The problem of capability for antibody formation in juvenile acute leukemia]

A report is presented on the quantitative behaviour of immunoglobulins G, A and M in 105 children with acute lymphatic leukaemia. Those 24 cases with a "total" hypoimmunoglobulinaemia referring to all three main classes are particularly analysed. Initially hyperplastic forms of leukaemia had primarily lower Ig-levels and a considerably worse prognosis.     

Linezolid for the treatment of nosocomial infections after cardiac surgery]

Clinical and bacteriological efficacy of linezolid in the treatment of cardiosurgical patients with various localization nosocomial infections due to problem grampositive cocci was estimated. The group included 10 patients: children at the age 3 months to 12 years (n = 3) and adults at the age of 17 to 65 years (n = 7) with infectious complications such as infectious endocarditis (n = 4), pneumonia (n = 2), wound infection (n = 3) and sepsis (n = 1). All the patients isolated MR staphylococci. The use of glycopeptides was not possible in 6 patients because of vancomycin intolerance (n = 1), renal insufficiency (n = 1) and failure of the previous vancomycin therapy (n = 4). To all the patients linezolid was administered per os (tablets or suspension) or intravenously (infusion solution) in doses of 600 mg twice a day (1200 mg a day) for the adults and 10 mg/kg body weight every 12 hours (20 mg/kg body weight a day) for the children. Linezolid monotherapy was applied to 2 patients. 8 patients were treated with linezolid in combination with some other antibiotics. By the clinical findings the positive dynamics confirmed by thermometry and hemograms was observed in 8 patients beginning from the 4th day of the linezolid use. Eradication of MR staphylococci from the blood, sputum and wounds was stated in all 10 patients. No toxic or adverse reactions were noted. It was concluded that linezolid is an optimal alternative to vancomycin especially when the use of the latter is not possible. No nephrotoxic effects of linezolid provided its recommendation as a drug of choice in the treatment of patients with renal disturbances, including polyorganic insufficiency.     

Ciprofloxacin in the prevention and treatment of surgical infections]

A clinico-laboratory study on ciprofloxacin made by Bayer (Germany) was applied to patients with extended posttraumatic wounds and performed with the aim of preventing postoperative purulent complications in patients operated on the organs of the gastrointestinal tract. In the both groups ciprofloxacin was administered orally in doses of 500 and 1000 mg and intravenously in a dose of 200 mg. The results of the assay on ciprofloxacin sensitivity of the isolates from the wound excretion and urine showed that they were more sensitive to ciprofloxacin than to aminoglycosides and cephalosporins. 15 minutes after the intravenous administration the serum concentration of ciprofloxacin amounted to 7.5 +/- 0.9 micrograms/ml and in 6 hours it was equal to 0.45 +/- 0.45 micrograms/ml, the mean concentrations of ciprofloxacin being attained in the bile (8.7 +/- +/- 3.9 micrograms/ml), gallbladder wall (5.5 +/- 3.8 micrograms/g), liver (0.73 micrograms/g), muscles (1.93 micrograms/g) and tendon (0.15 microgram/g). After the oral administration in a dose of 500 mg ciprofloxacin was detected in the blood serum in an amount of 2.0 +/- 0.7 micrograms/ml in 1 hour and in an amount of 0.9 +/- 0.13 micrograms/ml in 6 hours. After the drug oral administration in a dose of 1000 mg the maximum concentrations were: 6.34 +/- 4.2 micrograms/ml on the average and 2.1 +/- 0.8 micrograms/ml in 6 hours (0.4 micrograms/g in the muscles, 1.4 micrograms/g in the skin and 0.34 micrograms/g in the bones). The study showed that ciprofloxacin was a highly efficient antimicrobial agent in the treatment of the complicated wound infections and the prophylaxis of the purulent complications during the postoperative period in the patients operated on gastrointestinal organs.     

Sparfloxacin (Sparflo) in the treatment of urological infections]

Sparfloxacin efficacy evaluation for the treatment of urogenital tract infections is presented. The trial was performed on 43 patients with chronic complicated infections of urogenital tract (pyelonephritis, prostatitis). Sparfloxacin (once daily for 7-14 days) was highly effective in the infection management according to clinical and bacteriological results (83.7 per cent and 78.1 per cent subsequently).     

The use of the cell separator in the treatment of leukemia]

In order to provide leukemic patients during the critical granulocytopenic stage with a sufficient amount of granulocytes a blood cell separator with a continuous extracorporeal circulation was developed. This permits to obtain up to 3.0-10(10) leukocytes during a 4---5 hours period from a single donor. According to our own experiences with 20 leukophereses performed in 13 healthy donors by the use of the AMINCO cell separator an average of 1.17-10(10) leukocytes with a granulocytic portion of 61% was collected per run. In two cases of agranulocytosis and septic fever (one case of pseudomonas septicaemia) the repeated administration of leukocyte concentrates, while specific antibiotic therapy was continued, led to a marked improvement over a longer period of time. Furthermore thrombocyte concentrates up to 7.0-10(10) platelets can be obtained by the cell separator. Applied as depletory method in the treatment of CML and CLL leukopheresis may rapidly diminish the peripheral leucocyte count while spleen and lymphomas decrease in size at the same time. A 20% reduction in cell count may be achieved by a serie of 3---4 leukophereses. Also the use of the cell separator in the treatment of makroglobulinemia by plasmapheresis is discussed.     

Cytogenetic studies as a contribution to the diagnosis of juvenile preleukemia and leukemia recurrence]

Hematologic changes in panmyelopathia are characterized by a wide-spreading spectrum of symptoms and a rare specifity. Therefore cytological and cytochemical findings do not allow a significant prognosis for the malignant or benign development of panmyelopathia. Cytogenetic experiments showed only the Philadelphia chromosome being of diagnostic value. MEISNER and co-workers, who studied adults with panmyelopathia and proven myelocytic leukemia and 5 children with acute lymphocytic leukemia, found that significant and persistent spontaneous division in unstimulated 24 hr. peripheral blood cultures is an indication of a malignant state. The present work shows that in two of five children with panmyelopathia and with significant spontaneous division chronic myelocytic leukemia developed or was in the very initial state; a third child with spontaneous division is still under control. In contrast to literature only one of 14 children with ALL had significant spontaneous cell division. Therefore the method applied must be checked for its usefulness in ALL and especially for its usefulness in early recognition of a relapse.     

Sulperazone in the treatment of severe infections in patients with cancer]

For the evaluation of rational sulperazone position in oncological hospital and elaboration of its implementation criteria investigation was performed. The trial included 193 patients (88 patients with injuries, 66 with hospital pneumonia, 39 with urinary track infection). From different clinical material of the patients were isolated 136 straines of Gram-negative bacteria. Suseptibile to sulperazone were 67 per cent of P. aeruginosa, 78-86 per cent of P. vulgaris, Klebsiella and E. coli isolates, 66 [symbol: see text] 60 per cent of Enterobacter and Serratia isolates subsequently. Comparative results of treatment with sulperazone as monotherapy and for combination with aminoglycosides (gentamycin or amicacin) in the case of P. aeruginosa infection demonstrated high sulperazone efficacy not lower than imipenem/cilsatatin and cefepime efficacy in the case of hospital infections treatment at critical care units. Low price of the sulperazone treatment when compared to imipenem/cilastatine is emphasized. Another advantage of sulperazone when compared to cefepime is anaerobic infection treatment--cefepime is administered in combination with metronidazole while sulperazone is used in monotherapy.