Concomitant therapy with cefmenoxime and cefsulodin for refractory complicated urinary tract infection (especially caused by Pseudomonas aeruginosa)

Cefmenoxime (2 g) and cefsulodin (1 g) were given twice daily for 5 days by concomitant intravenous drip infusion (mixed infusion) to 135 patients with complicated urinary tract infection (c-UTI) probably caused by Pseudomonas aeruginosa. The clinical efficacy was evaluated according to the criteria proposed by the UTI committee in Japan. Ninety one subjects met the criteria for c-UTI and were evaluable for drug efficacy. P. aeruginosa was detected in 44 cases (including mixed infection with other organisms). The overall efficacy rate was 73% of the 91 cases; 75% of the 44 cases with P. aeruginosa and 70% in the 47 cases without P. aeruginosa infection. As to bacteriological response, the eradication rate was 91% (105/116) for all cases. By organism, the eradication rate for P. aeruginosa, Serratia spp. and Citrobacter spp. were 82 (36/44), 100 (12/12) and 100% (10/10), respectively. The eradication rate for gram-negative rods was 93% (99/107). Twenty-three strains appeared after treatment, and the majority of them (13) were yeast-like organisms. There was only one strain of P. aeruginosa. As for side effects, eruption was found in 2 cases. Cefmenoxime and cefsulodin were administered concomitantly to patients with c-UTI which was suspected to be caused by P. aeruginosa. The high overall efficacy rate of about 70% on the average was obtained regardless of the causative organism and disease state. The eradication rate of as high as about 90% was obtained excluding Enterococcus faecalis. Neither severe side effects nor abnormal laboratory values were found. It appeared, therefore, that this dosage regimen was useful for the treatment of refractory complicated urinary tract infection.     

Clinical outcome of Burkholderia cepacia complex infection in cystic fibrosis adults.

BACKGROUND: The Burkholderia cepacia complex (BCC) is one of the most important groups of organisms infecting cystic fibrosis (CF) patients. The aim of the study was to examine how infection with BCC affects clinical outcome. METHODS: Nineteen CF adults infected with BCC and 19 controls infected with Pseudomonas aeruginosa were studied over a 4-year period. The best forced expiratory volume in 1 s (FEV(1)) and body mass index (BMI) for each year were recorded and annual rate of decline calculated. RESULTS: The BCC infected group displayed a significantly greater reduction of FEV(1) and BMI compared to the P. aeruginosa infected group (p=0.001 and p=0.009, respectively). Sixteen patients infected with a single Burkholderia cenocepacia strain had a significantly greater rate of FEV(1) decline compared to those infected with Burkholderia multivorans (n=3) or P. aeruginosa (p=0.01 and p<0.0001, respectively). The rate of BMI decline was significantly greater in patients infected with B. cenocepacia compared to those with P. aeruginosa (p=0.007), but not significantly different in those with B. multivorans (p=0.29). CONCLUSION: BCC infection is associated with an accelerated decline in pulmonary function and BMI. Infection with a single B. cenocepacia strain was associated with a more rapid decline in lung function than those infected with either B. multivorans or P. aeruginosa.     

Clinical studies of efficacy of imipenem/cilastatin sodium against urinary tract infections with ureterocutaneostomy]

Clinical efficacy of IPM/CS against urinary tract infections (UTI) was evaluated on 19 patients with malignancies (bladder tumor: 15, prostate cancer: 3, uterus cancer: 1) and 1 patient with a benign disorder (ureter stenosis) who had undergone ureterocutaneostomy between January, 1988 and December, 1990. Their ages ranged from 42 to 79 years. Postoperatively, they had UTI with pyuria of greater than or equal to 5/hpf and bacteriuria of greater than or equal to 10(4)/ml. IPM/CS was administered at a dose of 0.5 g (0.25g/0.25 g) twice a day through intravenous drip infusion. Its efficacy was evaluated according to the UTI criteria for clinical evaluation as ruled by the Japanese Society of Chemotherapy. Overall clinical value was rated "excellent" in 4 (20%), "moderate" in 9 (45%) and "poor" in 7 (35%) cases for a total of 65%. The efficacy by types of infection was 33% and 70.6% in the group of single infection and in the group of mixed infection, respectively. As to bacteriological efficacy 34 of the 38 strains (89.5%) isolated were eradicated following its administration. The eradication rate was 84.6% for P. aeruginosa, and 84.6% for E. faecalis. Microbes which appeared after its dosing amounted to 6 classes of 17 strains, 6 NFB strains of which were identified. As a side effect, elevation of serum GPT (5%) was noted. Regardless of the underlying conditions (malignant diseases and ureterocutaneostomy), clinical efficacy of IPM/CS was appreciable. In addition, the MIC for (P. aeruginosa, E. faecalis) of IPM/CS was lower than that of PIPC.     

Long term effect of erythromycin therapy in patients with chronic Pseudomonas aeruginosa infection.

BACKGROUND--Diffuse panbronchiolitis is a chronic infection of the lower respiratory tract common among the Japanese people, with a persistent Pseudomonas aeruginosa infection in the late stage and sustained neutrophil retention in the airways. The long term effect of erythromycin was examined retrospectively in a group of patients with diffuse panbronchiolitis, with and without P aeruginosa infection, and the relationship between drug-induced bacterial clearance and clinical improvement was investigated. METHODS--The history, daily volume of sputum, type of organisms in sputum cultures, pulmonary function tests, arterial blood gas tensions, and chest radiographs were compared in 16 patients with diffuse panbronchiolitis with P aeruginosa infection and 12 without. The total and differential cell counts in the bronchoalveolar lavage (BAL) fluid were compared in 14 of the 28 patients (five of whom were infected with P aeruginosa) before and after 1-12 months of treatment with erythromycin (600 mg/day). The outcome of treatment in patients showing clearance of organisms on repeated sputum cultures was compared with that in those demonstrating persistence of bacteria in the sputum and patients with normal flora. RESULTS--Erythromycin improved respiratory function and arterial blood gas tensions irrespective of the presence or absence of P aeruginosa in the sputum. Treatment also resulted in a reduction in the BAL fluid total cell count and the percentage of neutrophils in both groups of patients. There were no differences between patients in whom the bacteria cleared and those with persistent bacteria or patients with a normal flora with regard to the degree of improvement of respiratory function, arterial blood gas tensions, and BAL fluid cell composition. CONCLUSION--The results suggest that the efficacy of erythromycin in diffuse pan-bronchiolitis may be due to anti-inflammatory effect, independent of P aeruginosa infection or bacterial clearance.     

Clinical studies on ceftriaxone in complicated urinary tract infections

Ceftriaxone (CTRX) was clinically evaluated in 20 cases of complicated urinary tract infections. CTRX was administered for 5 days at the dose of either 1 g or 2 g once a day by intravenous injection into 10 cases. The clinical efficacy was excellent in 8 cases, moderate in 9 and poor in 3 to make an overall clinical efficacy was 91% in 11 cases with catheter indwelt. Bacteriologically, 18 out of 21 causative pathogens disappeared with an eradication rate of 86%. Neither subjective nor objective adverse reactions were observed in any case. CTRX administration once a day is effective for complicated urinary tract infections.     

全膝关节置换术后主动和被动锻炼促进关节功能恢复的前瞻性研究

目的 探讨全膝关节置换(TKA)术后持续被动活动和主动功能锻炼对患者关节功能康复效果的影响. 方法采用前瞻性研究方法,选取2007年2月至2008年6月行TKA的80例患者为研究对象,所有患者按入院序号应用随机数字表法分为持续被动活动组(CPM组)和主动功能锻炼组(AP组),每组40例.CPM组术后早期应用CPM机行康复治疗,AP组则在专业康复医师指导下进行主动功能锻炼.记录患者术后第3、6、9天时的VAS评分,术后第3、6、9天、出院及随访时的关节活动度,患者住院天数.采用美国膝关节外科学会的评分系统(KSS)对患者术前、术后3、6个月随访时的患膝关节功能进行评分. 结果术后第3天,CPM组、AP组的平均VAS评分分别为2.37、3.02分,差异有统计学意义(t=-2.52,P=0.03).术后第6、9天两组患者平均VAS评分差异均无统计学意义(P>0.05).术后3、6、9 d及出院时两组患者的关节活动度差异均无统计学意义(P>0.05).56例患者(CPM组30例,AP组26例)获得随访.术后3个月,CPM组、AP组患者的关节活动度为别为105.50°、112.96°,差异有统计学意义(P=0.04),但术后6个月时两组差异无统计学意义(P>0.05).术后3、6个月两组患者KSS评分差异均无统计学意义(P>0.05). 结论 TKA术后功能恢复应强调主动功能锻炼而非被动锻炼.不推荐常规应用CPM,但对痛觉过敏及无法进行主动功能锻炼的患者,仍应考虑CPM辅助治疗,以促进关节功能的恢复.     

全膝关节置换术后主动和被动锻炼促进关节功能恢复的前瞻性研究

目的 探讨全膝关节置换(TKA)术后持续被动活动和主动功能锻炼对患者关节功能康复效果的影响. 方法采用前瞻性研究方法,选取2007年2月至2008年6月行TKA的80例患者为研究对象,所有患者按入院序号应用随机数字表法分为持续被动活动组(CPM组)和主动功能锻炼组(AP组),每组40例.CPM组术后早期应用CPM机行康复治疗,AP组则在专业康复医师指导下进行主动功能锻炼.记录患者术后第3、6、9天时的VAS评分,术后第3、6、9天、出院及随访时的关节活动度,患者住院天数.采用美国膝关节外科学会的评分系统(KSS)对患者术前、术后3、6个月随访时的患膝关节功能进行评分. 结果术后第3天,CPM组、AP组的平均VAS评分分别为2.37、3.02分,差异有统计学意义(t=-2.52,P=0.03).术后第6、9天两组患者平均VAS评分差异均无统计学意义(P>0.05).术后3、6、9 d及出院时两组患者的关节活动度差异均无统计学意义(P>0.05).56例患者(CPM组30例,AP组26例)获得随访.术后3个月,CPM组、AP组患者的关节活动度为别为105.50°、112.96°,差异有统计学意义(P=0.04),但术后6个月时两组差异无统计学意义(P>0.05).术后3、6个月两组患者KSS评分差异均无统计学意义(P>0.05). 结论 TKA术后功能恢复应强调主动功能锻炼而非被动锻炼.不推荐常规应用CPM,但对痛觉过敏及无法进行主动功能锻炼的患者,仍应考虑CPM辅助治疗,以促进关节功能的恢复.     

Bacterial interference in mixed infection in the rat bladder

Interaction between Escherichia coli and Pseudomonas aeruginosa was studied in chronic bladder infection made in male Wistar rats by implanting a knotted silk thread holding organisms into the bladder. Strains isolated from patients were used. The number of organisms in bladder urine was measured 1 week after the inoculation. When E. coli and P. aeruginosa were inoculated simultaneously, P. aeruginosa grew less well than when inoculated alone. When P. aeruginosa was inoculated into the bladder colonized with E. coli, P. aeruginosa was almost always unable to grow in the bladder, while E. coli inoculated into the bladder colonized with P. aeruginosa was able to grow there in many animals. Bacteriocin activity had nothing to do with the results. These results indicate that E. coli interferes with the growth of P. aeruginosa in mixed infection in the bladder.     

A clinical evaluation of MK-0787/MK-0791 for long-term administration in urological infections

MK-0787 (Imipenem)/MK-0791 (Cilastatin sodium), a new compound of Thienamycin, was administered in treatment of 35 patients (36 cases) with chronic complicated UTI or for prevention of serious infections with much complicated factors. The patients were principally treated at a daily dose of 1 g for over 10 days. The efficacy rate of 26 patients who were evaluable in the early phase (4-7 days) was 88.5%, while it became up to 92.3% in the final phase judgment. As for clinical usefulness, the result was obtained to be as high as that of the clinical efficacy. In bacteriological study, 35 strains were clinically isolated including 7 strains of P. aeruginosa from UTI. All the strains disappeared with an eradication rate of 100% after treatment. Strains appearing after Imipenem/Cilastatin sodium treatment mainly consisted of fungi. Usefulness judgements tended to be greater in the final phase than in the early phase. As for side effects, vomiting was recorded in one case, in which the administration was discontinued. In laboratory findings there were 3 cases with elevated GPT, 2 cases with elevated GOT, one case with elevated gamma-GTP, one with thrombocytopenia, and one with eosinophilia each, but these abnormal values were slight and transient. In summary our clinical study showed that Imipenem/Cilastatin sodium was a very effective antibiotic in treatment on moderate or serious UTI or preventive use for infections in compromised hosts. Considering the features of this agent, it might be more effective and useful for clinical use in treatment on polymicrobial infections including stubborn organisms than any other antimicrobial compounds. Furthermore, it was safe and well tolerable in a long term treatment.     

肝脏移植术后桥脑中央髓鞘溶解症的病因探讨

目的　进一步总结肝脏移植术后桥脑中央髓鞘溶解症 (centralpontinemyelinolysis,CPM )的临床特征及发病原因。方法　回顾性研究 1999年 1月至 2 0 0 3年 5月 14 2例原位肝脏移植患者的临床资料 ,比较分析移植后有无中枢神经系统并发症及有无CPM者 ,围手术期血钠、血镁、血浆渗透压及环孢素A(CsA)浓度的变化和总手术时间。结果　 14 2例肝脏移植患者中 13例 (9 2 % )出现中枢并发症 ,其中CPM 5例 (3 5 % ) ,脑出血 /脑栓塞 8例 (5 6 % )。CPM患者中 ,移植前 2例血钠 <130mmol/L ,平均 (130 6± 5 5 4 )mmol/L ,与无中枢并发症和非CPM中枢并发症者比较显著降低 (P <0 0 5 )。CPM与非CPM中枢并发症及无中枢并发症患者移植前后 4 8h血钠的变化分别为(19 5± 6 5 )mmol/L ,(10 1± 6 4 )mmol/L ,(4 5± 4 3)mmol/L(P <0 0 1)。CPM患者术后血浆渗透压显著升高。所有患者肝脏移植前后均存在低镁血症 ,但无组间差异。并发CPM患者的总手术时间为 (492± 190 )min ,显著长于无中枢并发症患者 (P <0 0 5 ) ;术后所有移植患者的血CsA浓度在正常范围 ,但有中枢并发症高于无中枢并发症者 (P <0 0 5 )。结论　肝脏移植者是CPM的易患人群。CPM的发生可能与慢性低钠血症 ,围手术期血钠大幅波动 ,术后血浆渗透     

Hickman catheter site infections after allogeneic stem cell transplantation: single-center experience

Hickman catheter site infections are known to increase transplant-related mortality (TRM). A retrospective analysis of 103 patients who received allogeneic SCT (stem cell transplants) was performed to define the incidence and outcomes of Hickman infections. Seventy-six patients received peripheral blood stem cells (PBSCs) (73.8%) and 29 patients (28.2%), nonmyeloablative conditioning. During the median follow-up of 9 months, Hickman infections were observed in 10 patients (9.7%) at a median onset of 32 days posttransplantation (range, 2-102 days). The causative organisms were identified in 5 cases, including Staphylococcus species (n=4) and Pseudomonas aeruginosa (n=1). Six events were successfully resolved with antibiotic treatment, whereas the other 4 events required the removal of the Hickman catheters with subsequent death in 2 cases. The survival duration for the Hickman infection group was shorter than that for the Hickman no infection group (83 days vs 366 days, respectively; P <.001). Myeloid engraftment was delayed in the Hickman infection group (18.0 days vs 15.0 days, respectively; P=.038), plus Hickman infections were more frequent among BMT compared with PBSCT group (22.2% vs 5.3%, respectively, P=.019). Hickman infections were associated with TRM, especially during the first 3 months posttransplantation. As such, the current results emphasize both the importance of Hickman catheter care and the need for surveillance cultures after SCT.     

Sulbactam-ampicillin in surgery. Our experience]

The bacterial infections constitute a serious problem for the surgeon: the choice of antibiotic drugs is really important and, as often as possible, should be guided by antibiotic sensitivity tests. In this study we used sulbactam-ampicillin (Unasyn) who is an antibiotic combination between sulbactam, inhibitor of beta lactam and ampicillin. The preliminary results were as follows: Unasyn was administered to 21 hospitalized selected patients, 16 women and 5 man, who had clinical signs of intraabdominal infection, wound infection and subphrenic abscess after digestive surgery. In these patients were isolated the following organisms: Staphylococcus epidermidis (8), Staphylococcus aureus (11), serratia (1), streptococcus (3), E. coli (3). The daily dosage of Unasyn was 3-12 g/die administered in three to four divided doses, and was determined by the severity of infection, the antibiotic susceptibility of the causative organism(s) and the condition of the patient. Each dose was given by slow i.v. infusion in 15-30 minutes. Our success rate was 100%, and neither systemic nor local side effects were recorded.     

Timing and frequency of perioperative carotid color-flow duplex scanning: A preliminary report

PURPOSE: The results of intraoperative and early postoperative carotid color-flow duplex scanning (CFS) after endarterectomy were reviewed to determine whether any perioperative studies could be eliminated. METHODS: Patients undergoing carotid endarterectomy with intraoperative CFS between 1986 and 1997 were identified. Early postoperative CFS was performed between 1 day and 3 weeks postoperatively, then it was performed again at 6 months postoperatively. RESULTS: During the study period, 560 patients, 325 men and 235 women, underwent 621 carotid endarterectomies. A satisfactory intraoperative carotid CFS was completed in 611 (98.4%) patients. There were 20 (3.2%) vessels with a major defect that required revision for fronds or flaps (n = 11), retained atheroma (n = 5), low flow (n = 2), high velocity or turbulence (n = 1), or dissection (n = 1). Another 146 vessels (23.5%) had minor defects, such as retained proximal atheromas or small (less than 3 mm) fronds, but were not revised. The remaining 445 vessels were normal. The first postoperative CFS was normal in all the revised carotids and in 138 (94.5%) vessels with minor intraoperative defects. At 6 months, recurrent stenosis (more than 75% area reduction) was identified in 1 of 18 revised carotids (5.5%), 4 of 138 vessels (2. 9%) with minor defects, and 17 of 406 vessels (4.2%) that were normal intraoperatively. The incidence of recurrent stenosis was not significantly different in the three groups (P =.7). CONCLUSION: Intraoperative CFS is useful because major unsuspected defects can be corrected immediately, thus avoiding potential neurologic morbidity. However, the postoperative day 1 CFS can be eliminated in most cases, because it does not provide any relevant clinical information.     

Clinical study of ofloxacin (OFLX) on urinary tract infections

Fifty-three patients with urinary tract infections (UTI) were treated with Ofloxacin, a new oral synthetic antimicrobial agent, and its clinical efficacy was studied. Ofloxacin (600 mg/day) was administered to 35 patients with acute simple cystitis for more than three days, and to 17 patients with complicated UTI for more than five days except a case in which the treatment was interrupted for side effects. Acute simple cystitis: In ten cases meeting the criteria of UTI committee, overall effectiveness rate was 100%. All of the 26 strains isolated from 26 patients disappeared after the treatment. In all of acute simple cystitis cases, 94.3% were evaluated as excellent or as moderate by attending doctors. Complicated UTI: In 11 cases treated during five or seven days, 63.6% of patients showed improvement on pyuria. Seven out of nine strains isolated from seven patients disappeared. However, two strains of P. aeruginosa and P. cepacia persisted after the treatment. In all of the complicated UTI cases, 38.9% of patients were evaluated as excellent or as moderate by attending doctors. Some slight side effects were observed in four out of 53 cases. This study showed that Ofloxacin is effective against urinary tract infections.     

Burkholderia cenocepacia and Burkholderia multivorans: influence on survival in cystic fibrosis

INTRODUCTION: Burkholderia cepacia infection has been associated with a poor prognosis for patients with cystic fibrosis (CF). It is now recognised that organisms classified as B cepacia comprise a number of distinct genomic species each known as a genomovar of the B cepacia complex (BCC). The outcome of infection for CF patients with individual genomovars is unknown. The clinical outcome of infection with the two most commonly isolated genomovars (B cenocepacia and B multivorans) was studied at a specialist CF centre between 1982 and 2003. METHODS: The numbers of patients who progressed from initial to chronic infection were assessed. Control groups were created by matching patients with chronic BCC infection by percentage forced expiratory volume in 1 second with patients with Pseudomonas aeruginosa infection. Outcome measures were survival time, deaths from "cepacia syndrome", rate of decline in spirometry and body mass index (BMI), and treatment requirements. RESULTS: Forty nine patients had an initial infection with either B multivorans (n = 16) or B cenocepacia (n = 33); 8/16 and 31/33, respectively, developed chronic infection (p<0.001). Deaths from "cepacia syndrome" occurred in both BCC groups. Patients with B cenocepacia infection had a shorter survival than patients with P aeruginosa infection (p = 0.01). There was no difference in survival between CF patients infected with B multivorans and P aeruginosa. There were no observed differences in changes in spirometry and BMI or treatment requirements between the BCC groups and respective controls. CONCLUSION: In CF, the genomovar status of BCC may influence both the likelihood of progression from initial to chronic infection and the overall survival of the patients.     

A comparison of 2 continuous passive motion protocols after total knee arthroplasty: a controlled and randomized study

Effect of continuous passive motion (CPM) protocols on outcomes after total knee arthroplasty. In this prospective randomized controlled study, 147 patients were assigned to 1 of 3 treatment groups: CPM from 0 degrees to 40 degrees and increased by 10 degrees per day, CPM from 90 degrees to 50 degrees (early flexion) and gradually progressed into full extension over a 3-day period, and a no-CPM group. The CPM was administered twice a day for 3 hours over a 5-day period. All patients participated in the same postoperative physiotherapy program. Patients were assessed preoperatively, day 5, 3 months, and 1 year postoperatively. The early flexion group had significantly more range of flexion than both the standard and control groups at day 5. There was no significant difference between the groups for any other variable tested at any time frame. Key words: total knee arthroplasty, CPM, rehabilitation, outcomes.     

One-dose antibiotic prophylaxis against wound infection after appendicectomy: a randomized trial of clindamycin, cefazolin sodium and a placebo.

Two hundred and fifty patients were admitted to a prospective randomized trial of single dosage prophylaxis against wound infection after appendicectomy. There were 12 exclusions, 72 patients received placebo, 81 received 600 mg i.m. clindamycin phosphate and 85 received 1 1 g i.m. cefazolin sodium, the agent being given in the anaesthetic room. Clindamycin produced a significant reduction in the overall rate of wound infection from 33 per cent in the controls to 17 per cent. In cases with a gangrenous or perforated appendix the infection rate in controls was 78 per cent; this was reduced to 44 per cent by a single dose of clindamycin. Cefazolin significantly reduced the number of aerobic organisms isolated from wound infections, but did not significantly reduce the incidence of wound infection. We conclude that anaerobic organisms are more important than faecal aerobic organisms in the pathogenesis of wound infection after appendicectomy.     

The effect of bacterial contamination on neointimal hyperplasia in vascular grafts

Neointimal hyperplasia (NH) is the most significant contributing factor to long-term vascular graft failure. Inflammation is known to be important in its development; however, the role of bacterial infection is unclear. We examined the effect of contamination with common organisms on the development of NH in expanded polytetrafluoroethylene grafts. Thirty adult pigs were randomized into one of four groups: no infection, contamination with Staphylococcus aureus, mucin-producing Staphylococcus epidermidis, or Pseudomonas aeruginosa. An expanded polytetrafluoroethylene graft (6 mm x 3 cm) was placed as a common iliac artery interposition graft and was inoculated with 1-2 x 10(8) of the selected organism before closure. Grafts were explanted 6 weeks postoperatively. Microbiologic, histological, and morphometric evaluations were performed. All grafts were patent at the time of euthanasia. The mean areas of NH were 5.45 mm(2) in sterile grafts, 8.36 mm(2) in S. aureus, 7.63 mm(2) in S. epidermidis, and 11.52 mm(2) in P. aeruginosa grafts. Comparison of means via analysis of variance showed that P. aeruginosa grafts had significantly higher formation of NH than sterile grafts (P = 0.025). NH production in infected grafts appears to be organism specific and is significantly higher with P. aeruginosa than common Gram-positive organisms. Increased NH from subclinical infection may be a significant factor contributing to late graft failures.     

Epidemiological and therapeutic study on gonorrheal infection--study on NY-198 (lomefloxacin) single administration therapy. Sapporo Clinical Research Group for STD

The efficacy of single administration of NY-198 in the treatment of gonococcal infections was studied employing male patients with gonorrheal urethritis and female patients with gonorrheal cervicitis. The clinical efficacy was evaluated on the basis of the efficacy rates which was estimated on each observation day for each patient. In the male patients, NY-198 was administered in a dose of 200 mg in 25 cases and a dose of 400 mg in 65 cases. The rate of eradication of N. gonorrhoeae (i.e. efficacy) on the 3rd day of administration was 96% in the 200 mg administration group and 100% in the 400 mg administration group. On the 7th day after administration, the eradication rate was 100% in both the 200 mg and 400 mg administration groups. When the eradication rate on the 7th day was statistically estimated for patients who returned to the hospital only on the 3rd day, it was 97.9% in the 200 mg administration group. In the female patients, NY-198 was administered in a dose of 200 mg to 4 cases and a dose of 400 mg to 5 cases. The eradication rate on each observation day was 100% in both dosage groups. In conclusion, single administration of NY-198 in a dose of 200 mg or 400 mg was highly effective, and considered to be a therapeutic method highly useful clinically.     

Cytokine modulating effect of ginseng treatment in a mouse model of Pseudomonas aeruginosa lung infection.

The major cause of morbidity and mortality in cystic fibrosis (CF) patients is chronic Pseudomonas aeruginosa lung infection. In a mouse model of P. aeruginosa lung infection mimicking that in CF patients, the effects of ginseng treatment on cytokine responses and the correlation between the changes in cytokine production and the lung pathology were studied. Mice were challenged with alginate beads containing P. aeruginosa (10(9) CFU/ml). A saline extract of ginseng was injected subcutaneously at a dosage of 250 mg/kg of body weight/day for 7 days. Saline was used as a placebo control. One week after challenge, a significantly lower mortality was found in the ginseng treated group (P < 0.005). The lung cells from the ginseng treated group produced more interferon-gamma (IFN-gamma) (P < 0.04) and tumor necrosis factor-alpha (TNF-alpha) (P < 0.03) but less interleukin-4 (IL-4) (P < 0 .02) with a higher ratio of IFN-gamma/IL-4 (P < 0.004) after 6 and/or 24 h of incubation with specific and non-specific antigens as compared to the control group. The ginseng treated splenocytes produced more TNF-alpha (P < 0.03) and IFN-gamma (P0.05) than the control spleen cells. Furthermore, a significantly milder lung pathology (P < 0.025) and a faster bacterial clearance (P < 0.038) from the lungs were also found in the ginseng treated group compared to the control group. These results indicate a Th1-like immune response in the mice with P. aeruginosa lung infection after 7 days of ginseng treatment, which is an important mechanism accounting for ginseng's favorable action. We therefore believe that Th1 response might benefit the host with P. aeruginosa lung infection and ginseng treatment might be a promising alternative measure for the treatment of chronic P. aeruginosa lung infection in CF patients.