[Clinical studies of cefoxitin for the treatment of respiratory tract infections (author's transl)]

A total of 42 patients who were suffering from respiratory tract infections were treated with cefoxitin, and the following results were obtained. 1. Out of 32 patients clinically evaluated, excellent or good responses were observed in 30 patients (94%). 2. Presumed causative organisms were isolated in 14 patients. The organisms were eradicated in 11 patients and the eradication rate was 79% (11/14). The number of the organisms decreased or unchanged in 1 patient each. In other 1 patient the pathogenic agent was replaced with other agents during the course of treatment. 3. As for the side effects, skin eruption was observed in 3 patients. One patient received drugs other than cefoxitin concomitantly that might have caused the eruption. Another patient had an allergic history to many antibiotics. In 4 patients slight elevations of S-GOT and S-GPT were observed but improved soon after the completion of cefoxitin treatment. In 1 patient an elevation of serum creatinine was observed but this was not attributed to the administration of cefoxitin. 4. From the results stated above, cefoxitin is considered to be a safe and effective antibiotic which can be one of the first-choice antibiotics for the treatment of respiratory tract infections.

Aminoglycoside antibiotics. XIV. Synthesis and activity of 6-O-(3-amino-3-deoxy-alpha-D-glucopyranosyl)-and 5-O-(beta-D-ribofuranosyl)apramycins

6-O-(3-Amino-3-deoxy-alpha-d-glucopyranosyl)apramycin (17) was prepared by glycosidation of a suitably blocked 5,6-dihydroxy derivative (11) of apramycin with a blocked 3-aminoglucosyl chloride (15). Ribosylation of the 5-hydroxy-6-O-tetrahydropyranyl (THP) derivative (19) of apramycin gave 5-O-(beta-d-ribofuranosyl)apramycin (24) along with the 6 alpha (25) and 6 beta (26) isomers. Similar reaction with the 6-hydroxy-5-O-THP derivative (20) or 11 gave only 25 and 26, but not 24. 17 was at least as active as apramycin against most Gram-positive and Gram-negative bacteria tested and more active than apramycin against most Gram-positive and Gram-negative bacteria tested and more active than apramycin against strains producing aminoglycoside-modifying enzymes. Strains of Pseudomonas aeruginosa were generally less sensitive to 17 than to apramycin. 24 was the most active of the three ribofuranosyl derivatives prepared though it was less active than 17.

Glysperin, a new antibiotic complex of bacterial origin. II. Structures of glysperins A, B and C

Structures of glysperins A, B and C were determined on the basis of chemical degradation studies in conjunction with spectroscopic analyses. Glysperin A consisted of L-alanine, p-hydroxybenzoic acid, a C11-alkyl tetramine and four sugar moieties, three of which were identified as D-ribose, D-galactose and 2,4-diamino-2,4,6-trideoxy-D-galactose. The fourth sugar was a novel exoenose, 6-deoxy-D-xylo-hex-5-enose. Structural difference between glysperins A and B resided solely in the terminal polyamine moiety which was spermidine in glysperin B. Glysperin C contained D-glucose in place of the exoenohexose moiety of glysperin A. Glysperins A, B and C are, in some respects, structurally related to the glycocinnamoylspermidine antibiotics, LL-BM 123 beta, gamma 1 and gamma 2.

Successful pregnancy in a patient undergoing chronic hemodialysis

A 29-year-old woman who had been undergoing regular hemodialysis for 4 years became pregnant, and a male infant weighing 1320 g was delivered by cesarean section. The infant has grown uneventfully and shows no abnormalities at present. This is the first case in Japan and the eighth reported case to date (1979) in which a patient undergoing chronic hemodialysis became pregnant and was delivered of a live infant.

Case histories of neonates with congenital heart disease

The rate of extracardiac malformation (ECM) associated with congenital heart disease (CHD) is high in neonates. 108 cases of 212 neonates with CHD had ECM (50.9%). Main ECMs were digestive system anomalies (36.1%), chromosomal aberrations (26.8%), respiratory system anomalies (21.3%), CNS anomalies (13.0%), and other (2.7%). Single lesion of left to right shunt accounted for 77.2% (61/79) of CHD with ECM from other than chromosomal aberrations. The prognosis of neonates with CHD without ECM was also studied. Total anomalous pulmonary venous connection, pure pulmonary atresia (PPA), pulmonary stenosis (PS), hypoplastic left heart syndrome are not generally associated with ECM, but the prognosis is poor. Coarctation complex which is sometimes associated with ECM has a poor prognosis in neonates. There is an increase of the survival rate in the patients with hypoxemia, such as PPA or severe PS, extreme tetralogy of Fallot, and tricuspid atresia, which can be managed with prostaglandin E1. PDA associated with respiratory distress syndrome is ideally treated with indomethacin. In recent years, mortality from PDA has decreased in neonates. The mortality rate during the neonatal period was 46.8% (51/109): 37.5% (30/80) died before surgical interventions and 72.4% (21/29) died during or after surgery. Half of neonatal deaths from CHD occurred within 3 days of admission. Thus, early detection, early diagnosis, and early treatment of neonates with CHD is most important.

BBM-928, a new antitumor antibiotic complex. III. Structure determination of BBM-928 A, B and C

Structures of antitumor antibiotics BBM-928 A, B and C have been determined. They are cyclic decadepsipeptides containing 3-hydroxy-6-methoxyquinaldic acid as a chromophore. Two amino acids, not found in nature, L-beta-hydroxyl-N-methylvaline and trans-(3S,4S)-4-hydroxy-2,3,4,5-tetrahydropyridazine-3-carboxylic acid, were identified as structural constituents of the antibiotic. In gross structure, BBM-928 resembles the echinomycin group of antibiotics which are cyclic octadepsipeptides having a quinoxaline chromophore, but BBM-928 differs from the latter group by virtue of the lack of a sulfur-containing cross linkage.

Bu-2313, a new antibiotic complex active against anaerobes. II. Structure determination of Bu-2313 A and B

The structures of Bu-2313 A and B have been determined. They are dienoyltetramic acid-containing antibiotics structurally related to streptolydigin and tirandamycin.

Bu-2313, a new antibiotic complex active against anaerobes. III. Semi-synthesis of Bu-2313 A and B, and their analogs

Analogs of Bu-2313 A and B were prepared by C-acylation of tetramic acid derivatives with the dienoic acid moiety obtained by periodate oxidation of Bu-2313 A or B. The C-acylation proceeded in the presence of a strong base such as potassium t-butoxide, sodium hydride or lithium hydride, whereas the use of triethylamine afforded O-acylated products. The semi-synthetic Bu-2313 analogs exhibited antibacterial spectra similar to the parent antibiotic but none exceeded Bu-2313 B in activity.