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One hundred patients who underwent surgery using either an open or a closed technique for cholesteatoma removal were studied with the aim of establishing the criteria for deciding the choice of the surgical technique. It is clear that purely anatomical criteria, although valid, are insufficient. Results show that there are other elements such as the condition of mucosa, the presence of tubal dysfunction as well as the characteristics of the pathological condition like the clinical and surgical type of cholesteatoma, its location and extension which are as important as the anatomical considerations. Maximal risk groups for the occurrence of complications and failures (residual cholesteatoma, recurrence, reinfection, and probabilities of achieving success from a functional point of view) are established. Preoperative factors that can influence results are analyzed. It is concluded that the choice of a surgical technique--regarding both the surgical approach and type of reconstruction--has to be made intraoperatively, although once a decision is made the technique employed should be one perfectly standardized and included into one of the two possibilities: a closed technique (tympanoplasty with mastoidectomy, with or without subsequent tympanotomy and second surgical inspection after one year), and an open technique (removal and outpatient follow up).

A case is reported of a 72 year-old female patient with multiple cerebral tuberculomas and a clinical course of 11 months that was characterized by personality changes, disorientation and progressive mental obtundation. The patient had a fatal outcome in spite of ventricular drainage and antituberculous therapy. Postmortem examination disclosed small tuberculomas in the cerebellum and brain stem, as well as residual tuberculous lesions in the upper lobe of the right lung. The clinical interest of this case lies in the old age of the patient, the rarity of the disease in western countries, and the location of tuberculomas in the brain stem with associated tuberculous meningitis. The higher incidence of cerebral tuberculomas in eastern and african countries is commented upon, and its anatomical, clinical, diagnostic and therapeutic features are reviewed. Finally, the two existing pathological forms and their respective clinical and therapeutic peculiarities are analyzed.

A cell line used in the production of biologicals should be free of infectious agents, and 'described with respect to cytogenetic characteristics and tumorigenicity'. Vero, a continuous cell line derived from a normal African green monkey kidney, was examined for the presence of retroviruses and for tumorigenic potential. We were unable to detect the presence of retroviruses by reverse transcriptase assay, electron microscopy or hybridization of cellular genomic DNA with Mason-Pfizer monkey virus DNA probes. In addition, passage 156 Vero cells did not form progressively growing tumors in nude mice or grow with high efficiency in soft agarose.

C10H14O5, Mr = 214.22, orthorhombic, P2(1)2(1)2(1), a = 14.1084 (6), b = 10.6443 (3), c = 7.1970 (1) A, V = 1080.80 (6) A3, Z = 4, D chi = 1.317 Mg m-3, Cu K alpha, lambda = 1.5418 A, mu = 0.8571 mm-1, F(000) = 456, T = 293 K, R = 0.052 for 816 observed [3 sigma (I)] Friedel pairs. The determined absolute configuration may be described as 3S, 4R, 5R, the five-membered ring having an envelope conformation, with the bulky substituents at cis positions. The bond lengths and angles are in agreement with those of the bromoacetoxy derivative.

Lomofungin, an antibiotic active against fungi, yeasts, and bacteria, was found to be a potent inhibitor of purified Escherichia coli deoxyribonucleic acid (DNA)-dependent ribonucleic acid (RNA) polymerase. It prevents RNA synthesis by a direct interaction with the polymerase and not with the template or substrate; chain elongation is halted promptly. Three DNA-dependent RNA polymerases isolated from Saccharomyces strain 1016 were also sensitive to the antibiotic. Lomofungin does not appear to react generally with proteins, as bovine serum albumin did not prevent the inhibitory effect and numerous other enzymes were not affected by lomofungin.

Lomofungin, an antibiotic active against fungi, yeasts, and bacteria, rapidly inhibits synthesis of ribonucleic acid (RNA) but not protein by protoplasts of Saccharomyces strain 1016. With 40 mug of lomofungin/ml, RNA synthesis was almost completely halted after 10 min of incubation; protein synthesis continued for at least 40 min. Since lomofungin inhibits isolated RNA polymerases from yeast, but not in vitro protein synthesis, it is concluded that the primary action of lomofungin in yeast protoplasts is on RNA synthesis. Examination of the pulse-labeled RNA indicated that biosynthesis of both ribosomal precursor RNAs and messenger RNAs was severely inhibited after the protoplasts were incubated with lomofungin for 5 min, whereas formation of small-molecular-weight RNA (4 to 5s) was only slightly affected. Under these conditions, lomofungin almost completely prevented induction of alpha-glucosidase. Once the protoplasts had been induced, further production of the enzyme was not impaired by lomofungin until after 30 min of incubation, but was rapidly halted by cycloheximide (4 mug/ml). Lomofungin inhibition of invertase formation by protoplasts actively synthesizing the enzyme also became evident only after a lag of about 30 to 40 min, although synthesis was promptly halted by cycloheximide. These observations suggest the existence of relatively long-lived specific messenger RNAs for these enzymes.