Am J Surg, 1994 Jan, 167(1A), 31S - 36S Diabetic foot ulcers; Laing P; Neuropathic and vascular changes in patients with diabetes mellitus put them at risk for developing chronic foot wounds after minor trauma or after pressure has caused a breakdown in the integrity of the skin . Accurate diagnosis of the underlying cause is the first step toward a successful treatment plan, and in patients with severe ischemia, vascular reconstruction may be needed . Neuropathic ulcers respond well to less-invasive procedures, particularly when combined with reducing the pressure that caused the ulcer . When pressure is relieved by means of total contact casting, necrotic materials are removed, and protection is secured with a hydrocolloid dressing, these wounds have been found to heal, on an outpatient basis, after approximately 6 weeks . All diabetic foot ulcers are contaminated with a variety of organisms, but antibiotic treatments are usually unnecessary . When signs of a clinical infection are present and/or bone is exposed, osteomyelitis should be suspected . In these patients, aggressive surgical debridement, systemic antibiotics, and meticulous wound care regimens to restore the body's own bacterial barrier will often prevent amputation, the most serious complication of these wounds. Toxicol Pathol, 1994 Jan-Feb, 22(1), 15 - 22 Distribution of gentamicin to the cochlea of the chicken embryo; Fikes JD et al.; Aminoglycoside antibiotics are ototoxic in mammals and birds, including recently hatched chicks, but chicken embryos are insensitive to the ototoxicity of gentamicin, kanamycin, and streptomycin . To determine whether or not the insensitivity is due to a lack of antibiotic distribution to the avian cochlea, the distribution of gentamicin to the cochlea of the White Leghorn chicken embryo was compared to the distribution to the cochlea of the recently hatched White Leghorn chick . Fertile eggs were injected with a maximally tolerated dose of gentamicin sulfate (0.1 mg/egg/day) on incubation days 10-18, and the chicks were injected subcutaneously with either 5 mg (non-ototoxic) or 100 mg (ototoxic) gentamicin sulfate/kg body weight on days 1-9 after hatching . Gentamicin sulfate was histochemically detected within the basilar papilla (the avian equivalent of the organ of Corti) in all treated chicken embryos and chicks by 1 day after the first injection, and the staining was intense after 3 days of treatment . By ultrastructural immunocytochemistry, mild, diffuse labeling for gentamicin sulfate was detected within the endoplasmic reticulum of short and tall hair cells of chicken embryos by incubation day 17 . Moderate labeling of gentamicin sulfate was detected in the infracuticular region of lysosomes of hair cells in chicks receiving 5 treatments of gentamicin sulfate at 5.0 mg/kg body weight and after 1 treatment of gentamicin sulfate at 100 mg/kg body weight.(ABSTRACT TRUNCATED AT 250 WORDS) Rev Med Chil, 1994 Jan, 122(1), 102 - 8 {Active epidemiologic surveillance of tuberculosis}; Medina E; With 5,000 new active cases each year, tuberculosis in Chile remains as the most important communicable disease in the country . Since the type of control programs are linked to the epidemiologic situation as far as infection, morbidity and mortality are concerned, an effective surveillance system is needed, with analysis of the general data and an active search for other evidences which show the advantages and problems of the control programs . The number of active cases shows a downward trend with 66 new cases per 100,000 population in 1982 and 37 in 1992 . nevertheless, in Santiago, comparing years 1991 and 1991, an increase of 4% in morbidity, 37% of mortality and 33% in the case fatality rate are observed . Morbidity rates are variable with highest numbers in the I Region of Tarapaca probably linked to the prevalent ethnic type of the population . One quarter out of total tuberculosis deaths depends on the late effects of the disease and three quarter are the consequences of recent active disease . People over 55 years of age represents 25% out of total new cases . Besides classical indicators it is important to consider the frequency and results of the practice of diagnostic laboratory tests; the antibiotic therapy resistance; the results of the treatment, analyzing cohorts of treated people; the importance of different infection factors; the evaluation of BCG immunization; the meaning of animal tuberculosis infection; the slowness in the beginning of treatment in new cases; the results of the screening of high risk population and the systematic analysis of each death due to tuberculosis. J West Soc Periodontol Periodontal Abstr, 1994, 42(1), 5 - 8 Combination of tetracycline and metronidazole in the treatment and control of refractory periodontitis; Khatiblou FA; Nine patients with refractory periodontitis were selected for this study . Each patient had undergone surgery once or twice in the previous five years and had been on three-month recall for clinical examination and scaling . During the maintenance phase of therapy and despite regular scaling, each patient had additional pocket formation that was either localized or generalized . Pocket depths in each patient were recorded and scaling was carried out . Three months later the patients were examined, and again no improvement was observed in the pocket depths . This time all patients were scaled again, and 250 mg tetracycline every six hours for 20 days as well as 250 mg metronidazole every eight hours for seven days were systemically administered . After an additional three months, patients were again examined and pocket depths measured . The latter examination disclosed that the clinical condition of the gingiva, as shown by bleeding and exudate, had improved . The pocket depths had also been reduced . The scaling-alone mean pocket depths were 4.93 mm, whereas the scaling-plus-antibiotic measurements were reduced to 2.78 mm . The difference was significant (p = 0.01). Arch Orthop Trauma Surg, 1994, 113(3), 167 - 9 Tissue concentrations of third-generation cephalosporins (ceftazidime and ceftriaxone) in lower extremity tissues using a tourniquet; Papaioannou N et al.; Prophylactic antibiotic administration for selected major orthopaedic procedures is feasible with wide-spectrum antibiotics that can achieve high tissue levels . We studied the influence of tourniquet on the in vivo concentrations of ceftazidime and ceftriaxone in soft tissue and bone . Our study group consisted of 47 patients undergoing reconstructive operations of lower extremities . The effect of different time intervals between antibiotic administration and tourniquet inflation was examined . Our data suggest that the time interval resulting in the highest tissue concentrations is approximately 20 min between administration and tourniquet inflation. Scand J Gastroenterol Suppl, 1994, 201, 16 - 23 The role of acid inhibition in the treatment of Helicobacter pylori infection; Axon AT; The recognition that Helicobacter pylori is a causal factor in the development of most peptic ulcers (and may play a role in the pathogenesis of gastric cancer) has provided an impetus to the search for a suitable regimen that will eradicate the organism . Combinations of antibiotics with bismuth (triple therapy) eradicate the organism in around 90% of cases, but the regimens are complicated, and poor compliance and significant side effects are frequently seen . The observation that omeprazole in combination with a single antibiotic provides eradication rates of over 80% is an important advance, as this combination is a simple regimen and is well tolerated . In this article, the role of omeprazole in eradication therapy is discussed, the published data are reviewed and hypotheses relating to the mode of action of omeprazole are presented . Although the optimum therapy has yet to be identified, acceptable results should be obtained by using omeprazole, 40 mg twice daily, plus amoxycillin, 500 mg four times daily, for 2 weeks. J Gynecol Obstet Biol Reprod (Paris), 1994, 23(2), 193 - 201 {Premature rupture of membranes . Prospective study of 218 cases}; Coste JP et al.; OBJECTIVES: To verify the importance of a wait-and-see attitude after premature rupture of the membranes before 34 weeks of amenorrhoea when allowed by the initial physical examination and of an intervening attitude after 34 weeks . STUDY: A prospective study included 218 cases of premature ruptures of the membranes divided into four groups according to the weeks of amenorrhoea: Group 1, before 32 weeks (n = 11); Group 2, between 32 and 34 weeks (n = 26); Group 3, between 34 and 37 weeks (n = 18); Group 4 after 37 weeks (n = 163) . RESULTS: Before 34 weeks of amenorrhoea, the frequency of premature rupture of the membranes was 0.72%, of germ-positive infants 8% and of infected infants, 11% . Perinatal mortality was 80% and 17.4% of the infants were delivered by cesarian section . Labour was induced in 100 cases (46%), when there was evidence of infection, after a 24-hour waiting period or at 34 weeks of amenorrhoea . When the aspect of the cervix was unfavourable, cervical maturation was induced by intravenous injection of prostaglandins in 75 cases (34%) . CONCLUSION: When the rupture occurred before 34 weeks of amenorrhoea and without signs of infection, tocolysis should be entertained . From 28 to 34 weeks and when a favourable outcome is expected, maturation by corticoids can be proposed . When chorio-amniotic infection is suspected and is not confirmed by the laboratory, antibiotic prophylaxy does not appear to improve fetal outcome . The beneficial effect of a conservative wait-and-see attitude before 34 weeks and of intervening thereafter can only be demonstrated with a large randomized study . Thus each case must be managed individually, making it difficult to establish a standard recommended attitude. Vasa, 1994, 23(2), 159 - 62 {Autogenous reconstruction in mycotic inguinal aneurysm--long-term result}; Hegenscheid M et al.; A ruptured mycotic aneurysm of the left femoral artery in the groin area in a 44-year-old man had to be surgically treated in 1990 by an autogenous in-situ-repair consisting of aneurysmectomy including the femoral bifurcation, autologous vein interposition using medium-term absorbable suture material, and local application of an antibiotic bonded collagen . The infection could be checked in a short time . Three years after the operation the check-up gave evidence of an excellent local result with good arterial circulation in both legs . Autogenous in-situ-repair appears to be the most efficient procedure for treatment of an arterial infection or an infected graft . Especially in the area of bifurcations (i.e . inguinal and popliteal as well) this management is preferable to the aseptic extra-anatomic bypass procedure, since only this method can preserve the orthograde perfusion of the bifurcation branches. Vox Sang, 1994, 66(3), 200 - 5 Relative importance of immune and non-immune causes of platelet refractoriness; Doughty HA et al.; In this prospective study, 26 consecutive patients being treated for haematological malignancies receiving standard (i.e . non-leucocyte-depleted) blood components were observed for the development of refractoriness to platelet transfusions . One hundred and sixteen of the 266 (44%) platelet transfusions failed to produce a satisfactory response . In 102/116 (88%), the poor response was in the presence of non-immune factors known to be associated with platelet refractoriness . Non-immune factors were present alone in 78/116 (67%), and in combination with immune factors in a further 24/116 (21%) . Immune factors (HLA and platelet-specific antibodies) were present during 29/116 (25%) of unsuccessful platelet transfusions . Statistical analysis confirmed that platelet refractoriness was significantly associated with the presence of non-immune factors . The non-immune factors associated with refractoriness were often multiple, most frequently a combination of fever, infection and antibiotic therapy . This study provides evidence that immune mechanisms were not the predominant cause of platelet refractoriness in the patient population studied . It also suggests that measures for the prevention of HLA alloimmunisation, such as leucocyte depletion, may have a limited impact in reducing the incidence of refractoriness to platelet transfusions. Nat Toxins, 1994, 2(1), 4 - 13 Fusapyrone and deoxyfusapyrone, two antifungal alpha-pyrones from Fusarium semitectum; Evidente A et al.; A strain of Fusarium semitectum Berk . & Rav . from maize stalk rot in southern Italy produced bioactive metabolites when cultured on autoclaved rice kernels at room temperature for 4 weeks . The organic extracts of fungal culture showed a strong antibiotic activity towards Geotrichum candidum in disk diffusion assays, but they were not toxic to Artemia salina larvae . Two antifungal metabolites were isolated and characterized by chemical and spectroscopic methods as two 3-substituted-4-hydroxy-6-alkyl-2-pyrones, in particular, the 3-(4-deoxy-beta-xylo-hexopyranosyl)-4-hydroxy-6-{2-hydroxy-7-hydroxymeth yl- 1,1,5,9,11-pentamethyl-3,5,8-heptadecatrienyl}-2H-pyran-2-one and its 6-{2-hydroxy-1,1,5,7,9,11-hexamethyl} analog, which were named fusapyrone and deoxyfusapyrone, respectively. Respir Med, 1994 Jan, 88(1), 49 - 53 Effect of addition of exercise to chest physiotherapy on sputum expectoration and lung function in adults with cystic fibrosis; Baldwin DR et al.; Promotion of sputum expectoration by chest physiotherapy is an essential part of cystic fibrosis management . The role of exercise in improving sputum expectoration and lung function in these patients is more contentious . We therefore investigated the effect of adding an exercise programme to conventional chest physiotherapy in eight adult subjects (four male) with cystic fibrosis . Subjects were treated on two non-consecutive days of the second week of a course of in-patient antibiotic therapy in a cross-over fashion . On the exercise and physiotherapy day, subjects exercised 60 min before physiotherapy . On the physiotherapy alone day, subjects rested for 60 min instead of exercising . Physiotherapy was administered on both study days (postural drainage, percussion, deep breathing, vibrations, forced expiratory technique and coughing) . Lung function tests were performed at baseline, after exercise or rest and again immediately and 30 min after physiotherapy . Sputum weights were measured in the 60 min of exercise or rest (period A) and for the 60 min physiotherapy period and 30 min after physiotherapy (period B) . Mean total sputum expectoration (period A and B) was 14 g on physiotherapy alone and 21.5 g (4.8) on exercise and physiotherapy (mean difference 7.5 g, 95% CI 1.4-13.6 g, P = 0.02) . Mean sputum weights during period A (i.e . rest vs . exercise) on physiotherapy alone and exercise and physiotherapy were 2.6 and 7 g respectively (mean difference 4.4 g, 95% CI-0.07-8.8 g, P = 0.053).(ABSTRACT TRUNCATED AT 250 WORDS) Diagn Microbiol Infect Dis, 1994 Jan, 18(1), 7 - 12 Cultural studies on two isolates of "Mycobacterium genavense" from patients with acquired immunodeficiency syndrome; Tortoli E et al.; Two strains of the newly proposed species "Mycobacterium genavense" have been isolated, using the radiometric system (Bactec, Becton Dickinson), from the blood of two HIV-infected patients . Disseminated infections due to the new organism closely resemble those of the Mycobacterium avium complex, with prevalently intestinal symptomatology . We report here on the cultural behavior of the isolates, which are enhanced at pH 6, are inhibited by NAP, do not require supplements, and grow best at 37 degrees C . We also report on the antibiotic susceptibility of the isolates. Clin Exp Obstet Gynecol, 1994, 21(1), 33 - 7 Ceftriaxone in prevention of complications after cesarean section and its influence on the newborn; Sulovic V et al.; The study included 303 patients subjected to elective cesarean section . Thirty two (11%) patients were classified in group A (with prophylactic ceftriaxone administration), 28 (87.5%) of whom had uneventful postoperative courses and 4 (12.5%) who had complications . Group B (with therapeutical application of ceftriaxone) was composed of 135 (45%) patents, 127 (94.1%) with uneventful postoperative courses and 8 (5.9%) with complications . Group C (in whom other antibiotics were used) consisted of 95 (31%) patients, 72 (75.8%) with uneventful postoperative courses and 23 (24.2%) with complications . Group D (no antibiotics used) was composed of 41 (13%) patients, 31 (75.6%) with uneventful postoperative courses and 10 (24.4%) with complications . Statistical analysis revealed highly significant differences in distribution of complications according to whether any, and which one of the antibiotics was used (X2 = 17.81, p < 0.005) . This difference mainly resulted from lower incidence of complications associated with ceftriaxone use than in patients with no antibiotic therapy (X2 = 11.66; p < 0.005) as well as in patients using other antibiotics (X2 = 15.95; p < 0.005) . Significant difference was also noted when patients given antibiotics other than ceftriaxone were compared with patients receiving no antibiotics other than ceftriaxone were compared with patients receiving no antibiotic therapy (X2 = 4.45; p < 0.05) . Group A of newborns included 17 (89.5%) with high Apgar score, while 2 children (10.5%) had the score below 8 . Group B had 2 children (11.7%) with Apgar score below 8, while 15 (88.3%) children had higher scores.(ABSTRACT TRUNCATED AT 250 WORDS) Eye, 1994, 8 ( Pt 1), 35 - 40 The natural history and management of recurrent corneal erosion: a prospective randomised trial; Hykin PG et al.; One hundred and seventeen patients with a history of recurrent corneal erosion were recruited at initial hospital presentation . Seventy-five cases had a history of shallow corneal injury, 23 had epithelial basement membrane dystrophy (EBMD), 8 had both and 11 had neither . Mean age at presentation was 38 years and follow-up ranged from 6 to 16 months (mean 10.6 months) . Sixty-one patients presented with a first acute corneal erosion, 21 with a subsequent acute corneal erosion and 35 with chronic symptoms . Patients with EBMD or a trauma-related focal epithelial basement membrane abnormality were more likely to present with chronic recurrent symptoms than trauma-related cases with no abnormality on examination . Both EBMD and trauma-related cases typically recurred in the lower half of the cornea, frequently in the midline (z = 7.3, p < 0.0001), suggesting an intrinsic or acquired abnormality of the epithelial basement membrane at this site . Only four of 82 acute episodes did not resolve by 5 days with simple patching, cycloplegia and topical antibiotic ointment . In the vast majority of patients presenting with an acute erosion, simple management measures only are required . Of 117 cases started on prophylactic ointment at night, further therapy due to prophylaxis failure was required in only 5 . EBMD was a risk factor for failure (relative risk 10.77) . There was no difference in efficacy between once daily prophylactic paraffin and hypertonic saline ointments (p = 0.17), suggesting they both have only a lubricant action. J Dent Hyg, 1994 Jan-Feb, 68(1), 30 - 4 A study of oral candidiasis in HIV-positive patients; Van Meter F et al.; PURPOSE . Candidiasis may occur as the first clinical sign or symptom of HIV disease . Oral candidiasis was studied with respect to immunological status, and response to antifungal therapy in a group of HIV-positive individuals with a history of recurrent oral candidal infections . METHODS . Yeast cultures were obtained from 16 HIV-positive patients and identified and quantitated on a weekly basis until the infection was controlled . Thereafter, cultures were taken monthly or when recurrences occurred for a minimum of three to a maximum of 15 months . Ketoconazole and fluconazole were administered to control clinical signs and symptoms, which were evaluated by appearance and location in the oral cavity . Culture smears were quantitated by colony-forming units (CFUs) on dextrose agar plates . Individual patient medical histories included current medications, the presence of xerostomia, smoking habits, and denture wear . Frequency data only are reported due to the small number of patients included in the study . RESULTS . The presence of clinical lesions coincided with increased colony-forming units, and a combination of pseudomembranous and erythematous lesions was the most prevalent . Frequently, a patient's lesions had the same clinical appearance as previous episodes involving the same oral sites . However, the presence of Candida cannot be accurately assessed by clinical signs alone since high CFU counts were found in patients demonstrating no clinical signs or symptoms . CONCLUSIONS . An increasing yeast burden in the oral flora may result from a combination of local factors such as smoking, xerostomia, antibiotic or antiviral medication, and decreasing cell mediated immunity leading to immune tolerance towards Candida . Negative cultures following antifungal treatment most likely reflect a diminished yeast population rather than eradication of Candida . Subclinical Candida in the oral flora warrants consideration in prophylactic treatment options for the HIV-positive patient. DNA Seq, 1994, 4(4), 219 - 29 Cloning and nucleotide sequence of a region of the Kibdelosporangium aridum genome homologous to polyketide biosynthetic genes; Piecq M et al.; The actinomycete Kibdelosporangium aridum naturally produces ardacin, a new glycopeptide antibiotic, the biosynthetic pathway of which should involve the participation of a polyketide synthase (PKS) . A K . aridum 2.9 kb BamHI genomic fragment homologous to actI (a locus of the PKS cluster catalyzing polyketide chain assembly for actinorhodin biosynthesis in Streptomyces coelicolor) was isolated by shotgun cloning . This DNA fragment, called ardI, was sequenced and the deduced protein products were compared with those of other polyketide synthase genes, revealing similarities ranging from 50 to 80% . ardI was further used to probe a cosmid library of the K . aridum genome . Three hybridizing cosmids were obtained which contain overlapping inserts, together covering a 50 kb region, and including, 15 kb away from ardI, a fragment homologous to actIII, which codes for the ketoreductase of the actinorhodin PKS of S . coelicolor . All these findings indicate that at least part of a polyketide biosynthetic gene cluster has been isolated from the genome of the ardacin producer K . aridum. Respiration, 1994, 61(4), 231 - 5 Efficacy of cefazolin in promoting ovine tracheal epithelial repair; Barrow RE et al.; Inhalation of toxic materials has been shown injurious to the upper airways . Because secondary infection can slow the repair process, we undertook this study to determine the efficacy of antibiotic therapy in promoting the healing process of acute tracheal wounds . In 18 anesthetized sheep, a portion of the cervical trachea was exposed to smoke from smoldering cotton cooled to 38 degrees C . Nine received the broad-spectrum antibiotic, cefazolin, while none received saline placebo . At 13 days after injury, nonciliated and ciliated cell counts were 75% and 33% respectively of noninjured trachea receiving placebo, while in those receiving cefazolin, nonciliated and ciliated cell counts increased to 93% and 114% of paired noninjured trachea, respectively . We suggest that cefazolin therapy allows cell proliferation and differentiation to proceed more rapidly than observed with placebo therapy and thus may be a helpful augmentor to the healing of an acute airway injury. Nephrol Dial Transplant, 1994, 9(7), 797 - 9 Treatment of resistant peritonitis in continuous ambulatory peritoneal dialysis with intraperitoneal urokinase: a double-blind clinical trial; Innes A et al.; Resistant peritonitis in continuous ambulatory peritoneal dialysis (CAPD) is an indication for catheter removal, followed by interim haemodialysis and subsequent catheter replacement . This involves two surgical procedures using general anaesthetic and the availability of adequate hospital haemodialysis facilities . Urokinase is an alternative therapy but evidence of its effect is anecdotal and it has not been studied in a double-blind manner . Patients with resistant peritonitis (either no resolution of peritonitis within 4 days of appropriate antibiotic therapy or a third episode of peritonitis within 6 months) were randomized to receive intraperitoneal urokinase or placebo (saline) followed by 14 days of antibiotics in this double-blind prospective study . Treatment success was resolution of peritonitis within 4 days of giving urokinase/placebo (persistent infection) and no recurrence with the same organism for 6 months (recurrent infection) . Twelve patients received urokinase and 12 placebo . Treatment was successful in 8/12 in the urokinase group and 1/12 in the placebo group (Fisher's exact test; P = 0.0047) . Urokinase was successful in 8/12 patients with resistant peritonitis and significantly better than placebo . Urokinase is an effective and simple treatment that may avoid the need for catheter removal and interim haemodialysis in patients with resistant CAPD peritonitis. Invest New Drugs, 1994, 12(1), 67 - 70 Phase II trial of menogaril in metastatic adenocarcinoma of the prostate . A Southwest Oncology Group study; Taylor SA et al.; Menogaril, a semisynthetic anthracycline antibiotic, was administered to patients with metastatic adenocarcinoma of the prostate . Forty-five patients with measurable disease and 45 patients with evaluable disease received 150-200 mg/m2 over 1 hour every 28 days . There were three partial responses (PR) among 87 patients evaluable for response . Myelosuppression was dose limiting . There were two deaths related to leukepenia . Other toxicities included phlebitis, alopecia, nausea and vomiting . One patient developed acute nonlymphocytic leukemia . Menogaril at these doses and schedule is toxic and has no significant antitumor activity in metastatic adenocarcinoma of the prostate. Vet Res, 1994, 25(5), 489 - 94 Pharmacokinetics and distribution of thiamphenicol in sheep given repeated intramuscular doses; Abdennebi EH et al.; The pharmacokinetics of thiamphenicol and its distribution in various body fluids were studied after repeated intramuscular injection in clinically healthy adult Moroccan crossed Sardi-D'Man sheep . Thiamphenicol was rapidly absorbed from injection sites yielding peak plasma concentrations within 15-30 min . The elimination from the blood was also rapid, with a biological half-life of 1.51 +/- 0.51 h . The distribution pattern of thiamphenicol revealed that this antibiotic can penetrate many remote sites of the body . With the exception of the cerebrospinal fluid, concentrations of the drug in other body fluids were higher than the corresponding plasma concentrations. Pediatr Neurosurg, 1994, 21(1), 45 - 9 Low-velocity penetrating craniocerebral injury in childhood; Domingo Z et al.; Fifty-four children with low-velocity penetrating injury of the skull and brain are described . The incidence of septic complications was 43%, which is significantly higher than that seen in adults . Nine percent of children developed vascular complications . Due to the high septic complication rate, a more aggressive management protocol consisting of craniectomy and dural repair under antibiotic cover is suggested. Arch Virol, 1994, 137(3-4), 327 - 40 Replication of echo virus type 25 JV-4 reference strain and wild type strains in MRC5 cells compared with that of poliovirus type 1; Bailly JL et al.; In echo virus type 25/JV-4 the shut off of host cell protein synthesis took significantly longer and the kinetics of the synthesis of viral proteins and viral RNA occurred much later than in the poliovirus . However, these characteristics impaired neither polyprotein processing nor virus production in the JV-4 strain . In contrast the two wild strains M.1262 and Th.222 had a lower virus yield than strain JV-4 . The presence of a high Mr protein in the pattern of viral proteins of wild strains suggested that a defect in the polyprotein processing was responsible for the decreased virus yield . The infectious cycle of strain Th.222 differed from that of strains JV-4 and M.1262 in the rapid inhibition of host cell translation and the extent of viral protein synthesis . The sensitivity to actinomycin D was also investigated . Strain M.1262 was found to be insensitive . The virus yield of strains JV-4 and Th.222 was three- and fourfold lower respectively in the presence of actinomycin D . This sensitivity to the antibiotic was observed during viral RNA synthesis in strain JV-4 and during viral protein synthesis in strain Th.222 . These results suggest that cellular factors are involved in the replication of echo virus type 25 strains in MRC5 cells. Zentralbl Gynakol, 1994, 116(8), 479 - 83 {Expectant management of premature rupture of fetal membranes before completion of the 35th week of pregnancy--retrospective analysis of 44 cases}; Muller H et al.; 44 cases of preterm premature rupture of fetal membranes (PPROM) before 35 completed weeks of gestation were analyzed retrospectively . Expectative management was based on infection diagnosis, vaginal disinfection and in case of signs of infection on systemic antibiotic therapy . Glucocorticoids for induction of lung maturity were generally administered . Perinatal mortality was 11.4%, after exclusion of one congenital anomaly 9.3% respectively . Lung immaturity was the main cause of neonatal death . Only 5 neonates developed clinical infection, with 4 of these showing prepartal maternal signs of infection . Maternal signs of infection are not a specific signal for later neonatal infection . Cerebral bleeding complications and pathological neurologic status occurred in 10/39 and 8/39 cases respectively . Cesarean section rate amounted to 15/44 (34%). Scand J Infect Dis, 1994, 26(3), 339 - 47 Serological follow-up after treatment of Borrelia arthritis and acrodermatitis chronica atrophicans; Hammers-Berggren S et al.; To study the serological response to Borrelia burgdorferi after treatment of late Lyme borreliosis, consecutive serum samples from 20 patients with Borrelia arthritis and 21 with acrodermatitis chronica atrophicans were analysed with capture IgM ELISA and indirect IgG ELISA, both using B . burgdorferi flagella as antigen . Seven patients had positive IgM OD values, whereas all 41 had positive IgG OD values before therapy . In the majority, highly elevated IgG OD values were seen . All patients improved after antibiotic therapy, 32 recovering completely, while 9 had sequelae . At follow-up after 6 months to 5 years, 4/7 patients became negative IgM ELISA, whereas 3 still had slightly elevated IgM OD values 6 months, 1 year and 4.5 years, respectively, after therapy . Only one patient became negative in IgG ELISA during follow-up, although a significant decline in IgG OD values was seen in 22 of the remaining 40 initially IgG-positive patients . The serological response after successful treatment of Borrelia arthritis and acrodermatitis chronica atrophicans may persist for several years even with highly elevated IgG OD values in patients who have recovered completely. J Med, 1994, 25(1-2), 65 - 89 Effects of S-adenosylmethionine (SAMe) on doxorubicin-induced cardiotoxicity in the rat; Russo S et al.; One of the most important factors that determine the therapeutic limits of doxorubicin (DXR), an anthracycline antibiotic, appears in acute and late cardiotoxicity . The aim of our investigations was to evaluate the effects of S-adenosylmethionine (SAMe), an important precursor of the organic sulfated compounds and a fundamental agent in physiologic transmethylation, on DXR-induced cardiotoxicity . For that purpose, normotensive Wistar rats were treated with DXR associated with or without SAMe . Pretreatment with SAMe significantly reduced DXR-induced electrocardiographic and morphologic changes, lethality, and body weight . The protective effect of SAMe may partly be due to its scavenger ability against free radicals and superoxides . In addition to its action as a fundamental precursor of the sulfated compounds, the principal agent in physiological transmethylations, and an increase of glutathione (GSH) synthesis. Indian J Pediatr, 1994 Jan-Feb, 61(1), 63 - 9 Management of asymptomatic neonates with prolonged rupture of membranes; Teji JS et al.; Guidelines for management of asymptomatic term and preterm neonates born to mothers with prolonged rupture of membranes (PROM) have not been clearly established . A survey was conducted to identify current management practice of neonatologists in midwestern states and to find if there is consensus among physicians with regard to management of PROM without chorioamnionitis, with chorioamnionitis but without treatment prior to delivery, and with intrapartum maternal antibiotic therapy prior to delivery . One hundred thirty seven responses to the questionnaire were received . Management of asymptomatic at risk neonates varied in different clinical scenarios . Preterm neonates were screened (94% vs 82%, p < 0.001) and treated (64% vs 41%, p < 0.001) more often than term babies . In the absence of maternal symptoms of chorioamnionitis, term neonates were usually observed or treated based on screening test results . With maternal symptoms, 94% of physicians ordered screening test . Prematurity and perceived severity of maternal illness significantly influenced the decision to treat routinely irrespective of screening test results . Physicians favour routine treatment of infants born to mothers who had received intrapartum antibiotic therapy; opinion was divided about management of term asymptomatic infant born to mothers with chorioamnionitis without intrapartum antibiotic therapy . Lumbar punctures were not routinely done for term or preterm neonates prior to antibiotic therapy . Further studies are needed to answer questions regarding the benefits and risks of routine therapy of high risk neonates vs routine clinical observation and selective therapy of only infants who develop symptoms. Magy Traumatol Ortop Kezseb Plasztikai Seb, 1994, 37(3), 245 - 9 {Experience with peflacine in the treatment of osteomyelitis}; Szucs G et al.; Authors report on the treatment of 20 chronic osteomyelitis patients in whom direct antibiotic therapy was performed using the preparation Peflacine . The infected area was exposed in every case, the bony focus was excised and the wound was drained . During the operation, as an induction 800 mg Peflacine in slow drop infusion was given . Oral preparation (2 x 400 mg/die) followed, and was continued for 30 days . The secretion of the wounds ceased in every case, after 3 weeks the latest . In 2 cases mild gastrointestinal symptoms as side effects were observed . Relapse the first time occurred 5-7 months after ending the treatment in 3 patients . These were again explored and after the excision more thorough than before the secretion ceased . According their experience and in conformity with the literature the Peflacine is held an effective medicament in the treatment of the acute exacerbation of chronic osteomyelitis, together with the excision of the focus. Oncol Res, 1994, 6(1), 11 - 7 Inhibitory action of epiderstatin on EGF-stimulated growth of mouse epidermal . BALB/MK cells without direct effect on protein kinase activities; Osada H et al.; Epiderstatin, a distinctive glutarimide antibiotic isolated from Streptomyces pulveraceus subsp . epiderstagenes, has been revealed to be a potent inhibitor of the signal transduction of epidermal growth factor (EGF) . Epiderstatin inhibited the DNA synthesis induced by various peptide growth factors in a mouse epidermal cell line, BALB/MK, without inhibiting protein tyrosine kinase activity of EGF-receptor or serine/threonine kinase activity of protein kinase C . The 50% inhibitory concentration (IC50) value of epiderstatin for the EGF-stimulated incorporation of {3H}thymidine into BALB/MK cells was about 10 nM . When epiderstatin was added to the quiescent cells simultaneously with EGF-stimulation, the cells did not reenter into the growing cell cycle . The action of epiderstatin proceeded from the overexpression of c-fos and the suppression of c-myc transcription when EGF was added to quiescent BALB/MK cells. Toxicol Appl Pharmacol, 1994 Jan, 124(1), 149 - 58 Avian embryonic brain reaggregate culture system . I . Characterization for organophosphorus compound toxicity studies; Funk KA et al.; An avian reaggregate culture system was characterized biochemically and morphologically for use in acute and chronic organophosphorus compound (OP) toxicity studies . Ten-day-old chick embryo brains were dissociated, reaggregated, and maintained in a chemically defined, serum- and antibiotic-free media . Acetylcholinesterase (ACHE), neuropathy target esterase (NTE), and 2',3'-cyclic nucleotide 3'-phosphodiesterase (CNP) were examined due to inhibition of these enzymes as a result of acute OP toxicity (ACHE) or delayed toxicity (NTE, CNP) . The selected enzymes also indicate reaggregate neuronal (ACHE, possibly NTE), oligodendroglial (CNP), and astrocytic (glutamine synthetase (GS)) activities . Enzyme activities were compared to those in age-matched chick embryo and hatched chick brains . Reaggregate ACHE specific activity was similar to or higher than that of chick embryo or hatched chick . Reaggregate NTE specific activity was initially similar to that of 10-day-old chick embryo, and then increased but subsequently averaged 7.8 nmol/min/mg protein . In chick brain, NTE peaked at hatching and averaged 28 nmol/min/mg protein thereafter . Reaggregate CNP specific activity ranged from 103 to 426 nmol/min/mg protein, whereas activity gradually increased in chick embryo brain to an average of 140 nmol/min/mg protein posthatching . The mean GS activity ranged from 0.15 (Culture Day 4) to 1.09 nmol/min/mg protein (Culture Day 62) . Mean protein values per flask ranged from 2.47 to 7.58 mg . Ultrastructurally, myelination was detected at Culture Day 7 and synapses at Day 6 . The biochemical and ultrastructural features demonstrate that this reaggregate culture is a practical and sensitive in vitro system for studying both the acute and the long-term neurotoxicological effects of organophosphorus compounds. Yao Xue Xue Bao, 1994, 29(9), 656 - 61 {A fungus-derived novel nucleoside transport inhibitor potentiates the activity of antitumor drugs}; Su J et al.; Antibiotic C3368-B (CB), identified as 3,9-dihydroxy-1-methoxy-7-methylanthraquinone, is produced by a fungus strain, Chrysosporium verrucosum Tubaki, isolated from a soil sample collected from Antarctica . CB was found to be a highly-active nucleoside transport inhibitor . By radiolabelled nucleoside assay, CB was shown to markedly inhibit thymidine and uridine transport in Ehrlich carcinoma cells, with IC50 values of 7.5 and 9.6 mumol.L-1 respectively . CB showed fairly low cytotoxicity to tumor cells . The IC50 values for epidermoid cancer KB cells and hepatoma BEL-7402 cells in clonogenic assay was 77 and 69 mumol.L-1 . At relatively noncytotoxic concentrations, CB markedly enhanced the cytotoxicity of methotrexate, 5-fluorouracil, mitomycin C against KB cells and BEL-7402 cells . CB was also found to partly reverse the multi-drug resistance to vincristine and actinomycin D in leukemia L1210/MDR cells . The IC50 values were reduced by 4.9-fold (1.75 to 0.36 mumol.L-1) for vincristine and 3.3-fold (0.39 to 0.12 mumol.L-1) for actinomycin D . These results suggest that CB, as a newly-found nucleoside transport inhibitor, may be potentially useful in cancer chemotherapy. Retina, 1994, 14(5), 425 - 9 Histopathologic study of epiretinal proliferations after vitrectomy with daunomycin and silicone oil; Mietz H et al.; PURPOSE: The cellular composition of primary and recurrent periretinal proliferations has been widely described . The use of daunomycin, an antiproliferative antibiotic, has been recommended to reduce these proliferations . Two recurrent membranes after intraoperative application of daunomycin were examined . METHODS: Two epiretinal membranes, which were removed 5 months and 20 months after vitrectomy with daunomycin, were examined by light and electron microscopy to determine the structure and cellular composition of these membranes . RESULTS: The matrix of the membranes consisted of new collagen with fiber diameters between 20 and 22 nm . Fibrocytes and macrophages were present in both specimens . Retinal pigment epithelial cells and fibrous astrocytes were present in only one specimen . CONCLUSION: Retinal pigment epithelial cells, which are consistently present in primary periretinal membranes, were found in only one of the two specimens examined . Myofibroblasts, also normally present, were not found . The other cells found are typically seen in primary periretinal proliferations. Eur J Cardiothorac Surg, 1994, 8(11), 609 - 12 Cytoimmunological monitoring after homograft valve replacement; Schutz A et al.; Examination results concerning immunological reactions in cryopreserved allograft valves during the early postoperative course are so far not available . Cytoimmunological monitoring (CIM) is a well established method to prove rejection reaction after allograft transplantation and was used in this study . Allograft valves were harvested from patients who underwent heart transplantation, and did not require sterilizing in antibiotic solutions . The valves were dissected, conserved and subsequently frozen to -40 degrees C and stored in a freezing system at -196 degrees C . During the first 3 weeks following allograft implantation, CIM was performed daily . An activation index (AI) was determined from the cytological evaluation of the mononuclear concentrate in the peripheral blood . An increase of the AI > 1 was defined as an immunological reaction . As control we performed 98 CIM examinations in eight patients who underwent bioprosthetic valve replacement in the aortic position . Echocardiography (TTE and TEE) was used postoperatively as function control . Out of 16 patients who underwent cryopreserved aortic valve implantation in the aortic position, 336 CIM-results were obtained . An immunological reaction could be detected in all patients, starting on the 5th day on average . Comparing ABO-compatible (group I, n = 9) with ABO-incompatible (group II, n = 7) allografts, the AI-maximum in group I was 1.4 with a mean duration of 1.5 days . Group II was characterized by more intensive immunoreactions (mean = 2.3) which proved to be even more prolonged (mean = 3.3 days, P < 0.05) . Nevertheless it became apparent that all observed immunological events were completely reversible without the need for immunosuppressive drugs.(ABSTRACT TRUNCATED AT 250 WORDS) Ann Urol (Paris), 1994, 28(6-7), 330 - 3 {Male urethritis}; Bohbot JM; The incidence of sexually transmitted diseases (STD) is decreasing, but often take on a more subacute form, which may be difficult to detect . Acute gonococcal urethritis, diagnosed by direct examination and culture (with antibiotic susceptibility testing) requires immediate single-dose treatment . Chlamydia trachomatis urethritis is frequent and insidious and may cause a wide range of complications (serological diagnosis with raised IgG) . It is sensitive to tetracyclines (for 15 days) . Other forms of urethritis are due to Mycoplasmas, Trichomonas and Herpes . The presence of urethritis is a good indicator of high-risk sexual behaviour and warrants proposal of HIV screening. J Gastroenterol Hepatol, 1994, 9 Suppl 1, S109 - 11 The therapeutic strategy for peptic ulcer disease; Ivey KJ; Therapy of acid/peptic disease has evolved since the 1970s with development of: (i) more accurate endoscopes which permit precise examination and documentation of upper gastrointestinal lesions; and (ii) the histamine H2-receptor antagonists . As well, refined standards for clinical investigation have contributed to the clinical study of acid/peptide diseases . Initially, ulcer diseases were considered to be principally secondary to increased 'aggressive' factors (acid, pepsin) and the therapeutic focus was directed at antacids, the progressive evolution of additional histamine H2-receptor antagonists and recently the H+/K(+)-ATPase inhibitors . Later studies indicated efficacy of sucralfate, low dose antacids and prostaglandin analogues, drugs with either no or only modest antisecretory effect . This led to studies on the role of gastroduodenal mucosal defensive factors (mucus and bicarbonate secretion, blood flow, leucocyte adherence, cytokines, reactive oxygen radicals) . The prominent role played by aspirin and other non-steroidal anti-inflammatory drugs (NSAID) in initiating and causing recurrence of peptic ulcer disease has been increasingly realized . Recognition of those most at risk for NSAID-induced complication has led to newer approaches to treatment and prevention . Since 1983, Helicobacter pylori has been incriminated as a major factor in the pathogenesis of ulcer disease, particularly ulcer recurrences . Treatment of such ulcers now includes antibiotics and bismuth compounds in order to eradicate H . pylori . This therapeutic regimen is in a state of flux ('triple therapy' vs a H+/K(+)-ATPase inhibitor plus antibiotic) as is the question of how to work up and treat patients initially presenting with ulcer symptoms. Eur J Clin Microbiol Infect Dis, 1994, 13 Suppl 2, S18 - 22 Role of granulocyte-macrophage colony-stimulating factor as adjuvant treatment in neutropenic patients with bacterial and fungal infection; Bodey GP et al.; The results are presented of two preliminary studies conducted to assess the role of GM-CSF as adjuvant treatment in neutropenic patients with bacterial or fungal infections . In the first study the effect of GM-CSF on the rate of response to antibiotics was assessed . Febrile neutropenic patients (n = 91) were randomized to receive ticarcillin-clavulanate plus netilmicin with or without GM-CSF (60 micrograms/m2) . Response rates were significantly higher in patients who received antibiotics plus GM-CSF (p = 0.05) . An increase in neutrophil count was seen in 89% of GM-CSF patients with initial low neutrophil counts (< 100/microliters) compared with 67% of control patients (p = 0.04) . In the second study the activity of GM-CSF in patients with fungal infections was assessed . Neutropenic patients with documented fungal infections received amphotericin B plus GM-CSF . Of the eight evaluable patients, six responded and four had a complete response to treatment . The neutrophil counts of the two non-responding patients did not increase substantially during GM-CSF treatment and both died of their fungal infection . The prognosis of neutropenic patients with fungal infections is usually poor and the results of this pilot study are therefore very encouraging . The two studies show that GM-CSF is able to stimulate neutrophil recovery in neutropenic patients and may improve the response to antibiotic and antifungal treatment. Exp Clin Endocrinol, 1994, 102(5), 374 - 9 The effect of streptozotocin on the function of fetal porcine and rat pancreatic (pro-)islets; Liu X et al.; Streptozotocin (STZ) is a broad spectrum antibiotic with anti-tumor and diabetogenic properties . Although STZ has been studied for many years, the exact mechanism of its diabetogenic action has not yet been fully elucidated . The present study investigated the effect of STZ on both fetal porcine proislets (FPP) and fetal rat islets (FRI) in an attempt to elucidate the diabetogenic effect of STZ on fetal pancreatic beta cells . This study demonstrates that after in vitro exposure of both FPP and FRI for 30 min to 2.2 mM and 4.4 mM STZ, respectively, FPP showed microscopically an intact structure, a spherical shape and a translucent color, while, in contrast, most FRI were disrupted and showed a slight white color with dark centers . Based on these data, we first transplanted FPP and FRI beneath the renal capsules of nude mice . Three to four weeks later, a single dosage of streptozotocin (180 mg/kg) was intravenously administered . Six of the seven nude mice pretransplanted with FPP became diabetic (blood glucose, BG, 308.08 +/- 33.62 mg/dl) within 2-5 days and then gradually achieved normoglycemia 51.56 +/- 7.71 days after STZ injection . After removal of the grafts, all of the six diabetic mice with normoglycemia returned to hyperglycemia (BG > 300 mg/dl) . In contrast, all of the five nude mice pretransplanted with FRI persistently maintained hyperglycemia (BG > 300 mg/dl) and died 5 +/- 0.84 days after STZ injection.(ABSTRACT TRUNCATED AT 250 WORDS) Arch Toxicol, 1994, 68(10), 643 - 7 Effect of gentamicin-induced nephrotoxicity on some carbohydrate metabolic pathways in the rat renal cortex; Abdel-Gayoum AA et al.; Rats were injected with gentamicin at doses of 20, 40 and 80 mg/kg per day for 6 consecutive days . The treatment caused nephrotoxicity as evidenced by dose-related increases in serum creatinine concentration and renal tubular necrosis . The nephrotoxicity was accompanied by reduced renal cortical and fasting blood glucose levels, and by increases in serum lactate concentrations . The activities of cortical malate dehydrogenase and alanine transaminase were significantly reduced by the three doses of gentamicin . On the other hand, aspartate transaminase activity was lowered only by the highest dose of antibiotic used . However, the activity of cortical glucose-6-phosphate dehydrogenase was altered by the 20 and 40 mg/kg doses of gentamicin, but not by the 80 mg/kg dose . The two lower doses reduced the lactate content of the cortex but activated lactate dehydrogenase . The activity of isocitrate dehydrogenase was not altered by any of the gentamicin doses used. Wien Med Wochenschr, 1994, 144(10-11), 280 - 2 {Postpartum ovarian vein thrombophlebitis--case report}; Paulowitz HP et al.; Because of the low incidence and the lack of clinical symptomatology, puerperal ovarian vein thrombophlebitis has constituted a diagnostic problem now as ever, and diagnostic errors are frequent . With the help of US and CT, however, the chances of early detection have improved . On the 26-year old patient P . C . a section had to be performed in the 34th week of pregnancy because of premature rupture of the bag of waters . On the 7th postoperative day, the patient developed pyrexia inspite of antibiotic therapy . Sonographical examinated lead us to suspect a floating thrombus in the vena cava inferior . It was in the CT that the diagnosis of ovarian vein thrombosis was made for the first time . On the 13th day post partum a laparotomy and exstirpation of the v.ovarica dextra with removal of the thrombus plug from the v.cava inferior infrarenally was performed . Primarily, conservative treatment is given preference if the development is uncomplicated; operative sanitation is undertaken in case of difficulties only. Neurosurg Rev, 1994, 17(3), 199 - 203 Pituitary abscesses . Report of three cases; Gokalp HZ et al.; Three cases of pituitary abscess are presented . In spite of improvements in radiological evaluation, preoperative diagnosis of pituitary abscess is quite difficult and definite preoperative diagnosis is rare in the literature . In our three cases, diagnosis was made postoperatively . Pituitary abscesses are associated with high mortality and morbidity . When first suspected, prompt antibiotic therapy should be considered . Early operative drainage seems to be an important factor in decreasing this high mortality and morbidity. Microbios, 1994, 79(321), 231 - 9 Application of nuclear magnetic resonance spectrometry to measure the activity of bacterial macrolide esterase; O'Hara K; A new method of measuring the activity of macrolide antibiotic esterase in whole bacteria and in crude enzyme extracts was determined through the application of nuclear magnetic resonance spectrometry . The structure of the enzymatically esterolytic cleavage compound of oleandomycin was clearly shown to be the cyclic hemiacetal between the C-9 keto and the hydroxy group of C-13 in the open macrolide nucleus by physicochemical techniques. Eye, 1994, 8 ( Pt 5), 555 - 63 Drug resistance and Acanthamoeba keratitis: the quest for alternative antiprotozoal chemotherapy; Hay J et al.; Trophozoites and cysts of 20 isolates of Acanthamoeba from the cornea and five from related samples were tested in vitro for sensitivity to ten drugs (three aromatic diamidines, two aminoglycosides, two macrolides, a polyene macrolide antibiotic, an organoarsenical and an antimetabolite) and two cationic antiseptics (chlorhexidine and polyhexamethylene biguanide, PHMB) . Only chlorhexidine and PHMB showed uniform amoebacidal activity . Aromatic diamidines (pentamidine isethionate, propamidine isethionate and diminazene aceturate) generally proved effective against both forms of the amoeba; only pentamidine gave synergy with the biguanide while propamidine gave an additive effect . Other drugs tested proved erratic or ineffective against different isolates . Chlorhexidine alone, or together with propamidine, was subsequently used in two patients with proven Acanthamoeba keratitis; the causative isolates were sensitive to the individual compounds and to the combination in vitro . The treatment provided resolution of the clinical disease; amoebae were shown to be nonviable by histology and culture . The combination of chlorhexidine and propamidine is recommended for treatment of proven Acanthamoeba keratitis. Leuk Lymphoma, 1994, 14 Suppl 1, 121 - 5 The Scripps Clinic experience with 2-chlorodeoxyadenosine in the treatment of hairy cell leukemia; Piro LD et al.; Follow-up data is now available on 144 patients with hairy cell leukemia treated with 2-chlorodeoxyadenosine (2-CdA) at the Scripps Clinic . Of 144 patients followed for a median of 14.2 months, 123 (85%) obtained complete responses, 17 (12%) partial responses, 3 (2%) did not respond and 1 patients was unevaluable . So far, only 4 patients have relapsed at a median of 36 months . Fever was the major toxicity occurring in 43% of patients . Five patients resistant (3 patients) or intolerant (2 patients) to 2'-deoxycoformycin were also treated . Of these 5 patients, 4 obtained complete responses, including 2 patients resistant to 2'-deoxycoformycin, and 1 patient a partial response, suggesting a possible lack of cross-resistance between 2'-deoxycoformycin and 2-CdA in hairy-cell leukemia . More than 200 patients have been treated with 2-CdA worldwide with 82% obtaining complete remission and 12% partial remissions . Serial peripheral blood immunophenotypic analyses have documented the absence of circulating hairy cells . When bone marrow biopsies were examined using sensitive immunohistochemical staining techniques, residual hairy cells were detected in 25-50% of morphologic complete responders . Patients will need to be observed longitudinally to determine if this staining is predictive of relapse . A double-blind, placebo-controlled study of pentoxifylline, a modulator of tumor necrosis factor-alpha and other cytokines, was performed in 2-CdA-treated hairy cell leukemia patients to determine whether the incidence of neutropenic fever would be reduced . Although pentoxifylline resulted in less febrile, hospital and antibiotic therapy days than placebo, only the number of days in the hospitalized patients achieved statistical significance . 2-CdA is emerging as the treatment of choice for hairy cell leukemia given the high percentage of long-lasting, complete responses that follow a single course of therapy. Zentralbl Neurochir, 1994, 55(3), 156 - 61 {Postoperative spondylodiscitis as the cause of failed-back syndrome--clinical aspects, diagnosis, therapy}; Trappe AE et al.; Postoperative lumbar spondylodiscitis can cause a failed back syndrome . With 0.1 to 3% according to the literature it belongs to the rarer complications following lumbar disc surgery . We present the characteristic clinical picture and typical findings (ESR, plain X-rays, MR) with suspected spondylodiscitis on 19 patients (= 0.2% of 9492 operative interventions for lumbar disc prolapse from 1980 to 1990) and show MR tomography to be the most sensitive investigation . Principles of therapy consist of lumbar immobilisation with a light cast orthesis for an average of 12 weeks and additional antibiotic therapy up to two weeks beyond normalisation of ESR . Finally results of therapy are presented with a satisfying outcome in 84.2% of cases. Zentralbl Gynakol, 1994, 116(10), 555 - 60 {Puerperium after threatened premature labor--positive effects of infection screening by determination of CRP in pregnancy}; Winkler M et al.; Silent intrauterine infection as cause of preterm labour should be recognised early by measuring C-reactive protein (CRP) levels in the maternal serum . Ensuing antibiotic therapy may not only cause gestational prolongation, but also has a positive effect on pathology during the puerperal period . Consequently, we examined the rate of infectious puerperal complications of 181 patients who suffered from so-called idiopathic preterm labour . 84 patients showed normal CRP-levels at the onset of tocolysis (< 5 mg/l); an elevated level was found in 97 patients (> 5 mg/l) . Patients with elevated CRP-levels and supplemented antibiotic therapy during pregnancy (n = 51) showed significantly fewer symptoms of postpartal endometritis than women with similarly elevated CRP-levels but without antibiotics (n = 46) . This effect was not produced when preterm labour was associated with normal CRP-levels . Patients with premature contractions and elevated CRP-values at the onset of tocolysis seem to benefit from the antibiotic therapy during pregnancy because they show reduced infectious complications throughout the puerperal period. Tsitologiia, 1994, 36(5), 427 - 36 {Na+ and K+ ion transport across the human erythrocyte membrane during the formation of nystatin channels under in-vitro conditions: the characteristics and an analysis of the processes}; Borisov IuA et al.; The kinetic properties (the spontaneous lysis velocity, the time of achievement, and the concentration level of the stationary stage) are shown to be strongly different, while the human erythrocytes are resuspended in various salt media . The analysis of Na+ and K+ concentrations, under the effect of a polyene antibiotic nistatin, on the human erythrocytes as an integral kinetic function of time is carried out . The processes engaged in this kinetic function are characterized. Anaesthesiol Reanim, 1994, 19(5), 124 - 6 {Detection of Chlamydia pneumoniae in intrathoracic abscesses--a case report}; Schaffranietz L et al.; The case of a 52-year-old patient with intrathoracic abscesses following a traumatic fracture of the 11th thoracic vertebral body is described . The abscesses were resistant to conventional antibiotic therapy and attempts at local drainage under CT scan control remained unsuccessful . Finally, chlamydia pneumoniae was isolated using an immunofluorescence technique . Subsequent therapy with doxycycline caused complete resolution of the abscesses . We suggest that in cases of atypical pneumonias and abscesses, infection with chlamydia pneumoniae should be taken into consideration. Vestn Otorinolaringol, 1994 Jan-Feb, (1), 22 - 6 {Clinical and biochemical aspects in the treatment of acute maxillary sinusitis with antioxidants}; Nikolaev MP et al.; A trial has been made of traditional versus antioxidant treatment of acute maxillary sinusitides . The patients were injected a mixture consisting of 4 ml emulsion of 10% dibunol liniment and 2 ml of 5% ascorbic acid made by dilution of 10 g dibunol in 30 ml sterile 0.5% novocaine solution . The mixture was introduced into the sinuses 2 times a day, in one of the study groups it was combined with 500,000 U of ampicillin in cases of purulent sinusitis . In catarrhal form the mixture was injected once a day without the antibiotic . Control groups received 4 ml dioxidine in a single dose after the sinus lavage in catarrhal sinusitis and 500,000 U ampicillin plus hydrocortisone emulsion (1 ml in 4 ml solution) 2 times a day in case of purulent sinusitis . All the patients received aevit (one capsule daily) . The mean number of manipulations for the study groups were 4.4 +/- 0.4 in catarrhal sinuses and 6.3 +/- 0.5 in purulent sinusitis; in control groups, respectively, 5.9 +/- 0.5 and 10.7 +/- 0.7 . Mean duration of treatment reached 5.3 +/- 0.4, 6.2 +/- 0.3 and 7.1 +/- 0.1 in the study groups and 8.5 +/- 0.2, 10.2 +/- 0.4 days in the control groups . Positive response to the treatment with antioxidants was confirmed by positive changes in blood levels of LPO products, activity of lysosomal hydrolases and antioxidant defense enzymes . The results obtained justify the inclusion of antioxidants in the schemes of acute sinusitis treatment. Arch Tierernahr, 1994, 46(4), 321 - 5 {The effect of avilamycin and tylosin on the apparent digestibility of iron, zinc, copper, manganese and selenium in the beginning and ending performance of swine}; Kirchgessner M et al.; In two metabolism trials with growing and finishing pigs the effect of the antibiotic feed additives Avilamycin and Tylosin on the apparent digestibility of Fe, Zn, Cu, Mn and Se was investigated . The feed additives were supplied to the diet in levels of 40 ppm (growing pigs) and 20 ppm (finishing pigs) each . Dietary contents of Fe, Zn, Cu, Mn and Se covered the requirements of all treatment groups . Avilamycin and Tylosin increased the apparent digestibility by 4 (Fe), 4 (Zn), 5 (Cu), 2 (Mn) and 2 (Se) percentage units on an average. Rev Elev Med Vet Pays Trop, 1994, 47(4), 379 - 80 Efficacy of chlortetracycline for controlling goat coccidiosis in Burundi; Dacasto M et al.; Eighteen cross-bred goats of Burundi naturally infected to varying degrees with multiple coccidia species of the genus Eimeria were orally administered 25 mg/kg body weight/day chlortetracycline . Effectiveness percentages more elevated than 99.0% were reached within the 9th day of treatment . No adverse reactions have ever been reported . Results demonstrate that the antibiotic is effective for the control of coccidiosis of goats naturally infected in Burundi. Med Pregl, 1994 Jan-Feb, 47(1-2), 52 - 5 {Intravenous immunoglobulin in the treatment of infections in children with acute leukemias}; Gebauer E et al.; Infections are a common cause of complications in the course of applying highly aggressive combined cytotoxic therapy in children suffering from acute leukemias (ALL and ANLL) . The effect of adjuvant therapy of intravenous immunoglobulins (IVIG) was investigated in cases of infections of children with ALL and ANLL (24 with IVIG and 24 without this therapy) according to the system of matched pairs . The polyvalent functionally intact monomeric i.v . immunoglobulin "Endobulin" Immuno, 100 mg/kg was applied in infections--febrile episodes combined, if possible, with an aimed antibiotic therapy . It was established that children with the intravenous immunoglobulin therapy had had statistically significantly less febrile episodes (p < 0.01), as well as less febrile days (p < 0.05) . Although the acquired results speak in favor of this therapeutic possibility when applying this supportive therapy which is getting more and more important, authors made a conclusion that the final estimate of the value of this therapy remains open and requires further investigations. Cell Biophys, 1994, 24-25, 119 - 26 Effect of a bifunctional monoclonal antibody directed against a tumor marker and doxorubicin on the growth of epidermoid vulvar carcinoma grafted in athymic mice; Morelli D et al.; Even though the first monoclonal antibodies (MAbs) directed against tumor cells were produced 15 yr ago, the therapeutic application of immunoconjugates is still at the beginning . This is principally because of the enormous work that is required for the development of completely new therapeutic tools . An alternative could be to only use MAbs to improve conventional treatment such as chemotherapy . To this aim, a MAb directed against doxorubicin (DXR) was produced . DXR is an anthracycline antibiotic of which the clinical usefulness in cancer chemotherapy is limited by serious side effects, such as cardiomyopathy, bone marrow depression, and gastrointestinal tract mucositis . This toxicity was found to be reduced by treatment with the antidrug MAb, as shown by reduction in body weight loss and mortality of experimental mice . To improve the DXR therapeutic index, a bifunctional hybrid MAb (DOXER2), capable of simultaneously recognizing DXR and the epidermal growth factor (EGF) receptor, was produced . This reagent was found in vitro to increase the drug toxicity on the epidermoid carcinoma cell line A431, which overexpresses the EGF-R and, at the same time, to reduce DXR cytotoxicity on EGF-R negative cells . The effect of DOXER2 on the DXR biodistribution in vivo was also investigated . In mice previously injected ip with the DOXER2, the uptake of the drug, in comparison to the control group, was found to be reduced in the intestine and in myocardial tissue, and significantly increased in the tumor.(ABSTRACT TRUNCATED AT 250 WORDS) J Drug Target, 1994, 2(5), 363 - 71 Liposomes in the treatment of infections; Bakker-Woudenberg IA et al.; The use of liposomes in the treatment of severe infections is under investigation . Classical liposomes which localize in cells of the mononuclear phagocyte system (MPS) can be exploited in two ways . First for targeting of macrophage modulators such as muramyl peptides or IFN-gamma, to stimulate the cells of the MPS to maximal blood clearance capacity . This enhanced nonspecific anti-infectious resistance is important as in immunocompromised patients micro-organisms frequently appear in the blood from a local infection . Secondly, classical liposomes are successfully used as carriers of antibiotics in experimental intracellular parasitic-, viral-, fungal- or bacterial infections in MPS tissues . Based on these data extensive studies in patients with severe fungal infections have demonstrated successful treatment with liposomal or lipid-complexed amphotericin B . More recently, liposomal amphotericin B appeared to be effective in patients with drug-resistant visceral leishmaniasis . For the treatment of Mycobacterium avium complex infection in AIDS patients the efficacy of liposomal gentamicin is under investigation . With respect to infections in non-MPS tissues the applicability of Stealth liposomes characterized by long circulation half-lives is under investigation . Substantial localization of these liposomes in infected lung tissue of rats was demonstrated . Preliminary data in experimental bacterial lung infection showed superior efficacy of antibiotic encapsulated in Stealth liposomes. Vestn Khir Im I I Grek, 1994 Jan-Feb, 152(1-2), 75 - 8 {The diagnosis and treatment of acute hematogenous osteomyelitis in children}; Neikov GN et al.; A clinical analysis of the diagnostics and treatment of 329 children with acute hematogenic osteomyelitis (AHO) has shown that the coloured liquid crystal thermography allows determination of the localization and spread of the inflammatory process in the bone, control of treatment efficiency, prognosis of the course and outcome of the disease . The use of the continuous-intermittent lavage of the bone with an enzyme-antibiotic mixture modified in the clinic in complex with a general treatment gives an improvement of the general condition 4-5 days earlier as compared with the traditional treatment, the disease taking the chronic form in 7.6% of the cases only. Tsitologiia, 1994, 36(9-10), 1012 - 21 {Agents that act on chromatin structure affect the rate of intrachromosomal homologous DNA recombination in cultured cells}; Abramian DS et al.; A study was made of the influence of sodium butyrate and luminol on the rate of homologous recombination of aminoglycosidephosphotransferase gene copies, which contain non-overlapping deletions and are integrated in chromosomes of the Chinese hamster cells of line A238 . It is shown that treatment of cells of transformed clones with sodium butirate, which is known to stimulate DNA reparation and to loosen chromatin structure, inhibits intrachromosomal homologous recombination . Dexametazone, which is also capable of stimulating DNA reparation, displayed similar effect . In contrast, the treatment of cells with luminol, inhibiting DNA reparation and condensing chromatin structure, increased the efficiency of intrachromosomal homologous DNA recombination. Acta Vet Scand, 1994, 35(4), 321 - 7 Comparison of two semen extenders in terms of in vitro development of bovine embryos following IVF; Lonergan P et al.; In order to conform with current EC standards with regard to antibiotic cover, the Norwegian Cattle Association is currently investigating the use of Biladyl as an alternative to the milk-based extender which has been traditionally used in Norway . A study was carried out to investigate the effect of using semen frozen with either milk extender or Biladyl on the outcome of in vitro fertilization and embryo culture . Semen from 6 Norwegian Red bulls was used . There was a significant difference p < 0.05 in terms of cleavage rate between the 2 extenders for 1 bull, 78.2% vs 94.9% for milk and Biladyl extenders, respectively, and for the overall total of 71.3% vs 76.1% for milk and Biladyl extenders, respectively . There were no significant differences in terms of blastocyst yield amongst any of the bulls . In conclusion, the results suggest that Biladyl can be used as a replacement for the traditional milk-based extender without any adverse effects on blastocyst yields following in vitro fertilization. Biochem Soc Symp, 1994, 60, 173 - 82 Perception and transduction of an elicitor signal in cultured parsley cells; Nurnberger T et al.; Treatment of cultured parsley cells or protoplasts with a purified extracellular glycoprotein from Phytophthora megasperma f.sp . glycinea induces the transcription of the same set of defence-related genes as is activated in parsley leaves upon infection . Elicitor activity was shown to reside in a specific portion of the protein moiety which was isolated, sequenced and synthesized . Partial cDNAs encoding the entire mature protein as well as other related proteins have been isolated, indicating the presence of a small gene family . The elicitor-active oligopeptide is located in the C-terminal portion of the deduced amino acid sequence . Binding of the elicitor to target sites on the parsley plasma membrane appears to be the initial event in defence gene activation . The subsequent intracellular transduction of the elicitor signal was shown to involve rapid and transient influxes of Ca2+ and H+, as well as effluxes of K+ and Cl- . Inhibition of elicitor-induced ion fluxes by channel blockers also inhibited phytoalexin synthesis, while stimulation of similar ion fluxes by treatment of cells or protoplasts with the polyene antibiotic, amphotericin B, induced the production of phytoalexins and activated the complete set of defence-related genes in the absence of elicitor. J Ultrasound Med, 1994 Jan, 13(1), 7 - 10 Infected renal cysts: sonographic diagnosis and management; Frishman E et al.; IRC are rare entities characterized by fever and unilateral flank pain resistant to antibiotic therapy . In our series of nine IRC in eight patients, the predominant sonographic finding was an abnormal echogenic texture of the cyst contents, in contrast to previous reports that stressed the frequency of wall thickening as a sign of infection . Sonographically guided cyst aspiration and drainage of eight cysts in seven patients provided diagnostic material and resulted in relief of symptoms . Although the cause of IRC is uncertain, these entities may be more common than previously suspected. J Med Liban, 1994, 42(3), 117 - 22 {Infections in cancer patients with granulocytopenia . Retrospective studies of 59 febrile episodes with hospitalization}; Ghosn M et al.; A total of 59 febrile neutropenic episodes were retrospectively recorded at Hotel-Dieu de France Hospital between August 1st 1991 and December 31st 1992 . These episodes were recorded in 51 cancer patients . Median neutropenia was less than one week in 50% of the cases . The etiology of these fever was documented in 27 episodes (46%) and in 70% of the cases gram (-) rods were documented . B-Lactam and Aminoglycoside antibiotics were used in 34 episodes at the initial treatment of these patients . Success rate at this initial treatment or with a modification of the antibiotic therapy was recorded in 85% of the patients . Only 15% of the patients failed to this antibiotherapy, 2/3 of them had their disease in progression . The systemic use of Amphotericine E in those patients with prolonged febrile neutropenia and the concommitent use of growth factors in a sub-group of patients at high risk could lead to a higher success rate in these patients. J Pathol, 1994 Jan, 172(1), 73 - 9 Whipple's disease: a histological, immunocytochemical, and electron microscopic study of the small intestinal epithelium; Ectors NL et al.; At endoscopy, the duodenum in Whipple's disease frequently appears abnormal and some clinical features such as gastrointestinal blood loss and anaemia suggest epithelial damage . However, the intestinal epithelial cells themselves appear to be normal on light and electron microscopy . The aims of this study were to analyse in detail the cytological changes in epithelial cells over time and in response to therapy in biopsies obtained from 20 patients, to investigate the functional repercussion on digestive enzymes such as lactase, and to assess the expression by the epithelial cells of MHC antigens . Cytological changes were minimal at both the light- and the electron-microscopic level and MHC class I expression was preserved . However, changes indicative of functional deficits were demonstrated . Lactase and MHC class II expression were reduced or even absent . Antibiotic therapy resulted in normalization within 3-6 months . These findings are consistent with the clinical evolution and are of interest with regard to the importance of the immune response in aetiopathogenesis. Bone Marrow Transplant, 1994 Jan, 13(1), 37 - 41 Peripheral blood progenitors mobilised by G-CSF (filgrastim) and reinfused as unprocessed autologous whole blood shorten the pancytopenic period following high-dose melphalan in multiple myeloma; Ossenkoppele GJ et al.; Growth factor granulocyte colony-stimulating factor (G-CSF; filgrastim) is effective at progenitor release into the peripheral blood . After high-dose chemotherapy haematopoietic reconstitution occurs after reinfusion of these peripheral blood progenitor cells (PBPC) . However, the collection by leukapheresis and further processing of PBPC are very time consuming and expensive . We have studied the transplantation potential of a small volume of unprocessed autologous whole blood after G-CSF mobilisation . Six patients with plasma cell disorders received G-CSF 10 micrograms/kg sc during 6 days . Subsequently 11 of whole blood was collected by phlebotomy, kept unprocessed at room temperature and reinfused 24 h after high-dose melphalan 140 mg/m2 . CFU-GM content was 845 per ml blood (median, range 320-3472) and CD34+ cells rose to a median percentage of 0.9 (range 0.4-2.0) . Haematological recovery was significantly faster in the study group compared with the control group of 20 patients who received the same dose of melphalan without reinfusion of PBPC . The neutrophil count reached 0.5 x 10(9)/l at a median of 12.5 days after infusion of PBPC vs 38 days in the control group (p = 0.0003) . The platelet count reached 20 x 10(9)/l after a median of 23.5 days vs 38 days (p = 0.0218) . The shortened recovery was reflected by less transfusions, less antibiotic use and shortening of hospital stay (19 days vs 43 days, p = 0.0003) . We conclude that this easy technique of mobilisation and collection of PBPC is very effective for hastening haematologic recovery after high-dose chemotherapy. Ann Oncol, 1994, 5 Suppl 2, 123 - 5 Cytokine efficiency in the treatment of high-grade malignant non-Hodgkin's lymphomas: results of a randomized double-blind placebo-controlled study with intensified COP-BLAM +/- rhGM-CSF; Engelhard M et al.; In high-grade malignant non-Hodgkin's lymphomas (hNHL) recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) was evaluated as support to chemotherapy . In a phase III trial, 172 patients (age 18-73 years, stage II-IV) were risk-stratified according to LDH levels and lymphoma size and randomized to receive rhGM-CSF (400 micrograms) (87 patients) or placebo (85 patients) subcutaneously days 8-14 of each cycle of an intensified COP-BLAM regimen . RhGM-CSF significantly reduced the length and nadir of neutropenia, the length of fever episodes, the frequency of all and of severe infections, and of hospitalization and antibiotic requirements . Complete response rates were 63% for all patients and 64% vs . 61% (n.s.) in the rhGM-CSF vs . the control group . Deviations from protocol in applied dosages of myelotoxic drugs and in cycle intervals maintained differed slightly in favor of the rhGM-CSF arm . However, there were no significant differences in overall survival between the GM-CSF treatment and control groups (21 vs . 23 months) . Early relapse rates were markedly lower than in the standard-dose COP-BLAM/IMVP-16 regimen . Thus, GM-CSF abates toxic side effects of chemotherapy and may help to maintain dose intensity in high-risk hNHL. Nihon Kyobu Shikkan Gakkai Zasshi, 1994 Jan, 32(1), 55 - 61 {Pleuropulmonary aspergillosis with defective neutrophil functions--G-CSF effects on neutrophil functions}; Mineshita M et al.; A 66-year-old man was admitted to our hospital with productive cough and fever . Chest X-ray films showed pleural thickening of the right apex and calcification of the lung field . Antibiotic therapy was administered but no improvement was obtained . Chest CT scan revealed pleural thickening with effusion in the right apex . Needle aspiration biopsy was performed and Aspergillus fumigatus was isolated from pleural fluid . We began pleural drainage and intrapleural infusion of miconazole, with systemic administration of miconazole, amphotericin B and fluconazole . In spite of normal bone marrow findings, the neutrophil functions, NAP score and phagocytosis, of the patient were found to be subnormal . We commenced to treatment with granulocyte colony stimulating factor and his neutrophil functions improved (NAP score: 156-->309.5, phagocytosis: 64.9-->70.0%) . However, his fever persisted and he died following cardiopulmonary arrest . Autopsy revealed Aspergillus mycelia invading the visceral pleura . No intrapulmonary lesions caused by Aspergillus were found. Khirurgiia (Sofiia), 1994, 47(6), 14 - 7 {Our experience with treating acute noncalculous cholecystitis}; Iarumov N et al.; Based on a comprehensive literature survey, personal experience with the management of 89 patients, presenting acute noncalculous cholecystitis, is shared . All patients are clinically observed in the acute phase of the disease . In 60 cases the latter becomes manifest with recurrent attacks, and in 29 there are no previous signs or symptoms of biliary diseases . Diagnosis is made on the ground of active echographic and clinical observation . Conservative therapy is effective in 28 cases . The remainder (61) are operated at 1 to 4-day intervals after the onset of the disease because of persisting symptomatology and/or deterioration of the patient's condition . During laparotomy the gallbladder presents marked enlargement with thickened, exudate-imbibed wall . Cholecystectomy is done in all 61 cases . In twelve of them, owing to dilatation of the common bile duct and minimal serum bilirubin increase, stenosing papillitis is diagnosed by intraoperative cholangiography, treated by external biliary drainage and endoscopic sphincterotomy, undertaken after improvement of the general condition . Acute inflammation, free of fibrosis, with isolated foci of gangrene and necrosis of the bladder wall are histologically documented . In four senile patients presenting serious concomitant diseases, with exceptionally high operative risk, echographic percutaneous transhepatic cholecystectomy is resorted to, followed by antibiotic bladder instillations with a very good outcome . The summed up results of acute noncalculous cholecystitis treatment are estimated as very good. Khirurgiia (Sofiia), 1994, 47(6), 11 - 3 {Nonparasitic liver abscesses}; Stoianov G et al.; Abscess of the liver is a comparatively rate, but very serious disease, necessitating the undertaking of diagnostic and therapeutic measures on an emergency basis . The principal diagnostic method currently in use includes two imaging techniques--echography and CT . In therapeutic respect the target puncture under echographic or CT control has rather limited scope of application . Surgical therapeutic approach is the leading one--laparotomy, drainage of the abscess, and arbitrary use of a Kerr drainage for the choledochus and regional antibiotic therapy. Biochem Biophys Res Commun, 1993 Dec 30, 197(3), 1203 - 8 The inhibition of the inositol 1,4,5-trisphosphate receptor from rat cerebellum by spermine and other polyamines; Sayers LG et al.; Inositol 1,4,5-trisphosphate-induced Ca2+ release from rat cerebellar microsomes can be inhibited by polyamines at mM concentrations . Spermine, one of the most abundant naturally occurring polyamines, inhibits InsP3-induced Ca2+ release with an IC50 of 1 mM . However, the antibiotic neomycin proved most efficacious at inhibiting InsP3-induced Ca2+ release (IC50 0.4mM) . The order of potency being neomycin > spermine > spermidine > putrescine . Although binding of {3H}InsP3 to cerebellar microsomes is also inhibited by polyamines, this may be due to InsP3 complexing with the polyamines under the binding conditions used . Under Ca2+ release conditions InsP3 binds weakly to spermine and therefore inhibition of InsP3-induced Ca2+ release is consistent with polyamines interacting with the InsP3 receptor. FEBS Lett, 1993 Dec 28, 336(3), 496 - 500 Brefeldin A blocks protein glycosylation and RNA replication of vesicular stomatitis virus; Irurzun A et al.; Brefeldin A is a macrolide antibiotic that interferes with membrane traffic and blocks the growth of several animal viruses including vesicular stomatitis virus (VSV) . The inhibition of VSV by brefeldin A takes place at least at two different steps during the growth cycle: the glycosylation of VSV G protein and the replication of viral genomes . Our results indicate that interference with membrane traffic leads not only to inhibition of viral protein glycosylation, but also to the blockade of virus genome replication in several cytoplasmic RNA-containing viruses. Schweiz Med Wochenschr, 1993 Dec 18, 123(50), 2370 - 7 {Brucellosis: case report and synopsis of 10 cases (1973-1992) in the Chur canton hospital}; Canova CR et al.; A 33-year-old patient from former Yugoslavia presented with low back pain and fever . Plain X-rays and myelography were normal, but a technetium-99m scan was suspect for vertebral osteomyelitis . Serology and blood cultures were positive for Brucella (melitensis) . Antibiotic therapy with tetracycline and rifampicine rapidly improved the signs and symptoms of the infection . A retrospective analysis of 11 cases of Brucellosis treated in the Kantonsspital, Chur, over the years 1973 to 1992 revealed that 9 patients were foreign workers from rural areas in the Mediterranean region (Spain, Portugal, Italy, Yugoslavia, Greece) . The majority had a history of consuming milk and dairy products from their own farm animals up to a few months before the onset of symptoms . Blood cultures were positive in 5 cases (B . melitensis) while the remaining 6 had high titers of agglutinating antibodies . A diagnostic delay of several weeks to months was typical . Because Brucellosis usually presents with unspecific often flu-like symptoms, with unspecific laboratory findings, and with a varying array of organ manifestations a high index of suspicion is essential for a timely diagnosis. Blood, 1993 Dec 15, 82(12), 3770 - 7 Peripheral blood progenitor cell transplantation in lymphoma and leukemia using a single apheresis; Pettengell R et al.; Myeloablative treatment and peripheral blood progenitor cell (PBPC) transplantation are increasingly used for lymphomas and leukemias . We have sought to optimize conditions for priming, collection, and engraftment of the leukapheresis product . Fifty-four consecutive adult patients were eligible, 31 with high-grade non-Hodgkin's lymphoma of poor prognosis, 12 with Hodgkin's disease in chemosensitive relapse, and 11 with poor prognosis acute lymphoblastic leukemia . Filgrastim was administered after routine chemotherapy with VAPEC-B or HiCCOM to mobilize PBPC . A rapidly increasing white blood cell count was used to predict the time of peak PBPC release and plan leukapheresis . Forty-five patients underwent leukapheresis . A median of 14 L of blood was processed at a single apheresis . A median of 2.4 x 10(8)/kg mononuclear cells (MNCs), 1.04 x 10(6)/kg granulocyte-macrophage colony-forming cells (GM-CFCs), and 10.6 x 10(6)/kg CD34+ cells were obtained . Slightly fewer MNCs were obtained from the heavily pretreated Hodgkin's disease group . There were no other significant differences in the size or composition of the leukapheresis harvest in the three patient groups . Forty patients underwent high-dose therapy and PBPC transplantation . Filgrastim was administered by daily subcutaneous injection until the absolute neutrophil count was > or = 1 x 10(9)/L for 2 consecutive days . Rapid and sustained hematopoietic engraftment occurred in all patients . The median time to achieve a neutrophil count > or = 0.5 x 10(9)/L was 9 days (range, 8 to 16 days); to achieve a platelet count > or = 20 x 10(9)/L was 10 days (range, 6 to 88 days); and to achieve a platelet count > or = 50 x 10(9)/L was 15.5 days (range, 10 to 100 days) . Neutrophil recovery was faster than that of a historical control group treated with autologous bone marrow transplantation and filgrastim, but platelet recovery times were halved in the PBPC group . There was no secondary engraftment failure . Requirements for blood and platelet transfusions, antibiotic use, and parenteral nutrition were similar in the three patient groups . The median number of days in the hospital was 13 (range, 10 to 55) in the PBPC patients, compared with 19 (range, 14 to 51) in the historical controls . Leukapheresis yields (MNC, GM-CFC, and CD34+ cell numbers) were not useful for predicting the times to engraftment . We have shown that sufficient PBPC for transplantation can be obtained at a single leukapheresis after mobilization with routine chemotherapy and filgrastim in patients with non-Hodgkin's lymphoma, Hodgkin's disease, and acute lymphoblastic leukemia, even those heavily pretreated.(ABSTRACT TRUNCATED AT 400 WORDS) Neuroreport, 1993 Dec 13, 5(3), 197 - 200 Effect of ketamine on stress protein immunoreactivities in rat olfactory mucosa; Carr VM et al.; Administration of 9 mg ketamine per 100 g b.wt . to rats leads to transient enhancement of immunoreactivity to monoclonal antibodies against two stress proteins, ubiquitin and human 70 kDa heat shock protein (HSP70), in the supranuclear region of supporting cells of the olfactory epithelium and in the Bowman's gland acinar cells in the subepithelial lamina propria . In the supporting cells the enhanced immunoreactivities are not caused by other drugs used in our surgical anesthetic/antibiotic regimen (xylazine, buprenorphine, and gentamicin), but in Bowman's glands they are . Results are discussed in terms of possible ketamine binding to phencyclidine receptors (either NMDA-associated or not) and possible direct stress-inducing interactions of ketamine or ketamine breakdown products with the inhalant detoxification or secretory systems in the reactive cells. Pharmacoeconomics, 1994, 6 Suppl 2, 36 - 43 Economic analysis of lenograstim in the correction of neutropenia following chemotherapy for non-Hodgkin's lymphoma; Souetre E et al.; A prospective economic analysis of lenograstim and placebo was performed as part of a randomised double-blind trial in 162 patients receiving chemotherapy for non-Hodgkin's lymphoma (NHL) . The primary clinical end-point was the percentage of patients experiencing > or = 1 documented infection in each treatment group . The cost of hospitalisation and the cost of medical services used were the primary economic end-points . Economic analysis was based on the French Hospital perspective . Over the 56-day study period, patients in the placebo group received more days of inpatient intravenous (8.9 vs 5.3 days; p < 0.01) and oral (5.3 vs 4.2 days) antibiotic therapy than those in the lenograstim group . This difference was due to a higher rate of documented infection in the placebo group . Patients treated with placebo also spent more days in hospital for reasons other than administration of chemotherapy (18.5 vs 14.4; p < 0.05) . The number of days of chemotherapy was significantly greater in the lenograstim group than in the placebo group (19.4 vs 17.5; p < 0.001) because of shorter delays between chemotherapy cycles in the lenograstim group . The use of lenograstim to prevent chemotherapy-induced neutropenia in patients with NHL was associated with a reduction in total direct medical costs (excluding the cost of lenograstim) of FF7297 as a result of reduced patient morbidity . Furthermore, the higher rate of completion of chemotherapy in the lenograstim group may lead to better long term survival; this observation deserves further clinical investigation. Pharmacoeconomics, 1994, 6 Suppl 2, 27 - 35 Economic evaluation of lenograstim (glycosylated rHuG-CSF) in the treatment of inflammatory breast cancer for Germany and Italy; Mapelli V et al.; Data from a French placebo-controlled double-blind trial in 120 female patients treated with high dose fluorouracil, epirubicin and cyclophosphamide (HD-FEC) chemotherapy for inflammatory breast cancer were used to assess the economic impact of adjunctive lenograstim therapy . The analysis compared direct costs of treatment, with or without lenograstim, with reference to the Social Security (Germany) or to the National Health Service (Italy) . Resource utilisation differed between the 2 treatment groups . The lenograstim group reported 32% fewer antibiotic therapy days (9.8 days vs 14.6; p = 0.01) and 24% fewer inpatient days for any reason other than chemotherapy (7.4 'excess' days vs 9.8) . By reducing infection-related morbidity associated with a high dose chemotherapy regimen, lenograstim decreased treatment costs by DM 1794 and ItL 1.2 million, excluding the cost of lenograstim itself . Since lenograstim patients reported fewer chemotherapy delays (16.4 vs 30.5%) and, hence, benefited from 1.2 (p = 0.04) more chemotherapy days, the related cost was DM 1519 and ItL 0.9 million higher than for the placebo group . This cost difference would be expected to be smaller if the placebo group patients had been followed until completion of their full chemotherapy regimen . Assuming that the costs of chemotherapy were the same for both groups, the direct cost saving for the lenograstim group would be 30% in Germany and 34% in Italy. Int J Health Care Qual Assur, 1994, 7(3), 11 - 5 Comparative audit between hospitals: the example of appendectomy; Black NA et al.; How useful are routine, comparative audit systems? To attempt to answer this question, data from a system in North West Thames were used . A common procedure was selected (appendectomy) and data supplied by 17 surgeons between January and June 1990 were analysed . Aspects of the case-mix, clinical management, diagnostic accuracy and patient outcomes for the surgeons were compared . A total of 401 patients had been treated . All aspects of care varied between surgeons: mean age of patients (19-36 years), proportion of female patients (30-75 per cent), mean length of stay (2.1-7.1 days), prophylactic antibiotic use (0-85 per cent), diagnostic accuracy (40-100 per cent) and incidence of wound infections (0-4 per cent) . As a result of the small sample sizes (mean number of cases per surgeon was 23.6) few of these differences were statistically significant . In addition, there were some doubts about the accuracy of some of the data . If such methodological difficulties can be overcome, comparative audit systems offer a practical and useful way of uncovering unusual clinical practices and generating hypotheses for evaluative research. Schweiz Rundsch Med Prax, 1993 Dec 7, 82(49), 1424 - 8 {Abdominal pain, fresh blood in the anus}; Bauer S et al.; A 60-year-old lady with type II diabetes, arterial hypertension and 'melancholia' was treated with Lithium, a neuroleptic (Leponex) and an ACE inhibitor (Reniten) . She was referred to our hospital because of abdominal pain, subfebrile temperatures, diarrhea and hematochezia . The radiological and sonographic examinations showed a thickened wall of the left hemicolon . Colonoscopy revealed a sharply delineated segment with pronounced inflammation in the descending colon and the proximal sigmoid colon, suggestive for an ischemic colitis . Histology of the inflamed colon was compatible with this diagnosis . Under suspended enteral feeding and antibiotic therapy the symptoms disappeared within two weeks, and a control colonoscopy six weeks later was completely normal . 1 1/2 years later the patient suffered from a second episode of ischemic colitis exactly a the same site . Again, complete cure was achieved by conservative treatment. J Biol Chem, 1993 Dec 5, 268(34), 25385 - 8 Rapamycin-FKBP12 blocks proliferation, induces differentiation, and inhibits cdc2 kinase activity in a myogenic cell line; Jayaraman T et al.; Rapamycin is a potent immunosuppressant that binds to the cytosolic protein, FKBP12, and blocks T cell activation . Here we report that rapamycin also blocks myogenic proliferation and induces differentiation, associated with a decrease in p34cdc2 activity and cyclin A levels . In yeast and mammals, rapamycin blocks cell cycle progression by causing G1 arrest, arguing for a conserved signaling pathway governing the G1 to S transition . p34cdc2 has been shown to play a role in both the transition from G1 to S and from G2 to M in yeast . In higher eukaryotes the role of p34cdc2 in G1 to S transition is less clear . Rapamycin and the structurally related macrolide antibiotic FK506 both bind to a cytosolic protein, the FK506-binding protein (FKBP12) . We show that inhibition of myogenic proliferation is achieved at low doses of rapamycin (< 1 ng/ml) and is competed by a molar excess of FK506, indicating specificity for FKBP12 . The distinct FK506-calcineurin pathway did not affect myogenic proliferation, differentiation, or p34cdc2 kinase activity . Thus, the rapamycin-FKBP12 signaling pathway involves a specific and direct effect on p34cdc2 kinase activity at the G1 to S transition and identifies a regulatory step during myogenic differentiation. J Hand Surg {Br}, 1993 Dec, 18(6), 783 - 9 Closed continuous irrigation as a treatment for infection in the hand; Nemoto K et al.; A method of closed irrigation has been devised to treat infections in the hand . After adequate debridement, two tubes are placed in the infected area, an inlet tube and an outlet tube . For a small infection, one tube serves both purposes . The wound is closed completely . Irrigation with saline and antibiotic solution is continued for 1 week, extended up to 3 weeks in cases of severe infection . This method has been applied in 31 cases including pyogenic tenosynovitis, tuberculous tenosynovitis, pyogenic arthritis, osteomyelitis, bite injury, crush injury and amputation stump infection . Infection healed primarily in 29 cases . Further surgery was needed in two cases which healed finally. J Clin Microbiol, 1993 Dec, 31(12), 3090 - 5 Serodiagnosis in early Lyme disease; Aguero-Rosenfeld ME et al.; Using a commercially available enzyme-linked immunosorbent assay (ELISA) and an immunoblot assay (IB), we tested sera from 100 patients with erythema migrans (EM) seen in 1991 a the Westchester County Medical Center Lyme Disease Diagnostic Center . Convalescent-phase sera were available from 59 patients . Fifty-five patients had EM of < 7 days' duration, 31 had EM of 7 to 14 days' duration, and 14 had EM of > 14 days' duration . During the acute phase of infection, 35 patients had a positive ELISA result and 43 had a positive IB result by the recently published criteria of Dressler et al . (F . Dressler, J . A . Whalen, B . N . Reinhardt, and A . C . Steere, J . Infect . Dis . 167:392-400, 1993) for interpretation of IB in patients with Lyme disease . A greater sensitivity of IB was observed in patients with EM of < 7 days' duration, as follows: 14 of 55 (25%) for IB versus 7 of 55 (13%) for ELISA (P = 0.144) . Sera of all 14 patients with EM of > 14 days' duration were reactive by both tests, as follows: 13 positive and 1 equivocal by ELISA and 12 positive and 2 indeterminate by the IB . The band reactivity most frequently observed in the IB was to the 41- and 25-kDa antigens, the latter being the most frequent band observed in immunoglobulin M blots . Seroconversion was observed in 74 and 64% of evaluable patients by ELISA and IB, respectively, despite the use of antibiotic therapy. Zhonghua Yi Xue Za Zhi (Taipei), 1993 Dec, 52(6), 408 - 12 Acute lobar nephronia: a case report; Chen SC et al.; Acute lobar nephronia (ALN), a term analogous to acute lobar pneumonia, refers to a renal mass caused by acute focal infection without liquefaction . An alternative term is acute focal bacterial nephritis (AFBN) . Fever, flank pain or back pain are the most frequently encountered clinical characteristics . Imaging modalities used to establish a definite diagnosis of acute lobar nephronia included sonography, computed tomography and nuclear medicine . Uroradiographic findings in this condition can mimic a renal abscess or neoplasm . Further distinction between acute lobar nephronia and other renal masses is aided by the appropriate use of renal sonography and computerized tomography is the most effective and least costly method in diagnosis . Serial sonograms can be used to monitor response to antibiotic therapy . Clinical and uroradiographic characteristics of a six year-old female patient with acute lobar nephronia are presented, along with a review of literature. Pediatr Infect Dis J, 1993 Dec, 12(12 Suppl 3), S122 - 7 Comparative safety and efficacy of clarithromycin and amoxicillin/clavulanate in the treatment of acute otitis media in children; McCarty JM et al.; Clarithromycin is a new macrolide antibiotic with a wide spectrum of activity that includes the pathogens commonly causing pediatric otitis media . This randomized, investigator-blinded, multicenter trial compared the safety and efficacy of clarithromycin and amoxicillin/clavulanate in the treatment of acute otitis media in patients ages 6 months to 12 years . A total of 338 patients with acute otitis media diagnosed by otoscopy were randomized to receive clarithromycin 7.5 mg/kg twice daily, maximum 500 mg twice daily (n = 161), or amoxicillin/clavulanate 13.3 mg/kg three times daily, maximum 500 mg three times daily (n = 177), for 10 days . Treatment groups were comparable with respect to demographics, severity of infection and number of previous episodes . Efficacy was assessed by clinical examination performed within 48 hours of finishing study medication . A successful clinical response was seen in 90% (121 of 135) of evaluable clarithromycin patients vs . 92% (133 of 145) of evaluable amoxicillin/clavulanate patients (P = 0.681) . Clinical failure or relapse (Posttreatment Days 0 to 4) occurred in 10% (14 of 135) of clarithromycin-treated patients vs . 8% (12 of 145) of amoxicillin/clavulanate-treated patients . Gastrointestinal adverse events were the most commonly reported in both groups . Of these events diarrhea was the most frequent, occurring in 12% (19 of 161) of clarithromycin and 32% (57 of 177) of amoxicillin/clavulanate-treated patients (P < 0.001) . These results indicate that the efficacy of clarithromycin oral suspension was comparable with amoxicillin/clavulanate oral suspension in the treatment of acute otitis media in children . Clarithromycin was better tolerated than amoxicillin/clavulanate with a lower incidence of gastrointestinal side effects. J Laryngol Otol, 1993 Dec, 107(12), 1113 - 8 Radical mastoidectomy: its place in otitic intracranial complications; Singh B et al.; Standard recommended treatment for patients with intracranial complications from otitis media, has been radical mastoidectomy, whether cholesteatoma is present or not . This was established in the pre-antibiotic era to improve survival . Over a six-year period, from January 1985 to December 1990, 268 patients were admitted with intracranial and extracranial complications of otitis media . The prospective treatment consisted of antibiotics and surgery . Surgery entailed mastoidectomy and drainage of intracranial collections of pus in all patients . However, prospectively in these patients the ear pathology and not the complication dictated the type of mastoidectomy performed . Cortical mastoidectomy was performed in non-cholesteatomatous ears and radical mastoidectomy in cholesteatomatous ears . Recurrence of intracranial complications occurred in only four patients (two per cent), a temporal lobe cerebritis in the non-cholesteatomatous ear group, and, a temporal lobe abscess, posterior fossa abscess and subdural empyema in the cholesteatomatous ear group . The temporal lobe cerebritis settled on intravenous antibiotics whilst the temporal lobe abscess, posterior fossa abscess and subdural empyema required redrainage . In none of these was the ear surgery revised . There were 15 deaths (eight per cent), all occurring in patients with intracranial complications, 12 associated with brain abscess, two with subdural empyema and one with meningitis . Eight were from the non-cholesteatomatous group and seven from the cholesteatomatous group . The mortality was directly related to the patients consciousness level on admission and not to the type of ear pathology . It can therefore be concluded that radical mastoidectomy is unwarranted in the non-cholesteatomatous ear, even with an otogenic intracranial complication. Br J Oral Maxillofac Surg, 1993 Dec, 31(6), 360 - 5 The use of third molar surgery in clinical pharmacology; Meechan JG et al.; This review discusses the various sequelae that arise after third molar surgery and their use for assessing the efficacy of a variety of therapeutic measures . The surgical procedure provides an opportunity to investigate onset, depth, duration and possible systemic effects of local anaesthetic solutions . Also, the anxiety which often accompanies such surgery lends itself to the appraisal of different anxiolytic agents and sedation techniques . The immediate postoperative sequelae of pain, buccal swelling and trismus provides a useful clinical model for evaluating the efficacy of analgesics and anti-inflammatory drugs . Third molar tooth sockets are susceptible to infection and this propensity enables the assessment of different antibiotic regimens . A further advantage of the third molar model is its application for crossover studies, with the patient acting as their own control . Very few surgical procedures afford this facility, which further adds to the value of this model in clinical pharmacology. Can J Surg, 1993 Dec, 36(6), 522 - 4 Acute abdominal emergencies in patients on long-term ambulatory peritoneal dialysis; Wellington JL et al.; OBJECTIVE: To review intercurrent abdominal emergencies in patients receiving long-term peritoneal dialysis on an ambulatory basis . DESIGN: A chart review . SETTING: Tertiary care referral centre . PATIENTS: Seven patients receiving long-term peritoneal dialysis, who suffered an acute abdominal emergency during a 7-year study period . INTERVENTIONS: Laparotomy with appropriate management depending on the findings . Antibiotic therapy and dialysate culture . RESULTS: In all patients the acute abdominal process involved the colon: five patients had perforated diverticulitis and two had ischemic colitis . The death rate overall was 57% . Peritonitis in these patients was difficult to differentiate from the peritonitis that occurs commonly in patients on long-term peritoneal dialysis . As a result there was a delay in the initiation of therapy ranging from 2 to 27 days . CONCLUSIONS: Coincidental abdominal emergency should be considered when patients receiving long-term peritoneal dialysis on an ambulatory basis present with peritonitis that does not respond to established antibiotic protocols and when culture results show evidence of multiple enteric organisms. Plast Reconstr Surg, 1993 Dec, 92(7), 1342 - 9; discussion 1350-1 Diffusion versus iontophoresis in the transport of gentamicin in the burned rabbit ear model; Kaweski S et al.; This experimental study demonstrates that iontophoresis can be used to transport biologically active gentamicin into auricular cartilage . Fifty female New Zealand White rabbits were divided into three groups: live controls with unburned ears, live animals with burn-injured ears (deep or partial-thickness), and euthanized animals with unburned ears . Each group was then divided into subgroups that received gentamicin transported by iontophoresis or diffusion . In ears subjected to iontophoresis, adequate gentamicin activity could be demonstrated only in the cartilage of euthanized animals with unburned ears and live animals with full-thickness burned ears . Diffusion did not transport a detectable level of gentamicin in any instance . Diffusion is ineffective in the transport of gentamicin and should not be used as a primary method of treatment for ear chondritis . Iontophoresis did not transport active gentamicin across partial-thickness burns, presumably because the migrating antibiotic molecules were dispersed throughout the body by the circulation . However, if the circulation is destroyed, as in a full-thickness burn, iontophoresis can move the biologically active gentamicin into the cartilage. J Bacteriol, 1993 Dec, 175(23), 7571 - 80 The tcmVI region of the tetracenomycin C biosynthetic gene cluster of Streptomyces glaucescens encodes the tetracenomycin F1 monooxygenase, tetracenomycin F2 cyclase, and, most likely, a second cyclase; Summers RG et al.; Certain mutations in the tcmVI region of the Streptomyces glaucescens chromosome affect formation of the D ring of the polyketide antibiotic tetracenomycin C (TCM C) . This region lies immediately upstream from the TCM C polyketide synthase genes (tcmKLM), and the nucleotide sequence reveals the presence of three small genes, tcmH, tcmI, and tcmJ . On the basis of the phenotypes of mutants and the effects of these genes, when coupled on a plasmid with the tcmKLMN177 genes (tcmN177 is a 3'-truncated version of tcmN), on the production of TCM intermediates in a TCM- mutant, the tcmH gene encodes the C-5 monooxygenase that converts TCM F1 to TCM D3, the tcmI gene encodes the D-ring cyclase that converts TCM F2 to TCM F1 (mutations in this gene are responsible for the type VI phenotype), and the tcmJ gene most likely encodes the B-ring cyclase that acts in the biosynthesis of TCM F2 . Furthermore, it appears that the N-terminal domain of the tcmN gene product (encoded by the tcmN177 gene) acts later in the biosynthesis of TCM F2 than the product of tcmJ, suggesting that the N-terminal domain of the TcmN protein is the C-ring cyclase. Clin Orthop, 1993 Dec, (297), 238 - 41 Chronic septic arthritis caused by Borrelia burgdorferi; Battafarano DF et al.; Chronic arthritis occurs in 10% of Lyme disease patients . A patient had chronic septic Lyme arthritis of the knee for seven years despite multiple antibiotic trials and multiple arthroscopic and open synovectomies . Spirochetes were documented in synovium and synovial fluid (SF) . Polymerase chain reaction (PCR) analysis of the SF was consistent with Borrelia infection . Persistent infection should be excluded with silver stains and cultures in any patient with chronic monoarticular arthritis and a history of Lyme disease. J S Afr Vet Assoc, 1993 Dec, 64(4), 162 - 4 Emphysematous cystitis in a non-diabetic cat; Davies NL et al.; Emphysematous cystitis in man and domestic animals is reviewed . A case of emphysematous cystitis occurring 5 d after standard therapy for urethral obstruction in a non-diabetic male Siamese-cross cat is described . Escherichia coli was isolated, and the cystitis resolved after antibiotic therapy. Leuk Lymphoma, 1993 Dec, 12(1-2), 41 - 9 New insight into oncoprotein-targeted antitumor effect: herbimycin A as an antagonist of protein tyrosine kinase against Ph1-positive leukemia cells; Okabe M et al.; Herbimycin A, a benzoquinonoid anasamycin antibiotic, has been shown to reserve the oncogenic phenotypes of p60v-src transformed cells by the virtue of the inhibition of src protein tyrosine kinase . Furthermore, we previously demonstrated that herbimycin A displayed the antitumor activity on Ph1-positive leukemia cells and bcr/abl oncoprotein-associated transformed murine hematopoietic cells with the transfection of a retroviral vector expressing bcr/abl . Herbimycin A showed preferential inhibition on the in vitro growth of Ph1-positive leukemia cells and bcr/abl oncoprotein-associated murine hematopoietic cells through the inhibition of bcr/abl tyrosine kinase activity and the reduction of subsequent phosphotyrosyl proteins . Recently, from the view of investigating the oncogenic significance or of developing a future clinical application in malignancies, several developing agents targeted against oncoprotein have been tried . We reviewed the present progress in the mechanism of oncoprotein-targeted antitumor effects and focused on herbimycin A-induced antitumor activity on Ph1-positive leukemia cells. J Otolaryngol, 1993 Dec, 22(6), 415 - 20 Septic internal jugular vein thrombosis; Tovi F et al.; Septic Internal Jugular Vein Thrombosis (SIJVT) is a rare but potentially life-threatening condition which necessitates early clinical recognition and rapid administration of appropriate therapy . Although termed by some authors a "forgotten disease" in the antibiotic era, this entity is still present but frequently overlooked . Deep neck infections, Lemierre syndrome, central venous catheterization and mastoiditis are the etiologies in this series . The diagnosis of SIJVT utilized CT and Doppler ultrasound imaging . The treatment included aggressive abscesses, necrotizing fasciitis, mastoiditis) . Anti-coagulant agents were used in order to reduce the risks of pulmonary embolism. Comput Methods Programs Biomed, 1993 Dec, 41(2), 131 - 3 Microcomputer program for the assessment of one-way, two-way and factorial analysis of variance in pharmaceutical data; Abdullah ME et al.; A personal computer program in BASIC for the two-factor factorial analysis of variance has b