Susceptibility of haemophilus to antibiotics: Present status

Summary A total of 100 clinical isolates of Haemophilus were tested for susceptibility to 25 antibiotics. The activity of the five penicillins tested, including penicillin G, was good, almost all strains being inhibited by 6.25 µg/ml of the compounds. Erythromcyin and clindamycin showed similar activity: at 6.25 µg/ml, 100% of the strains were inhibited by erythromycin and 96% were inhibited by clindamycin; in contrast, oleandomycin and lincomycin were less inhibitory, with most strains being resistant to 6.25 µg/ml of these two drugs. MIC's of chloramphenicol and thiamphenicol ranged from 0.1–1.56 µg/ml with most strains inhibited by 0.78 µg/ml. Aminoglycosides and antibiotics belonging to the tetracycline group showed good inhibitory effect with the majority of the strains being inhibited by 3.12 µg/ml. Among the cephalosporins studied, cephradine and cephalexin were considerably less active than other members of this group. Cephapirin was the most active. This study suggests that prediction of the susceptibility of Haemophilus strains to cephalosporins, on the basis of one drug of this group tested alone, is likely to be hazardous.

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Der gegenwärtige Status der Haemophilus-Empfindlichkeit gegenüber Antibiotika

Zusammenfassung Es wurden insgesamt 100 Haemophilus-Stämme aus klinischem Material auf ihre Empfindlichkeit hin gegenüber 25 verschiedenen Antibiotika getestet. Die antimikrobielle Aktivität der fünf untersuchten Penicilline, einschließlich Penicillin-G, war gut; beinahe alle Stämme wurden von 6,25 µg/ml gehemmt. Erythromycin und Clindamycin zeigten eine ähnliche Empfindlichkeit wie die Penicilline (6,25 µg/ml). 100% dieser Stämme wurden durch Erythromycin gehemmt und 96% durch Clindamycin. Im Gegensatz hierzu wirkten Oleandomycin und Lincomycin weniger hemmend; die meisten Stämme waren gegenüber 6,25 µg/ml resistent. Die Minimalhemmkonzentrationen von Chloramphenicol und Thiamphenicol lagen zwischen 0,1–1,56 µg/ml, wobei die Mehrzahl bereits unter 0,78 µg/ml gehemmt wurde. Aminoglycoside und Antibiotika der Tetracyclin-Gruppe zeigten einen guten Hemmeffekt, der bei 3,12 µg/ml lag, bei der Mehrzahl der Stämme. Unter den untersuchten Cephalosporinen waren Cephradin und Cephalexin beträchtlich weniger antibiotisch wirksam als andere Substanzen dieser Gruppe; Cephapirin war am aktivsten. Diese Untersuchung läßt darauf schließen, daß eine Aussage über die Empfindlichkeit von Haemophilus-Stämmen gegenüber Cephalosporinen nicht auf der Basis einer Substanz dieser Gruppe gemacht werden kann.

     

A palate tumor revealed by pain

A 41-year-old female presented in April 1996 with a tumor of the hard palate revealed by increasing left palate pain. Adenoid cystic carcinoma was suspected on clinical and imaging data. Two limited surgical procedures showed a tumor histologically made of small lobules of granular cells, PAS positive and expressing S100 protein, infiltrating some medullary spaces of the palatine bone, consistent with a granular-cell tumour. Pain recurred in the territory of the maxillary branch of the left trigeminal nerve (V2). Imaging showed a tumor of the origin of V2-extending through the foramen rotondum. Two radical interventions in September and in October 2000 showed an infiltrating tumor of the V2 and palatine mucosa, with the same histology. There was no immuno-staining for p53, and less than 5% of nuclei expressed Ki67. Malignant Abrikossof tumors are exceptional, morphologically difficult to differentiate from benign ones, only metastasis proving malignancy. Tumor size above 5 cm, recurrence and infiltrative character are considered pejorative. The value of p53 and Ki67 expression remains controversial. We discuss our observation according to these criteria.     

Rebeccamycin derivatives as dual DNA-damaging agents and potent checkpoint kinase 1 inhibitors

Rebeccamycin is an indolocarbazole class inhibitor of topoisomerase I. In the course of structure-activity relationship studies on rebeccamycin derivatives, we have synthesized analogs with the sugar moiety attached to either one or both indole nitrogens. Some analogs, especially those with substitutions at the 6' position of the carbohydrate moiety, exhibit potent inhibitory activity toward checkpoint kinase 1 (Chk1), a kinase that has a major role in the G(2)/M checkpoint in response to DNA damage. Some of these compounds retained a genotoxic activity either through intercalation into the DNA and/or by topoisomerase I-mediated DNA cleavage. We explored the structure-activity relationship between these compounds and their multiple targets. These rebeccamycin derivatives represent a novel class of potential antitumor agents that have a dual effect and might selectively induce the death of cancer cells.     

A new method of three-dimensional computer assisted reconstruction of the developing biliary tract

A three-dimensional (3-D) computer assisted reconstruction of the biliary tract was performed in human and rat embryos at Carnegie stage 23 to describe and compare the biliary structures and to point out the anatomic relations between the structures of the hepatic pedicle. Light micrograph images from consecutive serial sagittal sections (diameter 7 mm) of one human and 16 rat embryos were directly digitalized with a CCD camera. The serial views were aligned automatically by software. The data were analysed following segmentation and thresholding, allowing automatic reconstruction. The main bile ducts ascended in the mesoderm of the hepatoduodenal ligament. The extrahepatic bile ducts: common bile duct (CD), cystic duct and gallbladder in the human, formed a compound system which could not be shown so clearly in histologic sections. The hepato-pancreatic ampulla was studied as visualised through the duodenum. The course of the CD was like a chicane. The gallbladder diameter and length were similar to those of the CD. Computer-assisted reconstruction permitted easy acquisition of the data by direct examination of the sections through the microscope. This method showed the relationships between the different structures of the hepatic pedicle and allowed estimation of the volume of the bile duct. These findings were not obvious in two-dimensional (2-D) views from histologic sections. Each embryonic stage could be rebuilt in 3-D, which could introduce the time as a fourth dimension, fundamental for the study of organogenesis.     

Biliary structures lead to tumour recurrences after laser-induced interstitial thermotherapy.

BACKGROUND AND OBJECTIVE: Thermal diffusion during laser-induced interstitial thermotherapy (LITT) has not yet been fully investigated in heterogeneous tissue architecture such as liver. LITT was performed on rabbit liver tumours to analyse the role of biliary structures in thermal diffusion. STUDY DESIGN/MATERIALS AND METHODS: Twenty-four VX2 tumours were grafted onto 12 rabbit livers. The animals were randomly separated into two groups when tumour size reached 8 mm. Thermotherapy was performed by delivering the 830-nm output of a diode laser to the centre of the tumour with a 300-,microm fibre. Irradiation conditions were 1.5 W over 900 sec. On day 7 or 14, the tumours were removed and stained with haematoxylin-eosin and picrosirius red F3BA (PR). Thermal damage was evaluated by PR and electron microscopic examinations. RESULTS: Among the treated tumours, recurrences were found both at the periphery (one on day 7, seven on day 14) and within the treated area (two on day 7, two on day 14). All recurrences were located in the vicinity of the biliary structures, which are frequently spared from thermal injury. CONCLUSION: Biliary ducts lead to a heat sink, thereby facilitating tumour recurrences.     

Laparoscopy for living donor left nephrectomy: Comparison of three‐dimensional and two‐dimensional vision

The main objective of this preliminary study was to evaluate the feasibility and safety of 3‐D laparoscopic living donor left nephrectomy (LDLN). The secondary objective was to compare intraoperative and postoperative outcomes between 3‐D and 2‐D laparoscopic LDLN. All patients who underwent a laparoscopic LDLN from January 2015 to April 2018 in a university center were included. All surgeries were performed by three experienced surgeons. Seventy three patients were included the following: 16 underwent a 3‐D laparoscopic LDLN (3‐D group), and 57 underwent a 2‐D laparoscopic LDLN (2‐D group). Operative time and warm ischemia time (WIT) were significantly lower in the 3‐D group (operative time: 80.9 ± 10.2 vs 114.1 ± 32.3 minutes in the 3‐D and 2‐D groups, P = .0002) (WIT: 1.7 ± 0.6 vs 2.3 ± 0.9 minutes in the 3‐D and 2‐D groups, P = .02). No conversion to open surgery occurred in both groups. Length of hospital stay was significantly shorter in the 3‐D group. No major postoperative complications (Clavien ≥ III) occurred. One‐year postoperative GFR was similar to 3‐D and 2‐D groups. Our preliminary study demonstrates that 3‐D laparoscopic LDLN is a feasible and safe surgical procedure. Intraoperative and postoperative outcomes were similar in both 2‐D and 3‐D vision systems, but 3‐D vision systems allow reduction in WIT and operative time.