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. In