No abstract available.
Doxycycline ; Humans ; Penicillin G Benzathine ; Syphilis

We reported previously that, combined with l. 0 gm of probenecid, sodium penicillin G. 4, 0 m.u.i.m. was slightly less effective than procaine penicillin G. 4. 8 m.u. i.m. in the treatment of uncomplicated male gonorrhea. We now present the effect of double dose of sodium penicillin G. in the treatment of uncomplicated gonorrhea. The subjects were 262 male patients with uncomplicated gonoccccal urethritis at the VD clinic of Choong Ku Public Health Center in Seoul during 5 months period from January to May 198l. The following criteria were used to identify gonococcal infection - Gram negative intracellular diplococci in urethral smear and/or oxidase positive typical colony formation on Thayer-Martin media composed of Gram negative diplococci. They were given 4.0 m.u. sodium penicillin G. i.m. proceeded 15 to 30 min. by 1. 0 gm. probenecid p.o.. Four hours later, same amount of sodium peniciIlin G. i.m. was repeated. Concornitant eomparison of procaine penicillin G. was not done because of recent una,vailability of the drug in Korea. To avoid pain, the drug is dissolved in 6 ml of normal saline plus 2 ml of 2% lidacaine. One hundred eighty five patients were able to be followed 3 to 7 days after the treatment. There were .24 (13%) failures and 17 (10. 6%) postgonococcal urethritis. During this study, l4 strains of PPNG (Penicillinase Producing Keisseria Gonarrhoeae) were detected with chromogenic cephalosporin slide method. There were 10 (5. 8%) failures among 171 patients with urethritis caused by non-PPNG.
Gonorrhea* ; Humans ; Korea ; Male* ; Oxidoreductases ; Penicillin G Procaine ; Penicillin G* ; Probenecid ; Public Health ; Seoul ; Sodium* ; Urethritis

PURPOSE: Patients with a history of allergic reaction to penicillin, but with no detectable specific IgE, are common and pose a dilemma. Challenge tests are considered to be the diagnostic gold standard. The aim of this study was to identify subgroups of patients with very low risk for reactions who could be safely tested using a more rapid and simple procedure. METHODS: A total of 580 consecutively referred adult patients with a history of non-serious cutaneous allergic reactions to penicillin, but with no IgE, were challenged with therapeutic doses of penicillin V (phenoxymethylpenicillin), penicillin G (benzylpenicillin), or both. RESULTS: Only 14 of 580 patients had a positive challenge test. In 11 of the 14, a reaction to challenge occurred within 2 hours, and none were anaphylactic. The year of the original reaction was known for 555 patients; a positive challenge was seen in only 0.4% of those with an original reaction >15 years before challenge, but in 4.6% of those with a more recent original reaction (P=0.001). Onset of a reaction within the first day of the original exposure was a predictive factor for a positive challenge (P=0.001) in patients challenged within 15 years of the original reaction. CONCLUSIONS: Among suspected penicillin-allergic patients with non-severe skin reactions and no detectable specific IgE, the subgroup of patients who originally reacted more than 15 years previously had very low risk for reacting to a challenge. The risk was higher in patients with a more recent original reaction, especially if the symptoms had occurred within the first day of exposure.
Adult ; Drug Hypersensitivity ; Exanthema ; Humans ; Hypersensitivity ; Immunoglobulin E ; Penicillin G ; Penicillin V ; Penicillins ; Risk Factors ; Skin

Penicillin expandase, also known as deacetoxycephalosporin C synthase (DAOCS), is an essential enzyme involved in cephalosporin C biosynthesis. To evaluate the catalytic behaviors of penicillin expandase under high penicillin G concentration and to identify mutants suitable for industrial applications, the specific activities of wild-type DAOCS and several mutants with increased activities toward penicillin G were determined by HPLC under high penicillin G concentrations. Their specific activity profiles were compared with theoretical predictions by different catalytic dynamics models. We evaluated the specific activities of wild-type DAOCS and previous reported high-activity mutants H4, H5, H6 and H7 at concentrations ranging from 5.6 to 500 mmol/L penicillin G. The specific activities of wild-type DAOCS and mutant H4 increased as penicillin G concentration increased, but decreased when concentrations of substrate go above 200 mmol/L. Other mutants H5, H6 and H7 showed more complex behaviors under high concentration of penicillin G. Among all tested enzymes, mutant H6 showed the highest activity when concentration of penicillin G is above 100 mmol/L. Our results revealed that the substrate inhibition to wild-type DAOCS' by penicillin G is noncompetitive. Other DAOCS mutants showed more complex trends in their specific activities at high concentration of penicillin G (>100 mmol/L), indicating more complex substrate inhibition mechanism might exist. The substrate inhibition and activity of DAOCS mutants at high penicillin G concentration provide important insight to help select proper mutants for industrial application.
Catalysis ; Intramolecular Transferases ; genetics ; Mutation ; Penicillin G ; pharmacology ; Penicillin-Binding Proteins ; genetics ; Streptomyces ; enzymology ; genetics

The authors has recently experienced a case of Argyll-Robertson pupil in neurosyphilis patient. Characteristic ophthalmological findings in this case are incomplete ptosis of right lid, bilateral loss of pupillay reflex, mydriasis of right eye, and miosis of left eye. The authors administered Benzathine penicilline intramuscularly during 4 weeks of admission, but dissociated pupil was not improved.
Humans ; Miosis ; Mydriasis ; Neurosyphilis ; Penicillin G Benzathine ; Pupil* ; Reflex

A case of lymphocytoma cutis, the circumscribed form in 9 year-old girl is reported. This is seldom conclusive without histological examinatien for a wide variety of conditions has to be considered. The circumscribed form usually responds rapidly to radiotherapy, although recurrence is possible and good results from the use of procaine penicillin especially in the disseminated form. In this case, I experienced good results from CO, slush and topical application of 0.25 % fluocortolone 3 times a day without recurrence in 3 months after treatment.
Child ; Female ; Fluocortolone ; Humans ; Penicillin G Procaine ; Pseudolymphoma* ; Radiotherapy ; Recurrence

Lues maligna (malignant syphilis), also called noduloulcerative syphilis, is a kind of cutaneous secondary syphilis, which presents virulent clinical features and is frequently associated with an immunosuppressed state. Though there are many possible debilitative diseases, it has recently been more frequently presented in the human immunodeficiency virus (HIV)-infected patients. Other causes are diabetes and chronic alcoholism. Prompt diagnosis and early treatment can result in a desirable recovery and prevent spread of the disease. We report two cases of lues maligna associated with the underlying diseases of HIV-infection and diabetes. The skin lesions in these cases showed favorable results after treatment with benzathine penicillin.
Alcoholism ; Diagnosis ; HIV ; Humans ; Penicillin G Benzathine ; Skin ; Syphilis

Although the penicillin is still the first choice of drug in the treatment of gonorrhea in most areas of the world, Neisseria gonorrhoea has become increasingly less sensitive to penicillin preparations. The proportion of such strains also varies from region to region. Sodium penicillin G. is a short acting preparation which enables to attain quick high blood level. The reason for combining the quick acting sodium penicillin G. with probenecid is that latter inhibits renal excretion of penicillin and maintains effective serum penicillin levela long enough to extinguish gonococcal infections. The subjects were 265 male patients with uncomplicated gonococcal urethritis at the VD clinic of Cboong Ku Public Health Center in Seoul during 5 months period from September 1980 to January 1981. The following criteria is used to identify gonococcal infection Gram negative intracellular diplococci in urethral smear and/or oxidase positive typical colony formation on Thayer-Martin media composed of Gram negative diplococci. The 265 patients were divided in two groups(A and B group). They were administered an oral dose of 1.0 gm. probenecid and, 15 to 30 min. later, 4.0 m.u. of sodium penicillin G. i.m. in A-group(152) and 4.8 m.u. procaine penicillin G. i.m. in B-group(113). Only those who were able to be followed up 3 to 7 days after treatment were contained for final analysis(A-group:108, B-group:88), A-group showed 22 failures(20.4%), and B-group 9 failures(10.2%). A significant difference is found between the two groups(P<0.05). Incidence of postgonococcal urethritis was 6(7.0%) in A-group and 5(6.3%) in B-group(P>0.05). We suggest a repeated injection 3 to 4 hours later or increased amonuts of sodium penicillin G. might give better result in the treatment of uncomplicated gonorrhea.
Gonorrhea* ; Humans ; Incidence ; Male* ; Neisseria ; Oxidoreductases ; Penicillin G Procaine ; Penicillin G* ; Penicillins ; Probenecid ; Public Health ; Seoul ; Sodium* ; Urethritis

BACKGROUND: Immediate early gene (IEG) is supposed to be linked in the continuous seizure induced long-term changes of specific neurons. We tried to investigate the effects of focal interictal epileptiform discharges on the c-JUN expression in the rat brain which is not clearly understood. METHODS:Epidural electrodes were placed on a male Sprague-Dawley weighing 150~230 g and benzathine penicillin (Pc) was applied cortically. After focal interictal epileptiform discharges were successfully identified, EEG was recorded regularly. Cardiac perfusion and extraction of the brain was done at 2, 4, 24 hours and 1 week after the Pc application. Sixteen rats were evenly distributed into 4 groups. Immunocytochemical staining with specific antisera (Santa Cruz) was performed. RESULTS: The epileptiform discharges were induced within an hour after topical Pc applications. At 2 hours after Pc application, c-JUN was moderately expressed in the dentate gyrus (DG) and weakly expressed in the CA3 pyramidal cell, amygdala, pyriform cortex, thalamus, and neocortex. At 4 hours, c-JUN was minimally expressed in DG and other regions. Whereas, at 24 hours, c-JUN was maximally expressed in the DG and also in the CA3 pyramidal cell, amygdala, pyriform cortex, thalamus, and neocortex. One week after Pc application, c-JUN was moderately expressed in the DG and weakly expressed in the CA3 pyramidal cell, amygdala, pyriform cortex, and neocortex. CONCLUSIONS: This data showed that even focal interictal epileptic activity can induce IEG encoded c-JUN protein in the specific distant brain regions of a rat until a late period and the expression pattern showed a synchronous and bimodal pattern.
Amygdala ; Animals ; Brain* ; Dentate Gyrus ; Electrodes ; Electroencephalography ; Humans ; Immune Sera ; Male ; Neocortex ; Neurons ; Penicillin G ; Penicillin G Benzathine ; Perfusion ; Pyramidal Cells ; Rats* ; Rats, Sprague-Dawley ; Seizures ; Thalamus

Erysipelothrix rhusiopathiae is an uncommon pathogen in humans, and it is caused by zoonotic infection. It usually induces localized skin infection (erysipeloid) in most cases of human infection. Endocarditis due to E. rhusiopathie is very rare, but it causes various cardiac valve complications including valve replacement. We reported here on a case of E. rhusiopathiae endocarditis in a 71 years old man who had liver cirrhosis and no underlying cardiac disease. This case was treated with intravenous penicillin G for 30 days and he improved without any surgical intervention.
Aged ; Endocarditis* ; Erysipelothrix* ; Heart Diseases ; Heart Valves ; Humans ; Liver Cirrhosis ; Penicillin G ; Skin ; Zoonoses