Biomedical subjects
Publications and source records attributed to H C Korting.
Amiodarone is one of the most effective antiarrhythmic and anti-anginose drugs. A rare but typical side-effect with an incidence of 1:100 is sunburn, and of 1:1,000 a black-violet to slaty pigmentation of the sun-exposed skin areas. According to histochemical and ultrastructural findings the skin pigment deposits are considered to be lipofuscin.
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The use of transport media has proved valuable in many fields of clinical bacteriology, and so has become quite common. However, this does not apply to the examination of stool in the search for Salmonella carriers. To evaluate its potential efficiency a commercial transport medium, the PortACul, has been tested parallel to the conventional glass tube in 315 cases. The greater detection rate even though not significant makes further examination important.
Lately, reports about bensylpenicillin-resistant meningococci have been made in Germany which ensued the presentation of results regarding MIC determinations of 82 strains freshly isolated from carriers. The geometric mean of all MIC values amounts to 0.026 mu/ml which value never exceeds 0.06 mu/ml which is why further spreading of benzylpenicillin-resistant meningococci does not appear to be likely as yet.
In the high-dose benzylpenicillin treatment of subacute bacterial endocarditis leucopenia can develop in rare cases. Often it is paralleled by anemia, sometimes also by a decrease in the number of platelets. Myalgia, gastric discomfort, or a sore threat deserve interest as premonitory symptoms. In every case this treatment inevitably needs through hematologic control.
Under the treatment with ampicillin or oxacillin resp. hematologic changes turn up very rarely except for eosinophilia, in addition it is only granulocytes or platelets alone which are involved in the cases yet published. In the case presented here therapy by an ampicillin/Oxacillin combination induces bone marrow depression with peripheral pancytopenia on a toxic or allergic base.
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Explore the source record for details and available documents.
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The addition of an anti-infective to a topical glucocorticoid preparation for superinfected atopic eczema is still controversial. To address this question in the context of the topical glucocorticoids of the non-halogenated double-ester type 0.25% prednicarbate cream was compared to the identical preparation incorporating the same amount of the disinfectant didecyldimethylammoniumchloride in patients suffering from atopic eczema carrying Staphylococcus aureus at a density of more than 10(6) colony-forming units per cm2. One of the preparations was used twice daily over 5 days according to a random plan in a blind fashion. Thereafter treatment was based on either prednicarbate cream or the corresponding vehicle according to clinical needs. Clinical and microbiological evaluation were scheduled for days 0, 6 and 34. Various clinical parameters were addressed individually as well as over all improvement using scores. A total of 143 patients was recruited. The patients of both groups improved rapidly with respect to clinical and microbiological findings. Essentially, there was no difference between the groups. Hence, the addition of an anti-infective to a topical prednicarbate preparation is not to be generally recommended.
Historically it has been assumed that the pharmacological effect is related to the free drug concentration. In exposing Candida albicans to itraconazole and ketoconazole serum concentration-time profiles, however, antifungal activity was not diminished despite intense albumin binding. The relevance of serum protein binding was further investigated, by in vitro susceptibility testing of C. albicans (40 clinical isolates) and Trichophyton rubrum (ten strains) against antifungal agents using microdilution tests allowing the determination of IC30- and MIC-values. The range of serum protein binding ranges from 11% with fluconazole to > 99% with itraconazole and terbinafine. The ratios of IC30- and MIC-values with and without serum protein (albumin, alpha- and gamma-globulin, human plasma) were related to the loss of susceptibility expected according to the free-drug hypothesis. A difference in the albumin effect with the test strains was not observed. With most antifungals including terbinafine, the activity declined as expected. IC30- and MIC-ratios for miconazole were 7 and 13 (observed) vs. 12-20 (expected), for fluconazole 1.5 and 3.5 vs. 1.1, for amphotericin B 10 vs. 11-20, for griseofulvin 3.6 vs. 4, and for terbinafine 61 vs. 100. Itraconazole activity, however, was not diminished by albumin (expected ratio 286), and ketoconazole effects decreased less than expected (ratio 5-15, expected about 100). alpha-globulin, but not gamma-globulin induced a major loss in anti-Candida activity of itraconazole and ketoconazole, which is paralleled by a decline in ketoconazole (but not itraconazole) activity due to plasma. With the other antifungals (except for ciclopiroxolamine) IC30-values for C. albicans increased, too. Due to the complete inhibition of T. rubrum growth by gamma-globulin, this species proved unsuitable for studying the gamma-globulin effects. The present study demonstrates that the effects of intense protein binding on drug activity are only partly predictable from binding studies in vitro.
The role of regular skin cleansing with soap or syndet in pre-acne is ill-defined. The intention of this study was to assess the relative value of an acidic syndet bar and a conventional soap bar in the prevention of acne lesions in acne-prone patients. In a randomized, open, comparative trial the three months' application of either an acidic syndet bar or a conventional soap to facial skin for 1 min each in the morning and in the evening was compared in 120 adolescents and young adults with inflammatory acne grade I or II according to the Plewig and Kligman classification. It was a confirmatory trial with the number of inflammatory lesions being the prime parameter of concern. In addition, non-inflammatory acne lesions were analyzed as were parameters of safety such as itching, redness and scaling. While the number of inflammatory acne lesions, i.e., papulopustules, did not differ in the two trial groups composed of 57 evaluable cases each, this was the case from 4 weeks of application onward: in the group using soap the mean number of inflammatory lesions increased from 14.6 (+/- 5.3) to 15.3 (+/- 6.0), while it decreased in the other group from 13.4 (+/- 5.2) to 10.4 (+/- 5.8) (p < 0.0001). Symptoms or signs of irritation were seen in 40.4% of individuals belonging to the former and 1.8% belonging to the latter group. The number of papulopustules characteristic of inflammatory acne thus is clearly lower when a syndet bar of the acidic type is regularly used for cleansing the face as compared to a (necessarily alkaline) soap.(ABSTRACT TRUNCATED AT 250 WORDS)
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The determination of the in vitro activity of antimycotics against dermatophytes has for long been considered as irrelevant from a practical point of view. Recently, however, this approach has been questioned. Various different tests such as agar diffusion test, agar dilution test and broth dilution test can be used for the determination of minimum inhibitory concentrations with dermatophytes. A close correlation between in vitro data and clinical outcome could especially be demonstrated for the micro dilution test. In future, the antimycogram of a dermatophyte isolated from an individual patient should gain more and more importance for the selection of the drug to be used and its dosage.
The quantitative determination of Malassezia furfur on normal human skin has been considered as difficult until recently. During the last years, however, several different media have been described which facilitate the quantification of M. furfur. As the efficacy of these media is still controversial, three different media were compared analyzing the chest and back of 20 healthy young adult volunteers. The highest counts of colony-forming units (CFU) per cm2 were found using a medium containing whole fat cow's milk as a major ingredient. At the chest the mean count read was 259, at the back 322. The corresponding figures related to other media were markedly lower (P less than 0.001). Hence, the use of the milk-containing medium for cultivation of M. furfur seems advisable for therapeutic trials.
The case of a young suckling is reported in whom widespread candidosis of the napkin area was followed by the clinical signs of both erythema multiforme and dermatitis seborrhoides infantum. Both these diseased states are considered as candidids.