[Effectiveness of ceftizoxime on various infections in patients with underlying diseases].

Ceftizoxime (CZX), a parenteral cephalosporin derivative belonging to the so-called third generation cephalosporin is reported to have a broad antibacterial activity, particularly against Gram-negative aerobic bacilli and some anaerobes, such as Bacteroides fragilis and a good stability to beta-lactamases. Clinical study was performed on a total of 20 cases, 9 females (1 case had urinary tract infection 3 times) and 11 males, aged from 27 to 82 years. All patients had the underlying diseases. They were bronchial asthma in 3 cases, influenza in 1, chronic pulmonary emphysema in 1, pulmonary fibrosis in 1, chronic bronchitis with strongyloidiasis in 1, lung cancer in 3, esophagus cancer in 2, stomach cancer in 1, hepatoma with urolithiasis in 1, liver cirrhosis with diabetes mellitus in 1, alcoholism with strongyloidiasis in 1, cholelithiasis in 1 and congestive heart failure in 1, respectively. Clinical diagnoses for infections were 2-acute bronchitis, 2-exacerbation of chronic bronchitis, 2-broncho-pneumonia, 2-pneumonia including one suspected case, 1-obstructive pneumonia, 2-secondary pulmonary infection, 1-pulmonary infection, 3-urinary tract infection (UTI), 1-UTI with sepsis, 1-sepsis, 1-sepsis with purulent meningitis, 1-biliary tract infection and 1-infected bronchoesophageal fistula. CZX was given by intravenous drip infusion, at a dose of 1 to 2 g, twice daily for 3 to 15 days. Because of severity in infections and underlying diseases, some cases were treated either steroid, gamma-globulin preparations or other antibiotics in combination with CZX. Twelve out of 15 cases assessed clinically responded satisfactorily to the treatment and efficacy rate was 80.0%.(ABSTRACT TRUNCATED AT 250 WORDS)

Aperture width of the osteomeatal complex as a predictor of successful treatment of odontogenic maxillary sinusitis.

Odontogenic maxillary sinusitis (OMS) is an inflammatory disease caused by the spread of dental inflammation into the sinus. The long-term administration of antibiotic medicine and/or treatment of the causative tooth are the usual initial treatments. These initial treatments are not always effective, and the reason is not well understood. The purpose of this study was to identify factors of significance that may contribute to the results of the initial treatment of OMS. Thirty-nine patients were studied, divided into two groups according to the results of initial treatment: effective or non-effective. The effective group comprised 20 patients who were cured by initial treatment. The non-effective group comprised 19 patients who required an additional operation. The duration of symptoms, spread into the other sinuses, aperture width of the osteomeatal complex (OMC) on the side of the maxillary sinus, and anatomical variations in the sinuses were compared between the groups. The only significant difference found was in the aperture width of the OMC, which was significantly narrower in the non-effective group than in the effective group. The aperture width of the OMC may be a significant predictor of the effectiveness of initial treatment of OMS.

Clinical significance of mean circulatory filling pressure and cardiac preload under anesthesia.

The circulatory effects of a rapid infusion of plasma substitute with intravenous administration of nitroglycerine (TNG) were investigated in low pressure systems of anesthetized patients by measuring various hemodynamic parameters. Measurements were made when the systolic blood pressure reached 70-80% of the control value after intravenous administration of TNG at 1-2 microg/kg/min and a 3.5% modified gelatin solution (Haemaccel) at a rate of 0.5 ml/kg/min. After the TNG was administered, the mean circulatory filling pressure (Pms) decreased, and the venous to arterial capacitance ratio (CV/CA) increased; however, they returned to control values after a rapid Haemaccel infusion. Changes in the pressure gradient between the X and Y valley of the right atrial pressure wave decreased to 70 +/- 14% of the control value when TNG was given and recovered to 106 +/- 22% by infusion. Pulmonary vascular resistance (PVR) decreased to 70 +/- 24% of the control value when TNG was administered and was restored to 96 +/- 40% by a rapid infusion. In the left ventricle, the mean velocity of myocardial circumferential fiber shortening (VCF) decreased in all cases when TNG was given and it recovered by a rapid infusion. In the right ventricle, VGF did not always decrease, and in a few case increased, but all cases recovered by a Haemaccel rapid infusion. We conclude that the augmentation of the right ventricular preload reserve is achieved by administration of TNG and infusion of a plasma substitute.