11(11), 843 - 6 {Leukocyte aggregation test for assessing cell-mediated immunity: its use in drug allergy (author's transl)}; Rouveix B; The author has designed a new quantitative leucocyte aggregation test a measure cell-mediated immunity in man . The test involves continuous recording of light absorbance by stirred leucocyte suspensions . Potentially, measurement of direct leucocyte aggregation offers considerable advantages in terms of sensitivity, reproducibility and simplicity of execution . The technique was initially developed in animals and made it possible to assay very small amounts of lymphokines . The results obtained in man with antigenic drugs, such as penicillin, confirm that the aggregation test is much more sensitive than the migration inhibition test . Its precise significance remains uncertain, but it already promises to constitute a simple and highly reliable means of diagnosing and preventing drug hypersensitivity. Arch Fr Pediatr, 1982 Mar, 39(3), 141 - 4 {Sickle cell anemia and functional asplenia (author's transl)}; Beauvais P; On the occasion of 34 spleen scintigrams performed in children with sickle cell anemia, the frequency and precocity of the "functional asplenia" is emphasized and its relationship with the infectious history of such children is discussed . The anti-bacterial role of the spleen and the responsibility, at least partial, or asplenia in the susceptibility of patients with sickle cell anemia to infections, especially pneumococcal ones, are reviewed . The pathophysiologic mechanism of functional asplenia is then discussed . The author concludes that asplenia has no predictive value in selecting children "at risk" for infection and stresses the necessity of a systematic prevention by penicillin therapy and antipneumococcal vaccination in such patients before 4 years of age. Aust Fam Physician, 1982 Mar, 11(3), 182 - 3, 186-7 Gonorrhoea and non gonococcal urethritis in the male . The specialist view; Young PS; Although exact figures of the incidence of gonococcal and non gonococcal urethritis is Australia are not available the majority of cases seen in sexually transmitted disease clinics are male patients with these conditions . Evidence of increasing resistance of the gonococcus to penicillin--particularly that due to plasmid mediated penicillinase production--and current interest in Chlamydia trachomatis associated diseases in males, females and neonates, necessitate constant review of the diagnosis and treatment of these conditions. J Bacteriol, 1982 Mar, 149(3), 1150 - 3 Penicillin is an active-site inhibitor for four genera of bacteria; Yocum RR et al.; The hypothesis that penicillin acts as an active-site inhibitor cell wall biosynthesis was tested by a method of partial proteolytic mapping of penicillin-binding sites versus substrate-binding sites in cell wall D-alanine carboxypeptidases . This enzyme was obtained from four genera of bacteria, purified, and tested. Int J Radiat Oncol Biol Phys, 1982 Mar-Apr, 8(3-4), 453 - 6 The lethal interaction of X ray and penicillin induced lesions following X-irradiation of Escherichia coli B/R in the presence of hypoxic cell sensitizers; Gillies NE et al.; When Escherichia coli B/r were x-irradiated under anoxia in the presence of different electron-affinic sensitizers and then incubated in broth containing penicillin (at a concentration that did not kill unirradiated cells) additional killing of the bacteria occurred provided the sensitizers were of relatively high lipophilicity . The overall effect was to increase the efficiency of these sensitizers . It is concluded that sensitizer-dependent latent radiation lesions(s) are produced in membrane components of the cell envelope that interact with damage caused by penicillin in the peptidoglycan layer and this causes the additional lethality. J Trauma, 1982 Mar, 22(3), 186 - 9 Effectiveness of penicillin irrigation in control of infection in sutured lacerations; Lindsey D et al.; We studied the incidence of infection in lacerations in a controlled, double-blind, Armitage sequential clinical trial . After standard prescribed preparation of the wound area, and immediately before suture, each laceration was flooded with the 10 ml content of a numbered, amber glass vial . Half of the vials contained a solution of 0.9% NaCl; half contained a 5% solution of sodium benzyl penicillin . No other factors were controlled . A single observer made the determinations of presence or absence of infection, purulent or nonpurulent, early and late after suture . After study of 260 lacerations the study indicated a clear superiority of penicillin over saline in lowering the incidence of infection with a statistical significance of p less than 0.00005 . In a sample of this size the 95% confidence limits of the magnitude of the superiority of penicillin cover a wide range, but it appears that two out of three or three out of four infections can be averted merely by flooding the wound with penicillin immediately before suture. Drug Intell Clin Pharm, 1982 Mar, 16(3), 205 - 10 Benzathine penicillin G in the treatment of neurosyphilis; Cuddy PG; The definition, pathogenesis, incidence, diagnosis, and treatment of neurosyphilis are discussed . Controlled trials of benzathine penicillin in the treatment of neurosyphilis are reviewed, as are recent case reports of benzathine penicillin failures . Although few well-controlled studies exist to document conclusively the efficacy of benzathine penicillin in the treatment of neurosyphilis, its use is recommended in selected situations. Otolaryngol Head Neck Surg, 1982 Mar-Apr, 90(2), 266 - 9 Malignant external otitis: a dangerous misnomer? Lucente FE, Parisier SC, Som PM, Arnold LM. Review of our experience in treating 16 patients with malignant external otitis, along with survey of the compromised defense mechanisms of diabetic patients, confirms the need for immediate, intense, and vigilant therapy . Radioisotope scans, high-resolution computed tomography scans, and multidirectional tomograms are used to delineate the extent of the disease . Therapy includes intravenous aminoglycoside and penicillin derivatives, limited surgery, and hyperbaric oxygenation . In view of the tendency for this infection to extend beyond the external auditory canal and to produce an invasive lethal osteomyelitis, we feel that the tendency to classify this disease as a variant of diffuse external otitis may foster undertreatment. Am J Vet Res, 1982 Mar, 43(3), 545 - 7 In vitro susceptibility of selected isolates of Brucella abortus to penicillin; Stinebring WR et al.; Brucella abortus isolates (n = 134) from 38 dairy herds in Vermont, Florida, and Canada exhibited 2 growth patterns on medium containing 5 U of penicillin/ml . The B abortus isolates from 7 herds in Vermont were always susceptible to the antibiotic at that concentration . Eleven of 12 isolates from 1 herd in Florida and 25 isolates (biotypes 1 and 4) from 30 Canadian herds grew at greater than or equal to 5 U of penicillin/ml, as determined using a gradient plate method . Penicillin susceptibility may be of value in identifying the source of infections in cattle. Br J Anaesth, 1982 Mar, 54(3), 343 - 7 Anticonvulsant activity of Althesin on experimental epilepsy; De Riu PL et al.; Anaesthetic doses of Althesin were tested in rabbits using two experimental models of epilepsy: generalized (OHP; oxygen at high pressure-induced seizure) and partial (penicillin cortical-induced seizure) . Althesin in both models always produced anticonvulsant activity which was more powerful in generalized convulsions . This agent was successful in preventing and treating OHP seizures . The authors conclude that a clinical history of convulsions must not be considered a contraindication to the use of this anaesthetic which has particularly useful properties for neurosurgery. J Pharm Sci, 1982 Mar, 71(3), 351 - 3 Separation of penicillin and its major degradation products by ion-pair reversed-phase high-pressure liquid chromatography; Ghebre-Sellassie I et al.; An ion-pair reversed-phase high-pressure liquid chromatographic technique capable of separating penicillin and its major degradation products within 8 min was developed . The influence of pH, counterion concentration, buffer concentration, and organic modifier content was studied and the observed behavior of the compounds during the chromatographic process was discussed. J Pharmacol Exp Ther, 1982 Mar, 220(3), 660 - 71 gamma-Aminobutyric acid (GABA) receptor stimulation . I . Neuropharmacological profiles of progabide (SL 76002) and SL 75102, with emphasis on their anticonvulsant spectra; Worms P et al.; Progabide (4-({(4-chlorophenyl) (5-fluoro-2-hydroxyphenyl)-methylene}amino) butanamide) is a gamma-aminobutyric acid (GABA) receptor agonist which readily enters the brain . In the body, progabide is metabolized to three active metabolites: SL 75102, gabamide and GABA . Progabide and SL 75102 readily enter the brain and GABA and gabamide are also formed within this organ . Both progabide and SL 75102 exhibit a broad spectrum of anticonvulsant activities against seizures which involve GABA-mediated events (bicuculline, picrotoxinin and pentylenetetrazol) or which are apparently independent of GABAergic mechanisms (penicillin, strychnine, electroshock and audiogenic seizures) . These data support the hypothesis that direct GABA receptor stimulation is an effective means of controlling convulsions of various origins . Progabide and SL 75102 have relatively minor secondary effects in comparison to commonly used antiepileptics . Myorelaxation occurs, but only at doses higher than the ED50 values in convulsant tests . Furthermore, these compounds are not sedative . Finally, these GABA agonists have a complex action in the extrapyramidal system . Anticonvulsant doses are antagonistic to dopamine receptor-mediated behaviors, whereas much lower doses seem to facilitate the effects of dopaminergic transmission. Immunology, 1982 Mar, 45(3), 537 - 43 Mice do not respond with delayed hypersensitivity to penicillin-derived determinants; Kristofferson A et al.; Penicillin structures of varying lipophilicity were used to induce delayed hypersensitivity (DH) in different strains of mice . Epicutaneous application on inflamed skin or intracutaneous or subcutaneous injection with Freund's complete adjuvant did not induce DH, despite the fact that picrylchloride readily produced such responses . Sheep, rabbit and mouse red cells as well as mouse lymph node and epidermal cells conjugated with various amounts of penicillin injected subcutaneously in the base of the tail did not induce a DH reaction to penicillin either, whereas such responses to other cellular components and also to the TNP determinant after using picryl sulphonic acid conjugated spleen cells were recorded . Since the mice in other studies have been shown to respond with antibodies to soluble penicilloyl protein conjugates, but never to penicillin itself, we concluded that this species of animal is incapable of responding to penicillin with DH. Mycopathologia, 1982 Feb 19, 77(2), 103 - 9 Contribution to the fungal flora of cereal grains in Egypt; El-Kady IA et al.; 30 genera and 77 species, in addition to 4 varieties were isolated from 25 samples of each of barley, wheat, maize and sorghum grains collected from different places in Egypt . The broadest spectrum of genera and species was recorded in wheat (25 genera and 59 species + 4 varieties) followed by barley (21 genera and 52 species + 2 varieties), sorghum (14 genera and 33 species + 2 varieties) and maize grains (11 genera and 29 species + 2 varieties) . Aspergillus, Fusarium, Penicillium, and Rhizopus were the most common genera in the four grains, except maize where Penicillin emerged in low frequency . Aspergillus was the main component of the fungal flora of the four grains and contributed 79-94.4% of the gross total count of fungi . From the preceding genera A . niger, A . flavus, A . fumigatus, F . oxysporum, P . chyrsogenum, P . corylophilum, P . notatum and R . stolonifer were the most frequent. Can J Ophthalmol, 1982 Feb, 17(1), 21 - 3 Distribution of penicillin in the cornea, tears and aqueous humour at various times following a single intravenous injection; Avaria M et al.; Bioassays performed by the disc diffusion technique on samples of blood, tears, aqueous humour and cornea from 30 rabbits killed 4 to 24 hours following a single intravenous injection of benzylpenicillin (40 mg/kg) showed that the penicillin content of these fluids and tissues progressively decreased with time . However, even after 24 hours the agent could be detected in the samples . The peripheral and central cornea contained similar amounts of penicillin up to 16 hours; thereafter, the peripheral cornea contained more of the agent. Am J Clin Pathol, 1982 Feb, 77(2), 210 - 3 Prevalence of penicillin-resistant pneumococci in Houston, Texas; Krause KL et al.; Pneumococci resistant to penicillin have been reported in increasing numbers world-wide . A survey for resistance to penicillin G in 222 clinical isolates taken from patients in Houston is reported here . Thirteen (5.9%) of the isolates screened exhibited moderate levels of resistance with MIC's ranging from 0.125-0.5 microgram/ml . The authors recommend routine screening for pneumococcal resistance in isolates from blood, cerebrospinal fluid and tissue exudates. Invest Ophthalmol Vis Sci, 1982 Feb, 22(2), 220 - 7 Liposomes in topical drug delivery; Schaeffer HE et al.; The possible use of liposomes as topical drug delivery vehicles for both water- and lipid-soluble drugs has been investigated . Data for two characteristic drugs, penicillin G and indoxole, are presented . Liposome uptake by the cornea is greatest for positively charged liposomes, less for negatively charged liposomes, and least for neutral liposomes, suggesting that the initial interaction between the corneal surface and liposomes is electrostatic adsorption . Positively charged unilamellar liposomes enhanced transcorneal flux of penicillin G across isolated rabbit cornea more than fourfold . Liposomal entrapment of drug is prerequisite to enhanced transport; corneal penetration was not enhanced when liposomes that were preformed in the absence of drug were mixed with penicillin G immediately before application to the cornea . Although penicillin G is water-soluble, the findings indicate that it secondarily associates with liposome membranes, possibly by insertion of its hydrophobic end into the lipid bilayer . Indoxole, however, was incorporated directly into the membranes of pure phosphatidyl choline liposomes . Liposome-mediated drug flux efficiency after topical instillation in rats was significantly greater than that obtained with equivalent concentration of drug delivered in polysorbate 80 . Ten times more drug in polysorbate 80 was required to equal liposome-mediated flux efficiency . The findings suggest that liposomes enhance corneal penetration of drug by adsorbing to the corneal surface, with direct transfer of drug from liposomal to epithelial cell membranes. Epilepsia, 1982 Feb, 23(1), 35 - 45 Feline generalized epilepsy induced by tranexamic acid (AMCA); Pellegrini A et al.; Epileptic activities induced by topical application of tranexamic acid (AMCA) and penicillin to the cortex of 12 cats in acute experiments were compared . Both substances when diffusely applied on a wide cortical area of both hemispheres at very low concentration produced an EEG pattern consisting of spike-wave bursts similar to the electrographic manifestations seen in feline generalized epilepsy induced by large parenteral doses of sodium penicillin . These epileptic bursts could be triggered by repetitive stimulation of nucleus centralis medialis . Increased concentrations of both AMCA and penicillin led to the appearance of bilaterally synchronous spikes and poly-spikes which were not further excited by NCM stimulation . Two factors seem to play an important role in eliciting spike-wave bursts in both models: (1) the area of the cortex exposed to the epileptogenic agent and (2) the concentration of the epileptogenic agent used . The similar effects observed in 5 chronic animals either by intravenous injection of high doses of AMCA or by intramuscular injection of sodium penicillin confirm the results obtained in acute experiments and suggest a new way of inducing feline generalized epilepsy. Biochem J, 1982 Feb 1, 201(2), 425 - 7 Interaction of the pBR 322-coded RTEM beta-lactamase with substrates . Evidence for specific conformational transitions; Citri N et al.; The rate of inactivation of RTEM-1 beta-lactamase by Pronase is accelerated by class A ('resistant') penicillins . Other substrates (class S penicillin and cephalosporins) protect against the inactivation . Cefoxitin, a semi-synthetic cephamycin, induces a more extensive, hysteretic response . In its presence the enzyme is inactivated by trypsin as well as by Pronase. Antimicrob Agents Chemother, 1982 Feb, 21(2), 195 - 200 Induction of cell lysis in Escherichia coli: cooperative effect of nocardicin A and mecillinam; Berenguer J et al.; Nocardicin A and mecillinam are two beta-lactam antibiotics with poor bacteriolytic activity against Escherichia coli . However, the combined use of these drugs resulted in the induction of a fast lytic response in E . coli cells . For this cooperative effect to take place, the formation of a complex between penicillin-binding protein 2 and mecillinam is apparently necessary . This suggests that penicillin-binding protein 2 might be actively involved in the response of E . coli to bacteriolytic beta-lactam antibiotics. Br J Dermatol, 1982 Feb, 106(2), 183 - 90 The role of penicillin in the pathogenesis of chronic urticaria; Boonk WJ et al.; Intracutaneous tests with penicilloyl-polylysine (PPL) and benzyl-penicillin G (PG) were performed in 245 patients suffering form chronic recurrent urticaria, including physical urticaria . Positive results were observed in fifty-nine patients (24%) . Sera from fifty-seven of these fifty-nine patients were investigated for circulating anti-penicilloyl antibodies by an enzyme-linked immunosorbent assay (ELISA) and a passive haemagglutination test (HA) . The results were compared to those form the ELISA and HA in a control group of thirty-five patients who had shown clinical allergic reactions to penicillin and had positive skin tests to PPL and/or PG . The in vitro tests revealed positive results in 12.3% and 37.1% respectively . In forty-three patients the course of the positive intracutaneous tests to penicillin, together with the duration of chronic urticaria, was followed over a period of time up to 3.5 years . In twenty-two out of forty-two patients with positive intracutaneous tests to penicillin, a diet free of dairy products proved to have a curative effect, compared to two out of forty control subjects with chronic urticaria and negative skin tests to penicillin . These studies indicate that penicillin has an important role in the aetiology and maintenance of chronic urticaria. Fortschr Med, 1982 Jan 28, 100(4), 146 - 9 {Therapy of acute diseases of the upper airway . Comparison of 2 antiseptic pharyngeal sprays in otorhinolaryngologic practice}; Klingbeil W; 100 out-patients with subacute or acute stages of pharyngitis, tonsillitis, pharyngotonsillitis or angina participated in a randomized 3 day trial on antiseptic mouth-sprays comparing one containing a combination of chlorhexidine, tramazoline and aluminiumtrilactate with one containing only hexetidine . At the beginning of therapy and 3 days afterwards the local symptoms rubor and tumefaction of the throat, dysphagia, fur, swelling and tenderness of the cervical superficial lymph nodes were classified according to a graded scale . Using the combination these symptoms were markedly improved in 34 patients, improved in 7; 8 showed no alteration and one patient showed a deterioration (n = 50) . With the monosubstance 18 patients showed good improvement, 11 an improvement, 17 no change and 3 patients a deterioration (n = 49), one patient needed penicillin-treatment during the trial . Under treatment with the combination the symptoms rubor and tumefaction of the throat showed a significant better improvement . The possible role played by a vasodilator are discussed. Brain Res, 1982 Jan 28, 232(1), 41 - 56 Membrane depolarization and prolongation of calcium-dependent action potentials of mouse neurons in cell culture by two convulsants: bicuculline and penicillin; Heyer EJ et al.; The convulsant compounds bicuculline (BICUC) and penicillin (PCN) are antagonists of GABA-mediated synaptic inhibition . In addition, we have shown that BICUC and PCN produced membrane depolarization of mouse spinal cord neurons in primary dissociated cell culture by blocking a potassium conductance, a non-synaptic direct effect . Both compounds also prolonged calcium-dependent action potentials of mouse dorsal root ganglion and spinal cord neurons in cell culture . Thus, BICUC and PCN had both synaptic and non-synaptic actions . The possibility that both synaptic and non-synaptic actions of BICUC and PCN are involved in their convulsant mechanism of action is discussed. Brain Res, 1982 Jan 7, 231(1), 131 - 41 Penicillin epileptogenesis in the rat: diffusion and the differential laminar sensitivity of the cortex cerebri; Holmes O et al.; When penicillin is applied electrophoretically from a fluid-filled microelectrode into the substance of the somatosensory cortex of the rat under urethane anaesthesia, the latent period for production of interictal epileptic spikes is least when the electrode lies 0.7 mm below the cortical surface . With low electrophoretic currents of --50 to 100 nA the increase in latent period as the tip of the electrode is placed further and further away from this level can be quantitatively accounted for by the time taken for penicillin to diffuse and to reach a threshold concentration throughout a critical mass of tissue at the 0.7 mm level . With these low currents, the generators of the interictal spikes are confined to a band of cortex centred at the 0.7 mm level . This is true even when the penicillin is applied away from the sensitive layer; in this circumstance the duration of electrophoresis needed to evoke interictal spikes is greater but when they do eventually appear the spikes are generated at the 0.7 mm layer . Histologically, the sensitive layer has been identified as the deep part of layer III . So far as the generation of interictal spikes is concerned, there is no evidence that, with low electrophoretic currents, penicillin has effects other than at the deep part of layer III; all the available evidence indicates that the penicillin has to diffuse to this layer and produces its effects there. J Gynecol Obstet Biol Reprod (Paris), 1982, 11(5), 589 - 91 {A case of post partum gonococcal arthritis}; Pigne A et al.; The authors report a case of gonorrhoea occurring immediately after delivery, characterized by acute inflammatory polyarthritis . The diagnosis was made from swabs taken from the lochia that were cultured on enriched media . The outcome of the disease treated with penicillin was good after 48 hours . The new-born's state of health after swabs take from the nostrils were positive was satisfactory all the time . A review of the literature shows how rare these conditions are, how serious they can sometimes be, and the management that should be undertaken in order to prevent complications occurring. Ann Med Interne (Paris), 1982, 133(8), 564 - 8 {Early syphilitic hepatitis . Two cases}; Echard M et al.; Two patients are presented as cases of secondary syphilitic hepatitis . Clinical and biological signs coincided with usual description of this affection . Syphilitic serological tests were all very positive . These two patients were homosexual men . In one case, we have found treponema in hepatic biopsy, underelectron microscope only, which confirmed the diagnosis . Evolution of both patients was improved by anti-syphilitic penicillin the rapy . Thus, this is an important diagnosis, which should not missed, because of the good prognosis of this affection with specific treatment, and because of the increasing frequency of syphilis for 20 years. J Gynecol Obstet Biol Reprod (Paris), 1982, 11(7), 829 - 32 {Pneumococcal peritonitis . An unusual diagnosis in gynecology}; Muray JM et al.; The authors, having had a case of primary pneumococcal peritonitis, review the features of this pathological condition which has become rare, and of gynaecological pneumococcal infections . Pneumococcal peritonitis presents as a very serious peritonitis and the usual diagnosis that is first made is peritonitis due to appendicitis . Pneumococcal peritonitis can be primary but it is possible that it is often secondary to genital pneumococcal infections . Treatment should always be by laparotomy to confirm the diagnosis, with a peritoneal toilet which is needed in order to stop a pelvic abscess developing . Antibiotics, which are usually of the penicillin group, should be given for at least 15 days . The treatment can be varied in those rare cases where cirrhotic ascites or serious nephrotic syndromes develop in children . Putting in drains and removing the appendix when it is normal are both useless. Aust J Biol Sci, 1982, 35(4), 363 - 72 Mechanisms of organic acid and monosaccharide transport in the kidney of the brush-tailed possum, Trichosurus vulpecula; Miller JH et al.; The mechanisms of organic acid and monosaccharide transport in the kidney of T . vulpecula were investigated using the renal cortical slice preparation . The kinetics, the sensitivity to inhibitors of metabolism and sodium transport, and the specificity of the concentrative uptake of p-amino-hippurate and alpha-methyl-D-glucoside were examined and compared with published results from studies in eutherian mammals . Some minor differences between metatherians and eutherians were noted with regard to the specificities of the renal slice uptake systems . Penicillin G, a competitor of organic acid transport in eutherian kidneys, did not interact with the marsupial uptake system, and sodium acetate, which stimulates transport in other mammals, inhibited p-aminohippurate uptake in the slice of the possum kidney . 2-Deoxy-D-glucose, which interacts with the phlorizin-sensitive monosaccharide transport system in the dog, rat and rabbit kidney, had no effect on alpha-methyl-D-glucoside uptake in the possum, and the magnitude of the interaction of D-fructose resembled that reported in the dog and rat but was greater than the inhibition reported in the rabbit . D-Glucuronic acid and D-glucuronic acid lactone inhibited alpha-methyl-D-glucoside uptake in the possum but had no effect on uptake in rat renal slices . In consideration of the reported variability of these parameters between different classes of eutherians, it was concluded that the primary mechanisms involved in organic solute transport by the proximal nephron of metatherians and eutherians were not significantly different. Soc Sci Med, 1982, 16(23), 2055 - 64 Penicillin, battery acid and sacrifice . Cures and causes in Nyole medicine; Whyte SR; The existence of therapeutic alternatives, a very widespread feature of medical systems, is to be distinguished from medical pluralism, which characterizes situations where orthodoxy and power accrue to one group of medical professionals . Local African medical systems are dynamic and inclusive and this is the basis for the ready incorporation of Western biomedical elements . Analysis of the medical perceptions, treatments and practitioners of the Nyole of Eastern Uganda reveals that new divination techniques and exotic sorcery medicines have been absorbed as well . Some of the recent changes in Nyole medicine may be indicative of a growing medical individualism . Explanations and treatments directed toward the social and ritual situation of the sufferer still bear the greatest ideological weight. Prog Clin Biol Res, 1982, 98, 73 - 81 Treatment of patients with sickle cell anemia--another view; Charache S et al.; Sickle cell anemia is a bad disease, and it occurs in black patients who still face obstacles that whites don't appreciate . Even if a new cure burst forth, it would not be available to many patients, and others would be afraid of it . It probably would not be as safe or effective as chloroquine for malaria or penicillin for pneumonia--and as a result, we should try to improve our present means for delivering care . Treatable complications must be recognized, and painful episodes must be managed with knowledge that no type of pain is exclusively physical or mental . If patients are to function in society, they must have marketable skills--and the current educational system in the United States is not prepared to provide such skills to such difficult students . Finally, there will be some lost souls, hopeless patients who live a shadowy life from which rescue seems nearly impossible . They need specialized care which is not currently available . Such care in special protected environments could be cost-effective, but would require such prolonged enthusiasm and commitment that it may be impossible to achieve. Pediatr Radiol, 1982, 12(2), 99 - 101 Coincidental occurrence of actinomycosis and Ewing's sarcoma in a child; Bjork O et al.; Pulmonary consolidation, rarefaction of adjacent ribs and pleural effusion, a triad frequently considered characteristic of actinomycosis, seemed in the present case to support this serologically entertained diagnosis . However, the subsequent course of disease disclosed the most uncommon association of actinomycosis an metastatic Ewing's sarcoma of the lung . The possibility of combined occurrence of an opportunistic infection by actinomyces and malignancy, calls for open biopsy in cases not responding to penicillin treatment or with an unexpected evolution of the clinical manifestations. Arthritis Rheum, 1982 Jan, 25(1), 42 - 7 Schönlein-Henoch syndrome in patients with familial Mediterranean fever; Flatau E et al.; Ten episodes of Schonlein-Henoch purpura (SHP) in 8 patients with familial Mediterranean fever (FMF) were observed . Five episodes developed 3-14 days after penicillin injections, suggesting an etiologic association . FMF and SHP have clear clinical similarities, and if the frequency of association of the 2 diseases is indeed high, perhaps a common etiologic factor should be sought . An immune complex mechanism might be the link between these 2 disease entities. Am Surg, 1982 Jan, 48(1), 25 - 7 Pelvic actinomycosis associated with use of intrauterine device: a new challenge for the surgeon; Doberneck RC; PIP: Recent reports suggest that pelvic inflammatory disease (PID) is more common among users of the IUD than among those using other forms of contraception and that there is an association between IUD use and pelvic actinomycosis . In 1979 a woman at the University of New Mexico Hospital died from pelvic actinomycosis, the 2nd reported death from this disease associated with the use of an IUD, although her death from pulmonary embolus and Candida endocartidis should more appropriately be considered a complication of intravenous hyperalimentation . At least 25 patients are reported to have had serious pelvic actinomycosis associated with the use of an IUD . No particular type of IUD seems less likely to be associated with actinomycosis . Actinomyces are normally present in the gut and oropharynx, so that inoculation of the vagina with stool or saliva in combination with trauma induced by the foreign body such as an IUD may allow the actinomyces to enter tissues . Actinomyces are easily detected by Papanicolaou-stained cervicovaginal smears and are present in as many as 25% of symptomatic women using IUDs . Culture techniques usually fail in detecting actinomyces, the need for an anaerobic environment or overgrowth by bacteria which invariably accompany actinomyces are the usual causes of failure . Usual signs of IUD-associated actinomycosis are pelvic and lower abdominal or back pain, vaginal discharge, fever, and elevation of leukocyte count which are similar to symptoms of mild PID . Therefore these symptoms demand a Papanicolaou-stained cervicovaginal smear and search for actinomyces . Treatment includes removal of the IUD and administration of penicillin . However at least 1 patient after receiving treatment returned later with actinomycotic tubo-ovarian and subphrenic abscesses . A period of at least 4-6 weeks of therapy is usually recommended . Most patients with pelvic masses underwent hysterectomy and bilateral salpingo-oophorectomy in addition to penicillin and IUD removal; a few were successfully treated with drainage of an intra-abdominal abscess . Acta Neurol Scand, 1982 Jan, 65(1), 51 - 8 EEG monitoring of focal lesions of the blood-brain barrier; Remler MP et al.; This paper presents a modified method for the EEG detection and monitoring of small focal blood-brain barrier (BBB) lesions . The method uses high dose IV penicillin (1.2 X 10(6) mu/kg) to produce a spike focus at BBB lesions, penicillin encephalopathy . The EEG is recorded and the epileptic spikes are counted by an automatic computer program . The computer produces an objective quantitative results . The method is verified empirically on traumatic and radiation BBB lesions. Klin Padiatr, 1982 Jan, 194(1), 31 - 4 {Hearing defects after purulent meningitis (author's transl)}; Overkamp H et al.; 80 children in the age of 4 to 20 years who got over a purulent meningitis in infancy or childhood were examined by means of several audiological methods . Two children (2,5 percent) were found to be deaf . In 4 cases (5 percent) deafness was detected only unilateral not preferring the right or left ear . Hearing impairment after the eights cranial nerve damage was found in four children . 4 children suffered from severe to profound hearing defects on one side or bilateral . No correlation could be found between incidence and severity of the hearing defects to the total dose of the antibiotics that were penicillin, ampicillin and gentamycin . Before the background of the literature reported on this subject and the presented results hearing impairment after purulent meningitis seems to be more likely a sequela of inflammation than a toxic side-effect of the antibiotics. Int Arch Allergy Appl Immunol, 1982, 67(3), 262 - 6 Antibody responses to impurities of penicillin in infants and rabbits; Ahlstedt S et al.; Antibody responses to penicilloyl were recorded in infants and children treated for about 1 week with intravenous ampicillin . In this single-blind, randomized study two commercially available preparations were compared, one of high-grade purity (less than 0.1 microgram antigen per gram) and the other slightly contaminated with high molecular weight proteinaceous material (1.5 microgram antigen per gram) according to a radioimmunoassay . The results showed no significant increase in the antibody titers in any of the patient groups . The immunogenic properties of high molecular weight proteinaceous impurities isolated from phenoxymethyl penicillin during manufacture were tested in rabbits given daily subcutaneous injections with 0.1-10 micrograms of the antigen over 10 day periods . When the 10-day period was repeated, the rabbits injected with more than 2 micrograms of antigen responded with both IgM/IgG and IgE antibodies . The clinical as well as the animal study indicates that antigen impurities in the preparations of the order of 2 micrograms per gram or less do not elicit a significant antibody response . However, the study in rabbits demonstrates that high molecular weight impurities can induce penicillin allergy if present in about 10-fold higher quantities than those usually found in the commercial penicillin preparations of today. Br Heart J, 1982 Jan, 47(1), 101 - 2 Penicillin-sensitive Moraxella prosthetic endocarditis . Near disaster caused by failure to treat with penicillin; Chen W et al.; A patient with late prosthetic endocarditis resulting from Moraxella non-liquefaciens is reported . Correct laboratory indentification is of therapeutic importance as Moraxella is often highly sensitive to penicillin . Because of suspected penicillin sensitivity, antibiotics other than penicillin were used, but failed to control the endocarditis . Prompt response occurred when penicillin was given . Penicillin remains by far the most effective antibiotic for the treatment of endocarditis, particularly when affecting prosthetic valves, and caused by organisms sensitive to penicillin. Infect Immun, 1982 Jan, 35(1), 187 - 92 Transfer of resistance with syphilitic immune cells: lack of correlation with mitogenic activity; Schell RF et al.; Hamsters infected intradermally with Treponema pallidum Bosnia A develop extensive chronic skin lesions, usually accompanied by metastatic lesions involving the paws, lips, and anal region and by lymph nodes teeming with treponemes . Throughout the course of syphilitic infection, cells from the inguinal lymph nodes responded poorly to stimulation with suboptimal, optimal, or supraoptimal concentrations of concanavalin A, phytohemagglutinin P, or lipopolysaccharide . The response of syphilitic spleen cells was variable . Depression of lymphocyte reactivity to mitogens preceded clinical signs of infection and correlated well with the chronicity of syphilitic infection . When syphilitic hamsters were treated with a curative dose of penicillin, their mitogenic responses returned to normal or were slightly elevated . No correlation existed between mitogenic activity and the ability of lymphoid cells to induce an effective immune response when transferred to normal recipients . No significant differences in protection were detected among recipients of immune cells with or without activity to mitogens . These results demonstrate that lymphocyte transformation by mitogens in vitro is not a measure of effective treponemicidal activity and so may not be a valid indicator of the protective immune status of syphilitic animals. Arch Intern Med, 1982 Jan, 142(1), 139 - 40 Meningovascular syphilis after 'appropriate' treatment of primary syphilis; Moskovitz BL et al.; Meningovascular syphilis developed in a patient two years after the treatment of primary syphilis with a single intramuscular injection of 2.4 million units of penicillin G benzathine as recommended by the Centers for Disease Control . Although it could not be established with certainty whether this infection represented a reinfection or a treatment failure, the case emphasizes the necessity for serologic follow-up examination in all patients treated for primary syphilis. Gastroenterology, 1982 Jan, 82(1), 135 - 9 Rectal mass caused by Treponema pallidum: confirmation by immunofluorescent staining; Quinn TC et al.; A 37-yr-old homosexual man presented with mild anorectal symptoms, a diffuse maculopapular rash, constitutional symptoms, and a reactive serologic test for syphilis . Sigmoidoscopy revealed a 2 x 2-cm indurated rectal mass 5 cm above the anal verge . Darkfield examination of rectal exudate revealed motile treponemes and rectal biopsy of the mass showed diffuse infiltration of plasma cells and lymphocytes . Large numbers of spirochetes were present on silver stain of the rectal biopsy specimen and these were shown to be Treponema pallidum by indirect immunofluorescence . The rectal mass and symptoms resolved following penicillin therapy . This case and a review of previously reported cases of anorectal syphilis emphasize the significance of these often neglected and misdiagnosed lesions of syphilis. Acta Odontol Scand, 1982, 40(5), 299 - 305 The effect of penicillin- and tetracycline-containing medicaments on the microhardness of human dental enamel . An in vitro study; Bjorvatn K et al.; While the sugar content of various medicaments has been accepted as a hazard to dental health, the possible detrimental effect of the medicaments per se has been largely overlooked . In the present study the microhardness of dental enamel was examined before and after the exposure to various salts of penicillin, to tetracycline chloride, and to human saliva . The Vickers hardness index was found to 1 . remain stable or increase slightly in enamel exposed to saliva, nonaqueous penicillin suspensions and certain watery solutions of phenoxymethylpenicillin calcium . 2 . decrease to a moderate degree in most aqueous penicillin solutions, and 3 . decrease drastically in tetracycline solutions and in phenoxymethylpenicillin calcium solutions containing citrate . The results indicate that a direct reaction may take place between the dental enamel and the medicament and/or its degradation products when antibiotic compounds are taken per os. Eur J Clin Pharmacol, 1982, 23(3), 245 - 8 Absorption of penicillin and paracetamol after small intestinal bypass surgery; Terry SI et al.; Drug absorption was studied in morbidly obese patients before and after jejunoileal bypass . The absorption of phenoxymethyl penicillin was considerably increased whilst that of paracetamol was unchanged. J Int Med Res, 1982, 10(5), 379 - 82 Bioavailability of paediatric mixtures containing phenoxymethylpenicillin calcium or potassium salt; Soininen K et al.; The bioavailability of the calcium and potassium salts of phenoxymethyl-penicillin (dose 38,000 I.U./kg) was investigated in eight healthy adult volunteers . Administration of the calcium salt as an aqueous oral mixture resulted in a mean peak plasma concentration of 8.52 mg/l (SD 1 X 96) and that of the potassium salt mixture in a concentration of 8.40 mg/ml (SD 2.61), p greater than 0.1 . The median time-to-peak levels were 0.75 h and 1.0 h, respectively (p greater than 0.1) . The mean AUC for the calcium salt mixture was 16.94 mg X h/l (SD 3.31) and for the potassium salt 15.84 mg X h/l (SD 4.76), p less than 0.09 . These findings confirm that an aqueous mixture of calcium phenoxymethylpenicillin is equivalent to a mixture of potassium phenoxymethylpenicillin. J Int Med Res, 1982, 10(1), 42 - 5 Single oral dose rosoxacin in the treatment of gonorrhoea in males; Limson BM et al.; A study of the new anti-bacterial agent, rosoxacin, a quinoline derivative was made in male subjects with uncomplicated acute gonorrhoea using a single oral dose of 200 mg and a single dose of 300 mg . Of the eight patients who received a single dose of 200 mg, post-treatment urethral smears and cultures for N . gonorrhoeae were positive in all and these subjects were considered as treatment failures . In contrast, a single dose of 300 mg was highly effective as all twenty-four who received this dose were cured as judged by negative urethral smears and cultures on the 7th post-treatment day . Of the thirty-eight isolates of M . gonorrhoeae obtained in the study, fifteen (39.5%) were penicillinase-producing, indicating that rosoxacin is effective in treating penicillin-resistant gonorrhoea . Mild to moderate dizziness and/or drowsiness was experienced by four of twenty-nine patients evaluated for safety on the 300 mg single dose, giving an incidence of side-effects of 14% . The symptoms were of brief duration and were self-limiting . A single oral dose of this drug appears to be an ideal treatment for the rapid cure of acute gonorrhoea. Vet Med Nauki, 1982, 19(5), 85 - 94 {Clinico-pharmacological trial of the preparation streptobicillin depot-syringae mammariae}; Tsolov S et al.; Streptobicillin depot-syringae mammariae contains: benzathin-penicillin--1,200,000 UI, streptomycin sulfa--1,000,000 UI, vitamin A oleosum--15,000 UI in a suitable base up to 10 ml . It is intended for the therapy and prophylaxis of inapparent mastitis of cows during the dry period . The preparation was tested in a total of 301 udder quarts of cows in terms of tolerance (general and local), depot effect, residual amounts, bactericidic effect, and therapeutic effect . The preparation was found to be well tolerated by the body and the parenchyma of the udder . The duration of its effect was 25 days . No residual amounts were found in the milk during the following lactation . The bactericidic effect in vitro reached 92.4 per cent, and in vivo--87.3 per cent of the cases . Positive therapeutic effect was found in 87.1 per cent of the cases, with subclinical mastitis it being 80.2 per cent, with latent infections--96.2 per cent, with secretion disturbances--94.3 per cent . Results revealed that the preparation was suitable to control inapparent mastitis in cows during the dry period. Folia Microbiol (Praha), 1982, 27(6), 370 - 6 DNA synthesis in Escherichia coli B/r after UV-irradiation; Kucerova H et al.; When studying the kinetics of DNA synthesis, growth and cell division in Escherichia coli B/r after irradiation with different doses of UV-radiation (254 nm) we could demonstrate, by means of pulse incorporation of 3H-thymidine, a lag in DNA synthesis after the irradiation . The relative rate of the restored DNA synthesis (related to the number of viable cells) was higher than in the non-irradiated culture . After 3 h the rate of DNA synthesis settled at a constant value, which was identical with the control rate up to the "critical dose" of 20 J/m2 . The irradiated cell population is heterogenous and contains basically two categories of cells--surviving and non-surviving . Cells of both types contribute to DNA synthesis restored after the lag period to a different extent . During the first hour after the irradiation even the nonviable portion of the population, i.e . cells that do not form colonies but are still penicillin-sensitive, is involved in the DNA synthesis. Exp Brain Res, 1982, 47(1), 154 - 7 Effect of sodium ions on penicillin-induced epileptiform activity in vitro; Hablitz JJ et al.; Intra- and extracellular recordings were obtained from the CA1 region of guinea pig hippocampal slices maintained in vitro . We studied the effect of reducing the extracellular sodium concentration on penicillin-induced epileptiform responses . In control experiments, Tris and choline were assayed as sodium substitutes . Choline was found unsuitable, since it induced repetitive firing in the absence of any convulsant agent . Replacement of 50% of the extracellular sodium ( {Na+}o) with Tris reduced the amplitude of the presynaptic fiber volley, the field EPSP, and the population spike . Intracellular studies showed that when {Na+}o was lowered, action-potential amplitudes were reversibly depressed by an amount close to that predicted by the Nernst relation . Orthodromically elicited epileptiform discharges, induced by penicillin, were reduced in a low-sodium medium when constant stimulus currents were employed . If orthodromic stimulus strengths in normal and low-sodium states were equated on the basis of the field-EPSP amplitude, no significant diminution of the depolarizing-wave component of the epileptiform response was observed . These results suggest that a synaptic component underlies penicillin-induced epileptiform discharges. Intensive Care Med, 1982 Jan, 8(1), 33 - 8 Cefotaxime in treatment of meningitis and ventriculitis? Evaluation of drug concentrations in human cerebrospinal fluid; Bruckner O et al.; In three groups of patients levels of cefotaxime in serumand cerebrospinal fluid were determined . Therapeutic value and efficacy are discussed in meningitis patients . Nine concentrations of cefotaxime in lumbar and ventricular CSF out of 19 in a group of seven neurosurgical patients with mild to moderate impairment of the blood-CSF-barrier were higher than 0.5 micrograms/ml . In seven determinations in a second group of six patients with no or very little dysfunction of the blood-cerebrospinal-fluid barrier only twice cefotaxime was not detectable in lumbar CSF . Concentrations of cefotaxime in 25 determinations of lumbar or ventricular CSF in six patients with bacterial meningitis ranged from 1.1 micrograms/ml to 19.2 micrograms/ml . Treatment with cefotaxime alone was successful in a patient with E . coli meningitis and ventriculitis after infection of a ventriculo-atrial shunt and in another patient with pneumococcal meningitis and penicillin allergy . The other four patients with bacterial meningitis were treated successfully by antibiotics including cefotaxime. Infection, 1982, 10 Suppl 3, S221 - 6 {Studies with azlocillin, mezlocillin, penicillin-g-potassium and sisomicin on tolerance in the cornea and the kinetics of inhibiting concentrations in the cornea and aqueous humor in rabbits}; Gauri KK et al.; We studied the effect of azlocillin, mezlocillin and sisomicin in concentrations of 1, 2.5 and 5% on the regeneration of stromal corneal wounds in rabbits following subconjunctival injections and treatment with eye drops . Concentrations of the antibiotics were also determined in corneal tissue and in aqueous humor and compared with that of penicillin G-potassium . Together with azlocillin, sisomicin proved to be the most effective and the safest . Mezlocillin only inhibited wound regeneration slightly and thus mezlocillin appears to be inferior to the other two antibiotics investigated in the local treatment of the eye. Infection, 1982, 10 Suppl 3, S172 - 5 Mezlocillin in the treatment of gonorrhea; Kataniwa Y et al.; Mezlocillin (2 g) was administered by a single intravenous injection to 32 male patients with gonorrheal urethritis and to five female patients with gonorrheal cervicitis, none of whom had received any pre-treatment or had had any complications . The results of the treatment were "good" in 32 cases (86.5%), "fair" in three (8.1%) and "poor" in two patients (5.4%) . One of the two "poor" cases showed no sensitivity to any penicillin derivative . Nausea during injection was observed twice, but the patients recovered immediately after the injection. Infection, 1982, 10 Suppl 3, S158 - 65 {Mezlocillin in neonatal medicine}; Sitka U et al.; The acylureido penicillin mezlocillin was tested clinically and pharmacologically in neonates and young infants who received the antibiotic for prophylactic and therapeutic reasons . On the basis of blood level determinations following the administration of various dosages, we consider a dose of 200 mg/kg per day necessary for premature babies and 300-400 mg/kg per day for full-term babies . Pharmacokinetic data showed age-dependent features . The clinical results were good in 40 children treated with mezlocillin . Twenty of these children received a combination of mezlocillin and gentamicin . No child died of an infection . Therapy was not successful in three babies suffering from productive bronchopulmonary infections . Important side-effects were not observed. Curr Med Res Opin, 1982, 8(4), 247 - 52 A controlled study of mezlocillin in uncomplicated acute gonorrhoea; Khan MH et al.; In a randomized trial, 149 patients with uncomplicated gonorrhoea were treated with a single intramuscular dose of 1.0 g mezlocillin, 150 with 2.0 g ampicillin plus 1.0 g probenecid orally and 150 with a single dose of 1.8 mega units of procaine penicillin . Cure rates at 3, 10 and 17 days after treatment were 97%, 99% and 96% for mezlocillin, 95%, 99% and 95% for ampicillin, and 97%, 98% and 98% for procaine penicillin, respectively . The incidence of post-gonococcal urethritis was 11.3% for ampicillin plus probenecid, 10.9% for procaine penicillin and 10.5% for mezlocillin . Side-effects after all three regimens were minimal. Physiol Bohemoslov, 1982, 31(3), 203 - 12 Penicillin activates spontaneous motility in chick embryos; Sedlacek J; The development of the motor reaction to i.v . injection of the sodium salt of penicillin G in a dose of 0.9 x 10(6) I.U./kg egg weight was studied in chick embryos (normal and spinal) from the 11th to the 19th day of incubation . Penicillin first caused standard activation of embryonal motility from the 15th day of incubation, in both normal and spinal embryos . Activation was at first continuous in character (a twofold increase in the frequency of spontaneous movements) . In 17- and particularly in 19-day embryos a typical paroxysmal reaction developed, with pronounced intervals of motor rest . The proportion of the spinal component in the penicillin reaction was abut 40% and of the supraspinal component about 60% of total motor activity . In older embryos (after the 15th day of incubation), the motor reaction to penicillin could be effectively modified by the systemic administration of glycine and GABA . It is concluded from the results that penicillin does not activate embryonal motor activity until a given stage of development of the CNS has been attained . It is a developmental phenomenon with a spinal and a supraspinal component, in which central inhibitory mechanisms participate. Dtsch Z Verdau Stoffwechselkr, 1982, 42(2-3), 85 - 93 {Cholestatic jaundice induced by D-penicillamine and oral steroid contraceptive in progressive systemic sclerosis (author's transl)}; Wozel G et al.; PIP: A 25 year old woman with progressive systemic sclerosis was treated with D-penicillamine (DPA) . 30 days after the initiation of therapy, cholestatic jaundice was observed . Moreover, for 2 years, the patient has taken the pill . Both drugs were discontinued, the jaundice disappeared, and the laboratory findings of the liver were normal . A rechallenge of DPA after 9 months induced no reaction . An underlying chronic liver disease before cholestasis could be excluded by liver biopsy . Allergic cutantests and lymphocyte transformation test with DPA and penicillin gave normal results . The frequency of cholestatic jaundice caused by DPA therapy is discussed and the possible pathomechanism is analyzed . (author's modified) Int Arch Allergy Appl Immunol, 1982, 68(4), 352 - 7 Development and use of three new radioallergosorbent tests in the diagnosis of penicillin allergy; Edwards RG et al.; The synthesis and characterisation of three novel reagents for use in the radioallergosorbent test (RAST) for the diagnosis of penicillin allergy are described . The antigenic determinants involved are the benzyl penicillanyl, thiol-linked benzyl penicillenate and thiol-linked penicillamine . These reagents, and also one specific for the benzyl penicilloyl group, have been used to evaluate the sea of subjects suspected of suffering from penicillin allergy and to explore the aetiology of the respiratory dyspnoea experienced by some workers exposed to penicillin-containing dusts . The use of these reagents, while confirming the importance of the penicilloyl or major determinant of penicillin allergy, has shown that there is heterogeneity in the IgE response of penicillin-allergic patients and some patients have IgE antibody specific for one or more of the new determinants only . These reagents will, therefore, increase diagnostic capabilities . Their use has also confirmed that the disorder induced by occupational exposure to penicillins is not primarily mediated by IgE antibody specific for allergenic determinants represented by any of the available reagents. Electroencephalogr Clin Neurophysiol, 1982 Jan, 53(1), 1 - 13 Laminar analysis of spindles and of spikes of the spike and wave discharge of feline generalized penicillin epilepsy; Kostopoulos G et al.; Intracortical laminar profiles of spindles and spikes of spike and wave complexes in feline generalized penicillin epilepsy were studied using two methods: (i) sequential microelectrode recordings at various cortical depths, and simultaneous recordings at multiple cortical depths using a fine multi-contact electrode . Raw EEG data and EEG epochs averaged with respect to peaks of surface EEG waves were analyzed . Spindles and the spikes of the spike and wave complexes showed similar laminar profiles . This supports the hypothesis that the two are basically the same cortical electrophysiological phenomenon, the spike being a spindle wave enhanced and slightly altered because of the penicillin-induced increased cortical excitability . The latter causes the weight of the thalamic input to shift from superficial to more deep lying synapses . Both surface negative and surface positive phases of spindles and of spikes of spike and wave complexes show similar laminar profiles, those of the former suggesting activation of excitatory synapses in the superficial cortical layers, those of the latter suggesting activation of more deeply located excitatory synapses . The profiles generally conform to the dipole hypothesis of cortical electrogenesis and suggest that spindles and spikes of spike and wave complexes are generated by the same pyramidal neurons, probably through activation of the same sets of synapses . Some inconstant and relatively minor deviations of the laminar profiles from the pattern predicted by the dipole theory of cortical electrogenesis were encountered and are tentatively explained in the light of some of the complexities of the microanatomical organization of mammalian neocortex. Neuroscience, 1982, 7(8), 1955 - 61 Neuronal responses to putative neurotransmitters during penicillin epileptogenesis; Avoli M et al.; An epileptogenic process was induced within the rat frontoparietal cortex by microiontophoretic applications of penicillin . The temporal development of the penicillin-induced activity was divided into (a) a first phase characterized by an increased rate of neuronal firing, (b) a pre-paroxysmal phase wherein neurons began to fire clusters of action potentials and (c) a paroxysmal phase characterized by a discharge of action potential clusters . The excitatory responses to glutamate and to acetylcholine appeared to be enhanced during the first and pre-paroxysmal phases, whereas a loss of the excitatory effectiveness of both glutamate and acetylcholine occurred during the final paroxysmal phase . Forty nine of 69 neurons studied (71%) showed a decreased sensitivity to gamma-aminobutyrate during the first phase of penicillin iontophoresis . However, during this same time, glycine-induced inhibition was not decreased . During the second phase, gamma-aminobutyrate-induced inhibition was even less effective, and glycine started to lose effectiveness . During the third phase, both these inhibitory neurotransmitters failed to affect the neuronal activity . The other 29% of the neurons studied showed a general diminution to the actions of both gamma-aminobutyrate and glycine when penicillin-induced action potential clusters appeared . Our results suggest that penicillin interferes with gamma-aminobutyrate-mediated inhibition in a large proportion of cortical neurons of the rat . Furthermore, these cortical neurons show changes in the responses to both excitatory and inhibitory neurotransmitters that closely parallel the development of penicillin-induced activity. Biochim Biophys Acta, 1981 Dec 29, 671(2), 109 - 16 Studies on the primary structures of the exocellular D-alanyl-D-alanine peptidases of Streptomyces strain R61 and Actinomadura strain R39; Duez C et al.; The Mr 37 000 D-alanyl-D-alanine peptidase excreted by Streptomyces R61 and the Mr 53 000 D-alanyl-D-alanine peptidase excreted by Actinomadura R39 are both characterized by a very uneven distribution of the basic (Arg + Lys) amino acid residues . Trypsin degradation of the heat-denatured enzymes generates (1) thirteen soluble peptides which contain from 2 to 28 residues in the case of the R61 enzyme and nineteen soluble peptides which contain 2 to 39 residues in the case of the R39 enzyme; and (2) three large segments or core peptides which, irrespective of the enzymes from which they originate, consist of 50-60, 70-80 and 110-120 residues . About 90% of the basic (Arg + Lys) amino acid residues are recovered in the soluble tryptic peptides . The core peptides represent 62% (Mr approximately 23 000) and 45% (Mr approximately 24 000) of the untreated R61 and R39 enzymes, respectively . One 28-residue soluble peptide isolated from the R61 enzyme represents the N-terminal portion of the protein whose sequence has been established . The penicillin attachment site of the R61 enzyme has been located in one of the core peptides . For the R39 enzyme, indirect evidence shows that the penicillin binding site is probably within one of the soluble peptides. JAMA, 1981 Dec 4, 246(22), 2583 - 4 Cerebrospinal fluid penicillin levels during therapy for latent syphilis; Ducas J et al.; Cerebrospinal fluid and serum penicillin levels were determined in patients with latent syphilis . Mean serum concentration one week after the third weekly dose of 2.4 million units penicillin G benzathine was 0.32 units/mL . Concurrent administration of probenecid orally produced a mean serum penicillin level of 0.41 units/mL . Doubled penicillin doses without and with daily orally administered probenecid resulted in mean serum concentrations of 0.75 and 1.00 units/mL, respectively . Two of six patients in the last group had CSF penicillin concentrations greater than 0.03 units/mL. Rev Electroencephalogr Neurophysiol Clin, 1981 Dec, 11(3-4), 317 - 23 {Transcortical reflexes of proprioceptive origin and motor epilepsy (author's transl)}; Gioanni Y et al.; The long-loop reflex involved in the triggering of paroxysmal activities by proprioceptive afferents is examined in monkeys with a chronic alumina focus and in cats with an acute penicillin focus . Electrical stimulation of a tibial nerve in monkeys as well as muscle stretch in cats elicit a cortical 'evoked spike', i.e., an evoked potential followed by an epileptic spike, accompanied by one or two motor bursts in the muscles concerned . With a very small acute focus, this transcortical reflex is shown to be quite topical: muscles in the vicinity are not affected . Relationships between evoked spike and myoclonic jerk are examined and it is shown that motor efferents usually follow the pyramidal tract . The concept of a transcortical reflex of proprioceptive origin is discussed on the basis of data collected from these models. Infect Immun, 1981 Dec, 34(3), 930 - 7 Effects of metabolic inhibitors on extracellular fructosyltransferase production in Actinomyces viscosus; Chak W et al.; Extracellular fructosyltransferase (levansucrase; EC 2.4.1.10) production in Actinomyces viscosus T14AV was demonstrated to occur concomitantly with cellular growth . The inhibition of both cellular ribonucleic acid and protein synthesis resulted in no further accumulation of enzyme activity . The antibiotic sodium clofibrate differentially inhibited the production of fructosyltransferase by strain T14AV . Furthermore, the antibiotic preferentially inhibited {14C}acetate incorporation into cellular lipid, but did not affect protein synthesis . In addition, no inhibition of fructosyltransferase production was observed upon the addition of the fatty acid acid synthesis inhibitor cerulenin . On the other hand, extracellular fructosyltransferase production was apparently stimulated in the presence of the cell wall synthesis inhibitors penicillin, amphomycin, and tunicamycin . These results are discussed in terms of the mechanism of extracellular protein production in A . viscosus. Clin Obstet Gynecol, 1981 Dec, 24(4), 1187 - 97 Medical and surgical management of the pelvic abscess; Benigno BB; PIP: A pelvic abscess is the end stage in the progression of a genital tract infection and is frequently preventable . The abscess may fill the pelvis and occasionally the lower abdomen, and is usually posterior to the uterus and bound by the sigmoid colon, loops of small bowel, cul-de-sac, and sidewalls of the pelvis . A tubo-ovarian abscess may occur in the acute stage of pelvic inflammatory disease (PID) but is more common with chronic or subacute PID . An abscess occurs when pus from the fallopian tube spills onto the ovary and infects it at the site of follicular rupture or by direct penetration . Pelvic and abdominal pain which is bilateral and aggravated by motion and intercourse, and fever possibly exceeding 103 degrees fahrenheit with leucocytosis, tachycardia, and prostration are the most common symptoms of pelvic abscess . The pelvic examination may reveal all gradations of pathology, but because of the degree of guarding and tenderness it elicits, the abscess may elude the examiner . The rectal examination, computerized tomography, and ultrasonography are useful in diagnosis . Other disorders such as acute appendicitis and ecoptic pregnancy may be mistaken for abscess . Patients with pelvic abscesses should be immediately admitted to hospital regardless of the size of the abscess because the broad-spectrum anerobic antibiotic coverage needed is most effectively provided there . Preservation of normal tubal function is rarely possible in patients developing tubal abscesses . Bed rest, fluid and electrolyte replacement, nasogastric suction when indicated, and antibiotics are the basis of medical treatment . Controversy exists regarding appropriate antibiotic therapy, but the probable presence of anaerobic organisms should be kept in mind . Patients with pelvic abscesses are frequently given a triple antibiotic regimen including clindamycin, gentamicin, and aqueous penicillin . Guidelines for the failure of medical management in patients with a pelvic abscess include persistent fever, increase in size of abscess, persistent ileus, suspicion of rupture, septic shock, and uncertainty of the diagnosis . A posterior colpotomy is preferable to a laparotomy if surgical treatment is necessary, but it is only suitable for selected patients . Removal of a pelvic abscess frequently involves a total abdominal hysterectomy . Operating instructions and diagrams are included . Rupture of a pelvic abscess is life threatening and requires immediate surgery . Zh Mikrobiol Epidemiol Immunobiol, 1981 Dec, (12), 36 - 9 {Comparative study of the behavior of capsular and noncapsular pneumococcus variants in the L929 cell culture}; Gotvianskaia TP et al.; The comparative study of the behavior of the capsular and noncapsular variants of pneumococci, serotype 27, in culture L929 revealed that under the conditions of the experiment both variants showed the same capacity for adhesion, but the capsular variant had a stronger cytopathic effect which was retained after subculturing the infective material in the cell culture . The possibility of isolating the noncapsular variant of pneumococci from culture L929 on a solid nutrient medium lasted only 9 hours, while the capsular variant could be isolated during the whole experiment . The noncapsular variant showed greater sensitivity to the action of penicillin and more pronounced capacity for L-transformation in vitro than the capsular one. Pediatr Res, 1981 Dec, 15(12), 1533 - 7 Chronic granulomatous disease: mode of action of sulfamethoxazole/trimethoprim; Gmunder FK et al.; Four possible modes of action for the clinically observed effectiveness of sulfamethoxazole/trimethoprim in chronic granulomatous disease were evaluated: (1) inhibition of bacterial catalase, (2) improvement of granulocyte oxygen metabolism, (3) synergism of the antibiotic with nonoxygen-dependent granulocyte killing mechanisms, and (4) a purely antibiotic effect based on uptake and concentration of the antibiotic by and within granulocytes . While the first three mechanisms were excluded, the fourth mechanism is highly probable; sulfamethoxazole was found to reach granulocyte associated concentrations 1.7-fold and trimethoprim 4.1-fold of extracellular levels . Penicillin G, a known nonpenetrating antibiotic, reached 0.3-fold, and tetracycline, a known penetrating agent, 7.1-fold the extracellular level . These findings indicate that sulfamethoxazole/trimethoprim is an antibiotic combination uniquely suited for the long-term prophylaxis of infections in patients with defects of intracellular phagocyte killing. Antibiotiki, 1981 Dec, 26(12), 920 - 32 {E . coli penicillin amidase . Methods for estimating the close ionization constants of ionogenic groups of the enzyme complex with substrates containing free amino groups}; Nys PS et al.; The possible use of various procedures for estimation of the ionization constants of the Michaelis complex by the pH dependence of the maximum enzymatic reaction rate is discussed . It is shown that the procedures described in the literature for estimation of the close ionization constants of the enzyme-substrate complexes have limitations and in some cases cannot be used . The paper presents the methods for estimation of the constants and means for quantitative description of the bell-shaped pH dependence of the kinetic and equilibrium parameters of the biocatalytic reaction . The equations recommended in the paper were used in analysis of the pH dependences of the maximum rate of the reactions during the enzymatic synthesis of cefalexin catalysed with immobilized penicillinamidase (IPA) (CE 3.5 . 1.11) . The ionization constants of the enzyme-substrate complexes of IPA were compared during hydrolysis and synthesis of the compounds acylated with phenylacetic and aminophenylacetic acids . The effect of the nature of the leaving substrate group and added nucleophilic gent on the electrochemical state of the Michaelis complex is discussed. Br J Vener Dis, 1981 Dec, 57(6), 357 - 62 Sexually transmitted diseases in Ethiopia . Social factors contributing to their spread and implications for developing countries; Plorde DS; PIP: The high prevalence of all types of sexually transmitted diseases (STD) in Ethiopia, estimated in various field studies at 32-70%, led to analysis of the economic and psychosocial factors influencing the spread of these diseases . These factors were examined primarily in relation to the Amhara people, who comprise 30% of the Ethiopian population and live in the central highlands . Increases in migration and urbanization associated with the struggle toward economic development have weakened family and community relationships and encouraged sexual promiscuity, leading to an increase in STD incidence . The disruptive effects of sudden land nationalization caused many farmers to leave the land, forcing their wives to seek employment, which puts them at high risk of contracting the spreading STD . Moreover, there are far more women than men in the roadside and market villages, and STD are spread when men travel through or bring goods to market . Most marriages among the Amhara are temporary, with dissolution obtainable by mutual agreement . This custom provides women with opportunities for numerous transient sexual liaisons . Because of the limited employment opportunities available to women in Ethiopia, many select beer selling and prostitution as a way to earn an income . Thus, changes in the social structure, particularly in relation to the status of women, are contributing to the spread of STD . In general, neither health professionals nor the general population in Ethiopia understand the transmission process of STD, the serious nature of the problem, or how these diseases should be treated . Most treatment is provided by relatively untrained "dressers." Laboratory tests are often not performed, and penicillin is administered indiscriminately . Longterm solution of the STD problem requires Ethiopia to: 1) join other African countries in establishing data on census and disease prevalence to assess the extent of the problem, 2) increase the availability of good health services and the number of trained personnel, 3) adopt an appropriate health education strategy, and 4) change the status of women by increasing their educational and occupational opportunities . As a 1st step, a committee has been appointed to devise a plan to eliminate prostitution . J Immunol, 1981 Dec, 127(6), 2410 - 4 The transition from specific to nonspecific desensitization in human basophils; MacGlashan DW Jr et al.; Human basophils can be desensitized to IgE-mediated stimuli either specifically (to the desensitizing antigen only) or nonspecifically (to all antigens) . It has been suggested that the specificity of desensitization depends on the number of membrane-bound, antigen-specific IgE antibody molecules per basophil . We have varied the number of IgE antibody molecules/basophil by passive sensitization of mixed leukocyte preparations with increasing concentrations of purified IgE anti-penicillin (BPO) antibody . The cells were then desensitized with penicillin-human serum albumin (BPO-HSA) . Desensitization was specific (lack of response to BPO-HSA only) with 1000 specific antibody molecules/basophil, and increasingly nonspecific (greater than 70% desensitization to rechallenge with anti-IgE and ragweed antigen E as well as lack of response to BPO-HSA) as the number of antibody molecules was increased to 14,000 . This formally established that the number of specific IgE antibody molecules/basophil determines the mode of desensitization. Dtsch Med Wochenschr, 1981 Nov 13, 106(46), 1541 - 4 {Arterial vascular occlusion in penicillin allergy (author's transl)}; Martin M et al.; A nodular exanthema of the skin was observed in an 8-year-old girl . She had been treated with penicillin a few days ago because of a gastrointestinal infection . Continuation of penicillin treatment led to occlusion of larger arteries with gangrene of the forefoot . This was accompanied by septic temperatures and superinfected skin lesions . Angiologic and angiographic investigations showed a right-sided femoro-popliteal occlusion and occlusions of the arteries of the lower leg . On the left side there was spasm of the superficial femoral artery . After cessation of penicillin and high-dose steroid therapy rapid restitution occurred . Arterial spasms regressed, the occlusions remained persistent, but there was adequate collateral blood supply and ischaemic acral necroses healed . An allergic reaction of the intermediary type involving major arteries can be considered causative underlying pathology. Med Klin, 1981 Nov 6, 76(23), 653 - 5 {Rat bite disease with meningoencephalitic involvement}; Kiefer H et al.; Reported is the case of a 32 years old man, who developed a severe condition with recurrent fever episodes, lymphadenopathy, liver and spleen enlargement, and severe headaches 6 weeks after having been bitten by a rat . The headaches even increased during the further course . Psychological tests indicated an increased instability and irritability . The brain scan revealed diffuse cerebral ischemias (on the basis of an increased cerebrovascular resistance) . Following the treatment with penicillin, the symptoms cleared almost completely . Although the pathogenic organism could not be identified, the findings and the clinical course of the disease indicate the presence of sodoku with meningoencephalopathic involvement. J Am Vet Med Assoc, 1981 Nov 1, 179(9), 896 - 8 Malignant hyperthermia in a halothane-anesthetized horse; Waldron-Mease E et al.; Malignant hyperthermia developed in a 4-year-old Thoroughbred horse following 3 hours and 15 minutes of halothane anesthesia, with supplementary succinylcholine . Clinical signs included fever, sweating, hyperventilation, tachycardia, and decreased blood pressure followed by a rapid increase in blood pressure . Biochemical aberrations included hypocalcemia, hyperkalemia, hyperphosphatemia, myoglobinuria, and high creatine phosphokinase and ornithine carbamyl transferase activities . Treatment consisted initially of surface cooling with cold water, alcohol and ice, IV administration of cooled balanced electrolyte solutions and sodium bicarbonate, and removal from the anesthetic and rebreathing circuit . Oxygen was given by endotracheal insufflation . The rectum was then packed with ice, the horse was moved to a recovery raft and pool, and his body was packed in ice . Xylazine and dantrolene were given during recovery from anesthesia . Following recovery, treatment consisted of administration of balanced electrolyte solutions, calcium borogluconate, potassium penicillin, meperidine, and additional dantrolene . Muscle biopsy demonstrated exaggerated contracture responses to halothane and caffeine, confirming a diagnosis of malignant hyperthermia . The horse was returned to training following a routine postsurgical convalescent period. Ann Emerg Med, 1981 Nov, 10(11), 593 - 5 Acute necrotizing ulcerative tonsillitis and gingivitis (Vincent's infections); Kaplan D; The cases of two patients with acute necrotizing ulcerative infections are reported . One had involvement of the tonsil and the other, of the gingivae . In both cases a Gram stain revealed abundant fusiform rods and spirochetes . Both patients responded to treatment with oral penicillin, showing improvement and/or healing in three to six days . These two cases demonstrate the usefulness of the Gram stain in supporting a diagnosis which would otherwise rest solely on clinical grounds. Res Vet Sci, 1981 Nov, 31(3), 281 - 3 Effect of repeated biopsy sampling on endometrial concentrations of sodium benzylpenicillin following intramuscular injection in pony mares; Allen WE et al.; Endometrial concentrations of sodium benzylpenicillin were determined in biopsy samples from anoestrous pony mares after intramuscular administration of the penicillin at 22,000 iu/kg . Serum samples, collected at the same time as biopsies, were also assayed for their penicillin content . In experiment 1 a single pair of blood and tissue samples was taken from each mare between five and 360 minutes after injection . In experiment 2 each mare was sampled consecutively six times (between five and 300 minutes) after injection . Both serum and endometrial concentration reached a peak between 15 and 30 minutes after injection . Tissue concentrations were lower than serum, except after 180 minutes in experiment 2 . This suggests that at the time intervals used in the present study, serial biopsies eventually caused an increase in the endometrial content of penicillin. Med J Zambia, 1981 Nov-1982 Jan, 16(1), 11 - 3 Abdominal actinomycosis; Elem B et al.; Four cases of abdominal actinomycosis managed during a two year period at Ndola Central Hospital are reported with a review of relevant literature . Difficulties associated in diagnosing this form of the disease are stressed . It is suggested that a limited form of surgery in combination with parenteral penicillin therapy is usually effective in the management of abdominal actinomycosis. Med J Zambia, 1981 Nov-1982 Jan, 16(1), 11 - 3 Abdominal actinomycosis; Elem B et al.; Four cases of abdominal actinomycosis managed during a two year period at Ndola Central Hospital are reported with a review of relevant literature . Difficulties associated in diagnosing this form of the disease are stressed . It is suggested that a limited form of surgery in combination with parentral penicillin therapy is usually effective in the management of abdominal actinomycosis. Rev Infect Dis, 1981 Nov-Dec, 3 suppl, S289 - 92 Vancomycin for treatment of bacterial meningitis; Gump DW; Clinical experience with vancomycin for the treatment of bacterial meningitis has not been extensive . Presently available data indicate that when meningeal inflammation is present intravenously administered vancomycin penetrates into cerebrospinal fluid and therapeutically effective levels of drug therein are frequently attained . Treatment of meningitis with vancomycin has been effective in clinical situations that precluded the use of the commonly administered agents, i.e., in infections due to resistant strains or to unusual organisms, in patients allergic to penicillin, and in patients for whom therapy with a first-choice antibiotic has failed . When response to intravenously administered vancomycin was unsatisfactory, the addition of intrathecal therapy resulted in a favorable outcome in some patients . Combination therapy with agents that act synergistically with vancomycin has been beneficial . Vancomycin warrants serious consideration as a useful alternate antibiotic for the treatment of bacterial meningitis. Otolaryngol Head Neck Surg, 1981 Nov-Dec, 89(6), 910 - 11 Peritonsillar abscess: needle aspiration; Herzon FS et al.; Needle aspiration and antibiotics (usually penicillin) were used as the sole initial treatment of peritonsillar abscess in 29 patients over a 2 1/2-year period . Positive aspirations occurred in 23 patients, 19 (82%) of whom had complete resolution of their abscesses without further initial therapy . The implications of these findings are discussed. Antimicrob Agents Chemother, 1981 Nov, 20(5), 693 - 5 Comparative efficacy of piperacillin and penicillin G in treatment of gonococcal urethritis; Landis SJ et al.; The comparative efficacy of 2 g of piperacillin and 4.8 X 10(6) U of penicillin G in the treatment of uncomplicated gonococcal urethritis was assessed in a randomized prospective study . Sixty-five evaluable patients received piperacillin, and 55 received penicillin G . All patients received either therapy were cured of gonorrhea . We conclude that piperacillin is as efficacious as aqueous procaine penicillin G in the therapy of uncomplicated gonococcal urethritis. Antimicrob Agents Chemother, 1981 Nov, 20(5), 613 - 9 Penetration of moxalactam into its target proteins in Escherichia coli K-12: comparison of a highly moxalactam resistant mutant with its parent strain; Komatsu Y et al.; An eschericia coli K-12 mutant highly resistant to moxalactam but only slightly resistant to other beta-lactam antibiotics was obtained by mutagen treatment . The affinity of moxalactam for its target penicillin-binding proteins was unchanged, as was the level of beta-lactamase activity . The penetration of {14C} moxalactam, however, was markedly reduced in the mutant . Electrophoretic analysis revealed alterations of the outer membrane proteins . A reduction in the amount of one of the pore-forming proteins (porins) was especially noteworthy . These data suggest that moxalactam resistance is the result of an alteration in the outer membrane structure. Clin Pharmacokinet, 1981 Nov-Dec, 6(6), 475 - 9 Mecillinam in cerebrospinal fluid in children; Garborg O; The penetration of mecillinam, a new beta-lactam penicillin-like antibiotic, into cerebrospinal fluid (CSF) was investigated in 11 children in whom all but 1 was presumed to have non-inflamed meninges . 30 minutes after a single intravenous dose of 30mg/kg, a concentration of approximately 0.30 micrograms/ml was achieved in the CSF (corresponding mean serum concentration 75 micrograms/ml), and this level was maintained during the next 4 hours in spite of rapidly declining serum concentrations, indicating a slow equilibration of mecillinam over the blood-liquor barrier . 1 child with suspected inflamed meninges showed a much higher CSF level of 12.1 micrograms/ml . It is concluded that mecillinam, as is the case for other penicillins, apparently crosses non-inflamed meninges poorly. Clin Allergy, 1981 Nov, 11(6), 579 - 87 Radioallergosorbent test with conjugates specific for 'minor' haptenic determinants in the diagnosis of IgE-mediated penicillin allergy in man; Kraft D et al.; Penicillamine-polylysine, benzylpenicillanyl-human serum albumin and ampicillin-polymers were coupled to CNBr-activated paper discs and used in addition to penicilloyl G and penicilloyl V discs in RAST investigations . Sera from sixty patients with case histories of penicillin allergy and with positive or negative skin tests to different penicillin determinants and from seventeen subjects with atopic diseases caused by allergens other than penicillin were tested . The penicilloyl-('major' determinant) specific RAST (Phadebas RAST Penicilloyl G and V) was positive in twenty out of twenty-four patients with positive skin tests to penicilloyl-polylysine, in eight out of twelve patients with sole skin reactivity to 'minor' determinants, and in five out of twenty-four patients with negative skin tests to all antigens used . The penicillamine-specific RAST was the only positive in vitro test in four patients with negative skin tests (two) or sole positive skin reactivity to 'minor' determinants (two), whereas benzylpenicillanyl and ampicillin-polymer discs added no more information than the penicilloyl structures in all patients tested . Antibodies specific to 'minor' determinants apparently show strong in vitro cross-reactivity with the penicilloyl determinant . It is, therefore, concluded that 'minor' determinant specific conjugates are of marginal importance for in vitro diagnosis of penicillin-allergic patients. Can J Ophthalmol, 1981 Oct, 16(4), 187 - 91 Enhancement and inhibition of phagocytic activity in the retinal pigment epithelium; Markowitz S et al.; The phagocytic activity of the pigmented epithelium of the bovine retina was studied with an organ culture model . Latex particles coated with immunoglobulin, or bovine rod outer segments, both labelled with radioactive iodine, were the objects to be phagocytosed . Various agents were tested with this model for their effects on phagocytosis by the retinal pigment epithelium . Iodoacetate significantly inhibited phagocytosis, as did penicillin, though to a lesser extent . Concanavalin A and gentamicin enhanced phagocytosis . Dimethyl sulfoxide had no effect . The results with lymphokines were not conclusive. Sex Transm Dis, 1981 Oct-Dec, 8(4), 266 - 79 A survey of 251 patients with acute syphilis treated in the collaborative penicillin study of 1943-1950; Kampmeier RH et al.; The dramatic and apparently curative effect of penicillin for the treatment of acute syphilis led to follow-up studies for only comparatively brief periods, and the acceptance of the long-term benefit of penicillin has rested on uncontrolled clinical impressions . More certainty about the efficacy of penicillin was sought by a follow-up review of 251 patients treated between March 1944 and December 1950 under the Penicillin Study of the Office of Scientific Research and Development (OSRD) and continued under U . S . Public Health Service after World War II . Eighty-eight patients were interviewed and examined . Telephone conversation or correspondence was had with 43 subjects; an additional nine are known to be living but did not respond to letters . Thirty-two patients died greater than or equal to 20 years after treatment, and 21 patients died within less than 20 years of treatment . Fifty-eight patients could not be found . Treatment failures were documented . Syphilis was not shown to be the cause of disability or death, except for a patient with meningovascular syphilis who died soon after initial treatment . Disabilities recorded and deaths documented revealed only diseases common to any middle-aged population . The outcomes of 17 pregnancies of women treated for acute syphilis were documented . Blood samples obtained from the 88 subjects examined were tested at the Center for Disease Control (Atlanta, Ga.); the results are recorded and discussed . Methods for locating the patients are described, and the psychosocial findings for the 88 patients interviewed are presented . The study has confirmed the clinical impressions of the therapeutic effectiveness of penicillin, which have been accepted for greater than 30 years. Acta Physiol Scand, 1981 Oct, 113(2), 245 - 52 Synaptic triggering of epileptiform discharges in Ca2 pyramidal cells in vitro; Gjerstad L et al.; Intra- and extracellular recordings were made in the transverse hippocampal slice in vitro to study the requirements for the triggering of epileptiform discharges of CA1 cells . Spontaneous and induced epileptiform discharges were produced by adding small amounts of sodium benzyl penicillin . Recorded intracellularly, the epileptiform activity consisted of a burst of action potentials superimposed on a depolarizing wave . Extracellular recordings demonstrated a marked synchronization . The epileptiform activity of the CA1 cells appeared without changes in the passive membrane properties or in the spike generating mechanism . Spontaneous epileptiform discharges of the CA2 cells depended upon a synaptic activation from the CA3 region . Stimulation of afferent fibres evoked an early and a late burst response in the CA2 cells . The long latency burst was caused by a re-excitation from the CA3 region . The early burst response seems to be an intrinsic property of the CA1 cells and may be induced by synaptic activation of either apical or basal dendrites . The findings suggest that synaptic depolarization is necessary for the generation of epileptiform discharges of the CA1 cells. Jpn J Pharmacol, 1981 Oct, 31(5), 661 - 75 Effects of penicillin on electrical activities of neurons in guinea-pig hippocampal slices; Abe H et al.; Epileptogenic action of penicillin (PC) was investigated in thin slices prepared from the guinea-pig hippocampus . Bath-applied PC (1.7 mM) provoked an epileptiform activity . A series of cellular events before during and after application of PC were shown by stable intracellular recording from the same neuron . The effect of PC became progressively pronounced when the temperature of the medium was raised from 30 degrees C to 40 degrees C . PC-induced epileptiform activity showed odd time courses, i.e., recurrent reduction during perfusion of PC and abrupt reversion during washing . Increased potassium concentration in the medium increased the rate of occurrence of the spontaneous epileptiform activity induced by PC . Removal of chloride from the medium converted the PC-induced epileptiform activity to colonic relapsing discharges . In the laminar field potential analysis, 'sink' for the epileptiform activities induced by PC appeared at a broad region of the middle and distal portions of the apical dendrite, whereas 'sink' for potentials considered to reflect mainly synaptic events appeared at a relatively restricted region of the proximal and middle portions of the apical dendrite . Together with other observations, these results led to the conclusion that not only the synaptic but also the non-synaptic process is involved in initiation of the epileptiform activity. Drug Intell Clin Pharm, 1981 Oct, 15(10), 802 - 6 Reversible neutropenia associated with ampicillin therapy in pediatric patients; Kumar K et al.; Hematologic abnormalities associated with penicillin compounds are uncommon, and neutropenia associated with ampicillin is reported even less frequently . Neutropenia developed in three pediatric patients after high-dose (150-400 mg/kg) ampicillin therapy over a period of 3 to 12 days . In all cases, the white blood cell and neutrophil counts returned towards normal within 4 to 11 days after discontinuation of the antibiotic . Bone marrow examination revealed a maturation arrest in one and slight shift to the left in the maturation of granulocytic cells in another . Other marrow components were normal . Red blood cells, reticulocytes, platelets, and hemoglobin did not show any abnormal alteration in any of the patients . Physicians administering ampicillin, particularly in high doses, should be alert to the possible development of neutropenia; however, all reported neutropenias have been reversible. J Gen Microbiol, 1981 Oct, 126(Pt 2), 311 - 9 Selection for increased penicillin titre following hybridization of divergent lines of Aspergillus nidulans; Simpson IN et al.; Sexual hybridization of two divergent lines of Aspergillus nidulans, which had been selected for increased penicillin titre through successive cycles of mutagenesis, released considerable variation for this character . The recovery of segregants with titres equivalent to that of the unselected ancestor suggested that mutations in different genes had been selected in the two lines . However, complementary segregants with substantially improved titres were not found, indicating interactions, probably of a duplicate nature, among the induced mutations . All the genetic variation released by hybridization was fixed following two generations of selection for high titre, but only a small gain over the initial selection lines was achieved . Hybridization of divergent strains has been widely advocated as a means of strain development . The failure to achieve the anticipated gains in this programme is attributed primarily to the unfavourable interactions amongst the induced mutations . Whether similar interactions occur generally in crosses between strains selected by mutagenesis remains to be established and will be an important factor in determining the contribution of recombinational approaches to yield improvement. Acta Pharmacol Toxicol (Copenh), 1981 Oct, 49(4), 301 - 4 The effect of food on the oral absorption of penicillin V preparations in children; Finkel Y et al.; The oral absorption of pc V in different preparations, given at various times before and after a meal, was investigated in children with upper respiratory infections . The best absorption with respect to peak concentration was observed when potassium pc V (Calciopen) was given after at least two hours of fasting with no food intake within the following hour . Shorter periods of fasting (1, 1/2, 0 hrs) before drug intake resulted in significantly lower plasma concentrations . When drug intake was followed by a meal, the absorption was also decreased to some extent . When pc V was given in an oil suspension (Fenoxypen), or in a small volume (Roscopenin) together with a meal, the peak concentration was significantly lower than when pc V was given in an aqueous solution with a larger volume (Calciopen). Arch Microbiol, 1981 Oct, 130(2), 150 - 4 beta-Lactamase activity and resistance to penicillins in Myxococcus xanthus; von Kruger WM et al.; Several mutants and other variants of Myxococcus xanthus HP100 were obtained with differences in their sensitivity to carbenicillin and other penicillin derivatives . The specific activities of beta-lactamase in different resistant organisms varied from strain to strain but were consistently higher than in HP100 . The relative molecular mass (Mr) of the enzyme in M . xanthus HP100 was found to be 22,300 . In certain carbenicillin resistant strains a second fraction of beta-lactamase activity of molecular weight 186,000 presumed to be an octamer of the other form was present . The enzyme was found in cell free extracts and also in culture supernatants of all carbenicillin resistant mutants but not in culture supernatants of strain HP100 . In all the carbenicillin resistant mutants a part of the intracellular enzyme activity was released by osmotic shock and this activity may be periplasmic . The forms of the enzyme present in the culture supernatants and released by osmotic shock were monomeric . Carbenicillin resistance was not transferable between strains by conjugation . One resistance allele inhibited the transfer of the R factor Sa between myxococci. Jpn J Antibiot, 1981 Oct, 34(10), 1401 - 9 {Chemotherapy of biliary tract infections . XIV . Biliary excretion and gallbladder tissue levels of piperacillin (author's transl)}; Tanimura H et al.; Piperacillin, a new injectable synthetic penicillin, was evaluated against biliary tract infections . 1 . Two grams of piperacillin was intravenously administered to patients received cholecystectomy . The mean level in gallbladder bile of PIPC was 795.6 microgram/ml except for 3 cases in obstruction of the cystic duct . The mean gallbladder tissue level was 31.2 microgram/g . The gallbladder tissue level in the cases with obstruction of the cystic duct was high levels as 71.3 microgram/g and 79.5 microgram/g . 2 . The excretion of PIPC into bile was compared with TIPC and APPC using crossover method . When administered 2 g of PIPC, the peak biliary levels were 950 microgram/ml to 2,120 microgram/ml at 2 hours and 20 minutes to 2 hours and 40 minutes after the administration, and biliary recoveries during 6 hours were 2.84% to 11.6% . The peak levels and biliary recoveries were lower after administration of TIPC 2 g . Mn and Zn were excreted enormously together with APPC into human bile . 3 . The influence on clinical laboratory findings was negligible . Therefore, PIPC may be expected to show excellent effects of biliary tract infections except rare occurrence of drug eruption. Allergy, 1981 Oct, 36(7), 471 - 8 Challenge of penicillin-allergic volunteers with penicillin-contaminated meat; Lindemayr H et al.; In order to obtain information about the clinical course and immunological background of possible allergic reactions due to penicillin-containing food, nine volunteers with penicillin allergy proved by case history, positive skin tests and/or positive penicilloyl-specific RAST were exposed to penicillin-contaminated pork . For this purpose a farm pig from an inbred strain received "therapeutic" doses of benzyl procain penicillin before being slaughtered . Meat samples were taken from muscle tissues, kidney and liver and analyzed by diffusion and extraction methods . Very small amounts of penicillin were detectable in muscle tissue, whereas kidney material contained up to five times as much (0.12 mcg/g) . Except two cases which reacted with itchy sensations after ingestion of penicillin contaminated meat "a la tartare", all probands were clinically free of symptoms . Assaying penicilloyl-specific IgE antibodies by RAST during the trial, a tendency to increased levels in the serum after 2 and 24 h was noted, whereas the titers of BPO-specific IgG antibodies measured by the red cell-linked antigen-antiglobulin reaction (RCLAAR) remained unchanged . It is concluded from this study that small and hidden amounts of penicillin and its derivatives in food seldom induce anaphylactic reactions in penicillin allergic patients. Physiologie, 1981 Oct-Dec, 18(4), 241 - 5 Penicilloyl-dextran conjugates as reagents for skin testing in penicillin allergy; Cirstea M et al.; A procedure for implanting amino groups in the dextran molecule is described . The aminated polymer prepared from a dextran sample with a molecular weight of 20,000 was found to contain approximately 16 amino groups per molecule . Similarly to polylysine, the aminated dextran may be penicilloylated by incubation with penicillin at high pH . The penicilloyl-dextran (P-Dex) conjugate prepared in this way was found to contain approximately 8 penicilloyl (PO) groups per molecule . P-Dex was found practically nonimmunogenic in rabbits and showed itself antigenically active in precipitin, passive hemagglutination and passive cutaneous anaphylaxis (PCA) tests performed with a PO specific antiserum . A good correlation was found between the skin tests performed parallelly with P-Dex and penicilloyl-polylysine (PPL) in four subjects with penicillin allergy. Electroencephalogr Clin Neurophysiol, 1981 Oct, 52(4), 372 - 4 Effects of post-ictal depression on experimental spike and wave discharges; Avoli M et al.; The effects of post-ictal depression on spike and wave (SW) discharges of feline generalized penicillin epilepsy (FGPE) were studied . After tonic-clonic seizures which are not uncommon in FGPE spindle bursts appeared during the post-ictal period . Upon recovery spontaneous and thalamically evoked SW discharges reappeared . Spindles before penicillin and during post-ictal depression showed a similar intraburst frequency (twice that of SW discharges) in the same animal . These findings add further evidence to the notion that any depression of cortical excitability in FGPE leads to replacement of SW by spindles and thus supports the hypothesis that SW discharges occur in hyperexcitable cortex in response to normally spindle-inducing thalamocortical volleys. Clin Chem, 1981 Oct, 27(10), 1642 - 50 A candidate reference method for determination of total protein in serum . I . Development and validation; Doumas BT et al.; We developed a candidate Reference Method for measuring total serum protein by use of the biuret reaction . The method involves a previously described biuret reagent (Clin . Chem . 21: 1159, 1975) and Standard Reference Material (SRM) 927 bovine albumin (National Bureau of Standards) as the standard . At 25 degrees C, color development for 30 or 60 min provides identical serum protein values . Glucose (up to 10 g/L) and bilirubin (up to 300 mg/L) do not interfere . Hemoglobin, at 3 g/L, increases apparent serum protein by 0.4 g/L . The presence of dextran in serum causes easily detected turbidity, but this interference can be eliminated by centrifuging the reaction mixture . Therapeutic concentrations of ampicillin, carbenicillin, penicillin, oxacillin, nafcillin, chloramphenicol, cephalothin, and methicillin in blood do not interfere, nor do triglycerides up to 10 g/L . Within-run and day-to-day standard deviations of the method are 0.1 and 0.4 g/L, respectively. Stroke, 1981 Sep-Oct, 12(5), 581 - 8 Simultaneous measurement of blood flow and glucose metabolism by autoradiographic techniques; Mies G et al.; A double tracer autoradiographic technique using 131I-iodo-antipyrine and 14C-deoxyglucose is presented for the simultaneous measurement of blood flow and cerebral glucose utilization in the same animal . 131I is a gamma emitting isotope with a half life of 8.06 days and can be detected with adequate resolution on standard autoradiographic films . Autoradiograms are made before and after decay of 131I; the time interval between the 2 exposures and the concentration of the 2 tracers is adjusted to avoid significant cross-contamination . In this way, 2 film exposures are obtained which can be processed quantitatively like single tracer autoradiograms . The validity of the method for the investigation of local coupling of flow and metabolism was tested under various physiological and pathophysiological conditions . Coupling was tight in barbiturate-anesthetized healthy animals, but not under halothane anesthesia where uncoupling occurred in various subcortical structures . Focal seizures induced by topical application of penicillin on the cortical surface led to a coupled increase of metabolism and flow in thalamic relay nuclei but not at the site of penicillin administration where increased glucose utilization was not accompanied by similar increase in blood flow . Both coupled and uncoupled increases in local glucose utilization were observed in spreading depression and in circumscribed areas of experimental brain tumors . The results obtained demonstrate that double tracer autoradiography allows allows the very precise local assessment of cerebral blood flow and glucose utilization, and, therefore, is particularly suited to the study of regional coupling processes under various experimental conditions. Antibiotiki, 1981 Sep, 26(9), 696 - 9 {Penicillin and streptomycin penetration into tissue by a modified electrophoretic method}; Ragelis SIu; A total of 377 experiments with healthy rabbits of the same species, age, weight and sex were performed with the use of the galvanization apparatus "Potok-1" . The penetration levels of penicillin and streptomycin into the tissues, i.e . the skin, muscles and bone after their administration with the modified method of electrophoresis were determined . It was found that the tissue levels of the antibiotics administered with the modified method of electrophoresis increased wit