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| Aust Vet J, 1980 Jun, 56(6), 292 - 5 Levamisole vaccine combinations . 2 . Retained anthelmintic efficacy; Forsyth BA et al.; Levamisole can be combined with polyvalent clostridial vaccine so as to retain the activity of both components . Antibody response is heightened and the anthelmintic activity of levamisole is unimpaired . Tissue reactions at the injection site are acceptable being within the normal range of each component when given separately. Helv Paediatr Acta, 1980 May, 35(2), 121 - 8 Necrotising enterocolitis and neuraminidase-producing bacteria; Seger R et al.; In 9 out of 26 newborns with necrotising enterocolitis (NEC) exposure of the Thomsen-cryptantigen (T-antigen), probably due to the action of circulating bacterial neuraminidase, was demonstrated on red blood cells . The serological titres seemed to correlate with the clinical course of the disease . Neuraminidase-producing clostridia were isolated in two of the patients . Reaction between the exposed T-antigen and anti-T-agglutinins, normally present in human blood, may lead to difficulties during blood transfusion . This potential transfusion hazard is best avoided by routine T-antigen-tests and by transfusion of packed or washed red blood cells to T-antigen-positive patients. Clin Orthop, 1980 May, (148), 233 - 6 Gas gangrene in a wound treated without skin closure: a case report; Buchanan JR et al.; Clostridial myonecrosis developed in a compound tibial fracture wound left open after extensive surgical debridement . The patient survived after having a below-knee amputation and postoperative erythromycin . Prophylactically administered cephalothin failed to prevent the clostridial infection. South Med J, 1980 May, 73(5), 676 - 8 Thrombotic thrombocytopenic purpura after a dogbite; Mars DR et al.; A man bitten by a pet dog had fulminant thrombotic thrombocytopenic purpura within 72 hours . Rhabdomyolysis was severe and acute anuric renal failure was present . The suspected causative agent was Pastuerella multocida or clostridia with possible endotoxemia, though early treatment precluded a definitive diagnosis . The patient responded dramatically to a combined therapeutic approach of antibiotics, steroids, splenectomy, and supportive hemodialysis. South Med J, 1980 Apr, 73(4), 427 - 9, 432 Isolation and evaluation of clostridia from clinical sources; Lewis JF et al.; During a two-year period, 133 isolates of clostridia from clinical courses were obtained . These isolates are reviewed as to clinical significance and antimicrobial susceptibility . Adequate charts were available on 63 patients, nine (14%) of whom had their clinical source significantly altered by the presence of clostridia . Clostridia of little or no clinical significance were isolated from blood cultures from six patients . The occurrence of clostridial infections is unpredictable, and adequate clinical information is necessary to determine the need for identification of clostridial isolates. Klin Wochenschr, 1980 Apr 1, 58(7), 337 - 45 {Antibiotic-associated diarrhoea and enterocolitis (author's transl)}; Loeschke K; Many antibiotics, particularly the lincomycins, may cause diarrhoea with or without enterocolitis . The pathogenesis of antibiotic-associated diarrhoea without colitis is uncertain; colloidosmotic water binding in the colon by endogenous glycoproteins undegraded by colonic bacteria is considered . Antibiotic-associated enterocolitis is now known to be due to toxin-producing clostridia, proven for Cl . difficile . Improved methods for the detection of toxin and clostridia are presently being studied . Endoscopically, pseudomembranes are characteristic but not antibiotic-specific, they may be absent or missed diagnostically . A possible role of asymptomatic clostridia-carriers in enterocolitis clustering remains to be determined . The potentially lethal course of the disease requires rapid diagnosis and therapy, with discontinuation of the antibiotic, intensive supportive measures and, at least in severe disease, oral vancomycin. Gut, 1980 Apr, 21(4), 265 - 78 Pathogenesis of necrotising enteritis with special reference to intestinal hypersensitivity reactions; Arseculeratne SN et al.; The aetiological aspects of 83 sporadic cases of necrotising enteritis (NE) have been studied . Of 56 cases in which histology of the intestine was possible, eight showed appearances (oedema and local eosinophilia) suggestive of a type I hypersensitivity reaction, while in 37 the appearances were suggestive of a type III reaction . We suggest that these reactions, which were more common in children and young adults, were initiating factors in the intestinal necrosis . The type III reactions (submucosal arteritis, fibrinoid necrosis of arteriolar walls, intramural and perivascular infiltration with polymorphonuclear, mononuclear, and eosinophil cells, and submucous oedema) were in seven cases accompanied by extraintestinal lesions (hypercellularity of glomeruli, amorphous material in the Bowman's capsular space, tubular casts, mononuclear cell infiltration into the hepatic portal tracts, congestion and oedema of the lung) which were compatible with systemic immune complex disease . The mesenteric lymph nodes in 12 out of 15 cases with intestinal arteritis showed appearances indicative of a humoral immune response . We suggest that NE is a two-stage process . In stage 1, a necrotic focus is established in the intestinal mucosa-submucosa by 'initiating' factors of vascular (functional or organic) or microbial (exotoxic, endotoxic, or Shwartzman) origin . Functional circulatory insufficiency in the intestine is of particular relevance to necrotising enteritis in neonates and in adults with traumatic shock or cardiac insufficiency . The jejunal and--to a lesser extent--the ileal microcirculation appear to be particularly vulnerable to microcirculatory insufficiency . Ninety-seven per cent of our cases were of NE of the small intestine of which 76% involved the jejunum alone or as a part of a jejunoileitis . These 'initiating' factors act either singly or synergistically with 'promoting' factors (changes in the volume, composition, or pH of the diet, intestinal stasis, or bacterial factors) in the establishment of necrotic foci in the intestine . Stage 2 results from the colonisation of the necrotic foci by intestinal clostridia, the toxigenic capacity of which will determine the progress of the intestinal lesion . Clinically established NE is essentially gas gangrene of the intestinal wall . Our bacteriological findings (microscopic, cultural, and serological) support a pathogenetic role of Cl . welchii in the established stages of necrotising enteritis . Strains of Cl . welchii from NE cases had significantly higher histidine decarboxylase activity than strains from control sources; it is possible that the resultant histamine production could act as a promoting factor in stage 1 . Neutralising antibody against the Wanowrie virus, an Asian arbovirus which produces haemorrhagic enteritis in mice, was absent in the paired sera from 10 cases examined. Clin Orthop, 1980 Mar-Apr, (147), 207 - 9 Clostridial myonecrosis following intra-articular steroid injection; Seradge H et al.; Fatal clostridial myonecrosis occurred in a 65-year-old man after intra-articular injection of steroids to the shoulder joint . Clinical evidence of the possibility of clostridial infection is sufficient reason to initiate treatment . The opportunity to save a life may be lost by waiting for paraclinical data for definitive diagnosis to initiate treatment . "Surgical skin prep" for every intra-articular injection is a preventive measure . Increasing joint pain after intraarticular injection should be considered a serious complaint and requires careful clinical follow-up observations. Acta Chir Scand, 1980, 146(4), 235 - 41 Hyperbaric oxygen treatment in gas-producing infections; Tonjum S et al.; Thirty patients with gas-producing infections were treated with surgery, antibiotics and hyperbaric oxygen during 1964-1977 . Fourteen patients were infected with C . perfringens or C . septicum, 8 patients with B . fragilis or B . melaninogenicus, in 7 patients only aerobic bacteria were found, and in one patient no bacteria could be demonstrated . Thirteen patients had infections due to wounds, lacerations and/or compound fractures . Nine patients had gas-producing infection after surgery . Eight patients had abscesses and gas-producing infection . Of the 14 patients with clostridial infections, 2 patients died, and 6 underwent amputation . Four of the 8 patients with Bacteroides infection died, no amputation having been performed . Of the 7 patients in whom only aerobic bacteria were demonstrated, 3 patients died. Arch Geschwulstforsch, 1980, 50(1), 58 - 65 {The effect of experimentally induced histamine deficiency on growth and rate of taking of model tumours (author's transl)}; Mose JR et al.; From oncolytically effective clostridial strains, the intact washed or fractionated material of the spores and vegetative forms and culture media were examined for histamine decomposing activity in previous in vitro experiments (14) . In a fractionated state, all strains cause a reduction of histamine activity . Therefore histaminases are present as endozymes . When the spores germinate to vegetative forms on the tumour following i.v . injection, the cell wall breaks open and the enzymes are released . Mose et al . (13) described rapid and nearly complete decomposition of plasmakinins (specifically bradykinin) by means of the above mentioned special preparations of clostridial strains with oncolytical effect (culture media partially excepted) . Bradykinin and histamine are vasoactive substances, which are significant in terms of fine regulation of the capillary circulation . Continuous inactivation of these tissue hormones effected by the (clostridial) vegetative forms concentrated in the tumour may decrease the capillary circulation and thereby favour necrotization or decomposition of the tumour . In this animal experiment the effect of this biogenic amine on growth and rate of taking of tumours by means of artificially produced changes in the flowing equilibrium of the histamine metabolism was to be shown . Mice: While feeding mice a pyridoxal phosphate-free diet, a Harding-Passey melanoma was inoculated: The tumour weights were slightly lower in the case of animals put on the diet than in controls . Rats: Histamine-free diet and treatment with semicarbazide (in the course of the treatment implanzation of a Walker tumour) . The taking of the tumours was significantly delayed or their growth reduced as a result of the diet or the treatment with semicarbazide or both. Zentralbl Bakteriol A, 1980, 246(4), 541 - 9 {Histamine reduction by means of oncolytically active and oncolytically non-active clostridial strains (author's transl)}; Mose JR et al.; Spores and vegetative forms of oncolytically active and oncolytically non-active clostridial strains were tested for histamine reducing activity (isolated ileum of guinea pig used for testing, waterbath method acc . to Magnus, Fig . 1) . Culture media and the washed intact material did not show any or only very little effectiveness . On the other hand the fractionated, charges diminished histamine standard solutions except for very little remaining activity in the case of all strains . This effect was stronger in vegetative forms than in spores (Fig . 2) . The histamine effect on the isolated organ was generally increased by means of culture media as well as by the washed intact material . In this respect, preparations of non-lytic strains showed a slightly higher effectiveness than preparations of lytic clostridial strains (Fig . 2) . It was shown in earlier investigations (cf . bibliography) that the charges of clostridial strains decompose plasmakinin (synthetic bradykinin) at varying rates . Reduction of histamine activity by means of clostridia could lead to a decrease of the microcirculation and capillary-permeability in the tumor tissue (as hypothesized for bradykinin) and thereby favour its disintegration. Zentralbl Chir, 1980, 105(5), 300 - 14 {The judgment on gas gangrene in the framework of liability cases and applications for the extension of compensation}; Schmauss AK; On the basis of law of the German Demoncratic Republic the problems for the judgement of clostridial infections in medical reports are discussed . If in exogenous infections severe mistakes against fundamental rules of surgery are evident, malpractice must be affirmed . Endogenous infections after operations on the gastrointestinal tract are in mostly all cases induced by bacteria for the viscera . Prophylaxis is not always possible, infections are not avoidable . So in these cases for malpractice there is practically no basis . The conditions for "materian aid" are also not existant. Arch Geschwulstforsch, 1980, 50(7), 628 - 34 {Influence of artificial hyperglycaemia on selected clinico-chemical parameters of Wistar-rats with Jensen's sarcoma (author's transl)}; Begand M et al.; By means of usual laboratory methods was investigated, whether glucose-induced hyperglycaemia -- applied within diagnostical and therapeutical conceptions (e.g . combined treatment with nonpathogenic clostridial spores) -- causes disturbances of organ functions in healthy and Jensen's sarcoma bearing rats or not . In this manner especially damages of liver, kidneys and muscular system were excluded with high probability . Possibilities of pathophysiological interpretation of the results as well as the question of usefulness of LDH-activity estimation for the judgement of tumour damage are discussed. Infection, 1980, 8 Suppl 2, S131 - 3 Aspects of anaerobic infections in animals; Goldberg HS; The recent literature on clostridial infections of animals and infections due to gram-negative anaerobic rods is reviewed . It is stressed that quite recently the literature is concerned with animal models for the evaluation and study of the chemotherapy, immunity mechanisms and pathogenesis of Fusobacterium and Bacteroides infections in animals came into being. Acta Chir Scand, 1980, 146(1), 71 - 5 Prophylactic metronidazole in electrive colo-rectal surgery; Hagen TB et al.; 38 patients participated in a double blind study comparing the effect of a single dose of 2.0 g metronidazole given 15 hours prior to surgery with a placebo in reducing postoperative infections after elective colonic surgery . In 17 patients given metronidazole, only 2 had infections caused by aerobes, no anaerobe was recovered . Among 8 infected patients among a total of 21 in the placebo group, there were 5 anaerobic isolates (Bacteroides 3, peptococci 1, clostridia 1) and 8 aerobic bacteria . There was a significant difference between both total number of infections in the groups receiving metronidazole and placebo (p = 0.015) . In addition, the clinical course of the 2 infections in the metronidazole group was moderate compared to that in the placebo group . Suppression of anaerobes appears to have enabled the body to better eliminate aerobes as well, since fewer aerobes were found in the metronidazole group . It is concluded that metronidazole given as short term prophylaxis produces suffiecent antibacterial levels in tissues and body fluids during and shortly after operation to significantly reduce the frequency of postoperative infections. Agents Actions Suppl, 1980, 7, 233 - 6 Evidence for a steroid receptor in rheumatoid synovial tissue cells; Braidman IP et al.; One mechanism by which glucocorticoids could exert their anti-inflammatory action is via rapidly saturable, stereo-specific cytoplasmic protein receptors . This report is of an investigation into such a possibility in synovial cells . Synovium, obtained from knee joints of rheumatoid patients undergoing surgery, was incubated with clostridiopeptidase A and trypsin-EDTA to obtain cell suspensions . These, together with cells obtained from synovial fluid aspirated from patients with rheumatoid arthritis, were identified by electron microscopy . Duplicate samples of these cell suspensions were incubated with increasing concentrations of H3Dexamethasone (1 x 10(-10)M-1 x 10(-9)M) for 30 minutes at 37 degrees C . Analysis of the proportion of steroid bound to whole cells showed evidence for specific, rapidly saturable, receptors in the cells obtained from synovial tissue, but this was not found in synovial fluid cells . Electron micrographs showed that cells obtained from synovial tissue consisted of synovial fibroblast - and macrophage-types, lymphocytes, monocytes and macrophages . Polymorphonuclear leucocytes appeared to be absent . However, in synovial fluid cell type polymorphonuclear leucocytes were the predominant cell type . We concluded from this, that one or more of the cell types present in synovial tissue contain a specific steroid receptor, but that this is lacking in synovial fluid polymorphonuclear leucocytes. Zentralbl Chir, 1980, 105(23), 1553 - 61 {Gas gangrene of the abdominal wall after cholecystectomy; recovery (author's transl)}; Michelsen EG et al.; A patient, 50 years of age, underwent cholecystectomy for gallstones . 62 hours later the first symptoms of a clostridial infection of the abdominal wall could be observed . 8 hours later the re-operation was carried out . Three quarters of the muscles of the abdominal wall had to be removed, the peritoneum could be preserved . The patient recovered . One and a half year later pressure readings of the abdomen were taken. Connect Tissue Res, 1980, 8(1), 9 - 20 De novo protein synthesis by human chondrosarcoma in cell and organ culture: evidence of unusually high collagen production by a neoplastic tissue; Miller DR et al.; Protein synthesis by human chondrosarcoma tissue and normal articular cartilage was studied in organ and primary monolayer cell culture systems . Protein synthesis by cell cultures was evaluated at 2.7 and 21 days after plating . When compared to normal, incorporation of 3H-proline and 35S-methionine into proteins was elevated in chondrosarcoma samples under both culture conditions . Hydroxyproline analyses of tissue hydrolysates indicated that chondrosarcoma samples contained significantly less collagen than normal articular cartilage, yet were incorporating significantly greater amounts of 3H-proline into 3H-hydroxyproline . Collagen production by cell cultures was assessed by digestion of samples with purified clostridial collagenase . Chondrosarcoma cells produced more collagenase-sensitive protein than normal cells at all intervals . SDS polyacrylamide gel analyses of all preparations showed two collagenase-sensitive proteins with apparent molecular weights of 165,000 and 175,000 . Decreased synthesis of another major protein, apparent molecular weight 210-220,000 was noted in chondrosarcoma preparations in both culture systems. Infection, 1980, 8 Suppl 2, S113 - 6 Mechanisms of pathogenicity of anaerobic bacteria of clinical interest; Collee JG; The host factors leading to anaerobic infection and the various models of anaerobic infection, namely direct effect of a single toxin, multiple toxin-aggressin-systems, enterotoxic mechanisms, endogenous infections with non-clostridial anaerobes, and synergistic infections, are reviewed . Production of carcinogens and co-carcinogens by anaerobes is also discusssed. Vet Rec, 1979 Dec 15, 105(24), 551 - 4 Field studies in sheep with multicomponent clostridial vaccines; Kerry JB et al.; Two commercially available multicomponent clostridial vaccines were studied under field conditions in sheep . An eight-component vaccine designed for use in an initial dose volume of 5 ml with subsequent injections of 2 ml produced significantly better results than a seven-component vaccine designed for use in a dose volume of 2 ml. Ann Plast Surg, 1979 Dec, 3(6), 558 - 66 The use of amniotic membrane in acute massive full-thickness loss of the abdominal wall from clostridial myonecrosis; Silverton JS et al.; A patient who developed clostridial infection of the abdominal wall following laparotomy for small bowel perforation is described . Immediate debridement resulted in the loss of the entire abdominal wall . Dressing of the exposed viscera during the period of stabilization and prior to reconstruction was achieved using amniotic membranes. Anaesthesia, 1979 Oct, 34(9), 877 - 81 Pseudotetanus; Stoddart JC; Pseudotetanus is a syndrome which is produced by a variety of non-Clostridial factors . It is usually not difficult to distinguish from tetanus but is must always be considered in the differential diagnosis . Six cases are reported in which tetanus was considered and in one of them the full treatment for the disease was started . It is hoped that by increasing the awareness of clinicians of this relatively common problem the risk of making an incorrect disagnosis will be reduced. Am J Med, 1979 Oct, 67(4), 707 - 10 Clostridial sepsis following hepatic arterial infusion chemotherapy; Tully JL et al.; Three patients with clostridial sepsis during or following hepatic arterial infusions for the regional chemotherapy of hepatic metastatic tumors are described . In all patients abdominal roentgenograms revealed lucencies in the right upper quadrant consistent with gas-containing hepatic abscesses at the time of clinically apparent sepsis and positive blood cultures . The occurrence of three such cases in one year and the low incidence of clostridial infections in non-catheterized oncology patients at our institution suggest that clostridial infection is a previously unrecognized complication of hepatic arterial infusion chemotherapy . The possible sources of the infecting organisms and pathogenesis of this infection are discussed. Surgery, 1979 Oct, 86(4), 655 - 62 Necrotizing anorectal and perineal infections; Bubrick MP et al.; Sixteen cases of spontaneous necrotizing infection of the anorectum and perineum are described . Thirteen patients had clostridial infections and three had infections with nonclostridial organisms . Six patients were diabetic and two had leukemia . All 16 patients presented with pain, tenderness, swelling, and crepitation . Four had an ominous black spot on the scrotum or posterior labia . Shortly after initial recognition by the patient, all infections rapidly disseminated to include all surrounding areas such as the external genitalia, the anterior abdominal wall, and thighs . Treatment consisted of radical debridement and antibiotics; hyperbaric oxygen was used in the clostridial cases . Ten of the 16 patients survived . Delayed diagnosis and delayed treatment were the primary factors responsible for death. Zentralbl Bakteriol {Orig A}, 1979 Sep, 244(4), 541 - 5 {Experiments to improve the oncolysis-effect of clostridial-strain M55 (author's transl)}; Mose JR; Decreasing the oxygen in the respiration-air of animals to 11-12%, it was possible to increase the oncolysis-effect of the Clostridial-Strain M55 significant (macroscopical complete oncolysis in comparison with the usual application: Ehrlich-Solid-Tumour +62%, Harding-Passey-Melanom +64%) . In nearly 30%, Tumours cured completely. Obstet Gynecol, 1979 Sep, 54(3), 292 - 8 Fatal perineal cellulitis from an episiotomy site; Shy KK et al.; Perineal cellulitis originating from an episiotomy incision resulted in 20% of the maternal mortality in King County, Washington, between 1969 and 1977 . Necrotizing fasciitis was present in 2 of the cases, and clostridial myonecrosis was present in 1 . These fatalities occurred because the practitioners were not aware that necrotizing fasciitis can occur in the fatty superficial fascia of the perineum and that resection of the necrotic tissue is necessary for successful therapy. Gastroenterology, 1979 Aug, 77(2), 295 - 7 Antibiotic associated pseudomembranous colitis with negative proctosigmoidoscopy examination; Tedesco FJ; Most investigators have stressed that the diagnosis of antibiotic associated pseudomembranous colitis is made by proctosigmoidoscopic examination . In our investigation, 6 patients with tissue culture evidence of a clostridial toxin in stools and either normal or only edematous rectal mucosa were studied with total colonoscopy . Five of six patients demonstrated pseudomembranes located in various areas of the colon at a time when the rectosigmoid area was uninvolved . This demonstrates the occurrence of antibiotic associated pseudomembranous colitis which can be missed by routine proctosigmoidoscopy . The incidence of rectal sparing in this disease remains undetermined . Further investigation to determine the occurrence of antibiotic colitis, response to different treatments, or sensitivity of tissue culture assays as a diagnostic aid in antibiotic associated pseudomembranous colitis must take this subgroup into account. Rev Gastroenterol Mex, 1979 Jul-Sep, 44(3), 115 - 7 {Emphysematous cholecystitis (author's transl)}; Corral R et al.; A case of emphysematous cholecystitis is reported . The gallblader size in this case was 25 x 12 cms . The patient underwent successful cholecystectomy and responded adequately to cloramphenicol, peniciline and metronidazol . The late antibiotics are usually recommended due to the prevalence of Clostridia and Escherinchia bacterial infections in the gallbladder of patients with this illness. Wien Klin Wochenschr, 1979 May 25, 91(11), 388 - 91 {Inhibition of PZ-peptidases by serum (author's transl)}; Nagelschmidt M et al.; The inhibition of two PZ-peptidases by several sera was studied with the aid of methods based on the PZ-peptidase assay of Wunsch and Heidrich Clostridiopeptidase A is inhibited by all sera, whilst the PZ-peptidase from the rabbit serum is inhibited only by heterologous sera . The inhibition is weak and cannot be compared with the strong serum inhibition shown by collagenases. Biochim Biophys Acta, 1979 Apr 12, 567(2), 392 - 400 Mode of action of bacterial collagenase on a synthetic substrate, (Pro-Pro-Gly)5; Oshima G et al.; Clostridial collagenase (EC 3.4.24.3) catalyzes the hydrolysis of (Pro-Pro-Gly)5 at minimum of three different rates, producing Pro-Pro, Gly-Pro-Pro and Gly-Pro-Pro-Gly, and various intermediate peptides . The intermediate and final products were separated by cation-exchange column chromatogrphy and identified, and their rates of formation were measured . Pro-Pro was released most rapidly with formation of the tridecapeptide . After the initial release of the N-terminal Pro-Pro, hexa- and heptapeptides were formed in larger amounts than tri-, tetra-, nona- and decapeptides from the tridecapeptide . The rates of disappearance of the intermediates decreased in the order trideca- greater than deca- and nona- greater than heptapeptide . The results indicate that the enzyme hydrolyzes inner linkages of the tridecapeptide having N- and C-terminal Gly residues, forming large peptides, preferentially to outer linkages, forming the tri- and tetrapeptides. Hosp Pract, 1979 Apr, 14(4), 75 - 80 Antibiotic-associated colitis; Dowell VR Jr; Pseudomembranous colitis, a relatively uncommon and sometimes severe diarrheal disease, recently has been linked to the administration of a number of broad-spectrum antibiotics . The cause has now been identified as a spore-forming clostridial species not previously recognized as a human pathogen . Since the organism is sensitive to moset commonly used antibiotics, its spores may be the key to the disease. Can J Comp Med, 1979 Apr, 43(2), 194 - 9 Identification of some anaerobic bacteria in nonspecific anaerobic infections in animals; Prescott JF; Over 200 anaerobic bacterial isolates were recovered in a veterinary diagnostic laboratory from nonspecific infectious disease from 72 specimens originating from ten animal species . The majority of isolates were nonsporeforming bacteria and about half were identified to species . Bacteroides species formed the major group and included B . oralis, B . fragilis, B . corrodens, B . ruminicola subspecies ruminicola, B . ruminicola subspecies brevis and various subspecies of B . melaninogenicus . Gram-positive anaerobic cocci constituted the next major group of isolates and the main species identified in cattle was Peptococcus indolicus . Clostridial species were uncommon . Nine specimens yielded a pure culture of an anaerobe and, in samples containing mixtures of bacterial species, each specimen yielded an average of 3.1 anaerobic and 1.4 aerobic bacterial species . The failure to identify many of the isolates is discussed. Zentralbl Bakteriol {Orig A}, 1979 Mar, 243(1), 102 - 12 Further progress with oncolysis due to apathogenic clostridia; Gericke D et al.; Cl . onc . apathogenic for human beings and small animals is not able to cure tumor-bearing hosts . Combined treatments with local X-irradiation and local HFH have decreased the death rate of Harding-Passey-Melanoma-bearing mice . A cure rate of ca . 20% has resulted for the first time in such experiments . The survival time has increased significantly, however relapses occured on the sites of transplantation which finally killed the animals . Therefore it was tried to repeat the threefold-combined treatment . The animals with a relapse tolerated such a second and third series well . After the second series of treatment some animals became free of relapse and some after the third series . That means, if repeating treatment with local HFH, local X-irradiation, and i.v . spore-application of Cl . onc., it is possible to cure the Harding-Passey-Melanoma of the mouse at a high percentage. Onkologie, 1979 Feb, 2(1), 38 - 40 {5-fluorouracil inhibits bacterial collagenase and the collagenolytic system of a human rhabdomyosarcoma}; Lubec G et al.; Protease inhibitory activity of eight cytostatic drugs on 5 proteases was tested by applying an immunoelectrophoretic system, a rhabdomyosarcoma's collagenolytic activity was investigated and inhibition studies were performed . We found 5-fluorouracil stopping collagenolytic activity of clostridial origin and the enzyme released by the tumor . No other cytostatic drug showed protease inhibition . The collagenolysis of the rhabdomyosarcoma was examined for its origin . Negative inhibition studies with ethylene-diamine-tetraacetate make the leukocyte origin highly improbable so that one can suggest that the hydrolytic enzyme derived from the tumor . Our findings could contribute to characterize the enzyme released by the tumor . We suggest its role as a mediator of invasion and metastasis and on the other hand we detected its relatively specific inhibitor, 5-fluorouracil, which could influence tumorous and normal growth, regeneration and the intermediary protein metabolism. Langenbecks Arch Chir, 1979, 348(1), 1 - 5 {Gas gangrene (author's transl)}; Schuppisser JP; Gas gangrene which is due to clostridial contamination of a wound is a rare disease . The clinical picture is quite characteristic . Untreated the disease has a near 100% mortality for which reason treatment should be started as early as possible . Surgical debridement remains the therapeutic cornerstone . Administration of antibiotics is recommended and the efficacy of treatment with hyperbaric oxygen is beyond doubt . The only proven prophylactic means consists in the proper surgical management of wounds. Ann Ist Super Sanita, 1979, 15(1), 9 - 17 Intestinal bacterial flora in normal adults in the U.K; Peach S; The A . reports on the composition of the bacterial flora being present all through the intestine of normal adults in the United Kingdom, listing the number and families of the aerobes and anaerobes occupying the various portions of the alimentary tract . Emphasis is then laid on a comparison between the normal "British" flora in the colon and rectum, where the ratio of anaerobes to aerobes is 100 to 1, and the flora found in normal adults in Africa, India and Japan, stressing the major differences in the numbers of clostridia and non-sporing anaerobes . The A . finally highlights the importance of the factors governing the intestinal bacterial ecology, as well as the serious consequences likely to arise from the alteration of such flora. Ann Ist Super Sanita, 1979, 15(1), 123 - 35 Metronidazole in the prevention and treatment of anaerobic sepsis; Willis AT; Clinical trials were carried out in order to determine the value of metronidazole in preventing the development of anaerobic infections after surgery . Following a successful controlled trial of hysterectomy patients, among whom the prophylactic use of oral metronidazole resulted in a reduction of the anaerobic sepsis rate from 25% to nil, further trials were carried out with patients having urgent appendicectomy, those having elective colonic surgery and pregnant women having delivery by the vaginal and caesarean routes . These studies were conducted as double-blind trials in which metronidazole was compared with a placebo; patients were randomly allocated to the two "drug" groups . Since completion of the hysterectomy trial over 618 hysterectomies have been performed under metronidazole cover, none of which were complicated by anaerobic sepsis . Among appendicectomy patients, anaerobic infection did not develop in any of the 49 patients who received prophylactic metronidazole, but bacteriologically confirmed clinical anaerobic infections developed in 9 (19%) of 46 control patients . Since completion of the trial over 1098 appendectomies have been performed under metronidazole cover, only two of which developed an anaerobic infection . Among colonic surgery patients, anaerobic infections did not develop in any of 27 patients who received prophylactic metronidazole, but bacteriologically confirmed clinical anaerobic infections developed in 11 (58%) of 19 control patients . Since completion of the trial over 126 colonic operations have been performed under metronidazole cover, none of which were complicated by anaerobic sepsis . Pregnant women having vaginal delivery were not especially prone to anaerobic infections so that metronidazole prophylaxis is not indicated in these patients . Delivery by caesarean section appears to carry a risk of post surgical anaerobic sepsis in about 20% of patients not protected with metronidazole prophylaxis . Metronidazole is regarded as the drug of choice for the treatment of those non-clostridial anaerobic infections that require antimicrobial therapy . It may be given orally, rectally, intravenously and topically, has virtually no side effects and its use is characterized by a strikingly rapid and sustained clinical and microbiological response. Scand J Infect Dis, 1979, 11(3), 253 - 5 Anaerobic, non-clostridial fasciitis and myonecrosis of the abdominal wall . Pure anaerobic infection originating from neglected inflammation of an urachal remnant; Scheibel JH et al.; A pure anaerobic infection of the abdominal wall of a 40-year-old man is described . The infection originated from an urachal remnant . Seven different bacterial strains were isolated . Even though no clostridia were involved, the infection caused extensive necrosis of the abdominal wall including both fascia and muscles. Lipids, 1978 Dec, 13(12), 966 - 78 Bile acids in tissues: binding of lithocholic acid to protein; Nair PP et al.; Human liver contains two forms of lithocholic acid . One form is readily extractable by 95% ethanol/0.1% ammonia (soluble lithocholate, SL), while the other remains firmly bound to the residue (tissue-bound lithocholate, TBL) . TBL could be hydrolytically released using clostridial cholanoylamino acid hydrolase, suggesting a peptide link between lithocholate and protein . With bovine serum albumin (BSA), lithocholic acid showed spontaneous amino group-modifying activity . When small molecular weight lysine (alpha-t-BOC-1-lysyl-beta-naphthylamide) and arginine peptides (alpha-CBZ-di-arginyl-beta-naphthylamide) were used in place of BSA, lithocholate bound specifically to the lysine peptide . The unusual affinity for lysine suggested that this amino acid might be involved as a residue in TBL . Synthesis of lithocholyl lysines and comparison with products of acid hydrolysis of TBL established epsilon-lithocholyl lysine as the predominant form in which lithocholic acid is found in tissue bound form. Zentralbl Bakteriol {Orig A}, 1978 Dec, 242(4), 512 - 6 {The use of clostridial antigens for a serological and autoradiographical early diagnosis of tumours (author's transl)}; Mose JR et al.; In continuation of the examinations on the usefulness of Cl . oncolyticum M 55 spores reported by Mose new experiments with an auto-radiographical method are plannes . After the isolation, chemical characterization of the cell wall antigens and the exo-antigens and the formation of antibodies, these antibodies should be at first labelled with 125 J and henceforth with 131 J . The iodine-labelled antibodies should allow the diagnosis and localization of the tumours. Schweiz Med Wochenschr, 1978 Nov 11, 108(45), 1787 - 90 {Pseudomembranous colitis caused by antibiotics}; Meyer B et al.; A case of antibiotic-induced pseudomembranous colitis is presented . Following resection of a carcinoma of the colon, an 81-year old man was treated with clindamycin for 9 days and with epicillin for another 9 days . One week after discontinuation of antibiotics the patient developed progressively severe diarrhea . Death from central pulmonary embolism ensued 10 days after the onset of diarrhea . Autopsy revealed severe pseudomembranous colitis of the entire large intestine . Pseudomembranous colitis is often observed as a complication after the administration of different antibiotics . The Anglo-American literature contains several recent reports of clindamycin-induced pseudomembranous colitis . The etiopathology of this drug-induced disease is still unclear . A possible interpretation is an antibiotic-induced change in the intestinal flora . Recent observations suggest that toxin-producing clostridia are responsible for the pseudomembranous colitis. Vet Rec, 1978 Oct 7, 103(15), 326 - 8 Rabbit dysentery: 1 . Clinical, epizootological and bacteriological studies; Sinkovics G; Individual and epizootological observations on scouring in a large flock of three-to 10-week-old growing rabbits indicate that spread from animal to animal is not characteristic in outbreaks of rabbit dysentery . Although the disease occurs chiefly after weaning, precipitation of the symptoms seems to be unrelated to weaning stress . Intestinal flora studies on infected and control animals have shown that the bacteriological background of the condition is varied . Marked increase of coliforms over controls occurred in 70 per cent of the cases, coliforms and clostridia had both increased in 20 per cent, and clostridia only in 5 per cent . In the remaining 5 per cent the intestinal flora did not differ from normal, although death from rabbit dysentery was readily obvious . Microscopic examinations for coccidial oocysts of mucosal scrapings from different intestinal segments have shown that oocyst counts sufficient to give rise to clinical coccidiosis were only exceptionally present. Zentralbl Bakteriol {Orig A}, 1978 Oct, 241(4), 463 - 72 {The differentiation of clostridial microcultures on nuclepore-filters by fluorescent antibodies as a rapid screening test for spores . II . Application of fluorescent antibodies (author's transl)}; Koch K et al.; The study deals with the question of whether a combination of microcolony-cultivation on polycarbonate-membrane-filters with the fluorescent-antibody-method will lead to a rapid-diagnosis method for clostridial-spores . Formaldehyd-inactivated vegetative cells of eight different clostridial-strains (Table 1) were used for the immunisation of rabbits according to the method published by Bohm and Strauch (5) . The results of the immunisation procedure, developed for aerobic-sporeformers, showed, that satisfactory results could not be obtained in all cases (Table 2) . The eight conjugates were tested against microcolonies of 32 strains of different clostridial-species on membrane-filters, produced by the technique described in the first communication . The results showed (Table 4) that differentiation was always possible when homologous antisera were used . In most cases, in order to differentiate between the various species, conjugates of several serotypes had to be employed together . However due to their uniform antigenic nature, Cl . feseri and Cl . tetani could both be identified by using one strain for each to immunize . With clostridial-spores the species could be identified within a period of 6 to 12 hours by using the membrane-filter-fluorescent-antibody technique. Zentralbl Bakteriol {Orig A}, 1978 Oct, 241(4), 448 - 62 {The differentiation of clostridial microcultures on nuclepore-filters by fluorescent antibodies as a rapid screening test for spores . I . Method of producing microcultures (author's transl)}; Koch K et al.; Spores of 32 strains of 11 different clostridial species (Table 1) were allowed to germinate as microcultures on Nuclepore membrane-filters to ascertain whether they could be differentiated according to their patterns of growth . The questions dealt with in the preliminary studies, investigated which pore-size of filters would be best for this purpose and which time necessary for each species to produce microcolonies of 10 to 20 cells from a single spore . Nuclepore-filters with a pore-diameter of 1 mu gave the best results and the times for producing microcolonies of the desired size ranged from 4 hours with Cl . septicum up to 10 hours with Cl . tetani (Table 3) . The final result of the study was, that the differences in the patterns of growth were not great enough to allow identification . Only Cl . perfringens formed specific and distinctive compact colonies (Tables 4 and 5). J Reprod Med, 1978 Sep, 21(3), 185 - 8 Rupture of a gravid bicornuate uterus in a primigravida associated with clostridial and bacteroides infection; Jones DE et al.; The case is presented of a primigravid patient with spontaneous rupture of a bicornuate uterus associated with significant anaerobic infection . Thinning of the myometrium at the site of the rupture was noted in the pathologic specimen . The anaerobic infection, primarily contained in the intact amniotic sac, resolved with total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic drainage and antibiotic therapy. Biochim Biophys Acta, 1978 Aug 7, 525(2), 429 - 37 Clostridiopeptidase B inhibition by plasma marcroglobulins and microbial antiproteases; Giroux E et al.; Clostridiopeptidase B (EC 3.4.22.8) was not inhibited by stoichiometric amounts of lima bean trypsin inhibitor, ovomucoid trypsin inhibitor, Kuntiz bovine trypsin inhibotor, Kunitz soybean trypsin inhibitor or ovoinhibitor . Activity was diminished at relatively high concentrations of the three latter inhibitors . Human plasma alpha 2-macroglobulin inhibited both the amidase and protease activity of the enzyme . Rat and dog plasmas contained high molecular weight inhibitors, presumably macroglobulins as well . Inhibition by this component was greater in rat plasma than in dog plasma, which may be related to the observation that clostridiopeptidase B-induced generation of kinin activity is indirect in the former plasma, but direct in the later . Leupeptin (N-acetyl-L-leucyl-L-leucyl-L-argininal) and antipain ({S)-1-carboxy-2-phenylethyl} carbamoyl-L-arginyl-L-valyl-L-argininal) inhibited clostridiopeptidase B (Ki of 2 . 10(-8) and 3 . 10(-8) M, respectively) . They were potent inhibitors of clostridiopeptidase B-induced kinin release in dog plasma. Appl Environ Microbiol, 1978 Aug, 36(2), 356 - 9 Tissue sterility in uneviscerated carcasses; Gill CO et al.; Sheep muscle tissue removed aseptically from control carcasses, from uneviscerated carcasses held at 20 degrees C for 24 h, and from carcasses of sheep subjected to stress before slaughter was examined for the presence of bacteria . All samples from a total of 68 carcasses were sterile . Whole-body autoradiography of mouse carcasses showed that 14C-labeled fixed bacteria injected after death remained in the lumen of the intestine . Live bacteria did not penetrate the mucosal surface until the tissue structure had been disrupted by proteolytic enzymes . Bacteria were unable to penetrate sections of intestine longitudinally until considerable structural breakdown had occurred, indicating that blood and lymph vessels do not normally offer a pathway for microbial invasion from the intestine . Clostridia, which have been reported to be responsible for deep spoilage of meat, reached maximum numbers 24 to 28 h after death in the intestines of guinea pig carcasses stored at 20 degrees C, but did not invade carcass tissues until the stomach ruptured as a result of proteolysis between 2 and 3 days after death. Plast Reconstr Surg, 1978 Aug, 62(2), 276 - 9 Early diagnosis of crepitant gangrene caused by Bacteroides melaninogenicus; Lewis VL Jr et al.; A rapid non-invasive test for the presence of B . melaninogenicus in the wounds of crepitant non-clostridial gangrene is described . The wounds are viewed under an ultraviolet light, and the presence of bright red fluorescene indicates the probable presence of B . melaninogenicus. Lancet, 1978 Jul 29, 2(8083), 226 - 8 Oral vancomycin for antibiotic-associated pseudomembranous colitis; Tedesco F et al.; Nine patients with antibiotic-associated pseudomembranous colitis were treated with oral vancomycin . All had severe diarrhoea, tissue-culture evidence of a clostridial toxin in stool, and typical lesions on sigmoidoscopic examination, despite discontinuation of all antimicrobials for periods of 10 days to 8 weeks . Oral vancomycin was given in doses of 2 g daily . All patients showed a good clinical response with gradual resolution of diarrhoea over 7 days and a rapid decrease in concentrations of the toxin in stools . Follow-up sigmoidoscopies in seven patients showed major improvement or complete clearing of lesions after 7-10 days of vancomycin treatment . The mean concentration of vancomycin in twenty-five stools obtained during treatment was 3100 microgram/g, levels in serum being very low . These results suggest a role for oral vancomycin treatment of antibiotic-associated pseudomembranous colitis which persists for extended periods despite discontinuation of the incriminated antimicrobial. Surg Gynecol Obstet, 1978 Jul, 147(1), 65 - 7 Gas-producing clostridial and nonclostridial infections; Skiles MS et al.; Clostridial infections have always been treated promptly and aggressively on the basis of history and Gram's strain . We believe that nonclostridial infections with similar fulminating, septic courses also should receive as prompt and radical treatment and perhaps more so, as hyperbaric oxygen therapy is of far less benefit in a nonclostridial infection . It is particularly important to treat the high risk, obese, patient with diabetes and an infection of the perineum or groin promptly and aggressively if the current, high morality is to be decreased. Ann Sclavo, 1978 Jul-Aug, 20(4), 588 - 98 {Research of the RNA-coliphages, in comparison with usual microbial and chemical indexes of biological pollution, for hygienic and sanitary evaluations of coast-waters (author's transl)}; Baldini I et al.; Hygienic significance of the usual microbial (E . coli, Enterococci, Clostridia) and chemical (COD, NH3, NO2) indexes of sea-water biological pollution was investigated, in comparison with RNA-coliphages assay . E . coli was confirmed as an easily measurable and significant index of biological pollution (at least for routinary investigations), while the other microbial and chemical parameters do not significantly increase the hygienic selectivity of the E . coli assay . RNA-coliphages assay, on the contrary, is able to increase the hygienic selectivity of sanitary investigations, particularly in lowly polluted coast-water . This behaviour of RNA-coliphages is in accordance with their great persistance in sea-water, due to their survival-time, closely comparable with human viruses . RNA-coliphages assay is therefore proposed as a simple and useful index of "viral pollution" for a complete hygienic evaluation of sea-water environment in addition to routinary E . coli assay. Am J Pathol, 1978 Jul, 92(1), 99 - 110 Mechanisms of platelet adhesion to the basal lamina; Huang TW et al.; The human glomerular basal lamina (HGBL) is composed of collagenous and noncollagenous glycoproteins . We assessed the role played by each costituent in platelet-basal-lamina interaction by selective cleavage and removal of each component by clostridial collagenase or by pepsin . When noncollagenous proteins are removed from HGBL, human platelets exhibit littel reactivity toward the residual collagen framework of the isolated basal lamina . With the noncollagen matrix of basal lamina, after removal of the bulk of the collagen, platelet adhesion and spreading proceed normally in the presence of divalent cations, similar to what occurs on intact basal lamina . No platelet degranulation or aggregation is observed . The results indicate that the basal lamina collagen, even in its native packing arrangement, lacks affinity for platelet adhesion and is incapable of triggering platelet release reactions . Platelet adhesion and spreading on the basal lamina appears to depend primarily on the presence of the noncollagen components and to require divalent cations . The data suggest the presence on platelets of receptors for basal lamina distinct from those for interstitial collagens . These receptors activate a unique modulation of platelet behavior, ie, adhesion and spreading without degranulation . A difference in biologic function of the basal lamina and interstitial collagens is apparent in these experiments. Biochem J, 1978 Jun 15, 172(3), 465 - 77 Comparative studies on two ferredoxins from the cyanobacterium Nostoc strain MAC; Hutson KG et al.; Two ferredoxins were isolated from the cyanobacterium Nostoc strain MAC grown autotrophically in the light or heterotrophically in the dark . In either case approximately three times as much ferredoxin I as ferredoxin II was obtained . Both ferredoxins had absorption maxima at 276, 282 (shoulder), 330, 423 and 465 nm in the oxidized state, and each possessed a single 2 Fe-2S active centre . Their isoelectric points were approx . 3.2 . The midpoint redox potentials of the ferredoxins differed markedly; that of ferredoxin I was --350mV and that of ferredoxin II was --445mV, at pH 8.0 . The midpoint potential of ferredoxin II was unusual in being pH dependent . Ferredoxin I was most active in supporting NADP+ photoreduction by chloroplasts, whereas ferredoxin II was somewhat more active in pyruvate decarboxylation by the phosphoroclastic system of Clostridum pasteurianum . Though the molecular weights of the ferredoxins determined by ultracentrifugation were the same within experimetnal error, the amino acid compositions showed marked differences . The N-terminal amino acid sequences of ferredoxins I and II were determined by means of an automatic sequencer . There are 11--12 differences between the sequences of the first 32 residues . It appears that the two ferredoxins have evolved separately to fulfil different roles in the organism. J Biochem (Tokyo), 1978 May, 83(5), 1321 - 5 Amino acid sequence of a ferredoxin from Chlorobium thiosulfatophilum strain Tassajara, a photosynthetic green sulfur bacterium; Hase T et al.; We have determined the amino acid sequence of a ferredoxin from a photosynthetic green sulfur bacterium, Chlorobium thiosulfatophilum strain Tassajara . It contains 61 amino acid residues with 9 cysteines, and 8 of the 9 were located at positions corresponding to those in clostridial-type ferredoxins . Other structural features were closer to those of ferredoxins from another photosynthetic bacterium, C . limicola, than to those of non-photosynthetic bacteria . Compared with ferredoxin from Chromatium, a photosynthetic purple sulfur bacterium, all photosynthetic bacterial ferredoxins have a common region in the carboxyl-terminal half with several extra residues and a unique cysteine residue . We compared all the photosynthetic bacterial ferredoxins that have been sequenced and concluded that C . thiosulfatophilum ferredoxin is most closely related to C . limicola ferredoxin I. J Bacteriol, 1978 May, 134(2), 668 - 70 Tetrahydrofolate enzyme levels in Acetobacterium woodii and their implication in the synthesis of acetate from CO2; Tanner RS et al.; Acetate synthesis from CO2 by Acetobacterium woodii may occur as in homoacetate-fermenting clostridia, as indicated by high levels of enzymes of the tetrahydrofolate pathway and by pyruvate-dependent formation of acetate from methyl-B12 and methyltetrahydrofolate. Appl Environ Microbiol, 1978 May, 35(5), 988 - 91 Superoxide dismutase in anaerobes: survey; Gregory EM et al.; Superoxide dismutase (SOD) was present in 23 of 28 strains of the genus Bacteroides tested . Several clostridia, anaerobic cocci, and anaerobic, grampositive, nonsporing rods contained measureable SOD, but the frequency of SOD occurrence was much lower than in the bacteroides . These data indicate that there is a large variation in SOD levels between genera and among species within a genus of anaerobic bacteria . There was also no correlation between source of isolate, SOD levels, and presumed pathogenicity of the isolate. Am J Surg, 1978 May, 135(5), 710 - 3 Ileostomy of the distal end of the bypassed intestine in a patient with jejunoileal bypass for obesity; Preston FW et al.; Ileostomy of the distal end of the bypassed segment of small intestine was done twenty-three months after a 28 to 20 cm (12 to 8 inch) end-to-end jejunoileal bypass for obesity (Scott operation) in a forty-eight year old white female, thus creating a Thiry fistula . Weight prior to jejunoileal bypass was 130 kg (287 pounds) . Before ileostomy it had stabilized at 80.3 kg (177 pounds) . Indications for ileostomy were three episodes of blind loop syndrome and three episodes of severe bleeding from the ileotransverse colostomy anastomotic site . Culture of the bypassed segment at laparotomy revealed bacteroides, clostridia, and other anaerobes as well as the usual aerobic large bowel flora . After ileostomy the bypassed segment contained no anaerobic bacteria . Daily fluid output from the ileostomy has decreased with time, averaging 436 ml per day for the first postileostomy month and 50 ml per day for the ninth month . Beneficial effects of the ileostomy include: (1) better sense of well being; (2) no further episodes of blind loop syndrome or intestinal bleeding; and (3) cessation of anal itching . Nine months after ileostomy, hyperoxaluria and acquired megacolon were present . Weight was 5.9 kg (13 pounds) greater than before ileostomy. Gastroenterology, 1978 Apr, 74(4), 744 - 6 Local gangrene: a complication of peripheral Pitressin therapy for bleeding esophageal varices; Greenwald RA et al.; Two patients developed local gangrene after subcutaneous infiltration of vasopressin (Pitressin, Parke, Davis & Company, Detroit, Mich.) utilized for the control of bleeding from esophageal varices . In the 1st patient, ischemic gangrene resulted in transmetatarsal amputation and also necessitated skin grafts on the forearm . The 2nd patient developed gangrene and clostridial sepsis and expired . The effects of systemically administered Pitressin are reviewed and suggestion to prevent local necrosis are presented. N Engl J Med, 1978 Mar 9, 298(10), 531 - 4 Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia; Bartlett JG et al.; A substance producing cytotoxicity in tissue culture was detected in stool specimens from all of four patients with pseudomembranous colitis due to antibiotics and in one of 54 with antibiotic-associated diarrhea . These stools also caused enterocolitis when injected intracecally into hamsters . On each occasion, cytotoxicity in tissue culture and enterocolitis in hamsters were neutralized by pretreatment with gas-gangrene antitoxin . The toxicity in both tissue cultures and hamsters could be reproduced with broth cultures of clostridia strains isolated from four of the five stools . These results suggest that toxin-producing clostridia are responsible for antibiotic-associated pseudomembranous colitis. J Clin Endocrinol Metab, 1978 Mar, 46(3), 425 - 33 Response to hormones of cells cultured from human giant cell tumors of bone; Goldring SR et al.; Giant cell tumors of bone obtained from 7 patients were dispersed with clostridial collagenase and trypsin and adherent cells were maintained in culture . Early cultures contained both mononucleated and multinucleated cells presumably derived from the stromal and giant cells of the original tumor . The original multinucleated cells did not survive for greater than 7-10 days whereas the mononucleated cells persisted and could be passaged by trypsinization . In 5 of 7 early cultures exposed to parathyroid hormone (PTH) there was a rise in cAMP within 5-10 min in both cells and medium which averaged approximately 12-fold . None of the cells responded to calcitonin and a variable rise in cAMP was seen after incubation with prostaglandin E2 . In cells cultured from 3 tumors the PTH response disappeared with passage of the cells, but in the remaining 2, PTH response persisted through multiple passages . The presence as well as the magnitude of the PTH-induced cAMP response in these cells is consistent with a skeletal origin. JAMA, 1978 Feb 27, 239(9), 847 - 9 Clostridial myonecrosis ('gas gangrene') during cephalosporin prophylaxis; Mohr JA et al.; Four cases of clostridial myonecrosis that developed in open fractures were treated with surgical debridement and with intravenous cephalosporins as antibiotic prophylaxis . All patients recovered following amputation of the involved extremity, and treatment with high-dose penicillin in three cases, and erythromycin plus high-dose cephalothin in the fourth . This complication was not seen in patients with similar injuries that were managed surgically but used other antibiotics, usually penicillin, as prophylaxis . In vitro susceptibility tests of clostridia to cephalothin were performed; the results demonstrated that nearly 50% of clostridia tested were resistant to cephalothin. J Biol Chem, 1978 Feb 25, 253(4), 1079 - 85 Studies on the mechanism of formyltetrahydrofolate synthetase . The Peptococcus aerogenes enzyme; McGuire JJ et al.; Two conflicting mechanisms have been proposed for formyltetrahydrofolate synthetase (EC 6.3.4.3) . Detailed studies with a clostridial enzyme support a sequential mechanism, while a stepwise mechanism with formation of a dissociable intermediate has been proposed for the Peptococcus aerogenes synthetase . However, the data supporting the P . aerogenes mechanism were obtained using synthetase of questionable purity and the results supporting the mechanism could be attributed to contaminating activities . Consequently, uncertainty still exists with regard to the enzyme mechanism . To resolve this uncertainty, the P . aerogenes formyltetrahydrofolate synthetase has been purified to homogeneity and used in experiments to reinvestigate the reaction mechanism . The results of P1:ATP, ADP:ATP, and formate:10-formyltetrahydrofolate exchange experiments as well as a steady state kinetic analysis revealed no difference in the mechanisms of the P . aerogenes or clostridial synthetases . The results are inconsistent with a stepwise mechanism involving a dissociable intermediate and consistent only with a sequential mechanism. Prep Biochem, 1978, 8(5), 387 - 407 A modified procedure for the purification of clostridial collagenase; Oppenheim F et al.; A method is described for the purification of clostridial collagenase from a crude enzyme preparation employing cation exchange chromatography on SP Sephadex, anion exchange chromatography on DEAE cellulose and gel filtration on Sephacryl S-200 . Emphasis was placed on purity using continuous shallow gradients for the ion exchange separations to increase resolution and monitoring eluates both with respect to ultraviolet light absorption at 230 nm and analytical disc gel acrylamide electrophoresis . In addition, protein fractions were assayed for collagenolytic and non-specific proteolytic activity . The purity of the final preparation was assessed by acrylamide electrophoresis, gel filtration and amino acid analysis . The isolated enzyme hydrolyzed between 30 and 40% of rat tail tendon collagen in 1 h at 37 degrees C and lacked measurable trypsin or elastase-like activity. J Trauma, 1978 Jan, 18(1), 34 - 7 The effect of antibiotics, primary and secondary closure on clostridial contaminated open fracture wounds in rats; Patzakis MJ et al.; In a study of experimentally induced open tibial or femoral fractures in rats, after either closing or leaving the wounds open, the animals were given: no antibiotic, cephalothin (Keflin), or penicillin . The rats with wounds closed primarily and receiving no antibiotics had the highest mortality rate (11 of 25) from experimentally produced clostridial myonecrosis . The lowest overall mortality rate (5 of 99) was found in the penicillin-treated groups . The higher mortality rate in the femur fracture groups was probably because of the large muscle mass of the thigh . The importance of ideal anaerobic conditions for producing experimental clostridial myonecrosis is emphasized.
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