No abstract

We report on 50 totally colectomised children, most of whom suffered from Hirschsprung's disease. Of the 50, one child died postoperatively of enteritis. On an average, the children were re-examined 5 1/2 years after the colectomy. The findings were as follows: With the exception of four, the size and weight of the patients were within the norm; 20 passed frequent stools of pulpy consistency; 16 suffered from disturbances of continence; 14 developed severe, partially recurrent enteritis. We did not find any advantage of a single method of operation, e.g. Martin's operation.

We analysed enoxacin concentrations in plasma, saliva, bronchial secretions, bronchoalveolar lavage fluid, and alveolar macrophages in nine patients five hours after the last dose (400 mg enoxacin b.i.d. per os for at least three days). The enoxacin levels in the alveolar film were extrapolated from the lavage content by using urea as an internal marker (lavage dilution factor = plasma/lavage urea concentration ratio). The concentration in the alveolar film amounted to 7.62 mg/l ( = 381% of the plasma value), on average, and exceeded the minimal inhibitory concentrations of the pathogens isolated from the patients. Thus, enoxacin is effectively concentrated in the surface film of the lung which represents an important barrier against pulmonary infections.

48 children who underwent high ligature of the internal spermatic vein for varicocele were re-examined. In one patient (2,1%) a hydrocele appeared postoperatively. In 30 boys (62,5%) the varicocele disappeared completely following surgery, in 18 patients (37,5%) the varicocele persisted which was in 9 boys only palpable and in another 9 boys clearly visible. High spermatic vein ligature according to Bernardi turned out to be a method providing good postoperative results and with few complications in childhood. In the case of persisting varicocele collateral veins should be considered and ligated in a second operation.

The in vitro activity of enoxacin was tested in 14 German microbiological centers shortly after the introduction of the drug in Germany. 2748 unselected clinical isolates including 15 bacterial species were analysed using microtiter plates. The MIC90-values were as follows: Staphylococcus aureus 4 mg/l, Enterococcus faecalis 16 mg/l, Enterobacteriaceae 0.5 mg/l, Pseudomonas aeruginosa 8 mg/l. There is good correlation between these results and those of former investigations. It is known that quinolones are only moderately active against enterococci. 8.5% of S. aureus, and 1.4% of Enterobacteriaceae were found to be resistant (MIC greater than 4 mg/l). As to P. aeruginosa, the study revealed that despite a generally low rate of resistance in specific clinical settings, specific problems can arise: in one institution, the MIC90 of P. aeruginosa was 32 mg/l, with a resistance rate of 56.1% (n = 57). In the other centers the MIC90 was 2 mg/l and the resistance rate 5.0% (n = 302). In the first center, many of the isolates were from paraplegic patients or patients with cystic fibrosis pretreated with quinolones. This study will be repeated in two years' time in order to determine an eventual change in resistance.