The effects of frequent follow-up on compliance in patients receiving PAP therapy due to OSA

OBJECTIVE

We planned to investigate the effect of close monitoring on compliance and the factors affecting compliance among patients receiving positive airway pressure (PAP) treatment due to obstructive sleep apnea (OSA).

PATIENTS AND METHODS

This study was a single-center, prospective, randomized, controlled study. Between January 2022 and May 2022, 192 patients who were 18 years of age or older, had been newly diagnosed with OSA, and underwent PAP titration at our sleep laboratory were included in the study.

RESULTS

One hundred twenty-eight patients were randomized as group 1 (study group) and group 2 (control group). There was no correlation between good continuous positive airway pressure (CPAP) compliance and diabetes mellitus, hypertension, hyperthyroidism, or allergic rhinitis. However, there was a statistically significant correlation between good CPAP compliance and chronic obstructive pulmonary disease (COPD) or asthma.

CONCLUSIONS

Sleeping with such a device will be very difficult and uncomfortable. As observed from previous studies, adherence to CPAP is a critical problem worldwide regardless of geography, education, age, and sex. Telemedicine monitoring may be a good follow-up tool. Nevertheless, the essential tool is interpersonal communication by phone calls, face-to-face computer communication, or frequent visits.

Long-term Results of ABI in Children With Severe Inner Ear Malformations

OBJECTIVE

To report the long-term outcomes of children who received auditory brainstem implant (ABI) because of severe inner ear malformations.

STUDY DESIGN

Retrospective chart review.

SETTING

Tertiary referral otolaryngology clinic.

SUBJECTS AND METHODS

Between July 2006 and October 2014, 60 children received ABI at Hacettepe University. Preoperative work up included otolaryngologic examination, audiological assessment, radiological evaluation together with assessment of language development and psychological status. The surgeries were performed via retrosigmoid approach with a pediatric neurosurgeon. Intraoperatively, electrical auditory brainstem response was utilized. Initial stimulation was done 4 to 5 weeks postoperatively. Outcomes were evaluated with Categories of Auditory Performance (CAP), speech intelligibility rate (SIR), functional auditory performance of cochlear implant (FAPCI) and Manchester Spoken Language Development Scale scores; receptive and expressive language ages were determined.

RESULTS

Sixty children who received ABI were between ages of 12 and 64 months. Thirty-five patients with follow up period of at least 1 year, were reported in means of long-term audiological and language results. The most prevelant inner ear malformation was cochlear hypoplasia (n = 19). No major complication was encountered. Majority of the patients were in CAP 5 category, which implies that they can understand common phrases without lip reading. SIR was found out to be better with improving hearing thresholds. Children with ABI were performing worse than average cochlear implantation (CI) users when FAPCI scores were compared. Patients with the best hearing thresholds have expressive vocabulary of 50 to 200 words when evaluated with Manchester Spoken Language Development Scale. There was no relationship between the number of active electrodes and hearing thresholds. The type of inner ear anomaly with the best and the worst hearing thresholds were common cavity and cochlear aperture aplasia, respectively. Patients with additional handicaps had worse outcomes. Among 35 children, 29 had closed set discrimination and 12 developed open set discrimination above 50%. It was determined that, progress of the patients is faster in the initial 2 years when compared with further use of ABI.

CONCLUSION

ABI is an acceptable and effective treatment modality for pediatric population with severe inner ear malformations. Bilateral stimulation together with CI and contralateral ABI should be utilized in suitable cases.

Sudden hearing loss: an effectivity comparison of intratympanic and systemic steroid treatments

Corticosteroid treatment has been considered the most effective treatment modality for sudden sensorineural hearing loss so far. Application route of corticosteroids may vary. We have designed a prospective randomized case-controlled clinical trial to evaluate the effectivenesses of the different application routes of steroids in the treatment of SSHL. Thirty-five patients were distributed randomly to two groups which were treated with either 'oral' or 'intratympanic' corticosteroids. Intratympanic steroid administration was performed three times every other day transtympanically. At the end of third month, recovery rate in the 'intratympanic' group was 84.2%, whereas in the 'oral' group, it was 87.5%. The difference between the recovery rates was not statistically significant. There were no major complications related to transtympanic steroid administration. These findings support that intratympanic steroid therapy is an alternative to systemic steroid therapy in the initial treatment of sudden hearing loss. In addition, transtympanic technique is an easy to perform and safe method for delivering steroids into the inner ear.

Prognostic Factors in Sudden Sensorineural Hearing Loss

BACKGROUND

Sudden sensorineural hearing loss (SSNHL) is still a complex and challenging process which requires clinical evidence regarding its etiology, treatment and prognostic factors. Therefore, determination of prognostic factors might aid in the selection of proper treatment modality.

AIMS

The aim of this study is to analyze whether there is correlation between SSNHL outcomes and (1) systemic steroid therapy, (2) time gap between onset of symptoms and initiation of therapy and (3) audiological pattern of hearing loss.

STUDY DESIGN

Retrospective chart review.

METHODS

Patients diagnosed at our clinic with SSNHL between May 2005 and December 2011 were reviewed. A detailed history of demographic features, side of hearing loss, previous SSNHL and/or ear surgery, recent upper respiratory tract infection, season of admission, duration of symptoms before admission and the presence of co-morbid diseases was obtained. Radiological and audiological evaluations were recorded and treatment protocol was assessed to determine whether systemic steroids were administered or not. Treatment started ≤5 days was regarded as "early" and >5 days as "delayed". Initial audiological configurations were grouped as "upward sloping", "downward sloping", "flat" and "profound" hearing loss. Significant recovery was defined as thresholds improved to the same level with the unaffected ear or improved ≥30 dB on average. Slight recovery was hearing improvement between 10-30dB on average. Hearing recovery less than 10 dB was accepted as unchanged.

RESULTS

Among the 181 patients who met the inclusion criteria, systemic steroid was administered to 122 patients (67.4%), whereas 59 (32.6%) patients did not have steroids. It was found that steroid administration did not have any statistically significant effect in either recovered or unchanged hearing groups. Early treatment was achieved in 105 patients (58%) and 76 patients (42%) had delayed treatment. Recovery rates were no different in these two groups; however, when unchanged hearing rates were compared, it was statistically significantly lower in the early treatment group (p<0.05). When hearing outcomes were compared according to initial audiological pattern, significant recovery and unchanged hearing rates did not differ between groups; however, slight recovery rate was highest in the "flat" type audiological configuration (p<0.05).

CONCLUSION

According to this patient series, oral steroid therapy does not have any influence on the outcomes of SSNHL. However, mid-frequency hearing loss of flat type and initiation of treatment earlier than 5 days from the onset of symptoms, seem to have positive prognostic effects. Further randomized controlled subject groups might contribute to determine prognostic factors of SSNHL.

Balance after stapedotomy: analysis of balance with computerized dynamic posturography

OBJECTIVES

The aim of this study was to investigate vestibular symptoms and their effect on the balance in otosclerosis patients undergoing stapedotomy operations.

DESIGN & SETTING

Prospective study at an academic tertiary referral centre.

PARTICIPANTS

Thirty-three patients undergoing stapedotomy were included in the study.

MAIN OUTCOME MEASURES

Sensory organisation test (SOT) protocol of computerized dynamic posturography was used to analyse the balance in patients preoperatively, in the first postoperative week and the first postoperative month. Postoperative vestibular symptoms were analysed with a grading system. Audiograms were obtained preoperatively and 1 month after the operation.

RESULTS

Preoperatively, all patients were asymptomatic when considering the vestibular system; however, eight of them got low SOT scores on vestibular examination. Postoperatively 82% of the patients had vestibular complaints in variable severity. In the first week, all but one patient become asymptomatic. This patient recovered by the end of postoperative second week. However, a significant drop in SOT scores was encountered at the first week testing (Student's T-test, P = 0.001). One month after the operation, all patients were asymptomatic and SOT scores recovered at least to preoperative level. Neither patient characteristics, nor audiological findings were found to be correlated with vestibular changes.

CONCLUSION

Stapedotomy causes a temporary balance loss in a high percentage of patients which then recover to their former levels in the first postoperative month.

Use of homograft dehydrated temporal fascia in tympanoplasty

OBJECTIVE

To investigate the results of myringoplasty operations using homograft dehydrated fascia temporalis (Tutoplast) and compare these with those performed with autograft fascia temporalis.

STUDY DESIGN

Prospective cohort.

SETTING

University hospital.

PATIENTS

Forty-three adult patients (> or =18 years of age) with central, dry perforations of pars tensa with intact ossicular chains.

INTERVENTION

Tympanoplasty with an endaural approach and underlay technique was performed. Homograft dehydrated temporal fascia was used in 22 patients, and autograft was used in the remaining 21 patients.

MAIN OUTCOME MEASURES

Preoperative and postoperative air-bone gap and speech reception threshold levels and postoperative compliance values of the homograft and autograft groups were compared.

RESULTS

Postoperative perforations were encountered in two patients (9.1%) from the homograft group and three patients (14.2%) from the allograft group. Significant postoperative improvements in air-bone gap and speech reception threshold values were detected for both groups (p < 0.05). Although the mean compliance of the tympanic membranes was significantly lower in the homograft group, no statistically significant difference was observed between groups when the postoperative air-bone gap and speech reception threshold values were compared.

CONCLUSION

Homograft temporal fascia can be used in tympanoplasty with the same success rate of autograft temporal fascia without impeding hearing. Its main advantages are the reduction in the duration of surgery and the length of preauricular and postauricular incisions. However, the advantages of the dehydrated homograft temporal fascia should be weighed against its cost and risk of transmission of viral and prion-mediated diseases.

Necrotizing sialometaplasia of parotid gland: a possible vasculitic cause

Necrotizing sialometaplasia at the parotid gland location is rare and simulates malignant disease. If it is seen at this location, the causes may be previous dental or parotid gland surgical procedures, which result in blood vessel injuries and thrombosis. We report a parotid gland necrotizing sialometaplasia of a 17-year-old girl, possibly caused by primary vascular damage or vasculitis.

Prognostic value of CD44 variant 6 in laryngeal epidermoid carcinomas

BACKGROUND

CD44 variant exon 6 (v6) belongs to a family of transmembrane glycoproteins involved in cell adhesion.

OBJECTIVES

To determine the prognostic role of CD44v6 in laryngeal cancer and to examine its relation with other clinicopathologic prognostic factors.

DESIGN

A retrospective cohort study was designed with 93 laryngeal cancer cases. They were selected randomly from patients treated with laryngectomy between January 1, 1983, and December 31, 1993.

SETTING

Faculty of Medicine, Hacettepe University, Ankara, Turkey.

PATIENTS

The ages of the patients ranged from 31 to 73 years. Eighty-eight patients were men and 5 were women. Three had stage I, 33 had stage II, 27 had stage III, and 30 had stage IV disease at the time of surgery.

INTERVENTION

Histological sections of tumors and metastatic lymph nodes were reevaluated for several histopathological factors. Sections were stained using anti-CD44v6 monoclonal antibody by immunohistochemical methods.

RESULTS

CD44v6 expression was seen only in the lower one third of the normal squamous epithelium but in all layers of dysplasia and in situ carcinoma. Besides a general evaluation of tumor staining, immunostaining was evaluated separately for cell groups located in the center of neoplastic islands (nonbasal cells), at the periphery of the neoplastic islands (basal cells), and at the infiltration zones (marginal cells). Decreased disease-free survival was noted when there was extensive staining in the general evaluation and in cases with extensive staining in marginal and nonbasal cells (P =.03). Using Cox regression analysis, the greatest dimension of the largest metastatic lymph node and extensive expression of CD44v6 in nonbasal tumor cells were independent prognostic factors.

CONCLUSION

Our results suggest that CD44v6 expression is an important prognostic factor in laryngeal cancer.

4-aryl-6,6-dimethyl-1,2,3,4,5,6,7,8-octahydroquinazoline-2,5-diones: synthesis, chromatographic resolution and pharmacological activity

In this study, a series of 4-aryl-6,6-dimethyl-1,2,3,4,5,6,7,8- octahydroquinazoline-2,5-diones were synthesized by condensing urea with 4,4-dimethyl-1,3-cyclohexanedione and appropriate aromatic aldehydes according to the Biginelli reaction. The structures of the compounds were characterized by spectroscopic methods. The racemic compounds were resolved into the enantiomers by HPLC on amylose tris(3,5-dimethylphenylcarbamate) (Chiralpak AD). The compounds were tested in vitro for their calcium antagonistic activities. BaCl2-induced contractions of rat ileum were inhibited dose-dependently. Compounds 3 and 5 exerted weak calcium antagonistic activity on smooth muscles compared with the standard, nicardipine.

The value of elective neck dissection in treatment of cancer of the tongue

PURPOSE

The "adequate" therapy of tongue cancer has not yet been determined. The authors report their experience with 58 N(0) patients to elucidate the role of elective neck dissection in surgical treatment of cancer of the tongue.

MATERIALS AND METHODS

The files of 58 N(0) patients with tongue cancer were evaluated retrospectively. In every patient, partial glossectomy continuous with neck dissection was the mainstay of the treatment. TNM staging, intraoperative N staging, pathologically confirmed cervical lymph node metastases and their levels, and clinical outcomes (local and regional recurrences) were recorded. The sensitivity and specificity of intraoperative staging was determined.

RESULTS

Fifty-four percent (31/58) of the patients presented as T(1), and 26% (15/58) as T(2). The overall occult metastasis rate was 29.3% (17/58). The occult metastasis rate for T(1) and T(2) lesions was 19.4% (6/31) and 26.7% (4/15), respectively. The sensitivity of intraoperative staging was 76.5%, and the specificity was 51.2%.

CONCLUSIONS

The rate of occult metastasis to the neck is too high in all tongue cancer cases to take the risk of regional recurrence, and the surgeon can not solely depend on neck palpation for determination of neck metastasis. Radiologic investigations and fine-needle aspiration decrease, but never reduce to zero the rate of false-negative examination. There is an obvious indication for neck dissection, even in early cases.

Studies on synthesis, chromatographic resolution, and antiinflammatory activities of some 2-thioxo-1,2,3,4-tetrahydropyrimidines and their condensed derivatives

In this study, the synthesis of some new 2-thioxo-1,2,3,4-tetrahydropyrimidines and their condensed derivatives, thiazolo[3,2-a]pyrimidines, are described. The structures of the compounds were confirmed by 1R, 1H-NMR, 13C-NMR, and mass spectroscopy. The direct high-performance liquid chromatographic separation of the compounds on derivatized cellulose chiral stationary phases such as cellulose tris(3,5-dimethylphenylcarbamate) (OD), cellulose tris(4-methylphenylcarbamate) (OG), and cellulose tris(4-methylbenzoate) (OJ) was studied. All of the compounds were screened for their antiinflammatory activity and also investigated histopathologically. Compounds 3 and 1a were found to be the most promising antiinflammatory agents in this group.

Melanotic neuroectodermal tumor of infancy: report of two cases and review of literature

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare, distinctive neoplasm containing melanin; it primarily affects the maxilla of the infants during the first year of life. Approximately 150 instances of this tumor are reported in the medical literature. Genesis of the tumor is obscure and the diagnosis is challenging for the pathologist. Two cases operated by the first author are presented, and the diagnostic features and treatment alternatives of MNTI discussed.

Enantioseparation of 3,4-dihydroxyphenylalanine and 2-hydrazino-2-methyl-3-(3,4-dihydroxyphenyl)propanoic acid by capillary electrophoresis using cyclodextrins

The enantiomeric separations of 3,4-dihydroxyphenylalanine (dopa) and 2-hydrazino-2-methyl-3-(3,4-dihydroxyphenyl)propanoic acid (carbidopa) by capillary electrophoresis were studied using several native, neutral and anionic cyclodextrins as chiral additives and uncoated fused-silica capillaries. The effect of the type and concentration of the cyclodextrin added to 20 mM phosphate buffer (pH 2.5) on enantioseparation and migration times was studied. A high resolution value of 15.63 was obtained for dopa enantiomers with a buffer containing 20 mM single isomer, heptakis(2,3-diacetyl-6-sulfato)-beta-cyclodextrin. The enantiomers of carbidopa were separated using 20 mM carboxymethyl-beta-cyclodextrin as a chiral resolving agent. Both methods allowed the determination of 0.1% of the D-enantiomer (second migrating) in the presence of the L-enantiomer (first migrating) of dopa and carbidopa with a good precision. These methods also gave good results in terms of precision for both peak area, migration time, linearity and accuracy.

Prognostic significance of PCNA expression in laryngeal cancer

OBJECTIVE

To assess the prognostic value of proliferating cell nuclear antigen (PCNA) in laryngeal carcinoma and its relation with other known prognostic clinicopathologic variables.

DESIGN

A retrospective cohort study of 92 patients chosen randomly from patients treated between 1964 and 1993 with the diagnosis of laryngeal cancer. Prognostic factors including PCNA expression, grade, lymphovascular invasion, depth of tumor margins, neck metastasis, and clinical outcome were evaluated.

SETTING

Hacettepe University Medical Faculty, Ankara, Turkey.

PATIENTS

Eighty-five men and 7 women operated on for squamous cell carcinoma of the larynx were studied. Sixty-nine patients had total and 20 patients had partial laryngectomy with neck dissection, and 3 patients had endolaryngeal tumor excision.

INTERVENTION

Hematoxylin and eosin-stained sections were reevaluated for grade, lymphovascular invasion, and depth of tumor margins; sections stained with monoclonal antibody against PC10 were examined for PCNA expression.

RESULTS

The PCNA index correlated with grade, lymphovascular invasion, depth of tumor margins, neck metastasis, and local-regional recurrence. The PCNA index values of patients with occult metastasis were significantly higher than those of patients without metastasis (P=.006).

CONCLUSIONS

The PCNA index is a more sensitive variable than grade in predicting tumor proliferation, occult lymph node metastasis, and prognosis. These results suggest that the PCNA index can be used in decision making for treatment and assessment of prognosis in laryngeal carcinomas.

Synthesis, chemical and pharmacological properties of some 4-aryl-1,2,3,4,5,6,7,8-octahydroquinazoline-2,5-diones

A series of 4-aryl-1,2,3,4,5,6,7,8-octahydroquinazoline-2,5-diones were synthesized by condensing urea with 1,3-cyclohexanedione and appropriate aromatic aldehydes according to the Biginelli reaction. The structures of the compounds were confirmed by elementary and spectroscopic analysis. The compounds synthesized were tested in vitro for their calcium antagonistic activities. BaCl2-induced contractions of rat ileum were inhibited dose-dependently. Compounds 3-8 exerted weak calcium antagonistic activity on smooth muscles compared with the standard nicardipine.

4-aryl-5-oxo-1,2,3,4,5,6,7,8-octahydroquinazoline-2-thione derivatives: synthesis, enantiomeric separation and in vitro screening as calcium antagonists

Fourteen new 4-aryl-5-oxo-1,2,3,4,5,6,7,8-octahydroquinazoline-2-thione derivatives were synthesized and screened in vitro for their calcium antagonistic activities. The compounds were prepared by reacting 1,3-cyclo-hexanedione with appropriate aromatic aldehydes and thiourea under modified Biginelli reaction conditions. The structures of the compounds were proved by IR, 1H-NMR, mass spectroscopy and elemental analysis. The compounds synthesized exerted calcium antagonistic action on smooth musculature by inhibiting BaCl2-induced contractions of isolated rat ileum. It was found that compound 12l having 3-methoxyphenyl group at the 4th position was the most potent compound in this series (pEC50: 4.00 +/- 0.20). Rasemic compound 12l was resolved into its enantiomers by high performance liquid chromatography (HPLC) using a commercially available cellulose tris(p-methylbenzoate) chiral stationary phase, known as Chiralcel OJ. The enantiomeric ratio was validated and peak identification for each enantiomer was established according to their optical rotation sign.

Determination of copper, chromium, manganese and zinc by graphite furnace atomic absorption spectrometry after separation on polyacrylamide modified with nitrilo triacetic acid

A new chelating collector, polyacrylamide modified with nitrilo triacetic acid (NTA) was developed for the separation and preconcentration of copper, chromium, manganese, and zinc prior to their determination by Graphite Furnace Atomic Absorption Spectrometry (GFAAS). The retention and recovery of the analyte elements were investigated by applying batch and column techniques. Cu(II), Cr(III), Mn(II) and Zn(II) were quantitatively retained by the collector at pH 5.5 or above. The chelating kinetics are so fast that in the batch procedure a quantitative separation of the analyte elements can be achieved in a few seconds. Since a very short contact time is enough to retain the analyte elements in column technique, a separation step can be completed quickly by applying fast flow rates in small columns. The elements collected were completely recovered with 2 mol/l of HCl. In the presence of sodium chloride up to 0.5% the analyte elements were quantitatively separated and recovered. Low blank values of the collector is another important advantage.

Synthesis and biological evaluations of some 2-thioxo-1,2,3,4-tetrahydropyrimidine derivatives

Several 1,2,3,4-tetrahydro-6-methyl-4-(substituted phenyl)-2-thioxo-5-pyrimidinecarboxylic acid methyl esters were synthesized by condensing thiourea with methyl acetoacetate and substituted benzaldehydes according to Biginelli reaction. The structures of the compounds were confirmed by spectral and elemental analysis and their calcium antagonistic activities were investigated. Furthermore, the compounds synthesized in previous and present studies were evaluated for their antiaggregating activities.

Synthesis and antimicrobial activities of some new tetrahydro-2H-1,3,5-thiadiazine-2-thione derivatives of cefadroxil

Eleven new 7-[2-(dihydro-5-substituted-6-thioxo-2H-1,3,5-thiadiazine-3( 4H)-yl)-2- (4-hydroxyphenyl)acetamido]-3-methyl-3-cephem-4-carboxylic acid derivatives were synthesized by the reaction of cefadroxil monohydrate, formaldehyde and substituted potassium dithiocarbamate. Their structures have been elucidated by spectral data and elementary analysis. The title compounds were tested for antimicrobial activity in vitro against gram-positive bacteria (Staphylococcus aureus, Streptococcus faecalis), gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa) and yeast-like fungi (Candida albicans, C. parapsilosis, C. stellatoidea, C. pseudotropicalis) in comparison with cefadroxil monohydrate. The activity of compounds 1 and 10 against S. aureus (MBC: 37.5 micrograms/ml) and compound 1 against E. coli (MBC: 75 micrograms/ml) were found to be the same as cefadroxil monohydrate. Compounds 1 and 10 were more effective than cefadroxil monohydrate against S. faecalis with 25 and 37.5 micrograms/ml MBC values, respectively. None of the compounds and cefadroxil monohydrate proved to be effective against P. aeruginosa (MBC: greater than 100 micrograms/ml). While cefadroxil monohydrate had no activity against yeast-like fungi, compounds 9 and 10 were significantly effective against yeast-like fungi (MFC: 37.5 micrograms/ml).

Synthesis and calcium antagonistic activity of some new 2-thioxo-1,2,3,4-tetrahydropyrimidine derivatives

A series of 1,2,3,4-tetrahydro-6-methyl-4-(substituted phenyl)-2-thioxo-5-pyrimidinecarboxylic acid methyl esters were synthesized by condensing thiourea with methyl acetoacetate and nonsubstituted or differently substituted benzaldehydes in absol. ethanol using HCl as a catalyst according to the Biginelli reaction. The structures of the compounds were confirmed by elemental and spectroscopic analysis. -The compounds were evaluated for their calcium antagonistic activity on the basis of their potency in inhibiting [3H] PN 200-110 binding on microsomes obtained from rat skeletal muscle.

Synthesis and antimicrobial activities of some new tetrahydro-2H-1,3,5-thiadiazine-2-thione derivatives of amoxicillin

A number of 6-[2-(dihydro-5-substituted-6-thioxo-2H-1,3,5-thiadiazine-3( 4H)-yl)-2-(4-hydroxyphenyl)acetamido]penicillanic acids has been synthesized as prodrugs by incorporating the amine group of amoxicillin trihydrate into tetrahydro-2H-1,3,5-thiadiazine-2-thione ring. The compounds have been prepared by the reaction of various alkyl or aralkyl amines with potassium hydroxide, carbon disulfide, formaldehyde and amoxicillin trihydrate. The structures of the compounds have been elucidated by UV, IR, 1H-NMR spectra and elementary analysis. The in vitro activity of these compounds against gram-positive bacteria (Staphylococcus aureus, Streptococcus faecalis), gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa) and yeast-like fungi (Candida albicans, C. parapsilosis, C. stellatoidea, C. pseudotropicalis) was investigated by the tube dilution method and compared with the activity of amoxicillin trihydrate. By this way their minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC) and minimal fungicidal concentration (MFC) values were determined. Compound I and Compound VII were significantly more effective than amoxicillin trihydrate against S. aureus (MBC: 6.25 micrograms/ml). Compound VI and Compound XI were effective against S. faecalis (MBC: 6.25 micrograms/ml) and Compound I and Compound VI were effective against E. coli (MBC: 12.5 micrograms/ml). All of the compounds and amoxicillin trihydrate were ineffective against P. aeruginosa (MIC: greater than 100 micrograms/ml). Compound IX and Compound X were the most active derivatives against yeast-like fungi; the MFC values for these compounds ranged between 6.25 and 37.5 micrograms/ml.