Nutrient intake and digestion as influenced by wash water solids as a protein source for lambs fed orchardgrass hay

Two experiments were conducted with sheep fed orchardgrass hay plus one of four supplements to evaluate use of a cheese processing wash water solid (WWS) material as a protein supplement. In both trials, lambs were fed either a cornstarch control (0% WWS-N) or a protein supplement containing 25, 50 or 75% N from WWS (25, 50 or 75% WWS-N, respectively). The majority of the remaining protein was supplied by soybean meal (SBM). Trial 1 was a replicated 4 x 4 extra-period Latin square. Protein supplementation increased total tract NDF and N digestibilities (P less than .10) 13% and 29%, respectively, compared with the cornstarch control. Total tract N digestibility was depressed (P less than .10) when 75% WWS-N (71.5%) vs 25 or 50% WWS-N (75.9 and 75.9%, respectively) was fed. Total VFA were depressed (P less than .10) 6 and 9 h postfeeding in sheep fed 75% WWS-N compared with the control (78.3 and 74.6 mM vs 98.8 and 94.6 mM for 6 and 9 h, respectively). Two hours postfeeding, lambs fed control had lower (P less than .10) ruminal pH compared with lambs fed 25, 50 and 75% WWS-N (6.2 vs 6.4, 6.5 and 6.5, respectively). Ruminal ammonia concentrations were 5 to 10 mg/dl lower (P less than .10) at all times in control lambs. In Trial 2, a metabolism study, feeding 75% WWS-N resulted in lower N digestibility (P less than .10) than did feeding 25% and 50% WWS-N (47.2 vs 56.4 and 55.2%, respectively). Data suggest that up to 50% of the SBM-N in a protein supplement for wethers may be replaced by WWS-N without adversely altering nutrient digestibility, ruminal fermentation or N metabolism.

Postmortem serum protein binding and brain concentrations of antiepileptic drugs in autoptic specimens from 45 epileptic patients

The free fraction of antiepileptic drugs can, in certain diseases, be greatly increased in the serum. In order to study the significance of this increase for the concentration in the brain, the postmortem concentrations of phenytoin (PT), phenobarbital (PB), carbamazepine (CBZ), and its metabolite carbamazepine-10,11-epoxide (CE) in the serum (total and free), as well as in specimens of the frontal cortex of 45 epileptic patients who died from various causes, were determined. The postmortem free fractions were higher than reported in the literature and varied considerably from subject to subject. For PT the free fraction was 21.7% (median), for PB 68.0%, for CBZ 33.4%, and for its metabolite CE 53.6%. The values for a control group of 236 otherwise healthy epileptic patients were in agreement with those given in the literature, namely 10.4% for PT, 55.6% for PB, 20.9% for CBZ, and 42.5% for CE. Using a nonparametric correlation coefficient (Kendall T), the concentrations in the frontal cortex of the autopsied patients correlated with the postmortem free serum concentrations, especially for the substances with high protein binding (PT and CBZ), better (PT r = 0.88, PB r = 0.86, CBZ r = 0.87, CE r = 0.79) than with the total concentrations (PT r = 0.69, PB r = 0.80, CBZ r = 0.77, CE r = 0.77). The study indicates that in critically ill patients the determination of the free concentration in serum is indispensable. If treatment is orientated solely on the total concentration, unexpectedly high concentrations in the brain and hence possible intoxication of the patient in the critical or final state can result.

[The combination of penicillin G and ofloxacin: a response to the empirical treatment of community acquired pneumonia]

The aim of this study was to assess the clinical efficacy of a combination of penicillin G and ofloxacin in the treatment of community acquired pneumonia. Thirty eight patients (23 males, 15 females, mean age 62.8 years +/- 19.6) were included. They presented a CAP with the following criteria: fever, abnormal chest X-ray pattern. They received the combination of IV penicillin 12 x 10(6) U daily and IV ofloxacin 200 mg bid. After 48 hours of apyrexia, this treatment was followed by oral ofloxacin alone 200 mg bid. In six cases, the etiologic agent was identified: 2 S. pneumoniae, 1 Chlamydiae psittaci, 2 Staphylococcus aureus, 1 Mycoplasma. In 32 cases, the bacteriological investigation was negative. Five patients were excluded: 2 deaths due to heart failure, 3 alterations of treatment. Twenty eight patients recovered: apyrexia was obtained in 3.5 days. Penicillin G was prescribed for 7.5 days +/- 2.65, followed by ofloxacin alone for 11.43 +/- 3 days. Five patients were considered as clinical failures: 2 deaths due to extensive pneumonia, 3 recoveries after alteration of treatment. Side effects were rare: 1 confusion, 2 skin rashes. As a conclusion: penicillin G and ofloxacin in combination for the initial therapy of CAP, rapidly relayed by ofloxacin alone, permitted 84.3% of recovery in our patients.

Fluctuations of unbound and total phenytoin concentrations during the day in epileptic patients on valproic acid comedication

The influence of daily fluctuations in the concentration of valproic acid (VPA) on the unbound and total concentration of phenytoin (PT) was examined in a prospective study. The serum concentrations of 28 patients with epilepsy (group PT + VPA) who were treated with PT and concurrently with VPA and 15 patients (group PT) who were treated with PT but without VPA comedication were determined at 8.00, 11.00, 14.00, 17.00, and in part at 20.00 h. The results show that there are significantly greater fluctuations in the total PT concentration among patients on VPA than those not on VPA. The fluctuations in the total PT concentration during the day correlated with the fluctuations in the VPA concentration. On the other hand, the fluctuations in the concentrations of unbound PT of patients on VPA were comparable with those not on VPA. In the absence of VPA, the diurnal fluctuations of the total PT concentration correlated highly significantly with the fluctuations of the unbound PT concentration. This is not the case in patients on VPA. Our data are a further indication of the smaller significance of the total PT concentration as compared with the unbound PT concentration in the combined treatment of PT and VPA.

[3H]Harman labels selectively and with high affinity the active site of monoamine oxidase (EC 1.4.3.4) subtype A (MAO-A) in rat, marmoset, and pig

[3H]Harman was used in binding studies with CNS tissue of rat, pig, and marmoset and with visceral organs of the rat. In the mitochondrial fractions of the CNS of the 3 species [3H]harman binding exhibits the same pharmacological profile in displacement studies. A detailed analysis reveals a high specificity for MAO-A. Furthermore, we applied [3H]harman binding to quantify the MAO-A content in 6 CNS regions of each species as well as in 6 visceral organs of the rat.

Valproic acid-induced carbamazepine-10,11-epoxide toxicity in children and adolescents

The study of 14 children and adolescents shows that the addition of carbamazepine (CBZ) to a basic valproic acid (VPA) therapy can result in unexpectedly high concentrations of carbamazepine-10,11-epoxide (CE) in the serum (up to 13 micrograms/ml). These concentrations were associated with marked side effects, especially vomiting and tiredness. The concentrations of CBZ were within the therapeutic range. Very high CE concentrations can largely be avoided at the commencement of the CBZ treatment if the CBZ dose is slowly increased. But high CE concentrations (4-8 micrograms/ml) associated with side effects can also be reached in later stages during the build up of CBZ treatment and under steady state conditions. The determination of the CE concentration is important when VPA and CBZ are administered together, especially when side effects occur.

Identification of a cis-acting element controlling induction of early gene expression in Dictyostelium discoideum

Using a new promoter analysis transformation vector for Dictyostelium discoideum (PAV-CAT), we have defined cis-acting elements in the promoter of the cyclic AMP-induced early-expressed gene A11H2, which encodes an alpha-fucosidase-related protein (A. Müller-Taubenberger, M. Westphal, A. Noegel, and G. Gerisch, FEBS Lett. 246:185-192, 1989). Sequences responsible for developmentally regulated gene induction could be separated from the basal promoter that conferred low levels of transcriptional activity. By gel shift experiments, we present evidence that the cis-acting element is the target of a trans-acting factor that by itself is subject to developmental regulation.

Effects of dairy biomass protein on ruminal fermentation and site and extent of nutrient digestion by lambs

Twelve ruminally and abomasally cannulated lambs (27 +/- 1.16 kg) and 16 intact lambs (28 +/- 1.49 kg) were used in two trials to study the influence of dairy biomass (a cheese processing wash water sludge) as a protein source in medium-concentrate diets. In Trials 1 and 2, lambs were assigned to one of three concentrate diets containing 0, 10 or 20% biomass with an additional positive control diet in Trial 2. Biomass provided 27.4 and 52.7% of the CP in 10 and 20% biomass treatments, respectively. Diets were similar in N content and were fed at 3.5% of initial BW (as fed). Apparent ruminal OM and N digestibilities were lower (P less than .10) in lambs receiving 20% biomass than in lambs fed 0 or 10% biomass. Postruminal N digestibility was higher (P less than .10) for lambs fed 20% biomass. Apparent OM and N digestibilities in both trials were reduced (P less than .10) in lambs fed 20% biomass. Apparent OM and N digestibilities in both trials were reduced (P less than .10) in lambs receiving 10% biomass compared to lambs fed other treatments. Plasma urea N concentration (mg/dl) was higher (P less than .10) at 3 and 9 h after feeding in lambs receiving 10 and 20% biomass compared with control lambs. Although N retention was unchanged, fecal N excretion was higher (P less than .10) and urinary N excretion was lower (P less than .10) in lambs consuming 10 and 20% biomass treatments. Non-ammonia N and feed N flow (g/d) were higher (P less than .10) in abomasal contents of lambs consuming 20% biomass vs other dietary treatments but N digestibility was decreased. In conclusion, digestibility was decreased and site of N digestion was altered by feeding biomass.

Amodiaquine-induced agranulocytosis: report of a case with in vitro studies of granulocyte-macrophage progenitor cells

We report a case of amodiaquine-induced agranulocytosis in a 60-year-old woman. Four months after the agranulocytosis episode we investigated the effect of the drug using in vitro agar culture techniques. Amodiaquine at increasing concentrations (0.005, 0.05 and 0.5 microgram/ml) displayed an inhibitory effect, probably dose-dependent, on the growth of the patient's bone marrow GM-CFU colonies in the absence of autologous serum. In contrast, no effect was found on the colony and cluster growth of bone marrow samples from 13 healthy controls. Though it has been shown in several cases that amodiaquine-induced agranulocytosis occurs via immune-mediated mechanisms, our data are in support of a direct toxic effect of the drug on abnormally sensitive myeloid progenitor cells.

Toxicity of HPA-23 (ammonium-21-tungsto-9-antimoniate) for normal human myeloid progenitor cells (GM-CFU) in vitro

HPA-23 is a competitive inhibitor of the RNA-dependent DNA polymerase (reverse transcriptase) of the human immunodeficiency virus (HIV). It may therefore potentially benefit patients with HIV infection. This study aimed at defining the haematopoietic toxicity of this drug and particularly its effects on the normal human granulocyte-macrophage progenitor cells (GM-CFU). Our in vitro studies, in semi-solid agar, have shown an inhibitory effect of increasing concentrations of HPA-23 on colony and cluster formation. This effect is probably dose-dependent. An almost complete inhibition of colony formation was observed at doses of more than 20 micrograms/ml. Regarding cluster formation, a similar although much more progressive inhibitory effect was found. Our experimental data should be extrapolated with caution to clinical situations. However, they must be kept in mind for optimal design of HPA-23 therapy in HIV infected patients.

Fluctuations of carbamazepine concentrations during the day for two slow-release preparations

Fluctuations in the carbamazepine (CBZ) concentration during the day were studied using the profiles of 88 patients on slow release CBZ preparations. Blood was taken at 800, 1100, 1400, 1700, 2000, 2200 and 800 hr of the following day. The CBZ dosage was divided into two equal doses and administered at 800 and 2000 h. The influence of different factors on the fluctuations in the CBZ concentration during the day was studied. The fluctuation correlated negatively (r = -0.51, p less than 0.001) with the level-dose ratio LDR (CBZ morning concentration-CBZ dose per body weight ratio). The co-medication and preparation had no additional significant influence on fluctuations in the CBZ concentration during the day. The maximal CBZ serum concentration during the day can be described for most patients as a function of the CBZ morning concentration and the level-dose ratio using a suitable regression equation (r = 0.93, standard error of estimate = 1.2 mg/L).

LFA1 expression in HIV infection

The expression of the adhesion molecule LFA1 was investigated in mononuclear cells from 200 samples of peripheral blood obtained from asymptomatic HIV-infected individuals and AIDS patients. The numbers and percentages of LFAI-positive cells were established by indirect immunofluorescence. A significant decrease in the number of labelled cells was observed (mean percentage 68.9) while 100% of the cells were positive in controls. These data suggest that LFA1-mediated cell-cell cooperation might be impaired in HIV infection, adding to the immune deficiency related to the disappearance of CD4+ cells.

Serum concentrations of carbamazepine and its epoxide and diol metabolites in epileptic patients: the influence of dose and comedication

The influence of carbamazepine (CBZ) dose, CBZ preparation used, comedication (phenobarbital, phenytoin, primidone, valproate), and factors such as age, weight, and sex on the concentration of CBZ and its metabolites carbamazepine-10,11-epoxide (CBZ-epoxide) and 10,11-dihydro-10,11-dihydroxy-carbamazepine (CBZ-diol) in serum was investigated. A non-linear regression analysis using the data of 609 patients shows that other anti-epileptic drugs can influence the metabolism of CBZ in various ways. The mean serum concentration of CBZ is lower when the drug is given in combination with phenytoin (59.4%), primidone (58.2%), phenobarbital (65.7%), and valproate (83.0%) than when CBZ is given alone (100%), whereas the mean concentration of CBZ-epoxide is increased by valproate (144.8%), by primidone (118.5%), and by a combination of the latter (167.4%). The CBZ-diol concentrations are also increased during concomitant treatment with the other antiepileptic drugs. Our results indicate a nonlinear relationship between the CBZ dose and the CBZ concentration, but a linear relationship between the CBZ dose and the CBZ-diol concentration.

Influence of sarsaponin on growth, feed and nitrogen utilization in growing male rats fed diets with added urea or protein

Two experiments were conducted with growing male rats to determine the effects of 120 ppm of dietary sarsaponin (S) on nitrogen (N) metabolism when urea or protein are added to the diet. Growth, feed efficiency, N digestibility and balance, urinary N and ammonia-N (NH3-N), and cecal urease and NH3-N were measured. Growth and feed utilization were unaffected by dietary S. Adding urea or protein to the diet increased apparent N digestibility and increased urinary-N excretion. Urea did not affect N balance, whereas growth, feed utilization and N balance were maximized with 22% compared with either 16 or 28% dietary protein. Urinary NH3-N excretion was decreased by S when urea was added to the diet but was not affected when fed with increasing dietary protein. Cecal urease was decreased by S when urea was added or when the protein level was increased in the diet; effects on cecal NH3-N varied between the two experiments. Plasma urea-N was decreased by S. It is concluded that S has minor effects on N metabolism in rats and that NH3-N formation or excretion is only marginally affected by dietary S. If S decreases NH3-N level in confinement facilities, it is concluded that the effect is after the waste material is excreted by the animal, perhaps through reduced urease activity.

[Treatment of post-traumatic and post-neurosurgical bacterial meningitis with ceftriaxone alone or in combination with fosfomycin]

From 1984 to 1986, 13 patients (10 adults, 3 children) with bacterial meningitis following neurosurgery or traumatism were given ceftriaxone alone 6 times at a dose of 40 mg/kg one IV injection per day, or in association 7 times with fosfomycin at a dose of 200 mg/kg/day, 3 IV perfusions every 4 h. The bacteriological diagnosis was confirmed in 9 cases (3 Staphylococcus aureus, 4 Streptococcus pneumoniae, 1 Klebsiella, 1 Peptococcus). In vitro neither synergy nor antagonism were observed between the two antimicrobial agents. The acute infections episode resolved in all patients except on who died with a negative CSF culture. One superinfection meningitis with Achromobacter was seen. CSF concentrations of ceftriaxone were assayed and found to be comparable with those reported by most authors. Tolerance was excellent for all our patients.

Acquired immunodeficiency syndrome after travelling in Africa: an epidemiological study in seventeen Caucasian patients

Seventeen Caucasian patients with acquired immunodeficiency syndrome (AIDS) contracted after long stays in Africa are reported. Central Africa was concerned in all cases. Men are particularly exposed to AIDS whatever their occupation. This study suggests that the risk of contracting AIDS in Africa is high; the transmission of the virus was related to sexual contact, particularly with prostitutes, in Africa in most of the cases. It suggests also that Caucasians who travel in Africa spread the virus throughout the world by means of their heterosexual relations.

[Indications for piperacillin in pediatrics]

The clinical activity of piperacillin was evaluated in 34 children (mean age: 8 years) presenting with severe infection (septicaemia, meningitis, bronchopneumonia, pyelonephritis). A bacteriological diagnosis was established in 24 cases. The mean duration of treatment was 11 days, and the mean dose 220 mg/kg/day administered in three injections. In 25 cases piperacillin was combined with another antibiotic, usually an aminoglycoside (20 cases). Clinical cure or improvement was obtained in 29 children (85%). Treatment was well tolerated, with only 2 cases of moderate blood eosinophilia. In view of these results the authors suggest that piperacillin could be used in children in two circumstances: severe infections caused by Gram-negative cocci or bacilli in children with cystic fibrosis or neutropenia, and against infections contracted in intensive care units, or in children with febrile leucopenia, combined with an aminoglycoside in the absence of, or pending bacteriological results.

[Clinical evaluation of timentin in intensive care]

16 patients admitted to a MICU were treated with timentin (ticarcillin + clavulanic acid) for bacterial infections: 11 cases of pulmonary infection, 3 cases of urinary tract infection, 2 septic shocks, 3 septicemias and 1 case of multifocal infection. The pathogens considered as a firmly established cause of infection were: 5 Acinetobacter, 12 Pseudomonas, 3 Serratia, 4 Klebsiella, 1 E. coli, 2 Proteus, 1 Providencia, 1 Staphylococcus aureus, 1 Staphylococcus epidermidis, 1 Streptococcus D and 1 Flavobacterium meningosepticum. The susceptibility of these pathogens to ticarcillin and timentin is reported. Timentin was prescribed alone in 9 cases and associated (with an aminoglycoside) in 7, in a daily dose of 9 to 18 g, for 6 to 45 days. 3 patients died. The value of timentin in infections due to multiresistant MICU pathogens is stressed.