Tubercle, 1989 Jun, 70(2), 123 - 6 Local anti-P32 humoral response in tuberculous meningitis; Van Vooren JP et al.; We report five cases of severe pulmonary tuberculosis admitted to hospital with a suspicion of meningeal involvement . The diagnosis of tuberculous meningitis was confirmed by standard bacteriological techniques in two of the five patients . Specific IgG class antibodies directed against the recently purified BCG antigen P32 were detected by a dot immunoblotting technique in the serum and in the cerebrospinal fluid of each patient; however, a higher anti-P32 immunoglobulins/total immunoglobulins ratio was observed in the cerebrospinal fluid of patients with tuberculous meningitis than in their serum while the reverse situation was observed in the other patients. Lepr Rev, 1989 Jun, 60(2), 109 - 17 Combined regimens of one year duration in the treatment of multibacillary leprosy--I . Combined regimens with rifampicin administered during one year; Pattyn SR et al.; In 1981, 1982 and 1983, 216 multibacillary patients in Anjouan (Comores) and Burundi were treated for 8 weeks with daily rifampicin (600 mg) ethionamide (500 mg) and dapsone (100 mg) or clofazimine (100 mg) followed for 44 weeks by once weekly rifampicin (600 mg) and daily ethionamide (500 mg) and dapsone (100 mg) or clofazimine (100 mg) . There were 109 previously untreated patients and 107 patients who had dapsone monotherapy, 16 of whom were infected with proven dapsone resistant Mycobacterium leprae . Clinical and bacteriological results were excellent but hepatotoxicity of this regimen remains a problem . No relapses were observed during a 2 to 6 years (mean: 4.29 years) follow-up period after the end of treatment (upper 95% confidence limit of 0.40 per 100 persons years) . It is concluded that multibacillary leprosy can be successfully treated with a regimen of one year duration, but less toxic regimens, more easily applicable in the field, are necessary. Del Med J, 1989 Jun, 61(6), 289 - 94 The tonsil and adenoid controversy; Witt RL; This paper will review the anatomy, histology, immunology, bacteriology, indications, complications, and trends in modern tonsil and adenoid surgery . Information on tonsils and adenoids, both in their normal and abnormal states, has proliferated over the last two decades . A considerable variation in opinion remains on the subject . Historical fluctuations in the indications for tonsil and adenoid surgery have resulted in swings in the quantity of surgery performed . This paper will attempt to bring contemporary information together to provide reasonable guidelines for management of disease tonsils and adenoids. Surg Clin North Am, 1989 Jun, 69(3), 529 - 49 Surgical management of necrotizing pancreatitis; Beger HG; The most important diagnostic step in the management of patients with severe acute pancreatitis is the discrimination between acute interstitial and necrotizing pancreatitis . Measurement of C-reactive protein, lactic acid dehydrogenase, alpha-1-antitrypsin, and alpha-2-macroglobulin and contrast-enhanced CT are useful in detecting the necrotizing course of acute pancreatitis . C-reactive protein, lactic acid dehydrogenase, and contrast-enhanced CT offer detection rates of 85 per cent to more than 90 per cent for pancreatic necrosis . Surgical decision-making in necrotizing pancreatitis should be based on clinical, morphologic, and bacteriologic data . Patients with focal pancreatic necrosis, in general, respond well to medical treatment and do not need surgery . Extended (50 per cent or more) pancreatic necroses, infected necroses, and intrapancreatic parenchymal necroses plus extrapancreatic fatty tissue necroses are indicators for surgical management . The decision for the timing of operation in patients with proved necrotizing pancreatitis should be based on clinical criteria: the development of an acute surgical abdomen, generalized sepsis, shock, persisting or increasing organ dysfunction, or some combination thereof despite maximum intensive care treatment for at least 3 days . Major pancreatic resection for the treatment of necrotizing pancreatitis appears disadvantageous . Necrosectomy and continuous local lavage allow debridement of devitalized tissue and preservation of vital pancreatic tissue . Postoperative local lavage thus results in an atraumatic evacuation of necrotic tissue, the bacterial material, and biologically active substances . The hospital mortality rate of patients treated with necrosectomy and continuous local lavage (the Ulm protocol) is below 10 per cent . Nevertheless, controlled prospective clinical trials should be performed in order to bring more precision to our clinical decisions in respect to the role of surgery for this disease. Otolaryngol Clin North Am, 1989 Jun, 22(3), 553 - 68 Advances in sinus disease in pediatrics; Hawkins DB; Advances in sinus diseases in pediatrics during the 1980s have occurred in both diagnosis and treatment . Perhaps the most significant development in diagnosis has been the increased sophistication of computerized tomography . In treatment, the most significant advances have been in the better understanding of the bacteriology of pediatric sinusitis and the development of endoscopic sinus surgery. J Pak Med Assoc, 1989 Jun, 39(6), 151 - 4 Outbreak of gastroenteritis in different areas of Pakistan; Khan MM et al.; Outbreak of acute gastroenteritis occurred during July to August, 1988 in districts of Mansehra, Swat and Muzaffarabad . Thirty cases, clinically diagnosed as cholera, were investigated . On examination, 22 (73.3%) cases were bacteriologically confirmed as cholera due to V . cholerae Eltor, ogawa . All strains were sensitive to chloramphenicol. J Am Acad Dermatol, 1989 Jun, 20(6), 1083 - 7 Topical 2% mupirocin versus 2% fusidic acid ointment in the treatment of primary and secondary skin infections; Gilbert M; The efficacy and side effects of topical mupirocin (Bactroban) and fusidic acid (Fucidin) ointment were compared in a double-blind, randomized trial in 70 patients who came to the Dermatologic Clinic of L'Enfant Jesus Hospital with primary or secondary (or both) skin infections . Thirty-five patients were treated with mupirocin and 35 patients were treated with fusidic acid three times a day for seven days . Clinical and bacteriologic assessments were conducted before and after treatment . The efficacy of mupirocin, in terms of resolution and improvement of clinical signs and symptoms of infection, as well as of the elimination of infecting organisms, was similar to that of fusidic acid . Of 34 patients (1 could not be evaluated) treated with mupirocin, a clinical cure was achieved in 18, and significant improvement was demonstrated in 15 . Similarly, of 35 patients treated with fusidic acid, a clinical cure was achieved in 18 and improvement occurred in 15 . Bacteriologic cure rates were 97% (30 of 31 patients evaluated) in the mupirocin-treated group, compared with 87% (27 of 31 patients evaluated) in the fusidic acid-treated group . No side effects were observed in either treatment group . Because topical 2% mupirocin has little or no potential for irritation, systemic side effects, or cross-resistance with other antibiotics, its efficacy is likely to make this new compound a useful agent for the treatment of superficial skin infections. South Med J, 1989 Jun, 82(6), 715 - 8 Netilmicin sulfate as single-agent therapy for Pseudomonas infections; Greenberg RN et al.; In a prospective multicenter clinical trial, 69 patients with Pseudomonas infections were treated with netilmicin sulfate as the only antipseudomonal antibiotic . Clinical resolution or improvement was observed for 81% of the infections, whereas 19% were considered treatment failures . The bacteriologic response, based on follow-up culture results, showed elimination of Pseudomonas from 62% of the infection sites, with persistence in 30% . All isolates were susceptible by disk susceptibility testing (zone greater than or equal to 15 mm), and by microdilution testing in unsupplemented broth . The majority of isolates, however, were resistant in cation supplemented media . The clinical failures could be accounted for by factors other than netilmicin failure . In conclusion, netilmicin appeared effective as treatment for netilmicin-susceptible Pseudomonas infections in nonneutropenic adults . A low incidence of nephrotoxicity (12%) occurred despite careful monitoring of serum levels. Enferm Infecc Microbiol Clin, 1989 Jun-Jul, 7(6), 316 - 20 {Combined use of rose Bengal and indirect immunofluorescence in the diagnosis of brucellosis}; Colmenero JD et al.; In the present prospective study we have evaluated the sensitivity, specificity and predictive value of the Bengal rose and indirect immunofluorescence (IIF) in 122 patients with a bacteriological diagnosis of brucellosis . The sensitivity of the Bengal rose was 95.79% and its specificity 98.43% . IIF had a sensitivity of 68.80% and a specificity of 100% when the polyvalent anti-IgS conjugate was used . The combined parallel use of Bengal rose and IIF-IgS resulted in a sensitivity of 89.17% and a specificity of 100% . There was a good correlation between Bengal rose and serum agglutination test (r = 0.72); on the contrary, there were not good correlations between the fluorescent conjugates and Bengal rose, agglutination and Coombs test . In conclusion, the combined use of Bengal rose as a screening test and IIF as a confirmation study is a good diagnostic strategy for human brucellosis. Agressologie, 1989 May, 30(5), 255 - 6 {Prevention of nosocomial infections at a cardiovascular surgery unit: therapeutic tactics, efficacy and results}; Medelli-Gamain D et al.; The experience of prevention of nosocomial infections inside a cardiovascular surgical unit leads to insist, among the various tactics, on the quality and the mode of disinfection of the operating room and the intensive care unit, in particular, the technics of air and surface processing (by Anios) of sterilizing water (by Hyconium B and Filtranios), of sterilized respirators (by Formobloc) . Quality and efficiency are bacteriologically controlled . The good results, obtained for 3 years, testify of the efficiency of such technics . However some architectural and structural drawbacks can jeopardize a strict compliance towards prevention of nosocomial infections. Acta Chir Belg, 1989 May-Jun, 89(3), 133 - 7 {Tuberculous wrist cyst . Case report}; Vansteenland H et al.; The authors present a case of tuberculous cyst of the wrist . The symptoms and the treatment are discussed on the basis of the literature . The symptoms are not specific . The histological and bacteriological examination leads to the diagnosis . The surgical treatment must be completed by an antituberculous treatment. Acta Paediatr Scand, 1989 May, 78(3), 369 - 72 The importance of C3d estimation in the diagnosis of generalized bacterial infections in newborn infants; Guillois B et al.; We evaluated the clinical relevance of a new C3d test in generalized bacterial neonatal infections . C3d was qualitatively evaluated by using an original counterimmunoelectrophoresis technique in 171 plasma . There were 13 cases of bacteriologically proven cases of septicemia and/or meningitis, 6 cases of probable and 42 cases of possible generalized infection . One hundred and ten non-infected samples were also tested . The sensitivity, specificity, positive and negative predictive values were 73.6, 83.6, 43.7 and 94.8%, respectively . The numbers of false positive and false negative were therefore found to be close to those observed when using classical infection markers. Age Ageing, 1989 May, 18(3), 205 - 7 Radiological features of pulmonary tuberculosis in elderly patients; Van den Brande P et al.; We reviewed the radiological findings in 55 hospital inpatients aged 60 and over with bacteriologically proven tuberculosis over a 5-year period 1981-5 . Since most of the patients were infected during childhood it was expected that the majority would show the 'typical' findings of post-primary disease with apicoposterior lung lesions . This was found in 43 of the patients (78%) . Unusual features were found in 12 patients: solitary pleural effusion (1), miliary tuberculosis (2), tuberculoma (1), isolated mediastinal or hilar lymphadenopathy (1), solitary ventrobasal and middle-lobe or lingular lesions (7) . No major differences were found in comparison with a group of 59 younger patients with proven pulmonary tuberculosis . Amongst these 15 (25%) had 'atypical' radiological findings . We conclude that the radiological manifestations of pulmonary tuberculosis in elderly patients do not differ in frequency or distribution from those seen in younger adults. Rev Med Interne, 1989 May-Jun, 10(3), 265 - 70 {Clinical and pharmacokinetic study of amikacin during repeated intramuscular administration in elderly patients}; Escande M et al.; Pharmacokinetics of amikacin in elderly patients during repeated intramuscular administration . The aim of the study was to evaluate a standard dosage of Amikacin, 7.5 mg/kg every 12 hours, in elderly subjects whose renal function was reduced by half, in view of the narrow therapeutic interval of the aminoglycosides . Twelve subjects, aged from 72 to 96 years (mean age: 82 years; mean weight: 58.7 kg) and suffering from severe infections, were therefore treated with intramuscular Amikacin as monotherapy at the dosage of 7.5 mg/kg repeated every 12 hours for 5 days . Clinical, biological (creatinine clearance estimated by the method of Cockroft) and bacteriological data were recorded on D0 and D5 . The pharmacokinetic study included plasma Amikacin assays at the following times: D0 (control), D1 (1h, 3h, 6h, 12h), D2 (24h, 25h, 27h, 36h), D3 (48h, 49h), D5 (96h, 97h, 99h, 102h, 105h, 108h), D6 (120h, 132h) . Clinical success was observed in 9 out of the 12 cases, with no undesirable side effects . At this age and at this dosage, peak concentrations (Cmax) remain close to the required "therapeutic" levels, 25 to 30 mcg/ml; the residual concentrations (Cmin), highly-correlated with creatinine clearance values, are also close to the desired levels (4-10 mcg/ml) . The absence of side effects, and in particular the lack of renal side effects, during this treatment trial suggest that the usual dosage of Amikacin IM, 7.5 mg/kg/12 h, need not be reduced in elderly subjects if creatinine clearance remains above 30 ml/mn and if the treatment is of short duration. J Antimicrob Chemother, 1989 May, 23(5), 785 - 8 Treatment of typhoid fever with ofloxacin; Wang F et al.; Ofloxacin, 300 mg 12-hourly, was given orally to 64 patients with typhoid fever, all with positive blood cultures . Almost 80% of the isolates were resistant to chloramphenicol, ampicillin and co-trimoxazole, but sensitive to ofloxacin and norfloxacin . Fever subsided within five days in most patients (mean 3.2 +/- 1.1), rates of clinical effectiveness and bacteriological cure both being 100% . Thirty patients were followed for 1-3 months after the completion of therapy with no occurrence of relapse. World J Surg, 1989 May-Jun, 13(3), 300 - 4; discussion 305-6 Dynamics of bile flow through the human choledochal sphincter following exploration of the common bile duct; Holdsworth RJ et al.; The opening pressure and flow rates through the sphincter of Oddi using the patient's own bile to prime the system were measured daily in 17 patients after cholecystectomy and exploration of the common bile duct . The sequential changes in these parameters were correlated with preoperative serum bilirubin, bile bacteriology, biliary lipid composition, and bile viscosity . The opening pressure fell from an initial value of 17.2 +/- 1.9 to 9.1 +/- 0.9 cm bile (p less than 0.01) on the seventh postoperative day, indicating a self-limiting hold-up following stone extraction . The low opening pressure after the fifth to sixth day is well below the maximal hepatic secretory pressure and suggests that the bile flow into the duodenum may be continuous after cholecystectomy . The flow rate through the sphincter measured at a fixed pressure head of 30 cm of bile increased from 23.9 +/- 3.9 to 40.0 +/- 6.1 ml during the same period (p less than 0.01) . Presumably, the latter represents the maximal flow rate of bile through the sphincter of Oddi under physiological conditions . These changes in flow could not be explained by alterations in the bile viscosity during the study period . The increase in flow rate was significant only in the nonjaundiced group and correlated positively with the phospholipid concentration in the bile . There were no significant differences in opening pressure, flow rates, and biliary lipid concentrations between patients with sterile bile and those with positive bile cultures. Crit Care Med, 1989 May, 17(5), 461 - 4 Comparison of two methods of bacteriologic sampling of the lower respiratory tract: a study in ventilated patients with nosocomial bronchopneumonia; Papazian L et al.; The purpose of this prospective study was to compare the results of bacteriologic assessment of the lower respiratory tract in mechanically ventilated patients by two sampling techniques: fiberoptic protected brush biopsy or blind bronchial aspiration of secretions . Thirty-three mechanically ventilated patients with acute bronchopneumonia were studied . Paired samples were collected by both techniques 47 times . Identical results were obtained in 93% of the cases . In 28 pairs, one or several identical organisms were cultured . In 16 pairs, no bacteria were isolated; in the three remaining pairs, results were contradictory . In five patients with concomitant positive blood cultures, the same organisms were cultured from fiberoptic protected brush biopsy, blind bronchial sampling, and blood cultures . These findings support the fact that blind bronchial sampling can be recommended for bacteriologic assessment of the lower respiratory tract in mechanically ventilated patients with diffuse nosocomial bronchopneumonia. Clin Prev Dent, 1989 May-Jun, 11(3), 14 - 20 Root surface caries: an update; Surmont PA et al.; Root surface caries lesions will become more predominant in the future . Recently, several definitions and graduations have been suggested . Objective, epidemiologic data are still lacking . The etiologic factors of root surface caries generally are parallel to those of coronal caries . However, some nuances needed to be identified . Differences concerning the bacteriologic characteristics, the substrate, the mineral composition, and the clearance are discussed . Some patients are more likely to develop multiple lesions than others . Restorative materials with bonding abilities to dentin are the preferred materials . Fluoride applications will probably be the most effective in preventing the development of root surface caries lesions. Agressologie, 1989 May, 30(5), 279 - 81 {The role of the bacteriology laboratory in the epidemiologic study of nosocomial infections}; Eb F; The knowledge and the control of nosocomial infections is based upon clinical and bacteriological data . The bacteriology laboratory is an important source of informations as more easily supplied than data are treated with computer . Results of the laboratory allow the control of bacteriological flora and sensitivity (or resistance) for each species and for each antibiotic, in each department and in the entire hospital. Klin Monatsbl Augenheilkd, 1989 May, 194(5), 337 - 40 {Bacteriologic and serologic studies}; Sundmacher R; With many infectious eye diseases, the practising ophthalmologist is faced by the question as to whether a serologic or microbiologic work-up pays off in terms of greater diagnostic or therapeutic efficiency . A critical appraisal indicates that on average, they are relatively insignificant, and so some time and money could probably be saved . Important exceptions to the rule are discussed separately. Surv Ophthalmol, 1989 May-Jun, 33(6), 523 - 8 Robert E . Wright and the development of facial nerve akinesia; Feibel RM; The name of Auguste Van Lint is linked with the development of facial nerve akinesia for ophthalmic surgery . Less well known is Robert Ernest Wright (1884-1977) who described techniques to block the facial nerve in the same manner as later published by Atkinson and Nadbath . This paper reviews Wright's life as an ophthalmologist and ophthalmic bacteriologist and pathologist in British India, and his role in the evolution of facial nerve akinesia. Kansenshogaku Zasshi, 1989 May, 63(5), 501 - 29 {Double-blind comparative study of roxithromycin (RU 28965) and midecamycin acetate (MOM) in the treatment of pneumonia}; Soejima R et al.; The clinical efficacy and safety of Roxithromycin (RU) were compared with those of Midecamycin acetate (MOM) in patients with pneumonia in a double blind study . RU and MOM were administered orally for 14 days with daily doses of 300 mg (150 mg b.i.d.) and 600 mg (200 mg t.i.d.), respectively . The following results were obtained . 1 . RU and MOM were administered to a total of 204 patients (RU: 101, MOM: 103) . The clinical efficacy was judged in 150 patients (RU: 70, MOM: 80), with 54 of the patients excluded from the total by the committee . 2 . The clinical efficacy rates were 81.4% for RU and 70.0% for MOM on the basis of the committee's judgement . There was no significant difference between the two groups . In the evaluation of the clinical efficacy by the doctors in charge, the efficacy rates were 81.4% for RU and 67.5% for MOM, which constitutes a significant difference between the two groups (p less than 0.05) . 3 . No significant difference was found between the two drugs in bacteriological efficacy . 4 . No significant differences were observed in either the incidence of side effects between RU (4.3%) and MOM (4.0%) or in abnormal changes in the laboratory findings . 5 . Regarding the clinical usefulness judged by the committee, RU showed a significantly higher rate than MOM (79.2% vs . 67.9%) . There was no significant difference in the judgement by the doctors in charge . From the above results, it was concluded that a daily dosage of 300 mg of RU was equal in usefulness to 600 mg daily of MOM in the treatment of mild to moderate pneumonia. Rev Chil Pediatr, 1989 May-Jun, 60(3), 173 - 8 {Thoracic actinomycosis}; Hoffmeister C et al.; Thoracic actinomycosis was identified in a 14 year old girl . The disease is infrequent in children and diagnosis is difficult . The occurrence of a protracted pulmonary lesion, together with osteomyelitis of several ribs and by fistulae formation in the chest wall, with production of characteristic "sulfur granules", were the key elements to suspect the right diagnosis, which was confirmed by a bacteriological and histological studies . Treatment with high doses of intravenous penicillin, 3 million U four times a day for 4 weeks, followed by long term oral therapy with the same drug was done, with remission of pulmonary, osseous and cutaneous lesions. Schweiz Med Wochenschr, 1989 Apr 15, 119(15), 467 - 72 {Abdominal tuberculosis and open lung tuberculosis caused by mycobacterium bovis}; Danuser H et al.; Abdominal tuberculosis is a rare disease in Western countries and remains difficult to diagnose . The most frequent symptoms are abdominal pain, weight loss, fever, vomiting, constipation and/or diarrhea . Clinical findings include abdominal tenderness, a palpable mass (often in the right fossa due to ileocecal infection), paleness, cachexia and ascites . Suggested radiological investigations include plain abdominal film, upper GI-series and barium enema . Chest X-rays often show signs of either active or inactive tuberculosis . Sputum and gastric juice should be cultured . Coloscopy serves to sample specimens for histology and bacteriology and may help to confirm the diagnosis, which is, however, not ruled out by negative findings . The same holds good for peritoneal biopsy and laparoscopy . Bowel perforation and ileus are frequent complications and always require surgery, whereas uncomplicated cases can be treated by drugs only. J Am Vet Med Assoc, 1989 Apr 15, 194(8), 1041 - 4 Intramammary antibiotic treatment at the end of lactation for prophylaxis and treatment of intramammary infections in ewes; Hueston WD et al.; Ewes treated by intramammary infusion of cephapirin benzathine at the end of lactation were less likely to develop new intramammary infections by early in the next lactation . A controlled clinical trial involving 135 treated ewes and 145 untreated control ewes evaluated the prophylactic and treatment efficacy of intramammary antibiotic treatment of ewes at the time of weaning lambs . Milk samples for bacteriologic examination and identification of intramammary infections were collected at weaning of lambs and 1 to 3 weeks into the subsequent lactation . Untreated ewes were 2.6 times more likely than treated ewes to develop new intramammary infections between sampling times . Existence of an intramammary infection in one mammary gland significantly increased the risk of the other mammary gland becoming infected . Treatment also appeared to be associated with a higher cure rate of existing infections. Lancet, 1989 Apr 8, 1(8641), 751 - 4 Diagnostic value of ascites adenosine deaminase in tuberculous peritonitis; Voigt MD et al.; The value of ascitic fluid adenosine deaminase activity in distinguishing tuberculosis from other causes of ascites was examined in a retrospective study of 41 patients with bacteriologically confirmed tuberculous peritonitis and 41 control patients, matched for age and sex, with ascites of other causes (12 alcoholic cirrhosis, 5 cryptogenic cirrhosis, 12 malignant disorders, 3 pancreatitis, and 9 miscellaneous causes) . The mean ascites adenosine deaminase activity was 99.8 (SD 49.1) in tuberculous patients and 14.8 (8.4) U/l in control patients (p less than 0.0001) . A cutoff of 32.3 U/l had a sensitivity of 95% and specificity of 98% in distinguishing between the two groups . In a subsequent prospective study of 64 patients with ascites, 11 were found to have tuberculosis . Of the others, 23 had cirrhosis (18 alcoholic, 5 cryptogenic), 17 malignant disorders, 3 pancreatitis, 5 cor pulmonale, 3 congestive cardiac failure, 1 systemic mastocytosis, and 1 renal failure and hypothyroidism . The mean ascites adenosine deaminase activity was 112.6 (45.0) U/l in the patients with tuberculous ascites and 16.3 (36.7) U/l (p less than 0.0001) in those with ascites of other causes . In this study, adenosine deaminase had a sensitivity of 100% and specificity of 96% in discriminating tuberculosis from other causes of ascites . These findings suggest that the ascitic fluid adenosine deaminase activity may be used to identify patients in whom the diagnosis of abdominal tuberculosis must be pursued. Ugeskr Laeger, 1989 Apr 3, 151(14), 880 - 2 {The choice of antibiotics in purulent meningitis without bacteriologic diagnosis}; Krarup HB; A case of meningitis in a 16 month old boy caused by Hemophilus influenzae resistant to ampicillin is presented . The question is raised whether a third generation cephalosporin such as cefotaxime should be the drug of choice in the treatment of bacterial meningitis with unknown etiology. Harefuah, 1989 Apr 2, 116(7), 356 - 8 {Endobronchial tuberculosis}; Wishnitzer R et al.; Endobronchial tuberculosis (EBTB) is not rare . It usually affects the upper lobe bronchi . Bronchoscopic examination may reveal white gelatinous material in the bronchial lumen, mucosal ulcerations, polypoid inflammation, scattered green-blue pigmented areas and narrowed bronchi with post-stenotic dilatation, some of which resemble colored dolomite caves . 2 women, aged 70 and 84, are presented, 1 of whom had been suffering for a year from persistent dry cough and the other from diffuse pneumonia resistant to several antibiotics . Fibreoptic bronchoscopy showed the characteristic picture of EBTB, later confirmed by positive cultures . Recognition of the clinical, radiological and bronchoscopic spectrum of EBTB makes it possible to start treatment before bacteriological diagnosis of tuberculosis from endoscopically recovered material. Rev Med Chir Soc Med Nat Iasi, 1989 Apr-Jun, 93(2), 299 - 302 {Hepatic abscesses}; Strat V et al.; The authors analyse 16 cases of hepatic abscesses recorded in a 10-year interval . The difficulties in assessing the etiology and diagnosis, as well as in indicating an effective treatment are discussed . The clinical aspects and investigation methods, among which scintigraphy, arteriography and especially echotomography are extremely useful in making the diagnosis and in localizing the collection, are reviewed . The bacteriological examination revealed the presence of various organisms in 14 patients, the examined specimen of pus being negative in the remainder of 2 cases . The treatment was surgical in most of the cases (15) consisting in an abdominal approach or posterolateral with rib resection (1 case) and drainage . In 3 cases the intervention was extended to cholelithiasis which was the underlying cause of the abscess . The ultrasound-guided transparietohepatic drainage was performed in 2 cases . No death was recorded. Kekkaku, 1989 Apr, 64(4), 305 - 11 {Retrospective assessment of the effectiveness of BCG vaccination by multiple puncture method (Kuchiki's needle) in childhood tuberculosis}; Kamigawara N; The retrospective assessment of the effectiveness of BCG vaccination by multiple puncture method (Kuchiki's needle) was examined in childhood tuberculosis patients treated at our hospital . They were 137 children aged 0 month to 15 years . Seventy-nine of them were vaccinated with BCG and 58 of them were not vaccinated . Forty-seven patients had been vaccinated at 3 to 4 months after birth, and excluding 2 cases who were revaccinated thereafter the remaining 45 patients were compared with unvaccinated 58 patients . Following results were obtained . 1 . Vaccinated 45 patients . 1) Within 3 months after the vaccination, 6 children showed breakdown of tuberculosis . Two of them were miliary tuberculosis . Three patients were positive bacteriologic findings . They were supposed to be infected before BCG vaccination or before the appearance of immunity by BCG vaccination . 2) From 4 months to 2 years after the vaccination, 12 children showed breakdown of tuberculosis, but they were all mild type and all of them were negative bacteriologic findings . 3) After 2 years or more from the vaccination, 27 children showed breakdown of tuberculosis . Three of them were positive bacteriologic findings . 2 . Unvaccinated 58 patients . 1) Thirty-seven patients, aged 0 month to 2 years and 4 months, showed breakdown of tuberculosis . Seventeen patients were positive bacteriologic findings . Three cases of tuberculous meningitis (2 of them died) and 2 cases of miliary tuberculosis were observed . Paratracheal lymph node swelling was recognized in 5 cases, and bronchial stenosis due to compression was seen in 4 cases (one of them died) . 2) Twenty-one patients were more than 2 years and 5 months old . Eight of them were positive bacteriologic findings.(ABSTRACT TRUNCATED AT 250 WORDS) Rozhl Chir, 1989 Apr, 68(4), 288 - 93 {Intravenous use of a derivative of metronidazole in abdominal surgery}; Hut'an M et al.; The authors give an account of a group of 11 patients with diffuse or circumscript peritonitis, treated by an intravenous derivate of metronidazol - Tiberal . Improvement was recorded in eight patients, three patients died . Based on their results, the authors recommend to administer metronidazol by the parenteral route combined with antibiotics effective against aerobic bacteria . In treatment they emphasize repeated bacteriological check-up examinations and an effective contact of the clinical and bacteriological department. Indian J Lepr, 1989 Apr, 61(2), 216 - 21 A study into bacteriological positivity and treatment of beggar leprosy patients; Rao PS et al.; Hundred beggar leprosy patients were medically examined and skin smears were taken for bacteriological positivity for A.F.B . Information regarding their treatment was collected . 20% of them were found bacteriologically positive and 40% of the positive cases were not taking treatment . Epidemiological and operational implications of the findings are discussed. Indian J Lepr, 1989 Apr, 61(2), 196 - 205 Evaluation of two multidrug regimen in hospitalised multibacillary cases; Chattopadhyay SP et al.; Fifty three multibacillary leprosy cases were treated with two regimens of MDT L1 consisting of Rifampicin, Dapsone and Ethionamide and L2 consisting of Rifampicin, Dapsone and clofazimine . The results were compared at regular intervals and at the end of the study (24 months) . Clinical inactivity, bacteriological negativity, ENL reactions, upgrading reactions were seen in L1 group in 65%, 4.54%, 50% and 41% of cases respectively while 65%, 25.8%, 30% and 45% respectively in L2 regimen group . Zero percent morphological Index was achieved in all cases in L1 regimen 90% in L2 regimen cases . No viability was found on mouse foot pad inoculation after 6 months in L1 while after 18 months in L2 cases. Clin Biochem, 1989 Apr, 22(2), 141 - 8 Adenosine deaminase in body fluids: a useful diagnostic tool in tuberculosis; Segura RM et al.; The performance of a colorimetric ADA determination in body fluids other than serum in the diagnosis of tuberculosis was assessed in 1063 patients from whom pleural (600), peritoneal (136), pericardial (77), or cerebrospinal (250) fluids were obtained . In exudative pleuroperitoneal and pericardial effusions, an ADA decision level of 0.71 mu kat/L displayed a sensitivity of 1.00, and was higher than those of histologic (0.83) and bacteriologic (0.62) studies . At this level, ADA reached a specificity of 0.92 and efficiency of 0.94 . In cerebrospinal fluid, an ADA catalytic concentration above 0.15 mu kat/L strongly suggests tuberculous meningitis in patients older than 7 years (sensitivity 1.00, specificity 0.99 and efficiency 0.99) . ADA results obtained with a UV-method were closely correlated with those of the colorimetric method in pleuroperitoneal effusions (r = 0.989) and in cerebrospinal fluids (r = 0.905) . Sample blanks should be processed, otherwise false positive results may be found in non-tuberculous cerebrospinal fluids (5.3%) and pleuroperitoneal effusions (3.8%). Am J Vet Res, 1989 Apr, 50(4), 560 - 3 Efficacy of long-acting oxytetracycline alone or in combination with streptomycin for treatment of Brucella ovis infection of rams; Marin CM et al.; Twenty-four rams inoculated with Brucella ovis by conjunctival and preputial routes were treated with a long-acting oxytetracycline alone or in combination with dihydrostreptomycin sulfate . The combined treatment eliminated Brucella ovis from 11 of 12 (91.6%) treated rams . Only 4 of 12 (33.3%) rams treated with oxytetracycline alone were bacteriologically negative . Neither treatment resolved clinical epididymitis in 2 rams affected before treatment . Many rams had pathologic lesions in the epididymis and ampullae, which limited the efficacy of antibiotic treatment. Mikrobiyol Bul, 1989 Apr, 23(2), 127 - 32 {Bacteriological comparison of colostrum and mature human milk}; Atalay S et al.; 15 colostrum and 15 mature milk were examined in bacteriology laboratory in Ankara Numune Hospital . The number of colonies cultured at "0" hour, 6-24 after at room temperature 24 after refrigeration were evaluated . It was noticed that the cultures obtained at 0 and 6 hours and after refrigeration did not reveal much bacteria . But cultures obtained from Colostrum and mature milk after 24 hours at room temperature revealed colonies . The colonisation in mature milk was significantly higher than the colostrum. Int J Gynaecol Obstet, 1989 Apr, 28(4), 373 - 80 Sarcoidosis of the female genital tract: a case presentation and survey of the world literature; Rosenfeld SI et al.; Sarcoidosis of the female genital tract is a rare clinical entity with only 20 cases reported in the world literature to date . An additional case is presented with a review of the previously reported cases . The diagnostic and histologic aspects of the disease are also discussed . The presence of granulomatous diseases in the female genital tract should initiate a thorough investigation for potential etiologies by both the pathologist and clinician . Etiologies of granuloma fraction must include coccidiomycosis, foreign body reactions, lymphogranuloma inguinale, and tuberculosis . Bacteriologic proof is essential to differentiate these from sarcoidosis. Kansenshogaku Zasshi, 1989 Apr, 63(4), 318 - 51 {A comparative study between cefodizime (CDZM) and cefotaxime (CTX) in respiratory tract infections}; Takebe K et al.; The clinical efficacy and safety of Cefodizime (CDZM), a new cephem antibiotic, was objectively compared with that of Cefotaxime (CTX) in patients with respiratory infections under a well-controlled comparative study . Patients were administered CDZM or CTX by drip infusion b.i.d . for 14 days in principle at a daily dose of two grams . The parameters assessed were clinical efficacy, safety and clinical usefulness . The following results were obtained: 1 . On the basis of committee judgement the clinical efficacy rate was 78.1% (125/160) for the CDZM group, 82.7% (124/150) for the CTX group, and no significant difference was observed between the two drug groups . On the other hand, on the basis of judgement by physicians in charge, the clinical efficacy rate was 83.1% (133/160) for the CDZM group, 83.9% (125/149) for the CTX group, and no significant difference was observed between the two groups . 2 . The corresponding figures for patients with pneumonia and pulmonary suppuration were 82.4% (70/85) for the CDZM group, 79.7% (59/74) for the CTX group and no significant difference was observed according to the committee judgement . The judgement by physicians in charge also revealed 83.5% (71/85) for the CDZM group and 82.2% (60/73) for the CTX group . No significant difference was noted between the two groups . While, the committee judgement for the clinical efficacy in patients with chronic respiratory tract infections showed 73.3% (55/75) for the CDZM group, 85.5% (65/76) for the CTX group, and no significant difference was observed between the two drug groups . The corresponding figures were 82.7% (62/75) for the CDZM group, 85.5% (65/76) for the CTX group, and no significant difference was observed between the two drug groups on the judgement by physicians in charge . Furthermore, the clinical efficacy of both drugs on chronic respiratory tract infections was assessed according to "Criteria for Evaluation of Clinical Efficacy of Chemotherapeutics on Chronic Respiratory Tract Infection" . It was 76.8% (53/69) for the CDZM group, 76.3% (58/76) for the CTX group, and no significant difference was observed between the two groups . 3 . The bacteriological eradication rate of causative pathogens was 92.4% out of 66 patients treated with CDZM and 95.5% out of 67 patients treated with CTX in whom judgement was possible . No significant difference was observed between the two drug groups . 4 . The adverse reactions occurred in 4 (2.2%) patients for the CDZM group and 8 (4.5%) patients for the CTX group respectively, with no significant inter-group difference in frequency of these reactions for all cases.(ABSTRACT TRUNCATED AT 400 WORDS) Akush Ginekol (Mosk), 1989 Apr, (4), 43 - 5 {Possibilities of using the CO2 laser in gynecology}; Shakhmatova MP et al.; A continuous-action CO2 laser of 15-20 W was used in 358 females on the treatment of largely benign or precancerous conditions of the cervix and external genitalia . The procedure is painless and produces no side-effects . There is no associated edema, bleeding or leukorrhea . The healing is fairly rapid and not accompanied by the development of secondary scars; menstrual and reproductive functions are not affected, so the method can be used in nulliparous women . Pre- and post-treatment control was made by means of colposcopic, cytologic, bacterioscopic, bacteriologic and histologic methods. Zentralbl Bakteriol Mikrobiol Hyg {B}, 1989 Apr, 187(4-6), 390 - 403 {Domestic hygiene over the ages}; Schadewaldt H; The family household belongs without doubt to the oldest social institutions of the history of mankind . If there were collecting and hunting tribes or already settled farmers, in every case the manufacturing, conserving and preparing of the hunted or gathered nutrition was always the focus of the household attention . Naturally next to it problems of clothing and heating played in this connection an important role . Very soon special instruments were developed for these purposes of production and workmanship by men and the advantages or disadvantages of certain proceedings were evident . As concerned the medico-historical view one can discern four different ways of consideration of domestic hygiene: 1 . Mystical-magical conceptions, which started from the ideas of the influence of foreign partially supernatural powers on manufacturing and conserving of food . 2 . The idea of the disastrous influence of an whatever supposed intoxication . 3 . With the beginning of bacteriology the opinion even in general public of the contamination of foods and at last 4 . The fear before a radiation contamination, which grew up recently with an increased importance . For all four considerations there will be put forward historical examples and beyond this it will be examined the influence of kitchen instruments and the increased automatic control in the household . But in parallel connection the increased knowledge of hygienic basic conditions and the application in the household area will be discussed . Shortly the changed part of the woman in household will be mentioned and its importance as concerned housekeeping in past and present will be demonstrated. Zentralbl Bakteriol Mikrobiol Hyg {B}, 1989 Apr, 187(4-6), 365 - 81 {Problems in disinfection of dental impression materials}; Borneff M et al.; In view of the risk of infection of the dentist and his staff in the dental surgery and dental laboratory and also of the patient with regard to hepatitis B and potentially also of AIDS, interruption of possible chains of infection by means of specific disinfection measures is to be demanded . Whereas appropriate hygiene concepts exist for disinfection of instruments, surfaces of equipment and furniture with regard to selection and application of various methods which may be considered, there are still extensive deficits for the domain of impression materials and their possible decontamination . In this regard, dentists frequently lack information with an adequate scientific basis that is understandable and oriented to practical requirements . Owing to the diversity of materials and their different behavior (cf . Tab . 1), appropriate recommendations can only be made on the basis of extensive studies . We assume that a practically relevant procedure must meet the following requirements: 1) sufficiently high rates of bacterial reduction in accordance with the guidelines of the DGHM, 2) lack of alterations in the dimensions or surfaces of the materials, 3) universal applicability, 4) practicability within a time period which is acceptable for smooth operation of the practice, 5) can be employed without problems for the staff . The object of the report are bacteriological results and materials testing data for the application of various methods of disinfection to selected impression materials . To summarize, it can be stated with regard to the bacteriological results that disinfection of impression materials is possible with fulfillment of the criteria specified above, but that there is a pronounced dependence of the results on the product formulation of the disinfectant and also of the impression material (cf . Fig . 4 and 5) . Investigations of the material-related effects of the disinfection measures showed that extrapolation of the findings from one group of materials to another is also not possible in this connection, and that moreover the materials used to produce the model must also be included besides the impression materials used (cf . Fig . 9) . Accordingly, statements on the suitability of a disinfection procedure are present admissible at most for the respective combination of materials tested, which makes practical introduction problematical. Otolaryngol Head Neck Surg, 1989 Apr, 100(4), 292 - 9 Otitis media in the pediatric intensive care unit: a prospective study; Derkay CS et al.; Otitis media has been previously shown to be a source of sepsis in the pediatric intensive care unit; however, pneumatic otoscopy and other otologic instruments are not commonly used in the pediatric intensive care unit . We undertook a prospective study to determine the prevalence of otitis media, to assess the risk factors involved with the development of these nosocomial infections, and to identify the causative organisms . We conclude that otitis media is a common entity in the pediatric intensive care unit, that it is probably caused by prolonged dysfunction of the eustachian tube associated with oral and nasally-placed tubes and that the bacteriology reflects that of the hospital environment and not that of the community. Rev Fr Gynecol Obstet, 1989 Mar 25, 84(3 Pt 2), 272 - 3; discussion 282-6 {Healthy carriers}; Levy G; The vaginal cavity is normally colonized by numerous strains, all "opportunist" . Bacteriological tests are therefore unnecessary in most cases and they could not be negative . If it is good to know which conditions keep vaginal germs in a quiescent state, it is especially important not to mistake a normal colonization for a vaginitis and run the risk of disturbing the ecological balance with an unnecessary and dangerous treatment. Rev Fr Gynecol Obstet, 1989 Mar 25, 84(3 Pt 2), 245 - 9; discussion 254-6 {Contribution of the bacteriology laboratory in genital infections in women}; Pean Y; It is obvious that in order to obtain precise informations from bacteriology in the diagnosis of female genital infections, it is absolutely necessary to respect a number of rules in the sampling method and their transportation . The author summarizes all these restrictions, of which physicians often are not too well aware of. Rev Fr Gynecol Obstet, 1989 Mar 25, 84(3 Pt 2), 250 - 1; discussion 254-6 {The role of celioscopy in the diagnosis and treatment of acute salpingitis}; Darbois Y; Laparoscopy is a valuable diagnostic tool in salpingitis, which enables to recognize the severity of their evolution and their bacteriological etiology . However, it should not be advocated in all circumstances and it is necessary to specifically select the time when it will be the most useful. J Med Microbiol, 1989 Mar, 28(3), 227 - 36 A pyrolysis mass spectrometry study of fusobacteria; Magee JT et al.; Strains of fusobacteria (143) were examined by pyrolysis mass spectrometry (Py-MS) with a Horizon Instruments PYMS 200X . Fusobacterium necrogenes, F . necrophorum, F . nucleatum, F . mortiferum, F . varium, F . gonidiaformans, F . naviforme, F . russii and Leptotrichia buccalis were discriminated . Strains of fusobacteria isolated from tropical ulcers, although similar to F . mortiferum in conventional tests, were discriminated from each of these species in Py-MS . Identification of 416 spectra to species level agreed with conventional bacteriological methods in 91.8% of cases, was equivocal in 3.4% and disagreed in 4.8% . Classification based on pyrolysis data resolved groups largely corresponding to the recognised species . However, F . nucleatum strains were divided between two distinct groups . The tropical ulcer strains were resolved as a distinct homogeneous group . Py-MS is a rapid, inexpensive and convenient procedure for characterisation of bacteria, with the capacity for a high throughput of samples, although the initial cost of the apparatus is high. Arch Exp Veterinarmed, 1989 Mar, 43(2), 215 - 22 {Experimental studies of intrabronchial foreign bodies in the dog}; Kutschmann K; Results obtained from clinical, endoscopic, bacteriological, and roentgenological investigations, following artificial introduction of foreign bodies into the tracheobronchial system of dogs, are reported in this paper . The foreign bodies included gauze pads, plastic halma pieces, larch, alder, and wood cones . Twenty of the 22 foreign bodies artificially placed into the bronchial tree of the experimental dogs were spontaneously coughed up, 16 of them between the 1st and 14th days from introduction . The cause underlying such high spontaneous healing rate of tracheobronchial foreign bodies in dog is discussed in some detail. Jpn J Antibiot, 1989 Mar, 42(3), 733 - 42 {Clinical experience with sulbactam/ampicillin in the pediatric field}; Sekiguchi T et al.; Sulbactam/ampicillin (SBT/ABPC) was given intravenously to 20 children with the following acute bacterial infections; 14 cases of pneumonia, 2 cases of purulent cervical lymphadenitis and 1 case each of bronchitis, pyothorax, cellulitis, and purulent meningitis . Good clinical responses were obtained in 18 out of 20 patients, and bacteriologically, all of the 14 isolated strains were eradicated . No side effect was observed except 2 cases of eosinophilia, and 1 case each of loose stool and elevated thrombocyte . From the above clinical results, it is apparent that SBT/ABPC is a useful antibiotic for the treatment of pediatric patients with various kinds of bacterial infections. Jpn J Antibiot, 1989 Mar, 42(3), 725 - 31 {Clinical study on sulbactam/ampicillin in the pediatric field}; Takeda E et al.; A combination drug of sulbactam/ampicillin (SBT/ABPC) was intravenously administrated to 18 patients with ages 3 months to 10 years 10 months with various acute infections including 14 cases of pneumonia, 1 case each of tonsillitis, subacute bacterial endocarditis, empyema and suspected sepsis . Clinical responses were excellent in 14 cases and good in 4 cases . Bacteriological responses of 8 isolated strains were: 7 strains were eradicated and 1 strain was decreased . No side effect was observed in any case . Eosinophilia was observed in 2 cases, thrombocytosis in 2 cases, elevation of GOT in 1 case and elevations of GOT and GPT in 1 case . From the above results, it seemed that SBT/ABPC was a useful drug for the treatment of bacterial infections in the pediatric field. Can J Public Health, 1989 Mar-Apr, 80(2), 142 - 8 Estimating the burden of illness in an Ontario community with untreated drinking water and sewage disposal problems; Chambers LW et al.; The Hamilton-Wentworth regional health department was asked by one of its municipalities to determine whether the present water supply and sewage disposal methods used in a community without piped water and regional sewage disposal posed a threat to the health of its residents . Three approaches were used: assessments by public health inspectors of all households; bacteriological and chemical analyses of water samples; and completion of a specially designed questionnaire by residents in the target community and a control community . 89% of the 227 residences in the target community were found to have a drinking water supply that, according to the Ministry of Environment guidelines, was unsafe and/or unsatisfactory . According to on-site inspections, 32% of households had sewage disposal problems . Responses to the questionnaire revealed that the target community residents reported more symptoms associated with enteric infections due to the water supply . Two of these symptoms, diarrhea and stomach cramps, had a relative risk of 2.2 when compared to the control community (p less than 0.05) . The study was successfully used by the municipality to argue for provincial funding of piped water. Lab Anim Sci, 1989 Mar, 39(2), 137 - 41 Idiopathic cardiomyopathy in C3Hf/Bd mice; Goad ME et al.; Male and female 16 to 18 month old C3Hf/Bd mice in a dermal carcinogenicity study were moribund or died at earlier time points than the expected 24 to 30 months . Clinical signs observed in both treated and control animals included dyspnea, lethargy, and death . Lesions seen in treated as well as control mice were cardiomegaly with myocardial degeneration and necrosis, hydrothorax and pulmonary edema, and ascites and chronic passive congestion of the liver . Mice were negative for serologic, bacteriologic and microscopic evidence of viruses, bacteria and protozoa which can induce heart lesions . Possible causes of the cardiomyopathy include metabolic, degenerative, genetic or undetermined infectious disease. Dent Mater, 1989 Mar, 5(2), 140 - 4 Pulpal and micro-organism responses to two experimental dental bonding systems; Blosser RL et al.; Several new bonding systems have been reported that promote strong adhesion . This in vivo study involves treatment with two experimental bonding systems of Class V cavity preparations in the teeth of three Macaca fascicularis primates and reports the pulpal responses and degree of micro-organism invasion associated with each treatment . In each monkey, the teeth in the upper left quadrant were treated with the experimental solution, containing 2.5% aluminum nitrate + 1.5% oxalic acid + 4.9% NPG, followed by application of PMDM and Silux XL composite . The lower right quadrant was treated with the experimental solution, containing 5.7% NPG + 2.4% nitric acid, followed by PMDM and Silux XL composite . The upper right and lower left quadrants were treated with clinical materials to establish positive and negative controls . After four, 25, and 59 days, the teeth were removed and underwent routine histological and bacteriological evaluation . Slight pathological conditions were noted for superficial and deep responses, but all values approached 0.0 by the 59th day . Micro-organisms were seen under only 12% of the restorations . Both experimental systems appear to be safe for human clinical trials. Taiwan Yi Xue Hui Za Zhi, 1989 Mar, 88(3), 232 - 5 Transrectal sonography of the prostate and seminal vesicles on patients with hemospermia; Tzai TS et al.; Morphological change of the seminal tract of patients with hemospermia was determined by means of transrectal sonography on 38 patients . Twenty-seven (71%) had positive sonographic findings, including 20 prostatitis and/or seminal vesiculitis, three benigh prostatic hypertrophy, three prostate calculi and one seminal vesicle stone . Simultaneous bacteriologic study revealed positive cultures on 11 patients; 9 of whom (81%) had morphologic appearance on transrectal sonography suggesting inflammatory origin . Our experience indicates that transrectal sonography is capable of surveying the histopathologic change of the prostate and seminal vesicles, and is therefore effective in studying patients with organic hemospermia. No Shinkei Geka, 1989 Mar, 17(3), 285 - 9 {Nocardial brain abscess: case report}; Yamaguchi Y et al.; A 25-year-old man, who was slightly immunosuppressed, presented headache and right motor weakness due to multiple brain abscesses disseminated from lung abscess . They were diagnosed, by bacteriological examination, as nocardial brain abscesses (nocardia asteroides) 4 weeks after the first operation . In spite of delay in the diagnosis, he was relieved by operations (three times) and chemotherapy including high doses of Sulfamethoxazole-Trimethoprim . He was eventually discharged . We stress the necessity of early diagnosis and the efficacy of Sulfamethoxazole-Trimethoprim for nocardial brain abscess. Rev Infect Dis, 1989 Mar-Apr, 11 Suppl 2, S360 - 5 Impact of present control methods on the problem of tuberculosis; Pio A; In spite of the considerable efforts that have been made to control tuberculosis in developing countries in the last three decades, the decline in the global epidemiologic problem has been slow . It is now realized that the possibility of rapidly influencing the tuberculosis problem in these countries with the present control technologies has been overestimated . It is clear that bacille Calmette-Guerin (BCG) vaccination, even in places where a high efficacy was demonstrated, does not substantially influence the chain of transmission . Case management, including bacteriologic diagnosis and chemotherapy, is a complex technology . Although it is potentially effective for the reduction of mortality and the risk of infection, there are many difficulties for its efficient application in developing countries . Although there should be no hesitation in the application and full utilization of what is already known, a major thrust in research may generate ways of accelerating the control of tuberculosis in developing countries . Without new developments in technology for tuberculosis control, the goal of worldwide control has still a long way to go. J Cardiovasc Surg (Torino), 1989 Mar-Apr, 30(2), 281 - 3 Cardiobacterium hominis endocarditis . Report of one case and review of the literature; Kiwan Y et al.; We report a case of infective endocarditis due to Cardiobacterium Hominis . This organism has rarely been recognized in the past as a human pathogen on the cardiac valves . This patient escaped early diagnosis, but he was successfully treated with parenteral ampicillin followed by elective aortic and mitral valve replacement . The bacteriological characteristics of this unusual cause of infective endocarditis are discussed and the world literature is reviewed. Med J Malaysia, 1989 Mar, 44(1), 35 - 40 The risk of neonatal infection following prolonged rupture of the fetal membranes; Boo NY; Over a seven month period in 1986, 164 (1.1%) of a total 15,131 neonates delivered in the Maternity Hospital, Kuala Lumpur were born to mothers with prolonged rupture of the fetal membranes . Septic work-ups were performed on 163 of these babies shortly after birth, 77 of them had no bacteriological, radiological or other clinical evidence of infection . The remaining 86 had additional history of illness . Nine of these 86 babies had proven infection: four with septicemia, one with meningitis and four others with congenital pneumonia . This study showed that neonates had risk of infection only when maternal history of prolonged rupture of the fetal membranes was associated with other clinical evidence of infection . However, even in this group of neonates at risk, 89.5% of them were not infected . Therefore, there is still a need to develop a simple, rapid, reliable and cheap laboratory method to help early identification of the infected from the non-infected neonates in order to prevent unnecessary antibiotic treatment and hospital stay. Am J Vet Res, 1989 Mar, 50(3), 323 - 8 Immunologic, histopathologic, and bacteriologic responses of five strains of mice to Brucella abortus strain 2308; Pugh GW Jr et al.; A study was conducted to establish baseline data on Brucella abortus infection induced in 5 strains of mice (CBA/NJ, BALB/c, CD-1, C3H/HeN, and C3H/HeJ) . The strains were compared on the basis of immunologic, histopathologic, and bacteriologic responses . There were 4 treatment groups for each strain of mice: (1) vaccinated with homologous lipopolysaccharide and challenge exposed to B abortus strain 2308; (2) not vaccinated but challenge exposed; (3) vaccinated and not challenge exposed; and (4) not vaccinated and not challenge exposed . Results indicated that mice can be used for comparative studies on the pathogenesis and immunogenesis of B abortus infections; strains of mice may vary in their responses to Brucella infection, regardless of their vaccination status . Bacteriologic and immunologic responses in mouse strains BALB/c, CD-1, C3H/HeN, and C3H/HeJ, but not those of CBA/NJ, were extrapolative among strains. Am Rev Respir Dis, 1989 Mar, 139(3), 748 - 51 Evaluation of an enzyme-linked immunosorbent assay (ELISA) using an IgG antibody to Mycobacterium tuberculosis antigen 5 in the diagnosis of active tuberculosis in children; Alde SL et al.; An enzyme-linked immunosorbent assay (ELISA) using Mycobacterium tuberculosis antigen 5 has been evaluated as a serodiagnostic test for active tuberculosis in children . Forty children of either sex, ages 1 to 14 yr, were studied, including 21 bacteriologically confirmed tuberculous patients and 19 control subjects who were evaluated for tuberculosis and found to be free of disease . At a 1:20 dilution, the test showed a sensitivity of 0.857 and a specificity of 1.000, with an accuracy value of 0.925, a positive predictive value of 1.000, and a negative predictive value of 0.864 . The prevalence of disease calculated directly from the data of the study was found to be of 0.525 . The geometric mean ELISA titer of the tuberculosis group was 1:58, and the difference in antibody titers between patient and control groups was found to be statistically significant (p less than 0.001) . From our results, we conclude that ELISA using M . tuberculosis antigen 5 may be useful in those situations of high prevalence of disease when children suspected of tuberculosis are being evaluated. Harefuah, 1989 Feb 15, 116(4), 194 - 5 {Tuberculous meningitis}; Kaufman N et al.; 2 cases of tuberculous meningitis are presented, 1 in a 54-year-old woman who had immigrated to Israel from Turkey 36 years before, and the other in a 10-year-old girl who recently immigrated from Ethiopia . Since diagnosis is difficult and prompt antituberculous treatment is life-saving, treatment may be instituted before the bacteriological diagnosis is established . A short term treatment of 9 months and a combination of rifampicin and isoniazid were successful in our patients. Epidemiol Infect, 1989 Feb, 102(1), 31 - 6 Exposure to Legionellaceae at a hot spring spa: a prospective clinical and serological study; Bornstein N et al.; Following the occurrence of five cases of Legionnaires' disease among patients and therapists at a French hot spring spa, a series of cleansing procedures and an epidemiological study were undertaken . During a 3-month period, the spring water was repeatedly sampled . Serum samples were taken from 689 randomly selected patients, 230 therapists, 134 administrative staff and a control group of 904 blood donors . Legionellaceae were present in the spring water at concentrations of 10(3)-10(5) colony forming units/l . Fifteen different species or serogroups were isolated with Legionella pneumophila serogroups 3 and 1 predominating . No clinical cases of Legionnaires disease were observed during the study . However, 11% of the therapists and 5% of the patients either had a high titre of antibody (greater than or equal to 256) to at least one species or serogroup or seroconverted during the study . Mean antibody titres in the three study groups were significantly higher than those in the blood donors against 11 of the 32 legionella antigens tested . Nine of these 11 antigens corresponded to species or serogroups isolated from the spring water . The highest mean antibody titres in all three study groups were against L . pneumophila serogroup 3, the most common legionella in the spring water . These findings have important implications for the maintenance of adequate standards of hygiene, bacteriological sampling and clinical surveillance in this and similar establishments. Indian Pediatr, 1989 Feb, 26(2), 122 - 8 A clinico-bacteriological profile of leprosy in children; Dayal R et al.; Clinico-bacteriological profile of 106 leprosy patients below 15 years of age was studied . Majority of the patients were males and fell in the 10-15 years age group (p less than 0.01) . Nearly 89% had not received any prior treatment because of financial constraints . Seventy per cent gave a positive history of contact with adult patients who were mainly of the lepromatous variety (p less than 0.01) . Skin lesions were present in 103 cases, mainly on the exposed areas and their number was found to increase significantly with advancing age (p less than 0.01) . These lesions were hypopigmented patches in 71% of the children and erythematous in the rest . Cutaneous sensations were affected in most of the patients while nerve thickening was observed in 45 . Positivity of the skin smears increased significantly as the number of skin lesions per patient increased (p less than 0.05) . With advancing age, the disease moved from the tuberculoid end of the spectrum towards the lepromatous end (p less than 0.01). Clin Nucl Med, 1989 Feb, 14(2), 97 - 100 Detection of acute osteomyelitis with indium-111 labeled white blood cells in a patient with sickle cell disease; Fernandez-Ulloa M et al.; A young patient with sickle cell disease (SCD) and multiple hospitalizations for crisis was admitted because of suspected osteomyelitis . Initial laboratory work, radiographs, and bone images were not contributory . An In-111 white blood cell (WBC) study demonstrated two areas of increased radionuclide uptake consistent with osteomyelitis . One of these had associated soft tissue infection . No other areas of active osteomyelitis were visualized, in spite of the presence of several additional infection sites . Imaging with In-111 WBC is probably not justified for routine diagnosis of acute osteomyelitis in areas free of previous disease, where conventional bone images are highly efficient . In-111 WBC imaging, however, may be helpful in detecting osteomyelitis in selected patients with SCD in whom Tc-99m bone images and radiographs are usually abnormal and difficult to interpret due to previous bone infarcts . Localization of the infection focus is very important in choosing the aspiration site for bacteriologic studies . A negative study, however, should be interpreted cautiously. Rev Fr Transfus Hemobiol, 1989 Feb, 32(1), 27 - 36 {Viability of human red blood cells preserved for 35 days after leukocyte depletion (in vitro study)}; Angue M et al.; 24 leukocyte poor red cells concentrates (L.P.R.C.) were prepared by sterile connection of a leucocyte filter between the primary bag and the SAGM bag of a blood unit after centrifugation . Their quality was followed up to 42 days by means of a panel of tests including, ATP and 2,3-DPG levels, hemolysis, plasma potassium, lactate and glucose, and counts of the microaggregates . 24 standard units acted as a control group . Results showed better preservation of LPRC and especially less hemolysis, higher ATP levels and at least equal oxyphoric capacity (explored by 2,3-DPG) . Microaggregate formation was dramatically reduced and bacteriologic checks (48 at day 25 and 48 at day 42) were all negative . Leucocyte depletion appears as a new way to improve functionality of erythrocytes during storage in the SAGM medium . 35 days shelf life will allow this blood product to be more available and its preparation more standardised. Ir Med J, 1989 Feb, 82(1), 11 - 3 Short course chemotherapy for pulmonary tuberculosis . A randomised controlled trial of a six month versus a nine month oral regimen; Howell F et al.; We report on the first trial in the Republic of Ireland to look at chemotherapy for TB . This management trial, carried out in single unit, which treats a third of all TB cases in the Republic of Ireland compared to effectiveness of a three drug/nine month regimen (Rifampicin (R), Isoniazed (R), supplemented with Ethambutol (E) for the first two months = RHE9) with a four drug six months regimen (R, H supplemented with E and Pyrazinamide (Z) for the first two months = RHEZ6) . Two hundred and eighty eight patients (288) were entered into the study . A total of 143, (76 were in the RHE9 group and 67 in the RHEZ6 group) completed the trial as planned . At the end of the third month, significantly more patients in the RHEZ6 regimen (98%) were culture negative compared to the RHE9 regimen (88%) . All were culture negative at the end of chemotherapy . Drug intolerance was seen in 35 (12%) patients with no significant difference in hepatitis between the two regimens . Toxicity from Pyrazinamide was minimal . One hundred and forty five (145) patients were invalid for analysis for the following reason:- bacteriologically negative TB (41), drug intolerance (35), death (23), non-compliance (19), diagnosis not TB (10), drug resistance (7), extrapulmonary disease (4), consent withdrawn (3), Mycobacteria other than tuberculosis (3) . All patients are being followed to monitor relapse rates. Epidemiol Infect, 1989 Feb, 102(1), 105 - 12 Bacteriological examination of the water supply on an Antarctic base; Harker C; Faraday Base represents a small isolated community producing its own domestic water by desalination of sea water . During the Antarctic winter of 1986 (April to October), regular bacteriological examination of the water supply and surrounding sea took place . Samples were collected and examined every 2 weeks by the methods described in the Department of Health and Social Security Report No . 71, on the Bacteriological Examination of Drinking Water Supplies (DHSS, 1982), for membrane filtration and colony counting . The results of these examinations are presented in this paper . The results obtained suggest that water of good bacteriological quality was produced by the desalination plant, but some samples from the distribution system contained coliforms or presumptive Escherichia coli in small numbers . The possible reasons for this low-level contamination are discussed . No cases of gastroenteritis occurred on the base during this time. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 1989 Feb, 11(1), 18 - 24 {Preliminary study of two inbred mice models for infection and immunity of Brucellosis}; Zhang JL; We established 2 animal models of Brucellosis using inbred mice (BALB/c and C57/BL) infected with virulent strains of B . melitensis 16, B . abortus 544 and B . suis 12 followed by bacteriological, serological, cellular immunological as well as histopathological examinations . It was shown that the BALB/c was more sensitive than C57/BL to brucella infection, especially to B . abortus 544 . It is suggested that BALB/c infected with 544A might be the experimental animal of choice for studying chronic brucella infection . Studies on PFC kinetics of murine Brucellosis were undertaken . It was found that there were varying degrees of immunosuppression of PFC formation in the infectious process of three species of brucella, particularly in B . melitensis 16 M infection . We also observed the allergic reaction of the infected mice to intracutaneous administration of brucellin and found that the C57/BL was more sensitive than BALB/c . It was shown that there was an immunosuppression period between the 37th approximately 45th days after infection in C57/BL . The above mentioned findings provide elementary data for study on the role of immunosuppression in the pathogenesis of Brucellosis . It also provides some basic data for the study of experimental brucella infection in inbred mice. Allergy, 1989 Feb, 44(2), 116 - 22 Allergy in patients with acute maxillary sinusitis; Savolainen S; The occurrence of allergy was studied in 224 patients with verified acute maxillary sinusitis by means of an allergy questionnaire, skin testing, and nasal smears . Allergy was found in 56 patients (25%) . In addition, allergy was considered probable in 14 patients (6.5%) . The corresponding percentages in the control group were 16.5 and 3, respectively . The difference is statistically significant P less than 0.05) . However, the frequency of allergy is lower in the present series than in those previously reported on chronic sinusitis . There were no differences between allergic and non-allergic patients in the number of prior acute sinusitis episodes or of previously performed sinus irrigations . Bacteriological and radiological findings did not differ significantly between the groups. Pol Tyg Lek, 1989 Jan 30, 44(5), 116 - 9 {Suppurative meningitis in 210 cases}; Jezyna C et al.; Clinical course, etiology and the results of treatment of the suppurative meningitis in 219 adult patients are discussed . Clinical course was extremely severe in 63.3% of the patients, moderately severe in 33.8% of the patients, and complicated by various coexisting disorders and skull trauma in several patients (35.7%) . Mortality rate was 8.6% . Combined therapy with 2 or 3 synergetically acting antibiotics was administered . An emphasis is on diagnostic problems especially in patients treated with various antibiotics prior to hospitalization (37.1%) and low percentage of bacteriological tests (22.9%). J Am Vet Med Assoc, 1989 Jan 15, 194(2), 273 - 7 Idiopathic gonitis in heifers: 34 cases (1976-1986); Madison JB et al.; Acute suppurative arthritis of the stifle joint was diagnosed in 34 Holstein heifers between 1976 and 1986 . Only 1 stifle joint was affected in each heifer; however, 1 heifer also had involvement of the contralateral radiocarpal joint . In each heifer, there was marked lameness and synovitis characterized by an effusion with high synovial fluid nucleated cell counts and total protein concentration . Seventy-four percent (25/34) of the heifers had radiographic evidence of an osteolytic lesion involving the lateral tibial plateau . Bacteriologic cultures of synovial fluid, synovial membrane, and bone yielded no growth . Eighteen of 23 (78%) affected heifers for which follow-up data was obtained became productive herd members after treatment. Ther Umsch, 1989 Jan, 46(1), 30 - 4 {Antibiotic therapy of bacterial pneumonia in the elderly}; Janssens JP et al.; After reviewing the epidemiological data of mortality and morbidity of pneumonia in old people, the various mechanisms of respiratory tract infections are described . This approach points out the very important problem of nosocomial pulmonary infections . The clinical diagnosis is not easy in this high risk population whose reactions to infection are usually weak and atypical . For multiple reasons, the bacteriological proof of the infectious disease in old age is very difficult to obtain, and the adapted antibiotherapy is uncertain . The choice of the medication will also have to be based on the modified pharmacokinetics for old people . Empiric considerations are very usefull as well as the discovery of new antibiotics, but above all, it is most important not to forget the possible immunization. Am Rev Respir Dis, 1989 Jan, 139(1), 14 - 7 The bacteriology of bronchiectasis in Hong Kong investigated by protected catheter brush and bronchoalveolar lavage; Pang JA et al.; Bacteria often colonize the lower respiratory tract of patients with bronchiectasis . Although the role of these bacteria in the pathogenesis of the disease is uncertain, their accurate identification is important for epidemiologic and treatment purposes . Therefore, the aims of this study were: (1) to identify these bacteria in patients with bronchiectasis without cystic fibrosis using the protected catheter brush (PCB) in order to avoid oropharyngeal contamination, and (2) to compare the results of bronchoalveolar lavage (BAL) with PCB . Quantitative culture was performed on PCB and BAL specimens obtained from the most severely affected lobes of 23 patients with bronchiectasis . Results of PCB showed no significant growth (less than 10(3) colony-forming units {cfu}/ml) in nine patients and 17 significant isolates (greater than 10(3) cfu/ml) in the rest: H . influenzae, 5; P . aeruginosa, 4; K . ozaenae, 2; S . aureus, 2; P . fluorescens, 1; S . pneumoniae, 1; Veillonella, 1; and coag.-ve Staph., 1 . For BAL, the results were the same (20 isolates) regardless of whether 10(4) or 10(5) cfu/ml was chosen as the cutoff point . More organisms were cultured from BAL specimens, and these included all but one of the organisms cultured from PCB . We conclude that the bacteriology of bronchiectasis in Hong Kong is different from that reported in sputum studies in the West (mainly H . influenzae, S . pneumoniae, and S . aureus), and with 10(4) cfu/ml as the cutoff point, BAL gives comparable results to PCB. Dis Colon Rectum, 1989 Jan, 32(1), 9 - 13 Povidone-iodine enema as a preoperative bowel preparation for colorectal surgery . A bacteriologic study; Hay JM et al.; To evaluate the effects of povidone-iodine (PI) enema on the bacterial flora of colorectal mucosa, the authors studied 113 patients who were candidates for colorectal surgery . The study of the rectum included 72 patients . Total bacterial concentrations after a PI enema (N = 44) were significantly lower than after a simple water enema (N = 12, P less than 0.001), or than after a water enema associated with intravenous metronidazole (N = 16, P less than 0.01) . The study of the colon included 41 patients . Total bacterial concentrations did not differ after a PI enema (N = 24) than after a water enema (N = 11); both groups were associated with intravenous metronidazole . In contrast, both preparations significantly reduced bacterial concentrations when compared with oral administration of polyethyleneglycol (N = 6, P less than 0.01) . Similar results were observed in rectal and colonic studies, when analysis was restricted to the anaerobic flora . PI is an antiseptic that, when administered alone in an enema or in association with metronidazole, significantly reduces bacterial concentrations in the mucosa of the colon and rectum . It may be proposed as a simple preoperative preparation for colorectal surgery. Ann Fr Anesth Reanim, 1989, 8(4), 326 - 33 {Autologous transfusion by peroperative salvage in orthotopic transplantation of the liver}; Houvenaeghel M et al.; As large quantities of blood are required during orthotopic liver transplantation, intraoperative autotransfusion is therefore often carried out in adult patients . This study aimed to assess the ease of use of this technique, its efficiency and possible side-effects . Intraoperative blood salvage was carried out using a Cell Saver 4R (Haemonetics) in 14 patients . The chest blood was collected, anticoagulated with heparin and sodium citrate, centrifuged and washed with Ringer lactate . During surgery, and the subsequent 5 days, the following data were recorded: red cell and platelet count, haemoglobin concentration, parameters of renal function, potassium, citrate and fibrinogen levels, parameters of renal function, blood cultures and the extubation delay . Autotransfusion was simple to use, with no side-effects during the procedure . An average of 20.5 red cell packs were required, of which 59.2 +/- 2.3% were supplied by autotransfusion . The volume of transfused blood was similar, or inferior, to other studies . The different haematological parameters, blood gases and serum potassium levels remained stable . Only 4 +/- 2.8 red cell packs were required postoperatively to maintain a stable haematocrit value . There was no increase in thrombin time, and therefore no effect due to the used heparin . Citrate levels were correlated with the amount of autotransfused blood . They were lower than in other studies because autotransfusion limited the citrate load . There was no haemolysis . Postoperative renal function remained normal . There was no change in the blood coagulation profile, except when large volumes were transfused, resulting in a dilutional coagulopathy . Extubation was always carried out during the first two postoperative days . Bacteriological studies remained negative, no bacteraemia being noted . During orthotopic liver transplantation autotransfusion is a simple, reliable technique, with few side-effects. Vestn Dermatol Venerol, 1989, (8), 65 - 7 {Chronic benign familial pemphigus}; Kovalev VM et al.; A female patient aged 50 is described, in whom candidiasis of the large folds has been erroneously diagnosed for 10 years; the diagnosis has not been confirmed by bacteriologic analysis, the therapy has been ineffective, the recurrences developed every year . The patient has developed symmetrical erythematous infiltrative areas in the armpits, groin, and in the folds under mammary glands, with solitary bullae up to 0.5-1.0 cm in diameter, with transparent contents, with thin flaccid covers and fragments thereof, as well as small pigmented vegetation . Basing on the histologic findings (suprabasal vesicles above the basal layer, acantholysis in the epidermis, and negligible lymphocytic infiltrate in the derma), Gougerot-Hailey-Hailey's disease has been diagnosed . The familial nature of the disease could not be established . Therapy with diphenhydramine, methyluracil, dimocifon, aloe extract, and aniline dyes, administered for 20 days, has resulted in clinical cure. Schweiz Arch Tierheilkd, 1989, 131(8), 495 - 8 {The treatment of Actinomyces pyogenes endometritis by intrauterine Gentaseptin administration}; Anetzhofer JV; 10 cows suffering from bacteriological proved A . pyogenes-endometritis have been treated by a single intrauterine infusion of GENTASEPTIN . All animals were cured . Clinical findings were confirmed by bacteriological tests . All animals conceived at the first insemination after treatment . The intrauterine application of GENTASEPTIN seems to be a very efficient treatment of A . pyogenes-endometritis as compared to hitherto existing treatments. Ital J Surg Sci, 1989, 19(3), 217 - 24 Lymph node biopsy in the diagnostic and prognostic assessment of patients with HIV infection; Badellino F et al.; Thirty-three anti-HIV positive patients with persistent generalized lymphadenopathy (PGL) who underwent lymph-node biopsy were studied to assess the diagnostic and prognostic relations existing between clinical, histological and laboratory findings . Patients were also examined for known risk factors, laboratory and bacteriological tests, and mononuclear cell surface marker analysis . 4 histological types were identified according to Racz's classification . At biopsy, there were 21 cases of LAS (64%), 6 cases of ARC (18%) and 6 cases of AIDS (18%); a clear prevalence of type 1 was evidenced in LAS/ARC patients, while only type 4 was present in the AIDS group . An ARC type 3 patient developed manifest AIDS within 13 months from biopsy . These results suggest that anti-HIV positive asymptomatic patients with PGL apparently do not require lymph node biopsy, as none of them showed histologic findings suggestive of opportunistic infections, malignant lymphoma or Kaposi's sarcoma . On the contrary, lymph node biopsy can play a diagnostic and prognostic role in anti-HIV negative subjects with PGL, and in ARC and AIDS patients. Acta Orthop Belg, 1989, 55(1), 22 - 5 Tuberculosis of the knee . Surgical or conservative treatment? Aguirre M, Bago J, Martin N. This report presents the clinical histories and the radiological, histologic and bacteriological findings of nine patients with tuberculosis of the knee, diagnosed and treated between 1974 and 1980 . The authors review the results of the medical and surgical treatments. Z Erkr Atmungsorgane, 1989, 173(1), 81 - 6 {Tuberculosis control strategy after 1988}; Kirsch M et al.; The early detection of new cases of tuberculosis, especially such with positive sputum, and the application of potent chemotherapy aiming at an early and lasting elimination of potential infection sources are urgent requirements of the basic strategy to combat the disease . The case finding must mainly aim at patients with bronchopulmonary complaints lasting over 3 to 4 weeks . X-ray testing of the whole population is no longer necessary . It should be abandoned in favour of careful screening of well defined high-risk-groups . Bacteriological diagnostics and tuberculin testing are now of greater importance within the changing case-finding-strategy . Major changes of therapeutical principles are not to be expected . Generalized protection and isolation measures should be critically scrutinized and reduced to the strictly necessary . Until the final eradication of tuberculosis a generally acceptable strategy related to the dynamic is required. Z Erkr Atmungsorgane, 1989, 173(1), 68 - 74 {Tuberculosis relapse in the GDR--causes and development}; Pohl S et al.; In a cooperative study 169 bacteriologically confirmed tuberculosis relapses of the years 1984-1986 were analysed with regard of causes or relapse favouring factors . In 58.5% relapse occurred 3 or more years after cessation of previous treatment . Relapse was presumedly caused in 22.3% by inadequate chemotherapy (considering duration and/or continuation and/or combination), in 25% by alcoholism and in 14.9% by silicosis . Resistance to 2 or more antituberculotic drugs was found only in 5.3% . Advanced age and polymorbidity are relapse favouring factors . Consideration of adequate chemotherapy is the most important factor to avoid relapse. Z Erkr Atmungsorgane, 1989, 173(1), 31 - 6 {The clinical picture of pulmonary tuberculosis during the course of 39 years}; Homolka J et al.; The change of signs and symptoms of pulmonary tuberculosis detected for the first time during the years 1948 through 1986 is analysed . During the entire period, the majority of patients attended the physician because of symptoms . Between 13 different evaluated symptoms cough was permanently most frequent . The other symptoms changed in their prevalence . The mean age of the patients increased from 29.7 to 59.0 years . The proportion of patients with cavities decreased from 75% to 37% . The increase of the proportion of patients in whom M . tuberculosis was detected, from 33.9 to 73.0%, is explained by the growing intensity of bacteriological examinations . To provide early case finding, health education of the population and appropriate qualification of physicians and other health providers are required at present as well as in the past. Plucne Bolesti, 1989 Jan-Jun, 41(1-2), 99 - 101 {The number of chronic patients contributing to total tuberculosis morbidity in the area of the city of Belgrade}; Pavlica R et al.; During four years (from 1984-1987) a group of 94 patients with chronic pulmonary tuberculosis were investigated . Mean age of patients was 51 years-the youngest was 27 and the oldest 78 . Mean time of disease was 5.4 years . They made 4.8% of all bacteriologically positive nonchronic patients . One third of them were resistant to one, 18% on two, 22% on three and 10% on all known antituberculosis drugs . It is very interesting that 19 patients or 20% were sensitive to all known antituberculosis drugs but tuberculosis still persisted. Khirurgiia (Sofiia), 1989, 42(3), 88 - 91 {The prevention of postoperative suppurative complications in stomach cancer}; Chakurov S et al.; Bacteriologic studies of gastric juice and purulent drainage fluids in the event of complications were carried out in 80 patients who had undergone gastric resections and had been on conventional parenteral antibiotic treatment (control group) . Another (experimental) group of 37 patient, having undergone the same operations, received prophylaxis of the suppurative complications with 5-nitrox and Flagyl solutions through nasogastric probe once in 3 hours for 6 to 8 days . The suppurative complications in the experimental group were reduced from 47.5 to 8.1 per cent and of the postoperative lethality due to suppurative complications from 22.5 to 0 per cent. Intensive Care Med, 1989, 15(4), 241 - 6 Nosocomial infections associated with long-term radial artery cannulation; Leroy O et al.; From January 1987 to December 1987, 193 radial artery cannulations were performed in 112 patients (87 males, 25 females; mean age = 57.5 years) . The mean duration of cannulation was 6.45 days . After removal, the tip of the catheter was cultured using a semiquantitative culture technique: 164 catheters were cultured and positive results were seen in 37 cases (22.5%); 98 samples of infusate were cultured . Positive results were observed in 23 cases (23.5%) . No bacteriological correlation was found between these two culture results . During the study, no catheter-related or infusate-related bacteraemia was detected . It is concluded that nosocomial infections associated with long-term radial artery cannulation are not commonly seen, in particular no catheter or infusate-related bacteraemia occurs even if the duration exceeds 4 days. Rev Laryngol Otol Rhinol (Bord), 1989, 110(2), 179 - 81 {Lymph node tuberculosis}; Ennouri A et al.; Ganglionic tuberculosis with a cervicofacial location is still frequent in Tunisia . The main problem posed is bacteriological . Over the last nine years, we have treated 110 patients . There is a clear male predominance . The preferential location is the jugulocarotid and upper spinal chain . The notions of contamination and a secondary location, particularly in the lungs, are rarely encountered . Extended cellulolymphadenectomy is the basis of surgical treatment, backed up by polychemotherapy over a period of 6 months. Rev Laryngol Otol Rhinol (Bord), 1989, 110(2), 165 - 7 {Cervicofacial actinomycosis . Apropos of 5 cases}; Ennouri A et al.; Concerning five observations of cervico-facial actinomycosis in the O.R.L . ward of Charles-Nicolle hospital, authors report sings, diagnosis and bacteriology . The cure consists in the extracting of the teeth concerned, the removal of the necrosed tissues and an antibiotherapic treatment based on ligh doses of penicillin relaying with cyclins. Probl Tuberk, 1989, (6), 33 - 7 {Clinico-roentgenologic characteristics of patients with pulmonary tuberculosis and damage to segment VI and results of their treatment}; Anastas'ev VS et al.; The clinicoroentgenological pictures of pulmonary tuberculosis located in segment VI in 90 patients and the results of their treatment were analyzed . Among the clinical forms, only infiltrative tuberculosis (88.9 per cent) and tuberculoma (11.1 per cent) were diagnosed . In 92.7 per cent of the patients the destruction phase was stated . Pneumonia was detected in almost half of the patients with acute and subacute processes of the disease . Tuberculosis in them was confirmed within the periods from 1 to 6 months . This is indicative of late diagnosis in some of them . Diagnostic mistakes were mainly associated with the features of the process localization and defective bacteriological and roentgenological examinations since the clinical signs and histories were typical of tuberculosis . The treatment results were estimated in 79 patients who stayed in hospital for at least 2 months . Closure of destructive cavities was observed in 73.7 per cent of the patients against 81.1 per cent in the control group . Abacillation was recorded in 96.5 per cent of the patients. Schweiz Arch Tierheilkd, 1989, 131(5), 267 - 75 {Chronic periorchitis and periepididymitis of cattle}; Gimbo A et al.; The Authors describe chronic vaginitis of bovines in intensive breeding . All of the 78 subjects examined presented vaginitis, accompanied by fibrinous hydrocele . On the spermatic cord and the tail of epididymis, initial lesions consisted of granulomas and fibrinous bridges between vaginalis propria of testicle and of epididymis . Subsequently appeared adherence and synechiae, which join the deferens and epididymis body to didymis, and thickening of albuginea . Synechiae can develop between peritesticular vaginalis propria and communis . Histopathological findings: peritoneal-like papillary structures with metaplastic mesothelial cells; diffuse lympho-plasmacellular infiltration with eosinophils and mast cells; intense capillary angiogenesis . The epididymal lesions are: diffuse mononuclear infiltration; periarteritis nodosa; papillary proliferations of endothelium; endothelial degeneration; tubular ectasia and stenosis; intraepithelial cyst . Noticeable within testis: periarteritis nodosa; fibrosis of albuginea; spermatocytes vacuolisation; multinucleate spermatids; epithelial shedding . The Authors pointed out: the serological and bacteriological testings furnished inconclusive results; only pathological finding always present is a large infestation of cremasteric muscle with Sarcocystis, to which is attributed the etiopathogenesis of flogosis, that is chronic from the beginning . The Authors propose the terminology of "Chronic peritesticular and periepididymal vaginitis" or "Chronic Periorchitis and periepididymitis". Rev Stomatol Chir Maxillofac, 1989, 90(4), 297 - 9 {Parotid tuberculosis . Apropos of 2 cases}; Marrakchi R et al.; The authors report 2 cases of parotid gland tuberculosis treated in the O.R.L . Service of C.H.U . H . Thameur, Tunisia . It's very rare infection even in the countries where the tuberculosis is common (Kuruvilla) (1981) (3) . The preoperative diagnosis is difficult with a pleomorphic adenoma, a sarcoma or every parotid tumor . A skin's fistula will help the diagnosis which is confirmed by pathology and bacteriology . The treatment consist in a operative management with specific antibiotics . The prognosis is commonly well. Rev Stomatol Chir Maxillofac, 1989, 90(4), 268 - 73 {Diffuse gangrenous cervicofacial cellulitis of stomatologic origin in 7 patients with HIV-1 infection}; Vuillecard E et al.; A new clinical aspect of AIDS in Africa is represented by acute gangrenous cervico-facial cellulitis . In most of cases, the infection was due to infected tooth . Seven patients presenting with such clinical findings were HIV-1 infected (Western Blot) . Bacteriological investigations failed to show bacteria responsible of these syndromes except for 4 cases . All patients healed after surgical treatment done in emergency and antibiotherapy . No mediastinal localisation was noticed . Prevention by removing all infected teeth must be emphasized in HIV infected patient. J Indian Med Assoc, 1989 Jan, 87(1), 4 - 6 A study on laboratory diagnosis of liver abscess in Pondicherry; Mehta RB et al.; A study was carried out to evaluate the role of laboratory investigations for diagnosis of liver abscess from the year 1976 to 1981 . Bacteriological, parasitological, serological, haematological, histopathological studies and liver function tests were carried out in 240 confirmed cases of liver abscess during the study period . Out of 219 cases, pus culture for pyogenic bacteria was positive in 68 cases (including 27 cases of secondary bacterial infection of amoebic liver abscess) and sterile in 151 cases . Ent histolytica was demonstrated in pus of 24 cases . The diagnostic titre of 1:128 and above was detected in 137 sera by isohaemagglutination test . The liver function tests were of limited value . Albumin globulin ratio was altered in 91.25% cases and there was moderate increase in the levels of alkaline phosphatase . Histopathological studies demonstrated Ent histolitica in 2 cases only . Changes characteristic of pyogenic liver abscess were observed in 6 cases . Rest showed no specific changes. Pharmatherapeutica, 1989, 5(5), 329 - 37 {Effectiveness and tolerance of amoxicillin/clavulanic acid ("Augmentin") in intravenous injections in adults}; el Filali KM et al.; A prospective study was carried out in 43 hospitalized patients with respiratory or other serious bacterial infections requiring intravenous antibiotic therapy to assess the efficacy and tolerance of amoxycillin/clavulanic acid ('Augmentin') . After bacteriological and laboratory investigations patients were started on 1 g amoxycillin plus 200 mg clavulanic acid intravenously every 8 hours for the first 3 days and then were treated orally at the same dosage . Duration of treatment varied according to the type and severity of the infection, with a minimum of 10 days . Efficacy of treatment was evaluated by the clinical response, judged by the resolution of signs and symptoms of infection . The results showed that there was a clinical cure rate of 88.4% . Local tolerance was excellent and there were few side-effects reported . Six patients experienced vomiting which led to the withdrawal of treatment in 1 patient. Bull Soc Pathol Exot Filiales, 1989, 82(2), 255 - 9 {Application of solar disinfection to drinking water in tropical regions}; De Lorenzi G et al.; Since unsafe water elicits a broad spectrum of bacteriological, parasitological and virological diseases, purification of polluted drinking water has to be developed in tropical rural regions . Around 70% of rural wells and 7% of bore-holes contain water unsafe for human consumption . Water is also contaminated during transport and storage . Several techniques of purification have been recommended to protect drinking water . Recently, sterilisation in the U . V . or simply in the sun rays has been systematically tested . In tropical rural areas, solar disinfection has given questionable results . It affords no guarantee for the health of the consumer in contrast with other techniques as chlorination. Bull Soc Pathol Exot Filiales, 1989 Jan, 82(1), 141 - 50 {An epidemic of cholera in the prefecture of Gisenyi . Epidemiologic, clinical and bacteriologic aspects}; Malatre X et al.; An outbreak of cholera occurred in the Prefecture of Gisenyi, Rwanda during the last two months of 1987 . From the bacteriologically confirmed cases, the authors report the epidemiological and clinical aspects of this epidemic . Their conclusions show advisability of following each case, the absence in certain patients of the classic symptoms . The efficacy of the prophylactic measures of a single dose of Fanasil taken on contact of patients is disputable. Ann Med Interne (Paris), 1989, 140(2), 106 - 7 {Nosocomial sinusitis and nasotracheal intubation . Prospective study of 53 patients}; Guerin JM et al.; The authors studied the frequency of sinusitis in nasotracheally intubated patients in an Intensive Care Unit . All patients intubated nasotracheally during an 8 day period were included in a prospective study which included CT scanning with views of all the paranasal sinuses . Sinusitis was defined as opacification of the sinus with an air-fluid level . Transantral punctures were performed in cases of maxillary sinusitis . Fifty-three patients were included . Local symptoms and/or unexplained fever were present in 22% of cases . CT scanning showed sinusitis in 49 of the 53 cases (pansinusitis 42 cases, maxillary alone 5 cases, sphenoidal 16 cases) . Bacteriological cultures of sinus punctures were positive in 39 cases, monomicrobial in 21 and polymicrobial in 18 cases . Twenty of the 53 patients developed a lower respiratory tract infection with the same germ and 10 developed septicemia (3 with isolated sinusitis and 7 with pneumonia) . Eighteen patients died (6 of their infection and 12 of the underlying disease) . This study shows the high frequency of bacterial sinusitis and the necessity of sinus puncture for bacteriological identification of the causal organism to adapt antibiotic therapy. Zentralbl Chir, 1989, 114(7), 462 - 6 {Experiences with percutaneous drainage of abscesses and pseudocysts}; Freitag J et al.; Percutaneous catheterised drainage of abscesses and pseudocysts as well as of circumscribed suppurations in soft-part tissue is considered an established therapeutic approach . Therapeutic puncture or drainage was successfully performed in 19 cases, following CT-targeted fine-needle puncture and subsequent cytological and bacteriological diagnosis . Inflammatory alterations were tackled by antibiotic therapy according to an antibiogram . Complications did not occur. Rev Mal Respir, 1989, 6(3), 261 - 4 {Adult respiratory distress syndrome, a manifestation of severe pneumococcal infection}; Thoreux PH et al.; A retrospective study analyzing the case notes of 49 hospitalized adults, either in intensive care (n = 26) or in thoracic medicine units (n = 23), for acute bacteriologically proven pneumococcal pneumonia based on samples obtained other than by sputum examination . The mortality was 54% in intensive care and 17% in the thoracic medicine unit . This significant difference may be explained in part by a respiratory distress syndrome in whom there were adequate criteria on admission for 7 patients in the intensive care group . Among these latter only one patient had had a splenectomy . The others did not have underlying disorders (three were chronic alcoholics); 7 patients were shocked on admission, four with a leukopenia less than 5,000/mm3 and six had a thrombocytopenia less than 100,000/mm3; finally 6 had a temperature of less than 38 degrees C . 7 patients died in less than four days (mean 2 days) in a clinical context of refractory hypoxemia . The significance of the respiratory distress syndrome is probably very different from the usual pneumonia; it seems rather to be an integration of the toxins induced by the pneumococcus . Its presentation can be particularly misleading as regards the diagnosis; the prescription of antibiotics once a diagnosis is obtained would seem insufficient by itself in this context to obtain a cure. Alaska Med, 1989 Jan-Feb, 31(1), 4 - 8 Surveillance for tuberculosis in Alaska, 1986; Beller M et al.; The incidence of tuberculosis in the Native population in Alaska (92.2/100,000) continues to be higher than the U.S . tuberculosis incidence (9.3/100,000) . This paper describes tuberculosis surveillance in Alaska and estimates the "predictive value positive" for cases recorded by the surveillance system during 1986 . (Predictive value positive refers to the proportion of all people identified who actually have the disease.) Active surveillance components included an itinerant chest clinic and survey chest roentgenography program, epidemiologic case investigations, and skin testing . Passive components included cases reported by health-care providers and the U.S . Immigration and Naturalization Service . Half of all new cases were reported by health-care providers . Only 42% of cases were bacteriologically confirmed (vs 87% nationwide) suggesting that some cases may have been false positives . many cases did not have a contact investigation completed . Recommendations to improve the surveillance system include: 1) following the Centers for Disease Control/American Thoracic Society diagnostic criteria more closely, 2) increasing the number of cases which have contact investigations completed, and 3) targeting surveillance activities towards high risk subgroups such as Southeast Asian immigrants. Ter Arkh, 1989, 61(2), 76 - 9 {Tuberculosis and its sequelae as a cause of death of patients in a multi-profile hospital}; Zhingel' IP et al.; The intravital diagnosis was established only in 20 patients (19.2 percent) out of 104 persons who died from tuberculosis and its sequelae over the last 20 years at the general hospital . The diagnostic errors were mainly accounted for by the difficulties in the recognition of the acute and generalized patterns of tuberculosis, by grave condition of the patients admitted to the hospital, by predominance among the patients of elderly persons with a number of concomitant diseases, by inadequate examination of the patients (the lack of x-ray, bacteriological and instrumental studies) as well as by the lack of attention on the part of internists to the clinical manifestations of tuberculosis today. Scand J Thorac Cardiovasc Surg, 1989, 23(1), 47 - 9 Autotransfusion of mediastinal blood in cardiac surgery; Lepore V et al.; A series of 135 adults undergoing cardiac surgery was randomized to an autotransfusion group (n = 67) or a control group (n = 68) . In the autotransfusion group mediastinal blood was collected and reinfused during the first 6 postoperative hours . Blood from the reservoir was taken for bacteriologic culture at the end of that time . The postoperative blood was comparable in the two groups . The average requirement of bank blood was 2.7 units in the autotransfusion group and 3.3 units in the controls (p less than 0.05) . The average volume of autotransfusion blood was 336 ml . There were no clinical infections in the autotransfusion group, although 19% of the cultures were positive, and no apparent alteration of the coagulation mechanisms arose from infusion of autologous blood . No clinically significant intergroup differences were found in hematologic, renal or hepatic parameters, neurologic function or use of antibiotics. Gig Sanit, 1989 Jan, (1), 19 - 21 {The role of sanitary and bacteriologic examination of water in the prevention of acute intestinal infections in the Estonian S.S.R}; Birk KF; Extension of a complex of sanitary, hygienic, antiepidemic and technical measures carried out in Estonia since the 60s assisted in reducing significance of the water factor in the prevalence of acute intestinal infections. Urol Nefrol (Mosk), 1989 Jan-Feb, (1), 12 - 5 {Cystoscopy and endovesical biopsy in renal tuberculosis}; Shapiro AL et al.; Cystoscopy and endovesical biopsy of the bladder wall were performed at early stages of investigation prior to the onset of tuberculostatic treatment in 77 patients with destructive renal tuberculosis, verified both bacteriologically and histologically . Cystoscopy proved to be valuable in 83.2% of the cases, particularly so where the destruction focus communicated with the renal calyx-pelvis system . Cystoscopic symptoms of renal tuberculosis occurred at the following rates: tubercles in 6.5%, focal hyperemia, in 18.2%, erosion and ulcer, in 9.1%, bullous edema of the ureteral opening, in 11.6%, all kinds of changes of ureteral opening, in 37.6% . There were no visible changes of vesical mucosa in 16.8% . The pattern of mucosal changes correlated with the markedness of X-ray morphological changes in the kidney . Endovesical biopsy was positive in 52%, its results, being significant in cases of open destructive developments and ureteral affection . The value of endovesical biopsy increased where it was performed at the peak of clinical and cystoscopic symptoms, at early stages of disease, before the onset of tuberculostatic treatment . False-negative results of endovesical biopsy do not exclude renal tuberculosis . High value of cystoscopy and endovesical biopsy makes them up-to-date diagnostic tests for renal tuberculosis. Intensive Care Med, 1989, 15(2), 94 - 8 Comparison of nonbronchoscopic bronchoalveolar lavage to open lung biopsy for the bacteriologic diagnosis of pulmonary infections in mechanically ventilated patients; Gaussorgues P et al.; We compared nonbronchoscopic bronchoalveolar lavage (NB-BAL) with open lung biopsy to determine the etiological diagnosis of lung infiltrates in patients requiring mechanical ventilation . NB-BAL was performed via a cuffed reusable 7F catheter generally used for right heart catheterization (BAL-C) . In 13 patients, BAL-C and open lung biopsy were performed in the same lobe immediately after death when the ventilator was still functioning . No organism was cultured from BAL-C cultures when histopathologic examination of the lung showed no pneumonia and lung culture isolated no organism . Among the 10 positive BAL-C cultures, lung biopsy showed histologic pneumonia in 9 cases . Among these 9 pneumonia cases, 14 organisms were isolated in lung cultures and BAL-C correctly identified the causative agent in 13 cases . BAL-C appears to be an effective and safe procedure in the diagnosis of pulmonary infections in patients under mechanical ventilation who have previously received antibiotic therapy. Actas Urol Esp, 1989 Jan-Feb, 13(1), 45 - 8 {Renopleural fistula secondary to xanthogranulomatous pyelonephritis}; Fernandez Garcia JS et al.; A case is presented of renopleural fistula secondary to xantogranulomatous pyelonephritis in an 18-year-old female patient . Although the renopleural communication was not observed radiologically, concomitant clinical signs, bacteriological isolation of E . coli in renal and pleural content and surgical findings, confirmed the existence of such fistula. Jpn J Antibiot, 1989 Jan, 42(1), 179 - 88 {Use of fosfomycin tablets in the treatment of purulent skin diseases}; Takahashi H et al.; Fourteen patients with purulent skin diseases were treated orally with fosfomycin (FOM) 1.5-3 g in the tablet form for 1 week to determine its efficacy and safety . The results obtained are summarized as follows . 1 . The clinical efficacy rate was 71.4% . A bacteriological eradication rate of 71.4% was obtained . 2 . As adverse reactions 3 patients experienced diarrhea and abdominal pain . But in all of these patients, symptoms were relieved with a reduction in dosage . 3 . Taking the efficacy and the safety into account, utility rate was assessed to be 71.4% . From these results it is considered that FOM tablets are useful equally to conventional FOM capsules. J Pharm Sci, 1989 Jan, 78(1), 73 - 7 Stability of parenteral ceftriaxone disodium solutions in frozen and liquid states: effect of freezing and microwave thawing; Kedzierewicz F et al.; The stability of ceftriaxone disodium solutions stored in glass bottles was tested in two parenteral solvents (0.9% NaCl; 5% dextrose) at two concentration rates (10 and 50 mg/mL) and three temperatures (-22 degrees C, 5 degrees C, room temperature) . The solutions, which had been initially frozen, were thawed at room temperature or by exposure to microwave radiations . The stability of each sample was determined by a quantitative bacteriological agar gel diffusion assay and by high-performance liquid chromatography . The results of this study indicate that admixtures of ceftriaxone disodium at the concentration rates tested can be frozen for six months without a significant loss in antibiotic activity . At room temperature, the stability is dependent on the concentration of ceftriaxone disodium . At 5 degrees C, the stability is related to the concentration of ceftriaxone and of the solvent . The results obtained by both analytical methods are very close . In order to perform routine assays, the high-performance liquid chromatography method was chosen on the basis of its rapidity and reproducibility. Indian J Lepr, 1989 Jan, 61(1), 103 - 6 A report on six cases of histoid variety of lepromatous leprosy in children; Mohan L et al.; Six cases of histoid variety of lepromatous leprosy among children below 12 years of age were detected in over 3 years period . Bacteriological index was high (3 to 5+) . None of the patients had received any anti-leprosy treatment . It is a public health problem because of infectious nature of the disease, therefore early detection and management of this entity among children is important. An Otorrinolaringol Ibero Am, 1989, 16(6), 607 - 18 {Nasosinusal aspergillosis}; Medina Banegas A et al.; The paper reports about a bilateral maxillary sinusitis and a right pansinusitis of this unusual disease . The allergic polyposis present in the second case is probably due to fungus sensitization (as Katzenstein's case) . None of them have had dental problems, not even foreign bodies inside of the sinuses (quoted from other AA.) . The diagnosis must be confirmed by both the pathologist and the bacteriologist . The treatment is surgery plus antifungal drugs. Biomed Pharmacother, 1989, 43(6), 427 - 30 Lyme borreliosis in Finland in 1986-1988; Schauman K et al.; In 1986-1988 there were 123 patients with positive serology for Lyme borreliosis out of 4000 sera referred to the Department of Bacteriology and Immunology, University of Helsinki . Of the 63 patients with positive serology in 1986-1987 20 showed a predominant involvement of the nervous system, 18 complained of joint symptoms and 11 patients merely showed a skin involvement including 8 patients with erythema chronicum migrans (ECM) and 3 patients with acrodermatitis chronica atrophicans (ACA) . Two of the patients had unspecific general symptoms and in 5 patients the type of involvement remained unknown . The serology was considered to be falsely positive in 2 patients with tuberculous meningitis, in one with syphilis and in another with recurrent fever. Nephrologie, 1989, 10 Suppl, 39 - 42 {Bacteriologic aspects of peritonitis in continuous ambulatory peritoneal dialysis}; Verschraegen G et al.; Despite the many advantages of chronic ambulatory peritoneal dialysis, peritonitis continues to be a major complication . Gram+ cocci tend to form the major part in the group of causative agent