Carbamazepine, diuretics, and hyponatremia: a possible interaction

Although carbamazepine is known to cause hyponatremia, no previous reports have indicated an interaction between carbamazepine and a diuretic. Two patients are described who were treated with this combination and developed symptomatic hyponatremia, which cleared when both drugs were discontinued in one patient and when the diuretic was discontinued in the second patient. The possible mechanisms of action of carbamazepine-induced hyponatremia are discussed.     

Synthesis of a new carrier for immunization: polytuftsin

Sequential poly(Arg-Thr-Lys-Pro) consisting mainly of the repeat of tuftsin Thr-Lys-Pro-Arg was synthesized by condensing the p-nitrophenyl ester of Arg(HCI)-Thr-Lys-(2-CI-Z)-Pro in the presence of HOBt . Two haptenic sequences of the Pre-S region of hepatitis B virus antigen (10–26 and 39–55) were prepared by solid phase and coupled to polytuftsin via glutaraldehyde. The peptides, either free or coupled to polytuftsin, were administrated to mice and the antisera were assayed by ELISA . Coupling the peptides to the polypeptide significantly improved the anti-peptide antibody titer in Freund complete adjuvant or in NaCI 0.9%. Cross-reaction between antibodies induced by the peptides and the native protein was also improved. Polytuftsin alone is very poorly immunogenic.     

Comparison of immune electron microscopy and genome electropherotyping techniques for detection of turkey rotaviruses and rotaviruslike viruses in intestinal contents.

Seventy-nine intestinal contents specimens from 65 turkey flocks were examined for rotavirus and rotaviruslike virus (RVLV) by immune electron microscopy (IEM) and genome electropherotyping. The IEM procedure was slightly more sensitive in detecting these viruses; 7 of 48 specimens (14.6%) positive for virus by IEM were negative by the genome electropherotyping technique. The genome electropherotyping technique more readily differentiated the rotaviruses and RVLVs than did the IEM procedure; 15 of 48 specimens (31%) positive for virus by IEM could not be differentiated into rotavirus of RVLV, whereas only 4 of the 41 specimens (9.7%) positive by genome electropherotyping produced incomplete genome electropherotypes and could not be differentiated. Thirty-one specimens negative by IEM were also negative by genome electropherotyping. Specimens determined to contain only rotavirus by IEM produced only rotavirus genome electropherotypes. Likewise, specimens determined to contain RVLV alone by IEM produced only RVLV genome electropherotypes. Three specimens contained viruses morphologically resembling rotaviruses that were not aggregated by either the anti-turkey rotavirus serum or the anti-turkey RVLV serum and possessed genome electropherotypes distinct from those of the turkey rotavirus and RVLV. These rotaviruses may represent a third, previously unrecognized serogroup of turkey rotaviruses.     

Clinical experience with cefodizime in bacterial infection of children

Clinical studies were performed on cefodizime (THR-221, CDZM), a new cephem antibiotic as described below. CDZM was administered to 13 patients in dose levels ranging from 55 to 96 mg/kg/day t.i.d. for 3-7 days (5.5 days on average). These patients included 8 with pneumonia, 2 with tonsillitis, 1 each with bronchitis, phlegmon and urinary tract infection. The overall efficacy rate was 92.3%, i.e., efficacy was excellent in 8, good in 4 and poor in 1. Bacteriological efficacy was 83.3%, i.e., 5 strains of bacteria (Streptococcus pneumoniae 1, Haemophilus influenzae 3, Haemophilus parainfluenzae 1) were eradicated and 1 was unchanged (Enterobacter cloacae, MIC greater than 100 micrograms/ml). Clinical side effect was not observed during the treatment. Laboratory abnormalities were observed in 2 cases, i.e., a slight elevation of GPT and a mild eosinophilia. The above results suggest that CDZM is a useful antibiotic for treating pediatric bacterial infections.     

Bronchial and cardiovascular effects of ocular topical B-antagonists in asthmatic subjects: comparison of timolol, carteolol, and metipranolol

B antagonists eye drops are most effective for the treatment of chronic open angle glaucoma. By this way of administration they have a very good systemic bioavailability. Bronchial, and cardiovascular effects of three of these topicals: timolol, carteolol and metipranolol have been evaluated in three parallel groups of asthmatic patients. The three topics induce bronchoconstriction without significant difference between them, and lower heart rate (sometimes very intensely) whatever the B antagonist studied. From these data, it is recommended to practitioners to follow carefully the rules of administration of B blockers, even in eye drops.     

The use of axial-pattern cutaneous and musculocutaneous flap transposition in the reconstruction of deep burns

From June 1979 to July 1987, 84 acute burned patients with localized deep wounds involving tendon, nerve, vessel, bone and joint were treated by utilising 26 types of island axial-pattern cutaneous or musculocutaneous flaps. All flaps survived completely with a primary healing rate of 91.4%. All patients were divided into 'urgent' (within 48 hours), 'early' (within 2 weeks), or 'infected' groups according to the time interval between the burn injury and the surgery conducted. The primary healing rates for each groups were 100%, 94%, and 86% respectively. No significant differences exist between the axial-pattern cutaneous flap and musculo-cutaneous groups. The measures for minimizing infection including thorough debridement, groups. The measures for minimizing infection including thorough debridement, avoiding of circulatory compromises of the flaps, effectively postoperative drainage, and the use of antibiotics were discussed. Four types of newly developed axial-pattern cutaneous flaps as well as a super-long latissimus dorsi-external oblique abdominis-rectus abdominis combined musculocutaneous flaps were presented.     

Local cerebral glucose utilisation in chronic alcoholics: a positron tomographic study.

Using positron tomography, a study of regional cerebral glucose utilisation was performed prospectively in a highly selected group of six neurologically unaffected primary chronic alcoholics. In this group, neuropsychological, behavioural and CT scan anomalies were comparable with those previously reported in more extensive studies. With respect to age-matched control values, cerebral metabolic rate was not significantly modified in the selected cortical, subcortical and cerebellar regions of interest. However, the metabolic regional distribution index, which reflects the distribution pattern of glucose utilisation, was selectively and significantly decreased in the medio-frontal area, pointing to a limbic metabolic dysfunction apparently linked to chronic alcoholism.     

RELATIVE CHANGES OF BLOOD AND CEREBRO- SPINAL FLUID SUGAR IN SCHIZOPHRENIC PATIENTS TREATED WITH INSULIhI*

Divisiort of Neuropsychiatry of Department of Medtczne and Department o/ Pharmacology, Natio礼ul rVedicat Ooltege of Shtrnghai, Shanghai, China. . As far as the writers are aware, few studies on the changes of blood and cerebrospinal fiuid sugar during hypoglycemia have been made in schizophrenic patients. While our work was in progress, two articles had come to our notice. In the paper by Dussik (1) the blood and cerebrospinal fluid sugar values at the time of insulm coma were determined, while in the communication by Day, Niver and Greenberg (2) the course of changes in blood ar.d cerebrospinal fIuid sugar after insulin was followed. The object of this paper is to report the results of a number of individual and serial determinations of both the bIood and cerebrospinal fluid sugar in schizophrenic patients treated by insulin according to Sakel''s method (3).