Experiences with ceftriaxone (rocephin) in perioperative antibiotic prophylaxis for elective colon surgery.
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Biomedical subjects
Publications and source records attributed to H Renner.
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The local efficacy of simultaneous radiochemotherapy was tested in 17 women with 18 carcinomas of the breast in stage T4 only. Treatment was conducted for a period of 6 months with 6 courses of drug therapy (A + E) coordinated simultaneously with 6 courses of radiotherapy. In 72% of the cases we found considerable (greater than 80%) or complete (100%) regression of the tumour as a result of this combined treatment. The median survival time is 35 months.
Reactive oxygen metabolites (ROM) (O2-, H2O2, 1O2, .OH, OX-) which are produced by stimulated alveolar macrophages (AM), neutrophils and eosinophils, play an important role in the pathogenesis of many acute and chronic lung diseases. With regard to a therapeutic application the influence of the antioxidants ascorbic acid (Vitamin C) and alpha-tocopheryl acetate (Vitamin E acetate) on the production of ROM by AM was investigated. The AM were isolated by bronchoalveolar lavage from patients with different lung disorders. The ROM were determined by means of chemiluminescence-measuring. alpha-Tocopheryl acetate solved in peanut oil causes a little increase of the yeast cell wall-induced chemiluminescence. Pure alpha-Tocopheryl acetate has no effect on the chemiluminescence. In contrast to alpha-Tocopheryl acetate the addition Vitamin C to the stimulated AM results in a strong diminution of the chemiluminescence signal. This result suggests that Vitamin C reduces the generation of ROM by AM. Therefore Vitamin C could be a suitable scavenger of radicals and oxidants in different lung diseases.
BAL was performed in different courses of sarcoidosis in order to evaluate the importance of this examination. We found a higher degree of lymphocytosis in Löfgren's syndrome and in relapses than in the others. Probably there is a direct connection between high intensity alveolitis and reduction of diffusing capacity. There could not be found any correlation to other markers of activity (lung function, SACE, 67-Gallium-Scan).
The phagocytic activity of alveolar macrophages (AM) in a group of patients with stage I, stage II and stage III pulmonary sarcoidosis (gradation according to Wurm) has been investigated. Additionally a classification in different forms of the course of sarcoidosis was made (acute = Loefgren's syndrome, latent = primary-chronic, and relapses). Patients with other lung diseases and healthy subjects were recruited as control group. The phagocytic activity (stimulation with opsonized yeast cell wall particles) of AM, which were isolated by bronchoalveolar lavage, was determined by means of chemiluminescence (CL)-measuring using lucigenin and luminol, respectively, as amplifiers. The investigations showed that the lucigenin-dependent yeast cell wall-induced CL of AM in patients with sarcoidosis is significantly increased in comparison to the control group. No significant changes of the luminol-dependent CL of AM from sarcoidosis patients could be detected. The lucigenin-dependent CL-response of AM is obviously an indicator of the intensity of the alveolitis and thus of the activity of the pathological process in sarcoidosis. The results suggest that in pulmonary sarcoidosis there is a hyperreactive AM/lymphocytes-system.
Acute lung damage was produced in rats by paraquat. Pretreatment with vitamin E showed no influence on the functional and morphological pattern. We conclude that there is no protective influence of vitamin E on acute paraquat intoxication of lung.
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The EEG is almost always abnormal in patients with Rett syndrome. This is demonstrated in a study based upon 230 EEG records obtained from 44 patients. Rhythmical slowing (mostly 3-5/sec) represents the most common EEG abnormality (30 patients). Diffuse, scattered or bilateral-synchronous spikes or sharp waves were found in 22 patients. Slow spike-wave complexes were present in 9 patients. With advancing age, the EEG abnormalities tend to decline and ill-defined low voltage records may develop. These changes may parallel an intrinsic disease course with an early active phase followed by a phase of residual impairment.
In a group of 100 patients with different lung diseases the diagnostic value of BAL was estimated comparing with conventional broncho-bioptical methods. Final diagnosis was obtained by BAL only in 3% of all cases in contrast to conventional broncho-bioptical methods with 49% positive findings. In a further group of 77 patients with acute and chronic forms of sarcoidosis in stage I and II a significant difference in BAL-lymphocytosis between acute and chronic forms was observed. Our findings demonstrate the limited value of BAL for diagnostic purpose but its valuability in estimation of the activity and the course of different lung diseases especially of granulomatous and fibrotic origin.
The effect of ambroxol and bromhexine on the yeast cell wall- and arachidonic acid (AA)-induced luminol-respectively lucigenin-dependent chemiluminescence (CL) of alveolar macrophages (AM) of patients with lung diseases has been investigated. Both drugs cause a suppression of the induced CL. These results suggest that ambroxol and bromhexine reduce the generation of reactive oxygen metabolites (ROM) by AM. The mechanism of action is thought to involve the activation of the acyl-CoA: lysophosphatide acyltransferase. The increase of this enzyme activity lowers probably the intracellular concentration of free AA and consequently also the production of ROM. The investigations show a new possibility for the influence of biosynthesis of ROM and likely of eicosanoids, which play an important role as pathogenetic mediators in different lung diseases.
A single dose of 0.05 mMol paraquat per kg body weight produced severe lesions in alveolar epithelial cells of type II and the capillary endothelial cells of rat lungs. The maximum damage pattern was seen after 48 hrs. Our results are in contrast to the general opinion in the literature, that paraquat leads to selective lesion of alveolar epithelial cells of type II in the lungs. The detection of the damage of the lung cells by semiquantitative histochemical investigations and the PO2 measurement as indicator of respiratory insufficiency were parallel in the time course. The right ventricular systolic pressure showed normal values.
A method is described for the partial purification of a granulomonopoiesis inhibitor derived from 200 l-batches equivalent to 1 kg or 2 X 10(12) leukocytes of porcine blood. Serum-free conditioned media were concentrated and separated via ammonium sulfate precipitation, acetone partitioning, ultrafiltration and gel chromatography. The active substance revealed a molecular mass of 500-700 Da and was not thiol-dependent, thus contrasting it with previously-reported granulopoiesis inhibitors. Inhibition of colony formation in an in vitro myeloid stem cell assay using various colony-stimulating factors showed that mature granulocytes and monocytes were equally affected. Apparent lack of cytotoxicity was suggested using a new reversibility test.
Combined simultaneous radiochemotherapy is our treatment conception for the locoregionally recurrent mammary carcinoma. With this therapy, complete or partial remissions are achieved in 92%. In only 25%, another recurrence appears within the irradiated region. The median survival time is 23 months. The results of the chemotherapy combination CMFV are better than the results of other combinations. Due to the good local effect, the quality of life without tumor of the thoracic wall is improved.
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Pregnancy can impair glucose tolerance severely enough to increase the perinatal mortality rate. In the presence of easily recognizable signs pointing to diabetes mellitus we have performed an oral glucose tolerance test. Among 634 patients who were investigated, 151 or 23.8% had impaired glucose tolerance. As there were 11,017 pregnancies in the observation period from January 1976 to May 1981, the detection rate of impaired glucose tolerance was 1.37%. The patients were treated by diet or by diet plus insulin (105 patients). The observed favourable fetal outcome justifies and promotes the proposed diagnostic procedures.
Substance P (6.25-25 p-mole) produced dose-dependent flare and wheal responses when injected intradermally into the volar surface of the human forearm. The maximum flare response was obtained within the first 3 min of injection and declined thereafter. The wheal response reached a maximum after 12 min following the injection. Only those peptides having one or more basic residues in the N-terminal region were effective in producing a flare reaction. Eledoisin-related peptide and SP1-9 were 17 and 7 times less active than substance P respectively, whilst [D-pro2, D-phe7, D-trp9]SP1-11 was twice as active. The N-terminal tetrapeptide, SP1-4 and eledoisin were inactive in the dose range tested. Wheal-producing activity was not dependent on the presence of basic residues and the rank order of relative potencies was: physalaemin (2.0): [D-pro2, D-phe7, D-trp9]SP1-11 (1.1): SP1-11 (1.0): SP4-11 (0.4): SP1-9 (0.15): eledoisin-related peptide (0.08): eledoisin (0.06). The N-terminal tetrapeptide failed to produce a wheal response in the dose range tested. Substance P was approximately equi-active with poly-L-arginine in the production of wheal and flare and both of these agents were about 10 times more potent than histamine. Adenosine triphosphate (25-400 n-mole) produced dose-dependent wheal and flare responses and was 10,000 times less potent than substance P. Pre-treatment of the subjects with the H1 histamine antagonist, chlorpheniramine, (20 mg I.V.) reduced the wheal and flare responses to substance P. Local anaesthetic injection into the skin reduced the spread of the flare response but did not affect the development of the wheal response. Pre-treatment of the skin with capsaicin reduced the flare but not the wheal response to intradermal injection of histamine. The results are discussed in relation to the mechanism of the 'axon reflex' vasodilatation in skin. This is thought to involve mast cells in addition to substance P-containing primary afferent neurones.
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