Clostridia

Clin Sci (Lond), 1992 Mar, 82(3), 277 - 82
Exposure of rat colonic mucosa to human semen in vivo induces mucosal cytolysis, abolishes fluid absorption and raises paracellular permeability; Mendizabal MV et al.; 1 . The effects of human semen on rat descending colon fluid absorption, permeability to 3H-labelled polyethylene glycol 4000 and the histological appearance of the mucosa were examined . Also, the semen was fractioned by centrifugation into plasma and sperm fractions and the effects of these fractions on rat colonic function were examined . The effects of trypsin and bacterial collagenase, mimetics of acrosin and seminal collagenase activity, were examined in order to investigate which component of human semen alters colonic permeability . 2 . Contact between human semen and rat descending colonic mucosa for 3 h decreased fluid absorption from 52.0 +/- 2.9 microliters h-1 cm-2 (control) to 10.7 +/- 3.4 microliters h-1 cm-2 (P less than or equal to 0.001), increased the permeability to polyethylene glycol 4000 from 0.099 +/- 0.006 cm/h (control) to 0.31 +/- 0.04 cm/h (P less than or equal to 0.001) and caused cytolysis of the surface mucosa . 3 . Spermatozoa inside the colonic lumen were destroyed within 1 h with release of acrosomal contents; this raised the activity of the acrosomal proteolytic enzyme acrosin by 40-fold (P less than or equal to 0.005) and of seminal plasma metalloproteinase (collagenase) by about twofold (mean activity 1623 +/- 240 units/ml of luminal fluid) . 4 . The changes in colonic permeability induced by seminal plasma were similar to those induced by similar activities of clostridial collagenase . 5 . We conclude that seminal collagenase is present in sufficient amounts to cause acute damage to the colonic mucosa, and that this could be a factor in facilitating viral transmission across the colonic wall.

Artery, 1992, 19(2), 112 - 23
Type I collagen fibril formation by human vascular endothelial cells in culture; Yamamoto K et al.; The formation of type I collagen fibrils by vascular human endothelial cells in culture was demonstrated by the indirect immunofluorescence method . The fibrillar structure was formed on the cell surface on the third day after subcultivation and had grown like a knitting ball of 0-3 microns in diameter and 0-200 microns in length on the seventh day . The fibril formation was stimulated by the addition of basic fibroblast growth factor, but completely blocked by the presence of beta-aminopropionitrile . The fibrils were eliminated by the treatment with clostridial collagenase or with 0.5% Triton X-100 . The pathophysiological significance of type I collagen fibril formation by vascular endothelial cells in vascular diseases is also discussed.

Zentralbl Chir, 1992, 117(9), 509 - 14
{Is penicillin G the drug of choice in gas gangrene? Results of a prospective documentation of clinical, microbiological and animal experiment data}; Erttmann M et al.; Between 1978 and 1990 98 patients with gas gangrene were treated in the departments of general surgery and traumatology of the University of Kiel . The microbiological results of tissue samples and results of animal infectious experiments were correlated to the clinical outcome . It could be shown, that gas gangrene due to C.perfringens alone had a higher mortality than gas gangrene due to polymicrobial infection . In trauma patients, however, the rate of amputations was lower in cases of clostridial monoinfections (25%), than in patients with mixed infections (48%) . The results of animal experiments with guinea pigs which were infected by patients' infectious material showed a correlation to the clinical outcome . This correlation could not bee shown using isolated and cultured clostridia . Therefore and because of the quantity of mixed infections it is necessary to use broad spectrum antibiotics for treatment in cases of gas gangrene and for perioperative antibiotic prophylaxis . Penicillin-G alone can not more be recommended for this purpose.

Chirurgia (Bucur), 1992, 41(1), 1 - 9
{The timely diagnosis of postoperative clostridial infection}; Radulescu D et al.; Authors report a case of clostridial myonecrosis postcholecystectomy . The causes of the occurrence of this severe, frequently lethal complication are reviewed, as well as the difficulties of an early diagnosis, the only factor able to save the patient . The curative treatment of the detected infection requires the initiation of a series of local and general measures and a permanent cooperation between the surgeon, the specialist in resuscitation and the infectionist.

Arch Med Res, 1992, 23(2), 31 - 3
Primary structures of alcohol and aldehyde dehydrogenase genes of Entamoeba histolytica; Samuelson J et al.; Ethanol is the major metabolic product of glucose fermentation by the protozoan parasite E . histolytica under the anaerobic conditions found in the lumen of the colon . With the goal of finding new targets for anti-amebic drugs, the E . histolytica NADP(+)-dependent alcohol dehydrogenase gene (EhADH1; EC 1.1.1.2) and an aldehyde dehydrogenase gene (EhALDH1; EC 1.3.2) were cloned . The EhADH1 alcohol dehydrogenase gene encoded -39 kDa protein with 62 and 60% amino acid identities, respectively, with NADP(+)-dependent alcohol dehydrogenases of anaerobic bacteria Thermoanaerobium brockii and Clostridia beijerinckii . In contrast, EhADH1 showed a 15% amino acid identity with the closest human alcohol dehydrogenase . An EhADH1-glutathione-S-transferase fusion protein showed the expected NADP(+)-dependent alcohol dehydrogenase and NADPH-dependent acetaldehyde reductase activities . The enzymatic activities of the EhADH1 fusion protein were inhibited by pyrazole and 4-methyl pyrazole . The E . histolytica aldehyde dehydrogenase EhALDH1 gene encoded a 60 kDa protein, which showed a 36% amino acid identity over a 451 amino acid overlap with the human stomach aldehyde dehydrogenase (ALDH3).

J Vasc Surg, 1992 Jan, 15(1), 205 - 13
Enzymatic harvesting of adult human saphenous vein endothelial cells: use of a chemically defined combination of two purified enzymes to attain viable cell yields equal to those attained by crude bacterial collagenase preparations; Suggs W et al.; Seeding vascular prostheses with enzymatically harvested endothelial cells can create endothelial linings that improve small-caliber prosthetic patency . But crude bacterial collagenases used for endothelial harvest contain cytotoxic nonspecific proteases and clostridial cell wall debris which might limit their clinical usefulness . We therefore compared the endothelial cell harvest efficiency of crude bacterial collagenase with that of purified bacterial collagenase alone, purified trypsin alone, and combinations of purified bacterial collagenase and trypsin using concentrations of pure collagenase equal in collagenolytic activity to the crude bacterial collagenase material . The efficiency of harvest from human saphenous vein segments was measured by a microtiter well-growth curve assay of the number of living endothelial cells capable of attachment to fibronectin and subsequent growth obtained per unit area of saphenous vein lumen . Whereas pure collagenase and purified trypsin alone both harvested less than 5% of the baseline endothelial cell density on the veins, a combination of purified collagenase and 0.01% w/v purified trypsin was found to harvest 22% +/- 10% (SD) (n = 8 veins) of the approximately 1.3 x 10(5) endothelial cells/cm2 available on normal saphenous veins . This figure was not statistically different from the harvest efficiency of 19% +/- 10% (N = 4 veins) (p greater than 0.05) obtained by use of 0.1% w/v crude collagenase alone . This result suggests that endothelial harvesting can be done with a defined mixture of pure enzymes which would be clinically preferable to presently used crude extracts of clostridial cultures as a standardized preparation for graft seeding.

Vet Res Commun, 1992, 16(6), 415 - 24
Causes of lamb morbidity and mortality in the Ethiopian highlands; Bekele T et al.; A study was conducted to investigate causes of lamb morbidity and mortality on farms and on-station at Debre Berhan during 1989 and 1990 . It showed pneumonia (bacterial and/or verminous), starvation-mismothering exposure (SME) complex, gastrointestinal parasites, enteritis, abomasal impaction and physical injuries to be important health constraints on productivity . Neonatal mortalities were 51.5% and 46.3% on farms and on-station respectively and occurred owing to management problems such as SME, abomasal impaction and physical injuries . On the farms the lamb birth weight was 2.56 +/- 0.25 kg and was significantly (p < 0.05) affected by the dam's age, lambing weight, litter size, sex of lamb and year of lambing, but not by the season of lambing . Birth weight significantly (p < 0.05) influenced lamb mortality . Lambs with a low birth weight tended to die from SME . Morbidities and mortalities due to infectious causes increased in older lambs, suggesting that infections were acquired with age when resistance was lowered owing to inadequate nutrition and poor management . Heavy loss of lambs could be overcome by such health management interventions as foster mothering, warming lambs during the cold season and vaccination with polyvalent vaccines against pasteurellosis, clostridial infection and Dictyocaulus filaria.

Klin Khir, 1992, (9-10), 47 - 9
{Changes in the microflora of the suppurative cavities resulting from the treatment of acute bacterial destruction of the lungs}; Krotov NF et al.; The results of complex bacteriologic examination of 62 patients with acute bacterial destruction of the lungs during the process of treatment were analysed . The complex of investigations included the express methods (bacterioscopy, studies in the ultraviolet light, chromatography-mass spectrometry), inoculation under aerobic and anaerobic conditions . A role of anaerobic non-clostridial infection in the development of acute pulmonary destruction, polymicrobial character of microflora are shown . It was established that complex conservative therapy with inclusion of the methods for drainage of the cavities of destruction, prolonged intraarterial infusion, aimed antibacterial therapy permitted to achieve rapid suppression of microflora, its anaerobic component in particular . In chronization of the disease, the gram-negative aerobic flora is playing the leading part in its pathogenesis.

J Biol Chem, 1991 Nov 25, 266(33), 22147 - 53
Glycine reductase protein C . Properties and characterization of its role in the reductive cleavage of Se-carboxymethyl-selenoprotein A; Stadtman TC et al.; The clostridial glycine reductase complex catalyzes the reductive deamination of glycine in an energy-conserving process that results in the esterification of orthophosphate . The complex consists of three protein components: selenoprotein A; protein B, a carbonyl group protein; and protein C, a sulfhydryl protein . The protein C component also catalyzes the arsenate-dependent decomposition of acetyl phosphate . Reaction of protein C with iodoacetate inhibits its ability to decompose acetyl phosphate, but this inactivation of the enzyme by alkylation is prevented in the presence of the substrate indicating the formation of an unreactive enzyme-bound acetylthiol ester . The Se-carboxy-methylselenocysteine residue of the selenoprotein A component of glycine reductase was generated by selective alkylation of the ionized selenol group at pH 6 with {14C}bromoacetate . Using this pure alkylated selenoprotein A as substrate, it was shown that protein C catalyzes the conversion of the {14C}carboxymethyl group, in selenoether linkage to protein A, to {14C}acetate in the presence of arsenate, dithiothreitol, and Mg2+ . A procedure using hydrophobic chromatographic matrices was developed for the large scale isolation of protein C, and a number of the properties of the enzyme were determined.

J Infect, 1991 Nov, 23(3), 293 - 5
Successful antibiotic therapy of clostridial septic arthritis in a patient with bilateral total hip prostheses; Kibbler CC et al.; We report a case of clostridial bacteraemia with infection of a prosthetic hip joint . The patient was successfully treated with IV benzyl penicillin and fucidin followed by oral amoxycillin and probenecid, without surgical intervention . She had no recurrence of her infection in the 19 months before her death . This is believed to be the first reported case of clostridial infection affecting a prosthetic joint.

Vet Rec, 1991 Sep 7, 129(10), 216 - 9
Treatment and control of an outbreak of fat cow syndrome in a large dairy herd; Andrews AH et al.; An outbreak of fat cow syndrome occurred in a herd of 300 Friesian and Friesian/Holstein dairy cows calving predominantly between January and May . The herd came in off grass in good condition despite a long and hot summer . The dry cows received a diet of grass silage, brewing waste and minerals until the end of December, but the grass silage was butyric and was partially replaced by maize silage . By January 23, 16 of 70 calving cows (23 per cent) had appeared to suffer milk fever . Subsequent blood tests revealed that the cows may have been ketotic, and clinical and post mortem examination showed that they were probably suffering from fat cow syndrome . The freshly calved sick cows were treated with glucose, and corticosteroids were injected every second day into those which remained ill . The cattle had received a high energy diet, but the cows still to calve were placed on a diet of low metabolisable energy (77 MJ/cow) but adequate levels of undegradable protein . The problem was associated with a possible clostridial infection in two cows and with reduced fertility.

Am J Surg, 1991 Sep, 162(3), 247 - 50
General surgical problems requiring operation in postoperative vascular surgery patients; Franko E et al.; Surgical intervention after vascular surgery usually occurs as a result of bleeding or thrombosis, whereas general surgical problems requiring operation after vascular surgery are unusual . The purpose of this study was to review the results of operations for general surgical problems done soon after major vascular surgery . From January 1985 to December 1989, 1,236 major vascular procedures were performed, and 15 patients developed significant postoperative general surgical problems including perforated duodenal ulcer (2), perforated diverticular disease (2), evisceration and dehiscence (2), liver infarct (1), gangrenous cholecystitis (2), clostridial myonecrosis (1), pseudomembranous colitis (1), and small bowel obstruction (4) . The overall mortality was very high (47%), and the chance of dying was significantly higher (p less than 0.05) if the initial vascular procedure was an emergency (100% mortality) . All the patients who died (n = 7) succumbed to sepsis . There was a long delay in diagnosis in all groups; however, the delay did not correlate with mortality . Although this is a study of a small group of patients with a very heterogenous group of complications, several observations can be made: (1) a general surgical problem after vascular surgery carries a very high mortality; (2) general surgical complications in postoperative vascular patients in whom the initial procedure was an emergency are very poorly tolerated and almost uniformly lethal; and (3) these elderly patients have multiple medical problems and seem unlikely to tolerate any septic insult.

J Cardiovasc Surg (Torino), 1991 Jul-Aug, 32(4), 472 - 4
Clostridial mycotic aneurysm of the suprarenal abdominal aorta; Skipper D et al.; Clostridial mycotic aneurysms are unusual . We therefore record a fatal case of a ruptured clostridial mycotic aneurysm of the suprarenal aorta which developed several weeks after the resection of a segment of gangrenous small bowel.

Am Surg, 1991 Jun, 57(6), 388 - 93
Clostridial bacteremia: implications for the surgeon; de Virgilio C et al.; Clostridial bacteremia is rare and has a variable presentation from asymptomatic to septic shock with disseminated intravascular coagulation (DIC), red cell hemolysis, and rapid death . In order to delineate the predisposing and prognostic factors in these patients, the authors reviewed 47 cases of clostridial bacteremia presenting over a seven year period at a major metropolitan teaching hospital . Predisposing factors included locally decreased oxidation reduction potential (Eh) in 43 per cent (including atherosclerosis, diabetes, and radiation therapy), systemic immunosuppression in 53 per cent (including alcohol abuse, chemotherapy, steroids, and malignancy), and a site of epithelial barrier disruption . The sites of clostridial invasion included: gastrointestinal tract (GI) (n = 22), pulmonary (n = 7), cutaneous (n = 7), undetermined (n = 7), and female genital tract (n = 4) . Seven patients were found to have malignancy . Seventy-nine per cent of the blood culture isolates were histotoxic species (Clostridia perfringens and C . septicum) . The overall mortality was 47 per cent . Significant differences between survivors and deaths included DIC, new onset renal failure, severe atherosclerotic disease, and age (P less than .05) . The authors conclude that clostridial bacteremia is uncommon but highly lethal and may occur when decreased tissue Eh, systemic immunosuppression, and an epithelial barrier disruption are present . Poor outcome appears to be a reflection of advanced age, underlying illness, and presence of a histotoxic species.

Wei Sheng Wu Xue Bao, 1991 Jun, 31(3), 221 - 6
{Study on ursodeoxycholic acid biotransformation by three strains of clostridia}; Huang A et al.; Using the improved TLC procedure, we measured the conversion rates of ursodeoxycholic acid(UDCA) from chenodeoxycholic acid (CDCA) by 3 strains of clostridia--C . perfringens HS-10, C . butyricum DL-20 and LQ-29 isolated . The orthogonal test was used to determine the optical conditions of biotransformation for HS-10 . It was found that the conversion rate of UDCA by HS-10 was over 80% during 6-48 h in RCM medium containing 0.2 mmol/L CDCA . The UDCA conversion rates were still over 70% when the CDCA concentrations were as high as 0.8-1.0 mmol/L . In addition, the WW-BCP (Waste water from bean curd production) without any supplemental nutrients was preliminarily proved to be a potential inexpensive conversion medium.

Biochemistry, 1991 Apr 23, 30(16), 4090 - 7
Mechanism of action of clostridial glycine reductase: isolation and characterization of a covalent acetyl enzyme intermediate; Arkowitz RA et al.; Clostridial glycine reductase consists of proteins A, B, and C and catalyzes the reaction glycine + Pi + 2e(-)----acetyl phosphate + NH4+ . Evidence was previously obtained that is consistent with the involvement of an acyl enzyme intermediate in this reaction . We now demonstrate that protein C catalyzes exchange of {32P}Pi into acetyl phosphate, providing additional support for an acetyl enzyme intermediate on protein C . Furthermore, we have isolated acetyl protein C and shown that it is qualitatively catalytically competent . Acetyl protein C can be obtained through the forward reaction from protein C and Se-(carboxymethyl)selenocysteine-protein A, which is generated by the reaction of glycine with proteins A and B {Arkowitz, R . A., & Abeles, R . H . (1990) J . Am . Chem . Soc . 112, 870-872} . Acetyl protein C can also be generated through the reverse reaction by the addition of acetyl phosphate to protein C . Both procedures lead to the same acetyl enzyme . The acetyl enzyme reacts with Pi to give acetyl phosphate . When {14C}acetyl protein C is denaturated with TCA and redissolved with urea, radioactivity remained associated with the protein . At pH 11.5 radioactivity was released with t1/2 = 57 min, comparable to the hydrolysis rate of thioesters . Exposure of 4 N neutralized NH2OH resulted in the complete release of radioactivity . Treatment with KBH4 removes all the radioactivity associated with protein C, resulting in the formation of {14C}ethanol . We conclude that a thiol group on protein C is acetylated . Proteins A and C together catalyze the exchange of tritium atoms from {3H}H2O into acetyl phosphate.(ABSTRACT TRUNCATED AT 250 WORDS)

Voen Med Zh, 1991 Apr, (4), 38 - 43
{The etiological diagnosis of nonclostridial anaerobic organic infection of the hepatobiliary system in military medical institutions}; Nechaev EA et al.; The results of B-bile bacterial examinations of patients who had undergone operations on biliary tract for acute or chronic cholecystitis in the military medical institutions of the USSR and the USA were retrospectively compared . Distinctive and similar features were revealed . The leading role of bacteroids, anaerobic found bacteria and clostridia was ascertained during the studies of etiological structure of anaerobic biliary infection . As for nonclostridial anaerobic infection of biliary tract, the polymicrobiotic process of aerobic and anaerobic associations is more typical . The centralization of bacteriological examinations in specialized "anaerobic" laboratory may improve the efficiency of microbiological diagnostics of nonclostridial anaerobic infection.

Appl Environ Microbiol, 1991 Feb, 57(2), 573 - 8
Gut microflora of vervet and samango monkeys in relation to diet; Bruorton MR et al.; The microflora in the gastrointestinal tracts of wild vervet and samango monkeys (Cercopithecus aethiops and C . mitis, respectively) were studied, using fermentation acid analysis, electron microscopy, and culturing methods . The diets of the two species of monkey differ considerably, with that of the samango including a greater proportion of cellulose-rich leaf material, and this is reflected in the microflora . Volatile fatty acid measurements along the gut of both species showed that these end products of bacterial metabolism were concentrated in the cecum and colon . Electron microscopy indicated that morphologically similar bacteria were present in the cecum and colon of both species, but the samango possessed a distinct stomach microflora . Bacteria in the lumina of the four main regions of the gut of the monkeys (stomach, small intestine, cecum, and colon) were plated on a number of anaerobic media (Mann, Rogosa, and Sharp; clostridial basal; and complex media) . The cecum and colon were found to contain higher numbers of microbes per gram (wet weight) of gut content than the stomach and small intestine . Microbial isolates were able to catabolize carboxymethyl cellulose and other polymers . This may aid the monkeys, particularly samangos, in the digestion of fibrous dietary components such as leaves.

Immun Infekt, 1991 Feb, 19(1), 18 - 21
{ADP ribosylation of actin--a cytotoxic principle of bacterial toxins}; Just I et al.; The ADP-ribosylation of actin is the pathobiochemical mechanism by which various clostridial toxins affect the eukaryotic target cell . The toxins are binary in structure and consist of a binding component and an enzyme component with ADP-ribosyltransferase activity . Probably endocytosis-mediated the binding component transfers the clostridial ADP-ribosyltransferase into the target cell, whereupon G-actin but not F-actin is ADP-ribosylated . The ADP-ribosylated actin is incapable of polymerization but binds to the barbed ends of actin filaments to inhibit polymerization of non-modified actin . Thereby the ADP-ribosylation of actin destroys the cellular architecture of the microfilament network . The ADP-ribosylating toxins are novel tools to study the physiological functions of actin.

Res Microbiol, 1991 Jan, 142(1), 87 - 93
Improved egg-yolk agar plate medium for the detection of clostridial phospholipase C activity; Gubash SM; A new modification of the egg-yolk agar plate medium, an egg-yolk triple-salt medium, is described . The medium incorporates a tryptic soy agar base, yeast extract, D-glucose CaCl2, MgCl2 and ZnSO4 . Only in egg-yolk triple-salt medium did all tested phospholipase-C-producing clostridia form a lecitho-vitellin precipitate after overnight incubation; 95.5% formed a high-density precipitate in the new medium as opposed to 6.1%, 6.6%, 10.6% and 20.2% of the isolates not forming a visible precipitate in liver-veal, Lombard-Dowell, McClung and Toabe modified, and "viande-levure" egg-yolk media, respectively, after the same incubation time.

Padiatr Grenzgeb, 1991, 30(3), 193 - 203
{Gas gangrene in childhood--a review}; Roloff D; Although gas gangrene in childhood is not mentioned in the paediatric literature, paediatric surgery textbooks included, this toxic wound infection also occurs in children . Prognosis totally depends on the early detection of the disease . Having checked over 2000 relevant literature sources, in which 110 cases of gas gangrene are mentioned, of which 24 are described in detail, this paper points to constellations paving the way for developing or favouring the infection . In aetiologic respect accidents range first, but also in children postoperative clostridial myonecrosis and those resulting from intramuscular injections are possible, but rare . On the basis of case reports the initial symptoms are stressed . In the foreground local (heavy pains, odematous swelling, "dirty" exudate, dyschromia, foetor) and general (tachycardia, rapidly deteriorating condition, shock, icterus) signs are dealt with, which occur after a latent period ranging between some few and 72 (up to 96) hours . Only through quick diagnosis and sufficient immediate therapy it will be possible to improve the prognosis and, in particular, reduce letality . A later publication in this journal will explain that also in children gas gangrene does not belong to those diseases which seldom occur.

Anaesthesiol Reanim, 1991, 16(1), 49 - 58
{Prerequisites for the transfer of patients with gas gangrene to a specialized facility}; Roloff D; According to the cases reported in the GDR as well as in the FRG, 1-2 persons contract a gas gangrene infection per week . The lethality is alarmingly high . In the GDR more than two thirds of the patients die . Among the numerous factors influencing the prognosis time is a very important one . Through early detection, adequate immediate therapy and subsequent prompt transfer to a treatment centre with facilities for hyperbaric oxygenation, the chances of survival can be improved considerably . Some experiences with the transfer of 275 patients under the tentative diagnosis "gas gangrene" are described, together with the preparation and actual transfer to a specialized centre . For the detection of the disease the clinical symptoms are of greatest importance . The histological findings confirm the diagnosis, bacterioscopy also provides early results . To start treatment early, one cannot wait for the result of the microbiological detection of clostridia which is virtually necessary for exact diagnosis . The initiated treatment (rigorous surgical removal of the gas gangrene focus, antibacterial and intensive therapeutic measures) has to be continued without interruption during transport with a rescue helicopter, aircraft or emergency ambulance . Medical care of the severely ill patient has to be provided throughout transportation . The practical measures are briefly described . The possibility for consultations should be used more frequently.

Microbios, 1991, 66(266), 7 - 20
Purification, characterization and antimicrobial properties of an antibiotic (wassumycin) from Streptomyces species 215; Singh S et al.; A yellow amorphous compound, wassumycin, was isolated from an unidentified strain of Streptomyces . Wassumycin inhibited the growth of several species of human and animal pathogenic bacteria especially Clostridia . Wassumycin also inhibited the growth of HeLa cells, and showed good antitumour activity against experimental mouse tumours such as L1210, P388 leukaemias, and B16 melanoma . On the basis of the chemical and antimicrobial properties, the antibiotic appeared similar to the chromomycins and olivomycins, but its ultraviolet, infrared, and proton magnetic resonance spectra differed from theirs significantly.

Sov Med, 1991, (10), 30 - 3
{Characteristics of the clinical course and surgical tactics in odontogenic suppurative mediastinitis}; Abakumov MM et al.; Odontogenic purulent mediastinitis arising with higher frequency in young males after mandibular periodontitis, is characterized by a rapid progression of intoxication and respiratory disorders . To achieve an immediate effect and avoid tracheostomy ameliorating the prognosis, it is necessary to perform early and adequate drainage of the purulent foci . The above form of mediastinitis should be preferably managed by bilateral transcervical drainage of the anterior and posterior mediastinum with addition of antibacterial therapy against ++non-clostridial anaerobic microflora as well as of passive and active immunization.

Probl Tuberk, 1991, (11), 58 - 63
{Effects of non-clostridial anaerobic infection on the course of chronic pulmonary tuberculosis in experimental animals}; El'shanskaia MP et al.; Influence of non-clostridial anaerobic infection on the course of chronic pulmonary tuberculosis caused by intrapleural administration of BCG used in a vaseline-lanolin mixture was studied experimentally on guinea pigs . Administration of Bacteroides fragilis in the presence of a mild tuberculous inflammation aggravates the course of a specific process promoting pleural empyema development, increase in the size of pulmonary granuloma, extension of pathologic changes into the parenchymatous organs and aggravation of a nonspecific inflammatory reaction . Animals with mixed infection exhibited a longer duration and higher level of M . tuberculosis and B . fragilis excretion than those having a mono-infection . The findings suggest M . tuberculosis and B . fragilis synergism.

Klin Khir, 1991, (9), 18 - 20
{The role of bacteriologic study of the bile in the surgical treatment of patients with cholangitis}; Andriushenko VP et al.; Bacteriologic study of the intraductal bile was performed in 123 patients operated on for cholangitis: chronic relapsing--in 47, acute--in 59, septic--in 17 . Aerobic microflora was revealed in 59%, anaerobic non-clostridial--in 12%, mixed--in 27% of cases . After operation, the reduction in bacteriobilia was noted . The microflora revealed was resistant to antibacterial preparations . The possibility to use the techniques of gas-liquid chromatography and pH-metry of bile in instant diagnosis of cholangitis is shown.

Lab Delo, 1991, (9), 69 - 70
{Gas chromatographic analysis of the metabolic products of anaerobic bacteria . 2 . Clostridia}; Tararin PA et al.; Qualitative and quantitative characteristics of clostridial metabolites (short-chain carbonic acids and alcohols) were analyzed in associations of these bacteria with facultative anaerobes . Various bacterial groups were found to vary as regarded the composition and quantitative ratio of the major bacterial metabolites . These data may become the criteria for the indication of pathogenic clostridia in mixed cultures after anaerobic passages for 24-48 h at 37 degrees in a medium with 1% glucose.

Clin Neurol Neurosurg, 1991, 93(2), 149 - 50
Sciatic neuritis as initial symptom of spontaneous clostridial myonecrosis; Hoefnagels WA et al.; A 21-year-old woman is reported with aplastic anaemia, who presented with pain in the leg . Rapid loss of sciatic nerve function followed . MRI showed irregular streaks of low intensity in the muscles of the pelvic region . A diagnosis of sciatic neuritis as initial symptom of clostridial myonecrosis was made.

Br J Clin Pract . 1990 Dec;44(12):752.
Clostridial cholecystitis--the need for early recognition and treatment; Sagar PM et al.; There remains some controversy regarding the timing of cholecystectomy after an attack of acute cholecystitis . Opinions vary between early operation within two and seven days and delayed operation readmitting the patient eight to twelve weeks later . There is, however, a small group of patients who require prompt emergency cholecystectomy . This group includes patients presenting with cholecystitis complicated by gas-forming organisms where the plain abdominal gas-forming organisms where the plain abdominal radiograph can establish the diagnosis.

Khirurgiia (Mosk), 1990 Oct, (10), 78 - 83
{Reconstructive and restorative operations in iatrogenic injuries of the extrahepatic bile ducts}; Kadoshchuk TA; The results of diagnosis and treatment of iatrogenic injuries of the extrahepatic biliary tract in 47 patients are analysed . The injury was detected during the operation only in 6 cases, in 41 cases it was revealed on the 1st-6th postoperative day . Intensive conservative therapy was applied in the preoperative period to correct the values of homeostasis and metabolism . Special attention was attached to antibacterial therapy aimed at suppression of ++non-clostridial anaerobic infection . Sixty-three surgical interventions were conducted on 47 patients; 47 of them were restorative or reconstructive, 15 were undertaken for emergency indications, one, for developed postoperative complication . One patient died . Particular importance was attached to adequate draining both in emergency and in reconstructive and restorative operations.

Biochimie, 1990 Aug, 72(8), 555 - 74
Hydrophobic cluster analysis: procedures to derive structural and functional information from 2-D-representation of protein sequences; Lemesle-Varloot L et al.; Hydrophobic cluster analysis (HCA) {15} is a very efficient method to analyse and compare protein sequences . Despite its effectiveness, this method is not widely used because it relies in part on the experience and training of the user . In this article, detailed guidelines as to the use of HCA are presented and include discussions on: the definition of the hydrophobic clusters and their relationships with secondary and tertiary structures; the length of the clusters; the amino acid classification used for HCA; the HCA plot programs; and the working strategies . Various procedures for the analysis of a single sequence are presented: structural segmentation, structural domains and secondary structure evaluation . Like most sequence analysis methods, HCA is more efficient when several homologous sequences are compared . Procedures for the detection and alignment of distantly related proteins by HCA are described through several published examples along with 2 previously unreported cases: the beta-glucosidase from Ruminococcus albus is clearly related to the beta-glucosidases from Clostridum thermocellum and Hansenula anomala although they display a reverse organization of their constitutive domains; the alignment of the sequence of human GTPase activating protein with that of the Crk oncogene is presented . Finally, the pertinence of HCA in the identification of important residues for structure/function as well as in the preparation of homology modelling is discussed.

J Periodontal Res, 1990 Jul, 25(4), 250 - 3
Accessible sialic acid content of oral epithelial cells from healthy and gingivitis subjects; Davis G et al.; The purpose of the present study was to determine if there were differences in the quantity of accessible sialic acid on superficial epithelial cells collected from different areas of the mouth, and from healthy subjects with good oral hygiene, as compared to subjects with gingivitis . Superficial epithelial cells were collected by gently scraping the tongue dorsum, hard palate, free gingiva and buccal epithelium . The cells were washed and treated with clostridial neuraminidase to release accessible sialic acid; this was quantitated using a fluorometric assay . Buccal cells released an average of 62.6 ng sialic acid per 10,000 cells, which was nearly 3-fold more than cells from the hard palate (24.1 ng), free gingiva (21.9 ng), or tongue (15.4 ng) . Buccal and free gingival cells collected from 5 healthy subjects had significantly higher levels of accessible sialic acid on their surface than cells collected from 5 subjects with gingivitis . These differences were significant at the p less than 0.001 and p less than 0.01 levels, respectively . The data obtained suggest that the oral hygiene status of an individual can influence the quantity of accessible sialic acid residues on oral epithelium; this would be expected to influence the attachment and colonization of bacteria which bind to sialic acid-containing receptors.

Vet Immunol Immunopathol, 1990 Jun, 25(2), 167 - 75
Humoral immunity in the ewe . 3 . The influence of adjuvants and immunisation regimes on immune reactivity in the breeding ewe and her progeny; Reynolds GE et al.; Breeding ewes were immunised with clostridial vaccine using different inoculation schedules . Results, showing differences in the class of antibody produced, were heavily dependent on the vaccination regime used . Immunoglobulin M (IgM) levels were significantly lower in ewes given double doses of vaccine compared to ewes given a single inoculation or no treatment at all (P less than 0.01) . Neonatal lambs showed significant de novo IgM production with interference in this antibody production in the lambs of ewes vaccinated with the clostridial vaccine (P less than 0.05) . Immunoglobulin G1 (IgG1) levels were significantly increased in all lambs which had mothers vaccinated with the clostridial vaccine prior to or during pregnancy (P less than 0.025) . The greatest quantity of IgG1 was transferred to lambs when their mothers were given a double injection with primary inoculation prior to conception and booster prepartum (P less than 0.025) . No antigen specific immunoglobulin G2 (IgG2) was detected in the lambs . Ewes were also immunised with BSA and their isotype specific serum antibody response was compared with their respective lambs . There was no detectable anti-BSA IgM in the lambs of all groups of ewes though specific IgG1 antibodies could be readily detected in the lambs of hyperimmunised ewes . The efficiency of transfer was related directly to the ability of the adjuvant to maximise IgG1 production in the ewe . Although immunised ewes produced high levels of IgG2, this was not transferred passively to the lamb.

J Clin Microbiol, 1990 Jun, 28(6), 1135 - 8
Accuracy and reproducibility of the MicroScan rapid anaerobe identification system with an automated reader; Stoakes L et al.; Rapid anaerobe identification (MicroScan) panels (4 h) were evaluated both visually and by the AutoScan-4, a computer-controlled microplate reader . The results of both reading methods were compared with identifications obtained by the conventional (Virginia Polytechnic Institute) method . In total, 237 anaerobes were tested . Correct identifications were obtained for 166 strains (70%) by visual reading and 157 strains (66.2%) by the AutoScan-4 . Supplementary tests resulted in 80.1 and 76.7% total correct identifications, respectively . Comparison of the two reading methods revealed complete agreement for 169 strains . Differences between the two reading methods were due to difficulties in reading specific reactions . This was especially true with the clostridial species . The performance of the MicroScan system in the identification of anaerobic bacteria appears comparable to that of other 4-h identification systems for anaerobes, but this system shows significant variance from the conventional system . Improvements in the trays and data base are required before the system can be recommended for routine use.

Vestn Khir Im I I Grek, 1990 Jun, 144(6), 28 - 31
{Improving the clinico-microbiological diagnosis and treatment of non-clostridial anaerobic peritonitis}; Zimon IN et al.; On the basis of clinico-microbiological examinations the presence of anaerobic flora was found in 104 out of 198 patients with peritonitis . The authors propose using intra-aortal++ transfusions of oxygenated blood in complex therapy of anaerobic peritonitis.

Khirurgiia (Mosk), 1990 Jun, (6), 33 - 8
{Characteristics of wound infection in long-term crush syndrome}; Fedorov VD et al.; Clinicobacteriological examination was carried out in 31 patients with the crush syndrome (CS) and extensive damage to the soft tissues in combination with bone fractures complicated by wound infection . Inadequate surgical treatment in the early periods after the trauma (complete closure of the wound, making small incisions of the involved skin and subcutaneous fat) is particularly hazardous in such cases because it leads to the development of severe wound infection . This disease is marked by a complex polymicrobial structure of the causative agents, massive dissemination of aerobic and opportunistic anaerobic bacteria in the purulent focus (10(7)-10(9) microbial bodies), and a high proportion (48.4%) of obligate anaerobic microflora . Wound infection in the CS takes a grave clinical course, but without profound microbiological study it is difficult to differentiate it into aerobic and anaerobic (clostridial and ++non-clostridial) forms . This is evidence of the need for emergency extended bacteriological diagnosis at all the stages of treatment . "Pure" aerobic infection was identified in half of the patients and mixed aerobic-anaerobic infection in the other half . The possibility of the involvement of asporogenic anaerobes is shown (35.5% of cases) . The high risk of the development of gas gangrene is detected (9.7%) and its is concluded that early prevention is necessary by adequate surgical intervention, adequate intensive antibacterial and detoxification therapy, including hyperbaric therapy . The efficacy of current antigangrene immunization agents must be evaluated.

Vestn Otorinolaringol, 1990 May-Jun, (3), 22 - 5
{The role of non-clostridial anaerobic infections in the etiology, pathogenesis, clinical aspects and treatment of inflammatory diseases of the paranasal sinuses}; Mirazizov KD et al.; This paper presents the results of clinical and bacteriological examinations of 116 patients with suppurative rhinosinusitis . Bacteriological tests under anaerobic conditions revealed in 53% of the patients nonclostridium anaerobic bacteria that were highly resistant to most antibiotics and sensitive to metronidazole and its derivatives . A protocol of conservative therapy of suppurative rhinosinusitis was developed . The protocol included etiotrophic antianaerobic drugs (metronidazole and its derivatives) and oxygenation of paranasal sinuses . This therapeutic approach yielded positive effects in 92% of the patients.

Berl Munch Tierarztl Wochenschr, 1990 May 1, 103(5), 167 - 72
{Bacteriological studies of the problem "Epidemic losses in hares and deer in habitats with high cultivation of 00-rapeseed"}; Bohnel H et al.; Within the scope of the research work for possible reasons of the so-called "wildlife mortality" more than 900 specimens of 440 animals (183 hares, 153 deer, 14 rabbits found dead, and 98 hares and 6 deer shot by hunters) were checked for the presence of Clostridia in inner organs . The results show that in 40.3% of the animals found dead but only in 13.3% of the hunted hares Clostridia were to be found . Out of the isolated Clostridia strains 24.4% could not be identified; potentially pathogenic species were found in 78.3% of isolates of hares, 81.7% of those of deer and in 9.2% of those of hunted hares . 23.9% of the isolates were C . perfringens . Considering the known epizootiology of clostridioses it can be concluded that clostridia certainly play a role in losses of wildlife, as well in hares as in deer . Triggering factors could lie in the kind of feed which is available for animals in modern agrarian landscape . During the critical period in autumn and winter there are mainly crop plants like rapeseed, wheat and barley only available for wildlife.

Orthop Rev, 1990 Apr, 19(4), 333 - 41
Gas gangrene . A review; Present DA et al.; Gas gangrene continues to cause significant morbidity and mortality . This monograph reviews the entire spectrum of clostridial infection, including its etiology, pathophysiology, diagnosis, current recommended treatment, and prophylaxis . The early diagnosis of gas gangrene is paramount, as delay in aggressive combined treatment may result in death.

J Pediatr Surg, 1990 Mar, 25(3), 346 - 8
Cyclic neutropenia with colonic perforation and nonhealing colocutaneous fistula; Langer JC et al.; Cyclic neutropenia is an hereditary disorder of white blood cells, characterized by profound neutropenic episodes approximately every three weeks . Septic complications are usually limited to cutaneous and oropharyngeal infections . A 4-year-old boy with known cyclic neutropenia was in shock with neutropenia, clostridial septicemia, and right lower quadrant peritonitis when he was admitted . At the time of laparotomy, inflammation of the cecum, with no gross perforation, was found; no resection or appendectomy was done . He subsequently developed a right lower quadrant abscess that was drained, resulting in a colocutaneous fistula . For the next 8 months his fistula persisted, with intermittent episodes of fever, increased fistula output, and abdominal pain during his neutropenic periods . Standard nonoperative approaches to healing the fistula failed (ie, elemental feeds, total parenteral nutrition, irrigations, antibiotics, and drains) . Attempts to medically abolish his neutropenic episodes using lithium, gammaglobulin, and steroids also failed . Ultimately, he underwent an ileocecal resection with primary anastamosis; the operation was done immediately following a neutropenic episode, in order to allow adequate healing of his anastamosis before his next period of neutropenia . Postoperative course was satisfactory, and he remains well after 8 months follow-up . This case, and several similar previously reported cases, illustrate that cyclic neutropenia may present with serious surgical complications . They also underlines the important role that neutrophils play in the healing of enteric fistulae.

J Foot Surg, 1990 Mar-Apr, 29(2), 141 - 6
Nonclostridial gas gangrene; Weisenfeld LS et al.; Although nonclostridial gas gangrene is not an unusual occurrence, relatively few cases including the distal lower extremity have been reported . Due to the serious nature of some of these infections, it is important for physicians to familiarize themselves with these nonclostridial crepitant infections, which are often confused with clostridial myonecrosis . Etiology, evaluation, and treatment is described by the authors . Also, a case study is presented.

Vestn Oftalmol, 1990 Mar-Apr, 106(2), 61 - 3
{Non-clostridial anaerobes as a cause of post-traumatic keratitis}; Volkov VV et al.; Up to present nonclostridial anaerobes in the opal cavity were not regarded as a cause of inflammatory ophthalmic diseases . The present case with injury to the cornea inflicted with a tooth fragment was extremely difficult to diagnose, and keratitis, induced by oral cavity anaerobes, difficult to cure . Only subtotal perforating keratoplasty stopped the process and prevented the death of the eye.

Arch Biochem Biophys, 1990 Feb 1, 276(2), 317 - 21
Kinetic study of nucleophile specificity in dipeptide synthesis catalyzed by clostridiopeptidase B; Fortier G et al.; The kinetic parameters of Clostridiopeptidase B-catalyzed aminolysis of carbobenzoxyarginyl methyl ester leading to the formation of various dipeptides are investigated . The deacylation rates of the acylenzyme were evaluated by direct product analysis using high-performance liquid chromatography on a reversed-phase column . On the basis of the partitioning ratio and the first-order and second-order rate constants for the deacylation step, large differences in the nucleophile reactivities, which appear to be related to a S'1-P'1 interaction, were observed . The order of specificity was established as Leu much greater than Ser greater than Phe greater than Val greater than Ala = Gly much greater than Pro with second-order rate constants ranging from 578,614 M-1 s-1 for leucinamide to 5132 M-1 s-1 in the case of prolinamide . All of the amino acid amides had a nucleophilic strength at least 10 times higher than that of water during the deacylation step . The data reported here represent the first experimental evidence for the existence of a S'1 site engaged in the recognition of the amino acid side chain residue for this enzyme . The recognition site showed an increase in the affinity along with an increase in the hydrophobicity of the amino acid amide side chains.

Clin Microbiol Rev, 1990 Jan, 3(1), 66 - 98
Toxigenic clostridia; Hatheway CL; Toxigenic clostridia belonging to 13 recognized species are discussed in this review . Each species or group of organisms is, in general, introduced by presenting the historical aspects of its discovery by early investigators of human and animal diseases . The diseases caused by each species or group are described and usually discussed in relation to the toxins involved in the pathology . Morphological and physiological characteristics of the organisms are described . Finally, the toxins produced by each organism are listed, with a presentation of their biological activities and physical and biochemical characteristics . The complete amino acid sequences for some are known, and some of the genes have been cloned . The term toxin is used loosely to include the various antigenic protein products of these organisms with biological and serological activities which have served as distinguishing characteristics for differentiation and classification . Some of these factors are not truly toxic and have no known role in pathogenicity . Some of the interesting factors common to more than one species or group are the following: neurotoxins, lethal toxins, lecithinases, oxygen-labile hemolysins, binary toxins, and ADP-ribosyltransferases . Problems in bacterial nomenclature and designation of biologically active factors are noted.

Scand J Infect Dis, 1990, 22(2), 205 - 8
Influence of ciprofloxacin on the colonic microflora in young and elderly volunteers: no impact of the altered drug absorption; Ljungberg B et al.; The colonic microflora was studied before, on the fifth day of dosing, and 2 weeks after a 5-day oral course of ciprofloxacin 500 mg BID given to 7 young and 7 elderly, healthy volunteers . Considerable changes in the aerobic microflora were found, while the effects on the anaerobic bacteria were less pronounced . Despite larger absolute bioavailability of the first dose in the elderly (77 vs . 63%; p less than 0.05), the effect of ciprofloxacin on the microflora was similar in the two groups of volunteers . A higher number of clostridia were detected in faeces from elderly subjects before, during, and after the ciprofloxacin regimen.

J Hyg Epidemiol Microbiol Immunol, 1990, 34(2), 191 - 8
Microbiological diagnosis of suppurative-inflammatory processes of the E . N . T . organs and the maxillo-mandibulo-facial region under suspicion of anaerobic non-clostridial infection; Mironov AYu et al.; The etiological role of non-sporulating anaerobic bacteria as causative agents of suppurative-inflammatory diseases (SID) of the maxillo-mandibulo-facial region and the E . N . T . organs as studied . Express diagnosis of anaerobic infection was carried out by means of gas-liquid chromatography . The species-specific composition of the microflora of the suppurative focus was investigated . It was established that only obligate anaerobes in monoculture or in association were isolated from patients with so-called "sterile" inoculations when strictly anaerobic bacteriological technique was used . The use of anaerobic bacteriological technique of investigation enlarged the spectrum of the microflora isolated from the suppurative focus from 5 to 26 species . Results of chromatographic and bacteriological examinations were compared; the main causes of obtaining false-positive and false-negative results of chromatography were analysed . Statistical processing using factor analysis has shown that the information power of chromatographic examination of the metabolites of anaerobic bacteria is higher in comparison with the main clinical-laboratory indices, but statistical processing using cluster analysis and correlation analysis has revealed that an index like metabolic activity reflects the degree of real participation of anaerobic microflora in the development of the pathological process, and can be used in the clinic for the evaluation of the degree of severity of the course of the SID and of the effectiveness of treatment.

Instr Course Lect, 1990, 39, 491 - 3
Clostridial myonecrosis; Patzakis MJ; The best treatment for gas gangrene is prevention by following the principles of thorough debridement, immediate effective parenteral antibiotic therapy, and delayed closure of open fractures.

Arch Orthop Trauma Surg, 1990, 109(2), 72 - 4
Antibiotic prophylaxis in lower-extremity amputations due to ischemia . A prospective, randomized trial of cephalothin versus methicillin; Thomsen S et al.; The efficiency of prophylactic antibiotic therapy in amputation surgery was studied in a prospective, randomized trial of a first-generation cephalosporin (cephalothin) compared with a narrow-spectrum beta-lactam stable penicillin (methicillin) . Eighty-eight patients received cephalothin 2 g X 4 on the day of operation, while 86 patients received methicillin 1 g X 4 . The patients were followed up for 21 days . Infected wounds occurred in 14.8% of the patients in the cephalothin group, compared with 14% in the methicillin group . The frequency of deep infections was 10.2% versus 4.7% (P = 0.1611) . The reamputation frequency was 18.2% in the cephalothin group compared with 12.8% in the methicillin group; the frequency of below-knee reamputation was 18.4% versus 7.7% (P = 0.1469) . No clostridial infections were found . The study did not demonstrate any significant difference between cephalothin and methicillin in the prophylaxis for lower-extremity amputations, although the latter drug tended to be the best choice.

J Infect Dis, 1990 Jan, 161(1), 116 - 9
SA11 rotavirus is specifically inhibited by an acetylated sialic acid; Willoughby RE et al.; Bovine salivary mucin (BSM) inhibits rotavirus replication in vitro and in vivo . The inhibitory effect of BSM in vitro is abolished by Arthrobacter ureafaciens neuraminidase but not by Clostridia perfringens neuraminidase; it is abolished by mild base deacetylation but not by influenza C acetylesterase . The data suggest that SA11 rotavirus binds to a specific sialic acid structure on BSM different from the sialic acids recognized by other viruses.

J Postgrad Med, 1990 Jan, 36(1), 13 - 5
Role of hyperbaric oxygen therapy in the rapid control of gas gangrene infection and its toxaemia; Trivedi DR et al.; Fifteen cases of proved gas gangrene infection were studied to assess the rapidity of control of infection and associated toxaemia, by hyperbaric oxygen therapy at 2 1/2 atmospheres pressure . Within 3-5 sittings, all the cases (100%) were found to become devoid of clostridial organisms as judged by smear and culture methods.

Chirurgie, 1990, 116(4-5), 378 - 83; discussion 383-4
{Surgical indications of hyperbaric oxygen therapy}; Baranger B et al.; Beside clostridial myonecrosis surgical utilization of hyperbaric oxygen remain unprecise . After review of literature, analysis of their experience, the authors define: principles and effects of hyperbaric oxygen, his position with regard to surgical intervention, its surgical utilizations: unquestionable (non clostridial and clostridial gas gangrene), relative (aerobic cellulitis, diabetic arterial disease), preventive.

J Pediatr, 1989 Dec, 115(6), 949 - 53
Transfusion of infants with activation of erythrocyte T antigen; Williams RA et al.; A protocol for transfusion of infants with erythrocyte T-antigen activation was evaluated for safety and effectiveness in a prospective, 3-year, sequential series of 1672 infants admitted for intensive care . Erythrocyte T antigens are activated by enzymes produced by clostridia or other bacteria in infants with sepsis, often in association with necrotizing enterocolitis . Transfusion of these infants with blood products containing plasma carries the risk of causing intravascular hemolysis . Our transfusion protocol included testing for T-antigen activation, restricting transfusion of patients with activated T antigens to washed erythrocytes or washed platelets whenever possible, and selecting donors with low-titer anti-T when plasma-containing blood products were required . In this series, 10 patients had T-antigen activation, including four with clostridial infections . Severe hemolysis occurred in one patient who received plasma before T-antigen activation developed . Of five patients who received low-titer anti-T plasma, mild hemolysis occurred in three and no hemolysis in two . Four patients who received no plasma-containing blood products experienced no hemolysis . Used cautiously, this protocol allows a full range of transfusion therapy to infants with T-antigen activation.

Crit Care Nurse, 1989 Nov-Dec, 9(10), 30 - 8
Gas gangrene: certain diagnosis or certain death; Corry M et al.; Clostridia are organisms which, in the right environment, can cause a rapidly spreading, fulminant myonecrosis . Early diagnosis and a combined management program are clearly paramount to a successful outcome . Knowledge of this disease and ongoing meticulous assessment are the tools that a nurse must use when dealing with patients who have gas gangrene or are at high risk of developing it . In the face of radical disfigurements that may follow therapeutic measures, the potential transfer to a distant center for treatment, and a deteriorating prognosis, the nurse must remain alert to patient and family psychologic needs.

Proc Natl Acad Sci U S A, 1989 Oct, 86(20), 7853 - 6
Clostridial glycine reductase: protein C, the acetyl group acceptor, catalyzes the arsenate-dependent decomposition of acetyl phosphate; Stadtman TC; The highly purified protein C component of clostridial glycine reductase is required in addition to seleno-protein A and protein B for the conversion of glycine to acetate and ammonia in the presence of arsenate . As shown by Arkowitz and Abeles {Arkowitz, R . A . & Abeles, R . H . (1989) Biochemistry 28, 4639-4644}, the products are ammonia and acetyl phosphate in the presence of phosphate . The protein C component alone catalyzes an arsenate-dependent decomposition of acetyl phosphate, showing that it serves as the acetyl group acceptor in the overall reaction . A thiol-reducing agent and Mg2+ are required for catalysis of the arsenolysis reaction by protein C . Alkylation or heating at 60 degrees C completely abolishes the ability of protein C to catalyze the arsenolysis reaction and to participate as an essential component in the overall glycine reductase reaction.

South Med J, 1989 Oct, 82(10), 1272 - 4
Spontaneous clostridial myonecrosis in a man with drug-induced agranulocytosis; Slovick FT et al.; A middle-aged man had spontaneous clostridial myonecrosis during a period of neutropenia caused by drug-induced agranulocytosis . This complication in the absence of any prior cytotoxic chemotherapy or any evidence of an ileocecal neoplasm argues for the central role of neutropenia in the development of this rare syndrome . Survival of the patient was dependent upon prompt, aggressive medical and surgical management and the spontaneous recovery of the neutrophil count.

J Dairy Sci, 1989 Oct, 72(10), 2565 - 72
Ammonia-treated alfalfa silage for lactating dairy cows; Kung L Jr et al.; Alfalfa was treated (3.3% of forage wet weight) with an aqua-NH3 (14% N) mix prior to ensiling in 2 consecutive yr . In the 1st yr, NH3-treated silage containing 30.5% DM was higher in pH, N, NH3N, acetic acid and butyric acid contents, and lower in amino acids, soluble carbohydrates, and lactic acid than two untreated silages having 32.8 and 47.5% DM . Milk composition and DM intake did not differ among treatments when these silages constituted 50% of the dietary DM and were fed to lactating cows . In situ and in vitro, but not in vivo, digestion of NDF was greater for NH3 silage . Dry matter content of NH3-treated silage in the 2nd yr was 36.1% and that of the two untreated silages was 37.8 and 54.9% . Silage N, NH3N, and acetic acid content were greater in treated silage . However, pH and butyric acid content were similar among treatments and lactic acid was greater for treated silage . Similar to findings in the 1st yr, milk production and DM intake were not different among treatments . Adding NH3 to alfalfa decreased proteolysis; however, when DM was low (30.5%), the buffering effect of NH3 apparently resulted in increased clostridial fermentation . This did not occur when silage DM was increased to 36.1%, presumably due to higher osmotic pressure . Ammonia addition enhanced fiber digestibility but had no effect on milk production.

Antibiot Khimioter, 1989 Sep, 34(9), 707 - 11
{Empirical antibiotic therapy of wounds complicated by anaerobic non-clostridial infection}; Borisova OK et al.; Antibacterial activity of 14 drugs against clinical strains of asporogenic anaerobes causing wound infections in the soft tissues i . e . Bacteroides fragilis and Bacteroides melaninogenicus as well as anaerobic gram-positive++ cocci was assayed with the method of serial dilutions in agar . It was shown that among the investigated species B . fragilis had the most marked resistance since out of the 14 drugs only 8 were sufficiently active against it i.e . carbenicillin, levomycetin, lincomycin, dioxidine, metronidazole, thinidazole, nitrazole and erythromycin . The choice of drugs for treating infections caused by B . melaninogenicus and anaerobic grampositive cocci unlike those caused by B . fragilis offered no difficulty since practically++ all the investigated drugs were highly active against the causative agents . There was observed relationship between the frequency of asporogenic anaerobes and the wound genesis . The characteristic features of the species composition connected with localization of the suppurative foci were indicated . The detected specific antimicrobial profiles of the asporogenic anaerobes causing wound infections and the peculiarity of their participation in development of purulent infections of the soft tissues provided a differential approach to empirical antibacterial therapy prior to the pathogen bacteriological investigation and availability of the antibioticograms.

Berl Munch Tierarztl Wochenschr, 1989 Sep 1, 102(9), 310 - 7
{The seasonal toxigenicity of different cultured plants for clostridia in relation to so-called wildlife mortality}; Bohnel H et al.; In the juice of plants which could be eaten by hares different amounts of toxins (haemolysin, lecithinase) could be found after the partly addition of a C . perfringens field strain and subsequent anaerobic incubation . Sterile filtrates showed a very pronounced toxigenicity . The presented results proof in tendency that oilseed-rape (00-rape seed), wheat, and barley as green plants can contribute in clostridial toxicosis in hares, whereas grass and beets are involved only partially, and clover is practically completely atoxigenic.

Vestn Khir Im I I Grek, 1989 Aug, 144(8), 21 - 4
{Characteristics of the course of peritonitis in relation to the degree of perforation of the gastrointestinal tract}; Shurkalin BK et al.; An examination and treatment of 80 patients with general forms of peritonitis has shown that the course of the disease is greatly dependent on the character of the bacterial dissemination of the abdominal cavity . A microbiological examination has shown that in all the levels of perforation of the gastro-intestinal tract there are associations of various microorganisms . The most severe course of peritonitis is observed when caused by infection by colonic contents with prevailing anaerobic ++non-clostridial microflora in the exudate . The method of repeated revisions of the abdominal cavity should be used for these forms of peritonitis.

Clin Orthop, 1989 Jul, (244), 254 - 7
Sepsis due to an infected pseudocyst of hemophilia . A case report; Ferenz CC et al.; A 42-year-old Factor-VIII-deficient hemophiliac developed an infected pseudocyst and subsequent clostridial sepsis . Wide surgical debridement and precise medical management provided for survival in this patient's case . The treatment of choice for this rarely encountered problem was radical excisional surgery along with antibiotics and replenishment of all necessary blood products.

Khirurgiia (Mosk), 1989 Jun, (6), 68 - 71
{Diagnosis and treatment of suppurative processes caused by non-clostridial anaerobic microflora}; Ofanesian SS; One hundred and fifty patients suffering from various purulent diseases (60 persons) and postoperative purulent complications (90 persons) caused by nonclostridial anaerobes were examined . Nonclostridial anaerobic bacteria were isolated most frequently in acute mastitis, paraproctitis, and postinfectious abscesses among patients of the first group and after appendectomy and resection of the large intestine among those of the second group . The character of the wound discharge, the location of the focus of infection, the tendency of the purulent process to form a great number of cavities and fistules, bacterioscopy of the native material, etc . help in establishing the diagnosis (before the results of bacteriological tests are obtained) . Purulent processes caused by a combination of anaerobic cocci and aerobic flora take a particularly unfavourable course . Antibiotic therapy should consists of high doses of one or two antibiotics combined with metronidazole and nystatin.

Biochem J, 1989 May 15, 260(1), 259 - 63
A continuous fluorimetric assay for clostridial collagenase and Pz-peptidase activity; Barrett AJ et al.; The peptide derivative N alpha-(2,4-dinitrophenyl)-L-prolyl-L-leucyl-glycyl-L-prolyl-L-tryptophanyl-D- lysine (Dnp-Pro-Leu-Gly-Pro-Trp-D-Lys) has been found to be a convenient substrate for the assay of clostridial collagenase and Pz-peptidase . The substrate shows a 25-fold enhancement of fluorescence (gamma ex . 283 nm, lambda em . 350 nm) following hydrolysis of the Leu2-Gly3 peptide bond . The value of Km for clostridial collagenase was 17 microM . The substrate for the first time makes possible continuous fluorimetric assays for Pz-peptidase and clostridial collagenase.

J Foot Surg, 1989 May-Jun, 28(3), 213 - 6
Nonclostridial gas gangrene; Markantone SS et al.; Podiatric physicians must realize that the presence of crepitus, and/or radiographic evidence of gas in the subcutaneous tissue, does not necessarily mean anaerobic clostridial gas gangrene . This is especially true in the diabetic where other gas producing organisms have been isolated . The authors provide a literature review, and case study, of nonclostridial gas gangrene.

J Am Acad Dermatol, 1989 May, 20(5 Pt 1), 774 - 81
Necrotizing fasciitis: a clinical, microbiologic, and histopathologic study of 14 patients; Umbert IJ et al.; We studied the clinical, microbiologic, and histopathologic findings from 14 patients with necrotizing fasciitis; also tissue obtained at autopsy was available from six patients . In all cases, material cultured was positive for multiple organisms, including Clostridia and fungi; organisms were identified by histochemical staining of tissue sections in 12 of 14 cases . The histologic pattern comprised edema, necrosis, and inflammation of skin, subcutaneous fat, and fascial tissue . Hyalin necrosis of sweat glands was observed in five patients . Thrombosis of vessels at all levels was a prominent feature, suggesting that study of coagulation factors may be important . Diagnosis may be confirmed by the histologic picture; however, microbiologic material is essential to guide therapy.

Ann Vasc Surg, 1989 Apr, 3(2), 146 - 52
Human microvessel endothelial cell isolation and vascular graft sodding in the operating room; Williams SK et al.; We have evaluated multiple factors inherent to an operating room-compatible endothelial cell procurement and sodding procedure . Microvessel endothelial cell isolations have been performed on fat tissue obtained from over 140 patients with a 100% success rate . Liposuction-derived fat was optimal with respect to cell yield, and isolation time . The devices and equipment used were acceptable to the operating room and the complete cell procurement procedure was successful even in the hands of personnel with minimal training . Fat digestion was achieved using crude clostridial collagenase, with an average cell yield of 1 x 10(6) microvessel endothelial cells/gm of fat . Evaluation of this procedure with canine fat using an operating room acceptable procedure resulted in a 100% procurement success rate requiring 1.5 hours (+/- .5 hrs) for completion of the fat isolation, and cell isolation procedure . Microvessel EC could subsequently be used in graft seeding or sodding techniques to establish endothelial cell monolayers on vascular grafts . Our results indicate that one person with minimal cell isolation background can reproducibly isolate large quantities of sterile autologous endothelial cells in the operating room for immediate use in endothelial cell seeding/sodding procedures.

Aust Paediatr J, 1989 Apr, 25(2), 99 - 100
Intestinal perforation in children; Wardhan H et al.; There were 102 cases of intestinal perforation seen in children at the Department of Paediatric Surgery at S.S . Hospital, Varanasi during a 3 year period . Enteric (typhoid) perforation (29%), intussusception (15%) Ascaris lumbricoides infestation (9%) and appendicitis (9%), which are rarities in the reported literature, were the major causes of intestinal perforation . Radiological evidence of pneumoperitoneum was seen in 88% of patients . The majority of cases in this study were older than 5 years of age (48%) . Peritoneal fluid culture revealed Escherichia coli and Klebsiella to be the most common aerobic micro-organisms, while Bacteroides fragilis, Clostridia and Peptostreptococcus were the most frequent anaerobes . The overall mortality rate was high (19%).

Presse Med, 1989 Apr 1, 18(13), 675 - 8
{Gas gangrene after aseptic orthopedic surgery}; Moine P et al.; Gas gangrene following scheduled orthopedic surgery is not uncommon . In order to assess its frequency and prognosis, identify possible predisposing factors and suggest preventive measures, we reviewed the records of 22 patients (14 males and 8 females, mean age 40 +/- 20 years) admitted between 1969 and 1987 who developed gas gangrene in the wake of orthopedic surgery . In all cases the lower limbs were the site of operation: the knee in 9, the hip in 4, the femur in 4 and the leg in 5 cases . Surgical procedures included on-site foreign material in 19 cases, pneumatic tourniquet in 6 and prolonged vascular stretch in 9 . Infection was diagnosed within 1.4 +/- 1.1 days of surgery; local signs, especially crepitants and pain, were prominent for the diagnosis . Pathologic findings consisted of myonecrosis in 18 patients and cellulitis in 4 . Local bacteriological studies, carried out in 19 patients, yielded organisms in 14, including 12 with Clostridia perfringens . Four patients (one despite surgical treatment) died within 24 hours of admission . The remainder were treated with a combination of surgery, antimicrobial therapy (18) and hyperbaric oxygen (17) . Subsequently, 13 patients had severe functional disability, while 5 recovered without sequelae . In view of the poor prognosis of gas gangrene, several preventive measures are suggested during aseptic surgery of the lower limbs . Careful skin preparation, cleaning of the anal region and short-term prophylactic antibiotic therapy with cefamandole or amoxycillin-clavulanic acid, are among them.

J Exp Med, 1989 Mar 1, 169(3), 1011 - 20
Activated murine macrophages secrete a metabolite of arginine with the bioactivity of endothelium-derived relaxing factor and the chemical reactivity of nitric oxide; Stuehr DJ et al.; L-arginine-dependent synthesis of nitrite (NO2-) and nitrate (NO3-) by macrophages correlates with and is required for their execution of nonspecific cytotoxicity toward some tumor cells and microbes . However, the bioactive L-arginine metabolites responsible for cytotoxicity are unknown . Mammalian endothelial cells have recently been shown to release nitric oxide (NO.); we therefore determined if this reactive metabolite was synthesized by activated murine macrophages . Macrophage-derived NO . was detected by two independent methods: a bioassay for NO.-mediated relaxation of preconstricted rings of rabbit aorta; and a spectroscopic measurement of the reaction of NO . with clostridial ferredoxin, an Fe-S protein . After activation with IFN-gamma and LPS, macrophages continuously secreted a substance that relaxed rabbit aortic rings denuded of endothelium . Production of the vasorelaxant was enhanced by 0.5 mM L-arginine and inhibited reversibly by NG-methylated L-arginine analogs that block macrophage NO2-/NO3- synthesis . The vasorelaxant was scavenged by ferrous myoglobin, was labile, and was neither NO2- nor a cyclooxygenase metabolite . Activated M phi also secreted a substance that bleached Fd, a reaction carried out by NO . and NO2, but not NO2- . Macrophage bleaching of Fd correlated directly with time, cell number, and concomitant NO2-/NO3- production, required L-arginine, and was independent of reactive oxygen intermediates . Thus, activated murine M phi release NO . and/or a closely related, highly reactive nitrogen oxide such as NO2, during their conversion of L-arginine to NO2-/NO3- . NO . and NO2 may mediate L-arginine-dependent pathologic effects of M phi, as well as physiologic effects not previously considered for this widely distributed cell type.

Dtsch Med Wochenschr, 1989 Feb 24, 114(8), 293 - 7
{Neutropenic enterocolitis}; von Herbay A et al.; In three patients with neutropenia who had died after a short period from their basic disease (myelodysplasia, medullary carcinoma, acute myeloic leukaemia), autopsy revealed segmental necrotising enterocolitis in the caecal region (neutropenic enterocolitis) . Morphologically the enterocolitis was characterised by necrotized mucosa, marked oedema of the intestinal wall, intramural gas, the absence of pseudomembranes and a nearly complete absence of inflammatory cell infiltrates . In one case a palpable abdominal tumour had been produced by pseudotumorous thickening of the intestinal wall . The pathogenesis in these three cases might be a neutropenia-associated disturbance of the intestinal flora with selective proliferation of toxin-producing clostridia.

Mol Biochem Parasitol, 1989 Jan 15, 32(2-3), 229 - 46
Identification, synthesis and immunogenicity of cuticular collagens from the filarial nematodes Brugia malayi and Brugia pahangi; Selkirk ME et al.; The major structural proteins of the cuticle of the filarial nematode parasites Brugia malayi and Brugia pahangi were identified by extrinsic iodination and sensitivity to clostridial collagenase . At least 16 acidic components were identified in adult worms by 2-dimensional electrophoresis, with molecular weights ranging from 35,000 to 160,000 . These proteins appear to be cross-linked by disulphide bonds, and localised in the basal and inner cortical layers of the cuticle . The outer cortex, containing the epicuticle, is insoluble in 1% sodium dodecyl sulphate and 5% 2-mercaptoethanol, and can be isolated free of cellular material . Despite their inaccessibility to the immune system in intact worms, antibodies to the cuticular collagens are provoked in humans infected with a variety of filarial parasites . Immunological cross-reactivity was demonstrated between a 35 kDa component and human type IV (basement membrane) collagen . Autoantibodies to type IV collagen were detected in a number of individuals with lymphatic filariasis, although no correlation could be drawn with observed pathology . Synthesis of cuticular collagens is discontinuous, occurs at negligible levels in mature adult male worms, and does not appear to involve the production of small molecular weight precursors, in contrast to Caenorhabditis elegans . Hybridisation with a heterologous cDNA probe coding for the alpha 2 chain of chicken type 1 collagen suggests that they are encoded by a multigene family.

South Med J, 1989 Jan, 82(1), 29 - 31
Clostridial bloodstream infections; Ingram CW et al.; In a ten-year review at a large community teaching hospital clostridia accounted for less than 1% of all positive bloodstream isolates (26 episodes in 25 patients) . All but one of the isolates were clinically significant . Twenty-two patients (88%) had a serious underlying medical condition, and 17 of the episodes (65%) were associated with a bowel source; twelve patients (48%) died of their infection . Clostridial bloodstream infections are particularly clinically significant in patients with serious underlying disease.

Khirurgiia (Mosk), 1989 Jan, (1), 78 - 80
{Non-clostridial anaerobes in the etiopathogenesis of perivesical cholangiogenic abscesses of the liver}; Zemskov VS et al.; The authors had under observation 318 patients who were subjected to operation and suffered from various inflammatory diseases of the bile tract; perivesical and cholangiogenic abscesses of the liver were found in 33 of them . Bacteriological tests of the contents of the abscesses demonstrated most frequently the presence of Bacteroides fragilis as a monoculture in cholangiogenic abscesses and associations of anaerobic and aerobic bacteria in perivesical abscesses . Early operation with obligatory consideration for the anaerobic component of the microflora is recommended.

Acta Chir Belg, 1989 Jan-Feb, 89(1), 25 - 8
"Spontaneous" non clostridial gas gangrene: case report and review of the literature; Hubens G et al.; The authors present a case of spontaneous non clostridial gas gangrene and discuss the possible etiology, the microbiology as well as the treatment compared to the literature.

Klin Khir, 1989, (10), 3 - 5
{Acute anaerobic destruction of the lungs}; Grigo'rev EG et al.; Seventy eight patients with bacterial destruction of the lungs were under observation . Non-clostridial anaerobic microflora was identified by a method of gas-liquid chromatography in 57(74.6%) patients . Of them, 8 had gangrene, 49--acute pulmonary abscesses . In all the cases, there were associations of asporous anaerobic microflora with aerobic bacteria . In all the patients with destruction of pulmonary tissue, the increase in the content of the middle mass molecules was noted, the greatest--in patients with gangrene of a lung . In these patients, the bactericidal activity of blood serum, IgM and IgA content were low . In all patients, the complex treatment was performed.

Z Rechtsmed, 1989, 103(1), 1 - 20
{Complications following cell therapy}; Bohl J et al.; So far, the law in the Federal Republic of Germany still allows the injection of fresh-cell preparations from animals as a roborant to increase the vitality of the organism and to strengthen the body's immune defense system . The use of "sicca-cell" preparations was provisionally forbidden in 1987 by the Federal Health Organization (Bundesgesundheitsamt; BGA) . Prohibition of fresh-cell injections would have exceeded the authority of this office, although the same serious reservations also applied in the case of this treatment method . Several publications that have appeared since 1955 have reported serious complications of this therapy, some life-threatening and some even lethal . Two further cases are now added: (1) A woman aged 69 had been receiving treatment with cell injections for 9 years . Immediately after an injection of sicca cells she collapsed and was hospitalized; 7 days thereafter she developed an ascending paralysis with increasing inability to swallow or breathe . She died 25 days after the injection as a consequence of central and peripheral respiratory failure . Autopsy revealed the alterations typical for acute Landry-Guillain-Barre-Strohl syndrome . (2) A 76-year-old healthy woman had been receiving treatment with fresh-cell preparations for several years . After an injection of cell suspensions a painful local swelling was observed . The symptoms were interpreted as the consequence of an iatrogenic local hematoma, and repeated punctures were performed to obtain blood . The patient was transferred to a surgical department for further therapy . Two days after the injection she suddenly died with signs of acute cardiovascular failure . Autopsy revealed the signs of a fulminating clostridial infection and also the characteristic signs of Landry-Guillain-Barre syndrome with involvement of the autonomic nervous system . In both cases the development of an inflammatory process in the peripheral nervous system could be interpreted as an immune-mediated allergic disease, related to the repeated injection of heterologous antigenic material containing nervous tissues . This hypothesis would also explain the two other cases already published and would be consistent with the observed perivenous leukoencephalopathy of the central nervous system . The human disease pictures correspond to the well-established animal models of EAEM (experimental allergic encephalomyelitis) and EAN (experimental allergic neuritis) . The pathogenesis is discussed; the major role of the central and peripheral nervous system is stressed, with special reference to the risk of acute autonomic failure . The need for specific autopsy techniques for the investigation of the entire nervous system, including spinal cord, roots, spinal ganglia and peripheral nerves with sympathetic chains, is raised.

J Comp Physiol {B}, 1989, 159(5), 517 - 25
The glue protein of ribbed mussels (Geukensia demissa): a natural adhesive with some features of collagen; Waite JH et al.; The Atlantic ribbed mussel Geukensia (Modiolus) demissa attaches itself to the roots of cord grass and other hard objects in tidal salt marshes by spinning adhesive byssal threads . The precursor of a protein apparently present in the adhesive plaques of the threads was isolated in quantity from the foot of the mussel . The protein has an apparent molecular weight of 130,000, a pI of 8.1, and contains a high proportion of Gly, Glu/Gln, Lys and 3,4-dihydroxyphenyl-L-alanine (DOPA) . Sequence of tryptic peptides suggests a pattern of repeated motifs, such as: Gly--DOPA--Lys, and X--Gly--DOPA--Y--Z--Gly--DOPA/Tyr--Lys, where X is Thr or Ala in octapeptides and Gln--Thr in nonapeptides . Y is variable, but more often than not hydrophobic; and Z is frequently Pro or 4-trans-hydroxyproline (Hyp) . The presence of Pro--Gly and Hyp--Gly sequences of delta-hydroxylysine in the protein is reminiscent of typical collagens; however, the protein is not labile to clostridial collagenase, nor does collagen cross-react with antibodies raised against the mussel protein . Unlike typical collagens, Gly probably occurs only at every 4th or 5th residue in this unusual mussel protein.

J Rheumatol, 1988 Nov, 15(11), 1677 - 82
In vitro protection of the articular surface by cross-linking agents; Stanescu R et al.; The effects of cross-linking agents on the resistance of the articular surface to digestion with clostridial collagenase were studied using a described in vitro system . Mouse femoral heads were treated with various concentrations of glutaraldehyde, with osmium tetraoxide and with dithiobis (succinimydil propionate), digested with the enzyme, labeled with cationized ferritin and examined by electron microscopy . Collagenase alone caused disruption of the articular surface with penetration of the large marker into the cartilage matrix . After treatment of the femoral heads with the cross-linking agents, no effects on the morphology and on the labeling of the articular surface and no penetration of the label into the cartilage matrix were observed . Increasing cross-linking at the articular surface might be a new route for therapeutic intervention . However, experiments would be needed to assess the effect of the procedure on the viability and nutrition of chondrocytes and on the functional properties of the tissue.

Postgrad Med, 1988 Oct, 84(5), 148 - 58, 161-3, 166-8
Systemic infections affecting the liver . Some cause jaundice, some do not; Cunha BA; The patient who has clinical jaundice, abnormal results on liver function tests, or both presents a difficult diagnostic challenge . Many infectious diseases affect the liver, and the extent of involvement determines the degree of clinically apparent jaundice . Some diseases that affect the liver minimally cause no jaundice at all . An important clue to the cause of the disorder is the pattern of abnormal results on liver function tests . Increased alkaline phosphatase predominates with Q fever, secondary or tertiary syphilis, clonorchiasis, and hepatic candidiasis, while elevated levels of serum transaminases characterize viral hepatitis, leptospirosis, mononucleosis syndromes, legionnaires' disease, typhoid fever, toxic shock syndrome, and yellow fever . Increases in serum bilirubin are typical with jaundice caused by clostridial myelonecrosis, severe bacterial sepsis, and relapsing fever (borreliosis) . These findings together with the patient's history, physical findings, and basic laboratory tests provide a presumptive diagnosis in most cases.

Mol Biochem Parasitol, 1988 Oct, 31(1), 27 - 33
Nucleotide sequence analysis of an Entamoeba histolytica ferredoxin gene; Huber M et al.; A cDNA clone (subclone B) previously isolated from the human parasite Entamoeba histolytica was characterized . DNA sequence analysis of subclone B identified the DNA as that encoding apoferredoxin . E . histolytica ferredoxin cDNA contains unusually short 5' and 3' noncoding regions of 9 and 25 nucleotides, respectively . A genomic ferredoxin clone was isolated from E . histolytica DNA, and comparison of genomic and cDNA sequences revealed that the ferredoxin gene is unspliced . The deduced amino acid sequence of E . histolytica ferredoxin resembles clostridial type of ferredoxins, and shows an arrangement of cysteines characteristic for the coordination of 2{4Fe-4S} centres . Of interest is the absence of an aromatic amino acid in the N-terminal region of the protein, a feature which is conserved in clostridial ferredoxins . Southern blot analysis of three different E . histolytica strains (200:NIH, Rahman and HM-1:IMSS) demonstrated the presence of a family of at least two ferredoxin genes . One of these genes is marked by restriction length polymorphisms in different strains of E . histolytica.

J Am Vet Med Assoc, 1988 Sep 15, 193(6), 668 - 70
Intramuscular injection techniques and the development of clostridial myositis or cellulitis in horses; Brown CM et al.; A survey of 584 veterinarians in equine practice was performed to determine their intramuscular injection techniques and the influence of those techniques on the development of clostridial myositis or cellulitis . Usable responses were obtained from 439 veterinarians (75.2%) . Of these, 414 used a new needle and syringe for each injection, 241 swabbed the site with a cleansing/disinfectant agent, and 242 swabbed the top of multidose injection bottles with a similar solution . Only 2 clipped the hair at the injection site . Twenty eight of the respondents reported that at least 1 horse developed a clostridial infection at the injection site following 1 of their injections . None of the various injection techniques had a significant influence on the development of clostridial infection at the injection site.

J Chromatogr, 1988 Jun 17, 442, 267 - 77
Detection by high-performance liquid chromatography of polyamines formed by clostridial putrefaction of caseins; Karlsson S et al.; Casein incorporated in building materials is degraded by species of alkali-tolerant Clostridia . A whole range of compounds have previously been detected in degraded building materials containing casein as an additive by gas chromatography (GC), including volatile and non-volatile organic acids, alcohols, ketones, aldehydes and monoamines . Using high-performance liquid chromatography (HPLC) it was possible, however, also to detect polyamines formed in degraded caseins . Histamine, agmatine, serotonine, tyramine, tryptamine, putrescine and cadaverine were detected in solutions containing casein in which the alkali-tolerant Clostriadia had been grown . Uninoculated, sterile incubated caseins contained no detectable amounts of polyamines . This gives clear evidence of the role of the biotic environment in the degradation of caseins . A combination of GC and HPLC therefore, provides a convenient set of techniques for studying the degradation products of casein.

J Biol Chem, 1988 Jun 5, 263(16), 7717 - 25
Isolation and characterization of the Saccharomyces cerevisiae MIS1 gene encoding mitochondrial C1-tetrahydrofolate synthase; Shannon KW et al.; C1-Tetrahydrofolate synthase is a trifunctional polypeptide found in eukaryotic organisms that catalyzes 10-formyltetrahydrofolate synthetase (EC 6.3.4.3), 5,10-methenyltetrahydrofolate cyclohydrolase (EC 3.5.4.9), and 5,10-methylenetetrahydrofolate dehydrogenase (EC 1.5.1.5) activities . In Saccharomyces cerevisiae, C1-tetrahydrofolate synthase is found in both the cytoplasm and the mitochondria . The gene encoding yeast mitochondrial C1-tetrahydrofolate synthase was isolated using synthetic oligonucleotide probes based on the amino-terminal sequence of the purified protein . Hybridization analysis shows that the gene (designated MIS1) has a single copy in the yeast genome . The predicted amino acid sequence of mitochondrial C1-tetrahydrofolate synthase shares 71% identity with yeast C1-tetrahydrofolate synthase and shares 39% identity with clostridial 10-formyltetrahydrofolate synthetase . Chromosomal deletions of the mitochondrial C1-tetrahydrofolate synthase gene were generated using the cloned MIS1 gene . Mutant strains which lack a functional MIS1 gene are viable and can grow in medium containing a nonfermentable carbon source . In fact, deletion of the MIS1 locus has no detectable effect on cell growth.

Development, 1988 Jun, 103(2), 259 - 67
The role of interstitial collagens in cleft formation of mouse embryonic submandibular gland during initial branching; Fukuda Y et al.; An interstitial collagenase was purified from the explant medium of bovine dental pulp and was shown to degrade collagens I and III but not IV and V . The enzyme halted cleft initiation in the epithelium of 12-day mouse embryonic submandibular glands in vitro, indicating the active involvement of interstitial collagens in the branching morphogenesis . Transmission electron microscopic observation of the intact 12-day gland without any clefts showed the scattered localization of a few collagen fibrils at the epithelial-mesenchymal interface of the bulb and also revealed the presence of numerous microfibrils around the stalk . Collagen bundles were regularly seen close to the wavy basal lamina at the bottom of clefts of the intact 13-day gland and 12-day gland cultured for 17 h under normal conditions . Mesenchymal cells were found in the clefts together with the frequent localization of peripheral nerve fibres and capillary endothelial cells . The collagen bundles were more often observed in the 12-day gland cultured in the presence of bovine dental pulp collagenase inhibitor, which had been shown to enhance cleft formation . In contrast, collagen fibrils were rarely found at the epithelial-mesenchymal interface of the 12-day gland cultured in the presence of Clostridial or bovine dental pulp collagenase . The findings indicated that the formation of interstitial collagen bundles is essential to form clefts in the epithelium both in vivo and in vitro.

FEBS Lett, 1988 May 9, 232(1), 145 - 7
Inhibition of N-acetylneuraminate lyase by N-acetyl-4-oxo-D-neuraminic acid; Gross HJ et al.; We show that the 4-oxo analogue of N-acetyl-D-neuraminic acid strongly inhibits N-acetylneuraminate lyase (NeuAc aldolase, EC 4.1.3.3) from Clostridum perfringens (Ki = 0.025 mM) and Escherichia coli (Ki = 0.15 mM) . In each case the inhibition was competitive . N-Acetyl-D-neuraminic acid; N-Acetylneuraminate lyase; N-Acetyl-D-neuraminic acid analog; 5-Acetamido-3,5-dideoxy-beta-D-manno-non-2,4-diulosonic acid; 2-Deoxy-2,3-didehydro-N-acetyl-4-oxo-neuraminic acid; Competitive inhibitor.

Biochem J, 1988 Mar 1, 250(2), 605 - 12
CO oxidoreductase from Streptomyces strain G26 is a molybdenum hydroxylase; Bell JM et al.; CO oxidoreductase was purified to 95% homogeneity from crude mycelial extracts of Streptomyces G26 . The purified preparation has a specific activity of 25.7 units/mg, a 13-fold improvement on crude soluble mycelial extracts . The native enzyme (Mr 282,000) is composed of non-identical subunits of Mr 110,000 and 33,000 . It is a molybdenum hydroxylase containing 1.6 mol of FAD, 7.3 mol of Fe, 8.3 mol of acid-labile sulphide and 1.3 mol of Mo per mol of enzyme . Purified CO oxidoreductase catalyses the reduction of benzyl viologen, confirming the previously reported ability of this enzyme to interact with low-potential acceptors . Cytochrome c reduction cannot be accounted for entirely by non-enzymic reduction by superoxide radicals . NAD+ and NADP+ are not reduced, nor is clostridial ferredoxin.

Clin Orthop, 1988 Mar, (228), 265 - 9
Postoperative clostridial infection . A case report; Moehring HD; The classic fulminating, rapidly progressive, and potentially lethal clostridial myonecrosis (CM), also known as gas gangrene, is a familiar entity . Nevertheless, individual experience with this dreaded disease is extremely rare or nonexistent . Clostridial cellulitis does not involve muscle necrosis and is associated with a lower mortality rate . Although still potentially limb threatening, clostridial cellulitis is a source of considerable morbidity . In a 13-year-old boy the symptoms did not appear until two weeks postoperatively . Definitive treatment was not instituted until five days later.

Rev Infect Dis, 1988 Mar-Apr, 10(2), 347 - 64
Unusual infections associated with colorectal cancer; Panwalker AP; Unusual infections associated with colorectal tumors may, in some instances, be the sole clue to the presence of a malignancy . The infections are either related to invasion of tissues or organs in close proximity to the tumor or secondary to distant seeding by transient bacteremia arising from necrotic tumors . Seven patients seen at one hospital over a 5-year period illustrate the clinical presentations of such infections . The infections identified in these seven patients include endocarditis, meningitis, nontraumatic gas gangrene, empyema, hepatic abscesses, retroperitoneal abscess, clostridial sepsis, and colovesical fistulae with urosepsis . A computer-assisted search of the English-language literature and cross-checks from other review articles identified other infections associated with colon cancer, which include nontraumatic crepitant cellulitis, suppurative thyroiditis, pericarditis, appendicitis, pulmonary microabscesses, septic arthritis, and fever of unknown origin . The clinical importance of these infections and their correlation with colorectal malignancies are reviewed.

Vestn Khir Im I I Grek, 1988 Mar, 140(3), 50 - 4
{Complications of non-clostridial anaerobic peritonitis}; Shurkalin BK et al.; Under observation there were 71 patients with non-clostridial anaerobic peritonitis, 37 of them having complications--suppurations of operation wounds, phlegmons of the abdominal wall, abscesses of the abdominal cavity, postoperative non-clostridial peritonitis . Fourteen patients died (37.8%).

J Pediatr Surg, 1988 Feb, 23(2), 130 - 4
Umbilical gangrene in the newborn; Stunden RJ et al.; Six neonates are described with a gangrenous omphalitis, a disease not reported for many years . They had many features in common including previous good health . In two, the disease was preceded by the application of tobacco ash to the umbilical stump . Clinically there was gangrene of the umbilicus with a blood-stained discharge and extensive cellulitis radiating into the abdominal wall . Despite aggressive therapy including excision of the affected area, the systemic effects of the local disease progressed rapidly until all of the first five infants who presented, died . Microbiologically there was a polybacterial infection involving a wide variety of organisms particularly E coli and Clostridia species . There appeared to be an appropriate response by the infants to an acute bacterial infection, and two patients investigated showed no evidence of cellular or humoral immunodeficiency . The pathology was an infection causing local tissue necrosis with a vasculitis and microabscess formation, which involved adjacent structures by direct extension . The severe systemic symptoms were attributable to an endotoxemia or exotoxemia . The evolution of therapy for gangreneous omphalitis in the newborn, successful in the sixth patient, is discussed.

J Invest Dermatol, 1988 Feb, 90(2), 127 - 33
Epidermolysis bullosa acquisita antigen: relationship between the collagenase-sensitive and -insensitive domains; Yoshiike T et al.; To clarify the relationship of the 290 and 145 kDa chains of the epidermolysis bullosa acquisita (EBA) antigen, we subjected urea extracts of skin basement membrane zone (BMZ) proteins and isolated 290 and 145 kDa chains of the EBA antigen cut out of sodium dodecyl sulfate polyacrylamide gels to treatment with clostridial collagenase . When the reaction products were electrophoresed, transblotted, and reacted with EBA patient sera or two monoclonal antibodies to the EBA antigen, the 290 kDa chain was degraded into the 145 kDa band that was resistant to cleavage with collagenase . The 145 kDa domain, isolated after collagenase treatment of the whole BMZ extract, was resistant to degradation by hyaluronidase, chondroitinase ABC, heparinase, and heparitinase but was readily degraded by V-8 protease . These data suggest that the EBA antigen consists of collagen and noncollagen domains of identical size (Mr 145,000), and that the 145 kDa noncollagen domain is generated via degradation of the native 290 kDa species by collagenase.

Z Erkr Atmungsorgane, 1988, 170(1), 70 - 5
{Diagnosis of anaerobic bacteria in bronchial secretions in pulmonary diseases}; Wendel H et al.; In 50 bronchoscopic examinations the microflora of bronchial secretions has been investigated especially in order to detect anaerobic microbes with the use of the glove-box-method . In 19 patients we found the bronchial secretions steril (particularly carcinomas) . Eight patients showed anaerobic gramnegative rods (Bacteroides and Fusobacteria) as predominant germs . Also in eight patients we found a mixed culture consisting in several anaerobic gram-negative rods, anaerobic gram-positive sporeless rods, anaerobic cocci, partly Clostridia and aerobes (carcinomas, pneumonias) . A contamination can be excluded . In a series of patients anaerobes must be considered as infectious agent, in abscessed pneumonias particularly Bacteroides and Fusobacteria . Repeatedly an impressive clinical improvement has been established under the treatment by Metronidazol . The evidence of anaerobes especially succeeded in cases with copious mucopurulent or pure purulent secretions . The accumulation of anaerobes in bronchial secretions in alcoholics is evident.

Vestn Khir Im I I Grek, 1988 Jan, 140(1), 74 - 7
{Surgical tactics in anaerobic non-clostridial peritonitis}; Shurkalin BK et al.; Under observation there were 128 patients with neclostridial peritonitis (NP) which made up 19.3% of the total number of patients with peritonitis . In spreaded NP when the source of NP was successfully eliminated and fibrinous layers on the peritoneum the laparotomy wound was tightly sutured up to the aponeurosis (included), primary delayed sutures were put on the skin . When it was impossible to completely remove all the fibrin from the peritoneum, the wound was sutured through all the layers, the sutures were tied in bows followed by numerous revisions of the abdominal cavity . Laparotomy was performed in postoperative NP with phlegmons of the abdominal cavity . The use of the tactics described allowed lethality to be reduced from 39.4% to 13.7%.

Agents Actions, 1987 Dec, 22(3-4), 310 - 3
Multisystem toxicity of indomethacin: effects on kidney, liver and intestine in the rat; Fracasso ME et al.; Some studies on the relationships among toxic effects in rat liver, kidney and intestine have been carried out . Indomethacin caused a marked reduction in microsomal enzymes, such as cytochrome P450, cytochrome b5 and aminopyrine N-demethylase in the kidney and the liver, greater in the former and for a shorter time than in the latter . Indomethacin induced intestinal lesions and marked overgrowth of intestinal bacteria, mainly of aerobic bacteria in the first 24 hours after its administration and anaerobic bacteria such as Clostridii in the second day . These findings enable us to suggest that the drug induces multisystem lesions through different mechanisms involving either a direct effect on the tissue or other microbiological or pharmacological factors.

Postgrad Med, 1987 Nov 1, 82(6), 77 - 9, 82, 84-5
Overwhelming infections in trauma; Hitchcock CR; Following trauma, wound contamination with aerobic and/or anaerobic bacteria should always be suspected . Treatment with antibacterial antibiotics should begin immediately in the emergency room, particularly for those patients with fractures . Patients with serious trauma are best treated by a team of specialists including general surgeons, orthopedists, infectious disease specialists, and intensive care specialists . The author recommends transport of seriously injured patients to major hospitals specializing in the care of trauma . Particularly when gas gangrene secondary to clostridial infection is suspected, the patient should be moved to a major trauma center with the capability for hyperbaric oxygen therapy.

Gastroenterology, 1987 Nov, 93(5), 986 - 93
Comparison of the biochemical changes in the jejunal mucosa of dogs with aerobic and anaerobic bacterial overgrowth; Batt RM et al.; Subcellular biochemical changes in the jejunal mucosa have been compared in dogs with either aerobic or anaerobic bacterial overgrowth to explore relationships between composition of the flora and mucosal damage . Affected animals comprised 17 German shepherd dogs with chronic diarrhea or weight loss, or both . Analysis of duodenal juice demonstrated aerobic overgrowth in 10 cases, most frequently comprising enterococci and Escherichia coli, and obligate anaerobic overgrowth in 7 cases, most frequently including Clostridia spp . Histologic changes were minimal; however, examination of peroral jejunal biopsy specimens by sucrose density gradient centrifugation revealed specific biochemical abnormalities . In the dogs with aerobic overgrowth, there was a selective loss of brush border alkaline phosphatase activity, and gamma-glutamyl transferase activity was increased, whereas activities of disaccharidases and aminopeptidase N were unaltered . In contrast, anaerobic overgrowth was associated with a reduction in brush border density, indicative of a considerable fall in the glycoprotein-to-lipid ratio of the brush border membrane, whereas brush border enzyme activities were unaltered . There was a loss of peroxisomal catalase activity in dogs with aerobic overgrowth, and an indication of mitochondrial disruption in dogs with anaerobic overgrowth, but little evidence for damage to other subcellular organelles . These findings demonstrate that aerobic and anaerobic overgrowth may be associated with distinct but different mucosal abnormalities particularly affecting the brush border membrane.

J Biol Chem, 1987 Oct 5, 262(28), 13706 - 12
Anchoring fibrils contain the carboxyl-terminal globular domain of type VII procollagen, but lack the amino-terminal globular domain; Lunstrum GP et al.; Type VII procollagen has been characterized as a product of epithelial cell lines . As secreted, it contains a large triple-helical domain terminated by a multi-globular-domained carboxyl terminus (NC-1), and a smaller amino-terminal globule (NC-2) . The triple helix and the NC-1 domain have previously been identified in anchoring fibril-containing tissues by biochemical and immunochemical means, leading to the conclusion that type VII collagen is a major component of anchoring fibrils . In order to better characterize the tissue form of type VII collagen, we have produced a panel of monoclonal antibodies which recognize the NC-1 domain . Peptide mapping of these epitopes indicate that they are independent and span approximately 125,000 kDa of the total 150,000 kDa of each alpha chain contained in NC-1 . All these antibodies elicit immunofluorescent staining of the basement membrane zone in tissues . Type VII collagen has been extracted from tissues . As previously reported, it is smaller than type VII procollagen, (Woodley, D . T., Burgeson, R . E., Lunstrum, G . P., Bruckner-Tuderman, L., and Briggaman, R . A., submitted for publication), and we now find that it predominantly occurs as a dimer . Following clostridial collagenase digestion, intact NC-1 has been recognized, indicating that the difference in apparent Mr between the tissue form of the molecule and type VII procollagen results from modification of the amino terminus . The size of the amino-terminal globule has been determined to be between approximately 96 and 102 kDa . Rotary shadowing analyses of extracted molecules indicate that dimeric molecules contain the NC-1 domain, but are missing intact NC-2 . We propose that the tissue form monomer, Mr = 960,000, be referred to as "type VII collagen." These studies strongly suggest that anchoring fibrils contain dimeric molecules with intact NC-1 domains . The data also support the previous suggestion that the NC-2 domain is involved in the formation of disulfide bond-stabilized type VII collagen dimers, and is subsequently removed by physiological proteolytic processing.

Klin Monatsbl Augenheilkd, 1987 Oct, 191(4), 292 - 5
{Gas gangrene of the eyelids and orbits}; Pittke EC et al.; Infections with Clostridia are very rare in the orbital region . On the basis of a case report of such an infection in the orbit the authors discuss the clinical behavior, diagnosis, and therapy of this infection with anaerobic bacteria . Computerized tomography was been very helpful in the diagnostic procedure.

Vestn Khir Im I I Grek, 1987 Sep, 139(9), 55 - 8
{Principles of treatment of non-clostridial anaerobic infection in the surgery of inflammatory diseases of the biliary tract}; Arik'iants MS; Based upon the clinico-bacteriological examination of 196 patients with different inflammatory diseases of bile ducts the author has established the role of non-clostridial anaerobic infection in the appearance of these diseases . Clinical symptoms of the infection have been systematically described . New principles of the surgical tactics and antibacterial prophylactics have been developed and used which allowed postoperative lethality to be reduced to 1% . The duration of treatment at the hospital became shorter (8.4 days).

Vestn Khir Im I I Grek, 1987 Jul, 139(7), 139 - 41
{Treatment of non-clostridial anaerobic infections in patients with diabetes mellitus in an isolated controlled abacterial medium}; Kuleshov EV et al.; The work presents data on treatment of 28 patients with neclostridial anaerobic infection developed against the background of diabetes mellitus . It was shown that characteristics clinical symptoms of the ailment and express-microscopic examination of the native material from the wound facilitated making the correct diagnosis in most cases without using complicated microbiological and chromatographic investigations.

J Theor Biol, 1987 May 7, 126(1), 15 - 32
Antibacterial immunity and its modeling in experimental tumor tetanus and wound tetanus of the mouse; Schneeweiss U et al.; The experimental and theoretical analysis of the tumor-tetanus phenomenon has provided us with new insights into the pathogenesis of tetanus infection . Our theoretical model of clostridial propagation in the proliferating tissue is based upon the principle of mitosis-controlled rod division (hit and cloning model) . It has lent itself to the description of early growth stages of the clostridial rod population in our experiments of tumor tetanus and of wound tetanus of the mouse . However, the later course of the tetanus lethality curves under antitoxin protection, about a week following injection of the tumor cell-spore or CaCl2-spore suspensions, reveals a pronounced delay in clostridial propagation . Based on our model we can explain this process by a humoral immune reaction directed against the clostridial rods taking into account the variability of elimination of the heterologous tetanus antitoxin applied . The experimental results are in good agreement with those obtained by computer simulation . The theoretical knowledge resulting from these studies can be used for the interpretation of the serodiagnostic tumor test with apathogenic clostridia as well as for the quantitative assessment of the malignancy of neoplastic growth.

Vet Rec, 1987 May 2, 120(18), 435 - 9
Injection site reactions and antibody responses in sheep and goats after the use of multivalent clostridial vaccines; Green DS et al.; Uncertainty concerning the use, efficacy and possible adverse effects of clostridial vaccination in goats prompted a study of the injection site reactions and antibody responses in 40 goats and 40 sheep . The vaccines used were Covexin 8, Heptavac and Tasvax 8 . In all the animals swellings averaging 2.5 cm in diameter were present at the injection site seven days after vaccination and were still apparent 28 days after vaccination . The injection site reactions could not be attributed to faulty vaccination technique because they did not occur in a control group injected with sterile water . By 14 days the reactions were significantly larger in sheep than in goats and by 28 days the reactions to Covexin 8 were larger than those to the other vaccines in sheep and goats . Serum antibody was present in all groups before vaccination and, with the exception of the goats vaccinated with Heptavac, increased 14 days after vaccination . The increase was greater in sheep than in goats . By 28 days antibody levels had declined in all but the sheep vaccinated with Heptavac in which a further increase occurred . At that time, the antibody levels in vaccinated sheep were still higher than in the unvaccinated sheep whereas the antibody levels in vaccinated goats were no longer different from those in the control goats . These results suggest that there is a difference between the vaccines used and between the responses of the two species and support the clinical observation that the protection afforded to goats by multivalent clostridial vaccines is poorer than that afforded to sheep.

J Vasc Surg, 1987 May, 5(5), 787 - 90
Control of infection in the diabetic foot: the role of microbiology, immunopathology, antibiotics, and guillotine amputation; McIntyre KE; Newer culture techniques have demonstrated that diabetic foot infections are polymicrobial, involving both anaerobic and aerobic bacteria . These infections are characteristically foul-smelling and create immense tissue destruction . Occasionally, despite the absence of clostridial organisms, subcutaneous gas may be present . The importance of adequate surgical debridement has been emphasized . In the event of advancing, unremitting infection involving the foot, ankle guillotine amputation may be a life-saving technique . Finally, the role of host-defense mechanism in diabetes is important . Polymorphonuclear leukocyte chemotaxis and phagocytosis are energy-dependent processes that are deficient in the diabetic . Better diabetic control with maintenance of normal blood sugars and avoidance of ketoacidosis may be the key to prevention of these morbid, lower extremity infections.

Vestn Khir Im I I Grek, 1987 Apr, 138(4), 38 - 42
{Effect of low-frequency ultrasound on non-clostridial anaerobic microflora}; Gostishchev VK et al.; Under analysis is an experience with the treatment of 78 patients with various purulent diseases of soft tissues caused by non-clostridial anaerobic microorganisms in a pure form or in combination with aerobic microflora treated with using low frequency ultrasound . The ultrasound was found not to alter the antimicrobial properties of antibacterial drugs . The degree of bacterial dissemination of the wounds was reliably lower . By the end of the treatment (on the 10-11th days) no growth of microflora was found in 25.7% of the examined patients . The sensitivity of anaerobic microorganisms to antibiotics not only became higher in the process of treatment with ultrasound but there appeared strains sensitive to other antibiotics.

Arch Pathol Lab Med, 1987 Apr, 111(4), 342 - 5
A method for cytologic examination of cartilaginous lesions; Mitchell ML et al.; Chondrocytes, dissociated from their matrix with trypsin and clostridial collagenase, retain their cytologic integrity . Successful preparations have been made from postmortem as well as surgical specimens . The method may lend itself to diagnosis of both neoplastic and developmental lesions.

Ann Chir Gynaecol, 1987, 76(2), 136 - 7
Perineal progressive myonecrosis following Thiersch's operation for rectal prolapse; Rye BA et al.; An extremely rare case of progressive perineal clostridial myonecrosis secondary to Thiersch's operation for rectal prolapse illustrates the need for early recognition of the initial clinical findings to maximize the chances for survival . Management of these infections include prompt administration of shock therapy, a broad spectrum of antibiotics, and thorough surgical debridement of all involved tissue . Prophylactic systemic antibiotic therapy must be considered, especially in high risk patients.

South Med J, 1986 Dec, 79(12), 1493 - 5
Infections of the lower extremities due to gas-forming and non-gas-forming organisms; Vo NM et al.; From 1977 to 1984, 87 above- and below-knee amputations were done on 77 patients for ischemic ulcerations and gangrene of the lower extremities . The overall three-month mortality was 14% and was mainly related to generalized atherosclerosis . Patients having infections with gas formations were more likely to be diabetic (80% vs 15%, P less than .01), have clinical sepsis and a higher preoperative WBC (19,000 vs 12,600/cu mm, P less than .01), and have a higher mortality (40% vs 12%, P less than .05) than those with infections due to non-gas-forming organisms . Mixed bacterial flora were cultured from most wounds . We conclude that infections with gas formation may be due to either clostridial or nonclostridial organisms, mortality is higher if gas accumulates and if the patient is diabetic, gas is more likely to accumulate in infected extremities of diabetic patients, and the combination of gas formation and diabetes is highly lethal.

Inflammation, 1986 Dec, 10(4), 347 - 61
Clostridial collagenase . A chemoattractant for human neutrophils; Walter RJ; Leukocyte chemoattractants markedly alter the morphology and membrane functions of leukocytes . Bacterial collagenase causes a change in cell shape similar to that seen with the leukocyte chemoattractant, f-Met-Leu-Phe, and also promotes capping of concanavalin A . Human neutrophils in suspension or adherent to cover glasses were exposed to clostridial collagenase (10-250 units/ml) for up to 30 min at 37 degrees C and then fixed . Collagenase (125 units/ml) caused more than 85% of PMNs to assume an asymmetric or motile morphology even in the presence of 1% gelatin or 10 mg/ml bovine serum albumin . Trypsin alone (0.01-1%) did not induce a shape change . A similar morphology was seen in some untreated PMNs (less than 5% of all cells) and is characteristic of f-Met-Leu-Phe-treated cells (more than 90%) . Collagenase inhibitors (i.e., reduced glutathione, cysteine, and acid-soluble collagen), however, prevented the shape change induced by collagenase but not by f-Met-Leu-Phe . At 4 degrees C, fluorescein-Con A (20 micrograms/ml) bound uniformly to both untreated and collagenase-treated cells . Upon further incubation at 37 degrees C, Con A was internalized over the entire cell periphery of the rounded, untreated cells but on collagenase-treated PMNs was rapidly gathered into a cap overlying the uropod or protuberant region of cytoplasm where it was subsequently internalized . Checkerboard Boyden chamber assays showed clostridial collagenase to be chemokinetic and chemotactic for human PMNs . In receptor binding experiments, the clostridial collagenase preparation competed poorly with {125I}formylhexapeptide for binding to PMN formylpeptide receptors (less than 15% reduction in binding at 200 units/ml collagenase) . Thus, collagenase does not seem to interact strongly with the neutrophil formylpeptide receptor and may stimulate PMN motility by interacting at an altogether different site.

Acta Chir Scand, 1986 Nov, 152, 715 - 6
Adenocarcinoma of the colon presenting as lower extremity gas gangrene (metastatic myonecrosis) . Case report; Sjolin SU et al.; Nontraumatic metastatic gas gangrene is often associated with occult gastrointestinal malignancies . Usually an ulcerative lesion of the intestinal mucosa serves as portal of entry for the clostridia . Unless treatment is promptly instituted the patients die from overwhelming sepsis within days . Patients surviving should be assumed to harbor an underlying malignancy until proved otherwise.

Anal Biochem, 1986 Nov 1, 158(2), 334 - 45
Accurate, quantitative assays for the hydrolysis of soluble type I, II, and III 3H-acetylated collagens by bacterial and tissue collagenases; Mallya SK et al.; Accurate and quantitative assays for the hydrolysis of soluble 3H-acetylated rat tendon type I, bovine cartilage type II, and human amnion type III collagens by both bacterial and tissue collagenases have been developed . The assays are carried out at any temperature in the 1-30 degrees C range in a single reaction tube and the progress of the reaction is monitored by withdrawing aliquots as a function of time, quenching with 1,10-phenanthroline, and quantitation of the concentration of hydrolysis fragments . The latter is achieved by selective denaturation of these fragments by incubation under conditions described in the previous paper of this issue . The assays give percentages of hydrolysis of all three collagen types by neutrophil collagenase that agree well with the results of gel electrophoresis experiments . The initial rates of hydrolysis of all three collagens are proportional to the concentration of both neutrophil or Clostridial collagenases over a 10-fold range of enzyme concentrations . All three assays can be carried out at collagen concentrations . that range from 0.06 to 2 mg/ml and give linear double reciprocal plots for both tissue and bacterial collagenases that can be used to evaluate the kinetic parameters Km and kcat or Vmax . The assay developed for the hydrolysis of rat type I collagen by neutrophil collagenase is shown to be more sensitive by at least one order of magnitude than comparable assays that use rat type I collagen fibrils or gels as substrate.

Biochem J, 1986 Oct 1, 239(1), 127 - 33
The structure of the hepatic insulin receptor and insulin binding; Haynes FJ et al.; Hepatocytes or hepatic plasma membranes were photoaffinity-labelled with radioiodinated N epsilon B29-monoazidobenzoyl-insulin . Analysis of the samples by SDS/polyacrylamide-gel electrophoresis and autoradiography revealed the insulin receptor as a predominant band of 450 kDa . When hepatic plasma membranes were first treated with clostridial collagenase and then photolabelled, the insulin receptor appeared as a predominant band of 360 kDa . This effect of collagenase treatment on the insulin receptor was due to Ca2+-dependent heat-labile proteinases contaminating the preparation of collagenase, and it could be mimicked by elastase . The decrease in size of the insulin receptor to 360 kDa resulted from the loss of a receptor component that was inaccessible to photolabelling . In contrast, the size of the insulin receptor of intact cells was not affected by collagenase treatment . This suggests that the site sensitive to proteolysis was located on the cytoplasmic side of the plasma membrane . In hepatic plasma membranes that were treated with collagenase or elastase, and contained the 360 kDa form of the insulin receptor, the binding affinity for insulin was increased by up to 2-fold . These findings support the concept that a component which is either a part of, or closely associated with, the insulin receptor may regulate its affinity for insulin.

Br J Dermatol, 1986 Oct, 115(4), 403 - 8
Degradation of porcine dermal connective tissue by collagenase and hyaluronidase; Friedman K et al.; Selective destruction of connective tissue may be a useful therapeutic tool in conditions associated with abnormal deposition of scar tissue . We have investigated intradermal injections of clostridial collagenase and bovine testicular hyaluronidase alone and in combination in Yucatan miniature hairless pigs . Collagenase in combination with hyaluronidase was quite efficient at destroying the connective tissue matrix, although elastic tissue appeared to be completely spared . Collagenase alone at higher doses degraded collagen, but hyaluronidase had little effect on connective tissue architecture.

Vestn Khir Im I I Grek, 1986 Sep, 137(9), 35 - 8
{Non-clostridial anaerobic infection in complicated cholecystitis}; Zemskov VS et al.; Results of bacteriological investigations and treatment of 112 patients with complicated forms of acute cholecystitis are described . It was found that in complicated forms of acute cholecystitis an important part was played by associations of bacteria among which neclostridial anaerobes were of leading importance responsible for the aggravation of the inflammatory process and course of the postoperative period . The intracholedochal antibacterial therapy with Dioxidin in combination with antibiotics is thought to be expedient.

Vestn Khir Im I I Grek, 1986 Aug, 137(8), 27 - 31
{Clinico-microbiological diagnosis of non-clostridial anaerobic infections in diseases of the biliary tract and liver abscess}; Dzhalashev IaKh et al.; The three-years experience of clinico-experimental examinations of 150 patients with various surgical diseases of bile ducts and abscesses of the liver is summed up . In 24 of them (16%) participation of non-sporulating anaerobes in the infection process was shown . The greatest etiological role of these pathogenic agents was found in purulent cholangitis and cholangitic abscesses of the liver . It was noted that the efficiency and reliability of microbiological diagnostics of biliary infection greatly depended on perfection of the methods used.

J Med Microbiol, 1986 Aug, 22(1), 29 - 31
Detection of clostridial toxins in stools from children with diarrhoea; Luzzi I et al.; A cell-culture assay was used to detect toxins directly in stools from sporadic cases of infantile diarrhoea . Cytotoxins were revealed in 11 out of 58 samples from children with diarrhoea, nine of whom had no common enteric pathogens in their stools . A preliminary characterisation of the cytotoxins was obtained by neutralisation tests with clostridial antitoxins.

J Biochem (Tokyo), 1986 Aug, 100(2), 311 - 8
Pyruvate dehydrogenase and the path of lactate degradation in Desulfovibrio vulgaris Miyazaki F; Ogata M et al.; Pyruvate dehydrogenase from Desulfovibrio vulgaris Miyazaki F was partially purified from the soluble fraction of the bacterial sonicate, and characterized . The enzyme catalyzes oxidative decarboxylation of pyruvate to produce acetyl-CoA, in contrast to statements in current review articles in which acetyl phosphate is indicated to be a direct decomposition product of pyruvate in sulfate-reducing bacteria . The established reaction stoichiometry is: pyruvate + CoA + FMN----acetyl-CoA + CO2 + FMNH2 . The Km values are 2.9 mM for pyruvate, 32 microM for CoA and 6.7 mumol for FMN . Participation of thiamine diphosphate in the enzymic process was not proven . 2-Oxobutyrate, but not 2-oxoglutarate, can substitute for pyruvate . The three flavin compounds, FMN, FAD, and flavodoxin, as well as clostridial ferredoxin, serve as electron carriers for the enzyme . Thus the enzyme is a kind of pyruvate synthase {EC 1.2.7.1}, but acts in the direction of pyruvate degradation in the growing cells . The rate of cytochrome C3 reduction is extremely low, but in the presence of flavodoxin as an electron mediator, the reduction rate of cytochrome C3 becomes faster than the reduction rate of flavodoxin alone . It seems that the physiological electron acceptor for this enzyme is flavodoxin, which might be complexed with cytochrome C3 to produce a very efficient electron transfer system in the cell . The soluble fraction of D . vulgaris cells has been proved to contain, in addition to the pyruvate dehydrogenase, lactate dehydrogenase (Ogata, M., Arihara, K., & Yagi, T . (1981) J . Biochem . 89, 1423-1431), phosphate acetyltransferase and acetate kinase, i.e., all the enzymes necessary to convert lactate to acetate, producing ATP by substrate level phosphorylation.

Antimicrob Agents Chemother, 1986 Jul, 30(1), 64 - 8
Randomized comparison between two ceftazidime-containing regimens and cephalothin-gentamicin-carbenicillin in febrile granulocytopenic cancer patients; Kramer BS et al.; Because the results of our published trial {R . Ramphal, B . S . Kramer, K . H . Rand, R . S . Weiner, and J . W . Shands, Jr., J . Antimicrob . Chemother . 12(Suppl . A):81-88, 1983} of ceftazidime versus cephalothin, gentamicin, and carbenicillin (KGC) revealed a preponderance of gram-positive superinfections, including those caused by clostridia, in patients treated with ceftazidime, we added vancomycin to the ceftazidime regimen at study entry 49 and continued with a 2:1 randomized comparison of ceftazidime-vancomycin (CV) versus KGC . Criteria for study entry were fever (temperature, greater than or equal to 38.5 degrees C on one occasion or greater than or equal to 38 degrees C on two occasions 6 h apart) and granulocytopenia (less than 500/mm3 or a falling count anticipated to be less than 500/mm3) . Ninety-five entries (79 patients) were evaluable . The numbers of initial clinical responses for ceftazidime-, KGC-, and CV-treated patients were 9 of 21 (43%), 21 of 37 (57%), and 21 of 37 (57%), respectively; differences were not significant . The death rate was lower with CV (2 of 37 patients) than with KGC (10 of 37 patients) (P less than 0.05 by two-tailed analysis) or with ceftazidime alone (7 of 21 patients) (P less than 0.025) . Death from presumed infections occurred in 9 of 37 KGC-treated patients versus 1 of 37 CV-treated patients (P less than 0.025) . Superinfections occurred in five ceftazidime-treated patients (24%) versus 7 KGC-treated patients (19%) but not in CV-treated patients (CV versus KGC, P less than 0.05; CV versus ceftazidime, P less than 0.01) . CV appears to be superior to KGC or ceftazidime alone in the management of febrile granulocytopenic cancer patients.

J Embryol Exp Morphol, 1986 Jul, 96, 65 - 77
Scanning electron microscopic observation of mouse embryonic submandibular glands during initial branching: preferential localization of fibrillar structures at the mesenchymal ridges participating in cleft formation; Nakanishi Y et al.; Branching submandibular glands of 12-day mouse embryos and those cultured in the presence and absence of a collagenase inhibitor from the culture medium of bovine dental pulp or a Clostridial collagenase were examined with the scanning electron microscope . Fracturing of fixed and dried glands with the tip of a fine needle succeeded in exposing the surfaces of the lobules and of their mesenchymal replicas at different stages of branching . At the beginning of branching, corresponding parts of the mesenchyme formed ridges on or in which the fibrillar structures were often found . At the stage forming deeper clefts thicker fibres, 0.5-2.5 micron in diameter, were observed between two adjacent lobules . On the contrary, no apparent differences in the fibrillar structures on the epithelial surfaces were detected between the shallow cleft and noncleft regions at the initial phase of branching . These fibrillar structures were very abundant in glands cultured with collagenase inhibitor and were completely lost in glands cultured with bacterial collagenase, strongly indicating that these materials consisted of collagen . The possible involvement of mesenchyme in epithelial branching is discussed with special reference to mesenchymal traction forces that would be elicited by fibrillar collagens.

J Comput Assist Tomogr, 1986 Jul-Aug, 10(4), 667 - 9
Mycotic right coronary artery aneurysm: CT and MR diagnosis; Strasser SF et al.; A clostridial mycotic aneurysm of the right coronary artery was diagnosed by the use of multiple imaging modalities including gated magnetic resonance imaging . Percutaneous drainage was performed as a palliative measure in hope of avoiding repeat sternotomy.

Cancer, 1986 May 15, 57(10), 2045 - 8
Clostridial septicemia complicating the course of leukemia; Caya JG et al.; The authors report an analysis of 47 leukemia patients (including 9 from our own medical center) whose courses were complicated by 48 episodes of clostridial septicemia . There were 36 adults and 11 children; acute myelogenous leukemia and acute lymphoblastic leukemia accounted for 61.7% and 14.9% of cases, respectively . All patients for whom remission status was known were in leukemic relapse . Fever was a presenting complaint in at least 36 patients whereas neutropenia, thrombocytopenia, and gastrointestinal lesions were noted in 100%, 90.9%, and 87.9%, respectively, of the patients for whom information on these parameters was available . Overall mortality from clostridial septicemia was 78%; none of the children and none of the patients with intravascular hemolysis survived . Overall, antibiotic therapy resulted in a 40% survival rate . However, among patients receiving beta lactam and/or chloramphenicol therapy, 57% survived their episode of clostridial septicemia . Prompt initiation of appropriate antimicrobial therapy offers the best chance of survival in leukemia patients with clostridial septicemia.

Postgrad Med J, 1986 May, 62(727), 403 - 4
Clostridial myonecrosis in association with etoposide therapy presenting as severe thigh pain; Smith D et al.; The case is described of a 68 year old man who was immunosuppressed as a result of receiving chemotherapy for small cell lung cancer and who presented with severe right thigh pain . This proved to be due to clostridial myonecrosis with none of the classical clinical features of clostridial infection . This is believed to be the first reported case of spontaneous clostridial infection associated with etoposide administration.

J Antimicrob Chemother, 1986 May, 17(5), 605 - 13
Is ciprofloxacin active against clinically important anaerobes?
Watt B, Brown FV.
The comparative activity of ciprofloxacin against 272 clinical isolates and reference strains of anaerobes was determined by an agar dilution method . The majority of strains of Bacteroides fragilis and clostridia were resistant (MIC greater than 2 mg/l) . The effect of pH, inoculum size and medium composition was also studied; the activity of ciprofloxacin was decreased at acid pH and by increasing inoculum size but was unaffected by the composition of the test media . Ciprofloxacin should not be used for the treatment of anaerobic infections because of its limited in-vitro activity against these organisms.

J R Soc Med, 1986 Apr, 79(4), 212 - 5
Fournier's gangrene: non-clostridial gas gangrene of the perineum and diabetes mellitus; Lamerton AJ; Three successfully managed cases of Fournier's gangrene, all with diabetes, are reported . A simple bacteriological classification is offered and the importance of diabetes mellitus as a predisposing factor is stressed.

Am J Vet Res, 1986 Apr, 47(4), 956 - 8
Equine endothelial cells in vitro; Lamar CH et al.; Certain in vitro culture conditions were determined for equine endothelial cells obtained from the aorta and pulmonary arteries . Cells were enzymatically isolated from the vessel lumen, using clostridial collagenase (2.5 mg/ml of Hanks's balanced salt solution) incubated at 37 C for 30 minutes . Cells were cultured in alpha minimum essential medium supplemented with plasma-derived and nonplasma-derived bovine fetal sera, endothelial cell-growth supplement, heparin, and antibiotics . Smooth muscle cell growth was not inhibited with nonplasma-derived animal sera, plasma-derived equine serum, or heparin . Heparin and a serum replacement were toxic to the cells used in the present study . Statistically significant differences were not found between the various media supplements.

Biochemistry, 1986 Mar 25, 25(6), 1383 - 90
Kinetics of electron transfer between cytochromes c' and the semiquinones of free flavin and clostridial flavodoxin; Meyer TE et al.; Rate constants have been measured for the reactions of a series of high-spin cytochromes c' and their low-spin homologues (cytochromes c-554 and c-556) with the semiquinones of free flavins and flavodoxin . These cytochromes are approximately 3 times more reactive with lumiflavin and riboflavin semiquinones than are the c-type cytochromes that are homologous to mitochondrial cytochrome c . We attribute this to the greater solvent exposure of the heme in the c'-type cytochromes . In marked contrast, the cytochromes c' are 3 orders of magnitude less reactive with flavodoxin semiquinone than are the c-type cytochromes . We interpret this result to be a consequence of the location of the exposed heme in cytochrome c' at the bottom of a deep groove in the surface of the protein, which is approximately 10-15 A deep and equally as wide . While free flavins are small enough to enter the groove, the flavin mononucleotide (FMN) prosthetic group of flavodoxin is apparently prevented by steric constraints from approaching the heme more closely than approximately 10 A without dynamic structural rearrangements . Most cytochromes c' are dimeric, but a few are monomeric . The three-dimensional structure of the Rhodospirillum molischianum cytochrome c' dimer suggests that the heme should be more exposed in the monomer than in the dimer, but no relationship is observed between intrinsic reactivity toward free flavin semiquinones and the aggregation state of the protein . Likewise, there is no evidence that the spin state or ligand field of the iron has any effect on intrinsic reactivity.(ABSTRACT TRUNCATED AT 250 WORDS)

J Biol Chem, 1986 Mar 15, 261(8), 3483 - 5
Electron spin-echo studies of the composition of the paramagnetic intermediate formed during the deamination of propanolamine by ethanolamine ammonia-lyase, and AdoCbl-dependent enzyme; Tan SL et al.; During the deamination of S-2-aminopropanol by the AdoCbl-dependent ethanolamine ammonia-lyase of Clostridia sp., a catalytic intermediate accumulates whose active site contains two paramagnetic species: cob(II)alamin and a free radical derived from the substrate molecule . Spin-echo spectroscopy has revealed that the unpaired electron on the substrate-derived radical is delocalized over a nitrogen atom that from its quadrupole splittings is probably a component of a secondary amide group . Experiments with 15N- and deuterium-labeled propanolamine gave no evidence of an interaction between this unpaired electron and the nitrogen originally attached to the substrate molecule . These results strongly suggest that the substrate-derived radical in this intermediate has already lost its nitrogen, and that this radical is stabilized by delocalization of the unpaired electron onto a nitrogen most likely situated in one of the peptide bonds of the enzyme backbone.

J Trauma, 1986 Mar, 26(3), 280 - 3
Clostridial gas gangrene complicating Colles' fracture; Werry DG et al.; We present a case of Clostridial gas gangrene following closed reduction of a Colles' fracture . A review of the laboratory and clinical literature on treatment of gas gangrene revealed wide differences of opinion regarding the effectiveness of surgery, antibiotics, antitoxin and especially hyperbaric oxygen . We found no previous report of clostridial gas gangrene in closed reduction of a Colles' fracture . The survival rates for 28 cases of Clostridial myonecrosis treated at Vancouver General Hospital with surgery, antibiotics and hyperbaric oxygen were 100% for extremity gangrene and 65% for trunk gangrene . We conclude: Gas gangrene is rare, but can complicate even minor trauma or procedures performed in hospital . Prevention depends on proper debridement of wounds and open fractures . Compartment syndromes may be important as etiologic and complicating factors . Hyperbaric oxygen may have therapeutic value but its use has not improved on survival rates achieved during World War II with surgery and antibiotics alone.

In Vitro Cell Dev Biol, 1986 Mar, 22(3 Pt 1), 113 - 9
Human chondrocytes in tridimensional culture; Bassleer C et al.; Cartilage was taken from the macroscopically normal part of human femoral heads immediately after orthopedic surgical operations for total prothesis consecutive to hip arthrosis . After clostridial collagenase digestion and repeated washings, chondrocytes (10(6) cells) were cultivated in a gyrotory shaker (100 rpm) . Under these conditions, cells were kept in suspension and after 3 to 5 d formed a flaky aggregate which, on Day 10, became dense . These chondrocytes were morphologically differentiated: they had a round shape, were situated inside cavities, and were surrounded by a new matrix . Histochemical methods showed the presence of collagen and polysaccharides in cell cytoplasm and in intercellular matrix, and the immunofluorescence method using specific antisera (anticartilage proteoglycans and anti-type II collagen) showed that these two constituents were in intercellular matrix . The measurement of the amounts of proteoglycans (PG) released into culture medium and those present in chondrocyte aggregate (by a specific PG radioimmunoassay) showed a maximum production on Days 3 to 5 of culture, then the production decreased and stabilized (from Day 10 to the end of culture) . The observed difference between the amounts of PG in aggregates after 20 d and those after 2 h of culture demonstrated that PG neosynthesis did occur during cultivation . This conclusion was supported by other results obtained by {14C}glucosamine incorporation in chondrocyte aggregates . Moreover, the aggregate fresh weight related to cell number (appreciated by DNA assay) increased significantly with culture duration . Three-dimensional chondrocyte culture represents an interesting model: chondrocytes were differentiated morphologically as well as biosynthetically and synthesized a new cartilage matrix.

J Urol, 1986 Mar, 135(3), 641 - 7
Humoral immune responses in Peyronie's disease patients receiving clostridial collagenase therapy; Hamilton RG et al.; Human IgG and IgE antibody responses to clostridial collagenase (Nucleolysin) were monitored in 150 untreated healthy blood donors and 44 patients receiving intrapenile injections of collagenase for treatment of Peyronie's disease . Pre, 1 and/or 2 month post treatment sera were analyzed in radioimmunoassays for human IgG and IgE antibodies using solid phase purified Cl . histolyticum collagenase to extract antibodies from serum and 125I-Protein A or rabbit anti-human IgE to detect bound IgG and IgE, respectively . IgG and IgE antibody levels greater than 2.5 Units and 0.2 per cent Bmax, respectively, were considered positive if the binding was greater than 80 per cent inhibitable with soluble collagenase . IgG anti-collagenase was detected in 34 per cent of the 150 healthy controls and 58 per cent (24/41) of untreated Peyronie's disease patients . Intralesional injection of 3,000 to 12,650 Units of collagenase induced an increase of two- to 10-fold in the IgG levels at one to two months in 88 per cent of patients . Of the 186 individuals tested, only one (0.5 per cent) had detectable collagenase-specific IgE antibody in his serum as defined by positive threshold and antigen inhibition criteria.

J Urol, 1986 Feb, 135(2), 354 - 5
Clostridial infection of renal cell carcinoma; Graham BS et al.; We report a case of a large gas-filled clostridial abscess in a previously unrecognized renal cell carcinoma . Neoplastic tissue has a nonhomogeneous blood supply, creating areas of hypoxia and reduced glucose concentrations, which lead to tumor necrosis and an environment conducive to the growth of anaerobic organisms . Anaerobic infection should be considered in any patient with carcinoma and fever . Conversely, abscess transformation of a tumor can be the explanation for what otherwise seems to be the spontaneous development of a parenchymal abscess.

Ann Chir Gynaecol, 1986, 75(5), 274 - 9
Spontaneous clostridial myonecrosis . A collective review and report of a case; Nordkild P et al.; A collected series from the English literature up to 1984 of spontaneous clostridial myonecrosis (SCM) is presented in order to reveal possible common denominators . SCM was associated with malignancy (colonic cancer and leukaemia), diabetes, and injections in descending order . C . perfringens was isolated in more than 70% of the cases followed by C . septicum in 27 and C . novyi in 7% . The pathogenesis is still speculative but is thought to be due to bacteraemia especially from the gastrointestinal tract, due to growth of dormant spores in tissue following antecedent trauma or as an infection descending along the ilio-psoas sheath from a gastrointestinal focus . The symptoms are pain in an oedematous, discoloured, crepitant area with haemorhagic bullae and often shock . The diagnosis is based on the clinical findings and Gram-positive rods in the exudate . Treatment instituted promptly constitutes of surgical debridement, antibiotics and hyperbaric oxygen . The prognosis of SCM is worse than for other cases of clostridial myonecrosis and survival was in this collected series only 19%.

Dev Biol Stand, 1986, 64, 119 - 27
Immunoelectrophoresis in quality control of veterinary clostridial products; White VJ et al.; Each year the pharmaceutical industry produces 150-250 batches of anti-Clostridial vaccines and sera for veterinary use in the U.K . Under Medicines Act requirements these products must be tested for potency before release to the public, such tests being performed in animals . The Ministry of Agriculture, as licensing authority, also carries out potency test on representative samples of these products . To avoid unnecessary use of animals we employ immunoelectrophoresis (IEP) as a screening test . Results obtained so far show a close correlation between values obtained by IEP and the statutory tests and offer a potential alternative to the use of animals in potency tests.

Scand J Infect Dis, 1986, 18(5), 477 - 81
Ludwig's angina and associated systemic complications . Bacteriology and current therapy; Schliamser SE et al.; A deep non-clostridial gas-producing infection originating from a dental abscess in a 36-year-old man is reported . It spread to the neck and descended to mediastinum, pericardium and pleura causing numerous systemic complications . The patient survived and was discharged in good condition after a long hospitalisation.

Lab Anim, 1986 Jan, 20(1), 32 - 5
Paresis of peristalsis and ileus lead to death in lactating mice; Kunstyr I; Based on the examination of 45 dead and 5 moribund female mice during a 2-year period, we are able to describe a new disease entity: ileus of the small intestine in lactating mice caused by a paresis of peristalsis . Diarrhoea was not observed and inflammation and infectious agents were not found . Females were affected during the 2nd week of their first lactation . The condition may have a mortality rate as high as 40% . It is assumed that exhaustion (calcium, glucose, etc.) is the cause of this condition . Consequently, the development of a dietary supplement or of a special diet for lactating mice may prove beneficial in preventing this disease . Endogenic (Clostridia) or exogenic toxic components may also play a role.

Dev Biol Stand, 1986, 65, 227 - 36
The use and standardization of multicomponent veterinary vaccines; Walker PD et al.; Farming practices necessitate the use of combined vaccines for the protection of sheep, cattle and pigs . Multi-component Clostridial vaccines have been available in veterinary medicine since the late 1950s and are standardized on the basis of antibody responses in small animals and/or challenge tests . The development of new vaccines against respiratory and enteric diseases has posed a number of standardization problems as small animal models are not readily available and antibody responses do not necessarily correlate with protection . Approaches to the standardization and use of these components will be discussed.

Scand J Infect Dis Suppl, 1986, 49, 56 - 63
Resistance factors in anaerobic bacteria; Tally FP et al.; Resistance transfer factors have been described in both Bacteroides and clostridia . The clindamycin (Cln) resistance transfer factors from the Bacteroides fragilis group of organisms have been best studied, including our own plasmid pBFTM10 . The clindamycin resistance determinant (Cln X) of pBFTM10 can be detected in 90% of Cln resistant Bacteroides isolated from dispersed geographical areas . This determinant can be located in the chromosome and on plasmids . Recent studies from our laboratory have shown that the Cln X genes of pBFTM 10 are carried on a compound transposon, Tn4400 . Bacteroides plasmids have been cloned in Escherichia coli and shuttle vectors have been developed that allow transfers of DNA from E . coli back to B . fragilis, using the broad host range plasmid RK2 to supply essential conjugation functions . We have shown that shuttle vectors containing pBFTM 10 can be retransferred from B . fragilis back to E . coli . In addition, a tetracycline transfer element from B . fragilis strain TM230 is able to promote high frequency conjugation between B . fragilis and E . coli . The results of these investigations indicate that Bacteroides has efficient mechanisms to exchange genetic material and that genetic exchange can occur between Bacteroides and E . coli, which exist in intimate contact in the human colon.

Dev Biol, 1986 Jan, 113(1), 201 - 6
Collagenase inhibitor stimulates cleft formation during early morphogenesis of mouse salivary gland; Nakanishi Y et al.; A collagenase inhibitor obtained from the culture medium of bovine dental pulp markedly enhanced the cleft formation of mouse embryonic salivary gland epithelium when the inhibitor was included in the culture medium for 12-day and 13-day salivary glands . Determination of collagenase activity using {3H}collagen as substrate indicated that there was a latent collagenase activity in 12-day glands . In addition, a highly purified Clostridial collagenase freed from protease and hyaluronidase activities, strongly inhibited initiation of the cleft formation of the 12-day epithelium . Scanning electron microscopic observation showed that abundant collagen-like fibrils were seen on the epithelium in the collagenase-inhibitor-treated glands compared to those in the control . These findings suggest that during early morphogenesis tissue collagenase may regulate the cleft formation in the epithelium.

Int J Biochem, 1986, 18(1), 89 - 92
Studies on the stimulation of the bacterial, collagenolytic enzyme clostridiopeptidase A by cobalt (II) ions; Evans CH et al.; Co(II) ions increase the Vmax of clostridiopeptidase A, producing a maximum stimulation of overall enzymic activity of 120% . Co(II) does not displace Zn(II) from the active site, nor Ca(II) from its binding site on the enzyme . There appears to be an additional transition metal-binding site on clostridiopeptidase A, accepting Zn(II), which is inhibitory (Ki = 550 microM), or Co(II), which is stimulatory (Kact = 200 microM).

Vet Med Nauki, 1986, 23(4), 35 - 8
{Trials of immunostimulation of an antitoxic response with levamisole in the immunization of sheep with a combined clostridial vaccine}; Bineva I et al.; Comparative investigations were carried out on the antibody level in test animals--sheep, vaccinated with a polyvaccine against C and D enterotoxemia and necrotic hepatitis as well as in combined application with Levamisol . It was found that with the use of the preparation the stimulation of immunogenesis with type D and necrotic hepatitis--type B antigens (included in the composition of the polyvaccine) was enhanced . No stimulation of immunogenesis with the type C specific antigen was found within the period of investigation . Immunity was better built up when the animals were treated with the combined product as compared with the controls, given the polyvaccine without Levamisol.

J Biol Chem, 1985 Dec 25, 260(30), 16411 - 7
Cleavage of bovine skin type III collagen by proteolytic enzymes . Relative resistance of the fibrillar form; Birkedal-Hansen H et al.; We have studied the susceptibility of fibrils formed from fetal bovine skin type III collagen to proteolytic enzymes known to cleave within the helical portion of the molecule (vertebrate and microbial collagenase, polymorphonuclear elastase, trypsin, thermolysin) and to two general proteases of broad specificity (plasmin, Pronase) . Fibrils reconstituted from neutral salt solutions, at 35 degrees C, were highly resistant to nonspecific proteolysis by general proteases such as polymorphonuclear elastase, trypsin, and thermolysin but were rapidly dissolved by bacterial and vertebrate collagenases at rates of 12-45 mol X mol-1 X h-1 . In solution, type III collagen was readily cleaved by each of the proteases (with the exception of plasmin), as well as by the true collagenases, although at different rates . Turnover numbers determined by viscometry at 35 degrees C were: human collagenase, approximately equal to 1500 h-1; microbial (clostridial) collagenase, approximately equal to 100 h-1; and general proteases, 23-52 h-1 . In addition it was shown that pronase cleaves type III collagen in solution at 22 degrees C by attacking the same Arg-Gly bond in the alpha 1(III) chain as trypsin . However, like other proteases, Pronase was rather ineffective against fibrillar forms of type III collagen . It was also shown that transition of type III collagen as well as type I collagen to the fibrillar form resulted in a significant gain of triple helical thermostability as evidenced by a 6.8 degrees C increase in denaturation temperature (Tm = 40.2 degrees C in solution; Tm = 47.0 degrees C in fibrils).

Hinyokika Kiyo, 1985 Dec, 31(12), 2255 - 9
{A case of gas gangrene in a vesico-vaginal fistula}; Kikuchi K et al.; A case of gas gangrene is presented . The patient was a 78-year-old woman who was admitted with the diagnosis of vesico-vaginal fistula . Cystography revealed a vesico-intestinal fistula and leakage of contrast medium into the prevesical space, in addition to the vesico-vaginal fistula . Right ureterostomy was performed . Two weeks postoperatively, she complained of severe pain and swelling of her right thigh . The swelling grew rapidly and general condition became worse . A diagnosis of gas gangrene was made 8 days after her first complaint by demonstrating subcutaneous and intramuscular gas formation in X-ray . She died the next day . By the bacteriological examination, this case was non-clostridial gas gangrene.

Am J Surg, 1985 Nov, 150(5), 550 - 3
Effect of aprotinin on fibrinopurulent peritonitis in rats; Chalkiadakis GE et al.; The effect of aprotinin on the clinical and pathologic course of experimentally induced peritonitis in the rat was studied . Peritonitis was induced in 40 rats by creating a closed ileal loop 4 cm long 5 cm from the ileocecal valve . The rats were divided into two groups of 20 rats each . Group 1 served as a control group, whereas each animal in Group 2 received a bolus dose of aprotinin (10 ml) intraperitoneally immediately after closing the laparotomy . In the aprotinin-treated group, survival was drastically increased (p less than 0.01) and formation of adhesions and abscesses was considerably reduced . The results of peritoneal cultures showed a decreased incidence of Escherichia coli and Clostridia in the aprotinin-treated group . We conclude that the administration of aprotinin significantly prolongs the survival time of animals with peritonitis and reduces the development of adhesions and abscesses in the peritoneal cavity . This beneficial effect can be attributed to decreased fibrinogen deposits within the peritoneal cavity and the stabilization of the organism after bacterial shock . Thus, bacteria were more susceptible to cellular and noncellular clearing mechanisms.

J Am Vet Med Assoc, 1985 Oct 1, 187(7), 732 - 6
Malignant edema in horses; Rebhun WC et al.; Malignant edema (clostridial myositis) was diagnosed in 9 horses with signs of illness that included fever, depression, painful muscular swellings, and toxemia . The infection followed intramuscular injections in 8 horses and developed in a puncture wound in 1 horse . Treatment consisted of surgical fenestration of the involved muscle, high doses of penicillin, nonsteroidal anti-inflammatory agents and analgesics, and supportive fluid therapy . Five horses recovered and 4 died . Those that died had advanced signs of the disease at admission.

Diabetologia, 1985 Oct, 28(10), 786 - 92
Photoaffinity labelling of hepatic plasma membranes suggests two classes of hepatic insulin receptor; Haynes FJ et al.; Photoaffinity labelling of hepatic insulin receptors revealed specifically-labelled bands of 130, 90 and 40 kDa . Endogenous protease activity in hepatic plasma membranes, as well as contaminating proteases present in preparations of clostridial collagenase, degraded some of the 130-kDa insulin-binding subunit to a 115-kDa form . However, a large proportion of the 130-kDa subunits were resistant to degradation, suggesting the presence of two classes of insulin receptor in hepatic plasma membranes . In one class the 130-kDa subunit was sensitive to proteolysis, while in the other it was not . In contrast, the 130-kDa receptor subunits of adipose tissue were all resistant to such degradation . Scatchard analysis of control and collagenase-treated plasma membranes demonstrated that conversion of the 130-kDa subunit to a 115-kDa form did not affect the insulin-binding characteristics of the receptor . It was also apparent that insulin binds to a single class of high-affinity sites in hepatic plasma membranes.

Ann Thorac Surg, 1985 Oct, 40(4), 396 - 7
Clostridial myonecrosis of the chest wall complicating spontaneous esophageal rupture; LoCicero J 3rd et al.; Spontaneous rupture of the esophagus (Boerhaave's syndrome) has a dismal survival rate without prompt surgical management . A variety of surgical regimens have achieved survival of 70% or greater; however, the postoperative course is frequently complicated by fistula, would infection, empyema, and sepsis . We report an unusual postoperative chest wound infection of clostridial myonecrosis, which presumably originated from the patient's gastric microflora . He was treated with immediate surgical debridement of all involved tissue, prolonged ventilation, total parenteral nutrition, and frequent dressing changes . The remaining defect was closed with a skin graft . Anaerobic wound infections of the chest wall and their management are discussed.

J Med Microbiol, 1985 Oct, 20(2), 233 - 8
Biotransformation of bile acids by clostridia; Owen RW; The metabolism of bile acids by nuclear dehydrogenating clostridia (NDC) was studied . NDC were able to desaturate the A-ring of 5 beta-cholan-3-oxo-24-oic acid, 12 alpha-hydroxy-5 beta-cholan-3-oxo-24-oic acid, 7 alpha-hydroxy-5 beta-cholan-3-oxo-24-oic acid, 6 alpha-hydroxy-5 beta-cholan-3-oxo-24-oic acid, 7 alpha, 12 alpha-dihydroxy-5 beta-cholan-3-oxo-24-oic acid, 3,12-dioxo-5 beta-cholan-24-oic acid but not 3,6-dioxo-5 beta-cholan-24-oic acid, 3,7-dioxo-5 beta-cholan-24-oic acid and 3,7,12-trioxo-5 beta-cholan-24-oic acid . In each case the sole product possessed a 4-ene-3-one structure . Desaturation of bile acids was more efficient than that of androstanes . NDC are, therefore, capable of introducing double bonds into the nucleus of bile acids as well as that of androstanes . The physiological significance of such reactions in relation to large bowel cancer has yet to be elucidated.

Life Sci, 1985 Aug 12, 37(6), 575 - 8
A novel inhibitor of mammalian collagenase; Clark DE et al.; N-{{{(5-chloro-2-benzothiazolyl)thiolphenyllacetyll-L-cysteine (WY-45,368) is a potent inhibitor of human skin fibroblast collagenase . Kinetic data show that the inhibition is competitive, with a Ki of 3.5 microM . WY-45,368 inhibits neither of two other metalloproteinases, thermolysin and angiotensin converting enzyme, nor does it inhibit clostridial collagenase--thus indicating specificity for mammalian collagenase.

J Urol, 1985 Aug, 134(2), 280 - 3
The use of collagenase in the treatment of Peyronie's disease; Gelbard MK et al.; Purified clostridial collagenase was administered intralesionally in 31 men with Peyronie's disease . Within 4 weeks of treatment 20 patients showed an objective improvement . Pain was eliminated in 13 of 14 patients with this complaint at presentation within the same 4-week period . The ability to have intercourse was restored in 3 of 4 patients with this problem . Except for a small corporeal rupture at the site of injection in 1 patient, no significant untoward effects were noted . During the mean 9.8-month followup 1 recurrence of bending was noted.

J Biol Chem, 1985 Jul 15, 260(14), 8292 - 6
Amino acid sequence of the {4Fe-4S} ferredoxin isolated from Desulfovibrio desulfuricans Norway; Bruschi MH et al.; The complete amino acid sequence of the {4Fe-4S} ferredoxin from Desulfovibrio desulfuricans Norway was determined by repetitive Edman degradation of the whole protein and peptides derived from tryptic digestion . The protein has 59 residues . Four of the six cysteine residues are involved in the binding of the {4Fe-4S} cluster in the same arrangement as in clostridial ferredoxins . This sequence is compared to various Desulfovibrio ferredoxin sequences and to the sequence and three-dimensional structure of Peptococcus aerogenes ferredoxin . Evidence of gene duplication is indicated . The requirement of some sequence features in the ferredoxin for an interaction process with its electron transfer partner, cytochrome c3, is postulated in the discussion.

J Bone Joint Surg Am, 1985 Jun, 67(5), 800 - 3
Prophylactic antibiotics in amputation of the lower extremity for ischemia . A placebo-controlled, randomized trial of cefoxitin; Sonne-Holm S et al.; Of 152 patients who were scheduled for an amputation for ischemia, seventy-seven were randomly assigned to perioperative prophylaxis with cefoxitin (Mefoxin) and seventy-five patients, to injections of a placebo . The patients were followed for twenty-one days or, in the case of wound complications, to the end of treatment . An infected wound occurred in 38.7 per cent of the patients in the placebo group and 16.9 per cent of those in the antibiotic group (p less than 0.005) . Clostridial infection occurred in eight patients in the placebo group and in none in the antibiotic group (p = 0.003) . Three of the patients with clostridial infection died of gas gangrene . A multivariate analysis showed that the absence of antibiotic prophylaxis increased the risk of infection by a factor of 3.3 (p = 0.004) and increased the need for reamputation by a factor of 4.5 (p = 0.003) . We concluded that amputation patients should have prophylaxis with a broad-spectrum antibiotic given perioperatively.

Eur J Clin Invest, 1985 Jun, 15(3), 128 - 31
Effect of in vitro non-enzymatic glycosylation of human skin collagen on susceptibility to collagenase digestion; Lyons TJ et al.; The effect of glycosylation on susceptibility of skin collagen to collagenase digestion was studied in a skin sample obtained at autopsy from the interscapular region of a 24 year old white male who had died of an acute illness and who had no history of diabetes . Homogeneous suspensions of insoluble collagen were prepared, and were incubated in 50 mmol l-1 dextrose at pH 7.35 and 37 degrees C for 7 days . Non-enzymatic glycosylation measured by the weak acid hydrolysis/thiobarbituric acid method increased from 13.1 +/- 1.0 (n = 5) to 45.2 +/- 5.5 (n = 8) nmol fructose per 10 mg collagen (P less than 0.001) . Digestion of collagen using clostridial collagenase was monitored by measuring (a) hydroxyproline content and (b) absorption at 206 nm of the supernatant after centrifugation to remove substrate . The rate of digestion was similar in glycosylated and control collagen . We conclude that the ketoamine link formed in non-enzymatic glycosylation does not increase the resistance of collagen to enzymatic digestion . The possibility remains that subsequent rearrangement of this link could be important in this respect.

Arch Biochem Biophys, 1985 Jun, 239(2), 379 - 87
Inactivation of Escherichia coli glutamine synthetase by xanthine oxidase, nicotinate hydroxylase, horseradish peroxidase, or glucose oxidase: effects of ferredoxin, putidaredoxin, and menadione; Stadtman ER et al.; Previous studies have shown that several mixed-function oxidation (MFO) systems are capable of catalyzing the inactivation of glutamine synthetase (GS) {R.L . Levine, C . N . Oliver, R . M . Fulks, and E . R . Stadtman (1978) Proc . Natl . Acad . Sci . USA 78, 2120-2124} and a number of the other enzymes {L . Fucci, C . N . Oliver, M . J . Coon, and E . R . Stadtman (1983) Proc . Natl . Acad . Sci . USA 80, 1521-1525} . It has now been found that in the presence of Fe(III), O2, and an appropriate electron donor (hypoxanthine or NADPH, respectively) glutamine synthetase is also inactivated by either milk xanthine oxidase or Clostridial nicotinate hydroxylase . Inactivation of glutamine synthetase by either of these flavoproteins is greatly stimulated by the presence of electron carrier proteins possessing nonheme-iron-sulfur (NHIS) clusters (i.e., ferredoxin or putidaredoxin) or by the presence of menadione . The inactivation reactions are partially inhibited by free radical scavengers, superoxide dismutase, (SOD), histidine, mannitol, dimethyl sulfoxide, and dimethylthiourea, and are inhibited completely by either Mn(II), EDTA, or catalase . The sensitivity to SOD inhibition is greatly suppressed when the xanthine oxidase system is supplemented with either ferredoxin or redoxin . In the presence of the latter NHIS-proteins (and only when they are present), MFO systems, comprised of either horseradish peroxidase and H2O2 or glucose oxidase, O2, and glucose, can also catalyze the inactivation of GS . The ability of ferredoxin and putidaredoxin to promote oxidation modification of GS by any one of these MFO systems suggests that proteins with NHIS centers may mediate the generation (or stabilization) of highly reactive radical intermediates.

Ann Emerg Med, 1985 May, 14(5), 459 - 66
Clostridial myonecrosis; Cline KA et al.; Clostridial infections, particularly myonecrosis, can be fulminant and fatal; they often arise without an obvious history of trauma . The cardinal diagnostic clues (Figure 3) must be recognized so that specific therapy can be initiated promptly and mortality can be minimized . Aggressive medical care, including crystalloid fluid therapy and antibiotics, must be initiated quickly . Vasopressors should be avoided . Antitoxin has no role in contemporary care . Early hyperbaric oxygenation is beneficial, but it should be preceded by decompressive fasciotomy if limb edema is marked . Otherwise, definitive debridement or amputation is best delayed until after hyperbaric therapy is begun . Regionalization of care and long transport times also must be considered seriously in determining the therapeutic approach.

Indian J Lepr, 1985 Apr-Jun, 57(2), 334 - 40
Anaerobic flora in trophic ulcers in leprosy patients; George M et al.; Material from 108 trophic ulcers from leprosy cases were studied bacteriologically . 4 cases showed growth of pure anaerobes and 69 showed mixed growth of aerobic and anaerobic bacteria . The predominant anaerobes were Fusobacteria (41), anaerobic cocci (30) and Bacteroides (25) . Clostridia were isolated only in 10 cases . Metronidazole, chloramphenicol, penicillin and ampicillin were found effective against anaerobes in in-vitro studies.

Lab Anim, 1985 Apr, 19(2), 111 - 8
Characterization of clostridia isolated from faeces of limited flora mice and their effect on caecal size when associated with germ-free mice; Itoh K et al.; 115 strains of clostridia were accumulated from 3 separate isolations from the faeces of 1 limited flora (LF) mouse produced by inoculation of germ-free mice with chloroform-treated faeces of conventional mice . These strains were divided into 36 types on the basis of conventional biochemical characteristics . There was some variation in types isolated on the 3 occasions . Although 3 groups of polyassociated (PA) mice were produced from mixing 46 monoassociated mice, each inoculated with 1 of 46 strains of 36 bacterial types, the caecal size of PA mice was still greater than that of the control mice prepared by inoculation of chloroform-treated faeces of an LF mouse . After PA mice of each group were housed together, the caecal size became smaller and was only slightly larger than the control.

J Pediatr Surg, 1985 Apr, 20(2), 155 - 9
Clostridial necrotizing enterocolitis; Kosloske AM et al.; In a bacteriologic investigation of infants with necrotizing enterocolitis (NEC), 16 of 50 infants had clostridia in cultures of blood or of peritoneal fluid obtained by paracentesis . Twenty-eight of the 50 infants had enteric bacteria other than clostridia, and six infants had sterile cultures . Of the 16 infants with clostridia, nine had C . perfringens and seven had other species of clostridia . Compared to infants with nonclostridial NEC, those with clostridial NEC were larger and more mature, had more extensive pneumatosis intestinalis and gangrene and more rapid progression of NEC . The nine infants with C . perfringens had a fulminant form of NEC, analogous to gas-gangrene of the intestine . Mortality in this group was 78% (7/9) . The seven infants with clostridial species other than C . perfringens had a mortality comparable to that of infants with nonclostridial NEC (32%) . Improved survival from NEC associated with C . perfringens may be possible only by prevention, rather than earlier diagnosis and improved heroic treatment.

Biochem J, 1985 Jan 15, 225(2), 553 - 6
The lanthanide-enhanced affinity chromatography of clostridial collagenase; Evans CH; Clostridiopeptidase A (EC 3.4.24.3) did not bind to a collagen affinity column in the absence of Ca2+, but did so in the presence of lanthanide ions (Ln3+) . The sequestered enzyme could be eluted with EGTA . For the four Ln3+ ions tested, the order of efficiency in promoting enzyme binding, Sm3+ greater than Lu3+ greater than Er3+ much greater than La3+, reflected their relative abilities to inhibit clostridiopeptidase A . By using Sm3+ as an adjunct, it proved possible to separate a highly active preparation of collagenase from crude clostridial collagenase . Sodium dodecyl sulphate/polyacrylamide-gel-electrophoretic analysis of the preparation revealed a major protein of Mr 95000 and a minor component of Mr 82000 . As both were stained by periodic acid/Schiff reagent, they were probably glycoproteins.

Acta Chir Scand, 1985, 151(7), 653 - 5
Gas-producing perianal infection; Raskov HH et al.; Five cases of nonclostridial, gas-producing perianal infection are reported and the resemblance to clostridial gas gangrene is discussed . The importance of early diagnosis followed by aggressive surgical debridement and prompt administration of broad-spectrum antibiotics is emphasized.

Boll Ist Sieroter Milan, 1985, 64(4), 294 - 301
{Comparative study in vitro on the activity of 7 antibiotics against anaerobic bacteria from hospital isolates}; Braga A et al.; One hundred and ninety-four anaerobic bacteria isolated from clinical sources were tested by agar dilution technique against seven antimicrobial agents . A comparison with international literature, generally used for selecting appropriate antimicrobial drug showed concordant patterns of susceptibility in the case of Cocci gram-positive, Clostridia, Fusobacterium and other species of Bacteroides excluded B . fragilis group . For these strains we did not found any particular problem in the choice of the therapeutic treatment . In the case of Bacteroides fragilis and B . fragilis group our data confirmed the widespread of resistance to clindamycin and cefoxitin . When the cefoxitin and clindamycin resistance is confirmed by in vitro tests, the piperacillin represent a valid alternative considering the safety profile compared to chloramphenicol (no bone marrow toxicity) and to carbenicillin (no sodium load).

Arch Geschwulstforsch, 1985, 55(1), 23 - 30
{Changes in selected parameters of carbohydrate metabolism during short term hyperglycemia therapy in Jensen's sarcoma}; Hoffmann FA et al.; Biochemical investigations of short term hyperglycemia together with tumor-lysing clostridia were undertaken in order to optimize the use of this combined anti-tumor therapy model . Repeated intraperitoneal glucose injections resulted in an increased concentration of glucose in tumor tissue which lasted several hours and paralleled the blood sugar level in tumor bearing animals . At the same time a tumor dependent deterioration in glucose tolerance appeared likely . Characteristic changes in the intratumor lactate concentration were demonstrable . Tumor acidosis lasted 4 to 7 hours . Tumor pyruvate concentrations varied little with hyperglycemia . Simultaneous blood lactate and pyruvate levels did not differ from those of controls . LDH activity as measured in the tumor and in blood serum gave no clear indication of tumor cell damage.

Nephron, 1985, 39(3), 228 - 36
Experimental studies on the hemolytic-uremic syndrome; Bolande RP et al.; Ultrastructural studies of blood cells during the acute stage of the hemolytic-uremic syndrome (HUS) revealed striking, but transient, changes in erythrocyte structure . These included membrane disruption, vacuolar degeneration, and Heinz body formation . There was also evidence of platelet injury, and there were peculiar tactile interactions between histiocytes and impaired red cells . These changes disappeared as the patients recovered . These changes were considered to be important in the pathogenesis of the hemolytic and thrombolytic features of HUS, and studies were directed at reproducing them in vitro and in vivo . Treatment of red cells with purified clostridial phospholipase C induced changes in red cells and platelets that were comparable to those encountered in HUS . Rats infused with phospholipase C developed hemolysis, thrombocytopenia, and hemoglobinuria . Their kidneys did not, however, reveal glomerular alterations similar to those seen in patients with HUS . It is proposed that HUS in some cases might be initiated by a nonspecific infectious injury to the intestinal mucosa thereby allowing increased absorption of toxins derived from indigenous gut flora and that these toxins could be responsible for the hemolysis, thrombolysis, and even the renal injury.

Surg Gynecol Obstet, 1985 Jan, 160(1), 27 - 32
Prospective randomized controlled study of prophylaxis with cefamandole in high risk patients undergoing operations upon the biliary tract; Cainzos M et al.; In this study, 52 high risk patients who underwent operations upon the biliary tract were assigned to receive either antibiotic prophylaxis or no treatment with antibiotics . Twenty-seven patients were given 2 grams of cefamandole intramuscularly 30 minutes before operation and 2 grams every eight hours for two days postoperatively . The remaining patients were in the control group and did not receive antibiotics . Surgical wounds were inspected daily by a surgeon while the patients were in the hospital and a follow-up revision was done four weeks after discharge from the hospital . Samples of exudate or pus were taken when the wound appeared infected and cultures of aerobic and anaerobic organism done . Chi-square affinity test with Yate's correction was used for statistical results; only p values more than or equal to 0.5 were considered significant . Seven patients (28 per cent) in the control group had complications develop postoperatively; seven surgical wound infections, one of which included a subphrenic abscess . Postoperatively, there were no septic complications in the group who received cefamandole as a prophylaxis . The incidence of infection was higher for females than males . The organisms most frequently isolated were Escherichia coli and Klebsiella; only in one instance was Clostridum sporogenes found . Polymicrobial infections accounted for 42.8 per cent of the infections . No incidences were reported with the use of cefamandole in those patients who were treated prophylactically . In view of these results, we believe that cefamandole is an ideal antibiotic to be used in the prophylactic treatment of infections of high risk patients who undergo operations upon the biliary tract.

J Emerg Med, 1985, 3(5), 353 - 60
Spontaneous clostridial myonecrosis; Turnbull TL et al.; Spontaneous clostridial myonecrosis (SCM) is an uncommon but frequently fatal tissue infection . The case report and review of the literature here provide some insight into the pathophysiology of this entity and clinical settings with which it is associated . It is hoped that this discussion will increase the reader's familiarity with SCM and provide clues that will lead to earlier diagnosis and more effective treatment.

Scand J Infect Dis Suppl, 1985, 44, 52 - 8
Changes in the oropharyngeal and colon microflora in relation to antimicrobial concentrations in saliva and faeces; Heimdahl A et al.; Phenoxymethylpenicillin, bacampicillin, clindamycin, erythromycin, doxycycline and tinidazole were given perorally for 7 days to a total of 56 subjects . Concentrations of antimicrobials in serum, saliva and faeces were determined daily, as were viable counts of different aerobic and anaerobic microorganisms in the oropharyngeal and colon microflora . Clindamycin, erythromycin, doxycycline and tinidazole were detected in saliva . Clindamycin, erythromycin and doxycycline were also detected in high concentrations in faeces . Phenoxymethylpenicillin, bacampicillin, tinidazole and doxycycline did only induce small changes in the oropharyngeal and colon microflora, while distinct suppression of anaerobic bacteria was observed in the oropharynx and colon when clindamycin was administered . Erythromycin decreased the numbers of aerobic bacteria in oropharynx and both aerobic and anaerobic bacteria in colon . Both clindamycin and erythromycin induced new colonization of the oropharynx and colon by potentially pathogenic Gram-negative enteric rods and fungi as well as toxin-producing clostridia.

Retina, 1985 Spring-Summer, 5(2), 98 - 100
Enzyme-assisted vitrectomy with bacterial collagenase . Pilot human studies; Moorhead LC et al.; Clostridiopeptidase A, a bacterial collagenase, was used to assist vitrectomy with membrane stripping in six patients with dense intravitreal fibroproliferative tissue associated with retinopathy of prematurity, diabetic retinopathy, or proliferative vitreoretinopathy . When it was injected intra-operatively, allowed to incubate for 15 minutes, and then removed by irrigation/aspiration, no side effects of lens opacity, lens dislocation, or retinal hemorrhage were observed . Use of this enzyme may facilitate removal of fibroproliferative tissue in certain difficult vitrectomy cases.

Arch Dermatol Res, 1985, 277(3), 214 - 9
Filamentous aggregates of collagen . Ultrastructural evidence for collagen-fibril degradation in situ; Kobayasi T et al.; Filamentous aggregates of collagen are distinct structures in the pathological dermis . These aggregates are distinguishable from fibrous long-spacing collagen (in vitro and at biopsy) and the Luse body . The aggregates are produced from dermal collagen fibrils by clostridial collagenase and culture-medium extract, which supposedly contains cellular collagenase at a neutral pH, as well as by organ cultures . In vitro experiments showed that carrageenan granuloma contains fibrous long-spacing collagen and segment long-spacing collagen . The granuloma also contains the aggregates . The aggregates were found in skin biopsies from syphilitic chancres, acrosclerotic scleroderma, morphea, mycosis fungoides, myeloid leukemia, mastocytosis and malignant melanoma . These findings indicate that the aggregates are products of the in situ degradation of collagen fibrils by some collagenolytic factor . This factor may originate in fibroblast-like cells, reticulum cells, leukemia cells, mast cells and melanoma cells.

Scand J Infect Dis Suppl, 1985, 46, 18 - 26
Host factors predisposing to anaerobic infections; Willis AT; Anaerobic bacterial infections of man are typically associated with locally comprised tissues and commonly also with a systemically compromised host . Thus, any condition that interferes with the systemic defence mechanisms of the host and thus predisposes to infection in general, increases the incidence of anaerobic infections also . It is generally true to say that anaerobic infections occur secondary to mechanical disruption of anatomical barriers, usually percutaneous in clostridial infections; in nonclostrial anaerobic infections the disrupted barriers are commonly mucosal surfaces where the offending organisms exist as the dominant part of normal bacterial floras . The most important single factor which enables anaerobes to flourish in the tissues is low oxygen tension which is usually the result in the first instance of a compromised blood supply and poor tissue perfusion . A variety of other predisposing factors may operate in concert, enabling the nonsporing anaerobes to cause a diversity of infective states in many different parts of the body . These host determinants are considered in relation to clostridial, nonclostridial and postsurgical anaerobic sepsis.

Anal Biochem, 1984 Nov 1, 142(2), 411 - 20
An evaluation of fluorometric proteinase assays which employ fluorescamine; Evans CH et al.; The sensitivity and utility of proteinase assays employing fluorescamine, a compound which reacts with primary amines to form a fluorescent adduct, was assessed . As little as 1 ng of purified trypsin or clostridiopeptidase A could be detected within 3 h of incubation at 37 degrees C, using casein or gelatin as substrates . Increasing the incubation period to 18 h permitted the detection of 250 pg of each enzyme . When gelled collagen was utilized as substrate, the sensitivity to clostridiopeptidase A was reduced to 2.5 ng at 3 h and 500 pg at 18 h . The techniques could be used to measure the gelatinase, caseinase, and collagenase activities of culture media conditioned by synovial tissue . The main disadvantage of this assay is its susceptibility to interference by compounds which fluoresce or quench . This, in turn, necessitates additional blanks, which may render the assay tedious.

Mutat Res, 1984 Oct, 141(2), 113 - 6
Collagenase perfusion of rat liver induces DNA damage and DNA repair in hepatocytes; Cesarone CF et al.; Evidence is presented that the collagenase perfusion of adult rat liver results in significant damage to nuclear DNA as evaluated by the alkaline elution technique . The extent of the damage is related to the perfusion time as well as to the clostridial enzyme preparation used . The DNA structure of isolated cells is almost completely repaired within 12 h of their culture in chemically defined medium.

Biochim Biophys Acta, 1984 Sep 25, 789(3), 245 - 56
Soluble and immobilized clostridial aminopeptidase and aminopeptidase P as metal-requiring enzymes; Fleminger G et al.; The dependence of enzymatic activity on Co2+ concentration was found to be bell-shaped for the soluble and immobilized clostridial aminopeptidase (alpha-aminoacyl-peptide hydrolase, EC 3.4.11.13) and aminopeptidase P (aminoacylpropyl-peptide hydrolase, EC 3.4.11.9), with maxima in the 3-18 microM range of Co2+ concentration . The Co2+-enzyme association constants derived from the activation of soluble, glass- and cellulose-bound clostridial aminopeptidase by Co2+ were KE-Co = 5.2 X 10(5), 4.5 X 10(6) and 2.0 X 10(5) M-1, respectively; for soluble and glass-bound aminopeptidase P, the KE-Co were 1.5 X 10(5) and 8.2 X 10(5) M-1, respectively . Kinetic measurements indicate the involvement of Co2+ in the enzyme-substrate binding . Cobalt-citrate (Co-cit) acted as a useful metallobuffer and protected both enzymes against inhibition by high concentrations of CoSO4 . For association of citrate with Co2+ under the assay conditions, KCo-cit was determined as (5.3 +/- 1.4) X 10(3) M-1 by anodic stripping polarography . In contrast to the rapid association of Co2+ with soluble and glass-bound clostridial aminopeptidase (less than 1 min at 4 degrees C), the dissociation process was very slow (hours to days), being slower for the glass-bound than for the soluble and cellulose-bound enzyme . For aminopeptidase P, both processes were rapid . All the interactions were shown to be reversible.

Br J Nutr, 1984 Sep, 52(2), 391 - 401
The effect of formaldehyde or glutaraldehyde application to lucerne before ensiling on silage fermentation and silage N digestion in sheep; Siddons RC et al.; The primary growth of lucerne (Medicago sativa) was ensiled after treatment with either formic acid alone (4.1 litres/t; silage F) or with formic acid and either formaldehyde (30.5 g/kg crude protein (nitrogen X 6.25; CP); silage FF), glutaraldehyde (44.2 g/kg CP; silage FG) or a mixture of the two aldehydes at approximately half their individual application rates (silage FFG) . Compared with formic acid alone, both formaldehyde and glutaraldehyde reduced protein breakdown and carbohydrate fermentation during ensiling . The extent of protein protection afforded within the silo was similar for the two aldehydes, whereas formaldehyde was more effective in restricting carbohydrate fermentation . The effect of treatment FFG on silage fermentation was confounded by the silo bag bursting and the development of a clostridial-type fermentation . All aldehyde treatments reduced silage soluble-N content but N disappearance when the silages were incubated in polyester bags in the rumen was high for all silages and reductions due to the aldehydes were small . Silage digestion was studied in four mature sheep each fitted with a rumen cannula and re-entrant cannulas in the proximal duodenum and distal ileum . The apparent digestibility of organic matter (OM) in the whole tract was reduced (P less than 0.05) to a similar extent by both aldehydes, whereas rumen OM digestion was reduced (P less than 0.05) more by glutaraldehyde than by formaldehyde . The effects on digestion appeared to be due to the action of the aldehydes on the foods rather than to any adverse influences of the aldehydes on the metabolism of the rumen microbes because, although rumen ammonia levels were lower (P less than 0.05) when the aldehyde-treated silages were given, rumen casein-degrading activity, the degradation of different feedstuffs when incubated in polyester bags in the rumen and microbial N flow at the duodenum did not differ (P greater than 0.05) between silages . All aldehyde treatments decreased (P less than 0.05) the apparent digestibility of N in the whole tract . Silage N degradability in the rumen was also decreased (P less than 0.05) from 0.82 for silage F to 0.67, 0.60 and 0.62 for silages FF, FG and FFG respectively, and consequently non-ammonia-N (NAN) flow at the duodenum increased (P less than 0.05) . The aldehydes did not adversely affect the apparent digestibility of NAN in the small intestine, and net NAN absorption from the small intestine increased from 8.8 g/d with silage F to 11.4, 15.3 and 14.2 g/d with silages FF, FG and FFG respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

Ital J Orthop Traumatol, 1984 Sep, 10(3), 405 - 10
The use of collagenase-clostridiopeptidase combined with chloramphenicol in orthopaedics and traumatology; Mariotti U et al.; The authors report a consecutive group of 95 patients suffering from chronic ulceration treated by a mixture of Collagenase Clostridiopeptidase A and 1% Chloramphenicol . Some cases involved skin only, some affected skin and muscle, and some also affected bone . The treatment was successful in all cases . The mixture acts by inducing debridement and cleansing of the necrotic areas and stimulating granulation tissue formation . This is followed by epithelialisation . At the same time the vitality of the deep tissues is maintained, even when it involves bone.

Anal Biochem, 1984 Aug 15, 141(1), 205 - 12
High-performance liquid chromatographic separation of glycopeptides from Nereis cuticle collagen; Sharma YD et al.; To facilitate the structural studies of invertebrate collagens, a sensitive and effective method was developed, using reverse-phase high-performance liquid chromatography for preparative isolation of the collagen subunits and their clostridial collagenase-derived peptides; the methods have been applied to Nereis cuticle collagen . The two subunits of denatured Nereis cuticle collagen, termed A and B, were initially separated by high-performance liquid chromatography . These polypeptides, with Mr of about 0.5 million, were each exhaustively digested with clostridial collagenase . The digest of the A subunit, which contains all of the uronic acid, was enriched for the uronic acid-containing glycopeptides by means of gel filtration . These glycopeptides were resolved into 23 major peaks, using reverse-phase HPLC, over a 5-h elution time, with an acetonitrile gradient (0-20%) containing 0.1% TFA . The amino acid composition data suggests that the peptides are of variable length, from 5 to 17 residues, while beta-elimination studies show that the uronic acid-containing moieties are all O-glycosidically linked to threonine residues, in the peptides examined . The amino acid sequence of one of the major glycopeptides was determined and found to be Gly-Hyp-Ala-Gly-Gly-Ile-Gly-Glu-Thr-Gly-Ala-Val-Gly-Leu-Hyp . The amino acid compositions of glycosylated and nonglycosylated peptides which had eluted, numbering about 100, showed a correspondence between hydrophobicity or hydrophilicity and emergence time from the column . We also found that the peptides most enriched in 4-hydroxyproline emerged earliest . These studies provide a foundation for elucidating the detailed structures of the large, unusual subunits of a well-characterized cuticle collagen.

South Med J, 1984 Jun, 77(6), 697 - 9, 702
Management of abdominal wall clostridial myonecrosis: the role of total gastrointestinal diversion; Schwartz RW et al.; We report the successful management of two patients with abdominal wall gas gangrene and emphasize the principles of proximal gastrointestinal diversion and the initial use of 100% fraction of inspired oxygen (FiO2) . Each patient lacked an abdominal wall and intractable fistulas developed . Complete diversion of their gastrointestinal tracts at a proximal level facilitated closure of the fistulas and prevented possible peritoneal contamination . One patient's arterial oxygen pressure was maintained in the 200 to 300 range for two days after admission . This level has been shown to be adequate to stop clostridial alpha toxin production.

Can J Microbiol, 1984 Jun, 30(6), 841 - 4
Sulfur isotope fractionation during SO3(2-) reduction by different clostridial species; Laishley EJ et al.; Sulfur isotope composition patterns for sulfide evolved from cultures supplemented with 1 mM Na2SO3, suggested that an inducible dissimilatory type SO3(2-) reduction pathway, as previously found in C . pasteurianum, probably exists in many clostridial species . Data are presented for five additional species which include pathogens and nonpathogens.

Isr J Med Sci, 1984 Apr, 20(4), 323 - 6
Hyperbaric oxygen therapy for gas gangrene casualties in the Lebanon War, 1982; Shupak A et al.; Four gas gangrene casualties from the Lebanon War, 1982, were treated with hyperbaric oxygen (HBO) . Myonecrosis was diagnosed in three and intraabdominal spread of clostridial infection in one . In all four cases, HBO treatment, in combination with meticulous but conservative surgical debridements and proper antibiotic coverage, was begun within 24 h of diagnosis . HBO therapy was terminated when bacteriostasis was attained, as evidenced by no further spread of myonecrosis and the alleviation of systemic toxic symptoms . All four patients recovered from the clostridial infection, but one died later from other causes . HBO therapy enhances the survival rate of patients with gas gangrene, lowers the anesthetic risk, allows for maximal tissue preservation and helps avoid radical mutilating surgery.

Fortschr Med, 1984 Mar 15, 102(10), 281 - 3
{Enzymatic debridement in venous ulcus cruris . Report of a multicenter clinical comparative study with various enzyme preparations}; Fischer H et al.; In a multicenter trial (comprising 258 patients in eight centers) three topical preparations for enzymatic debridement, which are widely used in our country, have been compared in the treatment of leg ulcers . Preparation A is a combination of bovine fibrinolysin and desoxyribonuclease (but without antibiotic); preparation B is a combination of clostridiopeptidase and chloramphenicol and preparation C of trypsin and framycetin sulphate . The results showed no significant difference in the effects of treatment between the preparation . Preparation A however was much better tolerated; preparation B and C induced a lot of side effects . This means that antibiotics in preparations for enzymatic debridement are not of real advantage.

Med J Aust, 1984 Mar 3, 140(5), 256 - 60
Gas gangrene . An 11-year review of 73 cases managed with hyperbaric oxygen; Unsworth IP et al.; An 11-year review is presented of 73 patients treated for gas gangrene at The Prince Henry Hospital . The geographical collection area extended throughout the States of New South Wales and Queensland and to Papua New Guinea . The commonest aetiological factor was found to be motor-vehicle trauma, motor-cycle accidents producing compound limb fractures in particular . The infecting organisms in these cases were most commonly clostridia . The diagnosis of the disease remains a clinical one . Treatment consisted of three facets: conservative surgery, as much of the limb or viable tissue as possible being preserved; high-dose penicillin administration; and hyperbaric oxygen therapy . Death occurred in 15 cases, gas gangrene being the principal cause in seven . However the incidence of gas gangrene has diminished since 1971, and there are hopes that it will decrease further through adequate prophylaxis and prevention in civilian surgical practice.

Rev Infect Dis, 1984 Mar-Apr, 6 Suppl 1, S293 - 9
Anaerobic bacterial diseases now and then: where do we go from here?
Willis AT.
Two developments of major importance followed Pasteur's discovery of anaerobiosis: Lister revolutionized surgery by recognizing the importance of Pasteur's germ theory of disease and by introducing the antiseptic surgical method . The day of the anaerobe hunter had dawned . The discovery of many anaerobic bacteria linked etiologically to human disease followed, so that by 1900 most of the pathogenic anaerobes were recognized . The frequent occurrence of anaerobic bacterial intoxications, during the two World Wars stimulated the study of clostridia, organisms that dominated the study of anaerobes until the 1960s . During the next decade the emphasis shifted to the non-spore-forming anaerobes due to the work of Finegold in Los Angeles, and Moore and Holdeman in Virginia . Their pioneer studies initiated and carried forward the "anaerobe revolution," and exerted an influence that transformed the clinical and microbiologic approach to anaerobic bacterial infections in almost every field of medical practice . In considering the question, "Where do we go from here?" the author discusses some aspects of anaerobic infections that remain areas of debate or provide pathways for future exploration . Reference is made to the acceptable "anaerobic specimen," and to the problem of "mixed infections." Pseudomembranous colitis is noted and the role of anaerobes in tonsillitis and pharyngitis, bronchitis, and nonspecific vaginitis (vaginosis) is discussed.

Proc Natl Acad Sci U S A, 1984 Mar, 81(5), 1544 - 8
Isolation of the specific glomerular basement membrane antigen involved in Goodpasture syndrome; Wieslander J et al.; The antigen involved in the glomerulonephritis associated with antibodies to glomerular basement membrane (GBM) was purified from human GBM digested with highly purified clostridial collagenase . The purified nonreduced sample contained two components with closely similar mobilities on sodium dodecyl sulfate/polyacrylamide gel electrophoresis . After reduction they moved as one, nonantigenic, component, corresponding to a molecular weight of 26,000 . Immunologically identical aggregates of higher molecular weight (i.e., 48,000) were also identified in the crude digest . Reduction of such aggregates after purification released some protein with a molecular weight of 26,000, but a large proportion was insensitive to reduction . Seven patients with Goodpasture syndrome all had circulating anti-GBM antibodies directed only against the purified antigen.

Fortschr Med, 1984 Jan 12, 102(1-2), 33 - 8
{Icterus - in intensive care}; Kluge F; Jaundice is often the first and also most prominent sign of liver disease . A knowledge of liver involvement in systemic and extrahepatic disease is of practical significance for a precise diagnosis and specific therapy . Since this syndrome is complex with multifactorial causes, the following classification has been employed . Jaundice in heart failure, drug-induced jaundice, jaundice resulting from infection, postoperative jaundice . In the discussion the following points have been emphasized . A pattern of jaundice similar to hepatitis can be observed even in isolated left heart failure . Tetracyclines are able to cause an acute fatty liver with jaundice . Clostridia infections should always be considered in the case of raised indirect bilirubin postoperatively . Cautious waiting is indicated initially in the case of "benign postoperative cholestasis".

Arch Geschwulstforsch, 1984, 54(6), 471 - 4
{Morphological studies on Jensen sarcoma in the rat under artificial short-term hyperglycemia}; Hoffmann FA et al.; Possible actions of artificial short-time hyperglycaemia, which is tested as an adjunctive measure in various therapeutical concepts of tumours (for instance in combination with oncolytic apathogenic Clostridia), were checked by histomorphological investigations in Jensen sarcoma of rats . The glucose-induced hyperglycaemia caused a considerable increase of the extend of necrosis in the whole tumour . These morphological findings gave evidence of the high tumour selectivity of the provable effects of artificial short-time hyperglycaemia.

Scand J Gastroenterol Suppl, 1984, 90, 53 - 64
Treatment of anaerobic infections; Willis AT; The anaerobic syndromes of gas gangrene and tetanus are due to systemic intoxications that develop following infection with clostridia at some site of trauma . Classically, these conditions developed as complications of accidental trauma, the spore-forming anaerobes being derived from the inanimate environment . While tetanus remains typically an exogenously derived disease, gas gangrene more frequently presents as an endogenously derived complication of elective surgery . Their treatment is briefly discussed, including the role of antimicrobial therapy . During the last decade there has been an increasing awareness of the importance of non-sporing anaerobes as a major cause of serious endogenously derived infections in man . They are not only a common cause of postoperative infection following appendicectomy, and acute and elective colorectal and gynaecological surgery, but they also cause a wide variety of infections at other sites, usually secondary to some preexisting pathology . In the management of these infections, surgical drainage of pus, when present, is of first importance . Systemic antimicrobial therapy, directed against the anaerobes is dramatically effective both in the management of established infections, and in their prevention in patients known to be at risk.

Arkh Patol, 1984, 46(1), 57 - 63
{Comparative clinico-morphological characteristics of peace-time anaerobic infections}; Ageev AK et al.; Altogether 26 cases of anaerobic infection (AI) of various etiology were analysed . Local tissue ischemia and operations on gastrointestinal organs in patients with secondary immunodeficit conditions are the factors facilitating the development of AI . The distinction is made between clostridial AI with a rapidly progressing gaseous gangrene and the non-clostridial AI with a slower course of a serous-purulent phlegmoma . Anaerobic myositis is observed in all forms of AI . Depending on the localisation of AI, anaerobic cellulitis and fasciitis are mentioned which occur mainly in non-clostridial AI . The treatment of AI and the mechanisms of death are discussed.

J Antimicrob Chemother, 1983 Dec, 12(6), 549 - 53
The in-vitro activity of bicozamycin against anaerobic bacteria of clinical interest; Watt B et al.; The in-vitro activity of bicozamycin (bicyclomycin, CGP 3543E; FR 1881), an oral antidiarrhoeal agent, was assessed against 389 clinical isolates and reference strains of anaerobic bacteria . The compound inhibited the majority of Gram-negative anaerobes at concentrations of 256 mg/l or less, but all of the test anaerobic cocci and 40 out of 43 strains of clostridia were resistant to this concentration, with MIC values usually in excess of 1024 mg/l . MBC values for bicozamycin against strains of Bacteroides fragilis were generally greatly in excess of MIC values.

J Endocrinol, 1983 Dec, 99(3), 387 - 99
Separation of two bone cell populations from fetal rat calvaria and a study of their responses to parathyroid hormone and calcitonin; Braidman IP et al.; Bone cells released from perinatal rat calvaria by digestion with clostridial peptidase were separated into two distinct populations (designated types B and C) by equilibrium density centrifugation on a two-step gradient of Percoll . They were extensively characterized by light and electron microscopy and for behaviour in culture, acid and alkaline phosphatase activity, collagen synthesis, collagenase secretion and adenylate cyclase response to parathyroid hormone (PTH) and calcitonin . Type C cells were predominantly large with up to seven nuclei and an unusual cytoplasmic appearance in cytocentrifuge preparations . They did not proliferate in culture and we have established culture conditions which prevented their overgrowth by contaminating proliferative cells . In culture these cells had low alkaline and high acid phosphatase and high aryl sulphatase activity, and synthesized little collagen . In contrast type B cells were mostly smaller and many had irregular cytoplasmic projections . In culture they became polygonal in shape, proliferated rapidly, and reached confluence in 4-5 days . These were low in aryl sulphatase and acid phosphatase, high in alkaline phosphatase activity, and synthesized labelled collagen actively with {3H}proline and ascorbic acid included in the culture medium . The two cell population were found to differ in culture in two important further respects . First, the type C cells showed an adenylate cyclase response to calcitonin but not to PTH, while the converse was true for type B cells; this was so over at least a 20-fold range of isobutylmethyl xanthine concentration . Secondly, type C cells in culture secreted an active collagenolytic enzyme . Type B cells secreted much lower levels of a predominantly latent collagenase which required activation by mersalyl . Co-culture of type C and type B cells led to a marked reduction in the content of active collagenase in the culture medium.

Arch Surg, 1983 Dec, 118(12), 1446 - 8
Total abdominal wall reconstruction; Luce EA et al.; A patient had full-thickness loss of abdominal wall from clostridial myonecrosis . Initial care consisted of resuscitation, debridement, and transfer to a hyperbaric chamber facility . After control of sepsis, multiple enteric fistulas were managed by enterotomies, gastric and duodenal defunctionalization with closed-loop gastrojejunostomy, gastrostomy, and end jejunostomy . Good nutritional status was maintained with total parenteral nutrition over a three-month period . Total abdominal wall reconstruction was accomplished by rotation of bilateral tensor fascia lata musculocutaneous flaps . Reconstruction was successful as the patient was able to return to an active life.

J Trauma, 1983 Nov, 23(11), 991 - 1000
Gas gangrene; Hart GB et al.; Gas gangrene is not a disease of the past . Despite improved awareness, earlier care of trauma victims, new antibiotics, and advanced monitoring techniques, histotoxic clostridia continue to cause loss of life and limb . A 20-year literature review on gas gangrene (Part I) indicates that a combined therapy approach with early recognition, surgical intervention, appropriate antibiotics, and hyperbaric oxygen (HBO) provides optimal care . Part II, a 15-year clinical experience, appears to be the largest English-language series reported using the combined therapy of antibiotics, surgery, and hyperbaric oxygen . One hundred thirty-nine patients (95 males and 44 females), average age, 38 years, were admitted with clostridial myonecrosis . Sixty-seven were in shock at admission and the 27 deaths occurred in this group . One hundred twelve patients (81%) survived the infection . There was a 5% mortality in post-traumatic extremity clostridial myonecrosis . Age and concurrent disease increased the mortality rate, as did delay from time of diagnosis to aggressive combined treatment.

Arthritis Rheum, 1983 Oct, 26(10), 1225 - 30
Comparative rates of proteoglycan synthesis and size of proteoglycans in normal and osteoarthritic chondrocytes; Teshima R et al.; Normal human and osteoarthritic cells were isolated from cartilage with clostridial collagenase . The cells were grown in media as a suspension culture in the presence of 35SO4 . Osteoarthritic cartilage of moderate histologic grade (4-8) yielded chondrocytes which incorporated 35SO4 at a rate 3-4 times greater than did normal chondrocytes . The rate of incorporation, however, decreased to normal levels with chondrocytes isolated from mild (grade 0-3) or more advanced (grade 9-13) stages of the disease . These results corroborate those obtained in earlier studies using organ cultures and show that when osteoarthritic cells are isolated from their matrix environment, they continue to synthesize macromolecules at an increased rate . Analysis of the material synthesized by the isolated cells on sizing column demonstrated an inverse relationship between the size of the 35SO4 containing molecules and the severity of the disease.

J Dent Res, 1983 Oct, 62(10), 1038 - 40
Neuraminidase-activated attachment of Actinomyces naeslundii ATCC 12104 to human buccal epithelial cells; Saunders JM et al.; The attachment of Actinomyces naeslundii ATCC 12104 to human buccal epithelial cells pre-treated with neuraminidase (sialidase) was evaluated . Both commercial clostridial neuraminidase and neuraminidase preparations from the test strain of A . naeslundii enhanced attachment . The results suggest that the A . naeslundii beta-galactoside-seeking ligand involved in hemagglutination and interbacterial coaggregation also mediates one type of binding to human buccal epithelial cells.

FEBS Lett, 1983 Sep 5, 161(1), 127 - 30
Occurrence of a new hematoside in the kidney of guinea pig; Hirabayashi Y et al.; We have isolated a new hematoside from guinea pig kidney . Like the usual hematoside (II3NeuAc LacCer), isolated from human erythrocytes, this new hematoside contained glucose, galactose, and N-acetylneuraminic acid in an equimolar proportion . By thin-layer chromatography (TLC), however, it migrated faster than the usual hematoside . After mild alkaline hydrolysis the TLC mobility of this ganglioside became identical to that of the usual hematoside . The sialic acid in this ganglioside was susceptible to Clostridial neuraminidase . Based on TLC mobility and the results of periodate oxidation, the sialic acid of the new hematoside was identified as 9-O-acetyl-N-acetylneuraminic acid . Therefore, the structure of this new hematoside is 9-O-Ac-NeuAc alpha 2 leads to 3Gal beta 1 leads to 4GLc beta 1 leads to 1'Cer.

Immun Infekt, 1983 Sep, 11(5), 153 - 68
{Anaerobic infections in operative medicine}; Schaal KP; Compared with other medical disciplines, anaerobic infections play an especially important role in operative medicine . In odontogenic soft tissue infections of the orofacial area, in intraabdominal suppurative processes and in post partum, post abortum or postoperative gynecological infections, anaerobic pathogens are almost inevitably encountered . Furthermore, even in times of peace exogenous or endogenous toxic clostridial infections do not occur so rarely that they should be excluded from considerations concerning differential diagnosis . Because of the substantial malignancy of some of these infections, because of considerable variation in the species composition of anaerobic infections at different body sites and because of the peculiar antibiotic sensitivity pattern of certain anaerobes, diseases caused by anaerobic pathogens deserve special diagnostic and therapeutic attention . The reliable recognition of the anaerobic etiology of inflammatory lesions is usually only possible when microscopic or cultural bacteriological examinations are performed . As complete bacteriological analyses may be comparatively time-consuming, the clinician's requirements for planning the appropriate treatment are met best when he is informed of the tentative diagnosis of an anaerobic infection as soon as possible . This may often be achieved by microscopic or gaschromatographic techniques within less than two hours . The treatment of "surgical anaerobic infections" usually consists of operative measures combined with antibacterial chemotherapy . Only in selected cases, incision and drainage will suffice to cure a localized anaerobic suppuration . As a rule, additional application of antibacterial drugs is necessary or at least advisable in order to reliably prevent relapses or systemic spread . Appropriate chemotherapeutics are selected according to the pathogens that are individually present or may be expected with some probability . Diseases due to Gram-positive, non-spore-forming anaerobes, fusobacteria and Bacteroides species of the melaninogenicus group are comparatively easy to treat as these organisms are usually susceptible to penicillins including benzylpenicillin in sufficiently high doses . Against beta-lactamase-producing intestinal Bacteroides species such as B . fragilis and B . thetaiotaomicron, lincomycins and nitroimidazoles have proved to be highly effective . Infections caused by these Bacteroidaceae may also respond to treatment with mezlocillin, cefoxitin, lamoxactam and possibly aminopenicillins combined with clavulanic acid.(ABSTRACT TRUNCATED AT 400 WORDS)

J Clin Microbiol, 1983 Sep, 18(3), 609 - 13
Comparison of three reagents for detecting indole production by anaerobic bacteria in microtest systems; Lombard GL et al.; Three reagents for detecting indole, Kovac, Ehrlich, and p-dimethylaminocinnamaldehyde (DMCA), were evaluated with commercial microtest systems for characterizing and identifying anaerobic bacteria . The DMCA reagent, the most sensitive of the three reagents, gave a positive reaction with 445 of 449 strains of various indole-producing anaerobic bacteria . There was 99.6% agreement between the results obtained with the DMCA in the microtest systems and results using the conventional tube test to detect indole by using xylene extraction and Ehrlich reagent . Ehrlich reagent detected indole in 163 of 176 (92.6%) indole-positive strains when the inoculum was overlaid with mineral oil before incubation . Kovac reagent was the least sensitive of the reagents tested . When the inoculum was overlaid with mineral oil, Kovac reagent detected only 80 of 108 (74.0%) of indole-positive strains . In addition to being the most sensitive reagent for detection indole, DMCA also allowed detection of indole derivatives (skatole, 3-indolepropionic acid, and 3-indolebutyric acid) produced by some clostridia.

Surg Gynecol Obstet, 1983 Sep, 157(3), 257 - 60
The effect of heparin upon fibrinopurulent peritonitis in rats; Chalkiadakis G et al.; The effect of heparin upon the clinical and pathologic course of experimentally induced peritonitis in the rat was studied . Peritonitis was induced in 40 rats by creating a closed ileal loop 4 centimeters long at a distance of 5 centimeters from the ileocecal valve . The rats were divided into two groups of 20 each . The first group served as the control group while each rat of the second group received 30 units of heparin subcutaneously per day postoperatively . Survival was drastically increased in the group receiving heparin (p = 0.001) . Adhesion or abscess formation was considerably reduced in this group . The results of peritoneal cultures showed decreased incidence of Escherichia coli and clostridia in the heparin-treated group . Blood cultures also showed decreased incidence of both aerobes and anaerobes in the treated group . It is concluded from this that the administration of heparin significantly prolongs survival time of animals with peritonitis and reduces the development of adhesions and abscesses in the peritoneal cavity . This beneficial effect could be attributed to decreased fibrinogen deposits within the peritoneal cavity, thus rendering the bacteria more susceptible to cellular and noncellular clearing mechanisms.

Fortschr Med, 1983 Aug 25, 101(31-32), 1407 - 12
{Acute and chronic biliary tract infections . Studies of the therapeutic effect of a new broad-spectrum cephalosporin}; Eisenburg J; Diseases of the biliary tract are common problems, frequently encountered in clinical practice . Infection is a major cause of mortality in patients with extrahepatic obstruction, especially in the elderly patient . Survival in patients with biliary tract stones, complicating cholecystitis and ascending cholangitis or abscess formation depends on timing of surgery with decompression of the biliary tract, attention to fluid and electrolyte management and on prompt institution of antibiotics . The initial choice of antibiotics should be based on the organisms most frequently encountered in biliary tract sepsis, especially E . coli, enterococci, klebsiella, pseudomonas, clostridia and ps . aeruginosa . Serum levels as well as the concentration of the antibiotic in the bile are important factors determining efficacy . Cefoperazon (Cefobis), a new cephalosporin with a spectrum of antimicrobial activity that differs from some previously marketed cephalosporins, in that it is effective also against ps . aeruginosa, achieves high biliary concentrations . A clinical study is presented which proves this new antibiotic to be a safe drug and the cephalosporin of choice to treat biliary tract infections.

Gut, 1983 Jul, 24(7), 678 - 9
Acute clostridial enteritis--or pig-bel?
Devitt PG, Stamp GW.
Acute postprandial gastric dilatation and associated clostridial enteritis necroticans is a well recognised but unusual clinical condition . Non-pathological overeating, gastric distension, and clostridial enteritis, termed pig-bel, has been reported in Papua, New Guinea . A similar condition (Darmbrand) was reported from Germany after the second world war, but it is not a condition seen in our society today . Gastric dilatation alone may be seen in individuals with anorexia nervosa, who may occasionally indulge in episodes of overeating (bulimia) . We wish to report a case of gastric dilatation associated with a fulminating enteritis, and discuss the similarities with enteritis necroticans (pig-bel).

J Biochem (Tokyo), 1983 May, 93(5), 1385 - 90
Structure of the extracellular ferredoxin from Rhodospirillum rubrum: close similarity to clostridial ferredoxins; Matsubara H et al.; The amino acid sequence of an {8Fe-8S} ferredoxin isolated from the culture medium of Rhodospirillum rubrum, a photosynthetic purple non-sulfur bacterium, was determined by a combination of various conventional procedures . The sequence was A-Y-K-I-E-E-T-C-I-S-C-G-A-C-A-A-E-C-P-V-N-A-I-E-Q-G-D-T-I-F-V-V-N-A-D-T-C-I-D-C - G-N-C-A-N-V-C-P-V-G-A-P-V-A-E (55 amino acid residues) . It lacked methionine, leucine, histidine, arginine, and tryptophan . The molecular weight was calculated to be 5,568 excluding iron and sulfur atoms . The distribution of 8 cysteine residues was exactly the same as that of clostridial-type ferredoxin, suggesting retention of the duplication of the bacterial ancestral ferredoxin gene . The extracellular ferredoxin of R . rubrum was compared with other ferredoxins observed in closely related photosynthetic bacteria and the evolutionary significance of this ferredoxin is discussed.

Clin Orthop, 1983 Apr, (174), 206 - 7
Gas gangrene after intramuscular injection of adrenaline; Teo WS et al.; A 13-year-old girl incurred gas gangrene after intramuscular injection of adrenaline to the buttock . Clinical evidence of very severe pain at the site of injection with septicemia and collapse within 24 to 48 hours should arouse the suspicion of clostridial myositis rather than pyogenic infection . Early diagnosis and treatment by adequate excision of necrotic muscle (with a wide margin of normal-appearing muscle) can prevent loss of life or limb in these patients.

Biochim Biophys Acta, 1983 Mar 30, 743(3), 437 - 46
Sequential hydrolysis of proline-containing peptides with immobilized aminopeptidases; Fleminger G et al.; Proline-containing polypeptides are shown to be sequentially degraded by two aminopeptidases . Clostridial aminopeptidase (EC 3.4.11-) cleaves off any N-terminal amino acid residue including proline from polypeptide chains, but does not cleave the N-terminal secondary peptide bonds involving a prolyl nitrogen . Aminopeptidase P (EC 3.4.11.9) cleaves exclusively such secondary bonds . The two enzymes were immobilized by coupling them covalently to porous amino glass beads . Highly stable preparations were obtained with unchanged pH optimum and thermal stability . The applicability of clostridial aminopeptidase to sequence determination was demonstrated by the time-dependent hydrolysis of enkephalin and Substance P octapeptide . Sequential hydrolysis with the two immobilized enzymes was demonstrated with the proline-containing (Pro-Gly-Pro)10, {Asn1, Val5}angiotensin II, bradykinin, Substance P and tuftsin . Absence of endopeptidase activities was demonstrated by resistance of cytochrome c to hydrolysis and by the ordered release of amino acids during the sequential degradation by immobilized clostridial aminopeptidase and aminopeptidase P.

J Biol Chem, 1983 Mar 10, 258(5), 2911 - 5
Evidence for a repeating 3,4-dihydroxyphenylalanine- and hydroxyproline-containing decapeptide in the adhesive protein of the mussel, Mytilus edulis L; Waite JH; Previous work has shown that the permanent adhesive of the marine mussel Mytilus edulis is a protein containing large amounts of hydroxyproline (13%) and 3,4-dihydroxyphenylalanine (Dopa, 11%) . The protein also known as the polyphenolic protein is produced and stored in the exocrine phenol gland of the mussel and deposited onto marine surfaces by the animal's foot during the formation of new adhesive plaques . The adhesive protein has been purified by a combination of ion exchange on sulfonylpropyl-Sephadex and gel filtration on low surface energy chromatographic media . Polyacrylamide gel electrophoresis of the protein at acidic pH shows it to consist of two components having a molecular weight of about 130,000 . Treatment of the protein with clostridial collagenase reduced the molecular weight by less than 10% . The collagenase-resistant fragment contains most or all of the Hyp and Dopa . Trypsin treatment of the polyphenolic protein results in extensive degradation . The major tryptic peptide (80%) contains 10 amino acids including Hyp and Dopa and was shown by sequence analysis to be H2N-Ala-Lys-Pro-Ser-Tyr-Hyp-Hyp-Thr-Dopa-Lys-COOH . Calculations suggest that this and related sequences may be repeated as often as 75 times in the polyphenolic protein.

J Biol Chem, 1983 Jan 10, 258(1), 508 - 22
Structure of Azotobacter vinelandii 7Fe ferredoxin . Amino acid sequence and electron density maps of residues; Howard JB et al.; The complete amino acid sequence of the 7Fe ferredoxin from Azotobacter vinelandii (Av Fd) was determined by repetitive Edman degradation of the whole protein and of peptides derived from CNBr cleavage or chymotrypsin digestion . The sequence was confirmed by the 2A electron density maps for the residues calculated with difference Fourier coefficients . The density maps for all residues are included in the paper . Av Fd has several important differences with the clostridial-type ferredoxins: (i) Av Fd is 106 residues (versus 55-60 for other bacterial ferredoxins); (ii) Av Fd has 9 cysteines, one of which (residue 24) is not homologous with the bacterial ferredoxins; (iii) Av Fd has 2 extra residues between 2 cysteines (residues 11 and 16) homologous to cysteines in the bacterial ferredoxins; and (iv) Av Fd has the unique sequence -Cys-Val-Glu-Val-Cys- (residues 16-20) which are two of the ligands of the 3Fe:3S center . These sequence features are compared to the sequences of various ferredoxin groups . Structure predictions for other suspected 7Fe ferredoxins are discussed.

J Foot Surg, 1983 Summer, 22(2), 126 - 33
Postoperative gas gangrene; Meltzer RM et al.; Gas gangrene is a rare complication of elective surgery . Caused by several species of Clostridia, it is an acute, highly invasive necrotizing infection of muscle and fascia often leading to coma and death . Gas gangrene should be suspected if the patient has unremitting pain, high temperature, tachycardia, and prostration . Edema, brown watery exudate emanating from he wound, evidence of gas in tissues, and gram-positive rods on smear support the clinical diagnosis . Rapid surgical decompression and debridement is the basis of treatment . Adjuvant antibiotic, hyperbaric oxygen, antitoxin, local, and supportive therapies aid in treatment . The authors review the literature and discuss etiologies, pathogenesis, clinical features, and treatment.

Acta Chir Scand, 1983, 149(6), 567 - 71
Postoperative gas gangrene in abdomen and in extremity . A comparison in nine cases of clostridial myonecrosis; Knutson L; Gas gangrene occurred after surgery on an extremity, as a rule highly arteriosclerotic, in 6 patients and after abdominal operations in 3 patients during an 18-month period in 1978-79 . The signs of toxemia after abdominal surgery preceded the signs of wound infection by one or two days and the diagnosis in the interval was extremely difficult . In its abdominal form the gas gangrene had such a fulminant course that, when the diagnosis had been established, the outcome was uninfluenced by prompt administration of shock therapy, surgical debridement and antibiotics . All 3 patients died.

Biochimie, 1983 Jan, 65(1), 43 - 7
Primary structure of the two (4 Fe-4 S) clusters ferredoxin from Desulfovibrio desulfuricans (strain Norway 4); Guerlesquin F et al.; The primary structure of a ferredoxin isolated from D . desulfuricans Norway strain, which we called ferredoxin II (Fd II) has been elucidated . This ferredoxin is a dimer constituted of two identical subunits of molecular weight 6000 . In ferredoxin II two (4 Fe-4 S) centers are present per subunit instead of one (Fe-S) center as is the case for the other ferredoxins isolated from Desulfovibrio and for Fd I from the same organism . The comparison of amino-acid sequences shows that ferredoxin II presents more homologies with clostridial type ferredoxin than with the ferredoxins from D . gigas and D . africanus.

J Biol Chem, 1982 Dec 25, 257(24), 14896 - 902
Coenzyme A thiosulfonate (coenzyme A disulfide-S,S-dioxide), an affinity analog of coenzyme A; Nishimura JS et al.; The structure of the CoA affinity analog-oxidized CoA disulfide (o-CoAS2) (Collier, G . E., and Nishimura, J . S . (1978) J . Biol . Chem . 253, 4938-4939) has been deduced to be that of the thiosulfonate of CoA, i.e . coenzyme A disulfide-S,S-dioxide . This deduction is based on several considerations among which are: the cleavage of o-CoAS2 by dithiothreitol under anaerobic conditions to equimolar amounts of CoASH and CoASO2H; the alkali-catalyzed dismutation of 3 mol of o-CoAS2 to 4 mol of CoASO2H and 1 mol of CoA disulfide; and comparison of the 13C-NMR spectra of CoA disulfide and o-CoAS2 . The results of studies with Clostridial phosphotransacetylase (EC 2.3.1.8) and pigeon muscle carnitine acetyltransferase (EC 2.3.1.7) were consistent with the action of o-CoAS2 as a CoA affinity analog on these enzymes . Inactivation was characterized by what appeared to be disulfide bonding between CoA and important sulfhydryl groups of the proteins.

Biochemistry, 1982 Dec 7, 21(25), 6366 - 75
Transient kinetics of electron transfer reactions of flavodoxin: ionic strength dependence of semiquinone oxidation by cytochrome c, ferricyanide, and ferric ethylenediaminetetraacetic acid and computer modeling of reaction complexes; Simondsen RP et al.; Electron transfer reactions between Clostridum pasteurianum flavodoxin semiquinone and various oxidants {horse heart cytochrome c, ferricyanide, and ferric ethylenediaminetetraacetic {horse heart cytochrome c, ferricyanide, and ferric ethylenediaminetetraacetic acid (EDTA)} have been studied as a function of ionic strength by using stopped-flow spectrophotometry . The cytochrome c reaction is complicated by the existence of two cytochrome species which react at different rates and whose relative concentrations are ionic strength dependent . Only the faster of these two reactions is considered here . At low ionic strength, complex formation between cytochrome c and flavodoxin is indicated by a leveling off of the pseudo-first-order rate constant at high cytochrome c concentration . This is not observed for either ferricyanide or ferric EDTA . For cytochrome c, the rate and association constants for complex formation were found to increase with decreasing ionic strength, consistent with negative charges on flavodoxin interacting with the positively charged cytochrome electron transfer site . Both ferricyanide and ferric EDTA are negatively charged oxidants, and the rate data respond to ionic strength changes as would be predicted for reactants of the same charge sign . These results demonstrate that electrostatic interactions involving negatively charged groups are important in orienting flavodoxin with respect to oxidants during electron transfer . We have also carried out computer modeling studies of putative complexes of flavodoxin with cytochrome c and ferricyanide, which relate their structural properties to both the observed kinetic behavior and some more general features of physiological electron transfer processes . The results of this study are consistent with the ionic strength behavior described above.

J Cell Sci, 1982 Dec, 58, 139 - 48
The mononuclear cell population in rat leg muscle: its contribution to the lysosomal enzyme activities of whole muscle extracts; Etherington DJ et al.; The mononuclear cell fraction of rat hind-limb muscle was obtained by digestion with clostridial collagenase in the presence of calcium ions, filtration through nylon screens and washing to remove the enzyme . Final traces of contaminant myofibrillar debris were separated by isopycnic centrifugation in a Percoll density gradient . Whole muscle, washed cells and Percoll-fractionated cells were extracted in the presence of non-ionic detergent and the supernatants assayed for the lysosomal enzymes cathepsins B + L, N-acetyl-beta-glucosaminidase, beta-glucuronidase and protein . The enzyme levels were highest in the muscle from young rats, but the percentage of recovered activity in the mononuclear cell fraction was little altered by the age of the animal . The values obtained were: cathepsin B + L, 2.4-4.0%; N-acetyl-beta-glucuronidase, 4.3-7.6%; and beta-glucuronidase, 6.3-10.3% . Because of unavoidable losses in preparation these are minimal values and the actual levels of activity from the mononuclear cell fraction in muscle would be higher . The specific activity values of the cell lysates were raised after isopycnic centrifugation and were nearly constant over the age range 65-180 days . Substantially higher specific activity values were obtained for the cells from rats of 38 days . When grown in culture the mononuclear cell fractions were seen to contain mainly fibroblasts and myoblasts with only few leucocytes . The cultures reached confluence by the second week, at which time numerous myotubes had formed . In addition there were groups of large, circular cells with a prominent centrosphere . The origin of these latter cells is uncertain . It was concluded that although total lysosomal enzyme activity was higher in young rats there was little effect of age on the distribution of activity between muscle fibres and mononuclear cells in the muscle.

Biochem J, 1982 Dec 1, 207(3), 479 - 84
Partial purification and characterization of an inhibitor from newborn-rat epidermis with activity against the proteinase of Schistosoma mansoni cercariae; Tzeng S et al.; The penetration of cercariae through the skin initiates infection of the host with the human trematode parasite Schistosoma mansoni . Many larvae fail to migrate into the living epidermal cell layer . In order to determine if chemical as well as mechanical barriers to cercarial skin penetration exist, inhibitory activity of epidermal cell extracts against the proteinase obtained from cercarial secretions was assayed . An inhibitor was purified 50-fold by gel filtration on Sephadex G 75 and cation exchange chromatography at pH 5.8 and 4.9 . The inhibitor has a relative molecular mass (Mr) of approx . 40 000-53 000 . Oxidation of the inhibitor with N-chlorosuccinimide eliminated its inhibitory activity and thus indicated a critical methionine residue . The inhibitor was active against a wide spectrum of serine proteinases: porcine pancreatic elastase, human granulocyte elastase, bovine trypsin, and bovine alpha-chymotrypsin . However, no inhibition was detected against papain or clostridial collagenase . The inhibitor did not cross react with antiserum to human or rat serum alpha 1-proteinase inhibitor.

J Bacteriol, 1982 Dec, 152(3), 1060 - 5
Pyruvate oxidation by the Reiter strain of Treponema phagedenis; George HA et al.; Spectrophotometric assays of pyruvate oxidation catalyzed by extracts of the Reiter strain of Treponema phagedenis indicated that viologen dyes, flavin nucleotides, and a ferric iron chelate, but not pyridine nucleotides, were utilized as electron acceptors . Benzyl viologen-linked activity partially sedimented during ultracentrifugation and appeared similar to clostridial pyruvate:ferredoxin oxidoreductase with respect to the spectral properties of the enzyme chromophore . Electron carrier activity in treponemal extracts was quantitated by a metronidazole-linked assay in which the oxidation of pyruvate by carrier-depleted extracts led to the reduction of electron carrier in the crude extracts which then reduced metronidazole . The rate of metronidazole reduction was proportional to the amount of electron carrier present in the assay . Electron carrier activity in Triton X-100-solubilized, crude extracts partially purified by DEAE-cellulose chromatography and gel filtration was attributed to a protein possessing the spectral and physical properties of a ferredoxin . A similar protein appeared to be present in extracts of Treponema denticola ST10.

J Bacteriol, 1982 Oct, 152(1), 201 - 7
Pathway of lysine degradation in Fusobacterium nucleatum; Barker HA et al.; Lysine was fermented by Fusobacterium nucleatum ATCC 25586 with the formation of about 1 mol each of acetate and butyrate . By the use of {1-14C}lysine or {6-14C}lysine, acetate and butyrate were shown to be derived from both ends of lysine, with acetate being formed preferentially from carbon atoms 1 and 2 and butyrate being formed preferentially from carbon atoms 3 to 6 . This indicates that the lysine carbon chain is cleaved between both carbon atoms 2 and 3 and carbon atoms 4 and 5, with the former predominating {1-14C}acetate was also extensively incorporated into butyrate, preferentially into carbon atoms 3 and 4 . Cell-free extracts of F . nucleatum were shown to catalyze the reactions of the 3-keto,5-aminohexanoate pathway of lysine degradation, previously described in lysine-fermenting clostridia . The 3-keto,5-aminohexanoate cleavage enzyme was partially purified and shown to have properties much like those of the clostridial enzyme . We conclude that both the pathway and the enzymes of lysine degradation are similar in F . nucleatum and lysine-fermenting clostridia.

J Med Microbiol, 1982 Aug, 15(3), 293 - 302
A reassessment of the microbial flora of the female genital tract, with special reference to the occurrence of Bacteroides species; Hammann R; Two hundred and twelve randomly selected vaginal or uterine cervical specimens were investigated for the presence of anaerobic and aerobic bacteria and yeasts . Anaerobes of possible clinical significance, including Bacteroidaceae, Peptococcaceae and clostridia were isolated from 34% of the specimens and were identified to specific or generic level . Among the Bacteroidaceae isolated, B . bivius was the most common, followed by other propionate-negative species . Members of the Bacteroides fragilis group were seldom isolated . Of the aerobic or facultatively anaerobic isolates, enterococci and Escherichia coli were most often found . The results show that clinically significant anaerobes, especially Bacteroides species, are not regular members of the vaginal flora and that the species distribution of anaerobes occurring in the genital tract is significantly different from that of the intestinal tract.

Clin Orthop, 1982 Aug, (168), 214 - 5
Tenosynovitis due to incense; Leonard MH; A 16-year-old girl accidentally incurred a puncture wound on an incense cone . The incense, like other ligneous materials, irritated the soft tissue and predisposed the radial bursa of the forearm to infection . The infectious organisms produced gas that was visible on roentogenographic examination . This caused concern until to Clostridia could be found in the wound . The bursal opening, secondary closure, and antibiotics produced a satisfactory result.

Med J Aust, 1982 Jun 12, 1(12), 515 - 9
Clostridial myonecrosis after resection of skin tumours in an immunosuppressed patient; Braithwaite PA et al.; This paper reports a case of clostridial myonecrosis (gas gangrene) which occurred in a vegetable gardener receiving immunosuppression therapy with prednisolone and azathioprine for renal allograft preservation . The infection developed after the excision of crusted squamous-cell carcinomata from the dorsum of the hand, the circulation of which was compromised by the presence of a radial artery/cephalic vein arteriovenous fistula . Amputation, followed by treatment with hyperbaric oxygen, was successful.

Biosci Rep, 1982 Jun, 2(6), 397 - 403
Large-molecular-weight somatostatin in human adrenal medullary tissue; Corder R et al.; Three human catecholamine-secreting adrenal medullary tumours, identified as phaeochromocytoma, were found to contain 774, 168, and 78 pmol/g of somatostatin-like immunoreactivity (SLI), compared to 40 pmol/g in a sample of normal human adrenal medulla . Sephadex-G50 gel-filtration chromatography of extracts from these tissues revealed SLI eluting in the position of somatostatin-14, somatostatin-28, and a peak eluting with a mol . wt . of about 5 K . After digestion of eluted material with clostridiopeptidase B, the predominant form of adrenal medullary SLI was found to elute in the position of a 7-K polypeptide.

Arthritis Rheum, 1982 Mar, 25(3), 318 - 25
Stimulation of DNA synthesis by ascorbate in cultures of articular chondrocytes; Krystal G et al.; The addition of 0.2 mM Na L-ascorbate increased the incorporation of 3H-thymidine by rabbit articular chondrocytes in cell and organ culture . The stimulatory response of explants to ascorbate was potentiated by pretreatment of the cartilage with 0.2% clostridial collagenase (type 1) or trypsin for 15-30 minutes . In explants there was a latent period of 3 to 4 days before increased labeling of the nuclei could be detected . The effect was transient and declined after 8 days of culture . It was more evident in organ cultures of immature (3-month-old) than 2- to 3-year-old rabbits . Age differences were not detected in cell cultures . Explants of adult human articular cartilage were stimulated by ascorbate when the medium was supplemented with 10% fresh human serum but not by fetal bovine serum . The findings indicated that synthesis of DNA by articular chondrocytes in situ is regulated by responsiveness of the cells proper to compounds such as vitamin C, by properties of the extracellular matrix, and by factors in the serum . Ascorbate was cytotoxic at concentrations greater than 0.2 mM in the presence of certain batches of serum.

South Med J, 1982 Mar, 75(3), 378 - 9
Spontaneous clostridial sepsis and sudden death; Andes WA; A neutropenic patient with leukemia treated successfully several times for infectious complications died suddenly after developing widespread gas formation in many tissues due to C septicum sepsis . Localized severe pain in a susceptible patient with few other signs or symptoms should alert the practitioner to the possibility of clostridial infection.

Am J Med Sci, 1982 Mar-Apr, 283(2), 94 - 8
Case report . Fatal gas gangrene following intra-articular steroid injection; Yangco BG et al.; Gas gangrene is a rare infectious disease syndrome complicating medico-surgical procedures . We describe a case of gas gangrene secondary to intra-articular steroid injection . Clostridia species and Escherichia coli were the etiologic organisms in this case . The presence of underlying diseases such as diabetes mellitus, hepatic insufficiency, and metabolic acidosis could have contributed to the fatal outcome of this patient . A high index of suspicion, early diagnosis, and appropriate treatment may improve the prognosis in gas gangrene . Although uncommon, infection is a significant complication of intra-articular steroid administration . Thus, meticulous aseptic technique should always be observed in the performance of this procedure.

Arkh Patol, 1982, 44(12), 69 - 72
{Anaerobic clostridial infection of surgical wounds}; Sidorin VS et al.; Two cases of anaerobic clostridial infection in operative wounds of the anterior abdominal wall in women of 65 and 86 are presented . The infection developed by the second or third day following surgical intervention for small intestine ileus . Death occurred with septic shock manifestations 10-13 hours after the onset of the first clinical symptoms of infectious complications which were contributed to by late hospitalization of the patients, inadequate antibacterial treatment as well as age-dependent decrease of immunologic responsiveness . An increasing incidence of anaerobic operative wounds infection is noted.

Microbiol Immunol, 1982, 26(10), 877 - 84
Variable sugar fermentation by clostridia; Nakashio S et al.; Forty-two sugar fermentation characteristics recorded as "d" in the 8th edition of Bergey's Manual of Determinative Bacteriology were reinvestigated by using eight different peptone media and 205 strains of nine species of pathogenic clostridia . In the absence of sugar, the final pH of 7-day cultures in the basal medium varied widely depending on the peptone employed, the species tested, and even the strain of the species . In the presence of sugar, the final pH of 7-day cultures was markedly influenced by these factors . Since the sugars with reactions recorded as "d" were weakly fermented and, consequently, the fermentation reactions were easily affected by cultural variations resulting in strain instability, we employed the pH difference method (delta pH method) in which the pH difference of 0.5 between cultures with and without sugar was used as the critical level . Thirty-six (86%) of the 42 sugar reactions recorded as "d" were sorted into "+" or "-" by the delta pH method . Six sugars, however, still remained as "d" because of their extremely weak fermentation characters . The use of the delta pH method in any peptone medium not only minimizes incorrect evaluation but also can provide some distinct criteria for identification of clostridia.

Lab Invest, 1982 Jan, 46(1), 1 - 9
In vitro correlates of endothelial injury and repair; Fillit HM et al.; The effects of immune complexes, microbial components, and glomerular basement membrane on cultured human umbilical endothelial cells were assessed in vitro using phase contrast microscopy, cell counts, 51Cr release, and terminal tritiated thymidine-labeling assays . Neither heat-aggregated IgG nor bovine serum albumin-antibovine serum albumin immune complexes altered endothelial cell growth as measured by cell counts, thymidine labeling, and phase contrast microscopy, nor did immune complexes induce cytotoxicity as measured by 51Cr release . Some microbial components appeared cytotoxic to endothelial cells, other microbial components had no effect, and one, clostridial neuraminidase, induced proliferation of endothelial cells as measured by phase contrast microscopy, cell counts, and thymidine labeling . Native and glycosidase-altered glomerular basement membrane also enhanced endothelial cell thymidine labeling . These studies show that microbial components directly alter endothelial cell growth in vitro, whereas immune complexes by themselves do not . Thus, in vivo microbial components by themselves may directly affect endothelial cells and cause vascular pathology, whereas immune complexes presumably must recruit other inflammatory systems to affect endothelial cells . Alterations of basement membrane during inflammation may also affect endothelial growth and, thus, vascular pathology.

Surg Gynecol Obstet, 1982 Jan, 154(1), 27 - 33
Ischemic proctitis; Nelson RL et al.; The rectum is rarely involved in ischemic colitis because of its abundant collateral blood supply . Thus, other forms of inflammatory intestinal disease, such as antibiotic associated or infectious colitis, are considered to be more likely if the rectum is inflamed . Yet, collateral flow develops slowly . Therefore, ischemic proctitis does occur in instances of sudden occlusion of the major blood supply to the rectum, such as after an aortic operation . The histopathology of this condition does not differ from that of infectious colitides, and the diagnosis of ischemic colitis can only be confirmed after careful culturing and assessment of the stool for clostridial toxins . Penile Doppler pressure measurements, as demonstrated in the patient presented herein, may be a simple, noninvasive method of inferring rectal blood flow and, therefore, aid in the diagnosis of ischemic proctitis.

Urol Res, 1982, 10(3), 135 - 40
Collagenase for Peyronie's disease experimental studies; Gelbard MK et al.; This pilot study was designed to test the feasibility of using purified clostridial collagenase in the clinical management of Peyronie's disease . The basic properties of this agent are discussed . We studied its effect on Peyronie's plaque tissue by a quantitative in vitro assay utilising the liberation of free alpha-amino groups as an index of enzymatic collagenolysis . Tissue from three patients with Peyronie's disease was used . Tunica albuginea from a second group of three normal patients was studied in the same manner, and no selectivity for the collagen of Peyronie's plaques was identified . Utilising human pericardium as a uniform collagenous substrate, a simple dose-effect relationship was established, and the distribution characteristics of injected collagenase observed . Its effects on blood vessels and nerves in vivo was determined as well as the effects of collagenase on the histology of normal and diseased human tissue in vitro . A tentative dose for use in Peyronie's disease was established, which is discussed in light of existing toxicological data . The study was designed to test the feasibility of purified collagenase in the clinical management of Peyronie's disease . Data included detail plaque digestion and dose-effect relationships in vitro, as well as the histological effects on plaques, blood vessels, and nerves in vivo and in vitro . It is concluded that collagenase may warrant further clinical testing in the treatment of Peyronie's disease.

Acta Derm Venereol, 1982, 62(3), 185 - 91
Desmosome formation in normal human epidermal cell culture; Hino H et al.; Keratinocytes were dissociated from normal human adult epidermis with clostridial collagenase, dithio-erythritol and trypsin, and cultured . Immediately after this, no connection was seen between contiguous cells . Ruptured desmosomes, with masses of tonofilaments and distinct attachment plaques were still left on the cell surface . As culture proceeded, however, they became internalized into cytoplasm . As soon as culture was started and the cells established contact with each other, forming conglomerates, they began to form desmosomes . The cell membranes of a limited area which were in contact with neighbouring cells became thicker and formed attachment plaques . In the intercellular space of the desmosomal portion, fine filaments developed and a midline formed . The progress of desmosome formation was classified into six types.

Int J Fertil, 1982, 27(3), 176 - 80
Estimation of hyaluronidase activity of human semen and its relationship with sperm density by means of a simplified method; Singer R et al.; Hyaluronidase activity was examined in 109 specimens of human semen of various sperm densities, seminal plasma, and spermatozoa sedimented by centrifugation . We used a modification of a method originally devised for estimation of hyaluronidase activity in Clostridia and which was bases on measurements of the area of hyaluronate digestion in agar plates . Enzyme activities in both semen and seminal plasma increased with increase in sperm density . The activity in seminal plasma, which appeared promptly after liquefaction and represented enzyme released from spermatozoa, ranged from 31% to 61% of the activity in semen . Activities of spermatozoa in sediments exhibited lower values than those calculated for sperm of whole semen, possibly due to leakage . Both activities, calculated per million sperm cells, gradually increased with decrease in sperm density . The possibility that with severe oligozoospermia the acrosome may become less prone to enzyme release or that the initial activity per cell may increase is discussed . These phenomena would represent additional characteristics of oligozoospermia.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1981 Dec, 251(1), 83 - 113
{Differentiation of pathogenic clostridia from material collected in the field and of reference strains by means of biostatistical analysis of the quantitatively recorded metabolic fatty acid patterns of the agents (author's transl)}; Seifert HS et al.; 34 reference and 9 exotic field strains of clostridia were analyzed by means of gas liquid chromatography (GLC) on their patterns of metabolic short chain fatty acids . To increase the number of criteria for the differentiation specimens were grown on pepton yeast medium with addition of 13 different carbohydrates and alcohols . Data of sequence and mean square space of GLC-peaks were stored in a data bank . With the SPSS discriminance analytical system the field strains were compared with the reference strains in order to classify field to reference strains . At the same time differences between reference strains of different origin were determined . C . novyi, C . histolyticum., C . sordellii, C . difficile, C . subterminale and C . sporogenes could be separated clearly from the C . chauvoei-, C . septicum- and the perfringens-group . Between different strains of C . chauvoei provided by several laboratories significant differences could be shown which make original classification doubtful . Similarities between the C . chauvoei- and the C . septicum-group do exist . Formerly C . perfringens type F is the sole type of C . perfringens which can be separated from the C . perfringens-group . There are similarities in fatty acid patterns between the C . chauvoei-, C . septicum-, and C . perfringens-group . Strains isolated from field cases of gas gangrene in Peru, Madagascar and Germany (Bavaria) were classified as completely different from the reference strains for Peru, partly similar to C . chauvoei for Madagascar, similar to C . chauvoei and C . septicum for Bavaria.

JAMA, 1981 Oct 9, 246(15), 1717 - 21
Severe necrotizing soft-tissue infections . Multiple disease entities requiring a common approach; Dellinger EP; The spectrum of severe soft-tissue surgical infections extends from synergistic necrotizing soft-tissue infections to histotoxic clostridial infections . These syndromes may demonstrate dramatic destruction of underlying tissue far out of proportion to the external evidence for infection, although a marked systemic response in common . The differential diagnosis hinges on the clinical presentation, the Gram's stain, and operative inspection . More important than the precise label placed on a given case is the early recognition of the urgent surgical nature of the infection . Signs indicating a rapidly spreading soft-tissue infection mandate fluid resuscitation, broad-spectrum antibiotics, and early operative exploration with aggressive debridement . These are highly lethal infections in which timely recognition and effective management may be lifesaving.

J Biol Chem, 1981 Sep 25, 256(18), 9737 - 41
Further characterization of the structure of GM1b ganglioside from rat ascites hepatoma; Matsumoto M et al.; A ganglioside named GM1b (Hirabayashi, Y., Taki, T., and Matsumoto, M . (1979) FEBS Let . 100, 253-257) with a sugar composition identical with that of GM1, II3 alpha NeuAc-GgOse4Cer (Gal beta 1 leads to 3GalNAc beta 1 leads to 4Gal(3 leads from 2 alpha NeuAc) beta 1 leads to 4G1c beta 1 leads to 1'ceramide), isolated from rat ascites hepatoma was further characterized . In contrast to GM1, the sialic acid in this ganglioside was susceptible to clostridial sialidase in the absence of bile salts . Based on the sequential enzymic hydrolysis, permethylation analysis and direct probe mass spectrometric analysis, the structure of this ganglioside is determined to be: NeuAc alpha 2 leads to 3Gal beta 1 leads to 3GalNAc beta 1 leads to 4Gal beta 1 leads to 4Glc leads to ceramide . The structure of this ganglioside is identical with that biosynthesized in vitro (Stoffyn, A., Stoffyn, P., and Yip, M . C . M . (1975) Biochim . Biophys . Acta 409, 97-103).

Cancer Res, 1981 Sep, 41(9 Pt 2), 3761 - 3
Nature of tissue-bound lithocholic acid and its implications in the role of bile acids in carcinogenesis; Turjman N et al.; Lithocholic acid, a monohydroxy secondary bile acid, is present in tissues in two forms . One form is extractable with 95% ethanol-0.1% ammonia (soluble lithocholate), and the other form is firmly bound to tissue residues and can be released only by the bile salt-deconjugating enzyme, clostridial cholanoylamino acid hydrolase (tissue-bound lithocholate) . Studies on bile salt-protein interactions revealed that lithocholic acid had amino group-modifying activity specifically directed against the basic side group of lysine residues . Degradative procedures yielded N-epsilon-lithocholyllysine, confirmed by comparison with the authentic compound synthesized in our laboratories . Studies on the distribution of tissue-bound lithocholate in tissues have revealed high concentrations of this form of lithocholate in livers of rats treated with the carcinogen, methylazoxymethanol . In light of these observations, the role of bile acids, and specifically lithocholic acid, as promoters of tumorigenesis must be further investigated.

Lancet, 1981 Aug 1, 2(8240), 219 - 22
Response to single dose of tetanus vaccine in subjects with naturally acquired tetanus antitoxin; Dastur FD et al.; Tests among 410 Indians not artificially immunised against tetanus showed that 80% had measurable antitoxin . Single doses (100 Lf or 250 Lf) of a potent tetanus toxoid were given to such individuals with naturally acquired antitoxin . The 100 Lf dose produced on average a ten-fold rise in antibody level, and the 250 Lf dose a twenty-fold rise . In adults who had been artificially immunised, a 5 Lf dose produced a four-fold to ten-fold rise in antibody level . In infants three doses of triple vaccine produced satisfactory antitoxin concentrations . The levels of antibody achieved after a single 250 Lf dose should protect for 5 years . Single-dose vaccination may be better than the conventional three-dose scheme for a population that is unlikely to comply with a three-dose regimen and in whom naturally acquired antitoxin is associated with partial tolerance to tetanus toxoid . Naturally acquired antitoxin in Indians is probably the result of chronic clostridial contamination of the small bowel . This contamination can induce immune tolerance in the gut and systemically and may be the reason for the poor responses to vaccination in all except infants.

Surg Gynecol Obstet, 1981 Jul, 153(1), 28 - 30
Atypical clostridial bacteremia; Fry DE et al.; Forty-seven patients identified with clostridial bacteremia not characterized by histotoxicity were studied to define better the clinical presentation and results of treatment . Patients were categorized into three groups--one, elderly debilitated patients with multiple associated illnesses and no identifiable focus of infection; two, patients with alcoholism and systemic complications of alcohol abuse and no primary focus of infection, and three, patients with a mechanically treatable primary focus of infection . The over-all mortality was an unacceptable 57 per cent . Antibiotic therapy apparently did not affect the survival rate . Portal bacteremia and ineffective hepatic reticuloendothelial function may be significant factors in those patients without a primary focus of infection.

J Thorac Cardiovasc Surg, 1981 Jul, 82(1), 98 - 102
Transmediastinal repair of complex coarctation and interrupted aortic arch; DeLeon SY et al.; In the past 2 years, eight patients have had repair of coarctation of the aorta or interrupted aortic arch along with an intracardiac procedure performed through a simple midsternotomy . Five underwent total repair and three had palliation for the intracardiac lesion . Four patients did well (including one who required a resection for recoarctation), two died intraoperatively, and two died postoperatively (11 and 21 days), one of them from clostridial sepsis and the other from cerebral anoxia that followed a cardiac arrest precipitated by a massive hemoptysis . We found that with this approach the aortic obstruction could be readily relieved and the intracardiac procedure carried out . Since the majority of these patients have compromised hemodynamic status, the ease of instituting immediate bypass, avoidance of a separate incision, and feasibility of total repair are major advantages.

Biochim Biophys Acta, 1981 Jun 15, 659(2), 457 - 65
The effect of electron carriers and other ligands on oxygen stability of clostridial hydrogenase; Khan SM et al.; The effects of various electron carriers, a substrate (H2) and a reversible inhibitor (CO) on the rate of irreversible oxygen inactivation of clostridial hydrogenase (ferredoxin: H+ oxidoreductase, EC 1.18.3.1) have been studied kinetically . Some electron carriers (e.g., clostridial ferredoxin and methyl viologen) greatly stabilize the enzyme, some (FAD, FMN) drastically reduce its stability, while others (benzyl viologen and methylene blue) only slightly alter the stability . Competitive experiments indicate that stabilizers and destabilizers do not compete with each other for binding with the active center of hydrogenase . Hydrogen and CO do not affect the rate of the oxygen inactivation . On the basis of the results obtained herein and kinetic data on hydrogenase catalysis from the literature, it is concluded that the active center of this hydrogenase comprises at least three different independent subsites . The first one (presumably an iron atom of the iron-sulfur cluster) binds H2 and CO and does not contribute to the oxygen stability . The second one binds stabilizers like methyl viologen while the third one binds destabilizers like FMN and FAD.

J Lipid Res, 1981 May, 22(4), 652 - 8
Epimerization of chenodeoxycholic acid to ursodeoxycholic acid by human intestinal lecithinase-lipase-negative Clostridia; Edenharder R et al.; Six strains of lecithinase-lipase-negative Clostridia, isolated from human feces, were capable of oxidizing chenodeoxycholic acid to 3 alpha-hydroxy-7 keto-5 beta-cholanoic acid and of epimerizing it to ursodeoxycholic acid . The identity of the reaction products was confirmed by comparing their mass spectra, obtained by combined gas-liquid chromatography-mass spectrometry, with those of authentic reference compounds . 3 alpha-Hydroxy-7-keto-5 beta-cholanoic acid was reduced by growing cultures of all clostridial strains to chenodeoxycholic acid and to ursodeoxycholic acid, the latter being the preferred conversion product of most strains . However, ursodeoxycholic acid was not attacked by any of the strains . Growth kinetic experiments with three strains showed that chenodeoxycholate was transformed during the log or lag phase . No bile acid conversion could be seen during the stationary phase . While the concentration of chenodeoxycholic acid decreased and that of ursodeoxycholic acid increased tending towards plateaus, and concentration of 3 alpha-hydroxy-7-keto-5 beta-cholanoic acid passes through a maximum . We proposed a reaction sequence with 3 alpha-hydroxy-7-keto-5 beta-cholanoic acid as an intermediate for the epimerization of chenodeoxycholic acid to ursodeoxycholic acid . This demonstration is the first using isolated bacterial strains.

J Am Diet Assoc, 1981 May, 78(5), 483 - 9
Sensory and microbiological qualities of beef loaf in four commissary food service treatments; Rini MJ et al.; Beef loaf prepared according to four treatment options occurring in commissary food service was evaluated for microbiological and sensory quality . General acceptability was scored significantly (p of less than 0.01) higher for beef loaf portions held hot for 1 hour than for those held 2 hours, or those chilled 24 hours and heated in a convection oven . No significant (p of less than 0.01) differences for any quality characteristic scored were found between a loaf held hot for 1 hour and that chilled for 24 hours, heated, and then held hot for 1 hour . Appearance of beef loaves held hot for 1 hour was significantly (p of less than 0.05) better than that of loaves heated in the convection oven but was not significantly better than that of loaves given any of the other treatments . Microbiological analyses revealed the presence of relatively small numbers of microorganisms and no significant differences among treatments . The lowest total plate count was found in loaves baked, chilled for 24 hours, heated in a gas deck oven, and then held in insulated plastic trays for 1 hour . The highest counts were for loaves which were baked, placed immediately in insulated plastic trays, and held for 1 hour . Increases in total microbial counts and clostridial counts were observed as meat was held chilled for 24 hours . But no increases were observed when meat was held for 2 hours in insulated plastic trays . Although these microbiological findings were not significant, data may have important implications for an actual operation, where conditions are not so carefully controlled.

J Trauma, 1981 May, 21(5), 349 - 55
Progressive necrotizing surgical infections--a unified approach; Kaiser RE et al.; Four types of progressive necrotizing surgical infections have been described, based on the type of infecting organism, the type and depth of soft tissue penetration and clinical findings, and the type of surgical therapy recommended, e.g., necrotizing fasciitis, clostridial cellulitis . A mortality rate of up to 50% continues to be reported . An experience with 20 such cases indicates that there is a considerable overlap in clinical-physical findings and bacteriology such that classification schemes are confusing and lead to treatment delays and the use of inappropriate therapy . The infections all seem to be variations of the same disease process, a spreading, necrotizing infection . Of the 20 cases, four were treated with antibiotics and delayed (1 to 3 days) excision of necrotic tissue with 75% deaths; four cases received antibiotics and multiple surgical incisions with 100% deaths . The other 12 cases were treated with a unified approach of resuscitation, antibiotics (penicillin, clindamycin, tobramycin), immediate surgical excision (3 to 4 hours) of all necrotic tissue, aggressive nutritional support, and early skin coverage, with an 8.3% mortality . We conclude that there seems to be no need to classify necrotizing infections into different types . Recognizing them as the same disease process and treating them with a unified approach resulted in a significant reduction in mortality.

Biol Bull Acad Sci USSR, 1981 May-Jun, 8(3), 223 - 30
Regulation of fatty acid composition of Cl . perfringens type A cells by hydrogen and hydroxyl ions; Sinyak KM et al.; The composition of the fatty acid profiles of Cl . perfringens type A, grown on media with initial pH values from 5.5 to 9.0, was determined by the method of gas-liquid chromatography . The fatty acid profiles are stabilized in 18- to 24-h cultures . Hydrogen ions stimulate the synthesis of cyclopropane carboxylic fatty acids and "desaturase" activity; hydroxyl ions inhibit these processes . The content of saturated fatty acids in the bacteria is regulated by the initial acid-alkaline conditions of the medium . An increase in biomass accumulation under the influence of hydroxyl ions is coupled with a decrease in the energy supply of the bacteria . Possible mechanisms of the development of resistance to hydrogen and hydroxyl ions during the cultivation of Clostridia on a period growth medium are discussed.

MMW Munch Med Wochenschr, 1981 Apr 24, 123(17), 691 - 4
{Emphysematous cholecystitis (author's transl)}; Togel H et al.; Emphysematous cholecystitis is a dangerous form of acute cholecystitis . Preoperative early diagnosis can only be made radiologically and is based on the presence of gas in the gallbladder, the gallbladder wall, or in the pericholecystic space . Cholelithiasis occurs in only 50% of cases, more often in men, significantly more frequently in diabetics . Bacteriologically, organisms of the clostridia group are predominant, but bacteriology is altogether negative in ca . 50% of cases.

Nouv Presse Med, 1981 Feb 26, 10(8), 556 - 8
{In vitro activity of cefotaxime on anaerobes (author's transl)}; Soussy CJ et al.; The comparative activity of cefotaxime, cefazolin, cefamandole and cefoxitin was studied on 80 strains of anaerobic bacterial species: 14 Clostridia, 60 Bacteroides fragilis, 6 Peptococcus . The new cephalosporins showed an increase in the in vitro activity against Bacteroides fragilis, but their efficacy was still inferior to that of the 5-nitro-imidazole derivatives.

J Med Microbiol, 1981 Feb, 14(1), 63 - 76
Neuraminidase production by Bacteroidaceae; Fraser AG et al.; The production of neuraminidase (EC 3.2.1.18) by 77 strains of Bacteroidaceae was investigated by techniques previously used to study neuraminidase production by clostridia . Conditions for culture and assay of Bacteroides fragilis neuraminidase were characterised . The enzyme is predominantly cell associated; it is not calcium dependent and the pH optimum for its production is c . 4.5 . Most neuraminidase-positive Bacteroides strains produced the enzyme well in the test media but a few strains failed to produce it consistently in one or other of the media . Because of these occasional variations, strains were grown and tested in at least two media before being defined as neuraminidase negative . Within the B . fragilis group of species, B . fragilis, B . vulgatus, B . distasonis, B . ovatus, B . thetaiotaomicron and B . variabilis were neuraminidase positive while B . eggerthii, B . uniformis and B . splanchnicus were negative . Two subspecies of B . melaninogenicus (ss . melaninogenicus and ss . levii) were positive but the other (ss . intermedius) was negative . Strains of B . oralis and B . bivius produced the enzyme while B . ruminicola, B . disiens, B . asaccharolyticus and B . corrodens did not . The microaerophilic B . ochraceus were also positive . None of the Fusobacterium or Leptotrichia species tested produced neuraminidase . Our results for neuraminidase production are consistent for all strains of each species examined and we suggest that tests for neuraminidase production would be a valuable addition to biochemical tests currently used in taxonomic studies of the Bacteroidaceae.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1981, 174(1-2), 91 - 104
{The significance of the bacterial steroid degradation for the etiology of large bowel cancer . VIII . Transformation of cholic-, chenodeoxycholic-, and deoxycholic acid by lecithinase-lipase-negative clostridia}; Edenharder R et al.; In order to examine their bile acid transforming capacities, lecithinase-lipase-negative Clostridia, 40 strains, isolate from the feces of patients with large bowel cancer, were cultivated in Schaedler broth containing either cholic, chenodeoxycholic or deoxycholic acid (250 muM) . Gas chromatographic analysis of bile acids as hexafluoroisopropylester-trifluoroacetates {on QF-1} showed that 14 strains (35%) attacked cholic acid and 13 strains (32%) chenodeoxycholic acid . Deoxycholic acid, however, was not attacked . About half of the strains transformed cholic and chenodeoxycholic acids as well to one or two products respectively . The metabolites were identified as 3 alpha, 12 alpha-dihydroxy-7-keto-5 beta-cholanoic acid, 3 alpha, 7 beta, 12 alpha -trihydroxy-5 beta-cholanoic acid resp . 3 alpha-hydroxy-7-keto-5 beta-cholanoic acid, and 3 alpha, 7 beta-dihydroxy-5 beta-cholanoic acid (ursodeoxycholic acid) by gas chromatography an combined gas chromatography-mass spectrometry . The Clostridial strains tested here are the first which have proved able to epimerize the 7 alpha-hydroxyl groups of bile acids . We could, however, find no relevance to the etiology of large bowel cancer.

Injury, 1981 Jan, 12(4), 288 - 90
Unusual gas-forming infection with Escherichia coli; Aghasi MK et al.; Infections with non-clostridial gas-forming organisms are not often encountered in orthopaedic practice . We present here a case of gas-forming infection with Escherichia coli which occurred 10 months after internal fixation of a closed fracture of the femur in an 84-year-old diabetic woman who suffered from septic nephrolithiasis . The wound infection was considered to have arisen by spread from the organisms of the infected kidney.

Scand J Infect Dis Suppl, 1981, 26, 19 - 23
The need for and choice of chemotherapy for anaerobic infections; Selkon JB; The Clostridia remain a frequent cause of anerobic infections and they also remain fully sensitive to benzylpenicillin, which continues to be the antibiotic of choice in their treatment . Penicillin is also the first choice for the treatment of dental and pulmonary infections due to anaerobic bacteria . However, currently the anerobic pathogen most frequently encountered in infections related to the gastro-intestinal and genital tracts is Bacteroides fragilis, an organism which produces beta-lactamase active against both the penicillins and cephalosporins . The antibiotics available for the treatment of B . fragilis infections are the tetracyclines, chloramphenicol, clindamycin, metronidazole and cefoxitin . Since at least 30% of strains of B . fragilis are now resistant to tetracycline and in view of the serious potential toxicity of chloramphenicol, the choice of agent thus lies with the latter three antimicrobial agents . If the in vitro activity of these agents is considered in relation to their pharmacodynamics, it is clear that only clindamycin and metronidazole can be expected to be effective in over 90% of infections with B . fragilis . Studies of the bactericidal activity of these agents against B fragilis have shown a kill of greater than 10(7) in 6 hours in metronidazole, of 10(5) to 10(6) in 30 hours in clindamycin and of 10(2) in 24 hours with cefoxitin.

Am J Pediatr Hematol Oncol, 1981 Summer, 3(2), 127 - 33
Cyclic neutropenia . A tale of two brothers and their family; Lange RD et al.; A family history encompassing four generations is presented . Definite cyclic neutropenia has been noted in two generations . In one member, the symptoms abated as she grew older . One 12-year-old member died of clostridial septicemia secondary to gangrene of the terminal ileum . At autopsy he was found to have amyloidosis . A trial of lithium carbonate therapy was carried out in a 7-year-old male but a positive hematologic response was not obtained.

Vet Med Nauki, 1981, 18(9), 37 - 42
{Method of determining the biochemical behavior of clostridia}; Petkov A et al.; A fast and readily applicable method is suggested for the determination of the biochemical reactions of the spore producing anaerobic organisms . A pepton coloid medium with the addition of 0.15 per cent agar-agar was used as a basic nutrient medium . The cultivation of bacteria did not require any special conditions . Reading of the results was carried out with the addition of 0.1 per cent phenol red after 48 hours of incubation of the cultures . This method showed a number of advantages over the methods used so far.

Appl Environ Microbiol, 1981 Jan, 41(1), 90 - 2
Survival of clostridial spores in animal tissues; Gill CO et al.; Spores injected intravenously into mice in numbers in excess of 10(2)/g of body weight were initially dispersed to most organs, but after a few days the remaining spores were concentrated in the liver, from which they were eliminated with a half-life of about 6 days . Intraperitoneal injection did not result in contamination of organs unless initial spore numbers exceeded 10(5)/g of body weight, in which case the spores behaved in the same manner as those injected intravenously . Oral administration of spores did not result in any contamination of tissues.

Dis Colon Rectum, 1980 Nov-Dec, 23(8), 570 - 1
Fatal clostridial infection following hemorrhoidal banding; O'Hara VS; A case is described in which death followed banding of hemorrhoids . The clinical course was suggestive of overwhelming toxemia due to clostridia.

Arch Ophthalmol, 1980 Oct, 98(10), 1829 - 39
Bacterial collagenase . Proposed adjunct to vitrectomy with membranectomy; Moorhead LC et al.; Clostridiopeptidase A digested preretinal cicatricial tissue without causing morphological alteration of normal retina during a 30-minute incubation in the rabbit . Light and transmission electron microscopy were used to determine effects on the inner limiting membrane and retinal ganglion and Muller's cells and to evaluate enzyme digestion of preretinal scarring . Removal of the injected collangenase by vitrectomy resulted in normal electroretinograms and retinal morphology 48 hours postoperatively . If the enzyme was left in the eye for 24 hours, lens opacities, partial erosion of the inner limiting membrane, and extensive hemorrhage resulted . The specificity of action of the collagenase is due to the high degree of purity of the enzyme used and a substantial biochemical difference between scar collagen and basement membrane collagen . The injection of purified collagenase capable of digesting vitreal scar tissue while leaving the retina undamaged could represent a new approach to vitrectomy, specifically to facilitate certain cases of membranectomy.

Chest, 1980 Oct, 78(4), 622 - 5
Clostridial pleuropulmonary infection; Spagnuolo PJ et al.; Primary clostridial pleuropulmonary infection occurred in two patients . The pathogenesis of infection was related to aspiration of oropharyngeal contents or hematogenous seeding of infarcted lung tissue . One patient was cured with penicillin; the other died secondary to sepsis and respiratory failure . Review of 13 additional cases from the literature demonstrated pulmonary infection due to Clostridia to be characterized by lobar or multilobar disease with uniform involvement of the pleura . Iatrogenic contamination of the pleural space may play some role in the pathogenesis of infection . The treatment of choice is penicillin and drainage of infected pleural fluid . The disease appears similar to other forms of bacterial empyema, although in some patients, a fulminant, fatal course may be seen.

J Pediatr Surg, 1980 Aug, 15(4), 558 - 64
A bacteriologic basis for the clinical presentations of necrotizing enterocolitis; Kosloske AM et al.; A study to identify putative bacterial pathogens in infants with necrotizing enterocolitis (NEC) was begun in 1976 . Cultures of blood and of peritoneal fluid obtained by paracentesis were carried out in 25 infants with NEC . Segments of intestine excised at operation were Gram stained . Of the 25 infants, 8 recovered with medical management and 17 required operations . The 8 medically treated infants had sterile peritoneal fluid and, with 2 exceptions, sterile blood cultures . Of the 17 operated infants, 16 had bacteria in their blood and/or peritoneal fluid . The majority of resected bowel specimens from these infants contained a confirmatory morphologic type of bacterium within the wall . The clinical course of 8 infants with clostridia was compared to that of 8 infants with gram-negative enteric bacteria (Klebsiella, E . coli, or Bacteroides fragilis) . The infants with clostridia were sicker . They had more extensive pneumatosis intestinalis, a higher incidence of portal venous gas, more rapid progression to gangrene, and more extensive gangrene . Infants with gram-negative rods had lower birth weights and lower platelet counts than the clostridial group . The difference in mortality between the two groups was not significant . The inherent pathogenicity of the gut flora may influence the clinical course of NEC . Among infants who develop intestinal gangrene, the clostridia appear to be more virulent than gram-negative enteric bacteria.

J Wildl Dis, 1980 Jul, 16(3), 315 - 7
Clostridial myonecrosis in a black bear associated with drug administration; Barnes DM et al.; Publication Types:

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