Epidemiol Infect, 1990 Feb, 104(1), 101 - 10 Horizontal transmission of Campylobacter jejuni amongst broiler chicks: experimental studies; Shanker S et al.; Horizontal transmission of Campylobacter jejuni was investigated in campylobacter-free broiler chicks . One hundred and twenty chicks housed individually, were provided with water containing 10(2)-10(9) c.f.u./ml C . jejuni . Colonization was rapid {47 of 73 (64%) positive cloacal cultures within 3 days and 65 of 73 (89%) within 7 days}, dependent on C . jejuni strain and inoculum size but independent of chick age . Groups of 5-24 chicks in isolators were exposed to C . jejuni-contaminated water or colonized seeder chicks . Transmission occurred in 2-7 days concurrent with a gradual increase of C . jejuni in litter, water and feed . Environmental samples were culture-negative within 3 days following removal of colonized chicks . Treatment of 1-day-old chicks with adult caecal microbiota did not affect colonization . Treated and control chicks were all C . jejuni-positive within 3 days of seeder challenge. Mayo Clin Proc, 1990 Feb, 65(2), 187 - 91 Does Helicobacter pylori colonize the gastric mucosa of Meckel's diverticulum? Fich A, Talley NJ, Shorter RG, Phillips SF. Helicobacter pylori (formerly, Campylobacter pylori) is a highly adapted organism that seems to infect only gastric-type mucosa . In this study, we attempted to determine whether gastric epithelium at a site distant from the stomach, the heterotopic gastric mucosa of Meckel's diverticulum, was susceptible to colonization by H . pylori . Retrospectively, we examined biopsy specimens from 23 patients who had undergone resection of Meckel's diverticulum that contained heterotopic gastric mucosa . As a methodologic control, we also reviewed antral biopsy specimens from 18 patients with chronic duodenal ulcer who had undergone antrectomy . Heterotopic gastric mucosa in Meckel's diverticulum was of antral type in 13 patients and fundic type in 10 patients . Six patients had an ulcer in the diverticulum . No evidence of chronic or active chronic gastritis was detected in the heterotopic gastric mucosa . H . pylori was not found in any Meckel's diverticula but was present in the antrum of 89% of patients with duodenal ulcer . These results suggest that H . pylori may not colonize the heterotopic gastric mucosa of Meckel's diverticulum and has no role in the development of ulceration at this site. APMIS, 1990 Feb, 98(2), 179 - 84 Adherence, enterotoxigenicity, invasiveness and serogroups in Campylobacter jejuni and Campylobacter coli strains from adult humans with acute enterocolitis; Lindblom GB et al.; Two hundred Campylobacter jejuni and Campylobacter coli strains from the same number of adult Swedish patients with acute enterocolitis were tested regarding adherence to and invasiveness in HEp-2 cells and for enterotoxigenicity by the CHO-cell assay . The serogroup characteristics, heat-stable and heat-labile, for each strain were also investigated . Eighty-four percent of the strains were classified as C . jejuni and 16 percent as C . coli . All of the strains were adherent to HEp-2 cells, 39% were invasive and 31.5% enterotoxigenic . We found significantly more invasive strains in the non-enterotoxigenic group than in the enterotoxigenic one . There would seem to be no correlation between enterotoxigenicity or invasiveness and serogroup . The results of this study suggest the existence of multiple mechanisms for C . jejuni- and C . coli-induced diarrhoea and that the mechanisms may differ from one strain to another. APMIS, 1990 Feb, 98(2), 150 - 5 In vitro activity of norfloxacin and other antibacterial agents against gastro-intestinal pathogens isolated in Sweden; Olsson-Liljequist B et al.; The in vitro activity of norfloxacin was compared to that of ampicillin, doxycycline, chloramphenicol, trimethoprim in combination with sulfamethoxazole (1/20), and erythromycin, against 272 clinical isolates of gastro-intestinal pathogens . Norfloxacin was the most active compound of those tested with MICs in the range 0.004-2 mg/l . Concentrations inhibiting 90% of the strains (MIC 90) were 0.008 mg/l for Vibrio cholerae, 0.016 mg/l for Aeromonas hydrophila, 0.032 mg/l for Vibrio cholerae non 01, 0.064 mg/l for Vibrio parahaemolyticus, Yersinia enterocolitica 03, enterotoxigenic (ETEC) and enteropathogenic (EPEC) Escherichia coli and Shigella species, 0.125 mg/l for Salmonella species, and 0.5 mg/l for Campylobacter species . Resistance to one or several of the other drugs was seen with higher or lower frequency in all the bacterial species tested . No cross-resistance between any of the other agents and norfloxacin was recorded. Gastroenterology, 1990 Feb, 98(2), 310 - 5 Lymphocytic gastritis in patients with celiac sprue or spruelike intestinal disease; Wolber R et al.; A distinctive form of gastritis, characterized by lymphocytic infiltration of pit epithelium, has recently been described in association with evidence of Campylobacter pylori infection . We have evaluated simultaneous small bowel and gastric biopsies from 22 patients with diarrhea or malabsorption, all of which showed small bowel changes characteristic of sprue or spruelike disease . In 10 of 22 patients, striking lymphocytic gastritis was identified . Cases positive for lymphocytic gastritis had a mean of 46.5 lymphocytes per 100 epithelial cells, compared with a mean of 3.5 in normal gastric controls and 5.1 in abnormal controls, including cases with Campylobacter gastritis . Concurrent small bowel biopsies had a mean of 47.2 lymphocytes per 100 epithelial cells . Cases without lymphocytic gastritis had means of 10.8 and 39.9 lymphocytes per 100 gastric and intestinal epithelial cells, respectively . Campylobacter organisms were identified in only 1 of the 10 patients with lymphocytic gastritis and in 3 of the 12 patients without lymphocytic gastritis . Intraepithelial lymphocytes in small bowel and stomach were positive for the antibody MT-1, indicating a T-cell infiltrate at both sites . These findings suggest that lymphocytic gastritis may occur as a manifestation of celiac sprue or spruelike disease and that the lymphocytic infiltration of celiac sprue may affect gastric epithelial mucous cells. Endod Dent Traumatol, 1990 Feb, 6(1), 1 - 5 Similarities in the microfloras of root canals and deep periodontal pockets; Kerekes K et al.; Although not universally accepted, retrospective histological, roentgenological and microbiological studies have indicated that cross-infection can occur between infected pulps and deep periodontal pockets . This review provides examples of similarities in the microfloras of these adjacent oral sites, supporting the idea that infection spreads from one site to the other . The organisms most often involved are probably bacteroides, fusobacteria, eubacteria, spirochetes, wolinellas, selenomonas, campylobacter, and peptostreptococci . Important qualities of cross-infecting organisms may be the ability to survive in highly reduced environments and motility . Precautions should be taken to prevent in vivo seeding of such micro-organisms, particularly in compromised teeth and hosts. Jpn J Antibiot, 1990 Feb, 43(2), 257 - 84 {Evaluation of effectiveness of rokitamycin dry syrup in acute enteritis in pediatrics . A comparative study on rokitamycin and fosfomycin dry syrups}; Motohiro T et al.; Because Campylobacter jejuni is most frequently identified as a causative organism of bacterial enteritis in pediatrics, a study was done to evaluate the clinical efficacy against Campylobacter enteritis and the safety of a macrolide antibiotic, rokitamycin (RKM) . In case of acute enteritis, RKM was used in a form of dry syrup at a dose level of approximately 30 mg (in potency)/kg body weight and its efficacy and safety were compared to those of fosfomycin (FOM) dry syrup which is currently in use at a dose level of 60 mg (in potency)/kg . Both drugs were administered, as a rule, in 3 divided daily dose (RKM before meal and FOM after meal) for 5 consecutive days . Comparisons of the drugs were made using a well-controlled method . Obtained results are summarized as follows . 1 . No significant differences in background factors of the 2 drug groups were apparent, hence it was deemed that no obstacles existed in making comparative studies of the 2 groups with regard to their efficacies and safeties . 2 . Overall efficacy rate against Campylobacter enteritis was 100% in the RKM group with a rate of excellent efficacy of 91.3% and the former was 94.4% in the FOM group with the latter of 72.2% . Though the RKM group apparently showed higher rates by 5.6% and 19.1%, respectively, for overall and excellent efficacies, they were not statistically significant as both drugs showed good efficacies . When acute cases of enteritis other than those caused by Campylobacter were included in the analysis, overall efficacy rates and rates of excellent efficacy were, respectively, 97.6% and 85.7% for the RKM group and 88.6% and 68.2% for the FOM group, thus RKM showed higher efficacy rates by 9.0% and 17.5%, respectively . These differences were deemed statistically significant using the U-test . 3 . Numbers of days required for most of the major symptoms to subside were 3 days or less for the group for which RKM was used against Campylobacter enteritis . Similar results were observed for the FOM group also . In cases of acute enteritis due to other causes than Campylobacter, slower recoveries were observed for both the RKM and the FOM groups than in Campylobacter enteritis cases, with the latter group slower than the former . In cases of puruloid stool, the recovery in the RKM group was significantly faster by U-test than the FOM group, and a similar trend was observed overall . 4 . Bacteriologically, the eradication rate of Campylobacter in the RKM group was very good at 91.3% with the FOM group showing a rate of 78.9%.(ABSTRACT TRUNCATED AT 400 WORDS) Ital J Gastroenterol, 1990 Feb, 22(1), 22 - 3 Morphological study of the gastric antral mucosa colonized by campylobacter pylori; Sirigu F et al.; Antral biopsies from 56 patients who underwent gastroscopy for upper gastrointestinal symptoms were studied by transmission electron microscopy . Campylobacter pylori was demonstrated in specimens from 39 patients . The bacteria were present in 3 of the 8 normal specimens and in 36 of the 48 cases with chronic gastritis . Electron microscopy showed that organisms were located deep the mucous layer in intimate relation with the luminar surface of the antral epithelium . No ultra-structural evidence was found to suggest bacterial invasion of the mucosa or phagocitic ingestion by neutrophils . Our results indicate a close correlation between active inflammation and Campylobacter pylori. Aliment Pharmacol Ther, 1990 Feb, 4(1), 49 - 54 Dosage of colloidal bismuth subcitrate in duodenal ulcer healing and clearance of Campylobacter pylori; Coghlan J et al.; Sixty consecutive patients with endoscopically proven duodenal ulcers were given colloidal bismuth subcitrate tablets either as 120 mg q.d.s . or 240 mg b.d., in a randomized single-blind study . The efficacy of each regimen was determined by endoscopic examination and antral biopsy at 4 weeks; if the ulcer remained unhealed, treatment was continued and endoscopy repeated at 8 weeks . The ulcer-healing efficacy of the two regimens was identical; however, in the four times daily group only 27% remained Campylobacter pylori positive after 8 weeks of treatment compared with 58% of the twice-daily group . Similarly, only 21% of twice daily patients were free of histological gastritis compared with 42% of the four times daily patients. Pathol Res Pract, 1990 Feb, 186(1), 154 - 8 Prevalence of Campylobacter pylori as demonstrated by histology or CLO-test in different types of gastritis . A study in 5 clinically predefined groups of patients; Koch HK et al.; The prevalence of Campylobacter pylori infection as detected by histology was studied in 5 predefined groups of patients . The associated histologic and endoscopic findings were registered . Validity of CLO-test was tested against the histologic detection . The following groups of patients were studied: A) Non-ulcer dyspepsia (defined by one or all of three symptoms: heartburn, nausea/inappetence, halitosis/belching) B) control group (no specific symptoms, no ulcer, no history of gastric surgery) C) Duodenal ulcer D) Gastric ulcer E) Billroth I or II resection of the stomach . 200 patients were recruited for group A-C, in group D 134 patients and in group E 113 patients were studied . A mean prevalence of 60% was observed . Prevalence was highest in patients with duodenal ulcer (86%) . In group D a prevalence of 65%, in A and E a prevalence of 54%, and in B of 40% were seen . The overall test sensitivity of the CLO-test compared against the histologic detection rate was 75%, the specificity 81% . Sensitivity was reduced in group A (69%) and E (53%) and in patients with inactive chronic gastritis (67%) . In all groups patients with active forms of gastritis showed the highest prevalence of C . pylori infection . The specificity of the CLO-test was reduced in patients with duodenal ulcer (46%) and gastric ulcer (48%) . Decreased specificity observed after therapy with histamin receptor (H2) blockers may explain this finding . The relationship of C . pylori infection with active types of gastritis or gastro-duodenal ulcer hints at a causal relation but is no definite proof of its etiologic role . The validity of the CLO-test seems questionable in patients with gastroduodenal ulcer or operated stomach. Scand J Gastroenterol, 1990 Feb, 25(2), 127 - 33 Acridine orange fluorescence, Campylobacter pylori, and chronic gastritis; Langdale-Brown B et al.; Endoscopic gastric biopsy specimens from 230 consecutive patients in a North Liverpool District were histologically studied by routine light microscopy and ultraviolet fluorescence after acridine orange staining . Eighty patients with chronic gastritis were further studied with regard to type of gastritis and its activity, presence of Campylobacter pylori (CP), and degree of colonization of the gastric mucosa . Miscellaneous gastritis, gastric ulcers, erosions, neoplasms, and histologically normal specimens were excluded from the study . The results show statistically significant correlation between chronic gastritis and CP (P = 0.01, Mann-Whitney test) . The activity of gastritis correlated well with CP, but there was no statistical significance between the density of neutrophils and degree of CP colonization (P greater than 0.5, Mann-Whitney test) . In a small sample of CP-positive specimens acridine orange stain was compared with Warthin-Starry, Giemsa (modified), cresyl fast violet, and haematoxylin and eosin stains . Acridine orange stain in the histologic identification of CP has been used only once before in a large study. J Am Vet Med Assoc, 1990 Jan 15, 196(2), 287 - 90 Toxoplasmosis and other causes of abortions in sheep from north central United States; Dubey JP et al.; Between 1983 and 1989, we examined 1,201 aborted fetuses and dead lambs from the north central United States . Toxoplasmosis was diagnosed in 17.5%, campylobacteriosis in 9.9%, chlamydiosis in 4.7%, and miscellaneous infections in 15.1% . Inflammatory lesions suggestive of infectious causes were seen in 13% . Noninfectious causes were identified in 6.1%, and a diagnosis was not reached in 33.3% . An agglutination test was used to detect Toxoplasma gondii-specific antibodies in ovine fluids . Toxoplasma gondii antibodies were detected in 223 of 1,064 (20.9%) fluids from fetuses and dead lambs . Of 201 seropostive (greater than or equal to 16) fetuses and lambs, T gondii antibody titers (reciprocal) were 16 (21 fetuses and lambs), 32 (10 fetuses and lambs), 64 (2 fetuses and lambs), 128 (7 fetuses and lambs), 256 (9 fetuses and lambs), 512 (5 fetuses and lambs), 1,024 (15 fetuses and lambs), 2,048 (13 fetuses and lambs), 4,096 (13 fetuses and lambs), 8,196 (13 fetuses and lambs), 16,392 (19 fetuses and lambs), and greater than or equal to 32,784 (74 fetuses and lambs). J Am Vet Med Assoc, 1990 Jan 15, 196(2), 291 - 4 Serologic and histologic diagnosis of toxoplasmic abortions in sheep in Oregon; Dubey JP et al.; Between 1983 and 1989, we examined 586 fetuses and dead lambs submitted to a diagnostic laboratory in Oregon . Toxoplasmosis was diagnosed in 74 (12.6%), campylobacteriosis in 89 (15.2%), chlamydiosis in 75 (12.8%), miscellaneous infections in 153 (26.1%), noninfectious causes in 37 (6.3%), and undetermined causes in 158 (27.0%) . Detection of Toxoplasma gondii agglutinating antibodies (greater than or equal to 20) in body fluids or heart serum was considered specific for the diagnosis of toxoplasmosis in ovine fetuses or lambs . Toxoplasma gondii antibody titers (reciprocal) in 285 fluids from fetuses or dead lambs were less than 20 (64.5%), 20 (4.5%), 40 (1.7%), 80 (0.7%), 160 (2.1%), 320 (1.7%), 640 (4.9%), 1,280 (2.8%), 2,560 (4.5%), 5,120 (3.8%), 10,240 (2.1%), and greater than or equal to 20,480 (6.3%). Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 1, S99 - 106 Epidemiology and pathophysiology of Campylobacter pylori infections; Blaser MJ; Since the first isolation of Campylobacter pylori in Australia in 1982, this bacterium has been isolated from persons in all parts of the world . Although initially recognized in patients with gastrointestinal symptoms, C . pylori can also be isolated from apparently asymptomatic persons . C . pylori infection is infrequent in young children in developed countries; during adulthood C . pylori infection becomes progressively more frequent, a phenomenon that parallels the age distribution of type B gastritis . In developing countries infection is more common and begins earlier . Infection, once acquired, appears to persist, possibly for life, but the mode of transmission to humans is unknown . C . pylori is well adapted for survival in the gastric milieu, but whether C . pylori plays a causative role in gastritis is of critical importance . Favoring this hypothesis are the results of inoculation studies in volunteers and animals in which challenge with C . pylori resulted in persistent infection and histologic lesions . Treatment studies with antimicrobial agents indicate that removal of C . pylori is associated with improvement in histologic appearance of affected tissues and that when infection recurs the histologic appearance worsens . The mechanisms by which C . pylori infection may cause gastritis are unknown but possibilities include production of cytotoxin, degradation of physiologic defenses against acid-pepsin damage, and adherence to epithelial cells. Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 1, S94 - 8 Bismuth subsalicylate in the treatment of gastritis due to Campylobacter pylori; McNulty CA; Fifty patients completed an investigator-blind trial comparing bismuth subsalicylate, erythromycin ethylsuccinate, and placebo matched to the bismuth salt in the treatment of gastritis associated with Campylobacter pylori . C . pylori was cleared from 14 (77.8%) of 18 patients given locally active bismuth, from one (6.7%) of 15 patients given erythromycin, and from none of 17 patients given placebo . Gastritis resolved in 13 (81%) of 16 patients treated with bismuth but in only three of 13 receiving erythromycin and in none of 16 patients given placebo . Results of endoscopic examination showed greater improvement in patients cleared of C . pylori than in those with persistent infection . Heartburn improved in 50% of patients who received bismuth compared with 17% of those given placebo . The success of bismuth is probably due to its local antimicrobial activity . Erythromycin may have been inactivated by the low pH in the areas colonized with C . pylori . Relapse is less frequent when a combination of bismuth and an antimicrobial agent is used; such a combination is characterized by local and systemic activity, stability at low pH, and good penetration into gastric mucus. Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 1, S87 - 93 Campylobacter pylori: its link to gastritis and peptic ulcer disease; Marshall BJ; Bismuth salts have been used to treat acid peptic disease for 150 years . Recently, the discovery of Campylobacter pylori and the observation that this bacterium is inhibited by bismuth salts have regenerated interest in the antibacterial properties of bismuth . Bismuth and heavy metals inhibit growth of all Campylobacter species and many enteric anaerobes . Bismuth alone cures C . pylori infection in only 30% of patients, but in combination with other broad-spectrum antibiotics, it can achieve a cure rate of 80%-90% in 2-4 weeks . Data from several studies indicate that eradication of C . pylori is curative for most patients with duodenal ulcer . Epidemiologic studies in the United States suggest that the incidence of new C . pylori infections is declining, so antibacterial therapy for symptomatic cases may be adequate therapy . In developing countries, however, curative therapy may not be possible in the presence of environmental sources of reinfection . In these areas intermittent suppressive therapy with bismuth salts may be useful. Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 1, S73 - 9 Epidemiology of travelers' diarrhea and relative importance of various pathogens; Black RE; Each year 12 million persons travel from an industrialized country to a developing country in the tropics or subtropics . These travelers experience a high rate of diarrhea caused by a wide variety of enteric pathogens acquired by ingestion of contaminated food or water . One or more pathogens can be found in the stool of a majority of ill individuals . Enterotoxigenic Escherichia coli generally are the most frequently identified pathogens, having been found in a median of 42% of travelers' diarrheal episodes in studies in Latin America, 36% in Africa, and 16% in Asia . Other pathogens that cause diarrhea in a smaller fraction of ill travelers include Shigella species, Salmonella species, Campylobacter jejuni, Vibrio, Aeromonas hydrophila, Entamoeba histolytica, Giardia lamblia, rotavirus, and 27-nm viruses, including Norwalk virus . Other organisms that may cause a fraction of the episodes of travelers' diarrhea include Plesiomonas shigelloides, enteroadherent E . coli, adenovirus or other viruses, and Cryptosporidium . Mixed infections of two or more of these pathogens also occur. Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 1, S41 - 50 Diarrhea in developed and developing countries: magnitude, special settings, and etiologies; Guerrant RL et al.; Diarrheal diseases are major causes of morbidity, with attack rates ranging from two to 12 or more illnesses per person per year in developed and developing countries . In addition, diarrheal illnesses account for an estimated 12,600 deaths each day in children in Asia, Africa, and Latin America . The causes of diarrhea include a wide array of viruses, bacteria, and parasites, many of which have been recognized only in the last decade or two . While enterotoxigenic Escherichia coli and rotaviruses predominate in developing areas, Norwalk-like viruses, Campylobacter jejuni, and cytotoxigenic Clostridium difficile are seen with increasing frequency in developed areas; and Shigella, Salmonella, Cryptosporidium species, and Giardia lamblia are found throughout the world . The rational management of infectious diarrhea requires the highly selective use of laboratory tests for these varied etiologic agents, depending on the clinical and epidemiologic setting . The purpose of this review is to provide an overview of the magnitude, special settings, and etiologies of diarrhea endemic to developed and developing countries . This information permits a practical approach to the diagnosis and management of common diarrheal illnesses in different settingsPIP: Diarrhea is the 2nd most frequent illness in the world . In a study done in Cleveland, Ohio from 1948-1957, researchers learned that people had diarrhea an average of 1.52 times annually . The age specific attack rates climbed from 1 episode/child 1 year old/years to 2-2.2 episodes/child 1-10 years old/year . In similar study in Charlottesville, Virginia between August 1975-July 1977, the overall diarrhea attack rate stood at 1.9 episodes/person/year and, for children 3 years old, it was 2.5 episodes/year . The incidence of diarrhea peaked in the winter months, unlike developing countries where it peaks in the summer months . In developing countries, attack rates range from 5-12 episode/child/year with the highest rates in the 1st 2 years of life (e.g., in India among the urban poor, 18.6 episodes/child/year . diarrhea stands as the leading cause of death in developing areas . Even though oral rehydration therapy is reducing the morality rate from acute diarrhea in developing countries, prolonged episodes of diarrhea of 14- 20 days continue to claim children's lives . In developed countries, diarrhea poses a distinct problem to hospitals, nursing homes., and day care enters . For example, researchers revealed 7.7 cases of nosocomial diarrhea/100 admissions in the medical intensive care unit at the University of Virginia Hospital . About 33% of the elderly patient in extended care facilities have a serious diarrheal illness each year . Reports show that attack rates among children in child care facilities range from 17-100% with considerable secondary attack rates in the children's families . People with AIDS often experience diarrhea which for them is often fatal . In the United State, 50-60% of them have it at diagnosis while in Africa and Haiti the percentage is 95% . Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 1, S115 - 9 Effect of oral bismuth subsalicylate on Campylobacter pylori and on healing and relapse rate of peptic ulcer; Eberhardt R et al.; A controlled, open clinical trial was performed to compare the effect of oral bismuth subsalicylate (600 mg three times daily) with that of cimetidine (800 mg/d) on Campylobacter pylori, ulcer healing, and rate of ulcer relapse in 49 patients with peptic ulcer . At the first endoscopic examination (to confirm the diagnosis) and at the second (after 4 weeks of treatment), biopsy specimens were taken from the gastric antrum; the presence of C . pylori in culture and the rate of ulcer healing were determined . The rate of ulcer relapse was determined by a 9-month follow-up examination . After cessation of treatment a significant rate of healing was seen in both treatment groups: 73% in the bismuth group and 65% in the cimetidine group . Ulcer healing was confirmed by endoscopic examination . Before therapy the number of C . pylori-positive cases (61%) was identical from the two groups; however, after 4 weeks of treatment, 75% of the previously culture-positive cases in the bismuth group reverted to negative (a statistically significant change), whereas only 40% of those in the cimetidine group reverted (not statistically significant) . The rate of clearance of C . pylori was statistically significant for the 29 patients with healed ulcers and correlated strongly with ulcer healing in the bismuth group only . The rate of relapse after 9 months of follow-up was 13% in the group treated with bismuth subsalicylate--a figure significantly lower than the 54% rate of relapse in the group treated with cimetidine. Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 1, S11 - 5 In vitro antimicrobial activity of bismuth subsalicylate and other bismuth salts; Manhart MD; This report demonstrates that bismuth subsalicylate (BSS) effectively inhibits growth of a number of bacterial strains known to cause diarrhea, including Escherichia coli, Salmonella, Shigella, and Campylobacter . Other bismuth salts and sodium salicylate, a hydrolysis product of BSS in the gut, also were examined and were shown to have various degrees of activity . Growth of the organisms was monitored in vitro by inoculating culture fluid that contained one of the compounds to be tested and determining the concentration of viable organisms over a 24-hour period . Control cultures of each organism were grown in the absence of bismuth subsalicylate . BSS inhibited growth of all organisms examined in a dose-dependent fashion . Reductions of 2-6 logs, as compared with controls, were observed in cultures grown in the presence of 10-50 mM BSS . Other bismuth salts displayed various degrees of inhibition . These results suggest that the efficacy of BSS as an antidiarrheal agent may be related to an antimicrobial mechanism of action. Rev Infect Dis, 1990 Jan-Feb, 12 Suppl 1, S107 - 14 Diagnosis of Campylobacter pylori infections: the "gold standard" and the alternatives; Barthel JS et al.; Both direct and indirect techniques are available for the detection of gastric infections due to Campylobacter pylori . These techniques vary in their degree of efficacy, invasiveness, and convenience . They fall into five major categories, based on either the particular characteristic of the C . pylori organism or the manifestation of the C . pylori infection that they detect . The five categories include histologic examination of culture biopsy specimens, serologic examination, rapid urease tests, and carbon isotype breath tests . The observed efficacies of the techniques for detection of C . pylori are influenced by the standard with which they are compared . At present, the best candidate for the "gold standard" appears to be histologic detection by examination of multiple mucosal biopsy specimens. Eur J Clin Microbiol Infect Dis, 1990 Jan, 9(1), 1 - 13 Microbiological aspects of Helicobacter pylori (Campylobacter pylori); Goodwin CS et al.; The human gastric pathogen Campylobacter pylori has recently been reclassified as Helicobacter pylori, and a related spiral bacterium found in the stomach of ferrets has been designated Helicobacter mustelae . The general microbiological features of Helicobacter pylori are delineated here, with details of phenotypic differences between Helicobacter pylori and Helicobacter mustelae; comparisons are made with Wolinella succinogenes and Campylobacter jejuni . The Helicobacter organisms possess an external glycocalyx which can be visualised by electron microscopy, and which may be involved in bacterial adherence . The finding of soluble and cell-associated haemagglutinins of Helicobacter pylori is reported . Detection of Helicobacter pylori in clinical specimens, susceptibility of the organism to antibacterial agents, and other aspects of practical and clinical significance are briefly reviewed. Nord Med, 1990, 105(1), 24 - 6 {Campylobacter pylori, gastritis and ulcer . Where are we going now?}; Wadstrom T et al.; Studies in human volunteers as well as animals clearly indicate that Campylobacter pylori is a key component in the development of type B-gastritis as well as in stomach- and duodenal ulcer disease . It seams likely that a better knowledge in how this microbe colonize the stomach mucosa will soon give us new and better possibilities to prevent and treat these diseases and their relapses. Clin Microbiol Rev, 1990 Jan, 3(1), 1 - 12 Campylobacter pylori and gastroduodenal disease; Buck GE; Campylobacter pylori is a newly described, spiral-shaped, gram-negative bacillus that is oxidase positive, catalase positive, and urease positive and grows slowly in culture . Although observed in human tissue at the beginning of the century, it was not cultured until 1982 . Because there are significant morphological and genetic differences between this organism and other species of Campylobacter, it will probably be reclassified in a new genus . Current information indicates that the organism primarily resides in the stomach tissue of humans and nonhuman primates and may occasionally spread to the esophagus or other parts of the alimentary tract under appropriate conditions . Significant evidence has accumulated in the last several years to show that it causes gastritis, and there is mounting evidence that it may participate in the development of duodenal ulcers . It may also be associated with gastric ulcers and nonulcer dyspepsia . It can be detected in patients by culture of biopsy specimens or histological staining of biopsy tissue . Indirect evidence for the presence of the organism can be obtained by detection of urease in a tissue biopsy specimen, by urea breath tests, or by detection of specific antibody . It may not be necessary to implement these procedures for routine use, however, until the role of the organism can be defined better . Ultimately, the discovery of this organism may lead to radical changes in the diagnosis and treatment of gastric disease. Med Clin North Am, 1990 Jan, 74(1), 29 - 38 Infectious causes of diarrhea in the differential diagnosis of inflammatory bowel disease; Farmer RG; The infectious causes of enteritis and colitis are numerous . However, the actual clinical differential diagnosis with either ulcerative colitis or Crohn's disease is usually not a significant problem, except, of course, in two circumstances: (1) acute onset of diarrhea with or without rectal bleeding, and (2) patients who have AIDS, are immunocompromised, or are male homosexuals . However, if one bears in mind that rectal bleeding and mucosal abnormalities which are diffuse and uniform are the hallmark of ulcerative colitis, that Crohn's disease has perianal and external manifestations as its significant clinical hallmark, and both diseases tend to be chronic and recurrent, the clinical distinction can usually be made . However, it is important to recognize that there is an increasing awareness of intestinal infections, partly as a result of study of male homosexuals or patients with AIDS, as well as increased recognition of other infectious causes of diarrhea, including traveler's diarrhea, that associated with C . difficile, and that found with infection due to Campylobacter . As is usually the case in clinical medicine, however, careful and accurate history, attention to detail on physical and sigmoidoscopic examination, and laboratory (usually stool culture) data will lead to the appropriate diagnosis. Gastroenterol J, 1990, 50(1), 32 - 7 {Does Campylobacter Helicobacter pylori infection have a clinical relevance? Methodologic, epidemiologic and clinical studies}; Dobronte Z et al.; The authors searched for Campylobacter pylori (CP) in gastric biopsies from 180 patients by means of microbiological culture . Warthin-Starry staining and urease activity determination . 50 patients with CP-positive antral gastritis were treated with bismuthsubsalicylate 2.4 g per day for 3 weeks, followed by a therapy-free interval of 7-10 days and then a control biopsy was performed . Combined results of bacterial culture and histology proved to be mostly reliable . The prevalence of CP in Hungary is similar to other European countries . CP-positivity was found at the following rates: endoscopically normal patients 30%; stump gastritis 30%; antral gastritis 75%; duodenal ulcer 89% . In all CP-positive cases chronic antral gastritis was seen, whereas normal antral mucosa was never CP-positive . There was no correlation between dyspeptic complaints and CP-positive chronic antral gastritis . Both decreased after bismuth therapy independently on the elimination of CP . CP-positivity in 2/3 of the control investigations points to fast recolonization . The clinical relevance of the CP-infection seems to be questionable. Sov Med, 1990, (5), 43 - 5 {State of local and total humoral immunity in duodenal ulcer with Campylobacter pylori infection}; Il'chenko AA et al.; A total of 83 patients with duodenal ulcer and a varying degree of gastric mucosa contamination with C . pylori were examined . Secretory IgA was less frequently detectable in the gastric juice of patients with higher level of gastric mucosa contamination with C . pylori and in lower concentrations than in the patients with a lesser C . pylori contamination . Healing of duodenal ulcer defects was associated with a decrease of gastric mucosa contamination and elevation of secretory IgA content in the gastric juice . The role of serum immunoglobulins in the gastric juice is less significant: IgG and IgA are rarely detected . Salivary content of secretory IgA depended on the gastric mucosa contamination and ulcer stage . Secretory IgA level increased by the ulcer remission, and C . pylori contamination decreased . Normal blood serum IgA, IgG, and IgM ratios were shifted in the patients with C . pylori contamination, particularly so in those with a higher level of contamination . These findings suggest a contribution of local and total immune reactions related to C . pylori to the pathogenesis of duodenal ulcer. Sov Med, 1990, (4), 19 - 23 {Isolation of Campylobacter pylori}; Il'chenko AA et al.; A total of 424 patients with gastroduodenal ulcers were examined . Spot biopsy specimens of gastroduodenal tissue were examined by histologic and microbiologic methods . Both methods equally frequently detected C . pylori (in 87 +/- 5 and in 85 +/- 6 percent of cases, respectively) . C . pylori were more frequently detected during ulcer exacerbation than during remissions . Detection of the agent in smears of smashed mucosal biopsy specimens was found to be a rapid diagnostic method, permitting detection of C . pylori in 90.8 percent of cases . High detection rate of C . pylori in patients with peptic ulcers and chronic gastritis necessitates accurate treatment of endofibroscopes. Scand J Infect Dis, 1990, 22(3), 321 - 6 Waterborne Campylobacter jejuni epidemic in a Finnish hospital for rheumatic diseases; Rautelin H et al.; A waterborne Campylobacter jejuni outbreak in the Rheumatism Foundation Hospital in Heinola, Finland, in November-December 1986 is described . 32 patients and 62 members of the staff developed gastrointestinal symptoms . C . jejuni heat-stable serotype 45 was isolated from the faeces of 32 enteritis patients and from none of the controls . No other enteropathogens were found . Positive serological responses to C . jejuni acid extract antigen were detected by enzyme immunoassay in 34% of the symptomatic hospital patients, in 40% of the symptomatic staff members, and in 10% of the controls . The clinical course of the illness was mostly mild and self-limited . No striking progress in the arthritis symptoms of the patients was found after the outbreak . The hospital has its own water supply . C . jejuni of the same serotype as the epidemic strain was isolated from the water of the pipeline system . After a careful examination some aged components of the waterworks were found to be responsible for leaks that resulted in the contamination of the water. Alaska Med, 1990 Jan-Mar, 32(1), 9 - 18 Epidemiologic surveillance of enteric diseases in Alaska--value of case investigation; Jenkerson SA et al.; Patients infected by Salmonella, Shigella, Giardia, Campylobacter, Yersinia, and Hepatitis A virus were interviewed during a 15-month period to evaluate the benefit of intensive follow-up, to assess the proportion of cases who had contact with children less than four years of age, and to determine risk factors . Of 746 reported infections, we interviewed 345 patients (46%) and identified 199 other ill people . Follow-up of sporadic, passively reported cases required considerable resources, but no large outbreaks were uncovered . Investigation of patients {N = 103 (43%)} who had contact with children less than four years of age, or children who attended daycare centers often resulted in identification of additional illness, especially for cases of giardiasis . Primary health care providers can play a key role in reducing enteric disease by increasing efforts to identify illness among daycare and family contacts of their patients. Pediatr Radiol, 1990, 20(3), 200 - 1 Campylobacter gastritis simulating Menetrier's disease by upper gastrointestinal radiography; Chaloupka JC et al.; Within this decade it has been determined that primary gastritis in both children and adults is frequently associated with infection of the gastric mucosa with Campylobacter pylori . It is characterized by a chronic inflammatory process in which the mucosa of the gastric antrum is typically most severely involved . Other regions of the stomach may be involved and associated peptic ulcers of the stomach and duodenal bulb are frequent . A case of C . pylori gastritis is reported in which involvement of the gastric fundus and body produced severe rugal hypertrophy that resembled Menetrier's disease. Trans R Soc Trop Med Hyg, 1990 Jan-Feb, 84(1), 122 - 5 A cohort study of enteric campylobacter infection in children from birth to two years in Bangui (Central African Republic); Georges-Courbot MC et al.; A cohort of 111 children from Bangui, Central African Republic, was followed for enteric campylobacter infection from birth until the age of 2 years . Stools were examined at each episode of diarrhoea, and bi-weekly up to the age of 6 months irrespective of the presence of diarrhoea . 349 episodes of diarrhoeal illness were recorded (1.6 per child-year) . Campylobacters were isolated from 41 (11.7%) of the 349 episodes, but in half of them another enteric pathogen was also isolated . Campylobacters were statistically associated with diarrhoea only before the age of 6 months . Bi-weekly sampling up to this age detected 75 infections (1.3 per child-year), yet only 12 (16%) were associated with diarrhoea . Campylobacter coli was isolated slightly more often (51%) than C jejuni (49%); biotyping and serogrouping showed that no strain was especially associated with disease . Fewer children who had campylobacter infection before the age of 6 months suffered campylobacter diarrhoea between 6 and 24 months of age than those who did not, but the difference did not reach statistical significance . A significantly higher rate of isolation was found in the homes of infected children (human and animal contacts) than of non-infected children . Campylobacter infections were statistically associated with the presence of live poultry and the lack of piped water in homes. Ter Arkh, 1990, 62(2), 62 - 4 {The characteristics of the clinical course of long-term nonhealing duodenal ulcers combined with chronic gastric erosion and the treatment of patients with the given pathology}; Preobrazhenskii VN et al.; The authors provide data on the follow-up and treatment of 76 patients with slow in healing ulcers and chronic erosions . In patients with associated pathology, the clinical course of the disease is marked by a steady painful syndrome that occurs 1 to 1.5 h after meal . In the presence of Campylobacter pyloridis in these patients, the treatment schedule is to include de-nol and the concentrate of granulocytes . The use of local administration of the concentrate of granulocytes combined with hyperbaric oxygenation turned out the most effective in multimodality treatment of such patients. Antimicrob Agents Chemother, 1990 Jan, 34(1), 25 - 8 Guinea pig model for antibiotic transport across gastric mucosa: inhibitory tissue concentrations of clindamycin against Helicobacter pylori (Campylobacter pylori) following two separate dose regimens; Westblom TU et al.; An animal model for antibiotic secretion across gastric mucosa was developed using adult guinea pigs . Antibiotics were given intramuscularly, and levels in serum and gastric mucosa were measured by high-pressure liquid chromatography at 1, 2, 4, 6, and 8 h postinjection . Mucosal levels of the drugs were measured in the superficial luminal portion of the mucosa, which was removed by mechanical scraping . Clindamycin levels were measured after doses of 10 and 100 mg/kg of body weight . After doses of 100 mg/kg, levels in serum peaked at 15.95 micrograms/ml at 2 h . Gastric mucosa showed a bimodal concentration curve with peaks of 15.91 micrograms/g at 1 h and 25.07 micrograms/g at 4 h . Concentrations in mucosa remained high when levels in serum fell, showing a mucosa/serum ratio of 87.70 after 8 h . At all times, clindamycin levels in mucosa were in excess of the MIC for 90% of the Helicobacter (Campylobacter) pylori strains tested. J Pediatr Gastroenterol Nutr, 1990 Jan, 10(1), 37 - 40 Factors influencing the duration of acute diarrheal disease in infancy; Househam KC et al.; The majority of episodes of acute infectious diarrhea in infancy are of relatively short duration . Prolongation of the diarrhea presents problems in management, deterioration of the infant's nutritional status, and an increased mortality . As part of a prospective study of the etiology of acute infectious diarrhea, some factors associated with the probability (more or less) of having self-limiting disease have been identified . The well-nourished infant over 6 months of age is more likely to have self-limiting disease, whereas this outcome is least likely in the very young infant under 3 months of age, particularly if underweight for age . With the exception of Shigella, bacterial enteropathogens (Campylobacter fetus jejuni, Salmonella B, and certain enteropathogenic Escherichia coli types) were also associated with a decreased likelihood of self-limiting disease . Rotavirus infection was associated with self-limiting disease except in the infant under 3 months of age, where the probability of self-limiting disease was decreased. FEMS Microbiol Lett, 1990 Jan 1, 54(1-3), 163 - 7 Enterotoxigenicity and frequency of Campylobacter jejuni, C . coli and C . laridis in human and animal stool isolates from different countries; Lindblom GB et al.; Campylobacter jejuni and C . coli strains were collected during three different years from adult patients with enterocolitis in Sweden (n = 372) from 49 patients in Kuwait, and Campylobacter strains from hens from Mexico, Pakistan and Sweden (n = 107) and Swedish pigs (n = 47) . C . jejuni was the predominant species in human and hen isolates, and C . coli in pigs C . coli was significantly more common in human isolates from Sweden, and more common in hen isolates from Pakistan, than in hens from Sweden and Mexico . C . laridis was only isolated from pigs (17%) and was in no case enterotoxigenic . Both in human and hen isolates, C . jejuni strains were more enterotoxigenic than C . coli strains . C . jejuni strains from Swedish hens were less enterotoxigenic than those from Pakistan and Mexico (P less than 0.001), and strains from pigs were less enterotoxigenic than those from hens (P less than 0.001) . We conclude that C . jejuni are more often enterotoxigenic and possibly more virulent than c . coli and C . laridis . The relative frequency of C . jejuni and C . coli in humans and animals differs from one country to another. Arch Environ Health, 1990 Jan-Feb, 45(1), 59 - 62 Prevalence and antibiogram of Campylobacter jejuni in domestic animals in rural Ghana; Abrahams CA et al.; A total of 134 samples of rectal and cloacal swabs taken from apparently healthy domestic animals that were in 43 of 76 homes located in rural Ghana were examined for Campylobacter jejuni . C . jejuni was isolated from 32.8% (44/134) of the animals . The highest isolation rate of 43.6% was from local domestic fowls, followed by goats (33.3%) and sheep (23%) . This organism was not detected in the pigs, cats, and ducks . All 44 strains of this bacterium produced hydrogen sulphide and hydrolyzed hippurate; antibiogram on 24 strains showed resistance to cephalothin, cephalexin, and sulfamethoxazole/trimethoprim . C . jejuni biotype 2 is the prevailing strain in animals in the area studied. J Clin Pathol, 1990 Jan, 43(1), 60 - 2 Campylobacter pylori in the upper gastrointestinal tract of patients with HIV-1 infection; Francis ND et al.; Fifty one patients with human immuno-deficiency virus (HIV-1) infection who had been consecutively endoscoped for upper gastrointestinal symptoms were biopsied (stomach or duodenum, or both) and compared with 59 age and sex matched controls for the presence of Campylobacter pylori . In 28 (47%) of the control group but in only seven (14%) of the HIV seropositive patients were C pylori seen on histological examination (p less than 0.001, odds ratio 5.6, 95% confidence interval 2.2-14.5) . Sixteen patients who were HIV antibody positive had other index diseases for the diagnosis of AIDS in the biopsy material and, when these were excluded, comparison with the control group still showed a significant difference; p less than 0.01, odds ratio 3.6, 95%, confidence interval 1.4-9.6 . In this series, therefore, C pylori were far less common in HIV antibody positive patients than in controls . Among the HIV positive patients, a higher proportion of C pylori negative cases had AIDS but this trend was not significant . The findings of this study indicate that whatever abnormalities of cell mediated mucosal immunoregulation are caused by HIV infection, they do not seem to be important in the response to infection by C pylori. Infection, 1990 Jan-Feb, 18(1), 3 - 7 The role of Campylobacter (Helicobacter) pylori in disorders of the gastrointestinal tract; Przyklenk B et al.; To evaluate the role of Campylobacter pylori in different gastrointestinal disorders, serum IgG antibodies against C . pylori were determined in dyspeptic patients and in a control group of healthy children and adults . Twenty-eight percent of the dyspeptic patients with normal mucosa were seropositive . Among the patients with altered mucosa, the seroprevalence increased from duodenitis (48%) to gastritis (89%) and gastric or duodenal ulcer, gastric stump gastritis and carcinoma (100%, for each group, respectively) . The C . pylori detection rate was lowest in patients with duodenitis alone (19%) and highest in patients with duodenal ulcers (95%) . Therefore, C . pylori does not play an important role in patients with duodenitis alone . About 30% of patients with gastritis, active duodenal or gastric ulcer had antibody levels as low as the seroconverted dyspeptic patients but with normal gastroduodenal mucosa . C . pylori was not considered a causative factor for mucosal damage in these patients. Microbiologica, 1990 Jan, 13(1), 7 - 9 Cholera-like enterotoxin in certain Campylobacter jejuni strains: some observations; Hariharan H et al.; Fourteen human isolates of Campylobacter jejuni (13 pathogenic + 1 non-pathogenic) and two animal isolates were studied for the production of a toxin immunologically related to the heat-labile enterotoxin (LT) produced by a strain of Escherichia coli of human (H) origin using an immuno-dot-blot assay with immunoaffinity purified antibodies against H-LT . Polymyxin-B sulfate extracts of 72 hrs growth in eight of the 15 pathogenic strains were positive in immuno-dot-blot . Six of these positive extracts also exhibited delayed permeability factor activity in rabbit skin. Microbiologica, 1990 Jan, 13(1), 1 - 6 Isolation and antimicrobial susceptibility of Campylobacter coli and Campylobacter jejuni from slaughter hogs; Hariharan H et al.; Cultural examination of cecal contents from 109 market weight hogs slaughtered in Prince Edward Island during May-July 1988 yielded 62 isolates of Campylobacter coli and seven Campylobacter jejuni . A commercial latex agglutination test helped to confirm the identification of Campylobacter . When tested against four drugs: erythromycin, tetracycline, kanamycin and ampicillin, 11 isolates showed multiple resistance . Resistance to erythromycin was seen in 19% and 28.6% of Campylobacter coli and Campylobacter jejuni respectively . All the isolates were susceptible to nitrofurans, gentamicin and chloramphenicol. Rinsho Byori, 1990 Jan, 38(1), 104 - 6 {Evaluation of agar media for growth of Campylobacter pylori}; Narikawa S et al.; The supporting ability for the growth of Campylobacter pylori was tested on various agar plates . C . pylori grew on media supplemented with blood, serum or egg-yolk, and it showed good growth on Mueller Hinton agar with horse blood, and on brain-heart infusion agar with yeast extract and horse blood . The organism grew moderately on Mueller Hinton agar, but could not grow on the other unsupplemented media . Mueller Hinton medium may be of use as a proper base of blood agar for growth of C . pylori . Egg-yolk may be substituted as a low-priced enrichment material for blood. Br Vet J, 1990 Jan-Feb, 146(1), 68 - 74 Control of Campylobacter fetus in artificially contaminated bovine semen by incubation with antibiotics before freezing; Chen SS et al.; Fresh, diluted semen containing 1.55 X 10(6) cfu/ml of Campylobacter fetus subsp . venerealis was incubated with 500 iu of penicillin, 500 micrograms of streptomycin, 160 micrograms of lincomycin and 300 micrograms of spectinomycin per ml at 35 degrees C for 0, 1, 2, 5, 10, 20 or 40 minutes . The semen was cooled to 5 degrees C, packaged in 0.25 ml French straws and then frozen in liquid nitrogen for 2 weeks . Immediately after thawing and removal of the antibiotics by centrifugation semen samples from each of the seven treatment groups were cultured as for C . fetus . Semen samples were also examined by in-vitro tests for sperm motility prior to and post-freezing . Incubation with the antibiotics for 5, 10, 20 or 40 min prior to freezing reduced the numbers of C . fetus in the semen to non-detectable levels in 38%, 69%, 88% and 100% of samples respectively . The incubated semen showed no significant reduction of sperm motility although fertility trials have not been done. Am J Gastroenterol, 1990 Jan, 85(1), 47 - 50 Gastric mucosal prostaglandin synthesis in the presence of Campylobacter pylori in patients with gastric ulcers and non-ulcer dyspepsia; Taha AS et al.; It is unclear how Campylobacter pylori (CP) interacts with gastric mucosal prostaglandins (PG) . In a double-blind study we measured gastric PG synthesis in 22 patients with benign gastric antral ulcers (GU) and 26 with non-ulcer dyspepsis (NUD) . CP status was determined by histology and bacteriology: 26 (16 GU plus 10 NUD) were CP positive, and 22 (6 GU plus 16 NUD) were CP negative . Patients with severe gastritis regardless of CP status) had significantly higher PGE2 and PGI2 values than those with mild gastritis . Severe gastritis was found in 36% of CP-negative subjects and 77% of the CP-positive patients (chi 2 = 8.64, p less than 0.01), but no significant differences in PG values were found between CP-positive or -negative patients. Ultrastruct Pathol, 1990 Jan-Feb, 14(1), 1 - 10 Duodenal ultrastructure in patients with chronic renal failure with a comment on the incidence of Campylobacter pylori infection; Shousha S et al.; This study was aimed at identifying ultrastructural abnormalities that may be present in the duodenum of patients with chronic renal failure who were undergoing hemodialysis and that may have an effect on the normal absorptive function of the duodenum . Duodenal biopsy specimens from ten patients and four controls were examined . Light microscopy showed gastric metaplasia in eight patients and in none of the controls . The main electron microscopic findings were related to the metaplastic changes, with abundant mucous globules and abnormal microvilli being seen in the affected columnar cells . Prominent lysosomes and wide intercellular spaces were seen in some areas . Goblet and enterochromaffin cells appeared to be normal . Some of the reported abnormal duodenal absorptive functions may be related to the ultrastructural abnormalities seen in the microvilli and the apical parts of the columnar cells . Because of the known association between gastric metaplasia and colonization of the duodenum with Campylobacter pylori, we looked for these organisms in our cases . Light microscopy demonstrated these bacteria in only one of the eight duodenal biopsy specimens with gastric metaplasia . Particles, probably representing degenerated bacteria, were seen by electron microscopy in most of the examined specimens, however, suggesting that the duodenum of these patients remains hostile to the growth of these organisms. N Y State J Med, 1990 Jan, 90(1), 4 - 7 Evaluation of methods for identification of Campylobacter pyloris infection; Santogade PJ et al.; Fifty unselected patients undergoing routine esophagogastroduodenoscopy were evaluated for infection with Campylobacter pyloris (CP) . Antral specimens were cultured, and biopsies from the antrum and the body of the stomach were examined histologically . Specimens of antral brushings were analyzed with Gram stain, and urease testing was performed on gastric aspirates, antral brushings, and antral biopsy homogenates . Twenty-seven (54%) patients were CP-positive by silver stain and/or culture of mucosal biopsies . The simplest and fastest diagnostic methods was Gram stain of antral brushing, which was 93% sensitive and 100% specific . CP-negative patients were more likely to have normal histology in antrum and body tissues, while CP-positive patients usually exhibited superficial or chronic gastritis (p less than 0.01) . Using ELISA technique, 67% of all patients and 89% of CP-positive patients had serum antibodies against sonicated CP organisms . We conclude that evidence of gastric CP infection is common, is associated with inflammatory changes of the gastric mucosa, is suggested by finding antibodies to CP in serum, and can be accurately and rapidly diagnosed by staining of endoscopically derived cytology and biopsy specimens. J Infect Dis, 1990 Jan, 161(1), 59 - 64 Production of specific monoclonal antibodies to Salmonella typhi flagellin and possible application to immunodiagnosis of typhoid fever; Sadallah F et al.; Four murine monoclonal antibodies (MAbs) to Salmonella typhi flagellin were produced . These MAbs did not react with eight other enterobacterial strains tested: Salmonella enteritidis, Salmonella typhimurium, Salmonella paratyphi A, Escherichia coli, Shigella flexneri, Shigella sonnei, Yersinia enterocolitica, and Campylobacter jejuni . All four MAbs cross-reacted with Salmonella muenchen flagellin indicating specificity for d antigenic flagellar epitope . One MAb (C4) was selected to develop a double antibody sandwich enzyme-linked immunosorbent assay (ELISA) to detect S . typhi flagellin in serum samples . By use of this assay S . typhi flagellar antigen was detected in 95.5% of serum samples from patients with positive hemoculture for S . typhi, in 93.6% of samples from patients with positive serodiagnosis of typhoid fever, in 26% of samples collected from patients who were initially hemoculture-positive for S . typhi and who had undergone 7-8 d of chemotherapy, in 8.5% of samples from healthy persons from an endemic area, and in no samples from healthy persons from a nonendemic area . The presence of high levels of flagellin antibody titers did not interfere with the antigen detection . The detection of S . typhi flagellar antigen in patient serum may have practical value for rapid diagnosis of typhoid fever. Arkh Patol, 1990, 52(10), 49 - 53 {Chronic gastroduodenitis in children and Campylobacter pylori}; Sklianskaia OA et al.; Gastric biopsies from 90 children (from 5- to 15-year-old) with chronic gastroduodenitis were examined for Campylobacter pylori (CP) by bacteriological, histological (Giemsa stain, argentation by Warthin-Starry, acridine orange stain) and electron microscopical methods . CP is detected in 81.2% children . The degree of colonization was low or moderate . The increase of occurrence was noted with age and duration of disease . Persistence of CP went down with the increase of atrophic change in the gastric mucosa and duodenum, but there was no clear-cut correlation with the morphological variant of gastritis and the stage of disease . Colonization with CP is regarded as an important part in the pathogenesis of chronic gastroduodenitis in children. Arkh Patol, 1990, 52(10), 45 - 9 {Campylobacter pylori in patients with liver cirrhosis of different etiologies}; Kataev SS et al.; The role of Campylobacter pylori (CP) in the development of chronic gastritis and ulcero-erosive lesions in 76 patients with liver cirrhosis of various etiology is studied . The incidence of CP bacteriosis in liver cirrhosis was 47.3% and the incidence of CP detection by bacteriological methods was not dependent on the cirrhosis etiology . The incidence of CP detection depended on the chronic gastritis activity and the presence of ulcero-erosive lesions . Hypochlorhydria is one of the important factors favouring CP colonization in liver cirrhosis . DE-NOL can be recommended for the treatment of chronic active gastritis and ulcero-erosive lesions. Arkh Patol, 1990, 52(10), 3 - 8 {Helicobacter (Campylobacter) pylori in the etiology and pathogenesis of gastritis and peptic ulcer}; Aruin LI; Current information on the role of Helicobacter pylori (HP) in the stomach and duodenum pathology is presented . HP is always found in active chronic gastritis and duodenal ulcer . HP damage to gastric superficial epithelium may result in the accelerated proliferation and incomplete differentiation of epithelium, this being a basis of chronic gastritis morphogenesis . Factors of aggression such as HCl hypersecretion provoke a stomach metaplasia of the duodenal mucosa . HP damage to such areas combined with the factors of aggression result in the transition of a preulcer state into ulcer. Arkh Patol, 1990, 52(10), 12 - 6 {Campylobacter pylori and the reparative processes in peptic ulcer}; Miagkova LP et al.; The paper deals with reparative potential of gastric and duodenal mucosa in ulcer in connection with the presence and quantity of Campylobacter pylori (CP) which is found practically in all patients not only with duodenal localization of ulcer but with mediogastric and pyloroantral localization as well . No correlation between the CP presence and CP mucosa colonization on the one hand and the type of reparative processes in the mucosa is found . The presence or the absence of CP as well as the degree of CP mucosal dissemination have no influence on the clinical course of the ulcer . Antiulcer treatment aiming at aggression factors (histamine H2-receptors blockers) and protective factors (enprostil) and lacking antibacterial activity improves the reparative processes but does not influence CP . Thus, CP is not etiological and probably is not a main pathogenetic factor in ulcer development . Its participation in the genesis of ulcer is possibly brought about under conditions of suppression of local protective mechanisms. Gastroenterol Clin Biol, 1990, 14(11), 801 - 5 {14C-urea breath test to diagnose gastric Helicobacter pylori colonization}; Coelho LG et al.; Helicobacter pylori (H . pylori), ex-Campylobacter pylori, is now considered to be the causative agent of active chronic gastritis in humans and may be diagnosed by histology, gram-stain, culture, urease test or noninvasively by 14C-urea breath test . The aim of this study was to determine the sensitivity, specificity, and reproducibility of the breath test as compared with the microbiological (culture) "gold standard" . Forty-one subjects were studied . Gastroscopy was performed in all participants and 2 antral mucosa biopsy specimens were taken for urease test and microbiological (gram-stain and culture) studies . The breath test was performed within one week after the gastroscopy . After fasting overnight, a control breath sample was obtained and a standard meal was offered to delay gastric emptying . Then, the participants drank 5 microCi of 14C-urea in 20 ml of water and breath samples were collected at 10, 15, 30 and 60 min in a hyamine-ethanol solution with a p-H indicator . A repeat test was performed in 9 subjects to assess test reproducibility . Twenty-nine subjects (71 percent) were Hp positive and 12 (29 percent) H . pylori negative . A highly significant difference (p less than 0.0001) was observed in 14CO2 exhalation in colonized and non-colonized subjects in samples collected at all times studied . As compared with culture we found that the breath test was 97 percent sensitive and 100 percent specific . We conclude that 14C-urea breath test is a simple, inexpensive, sensitive, and reliable method to detect H . pylori colonization . It is a useful test to epidemiologic and therapeutic trials. Digestion, 1990, 46(2), 65 - 71 Medical treatment of antral gastrin cell hyperfunction: role of nonantisecretory therapy; Delle Fave G et al.; Antral G cell hyperfunction (AGCH) is a rare condition, often associated with severe duodenal ulcer disease poorly responsive to medical therapy . Up to now, no studies have been designed to investigate a possible role of medical treatment in the management of this syndrome . In this study we treated 9 AGCH patients with duodenal ulcer, unhealed with the prolonging standard doses of H2 antagonists (300 mg/day ranitidine or 800 mg/day cimetidine), with a nonantacid therapy, tripotassium dicitrato bismuthate (TDB) . 6 out of 9 patients showed a complete healing after 8 weeks of treatment . The healing was irrespective to eradication of Campylobacter pylori . After 9 weeks' suspension of H2 blockers basal gastrin levels decreased significantly by 31.5%, whereas peak meal-stimulated levels, although decreased in 6 out 9 patients, were not significantly affected by the withdrawal of the H2 antagonists . Nonantisecretory therapy seems to be an efficacious alternative in the management of AGCH patients. Nord Med, 1990, 105(11), 299 - 300 {Helicobacter pylori}; Kjoller M; Ever since 1983 when Marshall & Warren succeeded in cultivating Helicobacter pylori (HP) (previously known as Campylobacter pylori) a high incidence thereof has been demonstrated in patients with ulcers and non-ulcerous dyspepsia . Helicobacter pylori is easily diagnosed via microscopy, cultivation and serological tests . The bacterium may be treated with antibiotics or the ulcer drug bismuth subcitrate (De-Nol) . The pathogenetic role of HP is not clear . Some studies have shown a lower recurrence rate of duodenal ulcers after treatment addressed to Helicobacter pylori with the ulcer drug De-Nol, which suggests that HP plays a role in the onset of recurrence in cases of ulcus duodeni. Int J Clin Pharmacol Res, 1990, 10(3), 179 - 82 Ranitidine in children with peptic ulcer and patients with pancreatic cystic fibrosis; Scorza A et al.; This article describes experience of the use of ranitidine in children with peptic ulcer and patients with pancreatic cystic fibrosis . Ranitidine proved to be efficacious and well tolerated, the percentage of healing being 89.4% . Ranitidine was also used in subjects with gastritis from Campylobacter pylori, obtaining rapid regression of subjective symptoms . Administration of ranitidine to cystic fibrosis patients improved the efficacy of the pancreatic extract, with consequent enhancement of digestive compensation. Gastroenterol J, 1990, 50(2), 97 - 100 {Combination of glandular and foveolar hyperplasia of the gastric mucosa--a rare mixed type}; Hantzschel U et al.; In a 28 year-old man with epigastric pain endoscopy detected giant gastric folds and multiple superficial erosions . Histologically a mixed form of glandular and foveolar hyper plasia of the gastric mucosa was suggested (Ming's type III) . Basal and pentagastrin stimulated secretion volume and acid output were moderately elevated, hypersecretion of protein was not found . Serum levels of calcium and gastrin were normal, also after secretin stimulation . The mucosa of the corpus was extensively infested with Campylobacter pylori . Therapy with cimetidine, antacids, pirenzepine and metronidazol resulted in relief of symptoms but not of histological findings . Bismuth (JatroxR) was successful in eradicating Campylobacter pylori and decreasing inflammation of the mucosa . Cause and prognosis of this mixed hyperplasia are not known. Scand J Rheumatol, 1990, 19(5), 350 - 5 Salmonella-reactive synovial fluid T-cell clones in a patient with post-infectious Salmonella arthritis; Hermann E et al.; From a patient with reactive arthritis following Salmonella typhimurium enteritis, synovial fluid T-lymphocytes were cloned and expanded in vitro . Seven out of 74 clones showed a marked proliferative response to antigens of heat-killed Salmonella typhimurium with autologous T-cell-depleted peripheral blood mononuclear cells as antigen-presenting cells . The Salmonella-reactive clones were of the CD4+ phenotype, antigen-induced proliferation could be inhibited by a monoclonal antibody to HLA class II . One clone recognized both Salmonella and Campylobacter jejuni antigens in the proliferation assay . The multiclonality of Salmonella-reactive synovial fluid T-cells indicates that the microorganisms have been present, at least transiently, within the affected joint and thus recruited specific T-lymphocytes that might initiate synovitis. J Clin Gastroenterol, 1990, 12 Suppl 1, S99 - 103 Campylobacter pylori interactions with gastric cell tissue culture; Wyle FA et al.; Many investigators have reported that gastric mucosal biopsies of patients with chronic gastritis and peptic ulcer disease show the presence of Campylobacter pylori in a large majority of cases . Histologic examinations of such tissues indicate a close approximation of C . pylori with gastric surface epithelial cells . A recent report has described both adherence and cell invasion of gastric cells by C . pylori . Using a transmission electron microscope, we have examined the interaction between C . pylori, C . jejuni, and E . coli in vitro with a gastric cancer cell line, Kato III . Our results indicate marked toxicity of E . coli and moderate toxicity of C . jejuni for Kato III cells . C . pylori had only a minor effect on tissue culture viability . C . pylori was found to have a strong association with the Kato III cell membranes and evidence of occasional cell invasion . Both C . jejuni and E . coli showed no attachment or association with the Kato III cells . We interpret these findings as indicating that C . pylori may have a specific adhesion for gastric cells. J Clin Gastroenterol, 1990, 12 Suppl 1, S92 - 8 Evidence for gastric mucosal cell invasion by C . pylori: an ultrastructural study; Wyle FA et al.; It is now generally accepted that Campylobacter pylori is closely associated with peptic ulcer disease and chronic type B gastritis . Whether C . pylori is the direct etiologic cause of either or both of these illnesses remains unclear . Possible pathophysiologic effects of C . pylori are still a matter of debate and conjecture . Utilizing a small group of patients with gastric ulcers and chronic gastritis, we examined the ultrastructural relationship between C . pylori and gastric cells . Forty-eight percent of our gastric ulcer patients and 57% of our chronic gastritis patients had C . pylori in their lower corpus mucosa . Examination with the transmission electron microscope indicated a very close proximation by C . pylori to the surface epithelial cells strongly suggesting adherence . We also describe for the first time the invasion of gastric cells by C . pylori . Although an uncommon occurrence, we had repeated observations of C . pylori invading surface epithelial cells, parietal cells, and chief cells . Most of the intracellular C . pylori were intact but other forms appearing to be degenerating organisms were also seen . We suggest that cell invasion may be one mechanism by which C . pylori causes pathologic changes in the gastric mucosa . These observations may also explain why C . pylori chronically infects gastric cells and frequently recurs after treatment. J Clin Gastroenterol, 1990, 12 Suppl 1, S135 - 8 The susceptibility of Campylobacter pylori to antiulcer agents and antibiotics; Nagate T et al.; The antibacterial activities of antiulcer agents and antibiotics against Campylobacter pylori were studied . The MIC90 values of three kinds of antibiotics--macrolides, beta-lactams, and metronidazole--were 0.05-0.78, 0.39-1.56, and 12.5 micrograms/ml, respectively . They were more active than antiulcer agents such as H2-blockers and cetraxate with MIC90 values of greater than or equal to 1,600 and greater than 1,600 micrograms/ml, respectively . Especially, clarithromycin, a new derivative of erythromycin, showed an MIC90 of 0.05 microgram/ml . However, the other antiulcer agents such as sofalcone and tripotassium dicitrate bismuthate (TDB) also had MIC90 values of 50 and 6.25 micrograms/ml, respectively . Clarithromycin, sofalcone, and TDB showed bactericidal activity against C . pylori CLO2 . The bactericidal actions of these drugs could be observed under electron microscopy. Digestion, 1990, 46(1), 46 - 54 Development of a human stomach explant organ culture system to study the pathogenesis of Helicobacter pylori; Smoot DT et al.; These studies were undertaken to define conditions under which Helicobacter (formerly Campylobacter) pylori and viable human gastric mucosa could coexist in tissue culture with the ultimate goal of developing an in vitro experimental model which could be used to study interactions between H . pylori and gastric epithelium . Antral gastric biopsies obtained at upper endoscopy were placed in culture in either CMRL-1066 or keratinocyte growth media and incubated at 37 degrees C in either an oxygen-enriched environment (45% O2, 50% N2, 5% CO2) or a standard oxygen environment (95% air, 5% CO2) . Without selective antibiotics to suppress growth of non-H.-pylori organisms, H . pylori could not be isolated from most initially positive tissue even after only 2 h in tissue culture; however, when selective antibiotics were utilized in the tissue culture media, H . pylori was isolated from 9 of 14 initially positive cases after 24-72 h in tissue culture . There was little difference in the morphology of either surface or glandular epithelium in H.-pylori-negative explants between time zero and 48-hour cultures . However, H.-pylori-positive explants after 48 h in tissue culture showed a significant increase in injury to both surface and glandular epithelium when compared to time zero specimens . These data demonstrate that viable H . pylori and human gastric epithelium can be maintained in explant organ culture and suggest that this gastric mucosal explant culture system may be useful in studying the significance of H . pylori infection of human gastric epithelia. Diagn Cytopathol, 1990, 6(4), 227 - 34 Identification of Campylobacter pylori by endoscopic brush cytology; Schnadig VJ et al.; To investigate the value of Papanicolaou-stained endoscopic brush samples in the diagnosis of Campylobacter pylori infection of the upper gastrointestinal tract, 138 brush and biopsy samples from the esophagus, stomach, and duodenum, taken concomitantly, were reviewed retrospectively . In 35 cases, Campylobacter-like organisms (CLOs) were found in both cytology and biopsy samples . In 15 cases, CLOs were seen in biopsy material only, and in 8 cases, CLOs were found in cytology material only . CLOs were found in 49% of the gastric specimens and 33% of the Barrett's esophagus specimens by histologic or cytologic examination or by both methods . CLOs were found by at least one method in 64% of the gastric samples with active gastritis 40% with borderline gastritis, 15% without gastritis, and in 64% with adenocarcinoma . Cytologic examination of endoscopic brush samples is a valuable technique for the diagnosis of gastric Campylobacter infections and can be performed easily in cytopathology laboratories. J Hyg Epidemiol Microbiol Immunol, 1990, 34(1), 57 - 61 To the problem of Campylobacter jejuni detectability in water; Pokorny J; In a series of model experiments two isolation procedures for the detection of water-borne Campylobacter jejuni were compared: a standard culture in thioglycolate broth enriched with 7% defibrinated sheep blood and supplement C and a modified membrane filtration method in which the filter (porosity 0.45 microns) plated on campylobacter agar surface was removed after the first 24 hours of incubation and the plate further incubated for 48 hours . The recovery rates by the thioglycolate broth method were markedly less pronounced than those obtained by the modification of membrane filtration technique, especially in the case of water rich in organics . The best isolation parameters were achieved with water samples of at least 10 ml in volume. Jpn J Antibiot, 1990 Jan, 43(1), 181 - 215 {Evaluation of norfloxacin in the pediatric field . Pediatric Study Group for Norfloxacin}; Fujii R et al.; Norfloxacin (NFLX, AM-715), a new quinolone antibiotic agent, was evaluated clinically and bacteriologically for its efficacy and safety in pediatrics by a study group organized with pediatricians from all over the country . A summary of the results of the evaluation is as follows . 1 . Incidence of NFLX-resistant strains (MIC over 12.5 micrograms/ml) isolated from children with various infections was 1.6% (8/512) . One resistant strain was observed among 45 isolates of Staphylococcus aureus, and none among 30 isolates of Pseudomonas aeruginosa . 2 . After single oral administration of 1.5-2.9, 3.0-4.8 and 5.1-6.1 mg/kg NFLX in tablet form at fasting, mean peak values of serum concentration of 0.37, 0.56, 0.92 micrograms/ml, T1/2 of 2.5, 2.6, 2.6 hours and urinary recovery rates in 8 hours at 25.3, 25.3, 27.1% were observed, respectively . 3 . Clinical effects were studied chiefly in intestinal and urinary tract infections . Among 317 patients from whom pathogens had been isolated, responses to the treatment were excellent in 187, good in 79, fair in 9, poor in 7, and unknown in 35 cases . The overall efficacy rate was 94.3% (266/282) and the efficacy rate for excellent responses was 70.3% (187/266) . Among all the 406 patients treated, including those with undetermined pathogens, responses were excellent in 233, good in 106, fair in 11, poor in 11, and unknown in 45 cases . The overall efficacy rate was 93.9% (339/361) . 4 . Clinical effects of NFLX classified by diseases with identified pathogens were 81.8% (9/11) for acute pneumonia, 80.8% (21/26) for other respiratory infections, 95.8% (23/24) for bacillary dysentery, 98.6% (70/71) for Campylobacter enteritis, 100% (24/24) for Salmonella enteritis, 100% (6/6) for other acute enteritis and 98.1% (104/106) for urinary tract infections . Including other infections as high as 94.3% (266/282) of efficacy rate was obtained in total . There was no significant difference in NFLX efficacies between unidentified and identified pathogens . Thus, the total clinical efficacy rate was 93.9% (339/361) . 5 . The total eradication rate of 325 pathogens evaluable was 84.3%, with identical eradication rates for Gram-positive cocci (GPC) (43/51) and for Gram-negative rods (GNR) (231/274) . 6 . The optimal daily dose of NFLX seemed to be in a range between 6.0 and 12.0 mg/kg, and the optimal duration of treatment to be 7 days for children over 5 years old . 7 . The clinical efficacy in treating P . aeruginosa infections in 12 patients was 100% (11/11) and the eradication rate was 83.3% (10/12).(ABSTRACT TRUNCATED AT 400 WORDS) Adv Pediatr Infect Dis, 1990, 5, 221 - 37 Campylobacter pylori: a new pathogen; Czinn SJ et al.; There is now considerable evidence suggesting that C . pylori is a human pathogen . The strong association between C . pylori and gastroduodenal disease is well documented . A number of hypotheses have been suggested for the pathogenic mechanisms of C . pylori-induced gastroduodenal disease, including the production of cytotoxins and the mechanical disruption of the epithelium . At the present time, treatment with a combination of antimicrobial agents eradicates the infection in approximately 50% of cases . Until an ideal therapeutic regimen is available, antimicrobial therapy is recommended only for those patients who continue to be symptomatic following 6 to 8 weeks of treatment with an H2-receptor. Antimicrob Agents Chemother, 1990 Jan, 34(1), 71 - 7 Molecular studies on the mechanism of tetracycline resistance mediated by Tet(O); Manavathu EK et al.; The mechanism of resistance to tetracycline in Escherichia coli mediated by the Campylobacter jejuni-derived resistance determinant Tet(O) was investigated . The cloned Tet(O) protein had no detectable effect on the intracellular accumulation of tetracycline . The presence of Tet(O) markedly diminished the inhibitory effect of tetracycline on protein synthesis both in vivo and in vitro . Ribosomes prepared from tetracycline-resistant and susceptible E . coli cells bound almost identical amounts of radiolabeled tetracycline . Thus, a reduction in the binding of the antibiotic to its target site on the ribosome is not the primary mechanism of resistance . Poly(U)-directed polyphenylalanine synthesis revealed that an S-100 fraction prepared from tetracycline-resistant cells made the ribosomes prepared from susceptible cells considerably more resistant to the inhibitory action of tetracycline . The N-terminal portion (1 to 150 residues) of Tet(O) is highly homologous to the GTP-binding domain of elongation factor Tu and to elongation factor G, indicating that the Tet(O) protein has the potential to bind GTP . These data suggest that the Tet(O) protein could function either as a tetracycline-resistant analog of this elongation factor(s) or by modifying the target sites on the ribosomes in a catalytic fashion. FEMS Microbiol Lett, 1990 Jan 1, 54(1-3), 303 - 6 Evaluation of a selective enrichment technique for the isolation of Campylobacter pylori; Morgan DR et al.; To cultivate Campylobacter pylori from contaminated biopsy specimens, Brucella broth was supplemented with 10% fetal calf serum, 1% Vitox, 1000 units/ml polymyxin B sulfate, 10 micrograms/ml vancomycin, and 2 micrograms/ml amphotericin B . Pseudomonas aeruginosa, Candida albicans, and Enterococcus fecalis were cocultivated with C . pylori . All four strains of C . pylori were recoverable at 24 h . When 21 C . pylori strains were studied in pure culture, 86% grew in the selective enrichment medium . In a clinical study, the selective enrichment technique resulted in isolation of C . pylori from 50% of patient samples, compared with isolation from only 36% of samples with agar cultivation . The selective enrichment technique may be more sensitive than techniques currently employed to isolate C . pylori from gastric tissue. Acta Clin Belg, 1990, 45(4), 240 - 6 Comparison of anti-Helicobacter (Campylobacter) pylori IgG antibodies between different areas of Belgium; Tomasi JP et al.; We have collected sera from 4053 patients of different parts of Belgium . Sera were randomly selected whatever the kind of pathology . Anti-Helicobacter (Campylobacter) pylori IgG were determined with an ELISA technique using whole formalized bacteria . The results suggest that the mean antibody titres differ between various areas, with an overall higher prevalence in the north-western part of the country. J Clin Gastroenterol, 1990, 12 Suppl 1, S131 - 4 Possible role of leukotrienes in gastritis associated with Campylobacter pylori; Fukuda T et al.; This study was done to evaluate the role of leukotrienes (LTs) in gastritis associated with Campylobacter pylori . Biopsy specimens of gastric mucosa were obtained endoscopically from 18 patients with nonulcer dyspepsia for bacteriological and histological examination and extraction of LTs . There was correlation between the LTB4 level in the mucosa and the degree of gastritis evaluated histologically . The level was higher when infiltration of neutrophils in the gastric mucosa was more extensive . The LTB4 level in mucosa infected with C . pylori was higher than that in noninfected mucosa . These findings suggest that endogenous LTs may be related to the pathogenesis of gastritis associated with C . pylori. Lab Anim Sci, 1990 Jan, 40(1), 42 - 6 Clinical and parasitologic aspects of cryptosporidiosis in nonhuman primates; Miller RA et al.; Eighty-one cases of acute cryptosporidiosis were diagnosed among 157 (52%) infant primates, predominantly Macaca nemestrina, housed in the nursery unit of the Washington Regional Primate Research Center . The mean age at onset of oocyst passage was 38 +/- 25 days . The outbreak was confined to the nursery and no cases were detected among juvenile or adult primates housed in other rooms within the colony . All but one animal manifested symptoms of enteric infection, including severe diarrhea and dehydration . Infected animals excreted oocysts for a mean of 36 days (range 7-78 days) . No reinfections occurred . Cryptosporidium was the second most common enteric pathogen detected in the population, after Campylobacter jejuni . The risk of infection was related to the length of time the animal was housed in the nursery and to social interaction with other monkeys . These findings are relevant to the understanding of the epidemiology of cryptosporidiosis among human infants and children in environments with close social interactions and minimal learned personal hygiene practices. J Clin Microbiol, 1990 Jan, 28(1), 83 - 6 Typing of Campylobacter pylori by bacterial DNA restriction endonuclease analysis and determination of plasmid profile; Simor AE et al.; Campylobacter pylori isolates from 37 symptomatic patients and 3 asymptomatic volunteers were examined by chromosomal DNA restriction endonuclease analysis and determination of plasmid profile . Restriction digests with HindIII, HaeIII, PvuII, and BglII produced clear and reproducible results that permitted discrimination between different strains . Only 35% of C . pylori isolates were found to have plasmid DNA . Isolates from different patients, including those from two pairs of siblings, had unique restriction patterns and plasmid profiles . Consecutive isolates obtained 1 year apart from each of two asymptomatic volunteers had identical restriction patterns and plasmid profiles, suggesting persistence of the same strain . A pair of isolates obtained one year apart from the third volunteer differed in plasmid DNA content but had similar chromosomal DNA restriction patterns . Plasmid profile determination and bacterial DNA restriction endonuclease analysis provide a reliable means of discriminating between different strains of C . pylori and may be useful for typing these organisms in epidemiologic studies. Cesk Epidemiol Mikrobiol Imunol, 1990 Jan, 39(1), 43 - 9 {Epidemiology of Campylobacter jejuni/coli}; Kourilova J et al.; The authors describe the epidemic incidence of diseases caused by Campylobacter jejuni/coli . During the 5-week follow up period (June 1-July 1, 1988) a total of 74 subjects fell sick . In 31 instances the suspect factor of transmission was non-pasteurized cheese prepared from sheep's milk . In this group of patients a significant shift to higher age categories was noted, contrary to the other 43 diseases . It did not prove possible to isolate Campylobacter from cheese, smears from the cottage or from rectal swabs of the workers from the cottage . In an investigation focused on assessment of survival of Campylobacter jejuni/coli in sheep's milk and cheese long-term survival of the microorganism only in non-pasteurized milk was found . The authors assume that cheese becomes contaminated secondarily, by lack of adherence to hygienic rules. Indian J Public Health, 1990 Jan-Mar, 34(1), 54 - 61 Etiological agents of diarrhoea; Ghosh AR et al.; Two decades of research have established newer pathogens and techniques in establishing several organisms of diarrhoeal diseases as aetiological agents . It is now possible to detect an agent in 80% of the situation of diarrhoea in a standard laboratory . The brief review describes the list of pathogens, their diagnostic techniques with short description on clinical and epidemiological statusPIP: In the early 1980s, microbiologists could isolate the causative agent of diarrhea in only 20% of cases, but now they can isolate an agent in about 80% of cases . Since then, they have identified more enteropathogens . In fact, 25 enteropathogens cause disease . Shigella species tend to afflict people in unhygienic areas with watery or mucoid diarrhea . They tend to strike infants during weaning . They often are resistant to several drugs, particularly nalidixic acid . IN 1984, S . dynsenteriae type 1 struck people in West Bengal, Assam, and Orissa, India . Salmonella species are other common agents of diarrhea . Unlike Shigella species, the infective dose for Salmonella is rather small . Food is the chief mode of transmission . In the early 1990s, they were responsible for considerable diarrhea morbidity in parts of West Bengal . birds carry Campylobacter, but person to person transmission occurs in nurseries . Studies in Calcutta indicate considerable asymptomatic infection of C . jejuni in 5 year old children . The enterotoxin of several types of Vibrio cholerae continues to cause outbreaks of profuse watery diarrhea . Vibrio parahaemolyticus dwells in marine animals and infection favors adults . In Calcutta, it is the 2nd most common health hazard and is present year round . Different strains of Escherichia coli cause diarrhea including enteropathogenic, enterotoxigenic, enteroinvasive, enterohemorrhagic, and enteroadherent E . coli. . A study published in 1984 indicates that, in Calcutta, enterotoxigenic E . coli was present in 12.1% of the feces of diarrhea patients from all age groups . Yersinia and Aeromonas species are also bacteria which cause diarrhea . Rotavirus is a common virus causing diarrhea . In India, Manipur and Calicut experience rotavirus epidemics every winter . Protozoans also cause significant diarrhea including Entamoeba histolytica, Giardia lamblia, and Cryptosporidium species . Indian J Public Health, 1990 Jan-Mar, 34(1), 38 - 40 Management of acute diarrhoea; Dutta P et al.; PIP: Before 1970, laboratory staff could not only identify the causative organism of acute diarrhea in 20% of cases, but in 1990, they could identify it in 80% of cases . These organisms are either bacteria, virus, or parasites . The bacteria include enterotoxigenic bacteria (Vibrio cholerae, enterotoxigenic Escherichia coli, Clostridium perfringens, and Staphylococcus aureus) and enteroinvasive bacteria (Campylobacter jejuni, C . coli, and Salmonella and Shigella species) . The leading cause of death in diarrhea patients is dehydration . Oral rehydration solutions (ORS) can alleviate mild and moderate dehydration regardless of the etiology of the diarrhea or the age of the patient . WHO recommends an ORS containing glucose and various electrolytes which permit salt and water absorption in many cases of acute diarrhea . Due to the possibility of excess salt entering the bloodstream (hypernatremia), some pediatricians do not use the WHO recommended ORS in newborns and young infants . Instead they use 2 parts ORS followed by 1 part water . This treatment is not easy for illiterate mothers to follow, however . Continued breast feeding during diarrheal episodes along with administration of ORS protects not only against dehydration, but also hypernatremia . ORS should not be administered in severe case of dehydration, however . Medical personnel need to administer replacement fluid such as Ringer's Lactate solution intravenously regardless of the age group . Once the initial deficit has been controlled, ORS administration and reintroduction of foods can follow . Antibiotics should only be administered if the medical personnel suspect severe cholera in an endemic area (tetracycline and furazolidone); shigellosis, but 1st the bacteria must be tested to see if the strain is multiple drug resistant (ampicillin, trimethoprim-sulphamethoxazole, furazolidone, nalidixic acid), and acute amebiasis or giardiasis (metronidazole and tinidazole) . Antidiarrheals should not be used . Arch Roum Pathol Exp Microbiol, 1990 Jan-Mar, 49(1), 79 - 88 The incidence and epidemiological significance of Campylobacter jejuni/coli serotypes in Romania; Rusu V et al.; The distribution per serotypes of 401 Campylobacter strains was studied by Lior's procedure, 241 strains being identified as C . jejuni (60.1%) and 160 as C . coli (39.9%): out of these 329 were of human origin (82%), including 225 C . jejuni and 104 C . coli, and 72 were isolated from fowls and swine (16 C . jejuni, 56 C . coli) . Out of the total of 401 strains, 363 (90.5%) were typable . Among human strains, 32 serotypes were identified, more frequently encountered being (in a decreasing order) 29, 4, 21, 2, 1, 9, 59, 44, 36, 48, 28, 8, 47, 5, 11, 57, 10, 32, 55 which sum up 89.5% of the 296 typable strains . Within C . jejuni species, serogroup 4 was the predominant one and for the C . coli one--29 . Animal strains were distributed into 16 serogroups out of which 29, 26, 48, 55, 44 were more frequently encountered . The serogroups identified among animal strains were encountered, with a single exception, among human strains, too, but with a different frequency . The importance of serogrouping as an epidemiological marker, was confirmed by serogroup identity of the strains within some family foci, by the oneness, as serogroups, in the case of repeated isolations from the same patient as well as by establishing an epidemiological diagnosis, in the case of an epidemic, occurring among the members of a given community. Acta Vet Scand, 1990, 31(4), 445 - 51 Immuno-histochemical and -cytochemical evidence suggesting the presence of Campylobacter jejuni and Campylobacter coli in cases of porcine intestinal adenomatosis; Eriksen K et al.; Antisera against a number of Campylobacter species were used in immuno-histochemical and -cytochemical studies on cases of porcine intestinal adenomatosis . Avidin-biotin-complex (ABC) and streptavidin immunoperoxidase methods were used on formalin-fixed, paraffin-embedded and frozen sections . Protein A gold method was used on formaldehyde fixed and frozen sections for immuno-cytochemistry . The antisera used were raised in rabbits by subcutaneous or intravenous injection of living or formalin treated organisms . Anti-sera against different serotypes of the thermotolerant, catalase positive campylobacters, Campylobacter jejuni and Campylobacter coli, gave positive reactions in the immuno-histochemical studies . The staining was found in intestinal epithelial cells both in the ileum and in the colon and was restricted to the apical cytoplasm of adenomatous epithelial cells . The staining had a granular pattern, the positive structures sometimes having the shape of Campylobacter . Epithelial cells in areas with normal differentiation of goblet cells did not stain . In contrast, no staining resulted with antisera against Campylobacter sputorum subsp . mucosalis and Campylobacter hyointestinalis . Immuno-cytochemistry, using antisera against Campylobacter jejuni, showed that the positive staining in altered epithelial cells were restricted to intracellular organisms having a structure resembling Campylobacter spp. Acta Gastroenterol Latinoam, 1990, 20(3), 159 - 61 Eradication of Campylobacter pylori and recurrence of duodenal ulcer . A six-month follow-up study; Mouzas IA et al.; Fifty-four patients were studied, 41 men and 13 woman, aged 26-76 years, suffering from duodenal ulcer that healed 4-8 weeks after colloidal bismuth subcitrate therapy (360 mgr twice a day) . All patients underwent endoscopy before treatment, 4-8 weeks and 6 months later . Biopsy was taken for campylobacter pylori (C.P.) detection by urease test . All patients were C.P . positive initially . The organisms were eradicated in 36/54 patients (67%) at the end of therapy . Ulcer healing was obtained after 8 weeks in 45/54 patients (83%) . They were re-examined 6 months later or sooner if symptoms had recurred . Twenty seven (66%) were then C.P . negative and 14 were C.P . positive . Ulcer recurrence was observed in 15/41 patients (37%) whose ulcer had previously cured . All patients with recurrence were C.P . positive . There was a statistically significant positive correlation between persistence of C.P . and ulcer recurrence rate (p less than 0.001) . It is concluded: a) that eradication of C.P . in duodenal ulcer patients has no influence on ulcer healing . b) Duodenal ulcer recurrence is correlated with persistence of C.P. Gastroenterol J, 1990, 50(4), 163 - 8 {Detection of Campylobacter pylori in gastric mucosa--relation to gastroscopy findings and degree of gastritis}; Hantzschel U et al.; In 862 unselected gastroscopies we could confirm the high percentage of campylobacter pylori infection in the antral gastric mucosa strongly associated with chronic superficial gastritis and active inflammatory signs . Significant correlation with age concerned the normal findings only . In patients with duodenal ulcers we found in 91% gastritis and in 88% campylobacter pylori in antral mucosa . A small group with duodenal ulcers was campylobacter pylori-negative as well as without gastritis signs . Comparing the antrum and corpus gastric mucosa (250 pat.) the antral mucosa was representative for the whole stomach in view of gastritis and campylobacter pylori test, sufficiently for practical use . Between the test methods (culture, urease, microscopy) we favoured the microscopic test. Perit Dial Int, 1990, 10(2), 177 - 8 Campylobacter jejuni peritonitis during chronic ambulatory peritoneal dialysis (CAPD); Van den Eden EJ et al.; A patient treated with chronic ambulatory peritoneal dialysis developed recurrent peritonitis . During a fourth episode, Campylobacter jejuni was cultured from the dialysate . She responded well to streptokinase and imipenem. Arch Inst Pasteur Madagascar, 1990, 57(1), 255 - 64 {Evaluation of the prevalence of the main enteropathogenic agents in the West Imerina region: Manarintsoa}; Cassel-Beraud AM et al.; For a 288 children's population aged from 5 to 14 years old and being school attendents in the village of MANARINTSOA, we have systematically investigated 60% of them in May 1988 and January 1989 . Bacterial, parasitical and viral study of these stools showed off an important number of A . dispar and E . coli strains which have special phenotypes characters . The prevalence of Campylobacter and Ascaris lumbricoides is higher in this rural zone than in TANANARIVE . Two poliovirus of type 2 have been isolated in January 1989. Arch Inst Pasteur Madagascar, 1990, 57(1), 223 - 54 {Infantile diarrheal diseases in Madagascar: bacterial, parasitologic and viral study}; Cassel-Beraud AM et al.; From November 1988 to October 1989, an etiological study showed off the prevalence and the part of several enteropathogen agents which are not yet studied in MADAGASCAR . 1,523 stool's samples from 884 children with diarrhea and 639 children without diarrhea from 0 to 14 years old have been investigated . A bacterial, parasitical or viral etiology was found from 36.3% of diarrheic children and 11.2% of healthy children . The three agents the most frequently identified from children with diarrhea are EPEC (10.5%), Campylobacter jejuni (10.3%) and rotavirus (10%) and associations of two or three pathogen agents are frequent (6.2%). Acupunct Electrother Res, 1990, 15(1), 51 - 69 Treatment of acute or chronic severe, intractable pain and other intractable medical problems associated with unrecognized viral or bacterial infection: Part I; Omura Y; In many cases of chronic intractable pain without any discernible causes, when both Western medical treatment and acupuncture treatment failed to eliminate the pain, this pain is often due to the unrecognized presence of viral or bacterial infection . Even effective anti-viral or bacterial agents often fail to eliminate or inhibit the infection, as these drugs may also fail to reach the most painful area where often unrecognizable circulatory disturbances co-exist . Using the Bi-Digital O-Ring Test Molecular Identification Method, we were able to localize substance P and thromboxane B2 (a good indicator of the presence and degree of circulatory disturbances) in the painful area along with virus or bacteria . Based on the Bi-Digital O-Ring Test localization method for specific substances or microbes, the author has successfully treated cases of chronic intractable pain by the combination of anti-viral or bacterial agents with either manual acupuncture, electro-acupuncture or transcutaneous electrical stimulation through a pair of surface electrodes . Among a variety of infections, the most common cause of severe intractable pain was herpes simplex virus, and the most common bacterial cause of intractable pain of moderate degree was campylobacter . In addition, chlamydia was a very common cause of mild intractable pain . When peripheral nerve fibers are hypersensitive from nerve injury due to viral infection, in addition to the drug therapy for infection, use of Vitamin B1 25 mg., 2 times a day for an average adult often accelerates recovery time . As an anti-viral agent for the herpes virus family, the author found that EPA (Omega 3 fish oil, Eicosa Pentaenoic Acid, C20:5 omega 3), at doses between 180 mg . and 350 mg (depending upon body weight) 4 times a day for 2 to 6 weeks, without prescribing the common anti-viral agent Acyclovir, often eliminated the symptoms due to viral infection including all well-known types of the herpes virus, such as herpes simplex virus, Epstein-Barr virus, and cytomegalovirus . Epstein-Barr virus and cytomegalovirus are usually not associated with intractable severe pain, but they are often associated with a recurrent burning or itching sensation and they can cause intractable frequent muscle twitching . Viruses belonging to the herpes family almost always exist between the midline of one side of the spinal cord and the midline of the front of the body where these nerves from the spinal cord end and the same virus is localized only on one side of the body at the same spinal level.(ABSTRACT TRUNCATED AT 400 WORDS) Przegl Lek, 1990, 47(10), 682 - 5 {Rotavirus diarrhea in children hospitalized in Wrocław clinics}; Gosciniak G et al.; Studies have been performed in 250 children aged 0 to 3 years suffering from diarrhoea . Rotaviruses have been founded in 25% of cases, most frequently in children aged 0 to 3 months (29.6%), and 6 to 12 months (21.8%) . Frequency of rotavirus infections was highest during February . In 26% of subjects studied the coexisting infection with enteropathogenic Escherichia coli strains or Salmonella and Campylobacter jejuni has been observed . The Rotazyme II test is more sensitive than the Rotalex and Rota-kit tests. Lab Delo, 1990, (10), 71 - 3 {The determination of C . pylori in patients with gastroduodenal diseases}; Bazhenov LG et al.; A total of 46 gastric mucosa biopsy specimens obtained during surgery and 90 gastric juice samples from patients with gastroduodenal diseases were examined . Campylobacter-like microorganisms were detected in 84.6 percent of biopsy specimens and in 73.9 percent of gastric juice samples (in gram-stained smears) . Urease activity was detected in 75.9 and 13.3 percent, respectively . C . pylori growth in solid nutrient medium in microaerophilic conditions was observed in 44.2 and 5.7 percent of the examined samples, respectively . The studies have demonstrated the efficacy of using disks with urea from standard kits manufactured by the Research Institute for Epidemiology and Microbiology in the city of Gorky in the urease test. Scand J Infect Dis, 1990, 22(4), 457 - 65 Detection of antibodies to Helicobacter pylori cell surface antigens; Guruge JL et al.; Serum IgG antibodies of Helicobacter pylori were detected in single-dilution ELISA using glycine extracted material . Among 148 endoscopy patients 59% displayed antibodies; as expected, a higher occurrence (90%) was found in patients with positive gastric culture for H . pylori than in culture negative patients (37%) . Among 68 blood donors the frequency of H . pylori antibodies was 28% . In 73 children less than 15 years of age examined for unrelated disorders the occurrence was 4% . By immunoblotting using the same extract, 3 prominent bands, 29K, 54K and 60K and several weak bands were identified . These were formed by 57%, 92%, and 65%, respectively, of the ELISA positive patient sera . Comparing culture positive and negative patients, the 3 bands occurred more often among the culture positive subjects though between 18 and 61% of the sera from culture negative patients gave either of the bands . When comparing the glycine extracts of 4 different H . pylori strains with separate haemagglutinating patterns no differences in the position of the major bands emerged . By absorption experiments no immunological cross-reactivity with components of Escherichia coli, Klebsiella pneumoniae, Campylobacter jejuni or C . fetus was found . Thus, the glycine extract seemed specific for the detection of antibodies to H . pylori. Lab Delo, 1990, (4), 6 - 9 {Diagnosis of Campylobacter pylori based on the level of urea in the gastric juice}; Rozhavin MA et al.; Comparison of urea levels in 3 portions of gastric juice, obtained on an empty stomach, basal, and stimulated, from 28 patients, C . pylori carriers, and 20 patients without C . pylori carriership, has shown that the presence of this bacterium in the gastric mucosa is related not so much with a decrease in the absolute level of urea in the portion collected on an empty stomach but mostly with changes in this parameter in three portions of gastric juice collected in succession . Decreased urea levels in the second portion as against the first one or in the third one as against the two previous ones were detected in 97% of patients with C . pylori carriership . In 100% of patients without C . pylori carriership urea levels in the three portions remained unchanged or were decreasing . The method for measuring urea levels in three portions of gastric juice is recommended for the diagnosis of C . pylori carriership in gastroduodenal diseases. Rev Prat, 1989 Dec 11, 39(29), 2583 - 9 {Infectious diarrhea in the adult}; Rampal P et al.; Infectious diarrhoeas are usually divided into two types; toxinogenic and invasive . Invasive diarrhoeas are copious and responsible for dehydration which is the principal clinical sign; mucosal lesions and bacteraemia are absent . The most typical of toxinogenic diarrhoeas is cholera, but enterotoxicogenic E . coli and Aeromonas infections have similar clinical features . In invasive diarrhoeas the responsible microorganisms penetrate into the epithelial cells of the intestine, producing fever and stools that contain blood and mucus . However, some organisms causing invasive diarrhoeas secrete cytotoxins; they include Shigella spp., Salmonella spp, some strains of E . coli, Campylobacter jejuni and Yersinia spp . When diarrhoea occurs in patients under antibiotics pseudomembranous colitis due to the proliferation of Clostridium difficile must be suspected; the diagnosis is suggested by endoscopy and confirmed by bacteriology . Toxic and infectious diarrhoeas due to food are increasingly frequent; they are usually caused by Salmonella spp., but sometimes by Clostridium perfringens or Staphylococcus aureus . In patients with suspected infectious diarrhoea symptomatic treatment combined or not with intestinal antibacterial agents is immediately initiated in most cases; stool cultures are reserved to severe or protracted diarrhoeas . Specimens must be collected under the best conditions and rapidly sent to the laboratory. Biochim Biophys Acta, 1989 Dec 8, 993(2-3), 297 - 300 Interaction of Campylobacter jejuni with extracellular matrix components; Kuusela P et al.; The adhesion of three strains of Campylobacter jejuni to coverslips and microwells coated with isolated extracellular matrix components, fibronectin, laminin and types I, III, IV and V collagens was studied . Fibronectin mediated the adherence of C . jejuni, but there were differences in the binding capacities of the strains . Type I, III and V collagens mediated very strongly the attachment of two strains of C . jejuni . All three strains attached weakly to basement membrane-specific type IV collagen . Laminin was capable of mediating the adhesion only when present at a higher concentration . The observations indicate that extracellular matrix components may serve as anchor molecules for C . jejuni adhesion and that several attachment mechanisms occur simultaneously. N Engl J Med, 1989 Dec 7, 321(23), 1562 - 6 Prevalence of Helicobacter pylori infection and histologic gastritis in asymptomatic persons; Dooley CP et al.; We estimated the prevalences of Helicobacter pylori (formerly called Campylobacter pylori) infection and histologic gastritis in 113 asymptomatic persons, using endoscopic biopsy of the gastric antrum and corpus . Unsuspected lesions, mainly mucosal erosions, were revealed at endoscopy in 16 subjects (14 percent) . Gastritis was found in 42 subjects (37 percent), of whom 36 (32 percent of the total) were found to be infected with H . pylori on the basis of hematoxylin-eosin staining . H . pylori was not found in any of the 71 subjects with normal histologic features . Gastritis and H . pylori were noted in both the antrum and corpus in 75 percent of those infected (n = 27) . The prevalence of H . pylori infection increased from 10 percent (2 of 20 subjects) in those between the ages of 18 and 29, to 47 percent (7 of 15) in those between the ages of 60 and 69, but the effect of age did not reach statistical significance . The prevalence of gastritis increased significantly with advancing age . Stepwise logistic regression ana