Structures of silver sulfonamides

The structures of silver sulfonamides were found to depend highly on the substituent at the amide nitrogen of the sulfonamide. Silver is coordinated to that nitrogen and the sulfonamide is in the amido form if no substituent is present or if the substituent is a phenyl, acetyl, or 2-pyrimidyl group. If the substituent is a 2-thiazolyl or 2-pyridinyl group, the sulfonamide is in the imido form and silver coordinates to the nitrogen of the substituent. Depending on the number of suitable donor atoms per sulfonamide, the silver compounds are charged or uncharged and the primary amino group may be involved in complexation.     

Traumatic instability of the proximal tibiofibular joint

Proximal tibiofibular instability, seems to be an infrequently diagnosed abnormality, which occurs in isolation or in combination with fractures of the leg and ankle. Four types of instability are distinguished: subluxation, anterolateral dislocation, posteromedial dislocation and superior dislocation.The method of treatment depends on the type of dislocation and on the presence or absence of dysfunction of the peroneal nerve.The methods of treatment are described. Ten patients treated for this instability are presented. The use of radiographs to define the lesion is discussed. Radiographs, taken at follow-up, showed degenerative changes in the proximal tibiofibular joint in 8 of the 10 patients.     

Results of 2 multicenter therapy studies in inoperable non-small cell bronchial cancer

A total of 166 patients with non-small cell lung cancer (NSCLC) were included in two multicenter trials testing different treatment regimens. In study I, 116 patients received 4 cycles of aggressive polychemotherapy consisting of cis-platinum 100 mg/m2 (day 1), etoposide 100 mg/m2 (days 4-6), and vindesine 3 mg/m2 (day 1) (CEV); patients without distant metastases subsequently received chest irradiation with 50 Gy. In study II, 50 patients were treated with monochemotherapy consisting of etoposide 250 mg/m2 (days 1-3), and ifosfamide 5 g/m2 as 24-h infusion (day 29). While this program was repeated in responders with extensive disease (ED), patients with limited disease (LD) subsequently received chest irradiation with 50 Gy using 20 mg/m2 cis-platinum weekly as a radiosensitizer. Response rates (CR + PR) to chemotherapy were higher in study I than in study II, and were 26% (CR 3%) vs. 8% (CR 0%) for all patients, 18% (CR 0%) vs. 4% (CR 0%) for ED, and 45% (CR 11%) vs. 13% (CR 0%) for LD. The increase in response rates by radiotherapy was marginal in study I (CR + PR 47%, CR 18%), but remarkable in study II (CR + PR 42%, CR 29%). While median survival was slightly longer in study I than in study II for ED (7.7 vs. 6.6 months) and LD (14.4 vs. 12.0 months), the 2-year survival rate was in favor of study II (10% vs. 25%). Toxicity was clearly more pronounced in study I, including 3 lethal complications and 16 discontinuations of therapy due to side effects or refusal. Thus, while in ED the efficacy of both treatment regimens was very restricted, in LD radiotherapy with cis-platinum as a radiosensitizer achieved a relatively high 2-year survival rate which justifies further testing of this treatment strategy.     

A clot-inducing wound covering with high vapor permeability: enhancing effects on epidermal wound healing in partial-thickness wounds in guinea pigs

Although the use of an occlusive wound covering accelerates the reepithelialization of a partial-thickness wound, it has the disadvantage of leading to wound exudate accumulation. The effect of an experimental polyetherurethane (PEU) wound covering with a high vapor permeability was compared with an occlusive wound covering (OpSite covering) and air exposure with respect to the rate of reepithelialization, eventual epidermal thickness, and scab thickness in 122 partial-thickness wounds in guinea pigs. The percentage of reepithelialization on day 2 was 85% in wounds covered with the permeable PEU membrane, whereas it was 66% and 35%, respectively, in wounds covered with the occlusive covering or exposed to air. The epidermal thickness did not differ among the three types of treatment. The scab thickness, however, was maximal in the uncovered air-exposed wounds. We conclude that epidermal wound healing is accelerated when the PEU wound covering is used. This wound-healing-promotion effect is apparently due to the high water vapor permeability of PEU, which induces clotting of the wound exudate, and subsequent jellifying of the clot layer.     

Keraunoparalysis, a 'specific' lightning injury

Lightning paralysis or keraunoparalysis, a transient paralysis associated with extreme vasoconstriction and sensory disturbances of one or more extremities as a result of lightning impact is described in two patients.     

Linkage studies in facioscapulohumeral muscular dystrophy

Possible linkage between the locus for autosomal dominant facioscapulo-humeral muscular dystrophy and the locus for the constant region of the heavy chains of the IgG immunoglobulins (Gm) was tested in 1 kindred (23 affected and 18 unaffected sibs) using the polymorphic DNA probe D14S1, which is known to be closely linked with Gm. No linkage between the loci for the disease and the probe was found, and the lod scores suggested that the locus for facioscapulohumeral muscular dystrophy is not situated on the distal part of the long arm of chromosome 14.     

Intestinal bacterial translocation in experimentally burned mice with wounds colonized by Pseudomonas aeruginosa.

Translocation of micro-organisms from the gastrointestinal tract may play a role in the pathogenesis of septic complications in severely burned patients. We therefore investigated the influence of burn wound infection with Pseudomonas aeruginosa on translocation in experimentally burned mice. The P. aeruginosa disseminated in 15% of the animals on the second day and in 20% of the animals on the third day postburn in the Pseudomonas-seeded group. Wound colonization with P. aeruginosa, compared with a control group, led to an increased incidence of translocation of Escherichia coli from the GI tract to the spleen (p < 0.005), liver (p < 0.03), lungs (p < 0.005), and peritoneal cavity (p < 0.03) on the second day postburn but not on the third day postburn. On both the second and third days, the number of viable E. coli in the organs in the Pseudomonas-seeded group exceeded that in the organs in the control group. In this model translocation of E. coli from the GI tract played a more important role than did hematogeneous dissemination of P. aeruginosa from the burn wound.     

Alteration of wound colonization by selective intestinal decontamination in thermally injured mice

The effects of selective intestinal decontamination on the bacterial colonization of burn wounds were investigated in experimentally burned mice. Prior to scalding pathogen-free mice were pretreated with bacitracin to induce intestinal overgrowth of Enterobacteriaceae. Mice treated for 20 days postburn with oral aztreonam had significantly reduced enterobacterial wound colonization compared to untreated controls. This study indicates that burn wound colonization is altered by selective decontamination of the intestinal tract.     

Remarks on the structure-activity relationship of some antibacterial silver non-sulfanilamide compounds

In this study some physical parameters of a number of silver non-sulfanilamide compounds (acetate, 4-nitrobenzoate, nitrate, salicylate and 2-thiosalicylate) and silver sulfadiazine are related to the antibacterialin vivo activity of these compounds. The stability constant and solubility are important factors in the development of the biological activity and the mechanism of action (active as silver ion or the whole molecule).