[Successful indirect cardiac massage as a cause of thoracic wall instability and respiratory insufficiency]. / Ucinná neprímá srdecní masáz jako prícina nestability hrudní steny a dechové nedostatecnosti.

The authors in their two cases describe unusual complication after successful indirect cardiac massage which was carried out in terrain. Both patients were then transferred to Dept. of gerontology and metabolic care. However the resuscitation was in both cases successful it caused in these two cachectic oseoporotic patients sternal and costal en block fractures. This iatrogenic trauma of thoracic wall showed up in further cause as a major problem. The patients could not have been disconnected from artificial support of ventilation and therefore their thoracic cage had to be surgically stabilized.

Autoantibodies to asialoglycoprotein receptor in chronic hepatitis C patients.

The aim of this study was to determine the incidence of autoantibodies to asialoglycoprotein receptor (ASGPR, anti-ASGPR) in chronic hepatitis C patients and to characterize the anti-ASGPR-positive and anti-ASGPR-negative patients in more detail. A total of 79 chronic hepatitis C patients were screened for the presence anti-ASGPR by ELISA. Anti-ASGPR were detected in 11 (13.9%) patients. No significant differences were found between the anti-ASGPR-positive and anti-ASGPR-negative patients in age, alanine transaminase (ALT) activity, histological findings and response and tolerance to alpha-interferon (alpha-IFN) therapy. The male predominance in the anti-ASGPR positive group was statistically significant. It was surprising that other tested autoantibodies (antinuclear autoantibodies [ANA], smooth muscle autoantibodies [SMA], type 1 liver-kidney microsome autoantibodies [LKM-1], anti-thyroglobulin and thyroid microsome autoantibodies) and increased levels of immunoglobulins A, G and/or M were observed significantly more frequently in the anti-ASGPR-negative group.

[Cross-sectional study of choice of drug therapy in the acute phase of treatment in acute myocardial infarct--part 1]. / Prurezová studie volby farmakoterapie v akutní fázi lécby akutního infarktu myokardu--1. cást.

INTRODUCTION: Treatment of acute myocardial infarction is undergoing changes. In the treatment of acute myocardial infarction in particular the following proved useful: thrombolysis, administration of anti-aggregating drugs, beta-blockers and inhibitors of angiotensin converting enzyme. An decisive part is played by the interval between the onset of symptoms and the beginning of hospital treatment. OBJECTIVE: To describe treatment of patients hospitalized at intensive care units for acute myocardial infarctions. Investigate differences between faculty and other hospitals. METHOD: The authors investigated by means of questionaires in a prospective study during the first three months in 1996 all patients who were hospitalized on account of acute myocardial infarction. The investigation was implemented in seven intensive care units of faculty hospitals and in nine intensive care units of hospitals and information on diagnosis, pharmacotherapy and results of therapy were assembled. During the first 24 hours of treatment more detailed information was procured. RESULTS: Antiaggregants were used in 88%, nitrates in 77.8%, thrombolytics, beta-blockers and and ACE inhibitors in ca 30% patients. Percutaneous transluminal coronary angioplasty was used in ca 7% patients. CONCLUSIONS: The authors describe treatment of the acute stage of myocardial infarction. In faculty hospitals in 1996 thrombolysis, percutaneous transluminal coronary angioplasty, beta-blockers and nitrates by the i.v. route were used more frequently.

Oral contraceptive failure rates and oral antibiotics.

BACKGROUND: Despite anecdotal evidence of a possibility of decreased effectiveness of oral contraceptives (OCs) with some antibiotics, it is not known whether antibiotic use in dermatologic practices engenders any increased risk of accidental pregnancy. OBJECTIVE: Our purpose was to examine the effect of commonly prescribed oral antibiotics (tetracyclines, penicillins, cephalosporins) on the failure rate of OCs. METHODS: The records from three dermatology practices were reviewed, and 356 patients with a history of combined oral antibiotic/OC use were surveyed retrospectively. Of these patients, 263 also provided "control" data (during the times they used OCs alone). An additional 162 patients provided control data only. RESULTS: Five pregnancies occurred in 311 woman-years of combined antibiotic/OC exposure (1.6% per year failure rate) compared with 12 pregnancies in 1245 woman-years of exposure (0.96% per year) for the 425 control patients. This difference was not significant (p = 0.4), and the 95% confidence interval on the difference (-0.81, 2.1) ruled out a substantial difference (> 2.1% per year). There was also no significant difference between OC failure rates for the women who provided data under both conditions, nor between the two control groups. All our data groups had failure rates below the 3% or higher per year, which are typically found in the United States. CONCLUSION: The difference in failure rates of OCs when taken concurrently with antibiotics commonly used in dermatology versus OC use alone suggests that these antibiotics do not increase the risk of pregnancy. Physicians and patients need to recognize that the expected OC failure rate, regardless of antibiotic use, is at least 1% per year and it is not yet possible to predict in whom OCs may fail.

PIP: Although some antibiotics are assumed to compromise the effectiveness of oral contraceptives (OCs), it is unknown whether the antibiotics used in dermatologic practice are associated with such a risk. To address this issue, a review was conducted in three US dermatologic practices of the records of 356 patients with a history of combined oral antibiotic/OC use in 1990-95 who responded to a follow-up questionnaire. 263 of these patients provided control data during the times they used OCs alone and an additional 162 patients were controls only. There were five pregnancies in 311 woman-years of combined antibiotic/OC exposure (1.6% annual failure rate) compared with 12 pregnancies in 1245 woman-years of exposure among controls (0.96% annual failure rate)--a nonsignificant difference. In addition, there were no significant differences between OC failure rates among women who served as both cases and controls or between the two control groups. All five cases who became pregnant had been taking an antibiotic (microcycline or a cephalosporin) for at least 3 months. Side effects potentially linked to reduced OC effectiveness (e.g., diarrhea, breakthrough menstrual bleeding) were not reported by the women who became pregnant. It is presumed that inter-individual differences in steroid plasma levels are a more important cause of OC failure than concomitant antibiotic therapy.

[Osteomyelitis of the ilium and traumatic rupture of a hydronephrotic right kidney imitating acute appendicitis]. / Osteomyelitis lopaty kosti kycelní a traumatická ruptura hydronefroticky zmenené pravé ledviny imitující obraz akutní apendicitidy.

The author describes two case-histories of profoundly different diseases which imitated in a similar way the symptoms of acute appendicitis. In both instances the authors had to operate under pressure of the local finding, although in the case of osteomyelitis of the ilium this diagnosis was contemplated before operation. The author draws attention to some specific features of work in developing countries.

Intrabronchial brachytherapy using 226-radium source.

Present work reports on results of manual brachytherapy in lung cancer using intrabronchial catheter and 226-radium source. Expected dosage was 18 Gy at 1 cm from the source. This therapy was combined with external radiotherapy by 60-cobalt till the dosage about 65 Gy. 19 men were treated, the mean survival was 14.3 months. Advantages and disadvantages of the method are discussed.

Radio-chemotherapy in the treatment of advanced cancer.

Tests in vitro and first clinical studies proved a radiosensitizing effect of cisplatin. In our study 40 patients with advanced resistant cancer of head, neck, lungs and rectum were treated by conventional radiotherapy and cisplatin. The drug was administrated in 10 mg after each irradiation. The tumor dose varied between 30-50 Gy in 3-5 weeks, within the total dose cisplatin 150-250 mg. In more than 70% of cases remarkable retreat of tumors, in some cases even a complete regression, were observed. Adverse reactions and toxicity often associated with administration of platin were very mild, so that even patients in rather poor physical condition could have been treated. Having performed no special hydratation serious nephrotoxicity was never observed. The potentiation of radiation by cisplatin can be therefore considered a relatively harmless treatment of inoperable advanced cancers useful especially in cases where other forms of palliative treatment have been exhausted or not feasible.

[Half-body irradiation in the palliative treatment of multiple bone metastases]. / Prínos pultelového ozárení k paliativní lécbe mnohocetných kostních metastáz.

The authors used as palliative analgetic treatment half-body irradiation in 13 patients with dissemination of a malignant tumour into bones. In six patients both halves of the body were irradiated. A long-term analgetic effect was observed in five patients (in one female patient more than 400 days, four patients 100-150 days), a short-term effect up to 100 days was recorded in six patients. The pain was not influenced in two patients. Mitigation of pain increased the patients' performance: according to the WHO scale in one case by 3 grades, in three patients by 2 grades, in six patients by 1 grade. The performance of three patients was not affected by irradiation. Side-effects of treatment were controlled by means of supporting treatment. They did not threaten life in any of the patients. The authors consider half-body irradiation an effective and useful analgetic treatment of multiple metastases into the bones.

Factors governing adherence of Candida species to plastic surfaces.

The ability of Candida albicans and Candida spp. to adhere to inert polymeric surfaces may allow these organisms direct ingress into the human host. Biophysical characterization of this adherence shows that the forces responsible for such adherence are attractive London-van der Waals forces (or hydrophobic forces) and electrostatic forces. The hydrophobic affinity of yeasts was determined by (i) a water-hydrocarbon two-phase assay and by (ii) measurement of the contact angle (theta) of a liquid droplet on a monolayer of yeast cells. The hydrophobicity of the yeasts correlated with the tendency of yeasts to adhere to polystyrene and was reduced in the presence of Tween 20. The adherence of yeasts to polymers of increasing hydrophobicity (determined by the contact angle method) was directly proportional to theta. Yeast surface charges were altered by selectively blocking amino and carboxyl groups. The more positively charged yeasts adhered in greater numbers. Increasing the molarity of NaCl increased yeast adherence. These forces probably contribute to the negative cooperativity (determined by Scatchard and Hill plot) that characterizes the adherence of yeasts to polymers.

The surface activity of Acinetobacter calcoaceticus sp. 2CA2.

The hydrocarbon metabolizing Acinetobacter calcoaceticus sp. 2CA2 reduces the surface tension of the culture broth during growth on liquid hydrocarbons. This activity, which is not evident during growth on soluble substrates, is associated with the whole cells. Removing the cells from the culture broth increases the surface tension of the liquid phase. The cells when resuspended in water result in a dramatic lowering of the surface tension. Acinetobacter sp. 2CA2 tends to partition between the two liquid phases during growth on hydrocarbons. Both the hydrocarbon bound and nonadhering cells are equally surface active. The whole cells are also able to form and stabilize kerosene-water emulsions. This ability is not related to the lowering of the liquid surface or interfacial tension, since both surface active and nonsurface active cells demonstrated the same emulsifying properties. An extracellular lipopeptide produced during growth on hydrocarbons is not surface active but effectively forms and stabilizes kerosene-water emulsions. The cells and extracellular lipoptide are also effective in de-emulsifying surfactant stabilized test emulsions. The lipopeptide product reduced the half-life of a Tween-Span (TS) stabilized kerosene-water emulsion from 650 to 0.4 h at product concentrations of less than 1% (w/v).

Characterization of Nocardia amarae as a Potent Biological Coalescing Agent of Water-Oil Emulsions.

Nocardia amarae grown in a liquid medium induced coalescence of emulsions which differed in type, composition of the organic phase, and structure of stabilizing emulsifiers. De-emulsifying activity varied with the type of growth medium, culture age, and postharvest treatment. Based on extraction and degradation studies, it was concluded that de-emulsifying properties are due to the bacterial cell surface. Thus, bacteria may provide a new source of de-emulsifying agents.

Surface-Active Lipids from Nocardia erythropolis Grown on Hydrocarbons.

Nocardia erythropolis (ATCC 4277) was grown in a 28-liter fermentor on mineral salts medium and 4% hydrocarbon. Extraction of the neutral lipids with pentane removed approximately 90% of the surface activity of the culture medium. The residual surface activity of the culture medium was attributed to the polar lipid fraction which was not extracted with pentane. Analysis of the pentane extracts with thin-layer chromatography showed the presence of four major compounds. A fatty alcohol reached a maximum concentration in the early log phase of growth and then decreased to the end of the fermentation. A monoglyceride, an ester, and a fatty acid appeared during the log phase of growth and continued to increase until the end of the fermentation. The fatty acids isolated from the culture grown on hexadecane had a carbon skeleton with the same length as the substrate, with 70% of the component as the saturated acid and 30% as a monounsaturated homolog. When isolated from a kerosene culture, the fatty acids consisted of a number of homologs from C(18) to C(20), including branched-chain and unsaturated acids, reflecting the distribution of the branched-chain isomers in the substrate.

Anaerobic co-oxidation of acetate and glucose by citrobacter intermedius and a species of Pseudomonas.

Analysis of gases evolved when Citrobacter intermedius and a Pseudomonas species are co-cultured on an acetate or glucose - nitrate - mineral salts medium indicates that acetate is anaerobically oxidized by CO2.

The effect of substrate on inhibition of Corynebacterium lepus by isonicotinic acid hydrazide (Isoniazid).

Isonicotinic acid hydrazide (INH) inhibits the growth of Corynebacterium lepus on hexadecane but has no effect on its growth on fructose. INH also inhibits the production of the mycolic acid containing lipopeptide bioemulsifier normally produced by C. lepus in response to an insoluble substate. The primary effect of INH appears to be inhibition of mycolic acid synthesis, which limits the growth of C. lepus on hexadecane by reducing the concentration of bioemulsifier.

New Method of Producing Protoplasts of Aureobasidium pullulans.

A rapid and relatively inexpensive method for producing protoplasts of the black yeast Aureobasidium pullulans is described. The procedure involves anaerobic incubation with the lytic preparation Driselase.

Cell surface measurements in hydrocarbon and carbohydrate fermentations.

Acinetobacter calcoaceticus was grown in 11-liter batch fermentations with hexadecane or sodium citrate as the sole source of carbon. Surface and interfacial tension measurements of the microbial broth indicated that surface-active compounds were being produced only during growth on the hydrocarbon substrate. Contact angle measurements of an aqueous drop on a smooth lawn of cells in a hexadecane bath indicated a highly hydrophobic surface of the cells in the initial stages of the hydrocarbon fermentation (120 degrees contact angle). At this stage, the entire cell population was bound to the hydrocarbon-aqueous interface. The contact angle dropped rapidly to approximately 45 degrees after 14 h into the fermentation. This coincided with a shift of the cell population to the aqueous phase. Thus, the cells demonstrated more hydrophilic characteristics in the later stages of the fermentation. Contact angles on cells grown on sodium citrate ranged from 18 to 24 degrees throughout the fermentation. The cells appear to be highly hydrophilic during growth on a soluble substrate. From the contact angle and aqueous-hydrocarbon interfacial tension, the surface free energy of the cells was calculated along with the cell-aqueous and cell-hydrocarbon interfacial tension. The results of these measurements were useful in quantitatively evaluating the hydrophobic nature of the cell surface during growth on hydrocarbons and comparing it with the hydrophilic nature of the cell surface during growth on a soluble substrate.

Lipase synthesis in hydrocarbon fermentation.

A study was undertaken to establish conditions and relationships for the production of lipases during hydrocarbon fermentation. A culture of Candida lipolytica was isolated by a kerosene enrichment technique from oil-soaked soil and this microbe was used to study the production of lipase on a kerosene-mineral salts medium. The optimum pH, medium, and temperature for lipase synthesis were established and the properties of the isolated enzyme in terms of its activity and lipid specificity were studied.

Analysis of corynomycolic acids and other fatty acids produced by Corynebacterium lepus grown on kerosene.

The saponifiable carboxylic acids of the extracellular product of Corynebacterium lepus grown on kerosene have been isolated and characterized. About 25% of these acids were a mixture of simple, saturated fatty acids ranging from C13 to C24 and including both even and odd homologues. The distribution of these acids was bimodal, with maxima at C15 and C21. The other 75% of the acids was a mixture of corynomycolic acids [R1--CH(OH)--CH(R2)--COOH] ranging from C28 to C43. The R1 alkyl fragments varied from C16 to C25, and R2 fragments varied from C6 to C14. Both even and odd corynomycolic acid homologues were observed, and the distribution had a single pronounced maximum at C32 and C33. Bacterial utilization of the carboxylic oxidation products of the kerosene substrate is suggested to account for the wide distribution in chain length of these saturated fatty acids and for the observation of both even and odd homologues.