Penicillin

J Bacteriol, 1975 Jun, 122(3), 1310 - 21
D-Alanine-requiring cell wall mutant of Escherichia coli; Olden K et al.; A mutant of Escherichia coli is described whose cells show a spherical or irregular morphology, associated with leakage of beta-galactosidase and other intracellular proteins . The expression of the morphologic abnormality is most marked when the mutant is grown in rich media and is suppressed by D-alamine, D-serine, D-glutamate, or glycine supplementation . D-Alanine is the most effective amino acid supplement, half maximally supressing this anomalous property at a concentration of 75 mug/ml, as measured by the reduction in beta-galactosidase released from the cells . The mutant is more sensitive to penicillin G, D-methionine, and D-valine and it is relatively resistant to lysozyme . These phenotypic abnormalities are likewise corrected by the above supplementations . The relative rates of peptidoglycan synthesis in mutant and parent, grown under restrictive conditions, were measured both in vivo and in vitro by rates of incorporation of L-{14-D}alanine and uridine-5'-diphosphate-N-acetyl-D-{1-15C-A1-glucosamine, respectively . There is not metabolic block in the biosynthesis of uridine-5'-diphosphate-N-acetyl-muramyl-pentapeptide as shown by enzymic analysis and the lack of accumulation of uridine-5'-diphosphate-N-acetylmuramyl-peptide precursors . These preliminary studies suggest that the mutant possesses a defect in the biosynthesis of peptidoglycan although the exact lesion has not yet been established.

Epilepsia, 1975 Jun, 16(2), 215 - 22
Effects of temperature on interictal discharge at penicillin epileptogenic foci; Lebovitz RM; The effects of local brain temperature on acute focal penicillin epilepsy in the exposed hippocampus of cat were studied . Results from anesthetized and from immobilized, unanesthetized animals were compared . Over the temperature range 26 to 43 degrees C (at the alveus), the interictal spike interval and duration of the spike discharge varied inversely with temperature . The former showed a Q10 of 2.4 and the latter a Q10 of 1.5, with no difference due to type of preparation . A significant trans-hippocampal thermal gradient may imply that these values are underestimates by 20% or more . The low Q10 of duration of the paroxysmal discharge was consistent with the known temperature dependence of impulse conduction velocity of intracortical neural networks . The high Q10 of the interictal interval, on the other hand, was consistent with the view that some slow endogenous, perhaps metabolic factor such as a NA,K-ATPase modulated excitability at the focus of penicillin spikes.

Br J Vener Dis, 1975 Jun, 51(3), 188 - 91
Treatment of gonorrhoea in the female with fortified procaine penicillin plus probenecid and with spectinomycin; Panikabutra K; 513 cases of uncomplicated gonorrhoea in females with positive results to cultures were treated with two regimens of treatment between January 1, 1972, and February 28, 1973, at the Department for Females, Bangrak Hospital, Bangkok . The highest incidence was found in the age group 20 to 24 years (215 out of 513) . The patients were divided into two groups . In the first, probenecid 1 g . was given orally 1 hour before an intramuscular injection of 4 million units fortified procaine penicillin, and in the second an intramuscular injection of 2 g . spectinomycin dihydrochloride was given . 335 cases were followed in the first group and there were no failures; 132 cases were followed in the second group and there was one failure (0.7 per cent.) . The fact that gonococci were found in the rectum in 23.7 per cent . of cases (117 out of 493) indicates that rectal tests are of considerable importance and should be included in the routine investigations . There was no evidence that gonorrhoeal infection of the rectum was more resistant to treatment than infection at other sites.

Zh Mikrobiol Epidemiol Immunobiol, 1975 Jun, (6), 115 - 22
{Treatment and prevention of experimental pneumonias, caused by L forms of bacteria}; Ermakova GL et al.; On a model of experimental pneumonia in mice caused by the L-forms of bacteria against the background of diminished immunity a study was made of the therapeutic efficacy of penicillin, lincomycin, lysozyme and gamma-globulin . Lincomycin, particularly in combination with biologically-active preparations, proved to be expedience for the treatment and prophylaxis of pneumonia caused by the mentioned bacteria; a rapid arrest of pneumonic process occurred and more animals survived . In the greater percentage of cases the use of penicillin was accompanied by generalization of the process.

JAMA, 1975 May 26, 232(8), 818 - 21
Anicteric carbenicillin hepatitis . Eight episodes in four patients; Wilson FM et al.; Carbenicillin disodium was temporally associated with eight episodes of a mild reversible anicteric hepatitis characterized by nausea, vomiting, and a tender, somewhat enlarged liver . Serum glutamic and oxaloacetic transaminase as well as alkaline phosphatase levels rose, but serum bilirubin values remained normal . There usually were no signs of concomitant allergy to penicillin, and other penicillins could be given subsequently without ill effects . Biopsy specimens of the liver showed spotty liver cell necrosis with no cholestasis.

C R Acad Sci Hebd Seances Acad Sci D, 1975 May 26, 280(20), 2405 - 8
{Preparation of an iodinated penicillin derivative for radioimmunologic use}; Wal JM et al.; A 125I-BSA Penicilloyl conjugate was prepared by coupling Penicillin G to Bovine Serum Albumine previously labeled with Iodine-125 . The reaction of fixation by covalent binding was made in alkaline solution without the use of carbodiimide . Immunoreactivity and specific activity of this labeled conjugate enable radioimmunoassay of penicilloyl groups.

Biull Eksp Biol Med, 1975 May, 79(5), 103 - 6
{Development of 7--11-week-old human embryonic gonads in organ culture}; Gapienko EF; The author suggests a simplified method of organic culture of the human gonads . Gonads (160) from 7--11-week embryos were cultivated on millipore filters in penicillin bottles . During the first week of cultivation the central necroses were observed both in the male and the female gonads, but later they disappeared in some of the explants . In the ovaries from the 9--11-week embryos the germ cells underwent development which continued to the pachytene stage, while in the ovaries from the 7--9-week embryos the development of the germ cells failed to reach the leptotene stage . In the case of testis germ cells they remained at the stage of spermatogonia.

Agents Actions, 1975 May, 5(2), 174 - 9
The optimization test in the guinea-pig . A method for the predictive evaluation of the contact allergenicity of chemicals; Maurer T et al.; Guinea-pigs were sensitized with various substances (DNCB, penicillin G, PPL, ethylaminobenzoate, formalin) by the Draize method, the maximization method and the new optimization method (intracutaneous test employing adjuvant) . The advantages of the optimization method favouring its adoption as a standard sensitization test are discussed in the light of the results obtained by this method and with the two established tests.

Mikrobiologiia, 1975 May-Jun, 44(3), 435 - 41
{Production and biological properties of L-like mutants (11r) of Escherichia coli}; Androsov VV et al.; Treatment of the strains of E . coli K12 with the mutagen N-nitroso-N-methylurea yielded mutants with the morphology similar to that of stable penicillin L-forms . Studies of the biological properties of the cultures have shown that the mutation of the gen 11r increases the susceptibility to antibiotics of various action spectra, ionic and non-ionic detergents and the resistance to UV and gamma radiation . Biochemical analysis of peptidoglycan from the cell walls of the parent bacterial cultures and L-mutants revealed no differences in its chemical composition.

Surg Neurol, 1975 May, 3(5), 277 - 80
Fulton and penicillin; Dohrmann GJ; John Fulton, the late noted neurophysiologist, played a little known role in bringing penicillin to the world . He contributed behind-the-scenes support to Howard Florey and the penicillin research and production.

Acta Paediatr Scand, 1975 May, 64(3), 421 - 4
Serum levels of penicillin v after oral administration of pediatric preparations to healthy subjects; Rollag H Jr et al.; The bioavailability of nine commercial pediatric preparations of penicillin V was tested in a double-blind, cross-over fashion on ten healthy student nurses who were given 1 mill I.U . of the various preparations . The serum concentrations were determined using the paper disc method of "AB Biodisc" Sweden . The preparations could be divided into two different groups: (1) the mixtures (2) the effervescent tablets, substance for drops and granulate . This classification is based upon the mean peak serum levels obtained . With one exception the peak serum levels in group 2 were significantly higher than in group 1 . 2,4 and 6 hours after ingestion there were no differences in the serum levels, indicating that none of the preparations gave sustained high serum levels . The results presented indicate that the preparations in group 2 should be preferred.

Br Heart J, 1975 May, 37(5), 478 - 81
Current practice in prevention of bacterial endocarditis; Durack DT; A survey of Oxfordshire dentists showed that most practise prophlaxis of bacterial endocarditis, but that few follow currently recommended regimens . for example, prophylactic antibiotics are started one or more days before the procedure by 72 per cent of dentists, and two or more days before by 25 per cent . Eight-seven per cent administer antibiotics for a total of four or more days . Penicillin is most often given, but tetracyline remains the commonest second choice . Only 12 per cent use intramuscular drugs as first choice, and procaine penicillin is seldom used . These practices are contrasted with current medical recommendations and discussed with reference to fresh experimental evidence on prevention of bacterial endocarditis.

J Pharm Pharmacol, 1975 May, 27(5), 348 - 52
The diffusion of penicillin G and ampicillin through phospholipid sols; Padfield JM et al.; The self-diffusion coefficients of penicillin G and ampicillin have been determined at 25 degrees in water and in the presence of a swamping concentration of electrolyte . The antibiotics diffused through phospholipid dispersions at a reduced rate due to interaction with the lipid aggregates . Ampicillin diffused through the phosphatidylcholine and phosphatidylethanolamine dispersions more rapidly than penicillin G, whereas the latter diffused more rapidly through the lysophosphatidylcholine dispersions . Estimates of binding have been made from these data and compared with those obtained from equilibrium dialysis studies . Surface tension measurements indicated that the antibiotics exhibited minimal surface activity . These results have been correlated with data obtained in other studies and a possible explanation has been advanced for the reported differences in vivo activity of penicillin G and ampicillin.

Arch Neurol, 1975 May, 32(5), 298 - 303
Plasma albumin concentration and diphenylhydantoin binding in man; Porter RJ et al.; The plasma protein binding of diphenylhydantoin sodium was determined in 26 patients who had been taking diphenylhydantoin regularly for more than two weeks . The free (unbound) diphenylhydantoin level was found to vary from 5.8% to 12.6% of the total drug concentration . This range of variation may be clinically important, if it can be established that the binding of diphenylhydantoin to plasma proteins limits entry of the drug into the brain . The binding of diphenylhydantoin was directly proportional to the plasma albumin concentration, which thus appeared to be the most important determinant of diphenylhydantoin binding . Diphenylhydantoin binding was independent of the plasma concentration of the drug in the usual therapeutic range . In vitro studies showed little effect by phenobarbital sodium or penicillin G; therapeutic levels of acetylsalicylic acid, however, increased free diphenylhydantoin by nearly 50%.

J Neurol Neurosurg Psychiatry, 1975 May, 38(5), 452 - 8
Peripheral neuropathy in acrodermatitis chronica atrophicans (Herxheimer); Hopf HC; Acrodermatitis chronica atrophicans is a dermatological condition that takes a chronically progressive course and finally leads to a widespread atrophy of the skin . Involvement of the peripheral nervous system is frequently observed, predominantly a sensory polyneuropathy . General reactions, the effect of penicillin treatment, the histological findings, and reports concerning a communicable agent transmittable from human to human as well in tissue cultures point to an infectious disease . Acrodermatitis chronica atrophicans follows a peculiar geographical distribution forming clusters of high prevalence in certain regions . Transmission by ticks is suggested.

JAMA, 1975 Apr 21, 232(3), 270 - 1
Penicillin treatment of neurosyphilis . Are recommended dosages sufficient?
Yoder FW.
A 60-year-old man with symptomatic neurosyphilis was treated with penicillin G procaine in the dosages recommended by the Public Health Service, and a less than spirocheticidal level of penicillin G was found in the cerebrospinal fluid.

Schweiz Med Wochenschr, 1975 Apr 19, 105(16), 502 - 4
{Results of the treatment of acute gonorrhea with spectinomycin . Comparison with the combination of aqueous penicillin and probenecid}; Gilliet F; Results following treatment of acute gonorrhea with aqueous penicillin combined with probenecid and spectinomycin hydrochloride (2.0 g) are compared and found to be statistically equivalent . Therefore, if a patient is allergic to penicillin, spectinomycin hydrochloride can be regarded as a valuable alternative . The results appear to be the same whether probenecid is administered simultaneously or 1/2-2 h before penicillin . It is advisable to control all patients one week after therapy . A second control after 2 weeks for men and after the next menstruation for women is highly desirable . If the patient fails to respond to treatment, not only an increase in the antibiotic dose, but also prolongation of therapy by administering the same dose on 3 consecutive days, is effective.

Indian J Physiol Pharmacol, 1975 Apr-Jun, 19(2), 71 - 5
Studies on the effect of penicillin, streptomycin and isonicotinic acid hydrazide on small intestinal oligosaccharidase; Sharma AK et al.; Studies have been done on the effect of Penicillin, Streptomycin and Isonicotinic Acid hydrazide on small intestinal oligosaccharidase and it was observed that the drug penicillin inhibited the enzyme lactase and sucrase by 62.7% and 34.7% respectively, whereas I.N.H . inhibited the enzyme sucrase and maltase by 57.1% and 56.14% respectively . Streptomycin did not show any inhibitory effect on those enzymes . Lactose tolerance test showed impairment of lactose absorption in case of penicillin . Fasting serum sugar level was diminished both in penicillin and streptomycin and the absorption capacity was increased after oral administration of streptomycin.

Am J Hosp Pharm, 1975 Apr, 32(4), 411 - 3
Acute psychotic reaction to procaine penicillin; Bradberry JC et al.; A case of a 23-year old black female admitted for treatment of an acute psychotic episode 48 hours after being treated with i.m . procaine penicillin G is reported . Literature reports of nonallergic psychotic responses to i.m . injections of aqueous procaine penicillin G are reviewed . Possible mechanisms for the reaction are discussed . Recommended drugs for treatment of the reaction include phenobarbital and chlorpromazine.

Chest, 1975 Apr, 67(4), 494 - 6
Systemic-to-pulmonary artery fistula following actinomycosis; Knoepfli HJ et al.; We report a case of pleuropulmonary actinomycosis in a child followed by a most unusual complication: the appearance of a systemic-to-pulmonary artery fistula in the area where the abscess was drained . Fifteen months after successful treatment with penicillin and surgical drainage, a continuous murmur was heard over the scar . Aortic angiography showed multiple connections between the intercostal arteries and the left pulmonary artery through an angiomatous lesion in the left lower lobe . This resulted in a considerable left-to-right shunt . Possible pathogenic mechanisms are discussed.

Biochem J, 1975 Apr, 147(1), 131 - 7
Purification of D-alanine carboxypeptidase from Escherichia coli B on a penicillin-Sepharose column; Gorecki M et al.; 1 . A soluble D-alanine carboxypeptidase from Escherichia coli strain B was purified on a p-aminobenzylpenicillin-Sepharose column . This one-step chromatography followed by an (NH4)2SO4 precipitation yielded an enzyme purified 1200-fold and some of its properties are reported . 2 . The pure D-alanine carboxypeptidase was devoid of D-alanine carboxypeptidase II activity and migrated as a single protein band on analytical disc gel electrophoresis . 3 . Triton X-100 in the purification procedure is an absolute requirement for obtaining a stable enzyme . 4 . The enzymic activity of D-alanine carboxypeptidase was greatly affected in solution of high salt concentrations and varied somewhat with the nature of the cation tested.

Br J Vener Dis, 1975 Apr, 51(2), 97 - 8
Single-dose treatment of uncomplicated gonorrhoea in males with minocycline; Shahidullah M; Minocycline in a single 300 mg . oral dose was given to 103 men with uncomplicated gonorrhoea, of whom 85 were followed-up for at least 2 weeks . The cure rate in the 85 followed was 94.1 per cent . There were no side-effects . Thus minocycline could be considered as an effective and safe alternative to penicillin in the single-dose treatment of uncomplicated gonorrhoea in the male, but at the moment it is too expensive for routine use.

J Hyg (Lond), 1975 Apr, 74(2), 169 - 81
The evaluation of hypersensitivity tests in cattle after foot-and-mouth disease vaccination; Black L et al.; The response to passive cutaneous anaphylaxis, dermal hypersensitivity and intravenous provocation tests has been compared in 30, 40, 31 and 24 cattle injected with foot-and-mouth disease vaccine 0, 1, 2 and 3 times respectively, using vaccine components and other substances as test materials . Reaginic antibodies demonstrated by passive cutaneous anaphylaxis in goats, were directed against BHK 21 cell extracts (20), hydroxypropylmethylcellulose (3) and an unidentified vaccine component (3), and distributed in 0, 5, 19 and 75 per cent of the cattle vaccinated 0, 1, 2 and 3 times . None of the animals showed clinical signs of allergy after vaccination . When BHK 21 cell extract was injected intradermally a significant correlation was noted between the development of large weals and the presence of reagins although the size of the weals was not correlated with the reagin titres . In the case of hydroxypropylmethylcellulose a similar trend was evident . The majority of cattle with large dermal weals possessed reagins but the number of reactions was too small for statistical evaluation . Dermal reactions to sodium penicillin, sodium carboxymethylcellulose, saponin and whole vaccine occurred in both unvaccinated and vaccinated cattle but BHK 21 cell lysate and normal bovine serum provoked weals which increased in frequency according to the number of vaccinations experienced . Intravenous hydroxypropylmethylcellulose elicited a response in all the animals previously injected with certain batches of vaccine but cell extract intravenously produced a clinical response in half the tested animals which was uncorrelated with the results of the passive cutaneous anaphylaxis or dermal hypersensitivity tests.

Antibiotiki, 1975 Apr, 20(4), 291 - 5
{Biosynthesis of penicillin and the biphasal development of a P . chrysogenum culture}; Lur'e LM et al.; The two-phase pattern of penicillin biosynthesis was observed only under definite cultivation conditions . When the conditions of the culture growth changed, the productivity curve also changed . The most high productivity levels on the glucose medium and the medium with glucose and lactose were noted at the beginning and in the middle of the process respectively . Under more or less equal conditions the productivity remained at the same level.

J Clin Pathol, 1975 Apr, 28(4), 321 - 3
Acute haemolytic anaemia due to IgM penicillin antibody in a 3-year-old child: a sequel to oral penicillin; Bird GW et al.; A hitherto undescribed form of immune haemolytic anaemia due to penicillin antibody is described . The antibody, which was of the IgM class, fixed complement and caused acute haemolysis . Oral penicillin seems to have been responsible both for antibody production and, on subsequent exposure, for the haemolytic anaemia.

Infect Immun, 1975 Apr, 11(4), 635 - 9
Reactivation of latent Herpes simplex virus after pneumococcal pneumonia in mice; Stevens JG et al.; In attempts to reactivate latent herpes simplex virus, we instilled Diplococcus pneumoniae intratracheally into mice harboring latent infections in sacrosciatic spinal ganglia . All mice developed a severe pneumonia within 24 h and were given penicillin therapy . Representative mice that survived the penumonia were sacrificed at daily intervals, and appropriate tissues were examined for evidence of viral reactivation . Herpes simplex virus was reactivated in the ganglia and appeared to travel both proximally and distally in associated nerve trunks . Clinically apparent disease due to the virus was not detected in any mice.

Prikl Biokhim Mikrobiol, 1975 Mar-Apr, 11(2), 274 - 6
{Isolation of alkaloid-like substances from penicillium fungi}; Penskaya LV et al.; Alkaloid-like substances have been obtained from the cultivation of fungi Penicillium granulatum and Penicillin corylophillum . The procedure for their preparative isolation has been developed . They do not have physico-chemical characteristics typical of alkaloids viridicatine and cyclopenine, previously isolated from Penicillium fungi . The presence of nitrogen in the structure has been shown in the product synthesized by Penicillium granulatum . Ultraviolet, infrared, nuclear magnetic resonance and mass spectra have been recorded for the product.

Prikl Biokhim Mikrobiol, 1975 Mar-Apr, 11(2), 219 - 25
{Preparation and kinetic properties of immobilized benzyl penicillin acylase}; Mandel MO et al.; An active insoluble preparation of immobilized benzyl penicillin acylase (IBA) EC 3.5.1.11 has been obtained by its entrapping into polyacrylamide gel lattice . Due to immobilization the preparation maintains up to 87% of its initial activity . The kinetics of IBA at low substrate concentrations obeys the Michaelis-Menten law; however, the apparent KM value decreases and the temperature optimum elevates . The inhibition by the reaction products--6-aminopenicillanic acid and phenylacetic acid--has been found to be 4.3 mM . The resultant IBA preparation proves to be suitable for hydrolysis of 5% benzyl penicillin solutions.

J S Afr Vet Assoc, 1975 Mar, 46(1), 115 - 9
Surgical techniques in equine colic; Boles C; Emergency equine abdominal surgery is easiest and most efficiently carried out with a team of surgeons . The surgical site should be as protected as possible by the use of sterile drapes and wound protectors . A ventral midline laparotomy incision has been found to be the most convenient approach to most equine intestinal obstructions . A standing laparotomy through the left paralumbar fossa gives adequate exposure for exploration of the abdomen and is, therefore, useful as a diagnostic tool . Horses tolerate having both ventral midline and left paralumbar laparotomy incisions well . If the cause of the intestinal obstruction is not readily apparent upon opening the abdominal cavity, a thorough systematic exploration of the abdominal cavity is necessary . If the problem cannot be found with the bowel in situ, intestine must be exteriorized for examination . The decision as to the extent of adequate bowel resection often depends on a subjective assessment of bowel function . In equivocal cases, the surgeon should choose to resect some normal bowel rather than taking a chance on leaving compromised bowel in place . Incarcerations are frequent causes of small intestinal obstructions . The small intestine may become incarcerated in the epiploic foramen, the inguinal canal or in an umbilical hernia . Thromboembolic compromise to intestinal vessels results in the longest lengths of embarrassed bowel requiring resection . Impactions are the most common obstructions associated with the caecum . Large colon torsions of 270 degrees or less may be corrected by surgical manipulation; with 360 degrees torsions of the large colon, however, vascular compromise is usually sufficient to devitalize this organ . Enterotomy of the large colon allows retrieval of most enteroliths from its lumen . Enterotomy of the right dorsal colon is also useful for removal of foreign bodies which cause obstruction of the most proximal portion of the small colon . In our Clinic a two-layer end to end anastomosis is usually utilized . Recently introduced automated stapling and ligating instruments have been useful in decreasing surgical time . Antibiotics, usually furacin and sodium or potassium penicillin in 2 litres of Normasol-R, are placed in the peritoneal cavity before closure of the abdomen . A Penrose drain is commonly placed into the abdominal cavity to provide drainage of the peritoneal cavity after surgery . The peritoneum is sutured with No 0 chromic gut in a simple continuous pattern . A second Penrose drain may be placed between peritoneum and ventral body wall, with its ends retracted through stab incisions in the skin . The linea alba is closed with simple interrupted sutures of stainless steel wire or No . 3 chromic gut . Employing the above described principles and techniques has increased the success of abdominal surgery in our Clinic.

J Am Vener Dis Assoc, 1975 Mar, 1(3), 118 - 20
Granuloma inguinale in Vietnam: successful therapy with ampicillin and lincomycin; Breschi LC et al.; Thirty-six patients having granuloma inguinale were treated at the 483 USAF Hospital, Cam Ranh Bay, Republic of South Vietnam between October 1970 and September 1971 . In 24 cases biopsy of the genital ulcerations revealed Donovan bodies pathognomonic for the disorder . The lesions generally did not heal during tetracycline therapy . All but 2 of the 31 cases treated primarily with ampicillin responded with complete healing of the local lesions which occurred primarily on the penis or in the groin . Of the remaining 2 patients, one responded to a second course of ampicillin and the other patient responded to a two week course of lincomycin after dorsal slit had been performed for partial phimosis and balanoposthitis . The 5 patients who were allergic to penicillin were treated primarily with lincomycin and all responded with complete healing . No previous reference could be found in the literature for the successful use of lincomycin in patients with granuloma inguinale . Further clinical trials with this medication are indicated.

J Neurophysiol, 1975 Mar, 38(2), 395 - 404
Spatial limits of epileptogenic cortex: its relationship to ectopic spike generation; Gabor AJ et al.; In order to investigate if ectopic spike generation was ubiquitous in and specific generation was ubiquitous in and specific to epileptogenic cortex, a method was devised to determine the limits of such an area based on a well-accepted physiologic characteristic of epileptogenicity . The limits of the penicillin-induced epileptogenic cortex were defined in terms of a retinal activation field; this is a circumscribed area whose stimulation by light evokes a characteristic cortical epileptiform wave . All lateral geniculate nucleus (LGN) neurons manifesting ectopic spike generation during interictal epileptiform waves had receptive fields within the activation field . During organized seizures, ectopic spike generation was observed in neurons with receptive fields outside the activation field . Because of these findings it was concluded that ectopic spike generation is a characteristic and specific feature of epileptogenic cortex and that it is a characteristic of the epeleptogenic process rather than a peripheral event related entirely to the direct effect of penicillin on neurons.

J Neurophysiol, 1975 Mar, 38(2), 250 - 6
Abnormal neuronal responses during evolution of a penicillin epileptic focus in cat visual cortex; Ebersole JS et al.; After defining the receptive fields of single units in cortical area 17 of anesthetized cats, recurrent on-off stimulation with bars of light of optimal configuration win from a second micropipette; Progressively, three distinct alterations of neuronal activity developed . The most longlasting and usually the earliest abnormality was an increase in the number and frequency of spikes comprising a neuron's response to stimuli that were effective prior to iontophoresis . This enhanced physiologic response (EPR) could be elicited from a cell independently of the discharge activity of an induced focus, but only with stimuli appropriate for the cell's receptive field . With additional iontophoresis an entirely new response developed, which was consistent with an extracellular paroxysmal depolarization shift (PDS) . This high-frequency burst of spikes appeared only in association with an ECoG interictal potential . It could be triggered, however, by stimuli which were previously effective or ineffective, as well as occur spontaneously . Characteristics which further distinguished the PDS from EPR included a longer and more-variable latency, a longer recovery period, and a different sensitivity to changes of stimulus intensity . A period of response inhibition also accompanied each interictal potential and persisted with a variable duration afterward . It was most noticeable as an interruption in the activity of tonically responding neurons and was often present before the cell began to generate PDSs . It was concluded that the EPR represents a direct effect of penicillin on the cell or its immediate synaptic connections, while the PDS appears dependent on the altered interactions within a population of such affected cells . The inhibitory phenomenon, in addition, seems a result of projected influences from cells more fully involved with the developing focus . A dynamic model of the EPR-PDS relationship is proposed.

Clin Allergy, 1975 Mar, 5(1), 43 - 57
Investigation of the response to some haptenic determinants in penicillin allergy by skin and in vitro allergy tests; Assem ES et al.; The role of three penicillin metabolites in human allergic reaction to penicillin has been assessed using sensitive in vitro tests in addition to skin testing . Conjugates of the benzylpenicilloyl (BPO), benzylpenicillenate (BPE) and penicillamine (PA) groups with human serum albumin (HSA) and bovine gamma globulin (BGG) have been made . In the passive haemagglutination test antibodies specific for all three determinants were found but there was no difference between allergic and non-allergic groups . However, the ratio IgG/IgM, specific for each determinant, was higher in normals than in allergics . In skin tests, histamine release from leucocytes and the lymphocyte transformation test, the BPO group was confirmed as the major determinant, but in some individuals the BPE or PA groups are more important.

Biomedicine, 1975 Feb 28, 23(2), 55 - 8
{Lymphocyte depletion through experimental anastomosis of the thoracic duct and cervical esophagus}; Kawai T et al.; In 25 dogs, a short segment of the left subclavian vein, adjacent to the connection of the thoracic duct, was dissected free with its jugular branch and ligated . An end-to-side anastomosis, using interrupted sutures was performed in two layers, between the side of the cervical esophagus and the proximal part of the jugular vein . This vein, acting as a reservoir, remains connected to the thoracic duct by the isolated segment of the subclavian vein . The original aspect, of our technique is the use of a catheter placed into a branch of the vein near the site of the anastomosis and through which a saline solution with heparin (1 mg/kg) and penicillin (40.000 U/kg) is injected daily . The catheter emerged on top of the dog's neck, and continuous perfusion was provided by a chronofusor . The catheter was removed after one month . In 30% of the dogs, the anastomosis was found patent after more than 6 weeks . This has been proved by fibro-esophagoscopy after injection of a solution of patent blue in the jugular catheter ; lymphangiograms obtained by direct injection of radio-opaque material through the jugular catheter, and a decrease in lymphocyte counts to 4% of the total white blood cell count, compared to 30% in the controls . There was no significant loss of weight in the surviving dogs.

N Engl J Med, 1975 Feb 27, 292(9), 449 - 54
Immunopathogenesis of syphilitic glomerulonephritis . Elution of antitreponemal antibody from glomerular immune-complex deposits; Gamble CN et al.; A renal biopsy was performed on a patient with syphilitic glomerulonephritis characterized clinically by the acute onset of nephrosis that responded dramatically to penicillin therapy . Histologic, electron microscopical and immunohistochemical studies revealed an early membranous glomerulonephritis characterized by the presence of subepithelial basement-membrane deposits containing IgG and C3 . The glomerular lesion, however, differed from that in the usual case of membranous nephropathy in that distinctive segmental lesions were present at the tubular poles of the glomeruli, and all the glomeruli exhibited mild proliferation of mesangial cells in association with the presence of IgM within mesangial areas . Antibody elution studies performed on the renal-biopsy specimen demonstrated the presence of antitreponemal antibody within the glomerular immune-complex deposits . This finding indicates that the glomerular injury occasionally complicating secondary syphilis is due to the deposition of treponemal antigen-antitreponemal antibody complexes.

Dtsch Med Wochenschr, 1975 Feb 21, 100(8), 367 - 70
{Acute necrotizing angitis with eosinophilic myocarditis in bronchial asthma(author's transl)}; Schafer A et al.; In a 34-year-old patient asthma had developed as an allergy to infection . He died suddenly from cardiac and respiratory arrest following parenteral penicillin and sulphonamides . At autopsy necrotizing angiitis of the myocardial vessels as well as eosinophilic myocarditis were shown . These findings are probably the expression of a drug allergy.

Lancet, 1975 Feb 8, 1(7902), 306 - 8
Penetration of penicillin into human phagocytes containing gonococci; Veale DR et al.; Human phagocytes that had ingested gonococci were incubated with increasing concentrations of penicillin in fresh human serum . Viable counts on phagocyte deposits before and after incubation indicated penicillin penetration at high concentrations but not at lower concentrations which were sufficient to kill extracellular organisms . With lower concentrations significant intracellular survival of gonococci occurred.

Thorax, 1975 Feb, 30(1), 2 - 8
An analysis of skin prick test reactions in 656 asthmatic patients; Hendrick DJ et al.; Of 656 asthmatic patients referred specifically for allergy assessments, 544 (84 percent) gave positive immediate skin prick tests to at least one of 22 common allergens used routinely . Comparison of these skin test positive patients with the 102 (16 percent) who were skin test negative showed a number of significant differences . The majority of the skin test positive patients (52 percent) were less than 10 years old at the time of onset of the asthma, whereas, of the skin test negative patients, 56 percent were aged over 30 years at the time of onset . Seventy per cent report rhinitis compared with 48 per cent of the skin test negative patients, and 29 per cent reported infantile eczema compared with 9 per cent . Symptoms attributed to house dust, pollens, and animals were noted two to three times more frequently by the skin test positive patients, while corticosteroid drugs had been used more commonly by the skin test negative patients (45 percent compared with 35 percent) . No significant differences were observed with the other factors studied, namely, history of urticaria or angio-oedema, family history of "allergic" disease, and awareness of sensitivity to foods, aspirin or penicillin . Prick test reactions in the skin test positive patients were most commonly seen to house dust or the acarine mite, Dermatophagoides farinae (82 percent), followed by pollens (66 percent), animal danders (38 percent), foods (16 percent), Aspergillus fumigatus (16 percent), and other moulds (21 percent) . There was a highly significant association of positive history with positive prick test for all allergens studied.

J Parasitol, 1975 Feb, 61(1), 79 - 88
Ammonia formation and amino acid excretion by Gyrocotyle fimbriata (Cestoidea); Bishop SH; Gyrocotyle fimbriata isolated from the spiral valve of Hydrolagus colliei were washed, then held in a filtered seawater-penicillin-Tris buffer medium . Ammonia and urea release to the medium declined together and ammonia production was minimal when the urea concentration was below detectable limits . Alanine and smaller amounts of glycine were released to the medium at a more constant rate . After 12 hr the alanine-glycine excretion was more than 20 times the ammonia excretion . L-arginine, L-serine, L-histidine, and urea were most effective in stimulating ammonia production by whole worms; other L-amino acids were essentially ineffective . L-glutamate dehydrogenase, L-amino acid oxidase, uricase, and ornithine transcarbamylase were below detectable levels . L-serine dehydrase, L-arginase, L-histidase, and urease were detected in tissue homogenates and probably account for most of the endogenous ammonia production . L-arginase has a molecular weight of 28,000 by Sehpadex gel filtration . The high levels of glutamate-pyruvate transaminase and lower levels of glutamate-oxalacetate transaminase correlate with the high level of alanine excretion . It is concluded that (1) ammonia production is not strongly linked to the overall energy metabolism of Gyrocotyle and is probably a result of a series of unrelated enzymatic reactions such as the action of urease of urea from the tissue of the rat fish, and (2) alanine and glycine are the major nitrogen excretory products and their production is linked to the energy metabolism of Gyrocotyle.

Gastroenterology, 1975 Feb, 68(2), 231 - 8
Phlegmonous gastritis; Miller AI et al.; We have reviewed 23 documented cases of phlegmonous gastritis reported since 1945 in the American literature, and have added 2 of our own . A small series of cases makes it somewhat difficult to draw any definite conclusions regarding the modes of presentation; nonetheless, some clinical trends are discernible . In a patient with a history of large ethanol intake, a recent bout of "gastritis," or recent upper respiratory infection, who presents with acute upper abdominal pain, peritonitis, purulent ascitic fluid, and fever, the diagnosis of phlegmonous gastritis must be considered in differential diagnosis . With normal serum amylase, no historical evidence of ulcer or gallbladder disease, the diagnosis becomes even more probable . Preoperative diagnosis is rare, but gastroscopy with or without biopsy, and culture of gastric contents may establish the diagnosis . The definitive treatment would appear to be resection or drainage of the stomach, combined with large doses of systemic antibiotics, usually penicillin . The surgical mortality in cases reviewed was 18.2%, while the medical mortality was 100% . The overall mortality was 67% . It is hoped that more frequent recognition of this disease entity will lead to earlier diagnosis and a resulting lower morbidity and mortality.

Chest, 1975 Feb, 67(2), 242 - 4
Disseminated Actinomycosis; Smith DL et al.; A patient with multiple subcutaneous abscesses was found to have disseminated actinomycosis . No predisposing cause was identified . No defects in immunity were found . His disease responded promptly to penicillin therapy.

Ann Intern Med, 1975 Feb, 82(2), 189 - 95
"Comparably massive" penicillin G therapy in renal failure; Bryan CS et al.; Impairment of penicillin G excretion in renal failure may result in life-threatening, dose-related toxicity . We report a method for achieving a desired mean serum penicillin G concentration in patients with renal failure, with minimal risk of both undertreatment and drug toxicity . The method is based on the linear relation between the total plasma clearance of penicillin G (Cpen) and the endogenous creatinine clearance . The daily maintenance dose of penicillin G (units) is defined by the product, Cpen (ml/min) times desired mean serum penicillin G concentration (mug/ml) times 2300 . Application of this method to patients with various degrees of renal impairment by either constant-rate infusion or intermittent infusion gave serum penicillin G concentrations within the desired range in all but 1 of 15 instances . On the basis of these observations, practical guidelines for "comparably massive" penicillin G therapy are suggested.

Nord Vet Med, 1975 Feb, 27(2), 65 - 76
{Persistance of resistant Escherichia coli in a calf herd}; Larsen HE et al.; In an experimental station for calf feeding the occurrence and distribution of drug resistant E . coli in faeces have been investigated among selected groups of calves . Samples were obatined just after the calves arrived 1--2 weeks old in January--February and at intervals until an age of 7--11 months . Daily from arrival to the age of 8 weeks all calves at the station received antibiotics in their feed . In 1971 it was chlortetracycline and in 1972 zincbacitracin . In addition, from 3.5 percent to 60 percent of all calves were every month given therapeutic doses of antibiotics, mainly penicillin + streptomycin and neomycin . Both years the highest number of treatments were administered in the months of February and March (cf . fig . 1) . In each of the years studied, a high prevalence of calves harbouring resistant E . coli (total resistance: greater than 88 percent) and R-+E . coli (1971: 83 percent and 1972: 50 percent) was demonstrated at the first sampling . As the calves grew older a general tendency to exchange the resistant strains with sensitive ones was recognized . The prevalence of calves with R-+ E . coli generally devreased at a faster rate than that of total resistance . A discussion is given of the epidemiological significance of cross infection and of selection pressure of antibiotics for the establishment of a resistant flora in individuals as well as for replacement of this flora with sensitive strains.

Arch Otolaryngol, 1975 Feb, 101(2), 104 - 6
Isolation of the spirochetes in the perilymph despite prior antisyphilitic therapy: a case report; Wiet RJ et al.; For the congenital syphilitic patient to develop sensorineural deafness is uncommon . For the congenital syphilitic patient to have persistence of treponemes after treatment is rare . To demonstrate viable organisms in the inner ear perilymph of the congenital syphilitic patient, despite treatment with penicillin, has not been recorded to date . This is a case report of such a patient.

J Trop Med Hyg, 1975 Feb, 78(2), 34 - 7
Acute tropical polyarthritis in Sri Lanka patients; Nagaratnam N et al.; This paper described the clinical manifestations and laboratory findings in 20 patients with an unusual form of arthritis . All but two were above the age of 20 years (range 14-79) . There were eight males and 12 females . The majority of them had fever . All had multi-joint involvement . The erythrocyte sedimentation rate was elevated (mean 74 mm./hr.) . All recovered completely with penicillin and salicylates; there were recurrences in two, but no tendency to chronicity.

J Med Chem, 1975 Feb, 18(2), 172 - 7
Preparation, hydrolysis, and oral absorption of alpha-carboxy esters of carbenicillin; Clayton JP et al.; Twelve alpha-carboxy esters of carbenicillin, a parenteral broad spectrum semisynthetic penicillin, were synthesized and examined as potential oral carbenicillin derivatives . The rates at which the esters were hydrolyzed in vitro to carbenicillin by animal and human tissues were compared and the carbenicillin serum levels arising after oral administration of the esters were measured in squirrel monkeys and human volunteer subjects . The alpha-carboxyphenyl ester of carbenicillin {carfecillin (British Pharmacopoeia approved name), BRL 3475} WAS SELECTED FOR FURTHER STUDY AND IS PRESENTLY UNDERGOING CLInical trial.

J Gen Microbiol, 1975 Feb, 86(2), 283 - 93
The inheritance of penicillin titre in wild-type isolates of Aspergillus nidulans; Merrick MJ et al.; In a sample of 52 wild-type isolates of Aspergillus nidulans, penicillin titre ranged from 0-0 to 14-4 units/ml . These differences in titre were under genetic control . Most of the variation between isolates was attributable to differences between heterokaryon-compatibility groups although significant differences were also found within groups . Genetic variation for penicillin titre was observed among the progeny in four of seven crosses between wild-type isolates . In these four crosses the variation was continuous, indicating that this is a polygenically determined character, and progeny with titres superior and inferior to those of the parents were produced . The genes determining penicillin production are predominantly additive in their action . Crosses between heterokaryon-incompatible isolates generated more genetic variation than those involving compatible parents, supporting the hypothesis that heterokaryon-compatible isolates are frequently closely related.

Aust N Z J Surg, 1975 Feb, 45(1), 66 - 8
Primary actinomycosis of the abdominal wall; Minocha VR et al.; A rare case of primary actinomycosis of the abdominal wall presenting as a tumour is described . The patient responded to penicillin therapy well . A brief account of the literature is included.

Br J Vener Dis, 1975 Feb, 51(1), 38 - 40
Sectinomycin in the treatment of gonorrhoea in females and males; Finger AH; 126 female patients with proven gonococcal infection were treated with 4 g . spectinomycin bihydrochloride given intramuscularly in a single does . In 120 cases followed up there were four possible treatment failures, giving a cure rate of 97-6 per cent . 99 male patients with acute gonococcal urethritis were treated with a single dose of 2, g . sectinomycin bihydrochloride . Of 88 cases followed up, there were three possible treatment failures, giving a cure rate of 96-6 per cent . Spectinomycin is an important addition to gonorrhoea therapy but should be reserved for penicillin sensitive patients and penicillin insensitive infections.

S Afr Med J, 1975 Jan 25, 49(4), 120 - 2
A case of recurrent subacute disseminated intravascular coagulation associated with malarial prophylaxis; Gon F et al.; An adult male who twice presented with a sudden haemolytic anaemia and disseminated intravascular coagulation of uncertain aetiology is described . A possible causative agent common to both episodes is the breakdown product of pyrimethamine (Daraprim) and chlorguanide (Paludring) . A very similar case has been attributed to penicillin sensitivety . The usefulness of high dosage heparin in the treatment of the subacute form of disseminated intravascualr coagulation is illustrated in the first admission.

Br Med J . 1975 Jan 25;1(5951):205.
Letter: Rupture of uterus during prostaglandin-induced abortion; Smith AM; PIP: The author describes the history of 2 patients who experienced rupture of the uterus during prostaglandin-induced abortion . Both patients, aged 29 years (15 weeks gestational length, parity 2) and the other, 35 years old (24 weeks gestation, parity 6) presented with fetal death in utero . Both patients were managed with high doses of oxytocin as well as intravenous infusion of prostaglandins (PG) E2 . Laparotomy and hysterectomy were performed on both patients . The 29-year old patient recovered uneventfully with the help of antibiotics . The 35-year old patient experienced a mild pelvic peritonitis which responded to penicillin and kanamycin . She recovered uneventfully but had to be readmitted to the hospital later because of pulmonary infarction . The infarction was successfully treated with intravenous heparin and later, warfarin . It is possible that uterine infection and multiparity predispose to rupture of the uterus although there was no evidence of old scarring in the excised uteri of the patients . The uterine rupture in both cases was associated with considerable morbidity from anemia, infection, and pulmonary infarction . It is possible that rupture of the uterus (very uncommon in midtrimester pregnancies) is a rare complication of prostaglandin-induced termination of pregnancies .

Med J Aust, 1975 Jan 18, 1(3), 65 - 8
Acute interstitial nephritis following ampicillin hypersensitivity; Woodroffe AJ et al.; A case of acute anuric renal failure following hypersensitivity to ampicillin is presented . Renal biopsy showed severe interstitial nephritis . Treatment with prednisolone and heparin, together with supportive measures and peritoneal dialysis, was followed by rapid recovery of renal function . It is concluded that hypersensitivity to ampicillin can cause acute interstitial nephritis, analogous to that seen with penicillin and methicillin.

Acta Paediatr Acad Sci Hung, 1975, 16(2), 139 - 42
Penicillin clearance in diabetic children; Madacsy L et al.; The clearance of crystalline penicillin G was found to be significantly higher in children in the early period of diabetes than in age-matched healthy controls . The therapeutic importance of the finding is emphasized.

Dermatologica, 1975, 151(4), 216 - 22
Improvement of refractory psoriasis vulgaris after tonsillectomy; Nyfors A et al.; In order to ascertain what effect tonsillectomy may have in the treatment of children and adolescents with recurring psoriasis vulgaris, refractory to topical therapy and courses of penicillin, and triggered by infection, and also to test a possible correlation between tonsillitis and exacerbations of psoriasis, a retrospective study of the course of psoriasis after tonsillectomy, using charts and questionnaires, was undertaken in 74 psoriatic patients . Each patient served as his won control . The average age of the patients at tonsillectomy and the duration of psoriasis were 14.2 years and 4.5 years, respectively, while the average follow-up period was 4.5 years . The clearing of the psoriasis was statistically significant (p less than 0.01) as it occurred throughout the entire follow-up period in one-third of the patients, while an additional third noticed considerable improvement of their psoriasis . After trying tropical therapies of various sorts as well as courses of penicillin, tonsillectomy might be considered for recurring, refractory psoriasis vulgaris in children and adolescents.

Zh Nevropatol Psikhiatr Im S S Korsakova, 1975, 75(8), 1189 - 93
{The pathogenesis of psychomotor epilepsy (a histochemical study of a penicillin epileptic focus in the rat hippocampus)}; Gusel' VA et al.; By the aid of histochemical methods the authors sutdied the activity and distribution of acetylcholinesterase, monoamineoxidase, glutamatedehydrogynase and gammaaminobutyric acid -- transferase in the dorsal hypocampus of rats . It was shown that the activity of all the studied enzymes are significantly changed following 0.5 and 1.5 hours and are restituted following 48 hours after the formation of a pathological focus . It is concluded that a drop in the activity of glutamatedehydrogenase and gammaaminobutyric acid may be directed toward an accumulation of gammaaminobutyric acid in the epileptogenic focus and an inhibition of its activity . A drop in the histochemical reaction to acetylcholinesterase may indicate a decrease in the functions of the cholinergic systems with an active epileptogenic focus in the hypocampus.

Ann Dermatol Syphiligr (Paris), 1975, 102(3), 241 - 50
{Venereal granuloma (donovaniasis) in France}; Duperrat B et al.; The study of six cases of MacLeod-Donovan chancre, 2 in Paris, 4 in Brest, in young men coming from the West Indies, showed after 15 days incubation, a balano-preputial lesion consisting of an oval-shaped granuloma, 1 to 4 cm diameter, raised, indurated, ulcerated, reddish-yellow, spontaneously painful, bleeding easily, accompanied in 50 p . 100 of cases by inguinal adenitis, due to secondary infection . Swabs, which should be repeated, showed Donovan bodies within numerous histiocytes . The inactivity of penicillin may be contrasted with the rapidly favourable effect of streptomycin, chloramphenicol or aureomycin.

Eur Neurol, 1975, 13(6), 555 - 9
Acute transverse myelopathy caused by penicillin injection; Bacci R et al.; A case of acute transverse myelopathy with anaesthesia and flaccid paralysis of both lower limbs, following intragluteal penicillin injection, is reported . This accident was probably due to a mistaken intra-arterial injection of the drug with retrograde progression through branches of the internal iliac artery up to the spinal cord . The treatment of such events in all the cases reported by the literature has been disappointing . Therefore, particular precautions must be taken in case of intramuscular penicillin injection, according to the present and the previous cases described, in order to avoid such accidents.

Scand J Gastroenterol, 1975, 10(5), 551 - 5
Penicillin concentrations in abdominal operation wounds after intravenous administration; Raahave D; The concentration of benzylpenicillin has been studied in serum and in homogenates of the subcutaneous tissue from abdominal operation wounds in 13 patients who underwent surgery of the colon and/or rectum . An intravenous bolus of 5 megaunits benzylpenicillin gave rise to a serum median concentration of 128.0 i.u./ml and a corresponding tissue median concentration of 29.6 i.u./ml in the operation wound . The serum concentration never fell below the tissue level in sequential periods, and a significant correlation between the concentrations in serum and tissue supports a hypothesis of penetration of penicillin into the wound tissue by diffusion . The results indicate that administration of benzylpenicillin initiated at the time of colo-rectal surgery ensures concentrations in the operation wound inhibitory to a variety of contaminating bacteria, thus being an adjunct to the tissue defences in combating the development of postoperative wound infection.

J Urol, 1975 Jan, 113(1), 108 - 10
Anaphylaxis manifested by hypotension alone; Viner NA et al.; Three instances of life-threating adverse reations to intravenous contrast media and penicillin have been presented . Hypotension was the major presenting sign, and was prolonged and relieved only by copious dluid therapy . In 1 case the onset of hypotension was delayed for an hour . Urologists should be aware of the variety and proper treatment of drug reactions.

Biull Eksp Biol Med, 1975 Jan, 79(1), 3 - 6
{Corticofugal influences of somatosensory areas of the cortex on signal transmission in the posterior ventral nucleus}; Lang E et al.; Acute experiments were conducted in cats under nembutal anesthesia . A study was made of responses in the thalamo-cortical fibers coursing to the first somato-sensory area of the cortex to the electric stimulation of the fibers of the medial lemniscus . Application of penicillin to the somato-sensory cortex and development of epileptoid activity considerably diminished the amplitude of the responses in the thalamo-cortical fibers . The first somato-sensory zone proved to be much more effective than the second one . The appearance of the epileptoid activity in the projection cortex considerably diminished the inhibitory process in the posterior ventral nucleus; this was revealed by giving paired stimuli to the medial lemniscus.

Vet Med Nauki, 1975, 12(9), 56 - 60
{Methods of treatment of puerperal endometritis in cows}; Radoslavov V; Tested were two drug combinations for the treatment of a total of 111 cows affected postpartum with acute endometritis . The cows showed equal values in terms of age, annual milk yield, tending and feeding . The animals were treated via the uterus, three times at the interval of 48 hours . Used were antibiotics in combination with other therapeutic means . The first combination used included: furaccillin 1g, furazolidon 0,5 g, kanamicyn 1 g, penicillin 1 g, citric acid 5 g, and trivitaminol 80 cu . cm . Its use contributed to a 76.3 per cent conception rate within the limits of an 80-day service period, and a 56.2 per cent conception rate at first insemination . The second combination consisted of tetracycline 0.5 g, norsulfasol 5 g, pepsin 3 g, citric acid 5 g, and trivitaminol 80 cu . cm . In this case the conception rate obtained was 47.4 per cent and 28.9 per cent, respectively . The cows treated with the first combination had a shorter service period (15.9 days shorter), and the insemination index was 0.3 lower as compared with the cows treated with the second combination.

Basic Life Sci, 1975, 5A, 405 - 18
The role of the rec genes in the viability of Escherichia coli K12; Capaldo FN et al.; Mutations in the recA, recB, or recC genes significantly reduce the growth rate and viability of Escherichia coli . Cultures of rec- strains are compose of three populations of cells: viable cells, nonviable but residually dividing cells, and nonviable and nondividing cells . Nondividing cells can be separated from dividing cells by penicillin treatment and velocity sedimentation . Nondividing cells of all rec- strains are greatly reduced in their ability to synthesize DNA . recB- recC- and recA- and recB- recC- nondividing cells contain DNA . This DNA synthesized in dividing cells and segregated into the nondividing cells . recA- nondividing cells contain little or no DNA . recA- recB- recC- nondividing cell DNA accumulates single-strand breaks.

Folia Microbiol (Praha), 1975, 20(4), 289 - 97
Penicillinamidohydrolase in Escherichia coli . II . Synthesis of the enzyme, kinetics and specificity of its induction and the effect of O2; Vojtisek V et al.; The differential rate of synthesis of penicillinamidohydrolase (penicillin acylase -- EC 3.5.1.11) was studied in Escherichia coli growing in some chemically defined media and in a complex medium . The enzyme is synthesized at a constant rate only during the exponential phase of growth of cells . Its synthesis is induced most effectively (with respect to quantity) by phenylacetic acid . The induction lag of the enzyme synthesis in a medium with acetate corresponds to two generation times . The highest rate of the enzyme synthesis is reached in a medium containing phenylacetic acid as the only source of carbon and energy . The enzyme synthesis is fully repressed by an increased concentration of dissolved oxygen in the medium, even when Escherichia coli is cultivated in the medium with phenylacetic acid as the only carbon and energy source.

Anaesthesia, 1975 Jan, 30(1), 56 - 8
Post-operative convulsions due to penicillin applied to the spinal theca; Bordbar A et al.; Two cases are described and discussed in which penicillin powder applied to the theca at the end of laminectomy caused delayed convulsions.

Am J Ophthalmol, 1975 Jan, 79(1), 115 - 20
Improved corneal storage for penetrating keratoplasties in man; Bigar F et al.; Twenty-six of 28 human corneas stored for up to seven days in a simple tissue culture medium (dextran dissolved in tissue culture medium with streptomycin-penicillin mixture) remained clear and thin after keratoplasty . Temperature reversal phenomenon and electron microscopy demonstrated high quality of such tissue after storage . The method is inexpensive, requires limited technical assistance, and provides the surgeon with excellent tissue at regular operation hours.

J Am Dent Assoc, 1975 Jan, 90(1), 159 - 61
Nonfatal anaphylaxis caused by oral penicillin: report of case; Glauda NM et al.; Severe allergic reactions may occur after the ingestion of oral penicillin . It is essential that the dentist who prescribes the drug is familiar with the rationale for therapy and is equipped to initiate urgently needed treatment.

Scand J Infect Dis, 1975, 7(2), 141 - 5
Influence of diarrhea on the oral absorption of penicillin V and ampicillin in children; Bolme P et al.; Oral ampicillin and penicillin V was given to 23 and 42 children, respectively, with upper respiratory infections . The absorption of the drugs was followed on one of the first days of treatment for 3 hours after administration by taking capillary samples and determining the serum levels . Approximately 60% of the children were tested for oral absorption during convalescence, 6-8 days after the initiation of the treatment . Diarrhea was evident in more than 60% of the children during treatment with both ampicillin and penicillin V . Diarrhea of short duration did not have influence on the absorption of the antibiotics . Only when persistent diarrhea over the whole therapy period existed, absorption of penicillin V was decreased.

Acta Haematol, 1975, 53(5), 300 - 8
In vitro and in vivo influence of penicillin G on platelet aggregation; Houbouyan L et al.; The influence of penicillin G on the in vitro and in vivo ADP-induced platelet aggregation and on the platelet electrophoretic mobility has been studied . The in vitro investigations in presence of penicillin concentrations varying between 1,000 and 10,000 IU/ml of plasma, and doses of adenosine diphosphate (ADP) between 0.3 and 25/muM/ml, have shown that the photometric aggregation, as well as the screen filtration pressure are both decreased, according to the doses of antibiotic and ADP . The electrophoretic mobility is also impaired . The in vivo study of 8 patients submitted to massive penicillin therapy for bacterial endocarditis seems to be in agreement with the in vitro results, and has shown a prolonged bleeding time, an hypoadhesiveness, an impaired photometric aggregation with an early disa-gregation and a decrease of the screen filtration pressure and platelet electrophoretic mobility.

Vox Sang, 1975, 29(1), 59 - 65
Positive direct antiglobulin (Coombs') test caused by cephalexin administration in humans; Schwarz S et al.; Of 71 patients showing a negative direct antiglobulin (Coombs') test (DAT) before administration of cephalexin (CEX) three developed a positive DAT after therapy with this drug (4 percent) . No case of immunohemolytic anemia was observed . The sera of the patients with a positive DAT reacted with cephalothin-coated red cells producing high titers, with penicillin cells normal titers and with CEX cells low titers . Since the red cell eluates of these patients did not give significant reactions with red cells sensitized with CEX, cephalothin and penicillin, a nonimmunological mechanism for the development of the positive DAT in these patients has to be assumed.

Bibl Cardiol, 1975, (33), 191 - 4
Ultrasonic-cardiographic long-term observations in patients with operated stenosis of the mitral valve; Bellin H et al.; 135 patients operated for stenosis of the mitral valve were observed and treated 10.3 years, on the average . Three years of this time belong to the preoperative period and 7.3 years to the postoperative one . For evaluating the degree of stenosis, several ultrasound cardiograms were made yearly . After the operation one ultrasound examination was made every year for observing progress . In order to examine the effect of penicillin metaphylaxis on the process of restenosis, the patients were classified into different groups . The best operative result was maintained if continuous postoperative treatment with penicillin was made.

Curr Med Res Opin, 1975, 3(5), 333 - 7
Adverse reactions to alclofenac; Hort JF; By far the largest proportion of adverse reactions reported with the use of alclofenac relate to skin rashes . Estimates of the incidence of rash in approximately 1,500 patients participating in clinical trials suggest that this reaction occurred principally with the tablet (10.3%) rather than the later capsule formulation (2.1%) and since the tablet form has been discontinued there have been fewer reports . Detailed investigation of medical records and re-examination of patients developing a rash with alclofenac therapy indicate that there may be a "cross-sensitivity" between alclofenac and other drugs such as penicillin, gold salts and salicylates . Other adverse reactions to alclofenac, such as gastro-intestinal haemorrhage and blood disorders, have been reported only rarely.

Folia Microbiol (Praha), 1975, 20(4), 298 - 306
Penicillinamidohydrolase in Escherichia coli . III . Catabolite repression, diauxie, effect of cAMP and nature of the enzyme induction; Vojtisek V et al.; Synthesis of penicillinamidohydrolase (penicillin acylase, EC 3.5.1.11) in Escherichia coli is subjected to the absolute catabolite repression by glucose and partial repression by acetate . Both types of catabolite repression of synthesis of the enzyme in Escherichia coli are substantially influenced by cyclic 3',5'-adenosinemonophosphate (cAMP) . Growth diauxie in a mixed medium containing glucose and phenylacetic acid serving as carbon and energy sources is overcome by cAMP . cAMP does not influence the basal rate of the enzyme synthesis (without the inducer) . Derepression of synthesis of penicillinamidohydrolase by cAMP in a medium with glucose and inducer (phenylacetic acid) is associated with utilization of the inducer, due probably to derepression of other enzymes responsible for degradation of phenylacetic acid . Lactate can serve as a "catabolically neutral" source of carbon suitable for the maximum production of penicillinamidohydrolase . The gratuitous induction of the enzyme synthesis in a medium with lactate as the carbon and energy source and with phenylacetic acid is not influenced by cAMP; however, cAMP overcomes completely the absolute catabolite repression of the enzyme synthesis by glucose.

Physiol Bohemoslov, 1975, 24(4), 315 - 24
Thalamocortical relations in the brain of the frog, Their role in the genesis of epileptic electrographic phenomena; Servit Z et al.; The existence of a thalamocortical reverberating circuit between the dorsal thalamic and primordial hippocampal structures could be proved in the brain of the frog (Rana temporarial) by evoking recruiting potentials . Unlike the turtle, this circuit does not take part in the genesis of electrographic phenomena in the corticogram of the frog under normal resting conditions . Spindle activity could not be observed in the EEG of curarized frogs . On the other hand, thalamic structures can influence paroxysmal susceptibility of the frog forebrain . The generation of the penicillin focus could be accelerated and paroxysmal electrographic activities elicited by iontophoretic application of penicillin into dorsal thalamic structures and/or rhythmic electric stimulation of this region . The features of thalamocortical cooperation in the frog and in the turtle have been compared.

Pathol Microbiol (Basel), 1975, 42(4), 254 - 66
{Immunochemical aspects of antigenicity (author's transl)}; Schneider CH; A number of chemically definable parameters related to antigenicity are discussed . These include determinant size and density, antigen shape as well as eliciting, inhibiting and tolerogenic capacities of model antigens, notably those of the penicillin allergy model . A kinitic argument for a restricted antibody diversity is presented.

Acta Derm Venereol, 1975, 55(6), 461 - 5
Treatment of generalized scleroderma with inhibitors of connective tissue formation; Asboe-Hansen G; 103 patients suffering from generalized scleroderma were studied in order to assess the effect of treatment with inhibitors of connective tissue formation . 93 patients with generalized scleroderma were given D-penicillamine, benzyl-penicillin-diethylamino-ethyl-ester hydroiodide, adrenal glucocorticoids, dextro-thyroxine, hydralazine, and "mixed treatment" (one or several of the drugs in consecutive courses, or concurrently) . The effect of dextrothyroxine could not be evaluated in this study . No improvement could be seen after adrenocortical steroid therapy . Hydralazine seemed to be effective . D-penicillamine improved 25 of 34 treated patients; penicillin hydroiodide 12 out of 16 . The dermal sclerosis of 6 patients regressed completely; in 16, sclerosis regressed with the exception of finger sclerosis; in 32, partial regression was registered; 20 had their progression arrested, but there was no regression; in 19 cases, there was no effect whatsoever . The prognosis seemed to be better for young than for old people . The age at onset was lower in the better groups . The higher the total dose, the better the results . The length of the treatment course is probably of some significance . The short-lasting cases had better prospects than the longer lasting . Ten untreated patients of this material and 11 patients seen earlier showed continued progression . Side effects leading to discontinuation of the drugs were seen in a substantial number of patients, especially after D-penicillamine . Twelve deaths could not be related to the treatments.

Int Arch Allergy Appl Immunol, 1975, 49(4), 428 - 33
Penicillin hypersensitivity in systemic lupus erythematosus; von Maur K et al.; The prevalence of positive immediate-type skin tests to penicillin antigens among patients with systemic lupus erythematosus (SLE) was compared with hospitalized controls without SLE and found not to differ significantly . On the other hand, we confirmed previous reports that the prevalence of histories of prior penicillin reaction was significantly higher in SLE patients than among controls . This is felt to be related to the primary disease process, and we conclude that patients with SLE do not have an increased risk of IgE-mediated allergic reactions to penicillin.

Int J Clin Pharmacol Biopharm, 1975 Jan, 11(1), 7 - 9
Penicillin immunogenicity in the presence of different pharmaceutical adjuvants; Portoles A et al.; Preliminary results in the variations of the penicillin immunogenicity in the presence of aminosugars, polysaccharides and terpenic substances are presented and the decreasings of the potential antigenicity of the penicillin molecule appeared in the presence of hexosamine molecules are estimated . It might be possible as a consequence of modifications in the early immunogenic interactions between antibiotic and serum proteins of the hipersensitive animals.

J Pharmacol Exp Ther, 1975 Jan, 192(1), 113 - 9
Cardiac histamine-ouabain interaction: potentiation by ouabain of the arrhythmogenic effects of histamine; Levi R et al.; Cardiac effects of histamine include stimulation of sinus rate and ventricular contractile force, impairment of atrioventricular conduction and increase in ventricular automaticity . Atrioventricular block and increase in ventricular automaticity are common features of digitalis toxicity . The purpose of the present investigation was to study the influence of low concentrations of ouabain on the cardiac effects of immunologically released and administered histamine . Hearts excised from guinea pigs passively sensitized to penicillin antigens responded to antigen with sinus tachycardia, atrioventricular conduction block, increase in ventricular automaticity, decrease in coronary flow rate and histamine release . During anaphylaxis in the presence of ouabain, 10-9 and 3 times 10-9 M, the duration of conduction arrhythmia and the incidence of ventricular automaticity were greatly increased . Dose-response studies for the cardiac effects of exogenous histamine were conducted in vitro in the presence of ouabain 10-9 and 3 times 10-9 M . Ouabain, in a concentration-dependent fashion, potentiated histamine-induced prolongation of the P-R interval, but not the increases in sinus rate and in ventricular contractile force . Oution block and idioventricular also greatly increased the incidence of histamine-induced atrioventricular conduction block and idioventricular rhythms . Our results clearly identify a histamine-Ouabain interaction leading to severe disruption of atrioventricular conduction and to increased ventricular automaticity.

Int Arch Allergy Appl Immunol, 1975, 48(3), 422 - 8
Immune response in the guinea pig to penicillin-autologous carrier proteins; Girard JP et al.; The spontaneous fixation of penicillin G on guinea pig serum protein was studied . Serum albumin and Ig were shown to fix firmly over 95% of penicillin . Therefore, guinea pigs were immunized with penicillin alone or penicillin-autologous carrier protein conjugates . The production of hemagglutinating antibody, of MIF and the in vitro stimulation of lymphocytes were analyzed as immunological parameters . The results showed that in all cases the strongest immunological response was obtained with animals immunized with the protein-hapten conjugates, whereas no response could be obtained with the carrier protein alone . Finally it was shown that the conjugates significantly stimulated purified T cell population . These results suggest that the antigenic recognition of penicillin involves the participation of lymphocytes.

WHO Chron, 1973 Oct, 27(10), 410 - 7
Venereal disease and treponematoses--the epidemiological situation and WHO's control programme; Idsoe O et al.; PIP: In recent years the epidemiological pattern of venereal disease and endemic treponematoses has undergone important changes in both developing and developed countries . This discussion outlines the present situation and indicates the role that the World Health Organization (WHO) is playing in efforts to combat these infections . About 15-20 years ago 2 contrasting epidemiological situations confronted health authorities around the world . The developed countries were experiencing the lowest recorded incidence of venereal diseases since World War 2 . At the same time in developing countries nonvenereal endemic treponematoses were becoming a major health problem because of their widespread endemicity and their disabling effect on the sufferers, which was causing a serious reduction in manpower resources . By the mid 1950s reports from several countries showed an increase in the incidence of early syphilis and gonorrhea and during the subsequent years the rising trend continued and began to affect most countries of the world . Simultaneously, the prevalence of endemic treponematoses dropped markedly in several developing nations as a result of WHO/UN International Children's Emergency Fund (UNICEF) assisted mass treatment campaigns . There can be little question that the introduction of penicillin for the treatment of venereal diseases and treponematoses made a major contribution to the developments outlined . The marked treponemicidal effect of this drug, its ease of administration, and the low incidence of side effects made it almost ideal for the safe, short-term, ambulatory treatment of both venereal and nonvenereal treponematoses as well as of gonorrhea . The immediate result of intensive antivenereal campaigns in the developed countries at the end of World War 2 as well as of the mass treatment campaigns against endemic treponematoses was excellent . Yet, it led some to believe that these infections could be completely eliminated by treatment alone . Subsequent experience has shown this opinion to be unjustified, because the transmission of venereal diseases and treponematoses is closely dependent upon the socioeconomic structure of the society concerned . It is clear at this time that a new approach is required in the field of endemic treponematoses . The era of mass treatment is most likely nearing its end . The endemic treponematoses will remain a longterm public health problem until the hygiene and socioeconomic conditions of the populations concerned are improved so as to eliminate low level transmission of the disease . In regard to the increase of early syphilis and gonorrhea reported from most countries since 1955-57, it should be noted that national statistics are unreliable . Underreporting is general and the statistics are variously estimated to represent between 10% and 50% of the true number of cases .

Br J Vener Dis, 1973 Oct, 49(5), 460 - 3
In search of an ideal single-session penicillin schedule for the treatment of gonorrhoea in Uganda; Arya OP et al.; PIP: To determine the most effective, economical therapy for gonorrhea in Uganda, 5 single-session penicillin schedules were compared in a group of 460 university students with urethral discharge . A total of 590 episodes of gonococcal urethritis were treated . Patients were randomly allocated to 1 of 5 schedules . Treatment schedules and cure rates were as follows: 1) aqueous procaine penicillin 2.4 m.u . (125 cases), 90.3%; 2) procaine penicillin 2.4 m.u . plus ampicillin 1 gm (143 cases), 97.1%; 3) procaine penicillin 3 m.u . (90 cases), 89.8%; 4) procaine penicillin 3 m.u . plus probenecid 1 gm (103 cases), 97.1%; and 5) probenecid 1 gm orally followed by benzyl penicillin 5 m.u . (129 cases), 96.8% . 30 of the 31 treatment failures were successfully treated with an alternate schedule . The results obtained with procaine penicillin alone are considered unfavorable . Although highly effective, the probenecid and benzyl penicillin regimen is expensive and requires the preparation of penicillin with lignocaine solution and an extra 30-minute wait, making it inappropriate for Uganda's busy multipurpose clinics . The procaine-ampicillin combination was also highly effective, but its high cost limits it use to private practice . The 3rd highly effective schedule, the combination of procaine penicillin and probenecid, appears to most closely approximate the ideal single-session penicillin schedule for treatment of gonorrhea in Uganda . It is both inexpensive and easily administered . Moreover, the prolonged penicillinemia achieved by 3 m.u . procaine penicillin may be more effective in eliminating cases of incubating syphilis than benzyl penicillin . Long-acting procaine penicillin in oil with aluminum monostearate (PAM), which is the most widely used treatment regimen in the rural medical units of Uganda, is no longer indicated and may, in fact, be encouraging the spread of less sensitive strains of gonorrhea . Any change toward a more effective treatment schedule must, however, be accompanied by improvement in the diagnostic and treatment facilities in the country .

Med Clin North Am, 1972 Sep, 56(5), 1101 - 4
Professional education and the control of the venereal diseases; Webster B; PIP: Although practicing physicians treat 80% of cases of venereal disease (VD) in the US, the teaching of VD control has almost disappeared from the medical schools . With the advent of penicillin treatment for syphilis, the medical profession became complacent about the dangers of syphilis, it was relegated to a minor position in medical school curricula, and federal budgets for VD control declined sharply . These factors, along with the decrease of infectious cases, brought about a general loss of interest, particularly in research and teaching . In many cases the physician undertaking VD treatment has not been prepared to do so . A 1965 survey receiving 450 replies from 76 countries indicated that an average of 17.1 hours were spent on VD when it was treated as a separate subject while 25.6 hours were spent when it was combined with another subject, usually dermatology, preventive medicine, or urology . Public health and epidemiological aspects apparently received little attention . Letters accompanying the survey replies, however, indicated a great interest in the problem and need for assistance . In an effort to promote the teaching of VD control, a demonstration project was established in the Department of Medicine at the New York Hospital and Cornell University Medical College with the assistance of the VD Control branch of the Centers for Disease Control . During 1971, 555 new cases of syphilis were studied, including 4 of neurosyphilis, 4 of cardiovascular syphilis, and 40 of syphilis in pregnancy . Close liaison is maintained with the Department of Infectious Diseases at the hospital, and the assistant residents and elective students rotate through the clinic . A contact investigator from the New York City Department of Health is assigned part time to the clinic, and students and residents participate in the investigations . Group discussions are held with residents of various other departments, especially medicine, obstetrics, and dermatology . The pilot project indicates that with a relatively small teaching grant, an active syphilis teaching program can be maintained in a university hospital . Educational materials describing proper diagnosis and treatment of VD should be made available to practicing physicians through state and county medical societies .

Obstet Gynecol, 1972 Mar, 39(3), 368 - 72
Quantitative method of evaluating the functional patency of human uterine tubes . Correlation with 61 laparotomy cases; Horne HW Jr et al.; PIP: A quantitative method of hydrotubation has been devised using a CO2 insufflator attached to a calibrated burette filled with penicillin-saline solution or plain saline . A constant pressure of 60, 120, or 180 mm of mercury is maintained from a gas cylinder against the saline efflux . The uterine cavity is filled, requiring 3 to 8 ml; then time required for 10 ml of the saline to flow is measured . Delay in flo w indicates tubal obstruction . The method is contraindicated in acute pelvic inflammatory disease, uterine bleeding, ovulation, or elevated body temperature . In more than 3000 tests there were only 2 with complications, in each case severe pain lasting for 1 day . Of the 12 patients who complained of some pain, 11 were later found at laparotomy to have tubal pathology . The preoperative status of tubal patency in 61 infertile patients was compared with findings at laparotomy by using an indigo-carmine dyne in the solution . A correct preoperative diagnosis had been made in 52 patients (85.2%) . In 48 in whom tubal patency had b een considered abnormal, 90% were found to be so at laparotomy . In 13 thought to have normal tubes 4 had tubal pathology and in 3 of these there was a normal tube on 1 side . This method is considered more reliable than tubal insufflation (Rubins's test) . It is safe, usually painless, and can be done as an office procedure . There is no x-ray exposure as in hysterosalpingography .

Gen Comp Endocrinol, 1971 Aug, 17(1), 22 - 32
{In vitro action of hypothalamic luteinizing hormone releasing factor (IRF) on lamb anterior pituitary . I . Kinetics of excretion of luteinizing hormone (LH)}; Jutisz M et al.; PIP: Partially and highly purified sheep LH-releasing factor (LRF) induced secretion of LH during incubations of anterior pituitary slices from ovariectomized ewes treated vaginally or by subcutaneous injection with fluorogestone acetate . The incubation medium contained Krebs-Ringer bicarbonate buffer with glucose, amino acids, mannose, galactose, fucose, glucosamine, galactosamine, sialic acid, calf serum, penicillin, and streptomycin . First, the optimum effect of a dose of 45 mg fluorogestone daily for 12 days before slaughter was demonstrated . These tissues yielded about 2-6 mcg LH per mg tissue in 2 hours . A dose curve of LRF showed 4.7 mcg per mg tissue was optimal, and this dose was adjusted for the purity of the LRF used in subsequent experiments . Added LH, 15.5 mcg highly purified, did not lessen LH production . LH production was fairly constant for 4-5 hours, if the medium were not changed, but increased for up to 7 hours if the medium were renewed . After incubation with labeled amino acids or proline, LH was purified 26-fold over other proteins by ammonium sulfate fractionation DEAE-cellulose chromatography, and Sephadex gel filtration . This LH was biologically active by radioimmunoassay and by the ovary ascorbic acid depletion assay, and of high specific activity, 2.2 Ci per mole LH .

Obstet Gynecol, 1971 Jul, 38(1), 29 - 36
Management of sexually assaulted females; Massey JB et al.; PIP: The victim of sexual assault has 5 needs: 1) care of injuries, 2) prevention of venereal disease, 3) prevention/alleviation of psychologic damage, 4) medicolegal examination with documentation for law enforcement authorities, and 5) prevention of pregnancy . The staff of Philadelphia General Hospital, in a program designed to meet these needs, treated 480 (24.6 per 100,000 population) victims of sexual assault in 1968 . 70% were ages 14-44, 24% below 14 years of age . In this program, serologic testing and cultures are followed by intramuscular injection of penicillin, 2,400,000 units . Both pediatric and adult victims are treated with reassurance, close follow-up and psychiatric referral as indicated . Detection of motile spermatozoa by examination of vaginal aspirate by a qualified experienced laboratory technician is of utmost importance . Postcoital contraceptive therapy revealed a high incidence of gastrointestinal side effects and 4 pregnancies were established in the treated cycle .

Ghana Med J, 1971 Mar, 10(1), 56 - 9
Stevens-Johnson syndrome following anticonvulsant therapy in penetrating head injury; Adeloye A et al.; Five cases of Stevens-Johnson syndrome are described in patients with penetrating head wounds who were treated with Penicillin, streptomycin, sulphadiazine and the anticonvulsant drugs, epanutin and phenobarbitone . One patient who continued to have only his anticonvulsants after the appearance of his skin eruption, died . In two other cases, epanutin and phenobarbiton each was responsible for the Stevens-Johnson syndrome.

Br J Vener Dis, 1970 Apr, 46(2), 141 - 4
Recent developments in the treatment of gonorrhoea; Willcox RR; PIP: Rising failure rates with single injections of penicillin in gonorrhea are causing alarm . In the Far East, the failure rate is about 30% after single injections of 2.4 mega units of aqueous procaine penicillin . In London, although there is rising gonoccoccus resistance to penicillin, single injections of 1.2 mega units of aqueous procaine penicillin nets a cure rate of 85.8% to 91.5% in male patients . Other recent experiences in the treatment of gonorrhea in London men are outlined in this article . The failure rate was reduced to 5.8% when a single injection of 2.4 mega units of procaine penicillin was given . When 1 gm probenecid was given orally along with 1.2 mega units of procaine penicillin, the failure rate was 6.6% . Streptomycin is so ineffective now against gonorrhea that it is no longer acceptable even as a first treatment in patients who are allergic to penicillin . In London, the failure rate with streptomycin is 31.7% . Experts think the rate will jump to 85.8% in the next year . Many other antibiotics can be used against gonorrhea, but, as in the case of streptomycin, they may lose their effectiveness . Some recent experiences show that a combination of rolitetracycline by injection and tetracycline by mouth does not give as good results as a single injection of aqueous procaine penicillin but that comparable results can be obtained with single oral doses of rifampicin and superior results (95.7% success) were obtained with 2 oral doses of dementhylchlortetracycline .

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