Zhonghua Liu Xing Bing Xue Za Zhi, 1990 Apr, 11(2), 72 - 4 {A prevalence survey to gonorrhea in Jilin}; Shi Y; 369 suspecious patients with gonorrhea from 6 general hospitals in Jilin between June and December, 1987, were examined clinically and bacteriologically . Gonococcus was found in 332 of 369 cases(90% positive rate) from their externalia excreta by Gram-staining technique . The period prevalence rate of gonorrhea was estimated at 27.8/100,000, ie, 332 from 1,199,445, the average population in Jilin, derived from Jilin Public Security Bureau . The population distribution survey to the patients shows more males than females, more married than unmarried, and more workers, salesmen, drivers and than others . Most of them received a middle-degree education . The cases were found mainly during July, August, and September . The result implies that gonorrhea trends to prevail in Jilin. Arch Esp Urol, 1990 Apr, 43(3), 298 - 9 {Bilateral abscess of the psoas and systemic lupus erythematosus}; Ochoa Urdangarain O et al.; Herein we describe a patient with systemic lupus erythematosus and bilateral psoas abscess, an uncommon condition caused by septic metastases from ulcerous necrotic lesions involving both lower limbs . We describe the clinical features and the complementary work up, which included ultrasound . Similarly, treatment is described, as well as the results yielded by bacteriologic analyses of pus specimen . The literature is reviewed, highlighting the most important criteria. Vet Microbiol, 1990 Apr, 22(2-3), 241 - 8 An evaluation of the delayed-type hypersensitivity test for diagnosing brucellosis in individual cattle: a field study; Bercovich Z et al.; A field study was conducted to evaluate the delayed-type hypersensitivity (DTH) test in diagnosing brucellosis in cattle, in particular the diagnosis of infection in individual cows . A total of 93 cows that were negative, suspect, or positive to the serum agglutination test (SAT), complement fixation test (CFT), or the milk ring test (MRT) were subjected to the DTH test . The cows were then slaughtered and the supramammary lymph nodes were collected for bacteriologic examination . In 989 cows the DTH test, MRT and serologic tests were negative . When the DTH test results were compared with bacteriologic results, 12 of the 93 cows with CFT titres greater than 1:200 tested negative in the DTH test while bacteriologic results were positive . The sensitivity of the DTH test (calculated on the remaining 81 cows) was 100%; the specificity was 83% . The sensitivity of the DTH test (calculated on 93 cows) was 81%; the specificity was 83% . The sensitivity and specificity of the DTH test correlated well with those of the CFT (86-83%) . We conclude that the DTH test is very sensitive, and specific enough to diagnose brucellosis in individual cows . The DTH test should be used in combination with serologic tests in the diagnosis of brucellosis. Hum Reprod, 1990 Apr, 5(3), 274 - 8 An experimental model for salpingitis due to Chlamydia trachomatis and residual tubal infertility in the mouse; Zana J et al.; A mouse model of salpingitis and subsequent tubal infertility induced by a human strain of Chlamydia trachomatis has been studied . C3H/He female mice were inoculated into the ovarian bursa . Some of the mice (six infected, five controls) were killed on days 15 and 23 and the remaining animals (10 infected, 10 controls) were mated on day 15 . On day 15, the infection was maximal with intratubal inflammation, elevated antichlamydial antibody titre and positive cultures in 12 cases out of 16 . After 19 weeks of housing with the male, the proportion of fertilized females was significantly lower in the infected group (20% versus 100% in the control group P less than 0.01) . In the killed mice, hydrosalpinx and or tubal occlusion were noted at this time in nine cases out of 10, despite an apparent bacteriological healing. Vaccine, 1990 Apr, 8(2), 121 - 9 Immunotherapeutic effects of a vaccine based on a saprophytic cultivable mycobacterium, Mycobacterium w in multibacillary leprosy patients; Talwar GP et al.; Immunotherapy with a vaccine consisting of autoclaved Mycobacterium w was given in addition to chemotherapy in 54 multibacillary, lepromin negative patients belonging to BB, BL and LL types of leprosy . Thirty-seven patients with similar types of diseases received chemotherapy and placebo injections . The 'vaccine' was repeated every 3 months . Bacterial clearance was more rapid in the vaccinated patients . Two lepromatous leprosy patients with initial bacterial index (BI) of 1.8 and 2.8 became bacteriologically negative in 1 year . One LL patient with BI of 6.0 had a BI fall to 0.16 after four doses of the vaccine . None of the LL patients belonging to placebo group during the same time period became bacteriologically negative . Rapid bacterial clearance was accompanied by distinct signs of clinical improvement . One hundred percent of BB, 85.7% of BL patients and 61.5% of LL patients converted to lepromin positivity after four doses of the vaccine . A significant number of vaccinated patients demonstrated an upgrading in skin lesions histopathologically. Am J Vet Res, 1990 Apr, 51(4), 666 - 76 Use of mucosal grafts and temporary tube implants for treatment of teat sinus mucosal injuries; Trent AM et al.; A mucosal lesion was created in the center of each test sinus of 6 mature, healthy, nonlactating Holstein cows by resecting a circumferential band of mucosa . Each lesion was then treated by implantation of strip grafts of autogenous oral mucosa, temporary silastic tube implant, or a combination of strip grafts and temporary silastic tube implant . All teats were evaluated for patency 6 weeks after treatment, and tube implants were removed through a second thelotomy incision . All teats were reevaluated for gross and radiographic patency 12 weeks after treatment, and teats were collected for histologic evaluation of lesions . All 4 teats treated with grafts only were obstructed at 6 and 12 weeks after treatment . Incomplete coverage of the lesion with mucosa was observed in all 4 teats . The major source of obstruction was proliferation of epithelium and keratin into the lumen . All 8 teats treated with temporary silastic tube implants alone were patent at 6 weeks after treatment, but were obstructed at 12 weeks after treatment . Foci of mucosa at the lesion site were detected in only 2 of the 8 teats . Obstruction resulted from proliferation of granulation tissue into the lumen . All 12 teats treated with grafts and a temporary tube implant were patent at 6 weeks after treatment and 11 of 12 were patent at 12 weeks after treatment, although marked luminal narrowing was evident in 9 of 11 teats . Partial to complete coverage of the lesion with mucosa was seen in all teats . Proliferative granulation tissue, epithelium, and keratin contributed to luminal narrowing in 10 of 11 patent teats . Bacteriologic culture of quarters from 6 of the 11 teats patent at the final evaluation yielded pathogens. Laryngoscope, 1990 Apr, 100(4), 403 - 6 Quantitative bacteriology of closed-suction wound drainage in contaminated surgery; Becker GD et al.; This study was designed to evaluate the predictive value of quantitative bacteriology of closed-suction postoperative wound drainage in identifying the patient likely to develop wound infection as well as its subsequent flora . Forty-one patients undergoing major cancer surgery of the head and neck were studied . Postoperatively, closed-suction wound drainage was cultured, and anaerobic and aerobic bacterial isolates were quantitated . The wound infection rate was 20% (8/41) . No trend toward increased rate of wound infection with increased numbers of bacteria colonizing the wound was observed . Additionally, there was no consistent correlation between species of bacteria isolated from closed-suction wound drainage and recovery from subsequent wound infection . Quantitative bacteriology of closed-suction wound drainage after contaminated head and neck cancer surgery does not accurately predict which patients were likely to become infected, or the probable bacteriology of subsequent wound infection. Obstet Gynecol, 1990 Apr, 75(4), 627 - 9 Bacteriologic findings of post-cesarean endometritis in adolescents; Berenson AB et al.; Two hundred four post-cesarean adolescents were compared with 751 adults to determine whether age was a risk factor for endometritis . Adolescents had an infection rate of 23%, compared with 11% for controls (P less than .001) . Length of labor, duration of ruptured membranes, and the use of an internal monitor were noted to be risk factors for endometritis in adults, but not in adolescents . Endometrial aspirates from adolescents exhibited significantly higher isolation rates of Chlamydia trachomatis (21 versus 6%, P less than .05) and Gardnerella vaginalis (32 versus 9%, P less than .005) than did those from adults . Antepartum isolation of these organisms in teenagers may help to identify those at risk for postpartum endometritis. West Afr J Med, 1990 Apr-Jun, 9(2), 89 - 97 Randomised comparative efficacy of clindamycin, metronidazole, and lincomycin, plus gentamicin in chronic suppurative otitis media; Rotimi VO et al.; Chronic suppurative otitis media is major health problem seen frequently in the ENT clinics in Nigeria and the outcome of most medical management in the past have been disappointing . A comparative randomised clinical trial involving combination therapies with systemic clindamycin, metronidazole, lincomycin, each with gentamicin, was conducted on a total of 14 patients . At the end of one week, and three-week, follow-up end points the clinical response with bacteriological cure were, for clindamycin and gentamicin 21%, metronidazole and gentamicin 33%, lincomycin and gentamicin 22%, and the control (aural toilet alone) 14% . However, when the clinical response was measured only by the ceasation of discharge, the outcome was more impressive . By this assessment the clinical response with clindamycin and gentamicin was 52% of the 140 patients, metronidazole and gentamicin 69%, lincomycin and gentamicin 47%, and the control 24% . The metronidazole and gentamicin regime was significantly more effective than the other regimes and it is suggested for use in prophylactic treatment of CSOM patients undergoing surgical procedures. Dtsch Zahnarztl Z, 1990 Apr, 45(4), 213 - 5 {Quantifying bacteriological findings in the subgingival flora}; Muller HP et al.; The variation of selected bacteriological parameters was investigated in 25 untreated A . actinomycetemcomitans-associated periodontitis patients . Samples of subgingival plaque were collected twice within 6 weeks with paper points for cultivation as well as with curettes for analyses of the morphological composition . Total counts of colony forming units, counts of A . actinomycetemcomitans as well as proportions of spirochetes were determined . Our results suggest a high reproducibility of quantitative data if a standardised sampling procedure with paper points is employed . On the other hand, considerable differences were observed in the morphological composition of subgingival plaque. Helv Chir Acta, 1990 Apr, 56(6), 825 - 34 {Soft tissue infection--osteitis--osteomyelitis}; Matter P et al.; Statistically the posttraumatic osteitis shows a clear tendency to decrease from 1972-76 in comparison with 1982-86 (AO/ASIF-documentation) . The incidence of infection varies considerably according to the different anatomical location of fractures . More recently atypical manifestations became of more importance and ask for differentiated bacteriological examinations . A close postoperative follow-up and exact wound-observations enable an immediate and adequate therapy in case of an infection. Clin Microbiol Rev, 1990 Apr, 3(2), 120 - 31 Transport of viral specimens; Johnson FB; The diagnosis of viral infections by culture relies on the collection of proper specimens, proper care to protect the virus in the specimens from environmental damage, and use of an adequate transport system to maintain virus activity . Collection of specimens with swabs that are toxic to either virus or cell culture should be avoided . A variety of transport media have been formulated, beginning with early bacteriological transport media . Certain swab-tube combinations have proven to be both effective and convenient . Of the liquid transport media, sucrose-based and broth-based media appear to be the most widely accepted and used . Studies on virus stability show that most viruses tested are sufficiently stable in transport media to withstand a transport time of 1 to 3 days . Some viruses may withstand longer transport times . In many cases, it is not necessary to store virus specimens in a refrigerator or send them to the laboratory on wet ice or frozen on dry ice . However, the specimen should not be exposed to environmental extremes . Modern viral transport media allow for more effective use of viral culture and culture enhancement techniques for the diagnosis of human viral infections. J Prosthet Dent, 1990 Apr, 63(4), 478 - 81 Monopoly coating on acrylic resin surfaces: a bacteriologic study; Aslan Y et al.; In an open bulb of a buccal flange obturator, it is almost impossible to polish the inner surface of the bulb . Because it cannot be cleaned easily, oral and nasal secretions lead to odors . To obtain a smoother surface, it is suggested that monopoly be painted on the unpolished surface of the open bulb . In this study, the effect of a monopoly coating on bacteria retention and washability of acrylic resin surfaces was investigated . Coated and uncoated acrylic resin samples were prepared and both were contaminated with Escherichia coli . After standard washing, the remaining viable E . coli colonies were counted . The statistical results showed that the difference in the number of E . coli colonies between coated and uncoated groups was highly significant (p less than 0.001) . It was suggested that monopoly should be applied to the acrylic resin surfaces where mechanical polishing cannot be done. Orv Hetil, 1990 Apr 1, 131(13), 691 - 5 {Topical treatment using granulated sugar in advanced mediastinitis following open heart surgery}; Szerafin T et al.; The complications caused by infection were examined prospectively in the case of 1164 patients who had undergone open heart operation . Postoperative mediastinitis occurred in 15 cases (1.3%) . Owing to mediastinal infection verified by bacteriological findings all patients had to undergo surgical intervention . Ten patients were treated by closed mediastinal irrigation . This method was effective in the case of five patients . Granulated sugar treatment was locally applied in five cases because of an infection, relapsing in spite of a closed treatment, and in four cases primarily, because of advanced mediastinitis and sternum osteomyelitis . With the mediastinal cavity being filled with granulated sugar twice a day, a rapid emptying of the wound and granulation tissue formation was observed in all patients . Redressing was easy and painless . Out of the 9 patients treated by granulated sugar three died before being discharged, but none of the deaths were due to wound complications . The rest of the patients were discharged cured averagely after 91.6 +/- 8.0 days . During the average 22 months' follow up period recurrence of sternal infection was not observed in the group treated by granulated sugar, while out of the 5 patients cured by closed mediastinal irrigation two had to undergo another operation after a few months because of the formation of sternal fistula . The authors consider the granulated sugar treatment to be an effective method in the treatment of obstinate and advanced mediastinal infections. Zh Mikrobiol Epidemiol Immunobiol, 1990 Apr, (4), 59 - 60 {The determination of hepatitis A antibodies in epidemiological practice}; Kornachev AS et al.; Epidemiological analysis of hepatitis A morbidity in a city with the population of 500,000 persons in 1960-1987 was carried out . Three periods of morbidity rises among children aged 3-6 years and 7-14 years and living at the same areas (microdistricts) were established . Blood sera from healthy children were tested for the presence of antibodies to hepatitis A in enzyme immunoassay . The data on the sanitary and bacteriological study of tap water were analyzed . Unsatisfactory results of water analysis in different microdistricts correlated with the presence of antibodies in the population of these microregions and with the average morbidity indices for many years. Am Rev Respir Dis, 1990 Apr, 141(4 Pt 1), 821 - 6 Rifabutin (ansamycin LM427) for the treatment of pulmonary Mycobacterium avium complex; O'Brien RJ et al.; During the period October 1983 through January 1988, the Centers for Disease Control (CDC) provided the experimental drug rifabutin (ansamycin LM427) to 406 patients with severe, progressive Mycobacterium avium complex pulmonary disease who had been unresponsive to standard therapy . Selected patients were randomly assigned to doses of 150, 300, or 450 mg rifabutin . Choice of companion drugs was left to the treating physicians . In the analysis of data from this program, we examined the relationship between response to treatment, as measured by bacteriologic sputum conversion, survival, weight gain, improvement in respiratory symptoms, and subjective assessment of clinical improvement, and a variety of patient and treatment variables . Although in some of the analyses a higher rifabutin dose appeared to be associated with sputum conversion, survival, and clinical improvement, the drug did not have a marked effect on outcome . The role of rifabutin in the treatment of this disease will best be assessed in a controlled clinical trial. Rev Med Chil, 1990 Apr, 118(4), 441 - 4 {Gonococcal arthritis during pregnancy . Considerations apropos of a case}; Pera MH et al.; A pregnant teenager was admitted with uterine contractions, metrorrhagia, migrating polyarthralgia and left knee arthritis with effusion . Disseminated gonococcal infection and arthritis of the knee were diagnosed by bacteriologic methods . Complete recovery followed appropriate antibiotic therapy . The outcome of pregnancy was timely and uneventful. Zhonghua Jie He He Hu Xi Za Zhi, 1990 Apr, 13(2), 95 - 8, 127 {Bacteriologic study of lung infection in 47 cases of burns}; Cui DJ; The culture results of sputum (SP), blood (BL) and wound secretions (WS) of 47 cases of burns with lung infection were analyzed . Symptoms of pneumonia within 5 days after burn were observed in 90.3% of inhalation injury patients (IIG, 31 cases) whereas only in 25.0% of noninhalation injury patients (NIIG, 16 cases) . The isolation rates of Gr(-) bacteria from the 3 sources of culture were markedly higher than those of Gr(+) cocci . The same bacteria, mainly Ps . aeruginosa and Staph . aureus, were identified simultaneously from the 3 sources of culture in 12 cases (25.5%) . Isolates from SP correlated well with those from WS, the coincidence rates of 4 main Gr(-) bacteria were over 58% . Ps . aeruginosa was the commonest pathogen of IIG but Staph . aureus was the commonest in SP and BL of NIIG . The isolation rate of fungi of SP in NIIG was about twice that in IIG . Ps . aeruginosa and E . coli were susceptible to Amikacin and Polymixin B, Ps . aeruginosa was more susceptible to Cefoperazone, while the Gr(+) cocci were susceptible to first generation Cephalosporins. J Chemother, 1990 Apr, 2(2), 113 - 5 Experience with ofloxacin in enteric fever; Sabbour MS et al.; Ofloxacin 200 mg b.i.d . for 8 days was employed in 28 patients with enteric fever with a positive blood culture . All patients were cured clinically and bacteriologically . The fever subsided within a mean of 3.1 days (range 1.6.5.3) . No relapse, clinical or bacteriological, was observed when patients were followed up for 12 weeks. Indian J Chest Dis Allied Sci, 1990 Apr-Jun, 32(2), 95 - 100 Clinical and bacteriological profile of hospitalized community acquired pneumonias--a preliminary study; Madhu SV et al.; The spectrum of clinical and bacteriological features of 46 cases of pneumonias presenting to U.C.M.S . and Guru Tegh Bahadur Hospital complex in East Delhi over a period of three months are presented and their etiopathogenesis discussed . The high incidence of pneumonias in admitted patients belonging to the population adjacent to the hospital is highlighted . Etiological diagnosis based on sputum culture and sensitivity tests was possible only in 37% cases, and there is need for the use of newer even though invasive methods for arriving at the bacteriological diagnosis. Indian J Chest Dis Allied Sci, 1990 Apr-Jun, 32(2), 125 - 8 Acute renal failure due to rifampicin; Agnihotri MS et al.; A 23-year-old male patient with bacteriologically proven pulmonary tuberculosis was treated with the various regimens of antituberculosis drugs for nearly 15 months . Rifampicin was administered thrice as one of the 3-4 drug regimen and each time he developed untoward side effects like nausea, vomiting and fever with chills and rigors . The last such episode was of acute renal failure at which stage the patient was seen by the authors of this report . The patient, however, made a full recovery. J Hosp Infect, 1990 Apr, 15 Suppl A, 61 - 4 Comparative clinical trial of ceftazidime and imipenem/cilastatin in patients with severe nosocomial pneumonias and septicaemias; Hartenauer U et al.; The efficacy and safety of ceftazidime and imipenem in patients with severe infections was compared in a randomized multi-centre trial . Patients on assisted respiration with clinical signs of pneumonia or septicaemia who had been in hospital for at least 3 days were studied . Twenty-one patients were treated with ceftazidime, 24 with imipenem . The mean duration of treatment was 9 days in both groups . At the end of the trial 17 patients (81%) of the ceftazidime group and 16 patients (67%) in the imipenem group were clinically cured or showed marked improvement . The bacteriological results showed an eradication of the causative pathogens in 17 of 21 cases in the ceftazidime group and 13 of 19 in the imipenem group. Pediatrie (Bucur), 1990 Apr-Jun, 39(2), 165 - 72 {The clinico-radiological aspects of tuberculosis in infants and young children}; Buta MG et al.; The primary pulmonary tuberculosis in the infant and small child is a reality we have to consider . Although the success in the antituberculosis struggle is evident and real in Romania, the contamination risk as this age is present and may lead to very severe forms . The bacteriologic investigation is the only way of establishing a certain diagnosis . But, since in the infant and the small child the etiologic agent is isolated only in 50% of cases, the clinical criteria with the test at tuberculin, radiologic examination, anamnestic data and epidemiologic inquiry increase considerably in importance . The study presents clinical-radiological observations on 6 cases of primary pulmonary tuberculosis in children under 3 years old. Presse Med, 1990 Mar 3, 19(8), 369 - 71 {Acquired syphilis during human immunodeficiency virus infection . 6 cases}; Caumes E et al.; We retrospectively studied the clinical, serological, bacteriological and histopathological data obtained in 6 HIV seropositive patients seen in our department from 1986 to 1989 for secondary syphilis . The clinical presentation was atypical in 4 of the 6 patients, with 2 palmoplantar keratodermas and 2 ulcerative syphilids . The diagnosis was made on darkfield examination in 2 patients, high titers of antibodies in 6 and histopathological examination (numerous plasma cells) in 4 . All were cured with the classical penicillin therapy recommended for early syphilis. Bull Acad Natl Med, 1990 Mar, 174(3), 413 - 9; discussion 419-20 {Immunochemical analysis of structural changes in ovalbumin caused by heat: possible application to the quick control of food sterilization}; Paraf A et al.; Bacteriological methods, to determine proper hygiene control for food for human consumption suffers from inordinate delay (1-4 days) in the methodology before an accurate answer can be given regarding the food safety . In contrast by immunochemistry results can be obtained in 15 to 30 minutes . As it is known that during heating processing protein structure is modified, a careful identification of epitopic changes by monoclonal antibodies could be of help . It was found that after heat treatment, ovalbumin structure modified depending upon the temperature of heating . Monoclonal antibodies were raised against either native or heat denatured ovalbumin . Such monoclonal antibodies bound to plastic can be used for the immunocapture of ovalbumin in solution which is then revealed by polyclonal antibodies . With five different monoclonal antibodies it was possible to identify either native ovalbumin or heat denatured ovalbumin between 50 degrees C and 65 degrees C or heat denatured ovalbumin between 85 degrees C and 100 degrees C . Work is in progress to recognize epitopes specific of temperature and time of heating. Ital J Orthop Traumatol, 1990 Mar, 16(1), 93 - 101 Arthrography of the prosthesetized painful hip: the importance of imaging and functional testing; Guercio N et al.; Thirty-four patients with painful prosthesetized hips were submitted to arthrography in order to evaluate the correlation between pain and the anatomical situation between the implants and the host bone . By injecting a local anaesthetic together with the contrast medium it was possible to perform functional tests comprising passive movements of the hip and full weightbearing for at least 5 minutes in order to ascertain whether or not the pain persisted . This yielded different results varying from total relief to persistence, depending on the type of mobilisation demonstrated by arthrography . In particular, pain was reduced in cases of mobilisation of the acetabular component, and persisted when mobilisation was in the femoral component . A correlation between functional testing, arthrography and bacteriological examination for possible low grade infection allowed for a closer study of the origin of pain, and more accurate planning of surgery when re-prosthesetization was being considered. Parazitologiia, 1990 Mar-Apr, 24(2), 102 - 5 {The infectiousness of Ixodes persulcatus ticks with the causative agents of Lyme disease and tick-borne encephalitis simultaneously}; Korenberg EI et al.; By means of individual bacteriological and virological investigations of adult Ixodes persulcatus ticks and comparison of obtained results there has been established their simultaneous spontaneous infection with agents of Lyme disease and tick-borne encephalitis . A possible frequency of such mixed infection in these vectors is being discussed. Antibiot Khimioter, 1990 Mar, 35(3), 38 - 42 {Characteristics of antibiotic use in children}; Poliak MS; In antibiotic therapy of children bacteriological findings should be considered . The choice of antibiotic doses depends on the drug pharmacokinetics and damaging effect, the state of the excretory organs and some other factors . Antibiotic elimination in children during the postnatal period is limited: there is a relationship between the gestation term and intensity of drug elimination . Antibiotics penetrate through the placental barrier . They are detected in the mother milk . The damaging effect of antibiotics in many respects depends on their properties, dosage and administration route . Children are more sensitive to the direct toxic action of antibiotics as compared to adults . Development of dysbacteriosis in children is frequent . Allergic reactions with diverse clinical signs are possible in children . Combined antibiotic therapy with observation of definite requirements is more efficient . Still, because of the antibiotic damaging effect monotherapy is more preferable in all possible cases. Vet Med (Praha), 1990 Mar, 35(3), 145 - 53 {Algorithms in the evaluation of electrical conductivity in milk in screening for mastitis}; Rysanek D; An algorithm of evaluation of diagnostic data for electronic screening of subclinical and clinical mastitis was derived from 5848 field measurements of the electric conductivity of mammary gland secretions and from the same number of clinical, bacteriological and cytological examinations of 92 dairy cows . The algorithm consists in the calculation of arithmetical mean of the two highest values of mixed, i.e . absolute, and or differential conductivity of a seven-day sliding cycle . Regardless of the intensity of disease forms, for healthy and colonized mammary glands, for mammary glands suffering from nonspecific subclinical mastitis, infectious subclinical mastitis and infectious clinical mastitis, the overall agreement with findings according to repeated clinical, bacteriological and cytological examinations made 88.8% with 4.2% of falsely negative and 7.0% of falsely positive findings . The overall agreement for persistent forms of diseases made 95.3% without falsely negative findings and with 4.7% of falsely positive findings. Indian J Med Res, 1990 Mar, 91, 126 - 8 Evaluation of different methods for detection of Helicobacter pylori in patients with gastric disease; Ayyagari A et al.; Endoscopic gastric antral biopsy specimens (133) from 92 dyspeptic patients with endoscopically evident gastritis (34; including one patient with dual pathology) gastric ulcer (13), duodenitis (17; including one patient with dual pathology) duodenal ulcer (29) and 41 subjects of non ulcer dyspepsia (NUD) with endoscopically normal upper gastrointestinal tract were examined for H . pylori by stained smear, various urease tests, culture and histopathology . Crushed tissue smear stained by Gram's method using carbol fuchsin counterstain proved to be the simplest and a reliable technique . Up to 4 h urease broth + ve test correlated well with smear and culture . Positive association of H . pylori with disease was considered when at least two of the above methods were suggestive . Significantly higher positivities were observed in gastritis (61.7%), gastric ulcer (84.6%), duodenitis (58.8%) and duodenal ulcer (82.8%) patients, as compared to NUD subjects (46.3%) . Severe histopathological lesions were frequently associated with multiple bacteriological test positives. J Laryngol Otol, 1990 Mar, 104(3), 255 - 8 Tuberculosis of the upper respiratory tract misdiagnosed as Wegener's granulomatosis--an important distinction; Couldery AD; Four cases, two personal, of mis-diagnosis of tuberculosis of the upper respiratory tract as Wegener's granulomatosis have been presented . Greater awareness of this possibility of mis-diagnosis may diminish the possibility of mis-treatment . It is suggested that fresh specimens should be sent for bacteriological examination and culture in all relevant upper respiratory tract lesions. Undersea Biomed Res, 1990 Mar, 17(2), 171 - 7 Inherent unsaturation in the treatment of pneumothorax at depth; Daugherty CG; In discussing the treatment of pneumothorax under pressure, standard diving medicine publications recommend only the insertion of a chest tube before decompression . However, there are marked difficulties in performing surgery in a typical offshore commercial chamber, and present knowledge of chamber bacteriology indicates there is important risk of serious infection . By contrast, the venerable principle of inherent unsaturation and known experimental data permit the rational and safe use of pressure and oxygen breathing to resolve this problem . This should be the treatment of first preference for, even if it is not effective, no other options are closed off . Two representative cases are presented. Lepr Rev, 1990 Mar, 61(1), 64 - 72 A re-appraisal of clinical and bacteriological criteria in the implementation of multiple drug therapy for leprosy control programmes and proposals for their better use; Georgiev GD et al.; Behind the appraisal of criteria above and our proposals, is the question 'To what extent and for what purpose should slit-skin smears be used in programmes implementing MDT?' The answer may lie somewhere between the extreme of abolishing them altogether and the present situation, in which many people seem to think that a comprehensive service has to be provided at many levels, including the periphery, almost regardless of quality and with minimal supervision . Our plea is twofold: (1) the much wider use of standardized clinical, as opposed to bacteriological, criteria for the grouping of the patients, the termination of treatment in multibacillary cases and follow up, and (2) the abolition of the routine use of slit-skin smear examination in the field, coupled with the phasing out of unsupervised peripheral units of doubtful quality and the identification of one laboratory at central or provincial level which is able to provide a reliable, high quality service for smears in selected cases . Clearly these proposals will not solve all the operational and methodological problems . There is an urgent need for research on the best ways to implement MDT on a large scale . But the truth of the matter is that 7 years after the WHO recommendations and for reasons which have so far been poorly defined, less than half the world's registered cases have so far received MDT . Most of the registered cases continue to take a form of treatment, dapsone monotherapy, which was condemned over 10 years ago as being hazardous on account of the dangers of resistance.(ABSTRACT TRUNCATED AT 250 WORDS) Endocrinology, 1990 Mar, 126(3), 1599 - 609 Effect of 1,25-dihydroxyvitamin D3 on induction of chondrocyte maturation in culture: extracellular matrix gene expression and morphology; Gerstenfeld LC et al.; Chondrocytes, derived from a tissue that remains as permanent hyaline cartilage in vivo (embryonic chicken caudal sterna) were treated with 10(-8) to 10(-8) M 1,25-dihydroxyvitamin D3 {1,25(OH)2D3} . These nonadherent rounded chondrocytes acquired an adherent, polygonal morphology in a dose-dependent fashion with 1,25(OH)2D3 treatment . During the first 4 days of 1,25(OH)2D3 treatment cell flattening was associated with a 10-fold increase in beta-actin and fibronectin and their corresponding messenger RNAs (mRNAs) . After adherence over the 12 days of continuous hormone treatment, a 2- to 4-fold increase in DNA synthesis and DNA accumulation were observed for the highest hormone dose (10(-8) M) . Over the same time course total collagen synthesis decreased 35-50% primarily due to decreased type II collagen synthesis, which accompanied comparable decreases in its mRNA . In contrast, both alpha 1(I) and alpha 2(I) showed a continuous 5- to 10-fold increase; however, type I collagen protein synthesis remained undetectable, indicating translational control of the type I collagen synthesis . alpha 1(X) mRNAs showed a 2- 3-fold increase after 12 days of hormone treatment, and its polypeptide was clearly detected by sodium dodecyl sulfate polyacrylamide gel analysis . Type IX collagen synthesis showed a 2-fold increase in synthesis and its mRNA levels during the first 4 days of 1,25(OH)2D3 treatment but thereafter had levels comparable to control cultures . Analysis of proteoglycan synthesis and core protein mRNA levels showed there was a 2-fold increase in core protein mRNAs while proteoglycan synthesis, as assessed by 35S incorporation, showed only a 10-20% increase . Direct hormone effects vs . those secondary to altered cellular morphology were determined by blocking cell adherence by growth of the 1,25(OH)2D3-treated cultures on bacteriological petri dishes . All of the observed effects on cytoskeletal and collagen mRNAs were blocked except the elevations observed in proteoglycan core protein and alpha 1(IX) mRNAs . DNA contents in hormone-treated cultures also remained elevated . These results suggest that 1,25(OH)2D3 both activates and suppresses specific genes, promoting chondrocyte maturation toward a more hypertrophic phenotype . However, prevention of the initial morphological alterations that are induced by 1,25(OH)2D3 blocks many of the subsequent changes in connective tissue expression. Infection, 1990 Mar-Apr, 18(2), 91 - 6 A randomized trial of ceftriaxone versus oral penicillin for the treatment of early European Lyme borreliosis; Weber K et al.; In a prospective randomized multicenter trial for the therapy of erythema migrans, 40 patients received ceftriaxone 1 g daily for 5 days and 33 patients obtained phenoxymethylpenicillin, 1 million units 3 times daily, for 12 days . Follow-up was for a mean of 10 +/- 5 months . Eight oral penicillin recipients (24%) and six ceftriaxone recipients (15%) developed minor consecutive manifestations . Two ceftriaxone and one penicillin recipient(s) still had elevated IgG antibody titers 10 to 20 months after therapy . Borrelia burgdorferi could be isolated from the erythema migrans in 29 out of 56 patients (52%) before therapy and in one oral penicillin recipient but none of 24 other patients after therapy . Ceftriaxone was superior to oral penicillin in a subgroup of patients with more than one symptom prior to therapy (p less than 0.01), but not in the overall evaluation of clinical, serological and bacteriological outcome data . Ceftriaxone ought to be preferred to oral penicillin in patients with more severe early Lyme borreliosis. Bol Asoc Med P R, 1990 Mar, 82(3), 125 - 8 {The use of ciprofloxacin in patients with osteomyelitis associated with vascular insufficiency}; Garcia-Rosario LN et al.; Osteomyelitis in patients with peripheral vascular insufficiency (PVI) has several characteristics which make its management a very difficult and controversial one . Generally it requires a prolonged course with broad spectrum intravenous antibiotics, which in turn requires hospitalization, increased risk of side effects and elevated cost . During the last years, the investigators developed the fluoroquinolones, which may help to simplify this treatment . These agents inhibit the synthesis of bacterial deoxyribonucleic acid . Ciprofloxacin is one of the most active of them . It has the following characteristics: broad spectrum of action, rapid absorption when administered by oral route, tolerated well by the patient, may be administered only twice a day, reach therapeutic concentrations in bone and it was more effective when compared with other antibiotics under the same conditions . Although the development of resistance against it has been clinically significant, it has been reported . We, the physicians, have the responsibility to use the quinolones correctly to avoid the development of resistance . Actually, ciprofloxacin is indicated for the treatment of osteomyelitis in patients with PVI, if it is bacteriologically documented . It is not indicated for empirical use . We use 750mg every 12 hours during 3 to 6 months . We have not been presenting ciprofloxacin as a panacea, but as an effective alternative, with clear indications that can decreases the cost of the treatment of osteomyelitis associated with PVI. J Am Vet Med Assoc, 1990 Mar 1, 196(5), 771 - 3 Coliform septicemia and pulmonary disease associated with canine parvoviral enteritis: 88 cases (1987-1988); Turk J et al.; Parvovirus infection was confirmed by fluorescent antibody staining or viral culturing in 137 (22%) of 615 necropsy accessions from dogs at the Missouri Veterinary Medical Diagnostic Laboratory from Jan 1, 1987 through Sept 30, 1988 . Septicemic colibacillosis was diagnosed in 88 (90%) of the 98 canine parvovirus-positive accessions in which liver or lung was cultured bacteriologically . Pulmonary edema or alveolitis similar to that seen in the human adult respiratory distress syndrome was observed in 63 (69%) of the 91 canine parvovirus-positive accessions in which the lungs were examined histologically. Allergol Immunopathol (Madr), 1990 Mar-Apr, 18(2), 91 - 4 T lymphocyte subpopulations in leprosy patients and their relation with circulating immune complexes; Bottasso OA et al.; The possible relationship between circulating immune complexes (CIC) and peripheral T lymphocyte populations was studied in thirteen active multibacillary leprosy (10 lepromatous--LL--and 3 borderline lepromatous--BL--) and 19 matched controls . Theophylline-resistant T cells (The-R, a lymphocyte subpopulation displaying helper activity on B cells) and total T cells were assessed by means of the E rosette technique, with and without previous theophylline incubation, 1h 37 degrees C, respectively . CIC were quantified by 125I-C1q binding test . Although leprosy patients showed a statistical non significant light depression in total T cells the remarkable variability in circulating levels of The-R T cells enabled us to separate them into two well delineated groups (in relation to this variable p less than 0.001) with no difference in age, sex and bacteriologic state: a) leprosy patients with The-R T cells proportionally conserved (6LL and 2BL); b) leprosy patients with The-R T cells proportionally depressed (4LL and 1BL) . Patients belonging to the latter group showed the highest statistically significant levels of CIC . Even though we do not discard an unknown factor being responsible for our findings, we believe that this inverse relationship between elevated CIC and depressed The-R circulating T cells might be representing a lower helper activity on antibody synthesis intending to reduce its excessive production. Z Orthop Ihre Grenzgeb, 1990 Mar-Apr, 128(2), 144 - 8 {Intra-operative shaft fissure--a possible cause of postoperative shaft pain following cement-free hip joint implantation . 2d experimental study}; Jantsch S et al.; Two experimental studies carried out at the Institute of Pathology and Bacteriology, Baumgartner Hohe, Vienna, in cooperation with the Department of Orthopaedics of the Centre of Pulmology, City of Vienna, confirm the danger of intraoperative shaft fissures occurring during implantation of cementless hip endoprostheses . It appears that such lesions are not visible either during implantation or on postoperative radiographs . The study was made using the Zweymuller shaft system which is normally implanted at our department . Pain of unknown origin in the shaft area during the phase of patients mobilization may be connected with shaft fissures due to implantation. J Card Surg, 1990 Mar, 5(1), 53 - 62 Predictors of outcome in patients with prosthetic valve endocarditis (PVE) and potential advantages of homograft aortic root replacement for prosthetic ascending aortic valve-graft infections; Miller DC; Seventy-five surgically treated patients with prosthetic valve endocarditis were treated at the Stanford University Medical Center . This was a multivariate analysis analyzing both patient related factors, bacteriology, and surgical findings . The conclusions among 10 patients with allograft valves, 20% had an annular abscess; this occurred in 36% of 29 patients with porcine valves, and 65% of these with mechanical prosthesis . Though prevention, again, is key in this especially devastating disease, once infection has been established and an aggressive approach is indicated, it would appear that a homograft re-replacement or free aortic homograft valve replacement can deal with severe tissue destruction to prevent recurrence. Nippon Koshu Eisei Zasshi, 1990 Mar, 37(3), 186 - 94 {Factors associated with development of tuberculosis among children and young adults: a study of newly registered cases}; Komatsu R et al.; In order to elucidate the factors relevant to the management and prevention of tuberculosis among children and young adults, a total of 191 tuberculosis cases who were newly registered at Health Centers in Saitama Prefecture and were aged less than 30 years were interviewed, and case-finding processes, treatment course and risk factors for clinical development were studied . Analyses of the time course from the patients' becoming aware of the clinical symptoms through the establishment of the diagnosis showed that the bacteriologically positive patients and the patients with cavitary lesion took a longer time before initiating medical action and before being finally diagnosed as tuberculous . Follow-up observation of patients' course of treatment revealed that 13% of the patients took prescribed medication irregularly or were lost to treatment . A case-control study was performed to determine the relationship between life style and disease risk . The control group was selected to match the patients for age and sex and also roughly with occupation . The risk factors found to be associated with the development of tuberculosis in this study included; family members' present or past history of tuberculosis, working night shift every week, eating at home less than once a day, diet not well balanced, indifference to personal health, lack of knowledge about tuberculosis and not attending 'cram' school . Also, patients were more likely to be taller and slimmer than controls. Tubercle, 1990 Mar, 71(1), 39 - 42 The mycobacteriology of pulmonary tuberculosis in South African gold miners; Cowie RL; Two bacteriological surveys of gold miners with pulmonary tuberculosis diagnosed for the first time, have shown a stable level of primary drug resistance which is substantially lower than that reported for the home areas of these men . Initial drug resistance was detected in 12.7% of the 205 cultures of Mycobacterium tuberculosis in 1983-1984 and in 10.7% of 253 cultures in 1988-1989 . Resistance to isoniazid was detected in 5.4% and 5.5% of the strains tested, to streptomycin in 6.8% and 5.1% and to rifampicin in 0% and 0.8% respectively . In a separate study, the sputum bacteriology of 691 miners with relapsed pulmonary tuberculosis was examined . M . tuberculosis was cultured from the sputum of 547 of the men and environmental mycobacteria (EM) in the remainder . Drug resistant tuberculosis was found in 20.5% of the previously treated men: isoniazid resistance in 14.3%, streptomycin resistance in 11.2% and rifampicin resistance in 3.7% . All of the rifampicin resistant strains were also resistant to isoniazid and 85% were resistant to streptomycin as well . Only EM were cultured from 29 of the 234, 1983-1984 sputum cultures, from 23 of the 276, 1988-1989 cultures and from 144 of the 691 relapse cultures . Mycobacterium kansasii (67%) was the commonest EM cultured. Res Vet Sci, 1990 Mar, 48(2), 196 - 200 Tuberculosis in captive seals: bacteriological studies on an isolate belonging to the Mycobacterium tuberculosis complex; Cousins DV et al.; Culture of tuberculous lesions from six of 14 captive seals yielded an organism which, on the basis of biochemical and drug sensitivity tests, was identified as Mycobacterium bovis, although the organism showed a weak cording pattern and was glycerol tolerant . It was pathogenic in rabbits and guinea pigs and after passage the organism exhibited strong cord formation and was glycerol intolerant . Restriction endonuclease analysis and sodium dodecyl-sulphate polyacrylamide gel electrophoresis indicated that the organism belonged to the Mycobacterium tuberculosis complex . Restriction patterns indicated that infection in the six seals was from a single source . Western blotting with monoclonal antibody to M bovis identified antigens at 23 and 27 kDa in M bovis which were absent from the seal isolates. Cas Lek Cesk, 1990 Feb 9, 129(6), 166 - 71 {The epidemiologic situation regarding tuberculosis and the effectiveness of tuberculosis surveillance in Bohemia in 1988}; Trnka L et al.; In the CSR (10 million inhabitants) in 1988 the system of TB surveillance was completed which comprises the national TB programme, the central TB register and the evaluation TB unit . The incidence of respiratory TB in 1988 in the CSR was 15.5/100,000 population . In 71% of the patients the disease was confirmed by bacteriological examination (11.0/100,000 population) . The incidence of extrapulmonary TB was 4.2/100,000 population . As compared with previous years, the number of patients declined except patients with already microscopically confirmed acid resistant rods in the sputum; their incidence, 5.5/100,000, remained the same in the CSR since 1986 . In this incidence participated in particular middle-aged men . The prevalence of active TB of the respiratory system was 20.0/100,000 population . It was only 1.3 times higher than the incidence, because treatment of TB patients was successful and principles of dispensarization were respected . The number of deaths from TB was 98 (0.9/100,000) . In 84 the diagnosis was established only during autopsy . The lethality was high in old people . The course of treatment was evaluated after one year in 1330 patients with respiratory TB diagnosed in 1987 . Satisfactory therapeutic results were achieved in 98% of the patients . In the remaining (17) patients bacteriological negativization of the sputum did not occur due to complications of treatment or lack of patient cooperation . 70% of the patients had a therapeutic regime with rifampicin . In-patient treatment was emphasized; the total mean period of administration of antituberculotics was 9.3 months. Pneumologie, 1990 Feb, 44 Suppl 1, 449 - 50 {Tuberculosis relapses in East Germany--a community related retrograde analysis 1984-1986}; Scharkoff H et al.; Basing on a retrospective analysis of 169 cases of relapses of tuberculosis that had been confirmed by bacteriological examinations, we explored possible causes and/or factors favouring a relapse . 6.5% of the mycobacteria cultivated when the relapse was discovered, were resistant to one antibiotic, and 5.3% to two ore more antibiotics . On treating the previous disease, side effects were seen in 31.6%, in 22.3% chemotherapy of the previous disease had been insufficient in respect of duration and/or continuity and/or combination, and in 22.5% the intake of drugs had lacked controlled supervision . In 56% of the relapses there were concomitant diseases (alcoholism in 24.5%, silicosis in 14.9%, diabetes mellitus in 9.7% and gastrointestinal diseases in 5.2%). J R Coll Surg Edinb, 1990 Feb, 35(1), 42 - 3 Bacteriology of aortic aneurysm sac contents; Stonebridge PA et al.; Aerobic and anaerobic cultures from the intraluminal thrombus of infrarenal aortic aneurysms were obtained from 239 patients . Culture results were related to the mode of presentation and the incidence of graft infection . Positive cultures were obtained from 27 patients (11.3%) . No statistical correlation between the result of thrombus culture and the mode of presentation was found. Acta Chir Scand, 1990 Feb, 156(2), 155 - 62 Biliary tract surgery: a bacteriologic and epidemiologic study; Hambraeus A et al.; The sources and routes of postoperative wound infections were prospectively studied in 440 patients undergoing biliary tract surgery . The overall infection rate was 7.3% . Specimens for culture were taken peroperatively from bile, liver bed and subcutaneous fat in 402 patients and also from skin in 64 . Of the 126 patients with positive bile culture (31%), all but one had bacteria in the other intraoperative cultures, with high counts of bile bacteria in liver bed and transfer of such bacteria to subcutaneous fat in 81.2% . The wound infection rate in this group was 12.8% . Of the 276 patients with sterile bile, more than 90% had bacteria in the other intraoperative cultures . The degree of contamination was low, with dominance of typical skin bacteria, and the group wound infection rate was 3.2% . In 19 postoperative wound infections intraoperative cultures were available for comparison . Eleven of these infections were classified as endogenous, six as exogenous and two as of uncertain origin . S . aureus was uncommon in bile and intraoperative wound cultures, but was almost as common as E . coli in the etiology of postoperative wound infections, indicating high pathogenicity. Pneumologie, 1990 Feb, 44(2), 55 - 61 {Reports of tuberculosis of the respiratory organs in Stuttgart 1986-1988--an epidemiologic study}; Neumann G et al.; This retrospective study is based on 427 cases of pulmonary tuberculosis, 153 smear positive, 101 culture positive, and 173 without bacteriologic confirmation, children and cases of pleurisy excluded, all notified by the Public Health Department of Stuttgart in 1986-1988 . Results are given by sex, age, nationality, cause of diagnosis, diagnosing institution, extent of disease, profession . These results are compared with those of former studies covering the periods 1964-1970 and 1980-1985 . There is a remarkable statistically significant and continuous increase in the rates of passive case-finding . Unfortunately the rate of far advanced cases has significantly increased from 1964-1970 to 1986-1988, due to the smaller contribution of active case-finding, particularly the cessation of mass miniature X-ray examinations . Passive case-finding yields more advanced cases than active case-finding . But in spite of this fact there is no plea for intensifying active case-finding . As far advanced cases are more dangerous than others to their contacts the shift to passive case-finding has a negative impact on the general decline of tuberculosis. Gastroenterology, 1990 Feb, 98(2), 302 - 9 The diagnosis of small bowel bacterial overgrowth . Reliability of jejunal culture and inadequacy of breath hydrogen testing; Corazza GR et al.; The reliability of a single jejunal culture in the diagnosis of small bowel bacterial overgrowth has recently been questioned . Seventy-seven patients thought to have bacterial overgrowth, defined as a jejunal culture yielding at least 10(6) organisms per milliliter of aspirate, took part in the study . Bacterial overgrowth was found in 74% of the patients with predisposing conditions and in 32% of those with no clear causes of bacterial colonization . The intestinal juice of some patients was taken at two different levels of the proximal jejunum, using both the closed- and open-tube systems . Highly significant correlations (rs = 0.90, p less than 0.001) were found between the numbers of bacteria per milliliter at the 2 jejunal levels and between the numbers of bacteria per milliliter of jejunal aspirate obtained from the closed and open tubes (rs = 0.84, p less than 0.001) . Compared with the jejunal culture, the gas chromatography of volatile fatty acids in jejunal aspirate and the glucose- and lactulose-hydrogen breath tests showed sensitivities of 56%, 62%, and 68% and specificities of 100%, 83%, and 44%, respectively . This work demonstrates the reliability of jejunal cultures and the inadequacy of breath hydrogen testing in the prediction of positive jejunal cultures . When results of testing for volatile fatty acids in jejunal aspirates are positive, this always indicates the presence of bacterial overgrowth; thus, this procedure would avoid the more complicated, time-consuming, and costly bacteriological analysis of jejunal samples. Dtsch Zahnarztl Z, 1990 Feb, 45(2), 98 - 102 {Development and significance of the cuticula dentis for the epithelial attachment}; Grossner B et al.; The purpose of this study was to identify those conditions governing presence and function of the secondary cuticle (cuticula dentis) by means of a clinical evaluation (Periodontal Status, Plaque Index, Decayed-Missing-Filled-Index) as well as radiological, bacteriological (plaque swabs) and histological studies . The secondary cuticle could be demonstrated mainly in individuals with mild bone resorption and minimal loss of periodontal attachment (age 20-50 years) . In most cases there was an intimate attachment of the junctional epithelium to the enamel or cementum surface . However, in most elderly subjects (older than 50 years) the secondary cuticle was found only in fragments or was not detectable at all . In these cases the junctional epithelium had proliferated apically (towards the apex dentis) and was only punctiformly attached to the tooth surface . Our histological findings suggested that the secondary cuticle is a secretory product of the junctional epithelium . Therefore, we assume it to be the essential structure in maintaining epithelial attachment. Bull Soc Ophtalmol Fr, 1990 Feb, 90(2), 199 - 204 {Syphilitic uveitis}; Mancel E et al.; The incidence of syphilitic uveitis is reportedly increasing, up to 1% uveitis in general, with often polymorphic and atypical manifestations . Three cases of syphilitic uveitis are reported here, at different stages (secondary, latent, late) . The bacteriologic sterilization is often unlikely in ocular syphilis, and recurrence is frequent; therefore a high-dose intravenous penicillin G treatment is then to recommend . HIV serology must be systematically associated with syphilitic tests. Zentralbl Veterinarmed B, 1990 Feb, 37(1), 19 - 27 Further evaluation of an indirect enzyme-linked immunosorbent assay for the diagnosis of bovine tuberculosis; Ritacco V et al.; The sensitivity and specificity of an ELISA for the detection of bovine IgG anti-Mycobacterium bovis antibodies were 73.6% and 94.1%, respectively, as determined in 53 bacteriologically confirmed tuberculous cattle and 101 healthy cattle from a tuberculosis-free area . In addition, the results of ELISA and tuberculin tests in 149 cattle were compared with those of subsequent necropsy studies . Both tests failed to detect 2 animals with tuberculous lesions and positive culture; 3/12 cattle with M . bovis isolation and no lesions, and 2/7 with atypical mycobacterial infection reacted to tuberculin, but none had antibodies; in 128 cattle with neither lesions nor mycobacterial isolation, 6 were tuberculin reactors and 7 others had antibodies . Negative results were obtained by ELISA in 21/22 paratuberculous cattle . Antibodies were not detected in 88.9% to 96.4% of 697 cattle from two tuberculin negative herds of an endemic area . In a herd with proved M . bovis infection, distribution of seropositive animals in tuberculin and non-tuberculin reactors was similar . Antibody responses to cutaneous tuberculin stimuli were observed in 4 experimentally infected cattle, but only in 2/10 healthy controls after repeated PPD stimuli . Nine controls which had either received a single tuberculin dose or none showed no increase in antibody levels . The low sensitivity of this ELISA limits its usefulness as a diagnostic tool for bovine tuberculosis eradication campaigns . However, it could be helpful in epidemiological surveillance if its efficiency to identify infected herds is demonstrated. Pathol Biol (Paris), 1990 Feb, 38(2), 126 - 9 {Prospective evaluation of modalities of ceftazidime prescription}; Fourrier A et al.; Between November 1987 and October 1988, we have prospectively studied 101 hospital prescriptions of ceftazidime, a third generation cephalosporine, including all the health care departements of St Joseph hospital . A standard questionnaire was used to collect the date: dosage, length, and conditions of prescriptions . We observed that this antibiotic is correctly prescribed concerning dosage, length of prescription, and is adapted to bacteriological findings . The striking results were a high proportion of empirical prescriptions (48%) comparing to less than 10% 6 months before the beninning of this study . 75% of these empirical prescriptions being later on confirmed by bacteriological exams. Offentl Gesundheitswes, 1990 Feb, 52(2), 58 - 64 {Decrease in tuberculosis mortality--a credit to medicine or sequela of an improved standard of living}; Tamm I; Tuberculosis was the major cause of death in 19th century Europe . A fall in the incidence of the disease was first observed in England . In Germany this reduced incidence - along with industrialization - did not take place until the time of the Reich . Scientists in the 19th century recognised various factors as being responsible for the decrease in incidence of the disease . Those who believed in the contagiousness of the disease hoped to be able to control it with preventive and hygienic measures resulting from their findings on the bacteriology of the epidemic . Constitutionalists, on the other hand, attached importance to hereditary factors and believed that "evolution by natural selection" would bring the disease under control . Social hygienists, whose findings at the beginning of the 20th century were a subject of wide discussion, found the disease to be chiefly influenced by eating, working, and living conditions . These assumptions were confirmed by a statistical analysis of the relationship between living conditions and the mortality associated with tuberculosis . It follows that better living conditions would help to reduce the number of deaths from tuberculosis better than any medical preventive measure. Genitourin Med, 1990 Feb, 66(1), 24 - 5 Bartholin's abscess: the role of Chlamydia trachomatis; Bleker OP et al.; Seventy-seven patients with a Bartholin's gland duct disorder were treated by incision and marsupialisation . At operation 18% were found to have a cyst and 82% an abscess . N gonorrhoea was isolated from four abscesses and C trachomatis from one . Bacteriological examination of the uterine cervix yielded one further case of N gonorrhoea and four more of C trachomatis . N gonorrhoea and C trachomatis are of limited aetiologic importance as causes of Bartholin's duct abscess . However, bacteriological examination for STD of the abscess and the cervix is mandatory because of adequate antibiotic treatment of the patients and their contacts. Wien Klin Wochenschr, 1990 Jan 19, 102(2), 45 - 7 {Changes in the thoracic roentgen image in patients with acquired immune deficiency syndrome}; Polzleitner D et al.; Since the earliest reports of what was later termed the acquired immune deficiency syndrome (AIDS) appeared in 1980/81, with the recognition of opportunistic infections and Kaposi's sarcoma in homosexual men and i.v . drug abusers, more than 60% of AIDS patients develop pulmonary manifestations at some time in the course of their disease . Radiographic evaluation of the chest plays an important role in diagnosis . In fact, radiological changes are unspecific and either bacteriological proof or histological verification needs to be confirmed. Tijdschr Diergeneeskd, 1990 Jan 15, 115(2), 51 - 60 {Postpartum endometritis in cattle}; de Kruif A; Postparturient endometritis in cattle is discussed in this review paper, considerable attention being paid to diagnosis and treatment . Clinical examination is stressed in the discussion of diagnosis . The diagnosis of endometritis may be established by rectal and vaginoscopical examination in nearly every case . Cytological and bacteriological examinations supply only little information . In view of the method of treatment, it is essential to determine whether or not the cow is affected with pyometra . Treatment of acute postparturient endometritis consists in intra-uterine administration of oxytetracycline (for a period of from one to three days) . Pyometra should be treated by injection of prostaglandins (PG) . When it is doubted whether pyometra is developing and a corpus luteum is present, treatment is nevertheless advisable . All other cases of chronic endometritis do not require therapy . The tendency to spontaneous recovery is so considerable in cattle that treatment cannot add anything to the results. J Am Vet Med Assoc, 1990 Jan 15, 196(2), 313 - 5 Brucella ovis excretion in semen of seronegative, clinically normal breeding rams; Bulgin MS; A commercial flock of Suffolk and Suffolk-cross breeding rams was monitored for 5 years in an effort to control epididymitis caused by Brucella ovis . Scrotal palpation, semen evaluations, and vaccination against B ovis were used the first 3 years . Serologic evaluation (complement fixation and ELISA) was added the fourth year, and bacteriologic culturing was added to the program the fifth year . Semen culturing in the fifth year revealed 9 (37.5%) of 24 rams were actively excreting B ovis; 6 of those 9 rams were seronegative . Neither semen quality nor the presence of WBC in the semen were dependable criteria to detect these seronegative carriers . In spite of the high percentage of B ovis excretors, few clinical signs of epididymitis were detected in the flock during the last 3 years of the study . It was hypothesized that vaccination protected rams against the clinical disease but not the carrier state . The importance of culturing semen for assessment of a control program was emphasized. J Med Genet, 1990 Jan, 27(1), 2 - 7 The polymerase chain reaction: current and future clinical applications; Lynch JR et al.; The polymerase chain reaction has undergone rapid improvement since its initial development, such that the technique currently permits rapid, accurate, predictive tests to be made in the field of prenatal diagnosis and has greatly aided forensic medicine . It is anticipated that the polymerase chain reaction will also facilitate advances in other fields, in particular preimplantation diagnosis, virology, bacteriology, and cancer therapy. Gastroenterol Clin Biol, 1990, 14(6-7), 555 - 60 {Effect of alcohol and cirrhosis on the presence of Helicobacter pylori in the gastric mucosa}; Pateron D et al.; The aim of this study was to determine whether there was any relationship between alcohol consumption, cirrhosis and Helicobacter pylori associated antral gastritis . One hundred and forty-four patients undergoing upper gastrointestinal endoscopy were prospectively included and classified in four groups . The first group of 23 patients had cirrhosis and an alcohol consumption below 80 g per day . The second group of 31 patients had cirrhosis and an alcohol consumption over 80 g per day . The third group of 34 patients had an alcohol consumption over 80 g per day without cirrhosis . The fourth group of 56 patients had an alcohol consumption below 80 g per day without any preexisting liver disease and underwent upper gastrointestinal endoscopy for non specific digestive symptoms . The diagnosis of Helicobacter pylori was made at histological examination using the hematoxylin and eosin stain and the Whartin-Starry stain in each case . Histopathological results were confirmed by a bacteriological study in 15 cases . One hundred and twelve of 144 patients (78 percent) had gastritis . Gastritis was more frequent (p less than 0.01) when Helicobacter pylori was present than when it was not (90 percent vs 68 percent) . Gastritis was more frequent when alcohol consumption was high (86 percent vs 72 percent) . Helicobacter pylori was found in 26 percent of the first group, 48 percent of the second group, 65 percent of the third group and 45 percent of the fourth group . These differences were significantly different (p less than 0.05) . A statistically significant relationship between high alcohol consumption and the presence of Helicobacter pylori was noted, even in the presence of cirrhosis (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) Pediatr Hematol Oncol, 1990, 7(1), 99 - 107 Acute chest syndrome in children with sickle cell anemia; Koren A et al.; Vaso-occlusive crisis is the most common cause of morbidity in patients with sickle cell anemia (SCA) . Those patients are frequently admitted with chest signs and symptoms suggesting an infective process . The term acute chest syndrome (ACS) is used to describe those chest episodes in SCA patients, and it is postulated that a primary bone vaso-occlusive crisis may be the cause of the acute chest syndrome in SCA patients . In this study we report 52 episodes of ACS in a group of 22 children with SCA . Chest pain, fever, and leukocytosis were a constant clinical finding . The hematological, radiological, and bacteriological studies are reported . There is a constant and significant fall in hemoglobin levels from 88 +/- 10 g/L (8.8 +/- 1.0 g/dl) to 68 +/- 15 g/L (6.8 +/- 5 g/dl) . Unilateral or bilateral pulmonary basal infiltrations were found in 50 episodes . Pleural effusion was noticed in 60 episodes, and it was bilateral in three . No significant bacteriological findings were present. Gig Tr Prof Zabol, 1990, (5), 7 - 10 {Diagnostic errors in silicotuberculosis (clinical-autopsy comparisons)}; Iakovlev VI et al.; Basing on 42 post-mortem examinations of silicotuberculosis cases, the contributors display the most frequently encountered errors in diagnosing this disease . Silicotuberculous bronchadenitis, conglomerate-cirrhotic lower-lobe silicotuberculosis and their complications (e.g . concomitant pericarditis and endobronchitis) are the most difficult cases for detection . To avoid diagnostic errors, a most detailed case history study is needed, along with a complex clinico-functional and tomography examinations, a wide use of endoscopy and bacteriological techniques. Pediatriia, 1990, (4), 52 - 8 {Clinico-bacteriologic and immunologic criteria in the formation of suppurative-inflammatory pathology in newborn infants}; Pavlova EV et al.; Based on the results of clinico-bacteriological and immunological studies carried out in the early neonatal period in 65 neonates afflicted with pyoinflammatory diseases and in their mothers, diagnostic criteria for intrauterine and early neonatal infection were elaborated . The significance played in this process of the character and level of microbial colonization of the amniotic fluid, placenta, labor tract of the mother, intrauterine antigenic stimulation of the fetus, changes in the peripheral blood and inflammatory alterations in the placenta was defined . Clinical, bacteriological and immunological prognostic criteria for the risk of the development of pyoinflammatory diseases in neonates were elaborated. Pediatriia, 1990, (4), 21 - 5 {Clinico-bacteriologic and immunologic characteristics of healthy newborn infants and their mothers}; Cherkasskaia RS et al.; A study was made of the establishment of biocenosis in the early neonatal period in healthy full-term neonates born to healthy mothers and in children belonging to a group at risk with an aggravated anamnesis but with no history of pyoinflammatory diseases . The study was related to bacterial colonization of the mother, amniotic fluid and placenta as well as to the immune status of the lying in woman and fetus . In 37% of children belonging to the group at risk, the minimal signs of intrauterine infection were discovered. Pediatr Pulmonol, 1990, 8(4), 268 - 72 Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated newborns; Rigal E et al.; The precise diagnosis of lower respiratory tract infection in the critically ill newborn remains a difficult challenge . The bronchoscopic protected specimen brush (PSB) is a reliable method in intubated adults . Because the bronchoscopic procedure is not generally available for young children, Zucker proposed a blind technique for introducing the PSB into the distal airways . His results were promising but were not compared with any bacteriologic reference method . Therefore, we wanted to evaluate this technique in comparison with the open lung biopsy (OLB) when it could be ethically accomplished . Eleven PSB were collected simultaneously with an OLB . The sensitivity of the PSB procedure was 100%, its specificity 88%, its positive predictive value 66%, and its negative predictive value 100% . There were no complications secondary to the PSB procedure . In this short study, the PSB procedure using a blind technique is safe and feasible to obtain uncontaminated specimens in intubated and ventilated newborns, and is largely accurate in identifying the bacterial etiologic agent of lower respiratory tract infection. Microbios, 1990, 62(251), 75 - 81 Influence of several feeds on bacteria in sheep and goat rumen liquor in vitro; Gonzalez-Lopez J et al.; Bacteriological studies were made with in vitro sheep and goat ruminal fluids supplemented with several feeds (alfalfa hay, wheat straw, Agave americana, Opuntia ficus indica and Atriplex nummularia) during anaerobic incubation at 38-39 degrees C . Drastic changes in the bacterial population of sheep ruminal fluids occurred in the presence of different feeds, particularly with addition of feeds of low nutritional quality (wheat straw, A . americana and O . ficus indica) . However, the bacterial population in goat rumen liquor was little affected by the addition of the same feeds . These results, which suggest that the rumen bacteria in goats are less affected by different nutritional conditions than the rumen bacteria in sheep, are discussed. Mikrobiol Zh, 1990 Jan-Feb, 52(1), 95 - 9 {A method of obtaining material for the bacteriological diagnosis of urethral diseases}; Stepanenko VI; An installation is developed for sampling the contents of urethra (A . c . USSR 980726) . The installation promotes acceleration of the correct diagnosis under the torpid and chronic inflammatory processes in the urethra . The above installation permits obtaining data on distribution of the microbic flora at a different depth of mucosa of the anterior area of the male urethra . In this case the mixing of samples taken for investigation from different sites is impossible. J Med Assoc Thai, 1990 Jan, 73(1), 53 - 7 Complete heart block complicating hyperthyroidism: a case report; Sriussadaporn S et al.; Complete heart block developed in a 29-year-old man with hyperthyroidism and acute febrile illness . The definite cause of acute febrile illness was unknown . The results of bacteriological and viral studies were negative . Endomyocardial biopsy revealed no evidence of carditis which is the common cause of heart block . All the abnormalities resolved completely after the fever subsided and the patient was treated with an antithyroid drug . Available information indicates that a high degree of heart block can sometimes occur in hyperthyroidism in either the presence or absence of additional factors which can independently impair atrioventricular conduction . This course of events which occurred in this patient suggest that complete heartblock may have been the direct manifestation of the hyperthyroid state, however, the acute febrile illness may have been an aggravating factor in the development of abnormal atrioventricular conduction. Ann Otolaryngol Chir Cervicofac, 1990, 107(3), 200 - 3; discussion 203-4 {Otorhinolaryngologic involvement in cystic fibrosis}; Denoyelle F et al.; ENT involvement is very frequent in mucoviscidosis, particularly rhinitis and sinusitis . This prospective study, which spanned from September 1st, 1988 to August 31st, 1989 anc included 27 children with cystic fibrosis of pancreas was carried out with the intent of determining the incidence of the various associated diseases, their bacteriologic profile, and the optimal therapeutic procedure . Less than a child in 5 is symptomless when the nose and sinuses are affected . Polyposis is found to occur in 6/27 cases, and all children have sinus radio-opacities . Ear disease is rare (1/4 of cases) and is manifested by asymptomatic tubal dysfunction with minimal audiometric repercussions . Bacteriologic specimens of sputum and sinus purulent discharge show simultaneous germ positivity (10 times out of 11) . Our therapeutic recommendations are based on our own experience as well as literature data, and are, in our opinion, only relevant for children with clinical signs of disease, as opposed to advocating systematic treatment of sinus foci found on X-ray. Ann Otolaryngol Chir Cervicofac, 1990, 107(2), 126 - 31 {Protracted otitis and subacute mastoiditis in children . A prospective study apropos of 118 cases}; Garabedian EN et al.; Antibiotherapy has lead to a substantial decrease in the number of infants with acute mastoiditis or complications thereof . However, the non-negligible incidence of protracted otitis currently observed has caused one to raise several pathogenid hypotheses, among which subacute mastoiditis figures as one needing to be detected early . This prospective study was conducted on 118 children treated for protracted otitis in the ENT Service at Hopital Trousseau, during the period from january 1987 to december 1988 . It allowed us to develop diagnostic and therapeutic strategies to cope with the difficult problem of protracted otitis, taking into account bacteriologic findings and risk factors, among other things. Arkh Patol, 1990, 52(1), 11 - 7 {The pathological anatomy of pneumococcal meningoencephalitis in adults}; Anisimova IuN; The results of the clinico-morphological examination of the bacteriologically confirmed meningoencephalitis in 12 autopsy cases are presented . The gravity of the clinical course of the pneumococcus meningoencephalitis is due to infectious-toxic shock the main morphological manifestation of which is disseminated intravascular coagulation . Neurotoxicosis symptoms prevailed in the clinical picture of the infectious-toxic shock even though the morphological changes characteristic of shock were found in the brain as well as in the internal organs particularly in the adrenals, lungs and kidneys . The peculiar feature of the disseminated intravascular coagulation was the domination of the hypercoagulation stage with the variety of intravascular fibrin formations (fibrin, hyaline, globular thrombi, prethrombi, fibrinous threads). Kansenshogaku Zasshi, 1990 Jan, 64(1), 1 - 11 {Clinical effect of NY-198 (lomefloxacin) for sexually transmitted disease--bacteriological effect of U . urealyticum}; Kawamura N et al.; We studied the efficacy of NY-198 (Lomefloxacin), a new quinolone derivatives, in the 46 cases of non-gonorrhoeae urethritis . NY-198 was mainly administered in doses of 600 mg three times a day for 7-14 days . The clinical and bacteriological effects of N . gonorrhoeae and C . trachomatis were already reported from many other authors, so we mainly summarized the cases of U . urealyticum . The 21 cases of isolated U . urealyticum, 19 cases of C . trachomatis and 2 cases of N . gonorrhoeae were all eradicated after this treatment . We concluded that NY-198 was a very useful drug for sexually transmitted disease. Gastroenterol Clin Biol, 1990, 14(2), 134 - 9 {Evaluation of decontamination procedures used at digestive endoscopy units in Gironde}; Raymond JM et al.; Decontamination procedures used for endoscopes were noted in 23 digestive endoscopy units, public and private, in the department of Gironde and compared to recommended procedures . Serial, bacteriological samples were obtained from one esogastroscope and one colonoscope in each unit, after upper endoscopy and colonoscopy diagnostic procedures at the end of the endoscopy session . Six units of 23 used complete decontamination procedures . In the 17 other units, principal errors of decontamination procedures were: inadequate cleaning of internal channel of scopes (12 units) and lack of utilization of glutaraldehyde between each endoscopy (8 units) . Bacteriological samples were negative in 11/12 endoscopes after a complete decontamination procedure and in 8/39 after an inadequate procedure (p less than 0.01) . Complete procedures are efficacious but not used often enough . Information and changes in endoscopic practices are necessary in digestive endoscopy units. Pneumonol Pol, 1990 Jan, 58(1), 26 - 32 {Value of transthoracic needle biopsy of the pleura in the diagnosis of diseases of the respiratory tract}; Traczyk K et al.; Pleural biopsy with Abram's needle was made in 160 consecutive patients with undiagnosed pleural effusions . The sampled fluid and pleural bioptates were examined histologically, cytologically and bacteriologically . In 40 cases malignant changes were found, out of 87 with confirmed malignancy . Neoplastic cells were found in 26 patients, ovreall the diagnosis was made in 65% of lung cancer cases . Out of 41 cases of tuberculosis, pleural biopsy provided this diagnosis in 24 patients (59%) . Bacteriological examination and pathological of the biopsy specimen allowed to increase the diagnostic field to 63% . Pleural biopsy did not yield any diagnosis in 9 cases of circulatory insufficiency, nor in ten patients with the following diagnoses -- pleuropneumonia, reumathoid arthritis, pulmonary thromboembolism and thoracic trauma . In 13 cases the diagnosis was not made . The diagnostic yield of pleural biopsy was similar to that reported by others . It is most valuable in cases suspected of malignancy and tuberculosis. Thorax, 1990 Jan, 45(1), 45 - 8 Mycobacterial infection in patients infected with the human immunodeficiency virus; Helbert M et al.; Of 207 homosexual or bisexual patients with the acquired immune deficiency syndrome (AIDS), 24 with the AIDS related complex, and 39 with asymptomatic HIV infection, 32 patients were found to have mycobacterial infection . Mycobacterium tuberculosis was found in 13 patients with AIDS and in two with the AIDS related complex . M avium-intracellulare was found in 15 patients with AIDS and was disseminated in 12 . One patient was infected with M kansasii and one with M ulcerans . Invasive procedures were frequently required to obtain positive bacteriological results . Subclinical carriage of M avium-intracellulare and other mycobacteria thought to be nonpathogenic was common in patients seronegative for the human immunodeficiency virus and at all stages of human immunodeficiency virus infection . All but one isolate of M tuberculosis were fully sensitive to standard antimycobacterial antibiotics . Response to treatment was usually rapid . M avium-intracellulare isolates were all resistant to first line agents in vitro, and antibiotics such as ansamycin and amikacin were required to obtain a clinical response. Rev Mal Respir, 1990, 7(2), 163 - 5 {Endobronchial tuberculosis simulating cancer}; Astoul P et al.; Endobronchial tuberculosis may simulate a bronchial neoplasm . It is the data from a bronchial biopsy carried out along with the X-ray and endoscopy examination followed by the bacteriology of the expectorating sputum which enables a diagnosis to be made . This form of diagnosis is known but is rare . The clinical outcome is very good after specific treatment, although the radiological signs and above all the endoscopic findings improve more slowly. Rev Stomatol Chir Maxillofac, 1990, 91(1), 41 - 6 {Diffuse sclerosing osteomyelitis of the mandible . Apropos of a case followed for more than 10 years}; Boutault F et al.; Diffuse sclerosing osteomyelitis (DSO) is a well-known chronic osseous disease . However, the diagnosis can be difficult as it has been observed for a case which is presented with more than 10 years survey . The clinical, radiographic, scintigraphic, histologic and bacteriologic aspects are discussed . The treatment can be made by various medical or surgical methods . None of these is completely efficient, even if good results could be observed in some cases . The prognosis seem to be at least uncertain . The real etiology is probably infection, but has never been proved. Exp Cell Res, 1990 Jan, 186(1), 109 - 14 Serum and serotonin induce retraction of calf aortic smooth muscle (CASM) cells in vitro: inhibition by ketanserin, a 5-HT2 receptor antagonist; De Wever B et al.; Calf aortic smooth muscle (CASM) cells cultured in vitro at high cell density (4 x 10(4) cells/cm2) on bacteriological petri dishes in the presence of serum pile up in clusters and create open spaces in the monolayer . This phenomenon is clearly visible 6 days after plating and is markedly enhanced by the addition of fetal calf serum . Serotonin is essential for the serum-induced retraction since (1) dialyzed serum has no effect, (2) of all the vasoactive agents we tested, only serotonin induced a similar degree of retraction, and (3) the serum-induced retraction was completely blocked by preincubating the cells with serotonin 5-HT2 receptor blockers such as ketanserin and ritanserin but not by preincubation with adrenergic-alpha 1 blockers or histamine antagonists . Serotonin caused CASM cell retraction in a dose-dependent way, with a maximum effect at 10(-6) M . The serotonin-induced retraction was reversible in time and was effectively blocked by ketanserin (IC50 = 1.2 x 10(-9) M) . It is therefore concluded that serotonin induces retraction of CASM cells, mediated by the serotonin 5-HT2 receptor. Arch Surg, 1990 Jan, 125(1), 17 - 22; discussion 22-3 Microbial infection and the septic response in critical surgical illness . Sepsis, not infection, determines outcome; Marshall J et al.; The differential roles of infection as a microbial phenomenon and sepsis as a host response were studied in 210 critically ill surgical patients . Infections occurred in 41.4% of all cases and in 82% of nonsurviving patients . Both infection and the expression of a septic response, measured as a sepsis score, were associated with significantly increased intensive care unit morbidity and mortality . Nonsurviving patients with infection had significantly higher sepsis scores than did survivors . Nonsurvivors with sepsis, on the other hand, did not differ from survivors with respect to any variable reflecting infection but did have higher mean sepsis scores . Maximum sepsis scores and sepsis scores on the day of death were similar in patients dying without infection and those dying with uncontrolled infection . The magnitude of the host septic response, independent of the presence, bacteriologic characteristics, or control of infection, is an important determinant of outcome in critical surgical illness. Surg Gynecol Obstet, 1990 Jan, 170(1), 49 - 55 Causes, presentation and survival of fifty-seven patients with necrotizing fasciitis of the male genitalia; Clayton MD et al.; This analysis of our experience with 57 men with necrotizing fasciitis of the genitalia was done to identify prognostic variables and to assess the results of a treatment policy of immediate and, if required, repetitive surgical debridements . The mean age of the patients was 55 years . Thirty-eight patients were alcoholics or diabetics, or both . All of the infections were of a genitourinary, anorectal or cutaneous source . Thirty-five per cent of the infections were confined to the genitalia and 65 per cent extended to the abdominal wall or thigh, or both . Forty-seven patients survived . Survival was associated significantly with a younger age, a serum blood urea nitrogen (BUN) level of less than 50 milligrams per deciliter at presentation, the absence of a constellation of abnormalities at presentation consistent with sepsis and a decreased incidence of major complications after initial debridement (p less than 0.05 to 0.01) . Survival was not associated with the extent of infection, the duration of symptoms before hospitalization, systemic risk factors, the source of infection, abnormal findings at presentation (excluding a BUN of greater than 50 milligrams per deciliter) and the bacteriologic factors of the infection . Both localized and extensive necrotizing fasciitis of the male genitalia are potentially lethal disorders that require prompt treatment. Medicina (B Aires), 1990, 50(1), 3 - 8 {Human immunodeficiency virus infection associated with tuberculosis}; Musella RM et al.; In order to detect an association between HIV infection and tuberculosis (TB), 130 TB inpatients were studied one of whom presented a pulmonary disease due to Mycobacterium avium intracellulare . All had advanced TB, 95.4%, with pulmonary localization . Serum anti-HIV antibodies were detected by ELISA and their presence confirmed by immunoblotting in 4 (3.1%) individuals, three males and one female, with different degrees of pulmonary TB . Of the males, 1 was bisexual, 2 were promiscuous, and the female was the sexual partner of a non symptomatic HIV-infected man . No immunological disturbances or other AIDS related alterations were observed . There was one case of miliary TB, but neither atypical X-ray abnormalities nor extrapulmonary involvement were found . Tuberculin reaction was positive in three of the four HIV infected patients . Clinical, radiological and bacteriological evolution were favorable . Adverse drug reaction occurred in two cases, one of them presenting serious toxidermia caused by isoniazid . Of the 130 individuals, 12 presented risk factors for HIV infection so that the prevalence of anti-HIV antibodies presented here, 4 cases out of 12, is consistent with data from previous reports for high risk populations. J Invest Surg, 1990, 3(4), 373 - 85 Totally implantable catheter system in the dog; Grosse-Siestrup C et al.; Four totally implantable catheter systems for arterial and venous access were implanted for a maximum of 17 months . Hematological and bacteriological tests were performed . The platelets remained normal . Occasionally observed bacteremias were successfully treated . The morphological and SEM results show that in comparison to the standard externalized catheter the totally implantable catheter system has a longer functional lifetime and less problems with sepsis while the well-being of the experimental animal is improved. Vestn Dermatol Venerol, 1990, (11), 56 - 9 {Mycetoma of the hand}; Siano VI et al.; A case with a rare localization of mycetoma, on the hand, is described . A 31-year-old male patient developed this condition in 5 months after injury with a rope . Surgical treatment for a phlegmon of the left hand was ineffective . After microscopic and bacteriologic studies the dermatologists have diagnosed a pseudomycotic (actinomycotic) mycetoma of the left hand and lower third of the left arm . Streptomycin, penicillin, and actinolysate therapy essentially improved the course of the process . A review of literature on the etiology, epidemiology, clinical picture and therapy of mycetoma is presented. Vestn Dermatol Venerol, 1990, (9), 73 - 6 {A case of chromomycosis in a nonendemic region}; Kovalev VM et al.; A 43-year-old miner of the Donetsk coal fields is described, who developed in a month after a microinjury of the skin of the thoracic left side an intumescence and skin reddening . Later an agglomeration of nodules formed there with small ulcers regularly appearing, that did not heal for a long time . Histologic and bacteriologic analysis confirmed chromomycosis . The disease focus was resected . No recurrences were recorded in the following 8 months . This observation points to a wider prevalence of chromomycosis in a nonendemic area, the European part of the USSR, than it is reported in literature. Scand J Infect Dis, 1990, 22(6), 735 - 7 Polymicrobial endocarditis with eight pathogens in an intravenous drug abuser; Mah MW et al.; A 17-year-old intravenous drug abuser with tricuspid endocarditis required valvulectomy for refractory infection due to 8 different bacterial pathogens . Only one organism was isolated from blood cultures in the first 48 h, and subsequent organisms were not isolated until 9-13 days after hospitalization . The spectrum of pathogens in this patient strengthens previous clinico-bacteriologic observations made in the literature, and emphasizes the need for empiric coverage of oropharyngeal flora in addition to the usual skin flora involved in drug-addict associated endocarditis. Ann Radiol (Paris), 1990, 33(3), 195 - 9 Cerebral complications of purulent meningitis in children assessed by transfontanellar ultrasonography in Yaounde (Cameroon); Gonsu-Fotsin J et al.; Sixty-one children, aged 0 to 12 months, all having meningitis confirmed by bacteriological and biochemical studies of CSF, were subjected to transfontanellar US exploration and clinical follow-up . Thirty-three (54.1%) children were normal, and 28 (45.9%) presented cerebral complications: hydrocephalus 20 cases (71.4%), ventriculitis 5 cases (17.9%), abscess and ventriculitis 2 cases (7.1%) and cerebral atrophy 1 case (3.6%) . 36.1% of patients with purulent or turbid CSF presented with complications . 24.6% of complications were due to unidentified bacteria and 11.4% due to pneumococcus group . 90.9% patients with coma, and 76.4% with convulsion showed cerebral complications . The authors recommend routine us exploration of children with confirmed meningitis in tropical milieu. Korean J Intern Med, 1990 Jan, 5(1), 44 - 50 Serum levels of soluble interleukin-2 receptor in pulmonary tuberculosis; Choi SJ et al.; It is well known that the activation of cell mediated immunity has an important role in the pathogenesis of pulmonary tuberculosis and the production of the protective immunity against Mycobacterium tuberculosis . During the activation of T-cell by Interleukin-1 released from the macrophage, not only Interleukin-2 but also the soluble Interleukin-2 receptor (sIL-2R) molecule is released into the extracellular fluid . In vitro study reveals that the level of this sIL-2R is well correlated with the degree of activation of the T-cell . We therefore carried out this study to evaluate the significance of the serum IL-2R level in determining the disease activity of pulmonary tuberculosis . The level of sIL-2R was measured by sandwich ELISA method . The level of sIL-2R in 42 patients with bacteriologically -proven active pulmonary tuberculosis (29 far and moderately advanced pulmonary tuberculosis, age: 30.3 +/- 10.3 yrs; 13 minimal pulmonary tuberculosis, age: 34.4 +/- 15.3 yrs) was 1111 +/- 424 mu/ml, which was significantly higher than the normal control group (age: 31.0 +/- 9.9 yrs) (365 +/- 143 mu/ml) and inactive pulmonary tuberculosis group (age: 37.3 +/- 16.9 yrs) (465 +/- 131 mu/ml) . But there was no significant difference between 29 patients with advanced pulmonary tuberculosis (1138 +/- 405 mu/ml) and 13 patients with minimal pulmonary tuberculosis (1051 +/- 474 mu/ml).(ABSTRACT TRUNCATED AT 250 WORDS) Nord Med, 1990, 105(12), 338 - 9 {Research in developing countries: will leprosy vaccine be produced in Nepal?}; Kurlberg G; Clinical, bacteriological and immunological research into leprosy is pursued at the Anandaban Leprosy Hospital on the outskirts of Kathmandu in Nepal with support from the World Health Organization and research laboratories in inter alia Holland and Australia . The bacteriological part consists of research into cultivation procedures on mice for diagnosis of Mycobacterium Leprae resistance to dapsone and rifampicin . Serological studies have also yielded M . Leprae-specific antibodies, a method which, it is hoped, will be further developed as an aid to diagnosis and follow-up of treatment . Research concerning a leprosy vaccine is also in progress. Rev Mal Respir, 1990, 7(1), 65 - 8 {Steroid-sensitive cavitating pulmonary opacity in Horton's disease}; Diot E et al.; We report the case of a 72 year old woman treated for seven months for Horton's disease presenting with a cavitating pneumonia of the left axillary segment associated with a deterioration of the general state, at the time of which the steroid therapy was in the course of being decreased . The radiological appearance and the clinical context of immune depression had led to a trial of a quadruple anti-tuberculous therapy in spite of the absence of any bacteriological proof . This rapid aggravation of the condition under treatment led to the suggestion of a pulmonary localisation of Horton's disease . The rapid regression of the lesions after increasing the dose of steroids and the negative cultures on Lowenstein medium pleaded in favour of this hypothesis . However the continuation of anti-tuberculous treatment seems justified in such cases in so far as the diagnosis of Horton's disease of the lung often cannot be maintained other than retrospectively in the absence of histological proof. Recenti Prog Med, 1990 Jan, 81(1), 33 - 4 {Abdominal lymph node tuberculosis: a diagnostic surprise}; Bernardeschi P et al.; The case of a patient submitted to sonographic abdominal examination because of recent onset of fever, abdominal pain and weight loss, with the finding of multiple enlarged lymph nodes along great vessels, is reported . Because of the negativity of noninvasive procedures, the patient underwent laparatomy and biopsy . The histologic and bacteriologic diagnosis of tuberculous lymphnodes was unexpected, as the patient was unreactive to the tuberculin skin test and had no signs of active pulmonary tuberculosis . Although uncommon, tuberculosis must be included in the differential diagnosis of subdiaphragmatic lymphadenopathies even if symptoms of mycobacterial infection or other signs of the infections are not presented. Padiatr Grenzgeb, 1990, 29(5), 373 - 6 {Neonatal sepsis: bases and possibilities for immunotherapy and immunoprophylaxis . 3: Immunoprophylaxis}; Borte M et al.; This paper reviews several specific and nonspecific procedures for immunoprophylaxis to prevent bacteriological infections in preterm and term newborns . An active or passive immunization is limited necessarily by the wide range of organisms causing neonatal infections . There exist first experiences regarding the prophylactic use of intravenous gammaglobulins for high-risk neonates or pregnant women with symptoms of infection and at risk for preterm delivery . Bacterial polysaccharide vaccines are under development, but up to now far off any universal availability. J Orthop Trauma, 1990, 4(3), 331 - 5 What's in a nail? Singer PJ, Seligson D. To determine the incidence of subclinical infection using routine swab methods in asymptomatic patients, 30 consecutive hollow intramedullary nails were studied . Variables identified were leukocyte count and differential, patient complaints, time elapsed from injury to nail implantation, duration of nail implantation, and the size of the nail . Specimens were gathered from the lumen of intramedullary nails using the routine swab method for bacterial culture as well as fungal and acid-fast growth . This material was also subjected to pathologic review with routine hematoxylin and eosin staining . There were no significant positive cultures in this study . The pathologic review indicated that the material in the canal of an intramedullary nail was either granulation tissue, fibrous tissue, or osseous tissue . No patient had a deep or superficial wound infection after implant removal . The results of this study indicate that the material in the lumen of the hollow intramedullary nail will fail to grew organisms when the swab method is used in gathering the specimen or the material is sent for quantitative bacteriology. Acta Leprol, 1990, 7(2), 109 - 17 {Late reversal reactions in leprosy}; Flageul B et al.; Since the application of short duration multidrug therapy (MDT) in leprosy, it has been reported that reversal reactions (RR) may occur after withdrawal of treatment . Surprisingly, such "late reversal reactions" have quite never been described after monosulphonotherapy . Such RR, especially in endemic areas, may represent diagnostic and therapeutic difficult problems . We report 5 cases of late RR . In 4 cases (1 BT patient and 3 BL-LLs patients), the RR occurred 1 month 1/2 to 3 years after cessation of MDT . In the last case (form LLs), the RR happened 6 months after that a 14 years monosulphonotherapy has been stopped . These observations strengthen the need of a complete clinical, bacteriological and immunological evaluation at the time of the diagnostic, more useful than a single bacteriological study, to differentiate late RR from relapses . Moreover, the last case confirms that late RR may occur after monosulphonotherapy. Skeletal Radiol, 1990, 19(6), 453 - 5 Case report 627: Septic arthritis of lumbar facet joint as initial manifestation of spondylodiscitis; Rousselin B et al.; In summary, septic arthritis of a lumbar facet joint has been rarely discussed in the literature {1, 4} . In this case report the histological and bacteriological diagnosis was established by percutaneous needle biopsy guided by fluoroscopy and the response to treatment was confirmed by CT scans. Scand J Infect Dis Suppl, 1990, 68, 46 - 9 A comparative study of ofloxacin and pivmecillinam in acute exacerbations of chronic bronchitis; Egede F et al.; In a double-blind study in 84 patients with chronic bronchitis and purulent exacerbations, ofloxacin 200 mg b.i.d . and pivampicillin 700 mg t.i.d., were compared with respect to efficacy and safety . Both treatments resulted in a uniform and very high bacteriological elimination rate (94.1% to 97.2%) and clinical cure rate (97.4% to 97.6%) . There were, however, signs of fewer adverse reactions and a better patient acceptance in the ofloxacin group. Scand J Infect Dis Suppl, 1990, 68, 41 - 5 Oral ofloxacin once daily and doxycycline in the treatment of acute exacerbations of chronic bronchitis; Punakivi L et al.; 192 patients, most of them ambulatory, with acute exacerbation of chronic bronchitis were treated with 10- to 14-day courses of oral ofloxacin receiving 400 mg once daily or doxycycline first 200 mg and then 100 mg once daily in this randomized observer-blinded multicentre study . 98 patients were included in the ofloxacin group and 94 in the doxycycline group . The clinical efficacy was 86/87 (98.8%) in the ofloxacin group and 87/91 (91.2%) in the doxycycline group . The bacteriological efficacy was 31/34 (91.2%) in the ofloxacin group and 19/24 (79.2%) in the doxycycline group . Some patients had more than one pathogen . There was no statistically significant difference in efficacy between the two treatment groups; both treatments were highly effective and well tolerated . The adverse events showed an expected pattern . Ofloxacin treatment was discontinued in three patients . In conclusion, both treatments were found to have similar safety and efficacy and were well tolerated when used for treatment of acute exacerbations of chronic bronchitis. Rev Pneumol Clin, 1990, 46(2), 69 - 72 {Isolated pleural actinomycosis . Apropos of 2 cases}; Touboul JL et al.; Two cases of isolated pleural actinomycosis are reported . This form is much less frequent than the pulmonary form, and it accounts for only 20% of thoracic actinomycoses . The bacteriological diagnosis is easily obtainable by pleural puncture, provided it has not been obscured by previous antibiotic therapy and provided the organism has systematically been cultured under anaerobic conditions . Pleural actinomycosis has a very favourable prognosis . Local treatment, sometimes surgical, is indispensable . If the condition is diagnosed at an early stage, systemic antibiotic therapy can be reduced to 6 to 12 weeks. Rev Laryngol Otol Rhinol (Bord), 1990, 111(3), 217 - 20 {Tuberculosis of the upper digestive and respiratory tract}; Ennouri A et al.; Based on seventeen cases of upper digestive and respiratory tract tuberculosis, the authors review the different localizations of the disease . The mean age of the patients is 34 years old . The diagnostic is based on bacteriological and especially histological examination . The prognostic of the affection is excellent if tuberculosis chemotherapy is used for a minimum of 9 months. Rev Laryngol Otol Rhinol (Bord), 1990, 111(2), 149 - 52 {Tuberculosis of the cavum, report of two cases}; Marrakchi R et al.; The authors report two cases of nasopharynx tuberculosis . This location is rare or misestimated . The sarcoidosis, the Wegener's granulomatis can be discussed . The diagnosis confirmation is based on the histologic features as a caseous necrosis in a langhans reaction cells or as the presence of mycobacterium tuberculosis at a Ziehl-Nielson coloration . The authors insist on the interest of a systematic biopsy of the nasopharynx at the presence of a nasopharynx lesion or a primitive cervical lymph-nodes . A bacteriologic investigation have to be done before the beginning of the specific treatment. Rev Laryngol Otol Rhinol (Bord), 1990, 111(2), 141 - 3 {Sinus infection and diving (a case of cerebral empyema)}; Buisson P et al.; Intracranial complications following swimming or diving accidents are exceptional . A recent observation of a cerebral empyema in a 15-year old boy, with neurological sequellae was an opportunity the clarify the issue . Apart from the rapidity of the neurological signs, two points drew our attention: bacteriology, with a predominance of anaerobic germs; and the problem of therapy, both for the timing of neurosurgery and for the role of anticoagulants in venous thrombosis. Plucne Bolesti, 1990 Jan-Jun, 42(1-2), 117 - 22 {Analysis of hospitalized tuberculosis patients at the Institute for Pulmonary Diseases and Tuberculosis in Belgrade, Serbia during 1988}; Radosavljevic G et al.; The report presents the analysis of TB patients treated at the Institute for lung diseases and tuberculosis of SR of Serbia during 1988--a total of 567 or 10.18% of discharged patients . There were 77% TB patients from Belgrade and 23% from the province . Tuberculosis retains the characteristics of a social disease with a morbidity peak in the fourth decade of age . There were 93% of cases discovered due to disease symptoms . In 82% of patients it was a case of newly discovered specific process, 7.5% had a recurrent disease and 10.5% of patients had a chronic form of the disease . The patients had almost all forms of the specific process: primary tuberculosis 0.35%, postprimary phthisis 84.4%, specific pleuritis 10.6%, tuberculom 1.9%, miliary tuberculosis 1.8%, lymphoglandular tuberculosis 0.9%, while 1.4% had extrathoracic specific lesions associated with pulmonary lesions . Cavernous tuberculosis was observed in 89% of TB patients and extensive phthisis in 14% of cases . Atypical forms of parenchymal specific process were observed in 12% patients . Bacteriological or histological confirmation of tuberculosis existed for 82% . In 13% of patients treatment lasted longer than 3 months . Six or 1% of patients died due to pulmonary tuberculosis. Schweiz Arch Tierheilkd, 1990, 132(6), 315 - 22 {Nocardia mastitis in cattle . 1 . Clinical observations and diagnosis in 7 particular cases}; Battig U et al.; Lately reports of nocardial mastitis have been increasing . Therefore the clinical aspects of 7 individual cases were investigated . Pathologic-anatomical changes of the udder were registered and bacteriological examination of tissue and milk probes were performed . All of the cows had a mastitis during previous lactation periods which had to be treated with antibiotics . The infected quarters recovered in no cases . Shortly after parturition 6 cows had a severe acute mastitis . The cows were treated intramammarily and parenterally with various antibiotics during several days . The infected quarter became indurated and strongly enlarged . These changes were not influenced by therapy, and the cows lost weight . 14 days after the outbreak of the illness, all 6 cows were culled . One cow had a chronic Nocardia mastitis with involution of the affected quarter . Though treated several times, this cow did not recover either . The histopathological examination of the affected quarters revealed an acute to chronic, necrotic to granulomatous mastitis . Nocardia asteroides was histologically and bacteriologically proven to be the causative agent . The reason for the frequent infections with Nocardia and the way of infection is not clear yet . Therapy with antibiotics brought no recovery in any cases . The infected cows should be removed from the herd or culled. Scand J Infect Dis, 1990, 22(2), 209 - 18 A randomised comparison of ceftazidime and piperacillin, both in combination with flucloxacillin for treatment of febrile episodes in neutropenic children . Finnish Three-Centre Study; Perkkio M et al.; 111 febrile episodes in 98 neutropenic children were randomly treated with either ceftazidime (CAZ) 150 mg/kg/day or with piperacillin (PIP) 200 mg/kg/day, both combined with flucloxacillin (FLUC) 50 mg/kg/day . A total of 37/47 (79%) eligible episodes in the CAZ group and 41/53 (77%) in the PIP group were cured without needing to stop the initial therapy . The success without modification of the treatment in the verified septicaemias in the CAZ group was 8/18 (44%) and in the PIP group 5/18 (28%) . Of the bacteriologically documented infections, 13/24 (54%) in the CAZ group and 11/24 (46%) in the PIP group were cured without modification of the therapy . Similarly, 17/31 (55%) of all the isolated bacteria in the CAZ group and 14/33 (42%) in the PIP group were eradicated with the initial therapy . Overall there were 13 deaths of which 4 in the CAZ group and 5 in the PIP group occurred during the infection . An increasing granulocyte count exceeding 0.25 x 10(9)/l at the end of the therapy was a good prognostic sign for the outcome of the infection . This study indicates that CAZ is as effective as PIP in the treatment of infections in neutropenic children. Kansenshogaku Zasshi, 1990 Jan, 64(1), 54 - 64 {Therapeutic evaluation of combination therapy using C-425, human native immunoglobulin liquid preparation for i.v . administration, with antibiotics in severe infections in the field of surgery}; Mishima Y et al.; In a nationwide study conducted in 11 surgical institutions of C-425, a newly developed human native immunoglobulin liquid preparation for intravenous injection, was combined with conventional antibiotic treatment to investigate the efficacy and safety . A total of 47 patients with severe infections which had not symptomatically responded to 3-day or longer treatment with any antibiotics was included . Doctors in charge judged the efficacy of C-425 to be "excellent" in 3 patients, "good" in 13, "fair" in 15, and "poor" in 4 . Thus, a total of 16 patients (45.7%) was judged to have responded to C-425 when the "excellent" and "good" responses were combined . The number responding was 31 (88.6%) when the "fair" cases were also included . Excluding 31 patients who did not meet the Committee's criteria, the Committee judged the efficacy of C-425 in a total of 16 patients; the efficacy was "excellent" in 2 patients, "good" in 4, "fair" in 9, and "poor" in 1 . The number of responding patients was 6 (37.5%) of the 16 when the "excellent" and "good" cases were combined, and 15 (93.8%) when the "fair" cases were added . Bacteriological assessment was conducted in a total of 9 patients . Causative bacteria were eradicated in 3 patients, decreased in number in 1, replaced in 2, and persisted in 3 . Thus, bacteriological efficacy was observed in 6 of the 9 patients (66.7%) . Neither adverse reactions nor drug-related laboratory abnormalities were observed in the 47 patients. Ann Dermatol Venereol, 1990, 117(1), 23 - 7 {The history of dandruff and dandruff in history . A homage to Raymond Sabouraud}; Saint-Leger D; In one of his books, written at the beginning of this century, Raymond Sabouraud devotes some 280 pages to the history of dandruff . Their reading illustrates how, from the Greeks to Sabouraud's era, this desquamative disease has been subjected to endless doctrinal and scientific conflicts, long before the so-called "present" controversies . One of the early conflicts, between Celsus and Galen, lies in the nature of the squames, i . e . dry or exudating, leading to the inclusion (or non inclusion) or pityriasis in the group of desquamative diseases, such as psoriasis or ichytosis . Translated into Latin (furfur, porrigo) and into Arabic, the word pityriasis was replaced in the Middle Age by tinea which then referred to any disease of the human scalp . With Plenk, Lorry, Willan and others, the 18th century brought a new attitude of mind where observation took precedence over doctrine, but owing to the lack of experimental approach there was no adequate description of the squames and their anatomical origin . This was the case with Hebra who, in the 1