A 3-month-old boy presented with a tail associated with lipomeningocele. Computed tomography and magnetic resonance imaging clearly demonstrated the presence of spina bifida and lipoma continuous from the tail to the thickened conus medullaris. The human tail may be related to spinal dysraphism and requires detailed neuroimaging investigation, and possibly microsurgery to prevent the tethered cord syndrome.
The Gm(1), Gm(2), Gm(5) and Inv(1) allotypes and Gc groups among Chinese and mountain aborigines in Taiwan and Ryukyuans have been determined. In China, the cline of Gm and Gc gene frequencies has been demonstrated; the frequency of Gm1,5 allele decreases from south to north and Gm1,2 and Gc2 alleles and Inv(1) phenotypes increase from south to north. Mountain aborigines are characterized by higher frequency of Gm1,5 and lower frequency of Gc2. There is a difference between Okinawa and Miyako islanders in the frequencies of Gm alleles.
The pharmacokinetics of cefotaxime and ampicillin in the cerebrospinal fluid (CSF) were studied by a HPLC method after administering each of the antibiotics singly or as a mixture to rabbits with experimental meningitis caused by Staphylococcus aureus. The half-lives of cefotaxime and desacetyl-cefotaxime in the serum and of ampicillin in the CSF were found to be significantly shorter in the mixture group than in the respective single administration groups. No other statistically significant differences were observed between the mixture and single administration groups with respect to the maximum concentrations (Cmax) of the antibiotics in the serum and the CSF, to the relative percentage of the Cmax of each antibiotic in the CSF to the Cmax in the serum, and to the relative percentage of the AUC of each antibiotic in the CSF to that in the serum. These results differ from earlier findings that the concentration of ampicillin in the CSF of rabbits was significantly lower in animals concomitantly dosed with latamoxef (moxalactam) and ampicillin than in a group dosed only with ampicillin.
Meningitis was induced in white rabbits with a non beta-lactamase producing strain of Staphylococcus aureus. There was no significant difference in the CSF level of ceftazidime after simultaneous administration of ceftazidime with ampicillin or after ceftazidime alone. In contrast the percentage CSF penetration of ampicillin decreased from 8.81% after administration of ampicillin alone to 2.77% after the simultaneous administration of ampicillin with ceftazidime. The ratio of AUC in CSF and serum was 19.4% after ampicillin alone and 7.71% after simultaneous administration with ceftazidime. When ceftriaxone was combined with ampicillin there was no effect on the CSF penetration of either drug. Cephalosporins have unpredictable effects on the CSF concentration of ampicillin, probably due to variable effects on the penetration of ampicillin from blood to CSF.
Concentrations of cefuzoname in cerebrospinal fluid (CSF) were determined in a total of 16 rabbits, 5 with healthy meninges, 5 with Staphylococcus aureus meningitis, and 6 with Escherichia coli meningitis. Mean percentages of the maximum concentration of the drug in CSF versus that in serum were 0.57, 3.37, and 4.40% for healthy rabbits, those with staphylococcal meningitis, and those with E. coli meningitis, respectively. The percentages of the area under the concentration-time curve of cefuzoname in CSF versus that in serum were, in the order of healthy group, staphylococcal meningitis group, and E. coli meningitis group, 0.61, 4.99, and 8.04% at 15 to 60 min, 1.44, 7.09, and 12.7% at 15 to 120 min, and 1.87, 8.07, and 15.8% at 15 to 180 min after administration, showing significant differences between the healthy and meningitis groups. All of the values in the E. coli meningitis group were greater than those of the staphylococcal meningitis group, but the differences were not significant. The ratios of the half-life of cefuzoname in CSF to that in serum were 2.10, 1.98, and 3.37 for the healthy, staphylococcal meningitis, and E. coli meningitis groups, respectively, with no significant difference between the three groups. Cefuzoname seems to be among the middle ranks of P-lactam agents as far as penetration rate is concerned; however, when its potent antibacterial activity and broad spectrum are taken into account, the concentrations in CSF in patients with meningitis seem worth examining.Cefuzoname (L-105) is a new, injectable cephalosporin developed by Lederle (Japan) Ltd. The compound has a wide antibacterial spectrum covering most aerobic and anaerobic gram-positive and gram-negative bacteria. The activity of cefuzoname is similar to that of cefazolin against staphylococci and to those of broad-spectrum cephems against gram-negative bacteria (M. Hikida, M. Inoue, and S. Mitsuhashi, Program Abstr. 24th Intersci. Conf. Antimicrob. Agents Chemother., abstr. no. 733, 1984).In view of the antibacterial potency of cefuzoname, it was thought that the compound might be effective in the therapy of purulent meningitis if it showed good penetration into Staphylococcal meningitis was induced by a method reported previously (11). S. aureus FDA 209 P was cultured in brain heart infusion overnight, and a 5-ml portion of the culture was inoculated into 100 ml of brain heart infusion and then shake cultured for 3 h. The culture was centrifuged, and the resultant precipitates were washed three times by suspending them in physiological saline and centrifuging them. The final washed cells were resuspended in the physiological saline to an optical density of 0.7 at 550 nm. The viable cell count of this suspension was approximately 108/ml, and no decrease in the viable cell count was observed during a 3-month period while the suspension was stored at -20°C. A
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