Science, 2005 Jan 14, 307(5707), 217 - 8 Cell signaling . Stat acetylation--a key facet of cytokine signaling? O'Shea JJ, Kanno Y, Chen X, Levy DE. National Institute of Arthritis, Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA. Clin Chem Lab Med, 2005 Jan, 43(1), 54 - 63 External failures as descriptor of quality in clinical microbiology laboratory services; Saarela U et al.; This study employed customer feedback surveys to assess the quality of the laboratory services provided by an accredited clinical microbiology laboratory . The purpose of the study was to classify external failures and determine the quantity of such errors, and to establish how much time was spent processing and correcting these errors, together with the costs arising . The study indicates that the quality of laboratory test results can be regarded as good based on the accuracy of the result . Customer needs were also well taken into account in practice because of the good quality of the service . However, improvements are required in providing customers with test results without delay . The cost of processing and correcting such errors was negligible . The use of a customer feedback system allows systematic monitoring of external failures . In the accredited laboratory under study, it is unnecessary to monitor continually the costs and working time involved in processing and correcting external failures . The most essential point is to monitor the effects of the quality measures taken to reduce the number of failures. Clin Diagn Lab Immunol, 2005 Jan, 12(1), 122 - 4 Identification of another B-cell epitope in the type-specific region of equine herpesvirus 4 glycoprotein g; Maeda K et al.; Recently, a novel 12-mer B-cell epitope, MKNNPIYSEGSL, in the type-specific region of equine herpesvirus 1 (EHV-1) glycoprotein G (gG) was identified and used as an antigen for enzyme-linked immunosorbent assay (Maeda et al., J . Clin . Microbiol . 42:1095-1098, 2004) . Although our prototype strain, TH20p, possesses two repeat sequences containing the B-cell epitope, the EHV-4 NS80567 strain has two repeat sequences that are not identical . One repeat sequence stretch contained the B-cell epitope, while the other contained the 11-mer, MKNNPVYSESL (underlining indicates a different amino acid) . In this study, heterogeneity of the type-specific region was compared among Japanese EHV-4 isolates . The 11-mer peptide, MKNNPVYSESL, specifically reacted with sera from horses naturally infected with EHV-4 but not with sera from horses experimentally infected with EHV-4 TH20p . The 11-mer peptide may be another B-cell epitope in the type-specific region. J Clin Periodontol, 2005 Jan, 32(1), 68 - 74 Evaluation of the relationship between smoking during pregnancy and subgingival microbiota; Buduneli N et al.; Buduneli N, Baylas H, Buduneli E, Turkoglu O, Dahlen G: Evaluation of the relationship between smoking during pregnancy and subgingival microbiota . J Clin Periodontol 2004; doi: 10.1111/j.1600-051X.2004.00633.x . (c) Blackwell Munksgaard, 2004 . Abstract Background: Numerous studies have shown that smoking negatively affects periodontal health . Hormonal changes, which occur during pregnancy have also been reported to have adverse effects on the periodontal tissues or indirectly through alterations in the subgingival bacterial flora . At present, no knowledge exists concerning possible effects of smoking on the composition of subgingival plaque in pregnancy . The purpose of the present study was to evaluate the effects of smoking during pregnancy on the subgingival plaque bacteria most commonly associated with periodontal disease . Methods: A total number of 181 women were examined within 72 h post-partum . Smoking status was recorded by means of a self-reported questionnaire and the study population was divided into three groups; non-smokers, light smokers, and heavy smokers . In each woman, two subgingival plaque samples were obtained from mesio- or disto-buccal aspect of randomly selected one molar and one incisor tooth by sterile paperpoints . Clinical periodontal recordings comprising presence of dental plaque, bleeding on probing (BOP), and probing pocket depth (PPD) were performed at six sites per each tooth at all teeth . Plaque samples were analysed by checkerboard DNA-DNA hybridization with respect to 12 bacterial species . In all analyses, the individual subject was the computational unit . Thus, mean values for all clinical parameters were calculated and bacterial scores from each individual sample were averaged . Statistical methods included chi(2) test, Kruskal-Wallis test and Mann-Whitney U-test . Results: Mean ages were similar in the study groups . Plaque, BOP and PPD recordings were lower in the heavy-smoker group, but the differences were not statistically significant (p>0.05) . The detection rates and bacterial loads of the specific subgingival bacteria exhibited no significant differences between the groups . No correlation could be found between smoking status and detection rates and bacterial loads of various bacterial species . Conclusion: The present findings suggest that smoking during pregnancy does not have a significant effect on the composition of subgingival plaque bacteria. Infect Control Hosp Epidemiol, 2004 Dec, 25(12), 1050 - 5 Mycobacterium simae outbreak associated with a hospital water supply; Conger NG et al.; OBJECTIVE: Mycobacterium simiae is found primarily in the southwestern United States, Israel, and Cuba, with tap water as its suspected reservoir . Our institution saw an increase in M . simiae isolates in 2001 . An investigation into possible contaminated water sources was undertaken . DESIGN: Environmental cultures were performed from water taps in the microbiology laboratory, patient rooms, points in the flow of water to the hospital, and patients' homes . Patient and environmental M . simiae were compared by PFGE . SETTING: Military treatment facility in San Antonio, Texas . PATIENTS: All patients with cultures positive for M . simiae between January 2001 and April 2002 . Medical records were reviewed . RESULTS: M . simiae was recovered from water samples from the hospital, patients' home showers, and a well supplying the hospital . A single PFGE clone was predominant among water isolates (9 of 10) and available patient isolates (14 of 19) . There was an association between exposure to hospital water and pulmonary samples positive for the clonal M . simiae strain (P = .0018) . Only 3 of 22 culture-positive patients met criteria for M . simiae pulmonary disease . Of them, two had indistinguishable M . simiae strains from tap water to which they were routinely exposed . CONCLUSIONS: This represents an outbreak of M . simiae colonization with one nosocomial infection . It is only the second time that M . simiae has been recovered from hospital tap water and its first presentation in municipal water . This study raises issues about the need and feasibility of eliminating or avoiding exposure to M . simiae from tap water. J Clin Microbiol, 2005 Jan, 43(1), 382 - 6 Aspergillus hyphae in infected tissue: evidence of physiologic adaptation and effect on culture recovery; Tarrand JJ et al.; Microbiologic cultures of fungi are routinely incubated at ambient temperatures in room air, and the rate of recovery of Aspergillus species from clinical specimens is poor . Failure of current culture methods to mimic the physiologic temperature and low-oxygen environment found in hypha-laden infected tissue may underlie this poor recovery . Experiments were performed to compare the recovery of Aspergillus spp . incubated at 35 degrees C in 6% O(2)-10% CO(2) with that at 25 degrees C in room air . The samples tested included Aspergillus-infected tissue specimens from a dog model and human autopsies, experimental anaerobically stressed Aspergillus inocula, and 10,062 consecutive clinical specimens . Culture at 35 degrees C in 6% O(2)-10% CO(2) significantly enhanced the recovery of Aspergillus spp . from the infected autopsy tissue samples . Incubation at 35 degrees C alone resulted in approximately 10-fold-improved culture recovery from the experimentally stressed hyphae, and the 6% O(2)-10% CO(2) atmosphere independently favored growth under temperature-matched conditions . Finally, incubation at 35 degrees C (in room air) improved the overall recovery of Aspergillus spp . from clinical specimens by 31% . Culture at 35 degrees C in a microaerobic atmosphere significantly enhances the recovery of Aspergillus spp . from various sources . Aspergillus hyphae growing in infected tissue appear to be adapted to the physiologic temperature and hypoxic milieu. Epidemiol Mikrobiol Imunol, 2004 Nov, 53(4), 169 - 73 {External quality control system in medical microbiology and parasitology in the Czech Republic}; Slosarek M et al.; The External Quality Control System (EQAS) of laboratory activities in medical microbiology and parasitology was implemented in the Czech Republic in 1993 with coded sera samples for diagnosis of viral hepatitis and bacterial strains for identification distributed to first participating laboratories . The number of sample types reached 31 in 2003 and the number of participating laboratories rised from 79 in 1993 to 421 in 2003 . As many as 15.130 samples were distributed to the participating laboratories in 2003 . Currently, almost all microbiology and parasitology laboratories in the Czech Republic involved in examination of clinical material participate in the EQAS . Based on the 11-year experience gained with the EQAS in the Czech Republic, the following benefits were observed: higher accuracy of results in different tests, standardisation of methods and the use of most suitable test kits. Clin Lab Sci, 2001 Winter, 14(1), 21 - 6 Predictive value of a senior comprehensive examination as to performance on a national certification examination; Wiggers TB et al.; OBJECTIVE: To determine what value a senior departmental comprehensive examination holds in predicting the future success of a student on the MT(ASCP) certification examination . DESIGN: Part 1: To evaluate the efficacy of the comprehensive examination, scores were obtained in the examination categories of hematology, clinical chemistry, immunohematology, and microbiology for all dinical laboratory science students who have graduated from the University of Mississippi Medical Center since 1993 . The data were analyzed to determine if a correlation exists between student performance on the senior comprehensive, and their future performance on the MT(ASCP) national certification examination . Part 2: To determine the extent to which a senior comprehensive examination was required for graduation at other university-based clinical laboratory science programs, a simple survey was e-mailed to members of the clinical laboratory science educators forum . SETTING: 2+2 university-based dinical laboratory science program PARTICIPANTS: Part 1: Previous graduates of the Clinical Laboratory Science Program at the University of Mississippi Medical Center since 1993 . Part 2: Program directors who are members of the Clinical Laboratory Sciences Educator's Forum . RESULTS: Part 1: Results indicated a distinct division between participants who scored higher than 74.36% (Group A) on the senior comprehensive examination, and those scoring below 74.36% (Group B) . In Group A, 100% of participants passed the MT(ASCP) national certification examination on the first attempt . Results were mixed for Group B . Part 2: The survey indicated that of the 40 respondents, most were similar to the University of Mississippi Medical Center Clinical Laboratory Science Program in that they require a comprehensive to be taken, that the grade received is part of another course grade, and that the examination is prepared using questions submitted by the faculty . CONCLUSIONS: Part 1: The senior departmental comprehensive examination is of value in predicting the future success of a student on the MT(ASCP) national certification examination . Part 2: Unlike the University of Mississippi Medical Center, 16 of the 40 respondents stated that passage of the comprehensive examination was a requirement for graduation . In those programs, the comprehensive was a major part of a course grade. Vector Borne Zoonotic Dis, 2004 Fall, 4(3), 249 - 60 Update on spotted fever group Rickettsiae in South Africa; Pretorius AM et al.; Until very recently, Mediterranean spotted fever caused by Rickettsia conorii was the only spotted fever group (SFG) rickettsioses recognized in southern Africa . However, increasing medical awareness of tick-borne infections, together with the introduction of improved isolation methods and the availability of molecular techniques, have led to the identification of several new SFG rickettsioses in the region . African tick bite fever, caused by Rickettsia africae, is currently the most important of these new rickettsioses, affecting large numbers of international travellers each year, but infections due to Rickettsia aeschlimannii and Rickettsia mongolotimonae have also been recently encountered . In this review, we describe the current status of the epidemiology, microbiology, clinical presentation, diagnosis, treatment, and prevention of SFG rickettsioses in southern Africa. Klin Khir, 2004 Oct, (10), 48 - 51 {Microbiocenosis of alimentary canal under the influence of the enteral tube feeding in patients with choledocholithiasis}; Impact of ventilator-associated pneumonia in patients with severe head injury; From the Critical Care and Emergency Department (M.D.R-F., J.M.F-C., S.R.L-N., F.M-C., M.A . M-S., J.I.S-O.) and the Supportive Research Unit (A.C.), University Hospital Virgen del Rocio, Seville, SpainBACKGROUND:: The impact of ventilator-associated pneumonia (VAP) on outcome seems to vary depending on the critically ill patients we analyze . Our objective, therefore, has been to evaluate the influence of VAP on the mortality and morbidity in patients with severe head injury (Glasgow Coma Scale score </= 8) . METHODS:: A prospective, matched, case-control study was conducted in our intensive care unit (ICU) for a 3-year period (1998-2000) . Seventy-two patients with severe head injury (HI) who developed VAP were matched with 72 patients with severe HI without VAP . The matching criteria were as follows: age (+/- 5 years); category of HI based on computed tomographic scanning; Acute Physiology and Chronic Health Evaluation II (+/- 4 points) score; Injury Severity Score (+/- 4 points); and duration of mechanical ventilation . VAP was diagnosed on the basis of quantitative microbiologic criteria . RESULTS:: Mortality did not differ significantly between cases and matched control subjects (15 {20.8%} vs . 11 {15.3%}, p = 0.54) . However, patients with VAP had a significantly longer duration of mechanical ventilation (median, 14 vs . 10 days; p = 0.015) and ICU stay (median, 21 vs . 15.5 days; p = 0.008) . The occurrence of multiple organ failure was also significantly more frequent among the case group (33.3% vs . 12.5%, p = 0.004) during the overall ICU stay . CONCLUSION:: VAP does not seem to be associated with a significantly increased risk of death in patients with severe HI, but it may be associated with greater morbidity during the ICU stay. Ying Yong Sheng Tai Xue Bao, 2004 Oct, 15(10), 1953 - 7 {Degradation mechanism of Chinese fir plantation}; Chen L et al.; Chinese fir (Cunninghanzia lanceolata) is a fast-growing species native to China, and has a very important status in production of commercial timber . In response to the growing need for timber, pure Chinese fir plantations have been extensively replanted on the same site in successive rotations, which has resulted in serious problems of soil fertility degradation and productivity decline, and these problems have caused considerable attention from foresters, microbiologists, soil scientists and ecologists . They have also done a lot of work on these problems and studied the mechanism of productivity decline of replanted Chinese fir plantation . In this article, the author described the characteristics of productivity decline and soil degradation, and summed up the factors caused lower productivity, and analyzed the degradation mechanism of replanted Chinese fir plantation . In sum, productivity decline and soil physical and chemical characteristics deterioration were the main properties of replanted Chinese fir plantation . The factors summarized primarily as two kinds of reasons . One was the unreasonable management that was the edogenic factor, and another was the biotic self-characteristics of Chinese fir that was the intrinsic factor of poor establishment of replanted Chinese fir plantation . The combination of the edogenic and intrinsic factors reduced the productivity decline and soil degradation of the replanted Chinese fir plantation. Rev Med Liege, 2004 Oct, 59(10), 570 - 6 {The return of pertussis}; Demaret P et al.; Pertussis (whooping cough) is a contagious respiratory tract bacterial infection due to Bordetella pertussis who makes global comeback despite routine vaccination . Bordetella pertussis produces a series of virulence factors that are involved in one of several steps of the pathogenesis of whooping cough (adhesins, toxins) . Unusual presentations are now most common . Clinical diagnosis of whooping cough is often difficult, and microbiologic evaluation is helpful . Treatment is based on antibiotherapy and sometimes intensive care management . Complications are most common in children younger than 6 months (death, malignant pertussis, respiratory and neurological complications) . Pertussis can be controlled by treatment of exposed people and by vaccination. Obstet Gynecol Surv, 2005 Jan, 60(1), 26 - 28 Vulvovaginal Symptoms in Women With Bacterial Vaginosis; Klebanoff MA et al.; To investigate the symptoms among women with bacterial vaginosis, the authors conducted a longitudinal study comparing symptoms experienced by women with and without a diagnosis of bacterial vaginosis confirmed by Gram stain and Amsel clinical criteria . Subjects were recruited from women making routine healthcare visits to clinics in Birmingham, Alabama.Participating patients were interviewed intensively for information about lower genital tract symptoms, including vaginal wetness, vaginal discharge, vaginal odor, persistent vaginal itch, pain with urination, and abdominal or pelvic pain . All subjects underwent an initial clinical assessment with pelvic examination and lower genital tract microbiologic evaluation, as well as detailed questioning, which included demographic factors, obstetric and gynecologic history, dental symptoms and practices, feminine hygienic and health behaviors, sexual history and practices, history of genital tract infections or sexually transmitted diseases, alcohol and drug use, and psychosocial status.There were 2888 eligible patients who had Gram stain results available . These women were predominantly black, young, parous, unmarried, and of low income . Thirty-seven percent (1063 patients) were positive for bacterial vaginosis by Gram stain . Positivity was more common in black women and women who smoked and increased with decreasing general health status . Women who were married, of higher income, and less than 20 years of age were less likely to have bacterial vaginosis.Few of the total study population reported pelvic or abdominal pain . More women who were positive for bacterial vaginosis reported vaginal wetness and vaginal odor, and more women who were free of bacterial vaginosis reported dysuria and vaginal irritation . The differences were significant, but the numbers of women in either group who had symptoms were small . The most common symptom was vaginal odor, but only 25% of the patients with and 18% of those without bacterial vaginosis noticed vaginal odor . In all, 58% and 57% of the positive and negative patients, respectively, reported experiencing wetness, discharge, and/or vaginal odor.Among sexually active participants, those who were positive for bacterial vaginosis were more likely to have any odor or fishy odor with sexual intercourse, but less than 20% of either group reported these symptoms . When analyses were performed using Amsel criteria to define bacterial vaginosis, the pattern of reported symptoms was largely unchanged.Participants were asked to describe their usual vaginal odor to clarify their reports of symptoms . No one description was more common than another, but all descriptive terms were more frequent among patients with bacterial vaginosis . The characteristic "fishy" odor was reported by only 6% and 4% of the positive and negative patients, respectively.Thirty-seven percent of the women with no reported symptoms, 26.3% of those with vaginal irritation alone, and 19.4% of those with both irritation and discharge or wetness were positive for bacterial vaginosis . Women who reported vaginal irritation were less likely to have bacterial vaginosis no matter what other symptoms or odor they reported . Vaginal discharge did not indicate the presence of bacterial vaginosis when experienced alone or with other symptoms . Vaginal odor was the only symptom with even a moderate association with bacterial vaginosis.At clinical examination, 35% of patients who reported no discharge, and 49% of those who said they had severe discharge, were described by the examining nurse as having a thin, homogeneous discharge . Similarly, 36% of those reporting no vaginal odor, and 48% of those who felt they had severe vaginal odor, were positive for the "whiff" test. BMC Ophthalmol . 2004 Dec 24;4(1):16 {Epub ahead of print} Keratocyte loss in corneal infection through apoptosis: a histologic study of 59 cases; Vemuganti GK et al.; BACKGROUND: Keratocyte loss by apoptosis following epithelial debridement is a well-recognized entity . In a study of corneal buttons obtained from patients of corneal ulcer undergoing therapeutic keratoplasty, we observed loss of keratocytes in the normal appearing corneal stroma, surrounding the zone of inflammation . Based on these observations, we hypothesized that the cell loss in the inflammatory free zone of corneal stroma is by apoptosis that could possibly be a non-specific host response, independent of the nature of infectious agent . METHODS: To test our hypothesis, in this study, we performed Terminal deoxyribonucleotidyl transferase- mediated d-Uridine 5" triphosphate Nick End Labelling (TUNEL) staining on 59 corneal buttons from patients diagnosed as bacterial, fungal, viral and Acanthamoeba keratitis . The corneal sections were reviewed for morphologic changes in the epithelium, stroma; type, degree and depth of inflammation, loss of keratocytes in the surrounding stroma (posterior or peripheral) . TUNEL positivity was evaluated in the corneal sections, both in the zone of inflammation as well as the surrounding stroma . A correlation was attempted between the keratocyte loss, histologic, microbiologic and clinical features . RESULTS: The corneal tissues were from 59 patients aged between 16 years and 85 years (mean 46 years) and included fungal (22), viral (15), bacterial (14) and Acanthamoeba (8) keratitis . The morphological changes in corneal tissues noted were: epithelial ulceration (52, 88.1%), destruction of Bowman's layer (58, 99%), mild to moderate (28;47.5%) to severe inflammation (31;52.5%) . Morphologic evidence of disappearance or reduced number of keratocytic nuclei in the corneal stroma was noted in 49 (83%) cases; while the TUNEL positive brown cells were identified in all cases 53/54 (98%), including cases of fungal (19), bacterial (14), viral (13), and Acanthamoeba keratitis . TUNEL staining was located mostly in the deeper stroma and in few cases the peripheral stroma . TUNEL positivity was also noted with the polymorphonuclear infiltrates and in few epithelial cells (10 of 59, 17%) cases, more with viral infections (6/10; 60%) . CONCLUSIONS: We report apoptotic cell death of keratocytes in the corneal stroma in infectious keratitis, a phenomenon independent of type of infectious agent . The inflammatory cells in the zone of inflammation also show evidence of apoptotic cell death . It could be speculated that the infective process possibly triggers keratocyte loss of the surrounding stroma by apoptosis, which could possibly be a protective phenomenon . It also suggests that necrotic cell death and apoptotic cell deaths could occur simultaneously in infective conditions of the cornea. Drug News Perspect, 1998 Jun, 11(5), 310 - 9 Medical mycology and current trends in antifungal chemotherapy; Fromtling RA; The Medical Mycological Society of the Americas (MMSA) and the American Society for Microbiology (ASM) are both premier scientific organizations which held their annual conferences in Atlanta, Georgia, May 17-21, 1998 . The MMSA scientific session focused on the role of animal models in drug development and on the immunology and molecular biology of the medically important fungi . The use of current molecular tools in identifying new fungal targets for the development of antifungal agents and for the study of fungal epidemiology was reviewed . At the ASM, several sessions were held which focused on the pathogenesis of fungal disease, the in vitro susceptibility testing of new (voriconazole, SCH-56592, LY-303366, metalloporphyrins) and established antifungal agents, the experimental in vivo activity of new antifungal drugs in various animal models of fungal disease and pediatric mycology; the clinical activity of fluconazole, itraconazole, liposomal nystatin and liposomal amphotericin B formulations was also reviewed . (c) 1998 Prous Science . All rights reserved. Clin Infect Dis, 2005 Jan 1, 40(1), 123 - 6 Epub 2004 Dec 06. Global Infectious Diseases and Epidemiology Network (GIDEON): a world wide Web-based program for diagnosis and informatics in infectious diseases; Edberg SC; The Global Infectious Diseases and Epidemiology Network (GIDEON) consists of 4 modules . The first is designed to generate a ranked differential diagnosis list for any infectious diseases scenario in any of 220 countries . The second follows the country-specific epidemiology of 337 individual diseases . The third presents a comprehensive encyclopedia of 308 generic anti-infective drugs and vaccines, including a listing of >9500 trade names . The fourth generates a ranked identification list based on the phenotype of bacteria, mycobacteria, and yeasts . The program performs well and serves as a useful paradigm for World Wide Web-based informatics . GIDEON is an eclectic program that can serve the needs of clinicians, epidemiologists, and microbiologists working in the fields of infectious diseases and geographic medicine. Clin Infect Dis, 2005 Jan 1, 40(1), 114 - 22 Epub 2004 Dec 06. A new paradigm for clinical investigation of infectious syndromes in older adults: assessment of functional status as a risk factor and outcome measure; High KP et al.; Adults aged >or=65 years comprise the fastest-growing segment of the United States population, and older adults experience greater morbidity and mortality due to infection than do young adults . Although age is well established as a risk factor for infection, most clinical investigations of infectious diseases in older adults focus on microbiology and on crude end points of clinical success, such as cure rates or death; however, they often fail to assess functional status, which is a critical variable in geriatric care . Functional status can be evaluated either as a risk factor for infectious disease or as an outcome of interest after specific interventions using well-validated instruments . This article outlines the currently available data that suggest an association between infection, immunity, and impaired functional status in elderly individuals, summarizes the instruments commonly used to determine specific aspects of functional status, and provides recommendations for a new paradigm in which clinical trials that involve older adults include assessment of functional status. Oral Microbiol Immunol, 2005 Feb, 20(1), 56 - 9 Down-regulation of interleukin-1alpha-induced matrix metalloproteinase-13 expression via EP receptors by prostaglandin E in human periodontal ligament cells; Noguchi K et al.; Noguchi K, Ruwanpura SMPM, Yan M, Yoshida N, Ishikawa I . Down-regulation of interleukin-1alpha-induced matrix metalloproteinase-13 expression via EP(1) receptors by prostaglandin E(2) in human periodontal ligament cells . Oral Microbiol Immunol 2005: 20: 56-59 . (c) Blackwell Munksgaard, 2005 . In the present study, we investigated the effect of prostaglandin (PG) E(2) on matrix metalloproteinase (MMP)-13 production in human periodontal ligament cells stimulated with interleukin (IL)-1alpha . IL-1alpha enhanced both MMP-13 and PGE(2) production . Indomethacin, a nonselective cyclooxygenase inhibitor, and NS-398, a specific cyclooxygenase-2 (COX-2) inhibitor, significantly enhanced IL-1alpha-induced MMP-13 production in periodontal ligament cells, although both the agents completely inhibited IL-1alpha-induced PGE(2) production . Exogenous PGE(2) reduced IL-1alpha-induced MMP-13 mRNA and protein production in a dose-dependent manner . 17-phenyl-omega-trinor PGE(2), a selective EP(1) receptor agonist, mimicked the inhibitory effect of PGE(2) on IL-1alpha-induced MMP-13 mRNA and protein production . On the basis of these data, we suggest that COX-2-dependent PGE(2) down-regulates IL-1alpha-elicited MMP-13 production via EP(1) receptors in human periodontal ligament cells . PGE(2) may be involved in the regulation of destruction of extracellular matrix components in periodontal lesions. Oral Microbiol Immunol, 2005 Feb, 20(1), 51 - 5 Recognition and phagocytosis of multiple periodontopathogenic bacteria by anti-Porphyromonas gingivalis heat-shock protein 60 antisera; Choi JI et al.; Choi J-I, Choi K-S, Yi N-N, Kim U-S, Choi J-S, Kim S-J . Recognition and phagocytosis of multiple periodontopathogenic bacteria by anti-Porphyromonas gingivalis heat-shock protein 60 antisera . Oral Microbiol Immunol 2005: 20: 51-55.(c) Blackwell Munksgaard, 2005 . The present study has been performed to evaluate Porphyromonas gingivalis heat shock protein (HSP) 60 as a candidate vaccine to protect against multiple putative periodontopathic bacteria . Mouse anti-P . gingivalis HSP antisera demonstrated the elevated IgG antibody titers against the multiple bacteria tested and cross-reacted with heat-induced bacterial proteins of the target bacteria . The antisera also demonstrated a significantly higher opsonophagocytosis function against all the target bacteria than the control sera (P < 0.01) . We concluded that P . gingivalis HSP 60 could potentially be developed as a vaccine against multiple periodontopathic bacteria. Oral Microbiol Immunol, 2005 Feb, 20(1), 47 - 50 Retinoic acid-inducible gene-I is induced by interleukin-1beta in cultured human gingival fibroblasts; Sakaki H et al.; Sakaki H, Imaizumi T, Matsumiya T, Kusumi A, Nakagawa H, Kubota K, Nishi N, Nakamura T, Hirashima M, Satoh K, Kimura H . Retinoic acid-inducible gene-I is induced by interleukin-1beta in cultured human gingival fibroblasts . Oral Microbiol Immunol 2005: 20: 47-50.(c) Blackwell Munksgaard, 2005 . Retinoic acid-inducible gene-I (RIG-I) is a member of the DExH box family protein, and details of its biological function are not known . We have studied the mechanism of the interleukin-1beta (IL-1beta)-induced RIG-I expression in human gingival fibroblasts in culture . We also addressed the possibility of enhanced expression of COX-2, RANTES and galectin-9 in fibroblasts overexpressed RIG-I . We stimulated cultured human gingival fibroblasts with IL-1beta and examined the expression of RIG-I mRNA and protein by reverse transcriptase-mediated polymerase chain reaction and Western blot analysis . The effect of cycloheximide, a protein synthesis inhibitor, on the IL-1beta-induced expression of RIG-I was examined . The expression of COX-2, RANTES, galectin-9 and monocyte chemoattractant protein-1 in gingival fibroblasts transfected with RIG-I cDNA was also examined . IL-1beta stimulated the expressions of mRNA and protein for RIG-I, in cultured fibroblasts, in a time- and concentration-dependent manner . Cycloheximide did not suppress the IL-1beta-induced RIG-I expression . Introduction of RIG-I cDNA into fibroblasts resulted in enhanced expression of COX-2 mRNA, and slightly enhanced the expression of mRNA for RANTES and galectin-9 . In contrast, RIG-I overexpression did not alter the level of mRNA for monocyte chemoattractant protein-1 . We conclude that IL-1beta stimulates RIG-I expression in human gingival fibroblasts. Oral Microbiol Immunol, 2005 Feb, 20(1), 25 - 30 Immunohistological analysis of Tannerella forsythia-induced lesions in a murine model; Gosling PT et al.; Gosling PT, Gemmell E, Carter CL, Bird PS, Seymour GJ . Immunohistological analysis of Tannerella forsythia-induced lesions in a murine model . Oral Microbiol Immunol 2005: 20: 25-30.(c) Blackwell Munksgaard, 2005 . Tannerella forsythia has been implicated as a defined periodontal pathogen . In the present study a mouse model was used to determine the phenotype of leukocytes in the lesions induced by subcutaneous injections of either live (group A) or nonviable (group B) T . forsythia . Control mice (group C) received the vehicle only . Lesions were excised at days 1, 2, 4, and 7 . An avidin-biotin immunoperoxidase method was used to stain infiltrating CD4(+) and CD8(+) T cells, CD14(+) macrophages, CD19(+) B cells, and neutrophils . Hematoxylin and eosin sections demonstrated lesions with central necrotic cores surrounded by neutrophils, macrophages and lymphocytes in both group A and group B mice . Lesions from control mice exhibited no or only occasional solitary leukocytes . In both groups A and B, neutrophils were the dominant leukocyte in the lesion 1 day after injection, the numbers decreasing over the 7-day experimental period . There was a relatively low mean percent of CD4(+) and CD8(+) T cells in the lesions and, whereas the percent of CD8(+) T cells remained constant, there was a significant increase in the percent of CD4(+) T cells at day 7 . This increase was more evident in group A mice . The mean percent of CD14(+) macrophages and CD19(+) B cells remained low over the experimental period, although there was a significantly higher mean percent of CD19(+) B cells at day 1 . In conclusion, the results showed that immunization of mice with live T . forsythia induced a stronger immune response than nonviable organisms . The inflammatory response presented as a nonspecific immune response with evidence of an adaptive (T-cell) response by day 7 . Unlike Porphyromonas gingivalis, there was no inhibition of neutrophil migration. Arch Med Res, 2004 Sep-Oct, 35(5), 435 - 41 Extrapulmonary tuberculosis: clinical and epidemiologic spectrum of 636 cases; Ilgazli A et al.; BACKGROUND: The aim of this study was to evaluate the percentage and characteristics of extrapulmonary tuberculosis (EPTB) cases in a Turkish industrial city, Kocaeli (population: 1,203,335) and to illustrate its extent as a serious health problem for this city and country . METHODS: We investigated the results of microbiologic, radiologic, and histopathologic findings of patients with extrapulmonary tuberculosis, retrospectively, who were admitted to four Tuberculous Dispensaries between 1996 and 2000 . RESULTS: Six hundred thirty six cases were diagnosed with EPTB . Three hundred forty five were males (54.2%) and 291, females (45.8%) . Mean age of patient cases was 22.5+/-17.1 years (range, 1-86 years); 41.4% of cases were <15 years of age and 30.9%, between 20 and 39 years of age . Contact history with tuberculosis cases was determined in 242 cases (38%); of these, 194 were <15 years of age (80.2%) . The most common form of EPTB was observed to be lymph node tuberculosis (56.3%); of these cases, 256 (71.5%) had involvement in intrathoracic, 92 (25.7%) in cervical, and 10 (2.8%) in axillary lymph nodes . The second most frequent extrapulmonary form was pleural tuberculosis (31.1%) . EPTB was diagnosed by histopathologic methods in 229 patients (36.0%) and by microbiologic methods in 27 (4.2%); tuberculin skin test was significantly positive (>10 mm) in 95.5% of patients . When cases were classified according to severity, 87 cases (13.7%) were found severe and 549 (86.3%) as less severe EPTB . Five hundred sixty one cases (88.2%) lived in urban areas and 75 (11.8%), in rural areas . CONCLUSIONS: EPTB is very common in early adulthood in the Kocaeli region, with lymph nodes the most common localization. Mol Biochem Parasitol, 2005 Jan, 139(1), 99 - 106 Multiple replication origins within the inverted repeat region of the Plasmodium falciparum apicoplast genome are differentially activated; Singh D et al.; The 35kb circular genome (plDNA) of the Plasmodium falciparum apicoplast replicates by the bidirectional ori/D-loop mechanism . PlDNA replication was previously shown to initiate within the inverted repeat (IR) region of the apicoplast genome {Williamson DH, Preiser PR, Moore PW, McCready S, Strath M, Wilson RJM (Iain) . The plastid DNA of the malaria parasite Plasmodium falciparum is replicated by two mechanisms . Mol Microbiol 2002;45:533-42; Singh D, Chaubey S, Habib S . Replication of the Plasmodium falciparum apicoplast DNA initiates within the inverted repeat region . Mol Biochem Parasitol 2003;126:9-14.} and the presence of at least two ori within each segment of the IR was postulated . Using 5' end-labelled nascent DNA as probe, we now demonstrate the utilization of several putative ori located within the IR for plDNA replication . Quantitation of signals obtained for different segments of the IR as well as determination of the number of molecules emanating from two ori regions by competitive PCR analysis indicated differential strengths of ori during plDNA replication prior to schizogony. Springer Semin Immunopathol . 2004 Dec 18; {Epub ahead of print} Surveillance B lymphocytes and mucosal immunoregulation; Velazquez P et al.; Mucosal lymphocyte homeostasis involves the dynamic interaction of enteric microbiota, the intestinal host epithelium, and the mucosal immune system . Dysregulation of mucosal lymphocyte homeostasis results in a variety of intestinal disorders, notably inflammatory bowel diseases like ulcerative colitis and Crohn's disease . One key cellular component regulating homeostasis are B lymphocytes that reside in gut-associated lymphoid tissue . This compartment includes Peyer's patches, isolated lymphoid follicles, lamina propria, and mesenteric lymph nodes . Recent data have pointed to two new and exciting aspects of B cells in the gut . First, there has been progress on identification and functional analysis of abundant isolated lymphoid follicle B cells that are key mediators of IgA genesis . Second, several groups have now clarified the functional identification and characterization of immunoregulatory B cells in the gut . This review examines the novel aspects of these B cells, and examines how each plays a role in mediating mucosal homeostasis in this bacteria-laden compartment. Nucleic Acids Res, 2005 Jan 1, 33 Database Issue, D321 - 4 Metagrowth: a new resource for the building of metabolic hypotheses in microbiology; Ogata H et al.; Metagrowth is a new type of knowledge base developed to guide the experimental studies of culture conditions of obligate parasitic bacteria . We have gathered biological evidences giving possible clues to the development of the axenic (i.e . 'cell-free') growth of obligate parasites from various sources including published literature, genomic sequence information, metabolic databases and transporter databases . The database entries are composed of those evidences and specific hypotheses derived from them . Currently, 200 entries are available for Rickettsia prowazekii, Rickettsia conorii, Tropheryma whipplei, Treponema pallidum, Mycobacterium tuberculosis and Coxiella burnetii . The web interface of Metagrowth helps users to design new axenic culture media eventually suitable for those bacteria . Metagrowth is accessible at http://igs-server.cnrs-mrs.fr/axenic/. Clin Microbiol Infect, 2004 Dec, 10(12), 1108 - 32 Guidelines for the diagnosis of tick-borne bacterial diseases in Europe; Brouqui P et al.; Ticks are obligate haematophagous acarines that parasitise every class of vertebrate (including man) and have a worldwide distribution . An increasing awareness of tick-borne diseases among clinicians and scientific researchers has led to the recent description of a number of emerging tick-borne bacterial diseases . Since the identification of Borrelia burgdorferi as the agent of Lyme disease in 1982, 11 tick-borne human bacterial pathogens have been described in Europe . Aetiological diagnosis of tick-transmitted diseases is often difficult and relies on specialised laboratories using very specific tools . Interpretation of laboratory data is very important in order to establish the diagnosis . These guidelines aim to help clinicians and microbiologists in diagnosing infection transmitted by tick bites and to provide the scientific and medical community with a better understanding of these infectious diseases. Mil Med, 2004 Nov, 169(11), 863 - 5 Bullis fever: a vanished infection of unknown etiology; Murray CK et al.; Camp Bullis, Texas, is an active training facility for the U.S . Army and Air Force with a storied history dating back to the late 19th century . In the early 1940s, an epidemic of a seasonal tick-borne rickettsial-like illness occurred at Camp Bullis; the last case was reported in 1947 . To date, the etiology of this disease has remained elusive . In an attempt to retrospectively identify the causal pathogen, we surveyed Camp Bullis for the presumed tick vector with intent to screen molecularly for Rickettsia and Ehrlichia . However, no ticks were recovered from primary dragging attempts in the spring or from harvested deer in the fall . Moreover, pathologic and microbiologic materials obtained during the epidemic are no longer extant, making them unavailable for analysis . In this study, we review potential circumstances that impact emerging and, in this case, vanishing infections . The etiology of Bullis fever will probably remain undetermined, and this once-emerging infection may have vanished into history . However, given Camp Bullis' status as an active medical training site, awareness of and surveillance for the disease should continue. Ann Dermatol Venereol, 2004 Nov, 131(11), 979 - 83 {Fahr syndrome associated to hypoparathyroidy, revealed by dermatologic manifestation}; Khadir K et al.; BACKGROUND: Fahr syndrome is defined by the presence at the brain base of strio-pallido-notched non-arteriosclerotic bilateral and symmetric calcifications . We report an observation of Fahr syndrome revealed by a growing pyodermitis in direct relation with hypocalcemia . OBSERVATION: A 17 year-old girl was admitted to the Dermatology Department for a growing pyodermitis of the large folds . The patient was known to be epileptic and had undergone surgery for a left eye cataract a year before . Microbiologic and mycologic examinations of the pus and of the cutaneous fragments were negative . During hospitalization, the patient had an attack of tetany, a laryngeal spasm and a generalized erythema thrust studded with pustules . The phosphocalcic assessment showed severe hypocalcemia and hyperphosphoremia . Parathormone serum rate was decreased . The brain tomodensitometry conveyed bilateral calcifications of the central gray nucleus . The diagnosis of a growing amicrobial pustulosis secondary to an idiopathic hypoparathyroidism and responsible for the Fahr syndrome was maintained . Treatment was composed of calcium (2 g/day) and vitamin D3 . The evolution was favorable with a relapse at 2 years . DISCUSSION: We report an idiopathic hypoparathyroidism associated with Fahr syndrome conveyed by growing amicrobial pustulosis . We discuss the dermatologic manifestations of Fahr syndrome associated with hypoparathyroidism and the physiopathologic mechanisms of the dermatologic lesions during hypocalcemia. BMC Infect Dis . 2004 Dec 15;4(1):59 {Epub ahead of print} Third generation cephalosporin use in a tertiary hospital in Port of Spain, Trinidad: need for an antibiotic policy; Pinto Pereira LM et al.; BACKGROUND: Tertiary care hospitals are a potential source for development and spread of bacterial resistance being in the loop to receive outpatients and referrals from community nursing homes and hospitals . The liberal use of third-generation cephalosporins (3GCs) in these hospitals has been associated with the emergence of extended-spectrum beta- lactamases (ESBLs) presenting concerns for bacterial resistance in therapeutics . We studied the 3GC utilization in a tertiary care teaching hospital, in warded patients (medical, surgical, gynaecology, orthopedic) prescribed these drugs . METHODS: Clinical data of patients (at or above 13 years) admitted to the General Hospital, Port of Spain (POSGH) from January to June 2000, and who had received 3GCs based on the Pharmacy records were studied . The Sanford Antibiotic Guide 2000, was used to determine appropriateness of therapy . The agency which procures drugs for the Ministry of Health supplied the cost of drugs . RESULTS: The prevalence rate of use of 3GCs was 9.5 per 1000 admissions and was higher in surgical and gynecological admissions (21/1000) compared with medical and orthopedic (8 /1000) services (p<0.05) . Ceftriaxone was the most frequently used 3GC . Sixty-nine (36%) patients without clinical evidence of infection received 3Gcs and prescribing was based on therapeutic recommendations in 4% of patients . At least 62% of all prescriptions were inappropriate with significant associations for patients from gynaecology (p<0.003), empirical prescribing (p<0.48), patients with undetermined infection sites (p <0.007), and for single drug use compared with multiple antibiotics (p <0.001) . Treatment was twice as costly when prescribing was inappropriate CONCLUSIONS: There is extensive inappropriate 3GC utilization in tertiary care in Trinidad . We recommend hospital laboratories undertake continuous surveillance of antibiotic resistance patterns so that appropriate changes in prescribing guidelines can be developed and implemented . Guidelines for rational antibiotic use though developed have not been re-visited or encouraged, suggesting urgent antibiotic review of the hospital formulary and instituting an infection control team . Monitoring antibiotic use with microbiology laboratory support can promote rational drug utilization, cut costs, halt inappropriate 3GC prescribing, and delay the emergence of resistant organisms . An ongoing antibiotic peer audit is suggested. Mikrobiologiia, 2004 Sep-Oct, 73(5), 674 - 86 {Mycology at the Institute of Microbiology, Russian Academy of Sciences: history and prospects for the future} {History of the study of biodiversity of photosynthesizing bacteria} {No authors listed} The tendencies in the study of anoxygenic photosynthesizing bacteria (APB) are considered in the review in the historical aspect, since APB discovery till present day . The contribution made by the researchers of the Institute of Microbiology, Russian Academy of Sciences, to the study of the phylogeny, ecology, and morphophysiological diversity of APB is noted . At present, the molecular-biological approaches play a decisive role in ecology and taxonomy . The most important task at the modem stage of the development of microbiology is to maintain the continuity of the historically formed classical approaches in the study of APB diversity. Acta Odontol Latinoam, 2004, 17(1-2), 23 - 7 Long-term sterility of orthodontic-surgical appliances; Brusca MI et al.; The aim of this study was to evaluate the long-term sterility of new dental appliances according to the non rigid wrapping employed and assess the effectiveness of sterilization in a steam autoclave at 134 degrees for 20 minutes using physical, chemical, and biological indicators . All the experimental (E) samples and the control samples (C) were assigned to one of three groups according to the type of packaging: paper bag (E1), paper/plastic pouch (E2), nylon tubing bag (E3) . Each bag contained standardized orthodontic wires and brackets and sterility indicators . The samples were evaluated at the following experimental times: immediately, and 6, 12, 24 and 30 months post-sterilization . The samples were analyzed under aerobic and anaerobic conditions in keeping with the protocol currently in use at the Department of Microbiology, School of Dentistry, University of Buenos Aires . The group of control, non-sterilized samples (C1, C2, C3) were analyzed prior to the onset of the study, and were found to be contaminated . None of the sterilized samples in any of the three experimental groups evidenced contamination at any of the experimental times . The results showed that, under the present conditions, the packages and orthodontic appliances remained sterile for 30 months . These results show the importance of controlling sterility and the storage conditions over time for all the orthodontic/surgical appliances used in invasive treatments. Bone Marrow Transplant . 2004 Dec 06; {Epub ahead of print} What is the clinical significance of positive blood cultures with Aspergillus sp in hematopoietic stem cell transplant recipients? A 23 year experience; Simoneau E et al.; Summary:Hematopoietic stem cell (HSC) transplantation is the most frequent underlying predisposing condition to invasive aspergillosis . However, the significance of positive blood culture with Aspergillus sp in this particular population remains uncertain . We retrospectively reviewed all blood cultures performed in 1453 patients who received HSC transplant at our institution between 1980 and 2002 . We identified 19 patients with positive blood cultures with Aspergillus sp . Only one of these patients had clinical, histologic or microbiologic evidence of invasive aspergillosis . Thus, even in a population at highest risk for invasive aspergillosis, positive blood cultures with Aspergillus sp remain unusual, and cannot be readily associated with invasive aspergillosis . A case by case assessment by treating physicians of the clinical and radiologic parameters should be systematically made to establish the significance of aspergillemia . Single bottle positivity, obtained with the lysis-centrifugation blood culture system, is a common indicator of pseudoaspergillemia.Bone Marrow Transplantation advance online publication, 6 December 2004; doi:10.1038/sj.bmt.1704793. Med Oral Patol Oral Cir Bucal, 2004, 9 Suppl, 114 - 9; 108-14 Necrotising periodontal diseases; Bermejo-Fenoll A et al.; Necrotizing gingivitis (NG) or necrotising ulcerative gingivitis (NUG) is considered to be an acute opportunistic gingival infection caused by bacterial plaque . It appears more frequently in undernurished children and young adults as well as patients with immunodeficiency . In its pathogenesis, there are factors related to the oral microbiota with invasion processes on the one hand, and on the other hand, factors associated with the host, such as signs of capillary and immunological disorders as well as undernurishment . The disease is characterized by pain, bleeding and papillary necrosis with tendency to relapse . Diagnosis is made by a simple clinical examination . However, complementary tests ought to be performed in order to eliminate the possibility of illnesses systemic or immunodeficiency . Early and sustained treatment is strongly recommended . Lesions of the gums (craters in the interdental papillae) as an aftermath of the disease is a possibility, or if there is necrotizing periodontitis there will be loss of attachment tissue. Med Oral Patol Oral Cir Bucal, 2004 Nov-Dec, 9(5), 467 - 70; 464-7 Fine-needle aspiration cytology in the diagnosis of cervicofacial actinomycosis: report of 15 cases; Custal-Teixidor M et al.; OBJECTIVES: Actinomycosis is quite an infrequent bacterial infection nowadays . However it can be considered in cases with a persistent cervicofacial disease . Although it is a bacterial infection, microbiologic cultures are frequently not diagnoses, therefore histopathologic studies and image studies are essential . Our interest is to explain our experience with cervicofacial actinomycosis; the clinical behaviour, evolution and treatment, always assisted by their elected diagnostic technique: the FNAC . STUDY DESIGN: In the last 16 years, 15 patients have been diagnosed with cervicofacial actinomycosis by FNAC, treated by Maxillofacial, Internal Medicine and Paediatrics units . Clinical course, evolution, anatomical space situation, antibiotic treatment, and surgical treatment have been studied . RESULTS AND CONCLUSIONS: The fine-needle aspiration cytology (FNAC) is an easy, safe and rapid method, with a high effect, that has made the final diagnosis in 15 cases in our Hospital . All the patients have had a good clinical evolution, only in one case did we need a new treatment for recidive . In all the cases treatment has been definitive . Our interest is to explain our experience in the treatment of cervicofacial actinomycosis, its clinical presentation and evolution, together with its elected method of diagnosis, FNAC. J Bacteriol, 2004 Dec, 186(24), 8295 - 300 MazF-mediated cell death in Escherichia coli: a point of no return; Amitai S et al.; mazEF is a stress-induced toxin-antitoxin module, located on the chromosome of Escherichia coli, that we have previously described to be responsible for programmed cell death in E . coli . mazF specifies a stable toxin, and mazE specifies a labile antitoxin . Recently, it was reported that inhibition of translation and cell growth by ectopic overexpression of the toxin MazF can be reversed by the action of the antitoxin MazE ectopically overexpressed at a later time . Based on these results, it was suggested that rather than inducing cell death, mazF induces a state of reversible bacteriostasis (K . Pederson, S . K . Christensen, and K . Gerdes, Mol . Microbiol . 45:501-510, 2002) . Using a similar ectopic overexpression system, we show here that overexpression of MazE could reverse MazF lethality only over a short window of time . The size of that window depended on the nature of the medium in which MazF was overexpressed . Thus, we found "a point of no return," which occurred sooner in minimal M9 medium than it did in the rich Luria-Bertani medium . We also describe a state in which the effect of MazF on translation could be separated from its effect on cell death: MazE overproduction could completely reverse the inhibitory effect of MazF on translation, while not affecting the bacteriocidic effect of MazF at all . Our results reported here support our view that the mazEF module mediates cell death and is part of a programmed cell death network. Biomaterials, 2005 May, 26(14), 2095 - 104 Efficacy of antibiotics-loaded interpenetrating network (IPNs) hydrogel based on poly(acrylic acid) and gelatin for treatment of experimental osteomyelitis: in vivo study; Changez M et al.; The safety and efficacy of gentamycin sulphate (GS)- or vancomycin hydrochloride (VCl)-loaded polymer devices based on poly(acrylic acid) and gelatin crosslinked selectively using 0.3mol % N,N'-methylene bisacrylamide and 1wt% glutaraldehyde were evaluated by varying the drug concentration onto the devices . The placebo and drug-loaded device of AxGx (acrylic acid:gelatin: 1:1 w/w) were employed for the treatment of experimental osteomyelitis in rabbit . Rabbits were categorized into four groups . Twelve rabbits in each group were treated with 12+/-1mg of AxGx-1a (22% w/w GS), 12+/-1mg of AxGx-1b (44% w/w GS), 16+/-1mg of AxGx-1b (44% w/w GS) and 16+/-1mg of AxGx-1c (44% w/w VCl) . The drug concentration was measured following implantation in the adjacent tissue of femoral cavity, and serum . In femoral cavity maximum drug concentration was found on the 7th day with all the four types of devices . No drug was found after 21 days, at the local site with devices AxGx-1a and AxGx-1b (12+/-1mg), whereas it was detected after 6 weeks with 16+/-1mg device (44% w/w GS or VCl) . Macroscopic evaluation after treatment revealed that swelling, redness, local warmth and drainage decreased depending upon the drug loading of the implants . Sequential radiographs, histology, microbiologic assay and scanning electron micrography demonstrated devices AxGx-1b and AxGx-1c (16+/-1mg of 44% w/w drug loading) to be the most suitable device, which heals the infection after 6 weeks of treatment . No significant difference (p>0.05) in the rate of healing was observed between GS- and VCl-loaded devices . None of the implant showed toxic level of drug in serum at any given time. Am J Dent, 2004 Oct, 17(5), 351 - 3 In vivo enamel fluoride uptake after use of fluoride products; Campus G et al.; PURPOSE: To evaluate fluoride uptake in enamel after use of products containing different fluoride components of distinct oral hygiene regimen in vivo . METHODS: 84 healthy subjects (24 females and 60 males aged 19-26 years, mean 22.2) recruited from the students attending the courses of the Medical Faculty of the University of Sassari, Italy, were randomly assigned to one of four treatments groups: A: treated with a dentifrice containing sodium monofluorophosphate (1250 ppm F-); B: treated with dentifrice with 1250 ppm F- from AmF; C: treated with an AmF toothpaste (1250 ppm F-) and a mouth rinse with 250 ppm F- from AmF; or D: treated with a NaMFP toothpaste (1250 ppm F-) plus 1250 ppm NaMFP varnish . Acid-etched enamel microbiopsies on the vestibular surface of the first maxillary premolar were collected at baseline (to), after 20 days of test product use (t1) and after 24 hours without treatment (t2) . Fluoride concentration was measured using an ion-specific electrode . All measurements were made in triplicate and analyzed statistically using two-way factorial ANOVA for independent samples standard weighted-means analysis . RESULTS: The fluoride uptake in the enamel shows a considerable variation between the groups . Significant differences were found both within all products in terms of fluoride concentration in enamel for (P < 0.0001 for two-way ANOVA, and later Tukey HSD test) . After 20 days of treatment, the group using AmF toothpaste plus AmF mouthrinse had a higher fluoride uptake than the groups using either of the other products (P < 0.05) . In conclusion, all products lead to an appreciable amount of fluoride uptake in enamel; AmF products led to higher concentrations . The concentration of fluoride accumulated during treatment phase remained high after 24 hours following the cessation of use. Appl Environ Microbiol, 2004 Dec, 70(12), 7355 - 64 PCR analysis of the distribution of unicellular cyanobacterial diazotrophs in the Arabian Sea; Mazard SL et al.; An oligonucleotide primer, NITRO821R, targeting the 16S rRNA gene of unicellular cyanobacterial N2 fixers was developed based on newly derived sequences from Crocosphaera sp . strain WH 8501 and Cyanothece sp . strains WH 8902 and WH 8904 as well as several previously described sequences of Cyanothece sp . and sequences of intracellular cyanobacterial symbionts of the marine diatom Climacodium frauenfeldianum . This oligonucleotide is specific for the targeted organisms, which represent a well-defined phylogenetic lineage, and can detect as few as 50 cells in a standard PCR when it is used as a reverse primer together with the cyanobacterium- and plastid-specific forward primer CYA359F (U . Nubel, F . Garcia-Pichel, and G . Muyzer, Appl . Environ . Microbiol . 63:3327-3332, 1997) . Use of this primer pair in the PCR allowed analysis of the distribution of marine unicellular cyanobacterial diazotrophs along a transect following the 67 degrees E meridian from Victoria, Seychelles, to Muscat, Oman (0.5 degrees S to 26 degrees N) in the Arabian Sea . These organisms were found to be preferentially located in warm (>29 degrees C) oligotrophic subsurface waters between 0 and 7 degrees N, but they were also found at a station north of Oman at 26 degrees N, 56 degrees 35'E, where similar water column conditions prevailed . Slightly cooler oligotrophic waters (<29 degrees C) did not contain these organisms or the numbers were considerably reduced, suggesting that temperature is a key factor in dictating the abundance of this unicellular cyanobacterial diazotroph lineage in marine environments. Front Biosci, 2005 Jan 1, 10, 166 - 79 Print 2005 Jan 1. Microsensors and microbiosensors for retinal implants; Zhou DD et al.; This paper concentrates on recent developments in microsensors and microbiosensors for the possible applications in visual prostheses, especially retinal prosthetic devices . A brief introduction on the developments of visual prosthesis will be presented . The importance for in-vivo pH measurements as well as the need for an implantable pH sensor will be demonstrated . Electrochemical biosensors developed for sensitive measurements of glucose and L-glutamate, a known neurotransmitter in the retina and brain will be reviewed . Novel electrode materials such as chemically modified thin-film diamond in applications for implantable biosensors will be shown . The challenges in the development of chronic implantable sensor systems, especially using MEMS technology for medical implants, will be discussed. Environ Sci Technol, 2004 Nov 15, 38(22), 5939 - 49 Sugars--dominant water-soluble organic compounds in soils and characterization as tracers in atmospheric particulate matter; Simoneit BR et al.; The presence of saccharides is being reported for aerosols taken in urban, rural, and marine locales . The commonly found primary saccharides are alpha- and beta-glucose, alpha- and beta-fructose, sucrose, and mycose with lesser amounts of other monosaccharides . Saccharide polyols are also found in some airsheds and consist mainly of sorbitol, xylitol, mannitol, erythritol, and glycerol . In temperate climate areas these compounds increase from negligible concentrations in winter aerosols (usually dominated by levoglucosan and related anhydrosaccharides from biomass burning) to a maximum in late spring-summer, followed by a decrease to winter . The composition of the saccharide mixtures suggests soil and associated microbiota as the source . Saccharide analyses of soils confirmed these compositions . Therefore, we propose resuspension of soil (also unpaved road dust) from agricultural activities as a major component of aerosol particles and the saccharides are the source specific tracers . In addition, the saccharides as well as the anhydrosaccharide derivatives from biomass burning are completely water soluble and thus contribute significantly to the total water-soluble mass of aerosols. J Microbiol Methods, 2005 Jan, 60(1), 107 - 13 McRAPD as a new approach to rapid and accurate identification of pathogenic yeasts; Plachy R et al.; Despite advances in antifungal prophylaxis and therapy, morbidity and mortality incurred by yeasts remain a significant burden . As pathogenic yeast species vary in their susceptibilities to antifungal agents, clinical microbiology laboratories face an important challenge to identify them rapidly and accurately . Although a vast array of phenotyping and genotyping methods has been developed, these are either unable to cover the whole spectrum of potential yeast pathogens or can do this only in a rather costly or laborious way . Random amplified polymorphic DNA (RAPD) fingerprinting was repeatedly demonstrated to be a convenient tool for species identification in pathogenic yeasts . However, its wider acceptance has been limited mainly due to special expertise and software needed for analysis and comparison of the resulting banding patterns . Based on a pilot study, we demonstrate here that a simple and rapid melting curve analysis of RAPD products can provide data for identification of five of the most medically important Candida species . We have termed this new approach melting curve of random amplified polymorphic DNA (McRAPD) to emphasize its rapidity and potential for automation, highly desirable features for a routine laboratory test. Clin Diagn Virol, 1996 May, 5(2-3), 121 - 9 Laboratory diagnosis of intrauterine and perinatal virus infections; Best JM; Background: Intrauterine infection with rubella, cytomegalovirus (CMV), varicella zoster virus (VZV), parvovirus B19 and human immunodeficiency virus type 1 (HIV-1) may occur following maternal infection . Diagnosis of congenital infection in the neonate is dependant on the appropriate laboratory techniques being used . Prenatal diagnosis of intrauterine infection may also be indicated . Herpes simplex virus (HSV), HIV-1, VZV, enteroviruses, hepatitis B (HBV) and hepatitis C viruses (HCV), human T-cell lymphotropic viruses (HTLV-1 and 2) and genital papillomaviruses (PVs) may be acquired at delivery . Neonatal HSV, VZV and enterovirus infections may be severe or even fatal . Perinatally acquired HBV, HCV, HIV-1 and HTLVs are associated with persistent infection and chronic disease in later life . However, if the mother is identified as a carrier in the antenatal period, mother-infant transmission of HBV may be prevented by active/passive immunisation of the neonate, HIV-1 by caesarian section or antiviral therapy, and of HTLV-1 by avoiding breast feeding . Objectives and study design: To review the techniques available for the diagnosis of intrauterine infections, neonatal infections with HSV, HIV-1, VZV and enteroviruses, maternal infection with HBV, HCV and HIV-1 and prenatal diagnosis of intrauterine rubella, CMV and B19 . Results: Congenital rubella may be diagnosed by detection of specific IgM, but virus detection is the technique of choice for congenital cytomegalovirus . Congenital VZV may be diagnosed by serological techniques in up to 71% of cases . Detection of virus in vesicle scrapings or swabs from the oropharynx is the technique of choice for neonatal HSV, while enterovirus infections are best diagnosed by detection of viral RNA . A clinical diagnosis of congenital VZV is often possible . HIV-1 may be diagnosed within 3 months of birth by testing serial blood samples with a combination of techniques . Maternal infection with HBV, HCV, HIV and {Formula: see text} may be diagnosed by serological techniques and genital PVs by detection of viral DNA . Chorionic villus samples, amniotic fluid and fetal blood may be obtained for prenatal diagnosis of infection . Although detection of virus in amniotic fluid is the technique of choice for prenatal diagnosis of CMV, insufficient data is currently available to determine whether it may be used for intrauterine rubella . The most reliable technique for diagnosis of fetal B19 infection is detection of viral DNA in fetal blood . Conclusions: Close liaison between clinicians and microbiologists/virologists is required in order that appropriate specimens are collected from infant and/or mother and appropriate tests conducted . The use of TORCH screening should be discouraged. Clin Diagn Virol, 1995 Jul, 4(1), 51 - 9 Laboratory acquired tick-borne meningoencephalitis: characterisation of virus strains; Avsic-Zupanc T et al.; Background: The handling of tick-borne encephalitis (TBE) virus is potentially hazardous, as indicated by a number of laboratory-acquired infections in the prevaccination era . Objectives: (1) To reemphasize the hazard of handling TBE virus without being vaccinated by describing the case of a laboratory-acquired full-blown TBE in a microbiologist who isolated the virus from a blood sample . (2) To molecularly characterize the causative virus strain isolated in Slovenia in comparison with the European prototype strain Neudoerfl . Study design: The virological diagnosis of the laboratory infection was established by serology and virus isolation . The virus was characterized by restriction fragment analysis of PCR products of amplified genomic sequences and a panel of monoclonal antibodies reacting with the major envelope protein . Results: The laboratory infection, most probably acquired by aerosol, resulted in a biphasic course of the disease with a severe meningoencephalitis in the second phase . Both by restriction fragment and monoclonal antibody analysis the Slovenian virus strains involved were indistinguishable from the European prototype strain . Conclusions: This report confirms the potential hazard of handling TBE virus in the laboratory without being vaccinated . The similarity of the virus isolates from Slovenia with the European prototype strain confirms the previously observed homogeneity of TBE virus strains from different European countries. J Endod, 2004 Dec, 30(12), 851 - 4 Simultaneous detection of Dialister pneumosintes and Filifactor alocis in endodontic infections by 16S rDNA-directed multiplex PCR; Siqueira Junior JF et al.; Dialister pneumosintes and Filifactor alocis have been recently considered as candidate endodontic pathogens . In this study, we devised a 16S rDNA-directed multiplex PCR protocol for simultaneous detection of these two bacterial species in endodontic infections . Samples were taken from infected root canals associated with asymptomatic periradicular lesions as well as from cases of acute periradicular abscesses . DNA extracted from the samples was used as template for simultaneous detection of D . pneumosintes and F . alocis through a multiplex PCR assay . Two fragments of the expected sizes, one specific for D . pneumosintes and the other for F . alocis, were simultaneously amplified from a mixture of reference genomic DNA containing DNA from both species . Clinical samples that were positive for the target species showed a single band of the predicted size for each species . D . pneumosintes was detected by multiplex PCR in 11 samples (7 asymptomatic and 4 abscesses) and F . alocis was identified in 9 cases (6 asymptomatic and 3 abscesses) . Six samples (3 asymptomatic and 3 abscesses) shared the two species . Data from the present study confirmed that D . pneumosintes and F . alocis are common members of the microbiota present in primary endodontic infections and thereby may participate in the pathogenesis of periradicular lesions . The proposed multiplex PCR assay is a simple, rapid, and accurate method for the simultaneous detection of these two candidate endodontic pathogens. An R Acad Nac Med (Madr), 2004, 121(2), 263 - 88 {Severe acute respiratory syndrome and aviar flu}; Eiros Bouza JM; Severe acute respiratoru syndrome (SARS) is a new disease that caused large ourbreaks in several countries in the first half of 2003, resulting in infection in more than 8.000 people and more than 900 deaths . The disease originated in southern China and a novel coronavirus (SARS CoV) has been implicated as the causative organism . We present an overview of the etiology, clinical presentation and diagnosis, based on the current state of knowledge derived from published studies and our experience in the National Microbiology Centre . Influenza is a zoonosis . This appreciation of influenza ecologyfacilitated recognition of the H5N1 'bird flu' incident in Hong Kong in 1997 in what was considered to be an incipient pandemic situation, the chicken being the source of virus for humans and . The current outbreak of avian influenza in South East Asia has resulted in a small number of human deaths . These findings highlight the importance of systematic virus surveillance of domestic poultry in recognizing changes in virus occurrence, host range and pathogenicity as signals at the avian level that could presage a pandemic. J Surg Oncol, 2004 Dec 1, 88(3), 161 - 81 Errors in pathology and laboratory medicine: consequences and prevention; Hollensead SC et al.; Reducing errors and improving quality are an integral part of Pathology and Laboratory Medicine . The rate of errors is reviewed for the pre-analytical, analytical, and post-analytical phases for a specimen . The quality systems in place in pathology today are identified and compared with benchmarks for quality . The types and frequency of errors and quality systems are reviewed for surgical pathology, cytopathology, clinical chemistry, hematology, microbiology, molecular biology, and transfusion medicine . Seven recommendations are made to reduce errors in future for Pathology and Laboratory Medicine. J Clin Periodontol, 2004 Dec, 31(12), 1117 - 21 In vitro studies on controlled-release cellulose acetate films for local delivery of chlorhexidine, indomethacin, and meloxicam; Cetin EO et al.; BACKGROUND: Delivery of medications into periodontal pockets to suppress or eradicate the pathogenic microbiota or modulate the inflammatory response, thereby limiting periodontal tissue destruction, has attracted significant interest with the purpose of effective periodontal treatment . However, no study has previously attempted to develop a controlled-release formulation of anti-inflammatory agents to be used in the field of periodontology . The aim of the present study was to examine the in vitro release profile of chlorhexidine gluconate, indomethacin, and meloxicam from cellulose acetate films . METHODS: Cellulose acetate films containing chlorhexidine gluconate, indomethacin, and meloxicam were prepared and cut in a form to fit to the periodontal pocket anatomy . The release of active agents was studied in 10 ml artificial saliva at 37 degrees C . Apparatus Vibrax was used at 150 r.p.m . Determinations were carried out spectrophotometrically and the release profiles were plotted as a function of time . RESULTS: The formulations showed two different release patterns for a total observation period of approximately 120 h . When the formulations of the three active agents were compared, the release patterns of meloxicam and chlorhexidine gluconate were found to be similar, while the indomethacin-containing formulation exhibited the fastest release rate . CONCLUSIONS: As a conclusion, cellulose acetate may be a suitable inert material for obtaining a prolonged local release of various anti-inflammatory agents like meloxicam . Further in vitro and in vivo studies are required before starting clinical applications of these controlled-release formulations of anti-inflammatory agents. Clin Invest Med, 2004 Oct, 27(5), 253 - 8 Bloodstream infection complicating trauma; Laupland K et al.; BACKGROUND: Bloodstream infection (BSI) is recognized as an important infectious complication of major trauma . However, its occurrence, the risk factors contributing to its development, and its outcomes have not been well described . DESIGN: Cohort with linkage of regional trauma and microbiology databases . PATIENTS: Adult trauma patients with injury severity score (ISS) > or = 12 admitted to a regional trauma centre during a 33-month period . RESULTS: Of 1797 victims of acute trauma identified (median ISS 20; interquartile range {IQR} 16-25), 71 (4%) had 77 episodes of BSI, for an overall rate of 2.9 per 1000 hospital days . BSI in the majority of patients (37 of 72, or 52%) had onsets within the first week of hospitalization; 7 (10%) patients had community-acquired BSI (onset within 2 d) . Independently associated with the development of nosocomial BSI were higher ISSs (odds ratio {OR} 1.04, 95% confidence interval {CI} 1.02-1.07); requirement for ICU admission (OR 7.06, CI 3.38-14.75); and burns (OR 5.75, CI 2.16-15.30) . Although trauma-related BSI was a predictor of increased in-hospital case fatality (15/71 v . 208/1726; relative risk 1.75, CI 1.10-2.78), it was not an independent predictor of death . CONCLUSION: In our series, 1 in 25 major trauma cases was complicated by BSI . The infection occurred within the first week after injury in over half of our cases . Knowledge of the epidemiology of these infections will be important for planning preventive or early therapeutic efforts. Pediatr Pulmonol, 2005 Jan, 39(1), 56 - 63 Use of laryngeal mask airway in flexible bronchoscopy in infants and children; Naguib ML et al.; In the past two decades, flexible bronchoscopy (FB) has gained increasing popularity among pediatric pulmonologists . The objective of this study was to review our experience with pediatric flexible bronchoscopy over the past 15 years, with special focus on route of bronchoscopy . This is a retrospective study . We reviewed our pediatric FB procedures performed at the University of Michigan, Mott Children's Hospital, from 1988-2003 . The study included 1,947 procedures in 1,548 patients, with a mean of 1.3 procedures/patient . The male:female ratio was 1.66:1, and age was 4.9 +/- 5.6 years (mean +/- SD) . Patients <2 years of age represented 46.6% of the study population . The laryngeal mask airway (LMA) was the most common route for flexible bronchoscopy in children 2 years of age and above . Complication rates were lower with the use of the LMA (1.9%) compared to the nasal route (3.5%) . Stridor was the most common indication in the age group <2 years (20.8%), while persistent pulmonary infiltrates were more common in the older age groups (32.2-37%) . Laryngomalacia was the most common finding in patients with stridor (31.5%), while inflammatory changes were more common with other indications . Procedure-related complications were reported in 2.3% of procedures . Bronchoalveolar lavage (BAL) samples were obtained and analyzed in 51.2% of FB procedures (n = 1,000), of which 19.4% yielded positive microbiology cultures . In conclusion, FB is a safe procedure in pediatrics . Children less than 7 years of age represent the majority of FB subjects . The LMA offered a lower rate of procedure-related complications when compared to the nasal route or endotracheal tube . It also reduced procedure time and anesthesia time . Pediatr Pulmonol . 2005; 39:56-63 . (c) 2005 Wiley-Liss, Inc. Infect Dis Clin North Am, 2004 Dec, 18(4), 939 - 62 Healthcare-associated pneumonia in adults: management principles to improve outcomes; Craven DE et al.; Guidelines for Management of HAP were developed jointly by the ATS and IDSA in 2004 . These guidelines were designed to improve patient outcomes and to decrease the emergence of MDR pathogens (see Fig . 1).Principles include early initiation of appropriate and adequate antibiotic therapy after cultures of blood and sputum are obtained . Quantitative distal airway sampling by bronchoscopy provides greater diagnostic specificity for VAP: in one randomized study, improved outcomes were noted, compared with clinical diagnosis with qualitative endotracheal aspirates . Higher doses of initial, empiric antibiotics also are recommended . Assessment of the patient's clinical response to empiric antibiotics should be correlated with microbiologic results to streamline, de-escalate, or stop unnecessary anti-biotic treatment . Duration of therapy for uncomplicated HAP should be limited to 7 days followed by close monitoring for relapse after cessation of antibiotics . The authors suggest that prevention strategies target modifiable short- and long-term risk factors . They also advocate the use of a multidisciplinary team that is dedicated to the treatment and prevention of HCAP and the basic principle of the modern Hippocratic Oath: "I will prevent disease whenever I can, for prevention is preferable to cure." Infect Dis Clin North Am, 2004 Dec, 18(4), 861 - 82, ix Acute exacerbations of chronic bronchitis: new developments concerning microbiology and pathophysiology--impact on approaches to risk stratification and therapy; Sethi S et al.; Exacerbations are a characteristic feature of chronic obstructive pulmonary disease and contribute significantly to associated morbidity and mortality . Renewed interest in this common clinical problem and research using new investigative tools has enhanced substantially the understanding of the pathogenesis of exacerbations . Results of recent clinical trials and observational studies have allowed refinements in treatment of exacerbations that should im-prove patient outcomes . This article discusses a rational, stratified approach to the use of antibiotics for this condition based on these recent studies. Rinsho Ketsueki, 2004 Oct, 45(10), 1100 - 4 {Methotrexate-induced interstitial pneumonitis in a child with acute lymphoblastic leukemia}; Tatsumoto C et al.; We report a case of 5-year-old boy with acute lymphoblastic leukemia who developed interstitial pneumonitis induced by methotrexate (MTX) . The patient was hospitalized with fever, cough, dyspnea and hypoxemia during maintenance treatment with low dose MTX and 6-mercaptopurine . A diagnosis of MTX pneumonitis was made based on the clinical findings, viral and serologic studies, negative microbiology and the radiological features . The patient recovered after cessation of the MTX treatment . Interstitial pneumonitis caused by MTX is well-recognized and the prevalence has been estimated to be 0.3-7.5% among patients with adult rheumatoid arthritis . However, there are few reports in the literature regarding this adverse effect in patients with leukemia . Furthermore, very few cases of childhood leukemia have been reported regarding MTX induced interstitial pneumonitis . Physicians should be aware of this rare complication during maintenance treatment with weekly low dose MTX for acute lymphoblastic leukemia in children. Clin Orthop, 2004 Oct, (427), 132 - 7 Polymerase chain reaction can detect bacterial DNA in aseptically loose total hip arthroplasties; Clarke MT et al.; Identifying low-grade infection in failed total hip arthroplasties is an important but difficult task . This study investigated the ability of the polymerase chain reaction to identify low-grade infection during revision of total hip arthroplasties that failed from aseptic causes . One hundred thirteen specimens from 31 total hip arthroplasties revised for aseptic loosening were compared with 105 control specimens from 28 primary total hip arthroplasties . All surgeries were done in laminar flow operating rooms . No primary or revision specimen had positive microbiologic cultures . No revision specimen had histologic evidence suggestive of infection . Using the polymerase chain reaction with a detection threshold of 10 organisms per cubic centimeter of specimen, bacterial DNA was identified in 39 of 85 revision tissue specimens (46%) compared with 18 of 84 primary tissue specimens (21.4%) . Bacterial DNA was identified in the synovial fluid of three specimens taken from 28 revision total hip arthroplasties (10.7%) and in two specimens taken from 21 primary total hip arthroplasties (9.5%) . As multiple specimens were sent for each hip, a maximum of 16 of 31 revision total hip arthroplasties (52%) and eight of 28 primary total hip arthroplasties (29%) were considered to be infected . Bacterial DNA can be found in many specimens obtained from revised total hip arthroplasties considered to be aseptically loose . Because bacterial DNA identified at primary total hip arthroplasty was assumed to be attributable to contamination rather than present in healthy tissues, the overall specimen contamination rate of 19% and case contamination rate of 29% indicate that the polymerase chain reaction has poor specificity at this sensitivity level for diagnosing infection in revision total hip arthroplasty. Biomed Microdevices, 2004 Dec, 6(4), 279 - 87 Membrane-based PDMS microbioreactor for perfused 3D primary rat hepatocyte cultures; Ostrovidov S et al.; To improve primary adult rat hepatocyte cultures, two types of PDMS microbioreactors containing a membrane, used as a scaffold for the attachment of cells, were built: one with a commercially-available polyester membrane, the other with a PDMS membrane (5 x 5 microm hole sizes) made in our laboratory . In that way, the relative surface area between blood perfusion and hepatocytes seen in vivo was mimicked and as cells were bathed in both sides by the culture medium they expressed much higher functions . A new technique to build such PDMS membrane was created . With this technique we could build various PDMS membranes with down to 5 x 5 microm holes and with thickness even below 20 microm . During the fifteen days of perfusion in these microbioreactors, good cell attachment then cell reorganization was observed . Moreover compared to static cultures in tissue-culture-treated dishes and in cultures in inserts with the same polyester membranes, seven and two times increases in the albumin secretion by the cultured primary rat adult hepatocyte were demonstrated, respectively . Ammonium removal also increased 7 times in perfused cultures compared to static cultures . These new microbioreactors, which closely mimic the in vivo liver architecture, revealed themselves to be very promising tools towards future applications in drug screening or liver tissue engineering. Clin Orthop, 2004 Oct, 1(427), 132 - 137 Polymerase Chain Reaction Can Detect Bacterial DNA in Aseptically Loose Total Hip Arthroplasties; Clarke MT et al.; Identifying low-grade infection in failed total hip arthroplasties is an important but difficult task . This study investigated the ability of the polymerase chain reaction to identify low-grade infection during revision of total hip arthroplasties that failed from aseptic causes . One hundred thirteen specimens from 31 total hip arthroplasties revised for aseptic loosening were compared with 105 control specimens from 28 primary total hip arthroplasties . All surgeries were done in laminar flow operating rooms . No primary or revision specimen had positive microbiologic cultures . No revision specimen had histologic evidence suggestive of infection . Using the polymerase chain reaction with a detection threshold of 10 organisms per cubic centimeter of specimen, bacterial DNA was identified in 39 of 85 revision tissue specimens (46%) compared with 18 of 84 primary tissue specimens (21.4%) . Bacterial DNA was identified in the synovial fluid of three specimens taken from 28 revision total hip arthroplasties (10.7%) and in two specimens taken from 21 primary total hip arthroplasties (9.5%) . As multiple specimens were sent for each hip, a maximum of 16 of 31 revision total hip arthroplasties (52%) and eight of 28 primary total hip arthroplasties (29%) were considered to be infected . Bacterial DNA can be found in many specimens obtained from revised total hip arthroplasties considered to be aseptically loose . Because bacterial DNA identified at primary total hip arthroplasty was assumed to be attributable to contamination rather than present in healthy tissues, the overall specimen contamination rate of 19% and case contamination rate of 29% indicate that the polymerase chain reaction has poor specificity at this sensitivity level for diagnosing infection in revision total hip arthroplasty. Cancer, 2004 Dec 15, 101(12), 2817 - 24 Rhabdomyosarcoma: value of myogenin expression analysis and molecular testing in diagnosing the alveolar subtype: an analysis of 109 paraffin-embedded specimens; Hostein I et al.; BACKGROUND: Identification of the alveolar subtype of rhabdomyosarcoma (ARMS) is important, because the poor prognosis associated with this subtype necessitates a modified therapeutic regimen . At present, ARMS diagnoses are made on the basis of histologic findings and the extent of myogenin immunopositivity . Nonetheless, the absence of an alveolar pattern in the solid variant, the low degree of differentiation in certain embryonal rhabdomyosarcomas (ERMS), and the increasing use of microbiopsy samples make the diagnosis of ARMS somewhat difficult . Two specific translocations have been found in ARMS, and fusion transcripts can be detected by reverse transcriptase-polymerase chain reaction (RT-PCR) analysis of paraffin-embedded tissue (PET) . METHODS: To assess the value of myogenin staining and molecular testing in the diagnosis of rhabdomyosarcoma, the authors examined 109 rhabdomyosarcoma samples (45 ARMS samples and 64 ERMS samples) . Real-time RT-PCR analysis of PET was performed in all 109 rhabdomyosarcomas, and RT-PCR analysis of frozen material was performed in 24 cases . RESULTS: PAX fusion transcripts were present in 44 cases (39 ARMS and 5 ERMS) and absent in 52 cases (2 ARMS and 50 ERMS) . In 13 cases (4 ARMS and 9 ERMS), the results were not interpretable . Results were concordant between paired frozen and fixed tumor samples . All 35 interpretable ERMS samples that contained < 50% myogenin-positive cells failed to yield detectable PAX fusion transcripts . Of the 61 interpretable tumor samples (41 ARMS and 20 ERMS) that contained > 50% myogenin-positive cells, 44 (39 ARMS and 5 ERMS) yielded detectable PAX fusion transcripts . CONCLUSIONS: The current study demonstrates that molecular detection of PAX fusion transcripts via real-time RT-PCR analysis of PET is a sensitive and specific method for the diagnosis of ARMS and that immunohistochemical analysis of myogenin expression can be used to select cases for such molecular testing . Although RT-PCR analysis appears not to possess diagnostic value in tumors with < 50% tumor cell immunopositivity, it is strongly recommended for the diagnosis of tumors containing > 50% myogenin-positive cells. Pneumologie, 2004 Nov, 58(11), 777 - 90 {Current diagnostic approach to pleural effusion}; Frank W; Pleural effusion is a common pneumologic and interdisciplinary problem . Transudate/exsudate discrimination of the pleural fluid by thoracentesis remains the diagnostic basic algorithm . Regardless of a number of new markers, classical LIGHT's criteria comprising the pleural fluid protein- and LDH-values (or their serum ratio respectively) reveal the highest potency with an overall accuracy of 95 % . Expansion to cholesterol-determination (triplet test) may be helpful to identify transudates in indeterminate cases . The need for further local diagnostic evaluation is then usually restricted to exudates . Bacterial pleurisy, malignant and tuberculous effusion are the principal differential diagnoses . With the use of a variety of conventional biochemical, cytologic, immunologic and microbiologic investigations, thoracentesis will allow- or substantially narrow-diagnosis of exudates in about 70 %, with novel cell biological markers in some conditions up to 90 % . In bacterial pleurisy thoracentesis provides information directly relevant to management in terms of local interventions . It also constitutes a platform for more invasive imaging- or endoscopy-guided investigations with a focus on medical thoracoscopy (pleuroscopy) . Blind needle biopsy is diagnostic in a range of 40 - 70 % both in malignancy and inflammatory disease, thoracoscopy may clarify exudative conditions in about 95 % . Thus malignancy may be specifically diagnosed in 97 % of cases, tuberculous effusion in virtually 100 % . The value of thoracoscopy is augmented by interventional options including complete evacuation of the pleural cavity, eventually followed by talc pleurodesis ("poudrage") in recurrent effusions or adhesiolysis, irrigation and fibrinolysis protocols in certain inflammatory conditions . These combined features as accomplished in local anesthesia on a remarkably high safety level characterise medical thoracoscopy as a gold standard tool for the management of pleural disease even in comparison to more elaborate surgical procedures. Proc Natl Acad Sci U S A, 2004 Nov 16, 101(46), 16322 - 7 Epub 2004 Nov 16. Integrated regulatory responses of fimB to N-acetylneuraminic (sialic) acid and GlcNAc in Escherichia coli K-12; Sohanpal BK et al.; Bacterial-host attachment by means of bacterial adhesins is a key step in host colonization . Phase variation (reversible on-off switching) of the type 1 fimbrial adhesin of Escherichia coli involves a DNA inversion catalyzed by FimB (switching in either direction) or FimE (mainly on-to-off switching) . fimB is separated from the divergent yjhATS operon by a large (1.4 kbp) intergenic region . Short ( approximately 28 bp) cis-active elements (regions 1 and 2) close to yjhA stimulate fimB expression and are required for sialic acid (Neu(5)Ac) sensitivity of its expression {El-Labany, S., Sohanpal, B . K., Lahooti, M., Akerman, R . & Blomfield, I . C . (2003) Mol . Microbiol . 49, 1109-1118} . Here, we show that whereas NanR, a sialic acid-response regulator, binds to region 1, NagC, a GlcNAc-6P-responsive protein, binds to region 2 instead . The NanR- and NagC-binding sites lie adjacent to deoxyadenosine methylase (Dam) methylation sites (5'-GATC) that are protected from modification, and the two regulators are shown to be required for methylation protection at regions 1 and 2, respectively . Mutations in nanR and nagC diminish fimB expression, and both fimB expression and FimB recombination are inhibited by GlcNAc (3- and >35-fold, respectively) . Sialic acid catabolism generates GlcNAc-6-P, and whereas GlcNAc disrupts methylation protection by NagC alone, Neu(5)Ac inhibits the protection mediated by both NanR and NagC as expected . Type 1 fimbriae are proinflammatory, and host defenses enhance the release of both Neu(5)Ac and GlcNAc by a variety of mechanisms . Inhibition of type 1 fimbriation by these amino sugars may thus help balance the interaction between E . coli and its hosts. J Nucl Med, 2004 Nov, 45(11), 1864 - 71 Diagnosing infection in the failed joint replacement: a comparison of coincidence detection 18F-FDG and 111In-labeled leukocyte/99mTc-sulfur colloid marrow imaging; Love C et al.; The objectives of this study were to investigate (18)F-FDG imaging, using a coincidence detection system, for diagnosing prosthetic joint infection and to compare it with combined (111)In-labeled leukocyte/(99m)Tc-sulfur colloid marrow imaging in patients with failed lower extremity joint replacements . METHODS: Fifty-nine patients--with painful, failed, lower extremity joint prostheses, 40 hip and 19 knee--who underwent (18)F-FDG, labeled leukocyte, and bone marrow imaging, and had histopathologic and microbiologic confirmation of the final diagnosis, formed the basis of this investigation . (18)F-FDG images were interpreted as positive for infection using 4 different criteria: criterion 1: any periprosthetic activity, regardless of location or intensity; criterion 2: periprosthetic activity on the (18)F-FDG image, without corresponding activity on the marrow image; criterion 3: only bone-prosthesis interface activity, regardless of intensity; criterion 4: semiquantitative analysis--a lesion-to-background ratio was generated, and the cutoff value yielding the highest accuracy for determining the presence of infection was determined . Labeled leukocyte/marrow images were interpreted as positive for infection when periprosthetic activity was present on the labeled leukocyte image without corresponding activity on the marrow image . RESULTS: Twenty-five (42%) prostheses, 14 hip and 11 knee, were infected . The sensitivity, specificity, and accuracy of (18)F-FDG, by criterion, were as follows: criterion 1: 100%, 9%, 47%; criterion 2: 96%, 35%, 61%; criterion 3: 52%, 44%, 47%; criterion 4: 36%, 97%, 71% . The sensitivity, specificity, and accuracy of labeled leukocyte/marrow imaging were 100%, 91%, and 95%, respectively . WBC/marrow imaging, which was more accurate than any of the (18)F-FDG criteria for all prostheses, as well as for hips and knees separately, was significantly more sensitive than criterion 3 (P < 0.001) and criterion 4 (P < 0.001) and was significantly more specific than criterion 1 (P < 0.001), criterion 2 (P < 0.001), and criterion 3 (P < 0.001) . CONCLUSION: Regardless of how the images are interpreted, coincidence detection-based (18)F-FDG imaging is less accurate than, and cannot replace, labeled leukocyte/marrow imaging for diagnosing infection of the failed prosthetic joint. S Afr Med J, 2004 Oct, 94(10), 851 - 4 Serum procalcitonin as an early marker of neonatal sepsis; Ballot DE et al.; BACKGROUND: It has recently been suggested that procalcitonin (PCT) is of value in the diagnosis of neonatal sepsis, with varying results . This study was to evaluate the role of PCT as a single early marker of neonatal sepsis . SETTING: Neonatal Unit, Johannesburg Hospital, and Microbiology Laboratory, National Health Laboratory Service (NHLS), South Africa . SUBJECTS AND METHODS: Neonates undergoing evaluation for sepsis between April and August 2002 were eligible for inclusion . Patients were categorised into 'no infection', 'possible infection' and 'definite infection' on the basis of C-reactive protein (CRP), white cell count (WCC), platelet count and blood culture results . PCT was correlated with infection categories . RESULTS: One hundred and eighty-three neonates were enrolled . One hundred and eighteen had no infection, 52 possible infection and 13 definite infection . PCT differed significantly among infection categories (p < 0.0001) and correlated significantly with CRP at presentation (correlation coefficient 0.404, p < 0.001) and CRP at 24 hours (correlation coefficient 0.343, p < 0.001) . PCT predicted 89.5% of definite infection . Receiver operating characteristic (ROC) analysis for PCT to predict definite infection showed odds ratio (OR) 1.145 (95% confidence interval (CI): 1.05-1.25) with an area under the curve of 0.778 . PCT had a negative predictive value of 0.95 (95% CI: 0.915-0.988) for definite infection . CONCLUSIONS: Although PCT was significantly related to the category of infection, it is not sufficiently reliable to be the sole marker of neonatal sepsis . PCT would be useful as part of a full sepsis evaluation, but is relatively expensive . A negative PCT on presentation may rule out sepsis, but this needs to be evaluated further. J Clin Microbiol, 2004 Nov, 42(11), 5065 - 9 Multilocus microsatellite typing system for Penicillium marneffei reveals spatially structured populations; Fisher MC et al.; For eukaryotic pathogens that have low levels of genetic variation, multilocus microsatellite typing (MLMT) offers an accurate and reproducible method of characterizing genetic diversity . Here, we describe the application of an MLMT system to the emerging pathogenic fungus Penicillium marneffei . Isolates used for this study were those held in the culture collections of the Centraalbureau voor Schimmelcultures, Utrecht, The Netherlands, and the Chiang Mai University Department of Microbiology, Chang Mai, Thailand . High genetic diversity and extensive spatial structure were observed among clinical isolates, with the geographical area of origin for each isolate strongly correlating with the occurrence of two deeply divided clades . Within each clade, multilocus linkage associations were highly significant and could be explained by genetically differentiated populations or by an exclusively clonal reproductive mode, or both . Our results show that southeast Asian penicilliosis is caused by a fungus with a complex population genetic structure . Furthermore, this MLMT system generates digital data that can be easily queried against a centrally held database via the internet ; this provides a powerful epidemiological tool for analyzing the underlying parameters that are responsible for the emergence of P . marneffei in human immunodeficiency virus-positive populations. J Clin Microbiol, 2004 Nov, 42(11), 5058 - 64 Characterization of ancestral Mycobacterium tuberculosis by multiple genetic markers and proposal of genotyping strategy; Sun YJ et al.; Sixty-eight ancestral Mycobacterium tuberculosis isolates were previously identified by using the tuberculosis-specific deletion 1 (TbD1) PCR and mycobacterial interspersed-repetitive-unit-variable-number tandem repeat (MIRU-VNTR) typing (Y . J . Sun, R . Bellamy, A . S . G . Lee, S . T . Ng, S . Ravindran, S.-Y . Wong, C . Locht, P . Supply, and N . I . Paton, J . Clin . Microbiol . 42:1986-1993, 2004) . These TbD1(+) ancestral isolates were further characterized and typed in this study by IS6110 restriction fragment length polymorphism (RFLP) typing, VNTR typing using exact tandem repeats (VNTR-ETR), and spoligotyping of the direct-repeat region . To our knowledge, this is the first characterization of this genogroup by multiple genetic markers based on a fairly large sample size . In this genogroup, all spoligotypes were characterized by the absence of spacers 29 to 32 and 34 . In addition, VNTR-ETR typing could add further resolution to the clustered isolates identified by MIRU-VNTR, and the combination of MIRU-VNTR and VNTR-ETR, called MIRU-ETR, showed the highest discriminatory power for these strains compared to IS6110 RFLP typing and spoligotyping alone . However, MIRU-ETR appeared to still cluster some probably epidemiologically unrelated strains, as judged by IS6110 RFLP divergence . Therefore, a typing strategy based on stepwise combination of MIRU-ETR and IS6110 RFLP is proposed to achieve maximal discrimination for unrelated TbD1(+) strains . This typing strategy may be useful in areas where TbD1(+) ancestral strains are prevalent. J Clin Microbiol, 2004 Nov, 42(11), 4937 - 46 Distribution of putative adhesins in different seropathotypes of Shiga toxin-producing Escherichia coli; Toma C et al.; The distribution of eight putative adhesins that are not encoded in the locus for enterocyte effacement (LEE) in 139 Shiga toxin-producing Escherichia coli (STEC) of different serotypes was investigated by PCR . Five of the adhesins (Iha, Efa1, LPF(O157/OI-141), LPF(O157/OI-154), and LPF(O113)) are encoded in regions corresponding to genomic O islands of E . coli EDL933, while the other three adhesins have been reported to be encoded in the STEC megaplasmid of various serotypes (ToxB {O157:H7}, Saa {O113:H21}, and Sfp {O157:NM}) . STEC strains were isolated from humans (n = 54), animals (n = 52), and food (n = 33) . They were classified into five seropathotypes (A through E) based on the reported occurrence of STEC serotypes in human disease, in outbreaks, and in the hemolytic-uremic syndrome (M . A . Karmali, M . Mascarenhas, S . Shen, K . Ziebell, S . Johnson, R . Reid-Smith, J . Isaac-Renton, C . Clark, K . Rahn, and J . B . Kaper, J . Clin . Microbiol . 41:4930-4940, 2003) . The most prevalent adhesin was that encoded by the iha gene (91%; 127 of 139 strains), which was distributed in all seropathotypes . toxB and efa1 were present mainly in strains of seropathotypes A and B, which were LEE positive . saa was present only in strains of seropathotypes C, D, and E, which were LEE negative . Two fimbrial genes, lpfA(O157/OI-141) and lpfA(O157/OI-154), were strongly associated with seropathotype A . The fimbrial gene lpfA(O113) was present in all seropathotypes except for seropathotype A, while sfpA was not present in any of the strains studied . The distribution of STEC adhesins depends mainly on serotypes and not on the source of isolation . Seropathotype A, which is associated with severe disease and frequently is involved in outbreaks, possesses a unique adhesin profile which is not present in the other seropathotypes . The wide distribution of iha in STEC strains suggested that it could be a candidate for vaccine development. Radiol Med (Torino), 2004 Oct, 108(4), 335 - 44 Advantages and limits of percutaneous breast core biopsy with Mammotome and stereotactic equipment in upright seated patient; Della Sala SW et al.; PURPOSE: To confirm the diagnostic accuracy of percutaneous core breast biopsy with Mammotome and stereotactic equipment in upright seated patients, and to compare results from this method with those obtained using the dedicated unit with prone table . MATERIALS AND METHODS: We analysed 72 microbioptic samples from 69 upright seated patients . These samples were obtained in the course of mammographies assisted by digital stereotactic equipment (Diamond Delta32 General Electric Medical System/Instrumen-tarium), and further equipped with a lateral arm to support the Mammotone probe . We studied the following lesions: 57 cases of isolated microcalcification clusters, 12 masses with microcalcification and three cases of plain masses . We describe in detail the various phases of our 30-minute long microbiopsy procedure . All 72 samples were extracted without problems . Only in one case a large haematoma emerged, but quickly disappeared . RESULTS: We were able to characterise the histology of the lesions in all our samples: in 39/72 cases they were identified as benign, 28 were classified as malignant, and the remaining 5 as atypia . In the 39 lesions identified as benign, the microbiopsy procedure could be carried out without surgical biopsy - consequently, these patients were available for routine follow-up exams, which confirmed the benign nature of their lesions . Our identification of the 28 malignant lesions was confirmed by surgical biopsy . The microbiopsy finding and the histological result did not agree in only two cases . The 5 cases with atypical ductal hyperplasia showed no neoplastic alteration following surgical biopsy . In our personal experience, core biopsy with Mammotome achieved a high diagnostic accuracy . CONCLUSIONS: After careful analysis of the results obtained using Mammotome in upright seated patients with stereotactic equipment, we can confirm the diagnostic accuracy of this procedure in mammography alterations not visible in sonography . In agreement with previous studies, we also confirm that the diagnostic accuracy of this approach, as well as possible complications deriving from it, do not depend on the position of the patient. Genetica, 2004 Jul, 121(3), 219 - 28 Number and nuclear localisation of nucleoli in mammalian spermatocytes; Berrios S et al.; In seven mammalian species, including man, the position and number of nucleoli in pachytene spermatocyte nuclei were studied from electron microscope (EM) nuclear sections or bivalent microspreads . The number and position of the nucleolar organiser regions (NORs) in mitotic and meiotic chromosomes were also analysed, using silver staining techniques and in situ hybridisation protocols . The general organisation of pachytene spermatocyte nucleoli was almost the same, with only minor morphological differences between species . The terminal NORs of Thylamys elegans (Didelphoidea, Marsupialia), Dromiciops gliroides (Microbiotheridae, Marsupialia), Phyllotys osgoodi (Rodentia, Muridae) and man, always gave rise to peripheral nucleoli in the spermatocyte nucleus . In turn, the intercalated NORs from Octodon degus, Ctenomys opimus (Rodentia, Octodontidae) and Chinchilla lanigera (Rodentia, Cavidae), gave rise to central nucleoli . In species with a single nucleolar bivalent, just one nucleolus is formed, while in those with multiple nucleolar bivalents a variable number of nucleoli are formed by association of different nucleolar bivalents or NORs that occupy the same nuclear peripheral space (Phyllotis and man) . It can be concluded that the position of each nucleolus within the spermatocyte nucleus is mainly dependent upon: (1) the position of the NOR in the nucleolar bivalent synaptonemal complex (SC), (2) the nuclear pathway of the nucleolar bivalent SC, being both telomeric ends attached to the nuclear envelope, and (3) the association between nucleolar bivalents by means of their NOR-nucleolar domains that occupy the same nuclear space . Thus, the distribution of nucleoli within the nuclear space of spermatocytes is non-random and it is consistent with the existence of a species-specific meiotic nuclear architecture. Ann Allergy Asthma Immunol, 2004 Oct, 93(4), 381 - 9 The Copenhagen Prospective Study on Asthma in Childhood (COPSAC): design, rationale, and baseline data from a longitudinal birth cohort study; Bisgaard H; BACKGROUND: The atopic diseases asthma, atopic dermatitis, and allergic rhinitis are the most common chronic diseases in children, and their prevalence has increased recently in industrialized nations . Little is known about the genetic-environmental interaction factors driving such proliferation . OBJECTIVE: To investigate the relationships among genetic, environmental, and lifestyle factors in the development of atopic diseases in high-risk children with the aim of developing evidence-based prevention strategies . METHODS: The Copenhagen Prospective Study on Asthma in Childhood is a single-center, birth cohort study of children of asthmatic mothers . Objective assessments begin at birth, with scheduled visits every 6 months and when acute symptoms manifest . Clinical outcomes comprise preasthma, asthma, atopic dermatitis, allergic rhinitis, allergy, lung function, and bronchial responsiveness . Exposure assessments comprise respiratory, intestinal, and skin microbiology; the child's diet; indoor and outdoor air quality; allergens; and indicators of lifestyle . Genetic characteristics of probands and parents are evaluated . Quality assurance follows Good Clinical Practice guidelines . RESULTS: Four hundred eleven infants of asthmatic mothers were enrolled at the age of 1 month . The children were born between August 2, 1998, and December 28, 2001 . Compared with the Copenhagen population, mothers of the cohort population were less likely to have given natural childbirth . The households were slightly less affluent, with fewer children and fewer pets . Whites may be overrepresented . At age 2 years, 93% of the infants were still actively participating in the cohort . CONCLUSIONS: This longitudinal birth cohort study of high-risk Danish infants consists of objective phenotyping, detailed information on exposure, high data quality, and a high participant retention rate. Nat Med, 2004 Nov, 10(11), 1177 - 85 From Pasteur to genomics: progress and challenges in infectious diseases; Rappuoli R; Over the past decade, microbiology and infectious disease research have undergone the most profound revolution since the times of Pasteur . Genomic sequencing has revealed the much-awaited blueprint of most pathogens . Screening blood for the nucleic acids of infectious agents has blunted the spread of pathogens by transfusion, the field of antiviral therapeutics has exploded and technologies for the development of novel and safer vaccines have become available . The quantum jump in our ability to detect, prevent and treat infectious diseases resulting from improved technologies and genomics was moderated during this period by the greatest emergence of new infectious agents ever recorded and a worrisome increase in resistance to existing therapies . Dozens of new infectious diseases are expected to emerge in the coming decades . Controlling these diseases will require a better understanding of the worldwide threat and economic burden of infectious diseases and a global agenda. J Bacteriol, 2004 Nov, 186(22), 7726 - 35 Responses of the Rhodobacter sphaeroides transcriptome to blue light under semiaerobic conditions; Braatsch S et al.; Exposure to blue light of the facultative phototrophic proteobacterium Rhodobacter sphaeroides grown semiaerobically results in repression of the puc and puf operons involved in photosystem formation . To reveal the genome-wide effects of blue light on gene expression and the underlying photosensory mechanisms, transcriptome profiles of R . sphaeroides during blue-light irradiation (for 5 to 135 min) were analyzed . Expression of most photosystem genes was repressed upon irradiation . Downregulation of photosystem development may be used to prevent photooxidative damage occurring when the photosystem, oxygen, and high-intensity light are present simultaneously . The photoreceptor of the BLUF-domain family, AppA, which belongs to the AppA-PpsR antirepressor-repressor system, is essential for maintenance of repression upon prolonged irradiation (S . Braatsch et al., Mol . Microbiol . 45:827-836, 2002) . Transcriptome data suggest that the onset of repression is also mediated by the AppA-PpsR system, albeit via an apparently different sensory mechanism . Expression of several genes, whose products may participate in photooxidative damage defense, including deoxypyrimidine photolyase, glutathione peroxidase, and quinol oxidoreductases, was increased . Among the genes upregulated were genes encoding two sigma factors: sigmaE and sigma38 . The consensus promoter sequences for these sigma factors were predicted in the upstream sequences of numerous upregulated genes, suggesting that coordinated action of sigmaE and sigma38 is responsible for the upregulation . Based on the dynamics of upregulation, the anti-sigmaE factor ChrR or its putative upstream partner is proposed to be the primary sensor . The identified transcriptome responses provided a framework for deciphering blue-light-dependent signal transduction pathways in R . sphaeroides. Laryngoscope, 2004 Nov, 114(11 Pt 3 Suppl 105), 1 - 26 Studies in otitis media: Children's Hospital of Pittsburgh-University of Pittsburgh progress report--2004; Bluestone CD; OBJECTIVES/HYPOTHESIS: The present Progress Report has summarized the key otitis media clinical trials and laboratory studies conducted since 1969 by investigators at the Children's Hospital of Pittsburgh-University of Pittsburgh (Pittsburgh, PA) . STUDY DESIGN: Review . METHODS: Included in the discussion are the following: 1) studies of the epidemiology and risk factors; 2) anatomy and pathology of the eustachian tube-middle ear from human temporal bone histopathological specimens; 3) physiology and pathophysiology of the eustachian tube-middle ear in humans and animal models; 4) pathogenesis; 5) otitis media in special populations (e.g., patients with cleft palate, Native Americans, patients with Down syndrome); 6) microbiology; 7) diagnosis; 8) outcomes of randomized clinical trials that evaluated efficacy of nonsurgical and surgical methods of treatment and prevention; 9) studies of certain complications and sequelae (e.g., effect of middle-ear effusion on hearing, early child development, and the vestibular system; chronic suppurative otitis media) . Also included are relevant summary tables and 256 references. An Med Interna, 2004 Oct, 21(10), 495 - 7 {Nonbacterial thrombotic endocarditis as initial event of lung cancer}; Herrera de Pablo P et al.; Nonbacterial thrombotic endocarditis (NBTE) is a rare