A fatal case of acute mediastinitis caused by periodontal infection]

A 57-year-old man had suffered from poorly controlled diabetes mellitus and liver cirrhosis due to alcohol and hepatitis C for about 10 years. He developed fever and swelling of the right cheek and neck due to periodontal infection. The symptoms worsened in spite of antibiotic therapy and were accompanied by dyspnea. He was therefore referred to our hospital. Chest radiographs and computed tomographs revealed widening of the superior mediastinum, pulmonary infiltrates and right pleural effusion. He was diagnosed as having mediastinitis, right pyothorax and pneumonia caused by periodontal infection. Tracheotomy and mechanical ventilation were performed. Antibiotic therapy resulted in improvement of the mediastinitis and pyothorax. However, renal and liver dysfunction developed and the patient died of multiorgan failure after 35 days of hospitalization. Death due to periodontal infection is rare. We give a review of the literature.     

Antibacterial activity of totarol and its potentiation.

Antimicrobial activity of six diterpenoids isolated from the bark of Podocarpus nagi (Podocarpaceae) has been tested against twelve selected microorganisms. Totarol [1], the most abundant compound among the six, exhibited potent bactericidal activity only against Gram-positive bacteria, among which Propionibacterium acnes was the most sensitive bacterium. Totarol also showed strong activity against four other Gram-positive bacteria tested: Streptococcus mutans, Bacillus subtilis, Brevibacterium ammoniagenes, and Staphylococcus aureus (both penicillin-resistant and penicillin-susceptible strains). The bactericidal activity of totarol was enhanced when it was tested in combination with several other natural products. Noticeably, the activity of totarol against Sta. aureus was increased eightfold when tested in combination with 1/2MIC of anacardic acid [9]. The synergistic activity of anacardic acid caused the minimum bactericidal concentration (MBC) of totarol to be lowered from 1.56 to 0.2 micrograms/ml.     

Sub-acute toxicity of piperonyl butoxide in F344 rats.

Piperonyl butoxide, alpha-[2-(2-Butoxyethoxy)ethoxy]-4,5-methylenedioxy- 2-propyltoluene, is a pesticide synergist. F344 rats of both sex were maintained on diets containing 0, 0.6, 1.2 or 2.4% of piperonyl butoxide for 13 weeks. At the end of experimental period, they were necropsied. Selected organs were weighted and serum was analyzed by clinical chemistry. In male and female rats of the 2.4%-group, body weight gains were depressed, macroscopically, hepatomegaly was marked and liver weights were significantly higher than those of the control group. In male and female rats of all treated groups, relative kidney weights were significantly increased in a dose-dependent manner. Rats of the 2.4%-group had increased levels of albumin, cholesterol, urea nitrogen and gamma-glutamyl transpeptidase. Examination of livers of the male 2.4%-group by light microscopy showed enlarged hepatocytes with glassy cytoplasm and fatty deposition. On occasion, there was coagulative necrosis of a few hepatocytes in the periportal area and oval cell proliferation. The kidney of treated rats showed atrophy of epithelium in the proximal convoluted tubules. These results indicated that toxicity of piperonyl butoxide in rats was directed primarily to the liver and kidney.     

Indium-111-labeled liposomes: quality and biodistribution in mice bearing human tumor xenografts

Phospholipid vesicles containing the ionophore A23187 in the bilayer (VesCan) are the only liposomes produced for clinical imaging purposes. We undertook preliminary experiments with In-loaded VesCan (indium-111-V-liposome) using normal rabbits and nude mice bearing human gastric (MKN45) and colon (COL0205) tumor xenografts before clinical application of the product. Two V-liposome vials with different expiration dates were labeled with ¹¹¹In and then injected into rabbits immediately or 24 h after loading. The blood clearances of ¹¹¹In were not significantly different from rabbit to rabbit, indicating that ¹¹¹In-V-liposomes did not vary among vial lots. Both MKN45 and COL0205 tumor xenografts in nude mice were successfully imaged with ¹¹¹In-V-liposome; V-liposome delivered sufficient radioactivity to allow tumor visualization as early as 8 h after iv injection. It was also found that MKN45 tumors exhibited uptake of 6.5% ID/g. The present results indicated that the quality and shelf life of ¹¹¹In-V-liposomes are good and that scintigraphy of ¹¹¹In-V-liposomes is a feasible technique for detecting tumor lesion in patients with cancer.