[A clinicobacteriologic study on clavulanic acid/amoxicillin in pediatric sinusitis].

We carried out clinical and bacteriological studies on clavulanic acid/amoxicillin and amoxicillin in pediatric sinusitis at 11 general practice settings. The results are summarized as follows. 1. The major isolated organisms from content of middle meatus were Streptococcus pneumoniae 32.2%, Haemophilus influenzae 32.0% and Moraxella subgenus Branhamella catarrhalis 25.1%. Similar results were observed for the major isolates from nasopharynx. 2. 62.1% of S. pneumoniae isolated were drug resistant S. pneumoniae (PISP, PRSP) and they were increasing year by year. 3. Drug resistant S. pneumoniae was isolated from 38.6% of all cases. 4. Regarding MIC90, CVA/AMPC showed superior antimicrobial activity against Streptococcus pneumoniae, Haemophilus influenzae and Moraxella subgenus Branhamella catarrhalis. 5. The clinical efficacy, bacteriological efficacy and utility of CVA/AMPC-treated group were 78%, 58% and 72.8%, respectively, and they were significantly superior to AMPC-treated group. 6. Adverse reactions were observed in 11.2% of CVA/AMPC group, involving diarrhea and stool loose and there was no statistical deference from those of AMPC group.

A case with quadruple primary cancers of head and neck.

Despite progress in techniques for early detection and treatment of cancers, cases of multiple primary cancers are apparently increasing. This paper reported quadruple primary cancers of stomach, lung, hypopharynx and maxillary sinus in a 63-year-old male. He finally died of brain metastasis and pneumonia by MRSA (Me Resistant S. aureus).

Analysis of C5b-8 binding sites in the C9 molecule using monoclonal antibodies: participation of two separate epitopes of C9 in C5b-8 binding.

C5b-8 binding sites in C9 were examined using mAbs raised against C9. Among 16 mAbs, two, designated P40 and X197, blocked C9-mediated EAC1-8 lysis. C9 pretreated with the mAbs failed to bind to EAC1-8 at 4 degrees C. In addition, the mAbs became inaccessible to the C9 that had been incorporated into EAC1-8 at 4 degrees C. These findings suggest that C9 binding to EAC1-8, but not its membrane spanning or polymerization, is blocked by mAbs. By immunoblotting analysis using alpha-thrombin proteolytic fragments derived from C9 [a N-terminal fragment of mol. wt 25,000 (C9a) and a C-terminal one of mol. wt 37,000 (C9b)] and tryptic fragments of C9 (mol. wts 53,000 (C9a') and 20,000 (C9b')), the epitopes of P40 and X197 were mapped to the N-terminal and C-terminal regions of C9b, respectively. Both P40 and X197 bound to the C9 polymerized with Zn2+ in the fluid phase, whereas X197 but not P40 reacted with the membrane attack complex (MAC) formed on membranes. The results suggest that two distinct epitopes are involved in C9 binding to EAC1-8, and behave in a different manner for globular C9 bound to EAC1-8 at 4 degrees C, C9 assembled in MAC, or poly-C9 induced by Zn2+. These mAbs may be useful in clarifying the conformational states of C9 and in analyzing the molecular interaction between C9 and its inhibitors.

[A case of cervico-mediastinal abscess, secondary to acute tonsillitis: investigation of the treatments].

No other infectious diseases in the field of otolaryngology cause rapid and lethal course than cervical abscess. A case of cervicomediastinal abscess secondary to acute tonsillitis was presented. The patient was a 43-year-old male with liver cirrhosis and primarily had the treatment of tonsillitis. The complication of duodenal perforation caused marked general deteriotation, and cervical abscess occured. Immediately after transfer to our department, he was treated by cervical drainage, laparotomy and chemotherapy. However, hepatic failure occured, and he died of sepsis on the 16th day after the onset of tonsillitis. Cervicomediastinal abscesses were classified according to severity in Stage 1-4. 34 cases of advanced cervical abscess were reported in Japan from 1976 to 1989. These cases were analyzed statistically in terms of primary focus of infection, surgical procedures, clinical isolates and chemotherapy, etc., and following results were obtained. 1) Primary focus; approximately 50% was due to the infection of the tonsills and the pharynx occupied about 50%, and the odontogenic infections, approximately 40%. 2) Surgical procedures; the neck doranaige approaching through the vertical incision resulted more effective. 3) Clinical isolates; aerobes and anaerobes accounted for 50% each of all strains. alpha-Streptococcus was predominant among aerobes, and Peptostreptococcus and Bacteroides were predominant among anaerobes. In order to confirm pathogenic bacteria of cervical abscess, clinical isolates of peritonsiller abscess and mandibular ostesis were compared with those of cervical abscess, because these infections are primary infectious diseases of cervical abscess.(ABSTRACT TRUNCATED AT 250 WORDS)