Effects of the new vagolytic compound ciclotropium bromide on heart rate and atrial vulnerability

The effects of the new vagolytic compound alpha-phenylcyclopentane-acetic acid-N-isopropyl-nortropine ester methobromide (ciclotropium bromide) on heart rate and atrial vulnerability were assessed in the animal experiment. Therefore, the comparative effects of atropine (A) and ciclotropium bromide (C) on heart rate (HR) and electrical stimulation thresholds for repetitive atrial extrasystoles (RET) and fibrillation (AFT) were established in 14 mongrel dogs (BW 20-30 kg, artificial ventilation, piritramide-N2O anaesthesia). AFT and RET were determined using trains of rectangular current pulses (13 single pulses, 2 ms, 200 Hz) applied to the right atrial endocardium via bipolar platinum electrodes during the vulnerable period of atrial excitation, which was determined by scanning of the relative refractory period in steps of 10 ms. A (0.025 mg/kg) caused a small transient increase in the AFT; HR rose from 82 +/- 7 to 138 +/- 10/min. Control values were regained after 30 min. RET did not show any significant change. C (0.25 mg/kg) effected a significant increase in the AFT from 7.7 +/- 2 to 34 +/- 6 mA and in HR from 93 +/- 5 to 148 +/- 6/min. The effects lasted about 2 h. RET was not altered.     

Pseudomonas aeruginosa: pathogenicity, prevention and therapeutic approaches

Pseudomonas aeruginosa has proved to be a dangerous nosocomial pathogen is growing importance. Its pathogenicity is attributable to its great variety of toxic mechanisms which are capable of attacking all parts of the organism, primarily organs with impaired resistance. Antibiotics had been found to yield little lasting success. Therefore, an attempt was made to apply to 30 patients three-per-cent boric acid to cope with locally delimited Pseudomonas wound infections. Therapy could be completed with good success in less than six days on average. Only germ reduction was achievable on three patients with chronic osteomyelitis. Toxic side-effects were not recordable.     

Screening of the new analgesic, bromfenac

A method is described for the screening of the new analgesic bromfenac via thin-layer chromatographic analysis of its acid hydrolysis product and subsequent Bratton-Marshall detection.     

Multiple generalized glomus tumors. Morphologic and biochemical findings

A 54 year-old woman developed approximately 150 generalized glomus tumors since she had been 23 years old. Painful tumors showed more glomus cells than those being not painful. Furthermore, the patient suffered from persisting congenital capillary hemangioma (strawberry mark). Histological examination revealed that glomus cells were located in the vessel walls. The large amount of Dopa found in the glomus tumor tissue supports the assumption that it may be innervated by adrenergic efferent nerves.     

Aspergillus brain abscess. A case report

The history and findings in a patient with erythroleukaemia who developed a fungal brain abscess during the agranulocytic phase of induction treatment is reported. The radiological features of fungal infection are reported, with emphasis on the importance of clinical judgement in making the diagnosis. The autopsy findings further illustrate the increasing importance of this previously very rare condition.     

Acute megakaryocytic leukemia in children. Clinical, immunologic, and cytogenetic findings in two patients.

An unusual presentation of acute megakaryocytic leukemia (AMKL) is reported in two young children. The first child had a 10-day history of ptosis of the right eyelid as the initial manifestation of AMKL, a clinical picture not previously described in this variant of leukemia. Computed tomographic scanning showed multiple intracranial mass lesions, and the diagnosis of AMKL was confirmed by immunophenotyping of bone marrow blasts. The second child had Down syndrome and received alkylating agents and radiation therapy for treatment of metastatic rhabdomyosarcoma of the orbit. She had AMKL as second malignancy. Both patients had acquired chromosome 21 anomalies in their leukemic blasts. The first patient, constitutionally normal, had an i(21q) in his leukemic blasts; the patient with constitutional trisomy 21 had tetrasomy 21 and additional chromosomal changes. The clinical symptoms and the results of morphologic, immunologic, and cytogenetic studies are discussed.     

Detection of legionellas in clinical samples using FITC-marked antibodies

Using serogroup/species specific FITC-conjugates against Legionella (L.) pneumophila serogroups (SG) 1 to 6, L. micdadei, L. bozemanii and L. jordanis 186 sputum samples, 43 pleural fluids and bronchial washings and 39 lung tissue samples from 251 pneumonia patients were checked for Legionellae with the direct fluorescent antibody technique (DFAT). In samples from 201 patients which were negative if tested for antibodies and for urinary antigen and/or using culture methods, the DFAT was negative, too. One Pseudomonas strain isolated from a bronchial washing showed crossreactions. In 19 out of 49 patients with legionellosis L. pneumophila SG 1 (3x), SG 2 (1x), SG 3 (4x), SG 4 (1x), SG 5 (5x), L. micdadei (3x) and L. bozemanii (2x) were found. Positivity of the DFAT was significant higher in specimens, taken in early stages of illness (p less than 0.01). DFAT can be used for specific detection of Legionellae in clinical specimens, but the relative low sensitivity (39%) does not allow to exclude legionellosis. Further diagnostic tests like detection of antibodies and urinary antigen and culture are necessary to diagnose legionellosis.     

Biochemical, clinical and genetic analysis of various aminoacidopathies (non-ketotic hyperglycemia, maple syrup urine disease, histidinemia, tyrosinemia)]

The genetical types were classified according to the clinical findings and biochemical results in cases of 13 newborn/children suffering from various aminoacidopathies. The genetical types were: 3 neonatal and 4 infantile types were found out of 7 non-ketotic disease (MSUD) patient was infantile type with 9.1 per cent keto acid decarboxylase activity in leukocyte homogenate. Among the 3 histidinemic patients 1 was severe neonatal type and 2 cases were chronic types. The 2 treated tyrosinemic children proved to be type III. (chronic with rickets).     

Two weeks treatment with amoxicillin/omeprazole for eradication of Helicobacter pylori.

In an open study, 62 patients with Helicobacter pylori-associated ulcer disease or functional dyspepsia were treated for two weeks with 2 x 20 mg omeprazole preprandially and 4 x 500 mg amoxicillin suspension one hour before meals and at night. 57 patients (active ulcer disease: n = 53, functional dyspepsia: n = 4) completed the study without contravening the protocol. The rate of eradication of the bacteria at least 4 weeks after cessation of study medication was 82.5% (47/57 patients). Three patients experienced side effects during the treatment period (stomatitis, self-limiting diarrhea, allergic exanthema). In one case allergic exanthema led to discontinuation of therapy. 11 patients with H. pylori-associated ulcer disease received 2 x 20 mg omeprazole for two weeks. In this group no eradication of bacteria was observed.     

Twenty-four-hour ambulatory blood pressure profiles in pediatric patients after renal transplantation

Ambulatory blood pressure monitoring was applied in 27 pediatric patients aged 6.3 – 24.3 (median 15.0) years who had been transplanted 1.5 – 8.4 years previously. Daytime values were compared with the mean of 10 concomitant casual blood pressure recordings. At the time of the study, antihypertensive drugs were given to 17 patients. Inulin clearance ranged from 18 to 116 (median 66) ml/min per 1.73 m². Ambulatory blood pressure monitoring confirmed hypertension or normotension determined by casual blood pressure measurements in 63% of patients. The physiological nocturnal dip in blood pressure was attenuated or reversed in 8 of 27 patients. It was reduced in all 3 patients with renal artery stenosis of the graft, in 3 of 4 patients with chronic rejection, in the only patient with recurrent focal segmental glomerulosclerosis, and in 1 of 6 patients with past acute rejection. The dipping was not related to inulin clearance. In conclusion, casual blood pressure measurements do not accurately reflect blood pressure in pediatric patients transplanted more than 1.5 years previously. A reduced nocturnal dip in blood pressure may indicate an underlying renovascular or renoparenchymal pathology. Ambulatory blood pressure monitoring should regularly be applied in patients with renal transplants. Received May 23, 1995; received in revised form June 18, 1996; accepted June 20, 1996