Platelet regeneration represents an important and separate element in the engraftment process for allogeneic stem cell transplantation. Fully automated flow cytometry using blood cell counters now allows reliable quantification of reticulated platelets, expressed as the immature platelet fraction (IPF). We studied the kinetics of IPF in six patients grafted with allogeneic peripheral blood stem cell transplantation (PBSCT), 12 patients with bone marrow transplantation (BMT) and seven patients with cord blood transplantation (CBT). Preconditioning therapy caused an immediate and rapid fall in tri-lineage hematopoiesis. IPF rose transiently above 3% after a mean duration of 11 days post-PBSCT, 18 days post-BMT and 19 days post-CBT. This was 1, 4 and 13 days earlier than platelet engraftment, respectively. A linear correlation model showed a close association between the rise of IPF and tri-lineage engraftment after transplantation. IPF counting may thus provide an accessible measure of thrombopoietic activity, leading to early evaluation of marrow function and allowing monitoring of platelet regeneration.

In a randomised trial based on a parallel design to determine the prophylactic effect of thiazide on stone formation, 210 calcium urolithiasis patients with idiopathic hypercalciuria were allocated either to treatment with trichlormethiazide (4 mg/day) or no treatment with only close follow-up; 35 patients were excluded for various reasons, including voluntary withdrawal. The background of the remaining 175 patients (82 in the thiazide group and 93 in the control group), including age and sex, was similar for both groups. In patients treated with thiazide there was a statistically significant fall in urinary calcium output. Statistical analyses also demonstrated that the stone formation rate in the thiazide group was significantly less than that in the control group. Adverse clinical reactions probably due to the drug were observed in 9 patients. These findings indicate that trichlormethiazide has a prophylactic effect on calcium urolithiasis in patients with idiopathic hypercalciuria.

Minocycline hydrochloride as a sclerosant for the treatment of simple renal cysts was evaluated. Cyst puncture was performed, and minocycline hydrochloride solution for intravenous administration was injected after aspiration. Of 154 cysts evaluated by ultrasound after 3 months or more, 69 were no longer demonstrable, 49 showed 50% or greater reduction in the maximum cyst diameter, and only 8 were unchanged or slightly increased in size. In contrast, only 1 of 20 cysts aspirated without minocycline hydrochloride injection (controls) showed 50% or greater reduction after 3 months. There was a significant difference in the reduction rates between the minocycline-treated group and control group (p < 0.01). These results suggest that minocycline hydrochloride is an effective sclerosant to treat simple renal cysts.

The pharmacokinetics of cefimetazole, a new cephamycin antibiotic, were examined after a 1-h intravenous drip infusion of 1 g to 5 healthy volunteers with normal renal function and 16 Group 1 was composed of five healthy volunteers with creatinine clearances of 95.6 to 155.6 ml/min. Group 2 was composed of four patients with creatinine clearances of 65.5 to 86.8 ml/min. In group 3 were four patients with creatinine clearances of 35.2 to 52.7 ml/ min. Group 4 had four patients with creatinine clearances of 10.2 to 24.8 ml/min. Group 5 was composed of four patients with creatinine clearances of 0 to 9.7 ml/min. Two patients in this group were being treated by hemodialysis twice weekly over 6 to 8 h.All of the subjects were given 1 g of cefmetazole dissolved in 200 ml of 5% dextrose-water. The drug was administered intravenously by drip infusion over a 1-h period. Blood samples were obtained just before infusion and 1, 2, 4, and 6 h after beginning the infusion. Urine specimens were collected from 0 to 2, 2 to 4, and 4 to 6 h. Because only two patients in group 5 were treated by periodic hemodialysis, they were studied between two dialysis sessions.Serum and urine samples were stored at -20°C until assayed. The concentrations of cefinetazole in serum and urine were determined by the thin cupplate method, with Micrococcus luteus ATCC 9341 as the test organism and heart infusion agar as the medium. For the measurement of serum concentrations, a standard solution series was prepared in pooled normal human serum. The assay range was from 200 to 7.8 itg/ml. For the measurement of urinary concentrations, the standard solution series of 20 to 1.25 ,ug/ ml was prepared with 1% phosphate buffer (pH 6.0). Urine was diluted with 1% phosphate buffer (pH 6.0) to give approximately a 5-,ug/ml sample solution. Table 1. The results demonstrated significant negative correlation between the serum concentration and the creatinine clearance (P < 0.05 at 1 h and P < 0.001 at 2, 4, and 6 h). As renal function declined, peak serum concentrations increased, i.e., the mean peak concentration in group 5 (severely impaired renal function) was 1.5 times that of normal subjects.

We investigated the source of organisms detected in blood specimens obtained during and immediately following prostatic surgery under perioperative antibiotic use, as related to the results of cultures of preoperative urines and prostatic tissues. Ninety patients with benign prostatic hyperplasia were studied. The incidence of bacteremia was 28.9%: 53.7% in patients with preoperative bacteriuria and 8.2% in those without bacteriuria, a significant difference (p < 0.01). Of these bacteremic patients, 5, who had preoperative bacteriuria, developed septicemia. Bacteremia developed more frequently in patients with positive than in those with negative prostatic cultures; this difference was significant (p < 0.05). The species in 80.8% of the isolates from blood specimens were identical with those isolated from preoperative urines, and the species in 53.8% were identical with those from prostatic tissues. These results indicate that in patients with urogenital infection, especially bacteriuria, septicemia can result from prostatic surgery even under perioperative antibiotic use. The incidence of postoperative bacteriuria was approximately 20% in the preoperative nonbacteriuric patients regardless of the duration of chemo-prophylaxis.