Microbial

Ann Ital Chir, 2002 Nov-Dec, 73(6), 611 - 7; discussion 617-8
{Acute pancreatic necrosis complicated by infection and gastro-intestinal translocation: pathogenesis correlation and therapeutic implication}; Miniello S et al.; The authors define pathogenetics correlations as a acute necrotizing pancreatitis complicated by infection and bacterial translocation . Acute necrotizing pancreatitis infection occurs for gastrointestinal bacterial translocation due to structural and functional modifications of intestinal mucosa . These modifications are results of mucosa ischemic-reperfusion system caused by systemic emodynamic instability in micro- and macro-circulation of splanchnic district . Emodynamic systemic instability has a central role in different multiple physiopathologic phenomena (ipovolemic shock; pancreatic shock, SIRS), which is caused by acute pancreatic necrosis and carries to common way established by severe systemics emodinamics modifications; these changes promote growth of adverse events which conduce by means of process previously described to bacterial translocation and infection of acute pancreatic necrosis . Indeed, emodynamic systemic instability of any etiology, can determine for one way bacterial translocation and on the other acute ischemic pancreatitis; both phenomena concur lead to cause beginning of acute necrotizing pancreatitis complicated by infection . The authors confirm that improved knowledge of acute pancreatic necrosis complicated by infection and own pathogenetic correlations with bacterial translocation, allows the realization of therapeutic measures aimed to prophylaxis of infection of acute pancreatic necrosis . Central emodynamic stability regularization of splanchnic perfusion and antibiotic prophylaxis, have a central role in prophylaxis of infection of acute pancreatic necrosis . Antibiotic is given by systemic (imipenem e.v.) and selective decontamination of gastrointestinal tract (SDD) . SDD provides for oral antibiotic prophylaxis (PTA protocol) and systemic antibiotic prophylaxis (cefotaxime and gentamicin), in addition to microbiologic and gastrointestinal monitoring . If on the one hand the role of SDD about mortality reduction is not clear, however, on the other it is well recognized capacity of reduction the intercurrents and pulmonary infections . Other Authors think that SDD is insignificant on early mortality, whereas, is a good option to reduce late and overall mortality of acute pancreatic necrosis complicated by infection.

Health Bull (Edinb), 2000 Jan, 58(1), 34 - 7
Adult pertussis in a general practice; Mitchell AA et al.; OBJECTIVE: To examine serologically the incidence of pertussis in a group of adults (> 15 years of age) presenting to their General Practitioner with symptoms which suggested the possibility of pertussis . DESIGN: One year's study of the results of testing blood samples . This was followed by a questionnaire to the General Practitioners involved, asking information on all the patients tested . SETTING: Specimens were tested as part of the normal workload in the Microbiology Department of a District General Hospital . SUBJECTS: The patients all attended a Health Centre in South Lanarkshire which caters for a population of 12,749 people . RESULTS AND CONCLUSIONS: Twenty of fifty six patients tested (35.7%) produced serological evidence of recent pertussis infection . The average age of the positive patients was 43.5, and the duration of their symptoms, before testing, was 4.2 weeks . The results suggest that pertussis in adults is not uncommon . Symptoms of "whoop" and/or vomiting were seldom reported in this series . "Paroxysmal coughing", "nocturnal coughing", and "shortness of breath" were more common in the positive cases than in the negative ones . The use of antibiotics did not appear to have any beneficial effect, probably due to them being given too late after the onset of infection . Most adults are susceptible to pertussis, as vaccine-induced immunity declines and is absent after 12 years following vaccination . In a vaccinated population, adults are now the primary source of infection for susceptible infants.

Diagn Microbiol Infect Dis, 2003 Jun, 46(2), 95 - 102
Early diagnosis of Exophiala CAPD peritonitis by 18S ribosomal RNA gene sequencing and its clinical significance; Lau SK et al.; Phenotypic identification of fungi in clinical microbiology laboratories is often difficult and late, especially for slow growing and rarely encountered fungi . We describe the application of 18S ribosomal RNA (rRNA) gene sequencing in the early diagnosis of a case of Exophiala peritonitis . A yeast-like fungus was isolated from the dialysate fluid of a 66-year-old man undergoing continuous ambulatory peritoneal dialysis . It grew slowly after 12 days of incubation to yield mature cultures to permit recognition of microscopic features resembling those of Exophiala, a dematiacerous mold . 18S rRNA gene sequencing provided results 12 days earlier than phenotypic identification and revealed 15 base difference (0.9%) between the isolate and Exophiala sp . strain GHP 1205 (GenBank Accession no . AJ232954), indicating that the isolate most closely resembles a strain of Exophiala species . The patient responded to 4 weeks of intravenous amphotericin B therapy . Early identification of the fungus was important for the choice of anti-fungal regimen . As opportunistic fungal infections in immunocompromised patients are globally emerging problems, the development of molecular techniques for fungal identification is crucial for early diagnosis and appropriate treatment.

IDrugs, 2003 Jun, 6(6), 573 - 80
Health aspects of probiotics; Ouwehand A et al.; Intestinal microbiota contribute in many different ways to our health; disturbances in the activity and/or composition of these microbiota may negatively influence health . In order to maintain a healthy intestinal microbiota, prebiotics and probiotics can be used . Selected probiotic strains safely shorten the duration of rotavirus diarrhea, relieve symptoms of lactose maldigestion and elicit beneficial immune-modulating effects . Other beneficial health effects have also been attributed to probiotics; however, these have not been sufficiently substantiated . Additional research into the mechanisms of probiotics is required.

Int J Syst Evol Microbiol, 2003 May, 53(Pt 3), 771 - 7
Chryseobacterium joostei sp . nov., isolated from the dairy environment; Hugo CJ et al.; Among a large collection of South African dairy isolates, a novel Chryseobacterium taxon (DNA group 3) was previously delineated by a polyphasic taxonomic study (Hugo et al., Syst Appl Microbiol 22, 586-595, 1999) . In the present paper, this taxon is further characterized using 16S rDNA sequencing, fatty acid methyl ester analysis and a comparative phenotypic analysis, resulting in the proposal of a novel species, Chryseobacterium joostei sp . nov . (type strain Ix 5a(T) = LMG 18212(T) = CCUG 46665(T)).

Acta Paediatr, 2003 Apr, 92(4), 506 - 9
Paraneoplastic limbic encephalitis masquerading as chronic behavioural disturbance in an adolescent girl; Lee AC et al.; AIM: To describe an unusual but treatable cause of behavioural disturbance in adolescence . METHODS: The case is reported of a 15-y-old girl presenting with acute confusion, memory problems and psychotic symptoms following an 18-mo history of change in personality, school failure and running away from home . A review of the literature is also presented . RESULTS: Microbiology, toxicology, computed tomography and magnetic resonance imaging did not show any pathology of the central nervous system . Bilateral ovarian immature teratomas were eventually diagnosed and removed . The rapid improvement in the patient's mental and cognitive functions after corticosteroid treatment and the abnormality shown on the single photon emission computed tomography suggested a diagnosis of paraneoplastic limbic encephalitis . CONCLUSION: Paediatricians and neurologists should be aware of this rare disease entity among the more common conditions of behavioural problems and substance abuse in adolescents.

Parasitol Int, 2003 Jun, 52(2), 169 - 73
Induction of permeability changes and death of vertebrate cells is modulated by the virulence of Entamoeba spp . isolates; Dvorak JA et al.; Although Entamoeba histolytica is capable of inducing an apoptotic response in vertebrate cells in vitro (Cell . Microbiol . 2 (2000) 617), it is not known whether vertebrate cell death requires direct amoeba-vertebrate cell contact or simply the presence of amoebae in the area of the vertebrate cells . In addition, Entamoeba spp . vary in their virulence and pathogenicity . The potential effects of these critical parameters also have not been elucidated . We tested the virulent HM-1:IMSS isolate and the non-virulent Rahman isolate of E . histolytica, and the non-virulent E . dispar CYNO16:TPC isolate against two vertebrate cell lines, HeLa and Chinese hamster ovary cells in vitro using ethidium homodimer as a fluorescent indicator of changes in vertebrate cell permeability . Fluorescence appeared in vertebrate cell nuclei within approximately 2-3 min of contact between HM-1 amoebae and vertebrate cells independent of vertebrate cell type . However, vertebrate cells in the immediate vicinity of but not contacted by HM-1 amoebae were not affected . In contrast, although both E . histolytica Rahman and E . dispar CYNO16 amoebae moved freely among and contacted vertebrate cells, the nuclei of the vertebrate cells never fluoresced implying that the cells remained alive and impermeant to the ethidium homodimer . This is the first demonstration that direct contact between virulent amoebae and vertebrate cells is required to kill vertebrate cells and that the process is restricted to virulent Entamoeba isolates . An understanding at the molecular level of the processes involved could help to reduce the pathology associated with this parasite.

Arch Oral Biol, 2003 Jul, 48(7), 495 - 502
PCR-based identification of Treponema maltophilum, T amylovorum, T medium, and T lecithinolyticum in primary root canal infections; Siqueira JF Jr et al.; OBJECTIVE: Molecular genetic methods have significantly contributed to the knowledge about the microbiota associated with infected root canals . Albeit spirochetes have been commonly observed in primary root canal infections, only recently they have been identified . The purpose of the present study was to investigate the occurrence of four treponemes-Treponema maltophilum, Treponema lecithinolyticum, Treponema amylovorum, and Treponema medium-in cases of primary endodontic infections associated with different forms of periradicular diseases through a 16S rDNA-based nested PCR assay . DESIGN: Samples were taken from thirty-one infected root canals associated with either asymptomatic or symptomatic apical periodontitis . DNA extracted from the samples was initially amplified using universal 16S rDNA primers, followed by a second round of amplification using the first PCR products to detect a specific fragment of the 16S rDNA of each target Treponema species . RESULTS: All cases were positive for the universal bacterial primers, indicating that samples contained bacterial DNA . Of the four target species, T . maltophilum was the most prevalent, being detected in 39% of the cases (33% of the asymptomatic cases and 50% of the symptomatic cases) . T . lecithinolyticum was the next more prevalent among the species tested, being found in 26% of the samples (33% of asymptomatic cases and 10% of the symptomatic cases) . T . amylovorum was found in 7% of the cases (5% of the asymptomatic cases and 10% of the symptomatic cases), while T . medium was in 13% of the cases (14% of the asymptomatic cases and 10% of the symptomatic cases) . None of the species tested was significantly associated with clinical symptoms . CONCLUSIONS: This was possibly the hitherto first study to report the occurrence of T . lecithinolyticum, T . amylovorum, and T . medium in infections of endodontic origin . Overall, findings suggested that these oral treponemes, particularly T . maltophilum and T . lecithinolyticum, can be involved in the pathogenesis of periradicular diseases.

Int J Tuberc Lung Dis, 2003 Jun, 7(6), 563 - 8
The high value of high-resolution computed tomography in predicting the activity of pulmonary tuberculosis; Wang YH et al.; SETTING: A 2500-bed medical centre in southern Taiwan . OBJECTIVE: To study the clinical value of high-resolution computed tomography (HRCT) in predicting the activity of pulmonary tuberculosis (TB) . DESIGN: HRCTs were performed prospectively in 148 patients whose chest radiographs (CXRs) showed highly suspicious signs of pulmonary TB, predominantly upper lung field infiltration . The HRCT findings, interpreted independently by a pulmonologist and a radiologist, were used to predict the activity of pulmonary TB . RESULTS: Pulmonologist-interpreted and radiologist-interpreted HRCTs showed high sensitivity (both 93%), specificity (83 vs . 88%), accuracy (86 vs . 90%), positive predictive values (76 vs . 83%) and negative predictive values (both 95%) . Kappa statistic indicates good inter-reader agreement . CONCLUSION: HRCT has a high value in predicting the activity of pulmonary TB . It is a useful tool in this regard when a patient with suspected pulmonary TB lacks microbiologic proof, when clinical condition makes invasive diagnosis impossible or when a patient has completed anti-tuberculosis treatment with no compatible unequivocal CXR.

Cornea, 2003 May, 22(4), 300 - 3
Advanced fusarium keratitis progressing to endophthalmitis; Dursun D et al.; PURPOSE: To review the clinical course, treatment, and visual outcomes of keratitis with endophthalmitis caused by the filamentary fungus Fusarium . METHOD: One hundred fifty-nine cases of Fusarium keratitis at Bascom Palmer Eye Institute between January 1, 1987 and August 21, 2000 were reviewed . Ten patients with culture-proven Fusarium keratitis progressed to endophthalmitis . All 10 underwent standard diagnostic microbiologic evaluation, and topical and oral antifungal therapy was instituted . Surgical therapy was applied when necessary . Main outcome measures included the incidence of intraocular invasion of fungal keratitis and response to treatment . RESULTS: Ten cases of 159 Fusarium keratitis patients had intraocular involvement that was culture proven . The isolated species were Fusarium oxysporum in seven cases and Fusarium solani in two cases, and in one case, the species could not be identified . Cultures of aqueous and intraocular tissues grew Fusarium in eight cases, whereas vitreous cultures were positive in two . Nine cases had preexisting risk factors . All patients received oral ketoconazole or fluconazole and topical natamycin 5% . In two cases, intravitreal amphotericin B injections were also given . Four patients required a penetrating keratoplasty, enucleation was performed in two patients, two patients required a combination of a penetrating keratoplasty and pars plana vitrectomy, and one patient developed phthisis . CONCLUSION: The combination therapy with oral imidazoles (fluconazole or ketoconazole) and topical natamycin is inadequate in severe Fusarium keratitis with intraocular spread . Early diagnosis and suspicion of endophthalmitis in patients with keratomycosis not responding to aggressive topical antifungal are important.

Medicine (Baltimore), 2003 May, 82(3), 147 - 58
Localized mucosal leishmaniasis due to Leishmania (Leishmania) infantum: clinical and microbiologic findings in 31 patients; Aliaga L et al.; The clinical and microbiologic characteristics of 31 patients with mucosal leishmaniasis due to Leishmania (Leishmania) infantum are described . Twenty-eight (90%) patients were male . Mean age at presentation was 48 +/- 14 years . Thirteen (42%) patients had no underlying disease, while 18 (58%) patients had several other medical conditions . Fifteen (48%) patients were immunocompromised, 7 patients were infected with human immunodeficiency virus (HIV), and 3 were graft recipients . The primary location of lesions was the larynx in 11 (35%) patients, oral mucosa in 10 (32%) patients, and the nose in 5 (16%) patients . Mucosal lesions were painless in all patients but 2 and consisted of whitish, red, or violaceous nodular swelling or tumorlike masses . Ulceration was reported in 6 patients . Pathologically, the lesions showed a chronic inflammatory infiltrate . Granuloma may be seen.The localization of the lesions determined the symptomatology of the disease . Symptoms included hoarseness, difficulty swallowing, and nasal obstruction . The disease presentation was usually protracted, with a mean time from the onset of symptoms to diagnosis of 13 months (range, 3 wk-4.5 yr), and the clinical diagnosis was usually mistaken for neoplasia of the upper aerodigestive tract . No laboratory abnormalities were found in these patients due to the localized disease, apart from those attributed to underlying diseases.Parasites were easily identified in smears or sections by Giemsa stain or hematoxylin-eosin stain . Leishmania was grown in culture in 12 (60%) patients; culture was negative in 8 (40%) patients . Leishmania (Leishmania) infantum was identified in only 9 instances . The following zymodemes were reported: MON-1 (2 patients), MON-24 (2 patients), MON-27 (1 patient), and MON-34 (1 patient) . Serologic test results were known in 25 patients . Serology was usually positive at low titer; 6 (24%) patients had negative serologic test results.Twenty patients were treated with antimonial compounds for between 3 and 36 days . Three patients were given drugs other than antimonial drugs . Five patients were treated only locally, by surgery (3 patients) or topical medical therapy . One patient received no therapy, and treatment was not reported in 2 cases . Patients were cured in 25 (89%) cases, and sequelae were uncommon (14%) . Relapse was detected in 2 individuals and 1 patient developed visceral leishmaniasis after treatment . Two HIV-coinfected patients died of causes unrelated to leishmaniasis.The results of the present report stress the clinical importance of searching for the presence of Leishmania in patients with suspected neoplasia of the upper respiratory tract if they have visited or resided in zones endemic for Leishmania (Leishmania) infantum . The treatment of choice for these patients is not established yet, but most patients respond to antimonial compounds given for 28 days or less.

Acta Pharmacol Sin, 2003 Jun, 24(6), 605 - 9
Neurotoxicity and toxicokinetics of norfloxacin in conscious rats; Zhang LR et al.; AIM: To study the neurotoxicity and toxicokinetics of norfloxacin (NFLX) in freely moving rats . METHODS: Rats were assigned randomly to four treatment groups that received a single iv dose of 50, 100, 200 mg/kg of NFLX and 0.9 % saline, respectively . Electroencephalogram (EEG) was continuously recorded with a computerized system in freely moving rats . Venous blood samples were collected for determination of the NFLX concentration by microbioassay method with Escherichia coli 441102 as the test strain . Toxicokinetic parameters were determined from serum concentration-time data with the 3p97 program . RESULTS: (1) The epileptiform discharges appeared in all NFLX groups with different latent periods, accompanied with limb twitching and clonic-tonic seizures . The relative total power of the EEG increased . (2) Drug serum concentration-time curves of different doses conformed to a two-compartmental model . The values of clearance, volume of distribution, and terminal half-life were dose-independent, while maximum serum concentrations (Cmax) and the areas under the concentration-time curve (AUC(0-infinity)) of NFLX increased with dosage . (3) The relative total powers of EEG were closely correlated with the administered dose, Cmax as well as AUC(0-infinity) . CONCLUSION: The present study established a suitable approach to quantitatively determine central nervous system (CNS) stimulant effect of NFLX . There is a significant correlation between AUC(0-infinity) and the changes of relative total power, which may serve as the index for judgement and prediction of the CNS toxic effect induced by NFLX.

Clin Experiment Ophthalmol, 2003 Jun, 31(3), 213 - 9
Trends in cataract surgery and postoperative endophthalmitis in Western Australia (1980-1998): the Endophthalmitis Population Study of Western Australia; Semmens JB et al.; OBJECTIVES: Postoperative endophthalmitis results from an intraocular infection and usually occurs following cataract surgery . It has significant morbidity and causes severe visual impairment or blindness of the eye . The aim of this study was to assess the trends in the incidence rates of cataract surgery and postoperative endophthalmitis in Western Australia for the period 1980-1998 . METHODS: The Western Australian Record Linkage Project was used to link the morbidity records for all patients treated for cataract surgery in Western Australia in 1980-1998 . Patient records were selected using the international classification for diagnosis and procedure codes pertaining to cataract surgery and postoperative endophthalmitis . All cases of postoperative endophthalmitis were validated by case-note review . The separate databases of the Royal Perth Hospital microbiology and anaesthetic departments as well as the vitreo-retinal surgeon logbooks were used to cross-validate the hospital morbidity database . Trends in the incidence rates of cataract surgery and postoperative endophthalmitis were assessed by Poisson regression . RESULTS: There were 94,653 cataract procedures performed for 63,007 patients in Western Australia during the 19-year period . The majority (88%) of cataract procedures performed were in patients aged 60 years or older . Postoperative endophthalmitis developed in 188 patients, with serious visual impairment occurring in 70.6% of patients for whom visual acuity data was available at presentation . The incidence rate of cataract surgery increased more than three-fold from 1981 (102 per 100,000 person years) to 1998 (345 per 100,000 person years), mainly due to the increase in extracapsular cataract extraction during the 1980s and phacoemulsification extraction from 1990 onwards . In contrast, the average annual incidence rate of postoperative endophthalmitis remained relatively unchanged at around 2 per 1000 cataract procedures over the same period . CONCLUSION: Cataract surgery is becoming more prevalent in the elderly as the life expectancy of the population increases . There has been a dramatic shift in surgical practice during the last 30 years with small-incision phacoemulsification being the predominant method of intervention used since 1990 . Despite changes in surgical practice the incidence rate of postoperative endophthalmitis has remained the same.

Eur J Clin Microbiol Infect Dis, 2003 Jun, 22(6), 349 - 56 Epub 2003 Jun 03.
Four-year experience of use of the Cobas Amplicor system for rapid detection of Mycobacterium tuberculosis complex in respiratory and nonrespiratory specimens in Greece; Levidiotou S et al.; To evaluate the experience of a clinical microbiology laboratory with a DNA amplification assay for routine detection of Mycobacterium tuberculosis, the Cobas Amplicor Mycobacterium tuberculosis (MTB) polymerase chain reaction (PCR) assay (Roche Diagnostics Systems, USA) was performed on 7,722 respiratory and 1,451 nonrespiratory specimens collected from 3,321 patients . The results were compared with those of culture in conventional Lowenstein-Jensen medium, culture in the MB/BacT system (Organon Teknika, France), and clinical investigations . A total of 240 of the 254 respiratory specimens culture positive for Mycobacterium tuberculosis were also positive in the PCR assay . Of the 7,300 culture-negative specimens, 45 (0.6%) were positive in the PCR . After detailed interpretation, the overall sensitivity, specificity, and positive and negative predictive values of the PCR assay were 84.5, 99.8, 94.1, and 99.4%, respectively, for respiratory specimens . The PCR assay was more sensitive for smear-positive respiratory specimens (97.1%) than for smear-negative respiratory specimens (48.6%) . Of the 18 culture-positive (smear-negative) nonrespiratory specimens, 9 were positive in the PCR . None of the 1,384 culture-negative nonrespiratory specimens were positive in the PCR . The inhibition rates detected by the internal control of the test were 2.2% for respiratory specimens and 3.4% for nonrespiratory specimens . After resolving the discrepancies, the overall sensitivity, specificity, and positive and negative predictive values of the PCR assay were 82.5, 99.8, 94.3, and 99.4%, respectively, when compared to the results of diagnostic culture . In conclusion, the use of the Cobas Amplicor MTB-PCR assay might enable clinical microbiology laboratories with considerable previous experience in molecular biology testing to perform PCR and confirm tuberculosis infection immediately, leading to improved patient management.

J Microbiol Methods, 2003 Aug, 54(2), 249 - 56
Use of denaturing gradient gel electrophoresis for analysis of the stool microbiota of hospitalized patients; Donskey CJ et al.; Denaturing gradient gel electrophoresis (DGGE) of PCR-amplified ribosomal RNA gene amplicons was used to study the stool microbiota of hospitalized patients and to examine the effect of antibiotic therapy . For one patient, 16 anaerobic species identified by random cloning and sequencing of PCR-amplified rRNA genes from stool were represented by bands on the DGGE gel . DGGE analysis and similarity index comparisons demonstrated that the anaerobic microbiota of this individual remained stable in the absence of antibiotic therapy, was minimally affected by ciprofloxacin but markedly reduced by clindamycin therapy, and recovery of some organisms was evident within days after discontinuation of clindamycin . DGGE analysis of additional patients demonstrated similar disruptions of the intestinal microbiota associated with antibiotic therapy . The DGGE banding patterns of nine patients showed considerable variability, but several bands were shared among patients . Thus, our findings are consistent with previous studies that utilized culture techniques, and suggest that DGGE is a useful technique for analysis of the stool microbiota of hospitalized patients.

J Cataract Refract Surg, 2003 May, 29(5), 989 - 97
Effects of topical nonsteroidal antiinflammatory drugs on the expression of matrix metalloproteinases in the cornea; Reviglio VE et al.; PURPOSE: To assess the effects of nonsteroidal antiinflammatory drug (NSAID) eyedrops on the expression of matrix metalloproteinases in corneal tissue . SETTING: Ocular Microbiology and Immunology Laboratory, Refractive Surgery Research Laboratory, The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA . METHODS: Seventy rats were divided into 2 groups: intact and debrided epithelium . Uniform central corneal epithelial defects were created in the right eye of the debrided corneal group . Each group was divided into 4 subgroups, each receiving 1 of the following eyedrops or artificial tears: The 3 NSAIDs were diclofenac sodium 0.1% (Falcon or Voltaren) and preservative-free ketorolac 0.5% (Acular PF) . The artificial tears were carboxymethylcellulose sodium 0.5% (Refresh Plus PF) . The eyedrops were administered 4 times a day for 1 week . The rats were killed on days 2 and 7 . The corneas were excised and processed for immunohistochemical staining, Western blot assay, and zymography studies to determine the localization of the production of the following matrix metalloproteinases (MMPs): MMP-1, MMP-2, MMP-8, and MMP-9 . RESULTS: Matrix metalloproteinase-1, MMP-8, and MMP-2 were detected in rat corneas at 48 hours in the debrided and intact epithelium groups treated with NSAID eyedrops . The MMP-1 and MMP-8 expression levels were higher in intact corneas in the diclofenac sodium groups than in the ketorolac and artificial tears groups . The expression was localized mostly in the epithelial cells and occasionally in keratocytes . CONCLUSION: This study provides preliminary evidence that topical application of some NSAIDs can induce the early expression of MMP-1, MMP-2, and MMP-8 in the cornea, suggesting that MMPs play a role in the corneal cytotoxicity of certain NSAIDs.

Pediatr Crit Care Med, 2002 Apr, 3(2), 171 - 176
Pediatric fiberoptic bronchoscopy: Clinical experience with 2,836 bronchoscopies; Nussbaum E; OBJECTIVE: To report 21 yrs of experience with pediatric flexible fiberoptic bronchoscopy in infants and children, explore newer applications, delineate potential complications, and make recommendations for its future application . DESIGN: Retrospective review . SETTING: A 20-bed pediatric critical care unit in a tertiary care, university-based children's hospital . PATIENTS: A total of 2,836 pediatric and infant fiberoptic bronchoscopies, performed over a course of 21 yrs, were reviewed . Measurement and MAIN RESULTS: A total of 2,836 children (1,536 girls) were subjected to flexible fiberoptic bronchoscopy . Of those, laryngeal mask airway was incorporated in 92 procedures (3.2%) and general anesthesia was applied in 198 cases (7%) . The youngest subject was a 1-wk-old, 600-g, premature infant . The procedure resulted in diagnoses that modified patient care, particularly in tracheostomized infants and those with upper airway obstruction, plastic bronchitis of acute chest syndrome, dyskinetic cilia syndrome, immunocompromised individuals, and those with unexplained chronic cough and recurrent pulmonary infiltrates . Microbiologic and cytologic data from bronchoalveolar lavage helped confirm the diagnoses of pulmonary hemosiderosis and gastroesophageal reflux and validated the presence, or lack of, bacterial or viral pathogens . A total of 21 patients (<1%) experienced life-threatening hypoxemia, prompting termination of the procedure . Laryngospasm or bronchospasm was observed in 17 individuals (<1%) undergoing bronchoalveolar lavage, and 4% of the total population experienced mild nasopharyngeal bleeding . No fatalities were encountered . CONCLUSIONS: Pediatric flexible fiberoptic bronchoscopy is a safe diagnostic and interventional tool, even in young or extremely premature infants . Although the rate of serious complications in this report is low, general anesthetic agents and incorporation of laryngeal mask airway is advocated for severe mucoid impaction, transbronchial biopsy, and chronic pulmonary infiltrates, which may necessitate extensive bronchoalveolar lavage.

Gastrointest Endosc, 2003 Jun, 57(7), 837 - 41
PEG with introducer or pull method: a prospective randomized comparison; Maetani I et al.; BACKGROUND: PEG by the conventional pull method has the potential drawback of being associated with a higher frequency of wound infection, presumably caused by contamination of the gastrostomy catheter as it passes through the oral cavity . This study investigated the occurrence of peristomal wound infection after PEG placement by using the pull and introducer techniques . METHODS: Between September 1999 and May 2002, consecutive patients with dysphagia for whom PEG was recommended were enrolled in the study and randomly assigned to two groups: PEG with the introducer method (Group I) or PEG with the pull method (Group II) . The peristomal area of each patient was evaluated on a daily basis for one week after PEG . Erythema and exudate were scored on a scale from 0 to 4 and induration on a scale of 0 to 3 . Criteria for infection were a maximum combined score of 8 or higher, or the presence of microscopic and microbiologic evidence of suppurating exudate . In each group, the endoscope was passed once during the procedure, and an antibiotic (piperacillin) was given prophylactically . All procedures were performed by one investigator with the assistance of another physician . RESULTS: Of the 60 patients enrolled, 30 were assigned to each group . PEG was successful in all patients . One patient was excluded from each group because of death (Group I, stroke; Group II, myocardial infarction) within one week of the procedure . Therefore, 58 patients, 29 in each group, were evaluated . There was no significant difference between the groups in terms of clinical parameters (age, gender, disease, performance score, mode of previous feeding, and recent antibiotic exposure) . The occurrence of peristomal infection within one week of PEG was lower in Group I (introducer method) (0 vs . 9; p = 0.00094) . The mean daily combined scores in Group I were significantly lower than those in Group II . Median of maximum parameter scores in Group I were significantly lower than those in Group II . There were no procedure-related mortalities or clinically significant wound infections that required surgical intervention . CONCLUSIONS: The risk of peristomal wound infection after PEG is lower with the introducer method compared with the pull method.

J Endod, 2003 May, 29(5), 317 - 20
Evaluation of protocols for field decontamination before bacterial sampling of root canals for contemporary microbiology techniques; Ng YL et al.; The effectiveness of sodium hypochlorite (NaOCl) (2.5%) or iodine (10%) for decontamination of the operation field (tooth, rubber dam, and gasket {Oraseal}) was compared by using bacterial cultivation . In addition, the final samples were also assessed for bacteria by using polymerase chain reaction . Teeth (n = 63) receiving root canal treatment were polished with pumice, isolated with rubber dam, and their margins sealed with Oraseal . The operation field was disinfected with hydrogen peroxide (30%), followed by iodine (n = 31) or NaOCl (n = 32), before and after access cavity preparation . The operation field was sampled before and after each decontamination, giving four samples per field . After the final decontamination, there was no significant difference (p = 0.602, 0.113, 0.204) in recovery of cultivable bacteria from various sites in either group . However, bacterial DNA could be detected significantly (p = 0.010) more frequently from the tooth surfaces after iodine (45%) compared with NaOCl (13%) decontamination, although on the rubber dam or Oraseal surfaces there was no difference . Root canal sampling for polymerase chain reaction might be better preceded by NaOCl decontamination than by iodine, based on the findings.

Sci Eng Ethics, 2003 Apr, 9(2), 215 - 20
Promoting research integrity at the American Society for Microbiology; Youngner JS; The American Society for Microbiology addresses issues of research integrity in several ways . There is a Code of Ethics for Society members and an Ethics Committee, a Publications Board has editorial oversight of ethical issues involved in Society journals and other publications, and the Public and Scientific Affairs Board is involved in ethical issues and scientific policies at the national level . In addition, the Society uses meetings and publications to inform and educate members about research integrity.

Mikrobiol Z, 2003 Jan-Apr, 65(1-2), 141 - 8
{Mycotoxins: past, present and future}; Zaichenko AM et al.; The paper deals with historical information concerning the investigation of mycotoxins and mycotoxicoses at the Institute of Microbiology and Virology of the NAS of Ukraine, main results of the works fulfilled for the last 25 years and possible trends of further investigations.

Mikrobiol Z, 2003 Jan-Apr, 65(1-2), 133 - 40
{Development of cyanobacterial phages at the Institute of Microbiology and Virology of the National Academy of Sciences of Ukraine (History and perspectives)}; Mendzhul MI et al.; The paper deals with the basic trends of fundamental investigations of the Department of Algae Viruses in the field of cyanophagia-ecology, biological and physico-chemical properties of cyanophages as well as interrelation with the host cells . Such problems as a possibility to use the system cyanophage-cyanobacteria as the experimental model for development of the unified functional model of productive infection, efficient methods of prophylaxis and therapy of virus infections as well as the solution of various biotechnological problems are discussed.

Mikrobiol Z, 2003 Jan-Apr, 65(1-2), 84 - 103
{Dynamics of research on phytopathogenic bacteria at the Institute of Microbiology and Virology of the National Academy of Sciences of Ukraine}; Hvozdiak RI et al.; The basic trends of the work of the Department of Phytopathogenic Bacteria from the beginning of its existence in the system of IMV of the NAS of Ukraine (1934) have been analyzed . The stages of personnel training, the Department relations with other departments of IMV and various institutions, investigation of plant bacterioses, regularities of appearance and development of the infection process, methods of diseases control have been distinguished . Special attention was given to phytopathogenic bacteria: ecology, morphology, antigens and their structure . Poliobiotrophy, heterogeneity of pathogens population and its relation with pathogenicity have been investigated . Many-sided relations of pathogens with epiphytes and endophytes have been revealed . Bacteriophages of phytopathogenic bacteria have been studied.

Mikrobiol Z, 2003 Jan-Apr, 65(1-2), 70 - 83
{Seventy years of research in experimental mycology at the Institute of Microbiology and Virology of the National Academy of Sciences of Ukraine}; Zhdanova NM; The history of development of mycology at the D.K . Zabolotny Institute of Microbiology and Virology of the NAS of Ukraine and main achievements of the Department of Physiology and Taxonomy of Micromycetes during 1933-2003 were described in this publication.

Mikrobiol Z, 2003 Jan-Apr, 65(1-2), 59 - 69
{Role of Semen Mykytovych Moskovets' in the foundation and development of plant virology at the Institute of Microbiology and Virology of the National Academy of Sciences of Ukraine (1960-1971)}; Kraiev VH; The historical events in the Zabolotny Institute of Microbiology and Virology of the NAS of Ukraine that were connected with professor's S.M . Moskovets work activity as director and organizer of plant virology investigations are analyzed.

Mikrobiol Z, 2003 Jan-Apr, 65(1-2), 31 - 42
{Department of Antibiotics--its history and the present}; Smirnov VV; The paper on the occasion of the 75th anniversary of the Institute of Microbiology and Virology of the NAS of Ukraine is dedicated to scientific activity of one of its oldest subdivisions: the Department of Antibiotics . The main trends of scientific research and their most important results for the whole period of the Department existence are presented.

CMAJ, 2003 May 27, 168(11), 1399 - 405
West Nile virus infection in 2002: morbidity and mortality among patients admitted to hospital in southcentral Ontario; Pepperell C et al.; BACKGROUND: In August and September 2002 an outbreak of West Nile virus (WNV) infection occurred in southern Ontario . We encountered a number of seriously ill patients at our hospitals . In this article we document the clinical characteristics of these cases . METHODS: We conducted a retrospective chart review of patients who came to the attention of infectious disease or neurology consultants or the microbiology laboratories at 7 hospitals in the municipalities of Toronto, Peel and Halton, Ont . Patients were included if they had been admitted to hospital or stayed overnight in the emergency department, had serological evidence of WNV infection and had clinical evidence of WNV fever, aseptic meningitis, encephalomyelitis or motor neuronopathy . RESULTS: In all, 64 patients met the inclusion criteria; 57 had encephalitis or neuromuscular weakness or both, 5 had aseptic meningitis, and 2 had WNV fever . The mean age was 61 years (range 26-87) . The patients were predominantly active, middle-aged or elderly people living independently in the community . Seven patients were immunocompromised A febrile prodromal illness preceded the neurological symptoms in almost all cases . The most common neurological abnormality was decreased level of consciousness; this frequently evolved to severe lower motor neuron neuromuscular weakness . Ataxia and swallowing disorders were frequent and important problems . Sixteen patients (25%) required intubation and mechanical ventilation because of a decreased level of consciousness, inability to clear secretions or respiratory muscle weakness; 9 others had disabling muscle weakness of one or more limbs . Ten patients died . The study patients were in hospital a total of 1856 patient-days, including 532 patient-days in an intensive care unit . Only 28% (13/47) of the patients who survived encephalitis or neuromuscular weakness, or both, were discharged home without additional support . Slow turnaround time for serological test results resulted in delayed diagnosis . INTERPRETATION: The 2002 WNV infection outbreak in Ontario caused serious morbidity and mortality in the subset of patients who had encephalitis or neuromuscular weakness severe enough to require hospital admission.

Vaccine, 2003 Jun 1, 21 Suppl 2, S83 - 8
Vaccination strategies . An overview; Del Giudice G; Existing vaccines have contributed significantly to the reduction of the mortality and morbidity burdens of many infectious diseases . In many instances, however, the development of these vaccines has been empirical . Furthermore, the impressive progress in the field of vaccines has been mainly driven the progress in molecular biology and microbiology more than by the progress in immunobiology . Nevertheless, the new challenges vaccinology is facing nowadays can be approached through a comprehensive understanding of the mechanisms behind the induction and the maintenance of efficacious immune responses triggered by vaccines . The new vaccination strategies aim at exploiting the new knowledge in the field of dendritic cells (DC; and their role in priming immune responses), in the field of antigen processing and presentation for the generation of antigen-specific cytolytic T cells, and in the field of induction and maintenance of immunological memory, with the ultimate goal of developing better vaccines with an enhanced safety and efficacy not only in children and adults, but also at neonatal age.

Curr Infect Dis Rep, 2003 Jun, 5(3), 246 - 253
Urban Tuberculosis: The New Face of an Old Problem; LaRosa JA et al.; Tuberculosis (TB) persists as a worldwide health crisis . Nearly one third of the world's population is infected with TB and it remains a critical public health issue . In the past two decades, international efforts have focused on improving identification of those infected with TB as well as supporting molecular microbiologists in developing better diagnostic techniques . Furthermore, implementation of programs such as directly observed therapy have assisted more patients in receiving and completing therapy . This review aims to identify some of the more relevant findings in the field of TB over the past few years with a special emphasis on TB in urban communities.

Tuberculosis (Edinb), 2003, 83(1-3), 165 - 72
The Mumbai experience in building field level partnerships for DOTS implementation; Rangan S et al.; In February 1999, the Revised National Tuberculosis (TB) Control Programme (RNTCP) was implemented in the city of Mumbai after a pilot phase of 5 years . The city has a population of more than 12 million people and an estimated annual TB incidence of 21,000 cases, 8000 of these being infectious . This paper describes a partnership between the TB programme and a Non Governmental Organization (NGO), which began with a methodological analysis of the problems faced by the programme to help identify other key organizations, who might usefully be involved . The work focussed on "networking" to ensure the optimum use of existing resources . The problems encountered affected all levels of TB control from access to drug supply and treatment . The major issues related to an inadequate public health infrastructure resulting in poor technical and administrative support to field staff . There was confusion over roles of the health personnel in the TB programme and the public health facility, as well as poor technical performance . Partnerships were found to be useful in addressing the following areas: (1) the implementation of an external quality assurance scheme for sputum microscopy through involvement of microbiologists from large hospitals and research organizations; (2) training and capacity strengthening of programme and public health facility staff through innovative training and team building exercises organized by the programme, NGOs and the private sector; (3) development of Information, Education and Communication (IEC) material through partnerships with NGOs, and (4) the involvement of local NGOs and private doctors to increase case finding and to improve access to direct observation of treatment (DOT) . The paper discusses the lessons learnt in this process and identifies some of the key issues in urban TB control, for consideration by policy makers.

Dermatol Clin, 2003 Apr, 21(2), 237 - 44, v
Tick-borne infections; Singh-Behl D et al.; Ticks, obligate, blood-sucking members of the order Acarina and class Arachnida, are the most common agents of vector-borne diseases in the United States . Ticks play an important role in transmitting viruses, bacteria, spirochetes, parasites, and rickettsia . This article reviews the epidemiology, microbiology, diagnosis, and treatment of the major tick-borne diseases in the United States.

Southeast Asian J Trop Med Public Health, 2002, 33 Suppl 2, 86 - 90
Clinical pathologist in Korea--training program and its roles in laboratories; Cho HI et al.; A rapid development of practice of laboratory medicine in Korea owes its success to the clinical pathologists (CP), who have played a role of a pathfinder for laboratories . The Korean CP postgraduate education (residency) program is unique in that it is exclusively for laboratory medicine . The training program for clinical pathologists includes diagnostic hematology, diagnostic immunology, clinical microbiology, clinical chemistry, blood bank, diagnostic genetics, informatics and laboratory management . The program has produced a strong group of about 600 laboratory physicians, officially clinical pathologists since 1963 . Most of Korean clinical pathologists work as laboratory directors, directors of university hospital laboratories or teaching faculty members in medical schools . The roles of clinical pathologists are laboratory management, interpretation of laboratory test results, clinical consulting services to clinicians and patients, ordering secondary tests after reviews of requested test results and utilization management . The clinical pathologists have developed clinical laboratories to be a main contributor for improved medical practice . During the last 40 years under the turbulent healthcare system, clinical pathologists have significantly contributed to safeguard the laboratory interests . The education program and the role of clinical pathologists are described.

Acta Obstet Gynecol Scand, 2003 May, 82(5), 439 - 42
Comparison between two cord blood collection strategies; Solves P et al.; BACKGROUND AND OBJECTIVES: Collection strategy is the first step for collecting good quality cord blood (CB) units . There are two principal different techniques to collect CB from the umbilical vein: in the delivery room while the placenta is still in the uterus by midwives and obstetricians or in an adjacent room after placental delivery by CB-bank trained personnel . In this study, the benefits and disadvantages between two different CB collection strategies were evaluated in order to improve CB bank methodology . DESIGN AND METHODS: Valencia CB bank maintains the two different collection strategies aforementioned . Before processing CB units, volume was calculated and samples were drawn for cell counts . After processing and before cryopreservation, samples for cell counts, CD34 analysis, viability, clonogenic assays and microbiology were drawn directly from the bags . We compared the efficiency of the two collection techniques . RESULTS: Obstetric date and umbilical CB was obtained from 848 vaginal (484 collected in uterus and 364 collected ex uterus) . The proportion of excluded CB units before processing was 33% for ex uterus and 25% for in uterus . The difference was statistically significant . A larger volume and a higher number of total nucleated cells, CD34+ cells and CFUs were harvested in the in uterus collection group . INTERPRETATION AND CONCLUSIONS: Based on our findings, we conclude that the mode of collection influences the hematopoietic content of CB donations . Collection before placental delivery is the best approach to CB collection and allows optimizing CB bank methodology.

Urologe A, 2003 May, 42(5), 634 - 40 Epub 2003 Apr 11.
{Modern diagnostics for urological infections}; Geisel R et al.; This paper provides a short overview of modern, molecular-based diagnostic procedures of urogenital tract infections . Although gaining importance, molecular methods have not yet become a reliable substitution for the classic procedures in terms of costs and quality standards . As an example of a new molecular approach in microbiology, a method for the detection of the most relevant uropathogens in a single PCR is presented . Furthermore, the development of a real time PCR is described.

J Dent Educ, 2003 Apr, 67(4), 459 - 67
Diabetes mellitus as a modulating factor of endodontic infections; Fouad AF; Diabetes mellitus is a chronic disease with serious health consequences . The association between diabetes and periodontal disease is well documented . However, the progression and healing of endodontic infections in diabetic patients has not been adequately studied . In this review, diabetes mellitus is explored as a potential modulating factor of endodontic pathosis . Recent data on the relationship between the clinical presentation of pulpal and periradicular disease, as well as the outcome of endodontic treatment in diabetic and nondiabetic patients, are presented . Diabetics who present for endodontic treatment, particularly those with periradicular pathosis, may have increased perioperative symptoms . Cases with preoperative periradicular lesions are less likely to be determined successful two years or longer postoperatively if the patient reports a history of diabetes . Studies examining the pathogenesis of periradicular lesions in mouse models with uncontrolled type 1 diabetes suggest that the lesion size may be increased and the animals have increased serious sequelae . Preliminary findings suggest that some bacterial species may be more prevalent in necrotic pulp of diabetic than nondiabetic patients . More studies are needed to further explore the microbiology of endodontic infections and to determine effective treatment strategies in both diabetic and nondiabetic patients.

J Periodontol, 2003 Apr, 74(4), 547 - 51
Severe alveolar bone loss and gingival hyperplasia as initial manifestation of Burkitt cell type acute lymphoblastic leukemia; Haytac MC et al.; BACKGROUND: The purpose of this case report is to present severe alveolar bone destruction and gingival enlargement as initial manifestation of Burkitt cell type acute lymphoblastic leukemia (ALL-L3) in a 14-year-old boy . METHODS: The patient was referred to the periodontology department with a 4-week history of gingival enlargement and loosening of teeth . The clinical examination revealed gingival enlargement and expansion of alveolar mucosa particularly in molar regions of both jaws . Almost all teeth had deep periodontal pockets and severe mobility . While the radiographs showed severe alveolar bone loss which extended to apical thirds of many teeth, the microbiologic analysis revealed that the patient did not harbor major periodontopathogenic bacteria species . The results of blood tests and bone marrow aspiration were compatible with ALL-L3 . RESULTS: Remission-induction treatment with BFM-90 ALL chemotherapy protocol was started; however, the patient died 4 weeks after the diagnosis due to neutropenic sepsis . CONCLUSIONS: Although no biopsy was performed, it is possible that the severe periodontal destruction and gingival enlargement in this case may have been due to the infiltration of leukemic cells in gingiva, periodontal ligament, and alveolar bone . The similarities of these findings with numb chin syndrome (NCS) and Burkitt's lymphoma (BL) are discussed in this report.

Rinsho Byori, 2003 Apr, 51(4), 370 - 4
{Postgraduate training program in laboratory medicine at a clinical teaching hospital}; Matsuo S; The Tenri Hospital resident system was introduced in 1976 and the training program for laboratory medicine began in 1982 . Thus, the author proposes goals for the the future on the basis of experience . It is appropriate that trainees study emergency tests, blood transfusion and microbiology(particularly Gram's stain and sputum culture) as practical matters, and in addition to these, learn how to reply to consultations from physicians, learn the laboratory flow(so-called laboratory system), and announce interpretations of laboratory data at reversed clinical pathological conference(R-CPC) . The objectives of these training programs are to gain skills for appropriate laboratory utilization and interpretation, and develop communications and consultations with clinical pathologists and medical technologists . The key points of success in the training are close cooperation of the laboratory and teaching divisions . Particularly, cooperation with medical technologists is necessary, and it is essential medical practice for trainees because they will have to work with them in future . Finally it should be emphasized that there training has a limited effect because of the short duration . It is thus important to communicate and discuss clinical matters regularly in medicine.

Hematology, 2003 Apr, 8(2), 119 - 23
Eradication of invasive mucormycosis--effectiveness of the Echinocandin FK463; Jacobs P et al.; BACKGROUND: Invasive rhinocerebral mucormycosis is a rare and often fatal opportunistic fungal infection . It is encountered in immunocompromised hosts exemplified by those with diabetes, human immunodeficiency viruses and particularly haematologic malignancies typically after high-dose chemotherapy and stem cell transplantation . In contrast to the more usual outcome with rapid progression and death . We now describe a successful eradication attributable to the use of a newly available antifungal agent . SETTING: Haematology department and bone marrow transplantation unit . MATERIAL AND METHOD: Two patients are contrasted . The first with acute leukaemia developed rapidly progressive facial swelling with mucormycosis proven on biopsy . Treatment over 2 months with maximally tolerated doses of amphotericin failed to halt intracranial extension and death resulted . The second, presented with acute lymphoblastic leukaemia in August 1997, underwent successful autologous bone marrow transplantation in February 1998 . Relapse followed in March 1999 and after reinduction and consolidation receive a matched unrelated volunteer allograft in September 1999 . A second recurrence was documented in April 2000 and in spite of achieving remission he developed a fever that was managed empirically with intravenous amphotericin and, on discharge, oral itraconazole . Left-sided facial swelling expanded rapidly and biopsy showed extensive invasion of the maxillary sinus with mucormycosis . FK463 was added on 5 June 2000 with gradual reduction in facial pain and within 1 month all clinical signs and resolved . Serial biopsies that included histopathologic investigation and microbiologic cultures confirmed eradication of the invasive mucor . In view of the potential danger of recrudescence this treatment regimen was continued through further chemotherapy and, once again disease-free, a second matched unrelated volunteer allograft took place in August 2000 . Full reassessment at the time failed to demonstration any residual fungus . Engraftment was confirmed but neutropenic sepsis resulted in severe inflammatory response syndrome with progression to multiple organ dysfunction to which he succumbed without any evidence of leukaemic or systemic mycosis . CONCLUSION: Echinocandin FK463 is of documented value in managing invasive candidiasis and aspergillosis . This is believed to be the first case of successful outcome with one of the angiotrophic zygomycetes.

Diagn Microbiol Infect Dis, 2003 May, 46(1), 73 - 5
Pseudooutbreak of Candida versatilitis fungemia in a microbiology laboratory; Brandt ME et al.; Candida versatilitis was isolated from 10 blood cultures that had been supplemented with olive oil to promote the growth of Malassezia spp., and from the stock olive oil bottle in the laboratory . This unusual non-pathogenic yeast isolate was readily identified by DNA sequencing methodology . This report also points out that care must be taken to ensure the sterility of supplements added to blood culture media.

Diagn Microbiol Infect Dis, 2003 May, 46(1), 13 - 7
The use of Niger seed agar to screen for Candida dubliniensis in the clinical microbiology laboratory; Lees E et al.; Candida dubliniensis is a recently described pathogenic yeast that is closely related to C . albicans . The germ tube test is used routinely in diagnostic laboratories for the identification of C . albicans, and C . dubliniensis may also produce germ tubes under the same conditions . We evaluated a previously described method for differentiating between the two species using Niger seed agar (Staib agar) . The aim was to find a useful, user-friendly and cost-effective method for use in diagnostic work . C . albicans produces only yeast cells on this medium after 24 h at 37 degrees C, while C . dubliniensis produces extensive hyphal and pseudohyphal growth that is easily observed . Of 495 yeasts isolated in, or sent for identification to, a diagnostic mycology laboratory 9 isolates (1.8%) were found to be C . dubliniensis . The method was found to be valuable for screening yeasts before proceeding to further identification if positive for hyphal/pseudohyphal growth on Niger seed agar . This method is therefore suitable for the screening of selected yeast isolates in order to identity C . dubliniensis and will further our understanding of the clinical importance of this species.

Arch Pathol Lab Med, 2003 Jun, 127(6), 687 - 93
A regional centralized microbiology service in Calgary for the rapid diagnosis of malaria; Church DL et al.; CONTEXT: A regional centralized laboratory service for the rapid diagnosis of malaria was implemented 3 years ago in May 1999 within the Division of Microbiology, Calgary Laboratory Services . OBJECTIVE: To describe the design and performance of this unique microbiology laboratory service . DESIGN: Blood specimens must arrive at the central laboratory within 2 hours of collection . Thin blood smears are read and reported from suspected acute cases within 1 hour of receipt, 24 hours per day, 7 days a week, by trained and experienced microbiology technologists . All positive malaria smears are reviewed by a medical microbiologist and confirmed by polymerase chain reaction at a reference laboratory . SETTING: Calgary Laboratory Services provides integrated laboratory services to the Calgary Health Region, an urban area of more than 1 million people . MAIN OUTCOME MEASURES: Performance of the service has been continuously monitored by measuring preanalytic and analytic test turnaround times, test accuracy, clinical relevance, and the results of proficiency testing . RESULTS: More than 90% of blood specimens for malaria from community locations have consistently arrived within 2 hours of collection, and hospitals have reached this target within the past year . Although polymerase chain reaction was more sensitive at detecting the presence of malaria, the expert microscopists were as accurate at determining the type of Plasmodium infection . More than 95% of all positive smear results are consistently reported within 2 hours of receipt of a blood specimen . CONCLUSIONS: Implementation of a regional centralized microbiology service has improved our ability to make a rapid and accurate diagnosis of malaria in this region.

Arch Pathol Lab Med, 2003 Jun, 127(6), 661 - 5
Results of the survey of the quality assurance for commercially prepared microbiology media . Update from the College of American Pathologists Microbiology Surveys Program (2001); Jones RN et al.; CONTEXT: Beginning in 1985, state-of-the-art surveys by the College of American Pathologists (CAP) led to M22-A guidelines by the National Committee for Clinical Laboratory Standards (NCCLS) for quality assurance (QA) of various commercially prepared isolation and diagnostic microbiology media . Some medium types were declared exempt from routine QA testing by each laboratory user, but manufacturer QA was maintained and specified in great detail . No update has occurred in more than 15 years as more complex media have been introduced into clinical microbiology practice . OBJECTIVE: To reassess the quality of commercially prepared microbiology media in the United States for the revision of NCCLS document M22-A2 . Methods.-A questionnaire was designed to conform to that used by the CAP in 1985 and 1988, and was updated by lists of 52 recently introduced diagnostic media . Queries included details of laboratory QA in the last 12 months, such as number of lots tested, number of items in a lot, number of items in a quality control (QC) sample, number of lots failed, and reasons for lot failure . All CAP Microbiology Surveys participants received the document in late 2001 . RESULTS: Data from nearly 300 000 media lots representing 32.7 million medium items were received from more than 3000 CAP Surveys subscribers . Lot raw data failure rates for all media ranged from 0.10% to 9.87% (average, 1.01%) . Failures with media having a significant QC experience (> or =1000 lots or > or =100 000 items) adjusted for QC strain-based failures (so-called extrapolated failure rate) ranged from 0.04% to 1.34% (average, 0.40%) . The threshold rate for QA exemption from 1985 analyses was expanded to 0.50% or less and now allows exemption of 27 media evaluated in this study . Local laboratory QA must remain in force (M22-A2) for the other 25 products . CONCLUSIONS: Generated QA failure results from the CAP Microbiology Surveys supplement recent results of the NCCLS M22 Subcommittee that will lead to more practical media QA guidelines and could significantly decrease costs for clinical microbiology laboratories through focusing QC on a smaller number of the most at-risk diagnostic products.

Kulak Burun Bogaz Ihtis Derg, 2003 Mar, 10(3), 122 - 30
{A review on experimental sinusitis models in rabbits}; Kara CO et al.; Experimental animal models are instrumental to study the pathogenesis of diseases and to examine the results of treatment . The great size and ease of accessibility have made rabbit sinuses popular in the investigation of experimental sinusitis . Microbiologic, histopathologic, and radiologic aspects of this model have been well-described and the effects of medical and surgical treatments on sinusitis have been examined . Ongoing research may provide further data to find more simple and non-invasive methods to induce sinusitis in rabbits that may more closely simulate sinusitis pathogenesis in humans . This article reviews the most recent data on technical, surgical, microbiologic, histopathologic, and radiologic aspects, and complications of sinusitis models in rabbits.

Obstet Gynecol, 2003 May, 101(5 Pt 2), 1094 - 7
Drug rash with eosinophilia and systemic symptoms syndrome and renal toxicity with a nevirapine-containing regimen in a pregnant patient with human immunodeficiency virus; Knudtson E et al.; BACKGROUND: Antiretroviral therapy is associated with serious adverse events . We report the case of a pregnant human immunodeficiency virus type 1-infected woman who developed drug rash with eosinophilia and systemic symptoms syndrome and renal failure shortly after initiation of a nevirapine-containing antiretroviral regimen at 27 weeks' gestation . CASE: A 26-year-old primigravida presented with a fever of 40.2C, urticarial rash, and icteric sclera 6 weeks after starting a nevirapine-containing antiretroviral regimen . Eosinophils, serum creatinine, bilirubin, and liver enzymes were markedly elevated, and abnormal coagulation studies were noted on admission . Serology testing was negative for viral hepatitis and microbiologic cultures were negative for growth . Abnormal laboratory findings at discharge resolved within 4 months after discontinuation of antiretroviral agents and systemic corticosteroid therapy . CONCLUSION: Our case suggests the need for close monitoring of liver and renal function after initiation of nevirapine-containing antiretroviral regimens.

J Am Acad Dermatol, 2003 May, 48(5 Suppl), S47 - 50
Massive exophytic abscesses and fibrotic masses of the chin: a variant of the follicular occlusion triad; Meyers SW et al.; We present a patient with an extensive cluster of exophytic nodules that developed on his chin . These nodules consisted of abscesses and fibrotic areas . Lesion morphology, histology, and microbiology support a follicular occlusion triad entity . However, the distribution is striking and does not fit the entities described in the triad . We present the case to show that follicular occlusion was the inciting factor in our patient's eruption and to broaden our concept of clinical manifestations that can arise from this pathologic process.

J Clin Microbiol, 2003 May, 41(5), 2102 - 5
Recombinant VP7-based enzyme-linked immunosorbent assay for detection of immunoglobulin G antibodies to Colorado tick fever virus; Mohd Jaafar F et al.; VP6, VP7, VP9, VP10, VP11, and VP12 of Colorado tick fever virus (CTF virus), a virus member of the genus Coltivirus, family Reoviridae, were expressed in bacteria with the pGEX-4T-2 vector . A partial sequence of VP7 (designated pVP7) was chosen to elaborate an enzyme-linked immunosorbent assay (ELISA) for detecting anti-CTF virus immunoglobulin G (IgG) antibodies in humans . This was based on two observations: (i) among all expressed proteins, pVP7 showed the highest immunoreactivity to an anti-CTF virus hyperimmune ascitic fluid; (ii) to provide the highest selectivity of antibody detection, the expressed sequence was chosen within a region which is highly divergent (49% amino acid identity) from the homologous sequence of another coltivirus, the Eyach virus . The pVP7 ELISA was evaluated with 368 serum samples from French blood donors and found to provide 98.1% specificity . Assays with the Calisher set of human serum samples, positive for anti-CTF virus antibodies (C . H . Calisher, J . D . Poland, S . B . Calisher, and L . A Warmoth, J . Clin . Microbiol . 22:84-88, 1985), showed that the pVP7 ELISA provided 100% sensitivity for the tested population . After elaboration of recombinant-protein-based ELISAs for diagnosis of infections with members of the viral genera Orbivirus, Orthoreovirus, and Rotavirus, it was shown that a recombinant protein could be used to detect antibodies to the human pathogen Colorado tick fever virus.

Presse Med, 2003 Mar 15, 32(10), 466 - 9
{Pharmacologic innovations, the fluoroquinolone model}; Bergogne-Berezin E; OBJECTIVES: Like all the disciplines involved in infectious diseases and antibiotic therapy, pharmacokinetics and pharmacodynamics (PK/PD) of antibiotics have evolved significantly . They include new investigation procedures like in vitro models and new animal models . There is a current trend towards better methods, newer definitions and improved quality of research in this particular field . DEFINITIONS: The current evolution of pharmacology of antibiotics is mainly characterized by the development of pharmacodynamics (PD) which offers the advantage of including microbiology data . New PD parameters have been defined . It is recommended to working groups involved in PK/PD research to compare their results and tend to a consensus on the methods to be used . CONCLUSION: Benefiting from such progress, preclinical phases of PK/PD studies of new molecules as well as revision of older antibiotics permit a rigorous and clinical approach to the use of antibiotics.

Presse Med, 2003 Mar 15, 32(10), 440 - 9
{Infections by Candida sp . in intensive care . Survey of French practices}; Gauzit R et al.; OBJECTIVE: The isolation of Candida sp in nosocomial infections is on the increase and over the past 10 years many guidelines for "good" practices and recommendations have been published on the modalities for the management of systemic candidiasis . The aim of this paper was to assess the habits in the intensive care units in this domain in France . METHOD: A transversal survey on the habits was conducted from March to May 2001, using a questionnaire mailed to 200 intensive care units . RESULTS: One hundred eighty questionnaires (surgical reanimation: 12%, medical: 18%, medico-surgical: 70%) out of 200 (92.5%) were returned . The indirect diagnostic examinations: serology, search for antigenemia and PCR (Polymerase Chain Reaction) were never used in 21, 35 and 65% of cases . The systematic search for colonisation (a mean of 4 areas sampled) was conducted in all the patients by 19% of the investigators, in some patients by 53%, and never by 28% . An antifungal treatment was prescribed: in the presence of a positive haemoculture alone, once out of twice if the sample had been taken from a central catheter and in 2 cases out of 3 when the sample was peripheral . It was prescribed 6 times out of 10 after isolation of Candida sp following surgery or on needle aspiration of an intra-abdominal abscess, varyingly in the case of cadiduria, isolation of a Candida sp in a broncho-pulmonary sample or in abdominal draining and positive culture of a catheter, depending on the intensity of the colonisation, the severity of the clinical picture and the presence of factors of risk for Candida infection . It is still prescribed empirically depending on the same elements and the absence of explanation for worsening . When faced with candidemia in a non-neutropenic patient, a central catheter is not changed in 18% of cases . Depending on the microbiology, fluconazole is prescribed in: the identification of yeast without further precision (78% of cases), Candida sp without further precision (86% of cases), Candida non albicans without further precision (57% of cases), C . albicans (93% of cases), Candida non albicans other than C . krusei and C . glabrata (62% of cases), C . glabrata (36% of cases) with an increase in dose in 1 out of 2 cases . In the presence of C . glabrata or C . krusei, amphotericin B is the choice in respectively 51 and 75% of cases . To adapt the treatment.

J Microbiol Methods, 2003 Jul, 54(1), 117 - 20
Improved fast gas chromatography for FAME analysis of bacteria; Buyer JS; Bacteria are frequently identified by fatty acid analysis . We previously reported on methods to speed up sample preparation and gas chromatography, resulting in greatly improved speed and throughput {J . Microbiol . Methods 51 (2002) 209} . In this paper, we demonstrate that further reductions in chromatographic retention times are readily achieved, leading to faster identification of bacteria.

Prog Biophys Mol Biol, 2003 Apr, 81(3), 201 - 17
Early assembly of cellular life; Trevors JT; Popular hypotheses that attempt to explain the origin of prebiotic molecules and cellular life capable of growth and division are not always agreed upon . In this manuscript, information on early bacterial life on Earth is examined using information from several disciplines . For example, knowledge can be integrated from physics, thermodynamics, planetary sciences, geology, biogeochemistry, lipid chemistry, primordial cell structures, cell and molecular biology, microbiology, metabolism and genetics . The origin of life also required a combination of elements, compounds and environmental physical-chemical conditions that allowed cells to assemble in less than a billion years . This may have been widespread in the subsurface of the early Earth located at microscopic physical domains.

Quintessence Int, 2003 Apr, 34(4), 258 - 68
Techniques for immediate core buildup of endodontically treated teeth; Smidt A et al.; Access to the pulp chamber for endodontic treatment is indicated inter alia as a result of extensive caries, trauma to the tooth causing fracture or loss of vitality, requiring restoration of the missing tooth structure . Different approaches and materials are described in the literature for foundation restorations, either with a cast post and core or immediately, with a chairside post-and-core system . This article briefly reviews the current data regarding the microbiologic, prosthetic, mechanical, and periodontal aspects while emphasizing the immediate approach using amalgam, resin composites, and glass ionomers . Factors affecting retention of the post are presented to guide the clinician in selecting a suitable post-and-core system to preserve optimal root structure and prevent root fracture . Three clinical cases are presented in which tooth structure was restored using different techniques: in the first two, provisional acrylic resin shells, one custom made and the other prefabricated, were used to house an amalgam coronal-radicular dowel core, where in the third case, a copper band was used for a composite post-and-core system . All cases emphasize the ease of production and short chairtime in the stages of crown fabrication.

Chemosphere, 2003 Jul, 52(1), 95 - 101
Cyst-based toxicity tests XVI--sensitivity comparison of the solid phase Heterocypris incongruens microbiotest with the Hyalella azteca and Chironomus riparius contact assays on freshwater sediments from Peninsula Harbour (Ontario, Canada); Belgis ZC et al.; In view of the complexity and costs of "traditional" whole sediment assays, a "culture/maintenance free" direct contact microbiotest has been developed with the freshwater ostracod Heterocypris incongruens . The new Toxkit assay (named Ostracodtoxkit) has been applied to 33 sediment samples from Peninsula Harbour, located in Lake Superior of the Great Lakes water basin in Ontario, Canada . The microbiotest was applied in parallel to direct contact tests with the amphipod Hyalella azteca and the midge larva Chironomus riparius, to compare its relative sensitivity with that of the two "conventional" assays . The study was undertaken in the framework of remediation action plans for specific areas of concern, to enable decision making by the Canadian authorities for the restoration of impacted aquatic environments . Most sediments were found non-toxic (<20% mortality) to both the conventional test species and the ostracod . For the large majority of samples, a very good correspondence was found between the two crustacean test species for the intensity of the toxic signal "mortality", as reflected by a 0.71 (p<0.05) correlation coefficient . Growth inhibition, which is determined in the ostracod microbiotest as a sublethal effect criterion, allowed the earmarking of some sediment samples, which were apparently more toxic for the amphipod than to the ostracod . For 20% of the samples, substantially higher mortality scores were noted with the ostracod assay than with the midge larvae tests and the overall correlation coefficient between these two tests was lower (r=0.60,p<0.05) . The results obtained in the present study corroborate those of previous research on sediments collected from various rivers in Flanders, Belgium, and confirm the potential of the new ostracod microbiotest as a reliable and sensitive low cost alternative for traditional whole sediment assays.

AIDS Read, 1999 Mar-Apr, 9(2), 97 - 9
Linear gingival erythema in an HIV-seropositive man; Lugo RI et al.; Linear gingival erythema (LGE) is part of the spectrum of periodontal disease that exists in the HIV-infected population . Here, a typical case of LGE is presented and described . The microbiology and therapeutics of LGE are discussed, as well as this condition's relationship to more severe, rapidly destructive infectious diseases--such as necrotizing ulcerative periodontitis and necrotizing stomatitis.

J Clin Virol, 2003 May, 27(1), 83 - 9
Multicentre Italian Study Group (MISG) for the standardisation of hepatitis C virus (HCV) PCR; Mancini C et al.; BACKGROUND: Several studies on standardisation of NAT assays for diagnosis of hepatitis C virus (HCV) infection have been carried out in European countries . In fact the widespreading use of nucleic acid amplification technology (NAT) in diagnostic centres for the evaluation of the HCV infection, requires the application of reference external standards to control laboratory performance; but up to date they are not routinely used . OBJECTIVES: Fifteen diagnostic centres of major Italian Hospitals participated to a quality control study for the standardisation of polymerase chain reaction (PCR)-based HCV-RNA detection, organised by the Committee for the Study of Biotechnology (CoSBio) of the Italian Society of Clinical Microbiology (AMCLI) . All the participant centres (PC) used commercial assays, automated or semi-automated . STUDY DESIGN: The study was performed in four rounds . Altogether each centre received 14 reference negative and 22 reference positive sera . The range of copies number per ml of the reference positive sera was 10(4)-10(7) . RESULTS AND CONCLUSIONS: Considering the 540 samples tested, 4.54% of false negative (FN) and 4.28% of false positive (FP) results were reported . Thereafter the sensitivity and the specificity were 95.65 and 95.89%, respectively . The errors were distributed among seven out of the 15 PCs . The percentage of FP results was uniformly distributed in each shipment, whereas FN results emerged with the sera at lower HCV genome copies number . The analysis of the data obtained suggests that FP as well as FN results may be attributable to errors or to others problems of laboratories . To improve the performance of Italian, as well as of laboratories throughout the world, the use of external reference standards in multicentre collaborative studies will be required.

Ann Surg, 2003 May, 237(5), 694 - 703
Champ Lyons: an incomplete life; Dalton ML; The life of Champ Lyons, MD, is presented, with emphasis on his tenure as Chairman of the Department of Surgery of the Medical College of Alabama (University of Alabama in Birmingham School of Medicine) from 1950 until 1965 . Before becoming chairman Dr . Lyons, as an esteemed microbiologist, participated in the early use of penicillin in wounded servicemen during World War II . Later in his career, he made many contributions to the emerging disciplines of vascular and cardiac surgery . After a brief illness in 1965, Dr . Lyons expired due to a brain tumor . His relatively brief career and his unanticipated sudden demise have lessened the fame of Dr . Lyons to which he is justly entitled . It is the purpose of this presentation to reawaken the surgical community to the importance of this giant of American surgery.

Appl Biochem Biotechnol, 2003 Spring, 105 -108, 649 - 57
Microbiologic oxidation of isosafrole into piperonal; Santos AS et al.; The biotransformation of isosafrole by Cladosporium sphaerospermum yielded piperonal, which is a compound of great commercial importance in the flavor and fragrance industries . The experiments were performed in 500-mL conical flasks containing 100 mL of Czapek-modified medium in an orbital shaker with controlled agitation and temperature . Spores of C . sphaerospermum were used as inocula, and after 96 h of incubation the substrate was added to the culture . Samples of 2 mL were withdrawn at 24-h intervals and analyzed by gas chromatography, (GC) and/or GC/MS spectroscopy.

Arch Orthop Trauma Surg, 2003 Jun, 123(5), 209 - 14 Epub 2003 Apr 26.
Management of infected shoulder replacement; Jerosch J et al.; BACKGROUND: The purpose of the present work is to present treatment options and our own results for patients with infected shoulder alloarthroplasties . METHODS: Twelve patients with an infected shoulder replacement were treated . Their age ranged from 56 to 82 years . Indications for surgical revision were clinical symptoms compatible with an infection or positive serologic tests, especially an elevated C-reactive protein . Aspirated intra-articular fluid with a white blood cell count above 30,000 or positive for bacterial growth was also an important diagnostic feature . Retrospective analysis differentiated three groups with three different treatment regimens . Group 1 with early infection but without soft-tissue involvement (n=1): this particular patient underwent arthroscopic synovectomy . Group 2 with early infection and soft-tissue involvement within 4 weeks after index surgery (n=1): this patient underwent open synovectomy . The largest group was group 3 with late infection (n=10): these patients were treated with two-stage revision and a temporary spacer . RESULTS: The time between explantation and reimplantation ranged between 4 weeks and 6 months . With the temporary spacer, an anatomically stable condition could be established for all patients, and reconstruction of the humeral length even in long implants was possible . All patients underwent physiotherapy with the temporary spacer in place . A positive intraoperative microbiologic specimen was only found in 4 patients . In both group 1 and 2 patients, the infection healed, and thus the original implant could be kept in situ . In 8 patients, the temporary spacer was removed and exchanged for a regular implant . The postoperative raw Constant score at the time of the last follow-up examination was 48, due mainly to a loss of motion and power . All shoulders were stable, and the elbow function was good . CONCLUSION: Use of an antibiotic-loaded spacer allows successful treatment of infected shoulder replacements.

Int J Infect Dis, 2002 Dec, 6(4), 314 - 8
Cyclospora cayetanensis in stools submitted to hospitals in Lagos, Nigeria; Alakpa G et al.; BACKGROUND: Cyclospora cayetanensis is an emerging human pathogen associated with gastrointestinal disease . The epidemiology and biology of the parasite are poorly understood, and numerous outbreaks of cyclosporiasis have been recorded from around the world since 1990, but the incidence of the parasite in Nigeria has not been described . DESIGN AND METHODS: A cross-sectional, laboratory-based study was conducted in Lagos-metropolis state in southwestern Nigeria . All stool samples submitted to the Microbiology and Parasitology Department between March 1999 and April 2000 were processed for the presence of Cyclospora cayetanensis . Data from each patient were obtained from health records and via questionnaires, including age, sex and reason for hospital visit . RESULTS: In total, 1109 stool samples were collected during the period of study . Eleven (0.99%) were confirmed to be positive for Cyclospora cayetanensis oocysts . Other parasites were also detected, including Cryptosporidium sp., Entamoeba sp., Ascaris, Trichuris, Strongyloides sp., and hookworm . CONCLUSIONS: Cyclospora cayetanensis is an infrequent but important cause of gastrointestinal disease in Lagos, Nigeria . This is the first report of Cyclospora infection in Nigeria and suggests that medical practitioners and laboratory scientists should be made more aware of the infection.

Infez Med, 2000, 8(4), 245 - 248
{Dental caries: from verminous to infectious disease}; Pistacchio E et al.; The purpose of our analysis is to study the evolution of knowledge about the etiology of caries . Since ancient times mankind has investigated the causes of a pathology which is at times most painful . Only in the second half of the nineteenth century, with the advent of microbiology, was the relationship between oral bacteria, food residues and tooth decay understood . This important discovery was due to Willoughby Dayton Miller, one of Koch's students . His "chemical-parasitical" theory was universally accepted in a few years . Even now, if we want to explain the causes of caries, we have to start from Miller's study

Environ Microbiol, 2003 May, 5(5), 412 - 23
Glutamine synthetase from the marine cyanobacteria Prochlorococcus spp: characterization, phylogeny and response to nutrient limitation; El Alaoui S et al.; The regulation of glutamine synthetase (EC 6.3.1.2) from Prochlorococcus was previously shown to exhibit unusual features: it is not upregulated by nitrogen starvation and it is not inactivated by darkness (El Alaoui et al . (2001) Appl Environ Microbiol 67: 2202-2207) . These are probably caused by adaptations to oligotrophic environments, as confirmed in this work by the marked decrease in the enzymatic activity when cultures were subjected to iron or phosphorus starvation . In order to further understand the adaptive features of ammonium assimilation in this cyanobacterium, glutamine synthetase was purified from two Prochlorococcus strains: PCC 9511 (high-light adapted) and SS120 (low-light adapted) . We obtained approximately 100-fold purified samples of glutamine synthetase electrophoretically homogeneous, with a yield of approximately 30% . The estimated molecular mass of the subunits was roughly the same for both strains: 48.3 kDa . The apparent Km constants for the biosynthetic activity were 0.30 mM for ammonium, 1.29 mM for glutamate and 1.35 mM for ATP; the optimum pH was 8.0 . Optimal temperature was surprisingly high (55 degrees C) . Phylogenetic analysis of glnA from three Prochlorococcus strains (MED4, MIT9313 and SS120) showed they group closely with marine Synechococcus isolates, in good agreement with other studies based on 16 S RNA sequences . All of our results suggest that the structure and kinetics of glutamine synthetase in Prochlorococcus have not been significantly modified during the evolution within the cyanobacterial radiation, in sharp contrast with its regulatory properties.

Int J Syst Evol Microbiol, 2003 Mar, 53(Pt 2), 425 - 33
Helicobacter sp . flexispira 16S rDNA taxa 1, 4 and 5 and Finnish porcine Helicobacter isolates are members of the species Helicobacter trogontum (taxon 6); Hanninen ML et al.; The term 'flexispira' refers to micro-organisms with a particular morphology: fusiform-shaped with helical periplasmic fibrils and bipolar tufts of sheathed flagella . Two flexispira taxa have been formally named, Helicobacter bilis and Helicobacter trogontum, a third named species is Helicobacter aurati and eight additional 16S rRNA sequence-based flexispira taxa have been described by Dewhirst et al . (Int J Syst Evol Microbiol 50, 1781-1787, 2000) and given the provisional designation Helicobacter sp . flexispira taxa 1-5, 7, 8 and 10 . In the present study, seven gastric or intestinal flexispira isolates from seven Finnish pigs originating from different farms were characterized . Morphologically, all these porcine isolates had typical flexispira morphology . Analysis of the 16S rDNA sequences of five isolates showed that they were most closely related to the sequences of flexispira taxa 4 and 5 and H . trogontum (taxon 6), but less closely related to taxa 1-3 and 8, H . bilis and H . aurati . Phenotypic characterization, analysis of RFLPs of 16S and 23S rDNAs and SDS-PAGE profiles revealed that all of the porcine isolates, reference strains of flexispira taxa 1, 4 and 5 and the type strain of H . trogontum (ATCC 700114T) had highly related characteristics that differed from those of the reference strains of taxa 2, 3 and 8 and H . bilis . Furthermore, a high DNA-DNA binding rate was found, in dot-blot hybridization studies, between the Finnish porcine strains, taxa 1, 4 and 5 reference strains and H . trogontum ATCC 700114T . In conclusion, polyphasic characterization of novel porcine flexispira isolates and previously described taxa 1, 4 and 5 reference strains showed that they all belong to a validly described species, H . trogontum, and that the taxonomy of known flexispiras is less complicated than proposed on the basis of 16S rDNA sequence analysis.

Pneumonol Alergol Pol, 2002, 70(9-10), 458 - 67
{VEGF (vascular endothelial growth factor) concentration in serum and pleural fluid of patients with pleural malignancy and pleural tuberculosis}; Ziora D et al.; The purpose of this study was comparison of VEGF (vascular endothelial growth factor) levels in serum and pleural fluid and estimation of this test usefulness in diagnosis of pleural effusions . VEGF levels were measured by ELISA method in 68 patients (45 males and 23 females) aged 19-81 years . By Light's criteria in 16 cases transudate and in 52 cases exudate was recognized . By means of fluid cytology, pleural biopsy, microbiology or thoracoscopy in 10 cases pleural metastases from distant organs, in 15 cases coexisting pulmonary neoplasm, in 11 cases mesothelioma and in 16 cases tuberculosis were determined as a cause of fluid accumulation in pleural space . The mean VEGF levels were significantly higher (p < 0.001) in patients with exudates than in patients with transudates (3833 pg/ml and 325 pg/ml respectively) . Based on likelihood ratios analysis, as a cut off value in differentiation of exudates and transudates a value 700 pg/ml was accepted . The sensitivity of this test was 75% and the specificity 93% and likelihood ratio (LR) 12.5 . The mean VEGF level in exudates was seven times higher than mean VEGF level in serum (3833 pg/ml and 573 pg/ml respectively) . Mean VEGF levels in malignant exudates (4615 pg/ml) were significantly higher than in tuberculous exudates (2073 pg/ml) . As a cut off value in differentiation between malignant and tuberculous exudates a value of 4500 pg/ml was accepted . We conclude that our results suggests the local VEGF production in pleural cavity and the significant role of this cytokine in pleural exudates accumulations and also suggests the usefulness of VEGF estimation in pleural fluid in differentiation transudates from exudates and malignant from tuberculous pleural fluids.

Med Sci Monit, 2003 Apr, 9(4), CR125 - 9
Non-contact lens related Acanthamoeba keratitis at a tertiary eye care center in south India: Implications for eye care programs in the region; Srinivasan M et al.; BACKGROUND: The purpose of our research was to determine diagnosis and outcomes for non-contact lens related Acanthamoeba keratitis in south India . MATERIAL/METHODS: A retrospective review of the medical and microbiology records of culture-positive Acanthamoeba cases presenting between 1987 and 2001 to a tertiary eye care center in south India . RESULTS: One hundred and three culture-positive cases of Acanthamoeba were identified during chart review . The majority of these cases (70.9%) were already on treatment for keratitis with antibiotics, antifungal and antiviral regimes prior to our examination; 45.2% were on different combinations of regimes . Cysts could be identified using 10% KOH mount in 83.5% of these cases . Clinical resolution with medical therapy was achieved for 83.5% of the cases; the median duration of treatment was 90.5 days . Outcomes - either clinical or visual - did not differ between CONCLUSIONS: Acanthamoeba keratitis cases presenting to this tertiary care center were non-contact lens wearers, and already on empirical treatment for either bacterial or fungal keratitis . A basic lab facility including only microscopy and smear examinations may aid etiological diagnosis of corneal ulcers, and reduce the current practice of using combinations of treatment regimes on an empirical basis.

Clin Chem, 2003 May, 49(5), 740 - 5
Quantitative analysis of pleural fluid cell-free DNA as a tool for the classification of pleural effusions; Chan MH et al.; BACKGROUND: Recently, much interest has been focused on the quantification of DNA in miscellaneous body fluids . In this study, the application is extended to classifying pleural effusions by measuring cell-free DNA in pleural fluid . METHODS: We recruited 50 consecutive patients with pleural effusions with informed consent . Pleural fluids were centrifuged at 13000 g, with supernatants aliquoted for extraction and analysis of beta-globin DNA sequence by quantitative real-time PCR . Serum and pleural fluid biochemistries were performed to classify pleural effusions using the modified criteria of Light et al . (Ann Intern Med 1972;77:507-13) . The ROC curve was plotted to determine the cutoff DNA concentration for classifying pleural fluids as transudates or exudates . Indicators of diagnostic accuracy were calculated for both pleural fluid DNA and modified criteria of Light et al., using the discharge, microbiologic, and histologic diagnoses as the reference standard . RESULTS: The area under the ROC curve was 0.95 {95% confidence interval (CI), 0.84-0.99} . At 509 genome-equivalents/mL, pleural fluid DNA alone correctly classified 46 of 50 pleural effusions with 91% sensitivity (95% CI, 76-98%), 88% specificity (95% CI, 64-98%), and positive and negative likelihood ratios of 7.7 (95% CI, 3.1-19.5) and 0.10 (95% CI, 0.04-0.27), respectively . With the modified criteria of Light et al., 43 of 50 pleural effusions were correctly classified with 97% sensitivity (95% CI, 91-100%) and 67% specificity (95% CI, 45-89%) . There were significant correlations between cell-free DNA and both lactate dehydrogenase and total protein in pleural fluid, suggesting their common origin . CONCLUSIONS: Pleural fluid DNA concentrations are markedly increased in exudative effusions, making it a potential new tool to evaluate the etiologic causes of pleural effusions.

Trends Microbiol, 2003 Apr, 11(4), 150 - 1
Response from Jeffrey I . Gordon et al.: Commensal bacteria make a difference; Gordon JI et al.; The importance of the gut microbiota has been recognized since the days of Pasteur . What makes today different from yesterday, and tomorrow so exciting, is that we now have the tools to identify the molecular mechanisms that regulate assembly of the microbiota and determine how its components affect postnatal mammalian development and adult physiology.

Infect Immun, 2003 May, 71(5), 2516 - 24
Kinetics of antibody response to Ehrlichia canis immunoreactive proteins; McBride JW et al.; Immunoreactive proteins of Ehrlichia canis and Ehrlichia chaffeensis that have been characterized include a family of 28-kDa major outer membrane proteins (p28) and two large antigenically divergent surface glycoprotein orthologs . We previously demonstrated that recombinant E . canis p28 and the 140- and 200-kDa glycoproteins gp140 and gp200, respectively, react strongly with serum antibodies from suspect canine ehrlichiosis cases that were positive for E . canis by immunofluorescent antibody test and in various phases of acute or chronic infection (J . Clin . Microbiol . 39:315-322, 2001) . The kinetics of the antibody response to these potentially important vaccine and immunodiagnostic candidates is not known . Acute-phase serum antibody responses to whole-cell E . canis lysates and recombinant p28, gp140, and gp200 were monitored for 6 weeks in dogs experimentally infected with E . canis . Irrespective of the inoculation route, a T-helper 1-type response was elicited to E . canis antigens consisting of immunoglobulin G2 antibodies exclusively in both acute and convalescent phases in most dogs . Analysis of immuoreactive antigens for peak intensity and relative quantity identified major immunoreactive E . canis antigens recognized early in the infection as the 19-, 37-, 75-, and 140-kDa proteins . Later in infection, additional major immunoreactive E . canis proteins were identified, including the 28-, 47-, and 95-kDa proteins and the recently identified 200-kDa glycoprotein . All dogs had developed antibody against the recombinant gp140, gp200, and p28 in the convalescent phase . Immunoreactivity and antibody response kinetics suggest that major immunoreactive proteins identified are immunodominant, but early recognition suggests increased dominance by some antigens.

Prog Urol, 2003 Feb, 13(1), 1 - 13
{Molecular and cytometric analysis of renal cell carcinoma cells . Concepts, techniques and prospects}; Li G et al.; At the present time, there is no reliable laboratory marker for the diagnosis and prognosis of clear cell renal cell carcinoma (RCC), while about 20% of small tumours detected by modern imaging techniques are benign and the clinical course is difficult to predict with considerable differences for the same stage and same grade . The molecular identification of clear cell RCC cells could satisfy these new requirements in the context of diagnosis of atypical or small renal tumours, allowing a more refined prognostic assessment, which is currently uncertain . Some of the antigens used for molecular diagnosis of clear cell RCC, such as cadherin-6, are present in the normal kidney, while others are newly formed antigens (TuM2PK, MN/CA9, CA12, calpain) or ectopic (PSMA, PSA, KLKI, cytokeratin 7 vimentin) or induce abnormal glycosylation (sialyl Lewis'X, galectins) indicating the malignant nature of the cells . The tumour's capacity for progression is related to dysregulations of the cycle (ras, Pax2, Tiam 1, waf/p21), division (tetracyclines, MIB1, PCNA, Nor Ag), apoptosis (bcl2, p53, CD95/Apo1), and the capacities for tissue invasion (proteases), disorganization (cadherin, catenins) or nidation (ICAM-1, CD44) . Finally, chromosomal anomalies (mutations, translocations) also occur . MN/CA9, cadherin-6, vimentin, mucin 1 and DNA content are particularly useful for the diagnosis and/or prognosis of clear cell RCC . These markers can be analysed by extremely sensitive cytometric (flow cytometry, plate cytometry) or molecular methods (RT-PCR, in situ hybridization) . These techniques lower the limit of detection of tumour cells in biological products (aspiration cytology, microbiopsy) and eventually in circulating blood . Proteomic and genomic methods (biochips) should considerably accelerate research in this field leading to the development of routine clinical applications.

J Cardiothorac Vasc Anesth, 2003 Apr, 17(2), 221 - 5
Antibiotic prophylaxis with cefazolin and gentamicin in cardiac surgery for children less than ten kilograms; Haessler D et al.; OBJECTIVE: Antibiotic prophylaxis is recommended in pediatric cardiac surgery, but no data concerning the current antibiotic regimen were available . DESIGN: Prospective study from April to June 2000 . SETTING: University hospital operating room and postoperative intensive care unit . PARTICIPANTS: Nineteen consecutive infants less than 10 kg with normal renal function undergoing cardiac surgery with cardiopulmonary bypass longer than 30 minutes . INTERVENTIONS: Intravenous administration of cefazolin, 40 mg/kg, and gentamicin, 5 mg/kg, at induction of anesthesia; followed by cefazolin, 35 mg/kg every 8 hours, and gentamicin, 2 mg/kg every 12 hours, over 48 hours . MEASUREMENTS AND MAIN RESULTS: Levels of serum antibiotics were measured: cefazolin (microbiologic) and gentamicin (fluorescence immunoassay) with 8 intraoperative and 5 postoperative samplings . Intraoperatively, cefazolin levels decreased from 166 +/- 44 (mean +/- standard deviation) down to 54 +/- 16 microg/mL and gentamicin from 20.8 +/- 9.5 down to 5.9 +/- 1.5 microg/mL . The postoperative trough levels were 12 +/- 7, 15 +/- 10, and 19 +/- 22 microg/mL for cefazolin and 1.1 +/- 0.5, 0.8 +/- 0.4, and 0.8 +/- 0.9 microg/mL for gentamicin . CONCLUSIONS: Antibiotic serum levels are consistent with satisfactory efficacy, but intraoperative gentamicin peak levels appeared too high .

Arch Intern Med, 2003 Apr 14, 163(7), 845 - 8
A case of "hot tub lung" due to Mycobacterium avium complex in an immunocompetent host; Cappelluti E et al.; Pulmonary disease due to Mycobacterium avium complex (MAC) typically occurs in patients with impaired cellular immunity or chronic lung disease . Recently, there has been an increase in the number of reports of pulmonary disease caused by MAC occurring in otherwise healthy individuals, including those reporting recent hot tub use . It is not clear if this respiratory illness represents a true infectious process or a hypersensitivity pneumonitis . We report a case of diffuse pulmonary disease caused by MAC in an immunocompetent individual after hot tub use . The patient's clinical course, transbronchial lung biopsy results, and microbiologic examination findings all pointed to a hypersensitivity reaction due to MAC . With avoidance of the hot tub, and no pharmacological treatment, the patient had complete resolution within 2 months . In light of the number of new cases of "hot tub lung" in otherwise healthy individuals, clinicians should advise their patients of the potential risk associated with hot tub use.

Eur J Pediatr, 2003 May, 162(5), 289 - 304 Epub 2003 Mar 01.
The discovery of agammaglobulinaemia in 1952; Hitzig WH; Fifty years ago a new disease, agammaglobulinaemia, was described . This was made possible by a great number of preceding technical innovations and theories on different fields of research, in particular haematology, microbiology/immunology and basic sciences . The widely used name "Bruton disease" credits one single man with a new observation which, however, was simultaneously made by several physicians . Agammaglobulinaemia was the first example of an immunodeficiency syndrome (IDS) . Based on new facts, new ideas emerged which in turn gave rise to innovative research, concerning both clinical observations and basic problems . Many similar diseases, usually resulting from a genetic defect, were described . Since 1970, an International Committee appointed by the WHO, has, with periodic reassessments, been working on the classification of the syndromes . All participants of an efficient immune reaction can be deficient in individual patients, that is: antibodies, lymphocytes, phagocytes and complement . Basic scientists presented striking results concerning the structure and action of all elements mentioned above.CONCLUSION: mutual stimuli coming from observations in families and from gene technology have resulted in the elucidation of the genetic defects of most IDS . Recent results of genetic engineering seem to justify some hope for success in therapy.

Clin Microbiol Rev, 2003 Apr, 16(2), 319 - 54
Impact of genotypic studies on mycobacterial taxonomy: the new mycobacteria of the 1990s; Tortoli E; The advancement of genetic techniques has greatly boosted taxonomic studies in recent years . Within the genus Mycobacterium, 42 new species have been detected since 1990, most of which were grown from clinical samples . Along with species for which relatively large numbers of strains have been reported, some of the new species of mycobacteria have been detected rarely or even only once . From the phenotypic point of view, among the new taxa, chromogens exceed nonchromogens while the numbers of slowly and rapidly growing species are equivalent . Whereas conventional identification tests were usually inconclusive, an important role was played by lipid analyses and in particular by high-performance liquid chromatography . Genotypic investigations based on sequencing of 16S rRNA gene have certainly made the most important contribution . The investigation of genetic relatedness led to the redistribution of the species previously included in the classically known categories of slow and rapid growers into new groupings . Within slow growers, the intermediate branch related to Mycobacterium simiae and the cluster of organisms related to Mycobacterium terrae have been differentiated; among rapid growers, the group of thermotolerant mycobacteria has emerged . The majority of species are resistant to isoniazid and, to a lesser extent, to rifampin . Many of the new species of mycobacteria are potentially pathogenic, and there are numerous reports of their involvement in diseases . Apart from disseminated and localized diseases in immunocompromised patients, the most frequent infections in immunocompetent people involve the lungs, skin, and, in children, cervical lymph nodes . The awareness of such new mycobacteria, far from being a merely speculative exercise, is therefore important for clinicians and microbiologists.

Pediatr Infect Dis J, 2003 Apr, 22(4), 349 - 54
Cluster of hemolytic-uremic syndrome caused by Shiga toxin-producing Escherichia coli O26:H11; Misselwitz J et al.; BACKGROUND: The epidemiology and clinical characteristics of the hemolytic-uremic syndrome (HUS) caused by Escherichia coli O157:H7 are well-known, but HUS attributable to non-O157:H7 Shiga toxin (Stx)-producing E . coli (STEC) are less thoroughly described . Here we report a cluster of HUS cases caused by STEC O26:H11 the most common non-O157:H7 STEC isolated from sporadic cases of HUS in Europe . METHODS: Three children between 13 and 17 months of age, living in the same small town, developed HUS within an interval of 5 days . We present clinical and microbiologic data on the patients and their infecting isolates . RESULTS: The clinical course ranged from mild uncomplicated HUS to severe HUS complicated by multiorgan involvement . Microbiologic investigation demonstrated STEC of serotype O26:H11 in stools of all the patients . The phenotypic and molecular characterization of the STEC O26:H11 isolates demonstrated that these strains were identical and, unusual for STEC O26, they harbored the stx2 but not the stx1 gene . None of the patients had evidence of STEC O157:H7 infection either by culture or by E . coli O157 serology . The source of the STEC O26:H11 infection was undetermined . CONCLUSIONS: Our results demonstrate that diagnostic procedures based on the detection of stx genes and/or Stx production and subsequent subtyping of the isolates using molecular methods are necessary to identify such outbreaks caused by non-O157:H7 STEC.

Crit Care Med, 2003 Apr, 31(4), 1250 - 6
2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference; Levy MM et al.; OBJECTIVE: In 1991, the American College of Chest Physicians (ACCP) and the Society of Critical Care Medicine (SCCM) convened a "Consensus Conference," the goals of which were "to provide a conceptual and a practical framework to define the systemic inflammatory response to infection, which is a progressive injurious process that falls under the generalized term 'sepsis' and includes sepsis-associated organ dysfunction as well." The general definitions introduced as a result of that conference have been widely used in practice and have served as the foundation for inclusion criteria for numerous clinical trials of therapeutic interventions . Nevertheless, there has been an impetus from experts in the field to modify these definitions to reflect our current understanding of the pathophysiology of these syndromes . DESIGN: Several North American and European intensive care societies agreed to revisit the definitions for sepsis and related conditions . This conference was sponsored by the SCCM, The European Society of Intensive Care Medicine (ESICM), The American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the Surgical Infection Society (SIS) . METHODS: The conference was attended by 29 participants from Europe and North America . In advance of the conference, five subgroups were formed to evaluate the following areas: signs and symptoms of sepsis, cell markers, cytokines, microbiologic data, and coagulation parameters . The subgroups corresponded electronically before the conference and met in person during the conference . A spokesperson for each group presented the deliberation of each group to all conference participants during a plenary session . A writing committee was formed at the conference and developed the current article based on executive summary documents generated by each group and the plenary group presentations . The present article serves as the final report of the 2001 International Sepsis Definitions Conference . CONCLUSION: This document reflects a process whereby a group of experts and opinion leaders revisited the 1992 sepsis guidelines and found that apart from expanding the list of signs and symptoms of sepsis to reflect clinical bedside experience, no evidence exists to support a change to the definitions . This lack of evidence serves to underscore the challenge still present in diagnosing sepsis in 2003 for clinicians and researchers and also provides the basis for introducing PIRO as a hypothesis-generating model for future research.

Enferm Infecc Microbiol Clin, 2003 Apr, 21(4), 196 - 9
{Necrotizing soft tissue infections: nomenclature and classification}; Sanchez U et al.; Terminology used to refer to necrotizing infections is extensive because of the absence of clear definitions and the use of classification systems based on a variety of criteria, including etiologic, microbiologic, anatomic, and clinical aspects . This situation has led to some confusion . In the attempt to unify terminology, it might be more appropriate to use only the terms necrotizing fasciitis and myonecrosis, in which differentiation is mainly anatomical . Another option would be to use only the expression necrotizing soft tissue infections, a non-specific term, since these constitute a group of clinical processes having similar pathophysiologic characteristics and therapeutic principles.

Lancet Infect Dis, 2003 Apr, 3(4), 230 - 40
British Society for Medical Mycology proposed standards of care for patients with invasive fungal infections; Denning DW et al.; Outcomes for invasive fungal infections have greatly improved in the past decade, and several new antifungal drugs have been or will be licensed in the next few years . Early accurate diagnosis and appropriate treatment have major impact on survival . In a 1995 survey of laboratory practice in the UK for mycology, major disparities were seen, with many laboratories not undertaking even simple diagnostic procedures . Delays in processing and inadequate procedures for handling samples, incomplete or delayed reporting of results, or a combination of these, compromise the care of patients . In randomised trials of antifungal chemotherapy, optimum treatments and good alternatives for others have been defined for some infections . High-quality care requires a multidisciplinary approach to diagnosis and management . In this review, we propose microbiology, histopathology, radiology, and clinical auditing standards, with the evidence base for each reviewed . The standards are absolutes, and, therefore, provide a straightforward basis for improving services to patients if they are all implemented.

J Chemother, 2003 Feb, 15(1), 37 - 42
Evaluation of semisolid agar screening tests for determining fluconazole and amphotericin B susceptibilities of Candida strains by using three different media; Esen N et al.; The susceptibilities of 164 Candida isolates against fluconazole and amphotericin B were determined by semisolid agar screening tests and the microdilution method according to NCCLS M27-A standards . The semisolid agar screening tests were performed with three different media containing 0.5% agar and 2, 8, and 40 microg/ml of fluconazole or 0.5 and 2.0 microg/ml of amphotericin B . These media were MOPS buffered RPMI 1640, brain-heart infusion and 1/3 diluted Sabouraud dextrose agar . The results of both methods were interpreted as susceptible, dose dependent susceptible and resistant for fluconazole and susceptible and resistant for amphotericin B . The agreement rates of semisolid agar screening tests using RPMI 1640, brain-heart infusion and Sabouraud dextrose media with the reference microdilution method were found to be 71.4%, 51.2%, and 57.3% for fluconazole and 79.3%, 53.7%, and 56.7% for amphotericin B, respectively . Overall, we conclude that semisolid agar screening tests using RPMI 1640 can be used for determining the susceptibilities of Candida isolates against fluconazole and amphotericin B in clinical microbiology laboratories.

Appl Environ Microbiol, 2003 Apr, 69(4), 2100 - 9
Secretory antibodies do not affect the composition of the bacterial microbiota in the terminal ileum of 10-week-old mice; Sait L et al.; Terminal restriction fragment length polymorphism (T-RFLP) analysis was conducted on the 16S rRNA genes of the bacterial communities colonizing the epithelial surfaces of the terminal ilea of open conventionally housed mice in an institutional small-animal facility . Polymeric-immunoglobulin-receptor-deficient (pIgR(-/-)) mice that were unable to secrete antibodies across mucosal surfaces were cohoused with normal and otherwise genetically identical wild-type (C57BL/6) mice for 4 weeks . If secretory antibodies played a role in modeling the gastrointestinal microbiota, C57BL/6 mice would have had a more distinct and uniform microbiota than their pIgR(-/-) cage mates . The T-RFLP profiles of the bacterial communities were compared by using Sorensen's pairwise similarity coefficient, a newly developed weighted pairwise similarity coefficient, and on the basis of Shannon's and Simpson's diversity indices . No systematic differences were observed between the dominant components of the mucosa-associated bacterial communities of the terminal ileal walls of the two types of mice, indicating that secretory antibodies do not control the composition of this microbiota . Similar analyses of experiments conducted at two different times, between which the bacterial community composition of the mouse colony in the small-animal facility appeared to have changed, showed that differences could have been detected, had they existed.

Acta Biotheor, 2002, 50(4), 357 - 73
Hyperstructures, genome analysis and I-cells; Amar P et al.; New concepts may prove necessary to profit from the avalanche of sequence data on the genome, transcriptome, proteome and interactome and to relate this information to cell physiology . Here, we focus on the concept of large activity-based structures, or hyperstructures, in which a variety of types of molecules are brought together to perform a function . We review the evidence for the existence of hyperstructures responsible for the initiation of DNA replication, the sequestration of newly replicated origins of replication, cell division and for metabolism . The processes responsible for hyperstructure formation include changes in enzyme affinities due to metabolite-induction, lipid-protein affinities, elevated local concentrations of proteins and their binding sites on DNA and RNA, and transertion . Experimental techniques exist that can be used to study hyperstructures and we review some of the ones less familiar to biologists . Finally, we speculate on how a variety of in silico approaches involving cellular automata and multi-agent systems could be combined to develop new concepts in the form of an Integrated cell (I-cell) which would undergo selection for growth and survival in a world of artificial microbiology.

Adv Biochem Eng Biotechnol, 2003, 78, 1 - 50
Overview of phytotechnologies; Tsao DT; Phytotechnologies are defined as: "The use of vegetation to contain, sequester, remove, or degrade inorganic and organic contaminants in soils, sediments, surface waters, and groundwater." This chapter is designed to provide the reader with a broad, introductory overview of phytotechnologies as well as environmental remediation in general . To familiarize the reader with the common acronyms, abbreviations, and parameters used in the environmental arena, an extensive list is provided for quick reference . Furthermore, due to the multi-disciplinary nature of phytotechnologies, a brief background on the pertinent information in plant physiology, soil microbiology, hydrogeology, and environmental engineering is provided as well . This covers the basic physiological processes occurring in the rhizosphere as well as in the plant system . Furthermore, these basic processes are related to the phytotechnology mechanisms that form the basis for the various applications used in the field today . Finally, basic design equations, site-specific considerations, and practical field implementation techniques are provided as well for the different applications.

N Engl J Med, 2003 May 15, 348(20), 1977 - 85 Epub 2003 Mar 31.
A cluster of cases of severe acute respiratory syndrome in Hong Kong; Tsang KW et al.; BACKGROUND: Information on the clinical features of the severe acute respiratory syndrome (SARS) will be of value to physicians caring for patients suspected of having this disorder . METHODS: We abstracted data on the clinical presentation and course of disease in 10 epidemiologically linked Chinese patients (5 men and 5 women 38 to 72 years old) in whom SARS was diagnosed between February 22, 2003, and March 22, 2003, at our hospitals in Hong Kong, China . RESULTS: Exposure between the source patient and subsequent patients ranged from minimal to that between patient and health care provider . The incubation period ranged from 2 to 11 days . All patients presented with fever (temperature, >38 degrees C for over 24 hours), and most presented with rigor, dry cough, dyspnea, malaise, headache, and hypoxemia . Physical examination of the chest revealed crackles and percussion dullness . Lymphopenia was observed in nine patients, and most patients had mildly elevated aminotransferase levels but normal serum creatinine levels . Serial chest radiographs showed progressive air-space disease . Two patients died of progressive respiratory failure; histologic analysis of their lungs showed diffuse alveolar damage . There was no evidence of infection by Mycoplasma pneumoniae, Chlamydia pneumoniae, or Legionella pneumophila . All patients received corticosteroid and ribavirin therapy a mean (+/-SD) of 9.6+/-5.42 days after the onset of symptoms, and eight were treated earlier with a combination of beta-lactams and macrolide for 4+/-1.9 days, with no clinical or radiologic efficacy . CONCLUSIONS: SARS appears to be infectious in origin . Fever followed by rapidly progressive respiratory compromise is the key complex of signs and symptoms from which the syndrome derives its name . The microbiologic origins of SARS remain unclear .

Radiology, 2003 Apr, 227(1), 183 - 91
Cystic lesions of the breast: sonographic-pathologic correlation; Berg WA et al.; PURPOSE: To understand the pathologic basis for sonographic features of cystic lesions of the breast and determine appropriate assessment and management recommendations for these lesions based on sonographic appearance . MATERIALS AND METHODS: From a database of 2,072 image-guided procedures performed from July 1995 through September 2001, 150 cystic lesions were identified . Diagnosis was established with fine-needle aspiration (n = 55), 14-gauge core-needle biopsy (n = 81), or both (n = 14) . Excision was performed for all malignant (n = 18) and atypical (n = 2) lesions and for 11 benign lesions, which recurred or enlarged at follow-up . Imaging follow-up was available for 92 of 119 benign lesions . Targeted sonography was performed with high-frequency (10-MHz center frequency) transducers . Imaging and histopathologic, cytologic, and/or microbiologic findings were reviewed . Lesions were categorized as simple cysts, complicated cysts (imperceptible wall, acoustic enhancement, low-level echoes), clustered microcysts, cystic masses with a thick (perceptible) wall and/or thick (> or =0.5 mm) septations, intracystic or mixed cystic and solid masses (at least 50% cystic), or predominantly solid masses with eccentric cystic foci . RESULTS: Of 150 lesions, 16 were simple cysts aspirated for symptomatic relief . Of 38 lesions characterized as complicated cysts and one cyst with thin septations, none proved malignant, nor did any of 16 lesions characterized as clustered microcysts . Of 23 masses with thick indistinct walls or thick septations, seven proved malignant . Of 18 intracystic or mixed cystic and solid masses, four proved malignant . Of 38 predominantly solid masses with eccentric cystic foci, seven proved malignant . CONCLUSION: Symptomatic complicated cysts generally warrant aspiration . All clustered microcysts were benign, but further study is required . Cystic lesions with thick indistinct walls and/or thick septations (> or =0.5 mm), intracystic masses, and predominantly solid masses with eccentric cystic foci should be examined at biopsy; 18 of 79 of such complex cystic lesions proved malignant in this series.

Environ Monit Assess, 2003 Mar, 83(1), 35 - 45
Induction of cytochrome P4501A and endocrine disrupting effects of school incinerator residues; Oh SM et al.; The emission of the dioxin-like compounds from on-site waste incinerators of seven schools in Kyonggi Province of Korea was evaluated by determination of the cytochrome P4501A(CYP1A) catalytic activity and antiestrogenic activity using cell culture microbioassay . The residue samples were extracted in a Soxhlet apparatus using toluene for 20 hr . The concentrated crude extracts were fractionated with a basic alumina column . Dioxin-like compounds were then extracted . Induction of CYP1A activity in a rat (H4IIE) hepatoma cell line was used as indicator of biological effect of incinerator residues and measured as 7-ethoxyresorufin-O-deethylase (EROD) activities . The EROD activities of fraction II extracts (one of the two extracts) in the H4IIE cells were from 0.044 +/- 0.002 to 4.424 +/- 0.351 ng-TEQ g(-1) (TCDD Toxicity equivalent), showing relatively high inducing capacity . Antisetrogenicity of the extracts was measured as decrease in E2-induced cell proliferation . Most of the extracts showed antiestrogenic activity in MCF7-BUS cell . The TEQ levels of the incinerator residues and the antiestrogenic activities were in good correlation, strongly suggesting that the potent toxic emissions were indeed produced from the on-site school waste semi-incinerators and could cause the antiestrogenicity.

An Med Interna, 2003 Jan, 20(1), 10 - 5
{Epidemiological and clinical study of patients diagnosed with tuberculosis in the northeastern area of Madrid}; Vieira Pascual MC et al.; OBJECTIVE: Estimate the incidence and the epidemiological and clinical characteristics of patients diagnosed with tuberculosis in a county hospital located in the north western area of the Autonomous Region of Madrid, to determine if there has been an increase due to immigration . MATERIAL AND METHODS: Tuberculosis cases from January, 1996 to June, 2001 were analysed, researched through the Microbiology and Pathologic Anatomy Laboratory, fetching information such as demographics, clinical studies and disease diagnostics from the different medical histories . RESULTS: A total of 66 tuberculosis cases were registered, ten of them among immigrants, with an incidence of 13/100,000 inhabitants in 1996, decreasing to a 7/100,000 incidence in 2000 . The age average is 34 with double the incidence in males (31/100,000) than females (17/100,000) . The main risk factor is alcoholism with 11 cases (16.7%) . The most commonly used diagnostic tests were the thorax radiography (61/66, 92%) with 57 (93.4%) positive identifications, culture of esputo (47/66, 71%) with 32 (68%) positive ids, and the Mantoux test (28, 42%) with 20 (71.4%) positive ids . The location of the illness is mainly pleuro-pulmonar in 50 cases (75%) . There were almost no atypical mycobacterium found (5 cases) . Overall, response to treatment with 3 drugs (isoniacide, rifampicine, piracinamide) was good in 88% of patients, with the average treatment lasting 6.8 months (ED: 2.8) . CONCLUSION: The incidence of tuberculosis in the north western area of Autonomous Community of Madrid is below that of the rest of our Community . It dipped in 1997 and has been stable around 9/100,000 inhabitants until 2000, even with the effect of immigration.

Health Bull (Edinb), 2001 Jul, 59(4), 233 - 7
The ascertainment and management of tuberculosis in Tayside, Scotland during 1993-94; Grove A et al.; OBJECTIVE: To evaluate whether utilising a database of dispensed prescriptions for anti-tuberculous chemotherapy could improve case ascertainment compared to standard methods . A further objective was to assess whether cases were managed according to standard guidelines . DESIGN: Retrospective case note audit . SETTING: Tayside, Scotland SUBJECTS: Patients identified by conventional (i.e . SMRI diagnostic codes, notifications to the Health Board, microbiology and pathology reports) and the data base (MEMO) as potentially having tuberculosis and receiving treatment between 1st January 1993 and 31st December 1994 . One hundred and ninety one potential cases were identified . One hundred and twenty two case notes were obtained for review . Eighty eight of these were initially thought to have tuberculosis and the results below refer to these 88 cases . RESULTS: MEMO identified 43 cases not found by conventional methods . Cases identified by MEMO were more likely to have been managed as outpatients and less likely to have positive microbiology than cases identified by conventional means . Only 26 cases were notified to the Health Board, including all smear positive cases . CONCLUSIONS: Notification of tuberculosis continues to be incomplete . Use of the MEMO system almost doubled case ascertainment . The absence of a firm diagnosis may lead to a reluctance to notify cases being treated as tuberculosis.

Intensive Care Med, 2003 Apr, 29(4), 530 - 8 Epub 2003 Mar 28.
2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference; Levy MM et al.; OBJECTIVE: In 1991, the American College of Chest Physicians (ACCP) and the Society of Critical Care Medicine (SCCM) convened a "Consensus Conference," the goals of which were to "provide a conceptual and a practical framework to define the systemic inflammatory response to infection, which is a progressive injurious process that falls under the generalized term 'sepsis' and includes sepsis-associated organ dysfunction as well . The general definitions introduced as a result of that conference have been widely used in practice, and have served as the foundation for inclusion criteria for numerous clinical trials of therapeutic interventions . Nevertheless, there has been an impetus from experts in the field to modify these definitions to reflect our current understanding of the pathophysiology of these syndromes . DESIGN: Several North American and European intensive care societies agreed to revisit the definitions for sepsis and related conditions . This conference was sponsored by the Society of Critical Care Medicine (SCCM), The European Society of Intensive Care Medicine (ESICM), The American College of Chest Physicians (ACCP), the American Thoracic Society (ATS), and the Surgical Infection Society (SIS) . METHODS: 29 participants attended the conference from Europe and North America . In advance of the conference, subgroups were formed to evaluate the following areas: signs and symptoms of sepsis, cell markers, cytokines, microbiologic data, and coagulation parameters . The present manuscript serves as the final report of the 2001 International Sepsis Definitions Conference . CONCLUSION: 1 . Current concepts of sepsis, severe sepsis and septic shock remain useful to clinicians and researchers . 2 . These definitions do not allow precise staging or prognostication of the host response to infection . 3 . While SIRS remains a useful concept, the diagnostic criteria for SIRS published in 1992 are overly sensitive and non-specific . 4 . An expanded list of signs and symptoms of sepsis may better reflect the clinical response to infection . 6 . PIRO, a hypothetical model for staging sepsis is presented, which, in the future, may better characterize the syndrome on the basis of predisposing factors and premorbid conditions, the nature of the underlying infection, the characteristics of the host response, and the extent of the resultant organ dysfunction.

J Clin Pathol, 2003 Apr, 56(4), 243 - 8
Pathology tests: is the time for demand management ripe at last?
Rao GG, Crook M, Tillyer ML.
With the ever increasing demands for pathology testing within the National Health Service there is a need to manage the demand for these tests . This review discusses strategies for the demand management of requests made by clinicians in the disciplines of biochemistry, haematology, and microbiology . The various approaches that have been used to manage demand will be described, along with specific clinical strategies for demand management.

Int J Tuberc Lung Dis, 2003 Mar, 7(3), 284 - 8
Evaluation of FASTPlaqueTB-RIF for determination of rifampicin resistance in Mycobacterium tuberculosis complex isolates; Kisa O et al.; SETTING: The Microbiology and Clinical Microbiology Department, Gulhane Military Medical Academy, Ankara, Turkey, a tertiary referral hospital in a region endemic for tuberculosis . OBJECTIVE: To evaluate rifampicin resistance of Mycobacterium tuberculosis complex strains using FASTPlaqueTB-RIF, a rapid and novel bacteriophage-based susceptibility technique . DESIGN: Results of isolates tested with the BACTEC 460 TB system were compared with FASTPlaqueTB-RIF . RESULTS: Susceptibility to rifampicin of M . tuberculosis complex isolates was tested for 88 isolates using FASTPlaqueTB-RIF . Sixty-seven isolates were susceptible and 21 were resistant to rifampicin using the BACTEC 460 TB system . Overall accuracy for FASTPlaqueTB-RIF was 94.3% (95%CI 87.3-97.5) for the detection of rifampicin susceptibility . The sensitivity and specificity of FASTPlaqueTB-RIF were respectively 100.0% (95%CI 84.5-100) and 92.5% (95%CI 83.6-96.7) . CONCLUSION: This study demonstrates that FASTPlaqueTB-RlFM is a rapid and inexpensive test which has a good correlation with the BACTEC 460 TB system.

Ophthalmic Epidemiol, 2003 Apr, 10(2), 133 - 45
Coding accuracy for endophthalmitis diagnosis and cataract procedures in Western Australia . The Endophthalmitis Population Study of Western Australia (EPSWA): second report; Li J et al.; As an initial phase of the Endophthalmitis Population Study of Western Australia (EPSWA), this paper reports the results from an intensive comparative validation of all possible surgery-related endophthalmitis cases identified for the period from 1980 to June 1999 from the Hospital Morbidity Data System (HMDS) of the WA Record Linkage Project with external sources . The external sources were the microbiology and anaesthetic databases from Royal Perth Hospital (where most of the cases of endophthalmitis were treated) and surgeon logbooks of two vitreoretinal surgeons treating endophthalmitis in Perth over the study period . As it was discovered that a large proportion of all cases coded with endophthalmitis did not have any ocular surgery, the validation also included a sample from these cases . The purpose of validating these cases was to ensure that our count of post-operative endophthalmitis had not excluded any cases whose surgery might not have been recorded in the HMDS database . It was also intended to provide an estimate of all miscoded endophthalmitis cases as a first step towards future improvement of coding accuracy . Since we suspected that phaco-emulsification was under-coded, we also examined a sample of cataract procedures . Of all surgery-related endophthalmitis cases coded in the HMDS, only 50.9% (274 of 538) were found to be valid cases . External sources identified 83 cases of endophthalmitis, 49 did not have endophthal-mitis codes but were in the HMDS file with an associated code . Of the remaining externally identified cases, 13 were missing altogether from the HMDS file, 7 of which were correctly coded in the notes while the other 6 were coded with associated codes, and 21 were diagnosed after the date the HMDS file was extracted . The validation of a random sample of the non-surgery-related cases coded with endophthalmitis suggested that the vast majority of them were miscoded (88%, 139 of 158 sampled from 1474 cases) . The systematic coding errors reported in this paper may be attributed to both the clinical and the coding departments of the hospital . In any case, coding inaccuracy itself is a serious concern for data quality of any linked database systems and for epidemiological researchers using such data . The increased use of aggregated data in epidemiological research further underscores the importance of coding accuracy and thus data validation . The use of external sources for case identification and case validation are two ways of ensuring data completeness/quality and validity of results.

Liver Int, 2003 Apr, 23(2), 71 - 7
The effects of supraphysiological doses of corticosteroids in hypotensive liver failure; Harry R et al.; BACKGROUND: In septic shock, supraphysiological doses of corticosteroids reduce norepinephrine requirements . We reviewed our experience of this treatment in hypotensive liver failure . METHODS: We retrospectively analysed 20 patients with liver failure who were treated with supraphysiological doses of hydrocortisone because of norepinephrine dependence . We compared their norepinephrine requirements, outcome, microbiology and incidence of gastrointestinal bleeding to an historical control group treated with norepinephrine but not corticosteroids . RESULTS: After 48 h of steroid treatment, the median norepinephrine dose was reduced (0.14 microg/kg/min to 0.08 microg/kg/min; P < 0.05) while the blood pressure over the same period of time did not change significantly (67.3 mm Hg to 70 mm Hg) . Duration of ITU stay was longer in the steroid treated group (13.5 days vs 3 days; P < 0.05) but survival was similar in both groups . There were 23 episodes of positive bacterial cultures after norepinephrine was started in the steroid treated group, compared with 18 episodes in the control group . More of the positive cultures were due to resistant organisms in the steroid treated group (65% vs 17% in the control group; P < 0.002) . There was no significant bleeding due to gastrointestinal inflammation in either group . CONCLUSIONS: Supraphysiological doses of corticosteroids reduce norepinephrine requirements in hypotensive liver failure . They do not improve survival but may extend time to find a suitable donor in those awaiting urgent liver transplantation.

Semin Respir Infect, 2003 Mar, 18(1), 33 - 9
Hot tub lung: infection, inflammation, or both?
Aksamit TR.
Increasing numbers of patients have presented with a hypersensitivity pneumonitis-type course in association with hot tub exposure . Mycobacterium avium complex (MAC) organisms have been isolated from both patient specimens and hot tub water with matching fingerprints by restricted fragment length polymorphism and electrophoresis when performed . Review of the clinical, microbiologic, and radiographic presentations of 9 patients to the Mayo Clinic with this diagnosis are compared with 32 patients in the published literature . The diagnosis, treatment, and prognosis of MAC hot tub lung are reviewed .

Infect Dis Obstet Gynecol, 2002, 10(4), 171 - 80
Accuracy of five different diagnostic techniques in mild-to-moderate pelvic inflammatory disease; Gaitan H et al.; OBJECTIVE: To evaluate the clinical diagnosis of pelvic inflammatory disease (PID) compared with the diagnosis of PID made by laparoscopy, endometrial biopsy, transvaginal ultrasound, and cervical and endometrial cultures . Study design: A diagnostic performance test study was carried out by cross-sectional analysis in 61 women . A group presenting PID (n = 31) was compared with a group (n = 30) presenting another cause for non-specific lower abdominal pain (NSLAP) . Diagnosis provided by an evaluated method was compared with a standard diagnosis (by surgical findings, histopathology, and microbiology) . The pathologist was unaware of the visual findings and presumptive diagnoses given by other methods . RESULTS: All clinical and laboratory PID criteria showed low discrimination capacity . Adnexal tenderness showed the greatest sensitivity . Clinical diagnosis had 87% sensitivity, while laparoscopy had 81% sensitivity and 100% specificity; transvaginal ultrasound had 30% sensitivity and 67% specificity; and endometrial culture had 83% sensitivity and 26% specificity . CONCLUSIONS: Clinical criteria represent the best diagnostic method for discriminating PID . Laparoscopy showed the best specificity and is thus useful in those cases having an atypical clinical course for discarding abdominal pain when caused by another factor . The other diagnostic methods might have limited use.

Epidemiol Mikrobiol Imunol, 2003 Feb, 52(1), 25 - 33
{Molecular genetics methods in medical mycology}; Korabecna M et al.; Molecular genetic methods that use the polymerase chain reaction (PCR) are due their speed widely employed in diagnostic approaches in microbiology . In this report, the possibilities of application of these methods in medical mycology are discussed with regard not only to species identification, but also for genotyping of strains for epidemiological purposes . Recently, a tendency to exploit molecular genetic methods rather for epidemiological studies than for routine species identification may be observed . With regard to the high inter-species variability, careful standardization using samples of isolates of the tested species from corresponding geographical origin is necessary . Perspectives of future development associated with the explanation of molecular biological relations between human tissues and the pathogen, with the recognition of mechanisms of virulence and resistance to antifungal drugs are discussed.

AIDS, 2003 Mar 28, 17(5), 653 - 61
Blocking of cell-free and cell-associated HIV-1 transmission through human cervix organ culture with UC781; Zussman A et al.; OBJECTIVE: To determine the efficacy of UC781 in preventing HIV-1 transmission through cervical tissue . DESIGN: Use of human cervical tissue organ culture, in which the cervix is in the upper chamber of a transwell and transmission of infective virus is quantified in the lower chamber . METHODS: Five-millimeter pieces of cervical tissues are exposed to UC781 . After thorough removal of the drug, the tissues are exposed to high doses of cell-free or cell-associated HIV-1 . Transmission of HIV-1 through the cervix is measured by determining infection of target cells in the lower chamber . RESULTS: Exposure of cervix to 0.5 microM UC781 for 30 min, followed by extensive washing away of the residual drug, resulted in 95% reduction of subsequent viral transmission . Exposure of the cervix to 1 microM UC781 for 20 min, or 10 microM UC781 for 2 min, resulted in neutralization of T- and M-tropic HIV-1 isolates of various clades, and prevention of cell-associated HIV-1 transmission . Moreover, a 20 min incubation with 10 microM UC781 abolished HIV-1 transmission through the cervix for 48 h after drug pretreatment . Importantly, UC781 was not toxic, even when the cervical tissues were exposed to 20 microM UC781 for 24 h . UC781 was effective against transmission of both cell-free and cell-associated HIV-1 also when formulated into a non-spermicidal (Replen) or spermicidal (BufferGel) gel . CONCLUSIONS: Exposure of the cervix to UC781 results in blocking of subsequent HIV-1 transmission with no toxicity . Therefore, UC781 is an excellent candidate microbiocide.

Biochem Biophys Res Commun, 2003 Mar 21, 302(4), 653 - 8
Role of protein kinase C alpha for uptake of unopsonized prey and phagosomal maturation in macrophages; Holm A et al.; Protein kinase C alpha (PKC alpha) participates in F-actin remodeling during phagocytosis and phagosomal maturation in macrophages . Leishmania donovani promastigotes, which inhibit phagosomal maturation, cause accumulation of periphagosomal F-actin instead of the disassembly observed around other prey {Cell . Microbiol . 7 (2001) 439} . This accumulation is induced by promastigote lipophosphoglycan (LPG), which has several effects on macrophages including inhibition of PKC alpha . To investigate a possible connection between PKC alpha and LPG's effects on actin dynamics, we utilized RAW264.7 macrophages overexpressing dominant-negative PCK alpha (DN PKC alpha) . We found increased cortical F-actin and decreased phagocytic capacity, as well as defective periphagosomal F-actin breakdown and inhibited phagosomal maturation in the DN PKC alpha-overexpressing cells, effects similar to those seen in controls subjected to LPG-coated prey . The results indicate that PKC alpha is involved in F-actin turnover in macrophages and that PKC alpha-dependent breakdown of periphagosomal F-actin is required for phagosomal maturation, and endorse the hypothesis that intracellular survival of L . donovani involves inhibition of PKC alpha by LPG.

J Card Surg, 2002 Nov-Dec, 17(6), 498 - 501
Association of sternal wound infection with parasternal muscle sutures; Stahl KD et al.; BACKGROUND: Sternal wound infection complicating open-heart surgery is a potentially devastating complication that has been associated with a number of risk factors . We recently consulted on three consecutive patients with this complication who had heavy nonabsorbable parasternal sutures placed in muscle tissue adjacent to the sternum . The aim of this report is to document our findings and caution that this technique to control bleeding from the parasternal intercostal muscles my increase risk of infection . METHODS: The pathology, surgical findings, and microbiology of these three cases are analyzed for similarity and possible cause of infection . RESULTS: By surgical observation and culture reports, each infection appeared to have originated at the site of nonabsorbable suture in devascularized parasternal muscle tissue . Sinus tracts could be probed to a similar site in each patient . CONCLUSION: Placement of sutures in the parasternal muscles where the sternal wires wrap around the bone leads to compression and necrosis of muscle tissue . We caution that this technique to control bleeding may cause a nidus of infection and increase the risk of deep sternal wound infection.

Hum Exp Toxicol, 2003 Jan, 22(1), 31 - 4; discussion 43-9
Commentary on hormesis and public risk communication: is there a basis for public discussions?
Flynn J, MacGregor D.
Research on radiation exposure is now focusing on microbiology and the impact of low dose exposures on cells and cell components . Eventually, this research may provide evidence to support changes in the models used to regulate human and environmental exposures . Currently, three models using older research results are subjects of interest and comparison . The linear no-threshold model, the most restrictive on behalf of public health values, dominates regulatory decision making . Alternative models (i.e., the threshold model and the hormesis model) could reduce costs of radiation management, depending upon new research results and public acceptance . Enacting a new public exposure model is a daunting task for risk communication given existing public risk perceptions and the established public decision-making processes . Each of the three prominent models must answer the question, 'what social good requires the use of this model in contrast to the others?'

East Afr Med J, 2002 Jul, 79(7), 343 - 6
Prophylactic effect of multi-herbal extract 'Agbo-Iba' on malaria induced in mice; Nwabuisi C; OBJECTIVE: To determine the efficacy of a multi-herbal preparation extract of 'Agbo-Iba' on rodent malaria induced in mice . DESIGN: An experimental design in which mice were divided into four groups A,B,C,D representing control, prophylactic, chloroquine and 'Agbo-Iba' groups respectively . Each mouse was intraperitoneally inoculated with Plasmodium yoelii nigeriensis and treated with oral herbal extract or chloroquine syrup depending on group . SETTING: College of Medicine of the University of Lagos Medical Microbiology and Parasitology Laboratory . SUBJECTS: One hundred and twenty male and female albino mice aged 10-12 weeks with an average weight of 25 grams . MAIN OUTCOME MEASURES: The herbal extract was effective, preventing the development of parasitaemia in the prophylactic group of mice . RESULTS: After intraperitoneal inoculation of Plasmodium yoelii nigeriensis, a prepatent period of two days was observed before parasitaemia was established in all but the prophylactic group of mice . Induced infection was promptly aborted with oral chloroquine treatment in group C, while in groups A and D, infection terminated fatally . Group B mice appeared normal throughout the duration of investigation with 100% survival rate . CONCLUSION: 'Agbo-Iba' extract has some prophylactic action against malaria induced in mice with no apparent significant side effects.

Pediatr Infect Dis J, 2003 Mar, 22(3), 277 - 80
Metastatic intracranial abscesses of bronchopulmonary origin; Agarwal A et al.; Intracranialabscesses are serious, life-threatening infections despite recent advances in diagnosis and treatment . We report the case of a child with metastatic brain abscesses and a chronic, sharp foreign body of the bronchus . Its presentation and endoscopic appearance and the microbiology of the abscesses are detailed . The detection of bacteria of respiratory origin should lead to a search for a bronchopulmonary source of contamination.

Acad Med, 2003 Mar, 78(3), 302 - 6
The reorganization of basic science departments in U.S . medical schools, 1980-1999; Mallon WT et al.; The evolution of biomedical science and technology over the last 50 years has made biomedical research inherently interdisciplinary . Such changes have led observers to speculate about the ways in which traditional basic science departments in U.S . medical schools are being changed or consolidated . The authors describe their findings from a study that constructed a 20-year longitudinal database (1980-1999) to examine how basic science departments have been reorganized at U.S . medical schools . The data reveal that, in fact, there were fewer basic science departments in the traditional disciplines of anatomy, biochemistry, microbiology, pharmacology, and physiology in 1999 than in 1980 . But as biomedical science has developed in an interdisciplinary manner, new basic science departments have been added . The most frequent type of change, however, has been in the renaming of existing departments . Overall, there were more, not fewer, basic science departments and more, not fewer, faculty members in these departments . These changes, taken together with the growth of interdisciplinary research centers and institutes and changing patterns of biomedical PhD training, affect both teaching and research in academic medicine . First, basic scientists are becoming increasingly dissociated from the traditional disciplines around which medical students' education is often organized . Second, the organization of biomedical research is in a state of transition that is responding to advances in scientific knowledge, technology, and targets of opportunity.

Euro Surveill, 2000 Nov, 5(11), 120 - 123
Development of a research netwrok for emerging foodborne pathogens in Germany; Werber D et al.; A network of epidemiologists, microbiologists, veterinarians, and clinicians is being developed in Germany to support local and state health departments and veterinary authorities in their research and epidemiological investigations on emerging foodborne

Euro Surveill, 1996 May, 1(5), 37 - 39
EWGLI: a European surveillance scheme for travel associated legionnaire s disease; Hutchinson EJ et al.; The European Working Group for Legionella Infections (EWGLI) was set up in 1986 and introduced the European Surveillance Scheme for Travel Associated Legionnaires Disease in 1987 . The microbiologists working in reference laborat-ories and the epidemiolog

Euro Surveill, 1996 Feb, 1(2), 11 - 12
An outbreak of cryptosporidiosis in the Netherlands; Van Asperen IA et al.; A hospital microbiologist in Spijkenisse, in the south west of the Netherlands - who had recently attended a parasitology course - identified cryptosporidial oocysts in stools from a patient with diarrhoea on 16 August 1995 . Re-examination of 89 stool spe

Folia Microbiol (Praha), 2002, 47(6), 587 - 639
Compounds isolated at the Institute of Microbiology in 1989-2001 and future trends; Rezanka T et al.; A total of 307 new compounds, natural, semisynthetic or synthetic, were isolated at the Institute of microbiology during the last twelve years . Due to the development of separation (chromatographic) methods and of analytical methods used to determine the chemical structure of these compounds, i.e . NMR, MS and X-ray diffraction, many new metabolites could be described.

Pediatr Pulmonol, 2003 Apr, 35(4), 302 - 8
Differential cytology of bronchoalveolar lavage fluid in asthmatic children; Najafi N et al.; Although asthma usually begins in childhood, limited information is available as to the inflammatory reaction of asthmatic children compared to adults and the influence of age . We investigated the cytology of bronchoalveolar lavage fluid (BALF) in 39 newly diagnosed wheezy children (minimum of 3 wheezing episodes during last 6 months): 21 allergic and 18 nonallergic subjects . None had received antiinflammatory treatment . Bronchoalveolar lavage (BAL) was performed, instilling 0.5 ml.kg(-1) body weight of warmed saline in 4 successive fractions . The first 2 aliquots (BALF 1) were pooled for microbiology and cytology, and the last 2 (BALF 2) for cytology only . Recovery correlated inversely with age, the most significant being for BALF 2 (r = -0.52, P = 0.001) . Children under 2 years of age had larger amounts of ciliated columnar and goblet cells (P = 0.0074) . Other cell types did not show age dependency . Differential cytology was characterized by a high number of creola bodies, bronchial epithelial cells (M = 68 x 10(3).ml(-1), R = 5-349), and neutrophils (M = 92 x 10(3).ml(-1), R = 0-1,257) . Eosinophils were the only cells distinguishing allergic from nonallergic subjects (P = 0.003) . The 16 children with positive microbiology had more neutrophils than the noninfected (P = 0.008), the latter still having more neutrophils than found in adults . These data suggest a limited age dependency in BALF cytology . Differential cytology in BALF might be helpful in differentiating asthma in children . Neutrophil inflammation might be more important than in adults .

Pathol Biol (Paris), 2003 Feb, 51(1), 5 - 12
{Species identification and molecular epidemiology of bacteria belonging to Ochrobactrum genus}; Teyssier C et al.; Two species of medical interest belong to the genus Ochrobactrum, Ochrobactrum anthropi and Ochrobactrum intermedium . They are members of the microbiota of soil and an increasing number of works report the isolation of O . anthropi from clinical specimen, especially from immunocompromised patients and nosocomial infection . Involving of each species in human infection is poorly estimated due to unclear differential phenotypic characters . We performed 16S rDNA sequencing for identification of 20 clinical isolates of Ochrobactrum sp . to the species level . Then, we studied the phenotype of each isolate especially, morphology, culture onto different media and at different temperatures, biochemical characters and antibiotics resistance pattern . Colony morphology after growth onto Trypticase-Soy and McConkey agar, culture at 45 degrees C onto Trypticase-Soja agar, presence of urease, and netilmycin, tobramycin and colistin resistance allowed identification of species . Ribotyping using HindIII and EcoRI gave a supplementary criterion for species determination but did not allow typing at the infra-species level . In contrast, Pulsed-Field Gel Electrophoresis showed high degree of polymorphism between strains and proved the clonality of certain isolates . Thus, this method could be a useful tool for molecular epidemiology of Ochrobactrum infections.

Med Mycol, 2003 Feb, 41(1), 65 - 74
Evaluation of a polymerase chain reaction reverse hybridization line probe assay for the detection and identification of medically important fungi in bronchoalveolar lavage fluids; Meletiadis J et al.; An assay system in which polymerase chain reaction (PCR) amplification of the ITS-1 region of ribosomal DNA (rDNA) is combined with a reverse-hybridization line probe assay (LiPA) was used for the identification of six Candida species and four Aspergillus species in pure cultures of clinical isolates, as well as in bronchoalveolar lavage (BAL) fluid samples from 42 patients with various underlying diseases . The results were compared with the results obtained with conventional routine identification methods as well as with a commercial enzyme-linked immunosorbent assay (ELISA) galactomannan detection assay and an Aspergillus-specific PCR . No discrepancies between the PCR-LiPA system and routine methods were found for pure cultures of Candida and Aspergillus species except in the case of Aspergillus versicolor . In BAL fluid samples in which Candida species were cultured, the PCR-LiPA system identified more species than did the routine methods . When routine analyses of patient samples were supplemented by adding data obtained by repurifying and re-identifying cultures and by taking isolates obtained from other body sites into account, the results agreed with PCR-LiPA system results in 81% of the cases (34/42) . Most of the remaining discrepancies (6/8) involved cases in which such supplementary data were not available . In BAL fluid samples from which A . fumigatus was cultured, the agreement between the PCR-LiPA system and the routine methods was low . Only 2 of 11 BAL samples shown to contain A . fumigatus in ELISA and genus-specific PCR assays were positive in PCR-LiPA system . The PCR-LiPA system enables the simultaneous detection and identification of different fungal species present in pure or mixed populations within 6 h in a single assay . Optimization is required, however, before it is useful as a diagnostic tool in the clinical microbiology laboratory.

Physiol Res, 2003, 52(1), 39 - 43
Statistics in three biomedical journals; Pilcik T; In this paper we analyze the use of statistics and associated problems, in three Czech biological journals in the year 2000 . We investigated 23 articles Folia Biologica, 60 articles in Folia Microbiologica, and 88 articles in Physiological Research . The highest frequency of publications with statistical content have used descriptive statistics and t-test . The most usual mistake concerns the absence of reference about the used statistical software and insufficient description of the data . We have compared our results with the results of similar studies in some other medical journals . The use of important statistical methods is comparable with those used in most medical journals, the proportion of articles, in which the applied method is described insufficiently is moderately low.

Can Assoc Radiol J, 2003 Feb, 54(1), 45 - 50
Abdominal computed tomographic findings of Mycobacterium tuberculosis and Mycobacterium avium intracellulare infection in HIV seropositive patients; Koh DM et al.; OBJECTIVE: To compare the computed tomographic (CT) findings of abdominal Mycobacterium tuberculosis (MTB) infection and Mycobacterium avium intracellulare (MAI) infection in patients with human immunodeficiency virus (HIV) infection . METHODS: A retrospective review of the CT findings of 30 patients with HIV and proven MTB (n = 9) or MAI (n = 21) infection was conducted . Images were reviewed by a radiologist blinded to the diagnosis, and the radiologic findings involving the abdominal viscera, peritoneum and lymph nodes were compared . RESULTS: The following were more frequent in patients with MAI infection: hepatomegaly (MAI 71% v . MTB 44%, p < 0.05), uniform attenuation of lymph nodes (MAI 90% v . MTB 55%, p < 0.05) and clustered pattern of lymph nodes (MAI 57% v . MTB 22%, p < 0.05) . In patients with MTB infection, lymph nodes with low attenuation centrally were more common (MAI 10% v . MTB 44%, p < 0.05), and mesenteric lymph nodes were significantly larger (MAI mean = 20 mm v . MTB mean = 40 mm, p < 0.05) . CONCLUSION: Although nonspecific, CT may be useful in the early diagnosis of MTB and MAI infection, allowing for presumptive treatment before microbiologic confirmation.

J Clin Microbiol, 2003 Mar, 41(3), 1299 - 303
Significant improvement of the recombinant Borrelia-specific immunoglobulin G immunoblot test by addition of VlsE and a DbpA homologue derived from Borrelia garinii for diagnosis of early neuroborreliosis; Schulte-Spechtel U et al.; We investigated whether the recombinant Borrelia Western blot test previously described (B . Wilske, C . Habermann, V . Fingerle, B . Hillenbrand, S . Jauris-Heipke, G . Lehnert, I . Pradel, D . Rossler, and U . Schulte-Spechtel, Med . Microbiol . Immunol . 188:139-144, 1999) can be improved by the addition of VlsE and additional DbpA and OspC homologues . By using a panel of sera from 36 neuroborreliosis patients and 67 control patients, the diagnostic sensitivity of the recombinant immunoblot test was significantly increased (86.1% versus 52.7%) without loss of specificity and was higher (86.1% versus 63.8%) than that of the conventional whole-cell lysate immunoblot test (U . Hauser, G . Lehnert, R . Lobentanzer, and B . Wilske, J . Clin . Microbiol . 35:1433-1444, 1997) . Improvement was mainly due to the presence of VlsE and DbpA.

J Clin Microbiol, 2003 Mar, 41(3), 1069 - 72
Detection and identification of Bartonella species pathogenic for humans by PCR amplification targeting the riboflavin synthase gene (ribC); Johnson G et al.; Several Bartonella species have now been implicated as human pathogens . The recovery of these fastidious organisms in the clinical microbiology laboratory remains difficult, and current methods are still relatively insensitive . Thus, the bartonellae are good candidates for detection by PCR . We have developed a PCR assay which uses a single primer pair targeting the riboflavin synthase gene (ribC) and detected six Bartonella species that have been implicated in human disease, B . henselae, B . quintana, B . bacilliformis, B . clarridgeiae, B . elizabethae, and B . vinsonii subsp . berkhoffii . Species identification is achieved simply by restriction enzyme digestion of the amplicon . This PCR assay appears to be specific for the Bartonella genus because it failed to amplify DNA from several other bacterial species.

J Clin Microbiol, 2003 Mar, 41(3), 1033 - 40
Serology and genetics of the flagellar antigen of Escherichia coli O157:H7a,7c; Ratiner YA et al.; Among Escherichia coli strains of the O55:H7 serovar, which is considered the ancestor of Shiga toxin-producing E . coli (STEC) O157:H7, two subtypes, H7a,7b and H7a,7c (briefly, H7a,b and H7a,c, respectively), of the H7 flagellar antigen have been described previously {J . Wright and R . Villanueva, J . Hyg . (Camb.) 51:39-48, 1953; Y . A . Ratiner and V . A . Sinelnikova, Zh . Microbiol . Epidemiol . Immunobiol . 3:111-116, 1969) . We have now studied 13 STEC O157:H7 strains and 1 O55:H7 strain that were epidemiologically unrelated, that originated from six countries on two continents, and that had different profiles when analyzed by multilocus enzyme electrophoresis, pulsed-field gel electrophoresis, and PCR for stx and eae . They were all found to possess the H7a,c flagellar antigen . Serum cross-absorption assays confirmed that their H antigens were indistinguishable from each other and from that of E . coli O55:H7a,c but differed from the standard H7a,b antigen of E . coli H test strain U5/41 . It was shown by phage-mediated transduction that the flagellin genes for these two H-antigen subserotypes were alleles of the E . coli fliC locus . On the basis of the serological data obtained in this study and the molecular characteristics of E . coli fliC(H7) alleles recently published, it is inferred that H7a,c and H7a,b are the main serological subtypes of the group of E . coli H7 flagellins.

J Clin Microbiol, 2003 Mar, 41(3), 1010 - 5
Conventional methods versus 16S ribosomal DNA sequencing for identification of nontuberculous mycobacteria: cost analysis; Cook VJ et al.; The clinical profile of nontuberculous mycobacteria (NTM) has been raised by the human immunodeficiency virus and AIDS pandemic . Different laboratory techniques, often molecular based, are available to facilitate the rapid and accurate identification of NTM . The expense of these advanced techniques has been questioned . At the National Reference Center for Mycobacteriology and the Health Sciences Center, University of Manitoba, in Winnipeg, Canada, we performed a direct cost analysis of laboratory techniques for commercial DNA probe-negative (Gen-Probe, Inc., San Diego, Calif.), difficult-to-identify NTM . We compared the costs associated with conventional phenotypic methodology (biochemical testing, pigment production, growth, and colony characteristics) and genotypic methodology (16S ribosomal DNA {rDNA} sequence-based identification) . We revealed a higher cost per sample with conventional methods, and this cost varied with organism characteristics: $80.93 for slowly growing, biochemically active NTM; $173.23 for slowly growing, biochemically inert NTM; and $129.40 for rapidly growing NTM . The cost per sample using 16S rDNA sequencing was $47.91 irrespective of organism characteristics, less than one-third of the expense associated with phenotypic identification of biochemically inert, slow growers . Starting with a pure culture, the turnaround time to species identification is 1 to 2 days for 16S rDNA sequencing compared to 2 to 6 weeks for biochemical testing . The accuracy of results comparing both methodologies is briefly discussed . 16S rDNA sequencing provides a cost-effective alternative in the identification of clinically relevant forms of probe-negative NTM . This concept is not only useful in mycobacteriology but also is highly applicable in other areas of clinical microbiology.

Ophthalmology, 2003 Mar, 110(3), 503 - 10
Infectious keratitis after LASIK; Karp CL et al.; PURPOSE: To report the clinical course, management, and outcomes of culture-proven infectious keratitis in 15 eyes of 13 subjects after LASIK . DESIGN: Retrospective, noncomparative, interventional case series . PARTICIPANTS: Fifteen eyes of 13 subjects who underwent LASIK and developed culture-positive keratitis . INTERVENTION: Infectious keratitis was encountered in the operative eyes between 1 day and 450 days . Cultures were obtained, and topical antibiotic therapy was administered in all cases . Some cases required flap lifting, irrigation, and soaking of the bed with antibiotics, flap amputation, or further surgical intervention . MAIN OUTCOME MEASURES: Time periods from onset to diagnosis, from clinical diagnosis to clinical resolution, final acuities, microbiologic profiles, and medical and surgical interventions were reviewed . RESULTS: Onset of symptoms of infection varied, depending on the infectious organism . Bacterial organisms tended to present earlier, whereas mycobacterial and fungal organisms had a later mean onset of presentation . Furthermore, the atypical organisms such as mycobacteria, fungus, and acanthamoeba also had a more delayed diagnosis, resulting in a prolonged disease course . CONCLUSIONS: Infectious keratitis after LASIK is a potentially vision-threatening complication . Onset of symptoms varies depending on causative agents . Furthermore, atypical organisms in the interface or beneath the flap can pose both diagnostic and therapeutic dilemmas . Location in the interface can make it more difficult to culture the organisms and prevent adequate penetration of topical antibiotics.

Bone Marrow Transplant, 2003 Feb, 31(4), 269 - 73
Comparison between two strategies for umbilical cord blood collection; Solves P et al.; The use of cord blood (CB) for transplantation has increased greatly in recent years . The collection strategy is the first step in collecting good-quality CB units . There are two main techniques for collecting CB from the umbilical vein: in the delivery room while the placenta is still in the uterus by midwives and obstetricians or in an adjacent room after placental delivery by CB bank trained personnel . In this study, the benefits and disadvantages between the two different CB collection strategies were evaluated, in order to improve CB bank methodology . Valencia CB bank maintains the two different collection strategies . CB was obtained from 569 vaginal and 70 caesarean deliveries and obstetrical and clinical charts were reviewed . Before processing CB units, volume was calculated and samples were drawn for cell counts . After processing and before cryopreservation samples were drawn for cell counts, CD34+cell analysis, viability, clonogenic assays and microbiology were drawn directly from the bags . We compared the efficiency of the two collection techniques . Obstetric data and umbilical CB were obtained from 569 vaginal (264 collected in utero and 305 collected ex utero) and 70 caesarean deliveries . The proportion of excluded CB units before processing was 33% for vaginal ex utero, 25% for vaginal in utero and 46% for caesarean deliveries . Differences were statistically significant . For vaginal deliveries a larger volume and a higher number of nucleated cells, percentage of CD34+ cells and colony-forming units (CFUs) were harvested in the in utero collection group . There was no statistical difference between CB collected after placental expulsion from vaginal and caesarean deliveries . Comparison between all vaginal and caesarean deliveries did not show any difference.We conclude that the mode of collection influences the haematopoietic content of CB donations . Collection before placental delivery is the best approach to CB collection and allows optimisation of CB bank methodology . Caesarean deliveries seem to contain similar progenitor content to vaginal deliveries.

Int Immunol, 2003 Mar, 15(3), 447 - 55
Stimulation by food proteins plays a critical role in the maturation of the immune system; Menezes Jda S et al.; The majority of contacts with foreign antigenic materials occur on the gut mucosa, and are represented by food proteins and the autochthonous microbiota . In the present study, we replaced intact dietary proteins by equivalent amounts of amino acids from weaning on and investigated its effects on the development of the immune system of mice . Adult animals reared on a balanced protein-free diet (Aa-mice) have a poorly developed gut-associated lymphoid tissue resembling suckling mice . They also display low numbers of lamina propria cells and TCRalphabeta intraepithelial lymphocytes, and low levels of secretory IgA . Levels of circulating IgG and IgA are also reduced in Aa-mice, whereas IgM levels are normal . In vitro cytokine production by cells from several lymphoid organs shows a predominant T(h)2 profile with a high concentration of IL-10 and IL-4, and a low concentration of IFN-gamma . These parameters also resemble the immunological patterns observed in pre-weaned mice . Thus, our data clearly show that exposure to food proteins after weaning has a physiological role in the maturation of the immune system both locally and systemically.

Mycopathologia, 2002, 155(3), 129 - 33
Multicenter evaluation of an enzyme immunoassay (Platelia Aspergillus) for the detection of Aspergillus antigen in serum; Lombardi G et al.; Invasive aspergillosis is a serious problem for immunocompromised patients, especially if neutropenic . The diagnosis of this infection is complicated, since clinical symptoms are often similar to those of other fungal diseases . The chance of detecting the presence of a specific antigen in the serum could confirm the suspected clinical diagnosis and . perhaps, be useful for the follow-up of the patient . The Medical Mycology Committee of the Associazione Microbiologi Clinici Italiani (AMCLI) decided to evaluate in a multicenter prospective study (from I November 1998 to 28 February 1999) the performance of the Platelia Aspergillus Kit (Bio-Rad) for the detection of Aspergillus galactomannan in human serum . The enrolled patients included various groups of immunosuppressed patients (mostly neutropenic) . Blood samples were drawn at the time of enrollment . This decision was based upon a clinical diagnosis of probable aspergillosis (antibiotic non-responsive fever for at least 96 hours, cough, hemophthosis and positive chest X-ray) . Additional blood samples were drawn on days 3, 6, 9, 12, 15 and 21 . Culture and histopathologic examinations were performed according to the individual laboratory workflow . For each patient the laboratory filled a form with all the available clinical information, to create a database on which to evaluate the results of the test . During the study, 187 patients with various kinds of immunosuppression were enrolled . A total of 256 sera were tested: for 117 patients (62.6%) only the basal sample was tested, whereas for the 70 symptomatic patients (37.4%) multiple specimens (range: 1-6) were tested . The results allowed the laboratories to exclude (68.6%) or confirm (31.5%: confirmed and/or probable) the clinical diagnosis of invasive aspergillosis; 4 cases remained undetermined . Based on the results of this study, it seems that the use of this test should be limited to those patients with clinical symptoms of aspergillosis.

Am J Respir Crit Care Med, 2003 May 1, 167(9), 1210 - 4 Epub 2003 Feb 13.
Acute respiratory distress syndrome after bacteremic sepsis does not increase mortality; Eggimann P et al.; To determine whether acute respiratory distress syndrome (ARDS) complicating bacteremic sepsis independently affects mortality in critically ill patients, we conducted a 3-year retrospective cohort study in a surgical intensive care unit . We included all consecutive patients with blood culture-positive sepsis and measured organ dysfunctions and mortality . Among 4,530 admissions, 196 cases of bacteremic sepsis were recorded . ARDS occurred in 31 (16%) of these patients . The case fatality rate was 58% in patients with ARDS compared with 31% in patients without ARDS . Using Cox proportional hazards regression with time-dependent variables, the unadjusted hazard ratio for death was 1.8 (95% confidence interval {CI}, 1.0-3.2) . After adjusting for comorbid factors that were present before the onset of sepsis, the hazard ratio was 2.2 (95% CI, 1.2-3.9) . After further adjustment was made for nonpulmonary organ dysfunctions and microbiologic factors that were independently associated with mortality, the adjusted hazard ratio for ARDS was 0.6 (95% CI, 0.3-1.2) . Among critically ill surgical patients, ARDS complicating bacteremic sepsis remains common, but it is not independently associated with short-term mortality, after adjusting for severity of illness and nonpulmonary organ dysfunctions evolving after the onset of sepsis.

Arch Surg, 2003 Mar, 138(3), 286 - 90
Effect of intraperitoneal antiadhesive fluids in a rat peritonitis model; Muller SA et al.; HYPOTHESIS: Phospholipids and icodextrin reduce peritoneal adhesions resulting from general peritonitis without promoting abscess formation . DESIGN: Evaluation of adhesion reduction fluids in a randomized animal study using a standardized peritonitis model . SETTING: Experimental animal model in a university laboratory . INTERVENTIONS: In 60 rats, experimental peritonitis was induced using the cecal ligation and puncture model . On day 1, the abdominal cavity was rinsed with 10 mL of isotonic sodium chloride solution and the cecum was resected . Animals were randomly assigned to 3 groups: the RL group, which received Ringer lactate intraperitoneally; the PL group, which received phospholipids intraperitoneally; and the ID group, which received icodextrin intraperitoneally . In each group, 50% of the animals were humanely killed at day 11 and 50% at day 21 . MAIN OUTCOME MEASURES: The areas of adhesions were measured and the abscess formation was scored according to location and size . Abscesses, abdominal fluid, and blood were sampled for microbiologic workup . RESULTS: The median area of adhesions was significantly lower in the PL groups (PL(11), 43.7 mm(2); PL(21), 20.4 mm( 2)) than in the RL groups (RL(11), 163.8 mm(2); RL( 21), 120.9 mm(2)) and ID groups (ID(11), 418.5 mm( 2); ID(21), 218.6 mm(2)) . Abscess formation was increased by icodextrin but not influenced by phospholipids, whereas microbiologic investigations did not reveal any differences among these 3 groups . CONCLUSIONS: In this model of general peritonitis, phospholipids significantly reduced adhesion formation without promoting septic complications . Icodextrin enhanced adhesion and abscess formation in this peritonitis model . Phospholipids may be beneficial for adhesion control in general peritonitis.

J Clin Pathol, 2003 Mar, 56(3), 237 - 9
Chronic osteomyelitis mimicking sarcoma; Gulmann C et al.; This report describes a rare case of chronic osteomyelitis in a 60 year old man mimicking a soft tissue sarcoma . Chronic osteomyelitis is an infrequent cause of a soft tissue mass and is usually diagnosed clinically by a combination of radiology and microbiology . Rarely, COM can mimic a primary bony neoplasm, but this is the first reported case where it mimicked a soft tissue sarcoma . The clinical, radiological, and histological appearances of this case will be discussed.

Cornea, 2003 Mar, 22(2), 166 - 8
Keratitis caused by an unusual fungus, Phoma species; Rishi K et al.; PURPOSE: To describe the histopathologic profile of a case of keratitis caused by Phoma species and to evaluate the role of polymerase chain reaction in the diagnosis of this unusual fungal infection . METHODS: Clinical information was extracted after a review of the medical records of a 72-year-old man developing a nonhealing corneal ulcer with brownish pigmentation . Microbiologic cultures and histopathologic examination were performed on the keratectomy specimen . Polymerase chain reaction was performed on DNA extracted from five (10-microm thick) paraffin-embedded sections using panfungal primers . RESULTS: Histopathologic examination revealed round spherules of variable diameter (5-30 microm) admixed with septate hyphae at the edges of the perforated cornea . Microbiologic cultures grew a fungus identified as Phoma species . Polymerase chain reaction from the specimen yielded a single product with an approximate size of 360 bp . CONCLUSION: Phoma species, though rarely pathogenic to humans, may cause keratitis in some patients . To our knowledge, this is the first well-documented case of Phoma keratitis.

Wien Klin Wochenschr, 2002 Aug 30, 114(15-16), 697 - 701
Economic burden of illness imposed by severe sepsis in Austria; Schmid A et al.; INTRODUCTION: Sepsis is a life-threatening disease, requiring instant treatment in an intensive care unit (ICU) . The aim of this study was to determine the direct and indirect costs occurring in Austria due to this disease . PATIENTS AND METHODS: Direct costs were calculated based on a retrospective chart analysis in four adult Austrian ICUs, evaluating 74 patient records from the years 2000/2001 . Patients were identified to have suffered from severe sepsis using ACCP-definitions . Assessed resource use (medication, laboratory analysis, microbiology analysis, consumer-goods, diagnostic procedures, staff costs, and basic bed costs) was linked with related center specific costs to determine direct costs per patient . Indirect costs due to productivity losses were calculated using official statistical material . RESULTS: The mean length of ICU stay (LOS ICU) of a severely septic patient was 18.1 days . Overall ICU mortality was found to be 43.2% and showed no gender difference . The mean daily direct ICU costs of care for severely septic patients were {symbol: see text} 1,617 and the mean total direct ICU costs per septic patient were {symbol: see text} 28,582 . In total costs, survivors were equally expensive as non-survivors ({symbol: see text} 28,699 vs . 28,463) although their length of study was considerably longer (21.9 vs . 13.2 days) . Considering a range of patients with severe sepsis in Austria from 6,700 to 9,500 per year, total direct costs in Austria range from {symbol: see text} 192 million to {symbol: see text} 272 million . Indirect costs determined by productivity losses due to unfitness for work (temporary and permanent) and premature death amount to {symbol: see text} 484 million to {symbol: see text} 686 million in Austria per year (same incidence range) . Total costs, i.e . burden of illness, combining direct costs with indirect costs, range from {symbol: see text} 676 million to {symbol: see text} 958 million . CONCLUSION: Patients with severe sepsis have a high mortality rate, spend prolonged periods of time in the ICU, and are expensive to treat . Indirect costs of severe sepsis due to productivity losses, particularly by premature death, are considerable.

Rev Esc Enferm USP, 2002 Jun, 36(2), 184 - 92
{Reutilization of paraformaldehyde tablets: assessment of their sterilizing effect}; Graziano KU et al.; The sterilizing activity of reused Paraformaldehyde tablets was assessed by microbiologic monitoring according to the Association of Official Analytical Chemists (AOAC) technic required in Brazil to register this class of sanitizing substances into the Health Ministry . Previous to the microbiologic tests, physical-chemscs assays were done through iodine titration according to the Society of Japanese Pharmacopoeia . It was possible, than, to draw a graphic showing a curve of the gaseous formaldehyde concentration discharged, at each sterilization cycle in relation to the number of reuse of the paraformaldehyde tablets . Through this graphic it was possible to chose the adequate moment to make the microbiologic analysis . After 12 cycles, the some group of the paraformaldehyde tablets kept the sterilizing activity at 3% concentration (3 g/100 cm3), at 50 degrees C, for 4 hours of exposition time with great relative humidity.

Int J Surg Pathol, 2003 Jan, 11(1), 39 - 42
Pulmonary hyalinizing granuloma associated with Aspergillus infection; Pinckard JK et al.; A 38-year-old immunocompetent man with occupational exposure to Aspergillus presented with dyspnea, pleuritic chest pain, and hemoptysis . Chest roentgenograms and computed tomography scans demonstrated multiple pulmonary nodules bilaterally . An initial set of bronchial washing cultures grew Aspergillus fumigatus, serologic testing showed an elevated anti-Aspergillus titer, and immunodiffusion testing was positive for antibody against A . fumigatus and A . niger . There was no microbiologic or serologic evidence of infection by other pathogens, and no clinical or laboratory evidence of autoimmune disease . An open lung biopsy was diagnostic of pulmonary hyalinizing granuloma . This novel association with Aspergillus infection not only expands the spectrum of pathogens linked to pulmonary hyalinizing granuloma but also documents a new pattern of lung disease that can be caused by Aspergillus.

Microsc Microanal, 2003 Feb, 9(1), 74 - 85
Simultaneous mechanical loading and confocal reflection microscopy for three-dimensional microbiomechanical analysis of biomaterials and tissue constructs; Voytik-Harbin SL et al.; At present, mechanisms by which specific structural and mechanical properties of the three-dimensional extracellular matrix microenvironment influence cell behavior are not known . Lack of such knowledge precludes formulation of engineered scaffolds or tissue constructs that would deliver specific growth-inductive signals required for improved tissue restoration . This article describes a new mechanical loading-imaging technique that allows investigations of structural-mechanical properties of biomaterials as well as the structural-mechanical basis of cell-scaffold interactions at a microscopic level and in three dimensions . The technique is based upon the integration of a modified, miniature mechanical loading instrument with a confocal microscope . Confocal microscopy is conducted in a reflection and/or fluorescence mode for selective visualization of load-induced changes to the scaffold and any resident cells, while maintaining each specimen in a "live," fully hydrated state . This innovative technique offers several advantages over current biomechanics methodologies, including simultaneous visualization of scaffold and/or cell microstructure in three dimensions during mechanical loading; quantification of macroscopic mechanical parameters including true stress and strain; and the ability to perform multiple analyses on the same specimen . This technique was used to determine the structural-mechanical properties of three very different biological materials: a reconstituted collagen matrix, a tissue-derived biomaterial, and a tissue construct representing cells and matrix.

Toxicol Pathol, 2003 Jan-Feb, 31(1), 134 - 9
Significance of hepatic preneoplasia in risk identification and early detection of neoplasia; Bannasch P et al.; Among the different types of liver tumor, hepatocellular neoplasms predominate by far in both animals and man . Consequently, preneoplastic foci of altered hepatocytes (FAH), preceding both hepatocellular adenomas and carcinomas, represent the most prevalent form of hepatic preneoplasia observed in animals for a long time, and identified in human chronic liver diseases associated with, or predisposing to, hepatocellular carcinomas more recently . Morphological, microbiochemical, and molecular biological approaches in situ revealed striking similarities in specific changes of the cellular phenotype of preneoplastic FAH developing in experimental and human hepatocarcinogenesis, irrespective of whether this was elicited by chemicals, hormones, viruses or radiation . The advantage of using FAH for risk identification (aiming at primary cancer prevention) in long-term and medium-term carcinogenesis bioassays has been well documented, but quantitative morphometric approaches appear to be indispensable for an appropriate evaluation of both bioassays . The detection of phenotypically similar FAH in various animal models and in humans prone to develop or bearing hepatocellular carcinomas favors the extrapolation from data obtained in animals to humans . Moreover, the recently reported frequent finding of FAH in fine-needle biopsies of patients suffering from chronic liver diseases opens new perspectives for secondary prevention of human hepatocellular carcinoma.

J Clin Virol, 2003 Jan, 26(1), 61 - 9
Distribution of the different genotypes of HCV among patients attending a tertiary care hospital in south India; Raghuraman S et al.; BACKGROUND: Genotyping of the hepatitis C virus (HCV) and assessment of viral load is important for designing therapeutic strategies and region specific diagnostic assays . OBJECTIVES: To determine the distribution of HCV genotypes among patients attending a tertiary care hospital in south India, and to correlate this with viral load . STUDY DESIGN: Ninety HCV RNA positive patients were recruited for the study . HCV genotyping was carried out using type-specific primers from the core region of the viral genome {J . Clin . Microbiol . 35 (1997) 201} . Viral load estimations were carried out using the Amplicor HCV Monitor (Versions 1.5 and 2, Roche Diagnostics, Branchburg, NJ, USA) . Clinical details were elicited from patients' hospital records . RESULTS: Genotype 3 was detected most frequently (62.2%) followed by infection with HCV genotype 1 (18.8%) . There was no significant difference seen in alanine aminotransferase (ALT) values between the two genotypes . Genotype 1 was associated with a significantly higher viral load as compared with genotype 3 (P=0.001) . Parenteral transmission accounted for 61% of all infection caused . Infection with genotype 1 was significantly associated with a history of haemodialysis (P=0.01) . Genotype 3 was detected more frequently in patients from east India, as compared with its detection in patients from south India (P=0.004) . Similarly, genotype 1 was detected with greater frequency in individuals from south India as compared with patients from east India (P=0.004) . The concordance between Ohno's genotyping assay and nucleotide sequencing, for genotypes 1 and 3, was 75% . CONCLUSIONS: HCV genotypes 1 and 3 accounted for 81% of HCV infections in patients from this geographical region . HCV genotype distribution showed regional differences and genotype 1 was associated with higher viral loads . Parenteral transmission was the major route for acquisition of HCV infection . Ohno's type-specific primer based genotyping assay can be used for distinguishing between HCV genotype 1 and non-1 HCV genotypes in laboratories that do not possess nucleotide sequencing facilities.

APMIS, 2002 Nov, 110(11), 819 - 24
Trimethylamine content in vaginal secretion and its relation to bacterial vaginosis; Wolrath H et al.; The presence of a fishy odor emanating from women who present with a malodorous vaginal discharge is well known . The odor is due to bacterial reduction of trimethylamine oxide to trimethylamine (TMA) in vaginal secretion . The release of TMA from specimens of vaginal fluid following the addition of alkali is often used in making a clinical diagnosis of bacterial vaginosis (BV) . We now report a sensitive gas chromatographic method for analysis and quantification of TMA in vaginal fluid in which weighed samples were used . In addition, a proper diagnosis of BV was obtained using Gram-stained smears of the vaginal fluid according to the method of Nugent et al . (R . P . Nugent et al., J Clin Microbiol 1991;29:297-301) . We also diagnosed BV according to Hallen et al . (A . Hallen et al . Genitourin Med 1987;63:386-9) . TMA was present in all women with a Nugent score between 7 and 10 and in almost all women diagnosed with BV according to the method of Hallen et al . TMA was not found or was only found in very low concentrations in vaginal fluid from women with Nugent scores of 0 to 3 . TMA was also found in four women with a negative sniff test . It seems that high levels of TMA in samples of vaginal fluid are typical for BV regardless of the scoring method used for diagnosis . However, low levels of TMA, <5 microg/g vaginal fluid, do not always correlate with BV.

Pediatr Infect Dis J, 2003 Feb, 22(2), 186 - 92
Intramedullary abscess of the spinal cord in children: a case report and review of the literature; Simon JK et al.; A case report of an intramedullary spinal cord abscess in a 13-month-old boy and a review of relevant existing pediatric literature is presented . Thirty-eight cases of pediatric intramedullary spinal cord abscess are analyzed for presenting signs and symptoms, microbiology of isolated organisms, surgical intervention, antibiotic administration and outcome . The most significant variable on outcome is timely surgical intervention, followed by appropriate antibiotic administration.

Rev Med Brux, 2002, 23 Suppl 2, 107 - 10
{The microbiology department}; Struelens M et al.; From the outset, the Department of Microbiology of Erasme Hospital has striven to offer to clinical teams a full range of high performance tests for diagnosis and therapeutic monitoring of bacterial, viral, fungal and parasitic infections, including opportunistic infections . Furthermore, the laboratory has developed and made available cutting edge tools for the epidemiologic surveillance and outbreak investigation in support to the hospital infection control and antibiotic resistance control programmes . Research and development programmes have led to technological innovation in the fields of molecular virologic diagnosis, notably for HIV and herpes viruses, rapid bacterial identification, detection of resistance genes and epidemiological typing . Research in collaboration with clinical teams has focused on congenital infections, HIV infection, opportunistic infections and prevention of nosocomial infection . The Department acts as national reference laboratory for a number of infectious diseases and co-ordinates or actively participates to several European multicentre studies and epidemiologic surveillance networks.

Zhongguo Yi Liao Qi Xie Za Zhi, 2001 Mar, 25(2), 85 - 7
{Automated microbiology identification and antibiotic susceptibility analysis system}; Gong JS et al.; This article introduces the principles, characters and application prospect of Model 2000 Automated Microbiology Identification and Antibiotic Susceptibility Analysis System.

Ophthalmology, 2003 Feb, 110(2), 276 - 85
An outbreak of Mycobacterium chelonae infection after LASIK; Freitas D et al.; OBJECTIVE: To describe an outbreak of mycobacterial keratitis after laser in situ keratomileusis (LASIK), including the microbiologic investigation, clinical findings, treatment response, and outcome . DESIGN: Retrospective, noncomparative, interventional case series . PARTICIPANTS: Patients (n = 10) who underwent LASIK surgery between August 22 and September 4, 2000, and developed mycobacterial infection . METHODS: Patients were prospectively followed in relation to microbiologic investigation, clinical findings, treatment response, and outcome . MAIN OUTCOME MEASURES: Most patients underwent bilateral simultaneous LASIK . Postoperative infection was signaled by the appearance of corneal infiltrates in the third postoperative week . The microbiologic workup was performed on cultures obtained either by direct scraping of the cornea or by lifting the flap . Medical therapy was instituted based on drug susceptibility testing . Surgical interventions such as corneal debridement and flap removal were performed during recurrences or when there was no satisfactory clinical response . RESULTS: Cultures revealed Mycobacterium subspecies chelonae . Patients were treated with topical clarithromycin (1%), tobramycin (1.4%), and ofloxacin (0.3%) . Oral clarithromycin (500 mg twice a day) was prescribed for those patients who did not respond clinically to topical treatment . Four eyes healed on this regimen . Flap removal was necessary in seven eyes . CONCLUSIONS: This report highlights mycobacteria as an etiologic infectious agent after LASIK . Diagnosis can be difficult and is often delayed . The treatment mainstay is prolonged antibiotic therapy . Surgical debridement and flap removal may shorten the disease course.

J Clin Microbiol, 2003 Feb, 41(2), 547 - 51
Identification of a specific antigenic region of the P82 protein of Babesia equi and its potential use in serodiagnosis; Hirata H et al.; The efficacy of the Be82 gene product fused with glutathione S-transferase (GST/Be82) in an enzyme-linked immunosorbent assay (ELISA) for the diagnosis of Babesia equi infection was reported previously (H . Hirata et al., J . Clin . Microbiol . 40:1470-1474, 2002) . However, the ELISA with the GST/Be82 antigen cross-reacted with Babesia caballi-infected horse sera, despite the high rate of detection of B . equi . These results suggested that GST/Be82 has an antigen in common with B . caballi or antigenicity similar to that of B . caballi . In the present study, we constructed a series of five clones with deletions in the Be82 gene product, each of which was fused with GST, and used them in ELISAs in order to overcome the cross-reactivity seen with B . caballi . One of the deletion clones, a clone with a deletion of the Be82 gene from positions 236 to 381 (Be82/236-381), specifically and sensitively detected B . equi-infected horse sera without cross-reactivity with B . caballi-infected horse sera . Assays with clones from which other gene products were deleted showed decreased sensitivities or remained nonspecific for the detection of B . equi-infected horse sera . These results suggest that the Be82/236-381 gene product is a novel antigen for the diagnosis of B . equi infection in horses.

Appl Environ Microbiol, 2003 Feb, 69(2), 996 - 1003
Complete detoxification of vinyl chloride by an anaerobic enrichment culture and identification of the reductively dechlorinating population as a Dehalococcoides species; He J et al.; A major obstacle in the implementation of the reductive dechlorination process at chloroethene-contaminated sites is the accumulation of the intermediate vinyl chloride (VC), a proven human carcinogen . To shed light on the microbiology involved in the final critical dechlorination step, a sediment-free, nonmethanogenic, VC-dechlorinating enrichment culture was derived from tetrachloroethene (PCE)-to-ethene-dechlorinating microcosms established with material from the chloroethene-contaminated Bachman Road site aquifer in Oscoda, Mich . After 40 consecutive transfers in defined, reduced mineral salts medium amended with VC, the culture lost the ability to use PCE and trichloroethene (TCE) as metabolic electron acceptors . PCE and TCE dechlorination occurred in the presence of VC, presumably in a cometabolic process . Enrichment cultures supplied with lactate or pyruvate as electron donor dechlorinated VC to ethene at rates up to 54 micromol liter(-1)day(-1), and dichloroethenes (DCEs) were dechlorinated at about 50% of this rate . The half-saturation constant (K(S)) for VC was 5.8 microM, which was about one-third lower than the concentrations determined for cis-DCE and trans-DCE . Similar VC dechlorination rates were observed at temperatures between 22 and 30 degrees C, and negligible dechlorination occurred at 4 and 35 degrees C . Reductive dechlorination in medium amended with ampicillin was strictly dependent on H(2) as electron donor . VC-dechlorinating cultures consumed H(2) to threshold concentrations of 0.12 ppm by volume . 16S rRNA gene-based tools identified a Dehalococcoides population, and Dehalococcoides-targeted quantitative real-time PCR confirmed VC-dependent growth of this population . These findings demonstrate that Dehalococcoides populations exist that use DCEs and VC but not PCE or TCE as metabolic electron acceptors.

J Am Coll Cardiol, 2003 Jan 1, 41(1), 152 - 6
Aspergillus aortitis after cardiac surgery; Sanchez-Recalde A et al.; OBJECTIVES: The aim of this study was to describe the clinical characteristics of Aspergillus aortitis in a small series of consecutive patients . BACKGROUND: Aspergillus infection of the ascending aorta after cardiopulmonary bypass surgery has rarely been reported and has always resulted in death . METHODS: Aspergillus aortitis was confirmed by pathologic and microbiologic analysis in eight men (61 +/- 8 years) of 9,375 consecutive patients who underwent cardiac surgery between 1975 and 2000 . RESULTS: Patients presented with Aspergillus aortitis after aortic valve replacement (n = 5), coronary revascularization (n = 2), or both (n = 1) . Initial symptoms appeared between the immediate postoperative period and up to two years after surgery . All patients had prolonged fever . Ante-mortem diagnosis was established in only three patients for whom transthoracic echocardiography was suggestive of aortic pseudoaneurysm and was confirmed by thoracic computed tomography or aortography . All patients had negative peripheral blood cultures . Seven patients died at short-term follow-up, and the one surviving patient was promptly treated by surgery and antifungal drugs . Pathologic examination confirmed Aspergillus aortitis with multi-organ dissemination without heart involvement in all patients except for two, in whom aortic valve endocarditis was found . Fungal cultures confirmed the presence of Aspergillus fumigatus in all patients . CONCLUSIONS: Aspergillus aortitis is typically found after aortic valve or coronary surgery . It commonly leads to lethal multi-organ dissemination without involvement of the intracardiac structure . This entity should be considered in patients with persistent fever and negative blood cultures after open-heart surgery involving significant aortic wall damage, irrespective of the postoperative period.

Cancer, 2003 Feb 15, 97(4), 1025 - 32
Refractory Aspergillus pneumonia in patients with acute leukemia: successful therapy with combination caspofungin and liposomal amphotericin; Aliff TB et al.; BACKGROUND: Pulmonary aspergillosis and other invasive fungal infections (IFIs) commonly complicate the management of patients with acute leukemia . Standard amphotericin-based therapies may be ineffective for many patients and the available salvage agents (itraconazole and caspofungin) are reported to possess only moderate activity against resistant infections . Laboratory evidence suggests a synergistic interaction between amphotericin and caspofungin . The authors treated a group of patients with amphotericin-refractory IFIs with the combination of caspofungin and amphotericin (or liposomal amphotericin) . METHODS: A retrospective evaluation of patients with amphotericin-resistant IFIs was conducted . Diagnosis was based on clinical, radiographic, and when available, microbiologic data . Response to combination antifungal therapy was graded as either favorable or unfavorable . Favorable responses included improvement of both clinical and radiographic signs of fungal pneumonia . All other responses were graded as unfavorable . RESULTS: Thirty patients were included in this analysis . Twenty-six patients had acute leukemia . Based on recently published criteria, the IFIs were classified as proven in 6 patients, probable in 4 patients, and possible in 20 patients . The median duration and dose of amphotericin monotherapy were 12 days (range, 4-65 days) and 7.8 mg/kg (range, 4.2-66.1 mg/kg), respectively . The median duration of combination therapy was 24 days (range, 3-74 days) . Eighteen patients (60%) experienced a favorable antifungal response . Twenty patients with acute leukemia received combination therapy for fungal pneumonias arising during intensive chemotherapy treatments . Favorable responses were observed in 15 of these patients (75%), and antifungal response did not depend on the response of the underlying leukemia . Survival to hospital discharge was significantly better (P < 0.001) in patients having a favorable response . Mild to moderate nephrotoxicity was noted in 50% of patients, necessitating the substitution of liposomal amphotericin . Mild elevation of alkaline phosphatase levels occurred in 30% of patients . Caspofungin was temporarily withheld from one patient who developed moderate but reversible biochemical hepatotoxicity . CONCLUSIONS: The antifungal combination of caspofungin and amphotericin can be administered safely to high-risk patients with hematologic malignancies . Although an absolute assessment of efficacy is limited by the design of this study, encouraging outcomes were noted for many patients . The authors plan to evaluate this regimen further in a randomized clinical trial .

J Agric Food Chem, 2003 Feb 12, 51(4), 890 - 6
Natural fungicides from Ruta graveolens L . leaves, including a new quinolone alkaloid; Oliva A et al.; Bioassay-directed isolation of antifungal compounds from an ethyl acetate extract of Ruta graveolens leaves yielded two furanocoumarins, one quinoline alkaloid, and four quinolone alkaloids, including a novel compound, 1-methyl-2-{6'-(3' ',4' '-methylenedioxyphenyl)hexyl}-4-quinolone . The (1)H and (13)C NMR assignments of the new compound are reported . Antifungal activities of the isolated compounds, together with 7-hydroxycoumarin, 4-hydroxycoumarin, and 7-methoxycoumarin, which are known to occur in Rutaceae species, were evaluated by bioautography and microbioassay . Four of the alkaloids had moderate activity against Colletotrichum species, including a benomyl-resistant C . acutatum . These compounds and the furanocoumarins 5- and 8-methoxypsoralen had moderate activity against Fusarium oxysporum . The novel quinolone alkaloid was highly active against Botrytis cinerea . Phomopsis species were much more sensitive to most of the compounds, with P . viticola being highly sensitive to all of the compounds.

Radiology, 2003 Feb, 226(2), 391 - 8
Detection of metallic implant-associated infections with FDG PET in patients with trauma: correlation with microbiologic results; Schiesser M et al.; PURPOSE: To prospectively evaluate the value of positron emission tomography (PET) with fluorine 18 fluorodeoxyglucose (FDG) in the detection of metallic implant-associated infections in patients with trauma . MATERIALS AND METHODS: Twenty-nine partial-body FDG PET scans in 22 patients suspected of having metallic implant-associated infections were obtained prior to surgery . In two of the 22 patients, data were acquired with a combined PET-CT in-line system . Soft-tissue and bone infections were evaluated . PET scans were analyzed by two experienced nuclear medicine physicians first separately and then in consensus . Disease status was defined on the basis of the results of microbiologic evaluation of surgical specimens together with intraoperative findings . Sensitivities, specificities, accuracies, interobserver variability (determination of kappa values), and receiver operating characteristic curves were obtained . RESULTS: Of 29 PET scans, 14 were true-positive, 14 were true-negative, and one was false-positive . Sensitivity, specificity, and accuracy were 100%, 93.3%, and 97%, respectively, for all PET data; 100%, 100%, and 100%, respectively, for the central skeleton; and 100%, 87.5%, and 95%, respectively, for the peripheral skeleton . The degree of overall interobserver concordance was high (kappa = 0.96) . CONCLUSION: FDG PET appears to be a sensitive and specific method for the detection of infectious foci due to metallic implants in patients with trauma.

J Bacteriol, 2003 Feb, 185(4), 1338 - 45
Growth phase-coupled alterations in cell structure and function of Escherichia coli; Makinoshima H et al.; Escherichia coli cultures can be fractionated into more than 20 cell populations, each having a different bouyant density and apparently representing a specific stage of cell differentiation from exponential growth to stationary phase (H . Makinoshima, A . Nishimura, and A . Ishihama, Mol . Microbiol . 43:269-279, 2002) . The density increase was found to be impaired at an early step for a mutant E . coli with the disrupted rpoS gene, which encodes the RNA polymerase RpoS (sigma-S) for stationary-phase gene transcription . This finding suggests that RpoS is need for the entire process of cell density increase . In the absence of RpoF sigma factor, the flagella are not formed as observed by electron microscopy, but the growth phase-coupled density increase takes place as in wild-type E . coli, confirming that the alteration in cell density is not directly correlated with the presence or absence of flagella . In the stationary-phase cells, accumulation of electron-dense areas was observed by electron microscopic observation of bacterial thin sections . By chemical determination, the increase in glycogen (or polysaccharides) was suggested to be one component, which contributes to the increase in weight-to-volume ratio of stationary-phase E . coli cells.

Z Naturforsch {C}, 2002 Nov-Dec, 57(11-12), 998 - 1003
The chemical composition of Microbiota decussata; Krauze-Baranowska M et al.; From the leaves of Microbiota decussata (Cupressaceae) biflavones: cupressuflavone, amentoflavone and 7-O-methylamentoflavone were isolated and identified . The amount of cupressuflavone in Microbiota decussata and xCupressocyparis leylandii (Leyland cypress) (Cupressaceae) was determined by HPLC (1.82% and 0.83%, respectively) . The chemical composition of essential oils from bark and leaves of Microbiota decussata was established by GC-MS (GC-FID) analysis . As a major component thujopsene (39.2% and 45.9%, respectively) was identified . Wiridiflorol (3.0%) and tau-muurolol (0.3%) were present only in leaves but globulol (1.5%) exclusively in bark . The content of essential oils in M . decussata was high--5.4% in bark and 12.6% in leaves . The essential oils from M . decussata and xC . leylandii were bioassayed towards different fungi of the genus Fusarium . Leyland cypress essential oil at 2% concentration fully inhibited the growth of all fungi.

Epidemiol Infect, 2002 Dec, 129(3), 499 - 505
Is household antibiotic use a risk factor for antibiotic-resistant pneumococcal infection?
Kwan-Gett TS, Davis RL, Shay DK, Black S, Shinefield H, Koepsell T.
We used microbiology and pharmacy data from health-maintenance organizations to determine whether antibiotic use by a household member increases the risk of penicillin-non-susceptible pneumococcal disease . Though it has been well established that an individual's antibiotic use increases one's risk of antibiotic-resistant infection, it is unclear whether the risk is increased if a member of one's household is exposed to antibiotics . We therefore conducted a case-control study of patients enrolled in health maintenance organizations in Western Washington and Northern California . Cases were defined as individuals with penicillin-non-susceptible pneumococcal infection; controls were individuals with penicillin-susceptible pneumococcal infection . Socioeconomic variables were obtained by linking addresses with 1997 census block group data . One-hundred and thirty-four cases were compared with 798 controls . Individual antibiotic use prior to diagnosis increased the odds of penicillin non-susceptibility, with the strongest effect seen for beta-lactam use within 2 months (OR 1.8, 95% CI 1.2, 2.8) . When household antibiotic use by persons other than the patient were considered, at 4 months prior to diagnosis there was a trend towards an association between penicillin non-susceptibility and beta-lactam antibiotic use, and a possible association in a small subgroup of patients with eye and ear isolates . However, no significant overall pattern of association was seen . We conclude that though antibiotic use of any kind within 2 months prior to diagnosis is associated with an increased risk of penicillin-non-susceptible pneumococcal disease, there is no significant overall pattern of association between household antibiotic use and penicillin-non-susceptible pneumococcal infection.

Vet Microbiol, 2003 Apr 29, 92(4), 311 - 25
Determination of the sequence of the complete open reading frame and the 5'NTR of the Paderborn isolate of classical swine fever virus; Oleksiewicz MB et al.; The classical swine fever (CSF) epidemic in the Netherlands in 1997-1998 lasted 14 months, during which 429 infected and 1300 at risk herds were culled, at an estimated economical cost of 2 billion US dollars . Despite the overwhelming scale of the epizootic, the CSF virus (CSFV) strain causing the outbreak has remained largely uncharacterized . The Dutch epizootic is epidemiologically linked to a small CSF outbreak in 1997, in Paderborn in Germany . E2 and partial 5' NTR sequencing has shown that the index Paderborn isolate, and several Dutch isolates taken during the 1997-1998 epizootic, are virtually identical, confirming that the Paderborn isolate triggered the Dutch outbreak, and furthermore showing that this single isolate was stable throughout the whole Dutch outbreak (the above reviewed in {C . Terpstra, A . J . de Smit, Veterinary Microbiol . 77 (2000) 3-15}) . We determined the nucleotide sequence of the 5' NTR (by 5' RACE) and the complete open reading frame of the Paderborn isolate (GenBank AY072924) . Our sequence was identical to previously published partial 5'NTR and E2 sequences for the index Paderborn 1997 and Dutch 1997 (Venhorst) isolates, confirming the identity of the virus we sequenced . Phylogenetic analysis based on the complete open reading frame showed that Paderborn is genetically very different from common European laboratory reference strains . Neutralization studies showed that Paderborn is also antigenically very different from common laboratory strains such as Alfort 187 . Paderborn is the only recent European CSFV field isolate for which a complete sequence is available, and given Paderborns genetic and antigenic uniqueness, the Paderborn sequence may have practical use for diagnostic and vaccine antigen development.

Enferm Infecc Microbiol Clin, 2003 Jan, 21(1), 20 - 3
{Q fever in Gran Canaria: 40 new cases}; Bolanos M et al.; INTRODUCTION: The aim of this study was to describe the clinical and epidemiologic features of Q fever in the southern area of the island of Gran Canaria (Spain) . METHODS: We conducted a retrospective analysis of the clinical and epidemiological data of the cases of Q fever diagnosed by the Microbiology Laboratory of the Hospital Universitario Insular in Gran Canaria between 1998 and 2000 . Antibodies against phase II Coxiella burnetii antigens were detected using an indirect immunofluorescence test . The diagnosis of acute Q fever was established by IgG titers > or = 1:320 and IgM titers > or = 1:80, or by seroconversion . RESULTS: During the period of study 59 cases of acute Q fever were diagnosed, making an incidence of 5 cases/100,000 inhabitants/year . The seroprevalence (IgG > or = 1:80) in the patients for whom Q fever serology was requested during that period was 23.9% . Clinical and epidemiologic data were available for 40 patients . All were sporadic cases and 57% were hospitalized . The mean age of the patients was 40.6 6 13.3 years (range 20-74 years), 85% were males and 67.5% came from a rural background . The majority of cases (65%) clustered from April to July . The most frequent clinical presentation was an acute febrile process with elevated liver enzymes (87.5%) . Pneumonia was infrequent (only three cases) . CONCLUSIONS: In our area Q fever is mainly manifested as an acute febrile illness with subclinical hepatic involvement . This fact and the small number of cases with pneumonia and chronic forms suggest the etiological involvement of C . burnetii strains different from those in other geographic areas.

Ann Pharmacother, 2003 Feb, 37(2), 192 - 6
Antifungal susceptibility testing in teaching hospitals; Pai MP et al.; BACKGROUND: An assessment of antifungal susceptibility testing (AST) has not been conducted since the introduction of the National Committee for Clinical Laboratory Standards (NCCLS) M27-A document . OBJECTIVE: To determine AST practices in teaching hospitals . METHODS: A questionnaire was mailed to the heads of 386 randomly assigned microbiology departments from teaching hospitals identified through the 2000 American Hospital Association Guide . Identifiers were used to delineate responders from nonresponders . A reminder letter was mailed 3 weeks after the initial mailing to all nonresponders . The hospital bed-size and number of inpatient days for respondents were obtained through the American Hospital Directory . RESULTS: The questionnaire was returned by 171 (44.3%) institutions . The total and median (range) number of candida isolates were 137,088 and 8.5 (1-145)/1000 inpatient days for the year 2000, respectively . Approximately 1% (1300) of candida isolates, from predominantly blood specimens, underwent AST . AST was reported by 115 (67.2%) hospitals, with testing on site at 27 hospitals and off site for 88 hospitals . NCCLS methodology (80% broth microdilution) was used by 75% of the hospitals performing on-site AST . The median time to obtain AST results was significantly lower when testing was performed on site (3 d) compared with off site (7-10 d) . SUMMARY: A large number of candida bloodstream isolates undergoes AST annually . AST results are obtained sooner when performed on site compared with off site.

Am J Pathol, 2003 Feb, 162(2), 691 - 702
CD4+ CD25+ regulatory T lymphocytes inhibit microbially induced colon cancer in Rag2-deficient mice; Erdman SE et al.; Inflammatory bowel diseases, including ulcerative colitis and Crohn's disease, increase the risk of colorectal cancer in humans . It has been recently shown in humans and animal models that intestinal microbiota and host immunity are integral in the progression of large bowel diseases . Lymphocytes are widely believed to prevent bacterially induced inflammation in the bowel, and lymphocytes are also critical in protecting against primary tumors of intestinal epithelia in mice . Taken together, this raises the possibility that lymphocytes may inhibit colon carcinogenesis by reducing bacterially driven inflammation . To examine the role of bacteria, lymphocytes, and inflammatory bowel disease in the development of colon cancer, 129/SvEv Rag-2-deficient and congenic wild-type mice were orally inoculated with a widespread enteric mouse bacterial pathogen, Helicobacter hepaticus, or sham-dosed with media only . H . hepaticus-infected Rag2-/-, but not sham-dosed Rag2-/- mice, rapidly developed colitis and large bowel carcinoma . This demonstrated a link between microbially driven inflammation and cancer in the lower bowel and suggested that innate immune dysregulation may have an important role in inflammatory bowel disease and progression to cancer . H . hepaticus-infected wild-type mice did not develop inflammation or carcinoma showing that lymphocytes were required to prevent bacterially induced cancer at this site . Adoptive transfer with CD4+ CD45RBlo CD25+ regulatory T cells into Rag-deficient hosts significantly inhibited H . hepaticus-induced inflammation and development of cancer . These results suggested that the ability of CD4+ T cells to protect against intestinal cancer was correlated with their ability to reduce bacterially induced inflammatory bowel disease . Further, regulatory T cells may act directly on the innate immune system to reduce or prevent disease . These roles for T cells in protection against colon carcinoma may have implications for new modes of prevention and treatment of cancer in humans.

J Thorac Imaging, 2003 Jan, 18(1), 48 - 52
High-resolution computed tomography appearance of pulmonary Mycobacterium avium complex infection after exposure to hot tub: case of hot-tub lung; Pham RV et al.; Reports detailing Mycobacterium avium complex (MAC) infection in an immunocompetent host after exposure to hot tub (hot-tub lung) are few and have not focused on the radiographic presentation . On high-resolution computed tomography (HRCT), hot-tub lung caused by MAC infection closely resembles subacute hypersensitivity pneumonitis and is difficult to distinguish based on imaging parameters alone . Centrilobular nodules of ground-glass attenuation with beading of the interlobular septae are prominent features on HRCT . Correlation of clinical history with radiographic, pathologic, and microbiologic findings are necessary to establish a diagnosis of hot-tub lung.

Thromb Haemost, 2003 Jan, 89(1), 18 - 24
Interaction of pathogens with the endothelium; Hippenstiel S et al.; The endothelium lines the inner surface of the vessel wall establishing a multifunctional, semi-permeable cellular barrier at blood-tissue interface . The large total surface of the endothelium is exposed to pathogens, pathogen-derived products as well as to agents of the activated host defense during an inflammatory reaction . The endothelium is not only specifically targeted by important infective agents like Rickettsiae (1) or Bartonella (2), it is involved in virtually most, if not all, acute inflammatory responses . Pathogens attack the endothelium by a wide variety of strategies, as different as activation of preformed receptor-mediated pathways in the endothelium, release of pore-forming exotoxins or intracellular replication and chronic parasitism . These pathophysiological forces affect the endothelial phenotype, resulting in endothelial barrier dysfunction, increased leukocyte-endothelial interaction, mediator release, and procoagulant activity . Moreover, endothelial responses retroact on the invading pathogen as well as on the host defense resulting in a complex and dynamic interaction . Endothelial activation contributes considerably to inflammation and resulting clinical characteristics . In this context the endothelium is not just a passive victim, it rather aggravates the ongoing struggle with the pathogen . In this review we focus on some important mechanisms of the cellular microbiology of endothelial infection by bacteria and viruses.

Analyst, 2002 Dec, 127(12), 1583 - 8
Real-time monitoring of lactate extrusion and glucose consumption of cultured cells using a lab-on-valve system; Schulz CM et al.; Microsequential injection (microST) provides microfluidic operations that are ideally suited for cellular function studies and as a means of validating targets for drug discovery . MicroSI carried out within the lab-on-valve (LOV) manifold, is an ideal platform for spectroscopic studies on living cells that are grown on microcarrier beads and kept thermostated while their metabolism is probed in real-time . In this paper a microbioreactor is integrated into the LOV manifold allowing measurement of cellular lactate extrusion and glucose consumption rates of a cell culture that is automatically renewed prior to each measurement . Glucose consumption and lactate extrusion are monitored using NAD-linked enzymatic assays . The microSI-LOV setup has demonstrated a linear analysis range of 0.05-1.00 mM for lactate and 0.1-5.6 mM for glucose . These assays were conducted in a serial fashion requiring 3 microL of cellular perfusate and 10 s for glucose determination and 30 s for the lactate assay . Overall waste generated per lactate/glucose assay is < 200 microL . This work was performed using two different transfected hepatocyte cell lines, which adhere to Cytopore microcarrier beads . This novel approach to metabolic screening allows for the rapid evaluation of the effects of dosing cells with chemical agents.

Transpl Infect Dis, 2002 Dec, 4(4), 195 - 200
The incidence of invasive aspergillosis among solid organ transplant recipients and implications for prophylaxis in lung transplants; Minari A et al.; BACKGROUND: Invasive aspergillosis (IA) is associated with significant morbidity and mortality in solid organ transplant recipients but data on the incidence rates stratified by type of solid organ are limited . OBJECTIVE: To describe the attack rates and incidence of IA in solid organ transplant recipients, and the impact of universal Aspergillus prophylaxis (aerosolized amphotericin B or oral itraconazole) in lung transplant recipients . PATIENTS: The 2,046 patients who received solid organ transplants at the Cleveland Clinic Foundation from January 1990 through 1999 were studied . METHODS: Cases were ascertained through computerized records of microbiology, cytology, and pathology reports . Definite IA was defined as a positive culture and pathology showing septate hyphae . Probable IA was clinical disease and either a positive culture or histopathology . Disseminated IA was defined as involvement of two or more noncontiguous anatomic sites . RESULTS: We identified 33 cases of IA (28% disseminated) in 2,046 patients (attack rate = 1.6%) for an incidence of 4.8 cases per 1,000 patient-years (33 cases/6,813 pt-years) . Both the attack and the incidence rates were significantly higher for lung transplant recipients vs . other transplant recipients: lung 12.8% (24 cases/188 patients) or 40.5 cases/1,000-pt year vs . heart 0.4% (3/686) or 1.4 per 1,000-pt year vs . liver 0.7% (3/439) or 2.1 per 1,000-pt year vs . renal 0.4% (3/733) or 1.2 per 1,000-pt year (P < 0.01) . The incidence of IA was highest during the first year after transplantation for all categories, but cases occurred after the first year of transplantation only in lung transplant recipients . The attack rate of IA in lung transplant recipients was significantly lower after institution of routine Aspergillus prophylaxis (4.9% vs . 18.2%, P < 0.05) . CONCLUSIONS: The highest incidence and attack rate of invasive aspergillosis among solid organ transplant recipients occurs in lung transplant recipients and supports the routine use of Aspergillus prophylaxis for at least one year after transplantation in this group.

Transpl Infect Dis, 2002 Dec, 4(4), 189 - 94
Clinical characteristics of 13 solid organ transplant recipients with ganciclovir-resistant cytomegalovirus infection; Isada CM et al.; BACKGROUND: Ganciclovir-resistant (GCV-R) cytomegalovirus (CMV) is now being reported with increasing frequency in solid organ transplant recipients . OBJECTIVE: To describe the clinical characteristics and outcomes of all solid organ transplant patients with GCV-R CMV seen between 1990 and 2000 at a single center . METHODS: Patients with clinically suspected GCV resistance had viral isolates subjected to phenotypic analysis by plaque reduction assay, and also genotypic analysis . Medical records of the 13 patients with GCV-R CMV were reviewed for demographic, microbiologic, clinical, and pathologic data . RESULTS: Thirteen patients were identified, including 5 kidney, 1 heart, and 7 lung transplant recipients . All but one patient (92%) were CMV donor seropositive, recipient negative (D+/R-), and 11/13 (85%) had tissue-invasive CMV . CMV viremia was recurrent in 9/13 (69%); in 2 others, the first CMV episode was fatal . Overall, 9/13 (69%) of patients have died, all of CMV or its complications . Of the 10 who received foscarnet, only one survived . All patients had received GCV-based prophylactic regimens; 8/13 patients (62%) had received CMV hyperimmune globulin (CMVIG) as part of prophylaxis, 6/13 (46%) had received oral ganciclovir, and 5/13 (38%) had received intermittent (3 x/week) IV ganciclovir for prophylaxis . CONCLUSIONS: GCV-R CMV is associated with CMV D+/R- status, tissue-invasive disease, and high mortality even with foscarnet therapy . Exposure to less than fully therapeutic levels of GCV, in the form of oral or intermittent IV GCV, is common . The use of CMVIG in prophylaxis does not appear to prevent resistance . Further work remains to be done to elucidate the risk factors and optimal mode of prophylaxis and treatment for GCV-R CMV.

Mol Microbiol, 2003 Feb, 47(3), 755 - 65
The DnaAcos allele of Escherichia coli: hyperactive initiation is caused by substitution of A184V and Y271H, resulting in defective ATP binding and aberrant DNA replication control; Simmons LA et al.; Chromosomal DNA replication is regulated at the level of commitment to this biochemical pathway . In Escherichia coli, DnaA protein appears to regulate this process . A mutant form, DnaAcos, carrying four amino acid substitutions, is apparently defective in responding to regulatory signals, because it induces hyperactive initiation from the bacterial replication origin (oriC) . In this report, the phenotype of hyperactive initiation is shown to be the result of two specific amino acid substitutions . One (A184V) immediately adjacent to a Walker A box (P loop motif) causes a defect in ATP binding (Carr and Kaguni, 1996, Mol Microbiol 20: 1307-1318) . The second amino acid substitution (Y271H) appears to stabilize the activity of the mutant protein carrying the A184V substitution . The mutant protein carrying both amino acid substitutions (A184V + Y271H) is defective in modulating the frequency of initiation from oriC, as demonstrated by marker frequency analysis of oriC and a locus near the replication terminus . These results indicate that a defect in ATP binding results in aberrant control of DNA replication.

Biol Blood Marrow Transplant, 2003 Jan, 9(1), 46 - 51
Gastrointestinal involvement in chronic graft-versus-host disease: a clinicopathologic study; Akpek G et al.; The original histopathologic description of chronic graft-versus-host disease (CGVHD) of the gastrointestinal (GI) tract was from autopsy series . There is little information on the evaluation of living patients with CGVHD and GI symptoms . We reviewed data on 40 consecutive patients with CGVHD and persistent GI symptoms who underwent endoscopic examinations . The diagnosis of CGVHD in these 40 patients was made on the basis of clinical criteria and confirmed by histology of other involved organs in 70% . Patients had progressive (in 19 patients, or 48%), quiescent (in 11, or 27%) or de novo-type (in 10, or 25%) onset of their CGVHD . Four groups were defined based on the following histologic criteria: (1) consistent with acute GI GVHD if there was marked apoptosis with or without cryptitis, (2) suggestive of acute GI GVHD if there was scattered apoptosis with or without cryptitis, (3) suggestive of chronic GI GVHD if there were at least 2 histologic indicators of chronicity such as fibrosis and significant crypt distortion, and (4) no histologic evidence of GVHD . Results of microbiologic, radiologic, and malabsorption studies, if performed, were also retrieved . Median time from diagnosis of CGVHD to GI endoscopy was 4.5 months (0-109 months) . The major GI symptoms at the time of endoscopy were diarrhea, abdominal pain/cramping, nausea/vomiting, weight loss, dysphagia, and early satiety . The endoscopic examination was nonspecific for the diagnosis of GI GVHD except for diffuse mucosal sloughing . Based on the histologic criteria in 22 patients with biopsies, 13 cases (59%) were considered to have acute GI GVHD, and 3 cases (14%) were felt to show possible chronic GI GVHD; changes of both acute and chronic GVHD were seen in 6 (27%) cases . GI dysmotility was diagnosed in 7 (18%) patients, including 2 of the patients who had histologic changes suggestive of chronic GVHD . Other causes of the GI symptoms included infection, drug side effect, and malabsorption . In conclusion, GI involvement by acute GVHD appears to be a major cause of persistent GI symptoms in patients with chronic GVHD . An isolated form of chronic GI GVHD confirmed by histology is an uncommon phenomenon in the actual clinical setting .

Braz J Med Biol Res, 2003 Jan, 36(1), 13 - 22 Epub 2002 Dec 19.
The conservative physiology of the immune system; Vaz NM et al.; Current immunological opinion disdains the necessity to define global interconnections between lymphocytes and regards natural autoantibodies and autoreactive T cells as intrinsically pathogenic . Immunological theories address the recognition of foreignness by independent clones of lymphocytes, not the relations among lymphocytes or between lymphocytes and the organism . However, although extremely variable in cellular/molecular composition, the immune system preserves as invariant a set of essential relations among its components and constantly enacts contacts with the organism of which it is a component . These invariant relations are reflected, for example, in the life-long stability of profiles of reactivity of immunoglobulins formed by normal organisms (natural antibodies) . Oral contacts with dietary proteins and the intestinal microbiota also result in steady states that lack the progressive quality of secondary-type reactivity . Autoreactivity (natural autoantibody and autoreactive T cell formation) is also stable and lacks the progressive quality of clonal expansion . Specific immune responses, currently regarded as the fundament of the operation of the immune system, may actually result from transient interruptions in this stable connectivity among lymphocytes . More permanent deficits in interconnectivity result in oligoclonal expansions of T lymphocytes, as seen in Omenn's syndrome and in the experimental transplantation of a suboptimal diversity of syngeneic T cells to immunodeficient hosts, which also have pathogenic consequences . Contrary to theories that forbid autoreactivity as potentially pathogenic, the physiology of the immune system is conservative and autoreactive . Pathology derives from failures of these conservative mechanisms.

Immunol Lett, 2003 Jan 22, 85(2), 207 - 11
A novel TB vaccine; strategies to combat a complex pathogen; Olsen AW et al.; Years of intense research aimed at developing a new and improved vaccine against tuberculosis (TB) are now moving from the laboratories and into the field . Many groups have provided strong evidence for the potential of novel vaccines using a variety of different strategies and the most promising are just beginning to enter human safety trials . As research has developed over the years, the complexity of the TB situation at the global level and its influence on vaccine development strategies has become more and more clear . From being mainly focused on the development of a vaccine that could be given at birth and provide lifelong protection, it is now clear that the current goal may need to be a vaccine to be given to a population where the majority is already sensitized either by previous infection, exposure to other mycobacteria or by Bacille Calmette-Guerin vaccination . With the increasing awareness of the different immune mechanisms operating under those circumstances, such a vaccine still represents a significant challenge for immunologists and microbiologists working in this field.

J Am Chem Soc, 2003 Jan 22, 125(3), 685 - 95
Nanomolar inhibitors of AmpC beta-lactamase; Morandi F et al.; beta-lactamases are the most widespread resistance mechanism to beta-lactam antibiotics, such as the penicillins and the cephalosporins . In an effort to combat these enzymes, a combination of stereoselective organic synthesis, enzymology, microbiology, and X-ray crystallography was used to design and evaluate new carboxyphenyl-glycylboronic acid transition-state analogue inhibitors of the class C beta-lactamase AmpC . The new compounds improve inhibition by over 2 orders of magnitude compared to analogous glycylboronic acids, with K(i) values as low as 1 nM . On the basis of the differential binding of different analogues, the introduced carboxylate alone contributes about 2.1 kcal/mol in affinity . This carboxylate corresponds to the ubiquitous C3(4)' carboxylate of beta-lactams, and this energy represents the first thermodynamic measurement of the importance of this group in molecular recognition by class C beta-lactamases . The structures of AmpC in complex with two of these inhibitors were determined by X-ray crystallography at 1.72 and 1.83 A resolution . These structures suggest a structural basis for the high affinity of the new compounds and provide templates for further design . The highest affinity inhibitor was 5 orders of magnitude more selective for AmpC than for characteristic serine proteases, such as chymotrypsin . This inhibitor reversed the resistance of clinical pathogens to the third generation cephalosporin ceftazidime; it may serve as a lead compound for drug discovery to combat bacterial resistance to beta-lactam antibiotics.

Am J Clin Pathol, 2003 Jan, 119(1), 38 - 44
Diagnosis of invasive mold infection by real-time quantitative PCR; Pham AS et al.; We report the design and evaluation of a quantitative real-time polymerase chain reaction (PCR) assay to diagnose invasive mold infection (IMI) by detecting mold DNA in the serum . This assay detected 200 fg to 20 ng (5-log range) mold DNA and permitted a cutoff of 110 fg (3 genomes) . Human or candidal DNA was not amplified . Specificity also was demonstrated by negative results in all 35 patients (76 serum samples) with unlikely IMI at the cutoff . For patients with possible, probable, and documented IMI diagnosed by a combination of clinical, microbiologic, and histologic criteria, this real-time PCR showed positivity in 40% (12/30), 68% (19/28), and 85% (11/13) cases, respectively, in testing of multiple serum samples . The overall serum positivity rate for these patients was 15.1% (73/483) . Quantitative analysis of the positive serum samples estimated the bodily circulating mold burden to be 1.6 x 10(5) genomes (5.3 ng) by geometric mean with 4.2 x 10(7) genomes (1,400 ng) the highest . These results suggest that for the diagnosis of IMI, this real-time PCR may be a promising alternative to other invasive methods . Further evaluation is underway.

Dent Clin North Am, 2003 Jan, 47(1), 103 - 14, x
Destructive periodontal diseases in minority populations; Craig RG et al.; Disparities in the prevalence and severity of destructive periodontal diseases have been reported for American minority populations and have raised the following questions . Are differences in destructive periodontal disease prevalence and severity due to genetic or other confounding variables associated with ethnicity race? Do risk factors for destructive periodontal diseases differ among American minority populations or differ from the population at large? Answers to these questions will have profound impact on the direction of future research and the allocation of resources to address disparities in destructive periodontal diseases in American minority populations . Risk assessment studies that examined a set of clinical, demographic, immunologic, and microbiologic parameters of Asian Americans, African Americans, and Hispanic Americans resident in the greater New York City region suggest that occupational status, monitored as a surrogate variable for socioeconomic status, may be a more robust risk factor than ethnicity/race for destructive periodontal diseases in these populations.

Saudi Med J, 2002 Dec, 23(12), 1499 - 503
Perianal sinuses in neonates and infants; Al-Wattar KM; OBJECTIVE: The aim of this study is to evaluate the etiology of perianal abscess or discharges in neonates and infants and some of them are perianal sinuses with blind inner end without connection to the anal canal, and some of these cases have a different histological pattern . Complete surgical excision and primary closure of their wounds can cure these patients . METHODS: Between January 1988 and December 2000, (81) neonates and infants (aged 2 weeks to 2 years) with perianal sinuses, fistula-in-ano abscess dealt in the Al-Zahrawi and Al-Khansa Teaching Hospitals, Mosul, Iraq, were studied . Fifty-one patients displayed an onset of symptoms during their first year of age, all cases had a gentle probing and proctoscopy under general anesthesia, and the discharge from abscess from the patients were sent for culture . Thirty patients with proper sinuses had excision of the sinus and primary closure; children with fistulae underwent fistulectomy; perianal abscesses drained . All the excised specimens were examined histopathologically . RESULTS: All children, except 3, were boys . Out of the 81 cases studied, 30 patients (37%) proved to have proper sinuses with blind inner end . Eight of these showed a different histological pattern, and in 2 cases, the histopathology was that of rectal duplication, the microbiology of the discharge from the proper sinuses was showing a predominance of non-gut derived organisms . All patients cured by excision of the sinuses and primary closure . CONCLUSION: Fistulae are the most common perianal discharging lesions in neonates and infants, blind sinuses are another cause in a considerable number . We propose a diagnostic strategy and treatment for those children presenting with discharging perianal lesions; for anticipation of these sinuses 3 points need to be considered before attempting surgery . 1) Blind sinus tract on gentle probing . 2) Normal anal and rectal mucosa on proctoscopy . 3) High bacterial yield of non-gut derived organisms on culture of the pus or discharge . Their treatment is by simple excision (coring) and primary closure; this method will shorten the healing and recovery time.

ASDC J Dent Child, 2002 May-Aug, 69(2), 138 - 42, 123
Atypical presentations of pediatric actinomycosis: report of a case; Sezer B et al.; It is well recognized that cervicofacial actinomycosis is rare in children, especially at maxilla . Actinomycosis involving the maxilla usually is seen as a localized intraoral infection in contrast to classical cervicofacial actinomycosis . In this article, we describe an 8-year-old patient who had actinomycosis involving the bone at the left maxillary lateral incisor region . The diagnosis was based on histologic report because of location and development of the lesion with unusual history . The treatment of choice was removal of the soft and hard tissues with concomitant prolonged penicillin administration . In cases of persistent oral infection the diagnosis of actinomycosis should be actively attempted through microbiologic and histologic examination.

Sex Transm Dis, 2003 Jan, 30(1), 1 - 5
Influence of HIV-1 coinfection on effective management of abnormal vaginal discharge; Moodley P et al.; BACKGROUND: Reports on microbiologic cure rates following syndromic management (SM) of women with nonulcerative sexually transmitted infections (STIs) are limited . GOAL: The goal of the study was to determine the effectiveness of the drugs used in SM of nonulcerative STIs and bacterial vaginosis in women and to compare the response among those with and without HIV-1 coinfection . STUDY DESIGN: This was a cohort study of women with nonulcerative STIs who were treated according to local SM protocols . RESULTS: Of 692 women recruited, 415 (80%) returned 8 to 10 days later, and 290 (70%) consented to a second examination, in which specimens were obtained . Clinical cure was reported by 67%, and microbiologic cure ranged from 80% to 89% for the three discharge-causing STIs and was independent of HIV-1 status . Only 38% of those with bacterial vaginosis were cured, and HIV-1-infected women were less likely to be cured (28% versus 52%; P < 0.001) . CONCLUSIONS: Clinical and microbiologic response to SM of the nonulcerative STIs was not affected by HIV-1 coinfection, but cure rates for bacterial vaginosis were reduced.

Biochem J, 2003 Apr 1, 371(Pt 1), 143 - 50
Mutations of penicillin acylase residue B71 extend substrate specificity by decreasing steric constraints for substrate binding; Morillas M et al.; Two mutant forms of penicillin acylase from Escherichia coli strains, selected using directed evolution for the ability to use glutaryl-L-leucine for growth {Forney, Wong and Ferber (1989) Appl . Environ . Microbiol . 55, 2550-2555}, are changed within one codon, replacing the B-chain residue Phe(B71) with either Cys or Leu . Increases of up to a factor of ten in k (cat)/ K (m) values for substrates possessing a phenylacetyl leaving group are consistent with a decrease in K (s) . Values of k (cat)/ K (m) for glutaryl-L-leucine are increased at least 100-fold . A decrease in k (cat)/ K (m) for the Cys(B71) mutant with increased pH is consistent with binding of the uncharged glutaryl group . The mutant proteins are more resistant to urea denaturation monitored by protein fluorescence, to inactivation in the presence of substrate either in the presence of urea or at high pH, and to heat inactivation . The crystal structure of the Leu(B71) mutant protein, solved to 2 A resolution, shows a flip of the side chain of Phe(B256) into the periphery of the catalytic centre, associated with loss of the pi-stacking interactions between Phe(B256) and Phe(B71) . Molecular modelling demonstrates that glutaryl-L-leucine may bind with the uncharged glutaryl group in the S(1) subsite of either the wild-type or the Leu(B71) mutant but with greater potential freedom of rotation of the substrate leucine moiety in the complex with the mutant protein . This implies a smaller decrease in the conformational entropy of the substrate on binding to the mutant proteins and consequently greater catalytic activity.

Ann Ig, 2002 Sep-Oct, 14(5), 443 - 6
{Unusual sources of L . pneumophila in hospital environment}; Delia S et al.; Owing to the very frequent reports of Legionella's cases arising in italian hospitals we have done a microbiologic monitoring on some equipments utilized in a several ward, what represent a potential source of diffusion of germ . It has been analysed water collected from 135 bubblers for oxygen-therapy, 11 pediatric incubators and 10 dental chairs . The isolated strains ware 31 (19.23%), of which: 3 L . Pneumophila sgr . 1; 11 sgr . 3; 8 sgr . 6; 2 sgr . 7 . For 6 strains identified as Legionella, have not been possible to establish sgr.

Med Inform Internet Med, 2002 Jun, 27(2), 99 - 109
Using the Web to aid biochemists and microbiologists: an example of computer-based learning using PCR as an example; Oliver J et al.; The aim of this study was two-fold: to make available to the medical community a fast, efficient tool for troubleshooting PCR problems, and to demonstrate that hypermedia allow one to approach this kind of problem in a new, more useful way . The Web provides access to an enormous amount of information in the medical area, and in particular enables troubleshooting of new techniques in the medical laboratory . Currently it is possible to find textual information but it is not always easy to find hypermedia information . In many cases authors change only the means of dissemination of a book or paper to the Web, but do not adapt the information to the features of this new medium . The prototype of our hypermedia application was developed using Director and Flash programs (Macromedia), the application was developed from a decision tree built as a result of information compiled from expert PCR users and the existing literature . It was implemented on a website using Dreamweaver (Macromedia) . The usefulness and possibilities of this application have been tested with physicians, medical laboratory technicians, and health science students, and have been proven to be more effective than traditional methods, both in education processes and in helping researchers and medical laboratory technicians in their daily work . The advance and popularization of the Internet in the medical profession requires information on the Web to adapt to the advantages offered by hypermedia . This new step must be taken, and the Web must offer medical users not only a different medium of information distribution but also a new way of handling and obtaining information.

Saudi Med J, 2002 Nov, 23(11), 1356 - 60
Prevalence of Hepatitis C virus antibodies among different populations of relative and attributable risk; Daw MA et al.; OBJECTIVE: To determine the prevalence of hepatitis C virus (HCV) antibodies among 5 different population groups including; healthy individuals, blood donors, hospital health care workers, renal dialysis patients and multiple blood transfusion group . To compare the ratios, relative and attributable risk among these groups . To outline a specific policy to reduce the potential risk of HCV among the different groups studied . METHODS: A prospective study was carried out in the Department of Microbiology, Faculty of Medicine, Tripoli, Libya, over a 2 year period for 1999 to 2001, to determine the prevalence of HCV-antibodies in sera collected from 5 distinct groups using enzyme-linked immunosorbent assay test . The groups included 800 healthy adults, 1200 individuals of blood donors, 459 hospital health care workers, 200 patients on renal dialysis and multiple blood transfusion group which included 250 patients . The prevalence of HCV was correlated with relative and attributable risk that contributed to the infectivity of HCV . RESULTS: A total of 2909 individuals participated in this study with 1.6:1 male to female ratio . The prevalence of HCV varied from one group to another . It was found to be 1.6% among the general population, 1.2% among blood donors, 2% among hospital health care workers, 20.5% among renal dialysis patients and 10.8% in the multiple blood transfusion group . The relative risk and attributable risk among these groups varies from 1.25 to 12.8 and from 0.4-18.9 . CONCLUSION: This study underlines the prevalence of HCV among different groups . The prevalence varies from one group to another, being the lowest among the blood donors and general population and the highest among the higher risk group in particular the renal dialysis patients . Specific measures should be implemented to reduce such risks . These may include specific programs for medical education, a meticulous infection control system in the hospitals, a registry program and clinical follow-up for patients positive for HCV.

J Gastrointest Surg, 2002 Nov-Dec, 6(6), 862 - 7
Surgical management of abdominal tuberculosis; Hassan I et al.; Recent reports suggest an increased incidence of abdominal tuberculosis in the United States, particularly in high-risk groups . The aim of this study was to review the spectrum of abdominal tuberculosis and its surgical management at a tertiary referral center in the United States . The medical records of patients treated for abdominal tuberculosis at our institution between January 1992 and June 2001 were retrospectively reviewed . Eighteen patients were diagnosed with abdominal tuberculosis by microbiologic and/or histologic examination . The 10 men and eight women had a mean duration of symptoms of 4 months (range 1 to 24 months) . Five were born in the United States, and 13 were foreign born (7 Asians and 6 Africans) . The United States-born patients with abdominal tuberculosis, as compared to the foreign-born patients, were older (mean age 74 years vs . 35 years), more likely to have chronic medical illnesses (80% vs . 7%), and had concomitant pulmonary tuberculosis (60% vs . 0%) . Computed tomography was the most frequent imaging modality (88%); findings suggestive of abdominal tuberculosis were mesenteric/omental stranding (50%), ascites (37%), and retroperitoneal lymphadenopathy (31%) . Seventeen of the 18 patients required operative intervention, and one patient underwent CT-guided drainage of a psoas abscess . Laparoscopy was useful for diagnosis in eight patients; laparotomy was performed for complications of abdominal tuberculosis in six patients and to obtain a tissue diagnosis in three patients . Abdominal tuberculosis continues to represent a diagnostic challenge to clinicians . Among native-born white Americans, abdominal tuberculosis is primarily a disseminated disease of elderly, debilitated patients with chronic illnesses . Among foreign-born individuals, abdominal tuberculosis occurs in young, immunocompetent patients from endemic areas . Characteristic CT findings should be evaluated for abdominal tuberculosis in the appropriate clinical setting . Laparoscopy is an effective modality for diagnosis of peritoneal tuberculosis.

Cornea, 2003 Jan, 22(1), 80 - 1
Fungal keratitis associated with vernal keratoconjunctivitis; Sridhar MS et al.; PURPOSE: To report a case of fungal keratitis associated with vernal keratoconjunctivitis . CASE REPORT: A 22-year-old man with a history of vernal keratoconjunctivitis since October 1999 developed a shield ulcer in the left eye in June 2000, which resolved with intensive topical steroid therapy . He presented in August 2001 with onset of acute pain, redness, and decreased vision . The tarsal conjunctiva in the left eye showed large papillae . The cornea showed a white plaque-like lesion with an underlying stromal infiltrate involving the upper half of the cornea . The overlying epithelial defect measured 4.5 x 2.5 mm . The anterior chamber showed 1+ flare and cells and hypopyon measuring about 1 mm . RESULTS: Corneal scrapings were performed for microbiologic investigations . Smears of corneal scrapings revealed septate fungal filaments, and the culture showed a significant growth of Aspergillus flavus . CONCLUSIONS: Fungal keratitis may be associated with vernal keratoconjunctivitis . Though rare, fungal keratitis should be considered in the differential diagnosis of infections associated with vernal keratoconjunctivitis.

Cornea, 2003 Jan, 22(1), 72 - 5
Unilateral fungal and mycobacterial keratitis after simultaneous laser in situ keratomileusis; Pache M et al.; PURPOSE: To report a case of unilateral fungal and mycobacterial keratitis after simultaneous laser in situ keratomileusis (LASIK) . METHODS: Case report of a 37-year-old woman who developed corneal infiltrates located at the flap-stroma interface in her left eye 3 weeks after LASIK for myopia . The infiltration progressed despite topical antibiotic therapy; therefore, the flap was lifted and irrigated with antibiotic solution . Parallel corneal scrapings were taken . The patient's condition deteriorated, prompting a lamellar keratoplasty . RESULTS: Corneal scrapings demonstrated no growth . Microbiologic cultures of the corneal specimen were reported as negative, whereas histopathologic examination disclosed fungal filaments . Two months later, the patient presented corneal infiltrates of the left eye again . Because the situation worsened despite therapy, a penetrating keratoplasty was performed . Histopathologic examination of the host cornea revealed no pathogenic species; microbiologic cultures, however, demonstrated Mycobacterium chelonae . CONCLUSION: Fungi and M . chelonae are rare and insidious causes of infectious keratitis after LASIK . Our case emphasizes the possible difficulties in diagnosing and treating a combined or subsequent infection with both species.

Cornea, 2003 Jan, 22(1), 51 - 5
Candida parapsilosis keratitis; Bourcier T et al.; PURPOSE: To present clinical, microbiologic, and histopathologic features of keratitis due to Candida parapsilosis . METHODS: Clinicomicrobiologic evaluation of four patients (four eyes) with culture-proven C . parapsilosis keratitis . The patients were evaluated for symptoms, visual acuity, clinical observations, microbiologic examination of corneal scrapings, and pathologic examination of corneal buttons . RESULTS: Three cases were observed after penetrating keratoplasty, and one case occurred after inhalation of corticosteroids . Clinical presentation of C . parapsilosis keratitis showed a great diversity . There was one case of crystalline keratopathy and three cases of suppurative corneal infiltrate . Histopathology of corneal buttons showed interlamellar accumulations of yeast . Medical treatment included topical amphotericin B and systemic triazoles . Penetrating keratoplasty was required in three patients . CONCLUSION: Risk factors for C . parapsilosis keratitis may include corticosteroid use and prior corneal transplantation . The prognosis of C . parapsilosis keratitis with antifungal and surgical therapy may vary from good visual outcome to intraocular extension with phthisis bulbi.

J Gen Appl Microbiol, 1999 Dec, 45(6), 295 - 300
Taxonomic heterogeneity of strains comprising Gluconacetobacter hansenii; Navarro RR et al.; The taxonomic standing of Gluconacetobacter hansenii was clarified through phenotypic characteristics, quinones, DNA base composition, DNA relatedness, and the production of gluconic and ketogluconic acids from glucose . All strains that Gossele et al . (Syst . Appl . Microbiol., 4, 338-368, 1983) employed in the establishment of Acetobacter hansenii (=G . hansenii) were used in this study . Phenotypic differences were shown among the strains of G . hansenii, suggesting heterogeneity within the species . The major ubiquinone was Q-10 for all strains of G . hansenii, except for strain IFO 3296, which was characterized by Q-9 . This excluded IFO 3296 from the species G . hansenii and placed it in the genus Acetobacter . DNA relatedness revealed four distinct homology groups (I, II, III, and IV) among strains of the species . Group I was distinguished from the other genomic groups by a lower G1C range from 58.9 to 59.2 mol% . Groups II, III, and IV showed higher G+C contents of 60.4 to 62.2, 60.8, and 61.7 mol%, respectively . Groups I and IV produced both 2- and 5-ketogluconic acids from glucose, and Group III produced only 2-ketogluconic acid . Group II included strains that produced both 2- and 5-ketogluconic acids and strains that produced only 2-ketogluconic acid . It is clear that G . hansenii consists of genotypically heterogeneous strains comprising four homology groups (I, II, III, and IV) . Since group I contains the type strain (IFO 14820(T)=LMG 1527(T)) of the species, this group is designated as the species G . hansenii.

J Pediatr Gastroenterol Nutr, 2003 Jan, 36(1), 105 - 11
Breath test using a single 50-mg dose of 13C-urea to detect Helicobacter pylori infection in children; Canete A et al.; BACKGROUND: The 13C-urea breath test is an accurate, noninvasive method for the diagnosis of in adults . A dose of 75 to 100 mg of urea is generally used, especially in adults, but the optimal dose in children is still unknown . Our aim was to determine whether urea breath test performed with a single 50-mg dose of 13C-urea was sufficient and accurate for diagnosing infection in children . METHODS: Consecutive children 4 to 14 years of age undergoing upper intestinal endoscopy to evaluate symptoms of recurrent abdominal pain were prospectively included . Exclusion criteria included use of antibiotics or proton pump inhibitors during the last month, gastric surgery, and previous eradication therapy . Reference criteria for diagnosis of infection were based on histology, culture, and serology . Urea breath test (TAU-KIT; Isomed, S.L., Madrid, Spain) was performed as follows: citric acid (Citral pylori) dissolved in 100 mL of water was initially given . Ten minutes later, a baseline exhaled breath sample was collected, and thereafter 50 mg of 13C-urea dissolved in 50 mL of water was given . A second breath sample was obtained 30 minutes later . Breath samples were analyzed by isotope ratio mass spectrometry . The endoscopist, the pathologist, the microbiologist, and the person responsible for reading the serology and the urea breath test were all unaware of status by the other diagnostic methods . RESULTS: One hundred children were included (40% males; mean age, 9.2 +/- 2 years; mean weight, 33.9 +/- 12 kg) . Based on the reference criteria, 45% were infected, 37% were not infected, and 18% were indeterminate . Sensitivity, specificity, positive predictive value, and negative predictive value were, respectively, 91% (95% confidence interval {CI}, 79%-96%), 97% (95% CI, 86%-99%), 98% (95% CI, 87%-91%), and 90% (95% CI, 76%-96%) . Positive and negative likelihood ratios were of 33 and 0.09 . Any cutoff point between 2 and 14 delta units had the same high diagnostic accuracy . The area under the receiver operating characteristic curve was 0.94 . No adverse effects were reported . CONCLUSION: Urea breath test using 50 mg of urea is sufficient and accurate for the diagnosis of infection in children . Use of a small test dose significantly lowers the cost of the test.

Kulak Burun Bogaz Ihtis Derg, 2002 Nov-Dec, 9(6), 425 - 8
{A case of sinonasal lymphoma}; Oguz F et al.; Sinonasal lymphoma is a rare disease that poses difficulties in diagnosis . A fifty-year-old male patient presented with a mass in the nasal vestibulum that destroyed the left nasal ala . Nocardiosis was considered in the light of the initial biopsy findings; however, microbiologic studies were not consistent with pathologic examination . A subsequent biopsy was obtained, which resulted in the diagnosis of peripheral T-cell lymphoma . Following the diagnosis, the patient was referred to the oncology clinic to receive chemotherapy . He died during the second course of chemotherapy.

Biodegradation, 2002, 13(3), 171 - 90
Evaluation of methods to predict bacterial yield using thermodynamics; VanBriesen JM; Thermodynamic models can be used to predict bacterial yields and develop stoichiometric representation of biological reactions in the absence of empirical data . Several methods have been used by microbiologists, biotechnologists, and environmental engineers . This manuscript illustrates that these formulations are related . Yields predicted by estimation of Gibbs energy of dissipation and yields predicted by assumed efficiency of energy capture are comparable . Direct comparison of yield predictions from different methods shows the effects of assumptions inherent in the methodologies . Mathematical relationships between estimated values from the different methods help identify the best predictions from each method to bound the estimate of bacterial yield.

Transplantation, 2002 Dec 15, 74(11), 1645 - 7
Scedosporium apiospermum pneumonia and sternal wound infection in a heart transplant recipient; Talbot TR et al.; BACKGROUND: The most common fungi that cause invasive infection in transplant recipients are the spp, spp, and the endemic fungi such as and . Recently, however, other fungal pathogens have emerged as important causes of invasive disease in these immunocompromised individuals, including the dematiaceous fungi, such as and the spp, species of and, and the hyalohyphomycoses, such as (Pseudallescheria boydii) (1) . METHODS: We present a single patient case report and literature review . RESULTS: We illustrate the first reported case of a postoperative sternal wound infection and pneumonia caused by in a heart transplant recipient and review the significant clinical, microbiologic, and therapeutic aspects of infection with this important opportunistic pathogen . CONCLUSIONS: Postsurgical wound infection should be added to the growing list of infections in the transplant population caused by.

Cytopathology, 2002 Dec, 13(6), 371 - 4
Gaucher's disease: morphological findings in a case studied with fine needle aspiration; Ortiz J et al.; Fine needle aspiration (FNA) is a diagnostic tool whose inexpensiveness, simplicity and innocuousness have led it to be increasingly accepted in daily medical practice . This method, which is useful for the study of lesions that are accessible by radiological exploration or palpation, provides information about the cytological aspects of punctured lesions . Sometimes, such information can be extended to the histological area through study of cell blocks, true microbiopsies, which are of great diagnostic use . This was the technique used in the case described in the present report.

J Dent Educ, 2002 Nov, 66(11), 1252 - 9
Undergraduate basic science preparation for dental school; Humphrey SP et al.; In the Institute of Medicines report Dental Education at the Crossroads, it was suggested that dental schools across the country move toward integrated basic science education for dental and medical students in their curricula . To do so, dental school admission requirements and recommendations must be closely reviewed to ensure that students are adequately prepared for this coursework . The purpose of our study was twofold: 1) to identify student dentists' perceptions of their predental preparation as it relates to course content, and 2) to track student dentists' undergraduate basic science course preparation and relate that to DAT performance, basic science course performance in dental school, and Part I and Part II National Board performance . In the first part of the research, a total of ninety student dentists (forty-five from each class) from the entering classes of 1996 and 1997 were asked to respond to a survey . The survey instrument was distributed to each class of students after each completed the largest basic science class given in their second-year curriculum . The survey investigated the area of undergraduate major, a checklist of courses completed in their undergraduate preparation, the relevance of the undergraduate classes to the block basic science courses, and the strength of requiring or recommending the listed undergraduate courses as a part of admission to dental school . Results of the survey, using frequency analysis, indicate that students felt that the following classes should be required, not recommended, for admission to dental school: Microbiology 70 percent, Biochemistry 54.4 percent, Immunology 57.78 percent, Anatomy 50 percent, Physiology 58.89 percent, and Cell Biology 50 percent . The second part of the research involved anonymously tracking undergraduate basic science preparation of the same students with DAT scores, the grade received in a representative large basic science course, and Part I and Part II National Board performance . Using T-test analysis correlations, results indicate that having completed multiple undergraduate basic science courses (as reported by AADSAS BCP hours) did not significantly (p < .05) enhance student performance in any of these parameters . Based on these results, we conclude that student dentists with undergraduate preparation in science and nonscience majors can successfully negotiate the dental school curriculum, even though the students themselves would increase admission requirements to include more basic science courses than commonly required . Basically, the students' recommendations for required undergraduate basic science courses would replicate the standard basic science coursework found in most dental schools: anatomy, histology, biochemistry, microbiology, physiology, and immunology plus the universal foundation course of biology.

Ann Pathol, 2002 Oct, 22(5), 416 - 21
{Fine needle aspiration biopsy of the pancreas}; Monges G; In the majority of cases, fine needle aspiration biopsy of the pancreas is used to confirm or exclude the presence of malignancy . New therapeutic trials need a precise diagnosis before treatment . Material consists of smears, microbiopsy and monolayer cytology . Microbiopsies and monolayer cytology can also be used for complementary techniques . The sensitivity of the technique is better for solid masses than for cystic lesions.

FEBS Lett, 2002 Dec 18, 532(3), 324 - 32
Relationship between protein kinase C and derepression of different enzymes; Salgado AP et al.; The PKC1 gene in the yeast Saccharomyces cerevisiae encodes for protein kinase C which is known to control a MAP kinase cascade consisting of different kinases: Bck1, Mkk1 and Mkk2, and Mpk1 . This cascade affects the cell wall integrity but the phenotype of pkc1Delta mutants suggests additional targets that have not yet been identified {Heinisch et al., Mol . Microbiol . 32 (1999) 671-680} . The pkc1Delta mutant, as opposed to other mutants in the MAP kinase cascade, displays defects in the control of carbon metabolism . One of them occurs in the derepression of SUC2 gene after exhaustion of glucose from the medium, suggesting an involvement of Pkc1p in the derepression process that is not shared by the downstream MAP kinase cascade . In this work, we demonstrate that Pkc1p is required for the increase of the activity of enzymatic systems during the derepression process . We observed that Pkc1p is involved in the derepression of invertase and alcohol dehydrogenase activities . On the other hand, it seems not to be necessary for the derepression of the enzymes of the GAL system . Our results suggest that Pkc1p is acting through the main glucose repression pathway, since introduction of an additional mutation in the PKC1 gene in yeast strains already presenting mutations in the HXKII or MIG1 genes does not interfere with the typical derepressed phenotype observed in these single mutants . Moreover, our data indicate that Pkc1p participates in this process through the control of the cellular localization of the Mig1 transcriptional factor.

Hum Immunol, 2002 Dec, 63(12), 1103 - 10
Human and mouse plasmacytoid dendritic cells; Hochrein H et al.; By virtue of their enormous potential to produce type I interferons it is clear that plasmacytoid dendritic cells are major players in the host defense against viruses and various pathogens . Plasmacytoid dendritic cells were first identified in humans and very recently the mouse equivalents have been isolated . This review focuses, where possible, on a comparison between the cells in these two species . The mouse and human plasmacytoid DC are remarkably similar in surface phenotype and they display similar responses to pathogenic stimuli . The discovery of the mouse plasmacytoid dendritic cells has allowed for further biological properties of these cells to be investigated and it is now clear that they represent a long-lived family of cells that differentiate into novel dendritic cells upon microbiologic stimulation.

Gig Sanit, 2002 Sep-Oct, (5), 73 - 5
{Space-time water monitoring system at the Iriklinsk hydroelectric power station}; Deriabin DG et al.; The Microbiosensor B 17677 F test system was applied to make a space-time monitoring of the biotoxicity of water used for production and everyday purposes at the Iriklinsk hydroelectric power station (IHEPS) and to identify the leading causes determining the biotoxicity of tested samples . There were seasonal variations in the biotoxicity with the maximum in spring and with minimum in winter and spring and a relationship of the spring rise in the biotoxicity to water pH changes . There was also an association of the certain values of the biotoxicity of industrial water with the concentration of petroleum products that are major pollutants at the IHEPS . The datum points that characterize the maximum level of technogenic exposure were identified.

Transfusion, 2002 Dec, 42(12), 1581 - 4
Coagulant stability and sterility of thawed S/D-treated plasma; Nifong TP et al.; BACKGROUND: Units of frozen S/D-treated plasma (SDP) must be transfused within 24 hours after thawing . To avoid waste, an attempt was made to determine how long SDP could be therapeutically effective after thawing and storing it at 20 degrees C . STUDY DESIGN AND METHODS: The microbiologic safety and the activity of labile coagulation factors were evaluated in units stored at 20 degrees C of thawed SDP units and FFP within 24 hours of collection (FFP24) . Five SDP and FFP24 samples of each ABO blood group were cultured and assayed for coagulation factors daily over 5 days . Assays included FV, FVII, FVIIa, FVIII, F IX, FXI, protein S, antiplasmin, fibrinogen, prothrombin times (PTs), and activated partial thromboplastin times (aPTTs) . RESULTS: None of the 80 bacterial cultures demonstrated growth under either aerobic or anaerobic conditions . FV, FVIII, F IX, FXI, fibrinogen, and the aPTT appeared to be stable in both thawed FFP24 and SDP . The PT increased slightly in thawed FFP24 and insignificantly in SDP . FVII decreased slightly in FFP24 but remained in the normal range, and FVIIa was low and constant . FVII was increased in SDP and FVIIa was markedly increased . Protein S decreased from initial normal values in FFP24 to very low values . Protein S was very low immediately after thawing in the SDP and continued to decline . Antiplasmin was normal and stable in thawed FFP24 but was low in SDP and remained constant after thawing . CONCLUSION: Sterile SDP that is stored at 20 degrees C provides sufficient coagulant activity of labile FV and FVIII to transfuse it for up to 5 days after thaw . Caution is warranted by decreases in Protein S and antiplasmin, clinical evidence of coagulopathy in some recipients of SDP, and a recent manufacturer's warning.

Arch Surg, 2002 Dec, 137(12), 1341 - 6; discussion 1347
Predictive factors of mortality due to polymicrobial peritonitis with Candida isolation in peritoneal fluid in critically ill patients; Dupont H et al.; BACKGROUND: Candida peritonitis (CP) is generally considered to be a severe disease, but its impact on outcome in critically ill patients remains unknown . HYPOTHESIS: The predictive factors of mortality due to CP can be determined by study of a population of patients with CP . DESIGN: A retrospective review of a prospective surgical intensive care unit (ICU) database of patients (January 1, 1994, through December 31, 2000) . SETTING: University hospital in Paris, France . PATIENTS: Eighty-three patients with generalized CP . MAIN OUTCOME MEASURES: Demographic and microbiologic data and outcome were collected, and nonsurvivors were compared with survivors . RESULTS: Overall ICU mortality due to CP was 43 (52%) of 83 patients . In a stepwise multivariate logistic regression, the following 4 variables were independently associated with mortality: APACHE II (Acute Physiology and Chronic Health Evaluation II) score on admission of at least 17 (odds ratio {OR}, 28.4; 95% confidence interval {CI}, 5.7-142.5; P<.001), respiratory failure on admission (OR, 10.6; 95% CI, 2.2-51.2; P =.003), upper gastrointestinal tract site of peritonitis (OR, 7.7; 95% CI, 1.7-34.7; P =.007), and results of direct examination of peritoneal fluid that were positive for Candida (OR, 4.7; 95% CI, 1.2-19.7; P =.002) . CONCLUSIONS: These results confirm the severity of CP in ICU patients and emphasize the prognostic value of direct examination of peritoneal fluid for Candida in this context.

Am J Pathol, 2002 Dec, 161(6), 2153 - 67
Nipah virus infection: pathology and pathogenesis of an emerging paramyxoviral zoonosis; Wong KT et al.; In 1998, an outbreak of acute encephalitis with high mortality rates among pig handlers in Malaysia led to the discovery of a novel paramyxovirus named Nipah virus . A multidisciplinary investigation that included epidemiology, microbiology, molecular biology, and pathology was pivotal in the discovery of this new human infection . Clinical and autopsy findings were derived from a series of 32 fatal human cases of Nipah virus infection . Diagnosis was established in all cases by a combination of immunohistochemistry (IHC) and serology . Routine histological stains, IHC, and electron microscopy were used to examine autopsy tissues . The main histopathological findings included a systemic vasculitis with extensive thrombosis and parenchymal necrosis, particularly in the central nervous system . Endothelial cell damage, necrosis, and syncytial giant cell formation were seen in affected vessels . Characteristic viral inclusions were seen by light and electron microscopy . IHC analysis showed widespread presence of Nipah virus antigens in endothelial and smooth muscle cells of blood vessels . Abundant viral antigens were also seen in various parenchymal cells, particularly in neurons . Infection of endothelial cells and neurons as well as vasculitis and thrombosis seem to be critical to the pathogenesis of this new human disease.

Tuberculosis (Edinb), 2002, 82(4-5), 183 - 5
The mtp40 gene is not present in Mycobacterium bovis; Koivula T et al.; The mtp40 gene was initially reported to be lacking in classical Mycobacterium bovis strains, while being specific to classical M . tuberculosis strains . Later two clinical isolates reported to be M . bovis were shown to possess the mtp40 gene (A . Weil, B.B . Plikaytis, W.R . Butler, C.L . Woodley and T.M . Shinnik, J Clin Microbiol 1996; 34: 2309-2311) . The two strains were, however, not fully characterized biochemically or genotypically . By PCR amplification of whole cell lysates and subsequent spoligotyping, which classifies isolates within the M . tuberculosis complex, the two strains were found to possess the spacers 40-43 which typically are lacking in classicalM . bovis, but had a spoligotyping pattern compatible with M . africanum . We conclude that the two strains, previously designated M . bovis, should be designated M . africanum . This reinvestigation has implications for the phylogenetic classification of M . bovis.

Proc AMIA Symp . 2002;:737-41.
Introduction of a hierarchy to LOINC to facilitate public health reporting; Steindel S et al.; Public health reporting of laboratory results requires unambiguous identification of the test performed and the result observed . Some laboratories are currently using Logical Observation Identifier Names and Codes (LOINC) for the electronic reporting of laboratory tests and their results to public health departments . Initial use revealed inconsistent identification and use of LOINC concepts by laboratories and public health agencies and an inability to systematically extend, for public health use, the tables when adding new concepts . We applied simple, logical rules to existing LOINC concepts to facilitate the creation of a hierarchy of concepts and to allow the identification and specification of appropriate terms for public health reporting and subsequent data aggregation . The hierarchy also allows the systematic addition of new concepts further supporting public health reporting . Application of the hierarchy is illustrated by using all laboratory LOINC concepts assigned to the subset of microbiology test types (CLASS MICRO).

Bull Exp Biol Med, 2002 Jul, 134(1), 60 - 3
Drift of tetM determinant in urogenital microbiocenosis containing mycoplasmas during treatment with a tetracycline antibiotic; Taraskina AE et al.; We studied the correlation between genetic transfer of tetM determinant in Tn916 conjugative transposon by urogenital mycoplasmas (Mycoplasma hominis and Ureaplasma urealyticum) and changes in the bacterial repertoire during treatment with a tetracycline antibiotic . Basic conditions favoring the nonspecific transfer of tetM determinant into mollicute cells are determined and the allele polymorphism of tetM determinant in clinical strains of M . hominis and U . urealyticum is evaluated . The structure of tetM gene in clinical mycoplasma and ureaplasma strains is characterized by a peculiar mosaic pattern and differs from all previously described alleles of this gene . The results suggest that tetracycline resistance in mollicutes is determined by mechanisms alternative to genetic transfer of tetM determinant.

J Pediatr Adolesc Gynecol, 2002 Aug, 15(4), 231 - 3
Tetralogy of Fallot, imperforate anus, and Müllerian, renal, and cervical spine (MURCS) anomalies in a 15-year-old girl; L Gilliam M et al.; STUDY OBJECTIVE: To examine the etiology of MURCs anomalies and the management of a patient with these anomalies as well as cardiac and anorectal abnormalities causing primary amenorrhea and abdominal pain . DESIGN: Case study . RESULT: Relief of pelvic pain following GnRH agonist therapy and continuous oral contraceptives . CONCLUSION: MURCS (Mullerian, Renal, Cervical Spine) is a well-described grouping of multi-organ, nonlethal abnormalities that are infrequently detected in women with menstrual abnormalities . The association of MURCS with cardiac and anorectal abnormalities may be one of coincidence or may indicate that the abnormalities share common genetic or environmental (cellular or microbiologic) etiologies.

Vet Microbiol, 2003 Feb 2, 91(2-3), 91 - 100
Development of a semi-nested PCR for the improved detection of Mycoplasma bovis from bovine milk and mucosal samples; Hayman B et al.; A new forward primer, Mb-F, was designed to improve the sensitivity and reproducibility of the Mycoplasma bovis-specific PCR developed by Ghadersohi et al . {Vet . Microbiol . 56 (1997) 87} for testing clinical samples . A semi-nested (SN) PCR configuration was developed and this provided enhanced sensitivity and reproducibility . The detection limit of the SN PCR was in the range of 10-100cfu/ml and the correct amplicon was amplified from 9.15pg/microliter of total extracted DNA (mixture of M . bovis and bovine cellular DNA) . A dot blot assay was also developed and compared with the SN PCR on a number of randomly selected milk and mucosal samples . The dot blot had the same level of detection as the SN PCR . The specificity of the SN configuration was confirmed by Southern blot analysis and automated sequencing of the PCR product . The results from the tests on the samples from cattle, together with those from sheep, provided evidence that M . bovis is host-specific and that most cattle are colonised . The assay was shown to be specific, sensitive and reproducible and could be used successfully to detect M . bovis directly from clinical material without pre-enrichment.

Appl Environ Microbiol, 2002 Dec, 68(12), 5826 - 33
Rhodanobacter sp . strain BPC1 in a benzo{a}pyrene-mineralizing bacterial consortium; Kanaly RA et al.; A bacterial consortium which rapidly mineralizes benzo{a}pyrene when it is grown on a high-boiling-point diesel fuel distillate (HBD) was recovered from soil and maintained for approximately 3 years . Previous studies have shown that mobilization of benzo{a}pyrene into the supernatant liquid precedes mineralization of this compound (R . Kanaly, R . Bartha, K . Watanabe, and S . Harayama, Appl . Environ . Microbiol . 66:4205-4211, 2000) . In the present study, we found that sterilized supernatant liquid filtrate (SSLF) obtained from the growing consortium stimulated mineralization of benzo{a}pyrene when it was readministered to a consortium inoculum without HBD . Following this observation, eight bacterial strains were isolated from the consortium, and SSLF of each of them was assayed for the ability to stimulate benzo{a}pyrene mineralization by the original consortium . The SSLF obtained from one strain, designated BPC1, most vigorously stimulated benzo{a}pyrene mineralization by the original consortium; its effect was more than twofold greater than the effect of the SSLF obtained from the original consortium . A 16S rRNA gene sequence analysis and biochemical tests identified strain BPC1 as a member of the genus Rhodanobacter, whose type strain, Rhodanobacter lindaniclasticus RP5557, which was isolated for its ability to grow on the pesticide lindane, is not extant . Strain BPC1 could not grow on lindane, benzo{a}pyrene, simple hydrocarbons, and HBD in pure culture . In contrast, a competitive PCR assay indicated that strain BPC1 grew in the consortium fed only HBD and benzo{a}pyrene . This growth of BPC1 was concomitant with growth of the total bacterial consortium and preceded the initiation of benzo{a}pyrene mineralization . These results suggest that strain BPC1 has a specialized niche in the benzo{a}pyrene-mineralizing consortium; namely, it grows on metabolites produced by fellow members and contributes to benzo{a}pyrene mineralization by increasing the bioavailability of this compound.

Antonie Van Leeuwenhoek, 2002 Aug, 81(1-4), 143 - 53
Does experimental evolution reflect patterns in natural populations? E . coli strains from long-term studies compared with wild isolates; Souza V et al.; Our results show that experimental evolution mimics evolution in nature . In particular, only 1,000 generations of periodic recombination with immigrant genotypes is enough for linkage disequilibrium values in experimental populations to change from a maximum linkage value to a value similar to the one observed in wild strains of E . coli . Our analysis suggests an analogy between the recombination experiment and the evolutionary history of E . coli; the E . coli genome is a patchwork of genes laterally inserted in a common backbone, and the experimental E . coli chromosome is a patchwork where some sites are highly prone to recombination and others are very clonal . In addition, we propose a population model for wild E . coli where gene flow (recombination and migration) are an important source of genetic variation, and where certain hosts act as selective sieves; i.e., the host digestive system allows only certain strains to adhere and prosper as resident strains generating a particular microbiota in each host . Therefore we suggest that the strains from a wide range of wild hosts from different regions of the world may present an ecotypic structure where adaptation to the host may play an important role in the population structure.

Environ Toxicol, 2002 Dec, 17(6), 533 - 7
Cyst-based toxicity tests XIV--application of the ostracod solid-phase microbiotest for toxicity monitoring of river sediments in Flanders (Belgium); Chial B et al.; In view of the need for rapid and low-cost solid-phase assays for contaminated sediments, a new 6-day "culture/maintenance-free" microbiotest has been developed with the freshwater ostracod crustacean Heterocypris incongruens at the Laboratory for Biological Research in Aquatic Pollution at the Ghent University in Belgium . The sensitivity of the Ostracodtoxkit F has been compared with that of the 10-day sediment contact test with the amphipod crustacean Hyalella azteca and the two pore water assays (on the anostracan crustacean Thamnocephalus platyurus and the microalgae Raphidocelis subcapitata) selected by the Flemish Environmental Agency for initial hazard assessment of contaminated sediments . The exercise was performed on 26 sediments collected at random from various rivers of the Flemish hydrographic basin in Belgium . The toxicity data ranged from nontoxic to highly toxic for the solid-phase assays and showed that the mortality of the two test biota varied from "nearly identical" to "substantially different," depending on the sediment . The correlation coefficient for the data pairs was weakly positive (r = 0.60), mainly because of 5 samples for which a low mortality had been noted with the ostracod versus a much higher mortality for the amphipod . However, for 4 out of the 5 samples of concern, a substantial growth inhibition was recorded for H . incongruens, showing that this assay eventually performed as did the amphipod test in detecting the toxic character of the sediments . The comparison of toxicity data of the two solid-phase assays with those of the two pore water tests again confirmed that both types of bioassay provided complementary (nonredundant) information . On the basis of its various advantages (independence of stock culturing/maintenance, user-friendliness, precision, and time and cost savings) the new ostracod microbiotest appears to be a promising tool for routine toxicity assessment of contaminated sediments .

Environ Toxicol, 2002 Dec, 17(6), 528 - 32
Cyst-based toxicity tests XIII--development of a short chronic sediment toxicity test with the ostracod crustacean Heterocypris incongruens: methodology and precision; Chial B et al.; Experiments were carried out with neonates of the freshwater ostracod Heterocypris incongruens to verify and complete previous choices of test parameters for a new culture/maintenance-free solid-phase microbiotest for freshwater sediments . From trials with increasing volumes of reference sediment, it was concluded that 300 microL was the most appropriate amount of substrate to be put in 12-cup multiwell plates with 2 mL of standard freshwater . Tests in 3-9 replicates eventually showed that six parallels were needed to have good assay precision (repeatability) . Application of the final test protocol to oil-contaminated sediments from the St . Lawrence River in Canada revealed that the 6-day chronic ostracod microbiotest had less variation in repeated tests than did the 10-day contact assay with Hyalella azteca and hence can be considered more precise . Based on the 95% confidence intervals for mortality and growth of the ostracods in the controls (reference sediment) of the 56 tests carried out for the Canadian project, a validity threshold of 20% for mortality was eventually selected, in analogy with the acceptability limits applied in many chronic bioassays . A minimum length of 600 microm in the control sediment after 6 days' exposure was also taken as the threshold for good health of the test organisms and for reliable test conditions . The new microbiotest has been tailored in a handy and user-friendly new toxkit, the Ostracodtoxkit, which is particularly suited for cost-effective routine monitoring .

Environ Toxicol, 2002 Dec, 17(6), 520 - 7
Cyst-based toxicity tests XII--development of a short chronic sediment toxicity test with the ostracod crustacean Heterocypris incongruens: selection of test parameters; Chial B et al.; Experiments were carried out with neonates of the freshwater ostracod Heterocypris incongruens hatched from cysts in order to develop a new culture/maintenance-free solid-phase microbiotest for the toxicity assessment of contaminated sediments . Based on preliminary investigations, a number of test parameters were investigated for a short-chronic assay: hatching time, size of the cups of the multiwell test plates, feeding of the test organisms prior to the test, amount of supplemental algal food, volume of sediment, and duration of the test . On the basis of the findings, a test protocol was formulated for a 6-day assay in 12-cup multiwell plates with 10 organisms per cup and 3 replicates . The test organisms were collected 52 h after the start of the incubation of the cysts in standard freshwater at 25 degrees C under continuous illumination after a 4-h prefeeding with 1.3 mg/mL Spirulina . The test biota in the cups were exposed to 300 microL of test sediment in 2 mL of standard freshwater with 3 x 10(7) live algal cells (Raphidocelis subcapitata) as food supplement . Calibrated sand was used as a reference sediment . Mortality and growth of the ostracods were determined after 6 days' incubation at 25 degrees C in darkness . The selected test parameters for the new microbiotest were found adequate for toxicity determination of natural sediments compared with the 10-day contact test with the amphipod Hyalella azteca .

Am J Respir Crit Care Med, 2003 Feb 15, 167(4), 599 - 602 Epub 2002 Nov 21.
Factors associated with tuberculin conversion in Canadian microbiology and pathology workers; Menzies D et al.; The risk of occupational tuberculosis (TB) infection and associated factors was estimated among all microbiology and pathology technicians and compared with a sample of nonclinical personnel in 17 Canadian acute care hospitals . Participants underwent tuberculin skin testing and completed questionnaires . Prior skin tests and vaccinations and all patients with TB hospitalized in the preceding 3 years were reviewed . Of the work areas where direction of air flow and air changes per hour were measured, only 51% were adequately ventilated . Among participating lab workers the average annual risk of tuberculin conversion was 1.0% . This was associated with lower hourly air exchange rates (16.7 versus 32.5 in workers with no conversion, p < 0.001) work in pathology (adjusted odds ratio {OR}: 5.4; {95% confidence interval: 1.3, 22}, higher proportion of patients with missed diagnosis in the first 24 hours (per 20% increase-OR: 2.0; {1.3, 3.2}, treatment delayed 1 week or more (per 20% increase-OR: 2.0; {3.2, 3.2}), and higher mortality (per 20% increase-OR: 2.5; {1.1, 5.6}) . We conclude that laboratory workers, with no direct patient contact, have increased risk of tuberculin conversion in hospitals where a greater proportion of patients with TB die, or have delayed, or missed diagnosis, although this may be modified by workplace ventilation.

FEMS Microbiol Lett, 2002 Nov 19, 217(1), 65 - 9
Detection of novel oral phylotypes associated with periodontitis; Sakamoto M et al.; A phylogenetic approach based on 16S rRNA (rDNA) has been recently applied to investigate the diversity of cultivable and uncultivable species in the human oral cavity without cultivation . In a previous study {Sakamoto et al . (2000) Microbiol . Immunol . 44, 643-652}, we identified a number of novel oral phylotypes, representing as yet uncultured organisms . The purpose of this study was to design specific PCR primers for five phylotypes AP12, AP21, AP24, AP50, and RP58, which are deeply branched particularly in the phylogenetic tree, and determine the prevalence of these phylotypes in 45 patients with periodontitis and 18 healthy subjects . The specificity of each primer was validated by the sequence analysis of PCR products obtained from saliva and subgingival plaque samples . Among phylotypes tested, phylotype AP24, which is closely related to oral clone DA014 reported previously {Paster et al . (2001) J . Bacteriol . 183, 3770-3783}, was significantly associated with saliva and subgingival plaque samples from patients with periodontitis (P<0.01), but the difference was not statistically significant in the presence of other phylotypes . These data suggest that phylotype AP24 may play an important role in periodontal disease.

J La State Med Soc, 2002 Sep-Oct, 154(5), 226 - 8
Acute otitis externa; Daneshrad D et al.; Acute otitis externa is a common presenting disorder seen in many primary care offices . Serious complications may be avoided by appropriate diagnosis and treatment . This article will summarize the basic anatomy and physiology of the external auditory canal, the pathophysiology and microbiology of acute otitis externa, the clinical presentation and diagnosis of this disease, and its potential complications and treatment.

Nippon Rinsho, 2002 Nov, 60(11), 2230 - 5
{Costs and benefits in hospital infection control}; Kumasaka K et al.; Economic concerns have taken on increasing importance in infection control since the mid 1970s in the US . The US studies on the economics of infection control have been mainly of the following types: 1) Cost estimates, 2) Effectiveness estimates, 3) Cost-effectiveness analysis, 4) Cost-benefit analysis, 5) Cost-utility analysis, 6) Cost-containment studies, 7) Cost minimization analysis and 8) Meta-analysis . The Japanese Society of Environmental Microbiology was established in 1986 . There are, however, few papers on the economics of infection control in Japan . The main problems are shortage in human resources and the health care system . It is high time that a new research system of hospital infections will be established in Japan.

Eur J Gastroenterol Hepatol, 2002 Nov, 14(11), 1225 - 30
Is lactose intolerance implicated in the development of post-infectious irritable bowel syndrome or functional diarrhoea in previously asymptomatic people?
Parry SD, Barton JR, Welfare MR.
OBJECTIVE: The relationship between lactose intolerance and post-infectious irritable bowel syndrome (IBS) in adults is uncertain . Bowel symptoms may persist after bacterial gastroenteritis and as post-infectious IBS . Acquired lactose intolerance may follow viral enteric infections in children . We compared the frequency of lactose intolerance after bacterial gastroenteritis in adults with and without symptoms of IBS or functional diarrhoea at 3-6-months' follow-up . DESIGN: A prospective cohort study was conducted . METHODS: All subjects with bacterial gastroenteritis confirmed by stool culture from the microbiology laboratory and without prior IBS or functional diarrhoea were eligible to participate . IBS and functional diarrhoea were diagnosed via self-completed Rome II modular questionnaires . Lactose intolerance was determined from a rise in breath hydrogen and plasma glucose and symptoms . RESULTS: One hundred and twenty-eight subjects with bacterial gastroenteritis were followed prospectively, from which a smaller cohort of 42 subjects took part in this study . The cohort was comprised of 24/25 subjects who developed post-infectious IBS (n = 16) or functional diarrhoea (n = 8) (9 male, 15 female) and 18 random controls (8 male, 10 female) chosen from the group without IBS or functional diarrhoea . The mean age of the subjects was 44.4 years (range 25-76 years) . In the group with functional diarrhoea or IBS, four subjects had failure of the plasma glucose to rise but none had abnormal glucose hydrogen breath tests . In the control subjects, one had a positive combined test and six had failure of plasma glucose to rise alone . No subject developed symptoms during the test . CONCLUSIONS: Bacterial gastroenteritis did not cause persistent lactose intolerance in our study population . Lactose intolerance does not appear to be implicated in the aetiology of post-infectious bowel symptoms, including IBS . Advice to avoid dairy products in patients presenting with post-infectious IBS on the basis that they may have lactose intolerance appears unnecessary in patients from northern England.

Infect Immun, 2002 Dec, 70(12), 6726 - 33
Chromosomal DNA deletions explain phenotypic characteristics of two antigenic variants, phase II and RSA 514 (crazy), of the Coxiella burnetii nine mile strain; Hoover TA et al.; After repeated passages through embyronated eggs, the Nine Mile strain of Coxiella burnetii exhibits antigenic variation, a loss of virulence characteristics, and transition to a truncated lipopolysaccharide (LPS) structure . In two independently derived strains, Nine Mile phase II and RSA 514, these phenotypic changes were accompanied by a large chromosomal deletion (M . H . Vodkin and J . C . Williams, J . Gen . Microbiol . 132:2587-2594, 1986) . In the work reported here, additional screening of a cosmid bank prepared from the wild-type strain was used to map the deletion termini of both mutant strains and to accumulate all the segments of DNA that comprise the two deletions . The corresponding DNAs were then sequenced and annotated . The Nine Mile phase II deletion was completely nested within the deletion of the RSA 514 strain . Basic alignment and homology studies indicated that a large group of LPS biosynthetic genes, arranged in an apparent O-antigen cluster, was deleted in both variants . Database homologies identified, in particular, mannose pathway genes and genes encoding sugar methylases and nucleotide sugar epimerase-dehydratase proteins . Candidate genes for addition of sugar units to the core oligosaccharide for synthesis of the rare sugar 6-deoxy-3-C-methylgulose (virenose) were identified in the deleted region . Repeats, redundancies, paralogous genes, and two regions with reduced G+C contents were found within the deletions.

Ann Clin Microbiol Antimicrob . 2002 Sep 16;1(1):1 {Epub ahead of print}
Hepatic adverse events during highly active antiretroviral therapy containing nevirapine: a case report; Gokengin D et al.; BACKGROUND: Hepatotoxicity is one of the most serious complications of highly active antiretroviral therapy (HAART) . The aim of this report is to analyse an HIV infected patient on HAART including nevirapine and taking antidepressive agents, with acute toxic hepatitis . CASE PRESENTATION: A 39 year old patient diagnosed as HIV positive one month ago administered to the clinical ward of the Department of Infectious Diseases and Clinical Microbiology in Ege University Medical School with high fever, malaise, nausea, diarrheae and elevated liver enzymes (ALT 1558 U/L, AST 4288 U/L) . He has been using HAART including zidovudine+lamivudine (2 x 1/day) and nevirapine (2 x 200 mg/day, following dose escalation) for 22 days, sertralin and diazepam for 12 days and lithium for 10 days.The patient was hospitalized . Antiretroviral and antidepressant treatments were stopped . The day after admission, his fever dropped and his symptoms improved . Clinical improvement continued on the following days . The patient was discharged upon his request on the 14th day of hospitalization . The liver function tests returned to normal levels in two weeks following discharge . CONCLUSION: Close monitoring of liver enzymes during the first 12 weeks of nevirapine therapy is critical to prevent life threatening events.

Clin Transplant, 2002 Dec, 16(6), 419 - 24
Fungal brain abscess in transplant recipients: epidemiologic, microbiologic, and clinical features; Baddley JW et al.; Fungal brain abscess is an unusual but serious complication associated with solid organ and hematopoietic stem cell transplantation . To examine the epidemiology and clinical features of fungal brain abscess in transplant recipients, we reviewed retrospectively all cases of fungal brain abscess diagnosed during a 3-yr period among 1,620 adult patients who underwent allogeneic or autologous stem cell, liver, heart, lung, or renal transplantation at one institution . Seventeen cases of fungal brain abscess were identified and occurred a median of 140 d post-transplantation . Fungal brain abscess was more common among allogeneic stem cell transplant recipients (p < 0.01) . Aspergillus species were most commonly isolated, but unusual, opportunistic molds were also identified . Altered mental status was present in 65% of patients, and multiple brain lesions were commonly seen on imaging studies . Although fungal brain abscess is an uncommon disease in this population, outcome was poor, suggesting that early recognition of this disease might be helpful.

Am J Respir Crit Care Med, 2003 Mar 15, 167(6), 835 - 40 Epub 2002 Nov 14.
Nontuberculous mycobacteria . II: nested-cohort study of impact on cystic fibrosis lung disease; Olivier KN et al.; The prevalence of nontuberculous mycobacteria (NTM) is high (approximately 13%) in sputum of patients with cystic fibrosis (CF), but the impact on lung disease is unknown . We followed 60 incident NTM-positive and 99 culture-negative patients with CF for 15 months and assessed clinical impact of NTM by FEV1 and high-resolution computed tomography (HRCT) of the chest . Mycobacterium avium complex was seen in 75% of NTM-positive subjects . The annual rate of decline in FEV1 was not different among control versus NTM-positive subjects who did not, or did, meet American Thoracic Society microbiologic criteria for NTM disease (3 +/- 1, 3 +/- 2, and 5 +/- 2%, respectively) . More subjects with three or more positive cultures for NTM had two or more characteristic findings on entry HRCT (60%, 9/15) as compared with subjects with two positive cultures or less (32%) or negative cultures (19%; p < 0.02) . All subjects with three or more positive cultures and exit HRCTs (n = 6) showed progression of HRCT findings, whereas only 17% of subjects with two positive cultures or less had progression (p = 0.0006) . In summary, no significant short-term effect on FEV1 was detected in patients with multiple positive NTM cultures, but an abnormal HRCT was predictive of progression . Patients with CF and multiple positive NTM cultures, characteristic HRCT findings, and progression of HRCT changes should be monitored closely and considered for antimycobacterial therapy.

Int J Hematol, 2002 Aug, 76 Suppl 2, 9 - 10
The role of morphology, cytochemistry and immunohistochemistry in the diagnosis of lymphoproliferative disorders; Chi HS; The bone marrow examination is a valuable procedure in the diagnosis and management of patients who have NHL . Posttherapy bone marrow examination is useful for assessing a patient's response to chemotherapy and for monitoring previously treated patients for evidence of recurrent disease . The bone marrow examination should include trephine biosy section, trephine imprints, aspiration smears, clot sections and blood smears and all of these preparations should be studied by the same pathologist . In addition to the morphologic evaluation, the aspirated marrow is the best material for several important supplemental studies for characterization of NHLs, including immunophenotyping by flow cytometry, cytogenetics, most molecular studies, and microbiologic cultures . Flow cytometric immunophenotyping studies to determine lineage, clonality of B-cell processes, and approximate stage of neoplastic infiltrates are the most useful adjuvant to morphologic assessment for NHLs . This review concentrates on the characteristic morphology, cytochemistry, immunohistochemical assessment and immunophenotyping of each clinical entity according to WHO classification . For the differential diagnosis, reactive lymphoid lesions, including lymphocytic aggregates, reactive polymorphous lymphohistiocytic lesions, benign follicles with germinal centers and polyclonal immunoblastic proliferations will be discussed.

Analyst, 2002 Oct, 127(10), 1293 - 8
Real-time determination of glucose consumption by live cells using a lab-on-valve system with an integrated microbioreactor; Schulz CM et al.; This paper describes a microquantitative method for glucose determination in situ of living cells in real-time . In this novel technique adherent cells are cultured onto microcarrier beads and packed into a renewable microcolumn within a microsequential injection lab-on-valve system (microSI-LOV) . Glucose sensing is performed through the use of a two-step, NAD-linked enzymatic process . The course of the assay is monitored in real-time, by absorbance of NADH at 340 nm . The microsequential assay based on plug/nozzle design has a linear dynamic range for glucose of 0.1 to 5.6 mM . The design of the (microSI-LOV) system allows the assay to be carried out using only 40 microL of the enzyme reagent and 3 microL of sample . The technique was tested on a murine hepatocyte cell line (TABX2S) adhered to Cytopore beads . Rapid cellular glucose consumption, in this technique, is facilitated by a high cell density, which allows a large number of cells (10(4)-10(5)) to be retained in a very small volume (3 microL) . In turn, this cell density results in the rapid depletion of glucose from the cell medium over short time periods (< 2 min) . In conjunction with the assay development, the plug/nozzle design and its ramifications on mixing in general are presented and discussed.

Enferm Infecc Microbiol Clin, 2002 Nov, 20(9), 448 - 61
{Infectious disease assessment in solid organ transplant candidates}; Ayats-Ardite J et al.; BACKGROUND: Infections are one of the leading causes of morbidity and mortality in solid organ transplant recipients . Many of these infections can be prevented or their effects reduced by accurate preoperative evaluation of risk in the transplantation candidate . The elaboration of guidelines using a multidisciplinary approach can help to establish more rational diagnostic, therapeutic, and preventive measures in this setting . OBJECTIVE: To elaborate guidelines for the assessment of infectious diseases in transplant candidates, based on consensus among professionals in this field and under the auspices of Spanish scientific societies . MATERIAL AND METHODS: The Infections in Transplant Patients Group (GESITRA), within the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), appointed a panel of four microbiologists and infectious disease specialists to elaborate a draft of the guidelines, which was subsequently approved by all the members of this Group . With the support of the National Transplant Organization, the GESITRA document was then presented to various professionals in this field so they could provide their comments and suggestions . RESULTS: The final document, after incorporation of all appropriate modifications and suggestions, is presented herein . The guidelines focus on the following: a) diagnosis of active and latent infections, and identification of risk factors in the candidate; b) recommended approach for infections diagnosed during the evaluation process and their corresponding treatment; c) definition of infections contraindicating transplantation; and d) prevention of post-transplantation infectious complications by systematic vaccination and instruction on preventive measures provided to patients, their relatives, and persons living with them . DISCUSSION: Using a multidisciplinary approach that included the efforts of experts in the field and the collaboration of scientific societies, a comprehensive document containing specific recommendations was elaborated . Systematic review of the guidelines in the future is considered worthwhile by both the authors and supporters of this document.

South Med J, 2002 Oct, 95(10), 1158 - 62
Complement and immunoglobulin levels in serum and ascitic fluid of patients with spontaneous bacterial peritonitis, malignant ascites, and tuberculous peritonitis; Yildirim B et al.; BACKGROUND: We determined complement and immunoglobulin levels in ascitic fluid and serum of 47 patients with spontaneous bacterial peritonitis, malignant ascites, or tuberculous ascites . METHODS: Paracentesis was done to confirm the underlying cause of ascites . Biochemical, hematologic, and microbiologic investigations were also done . RESULTS: The highest serum and ascitic fluid C3 and C4 levels and ascitic fluid IgM, IgA, and IgG levels were found in patients with tuberculosis . Ascitic fluid C3 level was found to be higher in the tuberculous group than in the patients with spontaneous bacterial peritonitis or malignant ascites . Ascitic fluid C4 levels were higher in patients with tuberculosis than in those with spontaneous bacterial peritonitis . CONCLUSION: We believe that further studies of the in vivo kinetics of immunoglobulins and complement in ascitic fluid of various causes are necessary for a better understanding of the host defense mechanisms of these fluids.

J Chemother, 2002 Aug, 14(4), 361 - 5
Diffusion of isepamicin into cancellous and cortical bone tissue; Boselli E et al.; The degree of penetration of an antibiotic into the infection site is an important factor in its therapeutic efficacy, particularly in bone and joint infections . In the present study, we examined the bone tissue penetration of isepamicin at a dose of 15 mg/Kg, and the results were correlated to microbiologic data to estimate the clinical efficacy of isepamicin in bone infections . In this open-label, single-arm, noncomparative study, subjects of similar age, body weight, height and creatinine clearance who were undergoing elective total hip replacement received a single, parenteral 15 mg/Kg dose of isepamicin . Plasma and bone tissue samples were collected a mean 1.3 hours later and analyzed by a high-pressure liquid chromatography method . Twelve patients (3 men and 9 women; mean age, 73.5 years; mean body weight, 53.5 Kg, mean creatinine clearance, 58.5 mL/min) were enrolled . The mean +/- SD plasma concentration of isepamicin at the time of bone removal was 43.0 +/- 10.4 microg/mL . The mean +/- SD isepamicin concentrations were 11.6 +/- 7.1 microg/mL in cancellous bone tissue and 12.0 +/- 7.3 microg/mL in cortical bone tissue . The mean +/- SD ratios of isepamicin concentration in bone and plasma (bone/plasma) were 0.28 +/- 0.14 for cancellous bone tissue and 0.31 +/- 0.20 for cortical bone tissue . The concentrations achieved in both cancellous and cortical bone tissue were greater than the minimum concentrations required to inhibit the growth of 90% of strains (MIC90) of most of the susceptible pathogens commonly involved in bone infections.

J Cell Biol, 2002 Nov 11, 159(3), 403 - 10 Epub 2002 Nov 04.
Accumulation of endoplasmic membranes and novel membrane-bound ribosome-signal recognition particle receptor complexes in Escherichia coli; Herskovits AA et al.; In Escherichia coli, ribosomes must interact with translocons on the membrane for the proper integration of newly synthesized membrane proteins, cotranslationally . Previous in vivo studies indicated that unlike the E . coli signal recognition particle (SRP), the SRP receptor FtsY is required for membrane targeting of ribosomes . Accordingly, a putative SRP-independent, FtsY-mediated ribosomal targeting pathway has been suggested (Herskovits, A.A., E.S . Bochkareva, and E . Bibi . 2000 . Mol . Microbiol . 38:927-939) . However, the nature of the early contact of ribosomes with the membrane, and the involvement of FtsY in this interaction are unknown . Here we show that in cells depleted of the SRP protein, Ffh or the translocon component SecE, the ribosomal targeting pathway is blocked downstream and unprecedented, membrane-bound FtsY-ribosomal complexes are captured . Concurrently, under these conditions, novel, ribosome-loaded intracellular membrane structures are formed . We propose that in the absence of a functional SRP or translocon, ribosomes remain jammed at their primary membrane docking site, whereas FtsY-dependent ribosomal targeting to the membrane continues . The accumulation of FtsY-ribosome complexes induces the formation of intracellular membranes needed for their quantitative accommodation . Our results with E . coli, in conjunction with recent observations made with the yeast Saccharomyces cerevisiae, raise the possibility that the SRP receptor-mediated formation of intracellular membrane networks is governed by evolutionarily conserved principles.

Clin Diagn Lab Immunol, 2002 Nov, 9(6), 1175 - 82
Lipoarabinomannan-induced cell signaling involves ceramide and mitogen-activated protein kinase; Sirkar M et al.; Lipoarabinomannan (LAM) is a major cell wall-associated lipoglycan, produced in large amounts (15 mg/g of bacteria) in different species of mycobacteria . Our laboratory has previously reported that LAM from Mycobacterium smegmatis exerts its cytotoxic activity via inhibition of protein kinase C, a key signaling molecule inside the mononuclear cells (S . Ghosh, S . Pal, S . Das, S . K . Dasgupta, and S . Majumdar, FEMS Immunol . Med . Microbiol . 21:181-188, 1998) . In this study we report that LAM from Mycobacterium tuberculosis induces a signal transduction pathway in favor of survivability of the host cells via the generation of ceramide, a novel second messenger . The endogenous ceramide level in mononuclear cells was found to be enhanced during LAM treatment . The effects of LAM on protein tyrosine phosphorylation in human peripheral blood mononuclear cells were examined . LAM enhanced the tyrosine phosphorylation of p42 mitogen-activated protein kinase and phosphoinositol 3-kinase (PI3 kinase) and dephosphorylation of stress-activated protein kinase . LAM-induced phosphorylation of p42 (extracellular signal-regulated kinase 2) was further enhanced by wortmannin, a PI3 kinase inhibitor . To examine whether these effects are due to elevation of endogenous ceramide, we exposed the cells to cell-permeative C(2)-ceramide exogenously and studied the activities of different protein kinases . Fluorescence-activated cell sorter analysis and morphological studies showed that LAM induces cell survival . Therefore, these results suggest the ability of LAM to induce ceramide in the altered signaling pathway and help in cell survival.

Intern Med J, 2002 Nov, 32(11), 512 - 9
Laboratory cross-contamination of Mycobacterium tuberculosis: an investigation and analysis of causes and consequences; Poynten M et al.; BACKGROUND: The misdiagnosis of Mycobacterium tuberculosis infection has many ramifications . These include medical and psychological implications for patients and their families and financial and public health implications for health-care institutions . Microbiology laboratory procedures should minimize the possibility of laboratory cross-contamination of specimens and maximize the ability to recognize a cluster of false-positive cultures . Newer molecular typing methods provide rapid, accurate and effective means of identifying false-positive M . tuberculosis cultures . AIMS: To investigate a cluster of patients with positive M . tuberculosis cultures that were processed in the mycobacteriology laboratory on the same day . METHODS: Five patients' medical records and radiology results were reviewed to determine whether the cases were epidemiologically linked and whether there was clinical suspicion of tuberculosis . Restriction fragment length polymorphism (DNA fingerprinting) was performed using repetitive elements IS6110 and pTBN12 . Laboratory processing procedures were analysed . RESULTS: On the basis of DNA fingerprinting using IS6110, the isolates from all five patients were identical . Molecular typing using pTBN12 was performed on four of the five isolates . All four had identical patterns . There was no epidemiological link between the patients . At least three (and probably four) of the five patients were misdiagnosed with tuberculosis . CONCLUSION: Microbiology laboratories should ensure that appropriate methodologies are in place to avoid cross-contamination of specimens . Clinicians need to critically interpret any positive laboratory result, especially in an unlikely clinical setting.

Spinal Cord, 2002 Nov, 40(11), 604 - 8
Tuberculosis of the spine (Pott's disease) presenting as 'compression fractures'; Dass B et al.; STUDY DESIGN: Case reports and survey of literature . OBJECTIVE: Case reports of two women with tuberculosis (TB) of the spine (Pott's disease) presenting with severe back pain and diagnosed as compression fracture are described . Physicians should include Pott's disease in the differential diagnosis when patients present with severe back pain and evidence of vertebral collapse . SETTING: Ohio, USA METHODS: A review of the literature on the pathogenesis, pathophysiology, clinical presentation, diagnostic methods, treatment and prognosis of spinal TB was conducted . RESULTS: After initial delay, proper diagnosis of spinal TB was made in our patients . Microbiologic diagnosis confirmed M . tuberculosis, and appropriate medical treatment was initiated . CONCLUSIONS: Although uncommon, spinal TB still occurs in patients from developed countries, such as the US and Europe . Back pain is an important symptom . Vertebral collapse from TB may be misinterpreted as 'compression fractures' especially in elderly women . Magnetic resonance imaging scan (MRI) is an excellent procedure for the diagnosis of TB spine . However, microbiologic diagnosis is essential . Mycobacterium tuberculosis may be cultured from other sites . Otherwise, biopsy of the spine lesion should be done for pathologic diagnosis, culture and stain for M . tuberculosis . Clinicians should consider Pott's disease in the differential diagnosis of patients with back pain and destructive vertebral lesions . Proper diagnosis and anti-tuberculosis treatment with or without surgery will result in cure.

Am J Orthod Dentofacial Orthop, 2002 Oct, 122(4), 420 - 8
Periodontic and orthodontic treatment in adults; Ong MM et al.; The purpose of this article is to provide an update of the interrelationship between periodontics and orthodontics in adults . Specific areas reviewed are the reaction of periodontal tissue to orthodontic forces, the influence of tooth movement on the periodontium, the effect of circumferential supracrestal fiberotomy in preventing orthodontic relapse, the effect of orthodontic treatment on the periodontium, microbiology associated with orthodontic bands, and mucogingival and esthetic considerations . In addition, the relationship between orthodontics and implants (eg, using dental implants for orthodontic anchorage) is discussed.

J Clin Microbiol, 2002 Nov, 40(11), 4317 - 20
Serological differentiation of infections with dengue virus serotypes 1 to 4 by using recombinant antigens; Ludolfs D et al.; The B domains of dengue virus serotypes 1 to 4 were expressed in Escherichia coli . The purified proteins were applied to immunoblot strips to detect serotype-specific antibodies in paired serum samples from 41 patients with primary and secondary dengue infections . A close correlation between the results obtained with the immunoblot strips and by type-specific reverse transcription-PCR (T . Laue, P . Emmerich, and H . Schmitz, J . Clin . Microbiol . 37:2543-2547, 1999) was observed.

J Clin Microbiol, 2002 Nov, 40(11), 4100 - 4
Estimation of the rate of unrecognized cross-contamination with mycobacterium tuberculosis in London microbiology laboratories; Ruddy M et al.; Isolates from patients with confirmed tuberculosis from London were collected over 2.5 years between 1995 and 1997 . Restriction fragment length polymorphism (RFLP) analysis was performed by the international standard technique as part of a multicenter epidemiological study . A total of 2,779 samples representing 2,500 individual patients from 56 laboratories were examined . Analysis of these samples revealed a laboratory cross-contamination rate of between 0.54%, when only presumed cases of cross-contamination were considered, and 0.93%, when presumed and possible cases were counted . Previous studies suggest an extremely wide range of laboratory cross-contamination rates of between 0.1 and 65% . These data indicate that laboratory cross-contamination has not been a common problem in routine practice in the London area, but in several incidents patients did receive full courses of therapy that were probably unnecessary.

J Antimicrob Chemother, 2002 Nov, 50(5), 713 - 8
Vancomycin therapeutic drug monitoring: is there a consensus view? The results of a UK National External Quality Assessment Scheme (UK NEQAS) for Antibiotic Assays questionnaire; Tobin CM et al.; This study investigated vancomycin therapeutic drug monitoring (TDM) and issues related to patient management . Questionnaires were distributed to 310 participants in the UK National External Quality Assessment Scheme (NEQAS) for Antibiotic Assays . The response rate was 57.4% . The majority (76%) had an 'in-house' assay service based, almost exclusively, in the microbiology department, and a fluorescence polarization immunoassay (FPIA) was used by 97% . Almost half (48.7%) had an assay service available for 24 h/day, 7 days/week and 92.7% expected same-day results . The majority (80%) had issued guidelines for vancomycin use . A 12 hourly initial dosing regimen was used by 89% . Trough assay samples were taken <10 min before the dose by 91.5% . For post-dose assay samples, 44% took a sample at 1 h, 28% at 2 h and the remainder at 'other' times . For trough target ranges, 93% quoted <10 mg/L or 5-10 mg/L . There was no consensus with regard to post-dose assay sample times and 23 ranges were quoted . The majority (74.4%) regarded a trough level of >or=10 mg/L as 'toxic' but 13 concentrations were quoted as toxic post-dose measurements . In conclusion, there was a wide variability and poor consensus with regard to post-dose vancomycin assay sampling times, target ranges and what constituted a toxic level.

Am J Respir Crit Care Med, 2002 Dec 15, 166(12 Pt 1), 1550 - 5 Epub 2002 Aug 15.
Developing cystic fibrosis lung transplant referral criteria using predictors of 2-year mortality; Mayer-Hamblett N et al.; The first objective of our study was to develop a model identifying the best clinical predictors of 2-year mortality among patients with cystic fibrosis (CF), to assist in selection of appropriate candidates for lung transplantation . Using multivariate logistic regression, we found that age, height, FEV1, respiratory microbiology, number of hospitalizations for pulmonary exacerbations, and number of home intravenous antibiotic courses were all significant predictors of 2-year mortality among 14,572 patients in the Cystic Fibrosis Foundation National Patient Registry who were 6 years of age or older in 1996 . The second objective was to compare the diagnostic accuracy of our model when used to guide referral for lung transplant with that of the widely used criterion of an FEV1 of less than 30% predicted . Surprisingly, this well-fitting model derived from the largest collection of data available on patients with CF provided no better diagnostic accuracy than the simpler FEV1 criterion . Both had high negative predictive values (98 and 97%, respectively) but only modest positive predictive values (33 and 28%, respectively) . Transplant referral decisions based either on a multivariate logistic model or on the criterion of an FEV1 of less than 30% predicted are likely to result in high rates of premature referral . Better clinical predictors of short-term mortality among patients with CF are needed.

J Environ Monit, 2002 Oct, 4(5), 803 - 8
Distribution of mercury in chemical fractions of contaminated urban soils of Middle Amur, Russia; Kot FS et al.; The distribution of mercury (Hg) in fractions of urban soils from two industrial cities in the Russian Far East which are subject to varying degrees of Hg contamination was examined . The speciation scheme applied was based on routine chemical extraction methods used in soil investigations . Such an approach enables the Hg data to be brought into correlation with soil basic fractions and the fate of Hg bound to different soil components to be followed . Humic acids and a non-hydrolysable residue (humin), i.e . the soil fractions most refractory to microbiotic and chemical attack, were found to be principal Hg repositories in the soils studied . This pattern was equally observed for slightly, moderately and heavily contaminated soils . Hymatomelanic acids do not appear to be an efficient Hg concentrator . In heavily contaminated soils, Hg concentrations were evident in mobile fractions of fulvic acids as well as in those fractions extracted by H2O and 0.05 M Na2-EDTA pH 3 . A portion of Hg extracted by 1 M HCl increased in lower horizons, reflecting relatively weakly bound Hg.

Crit Care Med, 2002 Oct, 30(10), 2260 - 70
Prognosis of hematologic malignancies does not predict intensive care unit mortality; Massion PB et al.; OBJECTIVE: To evaluate the correlation between specific prognosis of hematologic malignancies on the one hand and intensive care unit and hospital mortality in critically ill patients with hematologic malignancies on the other hand . DESIGN: Observational study during a 10-yr period . SETTING: A 22-bed medical-surgical intensive care unit . PATIENTS: A total of 84 consecutive patients with nonterminal hematologic malignancies with medical complications requiring intensive care . INTERVENTIONS: None . MEASUREMENTS: Demographic factors, acute physiology and organ dysfunction scores, microbiology, therapeutic support, and hematologic factors data on admission and during the intensive care unit stay were collected, together with mortality follow-up . Based on specific-disease prognostic factors and related published survival curves, the prognosis of hematologic malignancies was assessed and defined as good, intermediate, or poor according to a 3-yr survival probability of >50%, 20-50%, or <20%, respectively . MAIN RESULTS: Prognosis of hematologic malignancies does not predict intensive care unit or hospital mortality and almost reaches significance for 6-mo mortality (53%, 71%, and 84% rate for patients with good, intermediate, and poor prognosis, respectively, p =.058), but it determines long-term survival (p =.008) . Intensive care unit, hospital, and 6-mo overall mortality rates were 38%, 61%, and 75%, respectively . Using multivariate analysis, intensive care unit mortality was best predicted on admission by respiratory failure and fungal infection, whereas hospital mortality was predicted by the number of organ failures, the bone marrow transplant status, and the presence of fungal infection . The Acute Physiology and Chronic Health Evaluation II and the Simplified Acute Physiology Score II had no prognostic value, whereas the difference of the Multiple Organ Dysfunction Score between at the time of admission and at day 5 allowed quick prediction of hospital mortality . Diseases with the poorest 6-mo prognosis were acute myeloid leukemia and non-Hodgkin lymphoma.CONCLUSION The severity of the underlying hematologic malignancies does not influence intensive care unit or hospital mortality . Short-term prognosis is exclusively predicted by acute organ dysfunctions and by a pathogen's aggressiveness . Therefore, reluctance to admit patients with nonterminal hematologic malignancies to the intensive care unit based only on the prognosis of their underlying hematologic malignancy does not seem justified.

Biosens Bioelectron, 2002 Dec, 17(11-12), 1005 - 13
Glucose microbiosensor based on alumina sol-gel matrix/electropolymerized composite membrane; Chen X et al.; A procedure is described that provides co-immobilization of enzyme and bovine serum albumin (BSA) within an alumina sol-gel matrix and a polyphenol layer permselective for endogenous electroactive species . BSA has first been employed for the immobilization of glucose oxidase (GOx) on a Pt electrode in a sol-gel to produce a uniform, thin and compact film with enhanced enzyme activity . Electropolymerization of phenol was then employed to form an anti-interference and protective polyphenol film within the enzyme layer . In addition, a stability-reinforcing membrane derived from (3-aminopropyl)-trimethoxysilane was constructed by electrochemically-assisted crosslinking . This hybrid film outside the enzyme layer contributed both to the improved stability and to permselectivity . The resulting glucose sensor was characterized by a short response time (<10 s), high sensitivity (10.4 nA/mM mm(2)), low interference from endogenous electroactive species, and a working lifetime of at least 60 days.

Biopolymers, 2002 Nov 15, 65(4), 244 - 53
Temperature-pressure stability of green fluorescent protein: a Fourier transform infrared spectroscopy study; Scheyhing CH et al.; Green fluorescent protein (GFP) is widely used as a marker in molecular and cell biology . For its use in high-pressure microbiology experiments, its fluorescence under pressure was recently investigated . Changes in fluorescence with pressure were found . To find out whether these are related to structural changes, we investigated the pressure stability of wild-type GFP (wtGFP) and three of its red shift mutants (AFP, GFP(mut1), and GFP(mut2)) using Fourier transform infrared spectroscopy . For the wt GFP, GFP(mut1), and GFP(mut2) we found that up to 13-14 kbar the secondary structure remains intact, whereas AFP starts unfolding around 10 kbar . The 3-D structure is held responsible for this high-pressure stability . Previously observed changes in fluorescence at low pressure are rationalized in terms of the pressure-induced elastic effect . Above 6 kbar, loss of fluorescence is due to aggregation . Revisiting the temperature stability of GFP, we found that an intermediate state is populated along the unfolding pathway of wtGFP . At higher temperatures, the unfolding resulted in the formation of aggregates of wtGFP and its mutants .

Chest, 2002 Oct, 122(4), 1280 - 4
Role of contrast-enhanced dynamic CT in the diagnosis of active tuberculoma; Tateishi U et al.; STUDY OBJECTIVES: To assess the role of contrast-enhanced dynamic CT in the diagnosis of active tuberculoma . SETTING: Hospitals with an isolated ward for tuberculosis . METHODS: Fifty-five subjects with newly diagnosed active tuberculoma and 24 subjects with inactive tuberculoma were examined and evaluated retrospectively . Six subjects with active tuberculomas and seven subjects with inactive tuberculomas were confirmed by histologic and microbiologic evaluation of resected specimens, whereas the remainder of the subjects with tuberculoma were confirmed clinically . The subjects were receiving iopamidol, 370 mg/mL IV, at a rate of 3.0 mL/s on contrast-enhanced dynamic CT . The time-attenuation curve was obtained and adapted to a gamma function . The peak height (PH), maximum attenuation subtracted by the background attenuation, relative flow (RF), and mean regional flow were used for comparison . Measurements and results: In the surgically confirmed group, the PH and RF values of six subjects with active tuberculomas were significantly higher than those of the seven subjects with inactive tuberculoma (p < 0.05) . Similarly, in the subjects with noninvasive diagnoses, the PH and RF values of 49 subjects with active tuberculoma were significantly higher than those of the subjects with inactive tuberculoma (mean +/- SD PH, 43.4 +/- 4.1 Hounsfield units {HU} vs 11.6 +/- 2.7 HU, p < 0.0001; RF, 0.012 +/- 0.001/s vs 0.006 +/- 0.001/s, p < 0.05) . When the cutoff value was defined as mean +/- 2 SD, the sensitivity and specificity of the diagnosis for active tuberculoma were 77.1% and 96.4% in PH, and 68.5% and 88.8% in RF, respectively . CONCLUSION: Contrast-enhanced dynamic CT is a potentially valuable tool for the diagnosis of active tuberculoma.

Enferm Infecc Microbiol Clin, 2002 Oct, 20(8), 403 - 6
{Movies as a teaching resource for infectious diseases and clinical microbiology}; Garcia-Sanchez JE et al.; Since its inception, the cinema has constantly provided a reflection of infectious diseases because of their omnipresence in life and their importance to individuals and society . Few infectious diseases escape its eye, to the extent that the cinema constitutes an authentic treatise on these phenomena . The cinema is a very valuable educational resource, able to supplement classical teaching methods and to encourage critical thinking among students . The enormous flow of information, images, sounds, consequences, situations, and points of view that it provides should not be wasted and can be of great use, both in the spread of ideas and in training in infectious diseases and clinical microbiology.

Infect Dis Clin North Am, 2002 Sep, 16(3), 645 - 65, viii-ix
Infective endocarditis in the injection drug user; Brown PD et al.; Although infective endocarditis is certainly not the most common infection seen in injecting drug users, it is the infection that clinicians most commonly think of when they consider infectious complications of injected drug use . The microbiology of infective endocarditis in injection drug users has remained relatively stable over the last several decades . Tricuspid valve endocarditis has been associated most frequently with injection drug use, but recent reports have suggested that involvement of left-sided valves is seen more often now than in the past . The use of transesophageal echocardiography has greatly advanced the ability to diagnose infective endocarditis and the cardiac complications of valvular infection.

Ther Umsch, 2002 Sep, 59(9), 454 - 8
{Vulvar biopsy as the basis of effective therapy}; Weyers W et al.; Clinical and microbiologic examinations are not always sufficient for a correct and specific diagnosis of diseases of the vulva . In the case of an unusual clinical presentation or an unusual course of the disease, a histopathologic examination is warranted . Importance, technique, and limitations of biopsies of the vulva are illustrated on the basis of three case reports.

Trends Pharmacol Sci, 2002 Oct, 23(10), 487 - 90
Antarctica: a review of recent medical research; Olson JJ; This article reviews recent developments and areas of research in Antarctic medical science . Nineteen nations are part of the Antarctic treaty and undertake research programmes in Antarctica . Medical science is a small but important part of these programmes . Areas that have been studied include aspects of cold physiology, ultraviolet light effects, endocrine changes (including polar T3 syndrome), alterations in immune function, chronobiology, psychology, microbiology, epidemiology and telemedicine . Antarctica has been recognized as the closest thing on Earth to a testing ground for aspects of space exploration and as such has been termed a space analogue.

Clin Microbiol Rev, 2002 Oct, 15(4), 647 - 79
Interactions among strategies associated with bacterial infection: pathogenicity, epidemicity, and antibiotic resistance; Martinez JL et al.; Infections have been the major cause of disease throughout the history of human populations . With the introduction of antibiotics, it was thought that this problem should disappear . However, bacteria have been able to evolve to become antibiotic resistant . Nowadays, a proficient pathogen must be virulent, epidemic, and resistant to antibiotics . Analysis of the interplay among these features of bacterial populations is needed to predict the future of infectious diseases . In this regard, we have reviewed the genetic linkage of antibiotic resistance and bacterial virulence in the same genetic determinants as well as the cross talk between antibiotic resistance and virulence regulatory circuits with the aim of understanding the effect of acquisition of resistance on bacterial virulence . We also discuss the possibility that antibiotic resistance and bacterial virulence might prevail as linked phenotypes in the future . The novel situation brought about by the worldwide use of antibiotics is undoubtedly changing bacterial populations . These changes might alter the properties of not only bacterial pathogens, but also the normal host microbiota . The evolutionary consequences of the release of antibiotics into the environment are largely unknown, but most probably restoration of the microbiota from the preantibiotic era is beyond our current abilities.

Arch Pediatr Adolesc Med, 2002 Oct, 156(10), 995 - 8
A randomized placebo-controlled trial of mebendazole for halitosis; Ermis B et al.; OBJECTIVE: To test whether mebendazole, an antiparasitic drug, would affect recovery from halitosis . DESIGN: We conducted a randomized, double-blind, placebo-controlled trial between April 1999 and September 2001 . SETTING: A referral medical center . PATIENTS: One hundred sixty-two children aged 5 to 16 years whose parents complained about their chronic bad breath . INTERVENTIONS: Children were randomly assigned to receive mebendazole (n = 82) or placebo (n = 80) . MAIN OUTCOME MEASURE: Parents whose children had halitosis were evaluated for halitosis at 2 months of treatment by questionnaire . The microbiologist investigated the stool samples of children for parasitosis at the beginning of the trial and also at the end of the trial in children who were treated with mebendazole . RESULTS: Among those children who had evidence of parasites in stool samples at the beginning of the trial, 18 of 28 who were treated with mebendazole recovered from halitosis, compared with 2 of 24 who received placebo (relative risk {RR} for recovery, 7.7; 95% confidence interval {CI}, 2.0-29.9) . Among those who did not have stool parasites, 14 of 52 improved with mebendazole, compared with 10 of 48 taking placebo (RR, 1.3; 95% CI, 0.6-2.6) . Mebendazole intake made a significant difference whether or not the children had parasites (P =.002) . CONCLUSIONS: Parasitosis should be considered as a possible cause of halitosis in the pediatric patient population . Mebendazole therapy seems to offer benefit to those children with parasites as a potential cause of their halitosis.

Farmaco, 2002 Aug, 57(8), 685 - 91
Combination of antibiotic mechanisms in lantibiotics; Hoffmann A et al.; Recent studies on the mode of action have revealed exciting features of multiple activities of nisin and related lantibiotics making these peptides interesting model systems for the design of new antibiotics (Molec . Microbiol . 30 (1998) 317; Science 286 (1999) 2361; J . Biol . Chem . 276 (2001) 1772.) . In contrast to other groups of antibiotic peptides, the lantibiotics display a substantial degree of specificity for particular components of bacterial membranes . Mersacidin and actagardine were shown to bind with high affinity to the lipid coupled peptidoglycan precursor, the so-called lipid II, which prevents the polymerisation of the cell wall monomers into a functional murein sacculus . The lantibiotics nisin and epidermin also bind tightly to this cell wall precursor; however, for these lantibiotics the binding of lipid II has two consequences . Like with mersacidin blocking of lipid II inhibits peptidoglycan biosynthesis; in addition, lipid II is used as a specific docking molecule for the formation of pores . This combination of lethal effects explains the potency of these peptides, which are active in nanomolar concentration . Other type-A lantibiotics are believed to also use docking molecules for pore formation, although identification of such membrane components has not yet been achieved.

Curr Opin Crit Care, 2002 Oct, 8(5), 449 - 52
Surgical infections in the critically ill; Stafford RE et al.; Surgical infections in the critically ill patient population are a significant cause of morbidity and mortality . Intra-abdominal and surgical soft-tissue infections are responsible for a significant proportion of the disease burden . Multiple risk factors have been identified that are associated with the development of surgical infections and subsequent morbidity and mortality . The microbiologic spectrum associated with these infections is broad and is determined by the site from which the infection arises and whether the infection is community acquired or nosocomial in origin . The diagnosis and management of these infections require a high index of suspicion, prompt surgical intervention, and adequate antibiotic therapy and resuscitation . Therefore, these infections present a challenge to the intensivist caring for a critically ill patient.

Arthritis Rheum, 2002 Sep, 46(9), 2294 - 300
Predictors of infection in rheumatoid arthritis; Doran MF et al.; OBJECTIVE: Patients with rheumatoid arthritis (RA) have been shown to have an increased susceptibility to the development of infections . The exact causes of this increased risk are unknown, but may relate to immunologic disturbances associated with the disease or to the immunosuppressive effects of agents used in its treatment . This study was undertaken to identify predictors of serious infections among patients with RA . Identification of such factors is the necessary first step in reducing the excess risk of infection in RA . METHODS: Members of a population-based incidence cohort of Rochester, Minnesota residents ages >or=18 years, who had been diagnosed with RA between 1955 and 1994, were followed up longitudinally through their complete medical records until January 1, 2000 . We examined potential risk factors for the development of all objectively confirmed (by microbiology or radiology) infections and for infections requiring hospitalization . Potential risk factors included RA severity measures (rheumatoid factor positivity, elevated erythrocyte sedimentation rate, extraarticular manifestations of RA, and functional status), comorbidities (diabetes mellitus, alcoholism, and chronic lung disease), and other risk factors for infection (presence of leukopenia, smoking) . Predictors were identified using multivariate time-dependent Cox proportional hazards modeling . RESULTS: The 609 RA patients in the cohort had a total followup time of 7,729.7 person-years (mean 12.7 years per patient) . A total of 389 patients (64%) had at least 1 infection with objective confirmation, and 290 (48%) had at least 1 infection requiring hospitalization . Increasing age, presence of extraarticular manifestations of RA, leukopenia, and comorbidities (chronic lung disease, alcoholism, organic brain disease, and diabetes mellitus), as well as use of corticosteroids, were strong predictors of infection (P < 0.004) in both univariate and multivariate analyses . Notably, use of disease-modifying antirheumatic drugs was not associated with increased risk of infection in multivariate analyses, after adjustment for demographic characteristics, comorbidities, and disease-related variables . CONCLUSION: We identified a number of strong predictors of infections in a population-based cohort of patients with RA . These results can be used to prospectively identify high-risk patients, who may benefit from closer followup and implementation of preventive strategies.

J Clin Pathol, 2002 Oct, 55(10), 735 - 40
How do microbiology consultants undertake their jobs? A survey of consultant time and tasks in South West England; Riordan T et al.; AIMS: To measure the total consultant medical microbiologist (CMM) weekly workload, to identify time spent on different activities, and to differentiate those tasks that were viewed by a consensus of consultants as core activities from those that could be accorded a lower priority . METHODS: A self administered questionnaire completed by consultant medical microbiologists in the Public Health Laboratory Service South West Group . RESULTS: Reported hours worked by respondents ranged from 41 to 65 hours each week, excluding on call activities . Eleven of 20 respondents reported working in excess of 48 hours each week . There was no correlation between hours worked and laboratory workload as measured by numbers of specimens . Clinical liaison, result authorisation, infection control, and management activities took up most time . Working practices varied widely between individuals, partly reflecting their differing roles in the laboratory . A consensus was reached regarding the relative importance and priority of many regular CMM activities . CONCLUSIONS: Consultant microbiologists can identify, with consensus, both high and lower priority activities in their daily practice . If such clinical priorities can be more widely agreed across the profession, this would provide a rational approach to workload control.

Medicine (Baltimore), 2002 Sep, 81(5), 388 - 97
Nocardiosis in cancer patients; Torres HA et al.; Nocardiosis (NOC) is an important cause of infection in immunocompromised patients . However, large series in patients with cancer have not been described . We review the records of patients with cancer and NOC who were evaluated at The University of Texas M . D . Anderson Cancer Center, Houston, Texas, between 1988 and 2001, and we describe the incidence, microbiologic and clinical characteristics, treatment, and outcome of NOC in this population . Forty-two patients with a total of 43 episodes of NOC were identified (incidence of 60 cases of NOC per 100,000 admissions) . Twenty-seven patients (64%) had hematologic malignancies . In 13 patients, NOC complicated bone marrow transplantation . Neutropenia was observed in 4 (10%) of 40 episodes with information available, and lymphopenia in 20 (50%) of 40 episodes . Patients had received steroids for 25 episodes (58%) and had received chemotherapy for 10 episodes (23%) within 30 days before the onset of NOC . Nine episodes of breakthrough NOC were identified in 7 (23%) of the 40 patients with information available . Pulmonary NOC was seen in 30 (70%) of 43 cases; soft-tissue NOC in 7 (16%); central venous catheter-related nocardemia in 3 (7%); and disseminated NOC, central nervous system NOC, and a perinephric abscess each in 1 (2%) . Twenty-three percent of patients with pulmonary NOC had an acute presentation . complex was the most common causative species (77%) . Therapy for NOC was mainly concurrent trimethoprim/ sulfamethoxazole and either a tetracycline or a beta-lactam . The median duration of treatment was 113 days (range, 10-600 d) . Nine (60%) of 15 patients with outcome data died from NOC . NOC, although infrequent, is an important cause of morbidity and mortality in patients with cancer . It has pleomorphic manifestations, and it can be seen as a breakthrough infection . The present study confirms that timely diagnosis, the site of NOC, the type of, the presence of comorbidities, and cytomegalovirus coinfection influence the outcome of patients with cancer and NOC.

Medicine (Baltimore), 2002 Sep, 81(5), 333 - 48
Pseudallescheria boydii (Anamorph Scedosporium apiospermum) . Infection in solid organ transplant recipients in a tertiary medical center and review of the literature; Castiglioni B et al.; (Sca) is a ubiquitous filamentous fungus capable of causing invasive disease . We reviewed our electronic microbiology records and the English-language literature . Between 1976 and December 1999 we identified 23 solid organ transplant recipients with Sca infection, 7 of which occurred between December 1987 and December 1999 at our institution . Overall incidence was 1 per 1,000 patients, with a trend of higher incidence in patients receiving lung transplants compared with other transplant organs (p = 0.06) . The 23 patients included liver (4), kidney (8), heart (8), lung (2), and heart/lung (1) recipients . Male to female ratio was 19:4, and the mean age was 46 +/- 12 (SD) years . Fungal infection was diagnosed at a median of 4 months (range, 0.4-156 mo) after transplant . The clinical presentation included disseminated disease ( 8), skin lesions (3), lung disease (5), endophthalmitis (1), meningitis (1), brain abscess with or without extension to eye (3), fungal mycotic aneurysm (1), and sinusitis (1) . Seven (30%) patients had intravascular infection, and 11 (48%) patients had central nervous system involvement . Antifungal therapy was accompanied by surgical debridement in 9 cases . Three additional patients were found to have airway colonization only and received itraconazole prophylaxis, without evidence of disease . Of 22 patients with known outcome, 16 (72.7%) died . Five of 6 patients who survived had localized infections: skin lesions (n = 3), sinus fungus ball (n = 1), and solitary lung nodule (n = 1) . All patients with disseminated disease and 10 of 11 patients with central nervous system disease died . An exception was 1 patient with a brain abscess, successfully treated with voriconazole and surgical drainage . Sca infection is rare but is associated with high mortality . Early diagnosis by culture is important because Sca is resistant to amphotericin B, routinely used in the empiric therapy of invasive fungal infections . Treatment with the combination of an antifungal and surgery may have a better outcome . Voriconazole promises to be an effective antifungal agent . Cultures positive for Sca should not be ignored, and long-term antifungal prophylaxis in candidates and transplant recipients should be considered.

TDR News . 1998 Feb;(55):8, 10.
In sickness or in health: TDR's parners . 7 . Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Adolescent sexuality et al.; PIP: Major topics addressed by this article on adolescent sexuality include adolescent festivals, adolescent reproductive psychophysiology, contraception for adolescents, the World Federation of Contraception and Health, sexually transmitted diseases, and recommendations for research . The purpose of adolescent festivals is to increase communication between young people and their parents on subjects such as sexuality . Of particular concern is the traumatic emotional, physical, and financial impact of adolescent pregnancy, both in developed and developing countries . Contraceptive methods considered to be most appropriate for use in developing countries are injectable Depo-Provera and the Norplant contraceptive implant system . To reduce the problem of adolescent pregnancy, television programs need to portray responsible sexuality, family responsibility and involvement must be strengthended, funds for education and prevention programs should be increased, and there must be more intraprofessional collaboration . The World Federation of Contraception and Health, a nonprofit multicenter institution, has been created to make recommendations on how current resources can be utilized to address problems of adolescent sexuality . Adolescent clubs are being set up to provide adolescents and their families with computer support and information . Another concern is the spread of sexually transmitted diseases that cause infections in the genitourinary tract and threaten to impair future fertility . The incidence of diseases such as chlamydia trachomatis and nongonococcal urethritis is especially high in teenagers . Needed in the future are more multicenter studies conducted by microbiologists, pathophysiologists, family planning experts, epidemiologists, venereologists, gynecologists, obstetricians, and dermatologists on the many aspects of adolescent sexuality .

Blue Sheet, 1983 May 4, 26(18), 6 - 7
Gonococcal pilus vaccine development project by Bactex; Neoplastic pericardial effusion . Efficacy and safety of intrapericardial treatment with cisplatin; Department of Internal Medicine-Cardiology, Philipps University, Marburg, GermanyAIMS: To evaluate the clinical efficacy, safety, and long-term effect of intrapericardial treatment with cisplatin in large neoplastic pericardial effusions . METHODS AND RESULTS: Out of the registry of 260 patients undergoing pericardiocentesis, 42 patients with neoplastic pericardial effusion (69% males, mean age 58.8+/-13.2 years) were selected for treatment with cisplatin (single instillation of 30 mg.m(-2) x 24h(-1)) in addition to the tumour-specific systemic chemotherapy . All patients underwent clinical examination, echocardiography, pericardiocentesis, pericardioscopy, and epicardial biopsy . Pericardial effusion and biopsy analyses included biochemistry, cytology, serology, microbiology, histology, immunohistology, and PCR . The following malignancies were established: lung cancer, 52.4%; breast cancer, 19.0%; Hodgkin's disease, 4.8%; oesophageal cancer, 2.4%; mesothelioma, 2.4%; colon cancer, 4.8%; and undifferentiated cancer of unknown origin, 14.2% . Cisplatin appeared to prevent recurrence of pericardial effusion during the first 3 months of the follow-up in 92.8%, and after 6 months in 83.3% of the patients . Lung cancer patients had fewer effusion relapses at the 6 months follow-up (4.5%) than breast cancer patients (37.5%)(P<0.05) . Myocardial ischemia occurred after 1/42 cisplatin instillations, but there were no other complications . CONCLUSION: Intrapericardial treatment with cisplatin appeared to successfully prevent recurrences of neoplastic pericardial effusion . The treatment was more successful in lung than in breast cancer patients.

TDR News . 1998 Jun;(56):8.
In sickness or in health: TDR's partners . 8 . Kenya Medical Research Institute (KEMRI); Education the only defence; PIP: In Africa Aquired Immune Deficiency Syndrome (AIDS) is a serious public health problem, but its scale is masked by a lack of adequate infromation, particularly statistics . The World Health Organization (WHO) convened 9 Central African Countries--Burundi, Cameroon, Central African Republic, Congo, Gabon, Rwanda, Uganda, Tanzania, and Zaire--in an effort to extend its campaign against the killer disease into the continent . The objective of the Bangui workshop was to review available information on the spread of the disease in Africa, identify the clinical and epidemiological features of the disease, and make recommendations for its control . The workshop was attended by experts from the 9 countries and WHO specialists in clinical medicine, microbiology, epidemiology, and public health . Meeting participants agreed that there was not enough clear information available to reach sound conclusions about the extent of the spread of the disease in Africa . This was because of problems in collecting general health data in many countries . To help define the scale of the problem, the workshop agreed on a provisional case definition of AIDS which could be applied to suspected sufferers, without stringent laboratory tests . Once patients have been diagnosed according to this definition, their cases will be verified later in countries equipped with laboratory facilities . It was agreed that the case definition should provide a clear provisional figure for the disease's extent in Africa . Additionally, the participating countries agreed to establish their own surveillance systems to assess the AIDS risk in their own countries . These national systems would then file information to WHO headquarters in Geneva, where a worldwide data bank on the disease is being compiled . In a final report, the workshop concluded that since there was no cure for the disease, it could be controlled only through an effective information campaign coupled with a responsible attitude among those at risk . To cut the risk of transmission through exposure to AIDS-infected blood products, the workshop recommended that a new blood transfusion service be set up in Africa, and that transfusions be kept to a minimum .

Fertil Contracept, 1978 Jan, 2(1), 1 - 4
Screening for gonorrhoea in a central London family planning clinic; Nabarro JM et al.; PIP: The study objective was to measure the prevalence of cervical gonorrhoea in women attending a central London family planning clinic and to assess the need for routine screening . Between April 1974 and December 1975 1000 women were screened for cervical gonorrhoea at the Margaret Pyke Center for Study and Training in Family Planning . The median age of the women in the study was 23 years of age; 70% were single, 23% married, and 7% divorced, separated or widowed . 66% belonged to social class 3 (Registrar-General's Classification), 13% to social class 2, and 16% were unclassifiable . 14% were visitors from overseas . The majority of the women were using oral contraception . Specimens were taken from the endocervix with platinum wire loops . Gram-stained slides and cultures on Columbia-Agar medium, 48 hours after inoculation and incubation at 37 degrees C in a CO2-enriched atmosphere, were examined by 1 of the investigators at the Department of Microbiology of the Middlesex Hospital Medical School . 4 cases of cervical gonorrhoea were diagnosed, all of which were asymptomatic . Gonorrhoea was also diagnosed in 6 male contacts . Ideally, facilities for selective screening for gonorrhoea should be available in family planning clinics, but the lack of a simple, cheap diagnostic test seems to make their provision impracticable at this time .

NASPCP Newsl . 1995 Oct-Dec;:8.
The Second National AIDS Research Forum; Monzon OT; PIP: On November 17-18, 1995, the Second National AIDS Research Forum was held in the Philippines to explore the theme "Responding to the HIV/AIDS Epidemic." Individual conference sessions on the first day focused on such topics as 1) national strategies in HIV/AIDS prevention, 2) experiences in HIV/AIDS prevention research, 3) ethics in HIV research, 4) the current status of the HIV/AIDS epidemic in the Western Pacific region, 5) an up-date of national HIV surveillance, 6) HIV testing in Frontline Laboratories, 7) cofactors in HIV disease progression, 8) the natural history of HIV infection in female sex workers, 9) the impact of and HIV prevention workshop for men in metro Manila, 10) targeted sexually transmitted disease (STD) interventions, and 11) an advocacy campaign on STD/HIV/AIDS for child and youth sex workers . The second day was devoted to reports on 1) fungal infections in patients, 2) diagnostic tools for pulmonary opportunistic infections, 3) the sex behavior of urban Filipino males, 4) HIV/AIDS control among women working in commercial sex establishments, 5) HIV/AIDS risk behavior and knowledge, attitudes, and beliefs among truck crews, 6) hospitality women in Davao city, and 7) the risk exposure reported by young users of the Remedios hotline . The final symposia were characterized by their attention to 1) AIDS-related conditions and STDs, 2) a clinical and microbiologic profile of tuberculosis in Filipino AIDS patients, 3) STD prevalence and behavioral correlates of STD among female sex workers, 4) a possible link between bacterial vaginosis and HIV, 5) living with AIDS, 6) coping mechanisms of households affected with HIV/AIDS, and 7) a nongovernmental organization's response to HIV prevention .

AIDS Wkly Plus . 1996 May 27;:21.
Thailand study results of 100 percent for rapid HIV test; {In Egypt et al.; {No authors listed}

PIP: A May 1991 workshop on reproductive morbidity attended by 60 participants in Cairo included presentation of results of a study of 509 nonpregnant women aged 20-60 years . The study was conducted by an anthropologist, a biostatistician, 2 obstetrician-gynecologists, and a microbiologist in 2 rural villages of Gizeh . The majority of the women studied had married before age 19, and 80% were illiterate . Despite initial reticence, over 90% of the village women ultimately took part in the study . The team observed the frequency with which the women accepted illness, weakness, and pain as a normal part of life . Physical examinations revealed that 44% had vaginitis, 9% were anemic, 17% had severe anemia, 56% had prolapse, 18% were hypertensive, and 42% were obese . Survey questionnaires revealed that 36% experienced pain during intercourse, 18% had pain in the lower abdomen, 71% had menstrual pain, 15% had pruritus, and 48% feared they were sterile . The team observed that the women were apparently reluctant to use the local health services . The villages had their own health centers staffed by female physicians, but only 1/3 of the women giving birth in the preceding 2 years had sought prenatal care, and 75% chose to deliver at home . Relations between the health workers and the village women must be strengthened if the situation is to be improved . The seminar recommended that the health and social workers make greater efforts to encourage use of the health services by local women .

Indian J Sex Transm Dis, 1989, 10(2), 57 - 9
Comparison of Chacko-Nair and Thayer-Martin media for culture of N . gonorrhoeae; Siddappa K et al.; PIP: This article reports on a study designed to compare the efficacy and cost effectiveness of 2 selective media for culture of gonorrhea, the Chacko-Nair medium and the Thayer-Martin medium . The Chacko-Nair medium, an enriched egg=beef selective medium, is easily prepared from locally available ingredients in India . The Thayer-Martin medium, the standard selective medium used throughout the world, uses ready-made ingredients . In order to test the 2 mediums, researchers collected the urethral discharge of 240 male patients with acute gonorrhea and smear positive for N . gonorrhoea attending the Skin & STD, OPD of Chigateri General Hospital . All 240 specimens were subjected to culture study with the Chacko-Nair medium, and 190 were subjected to study with the Thayer-Martin Medium . The initial 30 cases under the Chacko-Nair medium did not show growth, since beef extract was used instead of fresh beef . Fresh beef was used in the remaining 210 samples, and they all showed profuse growth of organisms . All 190 sample under the Thayer-Martin medium showed good growth . While both mediums showed growth in 100% of the cases, the cost of the 2 differs considerably . Since all the ingredients are available locally, the Chacko-Nair medium is very cheap compared to the Thayer-Martin medium, whose ready-made ingredients are expensive and often difficult to procure . The Chacko-Nair medium, which can be prepared at any standard Microbiology Laboratory, has been used regularly at the Institute of Venerology in Madras, and has show results comparable to the Thayer-Martin medium . The report concludes that the Chacko-Nair medium is a good alternative to the Thayer-Martin medium .

New Afr, 1990 Apr, (271), 9 - 12
Africa and the AIDS myth; Versi A; PIP: The recently released television documentary, "Monkey Business, AIDS: The African Story," has created controversy in Europe with its premise that AIDS did not originate in Africa . Although AIDS 1st appeared in New York in 1981 and was not recorded in Africa until 1983, researchers and the media have promoted the theory that AIDS came from Africa through human contact with the green monkey . Subsequent research forced the original champions of this "green monkey connection" theory to acknowledge that the AIDS virus and the green monkey virus are so dissimilar that they could not be historically linked . Then, the focus turned to the theory that a remote pygmy tribe had been endemically infected with the AIDS virus and carried the disease, by airplane, out of the country . This theory, too, was refuted by the failure to locate any HIV-positive pygmies in the Central African Republic . Still determined to prove that AIDS did not have an American or European origin, researchers reported that blood testing conducted in 1984 revealed 50-90% of Africans to be HIV-infected . Retesting with a more accurate procedure revealed the rate of infectivity to be only 0.02%; yet the media have continued to portray Africa as the source of the AIDS scourge . Moreover, it appears that AIDS cases are actually overreported from Africa--not underreported--due to confusion with conditions such as malnutrition and tropical diseases . To some, this relentless drive to vilify Africa reflects racism . Others believe that it represents an effort to cover up the possibility that the AIDS virus is man-made--a result of an accident in gene technology or microbiology .

IDRC Rep, 1987 Jan, 16(1), 16 - 7
A deadly shadow: AIDS in Africa; Chouinard A; PIP: In Africa, acquired immunodeficiency syndrome (AIDS) has spread quietly across the continent . As yet, no one knows how AIDS began . In both the North and the South, most of those studying the virus have joined forces to try to control the epidemic . AIDS affects men and women roughly equal numbers (60 and 40% of cases, respectively) in Africa . Up to 1986, about 90% of the cases in North America have been homosexual and bisexual men, and 10% have been intravenous drug users, recipients of transfusions, sexual contacts of infected bisexual men, and babies of infected mothers . 3 doctors at the University of Manitoba in Canada maintain that the North American picture is likely to change with women increasingly becoming infected . Since 1979, the 3 Canadians have been working with scientists at Kenya's University of Nairobi . Dr . Allan Ronald, who heads the department of medicine at the University of Manitoba, and 2 of his colleagues, Drs . G.W . Hammond and Frank Plummer, reported their findings to the Canadian Medical Association in August 1986 . They reported the virus causing AIDS is transmitted in 3 ways . The main route is direct sexual contact, specifically genital to genital intercourse and receptive anal intercourse . A 2nd route is perinatal transmission, from infected mother to newborn . In such cases the transmission risk can be as high as 50% . In Africa, heterosexual intercourse is by far the most common route of infection, with prostitutes considered to be a high-risk group, but the virus has been slow to move into the heterosexual population in North America . Kenya was the 1st country in African to officially acknowledge the presence of AIDS, reporting cases to the World Health Organization (WHO), introducing a national policy aimed at preventing the spread of the disease, and creating an AIDS committee for control and investigation . The Kenya-Canada collaboration began with a study of genital ulcers in conjunction with the microbiology department of the University of Nairobi . It has since expanded to include all sexually transmitted diseases . According to Dr . Ronald, the best information from the international meeting held in Paris in June 1986 led to pessimism, that is, "there is no evidence that, if people become infected but live for a number of years without symptoms, they won't eventually die of the disease." Thus, the focus must be on prevention of the spread of AIDS through the use of condoms or other measures . The doctors from Manitoba also identify a change in sexual habits as another solution .

J Virol Methods, 2002 Sep, 105(2), 219 - 32
Comparison of four reverse transcription-polymerase chain reaction procedures for the detection of dengue virus in clinical specimens; Raengsakulrach B et al.; The sensitivity of dengue virus identification by mosquito inoculation and four reverse transcription-polymerase chain reaction (RT-PCR) procedures (Am . J . Trop . Med . Hyg . 45 (1991) 418 (H); J . Clin . Microbiol . 29 (1991) 2107 (M); J . Clin . Microbiol . 30 (1992) 545 (L); and Southeast Asian J . Trop . Med . Public Health 27 (1996) 228 (Y)) were compared using coded clinical specimens derived from areas in Thailand where all four dengue serotypes circulate . The sensitivity of virus detection in serologically confirmed dengue cases was 54, 52, 60, 79, and 80% for mosquito inoculation, procedures H, M, L and Y, respectively . In comparison to clinical specimens which yielded virus isolates by mosquito inoculation, there was relatively low sensitivity in detecting each of the four dengue serotypes by PCR: procedure H-dengue 4 (25%), procedure M-dengue 3 (73%), procedure L-dengue 1 (70%), and procedure Y-dengue 1 (79%) . Dengue virus was detectable by RT-PCR for more days of illness and in the presence of dengue-specific antibody when compared to virus isolated in mosquitoes . Procedures L and Y were more sensitive than mosquito inoculation or procedures H and M in detecting all four dengue serotypes in clinical specimens and may be the RT-PCR methods of choice for virus surveillance or research use.

S Afr Med J, 2002 Aug, 92(8 Pt 2), 647 - 55
Management of community-acquired pneumonia in adults; Working Group of the South African Thoracic Society; OBJECTIVE: To revise the existing South African community-acquired pneumonia guideline in the light of the following factors: Increased incidence of HIV infection in South Africa Emerging antibiotic resistance Introduction of new antibiotics International trends based on evidence published since the previous guideline . The main aim of the guideline is to recommend an initial choice of antibiotics in patients with community-acquired pneumonia encompassing the following subgroups: (i) adults without co-morbid illness; (ii) the elderly and/or those with associated co-morbid illness, including patients with concomitant human immunodeficiency virus (HIV) infection; and (iii) patients with severe pneumonia . OPTIONS: Studies comparing patient outcome obtained with the various treatment regimens have been reviewed . The choice of antibiotic is based on the most commonly isolated pathogens, with cost as a consideration . OUTCOMES: The empiric antibiotic therapy covers all commonly encountered organisms in patients with community-acquired pneumonia and is likely to achieve the best prognosis . EVIDENCE: Working group of clinicians and clinical microbiologists, following detailed literature review, particularly of studies performed in South Africa . BENEFITS, HARMS AND COSTS: The guideline pays particular attention to cost-effectiveness in South Africa and promotes rational antibiotic prescribing with the aim of limiting emergence of antibiotic resistance . RECOMMENDATIONS: These include details of likely pathogens, an appropriate diagnostic approach, indicators of severity of illness, need for hospitalisation and antibiotic treatment options . VALIDATION: The guideline was updated by a working group of the South African Thoracic Society, which included members of the Antibiotic Surveillance Forum of South Africa . Reference was made to the recently updated international guidelines from the UK, Canada and the USA.

Vet Microbiol, 2002 Oct 22, 89(2-3), 223 - 38
Simultaneous detection of Anaplasma and Ehrlichia species in ruminants and detection of Ehrlichia ruminantium in Amblyomma variegatum ticks by reverse line blot hybridization; Bekker CP et al.; The detection of Anaplasma and Ehrlichia species is usually based on species-specific PCR assays, since no assay is yet available which can detect and identify these species simultaneously . To this end, we developed a reverse line blot (RLB) assay for simultaneous detection and identification of Anaplasma and Ehrlichia species in domestic ruminants and ticks . In a PCR the hypervariable V1 region of the 16S ribosomal RNA (rRNA) gene was amplified with a set of primers unique for members of the genera Anaplasma and Ehrlichia {Int . J . Syst . Evol . Microbiol . 51 (2001) 2145} . Amplified PCR products from blood of domestic ruminants or Amblyomma variegatum tick samples were hybridized onto a membrane to which eight species-specific oligonucleotide probes and one Ehrlichia and Anaplasma catch-all oligonucleotide probe were covalently linked . No DNA was amplified from uninfected blood, nor from other hemoparasites such as Theileria annulata, or Babesia bigemina . The species-specific probes did not cross-react with DNA amplified from other species . E . ruminantium, A . ovis and another Ehrlichia were identified by RLB in blood samples collected from small ruminants in Mozambique . Finally, A . variegatum ticks were tested after feeding on E . ruminantium infected sheep . E . ruminantium could be detected in adult ticks even if feeding of nymphs was carried out 3.5 years post-infection . In conclusion, the developed species-specific oligonucleotide probes used in an RLB assay can simultaneously detect and identify several Ehrlichia and Anaplasma species . However, as no quantitative data for the detection limit are available yet, only positive results are interpretable at this stage.

J Wildl Dis, 2002 Jul, 38(3), 518 - 32
Medical dilemmas associated with rehabilitating confiscated houbara bustards (Chlamydotis undulata macqueenii) after avian pox and paramyxovirus type 1 infection; Bailey TA et al.; Projects to rehabilitate confiscated animals must carefully consider the risks of disease when determining whether to release these animals back into the wild or to incorporate them into captive breeding programs . Avipox and paramyxovirus type 1 (PMV-1) infections are important causes of morbidity and mortality during rehabilitation of confiscated houbara bustards (Chlamydotis undulata macqueenii) . This paper presents key findings of an intensive health monitoring program (physical condition, hematology, serology, endoscopy, microbiology, and virology) of two flocks of houbara bustards that survived outbreaks of septicemic avipox and PMV-1 respectively . Mortality in each flock from avipox and PMV-1 infections were 47% and 25% respectively, and the clinicopathologic features and management of each outbreak are presented . Avipox and PMV-1 viruses were not isolated from surviving birds monitored monthly for 11 mo after initial infection nor were septicemic or diptheritic avipox and PMV-1 infections detected in the captive breeding collection into which surviving birds were ultimately integrated up to 24 mo later . Adenovirus was isolated from four birds during the study demonstrating that novel disease agents of uncertain pathogenicity may be carried latently and intermittently shed by confiscated birds . This paper demonstrates the risk of importing pathogens with illegally traded houbara bustards and reinforces the need for surveillance programs at rehabilitation centers for these birds . We recommend that confiscated houbara bustards integrated into captive breeding programs be managed separately from captive-bred stock . Other measures should include separate facilities for adult birds and rearing facilities for offspring derived from different stock lines and strict sanitary measures . Additionally, health monitoring of confiscated birds should continue after birds are integrated into captive flocks.

Pflege, 2002 Jun, 15(3), 137 - 45
{What measures are described in the literature for treatment of mouth problems? An analysis of German and English publications between 1990 and 2001}; Gottschalck T et al.; The "mucous membrane, altered" is a frequently observed nursing diagnosis . It manifests itself in varying and extremely unpleasant forms of strain on the patient, even life-threatening complications are possible . The publications on mouth changes originate in the field of nursing care, however there is an increasing number in the medical fields of dentistry, oncology and microbiology as well as hygiene . A variety of remedies and instruments are suggested for nursing and treating patients with mouth problems . The purpose of the literary study was to summarize the mouth alterations to be dealt with according to each fundamental problem area as well as to systematize the available remedies and methods--which almost defy an orderly overview--according to the problem areas.

Microbiol Immunol, 2002, 46(7), 463 - 74
Studies on the rabies virus RNA polymerase: 3 . Two-dimensional electrophoretic analysis of the multiplicity of non-catalytic subunit (P protein); Eriguchi Y et al.; We described previously (Takamatsu et al., 1998 . Microbiol . Immunol . 42: 761-771) the rabies virus P protein as being composed of several components of different sizes, among which the full-sized major components were termed as p40 and p37 according to their electrophoretic mobilities, and radiolabeling studies with {32P}phosphate implied that p40 was a hyperphosphorylated form . We further examined here these proteins by two-dimensional (2-D) gel electrophoresis and immunoblotting, showing that a major component, p37, was composed of multiply modified subcomponents of different pIs (termed p37-1, p37-2, p37-3, etc., based on their acidity) in the virion and infected cells, but the unmodified precursor (termed p37-0) was little in amount . The viral nucleocapsid (NC)-bound P proteins were composed of multiple forms of p37 (the major one was p37-1) and also a minor component, p40-1 . P proteins which were bound to newly synthesized free N proteins were mostly composed of p37-1, indicating that hyperphosphorylation of P proteins occurred after their being used for the encapsidation . Treatment of the infected cells with okadaic acid induced accumulation of the more acidic forms of P proteins, suggesting that heterogeneity in the full-sized P proteins is a reflection of their dynamic aspects of multiple cycles of phosphorylations and dephosphorylations in the cell . Two-D gel analyses demonstrated also that p40 was not so acidic as we expected, and implied that our previous data of apparent hyperphosphorylation of p40 was due to very frequently recycled utilization of the protein, and preformed non-labeled P proteins were also 32P-phosphorylated in a radiolabeling period and were converted to the p40.

Int J Food Microbiol, 2002 Sep 15, 78(1-2), 99 - 117
Gut bacteria and health foods--the European perspective; Saarela M et al.; Probiotics, prebiotics, and synbiotics aimed at improving intestinal health currently represent the largest segment of the functional foods market in Europe, Japan and Australia . Evidence continues to emerge demonstrating that these ingredients have the potential to improve human health in specific intestinal disorders . The European Commission, through its 5th Framework Programme, is presently focusing on a substantial effort in the science of the intestinal microbiota, its interaction with its host and methods to manipulate its composition and activity for the improvement of human health and well being . Eight multicentre and multidisciplinary research projects now cover a range of topics required for the development of efficacious probiotic foods, from understanding probiotic mechanisms at a molecular level; developing technologies to ensure delivery of stable products; and demonstrating safety and efficacy of specific probiotics in defined treatment targets . This concerted research effort promises to provide us with an enhanced understanding of the human intestinal microbiota's role in health and disease, and new approaches and products to tackle a variety of intestinal problems.

Int J Food Microbiol, 2002 Sep 15, 78(1-2), 181 - 9
Prions, BSE and food; Dormont D; Biochemical and biophysical properties of prions including possible inactivation methods are reviewed . Possible molecular markers of transmissible spongiform encephalopathy (TSE) and mechanisms behind infectivity and correlation with clinical symptoms are discussed . The risk of Bovine Spongiform Encephalopathy (BSE) for humans i.e . variant Creutzfeldt-Jakob Disease (cCJD) is addressed in detail . The consequences of the emergence of the new cCJD and the lack of information on the infectivity of cCJD at the clinical stage of the disease in relation to the need to reconsider the biological concepts currently used in microbiology.

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