Bacteriological

J S Afr Vet Assoc, 1986 Dec, 57(4), 193 - 8
The prevalence of teat canal infections in lactating dairy cows as determined from foremilk and teat canal swab samples; du Preez JH; The diagnostic reliability of techniques for determining the prevalence of teat canal infections varies: bacteriological results obtained by examination of teat canal swabs were 20% higher on average than those of foremilk samples (FMS) examined and classified according to the criteria of the International Dairy Federation (IDF) . Since they are based exclusively on the bacterio-cytological results of the FMS, the IDF criteria for the classification of the various forms of subclinical udder conditions do not permit an accurate classification of the health status of the udder.

Arzneimittelforschung, 1986 Dec, 36(12), 1840 - 2
Ciprofloxacin in acute male gonorrhea; Szarmach H et al.; 100 male adults suffering from acute gonococcal urethritis were hospitalised and treated with decreasing doses from 2000 mg to 100 mg of ciprofloxacin (1-cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-3-quinoline carboxylic acid, Bay o 9867; designated tradename: Ciprobay) . Clinical signs (burning, exudate, edema, inflammation) and bacteriology (native and culture) were assessed hourly during the first 9 h and at 12, 24 and 72 h after start of therapy . Most patients were controlled during 10 days . 99 patients showed clinical and bacteriological cure . One patient with subacute gonococcal urethritis (protocol violation) did not react on 250 mg . No postgonococcal urethritis was seen . No side effects were reported . For the acute male gonococcal urethritis a 100 mg single dose treatment with ciprofloxacin can be recommended.

Int J Lepr Other Mycobact Dis, 1986 Dec, 54(4), 596 - 606
Classification of nerves is modified by the delayed recognition of Mycobacterium leprae; Ridley DS et al.; Biopsies of 42 concurrent nerve and skin lesions across the spectrum of leprosy were classified and compared histologically and bacteriologically . Observations were made as follows: a) The bacterial load was higher in nerve than in skin lesions of the same histological classification, and it was higher in nerve than in concurrent skin lesions irrespective of classification, although not at the lepromatous pole . b) There was some discrepancy between the histological classification of nerve and skin lesions in half the cases . Skin classification appeared to represent the general tissue response and, insofar as discrepancies existed, the skin classification was thought to give the better evaluation . Nerve classification was subject to minor variations of a random nature which were thought to be the outcome of local reactions due to the build up of antigen as a result of delayed recognition in an immunologically protected situation . Upgrading or downgrading ensued locally, depending on the level of antigen at the time of its detection . In such cases, the corresponding skin classification was usually BT, which occupied a critical point in the spectrum . A certain autonomy of the response between lesions of skin and nerve suggests an explanation for downgrading reactions . Although Mycobacterium leprae, alone among mycobacteria, has some sort of affinity for Schwann cells, it is the role of the nerves as protected sites which is fundamental to the course of the disease.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1986 Dec, 183(2-3), 304 - 25
{Keeping pets from the psychological viewpoint}; Bergler R; The research data are based on a representative psychological study (280 persons without domestic animals, 345 dog owners and 305 persons keeping other pets in their homes) and on an interdisciplinary pilot study in 30 households provided with dogs . The following major results deserve attention: Man and dog share a relationship of interaction and of mutual dependence . Animals are determined and shaped by man and vice versa . The dog contributes a great deal to the satisfaction of crucial human needs, to quality of life and well-being . As to adequate keeping of dogs suited to the animal there are still deficiencies in terms of knowledge; in addition, discernible tendencies towards humanization in pets frequently forestall desirable behavior . To convey and to enlarge existing awareness and existing behavioral norms in connection with animal-adjusted behavior, adequate feeding, proper care, vaccination prophylaxis but also in connection with personal hygienic necessities in dealing with the pet is therefore of particular significance . The bacteriological as well as the psychological results reveal that if nutrition, care and prophylaxis appropriate to the animal and personal physical hygiene are observed correctly, health hazards for man caused by the animal and vice versa are practically impossible to occur . Traceable pathogenic findings are results of human lapses and shortcomings; in the cases in which pathogenic germs occur the psychological man-dog-relationship is less positive the hygienic requirements and standards in connection with dog keeping are less differentiated on account of a limited personal sensitivity to hygiene there is neither constant care nor is time and attention devoted to the dog to the same invariable extent and deficiencies in terms of healthy nutrition become apparent . The relationship between man and animal--similar to human relations--is still characterized by prejudice, lack of information and thus insecurity with regard to correct behavior and also by mistakes and lapses . Particularly the veterinarians are called for--because of the greater impact of personal conversation and communication; not least also on behalf of competence in the field of behaviorism required and expected from them.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1986 Dec, 183(1), 86 - 8
{Demonstration of Legionella pneumophila in dental units}; Reinthaler F et al.; 42 dental units in 35 dentist practices were bacteriologically examined . Legionella of the species Legionella pneumophila--SG1 could be isolated from 4 dental units . Infection can occur during inhalation of finest aerosols, which are formed during the use of dental turbines and sprays.

J S Afr Vet Assoc, 1986 Dec, 57(4), 225 - 6
Examination of lochia as an aid to the early diagnosis of bovine brucellosis; Erasmus JA; The standard technique for diagnosing bovine brucellosis is the serological examination of blood samples . As affected females may excrete large numbers of the Brucella organism in the lochia, the bacteriological and smear examination of such material appeared to be a suitable alternative for early diagnosis . Of the lochia samples collected from 210 cows and heifers within 12-24 h after parturition or abortion, 10.9% were bacteriologically positive . Only 70% of these could be diagnosed correctly as positive by microscopic examination . This technique also resulted in 3.3% false negative and 1.4% false positive diagnoses . Results of the serological examinations of blood, collected simultaneously with the lochia samples, correlated fairly well with those obtained microscopically . Culture of lochia samples on a suitable medium appears to be the method of choice, when dealing with the early diagnosis of bovine brucellosis.

Ann Trop Paediatr, 1986 Dec, 6(4), 249 - 55
The diagnosis of pulmonary tuberculosis in malnourished Kenyan children; Cundall DB; Guidelines available for the diagnosis of pulmonary tuberculosis (TB) in children vary widely . In an area of high prevalence, pulmonary TB was often suspected but difficult to confirm . In a prospective study, diagnostic methods were recorded in 144 consecutive children admitted and diagnosed as having pulmonary TB . Six of the 144 children had bacteriologically confirmed tuberculosis . Seventy-five children had probable tuberculosis, the diagnosis being based on the tuberculin response in 19, a history of family contact in 34 and a diagnostic chest radiograph in 22 . The remaining 63 children had suspected tuberculosis: 23 of these had an inconclusive chest X-ray . The suspected group were significantly younger than the probable group (mean ages 2.8 and 4.4 years respectively), experienced a longer delay between admission and the start of antituberculous chemotherapy and suffered a significantly higher mortality (30% and 8% respectively) . A diagnostic process is proposed which takes account of the high proportion of nonresponders to tuberculin in a young, malnourished population . A trial of anti-tuberculous therapy is accepted as a valid diagnostic manoeuvre in suspected cases who are malnourished or have recently had measles.

Vet Rec, 1986 Nov 29, 119(22), 543 - 7
A field study of watery mouth: clinical, epidemiological, biochemical, haematological and bacteriological observations; Eales FA et al.; More than 500 cases of watery mouth in newborn lambs were recorded in 11 flocks and a detailed examination was performed in more than 200 cases . The condition occurred predominantly in lambs aged 24 to 48 hours . The incidence in a flock varied from 1 per cent to 24 per cent and the mortality in affected lambs varied from 7 per cent to 83 per cent . A bacteraemia was found in 38 per cent of the affected lambs . There were no consistent abnormalities of clinical biochemistry or haematology . Watery mouth was more common in twins and especially in triplets than in single lambs . In twins the highest incidence of watery mouth was recorded in lambs born to ewes in poor body condition . Antibiotic given orally within 15 minutes of birth greatly reduced the incidence of watery mouth.

Jpn J Antibiot, 1986 Nov, 39(11), 2897 - 913
{Evaluation of T-2588 in the treatment of respiratory tract infection}; Shimokata K et al.; T-2588 was used on 55 patients with respiratory tract infections and 44 cases were evaluated; 23 patients with pneumonia, 12 patients with acute bronchitis, 2 patients with chronic bronchitis, 1 patient with diffuse panbronchiolitis and 6 patients with bronchiectasis with infection . Clinical effects of T-2588 were as follows; excellent in 6 and good in 28 patients . The efficacy rate was 77.3% (34/44) . Bacteriological effects of T-2588 were prominent in 8 patients infected with B . catarrhalis, H . influenzae, K . pneumoniae and E . coli, but not in a patient infected with P . putida . The elimination rate was 90.0% (9/10 strains) . As side effects, stomatitis, anorexia, diarrhea X vomiting and pruritus were observed in one patient each . Abnormal laboratory findings were observed in 4 patients with elevated GOT and/or GPT . These side effects and abnormal laboratory findings were not serious . The usefulness of T-2588 was 68.2% (30/44) . Therefore, T-2588 is a useful drug and its effects are promising in clinical management of respiratory tract infections.

Rontgenblatter, 1986 Nov, 39(11), 311 - 2
{Cecal pole tuberculosis--an often forgotten differential diagnosis? Observations before and following tuberculostatic therapy}; Kapp-Schwoerer A et al.; If the barium enema reveals stenosing changes of the terminal ileum and caecum, tuberculosis must be considered in differential diagnosis, even if pulmonary evidence of the illness is lacking . Since, however, radiographically no exclusive typical changes for the tuberculosis of the terminal ileum and caecum can be seen, the diagnosis must be checked histologically and bacteriologically . Under drug therapy an obvious decrease of the inflammation of the mucosa of the colon could be seen.

J Antimicrob Chemother, 1986 Nov, 18 Suppl D, 133 - 8
Efficacy and safety of ciprofloxacin in patients with respiratory infections in comparison with amoxycillin; Gleadhill IC et al.; Ciprofloxacin and amoxycillin were compared in the treatment of respiratory infections (pneumonia, acute bronchitis, exacerbation of chronic lung disease) in a study of 48 patients randomly assigned to ten days treatment with standard doses of either drug . Forty-eight patients were evaluated, 26 in the ciprofloxacin group and 22 in the amoxycillin group . The response to therapy was judged by clinical and bacteriological criteria . Ciprofloxacin was as effective as amoxycillin with a successful outcome in 81% and 82% of cases respectively . A specific bacterial cause was determined in just over half the cases (28 patients) and eradication rates were higher for ciprofloxacin than for amoxycillin, 87% and 64% respectively . In particular, amoxycillin was unsuccessful in two patients infected with Branhamella catarrhalis . Both regimens were safe and produced little, if any, adverse effect (one possible episode in each treatment group) . Ciprofloxacin was found to be as effective in bacterial respiratory tract infections as amoxycillin.

Br J Surg, 1986 Nov, 73(11), 909 - 14
Enteric bacteriology, absorption, morphology and emptying after ileal pouch-anal anastomosis; O'Connell PR et al.; The aim was to determine whether changes in enteric bacteriology, absorption, morphology, and emptying occur after ileal pouch-anal anastomosis for ulcerative colitis, and to relate any changes to the clinical result . Twenty patients were studied 26 +/- 2 months (mean +/- s.e.m.) after operation . Eight patients had a good result, six a poor result, and six a history of recurrent pouch ileitis . Anaerobic and aerobic overgrowth occurred in the jejunum of patients with a poor result, but not in those with a good result or with pouch ileitis . In contrast, ileal pouch bacterial overgrowth occurred in all patients regardless of the clinical result . Patients with jejunal overgrowth had increased 24 h stool volume and stool nitrogen, but other patients did not . The larger the stool volume, the greater the anaerobic overgrowth . Pouch biopsies showed chronic inflammation in all patients, while 45 per cent had colonic metaplasia . Neither the inflammation nor the metaplasia correlated with the clinical result, nor did the clinical result correlate with the efficiency of pouch emptying . In conclusion, jejunal bacterial overgrowth after ileal pouch-anal anastomosis was associated with an increased stool output, azotorrhoea, and a poor clinical result . A distinguishing bacterial, absorptive, morphological, or emptying abnormality was not found in patients with a history of recurrent pouch ileitis.

Am J Vet Res, 1986 Nov, 47(11), 2343 - 5
Identification of bovine carriers of Moraxella bovis by comparative cultural examinations of ocular and nasal secretions; Pugh GW Jr et al.; The carrier state of Moraxella bovis was investigated, using bacteriologic examinations of ocular and nasal secretions from cattle under experimental and natural conditions of exposure and management . Moraxella bovis was isolated throughout the year from the ocular and nasal secretions of cattle naturally affected with infectious bovine keratoconjunctivitis . There was also 1 case of nasal transmission of M bovis without isolation of M bovis from ocular secretions and 1 case of M bovis isolation from the vagina of a calf contracted by contact with a calf affected with infectious bovine keratoconjunctivitis . The frequency of isolations and duration of infections, as determined by examination of ocular and nasal secretions, indicated that these secretions were comparable in the identification of M bovis carriers . The increased cultural isolations of M bovis from nasal secretions after shipment relative to the number of isolations before shipment indicated that shipment may serve as a stress factor causing an increase in the number of carriers.

Yale J Biol Med, 1986 Nov-Dec, 59(6), 613 - 20
Fever, frontal sinus mass, and CSF pleocytosis in a 44-year-old man; Berenson CS et al.; Intracranial complications arising from frontal sinusitis occur infrequently . However, they can progress with such rapidity that the clinical situation becomes far advanced before they are recognized . Radiographic imaging techniques may not be definitive early in the course of these complications . The infectious disease service was asked to evaluate a middle-aged man with acute global headache and nasal discharge for two weeks . CSF pleocytosis (3,600 WBC/mm3) was documented on lumbar puncture, and a dense mass was noted on sinus radiographs . At surgery, a large bony lesion was found extending from the right frontal sinus into the adjacent ethmoid sinus and nasal-frontal duct . The authors discuss the bacteriology, pathogenesis, and potentially serious intracranial and extracranial complications of frontal sinusitis which were considered during their evaluation of this patient.

Am J Clin Pathol, 1986 Nov, 86(5), 679 - 82
Proposed pathogenic mechanism for the diarrhea associated with human intestinal spirochetes; Rodgers FG et al.; Spirochetes resembling Brachyspira aalborgi were found in the feces and rectal biopsies of a patient with persistent diarrhea . Although the organism failed to grow on bacteriologic media, it was found attached to the surfaces of the epithelial cells on the rectal lumen . Blunting and destruction of the cellular microvilli was evident . These induced pathologic cell surface changes, together with the presence of intracellular bacteria in the cells of the rectal colon, suggest a pathogenic mechanism for the persistent diarrhea often associated with this condition . Both the spirochetosis and clinical symptoms disappeared on treatment with metronidazole.

Z Orthop Ihre Grenzgeb, 1986 Nov-Dec, 124(6), 692 - 700
{Tuberculosis of the pelvic girdle}; Richter R et al.; Between 1955 and 1980 a total of 67 patients (42 female, 25 male) with advanced tuberculosis of the pelvic girdle underwent surgery at the authors' clinic . In 43 patients the sacroiliac joint was affected (in 2 cases bilaterally), in 11 the ischium, in 9 the pubic bone, and in 2 each the ilium and the sacrum . The average of the patients (who included 4 migrant workers) was 44 . The youngest patient was 8, the oldest 67 years old . The average interval between the onset of complaints and diagnosis was 4.6 years (minimum 1 month, maximum 20 years) . Thirty-eight of the patients had already had treatment for an organic or osteoarticular tuberculosis . Although 24 (35.8%) of the patients were simultaneously suffering from a florid, specific infection localized elsewhere, and abscesses, fistulas, or a combination of these were identified in 40 patients (59.7%), only 17 (25.4%) were in slightly impaired general condition, and in over one-half of the patients, the hourly blood sedimentation rate was normal or only slightly elevated (up to 20 mm n.W.) . In 9 cases (13.4%) the only pointers to tuberculosis were the patient's history, clinical and radiological findings, and the subsequent evolution of the disease . In these cases the diagnosis could not be confirmed either by histologic or by bacteriologic study of focal tissue . In 67 patients, 66 osseous foci were removed and in 2 cases merely an abscess (after an average of 2-3 weeks' tuberculostatic therapy), the bone cavities were filled with a mixture of heterogeneous or autogenous spongiosa and tuberculostatics or merely with chemotherapeutic drugs, and primary closure of the wound was performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Surgery, 1986 Nov, 100(5), 828 - 35
Comparison of the postburn hyperdynamic state and changes in lung function (effect of wound bacterial content); Demling RH et al.; The pulmonary and systemic response to a full-thickness burn (15% of total body surface area) was determined in 15 adult sheep . Also compared was the effect of wound bacterial content and prostanoid release on this response . Burn wound thromboxane A2, measured as TxB2, and prostacyclin, measured as 6-keto-PGF1 alpha, were measured in burn wound lymph . Animals were monitored for 7 days . On the final day, a full-thickness biopsy specimen of burn tissue was obtained for quantitative bacteriology . Wounds with 10(4) or less organisms per gram of burn tissue were considered colonized, whereas those with 10(5) or more organisms per gram of burn tissue indicated wound infection . Seven sheep had 10(4) or less bacteria and the remaining eight sheep had 10(6) or greater bacteria . We noted a significant mean increase in cardiac index from a baseline of 5 to 6.2 L/min/m2, a decrease in systemic vascular resistance from 16 to 12 mm Hg/L/min, and a mean increase in oxygen consumption from a baseline of 135 to 165 ml/min/m2 during the 7-day study period . There were no differences in these responses between the colonized and the infected wounds . Pulmonary artery pressure increased from a mean baseline of 19 to 24 mm Hg and arterial oxygen tension (PaO2) decreased from a baseline of 90 to 80 mm Hg in the infected wound group, with values remaining at baseline in the colonized wound group . These changes corresponded with an increase in lymph and plasma TxB2 from a baseline of 200 to 210 pg/ml to 1000 +/- 250 and 600 +/- 190 pg/ml, respectively . Values in the animals with colonized wounds were not significantly increased.(ABSTRACT TRUNCATED AT 250 WORDS)

J Pediatr Ophthalmol Strabismus, 1986 Nov-Dec, 23(6), 292 - 7
Acute orbital pseudotumor with iatrogenic intraorbital air: a diagnostic dilemma; Wagner AL et al.; A 13-year-old black female was referred with unilateral granulomatous uveitis and orbital inflammation of sudden onset . Hematologic, serologic, bacteriologic, and ultrasonographic studies along with high resolution CT scans of the orbits were employed to determine the diagnosis and appropriate treatment . Subconjunctival corticosteroid injection containing air prior to referral obfuscated the ultimate diagnosis of pseudotumor . The Pediatric Infectious Disease service delayed definitive treatment with systemic steroids . Differential diagnosis of granulomatous uveitis with orbital inflammation are discussed . CT scan has significantly advanced the diagnosis and management of orbital pseudotumor.

Rev Infect Dis, 1986 Nov-Dec, 8 Suppl 5, S644 - 50
Sulbactam plus ampicillin: interim review of efficacy and safety for therapeutic and prophylactic use; Lees L et al.; The efficacy and safety of sulbactam/ampicillin has been evaluated in 39 studies of therapeutic use and six studies of prophylaxis . Studies of therapy were conducted in 899 patients: 751 seriously ill, many of whom had multiple concurrent diseases, and 148 with gonorrhea . Overall clinical and bacteriologic success was achieved in 92% of assessable cases; 88% of 768 pathogens in these patients were eradicated . Of these pathogens, 43% were resistant to ampicillin; eradication rates of 91% and 85% were achieved in ampicillin-resistant and ampicillin-sensitive organisms, respectively . In 388 patients who received prophylactic sulbactam/ampicillin, efficacy was similar to that of comparative agents and better than that of a placebo in preventing wound infections after appendiceal, biliary, upper-gastrointestinal, or gynecologic surgery . Adverse reactions were infrequent with the exception of injection-site pain, which occurred mainly after intramuscular injection and was reduced in incidence by concurrent administration of lidocaine.

Rev Infect Dis, 1986 Nov-Dec, 8 Suppl 5, S576 - 8
Effect of prophylactic administration of sulbactam/ampicillin on the rate of postoperative endometritis after first-trimester abortion; Krohn KT; In a single-blind randomized study, the efficacy of a single intravenous dose of sulbactam (0.5 g) plus ampicillin (1 g) was compared with that of placebo in the prophylaxis of early postoperative endometritis after abortion with vacuum aspiration in the first trimester . Administration of either sulbactam/ampicillin or placebo occurred immediately before the operation . The two treatment groups were equally matched with respect to patient's age, gestational age, presence of an intrauterine device, and baseline bacteriologic findings . During the first seven postoperative days, four of 145 patients who had received sulbactam/ampicillin and 11 of 140 patients who had received placebo were diagnosed as having endometritis . No adverse effects and no laboratory test abnormalities attributable to treatment were reported in either group . A single dose of sulbactam/ampicillin reduced the incidence of early postoperative endometritis after abortion with vacuum aspiration in the first trimester.

Clin Otolaryngol, 1986 Oct, 11(5), 323 - 7
Bacteriological aspects of swimming with grommets; el Silimy O et al.; A prospective bacteriological and symptomatic study was carried out on 50 swimmers and 50 non-swimmers who had grommets inserted for secretory otitis media . The risk of developing otorrhoea with positive bacterial pathogens was similar for swimmers (7.9%) and non-swimmers (8.0%) . Subdividing the non-swimmers into 'wetters' and 'strictly dry' there was a similar risk of ear symptoms and pathogens . All children who swim before the insertion of grommets should continue to do so postoperatively with no added risk of ear infections.

Clin Orthop, 1986 Oct, (211), 55 - 64
Long-term results of low-friction arthroplasty performed in a community hospital, including a radiologic review; Hamilton HW et al.; This report is a prospective review of 450 low-friction arthroplasties (LFAs) performed by a single surgeon from 1972 to 1983 in a community hospital . The clinical results show sustained quality of the result over a maximum follow-up period of 11 years . The radiologic review shows a slight increase in the number and size of radiolucent lines with time . Bacteriologic studies confirm that clean-air technology reduces the bacteriologic contamination of the operating room and the wound . Deep infections occurred in 1.6% of cases . The most notable complication was failure to obtain bony union of the osteotomized trochanter in 14% of cases . The revision rate for aseptic loosening of the cup was 0.7% and of the femoral prosthesis 0.0%.

Am Surg, 1986 Oct, 52(10), 555 - 9
The competence and bacteriologic effect of the telescoped intestinal valve after small bowel resection; Kholoussy AM et al.; In 20 dogs the distal one-third of the small intestine and the proximal 10 cm of the ascending colon were resected . Bowel continuity was established by the telescoping technique to create an intestinal valve in ten dogs (group A) and by conventional end-to-end anastomosis in ten dogs (group B) . Diarrhea and weight loss were similar in both groups . The ileal bacterial growth was significantly higher than the jejunum in group A (P less than 0.001) but not in group B . The jejunal bacterial growth in group B was significantly higher than that in group A (P less than 0.01) . Intestinal transit times were 212 +/- 16.0, 219 +/- 152.4, and 163 +/- 85.8 minutes for normal dogs, groups A and B respectively . The competence of the normal ileocecal valve, the telescoped valve, and conventional anastomosis were 56 +/- 1.7, 49.9 +/- 17.4 and 13.2 +/- 7.8 cm of barium, respectively . Artificial intestinal valve formed by the telescoping technique is safe, simple, and effective in reducing bacterial overgrowth in the jejunum and appears to prolong intestinal transit time.

Am J Surg, 1986 Oct, 152(4), 446 - 50
Preoperative irradiation potentiation with cisplatin: effect on rate of wound infection; Morain WD et al.; Platinum coordination complexes, such as cisplatin, potentiate the cytotoxicity of irradiation on squamous cell carcinoma and certain other solid tumors . Using a rat oro-cutaneous fistula model, an investigation was carried out to determine whether or not there was a concomitant potentiation with cisplatin of the deleterious effect of preoperative irradiation on the ability of a subsequent wound to handle a bacterial challenge . Auto-contaminated wounds were found to have increased rates of infection at single-dose orthovoltage pretreatments of 1,500 rads or more . Using quantitative bacteriologic techniques, would infection was found to be no more frequent after platinum-enhanced irradiation than after irradiation alone; however, there was the additive effect of weight loss associated with combined cisplatin treatment and irradiation.

Indian J Lepr, 1986 Oct-Dec, 58(4), 592 - 600
Evaluation of levamisole, an immunopotentiator, in the treatment of lepromatous leprosy; Kar HK et al.; Twenty subpolar lepromatous leprosy patients under multidrug therapy for a period of 1 to 3 years, who continued to be bacteriologically positive (BI 2 to 1 in Dharmendra's grade) were taken in the study . Ten cases (trial group) were given levamisole as an immuno-stimulator for 1 year along with chemotherapy . Another 10 cases (control group) continued to take chemotherapy alone . There was no conversion of Mitsuda reactivity in any of the cases from both the groups . There was no improvement of leucocyte migration inhibition in either group . In both trial and control groups, statistically significant clinical and bacteriological improvements and increase of E . rosette counts are found at the end of one year . However, only the bacteriological improvement in the trial showed statistical significance, when the improvements were compared with those of the control group . No adverse effect due to levamisole therapy was encountered.

Indian J Lepr, 1986 Oct-Dec, 58(4), 623 - 5
Multiple relapses in borderline leprosy--a case report; Ramachandran A et al.; A case of borderline lepromatous leprosy with a history of 5 years duration of disease, was first seen in 1971 and treated with graded doses of dapsone in the OP Clinic of the Institute . He became inactive and bacteriologically negative in 3 years . While continuing on dapsone therapy he relapsed into active dapsone resistant leprosy 3 1/2 years later . He was admitted in the hospital and given Rifampicin 600 mg . daily for 15 days along with dapsone 100 mg . daily . He again became inactive and bacteriologically negative within 3 years . 3 years later under regular dapsone therapy he relapsed again for the second time into active BT leprosy, but remained bacteriologically negative . He was given 3 drug regimen subsequently and became clinically inactive within 15 months.

Jpn J Antibiot, 1986 Oct, 39(10), 2780 - 94
{Clinical evaluation of cefoperazone in lower respiratory tract infections}; Ishibashi T et al.; Clinical evaluation and kinetics in serum of cefoperazone (CPZ) in patients with lower respiratory tract infections have been conducted as a multicenter trial participated by 20 institutions in Kyushu area during a period of 8 months from October 1984 to May 1985 . Mean serum CPZ levels up to 4 hours following the end of intravenous infusion of either 1 or 2 g CPZ remained higher than the MIC80 of CPZ against major causative organisms of lower respiratory tract infections such as H . influenzae, P . aeruginosa, K . pneumoniae, and S . pneumoniae . Serum half-lives of CPZ following intravenous infusion were prolonged in the elderly and in patients who showed moderate liver or kidney dysfunction, but did not exceed twofold of normal value . Clinical efficacy rates of CPZ were 82.9% (34/41) against pneumonia, 80% (4/5) against lung abscess, 88.9% (32/36) against acute exacerbation of chronic bronchitis, 66.7% (2/3) against panbronchiolitis, 100% (1/1) against acute bronchitis, and 85.7% (12/14), 64.3% (9/14) and 70.0% (7/10) against infections concurrent to chronic respiratory diseases, pulmonary emphysema and bronchiectasis, respectively . The overall efficacy rate was 81.5% (101/124) . Bacteriological eradication rates against P . aeruginosa, H . influenzae and S . pneumoniae were 60% (6/10), 88.9% (8/9) and 100% (3/3), respectively . The overall eradication rate including polymicrobial infection was 67.5% (27/40) . The clinical efficacy rate of CPZ in patients with underlying diseases such as lung cancer, pulmonary tuberculosis, and pneumoconiosis, etc . was not significantly different from the efficacy rate in patients without these underlying diseases . Of 20 patients who failed to respond to previous antibiotic treatments, 13 were effectively treated by CPZ . Adverse reactions occurred in 6.7% (11/164) of the patients, and consisted primarily of rash, fever, diarrhea and loose stool . Laboratory abnormalities were seen in 5 patients during the study . These included elevations of S-GOT and S-GPT, eosinophilia and neutropenia . CPZ is a very useful drug in the treatment of lower respiratory tract infections because of its excellent clinical efficacy and rare incidence of abnormal accumulations in sera following the recommended 2-4 g/day administration even in the elderly.

Jpn J Antibiot, 1986 Oct, 39(10), 2726 - 53
{A double-blind comparative study on the efficacy of S6472, cefaclor, in the treatment of bacterial bronchitis}; Oshima S et al.; Clinical efficacy and safety of S6472 (long active cefaclor (CCL)) and CCL were compared by a double-blind study using 248 patients with bacterial bronchitis . Patients were orally administered with either 375 mg of S6472 2 times or 250 mg of CCL 3 times daily for 7 days, and the following results were obtained . Clinical efficacy judged by a committee: The efficacy rates on acute bronchitis were 87.2% for S6472 and 82.6% for CCL, and the efficacy rates on chronic bronchitis were 70.3% for S 6472 and 64.7% for CCL . There was no significant difference between the 2 drugs in clinical efficacy . Clinical efficacy judged by doctors in charge: Results of the clinical efficacy judged by doctors in charge were similar to the efficacy judged by the committee . Bacteriological efficacy judged by the committee: Eradication rate for the S6472 group was 71.1% (32 of 45 patients) and that for the CCL group was 67.4% (29 of 43 patients) . There was no significant difference between the 2 drugs in the bacteriological efficacy . Side effects and abnormal laboratory findings: Side effects were observed in 5 cases (4.2%) in the S6472 group and in 5 cases (4.0%) in the CCL group . These side effects, however, were not serious, and no remarkable abnormal laboratory values were observed . There was no significant difference between the 2 drugs in the incidence of side effects or abnormal laboratory findings . Clinical utility: When the clinical utility was expressed by the utility rate (very useful and useful), it was 79.5% in the S6472 group (117 patients) and 76.2% in the CCL group (122 patients) (judged by the committee) . When the utility was judged by doctors in charge, it was 73.3% in S6472 group (120 patients) and 71.4% in CCL group (126 patients) . From the above results, it has been concluded that S6472 taken twice daily is equivalent to CCL in effectiveness on bacterial bronchitis.

Clin Gastroenterol, 1986 Oct, 15(4), 745 - 62
The colon in the pseudoobstructive syndrome; Anuras S et al.; Colonic pseudoobstruction can occur as part of a generalized chronic intestinal pseudoobstruction syndrome or as an isolated entity . Isolated colonic pseudoobstruction can occur in two unrelated forms: the acute and chronic forms . Acute colonic pseudoobstruction is frequently a hospital-acquired disease that arises as a complication of other illnesses . The syndrome must be recognized and treated with early colonoscopic decompression to prevent cecal or colonic perforation . Chronic colonic pseudoobstruction is a syndrome of many causes . The prognosis of patients with chronic colonic pseudoobstruction is much better than that of generalized chronic intestinal pseudoobstruction, because the patients become asymptomatic with appropriate operations . The pathogenesis of acute colonic pseudoobstruction and several types of chronic colonic pseudoobstruction is not known . Further investigations should include bacteriologic study, histopathologic studies (examinations of smooth muscle and myenteric plexus), and examination of extrinsic nerves of the colon . With these approaches, a better understanding of the pathogenesis of these syndromes will be achieved.

Burns Incl Therm Inj, 1986 Oct, 12(7), 518 - 20
Evaluation of a new antiseptic dressing in minor burns; Wilson GR et al.; A prospective trial was conducted to compare a new povidone iodine impregnated dressing (Inadine) with a standard petroleum jelly gauze dressing for small superficial burns treated on an outpatient basis . The results show no difference between comfort and ease of removal of dressings, in the number of positive bacteriological cultures or the number of days to healing . Inadine is more than twice as expensive as petroleum jelly gauze.

Crit Care Med, 1986 Oct, 14(10), 864 - 8
Bacteriologic assessment of the lower respiratory tract in intubated patients; Baigelman W et al.; Twelve patients with an endotracheal tube and a new infiltrate were assessed for differences in the bacteriologic information that could be obtained by routine tracheal suctioning (RTS), a double-lumen protected-sheath brush passed through a flexible fiberoptic bronchoscope (B-FFB), and suctioning through a flexible fiberoptic bronchoscope (S-FEB) . Gram stains and cultures were performed on all specimens . There was 100% agreement for the culture results obtained by RTS and S-FEB . It is concluded that RTS obtains comparable information to that obtained by the more expensive and more personnel-intensive B-FFB.

J Gen Microbiol, 1986 Oct, 132 ( Pt 10), 2693 - 707
A cooperative taxonomic study of mycobacteria isolated from armadillos infected with Mycobacterium leprae; Portaels F et al.; Seventeen strains of mycobacteria, recovered from six armadillos experimentally infected with Mycobacterium leprae, were examined in ten different laboratories . This collaborative study included use of conventional bacteriological tests, lipid analyses, determination of mycobactins and peptidoglycans, characterization by Py-MS, and immunological, metabolic, pathological and DNA studies . These armadillo-derived mycobacteria (ADM) formed five homogeneous groups (numbered ADM 1 to 5) on the basis of phenetic analyses . However, DNA studies revealed only four homogeneous groups since group ADM 1 and one of the two strains in group ADM 3 showed a high level of DNA relatedness . The phenetic and DNA studies confirmed that the ADM strains differed from all other known mycobacteria . Cultural, biochemical, metabolic and pathogenic properties as well as DNA-DNA hybridizations clearly differentiated these ADM from M . leprae.

Acta Leprol, 1986 Oct-Dec, 4(4), 479 - 89
{Practical problems encountered in the multi-drug therapy of leprosy in Senegal}; Naudin JC et al.; The authors make an inventory of the difficulties they have met while realizing the different stages of MDT treatment programmes in Senegal . Main problems were: Necessity of complementary training on theoretical, but even more on practical techniques for all the staff: Ridley and Jopling classification, neurological examination, bacteriological examination, data collection . Difficulty to maintain a true supervision . Necessity to settle a quality control of slit skin smears . Necessity to settle a system to trace irregular patients . Heaviness of centralized management, but its necessity to maintain "tightness" of the drugs distribution network . Difficulty to obtain a regular follow up of patients who are released for treatment . The evolution of anti-leprosy activities makes it necessary to adapt the "Service des Grandes Endemies".

Acta Leprol, 1986 Oct-Dec, 4(4), 465 - 72
{Clinical and bacteriological assessment 8 years after triple-drug therapy for multibacillary leprosy in Senegal}; Dousset-Faure I et al.; Increasing resistance to dapsone (DDS) leads to recommend triple drug chemotherapy (TCT) in multibacillary leprosy (ML) . To determinate long term evolution, we evaluated patients who received TCT 8 years ago . Between 1974 and 1976, 30 patients with ML received TCT (rifampicin, prothionamid, and DDS) during 6 or 12 months . At this time satisfactory clinical and bacteriological findings were reported, and from then DDS was given alone . Twelve of the thirty patients have been evaluated in 1983 . Six patients had bacteriological index greater than or equal to 2+, three of them had clinical relapse . Seven of the twelve patients did not take regularly DDS; the six relapses belong to this group.

Acta Leprol, 1986 Oct-Dec, 4(4), 453 - 60
{A new plan in the campaign against leprosy in Anjouan . Preliminary results}; Grillone S et al.; Treatment of PB leprosy patients with 10 weekly doses of RMP 600 mg gave a cure rate of 88% or more at 3 years as judged by histopathology . There were no severe neurological complications . The future will show if this regimen also prevents relapses . In MB leprosy a 2 months regimen of daily RMP, ETH, DDS followed by 10 months of daily ETH, DDS with weekly RMP gave excellent clinical and bacteriological results . There were no relapses during 2 and 3 years after the end of therapy among 111 newly diagnosed and previously treated patients (95% confidence interval 3.3%) of whom 67 were new patients (95% confidence interval 5.3%) . The hepatotoxicity of this regimen has to be followed closely . The results illustrate the possibility to cure MB leprosy by a treatment of finite duration.

Vet Med (Praha), 1986 Oct, 31(10), 587 - 92
{Use of Oxymycoin and Chronicin foam in the nonselective care of udders of dry dairy cows}; Vasil' M; The non-selective antibiotic treatment of dairy cows at the last milking in lactation was studied for its influence on the reduction in the occurrence of infectious processes in the udder after calving . The herd of 120 dairy cows, on an average, was housed in the K 98 cow-house and in a calving house equipped with the traditional technology . The non-selective treatment was performed in 125 dairy cows in the form of single administration of Oxymykoin foam (Galena) (70 cows) and Chronicin foam (Galena) (55 cows) after the last milking in lactation . The treatment of 53 bacteriologically positive cows with Oxymykoin foam had 86.8% therapeutic effectiveness; this indicates the excellent effectiveness of the preparation . Five additional new infections arose in this group of cows treated with Oxymykoin . The treatment of 36 bacteriologically positive cows with Chronicin foam had the effectiveness of 63.9%; in almost 2/5 of the treated cows (13 animals) the bacteria causing mastitis persisted in the post-parturient period . Eight new infections occurred in this group of treated cows . The results of the non-selective antibiotic treatment of dairy cows after the last milking in lactation prove the good effectiveness of the method reducing the percentage of infected cows in the period after calving.

Thorax, 1986 Sep, 41(9), 685 - 7
Pulmonary tuberculosis due to Mycobacterium bovis; Wilkins EG et al.; During 1969-84 Mycobacterium bovis was isolated from 20 patients with pulmonary tuberculosis . This represented less than 1% of the total cases of respiratory tuberculosis confirmed bacteriologically at the Liverpool Public Health Laboratory during this period . All 20 patients were considered to have reactivated disease and all presented with the typical features of respiratory tuberculosis . During the same period four cases of pulmonary infection by Mycobacterium africanum were recognised . This organism is difficult to differentiate from M bovis and failure to distinguish the two mycobacteria could lead to a misleading epidemiological picture of bovine tuberculosis in man.

Int J Clin Pharmacol Ther Toxicol, 1986 Sep, 24(9), 457 - 9
Ceftazidime in the treatment of Pseudomonas infections in intensive-care patients; Rondanelli R et al.; The present study was designed to define the clinical activity and pharmacokinetics of ceftazidime in Pseudomonas sp . infections . The intensive care patients included in this study were hospitalized for at least 2 weeks and have frequently received antibiotic treatment which contributed with poor host resistance to the infections with highly resistant Pseudomonas strains . Sixteen adult patients entered the study . Their age ranged from 18 to 70 years . Ceftazidime was administered in a dose of 2 g three times daily by a constant infusion over 20-30 min . Frequent clinical assessment multiple cultures and determination of renal, hepatic and bacteriological functions were performed . Bacterial cultures were obtained prior to the beginning of therapy and every 2-3 days thereafter with a follow-up period of about 1-2 weeks . Pharmacokinetics in the blood were performed . Measurements of ceftazidime were made by using HPLC . Mean peak serum concentration of ceftazidime was 58.5 micrograms/ml after administration of 2.0 g of ceftazidime and eight hours after dosing the mean plasma concentration was about 5 micrograms/ml . No accumulation of ceftazidime could be observed during the treatment period . Mean plasma half-life was 2.1 hours at the beginning and 2.2 hours at the end of therapy . The mean apparent volume distribution was 0.35 l/kg . No severe adverse effects were reported throughout the study . Ceftazidime may be effectively used as single antiinfective agent in various conditions and higher plasma concentrations are an important predictor of bacteriological and clinical response in pulmonary infections caused by Pseudomonas species.

Ann Vasc Surg, 1986 Sep, 1(2), 175 - 81
Vascular trauma in drug abuse: patterns of injury; Benitez PR et al.; We have reviewed 172 occurrences of vascular injuries caused by intravascular or perivascular drug injections . Various patterns of injury are discussed including presentation . Recommendations have been made for diagnostic evaluation, surgical and medical treatment based on proposed pathophysiologic etiologies and bacteriology . Expected outcomes are presented . It is important that all physicians become familiar with the management of these injuries as the number of patients who seek treatment for complications of substance abuse continues to increase in our present day society.

Jpn J Surg, 1986 Sep, 16(5), 367 - 70
Intrahepatic calculi associated with cholangiocarcinoma; Nishihara K et al.; A unique case of hepatolithiasis associated with cholangiocarcinoma is described . The intrahepatic calculi consisted mainly of cholesterol rather than calcium bilirubinate . A bacteriological study of the intrahepatic and gallbladder bile was negative, though bacterial infection of the bile duct has been considered a main factor responsible for formation of intrahepatic calculi.

Pacing Clin Electrophysiol, 1986 Sep, 9(5), 720 - 6
Antibiotic prophylaxis in pacemaker surgery: a prospective double blind trial with systemic administration of antibiotic versus placebo at implantation of cardiac pacemakers; Bluhm G et al.; In a double blind clinical trial, 106 consecutive patients scheduled for pacemaker implantation were randomly assigned either to a systemic prophylaxis group (SPG) (to be given flucloxacillin) or to a control group who would be given a placebo (CPG) . The SPG group received 2 g IV flucloxacillin 1 hour before the operation, then 1 g perorally every 8 hours for the next five days . In the CPG group, placebo infusions and tablets were given at the same schedule . There were a total of 106 patients (SPG 52, CPG 54) who met the criteria of the study . Of these, 102 patients (SPG 50, CPG 52) completed a follow-up of 7-35 months . Infection of the pacemaker system was not diagnosed in any patient in either group . Tissue fluid was drawn 24 hours postoperatively from the pacemaker pocket for culture and for determination of pocket antibiotic concentration . The mean flucloxacillin concentration of pocket fluid from 23 patients in the SPG was 7.5 micrograms/ml . The bacteriological cultures were positive in 9/32 patients in the SPG group and in 10/34 patients in the CPG group . This study suggests that antibiotic prophylaxis need not routinely be given at implantation of permanent pacemaker systems.

S Afr Med J, 1986 Aug 30, 70(5), 258 - 62
The implementation of tuberculosis policy in three areas in South Africa; Thomson EM et al.; The implementation of tuberculosis policy at hospital and clinic level was examined in three areas (Cape Town, Paarl and Ciskei) . Investigation showed that bacteriological diagnosis, standardized treatment regimens, supervision of therapy and contact tracing were not being correctly implemented . Compliance was also poor.

Lancet, 1986 Aug 16, 2(8503), 359 - 60
Relative importance of antibiotic and improved clearance in topical treatment of chronic mucopurulent rhinosinusitis . A controlled study; Sykes DA et al.; 50 patients with chronic mucopurulent rhinosinusitis were randomly allocated to treatment with nasal sprays of dexamethasone, tramazoline, and neomycin, dexamethasone and tramazoline with no antibiotic, or matched placebo (propellant alone) four times daily to both nostrils for 2 weeks . The patients were assessed in a double-blind manner for symptomatic response and improvement in nasal mucociliary clearance, nasal airway resistance, sinus radiographs, and intranasal bacteriology and appearance . Both active preparations (with antibiotic 14 of 20 patients responded; without antibiotic 12 of 20 patients responded) were more effective than the placebo (2 of 10 patients responded) . There was no significant difference in response between the active preparations with and without antibiotic . Thus, in treatment of chronic mucopurulent rhinosinusitis, reduction of the inflammatory response and decongestion make topical antibiotic unnecessary, probably by allowing host clearance mechanisms to recover.

J Am Vet Med Assoc, 1986 Aug 15, 189(4), 446 - 8
Actinomycotic mycetoma in a cat; Reinke SI et al.; Actinomycotic mycetoma, a chronic, progressive infection of the subcutaneous tissue characterized by tumefaction, draining sinuses, and grains, was diagnosed in the right hindlimb of a young adult, male cat . The organisms that cause actinomycetoma are soil or plant saprophytes that gain entrance to the skin through abrasion or traumatic implantation . Streptomyces griseus, an organism generally considered to be a saprophyte, was cultured bacteriologically . Despite extensive surgery and long-term antibiotic therapy, the infection persisted, and the cat was euthanatized.

Can J Med Technol, 1986 Sep, 48(3), 99 - 103
Determining productivity and unit costs in a bacteriology laboratory; Gopaul D et al.; This paper describes in detail the process of identification of the "products" of a department of clinical microbiology, the determination of resource requirements, the identification of total resource costs and the calculation of unit costs in order to identify the items which can be regarded as profitable in relation to the OHIP fee scale, as well as those services whose true cost is not met by that scale . The process permits an assessment of the overall profitability of the entire division and provides data for judging the probable gains from contracting out services.

J Dairy Sci, 1986 Aug, 69(8), 2163 - 72
Potential of somatic cell concentration in milk as a sire selection criterion to reduce mastitis in dairy cattle; Coffey EM et al.; Lactation records for somatic cell counts in milk, bacteriological culture results, antibiotic treatment for mastitis, and production were formed for cows in 30 cooperating dairy herds in Virginia . A second data set, including somatic cell counts and production information for cows in approximately 400 herds in Virginia (not including the original 30), was used to evaluate sires genetically for somatic cell count . Approximate genetic correlations between measures of cell count and measures of infection ranged from .36 to .67 . These were highest (lowest) for frequency of infection by major (minor) pathogens . Corresponding phenotypic correlations were similar but slightly smaller . Neither somatic cell counts nor measures of infection were well correlated with treatment . Production traits generally had small, negative genetic and phenotypic relationships with cell counts, rates of infection, and measures of treatment . Correlations for evaluations of sires for cell count were positive with daughter averages for infection rates (.20 to .38) and treatment measures (.02 to .13) . Largest (absolute value) correlations between evaluations of sires for cell count and production traits were for fat percentage (-.38) and fat yield (-.28) . Evaluation and selection of sires for decreased somatic cell count may augment management and treatment programs in the reduction of mastitis incidence.

An Esp Pediatr, 1986 Aug, 25(2), 111 - 4
{Abdominal pain in childhood due to a Cryptosporidium parasitosis}; Garcia Vila A et al.; Three cases of cryptosporidiosis in children are described . Abdominal pain without concomitant acute diarrhoea, was the main clinical symptom . No other intestinal pathological agent was isolated . All children were males, aged between 25-27 months, living in urban area and with a high socioeconomic level . They went to day nurseries and only one was contacted with home animal . This last child had a previous giardiasis treated with metronidazole . Nutritional status was normal . Neither humoral nor cellular immunodeficiency was detected . Cryptosporidium muris isolation was performed with Ziehl-Neelsen modified technique . All recovered with negativity of abdominal pain and bacteriologic controls, using solely dietetic measures.

Eur J Obstet Gynecol Reprod Biol, 1986 Aug, 22(4), 243 - 8
Non-menstrual toxic shock syndrome . A case report and a review of non-menstrual toxic shock syndrome in Western Europe; Vanderheyden JS et al.; Having been confronted with a post-operative toxic shock syndrome, we made a study of European literature and were struck by the more favorable course the disease promptly took when penicillinase-resistant antibiotics were used . We suggest that a new case, based on bacteriological analysis and phagotyping of the offending organism and wound appearance, was prevented by us when immediate antibiotic treatment was given.

J Bone Joint Surg Br, 1986 Aug, 68(4), 584 - 7
Acute septic arthritis in infancy and childhood . 10 years' experience; Wilson NI et al.; We have reviewed 61 children treated for septic arthritis from 1972 to 1981 . The diagnosis in all cases was confirmed by bacteriology or by radiographic changes . Routine arthrotomy was not performed, but most patients had a joint aspiration . The management and outcome are described . We suggest that arthrotomy should be selective rather than mandatory . Septic arthritis of the hip in infants requires arthrotomy, but in the older child an infected hip can be treated by aspiration if the duration of symptoms is less than four days; arthrotomy may be needed if there has been more delay . Infected joints other than the hip can be satisfactorily managed by aspiration.

Clin Orthop, 1986 Aug, (209), 215 - 8
Postlaminectomy disc space infection . A review of the literature and a report of three cases; Fernand R et al.; Postlaminectomy disc space infection is a relatively modern disease that is frequently mentioned, rarely encountered, sometimes not recognized, and unquestionably iatrogenic . A total of 125 cases have been reported since 1947 . The bulk of the evidence favors a bacteriologic agent, but the route of infection is still not clear, because both hematogenous and local origins are possible in a surgically traumatized area with poor blood supply . This report of three additional cases emphasizes the variety of presentations . The diagnosis is difficult but can be made if it is suspected . Patients complain of recurrent pain after initial relief of symptoms . Muscle spasm, elevated temperature, and positive straight leg raising test are the most common signs . Increased sedimentation rate is almost always present . The roentgenographic findings appear several weeks after the initial symptoms . Radioisotope and CAT scans may be helpful earlier . Needle biopsy/aspiration under image intensification increases the frequency of bacteriologic identification . Conservative management based on bed rest, immobilization, and antibiotics remains the treatment of choice . Early surgical treatment may be indicated in some cases and seems to eradicate the disease, hastening recovery . Late surgical intervention, when indicated, is facilitated by an anterior approach.

Clin Rheum Dis, 1986 Aug, 12(2), 343 - 67
Lyme disease; Goldings EA et al.; Although initially considered a localized epidemic form of arthritis . Lyme disease is now known to have protean manifestation (skin, joint, heart, nervous system) and worldwide distribution . It is caused by infection with the spirochaete Borrelia burgdorferi and is transmitted by a variety of hard ticks and, in some localities, fleas . Antigenic variation between isolates may determine the differences in clinical expression observed between cases in North America and Europe . The reservoir in the animal kingdom is primarily in deer and mice but house pets have also been implicated . The disease is easily treated with oral antibiotics (tetracycline or penicillin) at an early stage but requires parenteral penicillin and can become refractory to medication at late stages . Prompt diagnosis assures the best outcome . Whereas the classic rash, erythema chronicum migrans, is pathognomonic, diagnosis in its absence may rest on serological tests . Bacteriological isolation is seldom successful and is lengthy (Shrestha et al, 1985) . Since cloning of the DNA for several of B . burgdorferi antigens has been accomplished, utilization of hybridization techniques may allow rapid detection of the presence of the organism and confirm difficult cases in the future.

Vestn Khir Im I I Grek, 1986 Aug, 137(8), 63 - 6
{Diadynamophoresis of chemical and biologically active substances in the treatment of suppurative and inflammatory diseases in diabetes mellitus}; Gostishchev VK et al.; Treatment of pyo-inflammatory diseases in patients with diabetes mellitus should be complex, individual and controlled . Obligatory total and local examinations of the organism should be performed with the involvement of cytological, histological bacteriological methods and with determination of alterations of the carbohydrate, protein, water-salt, electrolytic metabolism, acid-base state and non-specific resistance of the organism . It was shown that diadynamophoresis of proteolytic enzymes, sodium thiosulfate, potassium permanganate in the treatment of pyo-destructive diseases in 362 patients with diabetes mellitus accelerated necrolysis of tissues, shortened time of cleaning the wound and thus made the period of treatment at the hospital shorter.

Laryngol Rhinol Otol (Stuttg), 1986 Aug, 65(8), 420 - 2
{Penicillinosis of the paranasal sinuses}; Nouri ME; A 29-year old female patient suffering from severe pain in her right eye, headache, ophthalmoplegia and ptosis of the right eye, total roentgenological opacity of the right maxillary sinus and ethmoidal cells , as well as signs of bone destruction in the orbital floor, was operated on under the suspicion of a tumour . Histological and bacteriological examinations as well as fungus cultures indicated, however, that the patient was suffering from a chronic infection caused by Penicillium notatum . Surgical treatment and postoperative intravenous administration of amphotericin B resulted in complete recovery of the patient.

Vet Rec, 1986 Jul 26, 119(4), 84 - 6
Problems associated with the serological diagnosis of Leptospira interrogans serovar hardjo infection in bovine populations; Hathaway SC et al.; Data combining sequential bacteriology and serology from a longitudinal study of a dairy herd were used to demonstrate the limitations of serology as a diagnostic method in cross-sectional sampling of bovine populations . Whole-herd point serological prevalences showed considerable variation over a two-year sampling period (38.8 to 76.2 per cent), and this was mainly due to varying age-specific prevalence . Owing to the rapid decline in titres and the varying persistence of infection, point serological prevalences failed to approximate to cumulative infection rates (either past or present) at different times of the year . A higher estimate of the number of susceptible animals in the herd than is the case results in inaccurate information on true incidence rates and can confuse assessments of the susceptibility of different age groups, especially if only small numbers are sampled . A sampling exercise demonstrated that a 10-cow sample usually provided little useful information other than establishing the presence or absence of hardjo in the herd . Increasing the sample size markedly improved epidemiological information, investigations of clinical disease, assessments of vaccination needs and public health tracebacks . Preferably 10 sera from each of the yearling, first calver, second calver and older age groups should be tested . Serology was an inadequate indicator of infection in individual animals . Group geometric mean titres taken from a mean serological response curve were shown to have limited application in the interpretation of field data, unless infection had occurred in the previous two months.

Schweiz Med Wochenschr, 1986 Jul 26, 116(30), 999 - 1002
{Enteropathogens in travellers returning from the tropics}; Markwalder K et al.; Diarrhea is not only the most common health hazard during travel in the tropics but also the most frequent condition which prompts returning travellers to see a physician . The prevalence of bacterial and parasitic enteropathogens in people attending our outpatient department after returning from the tropics has been studied and the laboratory results of stool examinations have been compared with clinical symptoms . Of the 173 persons enrolled, 19 (11%) harboured bacterial pathogens and pathogenic protozoans (Giardia lamblia and Entamoeba histolytica) were found in 26 (15%) . The data of 156 patients were evaluated . Enteropathogenic bacteria and/or protozoa were found in 29 (46%) of the 63 patients presenting with diarrhea at the time of investigation . In contrast, 10 (11%) of the 93 asymptomatic subjects had enteropathogenic organisms in the feces (p less than 0.01) . The results appear to confirm that bacteriological stool examinations of travellers returning from the tropics without diarrhea are not usually indicated, even if a history of transient travellers' diarrhea is reported . Parasitological investigations are justified in this group only if asymptomatic carriage of Giardia or E . histolytica is considered an indication for specific treatment.

Aust Vet J, 1986 Jul, 63(7), 209 - 11
Examination of rams culled during an ovine brucellosis accredited free flock scheme; Rothwell JT et al.; During the early stages of an Ovine Brucellosis Accredited Free Flock Scheme in New South Wales 62 rams were examined to determine the status of their flocks of origin with regard to infection with Brucella ovis . Forty rams were selected because they were either single reactors to low titre or one of a small number of reactors in a B . ovis complement fixation test of the whole ram flock . Twenty two rams were selected because they had palpable abnormalities within the scrotum but were negative serologically . After serological, pathological, bacteriological and histological examinations they were classified in the ensuing categories: 7 positive, 7 inconclusive, 26 false positive and 22 with other lesions . The usefulness of this classification, particularly within the accreditation scheme is discussed.

Rev Infect Dis, 1986 Jul-Aug, 8 Suppl 3, S350 - 7
Statistical aspects of clinical trials of antibiotics in acute infections; Huitfeldt B; Controlled clinical trials are important tools for evaluating antibiotics in acute infections . External and internal validity, definition of efficacy criteria, and size of the patient sample constitute special statistical problems in such studies . Critical issues regarding external validity pertain to the selection of patients and to the concept of consecutive patients . The internal validity of a study is influenced by the withdrawal of patients from the evaluation after randomization and the comparability of treatment groups with regard to prognostic factors . The definition of efficacy criteria on the basis of bacteriologic outcomes across control visits is not straightforward . Particularly, the evaluation of efficacy at the last follow-up visit must take into account the accumulated information rather than the cross-sectional information . The most common situation in comparative trials of antibiotics is that rather small differences in efficacy can be anticipated . Sometimes, the question at issue is the demonstration of antibiotic equivalence . For valid conclusions to be made in such situations, large samples must be used . A basic problem affecting many studies of antibiotics is that this criterion is not fulfilled.

Dig Dis Sci, 1986 Jul, 31(7), 769 - 72
Idiopathic chronic watery diarrhea from excluded rectosigmoid with goblet cell hyperplasia cured by restoration of large bowel continuity; Bories C et al.; A 73-year-old woman developed abnormal electrolyte and water loss from an excluded rectosigmoid segment after surgical treatment of a volvulus of the sigmoid colon . Rectal discharges lasted almost for a year, until it spontaneously resolved after restoration of large bowel continuity . Despite extensive investigation, including endoscopic, radiologic, microscopic, bacteriologic and parasitic examinations, no satisfactory explanation of the diarrhea could be found . The histologic pattern of the excluded segment showed a striking increase in mucosal thickness and in number and height of goblet cells . These abnormalities disappeared after closure of the colostomy . Electrolyte composition of the rectal fluid, which contained 134 mmol potassium and 22 mmol sodium per liter was remarkable and similar to that of normal stool water and anal discharges of patients with ulcerative proctitis.

Am J Public Health, 1986 Jul, 76(7), 783 - 6
A case-control study to evaluate the effectiveness of mass neonatal BCG vaccination among Canadian Indians; Young TK et al.; This paper reports a case-control study to assess the protective effect of BCG (bacille Calmette-Guerin) vaccination among Indian infants in Manitoba, Canada . A record of past BCG vaccination was found in 49 per cent of the tuberculosis cases, compared to 77 per cent of the controls, yielding a relative risk of 0.30 . Stratified analysis, controlling for age, increased the relative risk to 0.39 (95% confidence interval 0.22 - 0.69) . The preventive fraction was 44 per cent . Non-differential misclassification of exposure status could have occurred; if this was adjusted for, the relative risk would be reduced . If only bacteriologically confirmed cases were analyzed, the age-adjusted relative risk was 0.27 . The protective effect of BCG vaccination in the newborn among Manitoba Indians is therefore at least 60 per cent . The implications for health policy in this population are further discussed.

J Reprod Med, 1986 Jul, 31(7), 605 - 8
Significance of sperm bacteriology for the in vitro fertilization of human and mouse oocytes; Riedel HH et al.; The mouse oocyte was used to determine whether T-mycoplasma or Escherichia coli affects the fertilization and embryonal development of oocytes . Ureaplasma urealyticum (T-mycoplasma) in the mouse oocyte system had little influence on the fertilization rates achieved in vitro; however, in all the experiments there was a marked reduction of embryonal development after in vitro fertilization (IVF) of spermatozoa infected with Ureaplasma . Even in oocytes incubated with Ureaplasma only after having reached the two-cell stage, there was reduced development into blastocysts . Changes in the Ureaplasma concentration and incubation time had no major influence on the development into blastocysts . During IVF of mouse oocytes with spermatozoa infected with E . coli concentrations of 10(3)/mL, there were no changes in the fertilization or culture rate as compared to the control group . However, after insemination with 10(6) bacteria/milliliter there was no change in the IVF rates in the mouse oocyte; however, the culture rates were considerably reduced (19.5% as compared to 64.4% in the control group) . Whether there are additional changes in the pregnancy rate after the transfer of blastocysts obtained after insemination of oocytes with infected spermatozoa remains a matter for future investigation.

Acta Cytol, 1986 Jul-Aug, 30(4), 367 - 71
Actinomyces in cervical smears of women using intrauterine contraceptive devices; Mali B et al.; PIP: Cervical smears from 1784 women who attended a family planning clinic in India were examined for the presence of Actinomyces-like organisms . There were 57 (7%) positive smears among the 815 IUD users in this group . Bacteriologic culture studies were carried out in 40 of these women and Actinomyces israelii was isolated in 23 cases . The initial cervical smears of all IUD users and both the initial and repeat smears of all nonusers were negative for Actinomyces . None of the positive smears involved women with less than 1 year of IUD use and only 4 cases were positive with 1-2 years of IUD use . There was no association between the presence of Actinomyces-like organisms and type of IUD, however . The cervical and pelvic examination findings in the 57 women with positive Actinomyces smears were within normal limits at the time of smear collection . These findings suggest that longterm IUD use promotes the outgrowth of Actinomyces in the vagina . Routine cervical cytology and clinical observation are recommended for the early detection of possible pelvic inflammatory disease in these women .

J Pediatr Surg, 1986 Jul, 21(7), 644 - 6
Eikenella corrodens infections in children; Raffensperger JG; Techniques for obtaining, transporting, and culturing bacteriologic specimens have improved in recent years . The laboratory is now identifying rare fastidious organisms in surgical infections, which were previously unknown to clinicians . One of these organisms, Eikenella corrodens, was found in 28 children over 5 years . It was most commonly found in patients with perforated appendices or in wounds with oral contamination . Eikenella most often occurs in multibacterial infections but has also been grown in pure culture . When this bacteria is found in a patient with a serious surgical infection the wound must be widely opened and debrided of necrotic tissue . Prolonged antibiotic therapy based on culture and sensitivity is necessary to prevent prolonged or recurrent infection.

J Bone Joint Surg Am, 1986 Jul, 68(6), 912 - 9
Localized osteolysis in stable, non-septic total hip replacement; Jasty MJ et al.; We are reporting four cases of extensive, localized bone resorption adjacent to a rigidly anchored, cemented total hip replacement . None of these hips showed evidence of infection on clinical, bacteriological, or pathological evaluation . The tissue from the regions of osteolysis showed sheets of macrophages and foreign-body giant cells invading the femoral cortices . Abundant methylmethacrylate particulate debris was present in the tissues, but polyethylene wear debris was absent . The histological appearance of this tissue resembled that reported about loosened total hip implants with the exception of the synovial-like layer at the cement surface . The cases reported here show that aggressive bone lysis may occur around stable cemented total hip arthroplasties without the presence of sepsis or malignant disease.

Am Rev Respir Dis, 1986 Jul, 134(1), 27 - 33
A controlled clinical trial of 3- and 5-month regimens in the treatment of sputum-positive pulmonary tuberculosis in South India . Tuberculosis Research Centre, Madras, and National Tuberculosis Institute, Bangalore; Biochemical studies on Mycobacterium leprae; Very little information is available on the basic biology of Mycobacterium leprae . It is not known why the organism fails to grow in bacteriological media or in cell cultures and why it has an unusual predilection for certain tissues in the human host where cells derived from the neural crest occur (e.g . skin, peripheral nerves adrenal medulla) . Biochemical studies have revealed that M . Leprae contains an unusual form of the enzyme diphenoloxidase which has not been detected in other mycobacteria . The presence of a specific glutamic acid decarboxylase in the organism has been demonstrated . Although a few enzymes of glycolysis and tricarboxylic acid cycle have been investigated, nothing characteristic of the bacterium has been discovered, and how M . leprae derives energy for its survival and proliferation still remains obscure.

Aust Vet J, 1986 Jul, 63(7), 227 - 9
Investigation of aberrant positive reactions to serological tests for bovine brucellosis; Rogerson BA et al.; Fifty cattle thought not to be infected with Brucella abortus but giving persistent positive serological reactions, were investigated . It was concluded that only one of these was infected since exhaustive bacteriological examination produced only one isolate of B . abortus (strain 19) and none of the herds of origin was subsequently shown to be infected with brucellosis . Antibody was detected in stifle joint fluid of 15 cattle, which may have been stimulated by the presence of Strain 19 antigen that persisted in collagenous tissue long after the viable organisms had been eliminated.

Zentralbl Bakteriol Mikrobiol Hyg {B}, 1986 Jul, 182(4), 407 - 20
Computer analysis of some bacteriological, biological and physiochemical parameters of the coastal water of Lake Balaton; Ralovich B et al.; Some 61 coastal water samples were taken at four definite points of Balaton Lake . Seventeen parameters of each sample characterizing the quality of the water were studied by means of multiple correlation and regression analysis, one-way variance analysis and by factor analysis with the help of BMD computer program . Uni- and multilateral relationships could be observed among the single parameters . On the basis of the results of factor analysis six factors--phytoplankton system, anthropogenic effect, own bacterial system of the lake, nitrogen circulation, hydrocarbonate and reactive phosphate system and NH+4 circulation--could be separated . Significant qualitative differences could be found along the longitudinal axis of Balaton . It could be also demonstrated that the water of the lake in its present condition is suitable for the proliferation of bacteria . Further and deeper examinations are necessary for a better understanding of the biochemical and biological processes.

Am J Vet Res, 1986 Jul, 47(7), 1529 - 31
Comparison of the results of card, rivanol, complement-fixation, and milk ring tests with the isolation rate of Brucella abortus from cattle; Huber JD et al.; Specimens from 4,553 cows were examined by card, Rivanol, and complement-fixation (CF) tests and bacteriologic culture . A ring test was performed on milk from 1,003 of these cows . The isolation rate of Brucella abortus correlated directly with antibody titers, and the field strain predominated in adult-vaccinated cows when the Rivanol test titer was greater than + 100 and the CF test titer was greater than 4 + 40 . The CF test had the best balance of sensitivity and specificity in adult-vaccinated cows . The false-negative rate for the Rivanol and CF tests was higher in nonadult-vaccinated cows.

Tubercle, 1986 Jun, 67(2), 125 - 31
The diagnosis and management of tuberculosis in common hostel dwellers; Capewell S et al.; Edinburgh hostel dwellers have been regularly screened for pulmonary tuberculosis since 1957 . Sixty-eight cases were notified during the 7 years 1976-1982: 42 (65%) were detected by 4687 hostel survey X-rays, and a further 26 presented with symptoms . Disease was more advanced in the symptomatic hostellers both by radiological and bacteriological criteria with twice as many being sputum smear positive (58% vs . 26%) . Full clinical details were available for 65 of the 68 . Four were diagnosed at post mortem examination and two had chemotherapy stopped because the disease was considered inactive . Of the remaining 59 eligible for treatment, 47 (80%) received a complete course of adequate chemotherapy; 16 as hospital in-patients, 26 first in hospital and then under out-patient supervision and five simply as supervised out-patients; none relapsed . Twelve (20%) of the 59 defaulted from supervision after a mean follow-up period of 2.4 months.

Acta Pathol Microbiol Immunol Scand {B}, 1986 Jun, 94(3), 153 - 7
Reliability of a disk diffusion method using semiconfluent growth in the determination of aminoglycoside resistance; Huovinen P et al.; Susceptibility of 553 blood culture isolates to gentamicin, tobramycin, amikacin, and netilmicin was determined by a routine disk diffusion method with semiconfluent growth (AB Biodisk, Solna, Sweden) and a microtiter-method (Sensititre) . The disk diffusion test gave false sensitive results in 9.4-71% of the 9-39 aminoglycoside resistant strains studied . False resistant results occurred in 1.0-7.6% of measurements among the over 500 aminoglycoside sensitive strains . Because of the frequent error rate, the disk method with semiconfluent growth should be replaced with other methods in the determination of aminoglycoside resistance in bacteriological laboratories.

J Hyg (Lond), 1986 Jun, 96(3), 393 - 401
Sanitary study of surface water and of the beach of a water sports and leisure complex; Chabasse D et al.; This report presents the parasitological, bacteriological, mycological and physicochemical data obtained from both surface water and beach sand of a lake used for water sports . These show that the lake is contaminated in both winter and spring by water which overflows from the River Maine, and is self-purified by a mechanism of 'lagunage' . In summer signs of pollution are at their lowest level although use of the complex is at its peak . Conversely, the amoebic flora, which is independent of the usual criteria of pollution, predominates in summer, and serves as a marker for the need for increased surveillance . The sand of the beaches does not appear to show any infectious hazard . Environmental pressure will doubtless change these data over a period of time, and it is planned to monitor this.

Genitourin Med, 1986 Jun, 62(3), 202 - 4
Three day oral course of Augmentin to treat chancroid; Ndinya-Achola JO et al.; Amoxycillin and clavulanic acid (Augmentin; Beecham Research Laboratories) was used to treat patients with bacteriologically proved chancroid in three different dose regimens . A single dose of Augmentin (amoxycillin 3 g, clavulanic acid 350 mg) was found to be ineffective . A similar dose repeated after 24 hours was equally ineffective, but a dose (amoxycillin 500 mg, clavulanic acid 250 mg) given every 8 hours for three days was found to be effective . The drug was well tolerated and no side effects were noted in any of the patients treated.

Appl Environ Microbiol, 1986 Jun, 51(6), 1235 - 8
Selective medium for isolation of Fusarium species and dematiaceous hyphomycetes from cereals; Andrews S et al.; A selective medium containing 2 micrograms of dichloran per ml, 200 micrograms of chloramphenicol per ml, and 1.5% bacteriological peptone was developed for the isolation of Fusarium species and dematiaceous hyphomycetes from cereals . The medium, designated DCPA, was shown to select against species of Aspergillus, Penicillium, Cladosporium, and mucoraceous fungi . DCPA was evaluated for use as an enumeration medium and compared satisfactorily with dichloran-rose bengal-chloramphenicol agar when both media were tested with a range of cereal samples . Fusarium species and dematiaceous hyphomycetes produced well-formed colonies with good conidial production on DCPA, permitting rapid identification of such isolates on this medium.

Tijdschr Diergeneeskd, 1986 Jun 1, 111(11), 533 - 6
{Leptospira hardjo on a dairy farm}; Franken P et al.; The results of a bacteriological and serological study of the presence of L . hardjo on a dairy farm in view of a case of milk fever in a farmer are reviewed . In addition, the epidemiology, prevention and possible treatment of the infection on the dairy farm are discussed.

J Pediatr Surg, 1986 Jun, 21(6), 536 - 8
Comparative effects of ischemia, bacteria, and substrate on the pathogenesis of intestinal necrosis; Musemeche CA et al.; This study was undertaken to evaluate the relative contribution of ischemia, bacteria, and luminal substrate, the pathogenetic components of necrotizing enterocolitis (NEC), to the development of intestinal necrosis . Sprague-Dawley rats, either germ-free (No . = 25) or conventionally colonized (No . = 20) underwent laparotomy . Isolated ileal segments were created, two per rat . Ischemia was produced in one segment by application of a microaneurysm clip; the other segment served as a control . Segments were injected with 1 mL of either normal saline, dilute Similac formula, or standard formula . Groups were as follows: Group I (germ-free), received saline; Group II (germ-free), dilute formula; Group III (germ-free), standard formula; Group IV (conventional), saline; Group V (conventional), dilute formula; Group VI (conventional), standard formula . At 48 hours, the rats were evaluated for survival, gross bowel integrity, histologic severity of necrosis (graded 0 to 4+), and bacteriology . Gross analysis of bowel integrity showed no lesions in the ischemic segments of the germ-free rats (Groups I, II, and III) and necrosis in 75% of conventionally colonized animals (Groups IV, V, and VI; P less than 0.001) . Microscopic necrosis was more common (P less than 0.001) in ischemic segments of conventional rats than in ischemic segments of germ-free rats . There was no difference in necrosis attributable to ischemic time or to the presence of either standard or dilute formula . Of the three pathogenetic factors evaluated, the presence of bacteria was most crucial to the development of bowel necrosis in this model . Improved treatment and prevention of NEC may depend upon suppression and/or modification of the gut flora.

Int J Lepr Other Mycobact Dis, 1986 Jun, 54(2), 245 - 51
Hepatitis B virus (HBV) serum markers in Greek leprosy patients; Papaioannou DJ et al.; The prevalence of HBsAg, anti-HBs, and anti-HBc in the sera of 217 patients with the two polar types of leprosy and 382 hospital controls was studied in order to investigate the degree of exposure of Greek leprosy patients to HBV and the ability of these patients to clear HBV from the blood . Two distinct serological patterns were analyzed: effective exposure, characterized by the presence of one or more of the three serological markers, and active infection, characterized by the presence of HBsAg . From the statistical analysis it was found that TT as well as LL cases had a higher prevalence of effective exposure in comparison to controls (p less than 10(-5) and p less than 10(-6)) . No significant difference was found between the two polar leprosy types (p greater than 0.30) or between bacteriologically positive and negative LL cases (p greater than 0.30) . As far as the prevalence of active infection is concerned among the effectively exposed subjects of all groups, no significant difference existed between TT cases and controls, LL cases and controls, the two polar leprosy cases combined and controls, the two polar leprosy groups, and LL cases positive and negative for Mycobacterium leprae (p for all comparisons greater than 0.30) . It is concluded that leprosy cases are at a high risk of HBV infection, but the prevalence of active infection among those effectively exposed does not differ between leprosy cases and hospital controls.

Pathol Biol (Paris), 1986 Jun, 34(5 Pt 2), 634 - 8
{Treatment with erythromycin of experimental legionellosis in guinea pigs infected by aerosol}; Nowicki M et al.; The infectious strain L . pneumophila serogroup 1 Philadelphia (ATCC 33152) was cultured on charcoal dialysed yeast extract agar medium (CDYE agar) which produces more virulent strains than those grown on classical agar media . The aerosol was dispersed in a depression chamber by means of a nebuliser and the density was controlled by a density probe . Male albinos Dunkin-Hartley guinea pigs weighing 250-300 g were exposed for 30 minutes to an aerosol dose of 1 LD50 (10(3) viable organisms) and 10 LD50 (10(4) viable organisms) . Erythromycin lactobionate (Abbott) was administered subcutaneously 18 hours after the infection, at dosages of 270 mg/kg/day for 4 days in the animals treated with 1 LD50 and for 6 or 7 days in the animals treated with 10 LD50 . The guinea pigs were observed for 9 days (weight, rectal temperature; serological and bacteriological tests (cardiac blood, lungs, spleen) and erythromycin assays (serum, lungs) were performed and compared in the treated animals, the non-treated infected control animals and the control animals which only received erythromycin . The percentage survival in the treated guinea pigs after inhalation of 1 LD50 and 10 LD50 (2 tests) were 100%, 75% and 87.5% respectively . Three weeks after treatment, the survivors had antibody titres from 32 to 1,024; the bacteriological cultures and erythromycin assays were negative . In this study, an improvement in the treatment of experimental Legionnaires' disease was observed in comparison with previous experiments . The increased dosage and duration and the early initiation of treatment resulted in survival rates of 75%.(ABSTRACT TRUNCATED AT 250 WORDS)

Surg Gynecol Obstet, 1986 Jun, 162(6), 521 - 4
A prospective comparison of gentamicin and metronidazole and moxalactam in the prevention of septic complications associated with elective operations of the colon and rectum; McCulloch PG et al.; Bacteriologic evidence suggests that Latamoxef (moxalactam) is effective against colonic bacteria which cause infection during colonic and rectal operations . In a prospective comparative study, 86 patients undergoing colorectal operations were randomized to receive intravenously 24 hour antibiotic cover with either gentamicin and metronidazole or moxalactam . Six patients (13 per cent) in the gentamicin and metronidazole group and five (12 per cent) in the moxalactam group had wound sepsis develop . Perineal wound sepsis (31 per cent) was significantly more common than abdominal wound sepsis (7 per cent) . No complications were noted from the use of moxalactam . No clinical evidence of abnormal bleeding was seen and the results of studies on coagulation and platelet function postoperatively were normal . The results suggest that moxalactam provides effective, safe prophylaxis comparable with established antibiotic combinations in patients undergoing colorectal operations.

J Clin Invest, 1986 Jun, 77(6), 1831 - 40
Fibronectin mediates adherence of rat alveolar type II epithelial cells via the fibroblastic cell-attachment domain; Clark RA et al.; The lung alveolar surface is composed of types I and II epithelial cells . Extremely attenuated type I cells cover 90% of the surface and are prone to necrosis during acute lung injury . After denudation of type I cells, the alveolar epithelium is restored by proliferation of type II cells . During reepithelialization in vivo the type II cells have been observed to reorganize on an extracellular matrix that contains fibronectin . We thus sought to determine whether type II cells would adhere to purified fibronectin . Adherence assays of primary rat type II cells were performed in protein-coated bacteriologic microtiter wells for 24 h at 37 degrees C . Concentrations of fibronectin from 1 to 300 micrograms/ml mediated type II cell adherence, 10 micrograms/ml gave maximal adherence, and 4 micrograms/ml gave 50% maximal adherence . Adherence progressively increased from 1 to 72 h . Adherence on fibronectin was at least 50% greater than adherence on laminin, types I and III collagen, or IV collagen . Little or no adherence was observed on bacteriologic plastic or albumin . Spreading on these various substrata paralleled adherence . Adherence to fibronectin, laminin, and fibrinogen was specifically blocked by their respective polyclonal antibodies . Monoclonal antibodies (MoAb) to the fibronectin cell-attachment domain blocked adherence to fibronectin, whereas MoAb to other domains did not . From the data reported here and the previously mentioned in vivo study we propose that fibronectin is an important functional component of the extracellular matrix that supports type II cells during alveolar reepithelialization.

Jpn J Antibiot, 1986 Jun, 39(6), 1620 - 5
{Fundamental and clinical studies on imipenem/cilastatin sodium in the field of obstetrics and gynecology}; Takamura S et al.; The following results were obtained during pharmacokinetic, bacteriological and clinical evaluation of the usefulness of the combination (1:1) of imipenem (MK-0787) and cilastatin sodium (MK-0791), an inhibitor of dehydropeptidase-I, in the treatment of patients with obstetric and gynecologic infections . Plasma concentrations of MK-0787 in antecubital vein and uterine artery were 18.2 micrograms/ml and 16.4 micrograms/ml, respectively, and of MK-0791 were 9.5 micrograms/ml and 10.3 micrograms/ml, respectively, at 1.28 hours after the end of a drip infusion of 0.5 g/0.5 g of MK-0787/MK-0791 . Plasma concentrations of both MK-0787 and MK-0791 decreased slowly, and concentrations of the former in antecubital vein and uterine artery were 0.7 micrograms/ml and 1.0 micrograms/ml, respectively, and of the latter were 1.5 micrograms/ml and 1.9 micrograms/ml, respectively at 2.83 hours after the end of a drip infusion . Concentrations of the 2 agents in female genital tissues decreased with increasing time in a manner similar to concentrations in the plasma . Clinical responses in 10 patients were excellent in 2 and good in 8, and the efficacy rate was 100 percent . Organisms were isolated from all 10 patients before the treatment, but were eradicated in 9 patients by the treatment . No side effects were observed, but increase of eosinocytes was observed in 1 patient.

Jpn J Antibiot, 1986 Jun, 39(6), 1583 - 94
{Fundamental and clinical studies on imipenem/cilastatin sodium in the field of obstetrics and gynecology}; Yamamoto T et al.; Fundamental and clinical studies on imipenem/cilastatin sodium (MK-0787/MK-0791), a new carbapenem antibiotic, were performed and the following results were obtained . Concentrations of MK-0787 and MK-0791 in serum, internal genital organs and retroperitoneal fluid were determined after a 30 minutes drip infusion of 500 mg/500 mg dose . Venous serum levels of MK-0787 and MK-0791 were 47.3 to 67.5 micrograms/ml and 44.2 to 61.4 micrograms/ml, respectively, at the end of the administration . Sufficient transfer of MK-0787 and MK-0791 to internal genital organs and retroperitoneal fluid was demonstrated . In clinical trials, MK-0787/MK-0791 was given to 18 cases with obstetrical and gynecological infections, such as endometritis, puerperal fever, pelvic peritonitis, parametritis and lymphocystitis . The clinical efficacy was evaluated as excellent in 1 case, good in 14 and poor in 3 . The efficacy rate was 83.3% . In a bacteriological study, 43 strains were isolated from 16 cases and the eradication rate was 61.1% . No side effects were observed in any of the cases . In laboratory findings, a transient elevation of GOT, GPT was noted in 1 case . From the above results, it was concluded that MK-0787/MK-0791 was useful drug for infections in the field of obstetrics and gynecology.

Aust N Z J Surg, 1986 Jun, 56(6), 489 - 91
Wound and intraperitoneal infection following appendicectomy for perforated or gangrenous appendicitis; MacKellar A et al.; A series of 158 children, who were operated on for perforated or gangrenous appendicitis between 1980 and 1984 inclusive, are reviewed . A protocol of management, based on the results of bacteriology of the perforated appendix was introduced and the guidelines followed in all but four instances . Eight patients (5.0%) developed postoperative infections, either in the wound or intraperitoneally . The frequency of infection was affected by the adherence to protocol, as 50% of the infections occurred in patients who did not receive preoperative antibiotic prophylaxis . The use of drainage also contributed to the frequency of wound infection . Thorough peritoneal lavage and meticulous surgical technique should reduce the need for drainage.

Aust Vet J, 1986 Jun, 63(6), 172 - 4
The relationship between the isolation of Brucella abortus and serological status of infected, non-vaccinated cattle; Hornitzky M et al.; Seventy two non-vaccinated cattle with various complement fixation (CF), rose bengal (RB) and enzyme-linked immunosorbent assay (ELISA) results at slaughter were examined bacteriologically and serologically . Brucella abortus was recovered from 49 (68.1%) of the cattle and the use of a biphasic culture medium was entirely responsible for the detection of 6 (12.2%) of the culture positive cattle . The supramammary and retropharyngeal lymph nodes were the most rewarding tissues to culture . A comparison of culture results and serological status demonstrated that B . abortus could be isolated from cattle with negative RB and CF tests and that the ELISA was useful in detecting these cattle and infected cattle with low CT titres . The RB test was also useful as it detected all but 4 of the cattle found to be infected.

Arch Intern Med, 1986 Jun, 146(6), 1153 - 7
Cefotaxime vs nafcillin and tobramycin for the treatment of serious infection . Comparative cost-effectiveness; Moore RD et al.; To evaluate the cost-effectiveness of cefotaxime sodium at a dosage of 12 g/day vs nafcillin sodium and tobramycin sulfate for the treatment of serious infection, the hospital and physician charges of patients enrolled in a prospective, randomized, clinical trial were analyzed . For 187 patients receiving therapy empirically, mean hospital charges for the interval in which the trial antibiotics were used were $3,550 +/- $1,740 for cefotaxime and $3,160 +/- $1,990 for nafcillin and tobramycin . After adjusting for cost-generating factors, charges for cefotaxime were greater than for nafcillin and tobramycin, but the difference was not significant . For 107 patients with clinically or bacteriologically documented infection, mean charges were $3,980 +/- $1,800 for cefotaxime and $4,170 +/- $1,780 for nafcillin and tobramycin . Adjusted charges did not differ . Incremental charges for cefotaxime per additional response were $1,630 in all patients and -$820 in patients with clinically or bacteriologically documented infections.

Surg Gynecol Obstet, 1986 Jun, 162(6), 575 - 8
Comparative clinical study of Sulbactam and ampicillin and clindamycin and tobramycin in infections of soft tissues; Stromberg BV et al.; A prospective, randomized, double-blinded study was undertaken to evaluate the effectiveness of Sulbactam (a new semisynthetic, injectable penicillanic acid sulfone) to inhibit beta-lactamase activity of bacteria in infections of the soft tissue . Sixty patients with documented soft tissue infections were prospectively randomized . One-half received 1 gram of Sulbactam per 2 grams of ampicillin every six hours . The other half received 600.0 milligrams of clindamycin every six hours and 1.5 milligrams per kilogram of tobramycin every eight hours . Patient groups were similar in age, sex, associated medical problems and bacteriologic flora of wounds . Sulbactam and ampicillin showed a 93 per cent cure rate or improvement as compared with 81 per cent in the clindamycin and tobramycin group . Eradication of organisms was better in the Sulbactam and ampicillin group (67 versus 35 per cent) . Antibiotic activity of ampicillin was significantly augmented by the addition of Sulbactam . Of the 223 total bacteriologic isolates, 38 per cent were sensitive to ampicillin alone . Addition of Sulbactam improved sensitivity to 70 per cent . The Sulbactam and ampicillin combination is an effective combination for the treatment of soft tissue infections.

Br J Dermatol, 1986 Jun, 114(6), 705 - 16
Anti-androgen treatment in women with acne: a controlled trial; Miller JA et al.; Ninety female patients with acne were allocated randomly to one of three groups and treated either with Diane, a high dose cyproterone acetate (CPA) regime with ethinyloestradiol, or Minovlar . The same dose of oestrogen was common to all three treatment groups . Patients were assessed every 2 months for 6 months, by grading for severity of the acne, lesion counts and photography, and subjectively using a visual analogue scale . In addition, bacteriological sampling and sebum excretion rate (SER) measurements were performed . The results showed a clinical improvement in all three treatment groups, but a more rapid and complete response was seen in those groups who received CPA . There was also a consistent trend suggesting a more favourable response in those in the high dose CPA group . Although there was a marked reduction in SER in the groups treated with CPA, there was no correlation between reduction in SER and clinical improvement in individuals, nor could a reduction in the surface bacterial population be shown to be a primary event in the success of anti-androgen therapy . We have shown that the addition of CPA to oestrogen adds significantly to the therapeutic effect in acne and that anti-androgen and oestrogen combinations are more effective than standard oestrogen and progestagen contraceptive pills.

J Am Vet Med Assoc, 1986 May 15, 188(10), 1192 - 4
Chronic granulomatous bowel disease in three sibling horses; Sweeney RW et al.; Chronic granulomatous bowel disease was diagnosed in 3 sibling Standardbred horses . Clinical signs included weight loss, loose feces, and decreased appetite in the terminal stage of the disease . Abnormal laboratory findings included hypoproteinemia and low xylose absorption . Necropsy revealed granulomatous inflammation of the intestines, mesenteric lymph nodes, and liver . Eosinophilic infiltration of the granulomatous lesions was a prominent finding in one horse . A causative agent was not detected by special histochemical staining or bacteriologic culturing.

J Am Vet Med Assoc, 1986 May 15, 188(10), 1188 - 90
Cutaneous lesion caused by Mycobacterium tuberculosis in a dog; Foster ES et al.; A 5-month-old female mixed-breed dog was examined because of nonhealing wounds in the right submandibular region . Treatment with antibiotics and surgical excision was ineffective . Specimens of the right mandibular lymph node and surrounding tissues were submitted for bacteriologic culturing, and Mycobacterium tuberculosis was isolated . The dog was euthanatized . The risk of infection of human beings who associate with dogs that have cutaneous wounds caused by mycobacteria is unknown.

Can J Med Technol, 1986 Jun, 48(2), 99 - 103
Determining productivity and unit costs in a bacteriology laboratory; Gopaul D et al.; This paper describes in detail the process of identification of the "products" of a department of clinical microbiology, the determination of resource requirements, the identification of total resource costs and the calculation of unit costs in order to identify the items which can be regarded as profitable in relation to the OHIP fee scale, as well as those services whose true cost is not met by that scale . The process permits an assessment of the overall profitability of the entire division and provides data for judging the probable gains from contracting out services.

Vopr Virusol, 1986 May-Jun, 31(3), 310 - 4
{Significance of various respiratory viruses in the development of chronic nonspecific bronchopulmonary processes}; Ketiladze ES et al.; Combined virological and bacteriological studies were carried out in 83 patients with chronic bronchopulmonary diseases . Viral antigens, predominantly respiratory syncytial virus antigen, were detected in 72% of the patients in bronchial material obtained by bronchoscopy . Examinations for antibody of IgM and IgG classes specific for different viruses revealed acute infection in 79% of the patients which coincided with exacerbation of the process due to concomitant ARVD . The other patients had chronic virus infection . The over-time studies confirmed long-term persistence of viruses in bronchial epithelium in 15 patients (in 9 respiratory syncytial, in 5 adenovirus, in 1 parainfluenza virus) . Thus, the above results showed respiratory viruses not only to play a role in exacerbation of chronic bronchopulmonary diseases, but in a number of cases apparently to be the main cause of their development.

Postgrad Med J, 1986 May, 62(727), 363 - 8
Pulmonary infection with opportunist mycobacteria on Merseyside 1974-1983; Clague HW et al.; During a 10 year period 49 patients were recorded as having pulmonary infection caused by opportunist mycobacteria . Six different species were identified of which M . kansasii (65%) and M . avium-intracellulare (20%) were the most common . Cough and sputum (82%) or haemoptysis (26%) were frequent symptoms on presentation and over two thirds of patients had pre-existing respiratory disease . Chest radiographs showed predominantly apical disease with the right apex (44%) being twice as commonly affected as the left (22%) . In 30% the radiograph showed bilateral disease . Clinicians had an individual approach to treatment with no uniform pattern of drug prescribing . A majority of patients (59%) received rifampicin for at least 9 months and those patients with M . kansasii infection responded well with no bacteriological relapses in 20 patients followed for a mean period of 3.9 years . M . avium-intracellulare, M . malmoense and M . xenopi were less responsive to treatment and in four patients receiving chemotherapy death was attributed to mycobacterial infection.

Aust Paediatr J, 1986 May, 22(2), 143 - 4
Colonoscopy in the diagnosis of abdominal tuberculosis in children; Tam PK et al.; Childhood abdominal tuberculosis has protean manifestations and remains a difficult diagnosis problem, often requiring surgery for pathological confirmation . Colonoscopy, however, can now be performed with safety in children and appears to offer a new and better alternative to surgery . An earlier experience confirmed its value in the management of ileocaecal tuberculosis as it provided histological proof and bacteriological information to guide chemotherapy, avoiding the need for anaesthesia and laparotomy . However, colonoscopy hasn't been helpful in the diagnosis of the 'exudative' type of abdominal tuberculosis.

J Antimicrob Chemother, 1986 May, 17 Suppl C, 177 - 81
Timentin (ticarcillin and clavulanic acid) in combination with aminoglycosides in the treatment of febrile episodes in neutropenic children; Schaison G et al.; Timentin (ticarcillin + clavulanic acid) combined with an aminoglycoside usually netilmicin, was given to 33 children with neutropenic haematological malignancies . The combination of Timentin and aminoglycoside was effective treatment in 27 (87%) of 31 febrile episodes . There were four failures and three results which could not be interpreted . Bacteriological investigations were positive in 13 patients, three strains were resistant to ticarcillin but all were sensitive to Timentin . Clinical success, based upon reduction of fever within 48 h of treatment, was identical whether an organism was isolated or not . The combination of Timentin plus aminoglycoside was very successful and represents one of the best combinations available for empirical treatment for febrile neutropenic children.

Transfusion, 1986 May-Jun, 26(3), 293 - 5
A new method for monitoring the sterility of blood donation; Gueguen M et al.; Sterility of blood products is a cardinal contributor to patient safety . Bacteriologic controls of stable products comply with strict regulations, but legislation imposes only limited constraints in the case of perishable products, such as packed red cells (RBCs) or fresh-frozen plasma (FFP) . Therefore, it is essential to monitor the sterility of aseptic donations from uninfected donors . Such bacteriologic monitoring can now be carried out through a tertiary bag (containing a soybean casein culture medium) connected to the classical double-pack system . This system does not jeopardize the sterility of the whole system, as the connection is tightly stoppered by a membrane . After the blood drawing, this tertiary bag is filled with 5 ml of blood, and separated from the rest of the system . It is then incubated for 3 days at 30 degrees C and for 14 days at 22 degrees C, to test for eventual bacteriologic or fungal contamination . In order to check the feasibility of this technique, we studied 76 blood drawings in the control laboratory of the blood center, and the results confirm the value of this system.

J Antimicrob Chemother, 1986 May, 17 Suppl C, 189 - 94
Timentin in the treatment of post-operative infections; McLatchie GR et al.; In an open study 50 patients were treated for a variety of infections with 3.2 g Timentin 6, 8- or 12-hourly for a mean period of six days . Timentin was clinically successful in 87% of patients assessed at the end of treatment of whom 95% remained cured or improved at a later follow-up . Bacteriologically Timentin was successful against 92% of organisms, including all 11 which were ticarcillin or ampicillin resistant . Side effects were reported in seven patients, the majority of which were minor local reactions at the site of infusion . This open study shows Timentin to be a safe and effective antibiotic for the treatment of infection.

J Antimicrob Chemother, 1986 May, 17 Suppl C, 115 - 22
Timentin in the treatment of nosocomial bronchopulmonary infections in intensive care units; Schwigon CD et al.; A clinical trial with Timentin (ticarcillin plus clavulanic acid) was undertaken in patients with hospital-acquired lower respiratory tract infections . Two formulations, 3.2 and 5.2 g consisting of 200 mg clavulanic acid and 3 or 5 g ticarcillin, respectively were usually given three times daily . Eighty-one patients were evaluable for clinical efficacy and 89 for tolerance . The clinical cure rate was 96% of the assessable cases even though all patients had severe concurrent or underlying diseases . The pronounced synergism between ticarcillin and clavulanic acid resulted in a bacteriological elimination rate of 94% . Adverse effects were very rare and of a mild nature, and restricted to those usually seen with the well-tolerated penicillins . No toxicological abnormalities could be detected in extensive laboratory screening . Timentin is a highly effective broad-spectrum antibiotic with good tolerance . Its potentiated action in comparison to other penicillins against beta-lactamase-producing strains, could reduce the usage of aminoglycosides in the future.

Pathol Biol (Paris), 1986 May, 34(5), 325 - 7
{Bronchial diffusion of ceftriaxone}; Husson MO et al.; The value of a single daily injection of 2 g ceftriaxone in lower respiratory tract superinfections was demonstrated in 22 patients in a neurosurgical intensive care unit . Catheter bronchial samples were submitted to bacteriological investigation and ceftriaxone concentrations were determined in serum and bronchial secretions . Results show that sustained efficient levels of ceftriaxone were achieved and enabled the successful treatment of lower respiratory tract infections due to susceptible pathogens.

Jpn J Antibiot, 1986 May, 39(5), 1350 - 8
{Fundamental and clinical studies on imipenem/cilastatin sodium in the field of obstetrics and gynecology}; Iwase H et al.; Fundamental and clinical studies on imipenem/cilastatin sodium (MK-0787/MK-0791) in the field of obstetrics and gynecology were carried out . The concentration of MK-0787 in uterine tissue was 5.9-12.2 micrograms/g at 30 minutes after an administration of 500 mg/500 mg of MK-0787/MK-0791 by a 30-minute intravenous drip infusion and 0.9-1.1 micrograms/g at 185 minutes . The clinical application of the drug to 9 patients with gynecological infections produced "good" results with all the patients clearly showing clinical or bacteriological improvement . Neither side effects nor abnormal laboratory findings were observed . Based on these findings, MK-0787/MK-0791 appeared to be a useful antibiotic for the treatment obstetrical and gynecological infections.

Jpn J Antibiot, 1986 May, 39(5), 1342 - 9
{Clinical studies on the effect of imipenem/cilastatin sodium on infections in obstetrics and gynecology . Tissue concentrations and clinical effects}; Oomomo Y et al.; Tissue transfer and clinical effects of imipenem/cilastatin sodium (MK-0787/MK-0791), a new carbapenem antibiotic, were studied and the following results were obtained . Penetrations of MK-0787 into uterine arterial blood and into pelvic dead space exudate were good . When MK-0787/MK-0791 was administered at a dose of 500 mg/500 mg by a 30-minute intravenous drip infusion, the peak level of MK-0787 in uterine arterial blood was 22.2 micrograms/ml, 30 minutes after the completion of the drip infusion . The peak level of MK-0787 in pelvic dead space exudate was 12.9 micrograms/ml at 2 hours and it dropped to 2.6 micrograms/ml at 6 hours . MK-0791 levels were similar to those of MK-0787 . Penetrations of MK-0787 into tissues were also good . When MK-0787/MK-0791 was administered at a dose of 500 mg/500 mg by a 30-minute intravenous drip infusion, the level of MK-0787 was 2.2 +/- 1.1 micrograms/g in the oviduct, 2.7 +/- 2.1 micrograms/g in the ovary, 2.5 +/- 1.2 micrograms/g in the endometrium, 3.0 +/- 1.6 micrograms/g in the myometrium, 3.1 +/- 1.9 micrograms/g in the cervix uteri and 3.8 +/- 2.0 micrograms/g in the portio vaginalis at 1 hour after administration . These levels were reduced to halves, respectively, in approximately 2 hours . Four patients with intrauterine infections and 2 with vaginal stump infections were treated with MK-0787/MK-0791 at a daily dose of 1 g/1 g (500 mg/500 mg X 2) . Good clinical and bacteriological responses were observed in 5 patients and causative organisms were eradicated in 2 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Presse Med, 1986 Apr 26, 15(17), 787 - 90
{Infectious endocarditis surgically treated during the acute phase . 26 cases}; Touze JE et al.; Twenty-six patients with infective endocarditis were operated upon during the active phase . The endocarditis was native in 24 cases and developed on cardiac valve prosthesis in 2 cases . Depending on the valve involved, the patients were divided into 3 groups: Ao (aortic valve, n = 13), M (mitral valve, n = 10) and T (tricuspid valve, n = 3) . The overall mortality rate was 26% (group Ao 20%, group M 20%); death was due, in most cases, to haemodynamic failure . The duration of pre-operative antibiotic therapy, the functional stage of the disease and the cardiothoracic ratio had no influence on post-operative prognosis . In contrast, the presence of vegetations (notably on the aortic valve) at echocardiography and the pumping and aortic clamping times played a role in operative mortality . Twelve patients were followed up for a mean period of 23.9 months . They are all in stage I or II with significant decrease in cardiothoracic index . In Africa, where bacteriological facilities are often inadequate and cardiac valve diseases are diagnosed at a late stage, infective endocarditis is active in many cases . Under these conditions, early surgery is justified when heart failure is present and the infection is not clinically controlled.

Fed Regist . 1986 Apr 30;51(83):16111.
Research grants on alcohol and immunology including acquired immunodeficiency syndrome (AIDS)--NIAAA; Psoriasis . How to keep mild disease from becoming severe; Progress in care of mild psoriasis has been slight . Good, practical therapy of mild disease emphasizes organization of and strict compliance to well-known therapies rather than use of new therapies . Of greatest importance is prevention of disabling severe disease . For severe psoriasis, which occurs infrequently, care is best assigned to dermatologists with special experience . Advances in oncology, bacteriology, and photobiology have led to new and effective treatments for severe disease . Because psoriasis is so poorly understood, physicians should be restrained from making claims about its causes and aggravating influences . Every affected patient deserves to be thoroughly informed about the disease and helped to obtain independence through an inexpensive therapeutic regimen that can be adapted to his or her job, income level, and lifestyle . There is no simple cure for psoriasis today.

Indian J Lepr, 1986 Apr-Jun, 58(2), 233 - 9
Immunotherapy in leprosy: a new approach; Chattopadhyay SP et al.; An immunotherapeutic agent prepared from patient's own affected skin was tried in 30 leprosy cases . 53.6% cases of lepromatous and borderline lepromatous group showed lepromin conversion from lepromin negativity to positivity after 12 weeks of immunotherapy . The clinical and bacteriological improvement was also good . 88.1% cases of borderline tuberculoid also showed fair to good clinical recovery following 12 weeks of immunotherapy.

Q J Med, 1986 Apr, 59(228), 421 - 8
Cryptic miliary tuberculosis; Yu YL et al.; Fifteen patients with cryptic miliary tuberculosis seen over a six-year period in a large teaching hospital were reviewed . This form of tuberculosis tended to be difficult to diagnose and was most common in older people and those with underlying diseases such as malignancy or blood dyscrasias . Bacteriological investigation was of the little help in diagnosis while bone marrow and liver biopsies were more useful . The diagnosis was made during life in only seven (47 per cent) of the 15 cases, and the overall mortality was 80 per cent . Tuberculosis should be considered in all cases of pyrexia of unknown origin, and investigations performed to establish or exclude the diagnosis . A prompt and adequate therapeutic trial with antituberculous treatment even in the absence of definite evidence of tuberculosis can be life-saving.

Eur J Pediatr, 1986 Apr, 145(1-2), 18 - 21
C-reactive protein as an indicator of infection in the immunosuppressed child; Gronn M et al.; C-reactive protein (CRP) concentrations were determined in a prospective fashion in 50 children with malignant disease . In 35 children with active and aggressive disease, but without signs of infection, no significant increase in CRP was detected . Neither did aggressive cytostatic therapy (70 courses) in non-infected children result in an increase . In bacteriologically proven, and in clinical sepsis-suspected cases, CRP values increased in all cases to levels above 100 mg/l (normal values less than 5 mg/l) . Effective antibiotic therapy resulted in a prompt decline in CRP . Viral infections resulted in a much smaller increase . We conclude that serial measurements of CRP in these immunosuppressed children are of great help in monitoring infections and defining the group that needs antibiotic therapy . The measurement is also a good indicator of the effectiveness of the antibiotic therapy chosen.

Nippon Geka Gakkai Zasshi, 1986 Apr, 87(4), 403 - 7
{Surgical problems of Kock's continent ileostomy in patients with ulcerative colitis}; Kameyama J et al.; Postoperative problems including pathophysiology at follow up were investigated in Kock's continent ileostomy in patients with ulcerative colitis . The results obtained were as follows: Though postoperative complication was found in all 4 cases, it was improved in 3 of them by conservative or surgical treatment . Troublesome skin irritation, such as erosion or ulcer, was not found in any case . The patients empty the reservoir when it is convenient and intestinal discharge was 1 to 4 times per day and these results were proved from the studies of the pressure and capacity in the Kock's ileostomy . Various plasma amino acids in patients with Kock's ileostomy showed almost similar levels to those of the normal subjects . Bacteriological examination in the stool in Kock's ileostomy also revealed almost similar results to those of the normal subjects . From these results, we conclude that Kock's continent ileostomy should be more widely performed for the patients with ulcerative colitis when ileostomy is required.

Am J Obstet Gynecol, 1986 Apr, 154(4), 951 - 4
Comparison of cefotetan and cefoxitin as prophylaxis in cesarean section; Varner MW et al.; A study comparing the efficacy of cefotetan versus cefoxitin for prophylaxis in patients undergoing cesarean section was carried out at the University of Iowa . After institutional review, 36 subjects who met the study criteria and agreed to participate were entered into the study; of these, 29 were evaluable for efficacy . Twenty subjects received a single 2 gm dose of cefotetan, and nine subjects received three 2 gm doses each of cefoxitin . Both antibiotics were administered intravenously at the time the umbilical cord was clamped . The subsequent doses of cefoxitin were given intravenously at four and eight hours after the initial dose . Clinical and bacteriologic responses were evaluated; there were no statistically significant differences between the two groups, and both antibiotics provided effective prophylaxis against infection . It appears that cefotetan is a satisfactory antibiotic choice for cesarean section prophylaxis . Further, in this small study it appears that a single dose of cefotetan is as effective as three doses of cefoxitin . This implies that cefotetan would not only decrease administration time and supplies but would decrease the cost to the patient while maintaining very acceptable infection rates.

Urology, 1986 Apr, 27(4), 379 - 87
Treatment of bacterial prostatitis . Comparison of cephalexin and minocycline; Paulson DF et al.; The relative safety and efficacy of minocycline and cephalexin were examined in patients with acute or chronic prostatitis . The multicenter study was of single-blind, parallel-group design . Forty-two men received minocycline (200-mg initial dose followed by 100 mg twice daily) and 44, cephalexin (500 mg four times daily); each antibiotic was administered orally for four weeks . A follow-up period of patient assessment extended for an additional six weeks . Evaluable data were available for 20 minocycline-treated patients and for 24 cephalexin-treated patients . Clinical cure or improvement without recurrence was seen in 65 per cent of the patients who received minocycline and in 46 per cent of those given cephalexin . Bacteriologic cure without relapse or reinfection occurred in 45 per cent of the minocycline-treated men and in 21 per cent of the cephalexin-treated men . Serious adverse clinical experiences were not encountered in either treatment group . Although several factors, mainly the small number of patients, precluded a statistical analysis of comparative efficacy, it was evident that more patients in the minocycline-treated group had both clinical and bacteriologic cures (35%) than did those in the cephalexin-treated group (21%).

Arch Pathol Lab Med, 1986 Apr, 110(4), 284 - 8
A historical perspective as a compass for future of pathology; McLendon WW; A brief historical overview of pathology's role in the evolution of modern medicine is presented by highlighting the contributions of three outstanding figures in the history of pathology . Morgagni developed the concept of clinical-pathological correlation as a means of understanding "the seats and causes of diseases" . Virchow introduced the microscope to pathology as a means of better understanding disease through the study of cellular (and eventually subcellular) events . Welch applied the then-new approaches of bacteriology to the study of disease and established the laboratory as a central focus for the pathologist . Certain common themes in the lives and works of these three founders are analyzed with respect to their signification for pathologists today and in the future.

Rev Rhum Mal Osteoartic, 1986 Apr, 53(4), 249 - 52
{Reflections on ankylosing spondylitis in Black Africa . Apropos of a juvenile-onset case}; Leleu JP et al.; From the starting point of two cases of ankylosing spondylitis, one of which began in youth, observed in Abidjan, Ivory Coast, a review of the literature concerning the major cases amongst africans is carried out . This disease is unusual in tropical Africa: about thirty published cases, of varied origin . This low incidence of ankylosing spondylitis is correlated to the rarity of the HLA B27 group and of seronegative spondylitic joint diseases in general amongst the black population of Africa . Whereas the high incidence of forms with juvenile onset in North Africa suggests some connection with undetected Reiter's disease, the infrequency of this form of onset of the disease in sub-Saharan Africa and the lack of bacteriologic evidence make it impossible to reach any such conclusions.

Orthop Rev, 1986 Apr, 15(4), 232 - 6
Hip arthroplasty in quiescent mycobacterial infection of hip; Lin E et al.; Three patients underwent hip arthroplasty--one total hip replacement and two, Thompson's hemiarthroplasty . The diagnosis was degenerative joint disease and subcapital fracture of the femur, respectively . Histologic and bacteriologic examination revealed mycobacterial infection . None of the patients had a past history of mycobacterial infection . In one instance, there was a reactivation of the infection eight months following surgery, which was treated successfully by antituberculosis drugs.

Med Trop (Mars), 1986 Apr-Jun, 46(2), 121 - 9
{Kaposi's sarcoma in Burundi and the Central African Republic in the framework of acquired immunodeficiency syndrome (AIDS)}; Laroche R et al.; The authors carried out in 1985 a survey in two French speaking States in Central Africa, namely Burundi and Central African Republic (C.A.R.), in order to study the links between Kaposi sarcoma (K.S.) and A.I.D.S . In Burundi the prospective study conducted in Bujumbura, lead to collect in one year 25 cases of K.S . out of them 24 linked to A.I.D.S . No group at risk has been identified . The 24 K.S . linked to A.I.D.S . present a stage IV (cutaneous and visceral form) in 21 cases . 20 of them got an associated affection, 5 being tuberculosis bacteriologically confirmed . All of them present a cellular immunity deficiency . Evolution was fatal in 22 cases out of 24, average presumption of survival was 10 months . In C.A.R., retrospective survey conducted in Bangui made possible to find out 24 cases in 4 years, of which 20 having had a L.A.V . antibodies research, were considered . 9 of them were linked to A.I.D.S . No group at risk . 7 patients presented a sporadic form, 6 an African endemic form, 7 an epidemic form with associated infection . Out of 9 LAV positive patients, 5 deceased . Out of 11 LAV negative patients, 3 deceased with a A.I.D.S . clinical aspect . This survey carried out in Burundi and in C.A.R . demonstrates that K.S . is significantly in increase in these two countries . In Burundi it is significantly linked to A.I.D.S . In C.A.R., classical African K.S . do exist (sporadic, endemic), as well as K.S . linked to A.I.D.S., as underlined recently in Bayley's publications in Zambia . Since A.I.D.S . has been detected, it does exist an outbreak and a new clinical form of K.S . in Central Africa.

N Engl J Med, 1986 Mar 13, 314(11), 678 - 81
Widespread outbreaks of clam- and oyster-associated gastroenteritis . Role of Norwalk virus; Morse DL et al.; Consumption of raw shellfish has long been known to be associated with individual cases and sporadic outbreaks of enteric illness . However, during 1982, outbreaks of gastroenteritis associated with eating raw shellfish reached epidemic proportions in New York State . Between May 1 and December 31, there were 103 well-documented outbreaks in which 1017 persons became ill: 813 cases were related to eating clams, and 204 to eating oysters . The most common symptoms were diarrhea, nausea, abdominal cramps, and vomiting . Incubation periods were generally 24 to 48 hours long, and the duration of illness was 24 to 48 hours . Bacteriologic analyses of stool and shellfish specimens did not reveal a causative agent . Norwalk virus was implicated as the predominant etiologic agent by clinical features of the illness and by seroconversion and the formation of IgM antibody to Norwalk virus in paired serum samples from persons in five (71 percent) of seven outbreaks in which testing was done . In addition, Norwalk virus was identified by radioimmunoassay in clam and oyster specimens from two of the outbreaks . Determining the source of the shellfish was not always possible, but northeastern coastal waters were implicated . The magnitude, persistence, and widespread nature of these outbreaks raise further questions about the safety of consuming raw shellfish.

J Comput Assist Tomogr, 1986 Mar-Apr, 10(2), 254 - 6
Miliary tuberculosis associated with adrenal enlargement: CT appearance; Hauser H et al.; In two patients with miliary tuberculosis the diagnosis was first suggested with CT and then proven by histology in both and bacteriology in one case: Adrenal involvement was demonstrated with unilateral and bilateral enlargement, respectively.

Jpn J Antibiot, 1986 Mar, 39(3), 679 - 85
{Effects of cefoperazone on respiratory infections of patients of advanced age and/or with underlying respiratory diseases}; Motojima S et al.; Respiratory infections of 19 subjects of advanced age and/or with underlying respiratory disease were treated with cefoperazone (CPZ) and its clinical effects were studied . Sixteen subjects suffered from respiratory tract infection and 3 subjects had pneumonia . The age of the subjects ranged from 39 to 77 years with the mean of 63.8, 7 of them being more than 70 years of age . The underlying respiratory diseases included chronic pulmonary emphysema in 6 subjects, diffuse panbronchiolitis in 3, bronchiectasis in 3, silicosis in 2 and one each of chronic bronchitis, pulmonary fibrosis, lung cancer and old pulmonary tuberculosis . One case, 75 years of age, had renal insufficiency . The daily dose of CPZ was 4 grams in 18 of the 19 subjects and the duration of administration ranged 5 to 22 days . The remaining 1 subject received 2 g of CPZ daily for 6 days . Clinical effects were judged from the changes in fever, cough, amount of sputum, dyspnea, rales, cyanosis, chest X-ray, white blood cell counts, CRP, erythrocyte sedimentation rates and results of sputum culture . Clinical effects were good in 16 subjects, fair in 1, and poor in 2 . Bacteriological follow-up was carried out in 13 subjects . Infecting bacteria were eliminated from 5 subjects, reduced in 2 and, in 4 subjects, they were replaced by other bacteria . In 1 subject, P . aeruginosa was isolated from sputum even after the treatment with CPZ, and in another subject H . influenzae relapsed immediately after the cessation of the CPZ treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

J Chir (Paris), 1986 Mar, 123(3), 197 - 203
{Rational practice of preventive antibiotic therapy in surgery}; Vachon F; The use of preventive antibiotic therapy to reduce frequency and severity of infections related to certain surgical acts still remains a subject of polemic and confusion . The need to employ definitions and therefore a common language to arrive at a consensus in each surgical team and for each surgical procedure is emphasized . The major principles guiding bacteriologic objectives are discussed, as well as the choice of corresponding antibiotic and its mode of administration.

Tubercle, 1986 Mar, 67(1), 5 - 15
Controlled clinical trial of 4 short-course regimens of chemotherapy (three 6-month and one 8-month) for pulmonary tuberculosis: final report . East and Central African/British Medical Research Council Fifth Collaborative Study; Macrophage membrane alterations in leprosy as determined by change in sialic acid level; The level of sialic acid removable by neuraminidase from macrophages of bacteriologically-positive lepromatous leprosy (B(+)LL) patient is extremely low, compared to macrophages from tuberculoid leprosy patients or normal individuals . On the other hand macrophages from long term treated bacteriologically-negative lepromatous leprosy (B(-)LL) patients show a much higher level of sialic acid . This higher level is drastically reduced when these macrophages from (B(-)LL) patients are allowed to phagocytose Mycobacterium leprae . This modulation could be host- and pathogen-specific . It is demonstrated that M . leprae infection brings out membrane changes in the macrophages leading to alteration in the surface molecules . Such membrane changes may cause hindrance in the ability of macrophages to participate successfully in the immune process.

Br J Obstet Gynaecol, 1986 Mar, 93(3), 240 - 4
Diagnosis of intrauterine infection by demonstration of antibody-coated bacteria in the amniotic fluid; Moller M et al.; Immunofluorescence examination of amniotic fluid for the occurrence of antibody-coated bacteria was carried out in 72 consecutive women with premature rupture of the fetal membranes to assess this method in the diagnosis of intrauterine infection . Antibody-coated bacteria were demonstrated in 11 women with clinical signs of intrauterine infection, histological amnionitis and heavy growth of one bacterial species . The presence of intrauterine infection was considered possible in another 14 women . One patient had no clinical signs of infection, but positive histological and bacteriological evidence; antibody-coated bacteria were demonstrated in this patient, but not in the remaining 13 women . In 47 women clinical, histological and bacteriological signs of intrauterine infection were absent, and examinations for antibody-coated bacteria were negative in all of them . It is concluded that the demonstration of antibody-coated bacteria in amniotic fluid indicates the presence of intrauterine infection, and the examination may in some cases be positive before the appearance of clinical signs of infection.

Am J Optom Physiol Opt, 1986 Mar, 63(3), 177 - 80
Bacterial flora of the eye and contact lens . Cases during hydrogel lens wear; Callender MG et al.; Bacteriological comparisons between the tear fluids of soft contact lens wearers and noncontact lens wearers indicate that there is an increase in the bacterial population in contact lens wearers but not a significant change in the varieties present . Differences between groups of contact lens wearers appear to depend on the method of disinfection used.

Am J Trop Med Hyg, 1986 Mar, 35(2), 366 - 9
Application of indirect hemagglutination test and indirect fluorescent antibody test for IgM antibody for diagnosis of melioidosis in Thailand; Khupulsup K et al.; In hyperendemic areas such as Thailand, rapid diagnosis of melioidosis depends upon both bacteriological culture and serological methods . However, interpretation of indirect hemagglutination (IHA) for melioidosis which is the only test available, is seriously hampered by increased IHA titers present in one-third to one-half of the population . In order to get the best results from the available tests, IHA and indirect fluorescent antibody for IgM (IFA-IgM) were evaluated in controls and patients in Thailand . IHA titers of greater than or equal to 1:40 were considered remote or recent exposure to P . pseudomallei . IHA titers of this level were found in 47.1% of 227 blood donors and 29.5% of 210 sera submitted for other tests, while IFA-IgM was positive in only one donor who had an IHA titer of 1:1,280 . IHA was positive in eight out of nine patients with melioidosis with IHA titers of less than 1:20 to 1:2,560 . IFA-IgM was positive in six out of seven melioidosis patients whose sera were available for this test including a serum with IHA titer of less than 1:20 . Six patients were predisposed by diabetes mellitus . Among sera serologically tested for melioidosis, 33 had IHA titers of 1:80-1:1,280, 10 of which were positive for IFA-IgM . This study demonstrates high background IHA titers among IHA titers among Thai people which greatly limits its use for serodiagnosis of melioidosis . In sharp contrast, serodiagnosis by IFA-IgM was more successful . Positive IFA-IgM among healthy Thais did exist indicating that serologic tests for melioidosis at best are only supplementary to bacteriological culture and clinical awareness.

Vet Res Commun, 1986 Mar, 10(2), 113 - 24
Comparison of milk antitrypsin, albumin, n-acetyl-beta-D-glucosaminidase, somatic cells and bacteriological analysis as indicators of bovine subclinical mastitis; Mattila T et al.; Thirty-two quarters, five of which harbored subclinical mastitis, were examined daily for one month . The usefulness of milk antitrypsin, BSA (bovine serum albumin), NAGase, somatic cells and bacteriological analysis in differentiating the inflamed quarters from the healthy control quarters was analysed . Inter-quarter evaluation clearly improved each indirect mastitis parameter; NAGase and antitrypsin were better indicators of differences between infected and non-infected quarters than BSA or the somatic cell count.

Med Clin North Am, 1986 Mar, 70(2), 323 - 36
Seronegative spondyloarthritides; Calin A; Recently, there has been enormous growth in the clinical importance of the spondyloarthropathies, in part because of their close association with HLA, and in part because of the recognition that a substantial number of patients suffer from different forms of these disorders . Over the years, immunogeneticists, geneticists, epidemiologists, bacteriologists, membrane biologists, and clinicians have joined in the attempt to clarify our understanding of ankylosing spondylitis, Reiter's disease, psoriatic arthropathy, and other interrelated conditions . This article provides a summary of clinical and research developments in what is now recognized as a major area in rheumatology.

Arch Mal Coeur Vaiss, 1986 Mar, 79(3), 315 - 22
{Results of surgical treatment in acute native endocarditis . Apropos of 41 patients}; Soyer R et al.; This study was based on the analysis of 41 cases of infectious endocarditis of native valves operated during the acute phase . Patients with bacteriological cures, prosthetic valve endocarditis and endocarditis on congenital non-valvular lesions were excluded . There were 32 men and 9 women with an average age of 49 years . The valve lesions were aortic incompetence, mitral incompetence, mitro-aortic disease and mitro-tricuspid disease . Fourteen patients had preexisting valvular disease (rhumatic in 12 and congenital in 2 cases) . These patients were in an advanced clinical state at the time of operation: 23 Class IV, 16 Class III and 2 Class II operated for systemic embolism . The surgical indications were severe cardiac failure in 30 cases, systemic embolism in 2 cases and persistance of septicaemia with worsening cardiac function in 9 cases . The causal organism was isolated from blood cultures in 34 cases (83%) and from the excised valve in 13 cases . The early postoperative mortality during the first month was 5 patients (3 cases of aortic incompetence associated with mitral incompetence and 2 cases of aortic incompetence alone) . Death was caused in most cases by irreversible cardiac failure related to the advanced preoperative cardiac failure . All the other patients were followed up for 1 to 102 months (average 44 months) . There were 7 late postoperative deaths . The mortality rate was 3.4% per patient year including patients undergoing chronic haemodialysis . The actuarial survival was 79% at 78 months excluding the operative mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Radiology, 1986 Mar, 158(3), 597 - 603
Gastrointestinal complications of AIDS: radiologic features; Frager DH et al.; The radiologic features were examined in a retrospective review of 25 patients with gastrointestinal complications of acquired immunodeficiency syndrome (AIDS) . Factors of risk for AIDS present in these patients included homosexuality (n = 10), intravenous drug abuse (n = 7), multiple blood transfusions (n = 1), and unconfirmed or unknown factors (n = 7) . Gastrointestinal abnormalities identified on radiologic studies (including upper gastrointestinal, small bowel, and barium enema studies) were correlated with histopathologic specimens and the results of bacteriologic, viral, fungal, and parasitologic studies . The most common disorders (88%) were candidal esophagitis and cytomegaloviral colitis; neoplastic involvement of the gastrointestinal tract was far less common (12%), with only two patients (8%) having Kaposi sarcoma . Gastrointestinal studies, which can provide useful if not always definitive diagnostic information, are recommended to precede more invasive diagnostic studies in evaluating patients with suspected AIDS.

J Hosp Infect, 1986 Mar, 7(2), 176 - 84
Ultraviolet radiation and air contamination during total hip replacement; Carlsson AS et al.; Ultraviolet (uv) radiation of the operating room was assessed bacteriologically in an open randomized study of 30 total hip procedures . Volumetric air-sampling demonstrated that the number of colony forming units (cfu m-3) were significantly reduced (P less than 0.001) by uv light, both close to the wound and in the periphery of the operating room . No adverse effects of the uv-irradiation were observed either in the patients or the staff . In operating rooms fitted with a 'zonal ventilation' system and with an air change rate of about 70 h-1, the addition of uv irradiation during surgery may achieve 'ultra clean' air . However, in conventionally ventilated operating rooms uv-irradiation alone is probably not sufficient to do so.

J Am Vet Med Assoc, 1986 Feb 15, 188(4), 393 - 6
Association of age of ram with distribution of epididymal lesions and etiologic agent; Walker RL et al.; A 2-year study of the frequency of isolation of various organisms from mature and yearling rams with epididymitis was conducted at the US Sheep Experiment Station at Dubois, Idaho . Investigation into the distribution of lesions in the epididymis in relation to age of the ram also was studied . Serologic or bacteriologic evidence of Brucella ovis infection was demonstrated in 79.5% of the mature rams with epididymal lesions . Actinobacillus seminis and Histophilus ovis were the 2 most frequently isolated organisms from yearling rams with lesions . The tail(s) of the epididymis was the most frequent site of lesion development in the mature rams (86.4%) . Yearling rams developed lesions twice as frequently in the tail(s) of the epididymis as in the head(s) of the epididymis . When lesions were localized in the head(s) of the epididymis, an etiologic agent usually was not demonstrated.

Zh Mikrobiol Epidemiol Immunobiol, 1986 Feb, (2), 38 - 41
{Interrelation of the enterotoxigenic properties and the antigenic structure of Escherichia}; Romanenkova NI et al.; The enzymatic signs and serological characteristics of Escherichia enterotoxigenic strains isolated from patients with acute intestinal diseases and from healthy persons were studied . The cultures were subdivided into 24 enzymatic variants and classified with 48 serogroups and 61 serovars . The enterotoxigenic properties of the strains were compared with their serological characteristics and enzymatic signs . The strains, isolated from different persons and classified with the same serovar, belonged to the same variant with respect to the type of enterotoxin they produced (only thermostable enterotoxin, only thermolabile enterotoxin, or both), were similar in the degree of their toxigenicity and belonged, as a rule, to the same enzymatic variant . The data on the presence of manifest interrelation between the enteropathogenicity of Escherichia and their structure, as well as on the stability of the enterotoxigenic properties of these organisms, indicate that in acute intestinal diseases the determination of Escherichia enterotoxigenic strains can be carried out by common bacteriological techniques with the use of specific agglutinating sera.

Eur J Pediatr, 1986 Feb, 144(5), 497 - 502
Lymphocytic meningoradiculitis (Garin-Bujadoux Bannwarth): from syndrome to disease?
Schmedding E, Verboven M, Lauwers S, Ebinger G, Rom N, Loeb H.
In two children with lymphocytic meningoradiculitis (Bannwarth's syndrome), IgG and IgM antibodies to Borrelia burgdorferi were demonstrated . Clinical and laboratory parameters of the syndrome are described and recent bacteriological and serological findings that link the syndrome to the American Lyme disease are discussed, as well as the effects of antibiotic treatment.

Crit Care Med, 1986 Feb, 14(2), 135 - 7
Bacteriologic evaluation of the Servo 150 hygroscopic condenser-humidifier; Powner DJ et al.; The Servo 150 hygroscopic condenser-humidifier was evaluated during use to determine if the inner foam core became contaminated and if a bacteria-laden aerosol was produced during the inspiratory cycle of the patient's mechanical ventilator . Cultures from the core and of inspired gas were obtained from seven patients with known culture-positive sputum, after 4, 8, 12 and 24 h of humidifier use . In each case, the inner foam core was grossly contaminated after 4 h of use and colony counts increased during the 24-h testing period . The bacteria recovered were the same as those cultured from sputum . Despite the core's heavy bacterial growth, a bacteria-laden aerosol occurred in only 43% of the samples obtained during humidifier use . The Servo humidifier does not appear to increase the risk of airway exposure to airborne bacteria during mechanical ventilation.

Rev Rhum Mal Osteoartic, 1986 Feb, 53(2), 113 - 8
{Mycobacterial infection of the hip following total prosthesis . Study of 6 cases}; Delrieu F et al.; The authors present 6 cases of mycobacterial infection of the hip after total hip replacement: 5 cases of tuberculosis and 1 case of Mycobacterium fortuitum infection . They emphasise the clinical, radiological, bacteriological and histological signs which are generally very characteristic and unequivocal . A review of the literature reveals the rarity of these infections, but stresses the need for a complete bacteriological survey to avoid missing the diagnosis . A routine medicosurgical therapeutic approach is proposed.

Kidney Int, 1986 Feb, 29(2), 557 - 62
Glomerular IgA deposition in pulmonary diseases; Endo Y et al.; Glomerular changes of 70 cases of pulmonary diseases and 25 control cases among 1100 consecutive autopsy cases were studied by light, immunofluorescence, and electron microscopy . These pulmonary diseases consisted of 11 cases of chronic obstructive bronchiolitis (COB), 15 cases of bronchopneumonia, 4 cases of acute interstitial pneumonia, 22 cases of idiopathic interstitial pneumonia (IIP), and 18 cases of lung cancer free from IIP . Bacteriological examination of the lung was performed in these cases including control cases on autopsy . Mesangial IgA deposition was predominant in 25 out of the 70 study cases (36%) frequently accompanied by C3, whereas slight mesangial IgA deposition was observed in one of the control cases . Incidence of IgA deposition was 64% in IIP, 54.5% in COB, 13.3% in bronchopneumonia, 16.7% in lung cancer and 25% in acute interstitial pneumonia . The results of the present study suggest that recurrence or persistence of inflammatory processes of the lung leads to IgA-mediated immune abnormalities and to mild mesangial changes with predominant IgA deposition, which are similar to the immunopathologic features of IgA nephropathy.

J Clin Gastroenterol, 1986 Feb, 8(1), 82 - 4
Spontaneous bacterial peritonitis associated with an intrauterine device; Brinson RR et al.; Intrauterine contraceptive devices (IUD) have been associated with the induction of chronic anaerobic endometritis as well as superimposition of exogenous sexually transmitted diseases and unilateral tubo-ovarian abscesses . We report an unusual case of spontaneous bacterial peritonitis in a patient with ascites and an IUD . Bacteriological data support the concept that the source of infection was a chronic mixed endometritis induced by prolonged use of an IUD (16 years) . In the presence of ascites, a localized endometritis with its reservoir of bacteria provided the medium for systemic disease.

J Am Dent Assoc, 1986 Feb, 112(2), 194 - 7
Arresting caries by sealants: results of a clinical study; Mertz-Fairhurst EJ et al.; In each of 14 patients, one bilateral occlusal carious lesion was sealed and the other lesion was left open as a control . The control lesions showed patterns of sudden increases in cavity depth, as well as evidence of being active bacteriologically; whereas, with one exception, the sealed lesions were inactive bacteriologically . The residual carious material in the sealed lesions suggested a complete cessation of the carious process . No clinical or radiologic signs were seen to suggest that the health of the sealed tooth had been compromised.

J Dairy Res, 1986 Feb, 53(1), 17 - 22
Effects on mastitis of overmilking in conjunction with pulsation failure; Mein GA et al.; Half-udder comparisons were made using 56 cows for 2 months, in an experiment involving high bacterial challenge, to assess the combined effects of 5 min overmilking and pulsation failure (resulting from the use of shortened teacup liners) on teat condition and mastitis . Only three new infections were confirmed in over 12500 quarter milkings in quarters milked with control liners (of 148 mm effective length) indicating little or no effect of prolonged overmilking in these quarters . A 3.5-fold increase in the new infection rate (NIR) based on bacteriological diagnosis alone (P less than 0.01), or a 9-fold increase in NIR based on bacteriological diagnosis plus raised cell count and/or N-acetyl-beta-D-glucosaminidase (P less than 0.01), occurred in quarters milked with the same liners shortened to an effective length of 120-130 mm . The mean interval to infection or teat canal colonization (41 v . 60 milkings), and for a quarter infection to be confirmed by other diagnostic tests (45 v . 79 milkings) was significantly less in quarters overmilked with short liners . The results confirm that NIR increases whenever pulsation fails . Overmilking may increase NIR when it is associated with pulsation failure.

Vet Rec, 1986 Jan 4, 118(1), 17 - 9
Field trials with cefoperazone in the treatment of bovine clinical mastitis; Wilson CD et al.; A single dose of 250 mg cefoperazone in an oil based suspension infused into bovine quarters suffering from clinical mastitis resulted in an overall clinical cure of 82 per cent in 597 cases, as assessed by veterinarians in four countries (Sweden, Denmark, France and the United Kingdom) . Of those cases for which adequate bacteriological data were available 69 per cent of 434 cases were cured . There were no reports of adverse reactions following therapy of an affected quarter . The introduction of single dose treatment represents an advance in mastitis therapy as it offers a simpler and shorter treatment than most present day mastitis therapeutics when used according to recommendations.

Vet Q, 1986 Jan, 8(1), 5 - 11
The efficacy of mesenteric lymph node biopsy in the eradication of paratuberculosis from an infected dairy farm; Benedictus G et al.; Lymph node biopsy was performed on animals older than nine months on a dairy farm which carried 223 animals and was severely affected by paratuberculosis . Biopsies were examined histologically and bacteriologically for the presence of M . paratuberculosis infection . In this way paratuberculosis infection was diagnosed in 29 animals, in which other diagnostic methods (serum complement fixation test, intradermal johnin test and microscopic examination of the faeces) produced negative results . The value of lymph node biopsy is the early detection of infected animals . In the two years after the biopsies, no further cases of clinical paratuberculosis were detected on the affected farm, although infection with M . paratuberculosis persisted.

J Cancer Res Clin Oncol, 1986, 111(1), 54 - 8
Leukocytosis in non hematological malignancies--a possible tumor-associated marker; Shoenfeld Y et al.; Leukocytosis (WBC counts 10,000/mm3) was detected in 77 out of 252 patients (30%) with ten different types of nonhematological malignancy (NHM) at the time of diagnosis . A full search including serological and bacteriological screening was performed to exclude other possible causes of leukocytosis . Among the different tumors, carcinomas of the lung and colorectum were the most prevalently associated with leukocytosis . Absolute monocytosis was found in 25% of the patients and absolute eosinophilia in only 4.8% . The leukocytosis was attributed mainly to an increase in the mature polymorphonuclears, suggesting a release mechanism of WBC from storage pools by factors secreted or induced by the tumor . Neither the age nor the sex of the patients affected the incidence or magnitude of leukocytosis . However, the presence of metastases was associated with a significantly higher incidence of leukocytosis (p less than 0.05) . The associated leukocytosis may be regarded as a poor prognostic sign, and was associated with a significantly (p less than 0.007) shorter survival time . In contrast, absolute lymphocytosis may have a positive effect on the survival time (p = 0.01) . Tumor-associated leukocytosis may be an additional tumor-associated marker, of value in assessing and monitoring patients with NHMs.

Chest, 1986 Jan, 89(1), 75 - 7
Initial roentgenographic manifestations of bacteriologically proven Mycobacterium tuberculosis . Typical or atypical?
Farman DP, Speir WA Jr.
Admission chest roentgenograms were reviewed of all patients diagnosed with pulmonary and extrapulmonary tuberculosis (TB) at the Medical College of Georgia--Eugene Talmadge Memorial Hospital (MCG-ETMH) during a five-year period from 1979 to 1983 . Of 75 patients included, 51 had pulmonary TB, whereas 24 had extrapulmonary infection . Cavitary disease was common (28 of 51 patients with pulmonary TB) . Forty-four of 51 patients with pulmonary TB had involvement of apical and/or posterior segments of the upper lobes with cavitation or infiltrates . Pleural effusion, parenchymal nodules, lymphadenopathy, and lower lung field disease were uncommon . Thirteen of 24 patients with extrapulmonary TB had abnormal admission chest roentgenograms, suggesting the possibility of Mycobacterium tuberculosis infection . Despite recent studies suggesting that TB presents with atypical roentgenographic features more commonly than reported in the past, the roentgenographic manifestations of TB in our series were typical of those previously described as pathognomonic for the disease.

Cornell Vet, 1986 Jan, 76(1), 91 - 104
The prevalence of paratuberculosis in culled New England cattle; Chiodini RJ et al.; The prevalence of bovine paratuberculosis in New England was determined to be 18% based on a random survey of abattoir cattle . Six tissues from each of 100 animals were examined by histologic and bacteriologic methods . The cecal lymph node and the ileocecal valve yielded positive cultures most frequently, but isolations were also made from liver, tonsil, colon, and ileum . On the basis of the prevalence data, the economic significance of paratuberculosis to the New England dairy industry was estimated in excess of +15.4 million annually . Field studies identified 25 infected herds in New England . One of the infected herds from Connecticut was sold at public auction, an act which resulted in the dissemination of 95 potentially infected cattle to 28 farms in 8 different states.

Zentralbl Chir, 1986, 111(23), 1476 - 81
{Peritoneal lavage as a standard therapeutic principle in diffuse purulent peritonitis}; Kujath P et al.; Programmed peritoneal lavage was performed on 72 patients with diffuse purulent peritonitis . The intervals up to planned relaparotomy were one to two days . An average of 4.2 lavages was conducted . The abdominal cavity was provisionally closed . Eleven of 34 patients with incurable trias survived . Histological and bacteriological follow-up checks produced evidence to rapid healing of peritonitis in the course of the lavage programme.

Drugs Exp Clin Res, 1986, 12(11), 905 - 9
Efficacy and stability of two chlorine-containing antiseptics; Pappalardo G et al.; Dakin's solution and a chloroxydizer in a hypertonic sodium chloride solution were tested for bacteriological and clinical effectiveness and stability . No real difference in effectiveness was observed between the two products; however, only the chloroxydizer showed satisfactory stability at 150 days under the test storage conditions.

Ann Otolaryngol Chir Cervicofac, 1986, 103(7), 455 - 63
{Choice of the 3d portion of the jejunum for reconstruction of the pharynx in circular pharyngolaryngectomies . Indications and advantages}; Trotoux J et al.; Many procedures are used for reconstruction of a pharyngeal gutter after circular pharyngolaryngectomy, interrupter of digestive continuity . The operation chosen was used of third part of jejunum for reconstruction, and its indications and limitations are described . The choice was based on anatomic data from dissection of 100 cadavers and values for different measurements performed (length of transplant, height of mesentery, caliber and length of vessels), and more particularly on constancy and reliability of vascularization of this digestive segment . To these advantages are added bacteriologic, technical, histologic and physiologic reasons . Results are analyzed of 11 operations carried out in the same department, from among a larger group comprising now 45 cases . Postoperative course was usually uncomplicated with rapid restoration of deglutition (a mean of 11.77 days in 9 of the 11 cases) . Preoperative radiotherapy is not a contraindication and postoperative radiotherapy should be given routinely as a complement to surgery . It is usually well tolerated and transplant necrosis is not provoked . Nevertheless, the seriousness of this type of lesion is underlined by the high incidence of carcinologic failures, with an elevated risk of local and regional recurrence and of distant metastases.

J Hyg Epidemiol Microbiol Immunol, 1986, 30(4), 405 - 9
Water-borne Mycobacterium xenopi--a possible cause of pulmonary mycobacteriosis in man; Horak Z et al.; In the years 1980-1983 M . xenopi was isolated from the sputum of 37 persons, 30 of them living in the agglomeration of the regional town in the region of Northern Bohemia with 1,175,000 inhabitants . Only 7 of these 30 had manifestation of pulmonary disease . M . xenopi was found repeatedly in the sputum in 5 patients out of 7 affected and in 2 out of 23 persons who showed no signs of a disease . The prevalence was in males between the age of 52-67 years . All of them suffered from other diseases, as chronic bronchitis, TB healed after lobectomy, lung cancer, fibrotic lung lesions, diabetes mellitus, gastric ulcer healed by resection, chronic alcoholism . Investigations were made for detection of the source of infection . Bacteriological examinations of cold and warm tap water in flats of 9 persons with M . xenopi in their sputa were carried out, as well as cold and warm tap water from flats of 2 healthy persons . M . xenopi was found in tap water of 5 persons with M . xenopi in their sputum and in one of the two healthy persons . In the water of one household we found M . kansasii . We came to the conclusion, that transmission carried out in susceptible persons is most probably due to aerosol during washing and showering with water, containing these mycobacteria.

Acta Neurochir (Wien), 1986, 83(1-2), 20 - 3
Ventriculostomy-related infections--an epidemiological study; Stenager E et al.; In a prospective study involving a total of 87 ventriculostomies, ventriculostomy-related infections (based upon a bacteriological definition) developed in 15 patients (17.2 per cent) . Intraventricular haemorrhage was related to a higher infection rate . Infection was most frequent within the first days after the external ventricular drain (EVD) was inserted . There was no relation between infection and the number of manipulations of the EVD or antibiotic treatment during the time of EVD placement.

Ann Pathol, 1986, 6(3), 217 - 20
{Lumbar osteomyelitis of actinomycotic or atypical mycobacterial origin?}; Pialat J et al.; A case of lumbar epiduro-vertebral actinomycosis is related, in a 45 years old man, who was immuno depressed by an evolutive pulmonary sarcoidosis . 72 similar cases are reported in the literature . 50 of them are autopsied++ . Clinically our patient looked like a Pott disease . The infection began probably in the kidney . The smear's diagnosis was actinomycosis, confirmed by the routine examination . An atypical mycobacteria, Mycobacterium xenopi was bacteriologically isolated twice in the pus . It was considered as the pathogen agent for 14 months . Actinomycosis was never identified bacteriologically . The patient responded to surgery and penicillin therapy . In view of the pathologic constatations and the therapeutic response, the final diagnostic was epiduro-vertebral actinomycosis . Mycobacterium xenopi acted probably as an "accompaning " germ in this case.

Ann Otolaryngol Chir Cervicofac, 1986, 103(4), 223 - 6
{Epidemiology of postoperative infections in cervicofacial surgery}; Castelain MH et al.; Post-operative infections are studied about 150 patients distributed in five groups according to type of surgery (total pharyngolaryngectomy, hemilaryngectomy, bucco-pharyngectomy, cordectomy, cervicotomy) . An antibiotic prophylaxis by penicillin G and metronidazole was prescribed for all groups excepted the last . Only sixteen patients (seven of whom in bucco-pharyngectomy group) developed a local infection, therefore these antibiotics are indicated until mucosa cicatrisation . Systematic bacteriologic study of cervical drains is useless because they are frequently positive with non-pathogenic germs and in case of local infection the responsible germ is different of the germ obtained by culture of drain.

Int Orthop, 1986, 10(3), 201 - 7
Tuberculous osteomyelitis . A review of 125 cases; Martini M et al.; One hundred and twenty-five cases of tuberculous osteomyelitis have been observed by the authors since 1968 . The site of the lesion and the clinical and radiological findings have been analysed . The importance of accurate diagnosis by bacteriological and histological investigation is emphasized . Pitfalls in the differential diagnosis with chronic haematogenous osteomyelitis are described . Treatment is by chemotherapy, and immobilization is useless . Operation was limited to the drainage of three large abscesses . A favourable response to chemotherapy was obtained in 92% of the 105 cases which were followed up . The role of a super-added pyogenic bone infection in 8 cases of persisting sinus after chemotherapy is discussed . Finally, the authors stress the importance of preventing the development of tuberculous arthritis by the correct diagnosis and treatment of juxta-articular tuberculous osteomyelitis.

Z Erkr Atmungsorgane, 1986, 167(1-2), 52 - 7
{Diagnostic value of various tuberculin preparations}; Mydlak G et al.; Despite declining incidence of tuberculosis in developed countries importance of tuberculin testing has not subsided . Previous investigations of the equivalence of 7 tuberculin preparations from 6 countries to RT 23 have shown differences in the diagnostic value of the tuberculin preparations . The smallest rates of negative skin-reactions in cases with bacteriologically confirmed tuberculosis were found with the hungarian tuberculin PPD-5 TU (HU 5 TU) and RT 23 . The national tuberculin PPD Dessau 2 TU showed highest rates of non-reactors in tuberculous patients . In 400 cases of active bacteriologically confirmed tuberculosis further investigations were carried out to compare biologic equivalence of RT 23, HU 5 TU, tuberculin PPD Dessau 2 TU and the test-preparation PPD Dessau 5 TU with and without Tween addition and 7.5 TU without Tween . The results showed that with increase of antigen concentration to 5 TE or 7.5 TU the smaller reactions of 6 to 10 mm could be strengthened with a small, statistically not significant, increase of the mean value of reaction size but no increase of larger reactions of more than 20 mm . The rate of false negative reactions decreased using the test-preparation PPD 7.5 TU . The results allow to recommend the production of a national tuberculin preparation with higher antigen concentration biologically equivalent to RT 23 or HU 5 TU.

Z Erkr Atmungsorgane, 1986, 167(1-2), 163 - 7
The efficiency of chemotherapy with immunomodulators for patients with destructive lung tuberculosis; Khomenko AG et al.; Immunomodulators are to be prescribed to tuberculous patients in accordance with clinical and immunologic indices for 2 months . Taking into account that levamisol in dose 100 mg/24 hours is well tolerated by the patients and is as efficient as in the dose 150 mg/24 hours it is recommended to use this agent in dose 100 mg/24 hours three times a week . As it became evident from the clinical-roentgenologic, bacteriologic and immunologic data diuciphon is better tolerated by the patients and more efficient than levamisol.

J Gynecol Obstet Biol Reprod (Paris), 1986, 15(5), 571 - 4
{Frequency of vulvovaginal infections in independent practice}; Caspard H et al.; In the autumn of 1983 a representative sample of 78 gynaecologists practising independently were asked about the incidence and the bacteriological diagnosis of vulvovaginal infections in their practices . From this enquiry one can estimate that between 1 and 1.3% of French women who were over 18 years of age saw their gynaecologists complaining of vulvovaginal infections in the months of September and October 1983 . The organisms that were most frequently found on bacteriological examination were candida (49%), non-specific non-pathogenic germs (47%) and trichomonas (20%).

Chemotherapy, 1986, 32(4), 383 - 90
Ceftriaxone in the treatment of bacterial meningitis in children; Prado V et al.; A total of 24 pediatric patients with a diagnosis of meningitis, confirmed by positive CFS culture, were enrolled in the study . All patients received ceftriaxone in different doses . No difference in clinical outcome was found between the patients who received ceftriaxone twice a day and the 11 who received the drug as a single daily dose . The latter dosage proves to be preferable . The therapeutic outcome in this series of patients was 22 cured and 2 failures . Bacteriological and pharmacokinetic findings are discussed.

Avian Dis, 1986 Jan-Mar, 30(1), 234 - 7
Clinical outbreak of Bordetella avium infection in two turkey breeder flocks; Kelly BJ et al.; An acute upper respiratory disease was observed in two broad-breasted white (BBW) turkey primary breeder flocks . Associated clinical signs included sneezing, depression, and a deep dry cough originating from large conducting airways . Morbidity reached approximately 15-20% of the hens in an affected house . None of the turkeys died, and total feed consumption was not affected . A minimal effect upon egg production was noticed . Sera from an acutely affected flock exhibited a marked rise in titer to Bordetella avium compared with preinfection sera samples . In Case 1, B . avium was isolated in pure culture from affected birds . In Case 2, B . avium was diagnosed by serological results and clinical signs; bacteriological examination was not attempted . The findings presented here are consistent with an acute clinical outbreak of B . avium-induced turkey rhinotracheitis (turkey coryza) in BBW turkey breeder hens.

Rev Mal Respir, 1986, 3(2), 93 - 7
{Antitubercular therapeutic regimens routinely prescribed in Bas-Rhin and results of treatment}; Liard R et al.; The overall plans and therapeutic regimens prescribed for new cases of pulmonary tuberculosis notified in the Bas-Rhin in 1979 to 1980 (372 Subjects) were studied, as were relapses occurring over a three year period from the date of notification . As in the preceding analysis of cases between 1970/78, the proportion of patients treated exclusively at home was low (22.8%) and the duration of stay in a Sanatorium was lengthy (mean 86.6 days for cases without bacteriological confirmation and 142.3 days for bacteriologically positive cases) . The mean duration of chemotherapy was 12.5 months (+/- 3.7) . The therapeutic regimens prescribed showed a significant variability: if 80.6% of patients received, at one time or another, the combination of Isoniazid (H), Rifampicin (R) and Ethambutol (E), only 33.9% of the adults treated received the HRE/HR regimen, for periods of variable duration . Four relapses were seen during the fixed follow-up period.

Digestion, 1986, 34(1), 15 - 21
Histology and bacteriology of closed duodenal loop models of experimental acute pancreatitis in the rat; Dickson AP et al.; Three variants of closed duodenal loop models of experimental acute pancreatitis in the rat have been analysed histologically and bacteriologically . Histological studies showed that the resulting pancreatitis was usually mild to moderate, being severe only in association with sepsis . Furthermore the duodenal wall became necrotic in most animals . Bacteriological studies revealed gross infection as a major complication . Peritoneal fluid and blood cultures taken at the time of animal sacrifice consistently demonstrated large numbers of bacteria . It is concluded that although these models undoubtedly cause acute pancreatitis, other more severe pathological events occur . Deductions regarding acute pancreatitis drawn from this type of model are therefore not relevant to the human disease.

J Dairy Sci, 1986 Jan, 69(1), 27 - 31
Significance of the presence of bovine milk beta-glucuronidase in mastitis detection; Perdigon G et al.; The presence of beta-glucuronidase enzyme in bovine milk was related both to the existence of major and minor pathogens and to somatic cell counts . The detection of this enzyme in whole milk was made possible by the use of p-nitrophenyl-beta-glucuronide as a substrate . This detection allowed us to determine abnormal udder secretions with a high degree of specificity and sensitivity . The particular method of enzyme determination was considered important for mastitis detection because beta-D-glucuronidase, the most significant enzyme in inflammatory processes, is released selectively . The relationship between enzyme, presence of pathogens, and somatic cell counts was established in 220 milk samples obtained at random from individual quarters of apparently healthy udders of cows from four local dairy farms (Santiago del Estero and Tucuman, Argentina) . Four of these samples were from cows of recent parturition and two from cows with severe clinical mastitis . Only 17% of the milk samples were normal with somatic cell counts 500,000 cells/ml or less . This ratio is the usual one throughout the area, and the remaining 83% showed higher somatic cell counts . Taking the latter as 100%, the presence of beta-glucuronidase and the positive bacteriological analyses represented 76 and 74%, respectively.

J Int Med Res, 1986, 14(3), 153 - 7
Clinical experience with intravenous Augmentin in the treatment of paediatric infections; Ploechl E et al.; The clinical efficacy of intravenous Augmentin (a formulation containing amoxycillin plus clavulanic acid) was investigated in an open study in fifty-eight children with a mean age of 6 years (range 1-15 years) . The normal dosage was in the range 100-200 mg/kg/day Augmentin, administered parenterally by short i.v . infusion in 3 or 4 divided doses . Most patients were hospitalised for lower respiratory tract infections . Complete clinical cure or distinct clinical improvement was achieved in all assessable cases . Bacteriological success was obtained in 92% of the assessable cases . In two patients, mild, transient exanthema was noted after i.v . Augmentin was replaced by oral Augmentin . No additional therapeutic measures were required.

Chir Pediatr, 1986, 27(6), 359 - 62
{Osteoarthritis due to Kingella kingae . Apropos of 4 cases}; Clement JL et al.; The authors describe for cases of osteoarthritis with Kingella Kingae, among children . This gram less than 0 germ, which is not well known, tends to be located in bones and joints . In the light of for observations and some of the cases yet observed, we could identified the clinical, biological, and bacteriological characteristics of this germ that has been just described.

Chir Pediatr, 1986, 27(6), 339 - 47
{Subacute or initially chronic osteomyelitis in children . A series of 17 cases}; Gaubert J et al.; 17 cases of subacute or at once chronic osteomyelitis are shown . At this occasion, an analysis of epidemiological, topographical, clinical and bacteriological data is given . An immunological study has been made in 5 cases: diagnosis is difficult at all stages . A reflexion is proposed concerning the treatment to be performed.

Drugs Exp Clin Res, 1986, 12(12), 979 - 81
Rapid disappearance from the intestinal tract of bacteria resistant to rifaximin; De Leo C et al.; The appearance in the faeces of resistant bacteria after oral treatment with Rifaximin, a new, non-absorbable rifamycin derivative, was investigated . To evaluate the degree of colonization of the intestinal tract by the Rifaximin-resistant strains, long-term bacteriological monitoring of the faeces of drug-treated volunteers was carried out . The data obtained showed that after suspension of treatment the resistant bacteria disappeared rapidly.

Ann Rech Vet, 1986, 17(4), 409 - 24
{Experimental study of diarrhea induced by a strain of Escherichia coli (serogroup O-103) in growing rabbits}; Camguilhem R et al.; The experimental infection by mouth of weaned, 6 week old rabbits was performed with Escherichia coli strain O-103/10 without any adjuvant . The quantities of E . coli for the 3 experimental treatments were - none (control) - 10(4) or 10(7) per animal . The 142 rabbits were divided into 2 groups, each including the 3 treatments: A - observation of weight and eventual diarrhea during 25 days after infection; B - killing during the same period of some healthy and diarrheic animals every 2 or 3 days, for physiological, bacteriological, and histological observations . In the A group, mortality after 25 days was 0/24 in the control, 12 and 15/24 for 10(4) and 10(7) treatments respectively, but it was observed earlier for the 10(7) one . Diarrhea has been observed for 90% of infected and 20% of control rabbits, at first on day 7, 12 and 20 post-infection for the 10(7), 10(4) and control treatments respectively . The mean duration of diarrhea was 4 days in infected and only 2 in control rabbits . Always, diarrhea and weight lost were observed before death . Although the slowing down of growth rate during the experimental period, at the end, mean live weight was quite the same for animals surviving in the 3 treatments . Necropsy of killed rabbits of the B group, revealed hemorrhagic damages mainly on cecal and colonic wall, associated with high counts for E . coli (10(7) to 8 X 10(9} in the cecal content . In rabbits with highest counts (9/15), E . coli was also observed in blood . In diarrheic rabbits cecal pH was higher (6.61 vs 5.82) and cecal VFA concentration lower (53 vs 98 mM/l) than in healthy ones; but the proportions of acetic, propionic and butyric acids were not significantly affected . At constant VFA concentration in the cecum, pH and E . coli counts were correlated (r = + 0.35) . Histology revealed first, attachment of bacteria to the apex of villi cells, and furthermore destruction of the epithelium with hemorrhages and necrosis . Thus the strain O-103/10 of E . coli is confirmed to be pathogenic and will provide a good experimental model for studies of diarrhea due to E . coli.

Nahrung, 1986, 30(7), 687 - 92
The effect of proteolytic enzymes on the thermostability of egg-white; Niewiarowicz A et al.; The effect of proteolytic enzyme preparations such as Proteopol PB (bacterial origin), ficin, and pancreatin on the thermostability of egg-white proteins during pasteurization was investigated . Proteolytic activities of each enzyme were measured at three different doses which were calculated by the ANSON method . The degree of white protein degradation was evaluated by the determination of amino-nitrogen . Effectiveness in reducing the coagulation of egg-white proteins varied, depending on the type and dose of enzyme used . Proteopol PB showed only little effect, ficin demonstrated the best anticoagulation properties at the lowest dose, while for pancreatin the middle dose proved to be the most effective . It was concluded that moderate proteolysis is useful for improving the thermostability of egg-white proteins during pasteurization . Total bacterial counts increased considerably after incubation of egg-white with enzyme preparations, but after pasteurization the number of bacteria decreased to levels which were compatible with bacteriological standards for egg-white products.

Z Erkr Atmungsorgane, 1986, 167(1-2), 29 - 41
{Daily ultrashort chemotherapy and intermittent short-term chemotherapy with 4 drugs of communicable pulmonary tuberculosis treated for the first time . Results of a cooperative multicenter study}; Eule H et al.; Three short-course regimens, all comprising isoniazide (H), rifampicine (R), streptomycine (S) and pyrazinamide (Z), are compared in a randomized prospective cooperative clinical trial . The drugs are given daily in a 3-month regimen (3-HRSZ), twice a week in a 6-month regimen (6-HRSZ2), and in a further two-phase 6-month regimen the 4 drugs are administered 3 times a week for the first 3 months followed by the administration of HSZ twice a week (without R) for further 3 months (3-HRSZ3/3-HSZ2) . The number of patients admitted to study is 80, 144 and 139 respectively . The 3-month regimen has been stopped because of a high rate of relapses . 17 p.c . of the patients admitted have to be excluded from analysis for various reasons, out of these 5.8 p.c . because of adverse reactions . Two thirds of the patients had heavily positive sputum cultures at the start . 300 patients completed therapy . At the end of therapy cultures were negative in 94 p.c., 100 p.c . and 99 p.c . respectively . The rate of bacteriological relapses is 19 p.c . in 3-HRSZ, 9 p.c . in 3-HRSZ3/3-HSZ2 and 3 p.c . in 6-HRSZ2, during a follow-up period of 3-4 years after completing therapy . The acceptability was good in all treatment groups . Adverse reactions like "flu" were rarely observed . Increased blood urea was common but in general without clinical symptoms . Elevation of ALAT and ASAT was relatively frequent but mostly transient and without clinical importance . The results served as basis for the new "Recommendation for Treatment of Tuberculosis" and are interpreted with regard to practical consequences and possibilities for further rationalisation of treatment.

Z Erkr Atmungsorgane, 1986, 167(1-2), 23 - 8
{Case finding in Stuttgart 1980-1985 . Diagnosing institutions and cause for diagnosis}; Neumann G; From January 1, 1980, to April 30, 1985 in Stuttgart of 537 adult cases of registered bacteriologically confirmed endothoracic tuberculosis 31.1% were detected by the Public Health Office, of the 435 cases without bacteriological confirmation 40.9% . The rate of detection by general practitioners was 2.4 and 2.6 respectively in these groups from 1980 to 1982 and increased to 10.3 and 10.5% from 1983 to 1985 . With bacteriological confirmation 54.6% were detected because of symptoms, 10.2% by general examination, 7.8% by mass miniature X-ray, and 27.4% by other active diagnostic measures . Without bacteriologic confirmation the figures are 41.4, 4.1, 17.9, and 36.6% . Only very few differences as given by nationality, sex and age are statistically significant . Two of three cases with bacteriologic confirmation were positive by direct smear . If the detection was by symptoms the percentage is 74.4 which should be compared with 58.2% by general examination, 50.0% by mass miniature X-ray, and 59.2% by other active diagnostic measures . Active diagnostic must be continued in risk groups.

Scand J Infect Dis, 1986, 18(4), 337 - 45
Clinical significance of nontuberculous mycobacteria . A bacteriological survey of Swedish strains isolated between 1973 and 1981; Wickman K; An account is rendered of mycobacteria other than Mycobacterium tuberculosis isolated from specimens sent for culture during 9 years . The possible etiological significance of these bacteria was estimated from clinical data and the degree of bacterial growth . Pulmonary infection was the most common nontuberculous manifestation in the adults . In about 50% of the patients with slowly growing mycobacteria in their respiratory tract, these bacteria were considered to be an etiological factor . This applied to the species of the M . avium-intracellulare (MAI) complex and M . xenopi . M . Kansasii, a common cause of lung disease in many other countries, was rarely isolated . The corresponding figure for the rapidly growing mycobacteria belonging to the M . fortuitum-chelonei complex was 15% . These patients were all severely debilitated by other diseases . Lymphadenitis was the most common nontuberculous infection in children, but occurred only in children not vaccinated with BCG . Bacteria of the MAI complex was the predominating cause . Lung infection caused by nontuberculous mycobacteria did not occur in children.

J Hepatol, 1986, 3(1), 118 - 22
Biliary lavage with corticosteroids in primary sclerosing cholangitis . A clinical, cholangiographic and bacteriological study; Allison MC et al.; Bile duct perfusion with corticosteroids is reported to improve the cholangiographic and biochemical abnormalities in some patients with primary sclerosing cholangitis . In a randomised placebo controlled trial, thirteen consecutive patients received continuous bile duct irrigation with either normal saline (1 l/day) or normal saline plus hydrocortisone (100 mg daily) via a nasobiliary tube placed in a hepatic duct at endoscopic retrograde cholangio-pancreatography . Eleven patients completed lavage for 2 weeks but no cholangiographic changes were observed in either group . Liver function tests deteriorated during lavage, but later returned to pre-treatment levels . Although bile was sterile at start of lavage, a wide range of bacteria was isolated from bile in all patients during treatment, and cholangitis with septicaemia occurred in 2 patients . We conclude that nasobiliary lavage is not beneficial in treating primary sclerosing cholangitis.

Head Neck Surg, 1986 Jan-Feb, 8(3), 205 - 10
Identification and management of the patient at high risk for wound infection; Becker GD; Despite the use of perioperative antibiotics, wound infection remains a major source of morbidity after contaminated head and neck cancer surgery . Most adjunctive methods designed to control wound infection include techniques to reduce bacterial wound contamination . Additional methods include predicting the high risk patient and the bacteriology of subsequent wound infection, which allows antibiotic prophylaxis to be used on a selective basis . This article reviews relevant experimental and clinical data that evaluated these methods . Based on these results, as well as personal observations, guidelines are suggested for controlling wound infection in patients undergoing contaminated head and neck surgery.

Boll Ist Sieroter Milan, 1986, 65(2), 153 - 6
Prevalence of antibodies to Legionella pneumophila and micdadei in hospitalized children; Maggiolo F et al.; 217 children were studied by IFA technique to assess the incidence and prevalence of infections due to L . pneumophila and micdadei . The study was completed by a bacteriological environmental research . No acute infection was detected . Nevertheless 10.1% of all patients showed positive antibody titers . This percentage was 0 in children aged less than 1 year and reached 17.7% in children after 3 . Most positive sera were due to a pooled antigen containing L . pneumophila serotypes 1, 2, 3 . All environmental samples were negative . Our results demonstrate that our area has probably a low endemicity and that children are a low risk population . Nevertheless the absence of acute pulmonary pathology either during the period of investigation or at the anamnestic report seems to strengthen the reported possibility of infection without major pulmonary signs, with a course as an influenza-like syndrome or as an inapparent infection.

Biol Res Pregnancy Perinatol, 1986, 7(2), 71 - 3
Ceftazidime pharmacokinetics in preterm newborns on the first day of life; Padovani EM et al.; Ceftazidime pharmacokinetics were studied in 13 preterm newborns requiring antibiotic treatment, following intramuscular administration of a 50 mg/kg dose in the first 24 hours of life . The main pharmacokinetic parameters (peak concentration, time to reach peak, plasma half-life, area under the curve, elimination constant, distribution volume and plasma clearance) were determined directly from the serum concentrations observed . The clinical and bacteriological response to ceftazidime treatment was good; no side effects or alterations of biohumoral parameters were noted.

Avian Dis, 1986 Jan-Mar, 30(1), 117 - 21
Congo red medium to distinguish between invasive and non-invasive Escherichia coli pathogenic for poultry; Berkhoff HA et al.; In the course of our molecular studies of virulence factors associated with invasive avian Escherichia coli infections, it was first necessary to distinguish between common E . coli and those that cause septicemia in poultry . We found a direct correlation between the ability of clinical isolates of E . coli to bind Congo red dye (CR) and their ability to cause septicemic infection in chickens . This finding was supported by bacteriological studies of 30 broiler flocks (26 sick and 4 healthy) and by virulence studies in chickens and mice . All 144 isolates of E . coli from internal tissues of diseased birds were determined to be CR-positive (red colonies) . Congo-red-positive E . coli colonies were isolated from air sacs, pericardium, liver, lung, joint fluid, and heart blood of chickens with lesions of colisepticemia . In contrast, of 170 E . coli isolates from the poultry house environment and from the trachea and cloaca of healthy birds, more than half were CR-negative (white colonies) . No CR-negative (white) E . coli colonies were found in internal organs from birds with typical lesions of colisepticemia . We feel that these preliminary findings suggest that the CR dye binding could be used as a phenotypic marker to distinguish between invasive and noninvasive isolates.

J Hist Behav Sci, 1986 Jan, 22(1), 27 - 44
Lashley's shift from bacteriology to neuropsychology, 1910-1917, and the influence of Jennings, Watson, and Franz; Bruce D; From 1910 to 1917, Karl S . Lashley's research moved from bacteriology to neuropsychology through intermediate stages of zoology, comparative psychology, and the psychology of learning . This shift is examined with particular reference to Lashley's associations with John B . Watson, Shepherd I . Franz, and Herbert S . Jennings . Watson's impact was substantial, for he attracted Lashley to comparative psychology and was the source of many of his later research interests . The bridge to neuropsychological research was provided by Franz who trained Lashley in the lesion method of investigating the brain bases of learning . The influence of Jennings, Lashley's Ph.D . supervisor, was most evident in the divergence of the post-1915 interests of Lashley and Watson . Lashley's search for brain mechanisms of learning, as contrasted with Watson's concern with behavioral prediction and control, mirrored a similar earlier difference between Jennings and Jacques Loeb.

Z Erkr Atmungsorgane, 1986, 167(1-2), 197 - 204
{Aspects of tuberculosis control in the Republic of Nicaragua}; Willroth PO; In the years of Somoza-dictatorship the number of cases with tuberculosis important by increased and the fight against tuberculosis was not efficacious . After the revolutionary triumph under direction of the Sandinista National Liberation Front on 19 . July 1979 control of tuberculosis was founded with following main points: BCG-vaccination, detection of patients with smear-positive tuberculosis, bacteriological supervision of chemotherapy and examination of contact persons . Annual risk of infection is actual more than 1% . In the present time USA-administration violates permanently national sovereignty of Nicaragua with disadvantage for control of tuberculosis . Conclusion: Supports and peace for the Republic of Nicaragua.

Infection, 1986, 14 Suppl 4, S283 - 9
Ofloxacin in lower respiratory tract infections--a comparison with amoxicillin; Devogelaere R et al.; This study aimed at determining the clinical efficacy and clinical and biological safety of ofloxacin compared to amoxicillin . 44 patients were included, and 41 were evaluable . 33 patients were treated according to the randomization list, whereas 11 patients were treated in an open study . All patients were suffering from acute, recurrent or chronic, lower respiratory tract infections . 29 patients started ofloxacin treatment with a dosage of 200 mg or 300 mg b.i.d., and 15 other patients received 1 g amoxicillin b.i.d . or t.i.d . Three patients of this last group were treated with ofloxacin after amoxicillin treatment failure . Bacteriological eradication was achieved in 95% of ofloxacin-treated and in 78% of amoxicillin-treated patients . Clinical cure occurred in 86% of ofloxacin- and in 55% of amoxicillin-treated patients . Successful treatment (bacteriologic eradication associated with clinical cure) was observed in 75% of patients from the ofloxacin-group and in 36% of the amoxicillin-group . No clinical adverse reactions were seen in amoxicillin-treated patients, whereas one patient in the ofloxacin-group was complaining of mild, definitely drug-related, hypochondrial pain . No major drug-related disturbances of biological parameters were observed neither in the ofloxacin- nor in the amoxicillin-group.

Infection, 1986, 14 Suppl 4, S279 - 82
Clinical evaluation of ofloxacin in lower respiratory tract infections; Kobayashi H; The clinical efficacy and the safety of ofloxacin in lower respiratory tract infections were evaluated by 42 research groups in Japan . 127 patients with bacterial pneumonia and 399 patients with chronic lower respiratory tract infection were analyzed for clinical efficacy . The drug was orally administered, mostly in daily doses of 300 mg to 600 mg for an average of 15 days . The therapeutic success rate was 80% in bacterial pneumonias and 78% in chronic lower respiratory tract infections . As for bacteriological response, eradication rates of 93% and 72%, respectively, were observed against isolates from bacterial pneumonias and chronic lower respiratory tract infections . Side effects mainly in the gastrointestinal tract and central nervous system were noted in 7.6% of 540 patients, but none of them was severe.

Acta Chir Scand Suppl, 1986, 530, 35 - 8
The significance of bacteriological findings at cholecystectomy; Brismar B et al.; The value of routine bacterial culture and gram staining of bile intraoperatively was investigated in 84 patients undergoing cholecystectomy . A positive bile culture was found in five of eight patients with an acute cholecystitis and in three of five patients with stones in the common bile duct, but in only nine of 66 patients with chronic cholecystitis without a common duct stone (14%) . None of the patients with a normal gallbladder wall or cholesterolosis were bacteria-positive . Immediate microscopy of bile showed positive results in eight of 17 culture-positive bile specimens . As the majority of strains isolated from bile were aerobes sensitive to ampicillin and trimethoprim-sulphamethoxazole, any of these antibiotics can safely be administered intraoperatively to patients belonging to the risk group (acute cholecystitis, common bile duct stone) . Immediate microscopy of bile is an unrealiable method of limited value and is not recommended for routine use.

Swed Dent J Suppl, 1986, 31, 1 - 38
Hereditary amelogenesis imperfecta . An epidemiological, genetic and clinical study in a Swedish child population; Sundell S; Hereditary Amelogenesis Imperfecta (HAI) is a hereditary dental enamel disorder showing a varying clinical picture . Reviewing the literature, there seems to be a need for a better knowledge in many aspects concerning this disorder, not least to enhance the therapeutical approach for individuals suffering from HAI . The aims of this thesis, were to identify and to classify hereditary enamel defects and to estimate their prevalence in a Swedish child population . The oral health of individuals diagnosed as having HAI was also analysed and evaluated . 425 000 children, from the western part of Sweden, aged 3-19 years, were screened in order to identify individuals showing enamel defects of hereditary linkage . In this way, 105 children were identified . They were clinically classified into 12 different subgroups . Genetic analyses were also made . In 99 children, the oral health status was analysed and evaluated . In another patient material, 26 individuals aged 8-20 years and with HAI, the anterior open bite malocclusion was studied . The prevalence of HAI was estimated to be 1 case in 4000 . In analyses of genetic data, eight different subgroups of HAI were identified based on the two major types, the hypoplastic and the hypomineralized . The hypoplastic, rough-pitted type with autosomal dominance, represented the most common HAI disorder . A low caries susceptibility was found in children with severely hypoplastic and hypomineralized enamel . Bacteriological and salivary data in the children could not fully support the findings regarding the low caries susceptibility . A high number of restorations were recorded predominantly in severe cases of the hypomineralized type, in which group gingival inflammation, plaque and dental calculus also were frequently found . The open bite occlusion could be associated both with the hypoplastic and the hypomineralized types of HAI . This malocclusion was considered to be of skeletal origin . The prevalence found shows that HAI is a fairly common enamel disorder with a varying clinical expressivity . The oral health findings in individuals suffering from the disorder indicate a need for early treatment planning.

Rev Stomatol Chir Maxillofac, 1986, 87(2), 73 - 7
{Are orodental infectious foci responsible for bacterial pneumopathies? A statistical study}; Chabrand F et al.; A statistical study compared a group of 38 patients with clinically and bacteriologically confirmed bacterial pneumonia with a control group of 33 subjects . Results facted to demonstrate any significant role for buccodental infection in the genesis of bronchopulmonary infections capable of inciting stomatologists to adopt drastic measures with respect to mortified teeth within the framework of pulmonary disease.

Pharmatherapeutica, 1986, 4(10), 628 - 36
A clinical trial of hydrocortisone/potassium hydroxyquinoline sulphate ('Quinocort') in the treatment of infected eczema and impetigo in general practice; Jaffe GV et al.; A double-blind, multi-centre study was carried out in general practice in 76 patients with infected eczema and 43 with impetigo to assess the effectiveness and acceptability of treatment with 1% hydrocortisone plus 0.5% potassium hydroxyquinoline sulphate cream compared with that of 1% hydrocortisone plus 2% miconazole nitrate cream . Patients were allocated at random to receive treatment with one or other preparation, applied twice daily, over a period of 2 weeks . Assessments were made of total symptom severity scores on entry and at the end of each week, as also were bacteriological investigations . The results showed that both combinations produced marked clinical and bacteriological improvement or cure in approximately 90% of patients with infected eczema and the success rate was similar with each preparation . In the case of patients with impetigo, hydrocortisone/potassium hydroxyquinoline sulphate proved significantly more effective than the other combination, the success rates being 92% and 74%, respectively . Patient assessment of the two topical preparations in terms of greasiness, odour and staining showed that, whilst both were considered acceptable by most, there was a trend in favour of the hydrocortisone/potassium hydroxyquinoline sulphate cream . No systemic or local side-effects were reported.

Vet Med (Praha), 1986 Jan, 31(1), 21 - 6
{Mastitis in dairy cows in large-scale farming operations from the genetic aspect}; Stanik J et al.; Genetic predisposition to mastitis was studied in 893 dairy cows of the Black Pied Lowland breed, daughters of 19 breeding bulls used in stocks with large-scale production technology and with loose housing, over the years 1980 to 1983 . Every cow with positive bacteriological diagnosis or with a clinical manifestation of the disease was considered as suffering from mastitis . High resistance to mastitis was determined in the progeny of AO-4, EM-01, NC-17, NB-10, NEB-15, NUN-3, Nx-33 bulls, while opposite results were recorded in the progeny of NAR-45, NAR-47, NER-01, NOM-19 and REN-100 bulls . Higher milk efficiency, by 9 to 408 litres of milk was observed in positive dairy cows in the years of study . The coefficient of heritability (h2) is 0.3032 . It can be concluded that the systematic control of cows from the aspect of suitability for large-scale production technology and resistance to mastitis, and evaluation of bulls according to predisposition of their daughters to this disease, is very favourable in view of the prophylaxy of bovine mastitis.

Drugs, 1986, 31 Suppl 2, 18 - 21
Sulbactam/ampicillin versus cefoxitin in the treatment of obstetric and gynaecological infections; Senft HH et al.; Preliminary results of a randomised trial comparing parenteral sulbactam 1g plus ampicillin 2g every 8 hours and cefoxitin 2g every 8 hours in 75 patients with gynaecological infection are reported . Clinical and bacteriological cure were achieved in 87% and 91% of patients treated with sulbactam/ampicillin compared with 83% and 59% treated with cefoxitin . Both treatments were well tolerated.

Drugs, 1986, 31 Suppl 2, 14 - 7
A comparison of parenteral sulbactam/ampicillin versus clindamycin/gentamicin in the treatment of pelvic inflammatory disease; Gunning J; 60 hospitalized patients with pelvic inflammatory disease entered a randomised study to compare the therapeutic efficacy and tolerability of parenteral sulbactam/ampicillin with that of clindamycin/gentamicin . All 49 pathogens isolated at entry from 21 evaluable patients in the sulbactam/ampicillin group were eradicated . 34 out of 35 pathogens isolated from 18 evaluable patients in the clindamycin/gentamicin group were eradicated . All pathogens resistant to ampicillin in vitro were eradicated . The bacteriological, clinical and overall responses for the sulbactam/ampicillin group were 100%, 85.7% and 85.7%, respectively, compared with 97.1%, 94.4% and 94.4%, respectively, for the clindamycin/gentamicin group . The sulbactam/ampicillin combination was well tolerated.

Clin Gastroenterol, 1986 Jan, 15(1), 39 - 53
Viral diarrhoea; Davidson GP; It is apparent from this review that great progress has been made over the past 10 years in defining the aetiology of viral diarrhoea . Rotavirus is a major cause of gastroenteritis in children, particularly during the winter months . However, if bacteriological and virological data are pooled, our current aetiological knowledge reveals that a pathogen is not detected in 20 to 30% of cases in most perennial investigations . Now that human rotavirus has been cultured, complete characterization may be possible . However, practical methods for cultivating many of the other possible viral pathogens are needed before they can be characterized completely . Meanwhile, electron microscopy, although time-consuming, cumbersome and expensive, is the only method for detecting many of the other potential viral pathogens . We have much still to learn about the epidemiology of these agents, particularly in the developing countries, their importance in causing chronic diarrhoea, how they are transmitted, and the immune responses to infection . The development of a potential rotavirus vaccine is exciting and creates the possibility of control for this devastating disease.

Acta Paediatr Hung, 1986, 27(2), 123 - 31
Bronchial secretions and bronchial mucosa in children with cystic fibrosis: comparison of bronchoscopic, biochemical, bacteriological, microscopic and ultrastructural findings; Wunderlich P et al.; In children (mean age 12.1 +/- 2.9 years) with cystic fibrosis, 44 bronchoscopic examinations were done under general anaesthesia with muscle relaxation using a Friedel type ventilation bronchoscope . The endoscopic picture of the mucous membranes was compared with the state of the bronchial secretions, its bacteriologic findings and content of acid mucopolysaccharides and DNA fibres (semiquantitative estimations) . In all patients biopsy of the mucous membrane (central part of the bronchial tree) was performed for light and electron microscopy . The degree of reddening, swelling of the mucous membrane and hypersecretion was in some agreement with the intensity of the cellular infiltration and the production of pus (microscopic investigation) . Secondary ultrastructural changes were detected in nearly all children, consisting of cellular oedema, swelling of mitochondria, dilatation of the endoplasmatic reticulum, protrusion of cells and fusion of cilia, enlarged intercellular spaces, thickening of the epithelial basal membrane, increased number of goblet cells, microtubular abnormalities of the cilia, lesions of the apical cell membrane with loss of cilia and microvilli . These ultrastructural changes were not correlated with the above-mentioned signs of inflammation.

J Basic Microbiol, 1986, 26(2), 117 - 26
Biochemical studies on Mycobacterium leprae; Prabhakaran K; Very little information is available on the basic biology of Mycobacterium leprae . It is not known why the organism fails to grow in bacteriological media or in cell cultures and why it has an unusual predilection for certain tissues in the human host where cells derived from the neural crest occur (e.g . skin, peripheral nerves, adrenal medulla) . Biochemical studies have revealed that M . leprae contains an unusual form of the enzyme diphenoloxidase which has not been detected in other mycobacteria . The presence of a specific glutamic acid decarboxylase in the organism has been demonstrated . Although a few enzymes of glycolysis and tricarboxylic acid cycle have been investigated, nothing characteristic of the bacterium has been discovered, and how M . leprae derives energy for its survival and proliferation still remains obscure.

Z Orthop Ihre Grenzgeb, 1986 Jan-Feb, 124(1), 19 - 21
{Differential diagnosis of osteomyelitis of the calcaneus}; Khuri S et al.; The authers avalyse 6 cases of calcaneal osteomyelitis with rather chronic development . They present radiological and clinical differential diagnostic problems . Osteomyelitis was to seperate from Sever's disease, benign and malignant bone tumours . In 3 cases only histology or bacteriology allowed the proper diagnosis.

Vet Rec, 1985 Dec 21-28, 117(25-26), 662 - 4
Rhinitis in long term captive Mediterranean tortoises (Testudo graeca and T hermanii); Lawrence K et al.; Rhinitis is a common condition of captive Mediterranean tortoises (Testudo species) . The interpretation of the results of the bacteriological examination of naso-oropharyngeal swabs from affected individuals has proved difficult, because the normal bacterial population of this region was unknown . No substantial differences in the strains of bacteria isolated from healthy individuals and from those affected by rhinitis could be found in this study . The report that Sendai virus was implicated in the genesis of rhinitis in tortoises could not be substantiated . Paired blood samples failed to show a rise in titres against Sendai virus in either study group.

S Afr Med J, 1985 Dec 7, 68(12), 879 - 80
Ultrashort-course chemotherapy for culture-negative pulmonary tuberculosis--a qualified success; Cowie RL et al.; A group of 250 patients with new or enlarging apical lung lesions which were thought to be tuberculous, and who had positive tuberculin tests but negative sputum smears and cultures for Mycobacterium tuberculosis, were treated with an ultrashort (3-month), 4-drug (rifampicin, isoniazid, pyrazinamide and ethambutol) regimen . One patient developed bacteriologically positive pulmonary tuberculosis (PTB) during the treatment period and 35 others (14%) developed bacteriologically positive PTB after completing the drug regimen.

S Afr Med J . 1985 Dec 7;68(12):878.
Diagnosis of sputum smear- and sputum culture-negative pulmonary tuberculosis; Cowie RL et al.; A group of patients with new or enlarging apical lung lesions thought to be tuberculous was randomly selected for observation without treatment . All were tuberculin-positive and all had sputum negative for Mycobacterium tuberculosis on direct examination and on culture . Of the 152 patients, 88 (58%) developed bacteriologically confirmed pulmonary tuberculosis during a follow-up period of up to 65 months.

Kidney Int, 1985 Dec, 28(6), 936 - 43
Formaldehyde kinetics and bacteriology in dialyzers; Hakim RM et al.; The kinetics of formaldehyde washout in new and reused dialyzers with 2% (w/v) and 4% formaldehyde solution was studied . Using a standard method of rinsing, the concentration of formaldehyde decreases exponentially, but the rate of decrease and the steady-state level depends on the type of dialyzer . The residual quantity of formaldehyde using a 4% solution is more than twice that seen with a 2% solution in similar dialyzers . Bacteriological tests on water-adapted, formaldehyde-resistant organisms indicate that a significant proportion of these organisms can survive a 4-hr incubation with 4% formaldehyde at 20 degrees C . However, increasing the temperature of incubation to 40 degrees C or the addition of ethanol up to 8% (v/v) improved the bacteriological efficacy of formaldehyde . Under these conditions, a 1% formaldehyde solution allows eradication of all organisms tested . Similar results were observed in multiple-use dialyzers inoculated with the same organisms . There was no effect of incubation at 40 degrees C on the in vitro clearance determinations of new and reused dialyzers.

Int J Lepr Other Mycobact Dis, 1985 Dec, 53(4), 554 - 8
A single skin lesion--an unusual presentation of lepromatous leprosy; Yoder LJ et al.; Lepromatous leprosy presenting as a solitary lesion with a high bacterial count is a rare occurrence . Such a case has been followed at the National Hansen's Disease Center, Carville, Louisiana, U.S.A., since 1977 . The lesion was located on the left elbow and had been present for about nine months . The bacterial index in the lesion was 5+ and the morphological index was 0%, but slit-skin smears elsewhere were negative . The histopathology of the lesion was that of subpolar lepromatous leprosy, and the lepromin skin test was negative . Growth of the organism in the mouse foot pad was characteristic of Mycobacterium leprae, and the patient's response to dapsone monotherapy has been excellent . Therefore, this patient with a single skin lesion has lepromatous leprosy histologically, immunologically, and bacteriologically . This case illustrates the importance of slit-skin scrapings and biopsy in new cases with unusual lesions and, secondly, suggests that there are factors yet undetermined which play a significant role in determining host response to M . leprae.

Int J Epidemiol, 1985 Dec, 14(4), 624 - 7
Health risks of snorkel swimming in untreated water; Philipp R et al.; There are certain health risks associated with recreational exposure to bacteriologically polluted water . In this study, 27% (21/77) of swimmers who took part in a snorkel swimming event, experienced gastrointestinal symptoms within 48 hours of entering the untreated water . The incidence of these symptoms was statistically significantly greater than the incidence of such symptoms reported by two control populations (p less than 0.001), but not significantly different to 25% of people who had experienced gastrointestinal symptoms in a previous snorkel event in the same water environment . As the water quality came within the confidence intervals of the EEC standards for bathing water the adequacy of these standards needs further appraisal.

Gut, 1985 Dec, 26(12), 1296 - 305
Abdominal tuberculosis in urban Britain--a common disease; Palmer KR et al.; Between 1973 and 1983 abdominal tuberculosis was responsible for the admission of 90 patients to a west London district general hospital . Over the same period Crohn's disease was newly diagnosed in 102 hospitalised patients . In contrast with Crohn's disease, the majority (75) of tuberculous patients were Asian immigrants . Mean duration of residence in the United Kingdom was 4 +/- 0.9 (SD) years, and mean age at presentation was 34.9 +/- 1.1 years . Forty per cent of tuberculosis patients presented as an acute emergency to physicians, surgeons, or gynaecologists while the remainder presented a more insidious, chronic picture . Five groups of tuberculous patients were recognised . Forty two subjects had intestinal tuberculosis characterised by pain (100%), abdominal mass (43%) and abnormal contrast radiology (100%) . Ten of these underwent emergency laparotomy for intestinal obstruction or perforation . Twenty seven patients had tuberculous peritonitis although only 16 had ascites . Eight patients presented with pyrexia and granulomatous hepatitis . Five had pulmonary and abdominal tuberculosis . The remaining eight patients represented a miscellaneous group . The diagnosis of abdominal tuberculosis was established histologically (60 cases), bacteriologically (six cases) or radiologically (24 cases) . Chest radiograph, tuberculin skin testing and paracentesis were usually unhelpful . Five severely ill patients died . The remainder recovered completely after specific triple chemotherapy and response to treatment was usually evident within 14 days . In urban Britain tuberculosis is an important cause of abdominal disease . Prognosis is excellent following specific therapy.

Tubercle, 1985 Dec, 66(4), 237 - 49
Studies of case-finding for pulmonary tuberculosis in outpatients at 4 district hospitals in Kenya; Aluoch JA et al.; This investigation is the sixth in a series of case-finding studies in Kenya . It explores the potential for case-finding by the identification of tuberculosis suspects (individuals with a cough for 1 month or more) through careful screening of general outpatients attending 4 district hospitals for the first time . Of 2299 suspects identified among 87 845 new outpatients attending the hospitals, 4.7% had culture-positive pulmonary tuberculosis, 3.6% having sputum positive on smear as well . In the 3 hospitals with radiographic facilities, 1.3% of suspects (whose sputum was negative on culture) were considered on review of their clinical history and chest radiograph by an independent assessor to have radiographically active tuberculous lesions and a further 2.5% to have inactive lesions . The proportion of bacteriologically positive cases per 1000 of the general population aged 6 years or more decreased as the distance of their homes from the hospital increased (P less than 0.001 for the trend) . However, the proportion of cases per 1000 of the suspects identified increased as the distance of their homes from the hospital increased (P less than 0.001 for the trend) . History of cough for between 1 and 12 months was the most useful factor for the identification of cases of tuberculosis among the suspects, and would have identified 92% of the smear-positive cases from the examination of 70% of the suspects; a history of weight loss identified 84% of the smear-positive cases from the examination of 64% of the suspects . A history of weight loss and/or a history of cough for between 1 and 12 months would have detected all the smear-positive cases from the examination of 89% of the suspects . The proportion of bacteriologically positive cases in the younger suspects aged 9-32 years (who had been eligible for a mass BCG campaign) was greater among the non-vaccinated than among the vaccinated suspects, 4.9% and 2.3% respectively (P=0.04), implying protection from vaccination of the order of 50%.

Am J Hosp Pharm, 1985 Dec, 42(12), 2691 - 4
Pharmacy-based distribution system for enteral nutrition products; Craig SA et al.; A hospital pharmacy department's implementation of enteral nutrition product distribution and its proposal for an enteral nutrition product admixture service are described . Responsibility for the distribution of enteral nutrition formulations was transferred from the central distribution department to the pharmacy after problems with inventory control, billing procedures, and inappropriate administration of enteral nutrition products were recognized by personnel from the central-distribution area and nutrition services . After additional problems were identified using a multi-disciplinary approach, the pharmacy department implemented an enteral nutrition product distribution system and developed an enteral nutrition product formulary . A proposal was developed for a pharmacy-based enteral nutrition admixture service, but implementation of this service was deferred because data from a cost-effectiveness evaluation and random bacteriologic monitoring did not justify adding the service . Pharmacy-based distribution and formulary control of enteral nutrition products alleviated problems with inaccurate patient charges and accumulation of stock on the nursing units . Pharmacists at this hospital hope to develop an enteral nutrition product admixture program that will result in cost savings for the institution.

J Periodontol, 1985 Dec, 56(12), 734 - 9
Current concepts of the pathogenesis of periodontal disease . Microbiology emphasis; Newman MG; A summary of the major highlights of periodontal pathogenesis research with particular emphasis on periodontal microbiology is presented . Bacteriologic specificity, periodontal disease activity, anatomical plaque research, bacterial recolonization and the concept of bacterial succession are discussed . Periodontal immunology, gingival fluid, histopathology as well as clinical research are briefly mentioned as they interrelate with periodontal microbiology.

J Med Microbiol, 1985 Dec, 20(3), 373 - 8
The role of Robertson's cooked-meat broth in the bacteriological evaluation of surgical specimens; Miles RS et al.; The results were compared of submitting simple swabs, swabs in Stuart's Transport Medium (STM) and swabs in Robertson's cooked-meat broth (RCMB), from 100 potentially or definitely infected sites in patients undergoing general surgery . Significantly more positive bacterial cultures were obtained from swabs sent in RCMB (65), than from swabs sent either in STM (39) or as simple swabs (32) . The isolation of potentially significant organisms from only the RCMB series could influence clinical management . The conventional reluctance of bacteriologists to accept evidence obtained from RCMB cultures seeded directly in the ward or at operation is challenged.

Ital J Orthop Traumatol, 1985 Dec, 11(4), 455 - 65
Control of post-operative infection in orthopaedic surgery . Clinical and bacteriological findings in 2555 elective operations; Gallinaro M et al.; Post-operative infection is still a serious problem in orthopaedic surgery . Technological advances aimed at achieving aseptic conditions in the operating theatre, and the prophylactic use of antibiotics during operation have considerably reduced this complication during the last decade . Two indispensable factors in monitoring the effectiveness of these preventive measures are the determination of the incidence of post-operative infection and monitoring of the microbacterial population of the hospital.

J Hosp Infect, 1985 Dec, 6(4), 419 - 25
Does antibiotic prophylaxis at the time of catheter insertion reduce the incidence of catheter-related sepsis in intravenous nutrition?
McKee R, Dunsmuir R, Whitby M, Garden OJ.
Fifty-five patients referred for intravenous nutrition were randomised to receive either vancomycin (500 mg) or no vancomycin immediately before catheter insertion . Catheter insertion and management were standard in all patients . The mean duration of intravenous feeding was similar in both groups (vancomycin: 17.7 +/- 9.6 days; no vancomycin: 16.5 +/- 8.8 days) . Overall, the bacteriologically confirmed catheter-related sepsis was 25% and was not reduced by the prophylactic administration of vancomycin.

Z Gesamte Inn Med, 1985 Nov 15, 40(22), 664 - 8
{Rational diagnosis in pneumonology}; Diwok K; A survey is given of the rational use of diagnostic measures in pneumonology . Of the investigations following the anamnesis and the clinical findings (radiology, bacteriology, clinical chemistry, clinical immunology, electrocardiography, functional diagnostics, computed tomography) the radiological ones are most significant . Endoscopy is used in certain questions, in case that a diagnostic clarification could not be performed with the help of the simpler investigations . Rational diagnostics are always case-related, generalizations are only conditionally possible.

Jpn J Antibiot, 1985 Nov, 38(11), 3188 - 93
{A clinical evaluation of doxycycline in the treatment of genitourinary infections caused by Chlamydia trachomatis}; Sumii T et al.; The clinical effectiveness of doxycycline (DOXY) in the treatment of chlamydial infections was studied by giving it to 14 patients composed of 9 with nongonorrheal urethritis and 5 with cervicitis, all caused by Chlamydia trachomatis . DOXY was given in an oral dose of 100 mg twice daily for 4 to 19 days . The total dosage ranged from 800 to 3,800 mg . The overall clinical efficacy as assessed on the basis of both bacterial response and relief of subjective or objective symptoms was excellent in all of 12 evaluable patients . Two patients for whom we failed to perform postdose bacteriological examinations were excluded from evaluation . No side effect related to dosing of DOXY developed.

Arch Tierernahr, 1985 Nov, 35(11), 781 - 9
{Nitrogen and amino acid resorption in the small intestine of growing swine . 1 . Animal study method, nitrogen content and amino acid composition of the small intestine chyme by administration of various proteins}; Souffrant WB et al.; The amount of endogenous N in the chyme at the end of the small intestine and the amino acid composition of the ileum chyme were ascertained with growing pigs with ileorectostomy after feeding qualitatively differentiated protein sources . In dependence on the protein used, distinct differences turned out for some amino acids with regard to their content in the ileum chyme . Bacteriologic and histologic investigations subsequent to the dissection of the test animals showed that - in comparison to the control animals-the functions of the small intestine remained the same during the time of the experiment . The experiment method described appears to be suitable for absorption investigations up to the end of the small intestine of growing pigs.

Klin Monatsbl Augenheilkd, 1985 Nov, 187(5), 361 - 2
{Polyvinyl iodine in ophthalmic surgery}; Auerbach B et al.; The importance of minimizing the number of bacteria on the conjunctive before intraocular surgery has been undisputed for many years now . Bacteriological considerations led to antiseptic measures being preferred to antibiotics . Until recently there was no antiseptic agent available which was tolerated by both the cornea and the conjunctiva . The good results obtained in the treatment of bacterial and viral keratoconjunctivitis with PVP iodine led to this study of the preoperative preparation of 41 eyes prior to cataract extraction.

J Dairy Sci, 1985 Nov, 68(11), 3087 - 94
Factors affecting ability of skim milk to support phagocytosis by bovine polymorphonuclear leukocytes; Miller RH et al.; Milk samples from quarters were collected from 48 Holstein cows at 1.5, 3, 21, and 35 wk postpartum and at 1 wk after drying off . Foremilk samples were obtained for bacteriological examination, somatic cell count of milk, and for assay of phagocytosis . Thirty-two cows in first lactation and 16 in third lactation produced by two criteria of sire selection (high milk versus multiple trait) were studied . In vitro phagocytosis was assayed four times on each original quarter milk sample, yielding 3,840 determinations . Variance components were large for cow-associated variation . Cow, stage X cow, and cow X sample dilution were 18.7, 20.6, and 6.0% of total variance . Phagocytosis was 9% higher in skim milk from third lactations than from first . Phagocytosis was highest in dry period samples, followed by 1.5, 35, 3, and 21-wk postpartum samples . Milk somatic cell count tended to be related more closely to phagocytosis than was current bacteriological status of the quarter . Skim milk from genetically higher producing cows was less conducive to phagocytosis than skim milk from genetically lower producing cows, possibly because of dilution.

J Dairy Sci, 1985 Nov, 68(11), 2995 - 3003
Effect of bull selection for somatic cell count in first lactation on cell counts and pathogens in later lactations; Vecht U et al.; Somatic cell counts were measured one time on Meuse-Rhine-Ijssel cattle in The Netherlands . Experiment 1 involved 1,741 first lactation daughters of 31 bulls . Eleven bulls with daughters with either high or low average cell count were selected for further study of their daughters in third and fourth lactation . Cell counts and bacteriological tests were performed on 684 of the older daughters . A second experiment was conducted to measure daughters in second lactation and to obtain additional daughters in first lactation . This experiment recorded cell counts of 1,071 daughters of 10 of the bulls selected in Experiment 1 . Heritability of the natural logarithm of cell count in first lactation was .081 based on daughters of 31 bulls in Experiment 1 . Geometric daughter averages ranged from 206 to 700 X 10(3) cells/ml . Transmitting ability of bulls was estimated by the regressed least squares method . Ranking of bulls on first lactation cell count was different between the two experiments . Management factors and stage of lactation effects could be responsible for these differences . Within Experiment 2, the ranking of bulls on cell counts was nearly identical between first and second lactation . Daughter groups with low average cell count in first lactation in Experiment 2 had low averages in third and fourth lactation although some changes in ranking did occur . These results are consistent with a low to moderate genetic correlation between lactations for cell count . In general, daughter groups with higher average cell count had higher percentage of quarters with mastitis pathogens.

Handchir Mikrochir Plast Chir, 1985 Nov, 17 Suppl, 32 - 6
{Primary pyogenic infections of the hand and their treatment}; Geldmacher J et al.; 314 of 814 patients with pyogenic infections of the hand were treated conservatively . In 500 cases surgical treatment was necessary . Bacteriological findings, the value of antibiotic treatment and the necessary surgical procedures are discussed.

Arch Intern Med . 1985 Nov;145(11):2120.
Toxic megacolon in typhoid fever; Gonzalez A et al.; A 40-year-old man with bacteriologically documented typhoid fever who was receiving correct antibiotic treatment developed toxic megacolon . Because of progressive clinical deterioration, the patient underwent surgical treatment, with quick postoperative improvement while receiving antibiotics and total parenteral nutrition.

Zentralbl Bakteriol Mikrobiol Hyg {A}, 1985 Nov, 260(3), 329 - 38
{Determination of the number of pathogens in bacterial suspensions using laser nephelometry in comparison to the photometry and plate counting method}; Sonak R et al.; We determined the number of bacteria in suspensions of three bacterial species (S . aureus ATCC 25923, E . coli ATCC 25922, P . aeruginosa ATCC 27853) in liquid medium using two optical methods - laser-nephelometry and photometry . These results were compared with the CFU/ml determined by the agar plate test in each suspension . Further we defined the applicable range of measurement of both optical methods . The calculated factor of correlation (r = 0.99) attested the very good conformity of the results obtained by both optical methods . The determination of the number of bacteria in suspensions by laser-nephelometry is a simple though very sensitive method . The results can well be reproduced . A further advantage of this method is the immediate information about the number of bacteria in suspension . All these facts recommend laser-nephelometry as a method useful in any bacteriological routine laboratory for determination of the number of bacteria in suspensions.

J Appl Bacteriol, 1985 Nov, 59(5), 421 - 36
Preparation of simulated clinical material for bacteriological examination; Demello JV et al.; The preparation of mixtures of bacteria to mimic the flora found in pathological material is described . Such mixtures are useful for teaching, for practical examinations, for quality control of media and methods and for use in quality assessment schemes . The design of suitable mixtures is discussed and the stabilities of mixtures in transport media and in freeze-dried preparations are compared . Transport media provide short term storage for periods of several weeks and, with various modifications, are moderately successful with some, but not all, quite delicate pathogens . Freeze-drying however, provides greater stability over periods of months, allows preservation of delicate pathogens and is the preferred method where specimen quality is important.

Handchir Mikrochir Plast Chir, 1985 Nov, 17 Suppl, 28 - 31
{Primary pyogenic infections of the hand--a disease picture over the course of time}; Flugel M et al.; The changes and developments which have taken place during the course of the last century with respect to the occurrence, severity, bacteriology and therapy of primary pyogenic infection of the hand are discussed.

Int J Pediatr Otorhinolaryngol, 1985 Nov, 10(2), 181 - 90
Pneumococcal bacteriology after pneumococcal otitis media with special reference to pneumococcal antigens; Karma P et al.; Fifty-four ears with evidence of pneumococcus (Pn) in the first acute otitis media (AOM) in 38 infants and with prolongation or recurrence of the MEF during the follow-up were observed for 7-22 months for the presence of Pn by culture or of pneumococcal antigen (Pn-ag) by counterimmunoelectrophoresis or latex agglutination methods in their MEFs . During the first three 1-month observation periods, Pn and/or Pn-ags were detected in 24% to 9% of these ears, always of the initial type/group . Later on new Pn types/groups appeared also . In two of the 9 MEFs persisting for greater than or equal to 3 months, initial Pn-ag, with culturable Pn, was repeatedly found but not for longer than 5 months . Of the 12 ears resulting in secretory otitis media (SOM) only one showed initial Pn-ag (and Pn) in the MEF of SOM . Pneumococcal type/group pattern associated with prolongation or recurrence of infection did not differ from that of initial AOM . In another series of 151 SOM ears in 97 children, Pn-ags were detected in 7 MEFs . Four of them grew Pn, each of the corresponding group . Our studies suggest that the persistence of Pn-ags in the middle ear after AOM is limited and their occurrence in the MEFs of SOM is rare . Thus, the role of the persistence of Pn-ags in prolonged, recurrent or secretory otitis media seems questionable.

Antimicrob Agents Chemother, 1985 Oct, 28(4), 548 - 51
Comparative trial of rifampin-doxycycline versus tetracycline-streptomycin in the therapy of human brucellosis; Ariza J et al.; In an attempt to compare the efficacy of rifampin-doxycycline with tetracycline-streptomycin for the treatment of human brucellosis, we administered both combinations for a 30-day period, similar to the period recommended by the World Health Organization in a prospective, randomized trial . Forty-six patients were included in the final study (36 men and 10 women); 41 had blood cultures positive for Brucella melitensis . The 28 patients in group A received tetracycline hydrochloride at doses of 0.5 g every 6 h or doxycycline at 100 mg every 12 h for 30 days plus 1 g of streptomycin a day for 21 days . The 18 patients in group B received rifampin at 15 mg/kg per day in a single morning dose plus 100 mg of doxycycline every 12 h for 30 days . For patients with focal disease from both groups, therapy was prolonged to 45 days . All patients underwent rigorous clinical and bacteriological long-term follow-up . There were no therapeutic failures in either group, and the defervescence period was similar for both groups (3.1 days for group A, 2.6 days for group B) . Two patients (7.1%) from group A had relapses, as did seven (38.8%) from group B (P = 0.024), and blood cultures again became positive for B . melitensis in all of them . In both groups treatment was generally well tolerated . The results strongly suggest that the rifampin-doxycycline combination is a less efficacious mode of therapy for brucellosis to prevent relapses than is the classical tetracycline-streptomycin combination when both are administered for 30 days . A more prolonged period of administration of the rifampin-doxycycline combination may be required to obtain the same low relapse rate as that achieved with the classical tetracycline-streptomycin treatment.

Cell Biol Int Rep, 1985 Oct, 9(10), 911 - 21
Substratum topography and cell traction on sulphuric acid treated bacteriological-grade plastic; Lydon MJ et al.; Treatment of bacteriological-grade plastic with concentrated sulphuric acid is a well known technique which increases the wettability of the surface and renders it suitable for eukaryotic cell adhesion . We have noticed that these substrata present a distinctive surface topography in the presence of a serum supplement under normal culture conditions . The adsorbed serum layer is comprised of fine furrows and ridges and the influence of adherent cells on this layer leads to minute tears and distortions in the direction of the corrugations . This provides a novel system for the investigation of cell spreading and locomotion by scanning electron microscopy.

Jpn J Antibiot, 1985 Oct, 38(10), 2716 - 34
{Clinical evaluation of S6472 (prolonged action preparation of cefaclor) in the treatment of skin and soft tissue infections . A double blind comparison of S6472 and cefaclor}; Sakai K et al.; A double-blind comparative study of S6472 and cefaclor (CCL) was conducted to evaluate the therapeutic efficacy, safety and usefulness in the treatment of skin and soft tissue infections . Either 750 mg b.i.d . of S6472 or 750 mg t.i.d . of CCL was administered orally to patients for a period of 7 consecutive days . Of the 250 cases (123 cases of S6472 group and 127 cases of CCL group) recruited in this trial, 228 cases (114 cases of S6472 and 114 cases of CCL) were adopted by the committee members for the evaluation of therapeutic efficacy, 238 cases (118 cases of S6472 group and 120 cases of CCL group) for usefulness, and 245 cases (121 cases of S6472 group and 124 cases of CCL group) were adopted for the evaluation of side effects . The backgrounds of both patients group were almost similar . The results obtained were as follows: Overall clinical effectiveness Of the 114 patients treated with S6472, excellent clinical responses were obtained in 11 patients, good in 79, fair in 19, poor in 5 (efficacy rate 78.9%), and of the 114 patients treated with CCL, excellent were in 16, good in 78, fair in 13, poor in 7 (efficacy rate 82.5%) . There was no statistically significant difference between the 2 groups . Clinical effectiveness classified by initial severity and bacteriological efficacy There was no significant difference between the 2 groups in the clinical effectiveness classified by initial severity and in the bacteriological efficacy . Side effects were noticed in 5 patients of 121 treated with S6472 (4.1%) and in 2 patients of 124 treated with CCL (1.6%), and other 13 patients developed some abnormal laboratory findings . But these undesirable reactions were mild, and developed no significant difference between the 2 groups in the incidence of side effects . There was no significant difference between the 2 groups in the usefulness of the drugs . Conclusively, 750 mg b.i.d . of S6472 is anticipative of the same clinical efficacy, safety and usefulness as compared with that of 750 mg t.i.d . of CCL in the treatment of skin and soft tissue infections.

Pathol Biol (Paris), 1985 Oct, 33(8), 858 - 60
{Value of spiral automatic plating in quantitative bacteriology}; Cattoen C et al.; The Spiral plate count method, semi-automated plating technique, presents some advantages: saving of time and materials, fast and easy counting . This method appears well adapted for studies of microbial ecology.

Jpn J Antibiot, 1985 Oct, 38(10), 2977 - 3012
{Fundamental and clinical studies on ceftizoxime suppositories in children}; Motohiro T et al.; The peak levels of serum ceftizoxime (CZX) after a single rectal administration of CZX-S at doses of 125 and 250 mg in 157 pediatric patients were occurred at 21 approximately 25 minutes in pediatric patients aged less than 1 year and over than 7 years, at 16-20 minutes in 1-3 years patients, at more than 26 minutes in 4-6 years patients . They were 9.45, 9.58, 11.71, 12.43 mcg/ml, respectively . The mean highest levels of serum CZX were 8.56, 10.66, 12.50 mcg/ml after the administration of CZX-S as less than 10.0, 10.1-15.0, 15.1-20.0 mg/kg dose respectively, all of which were occurred at 21-25 25 minutes . A close dose response was observed . The pain of insertion was not observed in any cases . The discharge of melted suppository or defecation after administration was observed in 15.2% of total 184 cases, which was noticed more frequently in the lower aged children . There was no influence by dose . Clinical effects of CZX-S were studied in 72 pediatric patients with various infections . CZX-S was administered rectally at the mean daily dose of 41.0 mg/kg divided into 3 or 4 times for 6 days . Clinical responses were excellent in 46 cases, good in 24 cases, fair in 2 cases . The efficacy rate was 97.2% . Regarding side effects, the pain of insertion was noted in 2 cases (2.8%), diarrhea in 6 cases (8.3%), the elevation of eosinophil in 1 case (1.7%) . Bacteriologically, 23 strains (92.0%) out of 25 strains isolated from the patients were eradicated.

Jpn J Antibiot, 1985 Oct, 38(10), 2952 - 61
{Clinical experience with ceftizoxime suppositories in bacterial infections in children}; Hosoda T et al.; A clinical trial of ceftizoxime suppositories (CZX-S) was performed to evaluate the therapeutic effectiveness in children with bacterial infection . The subjects were 10 children comprising 4 with pneumonia, 3 with lacunar tonsillitis, 2 with pharyngitis, and 1 with UTI . They were given 1 suppository containing either 125 mg or 250 mg of CZX 2 to 4 times a day . The daily per kg body weight dose ranged from 17.1 to 60.0 mg . The result was "markedly effective" in 3, "effective" in 6, and "failure" was recorded in 1 . Bacteriologically, successful eradication of causative organisms was confirmed in all the 4 children who underwent the test . No clinical side effects were observed . The only laboratory test abnormality recorded in a single patient was eosinophilia, which was not definitely ascribable to CZX-S . In conclusion, CZX-S have proved to be a clinically safe and effective antibiotic preparation in infantile infection, even in children whose treatment with conventional antibiotics is associated with difficulties.

Jpn J Antibiot, 1985 Oct, 38(10), 2925 - 31
{Basic and clinical studies of ceftizoxime suppositories in the pediatric field}; Nishimura T et al.; A bacteriological and clinical study of ceftizoxime suppositories (CZX-S) let to the following results . The CZX serum concentration 10 minutes after insertion of one 250 mg suppository (i.e . 5.7-15.2 mg CZX per kg body weight) ranged from 1.64 to 6.53 micrograms/ml (average: 4.41 micrograms/ml) . In one child the concentration 7 minutes after insertion was 4.13 micrograms/ml . Therapeutic responsiveness was recorded as "effective" in 8 (88.9%) of the 9 children who were broken down into 6 with tonsillitis, 1 with pharyngitis, and 2 with UTI . Bacteriological studies conducted in 5 children have confirmed eradication in 4 children, one of whom showing appearance of another strain . The rate of discharge of the suppository within 10 minutes after insertion was 20.4% . Reddening and erosion of the anus were observed in 1 child.

No To Shinkei, 1985 Oct, 37(10), 991 - 7
{Effects of anticancer drugs on multicellular spheroid of 9L rat brain tumor}; Kohno T et al.; The effects of the anticancer drugs Nimustine (ACNU), Aclacinomycin A (ACR), Adriamycin (ADM), Bleomycin (BLM), Cisplatin (CDDP), and 5-Fluorouracil (5-FU) on the multicellular spheroid of a chemically-induced 9L rat glioma was studied . The multicellular spheroid in which cells grow in vitro as three-dimensional aggregates represents a biological model, which is intermediate between monolayer cells in vitro and solid tumors . Spheroids were initiated in bacteriological grade petri dishes seeded with 10(6) 9L rat glioma cells, cultured for four days and thereafter transferred and further developed in a spinner flask . Spheroids of 200-400 micron diameter were sorted and exposed for 24 hours to 5-FU and one hour for other drugs . After treatment both cytotoxic effect and growth delay were analyzed . Following disaggregation using collagenase, pronase and DNAase, cytotoxic effect on multicellular spheroids was measured by colony forming assay and were compared with those effects on 9L monolayer culture cells in the exponential growth . For growth delay assay, multicellular spheroids were individually transferred to 16 mm well containing 0.4 ml agarose base and 2 ml culture medium . Spheroid size was measured twice a week and growth curves were drawn . The growth delay was determined as the treated group vs . control differences in time required to a size four times that of the initial volume . For cells both in the monolayer culture and the multicellular spheroid, the dose response curve for ADM, BLM and 5-FU was "biphasic" and that for ACNU, ACR and CDDP "shoulder-threshold" type.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinogenesis, 1985 Oct, 6(10), 1537 - 9
Identification and quantification of 2-amino-3,4,8-trimethylimidazo- {4,5-f}quinoxaline (4,8-DiMeIQx) in beef extract; Takahashi M et al.; 2-Amino-3,4,8-trimethylimidazo{4,5-f}quinoxaline (4,8-DiMeIQx) was found in bacteriological-grade beef extract by liquid chromatographies with electrochemical detection and a photodiode array detector . 4,8-DiMeIQx was estimated to be present at a level of 10.0 ng per g of beef extract, and to account for 9% of the total mutagenicity of the extract.

Schweiz Med Wochenschr, 1985 Sep 28, 115(39), 1350 - 2
{Comparison of the shielded telescoping brush catheter with bronchial lavage in the diagnosis of pulmonary infiltrates}; Bille J et al.; The results of cultures from bronchial lavage (BL) were compared with those obtained with a telescoping protected brush catheter (PBC) in 56 nonselected patients presenting with a pulmonary infiltrate of unknown etiology . At the time of bronchoscopy, 34 patients were under antibiotics . In 20 cases, the cultures from PBC and/or BL were positive . On the basis of quantitative bacteriological analysis and medical chart review, we conclude that PBC is more sensitive and more specific than BL for the diagnosis of clinically significant infections of the lower respiratory tract.

Presse Med, 1985 Sep 28, 14(32), 1697 - 700
{Clinical value of rapid bacteriological results in nosocomial infections . Comparison with traditional methods}; Vincent P et al.; With automated analysers, bacterial identification and susceptibility testing can be performed in 4-5 hours instead of 12-18 hours with conventional methods . A controlled trial was carried out in the surgical ward of a university hospital to evaluate the clinical repercussions of these rapid methods . The automated analyser reduced delays in the laboratory by about 25%, and optimizing information transfer from laboratory to ward brought the reduction up to 50% . It was found that earlier results of susceptibility testing modified prescriptions and this may be expected to result in a more rational use of antibiotics.

Z Gesamte Inn Med, 1985 Sep 15, 40(18), 552 - 4
{Leprosy--observations, experiences, problems}; Ziegler K; From the field of view of own observative and experiences was tried to outline the present situation in leprosy . It is referred to the results of the modern epidemiological, bacteriological, immunological and medicamentous leprosy research which was particularly stimulated under the impression of the increasing DDS-resistance of the leprosy bacteria . At present ambulatory polychemotherapy, sometimes combined with a vaccination technique, is in the centre of the world-wide combat programme against leprosy . In no other infectious disease, however, social-economical points of view are so important as in leprosy and in the opinion of the author they are finally also decisive for an actually successful and permanent combat.

Br Med J (Clin Res Ed), 1985 Sep 7, 291(6496), 658 - 61
National survey of notifications of tuberculosis in England and Wales in 1983 . Medical Research Council Tuberculosis and Chest Diseases Unit.
{Clinical studies on SM-4300}
Sawae Y, Nagafuchi S.

Use of SM-4300, which is a newly developed human immunoglobulin preparation for intravenous administration, has clinically been evaluated in the patients with severe or intractable bacterial infections . Of total 13 cases of the admitted patients at the 1st department of internal medicine, faculty of medicine, Kyushu university, 10-pneumonia case were associated with blood diseases like acute myelocytic leukemia (AML) and multiple myeloma (MM), and in addition, with other underlying diseases like lung cancer and bronchiectasis, 1 was prosthetic valve endocarditis, 1 cholecystitis associated with pericarditis and 1 fever of undetermined origin (FUO) . SM-4300 of 5 g single bolus or 3 daily doses of 2.5 g per day were infused with chemotherapy drugs preceedingly administered for more than 3 days and the results were evaluated; good in 4, fair 4, poor 2 and unknown 3, and the efficacy rate was 40% . Bacteriologically, the results were decreased in 1, persisted 1 and the majority was unknown . Observed were no side reactions nor the changes in clinical examination variables incurred by this drug . It is therefore considered that SM-4300 is of use for the treatment of intractable bacterial infections when used with antibiotics.

Eur J Pediatr, 1985 Sep, 144(3), 255 - 8
Pneumonia in young children with homozygous sickle cell disease: risk and clinical features; De Ceulaer K et al.; The incidence and clinical features of pneumonia have been examined in children with homozygous sickle cell (SS) disease and in age/sex matched control children with a normal haemoglobin (AA) genotype followed in a cohort study of sickle cell disease from birth . Survival curve analysis indicated a similar incidence of pneumonia in the two genotypes up to the ages of 8 months after which pneumonia became significantly more prevalent in SS disease, the relative risk exceeding a factor of four by 4 years of age . Children with SS disease were also more prone to multiple episodes . Comparison of clinical features in the two genotypes yielded no difference in sex or seasonal involvement, or in the results of bacteriological and radiological investigations . Children with SS disease and pneumonia had an increased frequency and increased duration of hospital admission, and mortality was confined to this group . It is concluded that children with SS disease have an increased prevalence of single and multiple attacks of pneumonia and that these events run a more serious clinical course than in control children.

Tubercle, 1985 Sep, 66(3), 179 - 86
Tuberculosis in an Indochinese refugee camp: epidemiology, management and therapeutic results; Rieder HL; In a 3-year period tuberculosis was diagnosed in 629 patients in Thailand's largest camp for Kampuchean refugees: 62% had pulmonary disease and 38% extrapulmonary forms . Tuberculosis of lymph nodes was the most important extrapulmonary manifestation (50%) . The mean annual notification rates were 0.5% and 0.24% for all forms and smear-positive pulmonary tuberculosis respectively . There was a steep rise in the annual notification rate with increasing age . A 6-month course of fully supervised chemotherapy efficiently counteracted defaulting, early absconding and initial drug resistance . Seventy-three per cent of all patients remained on chemotherapy for the planned period; only 2% of the smear-positive patients failed bacteriologically on chemotherapy . Of the patients with the most common forms of extrapulmonary disease, 90% showed a favourable response to chemotherapy.

Tubercle, 1985 Sep, 66(3), 161 - 78
Tuberculosis in Tanzania--a national survey of newly notified cases . Tanzanian/British Medical Research Council Collaborative Study; Heterotrophic bacteria in water distribution systems . II . Sampling design for monitoring; In this paper, which is a continuation of the work presented in Part I in this issue, previous information on the spatial and temporal variability of bacteriological data from a water distribution system is used to develop a sampling design for use in future water quality monitoring . The water distribution system is considered to be composed of several zones where the variation of bacterial counts in each zone is modelled by the negative binomial distribution . Under the assumption that the objective of monitoring is to determine whether or not the mean bacterial density of the water exceeds a specific standard, a criterion is given which determines the optimal number of sampling stations allocated to each zone . These stations are determined by assuming that either the risk of sampling (i.e . making the wrong decision) is prespecified or that the total number of stations to be sampled is predetermined . Sequential sampling to evaluate the compliance of the water with the standard is also discussed.

Crit Care Med, 1985 Sep, 13(9), 763 - 6
Evaluation of a computer-based clinical reference library in an ICU; Burridge PW et al.; A computer-based clinical reference library (CRL) was developed as a subsystem of the Hewlett-Packard 5600 A patient data management system for use in the 10-bed ICU at the University of Alberta Hospital . The CRL contains 20 information modules and can be accessed at both bedside and central consoles . Information is classified under headings of: definition, incidence, etiology, pathophysiology, pathology, bacteriology, clinical course, diagnosis, treatment, complications, prognosis, and references . The CRL was evaluated by a nonrandomized pretest/post-test, control-experimental research paradigm . Medical students and residents exposed to the system "acquired" significantly more knowledge than their counterparts in a control group . Medical students and nurses used the system for continuing medical education, whereas residents accessed the system for problem-solving . Nurses had strong negative views about the computerized patient data management system and tended not to use the CRL . Correlation between instruction time and gain scores was positive but test correlation coefficients for each subgroup were not significantly different.

Vet Med (Praha), 1985 Sep, 30(9), 521 - 30
{Incidence of mastitis in cows of various breeds and their crosses-- estimation of the heredity of this disease}; St'avikova M et al.; In a large set of cows (24,165 head), consisting prevailingly of Bohemian Pied breed, Black Pied Lowland and Holstein breeds, and of their crosses, significant differences in the incidence of mastitis were proved . Mastitis was demonstrated by the bacteriological findings in milk . The lowest mean incidence was recorded in the cows of the acclimatized Bohemian Pied breed (8.0%) . As observed in the examined population, the increasing genetic proportion of solely dairy breeds results in higher demands on the environment, and the susceptibility of animals to mastitis usually increases . In three-breed crosses of this set, mastitis was found in 699 animals, i . e . in 25.4% . With respect to mastitis prevalence, a heritability estimate was performed on the basis of the first and second lactation using the method of alternative characters . In the Bohemian Pied breed, the heritability estimate was h2 = 0.17 +/- +/- 0.08, in the Black Pied Lowland breed h2 = 0.28 +/- 0.14.

Jpn J Antibiot, 1985 Sep, 38(9), 2647 - 59
{A clinical trial of SM-4300 against severe infections in surgery}; Ueda T et al.; SM-4300, a newly developed human immunoglobulin for intravenous use, has been evaluated clinically in combination with the antibiotics in the patients with severe bacterial, fungal or viral infections which are resistant to antibiotic therapy in the surgery . Total number of 26 patients affected with various severe infections were treated with SM-4300 . Clinical effects of SM-4300 were good in 10 cases, fair in 7 cases, poor in 7 cases and unknown in 2 cases . The efficacy rate was 41.7% . Severe infections in these 26 patients consisted of 14 cases of peritonitis, 5 cases of intrathoracic infections, 4 cases of sepsis suspected and 3 cases others . Twenty-three patients had underlying diseases, in which 15 cases were patients with cancer . Clinically isolated organisms were obtained from 12 cases, of 26 strains were evaluated for bacteriological effects which were eradicated in 10 strains, decreased in 3 and persisted in 13 strains, the eradication rate being 38.5% . The subjective and objective clinical side effects were noted.

Jpn J Antibiot, 1985 Sep, 38(9), 2481 - 8
{Clinical evaluation of SM-4300, a new human immunoglobulin preparation}; Saito A et al.; Clinical efficacy and safety of SM-4300, a newly developed human immunoglobulin preparation for intravenous use, were evaluated in 11 patients with severe infectious disease which are resistant to antibiotic therapy in the combined use with the antibiotics . Clinical effects of SM-4300 wee excellent in 1 case, good in 5 cases, fair in 1 case, poor in 1 case and unevaluable in 3 cases . The efficacy rate was summarized as 75% . Bacteriological responses were eradicated in 1 case and unknown in 10 cases . No side effects and abnormal laboratory findings due to SM-4300 were observed in this investigation.

J Biomed Mater Res, 1985 Sep, 19(7), 757 - 69
Fibronectin binding properties of bacteriologic petri plates and tissue culture dishes; Bentley KL et al.; With the aid of a monoclonal antibody-based ELISA assay, the fibronectin binding properties of poly(styrene) bacteriologic and tissue culture petri plates were studied . After treatment of the plastics with serum, both the rate of fibronectin binding and the maximum amount of fibronectin bound were found to be lower for bacteriologic than tissue culture plates . In contrast, when treated with purified fibronectin rather than serum, bacteriologic and tissue culture plates bound fibronectin equally well . Thus, serum proteins are more effective in inhibiting fibronectin binding to bacteriologic petri plates than to tissue culture dishes . The fibronectin binding properties of plastic substrata could be enhanced by oxidation with H2SO4 or diminished by dissolution and recasting of tissue culture dishes . Thus, the fibronectin binding properties of bacteriologic and tissue culture dishes can be interconverted . Plastics with enhanced fibronectin binding properties (tissue culture plates) were found to be hydrophilic and good substrates for cell attachment and growth while plastics with decreased fibronectin binding characteristics were found to be hydrophobic and poor substrates for cell attachment and growth . The cell-adhesive properties of bacteriologic and tissue culture plastic substrata were found to vary during incubation with cells . While cells remained firmly attached and spread on tissue culture plastics over a period of 5 days or more, previously attached cells gradually detached from bacteriologic plastics at incubation times beyond 12 h . The gradual detachment of cells from bacteriologic plates probably explains the poor properties of bacteriologic plastics for the growth of anchorage-dependent cells, in particular.

Jpn J Antibiot, 1985 Sep, 38(9), 2417 - 43
{Comparative clinical study of aspoxicillin and sulbenicillin in postoperative wound infections}; Yura J et al.; A well-controlled comparative study was performed to evaluate efficacy, safety and utility of aspoxicillin (ASPC) as compared with sulbenicillin (SBPC) in the treatment of postoperative wound infections . Either 2 g of ASPC or 2 g of SBPC was administered to patients by intravenous drip infusion twice a day for 7 days . The following results were obtained: Overall clinical effectiveness rates were 82.5% (66/80) in ASPC group and 77.0% (57/74) in SBPC group, with no statistically significant difference between 2 groups . Final overall clinical improvement rates were 83.8% (67/80) in ASPC group and 81.1% (60/74) in SBPC group, with no statistically significant difference between 2 groups . As to bacteriological effectiveness, eradication rates of clinical isolates were 70.4% (38/54) in ASPC group and 74.4% (32/43) in SBPC group . There was no statistically significant difference in 2 groups . Side effects and abnormal laboratory findings were observed in 6 cases (6.7%) and 11 cases (12.4%) in ASPC group (89 cases) respectively, and 4 cases (4.4%) and 7 cases (7.8%) in SBPC group (90 cases) respectively . Especially severe adverse reactions were not observed, and there was no significant difference in the incidences of side effects and abnormal laboratory findings between 2 groups . As to overall clinical utility, utility rates were 77.5% (62/80) in ASPC group and 70.3% (52/74) in SBPC group . There was no statistically significant difference between 2 groups . These results may be indicated that ASPC is as useful as SBPC in the treatment of postoperative wound infections.

J Appl Bacteriol, 1985 Sep, 59(3), 291 - 7
A bacteriological investigation of the effectiveness of cleaning and disinfection procedures for toilet hygiene; Scott E et al.; The bacterial contamination of hospital and institutional toilets and toilet areas which were cleaned daily was investigated . The effect of daily disinfection with hypochlorite or a quaternary ammonium product, or with a continuous-release hypochlorite disinfectant system, based on the chlorine-releasing agent trichloroisocyanuric acid, was determined . The continuous release system produced substantial and sustained reduction in contamination of the toilet itself (water, toilet bowl and rim) and some reduction in contamination of sites surrounding the toilet (seat, floor, and air) . By contrast, although daily disinfection produced some reduction in contamination compared with daily cleaning, the reductions were less than that associated with the continuous release system and indicated the inadequacy of daily disinfection and/or cleaning for toilets where effective procedures are required.

J Hosp Infect, 1985 Sep, 6(3), 252 - 6
The contaminated skin-knife--fact or fiction; Grabe N et al.; Three hundred and fifty-eight patients undergoing clean orthopaedic surgery were included in this prospective study . The knives used during surgery, i.e . the knife used for skin incision (the skin-knife) and the knife used to finish the operation were bacteriologically examined . We found no evidence that the practise of discarding the knife after skin incision reduced the incidence of wound infection after clean orthopaedic surgery . Laminar air flow significantly reduced the rate of knife contamination.

Acta Cytol, 1985 Sep-Oct, 29(5), 732 - 6
Fine needle aspiration biopsy in the diagnosis of tuberculosis; Bailey TM et al.; Bacteriologic data and aspiration smears obtained by fine needle aspiration (FNA) biopsy for a series of 39 cases of tuberculosis were reviewed . Based on the morphologic features of the aspiration smears, the cases were divided into two groups: 18 cases in which distinct epithelioid granulomas were present and 21 in which no granulomas were found but large amounts of necrotic debris with variable numbers of polymorphonuclear cells, histiocytes and lymphocytes were present . Material from the FNA biopsy specimen was submitted for culture and fluorescence studies in 34 cases (15 with and 19 without granulomas) . In the first group, auramine-rhodamine staining of smears was positive in 4 of 15 cases and Mycobacterium tuberculosis was isolated in 12 of 15 cases . In the second group, auramine-rhodamine staining was positive in 9 of 19 cases and culture was positive for M . tuberculosis in 16 of 19 cases . The results indicate that studying FNA smears by light microscopy and bacteriologic culture is an effective way of diagnosing tuberculosis.

Infusionsther Klin Ernahr, 1985 Aug, 12(4), 197 - 200
{The validity of using autologous placental blood in transfusion medicine}; Abel M et al.; Resuscitation of the newborn with severe anemia and shock requires rapid expansion of the circulatory volume . This study was done to answer the question whether an infant's autologous placental blood can be recommended for this purpose . In 20 term newborns we obtained immediately after placenta delivery placental blood for bacteriologic, biochemical, hematologic and hemostaseologic investigations by a special placental vein cannulation technique . Besides other coagulation tests resonancethrombography was done and proved to be a simple, quick and reliable method to study coagulability of the placental blood samples . Together with the well-known advantages of autologous blood use the results of this study encourage us to consider autologous placental blood valuable in situations of urgent neonatal volume resuscitation.

J Pediatr Gastroenterol Nutr, 1985 Aug, 4(4), 583 - 6
Relationships between lysozyme concentration of human milk, bacteriologic content, and weight gain of premature infants; Braun OH et al.; Lysozyme concentrations and bacterial colony counts were determined in 399 human milk samples obtained from 42 mothers (18 mothers of term infants, 24 mothers of preterm or small-for-date neonates) . The average lysozyme concentration was 21.39 +/- 13.19 mg/L . Lysozyme concentrations were significantly greater in preterm (24.99 +/- 15.05 mg/L) than in term milk (14.89 +/- 9.83 mg/L) (p less than 0.05) . Bacterial colony counts did not decline with increasing lysozyme concentration, i.e., no correlation between lysozyme concentration and bacterial count was found . Despite this lack of correlation, a significant correlation between lysozyme concentration and rate of weight gain was observed: the higher the lysozyme concentration, the better the weight gain . The mechanism of this observation remains to be elucidated; a trophic effect of lysozyme is suggested as a possible mechanism.

Carcinogenesis, 1985 Aug, 6(8), 1195 - 9
Quantification of 2-amino-3-methylimidazo{4,5-f}quinoline (IQ) and 2-amino-3,8-dimethylimidazo{4,5-f}quinoxaline (MeIQx) in beef extracts by liquid chromatography with electrochemical detection (LCEC); Takahashi M et al.; A simple and sensitive method was developed for quantification of mutagenic/carcinogenic aminoimidazoquinoline and aminoimidazoquinoxaline compounds in heated materials . Samples were partially purified by blue-cotton treatment, 0.1 N HCl-methylene dichloride partition and separation in a SEP-PAK silica cartridge . The recoveries of aminoimidazoquinoline and aminoimidazoquinoxaline compounds at the step of partial purification were estimated by spiking with 14C-labeled compounds . The compounds in partially purified materials were analyzed by liquid chromatography with electrochemical detection using a combination of two columns of octadecyl silane and cation exchange . Bacteriological-grade beef extract was found to contain 41.6 and 58.7 ng/g of 2-amino-3-methylimidazo{4,5-f}quinoline and 2-amino-3,8-dimethylimidazo{4,5-f}quinoxaline (MeIQx), respectively . MeIQx was also detected at a level of 3.1 ng per g in food-grade beef extract.

J Trop Med Hyg, 1985 Aug, 88(4), 249 - 52
Intestinal tuberculosis: bacteriological study of tissue obtained by colonoscopy and during surgery; Bhargava DK et al.; The biopsy tissue obtained during surgery and colonoscopy from 28 cases of intestinal tuberculosis was utilized for isolation and identification of mycobacteria . The mycobacteria could be isolated in 12 (42%) of 28 patients . Colonoscopy can be a successful method of bacteriological diagnosis of intestinal tuberculosis . Mycobacteria were scarcely ever seen on histological sections . Combined use of guinea pig inoculation and culture was more rewarding than either alone . The yield of positive cultures was greater in tissue with caseation necrosis, though organisms were also recovered from tissues showing non-caseating granuloma and non-specific inflammation . The intestinal tissue gave more positive cultures (41%) than did lymph nodes (14%) . The organisms were isolated in patients with or without pulmonary lesions and chemotherapy in the past . All the organisms were isolated as Mycobacterium tuberculosis.

Vet Med (Praha), 1985 Aug, 30(8), 501 - 5
{Effectiveness of the surface fixation test in the diagnosis of brucellosis in hares}; Handl R; In the course of two years the reliability of surface fixation test was tested in the diagnostics of hare brucellosis on 961 hare blood samples taken during chases at chosen localities of the Olomouc district . Out of 33 serologically positive hares, 29 reacting ones were subjected to complex laboratory examination for brucellosis . In all cases brucellosis was confirmed patho-anatomically, by cultivation in 78.95% of bacteriologically examined hares and in the rest cases by bioassay on guinea-pigs . The results have confirmed that the surface fixation test represents a highly effective method for the reliable serological diagnostics of hare brucellosis.

J Hyg (Lond), 1985 Aug, 95(1), 115 - 22
Superficial tuberculous lymphadenitis in Merseyside: 1969-1984; Wilkins EG et al.; The aetiology, epidemiology and clinical presentation of 137 bacteriologically confirmed cases of superficial mycobacterial lymphadenitis identified at the Liverpool Public Health Laboratory between 1969 and 1984 were reviewed . Despite a fall in pulmonary and total extrapulmonary isolates, the annual recovery of mycobacteria from lymph nodes remained relatively constant . Mycobacterium tuberculosis was the cause of infection in 121 patients (88.3%), M . bovis in 6 and the remaining 10 isolates were atypical mycobacteria . In European patients (68.6%) the highest incidence was in the elderly, whereas in non-Europeans (31.4%) the disease almost exclusively occurred in the third and fourth decades . The proportion of isolates from non-Europeans reflected the size of the immigrant population and increased during the period of study.

Arch Surg, 1985 Aug, 120(8), 889 - 98
Stratified outcome comparison of clindamycin-gentamicin vs chloramphenicol-gentamicin for treatment of intra-abdominal sepsis; Lennard ES et al.; A randomized, prospective trial was conducted of 93 patients with operatively confirmed intra-abdominal sepsis . The study compared clindamycin-gentamicin and chloramphenicol-gentamicin for treatment of carefully stratified patient groups . Malnutrition, age over 65 years, shock, alcoholism, gastrointestinal tract bleeding, steroid administration, diabetes, obesity, and organ malfunction were present with equal frequencies in each group . The duration of antibiotic treatment averaged 8 1/2 days, and the average length of postoperative hospitalization was 29 days . Study antibiotics were changed for bacteriologic reasons in 11 patients taking clindamycin-gentamicin and 12 patients taking chloramphenicol-gentamicin (25% of the total), and two patients in the clindamycin-gentamicin group had a minor adverse reaction . Initial satisfactory clinical responses were obtained in 59 (63%) patients . Twenty-five patients (27%) subsequently developed unsatisfactory courses, but 48 (52%) patients remained well through the 30-day period . Septic-related mortality occurred in 18 (19%) patients, and two (2%) patients had unrelated deaths . There were no significant differences between the study regimens by the outcome criteria evaluated.

Acta Ophthalmol (Copenh), 1985 Aug, 63(4), 375 - 9
Prostaglandin E2 level in tears during postoperative inflammation of the eye; Gluud BS et al.; The concentration of prostaglandin E2 (PGE2) in tears was measured by a radio immuno assay technique in 25 persons before cataract extraction and during the post-operative period . In addition we studied the clinical signs of inflammation, the tear secretion rate, the content of polymorphonuclear leucocytes (PMNs) in tears, the bacteriology of the conjunctival sac and the central corneal thickness (CCT) during this period . We found pre-operative median level of PGE2 of 82 pg/ml and on the first post-operative day a significant rise in PGE2 concentration despite increased tearing . There was a tendency towards further gradual increase in PGE2 concentration until the 5th day and thereafter a decline to pre-operative level 12 days after surgery . The conjunctiva is proposed as a possible source of the PGE2 in tears . No significant correlation could be demonstrated between PGE2 levels and clinical signs of inflammation, CCT, PMN level, bacteriology or tear secretion rate.

Dtsch Med Wochenschr, 1985 Jul 12, 110(28-29), 1115 - 8
{Management of acute gonorrhea in males with Rosoxacin}; Fischer-Brugge U et al.; A single dose of 300 mg of the quinoline carbonic acid derivative rosoxazin (Winuron) was used for treatment of 59 men with uncomplicated gonorrhoea and two males with fresh infection with penicillin-resistant gonococci . Within 48 hours full clinical remission was seen in all 61 cases confirmed bacteriologically for gonococci . Concomitant infection with other pathogens transmitted by intercourse, present in 69% of cases, could not be influenced or changed by this treatment . Tolerance was good: 21 patients (32%) complained of slight side effects, however, only 3 patients (5%) showed significant central nervous or gastrointestinal symptoms . Rosoxazin has the great advantage of reliable effectiveness even in case of penicillin-resistant gonococci . Thus, the substance offers an effective and well-tolerated orally applicable and reasonably priced alternative to conventional treatment of gonorrhoea.

Rev Rhum Mal Osteoartic, 1985 Jul-Sep, 52(7-9), 487 - 90
{Chronic arthritis in palmo-plantar pustulosis . Bacterid of Andrews}; Benhamou CL et al.; Report of a 30 years old man story pustulosis palmaris et plantaris, spondylodiscitis L5-S1, right sterno-clavicular arthritis, right sacro-iliitis, and pubic symphysitis . Multiple bacteriologic investigations did not discover any infectious articular process . Histologic articular findings were inflammatory pattern, non steroid anti-inflammatory drugs corrected the arthritis . Anterior thoracic arthropathies are quasi-constant . Inflammatory spondylodiscitis are frequent, while sacro-iliac involvement is infrequent, this pattern distinguishing pustular arthro-osteitis from classic pelvispondylitis . Radiologic lesions are peculiar by predominance on one articular side at each site . Nosology is discussed . Slow infection by non virulent germs has been suspected , but seems improbable . This affection seems close seronegative spondylo-arthropathies and reactive arthritis, like acne conglobata arthritis for instance . Usual absence of HLA-B27 antigen must be noted.

Radiologe, 1985 Jul, 25(7), 307 - 17
{Information value of x-ray computed tomography for the detection and control of spondylitis}; Heuck F et al.; The information content of early bone changes in computed tomography (CT) of pyogenic non-tuberculous spondylitis and spinal tuberculosis is analysed . The CT findings are compared with conventional x-ray images including tomography . In 3 of 16 patients no indications of osteomyelitis were found by conventional x-ray images, whereas CT revealed paravertebral soft tissue swelling or abscesses and osteolysis and thus established the diagnosis of spondylitis . In one patient the process caused neurologic symptoms by extending into the epidural space . The contributions of CT to the diagnosis of spondylitis are to delineate the extent of soft tissue swelling, to detect small defects in the vertebral bodies, to exclude disc involvement, and to differentiate inflammations and other destructive changes . CT can be used for fine needle localization and aspiration of tissue or pus for histological or bacteriological investigations to establish the pathological diagnosis.

J Infect, 1985 Jul, 11(1), 25 - 33
Ceftriaxone--clinical experience in the treatment of neonates; James J et al.; A group of 104 neonates with clinical signs of infection sufficient to justify treatment with penicillin plus gentamicin received instead monotherapy with ceftriaxone (50 mg/kg once daily) . Bacteriological cultures from 20 babies before treatment yielded significant isolates (9 had bacteraemia) . Following treatment, infecting bacteria were eradicated from 15/20 babies . Ten of the 104 babies died; all were examined post mortem . Only one death was attributed to bacterial infection . The remaining babies responded well to treatment . No adverse alteration in biochemical or haematological values was associated with ceftriaxone therapy . The incidence of diarrhoea, blood in the stools, necrotising enterocolitis or anti-coagulation problems was the same as in the babies not receiving ceftriaxone . Pharmacokinetic values were determined on 40 babies . Elimination half life (T1/2 beta) and minimum serum concentration (Cmin.) decreased and clearance increased with increasing postnatal age . Postnatal age was the single most significant factor affecting pharmacokinetics . Ceftriaxone is a safe and effective alternative to conventional therapy for infected neonates . Prolonged therapy is associated with superficial colonisation with inherently resistant bacteria.

Cutis, 1985 Jul, 36(1), 63 - 4
Needle aspiration for diagnosis of cellulitis; Liles DK et al.; Diagnosing the causative agent of bacterial cellulitis is difficult . Blood culturing and needle aspiration have been used: the former has an extremely low sensitivity, the yield of the latter ranges from 4 to 42 percent . A retrospective study was conducted to determine the diagnostic success of needle aspiration and culture of the leading edge of cellulitis with a 21 to 22 gauge syringe and conventional bacteriologic culture of blood in determining the agent that causes acute cellulitis . This agent was determined in 33 percent of patients by needle aspiration and in 4 percent using blood cultures.

Clin Nephrol, 1985 Jul, 24(1), 5 - 8
First exchange neutrophilia: an index of peritonitis during chronic intermittent peritoneal dialysis; Riera G et al.; During intermittent peritoneal dialysis (IPD) early diagnosis of peritonitis may be difficult, because of paucity in clinical signs and delays in bacteriologic studies . We examined prospectively leucocyte counts and their differential composition in initial ascites and dialysis effluent of patients on IPD and correlated these findings to the presence of subsequently bacteriologically proven clinical peritonitis . Total leucocyte counts from either ascites or first exchange effluent did not differentiate infected from noninfected patients . In contrast, first exchange effluent neutrophilia (greater than 43%) proved to be an early indicator of infection, being 100% sensitive and 94% specific for peritonitis . We conclude that in such patients peritoneal effluent neutrophilia should be considered an indication of possible infection.

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