We have previously shown that differences in cell surface carbohydrates can be detected in related murine tumor lines of varying metastatic capacity using plant lectins such as soybean agglutinin (SBA) or Vicia villosa (VV) but not concanavalin A (ConA). Here we show that weakly metastatic Eb cells bind SBA via four glycoproteins and one GL2-like glycolipid. The major high-affinity SBA binding component of weakly metastatic ESb-MP cells was a glycoprotein of 210-220 kd. Highly metastatic ESb cells also expressed this protein but the oligosaccharide side chains were altered in such a way that SBA-binding was completely lost while ConA and peanut agglutinin (PNA) binding remained similar. Quantitative binding studies using iodinated lectins indicated that SBA binding of ESb cells could only be detected at lectin concentrations greater than 75 micrograms/ml. The role of altered carbohydrates in metastasis is discussed.

Animals↗

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Teicoplanin in the treatment of skin and soft tissue infections: results of a multicentre study.

The clinical efficacy and safety of teicoplanin was studied in hospitalized patients with skin and soft tissue infections. In an open multicentre study 64 patients were treated with teicoplanin i.v. and/or i.m. Predisposing or complicating factors for infection were present in almost 80% of the patients. Teicoplanin was usually given as an initial loading dose of 400 mg (87.1%), or 800 mg (6.5%) or various doses (6.5%). During the course of the study, the mean daily dose of teicoplanin was 261.3 mg. Sixty of the 62 evaluable patients responded to treatment. 58 gram-positive pathogens were isolated, consisting of Staphylococcus aureus (n = 41), coagulase-negative staphylococci (n = 6) and streptococci (n = 11). Elimination of pathogens was seen in 37/47 of all microbiologically evaluable cases. Persistence, recurrence or reinfection occurred in 7/47, 2/47 and 1/47, respectively. Adverse reactions were reported in only three patients with allergic reaction, local reaction and rise in transaminases in one case each. Therapy failed only in two patients.

Adolescent↗

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Treatment of severe sepsis in bone marrow transplant recipients with teicoplanin in combination with beta-lactams and aminoglycosides.

We evaluated teicoplanin for suspected gram-positive infections after inadequate response to initial empiric beta-lactam and aminoglycoside combination therapy. All 20 patients included in this study received either an allogeneic (8 patients) or an autologous (12 patients) bone marrow transplant for acute myeloid leucaemia (AML), non-Hodgkin's-lymphoma (NHL, high grade) or other malignant diseases. All patients developing primary septicaemia of unknown origin (18 patients) or catheter-related septicaemia (2 patients) were treated with 400 mg teicoplanin, administered i.v. once daily in combination with a cephalosporin and an aminoglycoside (ceftazidime 2 g i.v., t.i.d.; netilmicin 400 mg once daily). All patients responded to therapy, 19 patients were clinically cured and one patient improved under therapy. The therapeutic regimen was well tolerated; only one adverse drug reaction was observed. We did not observe any delayed take or prolonged neutropenia or thrombocytopenia with this therapeutic regimen when our patients were compared to other bone marrow transplant patients (who did not receive this antimicrobial therapy). Our results suggest that teicoplanin is a potentially effective and well tolerated antimicrobial agent in bone marrow transplant patients with infections not responding primarily to beta-lactams and aminoglycosides.

Adolescent↗

PubMedDate not supplied

Pharmacokinetics of teicoplanin in hemodialysis patients.

As only insufficient knowledge about the dosage of teicoplanin in hemodialysis patients exists, a clinical trial was performed on 26 patients. An initial dose of 800 mg teicoplanin, followed by doses of 400 mg on day 8 and day 15, was administered. In addition to the common clinical parameters (fever, white blood cell count, C-reactive protein), the plasma concentrations of this substance were determined. The HLTterm was 159 +/- 35 h, the Vss 104 +/- 25 1/100 kg and the CLtot 5.3 +/- 1.3 ml/min. It could be shown that the dosage regimen mentioned above produced long-lasting and highly effective levels, sufficiently surpassing the MICs of the expected bacteria (streptococci and staphylococci). The easily administered substance showed no adverse side effects, based on clinical criteria. The above-mentioned therapy nearly always resulted in success according to clinical criteria. Therefore, and due to its easy administration, it seems advantageous to start treatment with teicoplanin in hemodialysis patients obviously suffering from bacterial infections.

Aged↗

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A randomized clinical trial of ceftriaxone and teicoplanin versus ceftazidime and teicoplanin as antibiotic therapy in febrile neutropenic cancer patients and bone marrow transplant recipients.

A prospective, randomized clinical trial comparing combination therapy with ceftriaxone and teicoplanin versus ceftazidime and teicoplanin in the treatment of febrile episodes in neutropenic cancer patients and bone marrow transplant recipients was performed. One hundred and two patients were randomized, but two patients were considered unevaluable for efficacy, and three patients were withdrawn due to incorrect randomization. Of the remaining 97 patients, infection resolved without modification of therapy in 31/49 (63%) patients treated with ceftriaxone/teicoplanin versus 27/48 (56%) patients treated with ceftazidime/teicoplanin (P = 0.48). Of all 97 patients treated therapy was modified in 18/49 (36%) with ceftriaxone/teicoplanin and 21/48 (43%) with ceftazidime/teicoplanin. Nineteen patients treated with ceftriaxone/teicoplanin received netilmicin and 21 patients treated with ceftazidime/teicoplanin also received netilmicin according to the study design (escalation therapy). When netilmicin was added infection resolved in 78% of patients treated with ceftriaxone/teicoplanin versus 84% of those treated with ceftazidime/teicoplanin. It was concluded that combination therapy with ceftriaxone/teicoplanin is an alternative to combination therapy with ceftazidime/teicoplanin, and has the advantage of once daily administration.

Adolescent↗

PubMedDate not supplied

Generation of adhesive tumor variants: chromosomal changes, reduction in malignancy and increased expression of a distinct membrane glycoprotein.

Tumor cell variants which grow adherent to a plastic surface could be isolated in a reproducible way from the high metastatic tumor cell line ESb which grows in a suspension culture. This occurred when starting selection from the uncloned parental line as well as from a freshly derived non-adhesive subclone. The variants showed changes in their karyotype. These were quantitative (tetraploidization) and qualitative (single chromosome aberrations involving the chromosomes 12 and 17 and a marker MX-7). Phenotypic cell surface changes were documented in vitro by immunofluorescence using a monoclonal antibody (mAb 12-15) directed against a distinct plasma membrane glycoprotein of 60-69kD (gp 60-69). The expression of gp 60-69 increased with time of selection for adherence to plastic surface. The adherent cells showed in all cases a greatly reduced overall malignancy as seen by a prolonged survival time of respective tumor bearing animals compared with the suspension growing parental cells.

Animals↗

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The prognostic significance of moderate hyperamylasemia in the evaluation of the emergency department patient.

Hyperamylasemia of greater than five times the upper limit of the normal range (200 IU/L) is highly specific for the diagnosis of pancreatitis, but the meaning of lower values is unclear. The purpose of this study was to evaluate the prognostic significance of amylase values > 200 and < 1000 IU/L. A controlled historical cohort study was conducted to determine whether moderate hyperamylasemia is associated with an increased severity of outcome compared to patients with normal amylase values. Subjects met certain inclusion criteria and had a serum amylase of > 200 and < 1000 IU/L (normal < 200 IU/L). The case group consisted of 44 patients (medium serum amylase = 307.5 IU/L) and resembled the control group of 77 patients (median serum amylase = 117.5 IU/L) with regard to sex distribution and presenting complaint. However, the case group was older, was on more medications, and had a shorter duration of symptoms prior to the ED visit (< 72 h). Analysis of clinically important outcomes revealed that the groups were similar in terms of 6-month mortality, general admission rate, ICU admission rate, and rate of surgical intervention. The proportion of patients who had radiologically or endoscopically documented gastrointestinal pathology was also similar. The results demonstrate that patients with moderate hyperamylasemia (i.e. amylase < 1000 IU/L), notwithstanding the fact that they are older, are on more medications, and have more acute symptomatology, did not have a worse outcome than patients with the same complaints and normal amylases.

Amylases↗

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Percutaneous ureteral clipping: long-term results and complications.

PURPOSE: The authors present their experience with ureteral clipping in patients with urinary fistulas. MATERIALS AND METHODS: The authors retrospectively reviewed records from eight patients in whom 14 ureters were ligated with use of a percutaneously applied stainless steel clip as treatment for urinary fistulas. All patients were female and had undergone pelvic radiation for treatment of cervical carcinoma (n = 7) or endometrial carcinoma (n = 1). Permanent urinary diversion was via percutaneous nephrostomy, which required routine change, at which time recurrence of symptoms and ureteral leakage were determined. Duration of follow-up (patient survival) ranged from 2 weeks to 17 months (mean, 7.1 months). RESULTS: All patients had significant improvement in their symptoms, with seven patients achieving complete perineal dryness. Two patients had recurrence of perineal symptoms due to nephrostomy tube blockage, which was successfully managed by means of interventional techniques. CONCLUSIONS: The authors believe that ureteral clipping is a safe and effective technique in the management of ureteral fistulas due to pelvic neoplasm and its treatment, despite the short life expectancy of these patients.

Female↗

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Successful retrieval of unexpanded stainless-steel Greenfield filters: report of four cases.

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Catheterization, Peripheral↗

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[Characteristics of therapy of heart diseases in old age].

Cardiac insufficiency, coronary heart disease, and arrhythmia are not only more frequent in elderly patients, they are very often combined. By reason of cardiac morbidity and general morbidity as well as changed physiological and pathophysiological conditions, diagnosis of cardiac disease in elderly patients is more difficult. These conditions also apply to modifications in the therapy of cardiac diseases in advanced age. Especially pharmacodynamic and pharmacokinetic effects in advanced age combined with multimorbidity also account for the risk of interactions because of the simultaneous application of different pharmacological groups.

Aged↗

PubMedDate not supplied

[Occupational medicine aspects of cutaneous leishmaniasis].

Cutaneous Leishmaniasis as an Occupational Disease We report 2 cases of cutaneous leishmaniasis with special regard to its significance for occupational health. Preventive measures are discussed as well as the difficulties in clarifying the diagnosis and therapeutic possibilities.

Dermatitis, Occupational↗