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Biomedical subjects

L Gutmann

Publications and source records attributed to L Gutmann.

At least 181 records · Page 10Linked to original sources
PubMed1989

Internalized myofiber capillaries: observations on their origin and clinical features.

Internalized capillaries limited to type 1 muscle fibers were noted in seven patients. They occurred in each case in association with a similar admixture of neurogenic and myopathic features that included atrophic and hypertrophic fibers, internal nuclei, fiber splitting, and endomyseal and perimyseal fibrosis. Internalized capillaries in enlarged type 1 fibers arose from fiber splits on step section study of four patients. They occurred in the gastrocnemius, quadriceps, and soleus muscles from patients with a variety of disorders that included Becker dystrophy, diabetes mellitus and strenuous leg activities, Achilles tendon rupture, and myotonic dystrophy. Exercise-induced myalgias were noted in the four patients with the most plentiful intramuscular capillaries, and in three of these muscle hypertrophy was present. The concurrence of internalized myofiber capillaries and exercise-induced myalgias may represent an associated biochemical/pathological defect.

Adolescent↗
PubMed1989

In vitro activity of combinations of beta-lactam antibiotics with beta-lactamase inhibitors against cephalosporinase-producing bacteria.

Combinations of different beta-lactam antibiotics, including cefotaxime, with three beta-lactamase inhibitors were tested against cephalosporinase producing bacterial strains. The most significant antagonism was obtained with a combination of clavulanic acid and cefotaxime, while almost no antagonism was observed with sulbactam and tazobactam. In strains belonging to five different species there was a correlation between the levels of cephalosporinase produced after exposure to different concentrations of inhibitors and the MICs of cefotaxime combined with the same concentrations of inhibitors. It is concluded that there is little likelihood of antagonism between beta-lactam antibiotics and sulbactam or tazobactam.

Anti-Bacterial Agents↗
PubMed1989

Pharmacokinetics of amoxycillin/clavulanic acid in serum and ascitic fluid in cirrhotic patients.

A combination of amoxycillin and clavulanic acid (Augmentin) might be useful for first-line treatment of spontaneous bacterial peritonitis in patients with cirrhosis. We have studied the pharmacokinetics of amoxycillin/clavulanic acid in serum and ascitic fluid of six cirrhotic patients. A total of 66 simultaneous serum and ascitic samples were analysed. Following iv injection of 1 g amoxycillin plus 0.2 g clavulanic acid, the ascites to serum AUC ratio was 1.38 for amoxycillin and 1.01 for clavulanic acid, indicating a good distribution of these drugs into the ascitic fluid. In this study, experimental data were fitted to a three compartment body model which revealed that the prolonged serum half-lives of amoxycillin (274 min) and clavulanic acid (200 min) were probably due to the slow return from the ascitic compartment.

Adult↗
PubMed1989

Tigemonam activity against clinical isolates of Enterobacteriaceae and Enterobacteriaceae with known mechanisms of resistance to beta-lactam antibiotics.

Tigemonam, a new oral monobactam, was at least as active as aztreonam or carumonam against clinical isolates of Enterobacteriaceae (MIC90:0.06-16 mg/l). Tigemonam was very stable in the presence of classical plasmid mediated beta-lactamases but its MICs were increased (4-256 mg/l) in the presence of new broad-spectrum plasmid mediated beta-lactamases (either TEM of SHV derivatives). Increased MICs (0.25-8 mg/l) were also observed for different isogenic mutants of Enterobacteriaceae, which either produced high levels of chromosome-encoded cephalosporinases, or had a permeability defect.

Anti-Bacterial Agents↗
PubMed1989

Antibacterial activity of meropenem against gram-negative bacteria with a permeability defect and against staphylococci.

Meropenem, like imipenem, showed a good affinity for high molecular weight PBPs of Escherichia coli and Pseudomonas aeruginosa and had a better affinity for PBP3 than imipenem. Meropenem, like imipenem, also remained almost fully active against permeability mutants of enterobacteria lacking in confirmed or putative porins. This good permeation of the carbapenems may relate to their zwitterionic character. In-vitro, mutants and clinical isolates of P. aeruginosa, for which the MIC of imipenem was greater than or equal to 4 mg/l, were always more sensitive to meropenem. Methicillin resistant staphylococci were sensitive neither to imipenem nor to meropenem.

Bacterial Proteins↗
PubMed1989

SHV-5, a novel SHV-type beta-lactamase that hydrolyzes broad-spectrum cephalosporins and monobactams.

SHV-5 (pI 8.2), a novel broad-spectrum beta-lactamase encoded by a ca. 150-kilobase plasmid, was found in Klebsiella pneumoniae 160. SHV-5 beta-lactamase caused decreased susceptibility to most penicillins, cephalosporins, and monobactams, except imipenem and compounds which have a C6 or C7 alpha-methoxy substituent. beta-Lactamase inhibitors (clavulanic acid, sulbactam, and tazobactam) inhibited its activity and showed a synergistic effect when associated with different hydrolyzable beta-lactam compounds. Hybridization studies suggested that this enzyme may be related to, or derived from, the SHV enzyme. Increased MICs of cephamycins and temocillin associated with a decreased synergistic effect of the inhibitors on K. pneumoniae 160 might be linked to a decrease in two outer membrane proteins.

Anti-Bacterial Agents↗
PubMed1989

Childhood onset inclusion body myositis mimicking limb-girdle muscular dystrophy.

Inclusion body myositis was initially recognized in patients with "steroid-resistant polymyositis" and subsequently in patients with other immune-mediated disorders. The finding of inclusion body myositis in a patient diagnosed for 30 years as having limb-girdle muscular dystrophy suggests yet another patient pool that may harbor this entity.

Adult↗
PubMed1989

End-plate dysfunction in acute organophosphate intoxication.

Acute organophosphate intoxication resulting from suicide attempts in 14 patients produced a series of electrophysiologic abnormalities that correlated with the clinical course. Spontaneous repetitive firing of single evoked compound muscle action potentials (CMAP) was the earliest and most sensitive indicator of the acetylcholinesterase inhibition. A decrement of evoked CMAP following repetitive nerve stimulation was the most severe abnormality. At the height of the intoxication no CMAP was evoked after the first few stimuli. The decrement-increment phenomenon occurred only at milder stages of intoxication and its features are characteristic of acetylcholinesterase inhibition. These electrophysiologic features proved to be the most useful for determining initial severity and clinical course of the acute organophosphate intoxication and differentiated this syndrome from those of myasthenia gravis, Eaton-Lambert syndrome, and botulism.

Adult↗
PubMed1989

[The decrement-increment phenomenon in disorders of neuromuscular transmission by inhibition of acetylcholinesterase].

Repetitive stimulation of the median nerve elicited a so far unknown course of the muscle action potentials in four patients with organophosphate intoxications. The amplitude of the initial muscle action potential decreased with the second stimulus and gradually increased to normal values by subsequent stimuli. With the second stimulus a loss of the repetitive muscle action potentials occurred. The Decrement-increment phenomenon was seen in early and/or late stages of severe intoxications when fasciculations were prominent. We suppose that the repetitive muscle action potential following the first stimulus results from backfiring. The second orthodromic nerve action potential collides with this antidromic activity leading to a partial extinction. Loss of backfiring with the second stimulus abolishes the phenomenon of collision and enables a recovery of the muscle action potential amplitudes.

Cholinesterase Inhibitors↗
PubMed1989

The incidence of beta-lactamase-producing pathogens.

In addition to the bacteria which naturally are able to enzymatically inactive penicillins and/or cephalosporins, a large number of species may develop this ability through mutation, acquisition of plasmids, or insertion of transposons. Characterization of the beta-lactamase activity of various pathogens has shown that a wide variety of enzymes exists and that new ones continue to evolve. The distribution of the genes for the numerous beta-lactamases vary according to geographic location and pathogen. Recently beta-lactamase inhibitors (sulbactam and clavulanic acid) have become available which, in combination with different beta-lactam antibiotics, expand the activity of those hydrolyzable antibiotics to pathogens producing beta-lactamases. The epidemiology of resistant pathogens and of the beta-lactamase genes that make them resistant are important factors in evaluating the role of these beta-lactam/beta-lactamase inhibitor combinations.

Anti-Bacterial Agents↗
PubMed1989

Guillain-Barre syndrome. Another immune-mediated disease with a predilection for young women?

Although the epidemiology of Guillain-Barre syndrome (GBS) has been studied extensively, some important aspects remain unrecognized. In a retrospective study of 92 patients with GBS, we identified an apparent increased frequency in young women, an epidemiological feature shared with other immune-mediated neurological diseases such as myasthenia gravis and multiple sclerosis.

Adolescent↗
PubMed1988

[Importance of antibiotic combinations with ceftazidime and usefulness in the prevention of resistance].

Different antibiotics can be used in combinations to extend the antibacterial spectrum, to obtain a synergistic bactericidal effect or to prevent bacterial resistance. Ceftazidime may be combined with other antibiotic to extend its spectrum to Staphylococci and Enterococci, or even anaerobes. A synergistic effect is mainly obtained with aminoglycosides. To prevent the emergence of resistant strains, ceftazidime may be combined with aminoglycosides and the new quinolones.

Aminoglycosides↗
PubMed1988

Prospective nerve conduction studies in cisplatin therapy.

We studied nerve conduction prospectively in 38 women receiving cisplatin for gynecological malignancies. Decreased sensory nerve action potential amplitudes and prolonged sensory latencies were the only significant changes identified. This prospective electrophysiological study validates the clinical observation of frequent sensory symptoms and occasional sensory neuropathies associated with cisplatin therapy.

Action Potentials↗