Positive antibacterial co-action between hop (Humulus lupulus) constituents and selected antibiotics.

The research reported here deals with co-action of the hop (Humulus lupulus)-derived anti-bacterial compounds, lupulone and xanthohumol, with several antibiotics. Among the antibiotics investigated for their co-action, polymyxin B sulfate, tobramycin and ciprofloxacin had a positive co-action in inhibiting selected test bacteria. The disc/well-diffusion assay and the minimum inhibitory concentration test (MIC) were employed to determine co-action. Both Gram-positive and Gram-negative bacteria were used in the evaluation. There was some co-action against all Gram-positive bacteria tested. Surprisingly, there was some positive co-action even against certain Gram-negative bacteria but not against others. Particularly, there was no co-action against E.coli. An antibacterial cream with lupulone, neomycin and polymyxin B sulfate was prepared and showed co-action. Ideas for other practical applications of this effect are put forth. The mechanism of the synergistic effect is briefly discussed but no attempt was made to prove it experimentally.

Atrioventricular fistula: an unusual complication of endomyocardial biopsy in a heart transplant recipient.

Endomyocardial biopsy remains the primary method for diagnosis of cardiac allograft rejection. Generally, endomyocardial biopsy is considered a relatively safe procedure in heart transplant recipients. Complications that have been reported are related to catheter insertion and include carotid arterial puncture, prolonged bleeding, vasovagal reaction, ventricular tachyarrhythmias, and transient conduction abnormalities. Serious complications such as right ventricular perforation with cardiac tamponade may also occur. Most complications are usually without significant long-term sequelae. This report describes an unusual case of atrioventricular fistula between the right atrium and left ventricle that occurred during a routine endomyocardial biopsy in a heart transplant recipient. Sudden hemodynamic compromise developed in this patient soon after heart biopsy associated with hemodynamic picture of high-output heart failure. Right heart catheterization, including oximetry, peripheral venous contrast echocardiography, color flow Doppler studies, and transesophageal echocardiography confirmed the diagnosis of fistulous communication between the right atrium and left ventricle, most likely through the membranous interventricular septum. Conservative medical management resulted in striking clinical improvement within 48 hours commensurate with spontaneous closure of the right atrium-to-left ventricle fistula documented by hemodynamic and echocardiographic studies.

Changes in gastric mucosal ornithine decarboxylase and tyrosine phosphorylation of proteins in postgastrectomy patients.

There is evidence to suggest that partial gastrectomy is associated with an increased risk of developing gastric carcinoma in humans. Since ornithine decarboxylase (ODC) and tyrosine phosphorylation of proteins are involved in the regulation of cell proliferation, the present study was undertaken to examine the time-dependent changes of these variables in the postgastrectomy stomach. Thirty-seven postgastrectomy patients (Billroth I (BI), n = 7, and Billroth II (BII), n = 30) underwent gastroscopy. For comparison, five patients with intact stomachs (three healthy and two postvagotomy and pyloroplasty) were also studied. Gastric mucosal biopsy specimens were obtained within 5 cm of the anastomosis and analyzed for ODC activity. In addition, tyrosine phosphorylation of membrane proteins was also determined in representative samples of BII patients. Gastric mucosal ODC activity was significantly higher in BII patients in whom gastrectomy had been performed > 15 years earlier compared with those in whom it had been performed < 15 years earlier (p < 0.001) or controls (p = 0.004). Although the mean ODC activity was higher in BII than in BI patients, the difference was not significant (p = 0.103). Isolated patients with high ODC activity demonstrated increased phosphorylation of tyrosine membrane proteins with M(r) of 55-60.

Hypertensive intracerebral hemorrhage stimulating acute myocardial infarction.

We describe the case of a patient who presented with cardiovascular collapse and ECG changes strongly suggestive of acute MI. Our experience and that of others with patients who had sustained intracerebral hemorrhage indicate the potential for this entity to be misdiagnosed as acute MI early in a patient's clinical course. Reports of mistaken administration of thrombolytic therapy to patients with pericarditis or aortic dissection, other conditions that may be electrocardiographically mimic MI, underscore the potential for error. Clinicians should consider the possibility of intracerebral hemorrhage before treatment of MI with thrombolytic agents.