[Perioperative prophylaxis in patients with head and neck tumors]. / Profilaxis perioperatoria en enfermos con tumores de cabeza y cuello.

Sixty-one cancerous patients of the larynx, hipopharynx and tongue underwent surgery under perioperative prophylaxis with Cefuroxim and Metronidazole during 3 days. Alterations of the healing process could not be observed and the parameters both clinic and chemical were normal. The seric level of antibiotics was effective against most of the bacteria cultured from tracheal secretions and from the posterior wall of the oral cavity. Perioperative antibiotic prophylaxis is compulsory when major surgery is performed in head and neck.

[Perioperative prophylaxis with cefmenoxime and metronidazole in patients with head and neck tumors]. / Perioperative Prophylaxe mit Cefmenoxim und Metronidazol bei Patienten mit Kopf-Hals-Tumoren.

Twenty-one patients with carcinoma of the larynx, hypopharynx and the tongue underwent surgery under perioperative prophylaxis with cefmenoxime and metronidazole. Healing was uneventful and the clinical and the chemical parameters remained normally. The level of the antibiotics was effective against most of the bacteria cultured from tracheal aspirate and the posterior wall of the oral cavity. Effective perioperative antibiotic prophylaxis is necessary in head and neck surgery: the use of simple antibiotics in short courses should be assessed.

[Bacteriological, clinical, and pharmacokinetic studies of perioperative antibiotic prophylaxis in head and neck surgery]. / Bakteriologische, klinische und pharmakokinetische Untersuchungen zur perioperativen Antibiotikaprophylaxe in der Kopf-Hals-Chirurgie.

The point of this study was to analyze the possible benefits of perioperative antibiotic prophylaxis in patients from whom oral cavity or throat tumors are removed. The criteria used to judge the efficacy of each treatment included the clinical course of the treatment, the bacterial colonization of the surgical area as well as the growth of bacteria during the postoperative phase. 50 patients were chosen and grouped according to their surgical treatment: laryngectomy (n = 20), partial laryngectomy (n = 22) or tongue, floor of the mouth, soft palate, gum or base of the tongue partial resection (n = 8). Within each surgical group, patients were randomly chosen for antibiotic prophylaxis; others constituted the untreated control group. The antibiotic prophylaxis consisted of 5 g Mezlocillin administered at the time of narcosis for 20 min followed by 0.5 g Metronidazol for 10 min. These medications were given in 8-hour intervals for three days following surgery. Investigation of the first 20 patients (prophylaxis group n = 7, control group n = 13) revealed that the combination of Mezlocillin and Metronidazol positively influenced post-operative recovery (no complications) while the patients without prophylactic antibiotic treatment suffered general or local complication leading to, in 10 cases, the necessity of postoperative therapy. On the basis of these results, the random grouping of the patients was ended and all 30 remaining patients were given the antibiotic prophylaxis. Regardless of antibiotic treatment, the great majority of microbes isolated from throat swabs and tracheal secretions were gram-negative, aerobic bacteria. A prerequisite for efficacious prophylaxis is that the antibiotics be applied before the operation, so that a sufficient concentration is present at the time of pharyngotomy. On the basis of pharmacokinetic investigations, administration of the antibiotic 30 min preoperatively fulfills this requirement. Further, our recommendation, based on our measurement of the spectrum of bacteria present and their growth is that the antibiotics be applied over a period of three days postoperatively. This recommendation is also based on the fact that some patients (those having undergone partial laryngectomy or tongue, floor of the mouth, base of the tongue partial resections) have suffered loss of the swallowing reflex so that there exists a continuous contamination of the surgical area with pathogens or facultative pathogens coming from the nasal or oral cavities.

[A data processing system for bacteriological and chemical water analysis]. / Datenverarbeitungssystem für bakteriologische und chemische Wasseranalysen.

Using the "Natural" computer language a menu-guided system for cataloguing, processing and evaluating bacteriological and chemical water analyses was designed. The program can be employed to different blocs of analyses, e.g. "TrinkwV"-analyses, standard-analyses, those on volatile chlorinated hydrocarbons and bacteriological water analyses as well. For each water sample the actual, the last and the next to the last value, also arithmetical means, minimal and maximal are stored and can be retrieved. The evaluation of the bacteriological analyses and those of the volatile chlorinated hydrocarbons is carried out by a choice of text variants, whereas the TVO- and standard-analyses are interpreted automatically. Managing laboratory data has become much easier during our three years experience using this system for information storage, search and retrieval in water research and routine; even untrained users are able to handle it after a short period of tuition.

[Metronidazole pharmacokinetics in perilymph, aqueous humor and cerebrospinal fluid]. / Metronidazol-Pharmakokinetik in Perilymphe, Kammerwasser und Liquor.

Since metronidazole is very effective against anaerobic bacteria, we studied its pharmacokinetics in perilymph, cerebrospinal fluid, aqueous humour, and serum. 1, 2, 4, 6, 10 and 16.5 hours after intraperitoneal injection of 200 mg/kg metronidazole to six groups of six guinea pigs each, we determined the drug concentrations by high-pressure liquid chromatography. In the serum, 1, 2 and 16.5 hours after application, drug levels of 194 +/- 22 mg/l, 127 +/- 54 mg/l and 2 +/- 1 mg/l respectively were found. Half-life was 6 hours. Similar high and long-lasting concentrations could be determined in the aqueous humour, cerebrospinal fluid and perilymph. In contrast to our findings with aminoglycoside antibiotics, beta lactam antibiotics and fosfomycin, we could not observe any retention of metronidazole in the perilymph.

[Occurrence of enteritis-causing agents in private households--a pilot study]. / Untersuchungen über das Vorkommen von Enteritis-Erregern im Haushalt--eine Pilotstudie.

The increasing occurrence of infectious enteritis caused us to perform a prospective, epidemiological pilotstudy in households, in order to receive informations about the practicability of such a project and the bacteriology of food prepared at home as well. 10 families were asked to gather samples of all foodstuffs consumed during the day in separate containers and to keep them frozen at - 20 degrees C until collected by us once a week. Thus we received 4.683 samples within a 6-months-period. In the laboratory those samples were mixed following Table 2 and examined concerning the occurrence of enteropathogenic bacteria. Additionally we carried out an investigation of kitchensurfaces and -utensils by means of "Rodac"-plates. The evaluation of the food-samples showed no growth of salmonella, shigella, yersinia or campylobacter; however, in 267 samples were found staphylococci, in 191 enterococci, in 388 enterobacteria, in 28 aerobic sporeformers and in 144 fungi. Mainly sausage- and meatproducts appeared to be contaminated by staphylococci, also enterococci and enterobacteria (Fig. 1); other groceries were colonized by these microorganisms only to a minor degree. Fungi and aerobic sporeformers were isolated primarily in salads, bakery- and milkproducts (Fig. 2). Though some of the foodstuffs contained up to 10(5) pathogenes/g (Fig. 5), no cases of gastroenteritis were observed within our families. In case of mishandling (e.g. storage of food in refrigerators with temperatures above 4 degrees C) the development of foodborne enteritis has to be taken into account. The kitchens' examination showed a relatively high degree of contamination with pathogenic resp. potentially pathogenic organisms, represented in Fig. 7 by data obtained from different objects of investigation (surfaces, sinks and cloths).

[Use of flocculants for detection of viruses in fluids (author's transl)]. / Virusnachweis in Flüssigkeiten mit Flockungsmitteln.

Hydroxide flocs of iron, aluminium, zinc, and tin were tested for their capabilities of virus enrichment in fluids (such as water and liquid foods). The virus used was polio type II att. The flocculation with tin yielded the best results because it gave the highest recovery rates (90%) and good reproducibility. A satisfactory enrichment was also obtained with the flocculation with aluminium- and iron salts. The losses were 31 and 33%. The lowest recovery rates were obtained with nickel- and zinc flocculation (losses: 70 and 77%). The difficulties in filtering the flocs and eluting the virus with 3% beefextract could be overcome by centrifugation and dissolution of aluminium and iron flocs with sodium-potassium-tartrate (average recovery rates 5 and 27%). In addition we tested the flocculation in lemonade as a model fluid loaded with a high content of organic material which usually interfere with the formation of flocs and in consequence the enrichment of viruses. An enrichment of viruses in lemonade was possible only with previously prepared and aged flocs of tin and iron. The loss was 18 and 12% respectively.