Rev Belge Med Dent, 1993, 48(4), 59 - 71 {The use of human dental enamel as an indicator of the extent of environmental pollution}; Cleymaet R et al.; Acid etch surface enamel microbiopsies were taken from permanent teeth of schoolchildren and analyzed for lead and cadmium using electrothermal atomic absorption spectrometry . A comparison concerning these heavy metals was made between children (7 and 12 years) from a school close to a non-ferrous metal plant and children from the same age group from a school situated near the same plant but in a less polluted zone . The lead concentrations in enamel biopsies from the first group were significantly higher than those from the second group . Cadmium shows the same trend but on a much lower level . A significant correlation between lead and cadmium was also found in both groups. Blood Purif, 1993, 11(6), 349 - 69 Monodisperse magnetic polymer particles . New biochemical and biomedical applications; Ugelstad J et al.; The method of activated swelling of polymer particles developed by the authors allows the preparation of monodisperse spherical beads of predictable size from 1 to 100 microns in diameter . The polymer particles may be prepared from a number of different monomeric materials and with various morphologies including macroporous structures . The porous beads form the basis for magnetizable monodisperse polymer particles which have magnetic iron oxides distributed as small grains all through the volume of the beads . The magnetic particles are being used extensively for selective cell separation and for immunomagnetic separation within microbiology and molecular biology . A review of recent work within these fields is given . New methods for positive cell separation are announced. Periodontal Clin Investig, 1993 Fall, 15(2), 8 - 12 Osteomyelitis associated with chronic periodontitis in a patient with end-stage renal disease: a case report; Tomaselli DL Jr et al.; The end-stage renal patient undergoing dialysis is susceptible to a number of infections . We report a case of localized suppurative osteomyelitis of the jaws, secondary to periodontitis, in a patient with chronic renal failure, with review of the physiologic and biochemical changes associated with renal failure . The clinical, radiographic, histologic, and microbiologic findings are presented with a discussion of the differential diagnosis and treatment provided. FEBS Lett, 1992 Dec 21, 314(3), 275 - 9 Diversion of the sign of phototaxis in a Chlamydomonas reinhardtii mutant incorporated with retinal and its analogs; Takahashi T et al.; The blind mutant FN68 of the unicellular flagellate green alga Chlamydomonas reinhardtii is negatively phototactic in the presence of the native chromophore all-trans retinal . In contrast, analog chromophores such as a ring-acyclic retinal and those in which trans/cis isomerization about the C11 = C12 double bond was blocked induced predominantly positive phototaxis in the same strain under the same experimental conditions . These observations can be interpreted by assuming that the negative and the positive phototaxis is mediated distinctively by two rhodopsin species which differ in their affinities with the exogenous chromophores . However, a more reasonable explanation, which requires fewer assumptions, is that the sign of phototaxis depends on a delay in intracellular photosignal transduction . This novel view was deduced directly from the widely accepted hypothesis {1980, Microbiol . Rev . 44, 572-630} on phototaxis mechanisms. J Clin Microbiol, 1992 Dec, 30(12), 3122 - 6 Antibody to a recombinant merozoite protein epitope identifies horses infected with Babesia equi; Knowles DP Jr et al.; Horses infected with Babesia equi were previously identified by the presence of antibodies reactive with a merozoite surface protein epitope (D . P . Knowles, Jr., L . E . Perryman, L . S . Kappmeyer, and S . G . Hennager . J . Clin . Microbiol . 29:2056-2058, 1991) . The antibodies were detected in a competitive inhibition enzyme-linked immunosorbent assay (CI ELISA) by using monoclonal antibody 36/133.97, which defines a protein epitope on the merozoite surface . The gene encoding this B . equi merozoite epitope was cloned and expressed in Escherichia coli . The recombinant merozoite protein, designated equi merozoite antigen 1 (EMA-1), was evaluated in the CI ELISA . Recombinant EMA-1 bound antibody from the sera of B . equi-infected horses from 18 countries . The antibody response to EMA-1 was then measured in horses experimentally infected with B . equi via transmission by the tick vector Boophilus microplus or by intravenous inoculation . Anti-EMA-1 antibody was detected 7 weeks post-tick exposure and remained, without reexposure to B . equi, for the 33 weeks of the evaluation period . The data indicate that recombinant EMA-1 can be used in the CI ELISA to detect horses infected with B . equi. Pediatr Infect Dis J, 1992 Dec, 11(12), 996 - 1003 Diarrhea among African children born to human immunodeficiency virus 1-infected mothers: clinical, microbiologic and epidemiologic features; Pavia AT et al.; Diarrhea and weight loss are common features of pediatric and adult human immunodeficiency type 1 (HIV-1) infection, particularly in developing countries . We studied prospectively episodes of diarrhea in 559 children, ages 10 to 15 months, participating in a longitudinal study of perinatal HIV-1 infection in Kinshasa, Zaire . Children with HIV-1 infection had more frequent episodes of diarrhea and were more likely to present with fever or moderate or severe dehydration and to have persistent or fatal diarrhea . Of 9 HIV-1-positive infants with diarrhea, 3 had enteroadherence factor-positive Escherichia coli, compared with 5 of 74 HIV-1-negative children with diarrhea (P = 0.04); no other pathogen was associated with HIV-1 infection . In a logistic regression model diarrhea was significantly associated with HIV-1 infection in the child, moderate or severe malnutrition and symptoms of acquired immunodeficiency syndrome in the mother . Diarrhea among children with perinatal HIV infection in Zaire is more severe than among uninfected children and is associated with malnutrition and advanced disease in the mother. J Med Virol, 1992 Dec, 38(4), 292 - 7 Detection and serotyping of rotaviruses in stool specimens by using reverse transcription and polymerase chain reaction amplification; Ushijima H et al.; Direct rotavirus serotyping (VP7, G type) in stool specimens was carried out by reverse transcription and polymerase chain reaction amplification (RT-PCR) and compared to serotyping by enzyme immunoassay with monoclonal antibodies (EIA-MAb) . The methods used for double-stranded (ds) RNA extraction, RT-PCR amplification, and the primers used were modified from previous reports {Gouvea et al.: Journal of Clinical Microbiology 29:519-523, 1990; Gentsch et al.: Journal of Clinical Microbiology, 1992} . For samples that were positive by both methods, the serotypes obtained were identical, however RT-PCR typing was found to be considerably more sensitive (70.4% samples serotyped) than EIA-MAb (35.6% of samples serotyped) . The overall sensitivities for detection of rotavirus in stool samples by latex agglutination, enzyme immunoassay, electron microscopy, polyacrylamide gel electrophoresis, and RT-PCR were essentially the same . The results confirm that RT-PCR typing (genotyping) is extremely valuable for G typing of samples which cannot be typed by EIA-MAb . We also developed a PCR confirmation technique for serotypes 1, 2, and 4. Med Lab Sci, 1992 Dec, 49(4), 340 - 2 Stereomicroscopy in clinical microbiology; Lynch MM; The stereoscopic microscope has many applications in clinical microbiology, relating generally to the examination of colonial morphology . However, although potentially important in the routine microbiology laboratory, little use is made of the stereomicroscope . In this paper the applications of this form of microscopy are briefly reviewed and the considerable benefits that may be obtained from its use outlined. Enferm Infecc Microbiol Clin, 1992 Dec, 10(10), 611 - 4 {Mycobacteriosis during 1980-1990 in a Madrid hospital}; Esteban J et al.; BACKGROUND: To assess the incidence and features of environmental mycobacteria that can produce disease over a ten years period (1980-1990) in an University Hospital from Madrid (Spain) . METHODS: Medical records of all patients in whom and environmental mycobacteria that can produce disease had been isolated were reviewed and classified as definite, possible or not clinically significant isolates, according to clinical features and microbiologic findings . RESULTS: Mycobacterium species were isolated in 415 patients (491 clinical samples over a total of 3003, 16.3%) . In 29 patients a environmental mycobacteria that can produce disease was identified . Medical records from 25 patients were retrieved, being this mycobacteria isolated classified as with definite clinical significance in 8 cases, with possible clinical significance in 4, and without clinical significance in 13 cases . Clinical features in the significant cases were: lung infection (3 cases), pleural and pericardial disease (1 case), peritonitis (1) and soft tissue infection (1) Two patients died . Surgical excision of the lesion was performed in the remaining patients, and clinical cure was achieved in five cases . CONCLUSIONS: The most prevalent mycobacterial infection in our environment is still due to M . tuberculosis infection, followed by M.avium-intracellulare . Surgical treatment is a valid approach in patients with localized infection by environmental mycobacteria that can produce diseases. Enferm Infecc Microbiol Clin, 1992 Dec, 10(10), 576 - 80 {Tuberculous meningitis in patients without HIV infection . Presentation of 21 cases}; Arzuaga JA et al.; BACKGROUND: Tuberculous meningitis accounts for 5% to 12% of all extrapulmonary tuberculosis cases in western-hemisphere population non infected by HIV virus, and carries a high mortality rate . METHODS: We analyze retrospectively 21 patients with tuberculous meningitis in HIV negative patients seen from 1975 to 1989, with emphasis on clinical, laboratory and therapeutic features . RESULTS: In 48% of cases there were not typical meningeal signs, and 61% of patients showed neurological focal signs and/or seizures . CSF examination revealed a clear fluid with high cell counts (mostly lymphocytes), high protein and low sugar levels in 67% of cases . However, the microbiologic examination had a low yield of diagnosis (33%) . The clinical course is prolonged, and treatment is usually delayed . Morbidity and mortality were high (34% and 10% of cases) . In this study, the use of steroids did not show a significant reduction in mortality nor in neurological sequelae . CONCLUSION: Tuberculous meningitis in HIV negative patients is a chronic infection, without meningeal signs in most cases and linked to a high rate of neurological defects . The microbiologic tests have low yield of diagnosis . Steroid drugs seem to be indicated only if there are additional complications. N Engl J Med, 1992 Nov 26, 327(22), 1541 - 8 Unilateral transplantation of human fetal mesencephalic tissue into the caudate nucleus of patients with Parkinson's disease; Spencer DD et al.; BACKGROUND . Parkinson's disease is characterized by the loss of midbrain dopamine neurons that innervate the caudate and the putamen . Studies in animals suggest that fetal dopaminergic neurons can survive transplantation and restore neurologic function . This report compares the clinical results in four case patients with severe Parkinson's disease who underwent stereotaxic implantation of human fetal ventral mesencephalic tissue in one caudate nucleus with the results in a control group of similar subjects assigned at random to a one-year delay in surgery . METHODS . Each case patient received cryopreserved tissue from one fetal cadaver (gestational age, 7 to 11 weeks) . Before implantation, adjacent midbrain tissue underwent microbiologic, biochemical, and viability testing . Cyclosporine was administered for six months postoperatively . RESULTS . The procedure was well tolerated . Three case patients showed bilateral improvement on motor tasks, as assessed on videotape, and were more functional in the activities of daily living, as assessed by themselves and neurologists, during both optimal drug therapy and "drug holiday" periods . One case patient, who died after four months from continued disease progression, had striatonigral degeneration at autopsy . In the patients who received transplants, optimal control was achieved with a lower dose of antiparkinsonian medications, whereas the controls required more medication . Positron-emission tomography with {18F}fluorodopa before and after surgery in one patient revealed a bilateral restoration of caudate dopamine synthesis to the range of normal controls, but continued bilateral deficits in the putamen . CONCLUSIONS . Although the case patients continued to be disabled by their disease, unilateral intracaudate grafts of fetal tissue containing dopamine diminished the symptoms and signs of parkinsonism during 18 months of evaluation. Biochim Biophys Acta, 1992 Nov 23, 1112(1), 7 - 13 Properties and the primary structure of a new halorhodopsin from halobacterial strain mex; Otomo J et al.; A new halorhodopsin-like pigment from the new halobacterial strain mex (Otomo, J., Tomoika, H . and Sasabe, H . (1992) J . Gen . Microbiol . 138, 1027-1037) was partially purified, and its amino acid sequence from helices A to G was determined using PCR technique . Two arginine residues in the A-B interhelix loop segment, a series of six amino acid residues (EMPAGH) in the B-C interhelix segment and most of the residues near the Schiff base of the retinal were found to be conserved in three halorhodopsins (halobium, pharaonis and mex) . This result strongly suggests that these residues are essential for anion pumping function in halorhodopsin . The light-induced ion-pump measurements have shown that the selectivity of anion transport between chloride and nitrate in mex halorhodopsin is lower than that of halobium halorhodopsin, but higher than that of pharaonis halorhodopsin . The number of amino acid residues in the B-C interhelix loop segments is different in each halorhodopsin, and it correlates with their anion (chloride and nitrate) selectivity . These results suggest that the length of the B-C segment affects the selectivity of anion transport in halorhodopsin. BMJ, 1992 Nov 21, 305(6864), 1243 - 4 About turn in US on interferon alfa; Roberts J; PIP: Researchers at the US National Institutes of Health reversed their previous dismissal of the efficacy of low dose interferon alpha (Kemron) developed in Kenya against AIDS under pressure for AIDS activists and black doctors stating that at least a clinical trial should be conducted . The National Medical Association stand was similar, although it did not approve Kemron . Interferon had been discovered by a veterinary microbiologist in Texas 20 years previously, and its anticancer use was promising as it proved effective against feline leukemia in 1989 . In 1989 it was administered to 204 AIDS patients in Kenya whose functional assessment increased by 66% after 10 weeks of treatment, and 18 became HIV negative . 12 other studies since then have been unable to confirm these findings, especially claims relating to seroconversion and increased CD4 cell counts . Oral interferon alpha has not been approved by the US Food and Drug Administration (FDA), but it is sold on the black market . As an FDA-approved anticancer injection drug (including against Kaposi's sarcoma often afflicting AIDS patients) its dose is 10,000 times higher than the oral dose . J Parenter Sci Technol, 1992 Nov-Dec, 46(6), 226 - 32 Key issues relating to the genetic stability and preservation of cells and cell banks; Simione FP Jr; The long term maintenance of genetically stable cells is important for ensuring reproducible results and continuity in the advance of microbiology, cell biology and biotechnology . As actively growing cultures, cells are constantly at risk of changing, and the necessity for subculturing living materials increases the chances for genetic change and contamination . Many techniques are available for stabilizing living cells; the method employed must be compatible with the intended use of the culture . The most commonly utilized means of preserving living cells are by freezing to cryogenic temperatures, and freeze-drying . Master stocks are usually maintained at liquid nitrogen or comparable temperatures, while working stocks can be frozen or freeze-dried, and maintained at more economical and easily managed temperatures where possible . However, low temperature techniques may cause damage that can result in genetic change, or potential selection when only a small portion of the population survives . Therefore, a good preservation program must include a comprehensive cell characterization regimen that is applied both before and after preserving the cells to ensure that changes are detected when they do occur . Assurance of long term stability necessitates well designed safekeeping and security measures that include minimizing specimen handling through well designed inventory systems, validation and monitoring of storage temperatures, provisions for backup inventory, and training of personnel . Cell banking also requires good cataloguing and data management practices to avoid duplication and misidentification, and to ensure proper tracking of specimens and ease of access. Antimicrob Agents Chemother, 1992 Nov, 36(11), 2398 - 402 Stability of antimycobacterial drugs in susceptibility testing; Griffith ME et al.; Aqueous solutions of 0.02% isoniazid, 0.2% streptomycin, 0.2% para-aminosalicylate, and 0.5% ethambutol and ethylene glycol solutions of 0.5% ethionamide stored at 3 to 7 degrees C remained stable for 1 year, as did aqueous solutions of 0.05% ethionamide hydrochloride, 0.05% kanamycin, 0.05% viomycin, and 0.1% capreomycin stored at -20 degrees C . The ethambutol and capreomycin solutions were tested by microbiologic methods; the other solutions were tested by both spectrophotometric and microbiologic methods . Prepared susceptibility testing media made with cycloserine, rifampin, and the above solutions incorporated into Middlebrook 7H10 medium showed acceptable stability when stored at 3 to 7 degrees C for 1 month . During incubation of the test medium at 37 degrees C, approximately half of the activity of isoniazid, ethionamide, ethambutol, cycloserine, and rifampin was lost after periods ranging from 2 to 4 days for ethambutol to 2 weeks for rifampin. J Oral Pathol Med, 1992 Nov, 21(10), 471 - 6 Transamidase and collagenase activity in healthy and diseased human gingival tissues; Robinson PJ et al.; Transamidases are a class of calcium-dependent mammalian enzymes which cross-link proteins by catalyzing the formation of (gamma-glutamyl)-epsilon-lysine bonds . It is possible that these enzymes play an important anabolic role in tissue healing . This study was to quantitate transamidase activity in human gingival tissue and examine the relation between transmidase activity and degree of inflammation . Forty-four out of a total 120 collected human gingival specimens from healthy and diseased patients were selected based on histometric and microbiologic criteria . Specimens were minced and homogenized in 10 mM CaCl2 and then extracted for 30 min, in 50 mM tris-HCl buffer (pH 7.5) containing 100 mM CaCl2 . Following low speed centrifugation at 4 degrees C, the supernatant solution was assayed for both transamidase and collagenase activities by radioactive amine incorporation, and digestion of tritiated collagen, respectively . Appreciable levels of transamidase and collagenase activities in healthy gingivae were found . These enzyme activities were significantly elevated in the diseased and healing tissues . Unlike other transamidases, calcium was required in the enzyme extraction process. Surg Gynecol Obstet, 1992 Nov, 175(5), 466 - 76 Aseptic technique in microgravity; McCuaig K; Within the next decade, the United States will launch a space station into low Earth orbit as a preliminary step toward a manned mission to Mars . Provision of asepsis in the unique microgravity environment, essential in operative and invasive procedures, is addressed . An assessment of conventional terrestrial aseptic methods and possible modifications for a microgravity environment was done during the microgravity portion of parabolic flight on NASA KC-135 aircraft . During 110 parabolas on three flight days, a "surgical team" (surgeon, scrub nurse and circulating nurse) using a life size mannequin fastened to a prototype surgical "work station" (operating table), evaluated open and closed gloving (ten parabolas), skin preparation (six parabolas), surgical scrub methods (24 parabolas), gowning (22 parabolas) and draping (48 parabolas) . Evaluated were povidone iodine solution, 1 percent povidone iodine detergent, Chloroxylenol with detergent, wet prep soap sponge, a water insoluble iodophor polymer (DuraPrep, 3M), disposable towels, disposable and reusable gowns, large and small disposable drapes with and without adhesive edges, disposable latex surgeon's gloves with and without packaging modifications and restraint mechanisms (tether, swiss seat, waist and foot restraint devices, fairfield and wire clamps and clips) . Ease of use, provision of restraint for supplies and personnel and waste disposal were assessed . The literature was reviewed and its relevance to the space environment discussed, including risk factors, environmental contamination, immune status and microbiology . The microgravity environment, limited water supply and restricted operating area mandated that modifications of fabrication and packaging of supplies and technique be made to create and preserve asepsis . Material must meet stringent flammability and off-gassing standards . Either a chlorhexidine or povidone iodine detergent prepackaged brush and sponge would provide an adequate scrub plus preliminary cleansing of a dirty wound . Choice may depend on ease of removal from the water supply as well as sensitivity to each compound of individual crew members . Rinsing was achieved with sterile water soaked gauze . Drying would be more efficient with two small hand towels, which would be easier to manipulate in microgravity and require less stowage volume . Skin preparation highlighted unexpected packaging problems, as centrifugal force was required to "shake" the solution out of the container on to the mannequin . To minimize contamination, a gown should be folded in an accordion manner and fastened to the base of its sterile wrapper, so that an assistant can compensate for the lack of gravity by applying constant tension.(ABSTRACT TRUNCATED AT 400 WORDS) J Histochem Cytochem, 1992 Nov, 40(11), 1693 - 704 Intra- and extracellular localization of hyaluronic acid and proteoglycan constituents (chondroitin sulfate, keratan sulfate, and protein core) in articular cartilage of rabbit tibia; Asari A et al.; To demonstrate the intra- and extracellular localization of hyaluronic acid (HA) in articular cartilage of the rabbit tibia, biotinylated HA binding region, which specifically binds to the HA molecule, was applied to the tissue . In comparison with the localization of HA, that of chondroitin sulfate (CS), keratan sulfate (KS), and the protein core (PC) of the proteoglycan was examined by immunohistochemistry . Strong positive staining for HA was detected in chondrocytes located in the transition between the superficial and middle zones of the tissue . Pre-treatment with chondroitinase ABC, keratanase II, or trypsin enhanced the stainability for HA in peri- and intercellular matrices . Immunohistochemistry with or without enzymatic pre-treatment demonstrated that immunoreactivity for CS, KS, and PC was distinctly discerned in chondrocytes and in the extracellular matrix located in the middle and deep zones . In particular, the immunoreactivity for KS and PC was augmented by pre-treatment with chondroitinase ABC not only in chondrocytes but in the extracellular matrix located in the middle and deep zones . Microbiochemical analysis corresponded well with histochemical and immunohistochemical results . These results suggest that HA is abundantly synthesized and secreted in chondrocytes located in the transition between the superficial and middle zones. Clin Lab Manage Rev, 1992 Nov-Dec, 6(6), 537 - 8, 543-6 Use of a modified nominal group process for improving laboratory performance in human immunodeficiency virus type 1 antibody testing . Reaching consensus on three questions concerning HIV-1 testing; Francis DP et al.; Using expert panels of medical technologists and public health microbiologists, a modified nominal group process was used to reach a consensus on three questions concerning current human immunodeficiency virus type 1 (HIV-1) testing methods . The questions related to important sources of error, improving the testing process, and improving proficiency testing . The modified nominal group process proved to be effective in developing lists of errors in laboratory testing; it provided a fast, economic means of identifying possible areas for improving laboratory quality assurance and training programs . For the HIV testing model, the focus group panelists indicated laboratory pipetting errors, labeling, and specimen identification as the most important sources of error . To improve the quality of this testing, the panel recommended standardizing test interpretation and restricting testing to laboratories licensed to perform HIV-1 testing . To improve proficiency testing, the use of blind specimens and establishing minimum standards of performance were suggested. J Gen Microbiol, 1992 Oct, 138 ( Pt 10), 2145 - 57 Global transcription pattern of phi C31 after induction of a Streptomyces coelicolor lysogen at different growth stages; Suarez JE et al.; Using two complementary strategies for low-resolution S1 mapping, the global pattern of phi C31 transcription was studied after induction of thermoinducible phi C31 lysogens of Streptomyces coelicolor A3(2) . A complex pattern of early transcripts was seen, with a peak of abundance at about 10 min post-induction . Nearly all of these transcripts were from DNA located to the right of the c (repressor) gene and to the left of the attP site: a region of about 14 kb . Early transcription was also observed immediately to the left of the c gene . The c gene itself was also induced, with an earlier expression peak (about 5 min post-induction) . Primary late transcripts were generally relatively long, but degraded . They apparently corresponded to most of the 18 kb region to the left of the c gene . Some shorter and more persistent late transcripts corresponded to DNA close to or overlapping the cos site . Large late transcripts from a region close to the left-hand end of the phi C31 genome showed evidence of processing to more stable, smaller RNA species . A failure of older cultures (more than 12 h old) to be induced productively was correlated with a much longer period of early transcription, reduced late transcription, failure to synthesize a major virion protein, and failure to package phi C31 DNA . Moreover, heat treatment of the older lysogenic cultures did not result in the phi C31-dependent shut-down of host rRNA transcription previously observed for young cultures (Rodriguez et al., Journal of General Microbiology (1986) 132, 1695-1701; Clayton & Bibb, Molecular Microbiology (1990) 4, 2179-2185). J Clin Periodontol, 1992 Oct, 19(9 Pt 1), 609 - 14 Periodontal diseases and HIV infection . A review of the literature; Robinson P; There have been many references in the literature to HIV-related periodontal diseases, which although poorly substantiated, seem to have established them as part of the expected range of HIV-associated conditions . The original studies have produced conflicting reports which may stem from shortcomings in design . Consequently, the picture remains confused with respect to the classification, epidemiology, microbiology, natural history and management of HIV-related periodontal diseases . Future studies should give greater attention to sampling methods, the use of control groups and defining criteria . This will allow comparison of data between centres and facilitate study of what may be an uncommon disease. Clin Microbiol Rev, 1992 Oct, 5(4), 370 - 86 Advances in nucleic acid-based detection methods; Wolcott MJ; Laboratory techniques based on nucleic acid methods have increased in popularity over the last decade with clinical microbiologists and other laboratory scientists who are concerned with the diagnosis of infectious agents . This increase in popularity is a result primarily of advances made in nucleic acid amplification and detection techniques . Polymerase chain reaction, the original nucleic acid amplification technique, changed the way many people viewed and used nucleic acid techniques in clinical settings . After the potential of polymerase chain reaction became apparent, other methods of nucleic acid amplification and detection were developed . These alternative nucleic acid amplification methods may become serious contenders for application to routine laboratory analyses . This review presents some background information on nucleic acid analyses that might be used in clinical and anatomical laboratories and describes some recent advances in the amplification and detection of nucleic acids. J Bacteriol, 1992 Oct, 174(20), 6368 - 76 Cloning and nucleotide sequence of celA1, and endo-beta-1,4-glucanase-encoding gene from Streptomyces halstedii JM8; Fernandez-Abalos JM et al.; The celA1 gene encoding an endo-beta-1,4-glucanase from a mesophilic actinomycete, strain JM8, identified as Streptomyces halstedii, was cloned and expressed in S . lividans JI66 . From the nucleotide sequence of a 1.7-kb DNA fragment we identified an open reading frame of 963 nucleotides encoding a protein of 321 amino acids, starting at TTG (instead of ATG) . The Cel1 mature enzyme is a protein of 294 amino acids (after signal peptide cleavage) and can be included in the beta-glycanase family B (N . R . Gilkes, B . Henrissat, D . G . Kilburn, R . C . Miller, Jr., and R . A . J . Warren, Microbiol . Rev . 55:303-315, 1991) . The Cel1 enzyme lacks a cellulose-binding domain as predicted by computer analysis of the sequence and confirmed by Avicel binding experiments . The promoter region of celA1 was identified by S1 mapping; the -35 region closely resembles those of housekeeping Streptomyces promoters . Three imperfectly repeated sequences of 15, 15, and 14 nucleotides were found upstream from celA1 {ATTGGGACCGCTTCC-(N85)-ATTGGGACCGCTTCC-(N2)-TGGGAGC GCTCCCA}; The 14-nucleotide sequence has a perfect palindrome identical to that found in several cellulase-encoding genes from Thermomonospora fusca, an alkalophilic Streptomyces strain, and Streptomyces lividans . This sequence has been implicated in the mechanism of induction exerted by cellobiose . Using an internal celA1 probe, we detected similar genes in several other Streptomyces species, most of them cellulase producers. J Bacteriol, 1992 Oct, 174(19), 6179 - 83 In vitro activation of dinitrogenase reductase from the cyanobacterium Anabaena variabilis (ATCC 29413); Bohm I et al.; Nitrogenase of the heterocystous cyanobacterium Anabaena variabilis was inactivated in vivo (S . Reich, H . Almon, and P . Boger, FEMS Microbiol . Lett . 34:53-56, 1986) . Partially purified and modified (inactivated) dinitrogenase reductase (Fe-protein) of such cells was reactivated by isolated membrane fractions of A . variabilis or of Rhodospirillum rubrum, and acetylene reduction was measured . Reactivation requires ATP, Mg2+, and Mn2+ . The activating principle is localized in the heterocyst and was found effective only when prepared from cells exhibiting active nitrogenase . It also restores the activity of modified Fe-protein from R . rubrum. Chest, 1992 Oct, 102(4), 999 - 1004 Bronchoalveolar lavage cell count and differential are not reliable indicators of amiodarone-induced pneumonitis; Ohar JA et al.; Amiodarone-induced interstitial pneumonitis is a serious, frequently fatal untoward effect of a commonly used antiarrhythmic agent . Recent reports suggest that bronchoalveolar lavage (BAL) fluid cellular analysis might be used to diagnose amiodarone-induced pneumonitis . The purpose of this study was to determine if the diagnosis of amiodarone-induced pneumonitis could be made by patient history, pulmonary function evaluation, and examination of BAL fluid . We studied five groups of patients . Three of the five groups received amiodarone: patients receiving amiodarone without evident lung toxic reaction, patients with amiodarone-induced pneumonitis, and amiodarone-treated patients diagnosed as having other pathologic processes involving the lung . The two other groups examined were healthy volunteers and patients with interstitial lung disease from causes other than amiodarone . Pulmonary function tests included vital capacity (FVC), first second forced exhaled volume (FEV1), total lung capacity (TLC), and diffusing capacity for carbon monoxide (DCO) . BAL fluid analysis included total and differential cell counts . We found that amiodarone-induced interstitial pneumonitis was not associated with an alteration in pulmonary function or BAL cellular composition which could permit its distinction from amiodarone-treated patients diagnosed as having an unrelated pulmonary process or patients with interstitial lung disease from other causes . The most frequent abnormality encountered in patients with amiodarone toxicity was a reduction in the percentage of macrophages in the differential cell count . The sensitivity, specificity, and predictive value of this finding was 82 percent, 69 percent, and 69 percent, respectively . The sensitivity, specificity, and predictive value of a > or = 15 percent reduction in DCO was 44 percent, 50 percent, and 36 percent, respectively . We conclude that amiodarone-induced interstitial pneumonitis remains a diagnosis of exclusion, and the role of BAL fluid analysis is to narrow the differential diagnosis through microbiologic culture and cytologic examination. Mem Inst Oswaldo Cruz, 1992 Oct-Dec, 87(4), 533 - 8 Pterigodermatites (Paucipectines) spinicaudatis n . sp . (Nematoda: Rictularidae) from Dromiciops australis (Marsupialia: Microbiotheriidae) in Bariloche, Rio Negro, Argentina . Biogeographical distribution and host-parasite relationships; Navone GT et al.; Pterigodermatites (P.) spinicaudatis sp . n . from Dromiciops australis is proposed and described . The simple morphology of the ovijector and the presence of a well developed spine between the two cuticular projections at the caudal extremity of the female distinguish the studied nematode from the remainder species of the genus parasitizing South American Edentata, marsupials and cricetid rodents . The distribution area of the hosts of the different species of P . (P.) are given . The studied genus does not parasitize any Australian marsupials . It was found in the endemic South American Microbiotheriidae . This fact suggests from a parasitological point of view that D . australis is not related to the Australian marsupials but to the South American ones. Eur J Biochem, 1992 Oct 1, 209(1), 357 - 65 Further characterization of the {Fe}-hydrogenase from Desulfovibrio desulfuricans ATCC 7757; Hatchikian EC et al.; The properties of the periplasmic hydrogenase from Desulfovibrio desulfuricans ATCC 7757, previously reported to be a single-subunit protein {Glick, B . R., Martin, W . G., and Martin, S . M . (1980) Can . J . Microbiol . 26, 1214-1223} were reinvestigated . The pure enzyme exhibited a molecular mass of 53.5 kDa as measured by analytical ultracentrifugation and was found to comprise two different subunits of 42.5 kDa and 11 kDa, with serine and alanine as N-terminal residues, respectively . The N-terminal amino acid sequences of its large and small subunits, determined up to 25 residues, were identical to those of the Desulfovibrio vulgaris Hildenborough {Fe}-hydrogenase . D . desulfuricans ATCC 7757 hydrogenase was free of nickel and contained 14.0 atoms of iron and 14.4 atoms of acid-labile sulfur/molecule and had E400, 52.5 mM-1.cm-1 . The purified hydrogenase showed a specific activity of 62 kU/mg of protein in the H2-uptake assay, and the H2-uptake activity was higher than H2-evolution activity . The enzyme isolated under aerobic conditions required incubation under reducing conditions to express its maximum activity both in the H2-uptake and 2H2/1H2 exchange reaction . The ratio of the activity of activated to as-isolated hydrogenase was approximately 3 . EPR studies allowed the identification of two ferredoxin-type {4Fe-4S}1+ clusters in hydrogenase samples reduced by hydrogen . In addition, an atypical cluster exhibiting a rhombic signal (g values 2.10, 2.038, 1.994) assigned to the H2-activating site in other {Fe}-hydrogenases was detected in partially reduced samples . Molecular properties, EPR spectroscopy, catalytic activities with different substrates and sensitivity to hydrogenase inhibitors indicated that D . desulfuricans ATCC 7757 periplasmic hydrogenase is a {Fe}-hydrogenase, similar in most respects to the well characterized {Fe}-hydrogenase from D . vulgaris Hildenborough. Minerva Stomatol, 1992 Oct, 41(10), 425 - 9 Polymerase chain reaction: relevance for oral pathology; Ficarra G et al.; The polymerase chain reaction (PCR) is a recent innovation in biotechnology for amplifying specific nucleic acid sequences by use of repeated cycles of DNA synthesis . Application of PCR has been extended to a wide variety of biological and medical disciplines; fields of application include molecular genetics, pathology, microbiology, forensic medicine, and infectious diseases . Because of its speed and powerful sensitivity, PCR has become a highly valuable method for detecting small amounts of target nucleic acid sequence with the caveat that it has certain limitations . Importantly, false-positive reactions can result from the amplification of contaminating DNA whereas false-negative reactions can result from introduction of inadequate numbers of primer sequences . The application of PCR in the context of oral pathology is presented along with a discussion of the utility of this technique to aid in the elucidation of the etiology of oral disease. Am J Obstet Gynecol, 1992 Sep, 167(3), 683 - 8 The presence of amniotic fluid leukoattractants accurately identifies histologic chorioamnionitis and predicts tocolytic efficacy in patients with idiopathic preterm labor; Cherouny PH et al.; OBJECTIVES: We tested these hypotheses: (1) that amniotic fluid from patients with idiopathic preterm labor and histologic chorioamnionitis contains leukoattractants and (2) that the detection of amniotic fluid leukoattractants is an accurate predictor of tocolytic efficacy . STUDY DESIGN: Amniotic fluid from 86 patients in idiopathic preterm labor was evaluated by microbiologic tests and leukotaxis assay . The tests' ability to predict histologic chorioamnionitis and response to tocolysis (51 tocolytic candidates) is established . Statistical analysis was performed with Fisher's exact test and unpaired Student t test . RESULTS: The detection of amniotic fluid leukoattractants was a better predictor of histologic chorioamnionitis (97%) than were amniotic fluid microbiologic tests (62%) (p less than 0.01) . Also, in patients with detectable amniotic fluid leukoattractants tocolysis failed significantly more often than in patients without detectable leukoattractants (93% vs 7%, p less than 0.01) . CONCLUSION: The presence of leukoattractants in amniotic fluid detected by the leukotaxis assay accurately identifies histologic chorioamnionitis and can additionally predict tocolytic efficacy in patients with idiopathic preterm labor. Acad Med, 1992 Sep, 67(9), 605 - 7 Prematriculation program grades as predictors of black and other nontraditional students' first-year academic performances; Hesser A et al.; This study explored the relative strengths of select background variables, including grades in a summer prematriculation program (SPP), as predictors of students' first-year academic performances . During the years 1980-1989, 115 black and other nontraditional prematriculants at the Medical College of Georgia School of Medicine attended a four-week SPP featuring courses in biochemistry, anatomy, and immunology . Canonical correlation analysis revealed that the combination of undergraduate grade-point average (GPA) and SPP grades in biochemistry and anatomy was the best predictor of the students' academic performances based upon their first-year grades in biochemistry, anatomy, and microbiology, and upon their GPAs for all first-year basic science courses . The authors conclude that SPP grades can be used to identify the specific academic weaknesses of nontraditional students at highest risk of falling into academic jeopardy. Arch Ophthalmol, 1992 Sep, 110(9), 1234 - 7 Ofloxacin vs tobramycin for the treatment of external ocular infection . Ofloxacin Study Group II; Gwon A; A multicenter, double-masked, randomized clinical investigation was conducted comparing 0.3% ofloxacin and 0.3% tobramycin for topical treatment of external ocular infection . One drop (1.35 micrograms) of either test solution was instilled six times daily for 2 days and thereafter four times daily for the next 8 days . At the day 3 to 5 follow-up examination, the severity of signs and symptoms based on a clinical summary score of 10 key variables was reduced from baseline values significantly (P less than .05) more with ofloxacin (-6.4 +/- 4.37; mean +/- SD) than with tobramycin (-4.78 +/- 3.13); by day 11, the difference between the groups was no longer significant . At days 3 to 5 and day 11 examinations, clinical, microbiologic, and overall improvement rates were similar, with no significant differences seen between the groups . Ofloxacin was found as effective, safe, and comfortable as tobramycin in patients with external ocular infection and may provide earlier symptom relief. Am Rev Respir Dis, 1992 Sep, 146(3), 757 - 62 Ultrasonographic evaluation of pulmonary consolidation; Yang PC et al.; A total of 161 patients with lobar or segmental consolidation were examined by realtime ultrasound and Doppler ultrasound . Air bronchograms were detected in 141 patients, fluid bronchograms in 27 patients, and parapneumonic effusion in 74 patients . In 36 patients with necrotizing pneumonia, ultrasound detected microabscesses in 33 (91.7%) compared with the air-fluid levels detected by standard chest radiographs in 20 patients (55.6%; p less than 0.05) . Of 31 patients with tumors causing obstructive pneumonitis, 29 (93.5%) had tumors detected by chest ultrasound, whereas only 11 patients (35.5%) had chest radiographs that suggested a tumor was causing the obstructive pneumonitis (p less than 0.05) . Chest ultrasound was used to guide thoracentesis for parapneumonic effusion in 65 patients, with a 100% success rate . Twenty-six patients with necrotizing pneumonia underwent ultrasound-guided needle aspiration of microabscesses . The procedure was successful in 24 patients (92.3%), and 21 patients (80.8%) had microbiologic confirmation . Twenty patients with tumor-associated obstructive pneumonitis received needle aspiration biopsy under ultrasound guidance; 19 patients (95.0%) had the histology confirmed . Five patients with malignancy manifesting as pulmonary consolidation underwent a diagnostic ultrasound-guided needle aspiration biopsy . Five patients (3.8%) developed complications of minimal pneumothorax or mild hemoptysis in 132 episodes of needle aspiration . We conclude that ultrasonography is useful for the evaluation of pulmonary consolidation . It can also be used for needle aspiration guidance for etiologic diagnosis of patients with complicated pneumonia. J Pediatr, 1992 Sep, 121(3), 459 - 65 Cefpodoxime proxetil compared with amoxicillin-clavulanate for the treatment of otitis media; Mendelman PM et al.; In a multicenter, randomized, investigator-blinded trial, patients were randomly selected to receive either cefpodoxime proxetil or amoxicillin-clavulanate potassium orally for the treatment of acute suppurative otitis media . Patients were seen before, during, and at the end of therapy, and 2 to 3 weeks after completion of therapy . A total of 229 patients, 153 receiving cefpodoxime and 76 receiving amoxicillin-clavulanate were entered into the study; all patients were examined to determine drug safety . A total of 146 patients, 98 in the cefpodoxime group and 48 in the amoxicillin-clavulanate group, completed the study and were examined to determine drug efficacy . End-of-therapy microbiologic eradication rates in assessable patients were 92% for cefpodoxime and 86% for amoxicillin-clavulanate (p = 0.14; 95% confidence interval (CI) on difference: -4.4%, 19.2%) . End-of-therapy clinical response rates for assessable patients were as follows: cured, 68% for cefpodoxime and 65% for amoxicillin-clavulanate; improved, 24% for cefpodoxime and 23% for amoxicillin-clavulanate; and failed, 8% for cefpodoxime and 13% for amoxicillin-clavulanate (p = 0.57; 95% CI: -8.4%, 16.5%) . Recurrence rates at long-term follow-up were 24% for cefpodoxime-treated patients and 25% for those given amoxicillin-clavulanate . Both drugs were well tolerated; 20.9% of those given cefpodoxime and 31.6% of amoxicillin-clavulanate-treated patients had drug-related adverse medical events (p = 0.102; 95% CI: -23.9%, 2.6%) . Gastrointestinal complaints were the most frequently reported drug-related side effect in both groups: 11.8% of cefpodoxime-treated patients and 21.1% of those given amoxicillin-clavulanate (p = 0.076; 95% CI: -20.8%, 2.2%) . Drug-related dermatologic side effects (e.g., diaper rash, pruritus, urticaria) were reported in 7.8% of cefpodoxime-treated patients and 14.5% of those who received amoxicillin-clavulanate (p = 0.160; 95% CI: -16.6%, 3.3%) . Our findings suggest that clinical efficacy for cefpodoxime administered twice daily is equivalent to that of amoxicillin-clavulanate administered three times a day. Thorax, 1992 Sep, 47(9), 734 - 7 An audit of the clinical investigation of pleural effusion; Walshe AD et al.; BACKGROUND: Pleural aspiration with pleural biopsy is advised for the investigation of pleural effusion . The clinical investigation of pleural effusion in a group of teaching hospitals was audited with reference to adequacy and diagnostic value of sampling procedures . METHODS: A retrospective review of case records of all patients investigated for pleural effusion during an eight month period was performed . The records of 112 patients, age range 16-91 years, who underwent 150 procedures were reviewed . RESULTS: Microbiology samples were obtained from 137 procedures, of which five provided a positive culture, including one for mycobacteria . Cytology samples were obtained from 145 procedures though approximately two thirds of samples were less than the recommended 30 ml . The pleural biopsy rate was 30%, varying from 0% in general or thoracic surgery to 68% in thoracic medicine (thoracic surgeons carried out thoracoscopy) . Twenty nine per cent of pleural biopsy samples were of poor quality . The complication rate was 2% for aspiration alone, and 4% for aspiration plus biopsy . The sensitivity of the first diagnostic procedure for a diagnosis of malignancy or tuberculosis was 53% for cytology alone, 50% for biopsy alone and 72% for cytology plus biopsy . CONCLUSION: The samples obtained from pleural aspiration and biopsy in the initial investigation of pleural effusion are often inadequate . Further education is necessary to improve the quantity and quality of specimens submitted for histological and cytological examination. Monatsschr Kinderheilkd, 1992 Sep, 140(9), 652 - 7 {Experiences with triple antibiotic combination in neonatal infection}; Paul T et al.; BACKGROUND: In-vitro and clinical efficacy of a combination therapy consisting of 3 antibiotic agents was to be assessed in neonatal septicemia . METHODS: From 1980 to 1987, 152 newborns with septicemia as proven by blood culture were treated with an initial antibiotic regimen consisting of azlocillin (150 mg/kg bw), cefotaxime (100 mg/kg bw), and tobramycin (5 mg/kg bw) . RESULTS: According to the microbiologic testing, antimicrobic therapy was effective in each of the 152 organisms: 101/152 bacteria were susceptible to all 3 agents; resistance to 1 or 2 of the antibiotics was evident in 33/152 and in 18/152 organisms, respectively . Mortality due to septicemia was 7.2% . CONCLUSION: As no difference was observed in the frequency in which one of the three antibiotic substances was the only effective drug, each of the 3 agents seemed to be necessary for clinical effectiveness of this antibiotic combination. Sex Transm Dis, 1992 Sep-Oct, 19(5), 295 - 7 Split-dose metronidazole or single-dose tinidazole for the treatment of vaginal trichomoniasis; O-Prasertsawat P et al.; In a double-blind, randomized, controlled trial, efficacy and safety of a single-day split dose of 1.6 g of metronidazole were compared with a single 2-g dose of tinidazole in the treatment of vaginal trichomoniasis . Women with symptomatic vaginal trichomoniasis were randomly assigned to one of the two treatment groups . There were 67 women in the group treated with the single-day split dose and 65 in group treated with the single dose . There was no significant difference between the two groups in terms of clinical characteristics (age, weight, and length of follow-up period) . The cure rates, using trypticase yeast extract iron serum (TYI) medium to confirm microbiologic cure, were 98.5% and 100% for the groups treated with a single-day split dose and with a single dose, respectively . The side effects were minimal and did not warrant any treatment . The differences in the results were not statistically significant . We recommend that the single-day split dose of 1.6 g of metronidazole regimen be given as an alternative drug for vaginal trichomoniasis . Its advantages include being highly effective, significantly less expensive, and with minimal side effects. J Appl Bacteriol, 1992 Sep, 73(3), 210 - 16 Laboratory performance in a food microbiology proficiency testing scheme; Peterz M; Results from two shipments in a proficiency testing scheme in which almost 200 food microbiology laboratories participated are summarized . Freeze-dried mixtures of bacteria were used as simulated food samples . Four and six samples, respectively, were examined . The statistical procedures used to evaluate the performance of participating laboratories are described . It is shown that laboratories which had been in the scheme for a long time perform, on average, better than those that had been in the scheme for a short time . The former laboratories produced fewer false and outlying results, and were more accurate and precise in their determinations. Biotechniques, 1992 Sep, 13(3), 450 - 3 Protecting researchers from instrument biohazards; Hambleton P et al.; The prevention and control of biohazards arising from the use of laboratory instruments have become increasingly important in clinical and research applications . Centrifuges can be susceptible to contamination because of intense wear on primary containers (specimen tubes and bottles), worn O-ring container seals, or rotors and buckets lacking tight seals . A recent study by the Center for Applied Microbiology and Research, Porton Down, UK, has determined the biological safety of certain rotors in various speed ranges . This paper presents and discusses these findings. Virology, 1992 Sep, 190(1), 316 - 29 Modulation of the cellular phenotype by integrated adeno-associated virus; Winocour E et al.; The adeno-associated virus (AAV) rep gene encodes a series of overlapping, multifunctional, nonstructural proteins (Rep proteins) which regulate the viral life cycle and which are also capable of trans-regulating nonviral gene expressions (reviewed in Berns, 1990, Microbiol . Rev . 54, 316-329) . To investigate the expression of the AAV rep gene in a cellular chromosomal context, SV40-transformed Chinese hamster embryo (OD4) cells were infected with an AAV/neo hybrid virus and progeny resistant to the antibiotic G418 were selected and amplified . Chromosomal integration and RNA transcription of the AAV and neo DNA inserts were confirmed by Southern and Northern blotting procedures . One of the G418R cell lines stably expressed a protein which reacted specifically with AAV anti-Rep antiserum in Western immunoblots . The stable integration of AAV rep DNA, which did not interfere with cell proliferation under normal growth conditions, was associated with two changes in cellular phenotype: eight of nine lines were markedly more sensitive to UV light (254 nm) than were the parental OD4 cells; and seven of the nine lines had lost the capacity to promote SV40 origin DNA amplification in vitro, in contrast to the parental OD4 cells . OD4 cells transformed to G418R by AAV/neo DNA constructs with a deleted rep gene, or by a neo DNA construct lacking AAV DNA, did not display these phenotypic changes . It is suggested that stable integration of the AAV rep gene interferes with cellular processes connected with DNA repair and gene amplification. J Prosthodont, 1992 Sep, 1(1), 47 - 50 The dental curriculum: is is relevant to dental practice? Welker WA. Does the undergraduate dental curriculum devote the appropriate amount of time to those areas of dentistry that are relevant to today's general dental practice? In a survey of dentists who graduated between 1980 and 1985, it was determined that they felt curriculum offerings in orthodontics, research, endodontics, periodontics, oral surgery, fixed prosthodontics, and occlusion had not been extensive enough . However, graduates also reported that their educational experiences in biochemistry, dental laboratory procedures, gross anatomy, microbiology, and occlusion were too extensive. East Afr Med J, 1992 Sep, 69(9), 508 - 14 The role of the laboratory in a Chlamydia control programme in a developing country; Peeling RW et al.; The laboratory components of a Chlamydia trachomatis disease control programme for a developing country are reviewed . Early diagnosis of chlamydial infections is the most cost effective means of preventing the long term sequelae of trachoma, pelvic inflammatory disease, ectopic pregnancy and infertility, which are now a major public health burden to the health care system in developing countries . Public health strategies are required to establish both a co-ordinated limited system of laboratory services, and to promote the diagnosis and treatment of disease syndromes in the absence of laboratory support . Laboratory tests for the specific diagnoses of chlamydial infections requiring different levels of expertise and equipment can be instituted within settings appropriate to the resources and technical expertise available . Emphasis is given to appropriate cost effective utilization of laboratory testingPIP: Current methods used for the laboratory diagnosis of a Chlamydia trachomatis disease control program for a developing country are reviewed to guide clinical microbiology laboratories to develop criteria for testing . Human chlamydia infections are a major public health problem in both developed and developing countries . Worldwide an estimated 360 million persons are infected by the ocular serovars of Chlamydia trachomatis and 6.4 million are blind from the scarring, sequelae . The genital strains of Chlamydia trachomatis cause cervical, endometrial or tubal infections in women, resulting in pelvic inflammatory disease (PID) or ectopic pregnancy, and infertility . Over 50% of chlamydia infections in women are asymptomatic and progress to silent PID and infertility . In industrialized countries chlamydia infections are the major cause of sexually transmitted disease-related infertility . Infants born to infected mothers are at risk for chlamydia pneumonia and ophthalmia neonatorum . More tentative associations of chlamydia infections exist with Reiter's Syndrome . Early diagnosis of chlamydia infections is the most cost effective means of preventing the longterm sequelae of trachoma, pelvic inflammatory disease, ectopic pregnancy and infertility, which are a major public health liability in developing countries . In many developed and developing countries, public health decision maker are not aware of the extent of chlamydia infections in the community . One of the priorities of the disease control program is to provide accurate epidemiologic data through seroprevalence studies . This includes estimates of persons infected, the severity of complications and sequelae . Public health strategies are required to establish laboratory services and to diagnose and treat the disease . The diagnostic methods for C . trachomatis include specimen collection, cytologic methods, serologic methods, cell culture method, antigen detection methods, and nucleic acid hybridization tests that should be available at the national reference laboratory . J Infect Dis, 1992 Aug, 166(2), 277 - 84 Association of gastric hypoacidity with opportunistic enteric infections in patients with AIDS; Belitsos PC et al.; To determine the relation and possible significance of gastric hypoaciditity to chronic diarrhea in AIDS, patients with and without chronic (greater than 1 month) diarrhea underwent fasting gastric juice pH measurement and microbiologic study and upper and lower endoscopy with biopsy . All 8 patients with diarrhea and high gastric pH (greater than 3; mean, 6.1 +/- 1.0) had gastric bacterial overgrowth (greater than 10(4) bacteria/mL) along with opportunistic enteropathogens in the duodenum or rectosigmoid, but only 1 of 6 patients with diarrhea and gastric pH in the normal range (less than or equal to 3; mean, 1.9 +/- 0.7) had overgrowth or an opportunistic enteropathogen . By contrast, all but 1 of 9 controls (AIDS patients without diarrhea) had normal fasting gastric pH (mean, 2.9 +/- 1.5) . Overall, the presence of gastric hypoacidity was associated with identification of opportunistic enteropathogens (P = .035) . Thus, gastric hypoacidity is associated with quantitative bacterial overgrowth and opportunistic enteric infections and may be etiologically important in the pathophysiology of the chronic diarrhea seen in some AIDS patients. Community Dent Oral Epidemiol, 1992 Aug, 20(4), 169 - 74 The University of North Carolina caries risk assessment study: caries increments of misclassified children; Graves RC et al.; The University of North Carolina caries risk assessment was conducted between 1986 and 1989 with 5000 children initially in grades 1 and 5 from low fluoride sites in South Carolina and Maine . Clinical, microbiologic, behavioral, and demographic factors served as independent variables used in logistic multiple regression models to determine the predicted caries risk classification of each child . The 3-yr DMFS increment of each child was the dependent variable, and the 20-25% of those in each cohort with the highest increment were considered the high risk group . Sensitivity and specificity values averaged 0.60 and 0.83 respectively, indicating the misclassification of substantial numbers of children . This paper reports analysis of the DMFS increments of the misclassified children . The majority of children had DMFS increments within one or two surfaces of the classification cut points . Many false negative children had increments composed entirely of filled surfaces, often of minimal extent and without evidence of previous decay . Many false positive children had increments composed of decayed surfaces and would have benefitted from being identified as high risk and assigned to a preventive program . Other false positive children had sealants placed after the baseline examination that undoubtedly reduced their true increment . It is concluded that the consequences of misclassification are not serious for most children in this study. J Am Vet Med Assoc, 1992 Aug 1, 201(3), 434 - 7 Plasma concentrations of 13,14-dihydro-15-ketoprostaglandin F2 alpha in mares during uterine involution; Sertich PL et al.; Twelve mares were allowed to foal naturally, after which they were monitored to study uterine involution . Starting on day 3 after parturition, the internal genital tract was examined per rectum manually and ultrasonographically every other day for changes in uterine characteristics and ovarian activity . By day 5, gravid and nongravid uterine horns were similar in size, and by day 7, uterine fluid was absent . On day 7 after parturition, endometrial biopsy samples were obtained for histologic evaluation, and uterine swab specimens were obtained for microbiologic culture . Uterine swab specimens from 10 of 12 mares had slight bacterial growth . The uteri of 8 of the 12 mares were histologically involuted by day 7 . All mares ovulated 7 to 12 days after parturition . Concentrations of 13,14-dihydro-15-keto-PGF2 alpha (PGFM) were measured in jugular plasma samples obtained daily for 21 days after parturition . Concentrations of PGFM were low by the day after parturition, and there was no significant correlation between uterine involution and PGFM concentrations in these mares . All 12 mares were bred at the first estrus after parturition, and 9 became pregnant. Gesundheitswesen, 1992 Aug, 54(8), 406 - 9 {Draft of the swimming pool water regulation . Presentation, status: 17 September 1991, according to the federal hearing of 11 December 1991 in Bonn}; Sacre C; Comments are given on the present status of regulations concerning water in swimming pools and baths--1991--(in connection with the KOK regulations--1972--and the Federal German standard {DIN} No . 19643-1984-) . Reference is made to microbiologic limits of Legionella pneumophila among others. Pediatr Rev, 1992 Aug, 13(8), 283 - 93 Transmission of infectious diseases in children; Goldmann DA; A rational approach to the control of pediatric infectious diseases requires an appreciation of their epidemiology and mechanisms of transmission . The setting in which the exposure occurs may have a major influence on the risk of infection . Unfortunately, the epidemiology of many important pediatric pathogens is complex and incompletely understood . Recent advances in diagnostic microbiology and molecular epidemiology may help to solve some of the remaining riddles. Zhonghua Liu Xing Bing Xue Za Zhi, 1992 Aug, 13(4), 226 - 8 {Investigation of rodents and Ixodes for Lyme disease and four strains of Borrelia burgdorferi first isolated from Ixodes granulatus Supino, Rattus confucianus and R . norvegicus in Fujian province}; Pan L; With BSK II medium, 4 strains of Borrelia burgdorferi was isolated from Ixodes granulatus Supino, Rattus confucianus and R, novregicus, which Ixodes and Ruttus all captured from forest areas in northern of Fujian province where have found Lyme cases . These isolated strains were identified by Institute of Epidemiology and Microbiology, Chinese Academy of Preventive Medicine. J Biol Chem, 1992 Jun 25, 267(18), 12559 - 61 Stereoselective hydrolysis catalyzed by related beta-1,4-glucanases and beta-1,4-xylanases; Gebler J et al.; Over 80 beta-1,4-glucanases and beta-1,4-xylanases can be classified into one of eight families on the basis of amino acid sequence similarities in their catalytic domains (Gilkes, N . R., Henrissat, B., Kilburn, D . G., Miller, R . C., Jr., and Warren, R . A . J . (1991) Microbiol . Rev . 55, 303-315) . As a test of this classification, the stereochemical course of hydrolysis of 10 enzymes representative of five families has been determined using proton NMR . These data, together with published data for six additional enzymes, show that representatives of a given enzyme family have the same stereoselectivity: four families catalyze hydrolysis with retention of anomeric configuration, two with inversion . The results support the hypothesis that family members share a common general fold, active site topology, and catalytic mechanism. Vet Clin North Am Food Anim Pract, 1992 Jul, 8(2), 361 - 72 Assessment of the mammary system; Donovan GA et al.; Assessing the health status of the mammary gland is a complex and often perplexing endeavor . One must use all of the faculties available to come up with an accurate diagnosis . A detailed history of the individual and the herd or flock plus a thorough physical examination that includes specific attention paid to the mammary gland are essential . One cannot overlook these basic tenets in favor of more sophisticated means of evaluation such as somatic cell counts and milk microbiology . A holistic approach to mastitis diagnosis, treatment, and, most importantly, control is necessary. J Bacteriol, 1992 Jul, 174(13), 4444 - 9 Cloning of a methanol-inducible moxF promoter and its analysis in moxB mutants of Methylobacterium extorquens AM1rif; Morris CJ et al.; In Methylobacterium extorquens AM1, gene encoding methanol dehydrogenase polypeptides are transcriptionally regulated in response to C1 compounds, including methanol (M . E . Lidstrom and D . I . Stirling, Annu . Rev . Microbiol . 44:27-57, 1990) . In order to study this regulation, a transcriptional fusion has been constructed between a beta-galactosidase reporter gene and a 1.55-kb XhoI-SalI fragment of M . extorquens AM1rif DNA encoding the N terminus of the methanol dehydrogenase large subunit (moxF) and 1,289 bp of upstream DNA . The fusion exhibited orientation-specific promoter activity in M . extorquens AM1rif but was expressed constitutively when the transcriptional fusion was located on the plasmid . However, correct regulation was restored when the construction was inserted in the M . extorquens AM1rif chromosome . This DNA fragment was shown to contain both the moxFJGI promoter and the sequences necessary in cis for its transcriptional regulation by methanol . Transcription from this promoter was studied in the M . extorquens AM1rif moxB mutant strains UV4rif and UV25rif, which have a pleiotropic phenotype with regard to the components of methanol oxidation . In these mutants, beta-galactosidase activity from the fusion was reduced to a level equal to that of the vector background when the fusion was present in both plasmid and chromosomal locations . Since both constitutive and methanol-inducible promoter activities were lost in the mutants, moxB appears to be required for transcription of the genes encoding the methanol dehydrogenase polypeptides. Chest, 1992 Jul, 102(1), 76 - 83 Diagnostic value of telescoping plugged catheters in HIV-infected patients with pulmonary infiltrates; Ferrer M et al.; To assess the diagnostic value of telescoping plugged catheters (TPC) in human immunodeficiency virus (HIV)-infected patients with pulmonary infiltrates (PI), we performed a prospective clinical study in 71 episodes of fever and PI in 66 HIV-infected patients (five patients had two different episodes of fever and PI) . A control group of 12 HIV-infected patients with fever and normal chest roentgenogram was also studied . In all patients and prior to antibiotic treatment (except in mechanically ventilated patients), a TPC using quantitative cultures (cutoff point established at 10(3) CFU/ml) and a bronchoalveolar lavage (BAL) sampling were performed via fiberoptic bronchoscope . The overall incidence of bacterial pneumonia in the study group was 21 percent . The TPC cultures resulted in a microbiologic diagnosis of bacterial pneumonia in eight patients (11 percent) from the study group and in one patient (8 percent) from the control group . The TPC sensitivity in diagnosing bacterial infections was 53 percent and specificity was 76 percent . Negative predictive value was 85 percent and positive predictive value was 38 percent . By means of BAL, 35 episodes from the study group and two from the control group were diagnosed as nonbacterial or mycobacterial pulmonary infections . Considering TPC and BAL together, diagnosis was performed in 42 cases of PI (59 percent) . Twenty percent (17/83) of HIV-infected patients suffered from bacterial colonization of their lower airways (a TPC culture greater than or equal to 10(3) CFU/ml without clinical evidence of bacterial infection) . We conclude that the combined use of TPC and BAL may be useful in HIV-infected patients with PI, since this combined use allows the proper diagnosis of bacterial and nonbacterial infections, thereby increasing the overall diagnostic accuracy . To distinguish bacterial colonization from pulmonary infection in HIV-infected patients with PI, the cutoff point of quantitative cultures of TPC may be 10(4) CFU/ml. Acad Med, 1992 Jul, 67(7), 470 - 4 Effects of expert and non-expert facilitators on the small-group process and on student performance; Davis WK et al.; At the University of Michigan Medical School in 1990, the authors investigated the effects of faculty facilitators' levels of content expertise on the educational process and learning outcomes of small-group teaching sessions . The study was conducted in a microbiology course for second-year students in which four small-group sessions were used to replace 38 hours of lecture and laboratory time . The interactions between 11 expert and ten non-expert faculty facilitators and 156 students were observed and coded . The students' levels of knowledge and satisfaction were measured . The results indicate that, although significant differences in faculty-student interactions were not observed, the students in the 11 groups led by the content experts had higher levels of satisfaction and higher examination scores. Infect Immun, 1992 Jul, 60(7), 2906 - 13 Localization and biochemical characterization of the ORF6 gene product of the Mycoplasma pneumoniae P1 operon; Layh-Schmitt G et al.; ORF6 represents one of the two open reading frames flanking the P1 attachment protein gene of Mycoplasma pneumoniae in the order ORF4-P1-ORF6 (J.M . Inamine, T.P . Denny, S . Loechel, U . Schaper, C.H . Huang, K.F . Bott, and P.C . Hu, Gene 64:217-219, 1988; J.M . Inamine, S . Loechel, and P.C . Hu, Gene 73:175-183, 1988; C.J . Su, V.V . Tryon, and J.B . Baseman, Infect . Immun . 55:3023-3029, 1987), indicating an operonlike organization . As described previously, we identified two proteins with molecular masses of 40 and 90 kDa (B . Sperker, P.C . Hu, and R . Herrmann, Mol . Microbiol . 5:299-306, 1991) which might represent two cotranslational cleavage fragments of the ORF6 gene product . To determine the site of the putative cotranslational cleavage, the first 10 amino acids of the N terminus of the isolated 90-kDa protein were sequenced . The data are consistent with the DNA-deduced amino acid sequence between amino acid positions 455 and 465 (RAGNSSETDAL) . Thus, the cleavage site was identified at amino acid position 455 (R) . In this study, the two proteins were localized and biochemically characterized . Both proteins are part of the insoluble fraction of M . pneumoniae as shown by immunoblots of supernatants and pellets of mechanically disrupted cells subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) . Surface proteolysis followed by SDS-PAGE and Western blot (immunoblot) analysis, covalent labelling of surface-exposed proteins with {125I}iodide and subsequent immunoprecipitation of both radiolabelled proteins, immunofluorescence studies with formalized and living M . pneumoniae, and immunoadsorption experiments provided strong evidence that the 40- and 90-kDa proteins are membrane-associated proteins expressing surface-exposed regions. J Infect, 1992 Jul, 25(1), 29 - 37 An evaluation of inpatient consultations conducted by clinical microbiologists in a teaching hospital; Yuen KY et al.; A systematic procedure for conducting consultations by clinical microbiologists requested by their clinical colleagues is described . The method was evaluated over a period of 17 months and involved sequential consultations related to 229 patients with known or probable infections . An attempt was made to elucidate the contributions of the clinical microbiologists in achieving a better understanding of the problems experienced in this particular setting and which in turn led to improved management of patients . It is hoped that this paper may provide a practical working framework for clinical microbiologists in the care of patients suffering from infection. Medicine (Baltimore), 1992 Jul, 71(4), 179 - 96 Centrofacial malignant granulomas . Clinicopathologic study of 40 cases and review of the literature; Grange C et al.; An important problem in the treatment of centrofacial ulcerations is to establish a precise diagnosis, since similar clinical and microscopic findings can result from many different causes (as in the centrofacial malignant granuloma syndrome {CFMG}) . A comprehensive surgical biopsy protocol (known as SNFMI/GMCF), involving microbiology, parasitology, immunology and pathology laboratories, allowed us to evaluate and to treat 40 cases of CFMG, who form the basis of this report . In 13 of them, specific diagnoses were found and curative treatments could be given . In the remaining 27, the optical microscopy pattern met the criteria for CFMG without identifiable origin or the presence of so-called lethal midline granulomas; however, a more precise evaluation with the help of immunofluorescence studies led to the recognition of malignant lymphoma (ulcerative lymphoma of the midface {ULM}) . Most of these lymphomas belonged to the T cell lineage; the others were of B lymphoid origin, or, more rarely, of histiocytic origin . Patients with ULM received radiotherapy and chemotherapy with a response rate of 70.3%; however, the toxicity was significant, with frequent occurrence of chemotherapy-induced neutropenia followed by severe infectious facial cellulitis . Six patients were enrolled in a preliminary open trial of treatment with recombinant alpha-2b interferon with little success . Three patients were treated with radiation therapy only, and survived . Thus, CFMG is a syndrome with specific causes and treatments, requiring multiple extensive biopsies to make the correct diagnosis . The recognition of ULM as the cause of the previously called "lethal midline granulomas" leads logically to the use of chemotherapy with growth factors in order to ameliorate its bad prognosis. Diabetes Res Clin Pract, 1992 Jul, 17(1), 1 - 8 The diabetic foot problem--a failed system of health care? Sussman KE, Reiber G, Albert SF. It is evident that there is excess morbidity and mortality as a consequence of foot problems in patients with diabetes mellitus . Most of the data relative to foot lesions is taken from the study of subsets of diabetic patients undergoing lower extremity amputation . Such data probably do not provide accurate information relative to the incidence and/or prevalence of diabetic foot problems . Available evidence does suggest that diabetic foot care may be inadequate and the efficacy of various diagnostic and therapeutic modalities has not been proven . Advances have been made in obtaining a better understanding of the microbiology of lower extremity infected lesions both in hospitalized patients and in those subjects being followed in the outpatient setting . Attention should be directed at developing a systematic classification of foot lesions which can be universally applied . We need to understand and relate to those risk factors contributing to the development and progression of lower extremity lesions in the diabetic patient . In evaluating the efficacy of diverse diagnostic and therapeutic approaches, well-controlled clinical investigations need to be undertaken . Attention should be focussed upon both measures of process and outcome where appropriate . Finally, there needs to be recognition that the problem of the diabetic foot lesion represents a major public health challenge. Int J Syst Bacteriol, 1992 Jul, 42(3), 370 - 7 Genomic fingerprinting by arbitrarily primed polymerase chain reaction resolves Borrelia burgdorferi into three distinct phyletic groups; Welsh J et al.; The causative agent of Lyme disease, Borrelia burgdorferi, was first identified by Burgdorfer et al . in 1982 (W . Burgdorfer, A . G . Barbour, S . F . Hayes, J . L . Benach, E . Grunwaldt, and J . P . Davis, Science 216:1317-1319, 1982) and was isolated by Barbour et al . in 1983 (A . G . Barbour, W . Burgdorfer, S . E . Hayes, O . Peter, and A . Aeschlimann, Curr . Microbiol . 8:123-126, 1983) . Since then, a large number of isolates have been collected, and there have been questions regarding the relationships among the various strains . Using genomic fingerprinting by an arbitrarily primed polymerase chain reaction, we resolved into three groups a collection of Eurasian and North American isolates of spirochetes that are generally categorized as B . burgdorferi . Group I strains have been identified in both North America and Eurasia, while strains belonging to Borrelia groups II and III have been found only in Eurasia . These same three groups have also been delineated by Baranton et al . (G . Baranton, D . Postic, I . Saint Girons, P . Boerlin, J.-C . Piffaretti, M . Assous, and P . A . D . Grimont, Int . J . Syst . Bacteriol . 42:370-375, 1992) by independent methods . Two isolates are distinct from all of the other strains in our collection but are clearly members of the genus Borrelia. Arch Pathol Lab Med, 1992 Jul, 116(7), 694 - 700 Quantification of errors in laboratory reports . A quality improvement study of the College of American Pathologists' Q-Probes program; Howanitz PJ et al.; Over a 3-month period, 61,496 errors were detected in clinical laboratory reports by 631 participants in the College of American Pathologists' 1990 Q-Probes program . Each error detected was defined as an opportunity for improvement . Almost 4% of the detected errors were attributed to nonlaboratory personnel and approximately 4% (A errors) had a major impact on patient care . Rates of B (serious errors, but unlikely to affect patient care) and C errors (minor clerical errors) were approximately equal . When expressed in terms of measures of laboratory work loads, four of six measures of mean errors were lowest in blood banking, intermediate in chemistry and microbiology, and highest in hematology . Thirteen percent of participants did not have an error detection system in place . We conclude that many errors go undetected, and we recommend that an effective system for error detection in patient reports should be employed in all laboratories. J Am Podiatr Med Assoc, 1992 Jul, 82(7), 361 - 70 Treatment of lower extremity infections in diabetics; Joseph WS; The infected diabetic lower extremity has enjoyed a surge in popularity in the medical literature . There have been numerous papers outlining classification systems for ulcer depth, surgical approaches, and microbiology . Discussions on antibiotic use have usually been directed toward therapy of the "diabetic foot infections" as a group, without regard to differences in severity and location of these infections . These infections can vary from the most superficial of processes to a severe life- and limb-threatening sepsis . The author presents a review of the processes involved in the diabetic lower extremity infection and suggests a classification system for selection of empiric antibiotic therapy based on the severity of the infection. Nippon Rinsho, 1992 Jul, 50(7), 1670 - 8 {Development and application of biosensors for medical field}; Karube I; Methods for the selective determination of organic compounds in biological fluids, such as blood, are very important in clinical analyses . Most analyses of organic compounds can be performed by spectrophotometric methods, based on specific enzyme-catalyzed reactions . However, because of the complicated procedure, these methods cannot be applied directly to bed-side monitoring . Alternatively, biosensors based on enzymes and electrochemical transducers possess excellent sensitivity for biological substrates and can determine a single compound in a biological fluid directly without need for a prior separation step . Therefore, in the past several years, many kinds of biosensors have been developed, and implantable microbiosensors for a body organ have also been reported. J Hosp Infect, 1992 Jul, 21(3), 163 - 7 Conventional screening for enteropathogenic Escherichia coli in the UK . Is it appropriate or necessary? Morris KJ, Rao GG. Enteropathogenic Escherichia coli (EPEC) is a well-recognized cause of infantile diarrhoea in the developing countries . In the developed countries, however, the incidence of EPEC associated outbreaks has dramatically declined . The last major outbreak in the UK was reported in 1980 . This paper reviews the recent advances in the field of pathogenesis of diarrhoea caused by EPEC and questions the need to screen routinely for EPEC by conventional serological methods used in clinical microbiology laboratories in the UK. J Clin Microbiol, 1992 Jul, 30(7), 1716 - 21 General primer polymerase chain reaction in combination with sequence analysis for identification of potentially novel human papillomavirus genotypes in cervical lesions; van den Brule AJ et al.; We recently described the detection of potentially novel human papillomaviruses (HPV) genotypes (HPV types X {HPV X}) in cervical smears (A . J . C . van den Brule, C . J . L . M . Meijer, V . Bakels, P . Kenemans, and J . M . M . Walboomers, J . Clin . Microbiol . 28:2739-2743, 1990) by using the general primer-mediated polymerase chain reaction method (GP-PCR) . In this study, the HPV specificities of GP-PCR products were determined by sequence analyses . M13 bacteriophage clones of PCR products derived from cloned unsequenced HPV genotypes 13, 32, 35, 43, 44, 45, 51, and 56 were subjected to dideoxy sequencing . Analyses of the putative amino acid sequences of these HPV types in addition to published HPV sequence data revealed stretches of highly conserved amino acid residues present in all HPV types, resulting in an HPV amino acid consensus sequence . Subsequently, HPV X-specific PCR products found in premalignant cervical lesions (n = 3), carcinomas in situ (n = 6), and invasive cancer (n = 6) were analyzed for their nucleotide sequences . Comparison of these sequences with published HPV nucleotide sequences and data obtained in this study revealed three HPV type 35, two HPV type 45, one HPV type 51, two HPV type 56, and six unique HPV X sequences, of which three types were present in four cases of carcinomas (in situ) . The nucleotide sequences determined appeared to be unique after a data bank search . Furthermore, the sequences of all HPV X isolates matched the HPV amino acid consensus sequence, thus confirming HPV specificity . This study illustrates the power of GP-PCR in combination with sequence analysis to determine HPV specificity and genotyping of PCR products derived from sequenced as well as unsequenced HPVs, including novel, not yet identified HPV types. Virology, 1992 Jul, 189(1), 334 - 9 Lytic infection of primary rhesus kidney cells by simian virus 40; von der Weth A et al.; In an attempt to analyze the persistent infection of rhesus monkey cells with Simian virus 40 (SV40) in vitro, as described previously (reviewed in L . C . Norkin, Microbiol . Rev . 46, 384-425, 1982), we infected primary rhesus cell cultures (PRK), derived from a SV40-free monkey colony with SV40 . Surprisingly, SV40 infected PRK cell cultures released as much infectious virus as cultures of the permissive African green monkey kidney cell line TC7 . Infected PRK cells exhibited typical symptoms of a lytic infection, and the bulk of infected PRK cells died within 8 days postinfection (p.i.) . A considerable proportion of infected PRK cells exhibited distinct SV40-caused cytopathic effects (CPE), similar to CPE in infected TC7 cells . We conclude that the in vivo persistence of SV40 in rhesus monkeys is not determined by cellular host factors, but by the immune system of the infected animals. Am J Med, 1992 Jun 22, 92(6A), 2S - 6S The carbacephems: a new beta-lactam antibiotic class; Copper RD; The carbacephems are a new class of beta-lactam antibiotics that are similar in structure to the cephalosporins . Carbacephems differ from cephalosporins, however, in the substitution of a sulfur atom in the dihydrothiazine ring with a methylene group to form a tetrahydropyridine ring . The result of this structural difference is the carbacephem class . Carbacephems have remarkable chemical stability that allows for structural manipulation in a manner that could not be done previously with the cephalosporin ring system . Potent broad-spectrum antibiotics result from the incorporation at the 3 position of substituents that include quaternary pyridinium or imidazole, sulfones, and heterocyclic thiazole structures . Because of the chemical stability of the carbacephems, these highly electronegative side chains can be added to the 3 or 3' position of the tetrahydropyridine ring system . Increasing the electronegativity of these side chains can increase the microbiologic activity of the compounds . In addition, utilizing the side chains that have traditionally conferred good oral absorption on the cephalosporins offers the possibility of a new series of broad-spectrum oral antibiotics . Loracarbef is the first carbacephem to undergo clinical development, and other experimental carbacephems are being produced with the aim of developing potent oral antibiotics that can be used against pathogens that cause infections commonly found in the outpatient setting. Br Dent J, 1992 Jun 20, 172(12), 453 - 6 The British Dental Journal: a report on its activities 1986-1991; Murray JJ; The contents of 139 issues of the British Dental Journal, published between January 11, 1986 and December 1991, have been analysed . Part I of the Journal contains, on average, one Leader, eleven items of news and notes, 12 letters and eight abstracts/book reviews . One thousand, three hundred and seventeen manuscripts were submitted for publication during the 6-year period . Of these, 403 original articles, 119 case reports and 203 review articles were accepted and published in Part II . Part III of the Journal is devoted to annual and other reports and policy documents, worldwide dentistry, practice management and vocational training, dental electives, trade news, meeting reports and obituaries . Over 40 'strap headings' denoting specialised areas of dentistry were used to describe articles published . Almost one-fifth of the papers were concerned with restorative dentistry . Case reports comprised 14% of the papers published . Oral surgery/oral medicine/oral pathology, and related subjects accounted for nearly 15% of papers published . Articles concerned with community dental health, orthodontics and paediatric dentistry accounted for a similar proportion of the total, as did the section comprising general dental practice, vocational training and practice management . Anaesthesia, analgesia, medical topics, microbiology and therapeutics took up 12% of articles published . The remaining 12% consisted of articles on dental education and research, oral biology, dental history, auxiliaries, dental instruments and diagnostic aids. Eur J Biochem, 1992 Jun 15, 206(3), 635 - 40 The plasma membrane of yeast acquires a novel heat-shock protein (hsp30) and displays a decline in proton-pumping ATPase levels in response to both heat shock and the entry to stationary phase; Panaretou B et al.; Recent studies have revealed that the action of the proton-translocating ATPase of the plasma membrane of yeast is an important determinant of several stress tolerances and affects the capacity of cells to synthesise heat shock proteins in response to heat shock {Panaretou, B . & Piper, P . W . (1990) J . Gen . Microbiol . 136, 1763-1770; Coote, P . J., Cole, M . B . & Jones, M . V . (1991) J . Gen . Microbiol . 137, 1701-1708} . This study investigated the changes to the protein composition of the Saccharomyces cerevisiae plasma membrane that result from a heat shock to dividing cultures and the entry to stationary growth caused by carbon source limitation . Plasma membranes were prepared from exponential, heat-shocked and stationary yeast cultures . The proteins of these membrane preparations were then analysed by polyacrylamide gel electrophoresis and immunoblot measurement of ATPase levels . The protein composition of plasma membranes displayed two prominent changes in response to both heat shock and the entry to stationary phase: (a) a reduction in the level of the plasma membrane ATPase; and (b) the acquisition of a previously uncharacterised 30 kDa heat-shock protein (hsp30) . The ATPase decline with heat shock probably exerts an important influence over the ability of the cell to maintain ATPase activity, and therefore intracellular pH, during extended periods of stress . Through in vivo pulse-labelling of plasma membrane proteins synthesised before and during heat shock, followed by subcellular fractionation, it was shown that hsp30 is the only protein induced by the yeast heat-shock response that substantially copurifies with plasma membranes . It might therefore exert a stress-protective function specifically at this membrane. Int J Dermatol, 1992 Jun, 31(6), 443 - 5 Ofloxacin versus cephalexin for treating skin and soft tissue infections; Lipsky BA et al.; Patients with acute localized skin or soft tissue infections were randomized to receive either ofloxacin (300 mg orally, b.i.d.) or cephalexin (500 mg orally, b.i.d.) . Among 401 enrolled patients, 382 were evaluable for safety and 148 for microbiologic response . Microbiologic cure occurred in 93.4% of ofloxacin-treated patients and in 94.0% of those treated with cephalexin . Clinical cure or improvement, respectively, was found in 85.2% and 11.1% of patients treated with ofloxacin, and 83.6% and 14.9% of patients receiving cephalexin . Adverse effects (primarily associated with the gastrointestinal tract and central nervous system) were considered to be drug-related in 7.9% of those receiving ofloxacin and 4.8% of those receiving cephalexin . Thus, ofloxacin is as effective and well tolerated as cephalexin and a good alternate antibiotic for treating skin and skin structure infections caused by a variety of pathogens. J Med Virol, 1992 Jun, 37(2), 149 - 57 Detection of adenoviruses in stools from healthy persons and patients with diarrhea by two-step polymerase chain reaction; Allard A et al.; The use of the polymerase chain reaction (PCR) for detection of human adenoviruses in diluted stool samples was investigated . Two sets of nested primers, including primers specific for the hexon-coding region and for the E1B region of enteric adenoviruses (EAd), were assessed by two-step amplification . The primers constitute two different PCR systems designed for the detection of adenoviruses belonging to all six subgenera (A-F), and the two EAds Ad40 and Ad41, respectively . In a two-step PCR mediated amplification a single virus particle was detected when the two sets of general hexon primers or EAd specific primers were used . Earlier results from PCR detection of adenoviruses in stool from children suffering from diarrhea gave indications that adenovirus particles are commonly shed in stools without being identified as the cause of illness {Allard et al.: Journal of Clinical Microbiology 28:2659-2667, 1990} . Therefore, the general and the EAd specific PCR assays were assessed on 150 stool specimens from three groups including 50 healthy children, 50 healthy adults, and 50 adults suffering from diarrhea . When the two sets of general hexon primers were used, 25 of the 50 specimens from the healthy children (mean age 21 months) were found positive by two-step PCR amplification . Nine of the 50 specimens from the healthy adults (mean age 32 years) were found positive whereas 12 of the 50 specimens from sick adults (mean age 31 years) gave amplification products, using the two sets of general hexon primers in a nested fashion . None of the 150 specimens were found to be positive by two-step PCR amplification using the two sets of EAd-specific primers.(ABSTRACT TRUNCATED AT 250 WORDS) J Clin Microbiol, 1992 Jun, 30(6), 1572 - 4 Statistical analysis of the incidence of positives in the examination of parasitological specimens; Mohr E et al.; Results of the examination of 2,000 parasitological specimens were analyzed for differences between results obtained by a technologist working in parasitology only and those obtained by general microbiologists who were also performing other laboratory work . The relative share of specimens determined to be positive by the specialist was approximately twice as high as the relative share determined by the general microbiologists. Clin Infect Dis, 1992 Jun, 14(6), 1195 - 200 Varied presentations and responses to treatment of infections caused by Mycobacterium haemophilum in patients with AIDS; Dever LL et al.; We describe three patients with AIDS who developed clinically significant infection with Mycobacterium haemophilum . One patient had skin and bone involvement and suspected laryngeal involvement; the second had extensive abdominal adenopathy with partial bowel obstruction; and the third presented with limited skin involvement . Each patient responded transiently to antimycobacterial therapy, but disease recurred and progressed in all three cases . Recovery of M . haemophilum requires a high level of clinical suspicion and special handling of mycobacterial cultures by the microbiology laboratory, including cultivation on enriched chocolate agar or heme-supplemented media and incubation at 30 degrees C for up to 8 weeks . Characteristic patterns of drug susceptibility for this organism have been only partially defined . Reported responses to antimycobacterial therapy in AIDS patients with M . haemophilum infection have been poor, and the optimal therapeutic regimen is not yet known . The prognosis for recovery appears to depend heavily on host-related factors, particularly the degree of immunosuppression. Am J Med, 1992 Jun, 92(6), 591 - 5 Uses and misuses of oxygen in hospitalized patients; Small D et al.; PURPOSE: To document the use/misuse of oxygen therapy as compared with antibiotics in internal medicine inpatients . To determine whether the same care was being taken in the prescription and administration of both forms of therapy . PATIENTS: Ninety-six eligible patients at a university teaching hospital were entered into a study examining the use of oxygen . They were compared with 60 patients for whom antibiotics were prescribed . MATERIAL AND METHODS: Three hundred thirty consecutive newly admitted patients were screened for the presence of either (1) oxygen apparatus at the bedside, (2) physician orders for oxygen, or (3) oxygen orders noted in nursing kardex . Those meeting one of these three criteria were observed on up to four occasions over 48 hours following study entry . Similarly, patients were screened for medical orders or nursing medication kardex notation for antibiotics and were also observed for proper prescription and administration of medication . Procedural errors, determined by kardex audit and direct patient observation, were compared for the individuals with specific oxygen orders and those receiving antibiotics . RESULTS: Oxygen delivery apparatus was found in the room in 17 of 96 patients without it ever having been ordered by the physician or noted in the nursing kardex . In 27 of 96 patients, oxygen was noted in the nursing kardex and administered to patients without a physician order . There were no cases of antibiotic therapy without a physician order . Observations of 47 patients with specific orders for oxygen revealed the following errors: (1) physician order incorrectly transcribed to nursing kardex (16%), (2) flow meter off (34%), (3) oxygen delivery apparatus improperly worn (57%), (4) wrong fractional inspired oxygen concentration (58%) . Improper transcription of antibiotic orders occurred on only one occasion (2%), and antibiotics were improperly administered in 5% . Arterial blood gas determinations preceded oxygen orders in 61%, whereas microbiologic cultures preceded antibiotic orders in 87% of the patients . CONCLUSIONS: We conclude that oxygen therapy is neither prescribed nor administered with the same attention that is given to other drugs such as antibiotics . Oxygen prescription and/or delivery is associated with significantly greater error than that seen with antibiotics . Education of medical personnel should stress more prudent prescription and use of oxygen in hospitalized patients. Med Lab Sci, 1992 Jun, 49(2), 103 - 6 Toxoplasmosis and laboratory workers: a case-control assessment of risk; Parker SL et al.; The health risks to staff employed in a toxoplasma reference unit were studied . Sixteen laboratory staff exposed to Toxoplasma gondii and age/sex-matched controls from the general population and a routine microbiology laboratory were assessed . Multiple assays were performed to establish the presence of toxoplasma infection, and laboratory workers were questioned regarding environmental and work-related exposure to the parasite . Details of all of environmental exposure to toxoplasma between the two groups of laboratory personnel, and seroprevalence rates were comparable in all three groups . Three laboratory accidents were recorded, a rate of one per 9300 hours exposure . One case of presumed work-related infection was identified, but significant illness was not observed . Given adequate training, strict adherence to conventional laboratory protocols and medical supervision, laboratory accidents are infrequent and work-associated toxoplasma infection is uncommon . The risks associated with occupational exposure to T . gondii have been over-estimated and we conclude that this organism does not represent a significant health hazard to laboratory technicians. Sheng Li Xue Bao, 1992 Jun, 44(3), 254 - 60 {Role of endothelium-derived relaxing factor in the contractions of intrapulmonary artery induced by oxygen-derived free radicals in chronic hypoxic rat}; Zheng YF et al.; The role of endothelium-derived relaxing factor (EDRF) on the effect of oxygen-derived free radicals (generated by xanthine-xanthine oxidase system) on intrapulmonary arterial in chronic hypoxic rats was studied by a microbioassay method . Intrapulmonary artery rings with intact or denuded endothelium of hypoxic (5,000 m, 10 days) and normoxic rats were prepared for observation of oxygen-derived free radicals induced contraction . It was shown that oxygen-derived free radicals induced contractions of intrapulmonary arterial rings with intact endothelium were obviously augmented in hypoxic rats than in normoxic controls . The augmented responses could be further potentiated by the addition of EDRF inactivator reduced hemoglobin (RHb), but diminished or even abolished by applying superoxide dismutase (Cu-Zn SOD) . However, no effect on denuded rings was observed when RHb or SOD was added . It is concluded that chronic hypoxia may attenuate the action of EDRF in the enhancement of the reactivity of intrapulmonary artery to oxygen-derived free radicals. Am J Infect Control, 1992 Jun, 20(3), 115 - 21 Microbiology, infection control, immunizations, and infectious disease exposure: education and practices in United States nursing schools; Goetz A et al.; BACKGROUND: Previous data suggest that nursing students in the United States are inadequately protected against hepatitis B . This survey focused on the immunization and education practices, infection control knowledge, and follow-up to infectious disease exposure by U.S . nursing schools . METHODS: To ascertain education requirements, immunization practices, and infectious disease postexposure follow up, a survey was sent to the director or dean of 1164 U.S . nursing schools . RESULTS: Seven hundred sixty-five schools (65.7%) responded to the survey . A microbiology course was required before clinical experience by 49% of schools . Clinical experience in the operating room was given by 16%, 65% of schools offered infectious and communicable disease courses, and 98% offered universal precaution instructions . The hepatitis B vaccine was required by 11%; 2% required yearly influenza vaccination . In a comparison of programs, the diploma schools were more likely to have written policies for infectious disease exposure follow-up and to use appropriate agencies for exposure follow-up (p = 0.0001) . CONCLUSIONS: A microbiology course before clinical experience should be encouraged . Immunization policies and infectious disease exposure follow-up are currently inadequate in U.S . associate degree and baccalaureate nursing programs. Matrix, 1992 Jun, 12(3), 189 - 96 Microbiochemical analysis of changes in proteoglycan and collagen in joint tissues during the development of antigen-induced arthritis in the rabbit; Beesley JE et al.; Microbiochemical assays of the proteoglycan and collagen content of articular cartilage and synovial lining have been performed on tissue sections taken from rabbits with antigen-induced arthritis . This experimental arthritis is a close analogue of the natural disease-rheumatoid arthritis . Animals were killed at intervals during the first 21 days following induction of arthritis to assess changes in the composition of the extracellular matrices of the synovial lining and articular cartilage during the early development of this experimental lesion . In confirmation of earlier studies these microbiochemical assays revealed a rapid and significant loss of proteoglycan from the articular cartilage . This loss was, however, not uniform but was restricted to the intermediate zone of the cartilage . Over the period studied, there was only a slight loss of proteoglycan from the superficial zone of the cartilage facing the joint cavity . These findings demonstrate that, at least in this model, cartilage proteoglycan loss is not due to the action of proteases present in the synovial fluid . Moreover it suggests that the chondrocytes in the mid-zone of the cartilage are responsive to those signals stimulating proteoglycan breakdown . There was no significant loss of collagen from the cartilage over the time period of this study . The synovial lining from arthritic joints, in contrast, showed a progressive increase in both proteoglycan and collagen. J Bacteriol, 1992 Jun, 174(12), 3889 - 95 Sequence analysis and characterization of the Porphyromonas gingivalis prtC gene, which expresses a novel collagenase activity; Kato T et al.; In order to examine the potential role of bacterial collagenases in periodontal tissue destruction, we recently isolated a gene, prtC, from Porphyromonas gingivalis ATCC 53977, which expressed collagenase activity (N . Takahashi, T . Kato, and H . K . Kuramitsu, FEMS Microbiol . Lett . 84:135-138, 1991) . The nucleotide sequence of the gene has been determined, and the deduced amino acid sequence corresponds to a basic protein of 37.8 kDa . In addition, Southern blot analysis indicated that the prtC gene is conserved among the three major serotypes of P . gingivalis . The enzyme has been purified to near homogeneity from Escherichia coli clone NTS1 following Mono Q anion exchange and sequential gel filtration chromatography . The molecular mass of the purified enzyme was estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis to be ca . 35 kDa, and the active enzyme behaved as a dimer following gel filtration chromatography . The collagenase degraded soluble and reconstituted fibrillar type I collagen, heat-denatured type I collagen, and azocoll but not gelatin or the synthetic collagenase substrate 4-phenylazobenzyloxycarbonyl-Pro-Leu-Gly-Pro-D-Arg . Enzyme activity was enhanced by Ca2+ and inhibited by EDTA, sulfhydryl-blocking agents, and the salivary peptide histatin . Preliminary evidence for the existence of a second collagenase expressed by strain 53977 was also obtained. Med Clin (Barc), 1992 May 30, 99(1), 27 - 9 {Chronic granulomatous disease and pulmonary nocardiosis}; Tirapu JM et al.; A 19-years-old male was admitted for left bilobar pneumonia . All microbiologic studies in blood and in several samples obtained by bronchoscopy were negative . The patient worsened progressively despite antibiotherapy of a wide spectrum . A fine needle transparietal puncture was performed . The cultures of the sample were positive for Nocardia asteroides, a positive catalase germ . Immunologic studies initiated after this time showed negative tetrazolium nitroblue test, the results of which led to the diagnosis of chronic granulomatous disease . This disease is very infrequent and the polymorphonuclear leukocytes are genetically incapable of producing peroxides whose absence impedes lysis of the positive phagocytic catalase germs with which a histologic reaction is produced in the form of granulomas from which the name of the disease is derived. Minerva Anestesiol, 1992 May, 58(5), 297 - 300 {Circulation effects of noradrenaline in hyperdynamic septic shock}; Padua G et al.; The authors report on a group of 8 patients in septic shock, treated with NA in association with dopamine and/or dobutamine, according to a personal therapeutic protocol . The use of NA in septic shock with low SVR showed an improvement in hemodynamic condition and a higher survival rate in the treated patients . During the study many clinical, laboratory and microbiologic data were also recorded. J Antimicrob Chemother, 1992 May, 29(5), 575 - 8 Sampling time for serum gentamicin levels; Edwards C et al.; A survey in 53 UK hospitals showed that 44% of clinical microbiologists recommended post-dose serum gentamicin concentrations to be measured at less than 40 min after an iv bolus dose . Serum gentamicin concentrations were measured in ten patients following bolus iv and im injections . Distribution of the drug occurred for up to 45 min following iv doses and maximum serum concentrations occurred at 45 to 60 min after im injection . The data validate current guidelines to sample at 60 min post bolus iv and im doses . Earlier sampling after iv bolus injections may result in significantly higher gentamicin concentrations, leading to potential interpretive errors of clinical significance. Ann Hematol, 1992 May, 64(5), 224 - 30 Improved microbioassay for plasma erythropoietin based on CFU-E colony formation; Sakata S et al.; We examined the conditions necessary for performing a reliable erythropoietin (EPO) assay based on CFU-E colony formation in fetal mouse liver cell (FMLC) microcultures using 96-well microtiter plates . Both linearity of colony numbers with the number of cells plated and comparison among the colony ratios at various densities of seeding cells indicated that the colonies originated from a single progenitor cell when 7500 or fewer cells were plated into individual microtiter wells . About a twofold CFU-E enrichment in 12- to 13-day FMLC was achieved by Ficoll-Paque centrifugation . Plasma treated with acid-boiling stimulated the colony formation most and contained no colony inhibitor . Dose-response curve for the plasma was parallel to the EPO standard curve . The "erythroid colony-stimulating activity" in the plasma was additive to that in the standard EPO, and was completely neutralized by a monoclonal antibody against recombinant human EPO . Using the assay procedure thus established, plasma EPO titer was determined in normal subjects, in patients with nonuremic anemia and polycythemia vera, and in dialysis patients with chronic renal failure . The use of different preparations of standard EPO resulted in a significant difference in the titers because their dose-response curves differed from one another . An inverse relationship was found between EPO titers and hemoglobin concentrations in the nonuremic anemic patients, but not in the dialysis patients with about one half the normal EPO level. AIDS, 1992 May, 6(5), 495 - 500 A system for surveillance of voluntary HIV testing: results of the first 2 years, 1989-1990; Goldberg DJ et al.; OBJECTIVE: In 1988, in order to improve the already established surveillance of AIDS and HIV-infected cases in Scotland, UK, the Communicable Diseases (Scotland) Unit {CD(S)U}, in collaboration with microbiologists responsible for HIV testing, instituted a routine system for the epidemiological surveillance of all voluntary HIV tests . METHODS: To facilitate information capture, a standardized HIV request form was introduced for use throughout the country by clinicians requesting an HIV test . In addition, a network of laboratory computers, operated by clerical personnel, was established for the collection and collation of data . RESULTS: In 1989, of 9483 individuals tested for HIV, 129 (1.4%) were HIV-antibody-positive compared with 130 (1.2%) of 11,111 tested in 1990 . A comparison of 1989 with 1990 rates of HIV among specific population groups, including injecting drug users (4.1%, 1989; 2.7%, 1990), homosexual men (5.2%, 1989; 4.5%, 1990), heterosexual men and women with high-risk partners (1.6%, 1989; 1.8%, 1990) and heterosexual men and women with lesser risk (0.3%, 1989; 0.5%, 1990), revealed no statistically significance differences at a 95% level of confidence . CONCLUSION: We believe that this surveillance system is the first of its kind to be implemented on a nationwide basis . The first 2 years' findings suggest a degree of stability in new transmissions of HIV occurring in Scotland . However, the increasing numbers of those known to be HIV-infected continue to cause considerable concern: 1943 individuals were reported to CD(S)U as HIV-antibody-positive by December 1991. Chest, 1992 May, 101(5), 1393 - 8 Efficacy of a low dose of cefotaxime in serious chest infections; Cade JF et al.; The optimal antibiotic dosage in serious chest infections is not established and commonly used regimens may well be excessive . We have compared the efficacy of a low dose of cefotaxime (2 g every 12 h) with a more usual dose (2 g every 8 h) in a prospective, randomized study of the treatment of chest infections in the seriously ill . Fifty intensive care unit patients received either regimen for five days . The two groups appeared demographically comparable . Clinical resolution occurred in 86 percent, no change occurred in 4 percent, and deterioration occurred in 10 percent . Microbiologic clearance occurred in 52 percent of those in whom a pathogen was isolated (46 percent of patients) . There was no significant difference in clinical or microbiologic response between the two regimens . It is concluded that cefotaxime in a dose of 2 g twice daily is effective in the treatment of serious chest infections. Arch Pathol Lab Med, 1992 May, 116(5), 521 - 3 Endometrial tuberculosis acquired by a health care worker in a clinical laboratory; Shireman PK; I describe a case of endometrial tuberculosis acquired by a microbiologist while she was working in a clinical laboratory . Granulomatous endometritis was found, and Mycobacterium tuberculosis was isolated . Respiratory tract exposure from a faulty exhaust hood is the likely source of infection . Endometrial tuberculosis and laboratory-acquired infections are briefly discussed. Infect Immun, 1992 May, 60(5), 2066 - 74 Characterization of the major membrane protein of virulent Mycobacterium tuberculosis; Lee BY et al.; A protein with a molecular mass of 19 kDa was isolated and purified from enriched membrane fractions of the virulent Erdman strain of Mycobacterium tuberculosis . The protein is different from another 19-kDa protein, a lipoprotein, that was recently described (D . B . Young and T . R . Garbe, Res . Microbiol . 142:55-65, 1991) . The sequencing strategy applied to this major membrane protein employed four different endoproteinases and resulted in sufficient overlapping peptide sequences for assignment of the entire protein sequence . Electron spray ionization mass spectrometry demonstrated a measured mass of 16,100, deviating from the predicted mass by only 2.86 atomic mass units . The sequence of this protein is unique . However, some similarities with other low-molecular-weight heat shock proteins were observed . Immunoblotting indicated that this protein is highly expressed in the virulent strains of M . tuberculosis . Its application to sera from patients with pulmonary tuberculosis showed promise as a serodiagnostic tool. Infect Immun, 1992 May, 60(5), 1845 - 53 Heterogeneity of outer membrane proteins in Borrelia burgdorferi: comparison of osp operons of three isolates of different geographic origins; Jonsson M et al.; Biochemical and immunochemical studies of the outer membrane proteins of Borrelia burgdorferi have shown that the OspA and OspB proteins from strains of different geographic origins may differ considerably in their reactivities with monoclonal antibodies and in their apparent molecular weights . To further characterize this variation in Osp proteins between strains, the osp operons and deduced translation products from two strains, one from Sweden (ACAI) and one from eastern Russia (Ip90), were studied . Polyacrylamide gel electrophoresis and Western blot (immunoblot) analyses confirmed differences between ACAI, Ip90, and the North American strain B31 in their Osp proteins . The sequences of the ospA and ospB genes of ACAI and Ip90 were compared with that of the previously studied osp operon of B31 (S . Bergstrom, V . G . Bundoc, and A . G . Barbour, Mol . Microbiol . 3:479-486, 1989) . The osp genes of ACAI and Ip90, like the corresponding genes of B31, were found on plasmids with apparent sizes of about 50 kb and are cotranscribed as a single unit . Pairwise comparisons of the nucleotide sequences revealed that the ospA genes of ACAI and Ip90 were 85 and 86% identical, respectively, to the ospA gene of strain B31 and 86% identical to each other . The ospB sequences of these two strains were 79% identical to the ospB gene of B31 and 81% identical to each other . There was significantly greater similarity between the ospA genes of the three different strains than there was between the ospA and ospB genes within each strain . These studies suggest that the duplication of osp genes in B . burgdorferi occurred before the geographical dispersion of strains represented by ACAI, Ip90, and B31. Diagn Microbiol Infect Dis, 1992 May-Jun, 15(4 Suppl), 71S - 76S Macrolide pharmacokinetics and dose scheduling of roxithromycin; Nilsen OG et al.; The 150- and 300-mg single-dose pharmacokinetics of roxithromycin were investigated in 12 healthy subjects in a crossover study . Serum concentrations were determined by high-performance liquid chromatography (HPLC) an