Experimental closure of gunshot wounds by fibrin glue with antibiotics in pigs.

BACKGROUND/AIM: Gunshot wounds caused by the automatic rifle M70AB2 (AK-47) 7.62 mm, after the primary surgical management, were closed with delayed primary suture during the next four to seven days. This period coincides with the fibroblastic phase of wound healing. Fibrin glue is used as a local hemostatic and as a matrix for the local dosed release of antibiotics. Antibiotics addition to fibrin glue resulted in continuous diffusion into the surrounding next 4 to 7 days. The aim of this study was to create the preconditions for gunshot wounds closing without complications by the application of fibrin glue with antibiotics 24 h after primary surgical treatment. METHODS: A total of 14 pigs were wounded in the gluteofemoral region by the bullet M67, initial velocity of 720 m/s. All wounded animals were surgically treated according to the principles of the war-surgery doctrine. Seven wounds were closed with primary delayed suture four days after the primary surgical treatment (traditional approach). Fibrin glue with antibiotics was introduced in seven wounds during the primary surgical treatment and primary delayed suture was done after 24 h. The macroscopic appearance and the clinical assessment of the wound were done during the primary surgical treatment and during its revision after 24 h, as well as histopathological findings at the days 4 and 7 after wounding. RESULTS: Gunshot wounds caused by the automatic rifle M70AB2 (AK-47) 7.62 mm, and treated with fibrin glue with antibiotics after primary surgical management, were closed with primary delayed suture after 24 h. In further wound evolution there were no complications. CONCLUSION: Uncomplicated soft-tissue wounds caused by an automatic M70AB2 rifle may be closed primarily with delayed suture without the risk of developing complications if on revision, 24 h after primary surgery, there were no present necrotic tissues, hematoma, and any signs of infection when fibrin glue with antibiotics (ceftriaxone and clindamycin) was applied. The use of this method should be limited to individual and strictly controlled cases in civil practice for now.

HPLC method development for determination of doxycycline in human seminal fluid.

The present paper reports the development and validation of an analytical method for doxycycline quantification in human seminal fluid by HPLC with UV detection. The separation of doxycycline was achieved at 40°C on a reversed-phase C18 column using isocratic elution. The mobile phase consisted of acetonitrile (A) and water buffered at pH 2.5 with a concentrated orthophosphoric acid (B) in the volume ratio of 20:80 (v/v), respectively. The detection was performed at 350nm. As an internal standard (IS), tetracycline was used. The proposed method involves the extraction of doxycycline from seminal fluid based on acidic precipitation of the proteins using perchloric acid. The method showed good intra- and inter-day precisions (RSD<7.0%), good accuracy (recovery for doxycycline>80%), and high correlation coefficient (r=0.998) for standards subjected to the entire procedure. The detection and quantification limits were 0.087µg/ml and 0.264µg/ml. The developed method was used to analyze doxycycline in the seminal fluids obtained from male subjects who were treated with doxycycline-hyclate. The mean doxycycline concentrations of 0.89±0.07µg/ml and 0.45±0.26µg/ml were detected in seminal fluid after 6h and 12h, respectively. This is the first study reporting extraction and HPLC determination of doxycycline in this complex sample and can be very useful in support of clinical and pharmacokinetic studies on this antibiotic.

[Drug interactions with grapefruit].

INTRODUCTION: The concentration of many orally given medications may be affected by grapefruit or grapefruit juice consumption. It may result in numerous harmful effects. INTERACTION OF GRAPEFRUIT WITH DRUGS: Taking only one cup of juice may induce interactions with different drugs even during the period of a few days. The effect is induced by suppression of cytochrome P450 isoenzyme CYP3A4 in the intestinal wall. The Latin name of grapefruit, Citrus paradisi, is quite opposite to the effects which could be induced by taking grapefruit and some medications at the same time. It is necessary to avoid taking grapefruit with the drugs whose pharmacokinetics could be altered by the active principles found in that fruit. DISCUSSION: The coloured grapefruit contains less furanocoumarins, but there is no difference in induction and intensity of pharmacokinetic interaction with drugs related to its colour. Other citrus fruits (orange, lemon) do not have such effects, but some other fruits (pomegranate, stella fruit, banpeiyu, hassaku, takaoka-buntan and kinkan) exert inhibitory effects on the activity of cytochrome P450 isoenzyme.

Diltiazem prevention of toxic effects of monosodium glutamate on ovaries in rats.

The female reproductive system is very sensitive to different harmful environmental factors. A great danger is hidden in an increased use of food additives like monosodium glutamate (MSG). Numerous studies have shown that application of high doses of MSG to different kinds of animals during the neonatal period may cause lesions of neural structures and the retina. Later in adulthood animals exhibit a series of neuroendocrine disorders: a stunted growth, obesity and infertility. The mechanism of MSG action is not well explained yet. We hypothesized that high concentration of MSG could alter permeability of neural membrane for calcium. We studied whether pretreatment with diltiazem prevented the effects of MSG on ovaries in rats. Female rat pups were treated with: 0.9% NaCl, MSG, diltiazem or diltiazem with MSG. MSG treatment resulted in a cystic degeneration of ovaries and irregular and prolonged estrus phase of estrus cycle. The other treated groups of rats had normal ovarian histology and estrus cycle. The pretreatment with diltiazem prevented development of morphological and functional disorders of ovaries. Our results suggest that calcium overloading play an important role in mechanisms of MSG toxicity.

Precancerous morphologic and functional aberrations in the rat mammary glands carcinogenesis.

The precancerous changes of mammary glands in 7,12-dimethylbenz(alpha)anthracene (DMBA) induced carcinogenesis in Wistar rats were examined. Carcinogen was inserted into the left fifth mammary gland of the anesthetised rats. After 35 days all the animals were sacrificed and mammary glands were extirpated. Macroscopic examination of mammary glands was performed and the tissue was processed for a pathohistological analysis. H&E, VanGieson's and Toluidine-blue methods were applied, as well as ABC immunohistochemical method with anti-cytokeratin antibodies.The identified precancerous changes resembled to aberrations of fibrocystic disease in women. The fibrosclerosis, lobular hyperplasia, cystic ductal dilatation and apocrine metaplasia of ductal epithelium were found. Micropapillomatoid hyperplasia was another frequent finding, but the presence of the real papilloma was not registered. The keratocysts with the squamous epithelial metaplasia were present in three of the animals. Dysplastic changes were found in the skin, above the treated glands. The difference in expression of cytokeratins, between normal and preneoplastic epithelium, makes cytokeratin useful for verification of early precancerous lesions. The epithelial ductus and ductulus cells of the mammary glands of animals belonging to the control group showed neither CK 19 nor CK 14 expression.